bluuebunny/crossref_metadata_2025 huggingface dataset:
Does Body Mass Index Impact the Clinical Response to Dupilumab Therapy in Atopic Dermatitis? A Monocentric Study of 170 Patients
Authors: Nicolosi Selene , Barei Francesca , Romagnuolo Maurizio , Fumagalli Silvio , Marzano Angelo Valerio , Ferrucci Silvia Mariel
Published: August 2024

Background: Dupilumab is a monoclonal antibody used for the treatment of moderate/severe atopic dermatitis (AD). In recent years, several studies have confirmed the positive association between AD and overweight/obesity, and a report demonstrated the effect of weight reduction on the improvement of AD symptoms. Methods: The weight of 170 patients under treatment with dupilumab was recorded at baseline and after 48 weeks (T48). Clinical monitoring was mainly conducted using the Eczema Area and Severity Index (EASI). The study aimed to assess a possible correlation between the clinical outcome of dupilumab therapy and BMI. Results: Although not statistically significant, patients with a BMI < 25 have a higher EASI percentage improvement than patients with a BMI ≥ 25 at any time point, and the percentage of overweight and obese patients that does not reach EASI-75 at T48 is higher compared to normal-weight patients (13.5% vs. 5.9%). Despite this, in the multivariate regression analysis, no baseline characteristic, including BMI, appears to increase the risk of not reaching EASI-75. In addition, the results show no differences in BMI between baseline and T48 in any age/sex group. Conclusions: The results suggest that overweight and obese patients have a lower response to dupilumab when considering the EASI score, but this difference does not appear to be clinically significant. Furthermore, dupilumab treatment does not seem to impact weight.
Incidence of Subsequent Injuries Associated with a New Diagnosis of Benign Paroxysmal Positional Vertigo and Effects of Treatment: A Nationwide Cohort Study
Authors: Mao Jhen-Jie , Lin Hung-Che , Lin Shih-Tsang , Lin Po-Cheng , Chang Ching-Hsiang , Chien Wu-Chien , Chung Chi-Hsiang , Chen Ying-Jiin , Chen Jeng-Wen
Published: August 2024

Background/Objectives: Benign paroxysmal positional vertigo (BPPV) is the most common cause of recurrent vertigo and the most common peripheral vestibular disorder. It is characterized by intense vertigo triggered by head and position changes. This study investigates the risk of subsequent injury in BPPV patients and the effects of treatment. Methods: A population-based retrospective cohort study was conducted using data from the Longitudinal Health Insurance Database 2005 in Taiwan. Patients with and without BPPV were identified between 2000 and 2017. The study outcomes were diagnoses of all-cause injuries. The Kaplan–Meier method determined the cumulative incidence rates of injury in both cohorts, and a log-rank test analyzed the differences. Cox proportional hazard models calculated each cohort’s 18-year hazard ratios (HRs). Results: We enrolled 50,675 patients with newly diagnosed BPPV and 202,700 matched individuals without BPPV. During follow-up, 47,636 patients were diagnosed with injuries (13,215 from the BPPV cohort and 34,421 from the non-BPPV cohort). The adjusted HR for injury in BPPV patients was 2.63 (95% CI, 2.49–2.88). Subgroup analysis showed an increased incidence of unintentional and intentional injuries in BPPV patients (aHR 2.86; 95% CI, 2.70–3.13 and 1.10; 95% CI, 1.04–1.21, respectively). A positive dose–response relationship was observed with increasing BPPV diagnoses. Treatment with canalith repositioning therapy (CRT) or medications reduced the risk of injury slightly but not significantly (aHR, 0.78; 95% CI, 0.37–1.29, 0.88; 95% CI, 0.40–1.40, respectively). Conclusions: BPPV is independently associated with an increased risk of injuries. CRT or medications have limited effects on mitigating this risk. Physicians should advise BPPV patients to take precautions to prevent injuries even after treatment.
Additional Value of Ultrasound in Patients with Psoriatic Arthritis within Treatment Target
Authors: Agache Mihaela , Popescu Claudiu C. , Enache Luminița , Mogoșan Corina , Filippucci Emilio , Codreanu Cătălin
Published: August 2024

Background: In psoriatic arthritis (PsA), musculoskeletal ultrasound is a complementary tool to physical examination, useful even in patients in remission to detect subclinical activity. Objectives: The objective of the study was to assess the ultrasound prevalence of active enthesitis and synovitis in patients who reached the therapeutic target. Methods: This cross-sectional study included patients with at least 6 months of therapy with a targeted synthetic or biological disease-modifying antirheumatic drug who were in treatment target (i.e., DAPSA < 14). Patients underwent bilateral clinical and ultrasound examination of the elbow lateral epicondyle, quadriceps insertion, distal patellar tendon insertion, and Achilles enthesis for assessing enthesitis, and hand and foot joints for assessing synovitis. Enthesitis and synovitis were considered active if the power Doppler signal showed at least a score of one. Results: The study included 51 PsA patients, women (52.9%), with an average age of 55 years. Although the patients were within the DAPSA treatment target, 21.6% had at least one painful enthesis at clinical examination, 19.6% had ultrasound evidence of at least one active enthesitis and 15.7% had ultrasound signs of at least one active synovitis. Conclusions: Among PsA patients thought to be within the therapeutic target, ultrasound detected a non-negligible percentage of active enthesitis and synovitis.
Precision Medicine in Acute Coronary Syndromes
Authors: Caffè Andrea , Animati Francesco Maria , Iannaccone Giulia , Rinaldi Riccardo , Montone Rocco Antonio
Published: August 2024

Nowadays, current guidelines on acute coronary syndrome (ACS) provide recommendations mainly based on the clinical presentation. However, greater attention is being directed to the specific pathophysiology underlying ACS, considering that plaque destabilization and rupture leading to luminal thrombotic obstruction is not the only pathway involved, albeit the most recognized. In this review, we discuss how intracoronary imaging and biomarkers allow the identification of specific ACS endotypes, leading to the recognition of different prognostic implications, tailored management strategies, and new potential therapeutic targets. Furthermore, different strategies can be applied on a personalized basis regarding antithrombotic therapy, non-culprit lesion revascularization, and microvascular obstruction (MVO). With respect to myocardial infarction with non-obstructive coronary arteries (MINOCA), we will present a precision medicine approach, suggested by current guidelines as the mainstay of the diagnostic process and with relevant therapeutic implications. Moreover, we aim at illustrating the clinical implications of targeted strategies for ACS secondary prevention, which may lower residual risk in selected patients.
Systematic Review of Platelet-Rich Plasma in Medical and Surgical Specialties: Quality, Evaluation, Evidence, and Enforcement
Authors: Rahman Eqram , Rao Parinitha , Abu-Farsakh Hany Niamey , Thonse Chirag , Ali Imran , Upton Alice E. , Baratikkae Shwetha Y. , Carruthers Jean D. A. , Mosahebi Ash , Heidari Nima , Webb William Richard
Published: August 2024

Background: Platelet-rich plasma (PRP) is widely used in various medical and surgical specialties for its regenerative properties, including aesthetics (facial rejuvenation, hair restoration, and skin tightening) and orthopedics (treatment of tendinitis and osteoarthritis). However, the inconsistent literature on PRP’s efficacy and safety leads to critical knowledge gaps. This systematic review evaluates quality control measures in PRP preparation and application and explores the regulatory environment governing its clinical use. Methods: Following PRISMA guidelines, a comprehensive search was conducted across multiple databases, including PubMed, EMBASE, and Web of Science, for studies published from January 2020 to April 2024. The review included randomized controlled trials (RCTs) involving human participants undergoing PRP treatment for aesthetic or regenerative purposes. Key parameters such as the PRP preparation methods, platelet concentration, and quality control measures were analyzed. The study protocol was registered with PROSPERO (ID: CRD42024557669). Results: Out of 75 RCTs involving 5726 patients, the review identified significant variability in PRP preparation methods and application techniques, including differences in centrifugation protocols and platelet concentration levels. A new evidence-based scoring system, the William–Eqram Scoring System for PRP Quality Reporting (WESS-PQR), was proposed to address these inconsistencies. Correlation analysis revealed a strong positive correlation (r = 0.79) between proper temperature control during preparation and PRP efficacy. Initial platelet count assessment showed a moderate positive correlation (r = 0.57) with efficacy. Conclusions: Standardized PRP preparation protocols and robust regulatory frameworks are urgently needed to ensure the safety and efficacy of PRP treatments. The proposed WESS-PQR scoring system can serve as a valuable tool for clinicians and researchers, promoting consistency and reliability in PRP applications.
Efficacy and Safety of Low-Dose Bisoprolol/Hydrochlorothiazide Combination for the Treatment of Hypertension: A Systematic Review and Meta-Analysis
Authors: Cicero Arrigo F. G. , ALGhasab Naif Saad , Tocci Giuliano , Desideri Giovambattista , Fiorini Giulia , Fogacci Federica
Published: August 2024

Objectives: This systematic review and meta-analysis aimed to assess the blood pressure (BP)-lowering effect and the safety profile of low-dose bisoprolol/hydrochlorothiazide combination treatment in patients with hypertension. Methods: Multiple electronic databases were systematically searched, and five clinical studies were included in the meta-analysis. Results: Treatment with bisoprolol/hydrochlorothiazide significantly reduced systolic BP (SBP) [mean difference (MD): −8.35 mmHg, 95% confidence interval (CI): −11.44, −5.25 mmHg versus control; MD: −9.88 mmHg, 95%CI: −12.62, −7.14 mmHg versus placebo] and diastolic BP (DBP) [MD: −7.62 mmHg, 95%CI: −11.20, −4.04 mmHg, versus control; MD: −8.79 mmHg, 95%CI: −11.92, −5.67 mmHg versus placebo]. Moreover, BP response rate and BP control rate after low-dose bisoprolol/hydrochlorothiazide combination treatment were significantly greater compared to control [odd ratio (OR) for response rate: 4.86, 95%CI: 2.52, 9.37; OR for control rate: 1.67, 95%CI: 1.11, 2.51]. Finally, treatment with low-dose bisoprolol/hydrochlorothiazide was associated with a reduced risk of any adverse event (AE) and peripheral edema compared to control. Conclusions: Overall, our results reaffirm the safety and efficiency of prescribing bisoprolol/hydrochlorothiazide combination treatment in stage I and II hypertension.
The Effect of Thickened Water on Ciprofloxacin Pharmacokinetics: A Comparative Study in Adult Males
Authors: Taki Iori , Yamazaki Taigi , Takahashi Nobuyuki , Yamamoto Myong Hwa , Toju Akiko , Ikeura Atsuko , Inoue Eisuke , Sambe Takehiko , Mizukami Takuya , Uchida Naoki , Harada Tsutomu , Hida Noriko
Published: August 2024

Background/Objectives: The use of food thickeners with ciprofloxacin tablets may result in a gelatinous appearance and experience delayed dissolution, which presents a challenge for the drug’s efficacy, creating a healthcare economic issue. However, the pharmacokinetic impact of this compound in humans remains uncertain. Therefore, a comparative pharmacokinetic study of ciprofloxacin was conducted on healthy adult Japanese males. Methods: We compared the effects of administering tablets with water or thickened water and crushed tablets mixed with thickened water. The maximum blood concentration (Cmax) of ciprofloxacin determines the drug’s efficacy. Results: There were variations in drug absorption across different administration methods. The group who took the tablets immersed in thickened water exhibited different results in the area under the blood drug concentration–time curve (AUC) and Cmax compared to the group who took the tablets in regular water. Notably, the group that consumed the crushed tablets mixed with thickened water demonstrated equivalent results for both AUC and Cmax. Conclusions: Administering crushed tablets in thickened water may yield pharmacokinetics comparable to those of tablets taken with water. However, the process of crushing tablets may result in the loss of active ingredients and compromise the formulation, necessitating a comprehensive assessment before administration.
The Clinical and Surgical Characteristics of Parotid Tumors with Parapharyngeal Space Involvement—A Multicenter Experience of the Polish Salivary Network
Authors: Stodulski Dominik , Mikaszewski Bogusław , Witkowski Paweł , Bartkowiak Ewelina , Pietruszewska Wioletta , Olejniczak Izabela , Markowski Jarosław , Piernicka-Dybich Aleksandra , Burduk Paweł , Wierzchowska Małgorzata , Czech Joanna , Radomska Katarzyna , Chańko Alicja , Majszyk Daniel , Bruzgielewicz Antoni , Gazińska Patrycja , Wierzbicka Małgorzata
Published: August 2024

Backgrounds/Objectives: Parotid gland tumors (PGTs) with parapharyngeal space (PPS) involvement have a specific clinical course and they can be a great challenge for surgeons, especially due to more difficult approaches and the risk of serious complications. The aim of this study is to present the characteristics of PGTs with PPS involvement. Methods: Retrospective, multicenter analysis of 1954 primary PGTs from 5 years (2017–2021) was performed. Comparative analysis was performed between groups with and without PPS involvement and included the following clinical and histopathological data: age, sex, place of residence, tumor size, FNAC result, percentage of malignant tumors, histological diagnosis, radicality of resection, and postoperative facial nerve (FN) dysfunction. Results: PPS involvement was found in 114 patients (5.83%). Secondary tumors affecting the deep lobe or the entire gland were predominant (46 and 60 cases, respectively). In a univariate analysis of tumors with and without PPS involvement, statistically significant differences were found in their size > 4 cm (12.97% vs. 37.72%), percentage of malignant tumors (7.12% vs. 17.55%), incidence of Warthin Tumors (WTs) (43.58% vs. 24.56%), percentage of R1 resection (5.53% vs. 12.50%), and rate of FN paresis (17.15% vs. 53.34%). Multivariate analysis showed that tumors with PPS involvement were statistically significantly characterized by larger size (tumors > 4 cm were 2.9 times more frequent), 2 times less frequent occurrence of WTs, and 1.6 times higher risk of FN paresis. Conclusion: PGTs with PPS involvement show certain clinical and histological differences and require more complex surgical accesses. Therefore, they cannot be treated as "ordinary" tumors occupying the deep lobe.
Relationship between Countermovement Jump and Sprint Performance in Professional Football Players
Authors: Oleksy Łukasz , Mika Anna , Kuchciak Maciej , Stolarczyk Artur , Adamska Olga , Szczudło Miłosz , Kielnar Renata , Wolański Paweł , Deszczyński Jarosław Michał , Reichert Paweł
Published: August 2024

Objectives: The aim of this study was to assess the relationship between the countermovement jump (CMJ) and sprint performance of professional football players, and to determine which strength and speed elements assessed by the CMJ translate into effective running. Methods: The research sample comprised 87 male professional football players (age 23.7 ± 4.20 years; body mass 82.33 ± 6.56 kg; body height 1.86 ± 0.05 m) who performed the CMJ on a dual-force platform, as well as the 30 m sprint test. The time and velocity of the run were recorded by photocells at 0, 5, 10, and 30 m of the distance. Results: No significant differences were noted in the time or velocity of the sprint over the initial 5 m between the groups of football players with a higher and lower braking rate of force development (RFD) in the CMJ (p > 0.05). However, at subsequent intervals (5–10 m and 10–30 m), players with a higher braking RFD achieved significantly better time and velocity than those with a lower RFD. Significant correlations in the group with a lower braking RFD between the CMJ and sprint variables occurred in the propulsion phase of the CMJ and most of them were in the first interval (0–5 m). In the group with a higher braking RFD, significant relationships were visible in both the propulsion (concentric) and braking (eccentric) phases of the CMJ, mainly during the second and third intervals of the sprint test. Conclusions: The noted observations may suggest that the relationship between strength and running performance is more complex than previously indicated, and that higher strength in the CMJ does not fully correlate with better sprinting. Therefore, it has been hypothesized that training aimed at generally increasing strength may not always be fully beneficial for running performance in football players and hence specific training guidelines are suggested for targeted strengthening of the required muscle performance characteristics. This may possibly contribute to reducing the unnecessary muscle overload during both training and matches, thereby preventing sports-related injuries.
Screening Mammography Diagnostic Reference Level System According to Compressed Breast Thickness: Dubai Health
Authors: Dalah Entesar Z. , Alkaabi Maryam K. , Al-Awadhi Hashim M. , Antony Nisha A.
Published: August 2024

Screening mammography is considered to be the most effective means for the early detection of breast cancer. However, epidemiological studies suggest that longitudinal exposure to screening mammography may raise breast cancer radiation-induced risk, which begs the need for optimization and internal auditing. The present work aims to establish a comprehensive well-structured Diagnostic Reference Level (DRL) system that can be confidently used to highlight healthcare centers in need of urgent action, as well as cases exceeding the dose notification level. Screening mammographies from a total of 2048 women who underwent screening mammography at seven different healthcare centers were collected and retrospectively analyzed. The typical DRL for each healthcare center was established and defined as per (A) bilateral image view (left craniocaudal (LCC), right craniocaudal (RCC), left mediolateral oblique (LMLO), and right mediolateral oblique (RMLO)) and (B) structured compressed breast thickness (CBT) criteria. Following this, the local DRL value was established per the bilateral image views for each CBT group. Screening mammography data from a total of 8877 images were used to build this comprehensive DRL system (LCC: 2163, RCC: 2206, LMLO: 2288, and RMLO: 2220). CBTs were classified into eight groups of <20 mm, 20–29 mm, 30–39 mm, 40–49 mm, 50–59 mm, 60–69 mm, 70–79 mm, 80–89 mm, and 90–110 mm. Using the Kruskal–Wallis test, significant dose differences were observed between all seven healthcare centers offering screening mammography. The local DRL values defined per bilateral image views for the CBT group 60–69 mm were (1.24 LCC, 1.23 RCC, 1.34 LMLO, and 1.32 RMLO) mGy. The local DRL defined per bilateral image view for a specific CBT highlighted at least one healthcare center in need of optimization. Such comprehensive DRL system is efficient, easy to use, and very clinically effective.
Insights into Ultrasound Features and Risk Stratification Systems in Pediatric Patients with Thyroid Nodules
Authors: Gambale Carla , Rocha José Vicente , Prete Alessandro , Minaldi Elisa , Elisei Rossella , Matrone Antonio
Published: August 2024

Thyroid nodules in pediatric patients are less common than in adults but show a higher malignancy rate. Accordingly, the management of thyroid nodules in pediatric patients is more complex the younger the patient is, needing careful evaluation by physicians. In adult patients, specific ultrasound (US) features have been associated with an increased risk of malignancy (ROM) in thyroid nodules. Moreover, several US risk stratification systems (RSSs) combining the US features of the nodule were built to define the ROM. RSSs are developed for the adult population and their use has not been fully validated in pediatric patients. This study aimed to evaluate the available data about US features of thyroid nodules in pediatric patients and to provide a summary of the evidence regarding the performance of RSS in predicting malignancy. Moreover, insights into the management of thyroid nodules in pediatric patients will be provided.
Improved Whale Optimization Algorithm for Maritime Autonomous Surface Ships Using Three Objectives Path Planning Based on Meteorological Data
Authors: Wu Gongxing , Li Hongyang , Mo Weimin
Published: August 2024

In recent years, global trade volume has been increasing, and marine transportation plays a significant role here. In marine transportation, the choice of transportation route has been widely discussed. Minimizing fuel consumption, minimizing voyage time, and maximizing voyage security are concerns of the International Maritime Organization (IMO) regarding Maritime Autonomous Surface Ships (MASS). These goals are contradictory and have not yet been effectively resolved. This paper describes the ship path-planning problem as a multi-objective optimization problem that considers fuel consumption, voyage time, and voyage security. The model considers wind and waves as marine environmental factors. Furthermore, this paper uses an improved Whale Optimization Algorithm to solve multi-objective problems. At the same time, it is compared to three advanced algorithms. Through seven three-objective test functions, the performance of the algorithm is tested and applied in path planning. The results indicate that the algorithm can effectively balance the fuel consumption, voyage time, and voyage security of the ship, offering reasonable paths.
Power Generation Optimization for Next-Generation Cruise Ships with MVDC Architecture: A Dynamic Modeling and Simulation Approach
Authors: Nuchturee Chalermkiat , Li Tie , Zhou Xinyi
Published: August 2024

The cruise industry is obliged by economic and environmental initiatives to pursue fuel-efficient solutions and lower ship exhaust emissions. The medium voltage DC (MVDC) distribution with intelligent power management has become a concept for next-generation onboard power systems as its energy-saving feature is to eliminate the frequency constraint and simultaneously optimize engine loads and speed in response to load variations. The incentive for this transition lies on one hand in the fuel efficiency consideration and the reduction of power losses from serial conversion stages. On the other hand, the DC-based technology has been conceived as high-power density design, thus significantly increasing the payload. This study investigates such potential benefits focusing exclusively on large cruise vessels. A highly representative model of the integrated power platform that incorporates all dynamic interactions from the ship hull and essential machinery typically installed on board cruise ships is proposed. The power management strategy also takes account of actual sea conditions and real-time operation requirements. The simulation results demonstrate that the optimization-based MVDC system is able to maximize the opportunity of search agents in finding optimum fuel efficiency areas throughout the scenario time. An analysis of the system structure weight and space reduction of the MVDC architecture is also performed through the utilization of more compact electrical distribution devices and very high power-dense combustion turbines.
YOSMR: A Ship Detection Method for Marine Radar Based on Customized Lightweight Convolutional Networks
Authors: Kang Zhe , Ma Feng , Chen Chen , Sun Jie
Published: August 2024

In scenarios such as nearshore and inland waterways, the ship spots in a marine radar are easily confused with reefs and shorelines, leading to difficulties in ship identification. In such settings, the conventional ARPA method based on fractal detection and filter tracking performs relatively poorly. To accurately identify radar targets in such scenarios, a novel algorithm, namely YOSMR, based on the deep convolutional network, is proposed. The YOSMR uses the MobileNetV3(Large) network to extract ship imaging data of diverse depths and acquire feature data of various ships. Meanwhile, taking into account the issue of feature suppression for small-scale targets in algorithms composed of deep convolutional networks, the feature fusion module known as PANet has been subject to a lightweight reconstruction leveraging depthwise separable convolutions to enhance the extraction of salient features for small-scale ships while reducing model parameters and computational complexity to mitigate overfitting problems. To enhance the scale invariance of convolutional features, the feature extraction backbone is followed by an SPP module, which employs a design of four max-pooling constructs to preserve the prominent ship features within the feature representations. In the prediction head, the Cluster-NMS method and α-DIoU function are used to optimize non-maximum suppression (NMS) and positioning loss of prediction boxes, improving the accuracy and convergence speed of the algorithm. The experiments showed that the recall, accuracy, and precision of YOSMR reached 0.9308, 0.9204, and 0.9215, respectively. The identification efficacy of this algorithm exceeds that of various YOLO algorithms and other lightweight algorithms. In addition, the parameter size and calculational consumption were controlled to only 12.4 M and 8.63 G, respectively, exhibiting an 80.18% and 86.9% decrease compared to the standard YOLO model. As a result, the YOSMR displays a substantial advantage in terms of convolutional computation. Hence, the algorithm achieves an accurate identification of ships with different trail features and various scenes in marine radar images, especially in different interference and extreme scenarios, showing good robustness and applicability.
SSL-LRN: A Lightweight Semi-Supervised-Learning-Based Approach for UWA Modulation Recognition
Authors: Ding Chaojin , Su Wei , Xu Zehong , Gao Daqing , Cheng En
Published: August 2024

Due to the lack of sufficient valid labeled data and severe channel fading, the recognition of various underwater acoustic (UWA) communication modulation types still faces significant challenges. In this paper, we propose a lightweight UWA communication type recognition network based on semi-supervised learning, named the SSL-LRN. In the SSL-LRN, a mean teacher–student mechanism is developed to improve learning performance by averaging the weights of multiple models, thereby improving recognition accuracy for insufficiently labeled data. The SSL-LRN employs techniques such as quantization and small convolutional kernels to reduce floating-point operations (FLOPs), enabling its deployment on underwater mobile nodes. To mitigate the performance loss caused by quantization, the SSL-LRN adopts a channel expansion module to optimize the neuron distribution. It also employs an attention mechanism to enhance the recognition robustness for frequency-selective-fading channels. Pool and lake experiments demonstrate that the framework effectively recognizes most modulation types, achieving a more than 5% increase in recognition accuracy at a 0 dB signal-to-noise ratio (SNRs) while reducing FLOPs by 84.9% compared with baseline algorithms. Even with only 10% labeled data, the performance of the SSL-LRN approaches that of the fully supervised LRN algorithm.
Modeling Fluid Flow in Ship Systems for Controller Tuning Using an Artificial Neural Network
Authors: Assani Nur , Matić Petar , Kezić Danko , Pleić Nikolina
Published: August 2024

Flow processes onboard ships are common in order to transport fluids like oil, gas, and water. These processes are controlled by PID controllers, acting on the regulation valves as actuators. In case of a malfunction or refitting, a PID controller needs to be re-adjusted for the optimal control of the process. To avoid experimenting on operational real systems, models are convenient alternatives. When real-time information is needed, digital twin (DT) concepts become highly valuable. The aim of this paper is to analyze and determine the optimal NARX model architecture in order to achieve a higher-accuracy model of a ship’s flow process. An artificial neural network (ANN) was used to model the process in MATLAB. The experiments were performed using a multi-start approach to prevent overtraining. To prove the thesis, statistical analysis of the experimental results was performed. Models were evaluated for generalization using mean squared error (MSE), best fit, and goodness of fit (GoF) measures on two independent datasets. The results indicate the correlation between the number of input delays and the performance of the model. A permuted k-fold cross-validation analysis was used to determine the optimal number of voltage and flow delays, thus defining the number of model inputs. Permutations of training, test, and validation datasets were applied to examine bias due to the data arrangement during training.
Numerical Simulation of Vertical Cyclic Responses of a Bucket in Over-Consolidated Clay
Authors: Jiang Jun , Luo Chengxi , Wang Dong
Published: August 2024

Multi-bucket foundations have become an alternative for large offshore wind turbines, with the expansion of offshore wind energy into deeper waters. The vertical cyclic loading–displacement responses of the individual bucket of the tripod foundation are relevant to the deflection of multi-bucket foundations and crucial for serviceability design. Finite element analyses are used to investigate the responses of a bucket subjected to symmetric vertical cyclic loading in over-consolidated clay. The Undrained Cyclic Accumulation Model (UDCAM) is adopted to characterize the stress–strain properties of clay, the parameters of which are calibrated through monotonic and cyclic direct simple shear tests. The performance of the finite element (FE) model combined with UDCAM in simulating vertical displacement amplitudes is evaluated by comparison with existing centrifuge tests. Moreover, the impact of the bucket’s aspect ratio on vertical displacement amplitude is investigated through a parametric study. A predictive equation is proposed to estimate the vertical displacement amplitudes of bucket foundations with various aspect ratios, based on the cyclic displacement amplitude of a bucket with an aspect ratio of unity.
Mutation Breeding of Monascus to Produce a High Yield of Orange Pigment and Low Citrinin Content Using the ARTP Method
Authors: Zhang Chan , Sun Qing , Yang Le , Ablimit Arzugul , Dong Huijun , Wang Haijiao , Wang Congcong , Wang Chengtao
Published: August 2024

Monascus is a filamentous fungus with a long history of application in China, which can produce a variety of secondary metabolites, including Monascus red pigments, Monascus orange pigments, Monascus yellow pigments, and citrinin. There is widespread attention being paid to natural pigments because of their safety. Among the many natural pigments, orange pigment has a wide range of applications because of its unique color, but current production levels in the orange pigment industry are limited to a certain extent due to the insufficiently wide range of sources and low production. In this study, the ARTP mutation was used to obtain a strain with high-yield orange pigment and low citrinin. The strain RS7 was obtained through two-step mutagenesis, and all three pigments were improved to different degrees. The color value of orange pigment was elevated from the original 108 U/mL to 180 U/mL, an increase of 66.7% compared to the original strain, and the citrinin content was reduced by 69%. The result of microscopic morphology showed that RS7 has more wrinkles and is more convex than the R1 strain, but there was little change between the two strains. Therefore, the ARTP mutation influenced the growth and the biosynthesis of pigments in Monascus. In addition, the conditions of ultrasonic extraction of Monascus pigments were optimized using the response surface, and the separation of pigments was achieved with the method of thin-layer chromatography. Pigment stability results showed that the temperature had no significant effect on orange pigment, while tea polyphenol could improve its stability. This study generated a strain with high-yielding orange pigment and could lay a foundation for the future application of Monascus orange pigment in the food industry.
Proportions and Seasonal Patterns of Respiratory Viruses via Rapid Tests in Adults at a Greek Hospital (Oct. 2023–Mar. 2024)
Authors: Rousogianni Eleni , Perlepe Garyfallia , Boutlas Stylianos , Rapti Georgia G. , Gouta Evdoxia , Mpaltopoulou Eleni , Mpaltopoulos Giorgos , Rouka Erasmia , Papagiannis Dimitrios , Gourgoulianis Konstantinos I.
Published: August 2024

Background: Respiratory infections pose a major public health threat. The predominant viruses causing viral respiratory infections are influenza A and B (Flu-A, Flu-B), coronaviruses, respiratory syncytial virus (RSV), and adenovirus. This study aims to investigate the proportion of these cases via rapid antigen tests and assess seasonal patterns. Methods: Clinical samples were collected from symptomatic adults presenting to the Emergency and Respiratory Medicine Departments of the University Hospital of Larissa (UHL), Greece from 16 October 2023 to 31 March 2024. Nasal specimens were antigen-tested for Flu-A/B, SARS-CoV-2, RSV, and adenovirus. Results: The total sample of specimens collected was 1434, of which 739 (51.5%) were female and 695 were male (48.5%). The mean age of participants was 57 ± 5.5 years. Among the positive results, we recorded a proportion of 40.18% and 11.40% for influenza A and B, respectively, followed by 35.79% for SARS-CoV-2, 10.70% for RSV, and 1.93% for adenovirus. Conclusions: In Greece, surveillance systems in infection control are underutilized. Rapid tests via multiple antigens can quickly identify viral infections, making them a valuable tool with financial benefits for health systems. Early detection of respiratory infections helps allocate resources efficiently, ensures adequate staff and facilities are available, and improves patient care through refined clinical management.
Intraocular Pressure Measurements in Standing, Sitting, Prone, and Supine Positions
Authors: De Bernardo Maddalena , Cione Ferdinando , De Pascale Ilaria , Pagliarulo Sergio , Rosa Nicola
Published: August 2024

In this study, intraocular pressure (IOP) was measured in sitting, supine, prone, and standing (ST) positions and again five minutes after standing (ST-5) utilizing a Tono-Pen AVIA in 124 eyes of 62 healthy subjects with ages ranging from 21 to 59 years (mean 30 ± 10 years). In each subject, the average IOP of both eyes was used for the statistical evaluation. The mean IOP difference between the ST and sitting positions was −0.13 ± 1.63 mmHg (p = 0.548); between ST-5 and sitting, it was 0.53 ± 1.24 mmHg (p = 0.001); between supine and sitting, it was 1.30 ± 1.48 mmHg (p < 0.001); between ST and supine, it was −1.43 ± 1.74 mmHg (p < 0.001); between ST-5 and supine, it was −0.77 ± 1.59 mmHg (p < 0.001); between prone and supine, it was 2.24 ± 1.92 mmHg (p < 0.001); between ST and ST-5, it was −0.67 ± 1.84 mmHg (range: −7.5 to 5 mmHg) (p = 0.007); between prone and ST, it was 3.46 ± 2.01 mmHg (p < 0.001); between ST-5 and prone, it was −2.46 ± 1.67 mmHg (p < 0.001); and between sitting and prone, it was −3.22 ± 1.56 mmHg (p < 0.001). The results show a significant IOP increase in the ST-5 position, suggesting that such measurements need to be performed in an attempt to explain the progression of glaucoma in apparently normal-tension patients.
Intraoperative Fluorescent Navigation of the Ureters, Vessels, and Nerves during Robot-Assisted Sacrocolpopexy
Authors: Jun Hye Sun , Lee Nara , Gil Bohye , Jang Yoon , Yu Na Kyung , Jung Yong Wook , Yun Bo Seong , Kim Mi Kyoung , Won Seyeon , Seong Seok Ju
Published: August 2024

In this study, we aimed to demonstrate the feasibility and safety of navigating the ureters, middle sacral artery (MSA), and superior hypogastric nerve (SHN) using indocyanine green (ICG) and near-infrared fluorescence (NIRF) imaging during robot-assisted sacrocolpopexy (RSCP). Overall, 15 patients who underwent RSCP for apical vaginal prolapse were retrospectively enrolled. All patients underwent cystoscopic intraureteric instillation of 5 cc ICG (2.5 mg/mL) before RSCP and intravenous injection of 3 cc ICG during presacral dissection and mesh fixation. In all patients, the fluorescent right ureter was clearly identified in real time. The MSA was visualized on ICG-NIRF images in 80% (13/15) of patients. The mean time from ICG injection to MSA visualization was 43.7 s; the mean duration of the arterial phase was 104.3 s. Fluorescent SHN was detected in 73.3% (11/15) of patients. The time from ICG injection to SHN fluorescence was 48.4 s; the duration of fluorescence was 177.2 s. There was no transfusion, iatrogenic ureteral injury, or bowel or urinary dysfunction. Our results indicated that intraoperative ureter, MSA, and SHN mapping using ICG-NIRF images during RSCP is a valuable and safe technique to avoid iatrogenic ureteral, vascular, and neural injuries and to simplify surgical procedures. Nonetheless, further studies are required.
The Search for Consistency in Residual Symptoms in Major Depressive Disorder: A Narrative Review
Authors: Pastuszak Michał , Cubała Wiesław Jerzy , Kwaśny Aleksander , Mechlińska Agnieszka
Published: August 2024

Residual symptoms are prevalent in major depressive disorder (MDD), encompassing a wide spectrum of symptoms such as sleep disturbances, changes in weight and appetite, cognitive impairment, and anxiety. These symptoms consistently impair daily functioning, diminish quality of life, and forecast disease relapse. Despite their clinical significance, residual symptoms lack a unified definition, potentially leading to confusion with treatment-emergent symptoms and ambiguity across studies, thereby hindering the generalizability of research findings. While some research identifies insomnia and mood disturbances as critical indicators, other studies emphasize different symptoms or find no significant correlation. Inconsistencies in defining residual symptoms, as well as methodological differences across studies, contribute to these conflicting results. While clinicians focus on alleviating negative symptoms to improve functional status, patients often prioritize achieving positive affect and overall well-being as essential components of successful treatment. It necessitates a comprehensive approach to patient care in depression. This review explores the phenomenon of residual symptoms in MDD, focusing on the ambiguity in definitions, clinical characteristics, and their impact on long-term outcomes. The lack of a standardized regulatory or academic definition for residual symptoms leads to varied interpretations among clinicians, underscoring the need for standardized terminology to guide effective treatment strategies and future research.
Neuroinflammatory Approach to Surgical Trauma: Biomarkers and Mechanisms of Immune and Neuroendocrine Responses
Authors: Silva Gustavo N. , Brandão Virna G. A. , Perez Marcelo V. , Blum Kenneth , Lewandrowski Kai-Uwe , Fiorelli Rossano K. A.
Published: August 2024

The severity and invasiveness of clinical outcomes from organic responses to trauma are influenced by individual, surgical, and anesthetic factors. A stress response elicits neuroendocrine and immune reactions that may lead to multi-organ dysfunction. The degree of neuroinflammatory reflex activation from trauma can increase pro-inflammatory cytokine production, leading to endothelial dysfunction, glycocalyx damage, neutrophil activation, and multisystem tissue destruction. A shift in patient treatment towards a neuroinflammatory perspective has prompted a new evaluation protocol for surgical patients, required to understand surgical pathogenesis and its link to chosen anesthetic–surgical methods. The goal of this study is to summarize and disseminate the present knowledge about the mechanisms involved in immune and neuroendocrine responses, focusing on video laparoscopic surgeries. This article outlines various measures cited in the literature aimed at reducing the burden of surgical trauma. It reviews anesthetic drugs, anesthetic techniques, and intensive care procedures that are known to have immunomodulatory effects. The results show a preference for more sensitive inflammatory mediators to tissue trauma serving as care tools, indicators for prognosis, and therapeutic outcomes.
Quantitative Analysis of Aeolian Sand Provenance: A Comprehensive Analysis in the Otindag Dune Field, Central Inner Mongolia, China
Authors: Cui Yingying , Zhou Yali , Lizaga Ivan , Dong Zhibao , Zhang Jin , Liang Aimin , Lü Ping , Feng Tong
Published: August 2024

The identification and quantification of aeolian sand contributions are essential for understanding the formation of dune fields and mechanisms of modern surface processes. In the present study, we take aeolian sand in the Otindag dune field (hereafter, often referred to as, simply, Otindag) as the research object. The dune field’s immediate source is quantitatively identified based on heavy minerals and the Conservativeness Index (CI), Consensus Ranking (CR), and the Consistent Tracer Selection (CTS) method. The primary source area of the aeolian sand was found to be from the northwestern, upwind area of the Otindag (59 ± 14%), followed by the Yinshan Mountain (17 ± 10%) and the lake basin (23 ± 12%). The proposed sediment transport model elucidates that sediments from the upwind of the Otindag are directly transported from the northwest to the Otindag, where they are deposited. Materials from the southern Yinshan Mountains are carried by rivers to the southern edge of the Otindag, where they are subsequently transported by wind and ultimately deposited. The lake deposits within the Otindag also contribute to the aeolian sand supply under the influence of wind. This study demonstrates that the fingerprinting techniques of CI, CR, and CTS serve as successful strategies for conducting quantitative provenance research in dune fields.
Analysis of the Spatiotemporal Changes in Cropland Occupation and Supplementation Area in the Pearl River Delta and Their Impacts on Carbon Storage
Authors: Huang Shu-Qi , Wu Da-Fang , Lin Jin-Yao , Pan Yue-Ling , Zhou Ping
Published: August 2024

In recent years, the “dual carbon” issue has become a major focus of the international community. Changes in land use driven by anthropogenic activities have a profound impact on ecosystem structure and carbon cycling. This study quantitatively assesses the spatiotemporal changes in cropland occupation and supplementation in the Pearl River Delta from 2000 to 2020 using the InVEST model, analyzing the spatial clustering of carbon storage changes caused by variations in cropland area. The PLUS model was employed to simulate land-use patterns and the spatial distribution of carbon storage in four future development scenarios. The results indicate the following: (1) From 2000 to 2020, the net change rate of cropland area in the Pearl River Delta was −0.81%, with a decrease of 16.49 km2 in cropland area, primarily converted to built-up land and forest land. (2) Carbon storage in the Pearl River Delta exhibited a pattern of lower values in the center and higher values in the periphery. The terrestrial ecosystem carbon storage in the Pearl River Delta was 534.62 × 106 t in 2000, 518.60 × 106 t in 2010, and 512.57 × 106 t in 2020, showing an overall decreasing trend. The conversion of cropland and forest land was the main reason for the decline in total regional carbon storage. (3) The area of carbon sequestration lost due to cropland occupation was significantly greater than the area of carbon loss compensated by new cropland, indicating an imbalance in the quality of cropland occupation and supplementation as a crucial factor contributing to regional carbon loss. (4) Under the ecological priority scenario, the expansion of built-up land and the reduction in ecological land such as cropland and forest land were effectively controlled, resulting in the minimal loss of carbon storage. The soil organic carbon pool of cropland is the most active carbon pool in terrestrial ecosystems and has a significant impact on carbon storage. Clarifying the relationship between “cropland protection measures–land use changes–ecosystem carbon storage” will improve cropland protection policies, provide references for regional carbon sequestration enhancement, and support sustainable socio-economic development.
Assessing Eco-Environmental Effects and Its Impacts Mechanisms in the Mountainous City: Insights from Ecological–Production–Living Spaces Using Machine Learning Models in Chongqing
Authors: Zhang Shuang , Liu Shaobo , Zhong Qikang , Zhu Kai , Fu Hongpeng
Published: August 2024

In the face of accelerating land use changes, conflicts between land use patterns and the eco-environment are increasingly pronounced. By calculating the eco-environment quality index (EQI) adopting the ecological–production–living spaces (EPLS) framework, we evaluate the eco-environment quality of land use changes within Chongqing’s central urban area from 2000 to 2020. The study employs a random forest model to elucidate the mechanisms influencing the eco-environment quality. The findings reveal the following: (1) Living spaces have expanded by 361.53 km2, while production and the ecological spaces have been experiencing a significant reduction of 331.42 km2 and 30.11 km2 over two decades. (2) The eco-environment quality has steadily declined from 0.3665 in 2000 to 0.3501 in 2020, indicating a degradation in overall quality. There is notable spatial variation in eco-environment quality, typically displaying a “low center–high periphery” pattern. (3) Pesticide usage, grain production, and the added value of the primary industry are the primary factors affecting ecological quality. The findings of this study provide valuable insights for global urban planning and environmental management. Rapidly, land use change regions worldwide face similar conflicts between economic growth and ecological sustainability. This research underscores the need for integrated land use policies that balance development with environmental preservation. The methodologies and findings can inform international efforts to optimize land use patterns, improve ecological quality, and achieving sustainable development goals, offering adaptable strategies for policymakers and urban planners globally.