bluuebunny/crossref_metadata_2025 huggingface dataset:
Effectiveness of a Manual Therapy Protocol in Women with Pelvic Pain Due to Endometriosis: A Randomized Clinical Trial
Authors: Muñoz-Gómez Elena , Alcaraz-Martínez Ana María , Mollà-Casanova Sara , Sempere-Rubio Núria , Aguilar-Rodríguez Marta , Serra-Añó Pilar , Inglés Marta
Published: May 2023

A randomized controlled trial was carried out to assess the effectiveness of a manual therapy protocol in terms of the clinical characteristics, quality of life, and emotional condition of the women with endometriosis-related pelvic pain. Forty-one women (mean age of 36.10 (6.97) years) with pelvic pain due to endometriosis were randomly divided into (i) a manual therapy group (MTG) (n = 21) and (ii) a placebo group (PG) (n = 20). Both groups received an 8-week intervention. Pain, lumbar mobility, endometriosis health profile, quality of life, depression and anxiety levels, and the patient’s perception of change were assessed before (T0) and after (T1) the intervention, as well as at a one-month follow-up (T2) and a six-month follow-up (T3). The MTG significantly improved pain intensity, powerlessness, lumbar mobility, and physical quality of life at T1 (p < 0.05). The results were maintained for pain intensity at T2 and T3. In addition, both the MTG and PG improved emotional wellbeing at T1 (p < 0.05). Neither group improved in terms of social support, self-image, and depression and anxiety levels after the intervention (p > 0.05). In conclusion, manual therapy may be an excellent complement to the gynecological treatment of endometriosis-related pelvic pain by alleviating pain and improving women’s endometriosis health profile and physical quality of life.
Elevated Neutrophil-to-Lymphocyte Ratio Is Associated with Severe Asthma Exacerbation in Children
Authors: Arwas Noga , Shvartzman Sharon Uzan , Goldbart Aviv , Bari Romi , Hazan Itai , Horev Amir , Golan Tripto Inbal
Published: May 2023

Asthma is the most common chronic respiratory disease in children. The neutrophil-to-lymphocyte ratio (NLR) is a marker of a chronic inflammatory state; however, data on the association of NLR with acute asthma exacerbations in children is lacking. In this cross-sectional study, between 2016 and 2021, children aged 2–18 years who were referred to the emergency department (ED) due to asthma exacerbation, were included. NLR, calculated from complete blood count upon arrival, was assessed as a continuous variable and was classified into four groups according to quartiles. The association between severity parameters and NLR quartiles was examined. A total of 831 ED visits for asthma exacerbation were included in the study. The median NLR was 1.6, 3.8, 6.7, and 12.9 in quartiles 1–4, respectively (p < 0.001). Demographic parameters, background diseases, and chronic medications were similar between the quartiles. Higher heart rate, body temperature, systolic blood pressure, and respiratory rate were observed in the higher NLR quartiles, as well as lower oxygen saturation. Higher urgency scale and higher rates of intravenous magnesium sulfate were observed in the higher NLR quartiles, with higher admission rates and prolonged hospitalizations. In summary, NLR upon admission is associated with the severity of asthma exacerbation and higher chances of hospitalization among children in the ED.
Functional Mitral and Tricuspid Regurgitation across the Whole Spectrum of Left Ventricular Ejection Fraction: Recognizing the Elephant in the Room of Heart Failure
Authors: Cammalleri Valeria , Antonelli Giorgio , De Luca Valeria Maria , Carpenito Myriam , Nusca Annunziata , Bono Maria Caterina , Mega Simona , Ussia Gian Paolo , Grigioni Francesco
Published: May 2023

Functional mitral regurgitation (FMR) and tricuspid regurgitation (FTR) occur due to cardiac remodeling in the presence of structurally normal valve apparatus. Two main mechanisms are involved, distinguishing an atrial functional form (when annulus dilatation is predominant) and a ventricular form (when ventricular remodeling and dysfunction predominate). Both affect the prognosis of patients with heart failure (HF) across the entire spectrum of left ventricle ejection fraction (LVEF), including preserved (HFpEF), mildly reduced (HFmrEF), or reduced (HFrEF). Currently, data on the management of functional valve regurgitation in the various HF phenotypes are limited. This review summarizes the epidemiology, pathophysiology, and treatment of FMR and FTR within the different patterns of HF, as defined by LVEF.
The Allium Ureteral Stent for the Treatment of Ureteral Complications Following Renal Transplantation—A Single-Center, Single-Surgeon Series
Authors: Weinberger Sarah , Hubatsch Mandy , Klatte Tobias , Neymeyer Jörg , Friedersdorff Frank
Published: May 2023

Ureteral complications such as urinary leak, ureteral necrosis or ureteral stenosis are common complications after renal transplantation with major short- and long-term issues, including graft impairment and graft loss. At present, there is no agreement on the optimal management of ureteral complications. The aim of the current study was to evaluate the safety and efficacy of the self-expanding, large-caliber Allium ureteral stent in patients with ureteral complications following renal transplantation. In this retrospective study, the electronic database of Charité University Hospital was screened for patients receiving the self-expandable Allium ureteral stent in the transplant ureter after kidney transplantation between January 2016 and March 2022. Descriptive statistics were used to describe the outcomes. There were six men and four women with a median age of 61 years (interquartile range, 55 to 68 years). Nine out of 10 patients had ureteric stenosis, which was diagnosed at a median of two years (interquartile range 10 months to 9 years) following renal transplantation. The median operating time was 49 min (interquartile range, 30 to 60 min). Endoscopic Allium stent placement was successful in all patients with ureteric stenosis. The median length of stay in the hospital was four days (interquartile range 2 to 7 days). Only one patient (#5) had a postoperative grade IIIb Clavien–Dindo complication. Patients had follow-ups every 3 months with ultrasound and serum creatinine. Dislocation of the Allium stent was seen in four patients; all occurred within three months. Ultimately, three patients required ureteric re-implantation, two of which had early dislocation of the stent. Six patients are managed with a permanent Allium stent. The median dwell time was 11 months (interquartile range 3 to 20 months) and maximum dwell time was 23 months. The overall success rate was 60% (6 out of 10). According to our data, the Allium stent represents a safe and minimally invasive option with a success rate of 60%. It might, therefore, represent an alternative to DJ stents, nephrostomies or immediate re-implantation. As all dislocations occurred within three months, frequent early postoperative follow-up is required.
Choice of the Dialysis Modality: Practical Considerations
Authors: Torreggiani Massimo , Piccoli Giorgina Barbara , Moio Maria Rita , Conte Ferruccio , Magagnoli Lorenza , Ciceri Paola , Cozzolino Mario
Published: May 2023

Chronic kidney disease and the need for kidney replacement therapy have increased dramatically in recent decades. Forecasts for the coming years predict an even greater increase, especially in low- and middle-income countries, due to the rise in metabolic and cardiovascular diseases and the aging population. Access to kidney replacement treatments may not be available to all patients, making it especially strategic to set up therapy programs that can ensure the best possible treatment for the greatest number of patients. The choice of the “ideal” kidney replacement therapy often conflicts with medical availability and the patient’s tolerance. This paper discusses the pros and cons of various kidney replacement therapy options and their real-world applicability limits.
Value of Fractional Exhaled Nitric Oxide in Diagnosing Mild Asthma Responsive to Inhaled Corticosteroids
Authors: Karamarkovic Lazarusic Natasa , Kasap Basioli Eugenija , Tolic Ena , Dokoza Martina , Pavlisa Gordana
Published: May 2023

Background: Mild asthma is often characterized by normal spirometric values and a negative bronchodilation test (BDT), which makes accurate diagnosis challenging. The aim of our study was to evaluate the diagnostic accuracy of fractional exhaled nitric oxide (FeNO) in mild asthma. Methods: In adults with symptoms suggestive of asthma and normal spirometry values, BDT, FeNO, BPT and skin prick testing were performed. Patients with positive BPT started inhaled corticosteroid (ICS) therapy. Those with positive response to ICS were considered asthmatics. Results: There were 142 asthmatics and 140 non-asthmatics. No significant difference was found in BDT between the groups, p = 0.233. Median FeNO levels were significantly higher in the asthma group (49.5 ppb) than in the non-asthma group (23 ppb), p < 0.001. BPT was positive in 145 (51.42%) and negative in 137 (48.58%) patients. Positive response to ICS treatment was recorded in 142/145 (97.9%) patients. In diagnosing asthma, FeNO ≥ 25 ppb had a sensitivity of 75.4% and specificity of 47.9%. Conclusions: FeNO has insufficient sensitivity and specificity in mild asthma and the application of BPT is often necessary to establish an accurate diagnosis.
Efficacy and Safety of Chemotherapy in Elderly Patients with Unresectable Pancreatic Cancer
Authors: Kwan Byung Soo , Lee Ok Jae , Kim Hyun Jin , Kim Kwang Min , Shim Sang Goon , Cho Dae Hyeon , Kong Sung Min , Kim Jun Young , Ji Jun Ho
Published: May 2023

Background/Aims: The incidence of pancreatic cancer (PC) is gradually increasing among elderly individuals, but there are insufficient clinical data on elderly individuals. To determine the efficacy and safety of chemotherapy, we compared the. the outcomes of elderly patients with unresectable PC. Methods: We enrolled patients aged 75 years or older diagnosed with PC from 1 January 2010 to 30 November 2021. Propensity score matching (PSM) was used to reduce the heterogeneity of the study population. For efficacy evaluation, the median overall survival (OS) was estimated for the chemotherapy and nonchemotherapy groups. Chemotherapy tolerability evaluations were also investigated. Results: The study included 115 patients, 47 of whom received chemotherapy and 68 who did not. After PSM, compared with the nonchemotherapy group, the chemotherapy group had more myocardial infarctions (14.6 vs. 0.0%, p < 0.001) and chronic obstructive pulmonary disease (4.4 vs. 0.0%, p = 0.043). The primary endpoint, median OS, was significantly different in the with vs. without chemotherapy groups (203 vs. 106 days, p = 0.013). In the chemotherapy group, 10 patients (21.3%) discontinued treatment due to adverse events. However, there were no reports of death due to severe adverse events. Conclusions: This study demonstrated that chemotherapy improved median OS among elderly patients. These data could support the use of chemotherapy for elderly patients with unresectable PC.
Utility of MRI in Quantifying Tissue Injury in Cervical Spondylotic Myelopathy
Authors: Khan Ali Fahim , Haynes Grace , Mohammadi Esmaeil , Muhammad Fauziyya , Hameed Sanaa , Smith Zachary A.
Published: May 2023

Cervical spondylotic myelopathy (CSM) is a progressive disease that worsens over time if untreated. However, the rate of progression can vary among individuals and may be influenced by various factors, such as the age of the patients, underlying conditions, and the severity and location of the spinal cord compression. Early diagnosis and prompt treatment can help slow the progression of CSM and improve symptoms. There has been an increased use of magnetic resonance imaging (MRI) methods in diagnosing and managing CSM. MRI methods provide detailed images and quantitative structural and functional data of the cervical spinal cord and brain, allowing for an accurate evaluation of the extent and location of tissue injury. This review aims to provide an understanding of the use of MRI methods in interrogating functional and structural changes in the central nervous system in CSM. Further, we identified several challenges hindering the clinical utility of these neuroimaging methods.
A Trend towards Diaphragmatic Muscle Waste after Invasive Mechanical Ventilation in Multiple Trauma Patients—What to Expect?
Authors: Mirea Liliana , Cobilinschi Cristian , Ungureanu Raluca , Cotae Ana-Maria , Darie Raluca , Tincu Radu , Avram Oana , Constantinescu Sorin , Minoiu Costin , Baetu Alexandru , Grintescu Ioana Marina
Published: May 2023

Considering the prioritization of life-threatening injuries in trauma care, secondary dysfunctions such as ventilator-induced diaphragmatic dysfunction (VIDD) are often overlooked. VIDD is an entity induced by muscle inactivity during invasive mechanical ventilation, associated with a profound loss of diaphragm muscle mass. In order to assess the incidence of VIDD in polytrauma patients, we performed an observational, retrospective, longitudinal study that included 24 polytraumatized patients. All included patients were mechanically ventilated for at least 48 h and underwent two chest CT scans during their ICU stay. Diaphragmatic thickness was measured by two independent radiologists on coronal and axial images at the level of celiac plexus. The thickness of the diaphragm was significantly decreased on both the left and right sides (left side: −0.82 mm axial p = 0.034; −0.79 mm coronal p = 0.05; right side: −0.94 mm axial p = 0.016; −0.91 coronal p = 0.013). In addition, we obtained a positive correlation between the number of days of mechanical ventilation and the difference between the two measurements of the diaphragm thickness on both sides (r =0.5; p = 0.02). There was no statistically significant correlation between the body mass indexes on admission, the use of vitamin C or N-acetyl cysteine, and the differences in diaphragmatic thickness.
Spin Label Study of the Orientational Preferences of Lysozyme in a Bioinspired Silica Composite
Authors: Bruno Francesco , Gigli Lucia , Ravera Enrico
Published: May 2023

Polycationic polypeptides prompt the polycondensation of inorganic oxides, most notably of silica. Hen egg-white lysozyme is a small polycationic protein that is quite conveniently used to this end. The fate of the protein after the completion of the polycondensation reaction is still a matter of debate. We have recently proven that lysozyme strongly interacts with silica. In this study, we use spin-label-based EPR spectroscopy to investigate whether the protein shows an orientational preference with respect to the silica surface within the composite. We find that a large share of the protein behaves as when it is adsorbed on pre-formed silica, albeit with a more marked preference for orientations that point the patches with higher surface charge density toward the material. In addition, a part of the protein shows a less-defined behavior. With this study, we provide additional information on the nature of the protein-material interactions in this class of bioinspired solids.
ZnO:V Nanoparticles with Enhanced Antimicrobial Activities
Authors: Alaya Leila , Saeedi Ahmad Mohammad , Alsaigh Ahmad Abdulhadi , Almalki Meshal H. K. , Alonizan Norah Hamad , Hjiri Mokhtar
Published: May 2023

In this study, we used sol-gel to synthesize undoped and V-ZnO nanoparticles with different vanadium concentrations (1, 3, and 5 at.%) under supercritical dry conditions of ethanol. XRD spectra showed that the obtained powders are well crystallized in the hexagonal wurtzite structure of ZnO nanoparticles. The average crystallite size, estimated by the Debye-Scherer formula, was found to be equal to 31 nm for the pure sample, and it was decreased to 27 nm for the 3at.% vanadium-doped one. SEM and TEM photographs indicated the spherical and elongated shapes of the nanoparticles. The stretching bands located at 419 cm−1 confirmed ZnO material formation. The efficacy of the produced ZnO NPs against Gram+, Gram− bacteria, and fungi was tested. Vanadium-doped ZnO, with low concentrations (10 µg/mL), exhibited a large influence on bacterial and fungi growth inhibition. For example, the inhibition zones IZ of S. aureus and E. coli bacteria reached 16 and 15 mm, respectively, for ZnO:V1%, while the IZ of these two bacteria were 14 and 12 mm for the undoped ZnO. The use of V-dopant enhanced the production of the reactive oxygen species ROS by the photogeneration of electron-hole pairs due to light absorption by ZnO in the visible region.
Incorporating Moldable Demineralized Dentin Matrix into Treatment for a Jaw Cyst
Authors: Ku Jeong-Kui , Kwak Han-Wool , Um In-Woong
Published: May 2023

The enucleation procedure is a standard treatment for jaw cysts; however, it often results in post-operative bony defects. These defects can lead to serious complications such as the risk of pathologic fracture and delayed wound healing, especially in the case of large cysts where there may be soft tissue dehiscence. Even in the case of smaller cysts, most cystic defects remain visible on postoperative radiographs and can be mistaken for cyst recurrence during follow-up periods. To avoid such complications, the use of bone graft materials should be considered. While autogenous bone is the most ideal graft material as it can be regenerated into functional bone, it has limitations due to the inevitable harvesting surgery. Many tissue engineering studies have been conducted to develop substitutes for autogenous bone. One such material is moldable-demineralized dentin matrix (M-DDM), which can aid in regeneration in cases of cystic defects. This case report highlights a patient who demonstrated the efficacy of M-DDM in bone healing for filling the cystic defect.
How Speededness of a Reasoning Test and the Complexity of Mental Speed Tasks Influence the Relation between Mental Speed and Reasoning Ability
Authors: Borter Natalie , Schlegel Katja , Troche Stefan J.
Published: May 2023

Although previous research has consistently reported a positive association between mental speed and reasoning ability, it remains unclear whether the magnitude of this association depends on whether the reasoning test is administered with or without a time limit. In addition, it is unknown how mental speed task complexity affects the mental speed–reasoning association when the effects of time limitations in the reasoning test (labeled “speededness”) are controlled for. The present study examined these questions in a sample of 200 participants who completed the time-limited Culture Fair Test (CFT) and a Hick task with three levels of complexity to measure mental speed. Results showed that the latent correlation between mental speed and reasoning was slightly lower when the effect of speededness in reasoning was statistically controlled for. However, for both controlled and uncontrolled reasoning, the correlation with mental speed was of medium size and statistically significant. When reasoning was controlled for the effects of speededness, only complexity-related mental speed aspects were correlated with reasoning, whereas basic mental speed aspects were correlated with the speededness factor and unrelated to reasoning. These findings demonstrate that time limitations in reasoning tests and complexity in mental speed tasks affect the magnitude of the mental speed–reasoning association.
Strategies for Green Shipbuilding Design and Production Practices Focused on Reducing Microplastic Pollution Generated during Installation of Plastic Pipes
Authors: Lučin Bože , Čarija Zoran , Alvir Marta , Lučin Ivana
Published: May 2023

In recent years, microplastic pollution has been given increasing attention in marine environments due to the hazard it poses for aquatic organisms. Plastic pipes are now being widely used in shipbuilding, and due to easy processing, they are often installed directly on ships. This includes the cutting and preparation of pipes for welding, which produces plastic debris in the immediate vicinity of the marine environment. Such plastic debris can easily become airborne, and when it is ultimately deposited into the water, it can be a contributor to marine microplastic pollution. This could be reduced if, during the design stage and outfitting stage, engineers would take into consideration ecological aspect of their design, which is currently not the case. Therefore, in this paper, suggestions for green shipbuilding practices, focused on the piping design and production phases, are presented for the possible reduction in operations with plastic pipes, with the main aim of reducing microplastic pollution. Based on these recommendations, additional economic and feasibility investigations are needed to obtain optimal results, which would be beneficial both from a manufacturing and ecological perspective.
Underwater 3D Reconstruction from Video or Still Imagery: Matisse and 3DMetrics Processing and Exploitation Software
Authors: Arnaubec Aurélien , Ferrera Maxime , Escartín Javier , Matabos Marjolaine , Gracias Nuno , Opderbecke Jan
Published: May 2023

This paper addresses the lack of “push-button” software for optical marine imaging, which currently limits the use of photogrammetric approaches by a wider community. It presents and reviews an open source software, Matisse, for creating textured 3D models of complex underwater scenes from video or still images. This software, developed for non-experts, enables routine and efficient processing of underwater images into 3D models that facilitate the exploitation and analysis of underwater imagery. When vehicle navigation data are available, Matisse allows for seamless integration of such data to produce 3D reconstructions that are georeferenced and properly scaled. The software includes pre-processing tools to extract images from videos and to make corrections for color and uneven lighting. Four datasets of different 3D scenes are provided for demonstration. They include both input images and navigation and associated 3D models generated with Matisse. The datasets, captured under different survey geometries, lead to 3D models of different sizes and demonstrate the capabilities of the software. The software suite also includes a 3D scene analysis tool, 3DMetrics, which can be used to visualize 3D scenes, incorporate elevation terrain models (e.g., from high-resolution bathymetry data) and manage, extract, and export quantitative measurements for the 3D data analysis. Both software packages are publicly available.
Reliability Analysis of the Deep-Sea Horizontal Clamp Connector Based on Multi-Source Information from an Engineering Background
Authors: Liu Weifeng , Yun Feihong , Wang Gang , Wang Liquan , Yao Shaoming
Published: May 2023

As a key piece of equipment in underwater production system, a reliability study of deep-sea connectors has important theoretical significance and engineering value for increasing fault-free operation time, improving engineering safety, and reducing maintenance costs. However, the diverse failure modes of connectors and the lack of high-quality and credible reliability data can lead to biased analysis outcomes. To tackle this problem, this study aims to establish a reliability model for deep-sea horizontal clamp connectors. Based on the actual engineering background, a fault tree model for deep-sea horizontal clamp connectors is developed, and the distribution types of bottom events are analyzed concerning the failure mechanism. To enhance the model’s credibility, a multi-source information approach is employed, combining prior product information, expert experience, and design information to quantitatively solve the reliability probability of the connector. The expert experience is quantified using the fuzzy quantitative analysis method, while the design information is estimated by developing a corrosion prediction model combined with grey theory. Thus, the reliability assessment of deep-sea horizontal clamp connectors is completed. Factory Acceptance Test (FAT) is performed on the improved connectors, and the closed-loop work of reliability analysis is completed.
Improved Convolutional Neural Network YOLOv5 for Underwater Target Detection Based on Autonomous Underwater Helicopter
Authors: Chen Ruoyu , Chen Ying
Published: May 2023

To detect a desired underwater target quickly and precisely, a real-time sonar-based target detection system mounted on an autonomous underwater helicopter (AUH) using an improved convolutional neural network (CNN) is proposed in this paper. YOLOv5 is introduced as the basic CNN network because of its strength, lightweight and fast speed. Due to the turbidity and weak illumination of an undesirable underwater environment, some attention mechanisms are added, and the structure of YOLOv5 is optimized to improve the performance of the detector for sonar images with a 1–3% increment of mAP which can be up to 80.2% with an average speed of 0.025 s (40 FPS) in the embedded device. It has been verified both in the school tank and outdoor open water that the whole detection system mounted on AUH performs well and meets the requirements of real time and light weight using limited hardware.
Borehole Instability in Decomposed Granite Seabed for Rock-Socketed Monopiles during “Drive-Drill-Drive” Construction Process: A Case Study
Authors: Sun Bo , Zhang Qi , Zhu Wenxuan , Leng Jian , Ye Guanlin
Published: May 2023

Monopiles are commonly used in the construction of offshore wind turbines. However, implementing drive-drill-drive construction techniques in decomposed granite seabed may lead to borehole instability during the window period between drilling and pile driving, resulting in significant project losses. This study provides a comprehensive understanding and approach to address the causes of borehole instability in rock-socketed monopiles in decomposed granite seabed. Using the Pinghai Bay offshore wind farm project in Fujian, China as an example, the details of drive-drill-drive and reverse-circulation drilling techniques employed in monopile construction were introduced. An improved sampling method was utilized to obtain decomposed granite samples, and a series of in situ and laboratory tests were conducted to analyze the physical and mechanical properties of marine-decomposed granite. By examining three cases of monopile construction, the factors contributing to borehole instability during rock-socketed monopile construction in decomposed granite seabed were identified, and corresponding recommendations were proposed. The results indicated that construction technology and unfavorable geological characteristics of decomposed granite are the primary causes of borehole instability. Collapses occurred mainly in highly and moderately decomposed granite layers. Employing smaller boreholes can reduce the likelihood and impact of borehole instability.
Multiphysics Co-Simulation and Experimental Study of Deep-Sea Hydrothermal Energy Generation System
Authors: Xie Keren , Li Tiefeng , Zhang Yanyan , Wu Shijun , Yang Canjun
Published: May 2023

With the continuous deepening of research on seafloor hydrothermal observations, the demand for a sustainable power supply of observation equipment is increasingly urgent. A kind of device that utilizes the temperature difference near hydrothermal vents to provide power is studied. However, the frequent experiments required for in-depth research on this device contradict the rare opportunities for hydrothermal field experiments and the difficulty in laboratory replication. In response to the above difficulties, a multiphysics co-simulation of the deep-sea hydrothermal energy generation system is studied in this paper. Firstly, the output performance analysis and modeling of the TEG installed in the device under pressure are carried out. An enhanced heat transfer model of the system is proposed for the hydrothermal fluids in the flow channel of the device. Then, the thermoelectric model of TEG and the heat transfer model of the device are jointly simulated by using Fluent and Simulink software. Eventually, the simulation data are compared with the data obtained through experiments. The average absolute of the relative error of the open-circuit voltage is 5.07%, and the maximum one is 6.28%. The corresponding values of the maximum output power are 5.16% and 6.79%, respectively. Therefore, the performance of the hydrothermal thermoelectric power generation system and the correctness of the proposed overall co-simulation model are verified.
Early Identification and Treatment of Trochlear Knee Dysplasia
Authors: Moya-Angeler Joaquin , Jiménez-Soto Cristina , Maestre-Cano Domingo , de la Torre-Conde Carlos , Sánchez-Jimenez Regina M. , Serrano-García Cristina , Alcaraz-Saura Miguel , García-Paños Juan Pedro , Salcedo-Cánovas César , Forriol Francisco , León-Muñoz Vicente J.
Published: May 2023

A shallow sulcus characterizes trochlear dysplasia (TD) of the femoral trochlea, which can lead to chronic pain or instability of the patellofemoral joint. Breech presentation at birth has been identified as a risk factor for developing this condition, which an ultrasound can identify early. Early treatment could be considered at this stage, given the potential for remodelling in these skeletally immature patients. Newborns with breech presentation at birth who meet the inclusion criteria will be enrolled and randomised in equal proportions between treatment with the Pavlik harness and observation. The primary objective is to determine the difference in the means of the sulcus angle between the two treatment arms at two months. Ours is the first study protocol to evaluate an early non-invasive treatment for TD in the newborn with breech presentation at birth using a Pavlik harness. We hypothesised that trochlear dysplasia could be reverted when identified and treated early in life with a simple harness, as it is done with developmental dysplasia of the hip.
An Update on COVID-19 Vaccination and Pregnancy
Authors: Juliá-Burchés Cristina , Martínez-Varea Alicia
Published: May 2023

Pregnant women are more prone to experience severe COVID-19 disease, including intensive care unit (ICU) admission, use of invasive ventilation, extracorporeal membrane oxygenation (ECMO), and mortality compared to non-pregnant individuals. Additionally, research suggests that SARS-CoV-2 infection during pregnancy is linked to adverse pregnancy outcomes, such as preterm birth, preeclampsia, and stillbirth, as well as adverse neonatal outcomes, including hospitalization and admission to the neonatal intensive care unit. This review assessed the available literature from November 2021 to 19 March 2023, concerning the safety and effectiveness of COVID-19 vaccination during pregnancy. COVID-19 vaccination administered during pregnancy is not linked to significant adverse events related to the vaccine or negative obstetric, fetal, or neonatal outcomes. Moreover, the vaccine has the same effectiveness in preventing severe COVID-19 disease in pregnant individuals as in the general population. Additionally, COVID-19 vaccination is the safest and most effective method for pregnant women to protect themselves and their newborns from severe COVID-19 disease, hospitalization, and ICU admission. Thus, vaccination should be recommended for pregnant patients. While the immunogenicity of vaccination in pregnancy appears to be similar to that in the general population, more research is needed to determine the optimal timing of vaccination during pregnancy for the benefit of the neonate.
Long-Term Outcomes after Transcatheter Mitral Valve-in-Valve or Valve-in-Ring Procedures
Authors: Wilbring Manuel , Petrov Asen , Arzt Sebastian , Eiselt Julia Patricia , Taghizadeh-Waghefi Ali , Matschke Klaus , Kappert Utz , Alexiou Konstantin
Published: May 2023

Background: Redo mitral valve surgery is the standard of care for failed mitral bioprostheses or recurrence of mitral regurgitation after repair. Nonetheless, catheter-based valve-in-valve (ViV) or valve-in-ring (ViR) procedures have increasingly become viable alternatives in high-risk subpopulations. Despite reported good initial results, little is known about longer-term outcomes. Here, we report the long-term outcomes of transcatheter mitral ViV and ViR procedures. Methods: All consecutive patients (n = 54) undergoing transcatheter mitral ViV or ViR procedures for failed bioprostheses or recurring regurgitation after mitral repair in the time period between 2011 and 2021 were retrospectively enrolled. The mean age was 76.5 ± 6.5 years, and 30 (55.6%) of the patients were male. The procedures were done using a commercially available balloon-expandable transcatheter heart valve. Clinical and echocardiographic follow-up data were obtained from the hospital’s database and analyzed. Follow-up reached up to 9.9 years with a total of 164.3 patient-years. Results: A total 25 patients received a ViV and 29 patients a ViR procedure. Both groups were at high surgical risk with an STS-PROM of 5.9 ± 3.7% in ViV and 8.7 ± 9.0% in ViR patients (p < 0.01). The procedures themselves were mainly uneventful with no intraoperative deaths and a low conversion rate (n = 2/54; 3.7%). VARC-2 procedural success was low (ViV 20.0% and ViR 10.3%; p = 0.45), which was either driven by high rates of transvalvular pressure gradients “>5 mmHg” (ViV 92.0% and ViR 27.6%; p < 0.01) or residual regurgitation “>trace” (ViV 28.0% and ViR 82.7%; p < 0.01). ICU-stay was prolonged in both groups (ViV 3.8 ± 6.8 days and ViR 4.3 ± 6.3 days; p = 0.96) with acceptable hospital stay (ViV 9.9 ± 5.9 days and ViR 13.5 ± 8.0 days; p = 0.13). Despite 30-day mortality being acceptable (ViV 4.0% and ViR 6.9%; p = 1.00), the mean posthospital survival time was disappointingly low (ViV 3.9 ± 2.6 years and ViR 2.3 ± 2.7 years; p < 0.01). Overall survival in the entire group was 33.3%. Cardiac reasons for death were frequent in both groups (ViV 38.5% and ViR 52.2%). Cox-regression analysis identified ViR procedures as a predictor of mortality (HR 2.36, CI 1.19–4.67, p = 0.01). Conclusions: Despite acceptable immediate outcomes in this high-risk subpopulation, long-term results are discouraging. Transvalvular pressure gradients as well as residual regurgitations remained drawbacks in this real-world population. The indication for catheter-based mitral ViV or ViR procedures rather than conventional redo-surgery or conservative treatment must be thoughtfully considered.
The Impact of Socioeconomic and Environmental Indicators on Economic Development: An Interdisciplinary Empirical Study
Authors: Pacifico Antonio
Published: May 2023

This paper aims to investigate the effects of environmental sources and health statistics on economic growth and other development indicators of interest. With population growth, urbanization, and industrialization of economies, the built environment for human health has emerged as an important and growing driver in interdisciplinary research and evidence-based policy development, improving a country’s growth prospects and the standard of living. A compressed structural Panel Vector Autoregression is used to address these issues. Methodologically, a hierarchical semiparametric Bayesian approach is involved to reduce the dimensionality, overtake variable selection problems, and model stochastic volatility. Policy-relevant strategies are also addressed to investigate causal relationships between sustainability indicators and economic growth.
Availability of Services in Wireless Sensor Network with Aerial Base Station Placement
Authors: Kabashkin Igor
Published: May 2023

Internet of Things technologies use many sensors combined with wireless networks for cyber-physical systems in various applications. Mobility is an essential characteristic for many objects that use sensors. In mobile sensor networks, the availability of communication channels is crucial, especially for mission-critical applications. This article presents models for analyzing the availability of sensor services in a wireless network with aerial base station placement (ABSP), considering the real conditions for using unmanned aerial vehicles (UAVs). The studied system uses a UAV-assisted mobile edge computing architecture, including ABSP and a ground station for restoring the energy capacity of the UAVs, to maintain the availability of interaction with the sensors. The architecture includes a fleet of additional replacement UAVs to ensure continuous communication coverage for the sensor network during the charging period of the air-based station UAVs. Analytical expressions were obtained to determine the availability of sensor services in the system studied.
Regional Digital Resilience and the 4Helix Model—The Higher Education Institutions’ Case in Romania
Authors: Grigorescu Adriana , Lincaru Cristina , Sigurjonsson Throstur Olaf , Pîrciog Speranța
Published: May 2023

Against the background of multiple and simultaneous global socio-economic shocks, coupled with digital transformation and the green transition, regional resilience triggers new structural transformations. The more complex processes that need to be addressed now require the usage of complex integrated tools. The novelty of the integrated approach is the combination of the models and the synthetic spatial–temporal picture offered. The quadruple helix, or 4Helix, model puts Higher Education Institutions (HEIs) at the nexus of generating regional digital resilience. We posit a new mindset and behavior of human capital to reinforce innovation and knowledge production and transfer. We explore, using the Romanian national case, to what degree the spatial 4Helix model generates regional digital resilience as a positive externality of adoption of the ‘new normal’ digital education. We analyze this process in three steps. (1) We determine the spatial distribution of HEIs at the Romanian county level (NUTS3). (2) We calculate the regional static and dynamic resilience indexes (at NUTS2) as the outcome of the method for multi-criteria decision making (MCDM) by each region’s digital economy as well as individual and regional wealth, social digital use and social digital connectivity dimensions. (3) Lastly, we provide the result of overlaid maps and radar charts (using HEIs number and spatial coverage and each region’s static and dynamic digital resilience). These three classes of digital resilience models of 4Helix by region indicate a generalized failure in adopting digital education in Romania. The study contributes by adding a powerful tool to explore the complex processes or phenomena and generating an integrated perspective using a pre-existing framework. In doing so, it enables researchers to better understand and address society’s needs, co-create knowledge and solutions together with the end-users, maximize the impact of these solutions, optimize resources usage, and increase the transparency and accountability of the decision-making processes.
Landslide Susceptibility Mapping Based on Interpretable Machine Learning from the Perspective of Geomorphological Differentiation
Authors: Sun Deliang , Chen Danlu , Zhang Jialan , Mi Changlin , Gu Qingyu , Wen Haijia
Published: May 2023

(1) Background: The aim of this paper was to study landslide susceptibility mapping based on interpretable machine learning from the perspective of topography differentiation. (2) Methods: This paper selects three counties (Chengkou, Wushan and Wuxi counties) in northeastern Chongqing, delineated as the corrosion layered high and middle mountain region (Zone I), and three counties (Wulong, Pengshui and Shizhu counties) in southeastern Chongqing, delineated as the middle mountainous region of strong karst gorges (Zone II), as the study area. This study used a Bayesian optimization algorithm to optimize the parameters of the LightGBM and XGBoost models and construct evaluation models for each of the two regions. The model with high accuracy was selected according to the accuracy of the evaluation indicators in order to establish the landslide susceptibility mapping. The SHAP algorithm was then used to explore the landslide formation mechanisms of different landforms from both a global and local perspective. (3) Results: The AUC values for the test set in the LightGBM mode for Zones I and II are 0.8525 and 0.8859, respectively, and those for the test set in the XGBoost model are 0.8214 and 0.8375, respectively. This shows that LightGBM has a high prediction accuracy with regard to both landforms. Under the two different landform types, the elevation, land use, incision depth, distance from road and the average annual rainfall were the common dominant factors contributing most to decision making at both sites; the distance from a fault and the distance from the river have different degrees of influence under different landform types. (4) Conclusions: the optimized LightGBM-SHAP model is suitable for the analysis of landslide susceptibility in two types of landscapes, namely the corrosion layered high and middle mountain region, and the middle mountainous region of strong karst gorges, and can be used to explore the internal decision-making mechanism of the model at both the global and local levels, which makes the landslide susceptibility prediction results more realistic and transparent. This is beneficial to the selection of a landslide susceptibility index system and the early prevention and control of landslide hazards, and can provide a reference for the prediction of potential landslide hazard-prone areas and interpretable machine learning research.
The Historic Urban Landscape Approach and the Governance of World Heritage in Urban Contexts: Reflections from Three European Cities
Authors: Cunha Ferreira Teresa , Rey-Pérez Julia , Pereira Roders Ana , Tarrafa Silva Ana , Coimbra Isabel , Breda Vazquez Isabel
Published: May 2023

Governance, and specifically local management and institutional systems, is among the key factors affecting the management of World Heritage (WH) properties in urban contexts. The adoption of the 2011 UNESCO Recommendation on the Historic Urban Landscape (HUL approach) promotes a governance reform towards more inclusive and integrated management. The purpose of this paper is to discuss how the HUL approach may help to solve the key governance challenges affecting WH in urban contexts. The governance of WH in three European cities is compared. Edinburgh, Porto, and Florence were chosen for their familiarity with the HUL approach and willingness to provide guidance and review policies and review their policies as management plans. The methodology includes a policy analysis of the management plans followed by a comparative analysis based on the six key governance challenges addressed in the recent literature. The results show that the HUL approach is supporting the governance of WH in urban contexts, and that more inclusive and integrated management has helped address the challenges affecting heritage management.
A Deep Feature Fusion Method for Complex Ground Object Classification in the Land Cover Ecosystem Using ZY1-02D and Sentinel-1A
Authors: Li Shuai , Tian Shufang
Published: May 2023

Despite the successful application of multimodal deep learning (MDL) methods for land use/land cover (LULC) classification tasks, their fusion capacity has not yet been substantially examined for hyperspectral and synthetic aperture radar (SAR) data. Hyperspectral and SAR data have recently been widely used in land cover classification. However, the speckle noise of SAR and the heterogeneity with the imaging mechanism of hyperspectral data have hindered the application of MDL methods for integrating hyperspectral and SAR data. Accordingly, we proposed a deep feature fusion method called Refine-EndNet that combines a dynamic filter network (DFN), an attention mechanism (AM), and an encoder–decoder framework (EndNet). The proposed method is specifically designed for hyperspectral and SAR data and adopts an intra-group and inter-group feature fusion strategy. In intra-group feature fusion, the spectral information of hyperspectral data is integrated by fully connected neural networks in the feature dimension. The fusion filter generation network (FFGN) suppresses the presence of speckle noise and the influence of heterogeneity between multimodal data. In inter-group feature fusion, the fusion weight generation network (FWGN) further optimizes complementary information and improves fusion capacity. Experimental results from ZY1-02D satellite hyperspectral data and Sentinel-1A dual-polarimetric SAR data illustrate that the proposed method outperforms the conventional feature-level image fusion (FLIF) and MDL methods, such as S2ENet, FusAtNet, and EndNets, both visually and numerically. We first attempt to investigate the potentials of ZY1-02D satellite hyperspectral data affected by thick clouds, combined with SAR data for complex ground object classification in the land cover ecosystem.
The In-Situ Spatial-Temporal Evolution of the Settlement Space along the Grand Canal Tianjin Section from the Perspective of Cultural Heritage
Authors: Zhao Yan , Bian Guangmeng , Sun Tianyi , Yan Jianwei
Published: May 2023

The Grand Canal of China, as a traffic artery in ancient China, has exerted profound influence on the development of the cities, towns and rural settlements along it. Now, with China’s rapid urbanization, numerous settlements along the canal are confronted with problems like slow cognition of the cultural heritage, loss of the local culture and damage of historical relics. Hence, research on the protection and updating of the settlement space along the canal is in urgent need. This paper, targeting the settlement space along the Grand Canal Tianjin Section, adopts such research methods as the Historical GIS analytical method, the kernel density estimation method and the average nearest-neighbor method to quantitatively analyze the evolution stage and distribution characteristics of the settlement space along the Grand Canal Tianjin Section from the perspective of cultural relics to reveal the in-situ rules of evolution of the settlement space. The research result indicates that the spatial-temporal evolution of the settlement space can be divided into five such periods of the settlements along the canal as the pre-canal period, the rudimentary period, the development period, the mature period and the transformation period. Each period features different cultural relics and settlement distribution patterns. The research shows that the natural geographical environment, the grain transportation projects and management systems, the wasteland opening, grain growing and military defense policies, the agricultural, commercial and economic growth and the migration and folk culture are the influencing factors of the spatial evolution of the settlement space along the Grand Canal Tianjin Section.