bluuebunny/crossref_metadata_2025 huggingface dataset:
A Simple Narrative Review of Progress on the Processing and Utilization of Functional Rice
Authors: Yi Ziying , Chen Dagang , Zhou Xinqiao , Guo Jie , Chen Ke , Ye Chanjuan , Liu Chuanguang , Liu Juan
Published: December 2024

This paper aims to review the research progress on the processing and utilization of functional rice and explore its potential to enhance human health. The research progress in the processing and utilization of colored rice, low-protein rice, high-resistant starch rice, micronutrient-enriched rice, and bioreactor rice was systematically analyzed through a comprehensive literature review. The impact of various processing techniques on the retention of nutritional components in functional rice was also discussed. This study found that functional rice exhibits great potential in terms of nutritional value, health effects, and market demand. However, issues such as the loss of bioactive components during processing, the maintenance of specific agronomic traits, and market acceptance still need to be addressed. The research and development of functional rice are significant for enriching people’s dietary choices and addressing global malnutrition and chronic disease problems. Future efforts should focus on further optimizing processing techniques and utilizing genetic engineering and molecular breeding technologies to enhance the nutritional value and agronomic traits of functional rice, thus meeting market demands and health objectives.
Advancements in Geohazard Investigations: Developing a Machine Learning Framework for the Prediction of Vents at Volcanic Fields Using Magnetic Data
Authors: Abdulfarraj Murad , Abraham Ema , Alqahtani Faisal , Aboud Essam
Published: December 2024

This study investigates the application of machine learning techniques for predicting volcanic vent locations based on aeromagnetic geophysical data. Magnetic data, known to reflect subsurface geological structures, presents a valuable source of information for understanding volcanic activity. Leveraging this data, we aim to develop and validate predictive models capable of discerning the presence of volcanic vents. Through a comprehensive data analysis, feature engineering, and model training, we explore the intricate relationships between magnetic variations and volcanic vent locations. Various machine learning algorithms were evaluated for their efficacy in binary classification, with a focus on identifying areas with a high likelihood of volcanic vent presence. The Random Forest model (RFM) was adopted given its high performance metrics, achieving a prediction accuracy of 92%. Our results demonstrate the successful prediction of volcanic vent locations, with a significant correlation of 86% between the actual and predicted vent locations and a high Degree of Certainty (DC) at 97%. This research contributes to the advancement of geospatial data analysis within the field of geoscience, showcasing the potential of machine learning in interpreting and utilizing magnetic data for volcanic hazard assessment and early warning systems. The findings represent a significant step towards enhancing our understanding of volcanic dynamics and improving the predictive tools available for volcanic hazard assessment.
‘The Figure of the Old with the Pathetic Tenderness of the New’: An Early Reading of Sterne’s A Sentimental Journey (1768)
Authors: Reed Daniel
Published: December 2024

This essay introduces the Reed ASJ as a new primary source for the early reception of Laurence Sterne’s second novel, A Sentimental Journey Through France and Italy (1768) and draws on recent developments in marginalia studies to locate it within its contemporary historical context. This framework informs discussion of the reader’s possible identity, their use of annotation, and wide-ranging responses to the novel such as comparative readings with Tristram Shandy (1759–1767), assessments of Sterne’s religiosity, and the depiction of French society and customs. Also explored are the reader’s strong interventions with passages in the novel that were beneath their expectations. And so, the recovery of the Reed ASJ suggests fresh possibilities for the reinvestigation of ASJ’s inherent paradoxes, its disputed sincerity in the sentimental mode and relationship to genre that fuel the novel’s ongoing popularity.
Knowledge and Practice of Urinary Incontinence Management Among Nursing Professionals in Serbian Nursing Homes: A Multicentre Study
Authors: Milutinović Dragana , Novković Joldić Mira , Simin Dragana , Živković Dragana
Published: December 2024

Background/Objectives: Urinary incontinence (UI) is a prevalent condition among older adults, particularly in nursing home residents. Furthermore, it is associated with significant physical, emotional, and financial burdens. Effective management of UI depends on the knowledge and practices of nursing professionals, who are responsible for fundamental care. However, their knowledge and practice gaps remain challenging. Therefore, the study aimed to assess the knowledge and practice of nursing professional regarding urinary incontinence, to explore whether there are differences in knowledge and practice concerning their sociodemographic characteristics and to determine if there is a correlation between knowledge and practice regarding UI. Methods: A multicentre descriptive, cross-sectional study design following STROBE guidelines was conducted. The sample comprised 171 participants, and as research instruments, the Urinary Incontinence Quiz (UIQ) and the Urinary Knowledge and Practice Instrument (UKPI) were used. Results: The overall knowledge of nursing professionals about UI in older people was suboptimal, but most were familiar with the causes of UI, and that toilet training can improve incontinence. Nursing professionals with continuing education or interest in learning more about UI demonstrated significantly higher knowledge levels. Practice scores revealed that continence care interventions were often implemented, but documentation and support practices such as comprehensive toileting plans were less frequently performed. A weak but significant positive correlation was found between knowledge and practice. Conclusions: The study highlights substantial knowledge and practice gaps in UI management among nursing professionals in Serbia. The findings underscore the need for targeted educational interventions to improve UI care.
Emergency Departments in Contemporary Healthcare: Are They Still for Emergencies? An Analysis of over 1 Million Attendances
Authors: Zaboli Arian , Turcato Gianni , Brigiari Gloria , Massar Magdalena , Ziller Marta , Sibilio Serena , Brigo Francesco
Published: December 2024

Background: Over the past few decades, emergency departments (EDs) have experienced an increasing workload. However, the variation in the types of patient accesses to these departments remains poorly understood. Objective: To evaluate the 5-year temporal trend in the volume of patients attending EDs based on the urgency of their conditions. Methods: This multicenter observational retrospective study was conducted from 1 January 2019, to 31 December 2023, across seven Italian EDs located within the same province. All patients accessing the EDs during the study period were included, totaling 1,282,735 patients. The triage code was used as an urgency index; non-urgent patients were defined as those who received a code 4 or 5 in triage, while urgent patients were defined as those who received a code 3, 2, or 1 in triage. Temporal analyses of admissions were conducted, also evaluating individual age groups to understand behavior over time. Results: From 2019 to 2023, there was a significant 10% increase in ED attendances by non-urgent patients. This increase was observed during both daytime and nighttime shifts. Notably, all age groups showed an increase in non-urgent patients, except for pediatric patients aged 0 to 14. Conclusions: Over the past 5 years, there has been a consistent upward trend in ED attendances by non-urgent patients. Healthcare policies should consider implementing strategies to manage or mitigate the overload in EDs, particularly related to non-urgent patient accesses.
The Impact of Anxiety and Depressive Symptomatology on Greek Practicing Lawyers’ Self-Esteem
Authors: Koukoulis Andreas-Nikolaos , Theocharidou Melissa , Kallergis Emmanouil-Ioannis , Kosta Olympia , Papadodima Stavroula , Tsellou Maria
Published: December 2024

Background/Objectives: This study examines the impact of anxiety and depressive symptomatology on self-esteem among Greek practicing lawyers. The high-stress environment of the legal profession is known to heighten the risk of mental health issues, yet limited research exists on Greek lawyers. The study aims to explore associations between anxiety, depressive symptoms, and self-esteem, hypothesizing that increased anxiety and depression correlate with reduced self-esteem. Method: The study utilized a correlational design with a sample of 80 Greek lawyers, recruited through professional associations. Participants completed the Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), and Rosenberg Self-Esteem Scale (RSES). Descriptive statistics, correlation analysis, and multiple regression were used to assess the relationships between anxiety, depression, and self-esteem. Results: The findings indicated significant negative correlations between self-esteem and both depressive (r = −0.631, p < 0.001) and anxiety symptoms (r = −0.405, p < 0.001). Multiple regression analysis demonstrated that both depression (β = −0.558, p < 0.001) and anxiety (β = −0.225, p = 0.014) were significant predictors of lower self-esteem, explaining approximately 44% of the variance in self-esteem scores. Conclusions: The study concludes that higher levels of anxiety and depressive symptoms significantly lower self-esteem among Greek lawyers, underscoring the need for mental health support within this profession. Addressing mental health issues in legal professionals may promote better self-esteem and overall well-being, with potential benefits for both lawyers and their clients.
The Impact of Job Satisfaction on the Quality of Life of Formal Caregivers of the Elderly
Authors: Sousa Marina , Martins Helena , Costa Alexandra , Silva Anabela
Published: December 2024

Background/Objectives: Absenteeism refers to the frequent, often unplanned, absence from the workplace. This study examines the interrelations among job satisfaction, quality of life (QoL), and absenteeism among formal caregivers for elderly individuals. With the significant demographic shift toward an aging population, understanding these dynamics is increasingly important. Methods: A sample of 82 caregivers from Portuguese Private Social Solidarity Institutions was used, with QoL assessed through the WHOQOL-Bref and job satisfaction measured via the Minnesota Satisfaction Questionnaire (MSQ). Results: The results reveal that higher levels of job satisfaction are associated with improved QoL and lower rates of absenteeism. Specifically, caregivers with higher satisfaction reported fewer sick leaves and a more favorable perception of their QoL. Conclusions: These findings underscore the need for supportive workplace policies that enhance caregiver satisfaction, ultimately contributing to both caregiver well-being and the quality of care provided.
The Effect of Endometriosis on In Vitro Fertilization Outcomes: A Systematic Review and Meta-Analysis
Authors: Mappa Ilenia , Page Zoe Pauline , Di Mascio Daniele , Patelli Chiara , D’Antonio Francesco , Giancotti Antonella , Gebbia Francesco , Mariani Giulia , Cozzolino Mauro , Muzii Ludovico , Rizzo Giuseppe
Published: December 2024

Objectives: The purpose of this study was to evaluate the impact of endometriosis on various outcomes of in vitro fertilization (IVF), including live birth rates, clinical pregnancy rates, fertilization rates, and implantation rates, through a systematic review and meta-analysis. Methods: Systematic searches were carried out using PubMed, MEDLINE, Cochrane Central Register of Controlled Trials, Scopus, EMBASE, and Web of Science from January 2010 to November 2023. Studies comparing IVF outcomes in women with and without endometriosis were included. The primary outcome was live birth rate; secondary outcomes included clinical pregnancy, fertilization, and implantation rates. Data were extracted and analyzed using odds ratio (OR) and 95% confidence interval (CI) with fixed or random-effects models, depending on heterogeneity. Results: From 1340 studies initially identified, 40 studies met the inclusion criteria, encompassing 8970 women with endometriosis and 42,946 control participants. There were no significant differences between the endometriosis and control groups in terms of live birth rate (OR 1.03, 95% CI 0.75–1.41, p = 0.84), clinical pregnancy rate (OR 0.86, 95% CI 0.72–1.02, p = 0.1), or fertilization rate (OR 0.96, 95% CI 0.79–1.15, p = 0.64). However, endometriosis was associated with a significantly lower implantation rate (OR 0.85, 95% CI 0.74–0.97, p = 0.02). Conclusions: Endometriosis significantly negatively affects implantation rates in women undergoing IVF, despite the absence of significant differences in live birth, clinical pregnancy, and fertilization rates. Further research is needed to evaluate the impact of different stages of endometriosis on IVF outcomes and to develop optimized management protocols for these patients.
Quantification of Phytochemicals in Cephalotaxus harringtonia: Insights into Plant Tissue-Specific Allocation
Authors: Lee Chang-Dae , Ku Jajung , Lee Sullim , Lee Sanghyun
Published: December 2024

Cephalotaxus harringtonia has garnered recent attention for its promising medicinal properties attributed to its alkaloid composition, including harringtonine and homoharringtonine known for their radical scavenging activities. High-performance liquid chromatography was used to assess the distribution of harringtonine, homoharringtonine, and ginkgetin in different plant parts of C. harringtonia. Additionally, DPPH and ABTS+ assays were conducted to evaluate the radical scavenging activity of C. harringtonia extracts. These results revealed that bud extracts from C. harringtonia exhibited the highest levels of polyphenols, along with elevated concentrations of harringtonine and homoharringtonine; nevertheless, this phenomenon only marginally influenced their antioxidant potential. These results suggest that, although a high concentration of compounds was detected in the buds of C. harringtonia, the detected compounds and their correlationwith radical scavenging activity appears to be weak. While harringtonine and homoharringtonine are synthesized and maintained at elevated levels within buds to fulfill various physiological functions, including modulation of signal transduction pathways and reinforcement of defense mechanisms, the involvement of other constituents and the potential synergistic interactions among compounds cannot be overlooked in mediating the observed radical scavenging activity. Moreover, the significant concentrations of harringtonine and homoharringtonine in bud extracts highlight the potential applications of C. harringtonia in the pharmaceutical industry and other similar fields. This study emphasizes the imperativeness of further exploring the medicinal applications of C. harringtonia and underscores its prospective implications in pharmaceutical and functional materials development.
Investigating Induced Infiltration by Municipal Production Wells Using Stable Isotopes of Water (δ18O and δ2H), Four Mile Creek, Ohio
Authors: Ngoma Idah , Levy Jonathan , Rech Jason A. , Berhane Tedros M.
Published: December 2024

Many municipalities around the world place their production wells in shallow alluvial aquifers that are adjacent to streams. Pumping these wells then induces the infiltration of surface water into the aquifer, allowing the greater extraction of water without significantly depleting the aquifer. However, induced infiltration poses a risk of introducing contamination from surface water into groundwater systems. The goal of this study was to quantify the amount of induced infiltration due to municipal pumping at the Four Mile Creek well field in Oxford, Ohio, using stable isotopes of water oxygen (δ18O) and deuterium (δ2H). In areas of municipal pumping, we sampled water from the production wells, Four Mile Creek, and from monitoring wells that we hypothesized to be both influenced and not influenced by induced infiltration. Samples were collected over 10 months in 2012 and over 12 months in 2021. In 2012, surface water δ18O values ranged from −3.89 to −8.04‰, and δ2H ranged from −26.55 to −55.65‰ at sampling sites. PW1 δ18O values ranged from −4.71 to −7.39‰ with a mean of −6.61 and −32.01 to −47.86‰ with a mean of −42.74‰ for δ2H. PW2 δ18O values ranged from −5.74 to −7.34‰, with a mean of −6.45‰, and δ2H ranged from −36.29 to −47.82‰ with a mean of −42.43‰. PW3 had lower values of both δ18O and δ2H, ranging from −6.36 to −8.02‰ and −47.7 to −40.35‰, and with means of −7.08 and −45.11, respectively. In 2021/2022, surface water δ18O values ranged from −5.32 to −7.93‰, and the δ2H ranged from −36.14 to −50.56‰. PW1 δ18O values ranged from −6.15 to −7.54‰ with a mean of −7.13‰, and δ2H ranged from −43.52 to −49.01‰ with a mean of −45.99‰. PW2 δ18O values ranged from −5.72 to −7.34‰, with a mean of −6.70‰, and δ2H ranged from −36.69 to −46.14‰, with a mean of −43.61‰. Using the time averaged values of δ18O of groundwater, production wells and surface water, the percentages of surface water resulting from induced infiltration in 2012 were 57%, 59% and 15% at the three wells, respectively, while in 2021, PW1 had 35% and PW2 91%. The amount of induced infiltration was apparently related to the pumping rates of the production wells, the length of time of pumping and the distance between Four Mile Creek and production wells. Our results indicate that stable isotopes of water provide a reliable method of quantifying groundwater/surface water interaction in alluvial aquifers.
A SHACL-Based Approach for Enhancing Automated Compliance Checking with RDF Data
Authors: Anim Joseph , Robaldo Livio , Wyner Adam Z.
Published: December 2024

Automated Compliance Checking (ACC) has emerged as a critical tool for enforcing legal regulations across various domains. This paper contributes to ongoing research in Semantic Web technologies, particularly focusing on the execution of SHACL-SPARQL rules on RDF data. The RDF, being one of the most widely used knowledge representation (KR) formats, serves as the foundation of our approach, ensuring compatibility with existing standards and enhancing interoperability. Our research enhances the aggregate and temporal aspects of ACC by addressing the limitations of traditional ACC methodologies, which often fall short in managing the nuanced temporal and aggregate requirements essential for legal reasoning. Through a case study analysis of selected regulations with aggregate and temporal facets in LI 2204, which regulates local content and participation in Ghana’s upstream petroleum industry, this paper demonstrates the effectiveness of the proposed solution in achieving these dimensions of ACC. The findings underscore the potential of Semantic Web technologies to transform ACC practices by moving towards standardized, interoperable solutions. All source codes are freely available online together with instructions to locally reproduce the simulations.
Clustering Visual Similar Objects for Enhanced Synthetic Image Data for Object Detection
Authors: Rolf Julian , Gerhard Detlef , Kosic Pero
Published: December 2024

Object detection often struggles with accurately identifying visually similar parts, a challenge commonly faced in industrial applications. To address this issue, we propose a clustering methodology based on the visual similarity of 3D object models. This approach is particularly effective when integrated with synthetic image generation, as both processes rely on 3D models. In this case study, we observed more than a 20% increase in classification performance on two different object detector architectures on a validation dataset when training an object detector on visually similar groups rather than on all classes, suggesting the potential of our method as a baseline for a multi-stage classification scheme.
Extracting Bridge Modal Frequencies Using Stationary Versus Drive-By Modes of Smartphone Measurements
Authors: McSweeney Niall , Ghiasi Ramin , Malekjafarian Abdollah , Ozer Ekin
Published: December 2024

In this research, we harmonize the two mobility approaches, stationary and mobile measurements, within the same framework to generate comparison opportunities, particularly in terms of identified bridge modal frequencies. Vibration tests were conducted to determine the natural frequency of a pedestrian bridge located in University College Dublin using smartphones. Both stationary and mobile smartphone measurements were collected, a novel use of two levels of mobility. Stationary measurements involved leaving the smartphone on the bridge deck at different positions along the bridge for a period of time, and mobile measurements were carried out using an electric scooter to ride across the bridge with the smartphone attached to the scooter deck. Single-output identification results were then compared to visualize the differences at two mobility levels. The tests showed that it is possible to extract the first natural frequency of the bridge using both stationary and mobile smartphone measurement techniques, although operational uncertainties seemed to alter the latter one. A first natural frequency of 5.45 Hz from a reference data acquisition system confirmed the accuracy of stationary smartphone data. On the other hand, the mobile data require consideration of the driving frequency, a function of the speed of the test vehicle and length of the bridge. These results show that smartphone sensors can be regarded as an alternative to industrial accelerometers with certain barriers to account for the multi-modality of the mobile sensing and identification process.
The Integration of Thermal Energy Storage Within Metal Hydride Systems: A Comprehensive Review
Authors: Davis Cortina Matias , Romero de Terreros Aramburu Manuel , Neves Andre Martins , Hurtado Lourdes , Jepsen Julian , Ulmer Ulrich
Published: December 2024

Hydrogen storage technologies are key enablers for the development of low-emission, sustainable energy supply chains, primarily due to the versatility of hydrogen as a clean energy carrier. Hydrogen can be utilized in both stationary and mobile power applications, and as a low-environmental-impact energy source for various industrial sectors, provided it is produced from renewable resources. However, efficient hydrogen storage remains a significant technical challenge. Conventional storage methods, such as compressed and liquefied hydrogen, suffer from energy losses and limited gravimetric and volumetric energy densities, highlighting the need for innovative storage solutions. One promising approach is hydrogen storage in metal hydrides, which offers advantages such as high storage capacities and flexibility in the temperature and pressure conditions required for hydrogen uptake and release, depending on the chosen material. However, these systems necessitate the careful management of the heat generated and absorbed during hydrogen absorption and desorption processes. Thermal energy storage (TES) systems provide a means to enhance the energy efficiency and cost-effectiveness of metal hydride-based storage by effectively coupling thermal management with hydrogen storage processes. This review introduces metal hydride materials for hydrogen storage, focusing on their thermophysical, thermodynamic, and kinetic properties. Additionally, it explores TES materials, including sensible, latent, and thermochemical energy storage options, with emphasis on those that operate at temperatures compatible with widely studied hydride systems. A detailed analysis of notable metal hydride–TES coupled systems from the literature is provided. Finally, the review assesses potential future developments in the field, offering guidance for researchers and engineers in advancing innovative and efficient hydrogen energy systems.
Evaluation of the Efficacy and Accuracy of Super-Flexible Three-Dimensional Heart Models of Congenital Heart Disease Made via Stereolithography Printing and Vacuum Casting: A Multicenter Clinical Trial
Authors: Shiraishi Isao , Yamagishi Masaaki , Hoashi Takaya , Kato Yoshiaki , Iwai Shigemitsu , Ichikawa Hajime , Nishii Tatsuya , Yamagishi Hiroyuki , Yasukochi Satoshi , Kawada Masaaki , Suzuki Takaaki , Shinkawa Takeshi , Yoshimura Naoki , Inuzuka Ryo , Hirata Yasutaka , Hirose Keiichi , Ikai Akio , Sakamoto Kisaburo , Kotani Yasuhiro , Kasahara Shingo , Hisada Toshiaki , Kurosaki Kenichi
Published: December 2024

Three-dimensional (3D) printing is an advanced technology for accurately understanding anatomy and supporting the successful surgical management of complex congenital heart disease (CHD). We aimed to evaluate whether our super-flexible 3D heart models could facilitate preoperative decision-making and surgical simulation for complex CHD. The super-flexible heart models were fabricated by stereolithography 3D printing of the internal and external contours of the heart from cardiac computed tomography (CT) data, followed by vacuum casting with a polyurethane material similar in elasticity to a child’s heart. Nineteen pediatric patients with complex CHD were enrolled (median age, 10 months). The primary endpoint was defined as the percentage of patients rated as “essential” on the surgeons’ postoperative 5-point Likert scale. The accuracy of the models was validated by a non-destructive method using industrial CT. The super-flexible heart models allowed detailed anatomical diagnosis and simulated surgery with incisions and sutures. Thirteen patients (68.4%) were classified as “essential” by the primary surgeons after surgery, with a 95% confidence interval of 43.4–87.4%, meeting the primary endpoint. The product error within 90% of the total external and internal surfaces was 0.54 ± 0.21 mm. The super-flexible 3D heart models are accurate, reliable, and useful tools to assist surgeons in decision-making and allow for preoperative simulation in CHD.
Identifying Demographic and Clinical Determinants of Ischemic Workup in Patients with Heart Failure
Authors: John Kristen M. , Wenn Peter , Hai Ofek , Zeltser Roman , Makaryus Amgad N.
Published: December 2024

Background/Objectives: Coronary artery disease (CAD) is a common and treatable cause of heart failure (HF), but ischemic evaluation is often overlooked when evaluating patients with new-onset HF. Here, we sought to discern demographic and clinical predictors of ischemic workup in patients with newly diagnosed HF. Methods: A retrospective study of 200 consecutive patients with new-onset HF admitted to our safety-net hospital between 2011 and 2015 was performed. We developed a multivariate logistic regression model to analyze determinants of undergoing ischemic evaluation. Results: A total of 99 patients (49.5%) underwent ischemic workup, while 101 patients (50.5%) did not. The mean age of the cohort was 73.9 ± 16, with 50% as male and 51% as White. In total, 41.5% of patients had HF with reduced ejection fraction, and 37% of patients had HF with preserved ejection fraction. Among the patients who underwent ischemic evaluation, 63.6% received nuclear stress testing, 24.2% received cardiac catheterization, 9.1% received stress echocardiography, and 3% received computed tomography angiography. Demographic and clinical factors such as sex, age, race, presence of hypertension, hyperlipidemia, chronic kidney disease, diabetes, or obesity had no significant association with receiving ischemic workup (p > 0.05). Patients with known CAD (OR 2.816, p = 0.015) and a higher social deprivation index (SDI) (OR 1.022, p = 0.003) were significantly more likely to receive an ischemic evaluation. Atrial fibrillation was significantly negatively associated with receiving ischemic workup (OR: 0.24; p = 0.001). Conclusions: In our single-center safety-net hospital analysis, known CAD and higher SDI were significant predictors of ischemic evaluation in patients with newly diagnosed HF. Multiple demographic features, including age, sex, race, and clinical features, including HF type, hypertension, hyperlipidemia, and diabetes, had no significant correlation with ischemic workup.
Pregnancy Outcomes in Women with Biventricular Circulation and a Systemic Right Ventricle: A Systematic Review
Authors: Grantza Triantafyllia , Arvanitaki Alexandra , Baroutidou Amalia , Tsakiridis Ioannis , Mamopoulos Apostolos , Giannopoulos Andreas , Ziakas Antonios , Giannakoulas George
Published: December 2024

Background: Pregnancy in women with biventricular circulation and a systemic right ventricle (sRV) is considered high risk, with limited data available on pregnancy outcomes. This study aimed to investigate pregnancy outcomes in this population. Materials and Methods: A systematic review was conducted using four major electronic databases. Pregnant women with a complete transposition of great arteries (d-TGA) after an atrial switch operation or a congenitally corrected transposition of the great arteries (ccTGA) were included. Results: In total, 15 studies including 632 pregnancies in 415 women with an sRV and biventricular circulation were identified, of whom 299 (72%) had d-TGA and 116 (28%) ccTGA. Maternal mortality or cardiac transplantation occurred in 0.8% of pregnancies. The most frequent maternal complications were the worsening of systemic atrioventricular valve regurgitation [pooled estimate (PE): 16%, 95% CI: 5;26], the deterioration of sRV function (PE: 15%, 95% CI: 2;27), the worsening of the NYHA class (PE: 13%, 95% CI: 6;20), all-cause hospitalization (PE): 10%, 95% CI: 7;12), arrhythmias (PE: 8%, 95% CI: 5;11), and symptomatic heart failure (PE: 6%, 95% CI: 3;10). Stillbirth occurred in 0.7% of pregnancies and neonatal death in 0.4%. Small-for-gestational-age neonates were encountered in 36% (95% CI: 21;52) of pregnancies and preterm delivery in 22% (95% CI: 14;30). A subgroup analysis showed no significant difference in outcomes between women with d-TGA and those with ccTGA, except for the worsening of the NYHA class, which occurred more often in d-TGA (18%, 95% CI: 12;27 vs. 6%, 95% CI: 3;15, respectively, p = 0.03). Conclusions: Maternal and fetal/neonatal mortality are low among pregnant women with biventricular circulation and an sRV. However, significant maternal morbidity and poor neonatal outcomes are frequently encountered, rendering management in specialized centers imperative.
Plasma Non-Esterified Fatty Acid Levels Throughout Childhood and Its Relationship with Leptin Levels in Children
Authors: Pomares Olga , Vales-Villamarín Claudia , Pérez-Nadador Iris , Mejorado-Molano Francisco J. , Soriano-Guillén Leandro , Garcés Carmen
Published: December 2024

Background/Objective: The relationship of non-esterified fatty acid (NEFA) levels with obesity and obesity-related alterations shows age-dependent variability in children. Leptin, with an important role in energy homeostasis and lipid metabolism, may be related to NEFA levels throughout the first decades of life. This cross-sectional study aims to analyse plasma NEFA levels in children of different ages and evaluate the relationship of leptin with NEFA levels depending on age. Methods: The study sample included 818 prepubertal children (age 6–8 years) and 762 adolescents (age 13–16 years). NEFA levels were measured using the Wako NEFA-C kit. Insulin and leptin levels were determined by IRMA and ELISA, respectively, using commercial kits. Results: The results of the study were found to show that NEFA levels were significantly higher (p < 0.001) in prepubertal children than in children aged 13 to 16 years (0.68 ± 0.3 mmol/L vs. 0.42 ± 0.2 mmol/L, respectively, in males; 0.71 ± 0.3 mmol/L vs. 0.44 ± 0.2 mmol/L, respectively, in females), showing a progressive decrease according to years of life in this cohort of adolescent in both sexes. Leptin and insulin correlated negatively with NEFA levels in younger children but not in older participants. The negative association between NEFA levels and leptin occurring in prepubertal children remained significant when adjusting for insulin. Conclusions: Besides reporting that NEFA levels decrease between the prepubertal age and adolescence, our findings indicate that, in children aged 6–8 years, leptin is associated with NEFA levels, independently of insulin. However, this relationship is not present in older children. Further studies analysing these associations according to pubertal status would be useful to deepen our understand of these findings.
Proteomic Changes of Glycolipid Pathways in Age-Related, Diabetic, and Post-Vitrectomy Cataracts
Authors: Karakosta Christina , Samiotaki Martina , Panayotou George , Papaconstantinou Dimitrios , Moschos Marilita M.
Published: December 2024

Background: Alterations in glycolipid and glycosphingolipid pathways lead to compromised cell membranes and may be involved in cataract formation. However, the exact role of glycolipids in lens opacification is not completely understood. The aim of the current study is to investigate proteome complexity and the role of glycolipid and glycosphingolipid pathways in cataract formation. Methods: The anterior capsule and phacoemulsification (phaco) cassette contents were collected during cataract surgery from eleven participants with diabetic cataract (DC), twelve participants with age-related cataract (ARC), and seven participants with post-vitrectomy cataract (PVC). Liquid chromatography–mass spectrometry with data-independent acquisition (DIA) was used for the identification and quantification of proteins. Results: The results of this study revealed that the main significantly differentially expressed pathways in the ARC group compared to the DC and PVC groups in phaco cassette samples included the glycolipid metabolic, glycosphingolipid biosynthetic, and glycosphingolipid metabolic processes, with GLA being among the most significant proteins in the ARC group. Similarly, in the anterior capsule samples, the main significantly differentially expressed pathways in the ARC group compared to the DC and PVC groups were the glycolipid metabolic, glycosphingolipid biosynthetic, and glycosphingolipid metabolic processes, with ST3GAL5 being among the most significant proteins in the ARC group. Conclusion: Glycolipid and glycosphingolipid metabolic processes may be involved in cataract formation. ST3GAL5 may modify the cell-to-cell interaction induced by cell surface sugar chains, leading to the formation and progression of cataract. GLA, associated with the breakdown of glycolipids, may lead to cataract formation when a certain threshold is surpassed, secondary to increased glycolipid metabolism.
Controversies in the Management of the Airway in Panfacial Fractures: A Literature Review and Algorithm Proposal
Authors: Marí-Roig Antonio , McLeod Niall M. H. , De Lange Jan , Dubois Leander , García Reija Maria Fe , Van Minnen Bauke , Essig Harald
Published: December 2024

Panfacial fractures are complex fractures involving multiple regions of the facial skeleton and may require multiple surgeries over a relatively short period. They are often associated with polytrauma and other injuries including neurotrauma, which require either immediate (ATLS) airway management, prolonged intubation, or repeated intubations for staged surgeries. The choice of airway for the surgical management of these fractures is difficult, as an assessment of the occlusion is required, and the central nasal complex and/or skull base may be involved, making classical orotracheal or nasotracheal intubation problematic. Submental intubation is increasingly reported as a method of airway management with the aim of avoiding a tracheostomy and its related complications. A review of the different techniques of airway management in the elective treatment of panfacial fractures was performed, focusing on the pros and cons of each method. Most articles were retrospective studies, with only one prospective study comparing submental intubation to tracheostomy in panfacial fractures. An algorithm for the management of the airway in panfacial fractures was presented, based on a sequential assessment of the existing airway, the surgical access required, and the need for prolonged or repeated intubation. Front of neck access, orotracheal and nasotracheal intubation, and submental intubation are all appropriate techniques in different circumstances, and the advantages and disadvantages of each are presented.
Binaural Processing Deficits in a Child with Chiari Malformation (Type 1)
Authors: Rance Gary , Zanin Julien
Published: December 2024

Background: Chiari malformation is a condition involving caudal descent of the hindbrain which herniates the cerebellar tonsils through the foramen magnum. The purpose of this study was to quantify auditory deficits in an affected individual and to explore the hypothesis that cerebellar malformation specifically disrupts binaural processing. Methods: We present audiometric, electrophysiologic, imaging and auditory perceptual findings for a 17-year-old female with Chiari 1 malformation and for a cohort of 35 hearing- and age-matched controls. Results: The patient presented with auditory deficit consistent with cerebellar disorder—that is, an impaired ability to judge the duration of auditory stimuli. In addition, she showed evidence of abnormal binaural processing affecting her capacity to localise sound sources to optimise speech perception in background noise. The provision of a remote microphone listening device was successful in improving her perceptual ability to normal levels. Conclusions: Despite normal sound detection ability, this child with Chiari 1 malformation suffered functional hearing deficits severe enough to impact everyday listening/communication and educational progress. These limitations were ameliorated through auditory intervention.
Challenges in Transitioning from Controlled to Assisted Ventilation in Acute Respiratory Distress Syndrome (ARDS) Management
Authors: Battaglini Denise , Rocco Patricia R. M.
Published: December 2024

Acute respiratory distress syndrome (ARDS) presents significant challenges in critical care, primarily due to its inflammatory nature, which leads to impaired gas exchange and respiratory mechanics. While mechanical ventilation (MV) is essential for patient support, the transition from controlled to assisted ventilation is complex and may be associated with intensive care unit-acquired weakness, ventilator-induced diaphragmatic dysfunction and patient self-inflicted lung injury. This paper explores the multifaceted challenges encountered during this transition, with a focus on respiratory effort, sedation management, and monitoring techniques, and investigates innovative approaches to enhance patient outcomes. The key strategies include optimizing sedation protocols, employing advanced monitoring methods like esophageal pressure measurements, and implementing partial neuromuscular blockade to prevent excessive respiratory effort. We also emphasize the importance of personalized treatment plans and the integration of artificial intelligence to facilitate timely transitions. By highlighting early rehabilitation techniques, continuously assessing the respiratory drive, and fostering collaboration among multidisciplinary teams, clinicians can improve the transition from controlled to assisted MV, ultimately enhancing recovery and long-term respiratory health in patients with ARDS.
Machine Learning Classification of Pediatric Health Status Based on Cardiorespiratory Signals with Causal and Information Domain Features Applied—An Exploratory Study
Authors: Rosoł Maciej , Gąsior Jakub S. , Korzeniewski Kacper , Łaba Jonasz , Makuch Robert , Werner Bożena , Młyńczak Marcel
Published: December 2024

Background/Objectives: This study aimed to evaluate the accuracy of machine learning (ML) techniques in classifying pediatric individuals—cardiological patients, healthy participants, and athletes—based on cardiorespiratory features from short-term static measurements. It also examined the impact of cardiorespiratory coupling (CRC)-related features (from causal and information domains) on the modeling accuracy to identify a preferred cardiorespiratory feature set that could be further explored for specialized tasks, such as monitoring training progress or diagnosing health conditions. Methods: We utilized six self-prepared datasets that comprised various subsets of cardiorespiratory parameters and applied several ML algorithms to classify subjects into three distinct groups. This research also leveraged explainable artificial intelligence (XAI) techniques to interpret model decisions and investigate feature importance. Results: The highest accuracy, over 89%, was obtained using the dataset that included most important demographic, cardiac, respiratory, and interrelated (causal and information) domain features. The dataset that comprised the most influential features but without demographic data yielded the second best accuracy, equal to 85%. Incorporation of the causal and information domain features significantly improved the classification accuracy. The use of XAI tools further highlighted the importance of these features with respect to each individual group. Conclusions: The integration of ML algorithms with a broad spectrum of cardiorespiratory features provided satisfactory efficiency in classifying pediatric individuals into groups according to their actual health status. This study underscored the potential of ML and XAI in advancing the analysis of cardiorespiratory signals and emphasized the importance of CRC-related features. The established set of features that appeared optimal for the classification of pediatric patients should be further explored for their potential in assessing individual progress through training or rehabilitation.
Depression and Anxiety in 336 Elective Orthopedic Patients
Authors: Kuik Leszek , Łuczkiewicz Piotr
Published: December 2024

Background/Objectives: Depression and anxiety are the two most common mental health disorders that can affect the well-being of the entire body. Multiple studies confirm that they can threaten the musculoskeletal system and the effects of orthopedic treatment as well. In turn, orthopedic disorders may worsen the symptoms of depression and anxiety. The study is aimed at assessing the incidence of depressive and anxiety disorders in orthopedic patients of our department and what are the characteristics of orthopedic patients regarding depressive disorders. Methods: After obtaining personal consent for trial, 336 patients undergoing elective orthopedic surgery over a 12-month period were evaluated. Preoperatively, patients completed surveys containing questions from the PHQ-9 and GAD-7 forms. The pain was assessed with the VAS scale of 0–10 points and the information on the current psychiatric treatment was acquired. Patients were divided into subgroupsand statistical analysis was performed. Results: The incidence of moderate depression and generalized anxiety symptoms in orthopedic patients was 12.2% and 11.3%, respectively (several times higher than in the general population). In the group most at risk of depression, i.e., women over 40 and with foot and ankle diseases, the incidence of treated depression was 36%. In foot and ankle patients, prevalence for depression was more than three times higher (OR = 3.24, 95% CI 1.542–7.24) compared to the reference group. Conclusions: The problem of depression and generalized anxiety in orthopedic patients is clearly more common than in the general population. In our study, patients with foot and ankle disorders are the most vulnerable to depression.
Hyperenhancement of LA Wall by Three-Dimensional High-Resolution Late Gadolinium-Enhanced MRI and Recurrence of AF After Catheter Ablation
Authors: Kagimoto Minako , Kato Shingo , Takizawa Ryouya , Kodama Sho , Suzurikawa Keisuke , Azuma Mai , Nakayama Naoki , Iguchi Kohei , Fukui Kazuki , Ito Masanori , Iwasawa Tae , Kino Tabito , Utsunomiya Daisuke
Published: December 2024

Background/Objectives: This study investigated the relationship between LA (LA) enhancement on three-dimensional (3D) late gadolinium enhancement (LGE) MRI and recurrence after catheter ablation in patients with AF (AF). Methods: A total of one hundred patients with AF (mean age: 68 ± 9 years, 50% with paroxysmal AF) were included in this study. Each patient underwent a high-resolution 3D LGE MRI prior to catheter ablation, allowing for detailed imaging of the LA wall. Quantitative analysis of the enhancement was performed using dedicated software designed for volumetric measurements of LA LGE. Recurrence of AF was monitored over a 90-day period following the ablation procedure. The primary outcome was the correlation between the volume of LGE in the LA and the recurrence of AF. Results: Multivariate analysis confirmed that the volume of LA LGE, defined as the volume exceeding 1SD above the mean signal intensity of the LA, was an independent predictor of recurrence [hazard ratio: 1.16 (95%CI: 1.04–1.29, p = 0.0057)]. The area under the curve for recurrence prediction using 3D LGE MRI was 0.74 (95%CI: 0.63–0.86), with an optimal threshold of 11.72 mL, providing a sensitivity of 55% (95%CI: 32–77%) and a specificity of 86% (95%CI: 77–93%). Conclusions: LA enhancement assessed by high-resolution LGE MRI may serve as a valuable imaging marker for predicting the recurrence in patients with AF following catheter ablation.
Vasopressor Therapy
Authors: Vincent Jean-Louis , Annoni Filippo
Published: December 2024

Vasopressor therapy represents a key part of intensive care patient management, used to increase and maintain vascular tone and thus adequate tissue perfusion in patients with shock. Norepinephrine is the preferred first-line agent because of its reliable vasoconstrictor effects, with minimal impact on heart rate, and its mild inotropic effects, helping to maintain cardiac output. Whichever vasopressor is used, its effects on blood flow must be considered and excessive vasoconstriction avoided. Other vasoactive agents include vasopressin, which may be considered in vasodilatory states, and angiotensin II, which may be beneficial in patients with high renin levels, although more data are required to confirm this. Dobutamine should be considered, along with continued fluid administration, to help maintain adequate tissue perfusion in patients with reduced oxygen delivery. In this narrative review, we consider the different vasopressor agents, focusing on the importance of tailoring therapy to the individual patient and their hemodynamic response.
Resistance Welding of Carbon Fiber Reinforced Vitrimer Composites
Authors: Martinez Patricio , Nutt Steven
Published: December 2024

The welding behavior of prototype vitrimer composites with respect to adjustable parameters and protocols is investigated, and a method for resistance welding of vitrimer composites directly adapted from the welding of thermoplastic composites is described. Adherend laminates are positioned on either side of a matrix-saturated carbon fiber heating element, through which current is driven, and resistance heating welds the adherends and heating element together, forming a single lap joint. Weld strengths matched or exceeded the strength of composite parts produced using the manufacturer-recommended consolidation method (12.0 ± 2.6 MPa vs. 8.4 ± 0.6 MPa). Furthermore, repeating the welding process yielded greater shear strength, withstanding up to five weld–break–reweld cycles with an average increase of 4.6 ± 1.5 MPa or 65% compared to the first weld. The findings from resistance weld experiments highlight the suitability of vitrimer matrix composites for repair. Finally, a process for reversing a welded joint was shown, demonstrating the potential for vitrimers for temporary joining and rejoining.