bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of hypertension on coronary artery plaques and FFR-CT in type 2 diabetes mellitus patients: evaluation utilizing artificial intelligence processed coronary computed tomography angiography
Authors: Xi Yan , Xu Yi , Shu Zheng
Published: October 2024

Objective

This study utilized artificial intelligence (AI) to quantify coronary computed tomography angiography (CCTA) images, aiming to compare plaque characteristics and CT-derived fractional flow reserve (FFR-CT) in type 2 diabetes mellitus (T2DM) patients with or without hypertension (HTN).

Methods

A retrospective analysis was conducted on 1,151 patients with suspected coronary artery disease who underwent CCTA at a single center. Patients were grouped into T2DM (n = 133), HTN (n = 442), T2DM (HTN+) (n = 256), and control (n = 320). AI assessed various CCTA parameters, including plaque components, high-risk plaques (HRPs), FFR-CT, severity of coronary stenosis using Coronary Artery Disease Reporting and Data System 2.0 (CAD-RADS 2.0), segment involvement score (SIS), and segment stenosis score (SSS). Statistical analysis compared these parameters among groups.

Results

The T2DM (HTN+) group had the highest plaque volume and length, SIS, SSS, and CAD-RADS 2.0 classification. In the T2DM group, 54.0% of the plaque volume was noncalcified and 46.0% was calcified, while in the HTN group, these values were 24.0 and 76.0%, respectively. The T2DM (HTN+) group had more calcified plaques (35.7% noncalcified, 64.3% calcified) than the T2DM group. The average necrotic core volume was 4.25 mm3 in the T2DM group and 5.23 mm3 in the T2DM (HTN+) group, with no significant difference (p > 0.05). HRPs were more prevalent in both T2DM and T2DM (HTN+) compared to HTN and control groups (p < 0.05). The T2DM (HTN+) group had a higher likelihood (26.1%) of FFR-CT ≤0.75 compared to the T2DM group (13.8%). FFR-CT ≤0.75 correlated with CAD-RADS 2.0 (OR = 7.986, 95% CI = 5.466–11.667, cutoff = 3, p < 0.001) and noncalcified plaque volume (OR = 1.006, 95% CI = 1.003–1.009, cutoff = 29.65 mm3, p < 0.001). HRPs were associated with HbA1c levels (OR = 1.631, 95% CI = 1.387–1.918).

Conclusion

AI analysis of CCTA identifies patterns in quantitative plaque characteristics and FFR-CT values. Comorbid HTN exacerbates partially calcified plaques, leading to more severe coronary artery stenosis in patients with T2DM. T2DM is associated with partially noncalcified plaques, whereas HTN is linked to partially calcified plaques.
Application of zero trust model in preventing medical errors
Authors: Sood Nikhil , Parlapalli Roop , Sharma Pranav , Kashyap Rahul
Published: October 2024

Medical errors can occur in many areas of healthcare, including hospitals, clinics, and surgery centers. They can result in negative consequences for patients and their loved ones. Over the years, different methods have been used to reduce medical errors. Zero Trust is an information security model that denies access to applications and data by default. Other industries have successfully used Zero Trust Model (ZTM), and it has been shown to improve outcomes. This editorial analyzes how the ZTM can be introduced to prevent medical errors in healthcare settings. ZTM application in healthcare could potentially revolutionize patient safety by tightly controlling and monitoring access to sensitive patient data and critical systems. By enhancing security measures, the ZTM could address the paramount concerns of patient data privacy and safety in healthcare. The zero-trust approach offers a potential solution by identifying consistent causes of errors and providing viable solutions to prevent their recurrence. In the era of worsening ransomware attacks on healthcare systems, the ZTM could also have enormous implications in other cybersecurity aspects. With this manuscript, the authors advocate for the broader application of ZTM across other facets of healthcare cybersecurity.
Inter-individual differences in muscle damage following a single bout of high-intense whole-body electromyostimulation
Authors: Teschler Marc , Waranski Melina , Schmitz Boris , Mooren Frank C.
Published: October 2024

Purpose

This brief report aimed to characterize inter-individual training responses following a single session of high-intense whole-body electromyostimulation (WB-EMS) using markers of muscle damage over a period of 72 h.

Methods

Twelve healthy individuals (5 men, 7 women; 32.0 ± 7 years) participated in a single 20-minute high-intensity WB-EMS training session. Markers of muscle damage, creatine kinase (CK) and myoglobin (Mb), were assessed before and immediately after training, as well as at 1.5, 3, 24, 48 and 72 h post-exercise. Lactate levels were determined pre- and post-exercise.

Results

Overall, WB-EMS induced significant CK elevations, peaking at 72 h (18.358 ± 21.380 U/L; p < 0.01), and correlating Mb levels peaking at 48 h (1.509 ± 1.394 ng/dl, p < 0.01). Despite significant inter-individual variability in CK levels, both slow (SR) and fast responders (FR) were identified. FR showed significant increases in CK at all time points post WB-EMS (p < 0.05), whereas CK in SR significantly elevated after 48 h. Post-WB-EMS lactate concentration was identified to predict peak CK and Mb levels (r ≥ 0.65, both p < 0.05).

Conclusion

High-intensity WB-EMS has the potential to induce severe muscle damage, as indicated by elevated levels of CK and Mb. We identified two distinct groups of individuals, SR and FR, indicating variability in response to WB-EMS. Furthermore, we suggest that individual responses to WB-EMS can be predicted based on post-WB-EMS lactate concentration.
Case report: A rare secondary systemic candidiasis as a bite wound complication in a dog
Authors: Geum Yun-Joo , Han Hyun-Jung
Published: October 2024

An 11-year-old, 4.8 kg, intact male mixed-breed dog was evaluated for a bite wound that had occurred a day prior to consultation. On examination, the patient exhibited signs of early to-late decompensatory shock, hemothorax, pneumothorax, and rib fractures. Initial shock management and resuscitation were performed. After several days of stabilization, exploratory thoracotomy, thoracic wall reconstruction, culture sampling, and antibiotic susceptibility tests were conducted. Empirical antimicrobial treatments were performed while pending culture results. Despite aggressive antimicrobial therapy, the patient had focal seizures and wound dehiscence, presumably due to the worsening of infection and inflammation. Necrotic tissues adjacent to the dehiscence were debrided, and the wound was opened. A previous analysis of wound and blood cultures identified Candida glabrata, and itraconazole was initiated in accordance with the culture results. Successful treatment was achieved, and the wound was closed. The patient remained healthy after 2 months of monitoring. To the best of our knowledge, this was the first case report of systemic candidiasis in a dog secondary to a bite wound diagnosed via blood culture. Additionally, this case highlights successful treatment with itraconazole.
„Zniekształcona demokracja” differentia specifica reżimu przejściowego/ hybrydowego na przykładzie państw bałkańskich – szkic rozważań teoretyczno-sytuacyjnych
Authors: Bujwid-Kurek Ewa
Published: October 2024

The purpose of the article was an attempt to answer 4 fundamental questions: of “distorted democracy” and “transitional/hybrid regime” are to each other, secondly; which of the Balkan states are stigmatized by the phenomenon of “distorted democracy” and their political system is assessed as a transitional/hybrid regime, thirdly; whether it is possible to establish a common situational context for these countries that influences the assessment of the democratization of the transforming political systems, fourthly; what are the reasons for this state of affairs. For this purpose, the Freedom House Nations in Tranist Reports from 2021, 2022 and 2023 were analyzed regarding the Balkan countries characterized by a transitional/hybrid regime in alphabetical order: Albania, Bosnia and Herzegovina, Montenegro, Kosovo, North Macedonia and Serbia. These reports clearly confirm the presence of phenomena that significantly weaken the democratization process of the Balkan countries, which is called “distorted democracy”, which is an inherent feature of transitional/hybrid regimes. The situational context for the analyzed countries is almost the same. There are still problems with the functioning of democratic institutions, compliance with norms and procedures, as well as a lack of acceptance expressed in attitudes and
Procesy konsolidacji strukturalnej i funkcjonalnej jednostek samorządu terytorialnego w Norwegii i Chorwacji. Studium komparatystyczne
Authors: Osiński Joachim , Zawiślińska Izabela
Published: October 2024

The aim of the article is to synthesise the process of the introduction of the reform of the basic territorial division of the state in Norway between 2016 and 2020, creating a new structure of municipal and regional self-government with a simultaneous change in some of the tasks carried out at both levels of municipal and provincial (regional) self-government. We comparatively analyse the process of development of territorial selfgovernment in Croatia, with a particular focus on changes in the attitude of academia and politics towards the consolidation of local self-government units. The analysis is based on the assumptions and categories of neo-institutional methodology. The main thesis of the paper emphasises the importance of the process of structural and functional consolidation of local government units carried out in order to optimise the delivery of public services, enhance the well-being of local communities and exploit economies of scale. The essence and evolution of local self-government institutions in Norway and Croatia and their political and theoretical conditions will also be the subject of synthesis in the paper.
Adaptive Vision-Based Gait Environment Classification for Soft Ankle Exoskeleton
Authors: Yang Gayoung , Heo Jeong , Kang Brian Byunghyun
Published: October 2024

Lower limb exoskeletons have been developed to improve functionality and assist with daily activities in various environments. Although these systems utilize sensors for gait phase detection, they lack anticipatory information about environmental changes, which limits their adaptability. This paper presents a vision-based intelligent gait environment detection algorithm for a lightweight ankle exosuit designed to enhance gait stability and safety for stroke patients, particularly during stair negotiation. The proposed system employs YOLOv8 for real-time environment classification, combined with a long short-term memory (LSTM) network for spatio-temporal feature extraction, enabling the precise detection of environmental transitions. An experimental study evaluated the classification algorithm and soft ankle exosuit performance through three conditions using kinematic analysis and muscle activation measurements. The algorithm achieved an overall accuracy of over 95% per class, which significantly enhanced the exosuit’s ability to detect environmental changes, and thereby improved its responsiveness to various conditions. Notably, the exosuit increased the ankle dorsiflexion angles and reduced the muscle activation during the stair ascent, which enhanced the foot clearance. The results of this study indicate that advanced spatio-temporal feature analysis and environment classification improve the exoskeleton’s gait assistance, improving adaptability in complex environments for stroke patients.
The Design and Performance Analysis of a 15 g/mol Helium–Xenon Mixture Centrifugal Compressor
Authors: Zheng Jinchao , Tian Zhitao , Malik Adil , Xin Jianchi , Lu Huawei
Published: October 2024

One of the primary parts of a closed Brayton cycle that uses a helium–xenon mixture as the working medium is a centrifugal compressor. Nowadays, there has been minimal research on the theoretical underpinnings and design procedures of a helium–xenon mixture centrifugal compressors, and the internal flow mechanisms remain poorly understood. In this study, we present a redesign of the 15 g/mol helium–xenon centrifugal compressor originally developed by Bruno M, utilizing a helium–xenon mixture as the working fluid to enhance compressor performance and facilitate an in-depth analysis of the internal flow dynamics. The findings indicate a significant expansion of the stable operating range of the redesigned compressor under identical outlet conditions, with a 33.27% increase in flow margin and substantial improvements in the pressure ratio. Furthermore, under consistent inlet conditions, at an operational flow rate of 0.8657 kg/s, the redesigned compressor exhibits a pressure ratio that is 2.11% greater than that of the original design, along with a variable efficiency increase of 1.1%.
Revised and Generalized Results of Averaging Principles for the Fractional Case
Authors: Liaqat Muhammad Imran , Khan Zareen A. , Conejero J. Alberto , Akgül Ali
Published: October 2024

The averaging principle involves approximating the original system with a simpler system whose behavior can be analyzed more easily. Recently, numerous scholars have begun exploring averaging principles for fractional stochastic differential equations. However, many previous studies incorrectly defined the standard form of these equations by placing ε in front of the drift term and ε in front of the diffusion term. This mistake results in incorrect estimates of the convergence rate. In this research work, we explain the correct process for determining the standard form for the fractional case, and we also generalize the result of the averaging principle and the existence and uniqueness of solutions to fractional stochastic delay differential equations in two significant ways. First, we establish the result in Lp space, generalizing the case of p=2. Second, we establish the result using the Caputo–Katugampola operator, which generalizes the results of the Caputo and Caputo–Hadamard derivatives.
Advances in the Neuro-Rehabilitation of Parkinson’s Disease: Insights from a Personalized Multidisciplinary Innovative Pathway
Authors: Maggio Maria Grazia , Bonanno Mirjam , Manuli Alfredo , De Luca Rosaria , Di Lorenzo Giuseppe , Quartarone Angelo , Calabrò Rocco Salvatore
Published: October 2024

Background/Objectives: Parkinson’s disease (PD) is a progressive neurodegenerative disorder that requires comprehensive and personalized rehabilitation. This retrospective study focused primarily on the usability and patient acceptability of the innovative pathway. In addition, the secondary objective was to evaluate the effectiveness of a personalized and multidisciplinary rehabilitation pathway on cognitive function, especially executive functions. Methods: We conducted a retrospective study on 80 patients with PD (Hoehn and Yahr scores 1–3). Patients were divided into an experimental group (EG), which received the innovative pathway, and a control group (CG), which received traditional therapy. The rehabilitation program included three phases: initial outpatient assessment, a two-month inpatient program, and a telerehabilitation phase in a day hospital (DH) or home environment. Interventions combined traditional therapies with treatments based on robotic and virtual reality. Cognitive assessments (Mini Mental State Examination—MMSE—and frontal assessment battery—FAB), mood (Hamilton Rating Scale—Depression—HRS-D), anxiety (HRS-Anxiety—HRS-A), and goals achievement (GAS) were the primary outcome measures. Results: At baseline, there were no significant differences between the groups in terms of age, gender, education, or test scores. After rehabilitation, EG showed significant improvements in all measures (p < 0.001), particularly in cognitive tests and goal achievement. CG improved in GAS (p < 0.001) and mood (HRS-D, p = 0.0012), but less than EG. No significant changes were observed in the MMSE of CG (p = 0.23) or FAB (p = 0.003). Conclusions: This study highlights the high usability and acceptability of VR and robotics in PD rehabilitation, contributing to improved adherence and patient engagement. The experimental group showed greater cognitive benefits, particularly in executive functions. These results are in line with the existing literature on personalized technology-based rehabilitation strategies for PD.
Impact of Cortisol-Cosecretion on Adrenal Venous Sampling Results in Primary Aldosteronism: Study of 225 Cases
Authors: Lamas Cristina , Araujo-Castro Marta , Ostermair Lukas , Petersenn Erik , Parra Ramírez Paola , Rebollo-Román Ángel , Stuefchen Isabel , Bruedgam Denise , Ruiz-Sanchez Jorge Gabriel , Michalopoulou Theodora , Perdomo Carolina M. , Hanzu Felicia A. , Adolf Christian , Reincke Martin
Published: October 2024

Background/Objectives: Mild autonomous cortisol secretion (MACS) can coexist with primary aldosteronism (PA). The purpose of our study was to evaluate whether (MACS) influences parameters analyzed during adrenal venous sampling (AVS) in patients with PA. Methods: Patients with PA from the SPAIN-ALDO Registry and the German Conn’s Registry with available 1 mg-dexamethasone suppression test (DST) and AVS were included. MACS was defined as a post-DST cortisol > 1.8 µg/dL in the absence of specific signs and symptoms of Cushing’s syndrome. Results: Two-hundred and twenty-five patients were included, 98 (43.6%) of whom had concomitant MACS. The mean age was 54 ± 10 years and 37.3% were women. AVS was performed by simultaneous catheterization of both adrenal veins and analysis of basal samples in 157 patients (69.8%), with both basal and post-ACTH samples in 15 patients (6.7%), and during continuous ACTH infusion in 53 patients (23.6%). AVS was considered technically unsuccessful in 40 cases (17.8%), suggesting unilateral secretion in 106 (47.1%) and bilateral secretion in 79 (35.1%). We did not find significant differences in the percentage of unilateral and bilateral results, cortisol, corrected aldosterone, or selectivity indices in the dominant and non-dominant veins, nor in the lateralization index or the contralateral suppression index between patients with and without MACS. They also had similar rates of surgical treatment and biochemical and clinical response. Conclusions: Although pathophysiological reasoning suggests that MACS could hinder AVS identification of unilateral forms of PA, our data suggest that such interference, if it exists, is of moderate clinical relevance.
Metabolites and Lipoproteins May Predict the Severity of Early Acute Pancreatitis in a South African Cohort
Authors: Mazibuko Jeanet , Elebo Nnenna , Williams Aurelia A. , Omoshoro-Jones Jones , Devar John W. , Smith Martin , Cacciatore Stefano , Fru Pascaline N.
Published: October 2024

Background: Acute pancreatitis (AP) can be life-threatening with unpredictable severity. Despite advances in management, its pathogenesis remains unclear. This study investigated metabolites and lipoprotein profiles in AP patients of African descent to understand the underlying pathophysiological conditions so as to inform prognosis and management. Methods: Serum samples were collected from 9 healthy controls (HCs) and 30 AP patients (8 with mild AP, 14 with moderately severe AP, and 8 with severe AP) on days 1, 3, 5, and 7 post epigastric pain and subjected to nuclear magnetic resonance (NMR) spectroscopy. Wilcoxon and Kruskal–Wallis rank-sum tests compared numerical covariates. Lipoprotein characterization was performed using the Liposcale test, and Spearman’s rank test assessed data correlations. The p-values < 0.05 indicated significance. Results: Thirty-eight metabolic signals and information on lipoprotein subclasses were identified from the NMR spectra. The severity of AP correlated with increased levels of 3-hydroxybutyrate and acetoacetate and decreased levels of ascorbate. Distinct metabolic phenotypes were identified and characterized by unique inflammatory and lipoprotein profiles. High-density lipoprotein cholesterol (HDL-C) decreased across all the metabolic phenotypes of AP when compared with the HC, while elevated immediate density lipoprotein cholesterol (IDL-C) and very low-density lipoprotein cholesterol (VLDL-C) levels were observed. Time-dependent changes in metabolites were indicative of responsiveness to therapy. Conclusions: Our findings indicate that dysregulated metabolites and lipoproteins can be used to differentiate AP disease state and severity. Furthermore, integrating clinical parameters with data on metabolic and lipoprotein perturbations can contribute to a better understanding of the complex pathophysiology of AP.
Angiopoietin II in Critically Ill Septic Patients: A Post Hoc Analysis of the DRAK Study
Authors: Bucher Veronika , Graf Helen , Zander Johannes , Liebchen Uwe , Hackner Danilo , Gräfe Caroline , Bender Martin , Zoller Michael , Scharf Christina
Published: October 2024

Introduction: Angiopoietin II (Ang-II) plays a pivotal role in the development of microcirculatory dysfunction as it provokes endothelial barrier disruption in patients with sepsis or septic shock. In particular, those with acute kidney injury show high Ang-II concentrations. So far, it is unclear which covariates influence Ang-II concentration in the early phase of sepsis, especially if extracorporeal therapies also do. Methods: Ang-II concentrations were measured in 171 patients with sepsis after the first day of antibiotic treatment between 03/2013 and 01/2015. Ang-II was correlated with potential influencing factors (Spearman correlation). A multivariate model was established including the significant correlating parameters. The Mann–Whitney U test and the Kruskal–Wallis test were used to detect significant differences in Ang-II concentration. Results: The median Ang-II concentration was 8015 pg/mL (interquartile range (IQR): 5024–14,185). A total of forty patients were treated with kidney replacement therapy (KRT) and 20 were supported by venovenous extracorporeal membrane oxygenation (vv-ECMO). Sequential organ failure assessment (SOFA) score (r = 0.541), creatinine clearance (r = −0.467), urinary output (r = −0.289), interleukin (IL)-6 (r = 0.529), C-reactive protein (CRP) (r = 0.241), platelet count (r = −0.419), bilirubin (r = 0.565), lactate (r = 0.322), KRT (r = 0.451), and fluid balance (r = 0.373) significantly correlated with Ang-II concentration and were included in the multivariate model. There, creatinine clearance (p < 0.01, b = −26.3, 95% confidence interval (CI) −41.8–−10.8), fluid balance (p = 0.002, b = 0.92, 95% CI 0.33–1.51), and CRP (p = 0.004, b = 127.6, 95% CI 41.6–213.7) were associated with Ang-II concentration. Furthermore, patients with KRT (median: 15,219 pg/mL, IQR: 10,548–20,270) had significantly (p < 0.01) higher Ang-II concentrations than those with vv-ECMO support (median: 6412 pg/mL, IQR: 5246–10,257) or those without extracorporeal therapy (median: 7156 pg/mL, IQR: 4409–12,741). Conclusion: Increased CRP, positive fluid balance, and impaired kidney function were associated with higher Ang-II concentrations in critically ill patients in the early stage of sepsis in this post hoc analysis. In particular, patients with KRT had very high Ang-II concentrations, whereas the use of vv-ECMO was not related to higher Ang-II concentrations. The significance for clinical practice should be clarified by a prospective study with standardized measurements.
Exosome Cargo in Neurodegenerative Diseases: Leveraging Their Intercellular Communication Capabilities for Biomarker Discovery and Therapeutic Delivery
Authors: Zhang Shuai , Yang Yu , Lv Xinchen , Zhou Xue , Zhao Wangqian , Meng Linfeng , Zhu Shaohua , Zhang Zhixiang , Wang Ying
Published: October 2024

The inexorable progression of neurodegenerative diseases (NDs), including Alzheimer’s disease, Parkinson’s disease, Huntington’s disease, amyotrophic lateral sclerosis, and multiple sclerosis, is closely related to irreversible brain decline. Accurately characterizing pathophysiological features and identifying reliable biomarkers for early diagnosis and optimized treatment are critical. Hindered by the blood–brain barrier (BBB), obtaining sensitive monitoring indicators for disease progression and achieving efficient drug delivery remain significant challenges. Exosomes, endogenous nanoscale vesicles that carry key bioactive substances, reflect the intracellular environment and play an important role in cell signaling. They have shown promise in traversing the BBB, serving dual roles as potential biomarkers for NDs and vehicles for targeted drug delivery. However, the specific mechanisms by which exosome influence NDs are not fully understood, necessitating further investigation into their attributes and functionalities in the context of NDs. This review explores how exosomes mediate multifaceted interactions, particularly in exacerbating pathogenic processes such as oxidative stress, neuronal dysfunction, and apoptosis integral to NDs. It provides a comprehensive analysis of the profound impact of exosomes under stress and disease states, assessing their prospective utility as biomarkers and drug delivery vectors, offering new perspectives for tackling these challenging diseases.
Reevaluating Pediatric Osteomyelitis with Osteoarticular Tuberculosis: Addressing Diagnostic Delays and Improving Treatment Outcomes
Authors: Herdea Alexandru , Marie Harun , Negrila Ioana-Alexandra , Abdel Hamid Ahmed Aliss Delia , Ulici Alexandru
Published: October 2024

Background: Pediatric osteoarticular tuberculosis (TB) remains a significant global health challenge, particularly in resource-limited settings, where delayed diagnosis and treatment frequently lead to severe long-term complications. Despite advancements in TB control, skeletal TB in children is often misdiagnosed due to its non-specific clinical presentation, contributing to poor outcomes such as joint deformities, growth disturbances, and chronic pain. The complexity of diagnosing osteoarticular TB is further exacerbated by the limited sensitivity of conventional diagnostic tools and the overlap with other musculoskeletal conditions. This study seeks to evaluate the impact of early detection and multidisciplinary management on treatment outcomes in pediatric patients with osteoarticular TB. Methods: A retrospective review was conducted at the Pediatric Orthopedics Department of the “Grigore Alexandrescu” Children’s Hospital in Romania from 2009 to 2023. Case data included clinical, imaging, and microbiological findings, and treatment outcomes in children aged 0–18 years diagnosed with tuberculous osteomyelitis. Results: The study identified varied clinical presentations, with delayed diagnosis often linked to misinterpretation of symptoms as non-TB infections. Multimodal diagnostic approaches combining imaging, microbiological testing, and histopathology improved diagnostic accuracy. Early surgical intervention alongside anti-TB therapy proved effective in reducing long-term complications. Conclusions: Timely, accurate diagnosis and multidisciplinary treatment are critical to improving outcomes in pediatric osteoarticular TB. Vaccination status and comprehensive diagnostic tools significantly influence disease progression and treatment success. The study underscores the need for enhanced screening and diagnostic methods to prevent delays in treatment.
Allelopathic Molecular Mechanisms of the Two Main Allelochemicals in Sweet Potato
Authors: Shi Ruiguo , Jin Guimei , Shen Shicai , Xu Gaofeng , Zheng Fengping , Clements David Roy , Yang Yunhai , Yang Shaosong , Wan Fanghao , Zhang Fudou , Liu Bo
Published: October 2024

Sweet potato (Ipomoea batatas L.) is one of the most important global food crops. This crop exhibits excellent allelopathic potential against various weeds, but its allelopathic mechanism at the molecular level is unclear. Therefore, metabolomic and transcriptomic analyses were performed to explore the allelopathic effects, metabolic pathway, and associated genes for two major compounds with allelopathic activity, palmitic acid and linoleic acid. The sweet potato variety Ningshu 25 was employed in the current study. The results showed that palmitic acid and linoleic acid had strong allelopathic effects on seed germination, plant growth, antioxidant enzyme activity, and chlorophyll content of two weeds Digitaria sanguinalis and Bidens pilosa. The content of the two targeted metabolites was affected by different environmental conditions and was significantly increased under low temperature (15 °C). Five metabolic pathways involved in the two targeted metabolites of fatty acids were found: fatty acid biosynthesis, fatty acid elongation, fatty acid degradation, biosynthesis of cutin, suberine, and wax, and the linoleic acid metabolism pathway. The synthesis of palmitic acid is significantly enriched in the biosynthesis pathways of fatty acids, cutin, suberine, and wax, and the synthesis of linoleic acid is significantly enriched in the linoleic acid metabolism pathway. Under different environmental conditions, there were three key genes expressed—g4988, g11881, and g19673—located in the biosynthesis pathways of cutin, suberine, and wax; four key genes expressed—g31191, g60956, g49811, and g59542—located in the biosynthesis pathway of fatty acids; and six key expressed genes—g26575, g24787, g23517, g57649, g58562, and g4314—located in biosynthesis pathway of linoleic acid, respectively. Our study advances understanding of the molecular mechanisms behind allelopathic traits in sweet potato and provides a set of candidate genes for use in improving allelopathic potential in sweet potato germplasm resources.
Two-Step Screening for Depression and Anxiety in Patients with Cancer: A Retrospective Validation Study Using Real-World Data
Authors: Gascon Bryan , Elman Joel , Macedo Alyssa , Leung Yvonne , Rodin Gary , Li Madeline
Published: October 2024

Background: Although screening for distress is recommended by many cancer care guidelines, the uptake of such screening in cancer centers remains limited. Improving the acceptability of screening programs in cancer centers requires a reduction in clinical burden and an improved detection of distress. The purpose of this study was to validate the performance of the two-step screening algorithm used in the Distress Assessment and Response Tool (DART) for identifying cases of anxiety and depression. Methods: This retrospective validation study consisted of patients at the Princess Margaret Cancer Centre (PM) who completed the DART, which includes the Edmonton Symptom Assessment System depression (ESAS-D) and anxiety (ESAS-A) items, the Patient Health Questionnaire (PHQ-9), and the Generalized Anxiety Disorder (GAD-7). We evaluated the performance of a two-step screening approach, which modeled the ESAS-D, followed by the PHQ-9 and ESAS-A, then the GAD-7 for predicting a diagnosis of depression and anxiety disorders, respectively. A clinical psychiatric assessment was used as the gold standard reference. Results: A total of 172 patients with cancer were included in this study. A total of 59/172 (34%) and 39/172 (23%) were diagnosed with a depression or anxiety disorder, respectively. The sequential administration of the PHQ-9 ≥15 following the ESAS-D (>2) significantly increased the post-test probability of depression from 37% to 60% and improved the performance of predicting depression compared to both the ESAS-D or the PHQ-9 as standalone tests. The sequential administration of the GAD-7 after the ESAS-A did not improve the predictability of an anxiety diagnosis beyond the performance of the ESAS-A or the GAD-7 as standalone tests. Conclusions: The present study is among the first to demonstrate that a two-step screening algorithm for depression may improve depression screening in cancer using real-world data. Further research on optimal screening approaches for anxiety in cancer is warranted.
Prognostic Factors for Patients with Small-Cell Lung Cancer Treated with Chemoimmunotherapy: A Retrospective Multicenter Study
Authors: Hatori Takashi , Numata Takeshi , Shiozawa Toshihiro , Taguchi Manato , Sakurai Hirofumi , Tamura Tomohiro , Kanazawa Jun , Tachi Hiroaki , Kondo Kyoko , Miyazaki Kunihiko , Kikuchi Norihiro , Kurishima Koichi , Satoh Hiroaki , Hizawa Nobuyuki
Published: October 2024

Background: This study aimed to investigate prognostic factors for predicting the survival of patients with extensive-disease-stage small-cell lung cancer treated with chemoimmunotherapy. Methods: Patients were classified according to overall survival (OS): favorable corresponded to an OS ≥ 24 months, moderate corresponded to an OS of 6–24 months, and poor corresponded to an OS < 6 months. Multivariate Cox regression analyses were used to evaluate prognostic factors. Results: Of 130 patients, the proportions of performance status decline and liver metastasis were significantly higher in the poor-prognosis group. With regard to the laboratory findings, neutrophil/lymphocyte ratios and albumin levels differed significantly among the groups. Multivariate analysis showed that the independent prognostic factors for OS were liver metastasis and decreased albumin levels (<3.5 mg/dL). After classifying the patients into three groups according to the quantities of these prognostic factors, the OS differed significantly among the groups (18.3 vs. 13.5 vs. 3.8 months; p < 0.001). The incidence of immune-related adverse events (irAEs) was higher in patients without these prognostic factors than in those with both (36% vs. 5%; p = 0.01). Conclusion: Liver metastasis and decreased albumin levels are independent unfavorable prognostic factors. Patients with both prognostic factors showed unfavorable OS; however, patients without these factors may have a favorable prognosis but be at greater risk of irAEs.
Blockchain and Digital Twins in Smart Industry 4.0: The Use Case of Supply Chain-A Review of Integration Techniques and Applications
Authors: Roumeliotis Christos , Dasygenis Minas , Lazaridis Vasilis , Dossis Michael
Published: October 2024

The Fourth Industrial Revolution has transformed industries and supply chains by integrating advanced operations, tools, and logistics services. Despite these advancements, challenges persist, particularly in ensuring data dependability, security, and operational efficiency. Digital twins (DTs), which replicate real-world components and processes, have emerged as essential tools for enhancing predictive analytics, simulation, and product lifecycle management in Industry 4.0. However, traditional DT development relies on centralized systems, which are vulnerable to data tampering and security breaches, especially in the management of transaction logs and historical data. To address these challenges, this review provides a comprehensive analysis of the current state of integrating blockchain with DTs. Using a qualitative research methodology, including desk research, case studies, and interviews with industry experts, we analyze various blockchain-based DT applications across industries and specifically in supply chain management. The findings reveal that blockchain-enhanced DTs can significantly improve data integrity, traceability, and security, thus boosting operational efficiency and quality control in supply chains. Additionally, this study identifies key integration techniques and the role of blockchain in automating processes through smart contracts. This review provides insights into the practical implications of blockchain-based DTs, highlighting their potential to enhance the reliability and scalability of Industry 4.0 operations.
Hereditary Aortopathies as Cause of Sudden Cardiac Death in the Young: State-of-the-Art Review in Molecular Medicine
Authors: Salzillo Cecilia , Marzullo Andrea
Published: October 2024

Hereditary aortopathies are a group of rare genetic diseases affecting the aorta and its major branches, and they represent a cause of sudden cardiac death. These pathologies are classified into syndromic hereditary aortopathies and non-syndromic hereditary aortopathies. The epidemiology of hereditary aortopathies varies according to the specific genetic condition involved; however, these disorders are believed to account for a significant proportion of sudden cardiac death in young individuals with a family history of inherited cardiovascular conditions. The causes of hereditary aortopathies are primarily genetic, with pathogenic variants in various genes encoding structural proteins of the vascular wall, leading to dissection, aneurysms, rupture, and ultimately sudden cardiac death. When the cause of death remains unknown after an autopsy, it is referred to as sudden unexplained death, and post-mortem genetic testing, known as a molecular autopsy, is crucial to confirm hereditary aortopathies and assess the genetic risk in the patient’s relatives. This helps to facilitate diagnostic and therapeutic pathways and/or implement monitoring strategies to prevent sudden cardiac death. In this state-of-the-art review, we focus on syndromic and non-syndromic hereditary aortopathies causing sudden cardiac death in the young and explore preventive strategies for affected family members.
Assessment of Kidney Function Discrepancies in Pediatric CAKUT Patients Using Bedside Schwartz Equation and Renal Scintigraphy
Authors: Steflea Ruxandra Maria , Jammula Geethiikha , Kanka Akhila , Streian Caius Glad , Bratosin Felix , Roberta Avram Cecilia , Susan Monica , Harich Octavia Oana , Boru Casiana , Tanasescu Sonia , Cristescu Dan-Mihai , Banta Andreea-Mihaela , Doros Gabriela , Feciche Bogdan
Published: October 2024

Background and Objectives: This research explores the correlation between estimated glomerular filtration rates (eGFR) obtained using the bedside Schwartz equation, and renal scintigraphy in children with congenital kidney and urinary tract abnormalities (CAKUT). The objective is to enhance understanding and management of renal health in this demographic by analyzing kidney size-function relationships. Methods: A retrospective observational analysis was performed on 94 pediatric CAKUT patients at the “Louis Turcanu” Emergency Hospital for Children, Timisoara. Kidney function data, extracted from medical records, were evaluated using the Schwartz equation, renal scintigraphy, and the gold standard iohexol clearance. Ethical approval was secured for the study, which employed descriptive and inferential statistical methods, including t-tests and correlation coefficients, to compare eGFR values. Results: Significant variances were found in eGFRs across different body surface area (BSA) percentiles. For instance, the eGFR for the right kidney in the 25th–50th BSA percentile (102.02 ± 41.52 mL/min/BSA) was notably higher than that of the left (35.60 ± 26.05 mL/min/BSA; p = 0.01). The overall sample reflected a higher eGFR in the right kidney (76.03 ± 40.91 mL/min/BSA) compared to the left (57.46 ± 35.91 mL/min/BSA; p = 0.02). Additionally, a strong positive Pearson correlation (r = 0.80, p = 0.02) was found between scintigraphy and ultrasound measures in the 50th–75th percentiles for left renal percentiles, demonstrating consistent patterns across different evaluations of kidney function. Conclusions: This comparison indicates a complex relationship between eGFR values and kidney size, suggesting potential inaccuracies in standard bedside eGFR measurements for pediatric CAKUT patients. The findings underscore the necessity for accurate diagnostic tools specifically designed for pediatric applications and advocate for the integration of multiple diagnostic techniques to improve clinical management.
Development of Machine Learning-Based Production Forecasting for Offshore Gas Fields Using a Dynamic Material Balance Equation
Authors: Hyoung Junhyeok , Lee Youngsoo , Han Sunlee
Published: October 2024

Offshore oil and gas fields pose significant challenges due to their lower accessibility compared to onshore fields. To enhance operational efficiency in these deep-sea environments, it is essential to design optimal fluid production conditions that ensure equipment durability and flow safety. This study aims to develop a smart operational solution that integrates data from three offshore gas fields with a dynamic material balance equation (DMBE) method. By combining the material balance equation and inflow performance relation (IPR), we establish a reservoir flow analysis model linked to an AI-trained production pipe and subsea pipeline flow analysis model. We simulate time-dependent changes in reservoir production capacity using DMBE and IPR. Additionally, we utilize SLB’s PIPESIM software to create a vertical flow performance (VFP) table under various conditions. Machine learning techniques train this VFP table to analyze pipeline flow characteristics and parameter correlations, ultimately developing a model to predict bottomhole pressure (BHP) for specific production conditions. Our research employs three methods to select the deep learning model, ultimately opting for a multilayer perceptron (MLP) combined with regression. The trained model’s predictions show an average error rate of within 1.5% when compared with existing commercial simulators, demonstrating high accuracy. This research is expected to enable efficient production management and risk forecasting for each well, thus increasing revenue, minimizing operational costs, and contributing to stable plant operations and predictive maintenance of equipment.
Simulation of Responsive Envelopes in Current and Future Climate Scenarios: A New Interactive Computational Platform for Energy Analyses
Authors: Carlucci Francesco , Fiorito Francesco
Published: October 2024

Despite the strong interest concerning the responsive façades, today there are still few built examples and few tools to assess their benefits due to the complex description of the phenomenon. Energy simulations should consider the interactions between a time-varying environment and an environment-dependent envelope, increasing the intricacy of the problem; moreover, these strong environment–envelope interlinkages increase the importance of the location and climate scenarios considered. The aim of this study is to provide a tool to easily model these phenomena in different geographical and climate contexts. For this purpose, an innovative interactive computational platform (ICP) was developed based on EnergyPlus as a simulation engine, Python as a simulation manager, and Grasshopper as a user interface. Thanks to a single user-friendly environment, the users can simply select the climate scenario, the location, the responsive technology, and its main properties to set and run the dynamic energy simulation. After an overview of the current state of the art, this study provides a description of the structure and workflow adopted for developing this platform and details regarding its functioning and input management. Finally, the platform was tested to run an evolutionary optimization of an electrochromic window control strategy in different climate scenarios.
The Significance of Economic Complexity and Renewable Energy for Decarbonization in Eastern European Countries
Authors: Nuta Alina Cristina
Published: October 2024

Emerging states’ path to enhancing the welfare of their citizens has been strongly accompanied by environmental degradation; climate change effects often abrogate their economic results. This zero-sum game must change, and environmental concerns should be considered when the development of a country is discussed and assessed. In this sense, this study’s objective is to analyze the impact of economic complexity and renewable energy consumption in the presence of economic growth and urbanization in selected emerging European countries from 1995 to 2021. We used a multiple-methodologic approach to highlight the supportive effects of economic complexity and renewable energy consumption in mitigating carbon emissions. Furthermore, the effects of economic growth and urbanization were emphasized by applying the cointegration regression (CCR), fully modified OLS, and dynamic OLS (FMOLS–DOLS) approaches. Additionally, we used Driscoll–Kraay estimation regression to test the robustness of our results. The results reveal the beneficial role of renewable energy consumption and economic complexity in the decarbonization process of selected countries. Furthermore, the study highlighted the detrimental influence of urbanization and economic growth, which were feasible considering the emerging status of the countries included in the panel.
Effect of Fermentation by Probiotic Bacteria on the Bioaccessibility of Bioactive Compounds from the Fruit of the Juçara Palm (Euterpe edulis Martius)
Authors: Fernandes Maria Thereza Carlos , Farinazzo Fernanda Silva , Mauro Carolina Saori Ishii , Ferreira Milena do Prado , de Moraes Filho Marsilvio Lima , Tarley César Ricardo Teixeira , Guergoletto Karla Bigetti , Garcia Sandra
Published: October 2024

The underexplored fruit from the juçara palm tree (Euterpe edulis Martius) has bioactive compounds with antioxidant activities, such as phenolic acids and anthocyanins. This fruit’s pulp presents itself as an appropriate fermentation medium for probiotic bacteria growth. Therefore, this study was conducted to evaluate the effects of fermentation by Limosilactobacillus reuteri LR92 (JLR) and Bifidobacterium animalis ssp. lactis BB-12 (JBB) on the bioactive compound contents of the juçara pulp, before and after a gastrointestinal simulation. The pulp of the juçara fruit showed probiotic counts of 8.70 ± 0.07 log UFC/mL for JLR and 8.44 ± 0.09 log UFC/mL for JBB, after 24 h of fermentation. Fermentation with the strains used modified the proportions of fatty acids (fatty acids esters were quantified using a gas chromatography equipment) and fibers when compared to the non-fermented pulp. The antioxidant capacity determined by DPPH, FRAP and ABTS showed significant reduction after the gastrointestinal simulation for samples. Phenolic compound analysis by UPLC-MS/MS showed, after fermentation, a greater amount of ferulic, protocatechuic and catechin acids in the samples. These results show changes in the bioactive compounds due to the fermentation of the juçara pulp by probiotics. However, these compounds showed bioactive potential and were bioaccessible after the gastrointestinal simulation, with the pulp being a potential means for bacteria growth, which may bring health benefits.
Understanding the Molecular Interactions Between Pandan Pigment and Food Components for Enhanced Thermal Stability
Authors: Chen Junxia , Gu Chunhe , Wang Mengrui , Chang Ziqing , Zhou Junping , Yue Mingzhe , Liu Fei , Feng Zhen
Published: October 2024

Pandan pigment (Pandanus amaryllifolius) is widely used as a natural food coloring and flavoring agent. However, its application in food is limited because of its susceptibility to thermal degradation during food processing, which affects both pigment stability and color. Despite its growing use, there is limited research on how common food ingredients can mitigate this degradation. This study addresses this gap by exploring the effects of sucrose, lactose, rice starch, whey protein, and soy protein isolate on the thermal and color stability of pandan pigment under various heating conditions (65 °C, 95 °C, 115 °C, and 121 °C for 15 min). Spectroscopic techniques (UV–visible, infrared, and fluorescence) and laser confocal microscopy were used to elucidate the molecular interactions. The results revealed that rice starch provided the strongest protection, followed by whey protein, soy protein isolate, lactose, and sucrose, although the protective effects decreased at higher temperatures. These findings offer new insights into the use of sugars and proteins to increase the thermal stability of natural pigments in food applications.