bluuebunny/crossref_metadata_2025 huggingface dataset:
Invention of a Medical Glove Durability Assessment Device
Authors: Venturini Ashley , Pancake Mary , VanCleave Walt , Wan Yongbo , Cornish Katrina
Published: July 2022

Healthcare workers across the globe rely on medical gloves to prevent the transfer of harmful bacteria and viruses between themselves and their patients. Unfortunately, due to the lack of an in-use durability standard for medical gloves by the American Society for Testing and Materials, many of these gloves are of low quality and are easily torn or punctured, exposing wearers and patients to potentially deadly diseases. To solve this problem, a device that automatically detects material failures the size of a pinhole during active testing was invented. The device consists of a prosthetic hand, vacuum pump, mobile textured roller, pressure sensor, and liquid spray system. It works by creating a vacuum inside the glove and repeatedly moving the textured roller into contact with the fingertips, which, on the prosthetic hand, are porous. When a glove perforates, the vacuum is broken, pressure within the hand rapidly increases, and the operator is alerted on a touchscreen that the glove has failed. In addition, the liquid spray system allows the user to test gloves in “real world” conditions, because healthcare workers often come into contact with liquids that may alter glove durability. As a preliminary test of the device’s accuracy, five nitrile and five latex exam gloves were tested using the system’s default settings. Natural latex is known to be the highest performing glove material, so the nitrile gloves were expected to fail more quickly than the latex gloves. The test results concur with this expected order of failure: nitrile first, with an average failure time of 300 s and 42 average number of roller touches, followed by natural latex, with an average failure time of 2206 s and 300 average number of roller touches. These results provide evidence that the device accurately ranks glove durability, and therefore could be used to develop an ASTM durability standard and improve the quality of gloves made from different polymers.
Comparison between Standard and High-Definition Multi-Electrode Mapping Catheter in Ventricular Tachycardia Ablation
Authors: Conti Sergio , Sabatino Francesco , De Blasi Gabriele , Di Stabile Giuseppe , Sgarito Giuseppe
Published: July 2022

A high-definition mapping catheter has been introduced, allowing for bipolar recording along and across the spline with a rapid assessment of voltage, activation, and directionality of conduction. We aimed to evaluate differences in mapping density, accuracy, time, and consequently RF time between different mapping catheters used for ventricular tachycardia (VT) ablation. We enrolled consecutive patients undergoing VT ablation at our center. Patients were divided into the LiveWire 2-2-2 mm catheter (group A) and the HD Grid SE (group B). Primary endpoints were total RF delivery time, the number of points acquired in sinus rhythm and VT, and the scar area. Fifty-one patients were enrolled, 22 in group A and 29 in group B. More points were acquired in the Grid group in sinus rhythm (SR) and during VT (2060.78 ± 1600.38 vs. 3278.63 ± 3214.45, p = 0.05; 4201.13 ± 5141.61 vs. 10,569.43 ± 13,644.94, p = 0.02, respectively). The scar area was smaller in group B (Bipolar area, cm2 4.52 ± 2.72 vs. 2.89 ± 2.81, p = 0.05. Unipolar area, cm2 7.47 ± 4.55 vs. 5.56 ± 2.79, p = 0.03). Radiofrequency (RF) time was shorter in the Grid group (30.52 ± 13.94 vs. 22.16 ± 11.03, p = 0.014). LPs and LAVAs were eliminated in overall >93% of patients. No differences were found in terms of arrhythmia-free survival at follow-up. In conclusion, the use of a high-definition mapping catheter was associated with significantly shorter mapping time during VT and RF time. Significantly more points were acquired in SR and during VT. During remap, we also observed more LAVAs and LPs requiring further ablation.
Extracellular Vesicles Derived from Early and Late Stage Plasmodium falciparum-Infected Red Blood Cells Contain Invasion-Associated Proteins
Authors: Vimonpatranon Sinmanus , Roytrakul Sittiruk , Phaonakrop Narumon , Lekmanee Kittima , Atipimonpat Anyapat , Srimark Narinee , Sukapirom Kasama , Chotivanich Kesinee , Khowawisetsut Ladawan , Pattanapanyasat Kovit
Published: July 2022

In infectious diseases, extracellular vesicles (EVs) released from a pathogen or pathogen-infected cells can transfer pathogen-derived biomolecules, especially proteins, to target cells and consequently regulate these target cells. For example, malaria is an important tropical infectious disease caused by Plasmodium spp. Previous studies have identified the roles of Plasmodium falciparum-infected red blood cell-derived EVs (Pf-EVs) in the pathogenesis, activation, and modulation of host immune responses. This study investigated the proteomic profiles of Pf-EVs isolated from four P. falciparum strains. We also compared the proteomes of EVs from (i) different EV types (microvesicles and exosomes) and (ii) different parasite growth stages (early- and late-stage). The proteomic analyses revealed that the human proteins carried in the Pf-EVs were specific to the type of Pf-EVs. By contrast, most of the P. falciparum proteins carried in Pf-EVs were common across all types of Pf-EVs. As the proteomics results revealed that Pf-EVs contained invasion-associated proteins, the effect of Pf-EVs on parasite invasion was also investigated. Surprisingly, the attenuation of parasite invasion efficiency was found with the addition of Pf-MVs. Moreover, this effect was markedly increased in culture-adapted isolates compared with laboratory reference strains. Our evidence supports the concept that Pf-EVs play a role in quorum sensing, which leads to parasite growth-density regulation.
Caries Decline in Preschool Children from Low Social Classes and with Migration Background in Hamburg, Germany: Outcome from Repeated Cross-Sectional Caries Epidemiological Studies
Authors: Schiffner Ulrich
Published: July 2022

Over several decades, the dental caries burden in the deciduous dentition has decreased in Germany. However, a dependency of the caries burden on social parameters, such as socio-economic status (SES) or migration background, is generally described. Therefore, the aim of the evaluation was to analyse to what extent children with a low social class affiliation or a migration background have participated in the caries decline. For the city of Hamburg, Germany, data from a series of five caries epidemiological surveys in day-care centres are available since 1977. Using the same methodology, the dmft values were determined, according to WHO criteria, and in addition including initial caries (IC). For the present evaluation, the data and the changes of caries load (caries prevalence and caries experience; dmft) over time were compared with reference to SES and a migration background. A decrease in the caries prevalence from 58.4% to 22.7% and in the dmft value from 2.6 to 0.8 was determined from 1977 to 2016 (WHO criteria). Including IC, the caries prevalence has decreased from 91.0% to 44.4%, and the caries experience shows a decline from 6.4 to 1.8. The caries reduction can be observed in children of all social classes and regardless of a migration background, although significant differences in caries prevalence and caries experience remain recognisable for each survey through 2016. In conclusion, preschool children from families with low SES or with a migration background have not been left behind in the improvement of dental health, but have also benefited from caries prevention measures in roughly the same order of magnitude as other children.
Degenerative Cervical Myelopathy and Spinal Cord Injury: Introduction to the Special Issue
Authors: Soufi Khadija , Nouri Aria , Martin Allan R.
Published: July 2022

Damage to the spinal cord (SC) can arise from either traumatic or non-traumatic spinal cord injury (SCI) [...]
Scrambler Therapy for Chronic Pain after Burns and Its Effect on the Cerebral Pain Network: A Prospective, Double-Blinded, Randomized Controlled Trial
Authors: Lee Seung Yeol , Park Chang-hyun , Cho Yoon Soo , Kim Laurie , Yoo Ji Won , Joo So Young , Seo Cheong Hoon
Published: July 2022

Chronic pain is common after burn injuries, and post-burn neuropathic pain is the most important complication that is difficult to treat. Scrambler therapy (ST) is a non-invasive modality that uses patient-specific electrocutaneous nerve stimulation and is an effective treatment for many chronic pain disorders. This study used magnetic resonance imaging (MRI) to evaluate the pain network-related mechanisms that underlie the clinical effect of ST in patients with chronic burn-related pain. This prospective, double-blinded, randomized controlled trial (ClinicalTrials.gov: NCT03865693) enrolled 43 patients who were experiencing chronic neuropathic pain after unilateral burn injuries. The patients had moderate or greater chronic pain (a visual analogue scale (VAS) score of ≥5), despite treatment using gabapentin and other physical modalities, and were randomized 1:1 to receive real or sham ST sessions. The ST was performed using the MC5-A Calmare device for ten 45 min sessions (Monday to Friday for 2 weeks). Baseline and post-treatment parameters were evaluated subjectively using the VAS score for pain and the Hamilton Depression Rating Scale; MRI was performed to identify objective central nervous system changes by measuring the cerebral blood volume (CBV). After 10 ST sessions (two weeks), the treatment group exhibited a significant reduction in pain relative to the sham group. Furthermore, relative to the pre-ST findings, the post-ST MRI evaluations revealed significantly decreased CBV in the orbito-frontal gyrus, middle frontal gyrus, superior frontal gyrus, and gyrus rectus. In addition, the CBV was increased in the precentral gyrus and postcentral gyrus of the hemisphere associated with the burned limb in the ST group, as compared with the CBV of the sham group. Thus, a clinical effect from ST on burn pain was observed after 2 weeks, and a potential mechanism for the treatment effect was identified. These findings suggest that ST may be an alternative strategy for managing chronic pain in burn patients.
NICU Admission for Term Neonates in a Large Single-Center Population: A Comprehensive Assessment of Risk Factors Using a Tandem Analysis Approach
Authors: Talisman Shahar , Guedalia Joshua , Farkash Rivka , Avitan Tehila , Srebnik Naama , Kasirer Yair , Schimmel Michael S. , Ghanem Dunia , Unger Ron , Grisaru Granovsky Sorina
Published: July 2022

Objective: Neonatal intensive care unit (NICU) admission among term neonates is associated with significant morbidity and mortality, as well as high healthcare costs. A comprehensive NICU admission risk assessment using an integrated statistical approach for this rare admission event may be used to build a risk calculation algorithm for this group of neonates prior to delivery. Methods: A single-center case–control retrospective study was conducted between August 2005 and December 2019, including in-hospital singleton live born neonates, born at ≥37 weeks’ gestation. Analyses included univariate and multivariable models combined with the machine learning gradient-boosting model (GBM). The primary aim of the study was to identify and quantify risk factors and causes of NICU admission of term neonates. Results: During the study period, 206,509 births were registered at the Shaare Zedek Medical Center. After applying the study exclusion criteria, 192,527 term neonates were included in the study; 5292 (2.75%) were admitted to the NICU. The NICU admission risk was significantly higher (ORs [95%CIs]) for offspring of nulliparous women (1.19 [1.07, 1.33]), those with diabetes mellitus or hypertensive complications of pregnancy (2.52 [2.09, 3.03] and 1.28 [1.02, 1.60] respectively), and for those born during the 37th week of gestation (2.99 [2.63, 3.41]; p < 0.001 for all), adjusted for congenital malformations and genetic syndromes. A GBM to predict NICU admission applied to data prior to delivery showed an area under the receiver operating characteristic curve of 0.750 (95%CI 0.743–0.757) and classified 27% as high risk and 73% as low risk. This risk stratification was significantly associated with adverse maternal and neonatal outcomes. Conclusion: The present study identified NICU admission risk factors for term neonates; along with the machine learning ranking of the risk factors, the highly predictive model may serve as a basis for individual risk calculation algorithm prior to delivery. We suggest that in the future, this type of planning of the delivery will serve different health systems, in both high- and low-resource environments, along with the NICU admission or transfer policy.
The Prognostic Role of Mitral Valve Regurgitation Severity and Left Ventricle Function in Acute Heart Failure
Authors: Mazin Israel , Arad Michael , Freimark Dov , Goldenberg Ilan , Kuperstein Rafael
Published: July 2022

Aims: Data about the prognostic interplay between mitral regurgitation MR and left ventricular (LV) function in the outcome of patients admitted with acute heart failure (AHF) are scarce. We evaluated the prognostic impact of MR severity and LV function on mortality and on recurrent heart failure hospitalization (re-HFH) in patients admitted with AHF. Methods and Results: In total, 6843 patients admitted with AHF were evaluated: 2521 patients with LV ejection fraction (LVEF) ≤ 40% (reduced LVEF), 1238 of them (51%) having ≥moderate MR; and 4322 with LVEF > 40% (preserved LVEF), 1175 of them (27%) having ≥moderate MR. One-year mortality and re-HFH rates were higher in patients with ≥moderate MR unrelated to the baseline LV function (p = 0.028 and p < 0.001, respectively). After multivariable analysis, only reduced LVEF, and not the severity of MR, predicted mortality risk (HR: 1.31 [95% CI: 1.12–1.53] for patients with reduced LV function and ≤mild MR; HR: 1.44 [95% CI: 1.25–1.67] for patients with reduced LV function and ≥moderate MR); p < 0.001 for both. There was an increased risk for re-HFH in each group (HR: 1.35 [95% CI: 1.17–1.52] for patients with preserved LV function and ≥moderate MR; HR: 1.31 [95% CI: 1.15–1.51] for patients with reduced LV function and mild MR; and HR: 1.65 [95% CI: 1.45–1.88] for patients with reduced LV function and ≥moderate MR); p < 0.001 for all. Conclusions: In patients admitted with AHF, the LV function is the main prognostic determinant for mortality after 1 year. Significant (≥moderate) MR is associated with an increased risk of recurrent hospitalization.
Prediction of Tinnitus Perception Based on Daily Life MHealth Data Using Country Origin and Season
Authors: Allgaier Johannes , Schlee Winfried , Probst Thomas , Pryss Rüdiger
Published: July 2022

Tinnitus is an auditory phantom perception without external sound stimuli. This chronic perception can severely affect quality of life. Because tinnitus symptoms are highly heterogeneous, multimodal data analyses are increasingly used to gain new insights. MHealth data sources, with their particular focus on country- and season-specific differences, can provide a promising avenue for new insights. Therefore, we examined data from the TrackYourTinnitus (TYT) mHealth platform to create symptom profiles of TYT users. We used gradient boosting engines to classify momentary tinnitus and regress tinnitus loudness, using country of origin and season as features. At the daily assessment level, tinnitus loudness can be regressed with a mean absolute error rate of 7.9% points. In turn, momentary tinnitus can be classified with an F1 score of 93.79%. Both results indicate differences in the tinnitus of TYT users with respect to season and country of origin. The significance of the features was evaluated using statistical and explainable machine learning methods. It was further shown that tinnitus varies with temperature in certain countries. The results presented show that season and country of origin appear to be valuable features when combined with longitudinal mHealth data at the level of daily assessment.
Human Factors and Airway Management in COVID-19 Patients: The Perfect Storm?
Authors: Cortese Gerardo , Sorbello Massimiliano , Di Giacinto Ida , Cedrone Martina , Urdaneta Felipe , Brazzi Luca
Published: July 2022

The SARS-CoV-2 pandemic heavily impacted healthcare workers, increasing their physical and psychological workload. Specifically, COVID-19 patients’ airway management is definitely a challenging task regarding both severe and acute respiratory failure and the risk of contagion while performing aerosol-generating procedures. The category of anesthesiologists and intensivists, the main actors of airway management, showed a poor psychological well-being and a high stress and burnout risk. Identifying and better defining the specific main SARS-CoV-2-related stressors can help them deal with and effectively plan a strategy to manage these patients in a more confident and safer way. In this review, we therefore try to analyze the relevance of human factors and non-technical skills when approaching COVID-19 patients. Lessons from the past, such as National Audit Project 4 recommendations, have taught us that safe airway management should be based on preoperative assessment, the planning of an adequate strategy, the optimization of setting and resources and the rigorous evaluation of the scenario. Despite, or thanks to, the critical issues and difficulties, the “take home lesson” that we can translate from SARS-CoV-2 to every airway management is that there can be no more room for improvisation and that creating teamwork must become a priority.
Renal Tubular Acidosis in Pregnant Critically Ill COVID-19 Patients: A Secondary Analysis of a Prospective Cohort
Authors: Humbel Simona , Wendel-Garcia Pedro David , Unseld Simone , Noll Fabienne , Schuepbach Reto Andreas , Ganter Christoph Camille , Seeger Harald , David Sascha , Andermatt Rea
Published: July 2022

Background: Renal tubular acidosis (RTA) is an extremely rare cause of metabolic acidosis (10 in 100,000). RTA has been linked neither to pregnancy nor to severe coronavirus disease 2019 (COVID-19). The purpose of this study was to analyze the prevalence and clinical course of normal anion gap metabolic acidosis in critically ill pregnant COVID-19 patients and to compare them to an age-matched nonpregnant female patient cohort. Methods: Secondary analysis was conducted on a prospective observational cohort of critically ill patients suffering from COVID-19 consecutively admitted to a tertiary intensive care unit (ICU) between February 2020 and April 2021. Results: A total of 321 COVID-19 patients required admission to the ICU; 95 (30%) were female, and 18 (19%) were of childbearing age. Seven of eight (88%) pregnant women (all in the last trimester) required advanced respiratory support due to COVID-19. The estimated glomerular filtration rate was 135 (123–158) mL/min/m2 body surface area, and six pregnant women (86%) were diagnosed with a normal, respiratory compensated, anion gap metabolic acidosis (pHmin 7.3 (7.18–7.31), HCO3−min 14.8 (12.8–18.6) mmol/L, and paCO2 3.4 (3.3–4.5) kPa). Three (43%) acidotic pregnant women fulfilled diagnostic criteria for RTA. All women recovered spontaneously within less 7 days. Conclusions: Metabolic acidosis seems to be very common (85%) in pregnant critically ill COVID-19 patients, and the prevalence of RTA might be higher than normal. It remains to be demonstrated if this observation is an indirect epiphenomenon or due to a direct viral effect on the tubular epithelium.
Anesthetic Management during Robotic-Assisted Minimal Invasive Thymectomy Using the Da Vinci System: A Single Center Experience
Authors: Mohamed Ahmed , Shehada Sharaf-Eldin , Aigner Clemens , Ploenes Till , Alnajdawi Yazan , Van Brakel Lena , Ruhparwar Arjang , Hochreiter Marcel , Berger Marc Moritz , Brenner Thorsten , Haddad Ali
Published: July 2022

Background: Robotic-assisted surgery is gaining more adaption in different surgical specialties. The number of patients undergoing robotic-assisted thymectomy is continuously increasing. Such procedures are accompanied by new challenges for anesthesiologists. We are presenting our primary anesthesiologic experience in such patients. Methods: This is a retrospective single center study, evaluating 28 patients who presented with thymoma or myasthenia gravis (MG) and undergone minimal invasive robotic-assisted thoracic thymectomy between 01/2020–01/2022. We present our fast-track anesthesia management as a component of the enhanced recovery program and its primary results. Results: Mean patient’s age was 46.8 ± 18.1 years, and the mean height was 173.1 ± 9.3 cm. Two-thirds of patients were female (n = 18, 64.3%). The preoperative mean forced expiratory volume in the first second (FEV1) was 3.8 ± 0.7 L, forced vital capacity (FVC) was 4.7 ± 1.1 L, and the FEV1/FVC ratio was 80.4 ± 5.3%. After the creation of capnomediastinum, central venous pressure and airway pressure have been significantly increased from the baseline values (16.5 ± 4.9 mmHg versus 13.4 ± 5.1 mmHg, p < 0.001 and 23.4 ± 4.4 cmH2O versus 19.3 ± 3.9 cmH2O, p < 0.001, respectively). Most patients (n = 21, 75%) developed transient arrhythmias episodes with hypotension. All patients were extubated at the end of surgery and discharged awake to the recovery room. The first 16 (57.1%) patients were admitted to the intensive care unit and the last 12 patients were only observed in intermediate care. Postoperatively, one patient developed atelectasis and was treated with non-invasive ventilation therapy. Pneumonia or reintubation was not observed. Finally, no significant difference was observed between MG and thymoma patients regarding analgesics consumption or incidence of complications. Conclusions: Robotic-assisted surgery is a rapidly growing technology with increased adoption in different specialties. Fast-track anesthesia is an important factor in an enhanced recovery program and the anesthetist should be familiar with challenges in this kind of operation to achieve optimal results. So far, our anesthetic management of patients undergoing robotic-assisted thymectomy reports safe and feasible procedures.
Novel Biomarkers in Lung Cancer and Chronic Lung Diseases: From the Systematic Perspective of Yin–Yang Balance
Authors: Jeong Mi-Kyung , Chun Jaemoo , Oh In-Jae
Published: July 2022

New approaches to personalized medicine are made possible by the discovery of biomarkers [...]
Calibration and Validation of a PREMIUM-DT Item Bank to Measure the Experience of Drug Therapy for Patients with Severe Mental Illness
Authors: Fernandes Sara , Boyer Laurent , Zendjidjian Xavier , Loundou Anderson , Riedberger Jeremie , Llorca Pierre-Michel , Auquier Pascal , Fond Guillaume ,   Collaborators of the French PREMIUM Group
Published: July 2022

The aim of this study was to (1) calibrate an item bank to measure patients’ experience of drug therapy for adult patients with SMIs and (2) develop computerized adaptive testing (CAT) to improve its use in routine practice. This is a cross-sectional, multicentric study involving 541 patients with schizophrenia, bipolar disorder, and major depressive disorder. Analyses based on classical test and item response theories were performed. After 7 highly inter-correlated items and 4 items with low factor loadings were removed, the remaining 26 items were sufficiently unidimensional (RMSEA = 0.069, CFI = 0.969, TLI = 0.963) and showed adequate fit to the generalized partial credit model. There was no differential item functioning by gender, age, care setting, or diagnosis from moderate- to large-magnitude. The mean score was 46.0 ± 16.9 and was significantly higher for patients reporting good medication adherence. The resulting PREMIUM-DT item bank has strong psychometric properties, and CAT facilitates widespread use in clinical settings (an average of 8 items administered, corresponding to a reliability of >0.90). Our results suggest that practical information and information about the side effects of psychotropic treatments and how to cope with them should be targeted as a priority to improve patients’ experience of drug therapy.
Prognostic Implications of the Novel Pulmonary Hypertension Definition in Patients with Aortic Stenosis after Transcatheter Valve Replacement
Authors: Adamopoulos Dionysios , Pagoulatou Stamatia , Rovas Georgios , Bikia Vasiliki , Müller Hajo , Giannakopoulos Georgios , Mauler-Wittwer Sarah , Licker Marc-Joseph , Stergiopulos Nikolaos , Lador Frédéric , Noble Stéphane
Published: July 2022

Introduction: Pulmonary hypertension (PH), traditionally defined as a mean pulmonary artery pressure (PAP) ≥ 25 mmHg, is associated with poor outcomes in patients undergoing a transcatheter aortic valve replacement (TAVR) for severe aortic stenosis (AS). Recently, a novel definition for PH has been proposed, placing the cut-off value of mean PAP at 20 mmHg, and introducing pulmonary vascular resistance as an exclusive indicator for the pre-capillary involvement. In light of the novel criteria, whether PH still preserves its prognostic significance remains unknown. Methods: The study population consisted of 380 patients with AS, who underwent a right heart catheterization before TAVR. The cohort was divided according to the presence of PH (n = 174, 45.7%) or not. Patients with PH were further divided into the following groups: (1) Pre-capillary PH ((Pre-capPH), n = 46, 12.1%); (2) Isolated post-capillary PH ((IpcPH), n = 78, 20.5%); (3) Combined pre and post-capillary PH ((CpcPH), n = 82, 21.6%). The primary endpoint was all-cause mortality at 1 year. Results: A total of 246 patients (64.7%) exhibited mean PAP > 20 mmHg. Overall, the presence of PH was associated with higher 1-year mortality rates (hazard ratio (HR) 2.8, 95% CI: 1.4–5.8, p = 0.004). Compared to patients with no PH, Pre-capPH and CpcPH (but not IpcPH) were related to higher 1-year mortality (HR 2.7, 95% CI: 1.0–7.2, p = 0.041 and HR 3.9, 95% CI: 1.8–8.5, p = 0.001, respectively). This remained significant even after the adjustment for baseline comorbidities. Conclusions: Pre-interventional PH according to the novel hemodynamic criteria, is linked with poor outcomes in patients undergoing TAVR for severe AS. However, this is mainly driven by patients with mean PAP ≥ 25 mmHg. Patients with a pre-capillary PH component as defined by increased PVR present an even worse prognosis as compared to patients with isolated post-capillary or no PH who present comparable 1-year mortality rates.
Repeated Intra-Articular Administration of Platelet-Rich Plasma (PRP) in Temporomandibular Disorders: A Clinical Case Series
Authors: Sikora Maciej , Sielski Marcin , Chęciński Maciej , Nowak Zuzanna , Czerwińska-Niezabitowska Barbara , Chlubek Dariusz
Published: July 2022

Background: Temporomandibular joint disorders (TMDs) are manifested, inter alia, by pain and limited scope of the mandibular abduction. Among the treatment strategies for these ailments, intra-articular injections of autologous blood preparations, including platelet-rich plasma (PRP), are administered. This prospective case series was aimed at assessing the effectiveness of repeated platelet-rich plasma (PRP) administration to the TMJ cavities in terms of reducing articular pain and increasing the mobility of the mandible. Material and methods: 40 consecutive patients diagnosed with TMJ pain qualified for the case series. The entire treatment program consisted of five PRP administrations and a summary appointment. Regression was analyzed for (1) intensity of spontaneous pain; (2) effectiveness of spontaneous pain relief; (3) mastication efficiency values; (4) painless mandibular abduction; (5) maximum mouth opening. The correlations between the abovementioned variable series were analyzed. Results: The mean spontaneous pain decreased consistently with successive PRP administrations in line with the regression model: −0.4x + 4.2 (R2 = 0.98). Articular pain improvement was reported in 71% of joints treated. Improvement in chewing quality at the end of the entire injection cycle was found in 63% of patients. The equations for the linear regression models for painless mandibular abduction (five applications of PRP) and maximum mouth opening (the first four applications of PRP) were x + 34 (R2 = 0.89) and 0.6x + 43.6 (R2 = 0.96), respectively. Improvement in these domains was found in 78% and 53% of patients, respectively. The strongest correlations were found between pain and chewing efficiency (−0.95), pain and painless mandible abduction (−0.96), and painless mandibular abduction and mastication efficiency (0.94). Conclusion: PRP injections into TMJ cavities should be considered as a low invasive, highly accessible form of treatment for various TMDs causing pain and mandible movement limitation.
Two-Phase MDCT Protocol for the Screening of Small Hepatocellular Carcinoma
Authors: Paisant Anita , Boursier Jérôme , Dabli Djamel , Lebigot Jérôme , Oberti Frédéric , Michalak Sophie , Vilgrain Valérie , Aubé Christophe
Published: July 2022

Screening programmes for cirrhotic patients are based on ultrasound (US) examinations at 6-month intervals, but a US sensitivity of 47% has recently been reported. The aim of this study was to evaluate a two-phase MDCT protocol in terms of hepatic nodule detection within a hepatocellular carcinoma (HCC) screening situation and to evaluate a reduction in irradiation dose for the 6-monthly checks compared to the classic four-phase protocol. In total, 373 patients with 498 nodules that were suspected to be HCC and ranged from 10 to 30 mm in size were prospectively included. All patients underwent four-phase MDCT with an unenhanced phase, arterial phase (AP), portal phase (PP) and delayed phase (DP). The cumulative irradiation from the repeated 6-monthly MDCT protocol was calculated. Of the 498 nodules, only 4 (0.008%) were only seen in the PP and not in the AP or AP. Of the 319 HCC nodules, 270 (84.6%) had AP hyperenhancement, while 115 had washout in the PP and 224 had washout in the DP. Overall, 222 of the 224 (99.1%) HCC nodules with typical features were seen in the AP and DP. The dose reduction was estimated at 55.4% when using the two-phase protocol (AP and DP). The cumulative irradiation of the two-phase protocol, which was performed every 6 months over 5 years, was 96.5 mSv. MDCT with the two-phase protocol could offer an alternative to ultrasound screening with an interesting risk–benefit trade-off.
Brain Tumor Diagnosis Using Machine Learning, Convolutional Neural Networks, Capsule Neural Networks and Vision Transformers, Applied to MRI: A Survey
Authors: Akinyelu Andronicus A. , Zaccagna Fulvio , Grist James T. , Castelli Mauro , Rundo Leonardo
Published: July 2022

Management of brain tumors is based on clinical and radiological information with presumed grade dictating treatment. Hence, a non-invasive assessment of tumor grade is of paramount importance to choose the best treatment plan. Convolutional Neural Networks (CNNs) represent one of the effective Deep Learning (DL)-based techniques that have been used for brain tumor diagnosis. However, they are unable to handle input modifications effectively. Capsule neural networks (CapsNets) are a novel type of machine learning (ML) architecture that was recently developed to address the drawbacks of CNNs. CapsNets are resistant to rotations and affine translations, which is beneficial when processing medical imaging datasets. Moreover, Vision Transformers (ViT)-based solutions have been very recently proposed to address the issue of long-range dependency in CNNs. This survey provides a comprehensive overview of brain tumor classification and segmentation techniques, with a focus on ML-based, CNN-based, CapsNet-based, and ViT-based techniques. The survey highlights the fundamental contributions of recent studies and the performance of state-of-the-art techniques. Moreover, we present an in-depth discussion of crucial issues and open challenges. We also identify some key limitations and promising future research directions. We envisage that this survey shall serve as a good springboard for further study.
Instability and Failure of Subsea Structures
Authors: Gao Fu-Ping , Yin Zhen-Yu
Published: July 2022

Subsea engineering structures are an evolutive system with high diversity, e [...]
Hyperparameter Optimization for the LSTM Method of AUV Model Identification Based on Q-Learning
Authors: Wang Dianrui , Wan Junhe , Shen Yue , Qin Ping , He Bo
Published: July 2022

An accurate mathematical model is a basis for controlling and estimating the state of an Autonomous underwater vehicle (AUV) system, so how to improve its accuracy is a fundamental problem in the field of automatic control. However, AUV systems are complex, uncertain, and highly non-linear, and it is not easy to obtain through traditional modeling methods. We fit an accurate dynamic AUV model in this study using the long short-term memory (LSTM) neural network approach. As hyper-parameter values have a significant impact on LSTM performance, it is important to select the optimal combination of hyper-parameters. The present research uses the improved Q-learning reinforcement learning algorithm to achieve this aim by improving its recognition accuracy on the verification dataset. To improve the efficiency of action exploration, we improve the Q-learning algorithm and choose the optimal initial state according to the Q table in each round of learning. It can effectively avoid the ineffective exploration of the reinforcement learning agent between the poor-performing hyperparameter combinations. Finally, the experiments based on simulated or actual trial data demonstrate that the proposed model identification method can effectively predict kinematic motion data, and more importantly, the modified Q-Learning approach can optimize the network hyperparameters in the LSTM.
Review of the State-of-Art of MPS Method in Ocean Engineering
Authors: Sun Zhe , Dou Li-Yuan , Tan Si-Yuan , Xu Zi-Kai , Djidjeli Kamal , Zhou Yan
Published: July 2022

When dealing with the complex deformation of free surface such as wave breaking, traditional mesh-based Computational Fluid Dynamics (CFD) methods often face problems arising alongside grid distortion and re-meshing. Therefore, the meshless method became robust for treating large displaced free surface and other boundaries caused by moving structures. The particle method, which is an important branch of meshless method, is mainly divided into the Smoothed Particle Hydrodynamics (SPH) and Moving Particle Semi-implicit (MPS) methods. Different from the SPH method, which involves continuity and treat density as a variable when building kernel functions, the kernel function in the MPS method is a weight function which treats density as a constant, and the spatial derivatives are discretized by establishing the gradient operator and Laplace operator separately. In other words, the first- or second-order continuity of the kernel functions in the MPS method is not a necessity as in SPH, though it might be desirable. At present, the MPS method has been successfully applied to various violent-free surface flow problems in ocean engineering and diverse applications have been comprehensively demonstrated in a number of review papers. This work will focus on algorithm developments of the MPS method and to provide all perspectives in terms of numerical algorithms along with their pros and cons.
Invasive Fungal Infections 2021
Authors: Xess Immaculata , Pagano Livio , Dabas Yubhisha
Published: July 2022

Invasive fungal infections (IFIs) represent a significant problem in a large proportion of immunocompromised individuals and critically ill patients [...]
Co-Movement, Portfolio Diversification, Investors’ Behavior and Psychology: Evidence from Developed and Emerging Countries’ Stock Markets
Authors: Sahabuddin Mohammad , Islam Md. Aminul , Tabash Mosab I. , Anagreh Suhaib , Akter Rozina , Rahman Md. Mizanur
Published: July 2022

The issue of co-movements is still crucial and arguable in international finance. An optimum and significant level of co-movement is highly desirable to investors, and it mostly depends on investors’ decisions (behavior and psychology). We use frequency–time bands and multi-scale-based wavelet analysis to investigate the co-movement between developed and emerging countries’ stock markets for better asset allocation and portfolio diversification strategies. The results show that a significant level of co-movement is observed between conventional and Islamic stock markets in developed and emerging countries, and it varies in terms of its time–frequency domain properties. Particularly, the dependency among conventional and Islamic stock markets is strong at 4–512-band scales. However, the USA Islamic stock market illustrates a higher level of coherency with the UK, Japan and China’s Islamic stock markets, while a relatively lower level of co-movement is detected with the Chinese composite, Malaysian and Indonesian Islamic stock markets. The findings further confirm that the developed countries’ stock markets are substantially influenced by the GFC in 2007–2008 and the European debt crisis in 2012, while this trend is surprisingly not observed in the emerging markets on a similar scale. Therefore, these crises have opened the door for the grabbing of portfolio diversification benefits from the emerging countries’ stock markets. These findings give some interesting insights to policymakers, investors and fund managers for portfolio diversification and risk management strategies.
Examining the Asymmetric Effects of Third Country Exchange Rate Volatility on Trade between the US and the EU
Authors: Lee Chien-Hui , Li Shu-Hui , Lee Jen-Yu
Published: July 2022

This paper aims to examine the symmetric and asymmetric effects of third country exchange rate volatility on the trade flow between the US and EU from January 2003 through March 2021. The monthly disaggregated data of the top twelve export and import industries are the sample frame. We find that separating increased volatility from declines and introducing a nonlinear adjustment to the volatility shows a more significant outcome than symmetric analysis. Different industries carry distinctive behaviors regarding exchange rate risk, and the third country effect plays a vital role in trade. Moreover, increased CNY/USD real exchange rate volatility increases bilateral trade between the US and EU.
Examining the Influence of Spanish Heritage Language Learners’ Critical Language Awareness (CLA) Development on Ethnic Identity Formation
Authors: Gómez García Eva
Published: July 2022

As critical language pedagogies are being implemented in heritage language (HL) settings, there is an increasing need to examine the impact of critical approaches in Spanish HL speakers. The present study examines how the development of HL learners’ critical language awareness (CLA) influences ethnic identity formation in a university-level course that adopts a critical approach to HL instruction. As part of the curricular content, a CLA instructional intervention, consisting of a 4-week unit (10 h), was implemented. First, to measure ethnic identity, at the beginning (pre) and at the end of the semester (post), students completed the Ethnic Identity Scale (EIS) and provided comments with their answers. Additionally, in order to examine CLA development before and after the intervention, participants completed an existing questionnaire, which addresses topics such as language variation, language ideologies, and bilingualism. Overall, the results show that students’ CLA levels increased from “somewhat high” to “high”. Furthermore, participants reported different ethnic–racial identity statuses, which moved toward ethnic identity achievement. Higher CLA levels were associated with an achieved positive status. These findings can contribute to a better understanding of the link between students’ CLA and ethnic identity in HL educational settings, where a critical language pedagogy is applied.
The Genesis of Spanish /θ/: A Revised Model
Authors: Mackenzie Ian
Published: July 2022

This article proposes a revised model of the genesis of Castilian Spanish /θ/, based on (i) precise tracking across the Late Middle Ages of the orthographical d → z change in preconsonantal coda position and (ii) the potential for auditory indeterminacy between denti-alveolar variants of [s] and the non-sibilant [θ]. According to the findings, two non-sibilant phonemes, /θ/ and /ð/, are likely to have come into existence by the early 1500s, merger at the expense of /ð/ occurring shortly thereafter. This effectively inverts the normally assumed chronology, according to which devoicing preceded and indeed was implicated in the genesis of /θ/. The revised chronology weakens the teleological analysis of /θ/, which treats its genesis in terms of a functionally motivated widening of the articulatory distance between similar-sounding sibilants. Instead, the emergence of Castilian /θ/ is argued to be a natural reflex of the auditory permeability between the denti-alveolar type of [s] and the non-sibilant [θ], with analogous evolutions occurring outside the domain of Castilian Spanish. As part of this overall approach, the article assumes dissibilation (understood as the converse of assibilation) to be the fundamental process in the genesis of /θ/, rather than interdentalization.
Pharmacokinetics and Therapeutic Potential of Teucrium polium, a Medicinal and Endangered Species in Ha'il Region, against Liver Damage Associated Hepatotoxicity and Oxidative Injury in Rats: Computational, Biochemical and Histological Studies
Authors: Rahmouni Fatma , Badraoui Riadh , Ben-Nasr Hmed , Bardakci Fevzi , Elkahoui Salem , Siddiqui Arif , Saeed Mohd , Snoussi Mejdi , Saoudi Mongi , Rebai Tarek
Published: July 2022

This study investigated the druggability, pharmacokinetics and ethyl acetate extract of Teucrium polium (EA T. polium), from Ha'il, and the protective effect against carbon tetrachloride (CCl4) induced liver cirrhosis in rats. The total antioxidant capacity (TAC) and scavenging activity of the extract were examined. The in vivo protective study was based on the use of an animal model of CCl4-induced liver cirrhosis. Four groups of rats have been used: Group I: control rats; Group II: received CCl4 in olive oil (0.5 mL/kg); Group III: received the EA T. polium (25 mg/kg) of pretreatment for seven days by gavage then CCl4 in olive oil by gavage for 15 days. Group IV: received the EA of T. polium for seven days (25 mg/kg). EA T. polium was found to possess significant antioxidant capacity. CCl4 caused a hepatotoxicity associated increase in both levels of AST and ALT, which were reduced back to normal values following EA T. polium pretreatment. Hepatotoxicity associated structural modifications of liver tissues and increase in thiobarbituric acid reactive substances (TBARS), conjugated dienes (CD) and carbonyl proteins (CP), associated decreases in several assessed antioxidant enzymes such as superoxide dismutase (SOD), glutathione peroxidase (GPx) and catalase (CAT). The in vivo findings on the protective effect of T. polium were supported by its druggability, its pharmacokinetic properties and molecular docking assays. These results confirm the modulatory antioxidant and hepatoprotective potential of T. polium in this experimental liver cirrhosis model. T. polium phytochemicals are good candidates for further pharmaceutical explorations and drug design.
Fatty Acid Composition of Milk from Mothers with Normal Weight, Obesity, or Gestational Diabetes
Authors: Simon Sarkadi Livia , Zhang Miaomiao , Muránszky Géza , Vass Réka Anna , Matsyura Oksana , Benes Eszter , Vari Sandor G.
Published: July 2022

Gestation and the neonatal period are crucial periods in infant development. Many components of breast milk, including fatty acids, play an important role in strengthening the immune system. The aim of our research was to evaluate the fatty acid profiles of milk from 69 mothers, including subjects having a normal weight, obesity, or gestational diabetes. For the analyses, we used gas chromatography (GC) with flame ionization detection (FID) and GC coupled with mass spectrometry (GC/MS). The main fatty acids found in breast milk were palmitic acid (C16:0; 26–28%), linoleic acid (C18:2; 23–28%), and α-linolenic acid linoleic acid (C18:3; 15–17%), followed by myristic acid (C14:0; 5–8%), lauric acid (C12:0; 4–6%) and stearic acid (C18:0; 4–5%). The average breakdown of fatty acids was 50% saturated, 44% polyunsaturated, and 6% monounsaturated. Breast milk samples were classified using principal component analysis and linear discriminant analysis. Results showed that milk from the two major groups of obese and normal body mass index (BMI) could be distinguished with an accuracy of 89.66%. Breast milk samples of Hungarian and Ukrainian mothers showed significant differences based on the fatty acid composition, which variations are attributable to the mothers’ dietary habits.
Role of p53 in Regulating Radiation Responses
Authors: Okazaki Ryuji
Published: July 2022

p53 is known as the guardian of the genome and plays various roles in DNA damage and cancer suppression. The p53 gene was found to express multiple p53 splice variants (isoforms) in a physiological, tissue-dependent manner. The various genes that up- and down-regulated p53 are involved in cell viability, senescence, inflammation, and carcinogenesis. Moreover, p53 affects the radioadaptive response. Given that several studies have already been published on p53, this review presents its role in the response to gamma irradiation by interacting with MDM2, NF-κB, and miRNA, as well as in the inflammation processes, senescence, carcinogenesis, and radiation adaptive responses. Finally, the potential of p53 as a biomarker is discussed.
Effect of Aggregate Type on Properties of Ultra-High-Strength Concrete
Authors: Szcześniak Anna , Siwiński Jarosław , Stolarski Adam
Published: July 2022

In this work, we present an analysis of natural fine aggregates’ influence on the properties of ultra-high-strength concrete. The reference concrete mix was made of natural sand with the addition of fly ash and microsilica. It was assumed to obtain concrete with a very high strength without the addition of fibers and without special curing conditions, ensuring the required workability of the concrete mix corresponding to the consistency of class S3. The reference concrete mix was modified by replacing sand with granite and basalt aggregate in the same fractions. Five series of concrete mixes made with CEM I 52.5R cement were tested. Experimental investigations were carried out regarding the consistency of the concrete mix, the compressive strength, the flexural strength and the water absorption by hardened concrete. A comparative analysis of the obtained results indicated significant improvement in the concrete strength after the use of basalt aggregate. The strength of the concrete series based on basalt aggregate, BC1, allowed it to be classified as ultra-high-performance concrete. Concrete based on sand, SC1, was characterized by the lowest compressive and flexural strength but obtained the best workability of the mix and the lowest water absorption. The results presented in the paper, show a significant influence of the type of aggregate used on the mechanical and physical properties of ultra-high strength concrete.