bluuebunny/crossref_metadata_2025 huggingface dataset:
Efficacy of High-Intensity Training in Patients with Moderate to Severe Dysphagia after Glossectomy
Authors: Pavlidou Elena , Kyrgidis Athanasios , Vachtsevanos Konstantinos , Constantinidis Jannis , Triaridis Stefanos , Printza Athanasia
Published: August 2023

Dysphagia is the main impairment arising from glossectomy for tongue cancer treatment. The study aimed to determine if an eight-week training protocol paired with accuracy tasks and swallowing exercises is effective and can improve tongue strength and swallowing in patients after tongue resection. Maximum isometric pressures, tongue endurance, swallowing pressures, mealtime duration, and oropharyngeal swallow function were studied in patients with moderate to severe dysphagia after glossectomy. Twenty-five (25) patients and thirty-one (31) healthy participants were enrolled in the study. The therapy group (TG) consisted of seventeen (17) patients who followed an 8-week treatment protocol and had multiple measurements. The follow-up control group (FUG) consisted of eight non-treated patients who had a baseline and an 8-week follow-up examination. Healthy participants served as the reference group (RF). Maximum isometric pressures, endurance, and swallowing pressures increased significantly in the TG versus the FUG. Significant improvement was documented in the TG regarding the EAT-10 questionnaire, the Penetration-Aspiration Scale scores at thickened and solid boluses, and post-swallow residues at thickened and solid boluses. The treatment protocol with tongue strength exercises combined with accuracy tasks and swallowing exercises improves the post-operative swallowing function in patients after glossectomy. Patients in the TG had more significant and quicker improvement in pressures and endurance compared to FUG.
Retinitis Pigmentosa Masquerades: Case Series and Review of the Literature
Authors: Thenappan Abinaya , Nanda Arjun , Lee Chang Sup , Lee Sun Young
Published: August 2023

Retinitis pigmentosa (RP) displays a broad range of phenotypic variations, often overlapping with acquired retinal diseases. Timely recognition and differentiation of RP masquerades is paramount due to the treatable nature of many such conditions. This review seeks to present examples of pseudo-RP cases and provide a comprehensive overview of RP masquerades. We first present two pseudo-RP cases, including comprehensive clinical histories and multimodal retinal imaging, to highlight the important role of accurate diagnoses that subsequently steered effective intervention. Subsequently, we conduct an in-depth review of RP masquerades to provide valuable insights into their key distinguishing features and management considerations. The recent approval of ocular gene therapy and the development of investigational gene-based treatments have brought genetic testing to the forefront for RP patients. However, it is important to note that genetic testing currently lacks utility as a screening tool for inherited retinal diseases (IRDs), including RP. The integrity of a precise clinical assessment remains indispensable for the diagnosis of both RP and RP masquerade conditions, thereby facilitating prompt intervention and appropriate management strategies.
Chronotype and Cardiometabolic Parameters in Patients with Bipolar Disorder: Preliminary Findings
Authors: Aguglia Andrea , Natale Antimo , Conio Benedetta , De Michiel Clio , Lechiara Alessio , Pastorino Fabrizio , Fusar-Poli Laura , Costanza Alessandra , Amerio Andrea , Amore Mario , Serafini Gianluca
Published: August 2023

Cardiometabolic alterations are very common in bipolar disorder (BD). The aim of this study was to investigate the relationship between chronotype and cardiometabolic parameters in patients with a primary diagnosis of BD. This study is an observational clinical investigation including 170 subjects consecutively admitted to the Psychiatric Inpatient Unit of the IRCCS Ospedale Policlinico San Martino (Genoa, Italy), recruited over a period of 48 months. A psychometric tool assessing chronotype was administered and blood tests were performed. Furthermore, the atherogenic coefficient ((total cholesterol–HDL cholesterol)/HDL cholesterol), and Castelli risk index-I (total cholesterol/HDL cholesterol) and -II (LDL cholesterol/HDL cholesterol) were calculated. Patients with BD and an eveningness chronotype showed a higher body mass index, total and low-density lipotrotein cholesterol compared to patients with BD and an intermediate or morning chronotype. Furthermore, the Atherogenic Coefficient and Castelli Risk-Index I–II were found to be higher in bipolar patients with an evening chronotype. The role of chronotype in the development of obesity and cardiovascular risk is, therefore, a relationship worth being investigated, especially in the context of BD, to ameliorate the clinical and therapeutic approach, aiming at increasing the quality of life and reducing the mortality.
Influence of a Structured Microbiological Endotracheal Monitoring Program on the Outcome of Critically Ill COVID-19 Patients: An Observational Study
Authors: Dibos Miriam , Haschka Stefanie Julia , Abbassi Rami , Schneider Jochen , Schmid Roland M. , Rasch Sebastian , Lahmer Tobias
Published: August 2023

Background: In past influenza pandemics and the current COVID-19 pandemic, bacterial endotracheal superinfections are a well-known risk factor for higher morbidity and mortality. The goal of this study was to investigate the influence of a structured, objective, microbiological monitoring program on the prognosis of COVID-19 patients with mechanical ventilation. Methods: A structured microbiological monitoring program (at intubation, then every 3 days) included collection of endotracheal material. Data analysis focused on the spectrum of bacterial pathogens, mortality, as well as intensive care unit (ICU), hospital, and mechanical ventilation duration. Results: A total of 29% of the patients showed bacterial coinfection at the time of intubation, and within 48 h, 56% developed ventilator-associated pneumonia (VAP). Even though patients with VAP had significantly longer ICU, hospital, and mechanical ventilation durations, there was no significant difference in mortality between patients with VAP pneumonia and patients without bacterial infection. Conclusion: VAP is a common complication in COVID-19 patients. In contrast to already published studies, in our study implementing a structured microbiological monitoring program, COVID-19 patients with bacterial coinfection or VAP did not show higher mortality. Thus, a standardized, objective, microbiological screening can help detect coinfection and ventilator-associated infections, refining anti-infective therapy and positively influencing patient outcomes.
Interrelationships between Peak Strain Dispersion, Myocardial Work Indices, Isovolumetric Relaxation and Systolic–Diastolic Coupling in Middle-Aged Healthy Subjects
Authors: Minczykowski Andrzej , Guzik Przemysław , Sajkowska Anna , Pałasz-Borkowska Anna , Wykrętowicz Andrzej
Published: August 2023

In echocardiography, peak strain dispersion (PSD) is the standard deviation of the time to peak longitudinal strain for each left ventricular (LV) segment during systole. It assesses the coordination and synchrony of LV segment contractility. Global work efficiency (GWE) and global wasted work (GWW) quantify LV myocardial work and, if impaired, the coupling between LV systolic contraction and early relaxation. Isovolumetric relaxation (IVRT) measures the duration of initial LV relaxation, while the ratio of early diastolic recoil to systolic excursion (E′VTI/S′VTI) describes systolic–diastolic coupling. We evaluated these parameters in 69 healthy subjects and found that PSD correlated negatively with GWE (r = −0.49, p < 0.0001) and E′VTI/S′VTI (r = −0.44, p = 0.0002), but positively with GWW (r = 0.4, p = 0.0007) and IVRT (r = 0.53, p < 0.0001). GWE correlated negatively with GWW (r = −0.94, p < 0.0001) and IVRT (r = −0.30, p = 0.0127), but positively with E′VTI/S′VTI (r = 0.3, p = 0.0132). In addition, E′VTI/S′VTI was negatively correlated with GWW (r = −0.35, p = 0.0032) and IVRT (r = −0.36, p = 0.0024). These associations remained significant after adjustment for sex, age and LV mass index of the subjects. In conclusion, there is an interaction between measures of LV asynchrony, myocardial work, diastolic function and its systolic–diastolic coupling in middle-aged healthy subjects. The clinical value of these interactions requires further investigation.
Endometriosis and Adolescence: The Impact of Dysmenorrhea
Authors: Martire Francesco G. , Piccione Emilio , Exacoustos Caterina , Zupi Errico
Published: August 2023

Endometriosis affects approximately 10% of premenopausal women worldwide. Despite its impact on quality of life, the delay in diagnosing this chronic disease is well known. Many patients with endometriosis report having suffered from dysmenorrhea and chronic pelvic pain in adolescence or at a young age. However, this painful symptom is often highly underestimated and considered a normal and transient symptom in young women. The real prevalence of endometriosis in adolescence remains uncertain. Some authors recently described at least one ultrasound feature of endometriosis in 13.3% of a general population of adolescent girls, which increased to 35.3% in young girls with severe dysmenorrhea. Dysmenorrhea is classified as primary dysmenorrhea or secondary dysmenorrhea. Primary dysmenorrhea is defined as a menstrual pain without organic disease, while secondary dysmenorrhea is defined as a menstrual pain associated with organic pelvic pathology. Since endometriosis represents the main cause of secondary dysmenorrhea in adolescents and young women, it is important to determine whether the patient has primary dysmenorrhea or additional suggestive symptoms related to endometriosis. Endometriosis in adolescent patients is a challenging problem with clinical and pathological differences compared with its presentation in premenopausal women. Adolescents and young women with dysmenorrhea and painful symptoms that suggest endometriosis should be referred to dedicated endometriosis centers for an early diagnosis and appropriate medical and surgical management. This paper aims to describe the role of dysmenorrhea in adolescents and the management of these young patients to confirm or exclude endometriosis.
Prognostic Impact of Percutaneous Coronary Intervention in Older Patients Hospitalized with Acute Myocardial Infarction: Real-World Findings from the Lombardy Health Database
Authors: Marenzi Giancarlo , Cosentino Nicola , Resta Marta , Lucci Claudia , Bonomi Alice , Trombara Filippo , Della Rocca Michele , Poggio Paolo , Leoni Olivia , Bortolan Francesco , Savonitto Stefano , Agostoni Piergiuseppe
Published: August 2023

Background. Older patients are less likely to receive percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) compared to younger patients. We investigated the prognostic impact of PCI in a large population of patients hospitalized with AMI in the period 2003–2018 by using the administrative Lombardy Health Database (Italy). Methods. We considered all patients aged ≥75 years hospitalized with AMI (either STEMI or NSTEMI) from 2003 to 2018 in Lombardy. Patients were grouped according to whether they were treated or not with PCI during the index hospitalization. The primary outcome was in-hospital mortality. The secondary endpoints were 1-year mortality and 1-year re-hospitalization for acute heart failure (AHF) or AMI. Results. 116,063 patients aged ≥75 years (mean age 83 ± 6; 48% males; 46% STEMI) were hospitalized with a primary diagnosis of AMI. Thirty-seven percent of them (n = 42,912) underwent PCI. The in-hospital mortality rate was significantly lower in PCI-treated patients (6% vs. 15%; p < 0.0001). One-year mortality and 1-year re-hospitalization for AHF/AMI were less frequent in PCI-treated patients (16% vs. 41% and 15% vs. 21%, respectively; p < 0.0001). The adjusted risks of the study endpoints were lower in PCI-treated patients: OR 0.37 (95% CI 0.36–0.39) for in-hospital mortality; HR 0.37 (95% CI 0.36–0.38) for 1-year mortality; HR 0.74 (95% CI 0.71–0.77) for 1-year re-hospitalization for AHF/AMI. Similar results were found in STEMI and NSTEMI patients considered separately. Conclusions. Our real-world data showed that in patients with AMI ≥ 75 years of age, PCI use is associated with lower in-hospital and 1-year mortality.
Multicenter Retrospective Andalusian Study of the Use of Sonidegib for the Treatment of Local Advanced Basal Cell Carcinoma in Real Clinical Practice
Authors: Ruiz-Villaverde Ricardo , Herrera-Acosta Enrique , Ruiz de Casas Andres , Villegas-Romero Isabel M. , Moreno-Suárez Fátima G. , Vílchez-Márquez Francisco , Galán-Gutiérrez Manuel , Vázquez-Bayo Maria Carmen , Cases-Mérida Sandra , Almazán-Fernández Francisco M.
Published: August 2023

Introduction: Locally advanced basal cell carcinoma (LA-BCC) is defined as that BCC in which there is radiological confirmation of invasion of certain neighboring structures in depth and also, usually, a BCC that is of a sufficient size and invasion (although there is no radiological demonstration of deep invasion) in which surgery and radiotherapy are not adequate, are insufficient or are contraindicated to achieve the cure of the tumor, either due to characteristics of the tumor itself or of the patient. Sonidegib is indicated for the treatment of adult patients with locally advanced basal cell carcinoma that is not amenable to curative surgery or radiotherapy. Material and methods: This is a retrospective, multicenter and descriptive study in nine centers in Andalusia, Spain. Patients treated with sonidegib for >3 months for locally advanced BCC were included from 1 January 2021 to 1 January 2023. Epidemiological, efficacy and safety data were collected. Results: In the present study, a total of 38 patients were included, with a median age of 76.23 years (range 40–101). Prior treatment was surgery (31.57%; n = 25), radiotherapy (15.78%; n = 6), vismodegib (31.57%; n = 12). Eleven patients had not received prior treatment. LA-BCC were located in the cephalic pole, face or scalp. There was a total response in 9/38 patients (23.7%), partial response in 25/38 patients (65.8%) and no response in 4 patients (10.52%). In 6/34 patients, the dose was reduced to 200 mg every other day until it was discontinued due to adverse effects. The main adverse effects reported were dysgeusia (n = 8), asthenia (n = 8), = 6), muscle spasms (n = 6), alopecia (n = 4) and gastrointestinal intolerance (n = 4). Discussion: Sonidegib is the second iHh authorized for the treatment of adult patients with locally advanced BCC who are not amenable to curative surgery or radiotherapy, based on the results of the phase II clinical trial, BOLT. Sonidegib shows good effectiveness and an acceptable safety profile in routine clinical practice in the sample presented.
Epithelioid Sarcoma of the Spine: A Review of Literature and Case Report
Authors: Tan Yi Liang , Ong Wilson , Tan Jiong Hao , Kumar Naresh , Hallinan James Thomas Patrick Decourcy
Published: August 2023

Epithelioid sarcoma is a rare malignant mesenchymal tumor that represents less than 1% of soft-tissue sarcomas. Despite its slow growth, the overall prognosis is poor with a high rate of local recurrence, lymph-node spread, and hematogenous metastasis. Primary epithelioid sarcoma arising from the spine is extremely rare, with limited data in the literature. We review the existing literature regarding spinal epithelioid sarcoma and report a case of epithelioid sarcoma arising from the spinal cord. A 54 year old male presented with a 1-month history of progressive left upper-limb weakness and numbness. Magnetic resonance imaging (MRI) of the spine showed an enhancing intramedullary mass at the level of T1 also involving the left T1 nerve root. Systemic radiological examination revealed no other lesion at presentation. Surgical excision of the mass was performed, and histology was consistent with epithelioid sarcoma of the spine. Despite adjuvant radiotherapy, there was aggressive local recurrence and development of intracranial metastatic spread. The patient died of the disease within 5 months from presentation. To the best of our knowledge, spinal epithelioid sarcoma arising from the spinal cord has not yet been reported. We review the challenges in diagnosis, surgical treatment, and oncologic outcome of this case.
Assessment of Prevalence and Risk Factors for Central Sensitization Related to Shoulder Osteoarthritis and Rotator Cuff Tears Using the Central Sensitization Inventory: A Cross-Sectional Study in Shoulder Surgery Patients
Authors: Iio Ryosuke , Manaka Tomoya , Nakazawa Katsumasa , Hirakawa Yoshihiro , Ito Yoichi , Ogura Ayako , Nakamura Hiroaki
Published: August 2023

Shoulder disorders occasionally cause intractable pain. Central sensitization (CS) may be involved in such pain. Identifying risk factors associated with CS is crucial for effective pain control. This study aimed to determine the effects of shoulder osteoarthritis and rotator cuff tears (RCT) on CS and associated factors. This study included patients evaluated for CS using the Central Sensitization Inventory (CSI) before surgery for shoulder osteoarthritis, RCT, or cuff tear arthropathy. Patients with a CSI score of 40 or higher were defined as having CS. The relationships between glenohumeral osteoarthritis (GHOA), RCT size, and CS were statistically analyzed. Multiple regression analysis was performed to examine the factors affecting CSI scores. Subjects included 167 patients: 131 patients had RCT without GHOA, 23 had GHOA with RCT, and 13 had GHOA without RCT. The GHOA group had a significantly higher CSI score (27.5 [10.8–40.5] vs. 18.0 [10.0–27.5]) and CS prevalence (27.8% vs. 8.4%) than the RCT without GHOA group. There was no significant correlation between RCT size and CSI scores. Multiple regression analysis showed that female sex, severe pain, and long pain duration were associated with higher CSI scores. Considering the risk factors for CS might be helpful in shoulder treatment.
All-Cause Mortality and Its Predictors in Haemato-Oncology Patients with Febrile Neutropenia
Authors: Shmuely Haim , Monely Lea , Shvidel Lev
Published: August 2023

Febrile neutropenia (FN) is one of the most important life-threatening complications in haemato-oncology. Our objective was to report all-cause mortality rates in patients ill with a hematological malignancy (HM) hospitalized with a first FN episode and to identify predictors for mortality. We conducted a historical retrospective cohort study of consecutive patients with an HM, >18 years of age, admitted between January 2012 and August 2018 for a first episode of FN. Data on all-cause mortality 12 months after admission for FN were obtained. The Kaplan–Meier curve was used to describe mortality during the follow-up period. Univariate and multivariable analyses identified predictors for 1,3 and 12-month mortality. One hundred and fifty-eight patients (mean age 69.5, 49.4% males) were included. Overall, 54 patients died (15.8%, 25.9%, and 34.1% died after 1, 3, and 12 months, respectively). Lower serum albumin, higher serum gamma-glutamyl transferase (GGT), lower estimated glomerular filtration rate (eGFR), older age, higher temperature, and lower absolute lymphocyte count at admission were independent predictors of all-cause mortality after 12 months. Further studies are needed to confirm our results and identify therapeutic strategies to improve survival.
Atmospheric Wind and Pressure-Driven Changes in Tidal Characteristics over the Northwestern European Shelf
Authors: Challis Jack , Idier Déborah , Wöppelmann Guy , André Gaël
Published: August 2023

Understanding drivers of tidal change is a key challenge in predicting coastal floods in the next century. Whilst interactions between tides and atmospheric surges have been studied, the effects of wind and pressure on tides on an annual scale over the Northwestern European shelf have not been investigated. Here, a modelling approach using the shallow water MARS model is carried out to understand and quantify meteorological effects on tidal characteristics. The model setup is validated against the GESLA 3 tide gauge database. Combined and relative influences of wind and pressure are investigated using four modelling scenarios: tide only; tide, wind, and pressure; tide and wind; and tide and pressure. Influences are investigated using a single year of tidal forcing, and across multiple years of meteorological data to examine the sensitivity to temporally changing meteorological conditions. It is found that meteorology influences tidal constituent amplitudes by +/−1 cm, yielding changes that may locally reach 15 cm in the predicted highest tide. Analysis of the shallow water equations show three non-linear interaction terms between tide, wind, and pressure (advective effects, quadratic parameterization of bottom friction, and shallow water effect). Part of the observed changes is shown to arise from meteorologically induced mean sea-level changes.
A Safety Assessment Model for Handling Dangerous Goods in Port Operations: The Key Role of Detection Capability
Authors: Tseng Po-Hsing , Pilcher Nick
Published: August 2023

Recently, resilience studies have been emphasized in the port field, recognizing that many high-risk and unsafe factors in ports might bring serious disasters and economic losses. One major cause of significant losses is accidents from fires, explosions, and the resultant adverse impacts from dangerous goods. Whilst the occurrence of major events related to dangerous goods is relatively low in occurrence, their impact on the environment and economic and social loss, and on human casualties, can be extremely high when they do occur. In order to prevent potential risks and reduce losses, based on a literature review, a safety assessment model was developed with four criteria and 15 sub-criteria of dangerous goods in ports using a fuzzy analytic hierarchy process (FAHP) approach. This model formed the basis for a subsequent stage involving questionnaires with 25 experts. The results of these questionnaires found that the key criteria are detection capability, followed by recovery capability, rescue capability, and resistance capability. Sensitivity analysis is used to identify the criteria’s weight value changes under various scenarios. These findings concern dangerous goods operations management in ports. Critically, these findings emphasize the key role played in the initial stages of determining precisely and exactly what specific goods are in fact dangerous goods, thereby avoiding a domino effect of adverse consequences later. Suggestions are made for policymakers regarding funding and supporting processes for handling dangerous goods, as well as for future research.
Increase in Chronic Medications and Polypharmacy—The Multifaceted Burden of COVID-19 Disease on Public Health Care
Authors: Gallo Antonella , Covino Marcello , Lipari Alice , Pellegrino Simona , Ibba Francesca , Agnitelli Maria Chiara , Tosato Matteo , Landi Francesco , Montalto Massimo ,   Gemelli against COVID-19 Post-Acute Care Team
Published: August 2023

The long-term impact of COVID-19 disease is becoming a major global concern. In this retrospective monocentric analysis, we included consecutive subjects admitted to our COVID-19 Post-Acute Care Service for a SARS-CoV-2 infection that occurred between three and twelve months before. A home medication list relative to the period before SARS-CoV-2 infection (baseline) was recorded and compared with that one relative to the time of outpatient visit (follow-up). Drugs were coded according to the Anatomical Therapeutic Chemical Classification (ATC) System. In a total of 2007 subjects, at follow-up, a significant increase with respect to baseline was reported in the total median number of chronic medications (two [0–4] vs. one [0–3]) and in specific ATC-group drugs involving the alimentary, blood, cardiovascular, genitourinary, muscle–skeletal, nervous and respiratory systems. In a multivariate analysis, COVID-19 disease severity and age > 65 years resulted in the best predictors for an increase in the number of medications, while anti-SARS-CoV-2 vaccination played a significant protective role. The long-term care of patients infected by COVID-19 may be more complex than reported so far. Multidisciplinary and integrated care pathways should be encouraged, mainly in older and frailer subjects and for patients experiencing a more severe disease. Vaccination may also represent a fundamental protection against long-term sequelae.
Hearing Impairment and Neuroimaging Results in Mitochondrial Diseases
Authors: Cadoni Gabriella , Primiano Guido , Picciotti Pasqualina M. , Calandrelli Rosalinda , Galli Jacopo , Servidei Serenella , Conti Guido
Published: August 2023

Mitochondrial diseases (MDs) are heterogeneous genetic disorders characterized by mitochondrial DNA (mtDNA) defects, involving tissues highly dependent on oxidative metabolism: the inner ear, brain, eye, skeletal muscle, and heart. We describe adult patients with genetically defined MDs, characterizing hearing function and neuroimaging results. We enrolled 34 patients (mean age: 50.02 ± 15 years, range: 18–75 years; 20 females and 14 males) classified in four groups: MELAS, MIDD, PEO, and Encephalopathy/Polyneuropathy. Audiological evaluations included psychoacoustical tests (pure-tone and speech audiometry), electrophysiological tests (Auditory Brainstem Responses, ABRs), and Impedenzometry. Neuroimaging evaluations considered global MRI abnormalities or structural brain changes. In total, 19/34 patients carried the m.3243A > G mutation (6 affected by MELAS, 12 affected by MIDD, and 1 affected by PEO); 11 had an mtDNA deletion (all affected by PEO); 3 had nuclear genes associated with MDs (POLG1 and OPA1); and 1 patient had an mtDNA deletion without an identified nuclear gene defect (affected by PEO). Sensory neural, bilateral, and symmetrical hearing loss was present in 25 patients (73.5%) to different degrees: 9 mild, 9 moderate, 5 severe, and 2 profound. The severe/profound and mild hearing losses were associated with pantonal and high-frequency audiograms, respectively. Instead, moderate hearing losses were associated with both high-frequency (five cases) and pantonal (five cases) audiogram shapes. In addition, 21/25 patients showed a cochlear site of lesion (84%), and 4/25 (16%) showed a retrocochlear site. We found global MRI abnormalities or structural brain changes in 26/30 subjects (86.6%): 21 had white matter abnormalities, 15 had cortical atrophy, 10 had subcortical atrophy, 8 had basal nuclei involvement or cerebellar atrophy, 4 had stroke-like lesions or laminar necrosis, and 1 had cysts or vacuolated lesions. We concluded that genetic alterations are associated with different clinical presentations for both auditory function and neuroradiological findings. There is no fixed relationship between genotype and phenotype for the clinical conditions analyzed.
Grounded in the Landscape—Climate Action, Well-Being and Public Space in a Small Town in the Lisbon Metropolitan Area
Authors: Morgado Sofia , Cunha Jeanna de Campos
Published: August 2023

Retaining their ancestral footprint, rural settlements anchored developments driven by suburbanisation and became small towns embedded in the generic metropolitan landscape in the late 20th century. In subsequent phases, they integrated the functional diversity necessary to maintain a certain autonomy, while always being rooted in a community whose bonds are densified. In the specific case of Queijas, in the municipality of Oeiras (Lisbon metropolitan area), apart from the recent identification of the historical nucleus and the maintenance of public spaces, one can infer from the Oeiras Municipal Master Plan (2022) the need for an integrated approach to urban design and planning, which is linked to the requalification of place and the community. That is how climate action, well-being and public space took priority as the leading factors in the present study.
Straw Mulch Application Enhanced Soil Properties and Reduced Diffuse Pollution at a Steep Vineyard in Istria (Croatia)
Authors: Dugan Ivan , Pereira Paulo , Defterdarovic Jasmina , Filipovic Lana , Filipovic Vilim , Bogunovic Igor
Published: August 2023

Straw mulching is a sustainable practice used to control soil erosion. However, different doses of mulch affect the efficiency of straw conservation. This study presents detailed research on how soil physicochemical properties and the hydrological response react to different types of vineyard soil management (Tilled, Grass, Low Straw, High Straw) and seasons (spring, summer, autumn) under conventional management on Anthrosols in Mediterranean conditions. To assess soil properties, core samples and disturbed samples were taken from the topsoil layer (0–10 cm). To evaluate erosion rates, a rainfall simulation experiment was conducted (58 mm h−1 for 30 min) with 10 replicates per treatment and season (120 in total). The results show higher water-stable aggregates (WSA) and soil organic matter (SOM) and lower bulk density (BD) in the mulch and grass treatment groups compared with the Tilled treatment group. High Straw treatment successfully mitigated runoff, while other treatments had significantly higher runoff that triggered sediment loss (SL) and translocation of P, K, Zn and Ni down the slope. There were 254% and 520% higher K losses with Tilled treatment in autumn compared with Low Straw and Grass treatments, respectively. Statistical analysis showed a strong association between element loss and SL, which indicates an ecological threat in degraded and endangered vineyards. Mulch application and grass cover reduce the vulnerability of vineyards, reduce evaporation, act as insulation against high temperatures, reduce erosion and suppress weed growth. The mulch dosage varies depending on the goals and conditions of the vineyard; thus, lower mulch dosage (2 t/ha) is appropriate when soil conditions are favourable and there is no significant need for moisture retention, while higher mulch dosage is necessary in dry regions to maintain soil moisture during high-temperature periods, as well as in sloped areas subjected to erosion.
Spatiotemporal Variations in the Carbon Sequestration Capacity of Plateau Lake Wetlands Regulated by Land Use Control under Policy Guidance
Authors: Chen Bo , Zhang Meiqi , Yang Rui , Tang Wenling
Published: August 2023

Lake wetlands play a crucial role in mitigating climate change. Human activities and climate change impact the carbon sequestration capacity of lake wetlands. However, this process is intricate. Clarifying the decisive factors that affect carbon sequestration is crucial for preserving, utilizing, and enhancing the carbon sequestration capacity of plateau lake wetlands. Here we analyzed the regulatory role of land use under policy guidance on the carbon sequestration capacity of the plateau lake wetland of Caohai (CHLW), SW China. The results show that: (1) The cumulative carbon sequestration varied significantly from 1990 to 2020, with the highest carbon sequestration of 15.80 × 105 t C in 1995 and the lowest of 3.18 × 105 t C in 2020, mainly originating from endogenous carbon sequestration within the plateau lake wetlands. (2) As of 2020, the carbon stock of CHLW was approximately 2.54 × 108 t C. (3) The carbon sequestration in CHLW experienced a dynamic change process of decrease-increase-decrease over 30 years, mainly influenced by land use changes under policy regulation, with human and natural factors accounting for 91% and 9%, respectively. (4) Under three simulated scenarios (Q1, Q2, and Q3), the ecological priority scenario exhibited positive regulation on the carbon sequestration of CHLW and the entire protected area in 2030 and 2060, with the highest increase in carbon sequestration. This scenario is consistent with the current conservation policy, indicating that the current protection policy for CHLW is scientifically reasonable. This research demonstrates how land use and climate changes impact carbon storage in wetlands, with consideration of policy guidance. It provides references for utilizing and conserving lake wetlands worldwide, ultimately achieving the dual goals of wetland conservation and carbon neutrality.
Fighting Cardiac Thromboembolism during Transcatheter Procedures: An Update on the Use of Cerebral Protection Devices in Cath Labs and EP Labs
Authors: Preda Alberto , Montalto Claudio , Galasso Michele , Munafò Andrea , Garofani Ilaria , Baroni Matteo , Gigli Lorenzo , Vargiu Sara , Varrenti Marisa , Colombo Giulia , Carbonaro Marco , Della Rocca Domenico , Oreglia Jacopo , Mazzone Patrizio , Guarracini Fabrizio
Published: August 2023

Intraprocedural stroke is a well-documented and feared potential risk of cardiovascular transcatheter procedures (TPs). Moreover, subclinical neurological events or covert central nervous system infarctions are concerns related to the development of dementia, future stroke, cognitive decline, and increased risk of mortality. Cerebral protection devices (CPDs) were developed to mitigate the risk of cardioembolic embolism during TPs. They are mechanical barriers designed to cover the ostium of the supra-aortic branches in the aortic arch, but newer devices are able to protect the descending aorta. CPDs have been mainly designed and tested to provide cerebral protection during transcatheter aortic valve replacement (TAVR), but their use in both Catheterization and Electrophysiology laboratories is rapidly increasing. CPDs have allowed us to perform procedures that were previously contraindicated due to high thromboembolic risk, such as in cases of intracardiac thrombosis identified at preprocedural assessment. However, several concerns related to their employment have to be defined. The selection of patients at high risk of thromboembolism is still a subjective choice of each center. The aim of this review is to update the evidence on the use of CPDs in either Cath labs or EP labs, providing an overview of their structural characteristics. Future perspectives focusing on their possible future employment are also discussed.
Head-to-Head Comparison of FDG and Radiolabeled FAPI PET: A Systematic Review of the Literature
Authors: Guglielmo Priscilla , Alongi Pierpaolo , Baratto Lucia , Abenavoli Elisabetta , Buschiazzo Ambra , Celesti Greta , Conte Miriam , Filice Rossella , Gorica Joana , Jonghi-Lavarini Lorenzo , Lanzafame Helena , Laudicella Riccardo , Librando Maria , Linguanti Flavia , Mattana Francesco , Miceli Alberto , Olivari Laura , Piscopo Leandra , Romagnolo Cinzia , Santo Giulia , Vento Antonio , Volpe Fabio , Evangelista Laura
Published: August 2023

FAPI-based radiopharmaceuticals are a novel class of tracers, mainly used for PET imaging, which have demonstrated several advantages over [18F]FDG, especially in the case of low-grade or well-differentiated tumors. We conducted this systematic review to evaluate all the studies where a head-to-head comparison had been performed to explore the potential utility of FAPI tracers in clinical practice. FAPI-based radiopharmaceuticals have shown promising results globally, in particular in detecting peritoneal carcinomatosis, but studies with wider populations are needed to better understand all the advantages of these new radiopharmaceuticals.
Allergic Proctocolitis: Literature Review and Proposal of a Diagnostic–Therapeutic Algorithm
Authors: Barni Simona , Mori Francesca , Giovannini Mattia , Liotti Lucia , Mastrorilli Carla , Pecoraro Luca , Saretta Francesca , Castagnoli Riccardo , Arasi Stefania , Caminiti Lucia , Gelsomino Mariannita , Klain Angela , del Giudice Michele Miraglia , Novembre Elio
Published: August 2023

Allergic proctocolitis (AP) is a benign condition, frequent in childhood, that is classified as a non-IgE-mediated food allergy. The prevalence is unknown; however, its frequency appears to be increasing, especially in exclusively breastfed infants. Clinical manifestations typically begin in the first few months of life with the appearance of bright red blood (hematochezia), with or without mucus, in the stool of apparently healthy, thriving infants. Most cases of AP are caused by cow’s milk proteins; however, other allergens, such as soy, egg, corn, and wheat, may be potential triggers. Diagnosis is based on the patient’s clinical history and on the resolution of signs and symptoms with the elimination of the suspected food antigen from the diet and their reappearance when the food is reintroduced into the diet. The treatment of AP is based on an elimination diet of the trigger food, with resolution of the symptoms within 72–96 h from the beginning of the diet. The prognosis of AP is good; it is a self-limiting condition, because most children can tolerate the trigger food within one year of life, with an excellent long-term prognosis. The purpose of this review is to provide an update on the current knowledge and recommendations in epidemiological, diagnostic, and therapeutic terms to the pediatricians, allergists, and gastroenterologists who may find themselves managing a patient with AP.
Synergism of Carbamoylated Erythropoietin and Insulin-like Growth Factor-1 in Immediate Early Gene Expression
Authors: Rothschadl Morgan J. , Sathyanesan Monica , Newton Samuel S.
Published: August 2023

Trophic factors are secreted proteins that can modulate neuronal integrity, structure, and function. Previous preclinical studies have shown synergistic effects on decreasing apoptosis and improving behavioral performance after stroke when combining two such trophic factors, erythropoietin (EPO) and insulin-like growth factor-1 (IGF-1). However, EPO can elevate the hematocrit level, which can be life-threatening for non-anemic individuals. A chemically engineered derivative of EPO, carbamoylated EPO (CEPO), does not impact hematological parameters but retains neurotrophic effects similar to EPO. To obtain insight into CEPO and IGF-1 combination signaling, we examined immediate early gene (IEG) expression after treatment with CEPO, IGF-1, or CEPO + IGF-1 in rat pheochromocytoma (PC-12) cells and found that combining CEPO and IGF-1 produced a synergistic increase in IEG expression. An in vivo increase in the protein expression of Npas4 and Nptx2 was also observed in the rat hippocampus. We also examined which kinase signaling pathways might be mediating these effects and found that while AKT inhibition did not alter the pattern of IEG expression, both ERK and JAK2 inhibition significantly decreased IEG expression. These results begin to define the molecular effects of combining CEPO and IGF-1 and indicate the potential for these trophic factors to produce positive, synergistic effects.
CFD Modeling of Primary Breakup in an EIGA Atomizer for Titanium Alloy Powder Production
Authors: Guo Kuaikuai , Liu Changsheng , Chen Wei , Luo Chang , Li Jianzhong
Published: August 2023

Electrode induction melting gas atomization (EIGA) technology is a commonly used and effective method for producing spherical metal powders in additive manufacturing. In this paper, we aim to describe the atomization and fragmentation of liquid sheets from a typical swirl nozzle and highlight the primary breakup of titanium alloy powder production. We developed a computational fluid dynamics (CFD) approach to simulate the primary disintegration process of the molten metal using the volume of fluid (VOF) method coupled with the large eddy simulation turbulence model (LES). Our numerical results show that high-speed spraying creates supersonic airflow in the atomization chamber. Recirculation is the main area where primary atomization occurs. The formation of the recirculation zone is the direct driving force that allows atomization to proceed, which will increase turbulence intensity and achieve higher atomization efficiency. VOF-LES simulation can capture some qualitative results such as conical melt-sheet shape, wave formation, ligament formation, and perforation formation. The primary droplet size mainly ranges between 200 and 800 μm. Finally, with increasing gas pressure, the particle size of the atomized powder gradually decreases, and the particle size distribution becomes narrower.
Managing Delays for Realtime Error Correction and Compensation of an Industrial Robot in an Open Network
Authors: Asif Seemal , Webb Phil
Published: August 2023

The calibration of articulated arms presents a substantial challenge within the manufacturing domain, necessitating sophisticated calibration systems often reliant on the integration of costly metrology equipment for ensuring high precision. However, the logistical complexities and financial burden associated with deploying these devices across diverse systems hinder their widespread adoption. In response, Industry 4.0 emerges as a transformative paradigm by enabling the integration of manufacturing devices into networked environments, thereby providing access through cloud-based infrastructure. Nonetheless, this transition introduces a significant concern in the form of network-induced delays, which can significantly impact realtime calibration procedures. To address this pivotal challenge, the present study introduces an innovative framework that adeptly manages and mitigates network-induced delays. This framework leverages two key components: controller and optimiser, specifically the MPC (Model Predictive Controller) in conjunction with the Extended Kalman Filter (EKF), and a Predictor, characterised as the Dead Reckoning Model (DRM). Collectively, these methodologies are strategically integrated to address and ameliorate the temporal delays experienced during the calibration process. Significantly expanding upon antecedent investigations, the study transcends prior boundaries by implementing an advanced realtime error correction system across networked environments, with particular emphasis on the intricate management of delays originating from network traffic dynamics. The fundamental aim of this research extension is twofold: firstly, it aims to enhance realtime system performance on open networks, while concurrently achieving an impressive level of error correction precision at 0.02 mm. The employment of the proposed methodologies is anticipated to effectively surmount the intricacies and challenges associated with network-induced delays. Subsequently, this endeavour serves to catalyse accurate and efficient calibration procedures in the context of realtime manufacturing scenarios. This research significantly advances the landscape of error correction systems and lays a robust groundwork for the optimised utilisation of networked manufacturing devices within the dynamic realm of Industry 4.0 applications.
Topology and Size Optimized Design and Laser Welding of the U-Frame for Free-Space Laser Communication Telescopes
Authors: Li Guangzhen , Huo Zhanwei , Yuan Jian , Tan Luyang , Zhang Lei , Li Ji
Published: August 2023

The success of laser communications heavily relies on the stiffness, dynamic properties, static performance, and manufacturability of the U-frame. The U-frame is a fundamental element in satellite-to-ground laser communication telescopes. However, there is currently a lack of research on the optimal design of U-frames, leading to a significant gap between ideal construction and practical manufacturability. To address these concerns, this study proposes a comprehensive approach that combines multi-objective topology optimization and multi-start size optimization techniques. This approach considers the multidisciplinary constraints imposed by mechanical, control, and optical systems. The objective is to achieve both the conceptual and detailed design of a novel U-frame, while also ensuring thorough consideration of the structure’s manufacturability during the optimization process. The prototype of the optimized U-frame was successfully fabricated using laser welding processes. The tensile test conducted on the prototype supported the idea that laser welding can enhance the micro-grain size of the joint, leading to improved overall mechanical properties. In particular, the joint strength achieved through laser welding was found to be 1.5 times greater than that achieved through TIG (Tungsten Inert Gas) welding. Additionally, the results obtained from the free vibration experiment closely aligned with the simulation, confirming the feasibility of manufacturing the optimized structure. The optimized structure demonstrated an improvement of 7.13% in dynamic performance and 29.61% in static performance compared to the first-generation structure. Additionally, there was a reduction of 29.89% in mass without affecting the remaining performance aspects. The successful fabrication of the prototype validates the feasibility of the proposed welding process and highlights the superiority of the new U-frame.
Potential Agricultural Uses of Micro/Nano Encapsulated Chitosan: A Review
Authors: García-Carrasco Melissa , Valdez-Baro Octavio , Cabanillas-Bojórquez Luis A. , Bernal-Millán Manuel J. , Rivera-Salas María M. , Gutiérrez-Grijalva Erick P. , Heredia J. Basilio
Published: August 2023

Chitosan is a non-toxic, biodegradable, and biocompatible natural biopolymer widely used as a nanocarrier, emulsifier, flocculant, and antimicrobial agent with potential applications in industry. Recently, chitosan has been used as an encapsulating agent for bioactive plant compounds and agrochemicals by different technologies, such as spray-drying and nanoemulsions, to enhance antimicrobial activity. Chitosan nanocomposites have been shown to increase potential biocidal, antibacterial, and antifungal activity against pathogens, presenting higher stability, decreasing degradation, and prolonging the effective concentration of these bioactive compounds. Therefore, the objective of this work is to review the most outstanding aspects of the most recent developments in the different methods of encapsulation of bioactive compounds (phenolic compounds, essential oils, among others) from plants, as well as the applications on phytopathogenic diseases (fungi and bacteria) in vitro and in vivo in cereal, fruit and vegetable crops. These perspectives could provide information for the future formulation of products with high efficacy against phytopathogenic diseases as an alternative to chemical products for sustainable agriculture.
Identification and Control of Rehabilitation Robots with Unknown Dynamics: A New Probabilistic Algorithm Based on a Finite-Time Estimator
Authors: Alotaibi Naif D. , Jahanshahi Hadi , Yao Qijia , Mou Jun , Bekiros Stelios
Published: August 2023

The control of rehabilitation robots presents a formidable challenge owing to the myriad of uncharted disturbances encountered in real-world applications. Despite the existence of several techniques proposed for controlling and identifying such systems, many cutting-edge approaches have yet to be implemented in the context of rehabilitation robots. This highlights the necessity for further investigation and exploration in this field. In light of this motivation, we introduce a pioneering algorithm that employs a finite estimator and Gaussian process to identify and forecast the uncharted dynamics of a 2-DoF knee rehabilitation robot. The proposed algorithm harnesses the probabilistic nature of Gaussian processes, while also guaranteeing finite-time convergence through the utilization of the Lyapunov theorem. This dual advantage allows for the effective exploitation of the Gaussian process’s probabilistic capabilities while ensuring reliable and timely convergence of the algorithm. The algorithm is delineated and the finite time convergence is proven. Subsequently, its performance is investigated through numerical simulations for estimating complex unknown and time-varying dynamics. The results obtained from the proposed algorithm are then employed for controlling the rehabilitation robot, highlighting its remarkable capability to provide precise estimates while effectively handling uncertainty.