bluuebunny/crossref_metadata_2025 huggingface dataset:
A Survey of Knowledge Graph Approaches and Applications in Education
Authors: Qu Kechen , Li Kam Cheong , Wong Billy T. M. , Wu Manfred M. F. , Liu Mengjin
Published: June 2024

This paper presents a comprehensive survey of knowledge graphs in education. It covers the patterns and prospects of research in this area. A total of 48 relevant publications between 2011 and 2023 were collected from the Web of Science, Scopus, and ProQuest for review. The findings reveal a sharp increase in recent years in the body of research into educational knowledge graphs which was mainly conducted from institutions in China. Most of the relevant research work adopted a quantitative method, such as performance evaluation, user surveys, and controlled experiments, to assess the effectiveness of knowledge graph approaches. The findings also suggest that knowledge graph approaches were primarily researched and implemented in higher education institutions, with a focus on computer science, mathematics, and engineering. The most frequently addressed objectives included enhancing knowledge representation and providing personal learning recommendations, and the most common applications were concept instruction and educational recommendations. Diverse data resources, such as course materials, student learning behaviours, and online encyclopaedia, were processed to implement knowledge graph approaches in different scenarios. Relevant technical means employed for the implementation of knowledge graphs dealt with the purposes of building knowledge ontology, achieving recommendations, and creating knowledge graphs. Various pedagogies such as personalised learning and collaborative learning are supported by the knowledge graph approaches. The findings also identified key limitations in the relevant work, including insufficient information for knowledge graph construction, difficulty in extending applications across subject areas, the restricted scale and scope of data resources, and the lack of comprehensive user feedback and evaluation processes.
Malware Detection and Classification System Based on CNN-BiLSTM
Authors: Kim Haesoo , Kim Mihui
Published: June 2024

For malicious purposes, attackers hide malware in the software used by their victims. New malware is continuously being shared on the Internet, which differs both in terms of the type of malware and method of damage. When new malware is discovered, it is possible to check whether there has been similar malware in the past and to use the old malware to counteract the new malware; however, it is difficult to check the maliciousness and similarity of all software. Thus, deep learning technology can be used to efficiently detect and classify malware. This study improves this technology’s accuracy by converting static features, which are binary data, into images and by converting time-series data, such as API call sequences, which are dynamic data with different lengths for each datum, into data with fixed lengths. We propose a system that combines AI-based malware detection and classification systems trained on both static and dynamic features. The experimental results showed a detection accuracy of 99.34%, a classification accuracy of 95.1%, and a prediction speed of approximately 0.1 s.
Climate Change and Energy Security: A Comparative Analysis of the Role of Energy Policies in Advancing Environmental Sustainability
Authors: Elkhatat Ahmed , Al-Muhtaseb Shaheen
Published: June 2024

This review analyzes the complex relationship between climate change and energy security and their joint impact on global development. It emphasizes the need for sustainable energy solutions to tackle increasing global warming effects and energy demands. A thorough literature analysis highlights the link between energy policies, climate goals, and sustainable development aspirations. Moreover, it examines the effectiveness of energy policies in various national contexts in promoting environmental sustainability and emphasizing regional dynamics, socio-economic factors, and diverse energy planning approaches. The review explains the multifaceted relationship between climate change, energy security, and environmental protection. Key recommendations related to renewable energy transitions are provided as crucial means to address global energy demand and resource constraints while reducing dependence on fossil fuels. The analysis underscores renewable energy’s key role in aligned energy strategies that balance security and sustainability for a low-carbon future. It emphasizes the critical need for coordinated policies, technological innovation, and collaborative action between academia, industry, and policymakers to advance integrated energy systems and thermal storage solutions.
Life Estimation of HVDC Cables Subjected to Fast and Slow Polarity Reversals
Authors: Diban Bassel , Mazzanti Giovanni , Marzinotto Massimo , Battaglia Antonio
Published: June 2024

This paper aims at estimating the life of extruded HVDC cable insulation subjected to fast and slow voltage polarity reversals (VPRs). An ad hoc MATLAB code is used for the transient electric field simulation in the cable insulation thickness by solving numerically Gauss, ohm, and current continuity equations beside a macroscopic conductivity equation. A transient temperature is also considered during slow VPR transients. The results show a significant localized reduction in the life of the inner insulation, making the life distribution non-monotonous inside the insulation thickness. The results show that fast VPRs are the most stressing transients in this study. The longer the duration of the zero-voltage period in slow VPR, the less stressed the insulation, hence, the longer the local life in the inner insulation of the cable. The latter is justified by the charge relaxation during slow VPRs.
Control and Stability of Grid-Forming Inverters: A Comprehensive Review
Authors: Mirmohammad Marzie , Azad Sahar Pirooz
Published: June 2024

The large integration of inverter-based resources will significantly alter grid dynamics, leading to pronounced stability challenges due to fundamental disparities between inverter-based and traditional energy systems. While grid-following inverters (GFLIs) dominate current inverter configurations, their increased penetration into the grid can result in major stability issues. In contrast, grid-forming inverters (GFMIs) excel over GFLIs by offering features like standalone operation, frequency support, and adaptability in weak grid scenarios. GFMIs, unlike GFLIs, control the AC voltage and frequency at the common coupling point, impacting the inverter dynamic response to grid disturbances and overall stability. Despite the existing literature highlighting differences between GFLIs and GFMIs and their control strategies, a comprehensive review of GFMIs’ stability and the effects of their control schemes on grid stability is lacking. This paper provides an in-depth evaluation of GFMIs’ stability, considering various control schemes and their dynamics. It also explores different types of power system stability, introduces new stability concepts that correspond to power grids with integrated inverters, i.e., resonance and converter-driven stability, and reviews small-signal and transient stability analyses, which are the main two types of GFMI stability studied in the literature. The paper further assesses existing studies on GFMI stability, pinpointing research gaps for future investigations.
Unveiling a Novel Antidote for Deoxynivalenol Contamination: Isolation, Identification, Whole Genome Analysis and In Vivo Safety Evaluation of Lactobacillus rhamnosus MY-1
Authors: Yao Jie , Chen Songbiao , Li Yijia , Liao Chengshui , Shang Ke , Guo Rongxian , Chen Jian , Wang Lei , Xia Xiaojing , Yu Zuhua , Ding Ke
Published: June 2024

Deoxynivalenol (DON) is a global contaminant found in crop residues, grains, feed, and animal and human food. Biodegradation is currently the best solution for addressing DON pollution. However, efficient detoxification bacteria or enzymes that can be applied in complex matrices are lacking. The aim of this study was to isolate a DON-detoxifying probiotic strain with a high degradation rate, a good safety profile, and a clear genetic background. One hundred and eight bacterial strains were isolated from 300 samples collected from a school farm and surrounding livestock farms. A new DON-degrading strain, Lactobacillus rhamnosus MY-1 (L. rhamnosus MY-1), with a degradation rate of 93.34% after 48 h and a comprehensive degradation method, was identified. Then, MY-1 at a concentration of 1 × 108 CFU/mL was administered to mice in a chronic intoxication experiment for 28 days. The experimental group showed significantly higher weight gain and exhibited good production performance compared to the control group. The length of the ileal villi in the experimental group was significantly longer than that in the control group. The expression of pro-inflammatory cytokines decreased, while the expression of anti-inflammatory factors increased in the experimental group. Whole-genome analysis revealed that most of the MY-1 genes were involved in carbohydrate metabolism and membrane transport, with a cluster of secondary metabolite genes encoding antimicrobial properties. In summary, this study successfully identified a Lactobacillus strain with good safety performance, high DON degradation efficiency, and a clear genetic background, providing a new approach for the treatment of DON contamination.
Payment Systems, Insurance, and Agency Problems in Healthcare: A Medically Framed Real-Effort Experiment
Authors: Karunadasa Manela , Sieberg Katri K.
Published: June 2024

Background: This study aims to examine the impact of different healthcare payment systems, specifically salary and fee-for-service (FFS) models, on service provision, patient welfare, and quality of care. The influence of payment models on healthcare delivery and patient outcomes, as well as how these models affect doctors’ decision-making based on patients’ insurance coverage, is not well understood. Methods: A medically framed real-effort task experiment was conducted. This study compared two payment systems: salary and FFS models. Key outcomes measured included the level of service provision, patient welfare, and quality of care. The analysis focused on how financial incentives and patient insurance coverage influenced healthcare decisions. Results: This study found overtreatment in FFS models and undertreatment in salary-based models. Healthcare decisions are significantly influenced by financial incentives and patient needs. Specifically, in FFS models, decisions are driven by self-interest, while in salary models, they are guided by patient needs. Within the FFS model, insurance coverage affects doctors’ decisions and patients’ benefits. Insured patients often receive unnecessary or incorrect procedures, indicating a supply-side moral hazard. Conclusions: Financial incentives and patient insurance coverage significantly influence healthcare decisions, with FFS models promoting self-interested decision-making and salary models focusing more on patient needs. This study contributes to the literature on supply-side moral hazard to health economics studies that use laboratory experiments to model medical decision-making.
Hydrogel-Based 3D Bioprinting Technology for Articular Cartilage Regenerative Engineering
Authors: Zhang Hongji , Zhou Zheyuan , Zhang Fengjie , Wan Chao
Published: June 2024

Articular cartilage is an avascular tissue with very limited capacity of self-regeneration. Trauma or injury-related defects, inflammation, or aging in articular cartilage can induce progressive degenerative joint diseases such as osteoarthritis. There are significant clinical demands for the development of effective therapeutic approaches to promote articular cartilage repair or regeneration. The current treatment modalities used for the repair of cartilage lesions mainly include cell-based therapy, small molecules, surgical approaches, and tissue engineering. However, these approaches remain unsatisfactory. With the advent of three-dimensional (3D) bioprinting technology, tissue engineering provides an opportunity to repair articular cartilage defects or degeneration through the construction of organized, living structures composed of biomaterials, chondrogenic cells, and bioactive factors. The bioprinted cartilage-like structures can mimic native articular cartilage, as opposed to traditional approaches, by allowing excellent control of chondrogenic cell distribution and the modulation of biomechanical and biochemical properties with high precision. This review focuses on various hydrogels, including natural and synthetic hydrogels, and their current developments as bioinks in 3D bioprinting for cartilage tissue engineering. In addition, the challenges and prospects of these hydrogels in cartilage tissue engineering applications are also discussed.
Deafness DFNB128 Associated with a Recessive Variant of Human MAP3K1 Recapitulates Hearing Loss of Map3k1-Deficient Mice
Authors: Faridi Rabia , Yousaf Rizwan , Inagaki Sayaka , Olszewski Rafal , Gu Shoujun , Morell Robert , Wilson Elizabeth , Xia Ying , Qaiser Tanveer , Rashid Muhammad , Fenollar-Ferrer Cristina , Hoa Michael , Riazuddin Sheikh , Friedman Thomas
Published: June 2024

Deafness in vertebrates is associated with variants of hundreds of genes. Yet, many mutant genes causing rare forms of deafness remain to be discovered. A consanguineous Pakistani family segregating nonsyndromic deafness in two sibships were studied using microarrays and exome sequencing. A 1.2 Mb locus (DFNB128) on chromosome 5q11.2 encompassing six genes was identified. In one of the two sibships of this family, a novel homozygous recessive variant NM_005921.2:c.4460G>A p.(Arg1487His) in the kinase domain of MAP3K1 co-segregated with nonsyndromic deafness. There are two previously reported Map3k1-kinase-deficient mouse models that are associated with recessively inherited syndromic deafness. MAP3K1 phosphorylates serine and threonine and functions in a signaling pathway where pathogenic variants of HGF, MET, and GAB1 were previously reported to be associated with human deafness DFNB39, DFNB97, and DFNB26, respectively. Our single-cell transcriptome data of mouse cochlea mRNA show expression of Map3k1 and its signaling partners in several inner ear cell types suggesting a requirement of wild-type MAP3K1 for normal hearing. In contrast to dominant variants of MAP3K1 associated with Disorders of Sex Development 46,XY sex-reversal, our computational modeling of the recessive substitution p.(Arg1487His) predicts a subtle structural alteration in MAP3K1, consistent with the limited phenotype of nonsyndromic deafness.
Persistent Vascular Complications in Long COVID: The Role of ACE2 Deactivation, Microclots, and Uniform Fibrosis
Authors: Sideratou Christina-Michailia , Papaneophytou Christos
Published: June 2024

Angiotensin-converting enzyme 2 (ACE2), a key regulator in vasoregulation and the renin–angiotensin system, is hypothesized to be downregulated in patients with COVID-19, leading to a cascade of cardiovascular complications. This deactivation potentially results in increased blood pressure and vessel injury, contributing to the formation and persistence of microclots in the circulation. Herein, we propose a hypothesis regarding the prolonged vascular complications observed in long COVID, focusing on the role of ACE2 deactivation and/or shedding, the persistence of microclots, and the unique pattern of fibrosis induced by severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2). Furthermore, we propose that the distinctive, uniform fibrosis associated with COVID-19, which is challenging to detect through conventional X-ray imaging, exacerbates vascular injury and impairs oxygenation. The persistence of these microclots and the unique fibrosis pattern are suggested as key factors in the extended duration of vascular complications post-COVID-19 infection, regardless of the initial disease severity. Moreover, plasma ACE2 activity has the potential to serve as prognostic or diagnostic biomarkers for monitoring disease severity and managing long COVID symptoms. Elucidating the role of ACE2 deactivation and the consequent events is vital for understanding the long-term effects of COVID-19. The experimental verification of this hypothesis through in vitro studies, clinical longitudinal studies, and advanced imaging techniques could yield significant insights into the pathophysiological mechanisms underlying long COVID, thereby improving the management of patients, particularly those with cardiovascular complications.
Automated Geospatial Approach for Assessing SDG Indicator 11.3.1: A Multi-Level Evaluation of Urban Land Use Expansion across Africa
Authors: Cardenas-Ritzert Orion S. E. , Vogeler Jody C. , Shah Heydari Shahriar , Fekety Patrick A. , Laituri Melinda , McHale Melissa
Published: June 2024

Geospatial data has proven useful for monitoring urbanization and guiding sustainable development in rapidly urbanizing regions. The United Nations’ (UN) Sustainable Development Goal (SDG) Indicator 11.3.1 leverages geospatial data to estimate rates of urban land and population change, providing insight on urban land use expansion patterns and thereby informing sustainable urbanization initiatives (i.e., SDG 11). Our work enhances a UN proposed delineation method by integrating various open-source datasets and tools (e.g., OpenStreetMap and openrouteservice) and advanced geospatial analysis techniques to automate the delineation of individual functional urban agglomerations across a country and, subsequently, calculate SDG Indicator 11.3.1 and related metrics for each. We applied our automated geospatial approach to three rapidly urbanizing countries in Africa: Ethiopia, Nigeria, and South Africa, to conduct multi-level examinations of urban land use expansion, including identifying hotspots of SDG Indicator 11.3.1 where the percentage growth of urban land was greater than that of the urban population. The urban agglomerations of Ethiopia, Nigeria, and South Africa displayed a 73%, 14%, and 5% increase in developed land area from 2016 to 2020, respectively, with new urban development being of an outward type in Ethiopia and an infill type in Nigeria and South Africa. On average, Ethiopia’s urban agglomerations displayed the highest SDG Indicator 11.3.1 values across urban agglomerations, followed by those of South Africa and Nigeria, and secondary cities of interest coinciding as SDG Indicator 11.3.1 hotspots included Mekelle, Ethiopia; Benin City, Nigeria; and Polokwane, South Africa. The work presented in this study contributes to knowledge of urban land use expansion patterns in Ethiopia, Nigeria, and South Africa, and our approach demonstrates effectiveness for multi-level evaluations of urban land expansion according to SDG Indicator 11.3.1 across urbanizing countries.
The Application of Space Syntax to Enhance Sociability in Public Urban Spaces: A Systematic Review
Authors: Askarizad Reza , Lamíquiz Daudén Patxi José , Garau Chiara
Published: June 2024

Public urban spaces are vital settings for fostering social interaction among people. However, understanding how spatial layouts can promote positive social behaviors remains a critical and debated challenge for urban designers and planners aiming to create socially sustainable environments. Space syntax, a well-established theory and research method, explores the influence of spatial configurations on social aspects. Despite its significant contributions, there is a lack of comprehensive systematic reviews evaluating its effectiveness in enhancing social interaction within urban public spaces. This study aims to identify the existing scientific gaps in the domain of space syntax studies, with a primary focus on sociability in public urban spaces. Following the PRISMA framework, a thorough literature search was conducted in the Scopus database, yielding 1107 relevant articles. After applying screening and eligibility criteria, 26 articles were selected for in-depth review. This review adopted a novel approach to synthesizing and analyzing the findings for identifying underexplored scientific gaps. The findings suggested a wide variety of research gaps to address, encompassing evidence, knowledge, practical, methodological, empirical, theoretical, and target populations to provide a thorough overview of the current state of knowledge in this field. In conclusion, by exploring the interplay between space syntax and design elements such as the urban infrastructure, landscaping, and microclimate in these areas, future research can bridge this gap, particularly when considering a cross-cultural lens. This study underscores the importance of space syntax in promoting social interaction in urban public spaces, offering a robust foundation for future research and practical applications to create more socially engaging environments.
Patients with a Bicuspid Aortic Valve (BAV) Diagnosed with ECG-Gated Cardiac Multislice Computed Tomography—Analysis of the Reasons for Referral, Classification of Morphological Phenotypes, Co-Occurring Cardiovascular Abnormalities, and Coronary Artery Stenosis
Authors: Machowiec Piotr , Przybylski Piotr , Czekajska-Chehab Elżbieta , Drop Andrzej
Published: June 2024

Background/Objectives: The aim of this study was to analyze a group of patients with a bicuspid aortic valve (BAV) examined with ECG-gated cardiac CT (ECG-CT), focusing on the assessment of the clinical reasons for cardiac CT, cardiovascular abnormalities coexisting with their BAV, and coronary artery stenosis. Methods: A detailed statistical analysis was conducted on 700 patients with a BAV from a group of 15,670 patients examined with ECG-CT. Results: The incidence of a BAV in ECG-CT was 4.6%. The most common reason for examination was suspicion of coronary heart disease—31.1%. Cardiovascular defects most frequently associated with a BAV were a VSD (4.3%) and coarctation of the aorta (3.6%), while among coronary anomalies, they were high-take-off coronary arteries (6.4%) and paracommissural orifice of coronary arteries (4.4%). The analysis of the coronary artery calcium index showed significantly lower values for type 2 BAV compared to other valve types (p < 0.001), with the lowest average age in this group of patients. Moreover, the presence of a raphe between the coronary and non-coronary cusps was associated with a higher rate of significant coronary stenosis compared to other types of BAVs (p < 0.001). Conclusions: The most common reason for referral for cardiac ECG-CT in the group ≤ 40-year-olds with a BAV was the suspicion of congenital cardiovascular defects, while in the group of over 40-year-olds, it was the suspicion of coronary artery disease. The incidence of cardiovascular abnormalities co-occurring with BAV and diagnosed with ECG-CT differs among specific patient subgroups. The presence of a raphe between the coronary and non-coronary cusps appears to be a potential risk factor for significant coronary stenosis in patients with BAVs.
KidsTUMove—A Holistic Program for Children with Chronic Diseases, Increasing Physical Activity and Mental Health
Authors: Stöcker Nicola , Gaser Dominik , Oberhoffer-Fritz Renate , Sitzberger Christina
Published: June 2024

The prevalence of chronic diseases in children and adolescents has risen alarmingly worldwide. Diseases such as asthma, diabetes, obesity, mental disorders, and congenital heart defects are increasingly affecting the lives of children and pose significant challenges for the healthcare system. Physical activity plays a crucial role in preventing and treating these diseases. Numerous studies have shown that regular exercise improves physical performance, increases well-being, and leads to better health in the long term. Specially tailored sports programs that meet the individual needs and abilities of the children and adolescents affected are particularly important. The KidsTUMove project addresses this by developing tailored exercise programs for children with chronic diseases’ specific needs, medical conditions, and physical abilities. Therefore, it closes the gap in care provision and can thus sustainably improve the health prospects of these children and adolescents. KidsTUMove is positioned to make a significant impact on the lives of affected children across Europe. Promotion of such programs should therefore be an integral part of future health strategies.
Nephrotoxicity Associated with Cytoreductive Surgery Combined with Cisplatin-Based Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Malignant Disease: A Systematic Review and Meta-Analysis
Authors: Grillo-Marín Cristián , Antón-Rodríguez Cristina , Prieto Lola , Ortega-Pérez Gloria , González-Moreno Santiago
Published: June 2024

Background: Cisplatin is employed in hyperthermic intraperitoneal chemotherapy (HIPEC) after cytoreductive surgery (CRS) for peritoneal surface malignancies (PSMs). The main concern regarding intraperitoneal cisplatin administration is nephrotoxicity. Numerous reports in this context are available. Our objective was to conduct a systematic review and meta-analysis to assess cisplatin-based HIPEC-related nephrotoxicity (CHRN). Methods: A systematic literature review on CHRN after CRS for the treatment of PSMs was performed. The literature search was carried out using Medline, Cochrane, and Embase. The last day of the search was 23 October 2023. PRISMA guidelines were used. A meta-analysis was then conducted. The main endpoint was the incidence of acute and chronic renal impairment after CHRN. Secondary endpoints included the potential impact of several clinical variables on the primary endpoint and a critical appraisal of the different renal impairment scales employed. Results: Our study included 26 articles with a total sample of 1473 patients. The incidence of acute kidney injury (AKI) was 18.6% (95% CI: 13.6–25%, range of true effects 3–59%). For chronic kidney disease, it was 7% (95% CI: 3–15.3%, range of true effects 1–53%). The variables that statistically influenced these results were the scale used to measure renal insufficiency, the use of nephroprotective agents, and the presence of pre-existing renal disease. Conclusions: The reported incidence of renal impairment following cisplatin-based HIPEC is highly variable. The incidence of renal failure obtained in this meta-analysis should be used as a reference for subsequent reports on this topic. Further prospective studies are warranted to establish optimal and standardized management.
Extracorporeal Membrane Oxygenation for Respiratory Failure: A Narrative Review
Authors: Grotberg John C. , Reynolds Daniel , Kraft Bryan D.
Published: June 2024

Extracorporeal membrane oxygenation support for respiratory failure in the intensive care unit continues to have an expanded role in select patients. While acute respiratory distress syndrome remains the most common indication, extracorporeal membrane oxygenation may be used in other causes of refractory hypoxemia and/or hypercapnia. The most common configuration is veno-venous extracorporeal membrane oxygenation; however, in specific cases of refractory hypoxemia or right ventricular failure, some patients may benefit from veno-pulmonary extracorporeal membrane oxygenation or veno-venoarterial extracorporeal membrane oxygenation. Patient selection and extracorporeal circuit management are essential to successful outcomes. This narrative review explores the physiology of extracorporeal membrane oxygenation, indications and contraindications, ventilator management, extracorporeal circuit management, troubleshooting hypoxemia, complications, and extracorporeal membrane oxygenation weaning in patients with respiratory failure. As the footprint of extracorporeal membrane oxygenation continues to expand, it is essential that clinicians understand the underlying physiology and management of these complex patients.
Using Pupillometry to Evaluate Balance in Patients Implanted with a Cochleo-Vestibular Implant
Authors: Tang Joyce , Ramos de Miguel Ángel , Falcón González Juan Carlos , Borkoski Barreiro Silvia , Rodriguez Montesdeoca Isaura , Ramos Macías Ángel
Published: June 2024

Maintaining balance comes naturally to healthy people. In subjects with vestibulopathy, even when compensated, and especially if it is bilateral, maintaining balance requires cognitive effort. Pupillometry is an established method of quantifying cognitive effort. Background/Objectives: We hypothesized that pupillometry would be able to capture the increased effort required to maintain posture in subjects with bilateral vestibulopathy in increasingly difficult conditions. Additionally, we hypothesized that the cognitive workload during balance tasks, indexed by pupil size, would decrease with the activation of the BionicVEST cochleo-vestibular implants. Methods: Subjects with a cochleo-vestibular implant as of March 2023 were recruited, excluding those with ophthalmological issues that precluded pupillometry. Pupillometry was performed using a validated modified videonystagmography system. Computed dynamic posturography and a Modified Clinical Test of Sensory Integration on Balance were performed while the pupil was recorded. Tests were first performed after 24 h of deactivating the vestibular component of the implant. Thereafter, it was reactivated, and after 1 h of rest, the tests were repeated. The pupil recording was processed using custom software and the mean relative pupil diameter (MRPD) was calculated. Results: There was an average of 10.7% to 24.2% reduction in MRPD when the vestibular implant was active, with a greater effect seen in tasks of moderate difficulty, and lesser effect when the task was easy or of great difficulty. Conclusions: Despite technical challenges, pupillometry appears to be a promising method of quantifying the cognitive effort required for maintaining posture in subjects with bilateral vestibulopathy before and after vestibular implantation.
Pyoderma Gangrenosum Post-Breast Surgery: A Case Report and Comprehensive Review of Management Strategies
Authors: Pop Ioan Constantin , Ilies Radu Alexandru , Baican Corina , Strilciuc Stefan , Muntean Valentin , Muntean Maximilian
Published: June 2024

Background/Objectives: Pyoderma gangrenosum (PG) is a rare, autoimmune skin condition characterized by painful, rapidly progressing ulcers, often associated with autoimmune dysregulation. Managing PG following breast surgery presents unique challenges due to its pathergy phenomenon, which complicates surgical interventions. This article outlines the case of PG in a 48-year-old female post-breast surgery and reviews management strategies through a systematic analysis of the literature. Methods: A systematic literature review from 2018 to 2023 identified 24 relevant articles on PG management post-breast surgery. The studies were analyzed to compare the efficacy and complications of conservative versus combined (conservative and surgical) treatment strategies. Results: Results indicate that while conservative management, primarily with corticosteroids, remains preferred, combined strategies, including systemic therapies, vacuum-assisted closure, and surgery, offer significant benefits in select cases. Conclusions: Our findings suggest that a personalized, multifaceted treatment plan is crucial for managing PG effectively, emphasizing the need for early detection, meticulous planning, and comprehensive care to optimize patient outcomes.
Psychometric Analysis of the Spanish-Language Version of the Instrument for the Evaluation of Handovers in Critically Ill Patients in Urgent and Emergency Care Settings
Authors: Tortosa-Alted Ruth , Reverté-Villarroya Silvia , Berenguer-Poblet Marta , Valls-Fonayet Francesc , Fernández-Sáez José , Martínez-Segura Estrella
Published: June 2024

Background/Objectives: Patient handover is the process by which the responsibility for care is transferred from one health care professional to another. Given the lack of validated scales to assess the handover of critically ill patients, our aim was to evaluate the reliability and validity of the Instrumento de Evaluación de la Transferencia de Enfermos Críticos (IETEC) (English: Instrument for the Evaluation of Handovers in Critically Ill Patients). Methods: Psychometric analysis of the reliability and validity (construct, convergent, and discriminant) of the IETEC. This single-center study included professionals (nurses, physicians, and emergency medical technicians) involved in the care of the critically ill in urgent care and emergency situations. Results: We evaluated 147 handovers of critically ill patients. The KR-20 score was 0.87, indicting good internal consistency. Of the 147 handovers, 117 (79.6%) were classified as unsafe and 30 (20.4%) as safe. The model fit showed an acceptable construct validity (24 items and four factors: Identification, Communication, Quality, and Family). The Communication domain had the strongest correlation with the total scale (r = 0.876) while Family had the weakest (r = 0.706). The Communication and Family domains were closely correlated (r = 0.599). The IETEC reliably differentiated between safe and unsafe handovers, with a mean (SD) score of 26.3 (1.2) versus 19.0 (4.8), respectively. No significant differences (p = 0.521) in mean IETEC scores were observed between the physicians and nurses. Conclusions: These results show that the IETEC presents adequate psychometric properties and is, therefore, a valid, reliable tool to evaluate handovers in critically ill patients in urgent care and emergency settings.
Surgical Outcomes of Adults with Spinal Caries from 1992 to 2019: A Single-Center Study-Risk Factors for the Progression of Kyphosis after Anterior Spinal Fixation Reveal Cases Needing Additional Posterior Instrumentation
Authors: Furukawa Mitsuru , Fujiyoshi Kanehiro , Kitagawa Takahiro , Shibata Reo , Hashimoto Shogo , Kobayashi Yoshiomi , Konomi Tsunehiko , Yato Yoshiyuki
Published: June 2024

Background: This study aims to investigate the postoperative improvement of paralysis, fusion rate and risk factors for kyphosis progression in adults affected with spinal caries. Methods: Overall, 134 patients with spinal caries from the thoracic to lumbar spine from 1992 to 2021 were included in this study. Data concerning the affected level (thoracic, thoracolumbar, lumbar, and lumbosacral), bone fusion rate, and progression of the postoperative local kyphosis angle were collected. The risk factors for the progression of local kyphosis angle after anterior spinal fixation (ASF) were determined using linear regression analysis. Results: Preoperatively, the degree of spinal cord paralysis was D and E on Frankel classification. Improvement of paralysis was good with surgery, especially from C, D. The overall bone fusion rate was 83.2%. The only factor influencing the progression of local kyphosis angle after ASF was the level of the affected vertebra. Progression of kyphosis angle after ASF was very advanced in the thoracolumbar transition area. Conclusions: Surgical improvement in paraplegia and the fusion rate of ASF with only grafted bone was good. However, in patients affected in the thoracolumbar spine region, posterior instrumentation is desirable because of local kyphosis progression risk after surgery.
Retinal Perfusion Analysis of Children with Diabetes Mellitus Type 1 Using Optical Coherence Tomography Angiography
Authors: Vasilijevic Jelena , Kovacevic Igor , Polovina Snezana , Dacic-Krnjaja Bojana , Kalezic Tanja , Miletic Suzana , Al Barri Leila , Stanca Simona , Ferrari Francis , Jesic Maja
Published: June 2024

(1) Background: This study aims to evaluate retinal perfusion by optical coherence tomography angiography (OCTA) in pediatric patients with type 1 diabetes mellitus (T1D) without diabetic retinopathy (DR). (2) Methods: Thirty-one patients affected by T1D were enrolled. All participants were evaluated using OCTA. The foveal avascular zone (FAZ) and superficial and deep macular vessel density (VD) were analyzed. The correlation of these parameters with metabolic factors such as body mass index (BMI), glycated hemoglobin (HbA1c), and the type of insulin therapy (multiple daily injections, MDI vs. continuous subcutaneous insulin infusion, CSII) was determined. (3) Results: None of the OCTA parameters were significantly different between the groups. The patients’ HbA1C level did not influence any of the OCTA parameters. The use of MDI tended to reduce the parafoveal and perifoveal deep VD (p = 0.048 and p = 0.021, respectively) compared to CSII. An elevated BMI tended to increase the deep macular (p = 0.005) and perifoveal VD (p = 0.006). (4) Conclusion: VD and FAZ are normal in pubescent children with T1D without signs of DR. Treatment with CSII may be a better choice compared to MDI, as CSII may be protective against retinal microvascular damage. Our results indicate the need for new clinical parameters of glycemic control in addition to HbA1c which could assess the risk of DR.
Diagnosis, Prevention, and Management of Fetal Growth Restriction (FGR)
Authors: Tsikouras Panagiotis , Antsaklis Panos , Nikolettos Konstantinos , Kotanidou Sonia , Kritsotaki Nektaria , Bothou Anastasia , Andreou Sotiris , Nalmpanti Theopi , Chalkia Kyriaki , Spanakis Vlasis , Iatrakis George , Nikolettos Nikolaos
Published: June 2024

Fetal growth restriction (FGR), or intrauterine growth restriction (IUGR), is still the second most common cause of perinatal mortality. The factors that contribute to fetal growth restriction can be categorized into three distinct groups: placental, fetal, and maternal. The prenatal application of various diagnostic methods can, in many cases, detect the deterioration of the fetal condition in time because the nature of the above disorder is thoroughly investigated by applying a combination of biophysical and biochemical methods, which determine the state of the embryo–placenta unit and assess the possible increased risk of perinatal failure outcome and potential for many later health problems. When considering the potential for therapeutic intervention, the key question is whether it can be utilized during pregnancy. Currently, there are no known treatment interventions that effectively enhance placental function and promote fetal weight development. Nevertheless, in cases with fetuses diagnosed with fetal growth restriction, immediate termination of pregnancy may have advantages not only in terms of minimizing perinatal mortality but primarily in terms of reducing long-term morbidity during childhood and maturity.
Beta Maximum Power Extraction Operation-Based Model Predictive Current Control for Linear Induction Motors
Authors: Ghalib Mohamed. A. , Hamad Samir A. , Elmorshedy Mahmoud F. , Almakhles Dhafer , Ali Hazem Hassan
Published: June 2024

There is an increasing interest in achieving global climate change mitigation targets that target environmental protection. Therefore, electric vehicles (as linear metros) were developed to avoid greenhouse gas emissions, which negatively impact the climate. Hence, this paper proposes a finite set-model predictive-based current control (FS-MPCC) strategy of linear induction motor (LIM) for linear metro drives fed by solar cells with a beta maximum power extraction (B-MPE) control approach to achieve lower thrust ripples and eliminate a selection of weighting factors, the main limitation of conventional model predictive-based thrust control (which can be time consuming and challenging). The B-MPE control approach ensures that the solar cells operate at their maximum power output, maximizing the energy harvested from the sun. Considering a single cost function of primary current errors between the predicted values and their references in αβ-axes, the proposed method eliminates the need for weighting factor selection, thus simplifying the control process. A comparison between the conventional and the presented control method is conducted using MATLAB/Simulink under different scenarios. Comprehensive simulation results of the presented system on a 3 kW LIM prototype revealed that the introduced system based on FS-MPCC surpasses the conventional technique, resulting in a maximum power extraction from solar cells and a suppression of the thrust ripples as well as an avoidance of weighting factor tuning, leading to fewer computational steps.
Analyzing the Dynamics of Customer Behavior: A New Perspective on Personalized Marketing through Counterfactual Analysis
Authors: Ebadi Jalal Mona , Elmaghraby Adel
Published: June 2024

The existing body of research on dynamic customer segmentation has primarily focused on segment-level customer purchasing behavior (CPB) analysis to tailor marketing strategies for distinct customer groups. However, these approaches often lack the granularity required for personalized marketing at the individual level. Moreover, the analysis of customer transitions between different groups has largely been overlooked. This study addresses these gaps by developing an efficient framework that enables businesses to forecast customer behavior, assess the impact of various strategies on each customer separately, and analyze customer transition between segments. This can facilitate providing personalized marketing strategies, fostering a gradual transition toward a desired customer status, and enhancing the overall marketing precision. In this study, we employ time series feature vectors encompassing recency, frequency, monetary value, and lifespan, applying the K-means algorithm with a range of distance metrics for customer segmentation along with classification algorithms to predict customer behavior. Leveraging counterfactual analysis, we establish a solution for analyzing customer transitions between groups and evaluating personalized marketing strategies. Our findings underscore the superior performance of the Euclidean distance metric, closely followed by the Manhattan distance, in distinguishing the patterns in time series customer behavior, with logistic regression excelling in predicting customer status. This study enables decision-makers to forecast the impact of diverse marketing strategies on customer behavior which facilitates customer retention and engagement through well-informed decisions.
Feature-Differencing-Based Self-Supervised Pre-Training for Land-Use/Land-Cover Change Detection in High-Resolution Remote Sensing Images
Authors: Feng Wenqing , Guan Fangli , Sun Chenhao , Xu Wei
Published: June 2024

Land-use and land-cover (LULC) change detection (CD) is a pivotal research area in remote sensing applications, posing a significant challenge due to variations in illumination, radiation, and image noise between bi-temporal images. Currently, deep learning solutions, particularly convolutional neural networks (CNNs), represent the state of the art (SOTA) for CD. However, CNN-based models require substantial amounts of annotated data, which can be both expensive and time-consuming. Conversely, acquiring a large volume of unannotated images is relatively easy. Recently, self-supervised contrastive learning has emerged as a promising method for learning from unannotated images, thereby reducing the need for annotation. However, most existing methods employ random values or ImageNet pre-trained models to initialize their encoders and lack prior knowledge tailored to the demands of CD tasks, thus constraining the performance of CD models. To address these challenges, we introduce a novel feature-differencing-based framework called Barlow Twins for self-supervised pre-training and fine-tuning in CD (BTCD). The proposed approach employs absolute feature differences to directly learn unique representations associated with regions that have changed from unlabeled bi-temporal remote sensing images in a self-supervised manner. Moreover, we introduce invariant prediction loss and change consistency regularization loss to enhance image alignment between bi-temporal images in both the decision and feature space during network training, thereby mitigating the impact of variation in radiation conditions, noise, and imaging viewpoints. We select the improved UNet++ model for fine-tuning self-supervised pre-training models and conduct experiments using two publicly available LULC CD datasets. The experimental results demonstrate that our proposed approach outperforms existing SOTA methods in terms of competitive quantitative and qualitative performance metrics.
Coupling Coordination Relationship and Spatiotemporal Heterogeneity between Urbanization and Ecosystem Services in the Songhua River Basin
Authors: Bai He , Chen Yuanyuan , Wang Shaohan , Chu Rui , Fang Jiyuan , Zhang Huina , Xing Shuhan , Wang Lei , Xu Dawei
Published: June 2024

Rapid urbanization in the Songhua River Basin (SRB), a crucial ecological barrier in China and Northeast Asia, has led to the degradation of ecosystem service functions and a decline in their value, thereby posing a significant threat to regional ecological security. Clarifying the complex coupling coordination relationship between urbanization and ecosystem services (ESs) and identifying the spatiotemporal heterogeneity of their interactions will facilitate the high-quality and coordinated development of urbanization and ESs in the SRB. This study employed a systems approach, treating urbanization and ESs as overarching systems and delineating different aspects of urbanization and ecosystem service functions as subsystems within these systems. The spatiotemporal characteristics of urbanization and the ecosystem service value (ESV) in the SRB from 1985 to 2021 were revealed. The coupling coordination relationship and the spatiotemporal heterogeneity of the interactions between urbanization and ESs in the SRB at both the system and subsystem levels were analyzed using the coupling coordination degree (CCD) model and the spatiotemporal geographically weighted regression (GTWR) model. The findings indicated that during the study period: (1) The urbanization index of SRB rose from 0.09 to 0.34, while the ESV experienced a decrease from 2091.42 × 107 CNY to 2002.44 × 107 CNY. (2) The coupling coordination degree (CCD) between urbanization and ESs in the SRB at both the system and subsystem levels increased significantly, generally transitioning from the moderately unbalanced to the basically balanced stage. Areas with high CCD values were mainly distributed in ecological function areas and low-level urbanized areas, while areas with low CCD values were mainly distributed in grassland ecological degradation areas, ecologically fragile areas, resource-dependent old industrial cities, and highly urbanized areas. (3) The subsystems of urbanization had an overall negative impact on Ess, with varying trends, but the spatial distribution pattern of the interactions remained relatively stable. Conversely, the subsystems of ESs all exhibited a trend of initially strengthening and then weakening their negative impacts on urbanization, and the spatial distribution pattern was highly correlated with the spatial distribution pattern of ESV in the SRB.