bluuebunny/crossref_metadata_2025 huggingface dataset:
Are Nurses Aware of Their Contribution to the Antibiotic Stewardship Programme? A Mixed-Method Study from Qatar
Authors: Hassan Nesiya , Ali Alomari Albara Mohammad , Kunjavara Jibin , Singh Kalpana , Joy George V. , Mannethodi Kamaruddeen , Al Lenjawi Badriya
Published: July 2024

The antibiotic stewardship programme (ASP) is a new concept initiated by WHO, but nurses are not yet ready to adopt the program. The training and empowerment of nurses are the best strategies for enhancing their knowledge and engagement in ASP. This mixed-method study was used to assess perceived roles and barriers of nurses’ involvement in ASP. An online survey was conducted among 420 clinical nurses to identify their role, and 23 individual interviews were performed among nurses and infection control practitioners to explore the barriers and recommendations to overcome the identified barriers. The majority of the nurses agreed with the sixteen identified roles in ASP, of which ‘antibiotic dosing and de-escalation’ (82.61%), ‘IV to PO conversion of antibiotic, outpatient antibiotic therapy’ (85.23%), and ‘outpatient management, long-term care, readmission’ of the patients (81.19%) had the lowest agreement from the participants. The major themes generated through the qualitative interviews were a lack of knowledge about ASP, poor communication between multidisciplinary teams, lack of opportunity and multidisciplinary engagement, lack of formal education and training about ASP, lack of ASP competency and defined roles in policy, role conflict or power/position, availability of resources, and lack of protected time. Nurses play an integral role in the successful implementation of antibiotic stewardship programs. The empowerment of nurses will help them to adopt the unique role in ASP. Nurses can significantly contribute to antibiotic stewardship efforts and improve patient outcomes through addressing these challenges.
Treatment of Superficial Vein Thrombosis: Recent Advances, Unmet Needs and Future Directions
Authors: Di Nisio Marcello , Camporese Giuseppe , Di Micco Pierpaolo , Martini Romeo , Ageno Walter , Prandoni Paolo
Published: July 2024

Once considered relatively benign, superficial vein thrombosis (SVT) of the lower limbs is linked to deep vein thrombosis (DVT) or pulmonary embolism (PE) in up to one fourth of cases. Treatment goals include alleviating local symptoms and preventing SVT from recurring or extending into DVT or PE. Fondaparinux 2.5 mg once daily for 45 days is the treatment of choice for most patients with SVT. Potential alternatives include intermediate-dose low-molecular-weight heparin or the direct oral factor Xa inhibitor rivaroxaban, however, these require further evidence. Despite these treatment options, significant gaps remain, including the role of systemic or topical anti-inflammatory agents alone or combined with anticoagulants, and the optimal duration of anticoagulation for patients at varying risk levels. Additionally, the efficacy and safety of factor Xa inhibitors other than rivaroxaban, management of upper extremity SVT, and optimal treatment for SVT near the sapheno-femoral or sapheno-popliteal junctions are not well understood. This narrative review aims to summarize current evidence on anticoagulant treatment for SVT, highlight key unmet needs in current approaches, and discuss how ongoing studies may address these gaps.
Strengthening the Voices of Hispanic/Latine Immigrants Managing Chronic Disease: A Mixed Methods Approach to Understanding Perspectives of Health
Authors: Zamarripa Kathy , Crusan Ambria , Roozen Kerrie , Godoy-Henderson Clara , Evans Angela
Published: July 2024

Individuals who migrate from their home country face a variety of challenges while adapting to the culture in the United States. Immigrant communities are at a significantly higher risk for poor health outcomes; therefore, assessing healthcare treatment for diverse and resilient immigrant populations, including Hispanic/Latine communities, is crucial to preserving their health, culture, and spirit. A paucity of literature exists surrounding perceptions of well-being in immigrant, Hispanic/Latine adults managing chronic diseases. Past studies have shown a discrepancy between providers’ and patients’ perceptions of healthcare options for overall well-being. We aim to share varying perspectives found within our work geared towards improving the quality of life for Hispanic/Latine immigrants managing chronic disease, especially type 2 diabetes mellitus and hypertension. The primary objective of this article is to strengthen the understanding of intersections between social, physical, financial, and spiritual health within an (im)migrant Hispanic/Latine community using semi-structured ethnographic interviews. These interviews have highlighted community resilience, demonstrating that individuals can adapt to major life transitions while maintaining balance across dimensions of health. This knowledge could be implemented by actively listening to patient concerns regarding their health dimensions to improve individualized and patient-centric care.
Self-Perceived Quality of Life (WHOQOL-Bref), and Self-Reported Health, Social and Environmental Factors Related to Its Improvement among Residents of Anil, Rio de Janeiro—Cross-Sectional Study
Authors: Barros Rosemerie , Ohnuma Alfredo Akira , Manso Maria Conceição
Published: July 2024

This study aims to assess the self-perception of the QoL (WHOQOL-bref) in the Canal of Anil zone and its neighbor zone of the center of the District of Anil in Rio de Janeiro and to identify which factors are associated with the population self-perception of the need to “improve” their quality of life (QoL). A cross-sectional observational analytical study was carried out after approval by the competent ethics committee (CEP/CONEP) approval. A non-probabilistic sampling of residents of the Canal of Anil (n = 494) and the central district of Anil (n = 250) was used. A questionnaire was administered in person to collect data on self-reported sociodemographic characteristics, general health, sanitation, lifestyle in the residential area, and the WHOQOL-Bref. Although with a worse self-perceived water/sanitation participants in the Anil Canal community report fewer allergies, less medication, fewer skin diseases, less Zika virus, and less Chikungunya, among others. The self-perception of the need to improve the QoL in the Anil Canal community and the zone at the central District of Anil has proved to be influenced by several social and economic factors as well as residential practices and conditions. The multivariate analysis allowed us to identify both modifiable and non-modifiable risk factors for the need to improve physical QoL: taking medication, respiratory problems, skin disease diagnosed by a doctor, having a water tank at home or having filtered water at home, unpleasant odor of the water of the Anil Canal and the level of education, and age. Regarding the need to improve the environmental QoL, both areas are largely modifiable (e.g., having had ascariasis/roundworm; having a water tank in the house; not drinking bottled water; not having pavements in the street). Sociodemographic and environmental factors, in addition to health conditions, play a pivotal role in influencing individuals’ perceptions of the necessity for enhanced physical and environmental well-being.
What’s the Impact of Safety Footwear on Workers Concerning Foot-Related Problems? A Systematic Review
Authors: Arceri Alberto , Mazzotti Antonio , Liosi Sofia Gaia , Zielli Simone Ottavio , Artioli Elena , Golinelli Davide , Brognara Lorenzo , Faldini Cesare
Published: July 2024

Background: This study aims to assess the impact of safety footwear (SF) on workers concerning foot-related problems, especially regarding discomfort, foot pain, and skin lesions. Methods: A literature search of PubMed, Embase, Scopus, and Cochrane databases was performed according to PRISMA guidelines. Studies reporting foot-related problems in workers wearing SF were included. Exclusion criteria included non-English papers, reviews, laboratory and animal studies, expert opinions, letters to the editor, and grey literature. The quality assessment was performed using the Newcastle–Ottawa Scale. Descriptive statistic was used to present data. Result: The initial search results yielded 483 articles; 7 articles were included in the review process. Despite the extensive variety of SF, all studies consistently reported symptomatic discomfort and pain. The discomfort factors included heat, sweating, heaviness, and footwear flexibility, with primary issues in the toes, toecaps, or metatarsal–toe crease region. The pain prevalence ranged from 42.3% to 60.8% in various anatomical regions. Irritant Contact Dermatitis was the most common (97.9%) foot dermatosis, but other foot lesions were reported: dry skin (30.2%), calluses (30%), hard nails (28%), corns (27%), and blisters. Conclusions: Current SFs are designed to comply with safety regulations but are influenced by the frequent occurrence of discomfort and foot problems. The literature review identified weaknesses in certain design features. Recommendations have been proposed to improve SF development. These include addressing issues such as the selection of specific types and designs of SF based on task performance and the working environment, footwear weight, and breathable materials for moisture permeation. Considerations should also encompass distinct sizing for an optimal fit, insole application, especially for prolonged standing users, and education programs to prevent foot-related issues.
The Perspectives of Individuals with Chronic Stroke on Motor Recovery: A Qualitative Analysis
Authors: Cain Amelia , Winstein Carolee J. , Demers Marika
Published: July 2024

The priorities of individuals with chronic stroke are not always reflected in clinical practice. This study provides insight into meaningful factors related to long-term motor recovery in stroke survivors. Thirty individuals with chronic stroke participated in semi-structured interviews about movement, recovery, and barriers to and facilitators of mobility and paretic arm use. The interviews were analyzed using inductive thematic analysis. Three categories, the individual, environment, and task, defined five emergent themes. Individual: (1) mindset is a strong and consistent influencer of daily physical activity and overall recovery; (2) severe physical impairment limits physical activity and recovery, regardless of other factors; and (3) a negative perception of disability impacts mindset and willingness to move in public. Environment: (4) social and physical environments influence physical activity and recovery. Task: (5) participation in meaningful activities increases physical activity and promotes long-term recovery. Strategies to incorporate paretic arm use, exercise, and encouragement from others facilitate physical activity. Insufficient paretic limb function, environmental obstacles, and fear are barriers to physical activity. Neurorehabilitation must address the factors that are meaningful to stroke survivors. Building motor capacity is essential and must be integrated with factors such as a positive mindset and proper environment. Individual differences reinforce the need for personalized care.
The Impact of Statins on Disease Severity and Quality of Life in Patients with Psoriasis: A Systematic Review and Meta-Analysis
Authors: Aleid Abdulsalam Mohammed , Almutairi Ghadah , Alrizqi Rudhab , Nukaly Houriah Yasir , Alkhanani Jomanah Jamal , AlHuraish Deemah Salem , Alshanti Hawazin Yasser , Algaidi Yaser Sami , Alyami Hanan , Alrasheeday Awatif , Alshammari Bushra , Alsaleh Kawthar , Al Mutair Abbas
Published: July 2024

Background: Psoriasis, a chronic autoimmune condition, imposes significant burdens on patients’ well-being. While corticosteroid medications are commonly used, their prolonged use presents risks. Statins, known for their immunoregulatory and anti-inflammatory properties, have emerged as potential alternatives. Previous reviews indicated that statins might improve psoriasis symptoms but showed inconsistent results and lacked meta-analyses that generated pooled effect estimates. Therefore, this study addresses this gap by providing a comprehensive overview of the impact of statins on psoriasis severity and quality of life (QoL) for patients with psoriasis. Methods: A thorough search of four electronic databases (PubMed, Cochrane Central Register of Controlled Trials, Scopus, and Science Direct) was conducted for relevant studies published before April 2024. Results: Seven studies involving 369 patients were included. This meta-analysis showed a statistically significant reduction in PASI scores at week 8 with statin treatment (MD = −1.96, 95% CI [−3.14, −0.77], p = 0.001). However, no statistically significant difference was found between statins and placebo at week 12 (MD = 0.19, 95% CI [−0.18, 0.55]). Additionally, DLQI scores indicated a significant improvement in quality of life with statins compared to placebo (MD = −3.16, 95% CI [−5.55, −0.77]). Conclusions: Statins can improve disease severity and quality of life in psoriasis patients, suggesting the potential benefits of statin therapy. However, further research is needed to determine the optimal treatment duration, address outcome heterogeneity, and explore additional benefits such as cholesterol and triglyceride reduction.
Efficient AAV9 Purification Using a Single-Step AAV9 Magnetic Affinity Beads Isolation
Authors: Sia Kian Chuan , Fu Zhen Ying , Mohd Rodhi Siti Humairah , Yee Joan Hua Yi , Qu Kun , Gan Shu Uin
Published: July 2024

Adeno-associated viruses (AAVs) have emerged as promising tools for gene therapy due to their safety and efficacy in delivering therapeutic genes or gene editing sequences to various tissues and organs. AAV serotype 9 (AAV9), among AAV serotypes, stands out for its ability to efficiently target multiple tissues, thus holding significant potential for clinical applications. However, existing methods for purifying AAVs are cumbersome, expensive, and often yield inconsistent results. In this study, we explore a novel purification strategy utilizing Dynabeads™ CaptureSelect™ magnetic beads. The AAV9 magnetic beads capture AAV9 with high specificity and recovery between 70 and 90%, whereas the AAVX magnetic beads did not bind to the AAV9. Through continuous interaction with AAVs in solution, these beads offer enhanced clearance of genomic DNA and plasmids even in the absence of endonuclease. The beads could be regenerated at least eight times, and the used beads could be stored for up to six months and reused without a significant reduction in recovery. The potency of the AAV9-purified vectors in vivo was comparable to that of iodixanol purified vectors.
Role of Csdc2 in Regulating Secondary Hair Follicle Growth in Cashmere Goats
Authors: Zhu Heqing , Li Yingying , Xu He , Ma Yuehui , Andersson Göran , Bongcam-Rudloff Erik , Li Tiantian , Zhang Jie , Li Yan , Han Jilong , Yang Min
Published: July 2024

Cashmere goats possess two types of hair follicles, with the secondary hair follicles producing valuable cashmere fiber used for textiles. The growth of cashmere exhibits a seasonal pattern arising from photoperiod change. Transcription factors play crucial roles during this process. The transcription factor, cold-shock domain, containing C2 (Csdc2) plays a crucial role in modulating cell proliferation and differentiation. Our preceding research indicated that the expression of Csdc2 changes periodically during anagen to telogen. However, the mechanisms of Csdc2 in regulating SHF growth remain unclear. Here, we found that the knockdown of Csdc2 inhibits the proliferation of dermal papilla cells. ChIP-Seq analysis showed that Csdc2 had a unique DNA binding motif in SHFs. Through conjoint analysis of ChIP-Seq and RNA-Seq, we revealed a total of 25 candidate target genes of Csdc2. Notably, we discovered a putative Csdc2 binding site within roundabout guidance receptor 2 (Robo2) on chromosome 1 of the goat genome. Furthermore, qRT-PCR and dual-luciferase reporter assay confirmed Csdc2’s positive regulatory influence on Robo2. These findings expand the research field of hair follicle transcriptional regulatory networks, offering insights into molecular breeding strategies to enhance cashmere production in goats.
Discovering Native Ant Species with the Potential to Suppress Red Imported Fire Ants
Authors: Ni Meihong , Yang Xinyi , Zheng Yiran , Wang Yuan , Jiang Mingxing
Published: July 2024

Native ants have long been considered for their potential to suppress the red imported fire ant, Solenopsis invicta Buren (Hymenoptera: Formicidae), a highly invasive and destructive species. However, the knowledge in this field is limited to behavioral observations of a few related native ants. In this study, by setting up a series of ant combinations of three native ants, i.e., Monomorium chinense Santschi, the robust crazy ant Nylanderia bourbonica Forel, and Iridomyrmex anceps Roger, with S. invicta, we observed the aggression levels and mortality rates. Using baited vials, we also investigated the abundance of native ants in four types of habitats in Eastern China that are preferred by S. invicta (woodland, green belts on roadsides, grassland, and farmland), as well as their seasonal abundance when co-existing with S. invicta and their spatial distribution before and after control of S. invicta. We found that M. chinense and N. bourbonica show a degree of aggression towards S. invicta and can kill substantial proportions of S. invicta under laboratory conditions, but I. anceps does not. Both M. chinense and N. bourbonica can occur in each type of habitat investigated and are more abundant in green belts (particularly lawns with turf) and grasslands relative to other habitats. In grasslands with S. invicta, M. chinense maintained a low density before early July; however, its abundance increased thereafter and reached a peak in September. N. bourbonica also had a low density early in the season and increased steadily from April. Its abundance began to decrease substantially from November. In grasslands invaded by S. invicta, both M. chinense and N. bourbonica were restricted to sites close to the margins before S. invicta was controlled; however, they spread to a larger range within a few weeks after control of S. invicta. In conclusion, M. chinense and N. bourbonica have the potential to suppress S. invicta invasion in habitats that are abundant with these two native ants.
Co-Occurring Driver Genomic Alterations in Advanced Non-Small-Cell Lung Cancer (NSCLC): A Retrospective Analysis
Authors: Attili Ilaria , Asnaghi Riccardo , Vacirca Davide , Adorisio Riccardo , Rappa Alessandra , Ranghiero Alberto , Lombardi Mariano , Corvaja Carla , Fuorivia Valeria , Carnevale Schianca Ambra , Trillo Aliaga Pamela , Spitaleri Gianluca , Del Signore Ester , Guarize Juliana , Spaggiari Lorenzo , Guerini-Rocco Elena , Fusco Nicola , de Marinis Filippo , Passaro Antonio
Published: July 2024

Background: Actionable driver mutations account for 40–50% of NSCLC cases, and their identification clearly affects treatment choices and outcomes. Conversely, non-actionable mutations are genetic alterations that do not currently have established treatment implications. Among co-occurring alterations, the identification of concurrent actionable genomic alterations is a rare event, potentially impacting prognosis and treatment outcomes. Methods: We retrospectively evaluated the prevalence and patterns of concurrent driver genomic alterations in a large series of NSCLCs to investigate their association with clinicopathological characteristics, to assess the prognosis of patients whose tumor harbors concurrent alterations in the genes of interest and to explore their potential therapeutic implications. Results: Co-occurring driver alterations were identified in 26 out of 1520 patients with at least one gene alteration (1.7%). Within these cases, the incidence of concurrent actionable gene alterations was 39% (0.7% of the overall cohort). Among compound actionable gene mutations, EGFR was the most frequently involved gene (70%). The most frequent association was EGFR mutations with ROS1 rearrangement. Front-line targeted treatments were the preferred approach in patients with compound actionable mutations, with dismal median PFS observed (6 months). Conclusions: Advances in genomic profiling technologies are facilitating the identification of concurrent mutations. In patients with concurrent actionable gene alterations, integrated molecular and clinical data should be used to guide treatment decisions, always considering rebiopsy at the moment of disease progression.
Assessment of Tricuspid Regurgitation by Cardiac Magnetic Resonance Imaging: Current Role and Future Applications
Authors: Pype Lobke L. , Domenech-Ximenos Blanca , Paelinck Bernard P. , Sturkenboom Nicole , Van De Heyning Caroline M.
Published: July 2024

Tricuspid regurgitation (TR) is a prevalent valvular disease with a significant mortality rate. The evaluation of TR severity and associated right heart remodeling and dysfunction is crucial to determine the optimal therapeutic strategy and to improve prognosis. While echocardiography remains the first-line imaging technique to evaluate TR, it has many limitations, both operator- and patient-related. Cardiovascular magnetic resonance imaging (CMR) has emerged as an innovative and comprehensive non-invasive cardiac imaging technique with additional value beyond routine echocardiographic assessment. Besides its established role as the gold standard for the evaluation of cardiac volumes, CMR can add important insights with regard to valvular anatomy and function. Accurate quantification of TR severity, including calculation of regurgitant volume and fraction, can be performed using either the well-known indirect volumetric method or novel 4D flow imaging. In addition, CMR can be used to assess the impact on the right heart, including right heart remodeling, function and tissue characterization. Several CMR-derived parameters have been associated with outcome, highlighting the importance of multi-modality imaging in patients with TR. The aim of this review is to provide an overview of the current role of CMR in the assessment and management of patients with TR and its future applications.
A Comparison of Tracheal Intubation Using Direct Laryngoscope and Video Laryngoscope in the Sellick and Trendelenburg Position with That Using Direct Laryngoscope in the Supine Sniffing Position: A Randomized Controlled Trial
Authors: Chae Yun-Jeong , Moon Jung-Yoon , Lee Min-Gyu , Joe Han-Bum
Published: July 2024

Background: Tracheal intubation in the Sellick and Trendelenburg position (ST position) can prevent pulmonary aspiration but increase the difficulty of tracheal intubation. We compared tracheal intubation using video and direct laryngoscopy in the ST position with direct laryngoscopy in the supine sniffing position to evaluate the overall intubation performance. Methods: One hundred and twenty patients were randomly assigned to three groups: direct laryngoscope in the supine sniffing position (control), direct laryngoscope in the ST position (ST direct), and video laryngoscope in the ST position (ST video). The primary outcome was the intubation time; secondary outcomes included the first attempt success rate of tracheal intubation, intubation difficulty scale score, operator’s subjective assessment of intubation difficulty, and modified Cormack–Lehane grades. Results: The median intubation times were greater in the ST direct (36.0 s) and video (34.5 s) than the control (28.0 s) groups. The first attempt success rate decreased in the ST direct (77.5%) but not the video (95.0%) group compared with the control group (100%). Conclusions: The challenges of tracheal intubation in the ST position, aimed at reducing the risk of pulmonary aspiration, can be mitigated by using a video laryngoscope, despite slightly longer intubation times.
Confocal Laser Endomicroscopy in Resection of Sinonasal Malignant Melanoma—Preliminary Report on Real-Time Margin Assessment and Support in Surgical Decision-Making
Authors: Wenda Nina , Fruth Kai , Wagner Sebastian , Fisseler-Eckhoff Annette , Gosepath Jan
Published: July 2024

Background/Objectives: Building upon the rising value of Confocal Laser Endomicroscopy (CLE) in squamous cell carcinoma of the head and neck, we present the first application of CLE during the resection of sinonasal malignant melanomas. This study aims to evaluate the potential of CLE to assist surgeons in intraoperative decision-making, with a particular focus on resection margin assessment within the constrained nasal cavity. Methods: Two cases of sinonasal malignant melanoma were included in this study. CLE was employed to examine visible tumors and their margins, both pre- and post-endoscopic resection. The findings were compared to histopathological results as well as data on squamous cell carcinoma, for which malignancy criteria had already been established in prior projects. Results: CLE provided the real-time visualization of sinonasal malignant melanomas and their margins, successfully differentiating between healthy and neoplastic tissue compared to histopathological findings. Conclusion: CLE offers the potential for real-time assessment, aiding surgeons in more precise tumor resection and potentially improving patient outcomes. This study demonstrates the feasibility of using CLE in the resection of sinonasal malignant melanoma, highlighting its ability to differentiate between healthy and neoplastic tissue intraoperatively.
Comparison of Clinical and Laboratory Characteristics in Lupus Nephritis vs. Non-Lupus Nephritis Patients—A Comprehensive Retrospective Analysis Based on 921 Patients
Authors: Kosałka-Węgiel Joanna , Dziedzic Radosław , Siwiec-Koźlik Andżelika , Spałkowska Magdalena , Milewski Mamert , Wach Anita , Zaręba Lech , Bazan-Socha Stanisława , Korkosz Mariusz
Published: July 2024

Background: Lupus nephritis (LN) is an inflammation of the kidneys that is related to systemic lupus erythematosus (SLE). This study aimed to evaluate the differences in clinical and laboratory characteristics between LN and non-LN SLE patients. Methods: We conducted a retrospective analysis of medical records collected from SLE patients treated at the University Hospital in Kraków, Poland, from 2012 to 2022. All patients met the 2019 European League Against Rheumatism and the American College of Rheumatology (EULAR/ACR) criteria for SLE. Results: Among 921 SLE patients, LN was documented in 331 (35.94%). LN patients were younger at SLE diagnosis (29 vs. 37 years; p < 0.001) and had a male proportion that was 2.09 times higher than the non-LN group (16.62% vs. 7.97%; p < 0.001). They were more often diagnosed with serositis and hematological or neurological involvement (p < 0.001 for all). Hypertension and hypercholesterolemia occurred more frequently in these patients (p < 0.001 for both). LN patients exhibited a higher frequency of anti-dsDNA, anti-histone, and anti-nucleosome antibodies (p < 0.001 for all). Conversely, the non-LN group had a 1.24-fold (95% CI: 1.03–1.50; p = 0.021) increase in the odds ratio of having positive anti-cardiolipin IgM antibody results. LN patients were more frequently treated with immunosuppressants. The risk factors for experiencing at least three LN flares included female sex, younger age at the onset of LN or SLE, LN occurring later than SLE onset, the presence of anti-nucleosome or anti-dsDNA antibodies, and certain SLE manifestations such as myalgia, arthritis, proteinuria > 3.5 g/day, and pathological urinary casts in the urine sediment. Conclusions: LN patients differ from non-LN patients in the age of SLE diagnosis, treatment modalities, and autoantibody profile and have more frequent, severe manifestations of SLE. However, we still need more prospective studies to understand the diversity of LN and its progression in SLE patients.
Outcomes of Mitral Valve Regurgitation Management after Expert Multidisciplinary Valve Team Evaluation
Authors: Welman Myrthe J. M. , Streukens Sebastian A. F. , Mephtah Anass , Hoebers Loes P. , Vainer Jindrich , Theunissen Ralph , Heuts Samuel , Maessen Jos G. , Segers Patrique , Vernooy Kevin , van ‘t Hof Arnoud W. J. , Sardari Nia Peyman , Vriesendorp Pieter A.
Published: July 2024

Background/Objectives: Mitral regurgitation (MR) affects millions worldwide, necessitating timely intervention. There are significant clinical challenges in the conservative management of MR, leaving a knowledge gap regarding the impact of multidisciplinary decision-making on treatment outcomes. This study aimed to provide insights into the impact of multidisciplinary decision-making on the survival outcomes of MR patients, focusing on conservative approaches. Methods: This study retrospectively analyzes 1365 patients evaluated by an expert multidisciplinary heart team (MDT) in a single center from 2015 to 2022. Treatments included surgery, catheter-based interventions, and conservative management. Propensity matching was utilized to compare surgery and conservative approaches. Results: Surgical intervention was associated with superior long-term survival outcomes compared to conservative and catheter-based treatments, particularly for degenerative MR (DMR). Survival rates of patients deemed by the MDT to have non-severe DMR were comparable to surgical patients (HR 1.07, 95% CI: 0.37–3.12, p = 0.90). However, non-severe functional MR (FMR) patients trended towards elevated mortality risk (HR 1.77, 95% CI: 0.94–3.31, p = 0.07). Pharmacological treatment for DMR was associated with significantly higher mortality compared to surgery (HR 8.0, 95% CI: 1.78–36.03, p = 0.001). Functional MR patients treated pharmacologically exhibited a non-significantly higher mortality risk compared to surgical intervention (HR 1.93, 95% CI: 0.77–4.77, p = 0.20). Conclusions: Survival analysis revealed significant benefits for surgical intervention, contrasting with elevated mortality risks associated with conservative management. “Watchful waiting” may be appropriate for non-severe DMR, while FMR may require closer monitoring. Further research is needed to assess the impact of regular follow-up or delayed surgery on survival rates, as pharmacological therapy has limited long-term efficacy for DMR.
Comparative Clinical Behavior of Zirconia versus Titanium Dental Implants: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Authors: Morena Danilo , Leitão-Almeida Bruno , Pereira Miguel , Resende Rodrigo , Fernandes Juliana Campos Hasse , Fernandes Gustavo Vicentis Oliveira , Borges Tiago
Published: July 2024

Objective: The goal of this systematic review and meta-analysis was to assess whether there were clinically relevant differences in the treatment of edentulous areas comparing zirconia (Zr) and titanium (Ti) dental implants. The null hypothesis is that no differences can be observed in terms of the clinical parameters; the positive hypothesis I is that Zr implants have generally better results compared to Ti implants; and the positive hypothesis II is that Ti implants have a generally superior result than Zr implants. Methods: This review work was registered on the PROSPERO platform, and its development was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. The electronic search process was conducted on three databases (PubMed/Scopus/Web of Science), including randomized controlled trials (RCTs) from the past 10 years (up to April 2024). Identified articles were analyzed and included/excluded based on pre-defined selection and exclusion criteria. The quality assessment and risk of bias were evaluated using a Cochrane risk-of-bias assessment tool specifically designed for randomized trials (RoB2). A meta-analysis was conducted to correlate different treatment options based on the described outcomes; a random-effects model was used in the analysis of the variables. The analysis of heterogeneity was conducted by means of Cochran’s Q-test and Higgins’ I2 statistic. Results: Six RCTs were enrolled; 152 patients (90 males and 62 females) and 448 implants (267 Zr and 181 Ti) were included. Dental implant placement involved both the maxillary and mandibular arches. The implant sites showed heterogeneity in receiving Zr and Ti dental implants; in particular, 22 dental implants were placed in the mid-palatal region and 426 dental implants in the alveolar region (255 were in Zr and 171 in Ti). Regarding the success rate, it was better for Zr but with no statistical difference (p > 0.05); bleeding on probing had slight differences between Ti with 0.34% ± 0.42 and Zr with 0.26% ± 0.36 (p > 0.05); plaque score showed 0.46 ± 0.47 for Ti compared to 0.44 ± 0.49 for Zr (p > 0.05); no statistically significant difference was observed for pink esthetic score (PES). Statistically significant results were found for survival rate, which favored Ti implants (77.6%) compared to Zr (70.3%) (p < 0.05), and for marginal bone loss, which showed less loss in Ti implants (0.18 mm ± 0.47) compared to 0.42 mm ± 0.40 in Zr at 12 months (p < 0.001). Conclusions: The present systematic review and meta-analysis identified the positive hypothesis I and rejected the null and positive hypothesis II; it was possible to conclude that Ti dental implants have a better survival rate and less marginal bone loss than Zr dental implants after 1-year follow-up.
Effect of Obesity on Aquaporin5 Expression in Human Placental and Uterus Tissues
Authors: Kemény Kata Kira , Kozinszky Zoltan , Altorjay Ábel T. , Kolcsár Bálint , Surányi Andrea , Ducza Eszter
Published: July 2024

Background: Obesity and overweight are also becoming more prevalent among women of childbearing age and pregnant women. In maternal obesity, the activation of metabolic, inflammatory, and oxidative stress pathways is proven, which appears to be a key step in the pathological changes observed in placental and uterine function. Several recent studies have evidenced that aquaporins (AQPs) are critical players in adipose tissue biology and are involved in the onset of obesity. Methods: Our studies aimed to investigate the changes in placental volume and vascularization and measure the AQP5 expression and total antioxidant capacity (TAC) in the placenta and uterus tissues in obese and typical-weight mothers. We also aim to measure the AQP5 plasma concentration. Results: We found AQP5 dominance in the uterus and plasma at 34 weeks of normal pregnancy. The placental volume increased and the vascularization decreased in obese mothers compared to the control. The AQP5 expression increased in the uterus of the obese group and did not change in the placenta. The TAC decreased in the plasma of overweight mothers. Conclusions: We hypothesize that increased AQP5 expression prolongs the length of pregnancy and inhibits the onset of contractions. Based on our findings, we can develop diagnostic tests and provide new targets for tocolytic drug development.
A Psychometric Perspective on the Associations between Response Accuracy and Response Time Residuals
Authors: Lyu Weicong , Bolt Daniel
Published: July 2024

We provide an alternative psychometric perspective on the empirical statistical dependencies observed between response accuracy residuals (RARs) and response time residuals (RTRs) in the context of the van der Linden model. This perspective emphasizes the RAR (or parts of the RAR) as being exogenous and having a directional influence on response time. Our simple and theoretically justifiable perspective adds to previous joint response time/accuracy models and comports with recent generalizations of the D-diffusion IRT model incorporating person-by-item interactions, and thus similarly reproduces many of the recently highlighted empirical findings concerning the associations between RARs and RTRs. Using both empirical and simulation-based results, we show how our psychometric perspective has both applied and interpretational implications. Specifically, it would suggest that (1) studies of item parameter estimate heterogeneity in relation to response times may reflect more of a psychometric artifact (due to the exogenous effects of the RARs) as opposed to providing insights about the response process (e.g., the application of different response strategies) and that (2) efforts to use RTRs as indicators of latent proficiency should attend to the anticipated interactions between the latent proficiency and RAR on response times. The validity of our psychometric perspective against alternatives likely relies on appeals to theory; the best perspective to take may vary depending on the test setting.
Application of 3D and 4D Printing in Electronics
Authors: Aronne Matilde , Polano Miriam , Bertana Valentina , Ferrero Sergio , Frascella Francesca , Scaltrito Luciano , Marasso Simone Luigi
Published: July 2024

Nowadays, additive manufacturing technologies have impacted different engineering sectors. Three- and four-dimensional printing techniques are increasingly used in soft and flexible electronics thanks to the possibility of working contemporarily with several materials on various substrates. The materials portfolio is wide, as well as printing processes. Shape memory polymers, together with composites, have gained great success in the electronic field and are becoming increasingly popular for fabricating pH, temperature, humidity, and stress sensors that are integrated into wearable, stretchable, and flexible devices, as well as for the fabrication of communication devices, such as antennas. Here, we report an overview of the state of the art about the application of 4D printing technologies and smart materials in electronics.
Numerical Simulation of the Behavior of Caisson Based on Physical Modeling
Authors: Huang Sifen , Han Yuwei , Li Shuyi , Zhou Mi
Published: July 2024

Stiffened caissons are a new kind of offshore platform foundation which has been widely used in recent years. Stiffeners are employed to avoid buckling during the installation process. However, they also create a significant challenge in terms of understating the soil-flow patterns and corresponding installation resistance prediction. Although centrifuge and in situ tests can simulate the caisson installation process very well, their high costs prevent their widespread application. Model tests have been widely used in research on caisson behavior during installation, as they are convenient and cost less compared to centrifuge and prototype tests. However, the quantitative conclusions of the resulting predictions of installation resistance have some uncertainties because it is quite hard to strictly follow the similarity principle in 1 g model tests. Therefore, it is important to establish a method to calibrate the data from model tests, providing better estimates of caisson behavior in field tests. In our research, large deformation finite element (LDFE) analyses were conducted to provide insights into differences in the outcomes of caisson installation approaches between prototype tests and 1 g model tests. Prior to carrying out parametric studies, validations were conducted with good results. The results show that normalized soil strength significantly influences the behavior of caissons of various dimensions in 1 g model tests. In uniform clay, caissons exhibit consistent installation behavior; otherwise, they show significant differences. Based on systematic research, this paper reveals the mechanisms of the difference between model tests and prototype tests with different sizes of caissons and identifies the factors influencing these differences.
Enhancing Wave Energy Converters: Dynamic Inertia Strategies for Efficiency Improvement
Authors: Maria-Arenas Aleix , Garrido Aitor J. , Garrido Izaskun
Published: July 2024

Wave energy conversion is a promising field of renewable energy, but it still faces several technological and economic challenges. One of these challenges is to improve the energy efficiency and adaptability of Wave Energy Converters to varying wave conditions. A technological approach to solve this efficiency challenge is the negative spring mechanisms illustrated in recent studies. This paper proposes and analyzes a novel negative spring technological concept that dynamically modifies the mass and inertia of a Wave Energy Converter by transferring seawater between its compartments. The added value of the presented technology relies on interoperability, ease of manufacturing and operating, and increased energy efficiency for heterogeneous sea states. The concept is presented in two analyzed alternatives: a passive one, which requires no electrical consumption and is purely based on the relative motion of the bodies, and an active one, which uses a controlled pump system to force the water transfer. The system is evaluated numerically using widely accepted simulation tools, such as WECSIM, and validated by physical testing in a wave flume using decay and regular test scenarios. Key findings include a relevant discussion about system limitations and a demonstrated increase in the extracted energy efficiency up to 12.7% while limiting the maximum power extraction for a singular wave frequency to 3.41%, indicating an increased adaptability to different wave frequencies because of the amplified range of near-resonance operation of the WEC up to 0.21 rad/s.
Thermo-Economic Comparison between Three Different Electrolysis Technologies Powered by a Conventional Organic Rankine Cycle for the Green Hydrogen Production Onboard Liquefied Natural Gas Carriers
Authors: Elrhoul Doha , Naveiro Manuel , Romero Gómez Manuel
Published: July 2024

The high demand for natural gas (NG) worldwide has led to an increase in the size of the LNG carrier fleet. However, the heat losses from this type of ship’s engines are not properly managed, nor is the excess boil-off gas (BOG) effectively utilised when generation exceeds the ship’s power demand, resulting in significant energy losses dissipated into the environment. This article suggests storing the lost energy into green H2 for subsequent use. This work compares three different electrolysis technologies: solid oxide (SOEC), proton exchange membrane (PEME), and alkaline (AE). The energy required by the electrolysis processes is supplied by both the LNG’s excess BOG and engine waste heat through an organic Rankine cycle (ORC). The results show that the SOEC consumes (743.53 kW) less energy while producing more gH2 (21.94 kg/h) compared to PEME (796.25 kW, 13.96 kg/h) and AE (797.69 kW, 10.74 kg/h). In addition, both the overall system and SOEC stack efficiencies are greater than those of PEME and AE, respectively. Although the investment cost required for AE (with and without H2 compression consideration) is cheaper than SOEC and PEME in both scenarios, the cost of the H2 produced by the SOEC is cheaper by more than 2 USD/kgH2 compared to both other technologies.
Identification of Complex Multi-Vessel Encounter Scenarios and Collision Avoidance Decision Modeling for MASSs
Authors: Lyu Hongguang , Ma Xiaoru , Tan Guifu , Yin Yong , Sun Xiaofeng , Zhang Lunping , Kang Xikai , Song Jian
Published: July 2024

Complex multi-vessel encounter situations are a challenging problem for ships to avoid collisions, and the International Regulations for Preventing Collision at Sea, 1972 (COLREGs) do not provide a clear delineation of multi-vessel encounter situations and the responsibility of collision avoidance (CA). Furthermore, Marine Autonomous Surface Ships (MASS), which realize autonomous navigation functions, face the problem of recognizing complex multi-ship encounter situations and the corresponding CA decisions. In this study, we adopt the velocity obstacle (VO) algorithm to visualize and identify the danger of multi-ship encounters with the own ship (OS) as the first viewpoint. Additionally, we consider the motion changes in target ships (TSs) and their possible CA behaviors as the basis of the ship’s CA decision-making. According to COLREGs, a simplified method for classifying the encounter situations of multiple clustered ships is proposed, considering the coupling of collision hazards and CA responsibilities between related TSs. On this basis, the corresponding CA decisions for each classified situation are proposed, and a large number of simulation experiments are conducted based on the proposed method by considering the three-ship and four-ship encounter model in the Imazu problem as an example. The experimental results indicate that the proposed method can effectively recognize the complex multi-ship encounter situation in the Imazu problem, and it can adjust the CA measures of the OS in time according to the COLREGs and the behavior of TSs. This provides the basis and reference for MASS when facing complex multi-ship encounter situations.
Unveiling the Sensitivity Analysis of Port Carbon Footprint via Power Alternative Scenarios: A Deep Dive into the Valencia Port Case Study
Authors: Issa-Zadeh Seyed Behbood , Esteban M. Dolores , López-Gutiérrez José-Santos , Garay-Rondero Claudia Lizette
Published: July 2024

The Port of Valencia, a prominent maritime center, is actively working towards minimizing its carbon emissions and aims to become a completely carbon-neutral port soon. This research uses data-driven sensitivity analysis to explore realistic power-generating options for a seaport to reduce its emissions. This approach comprises changing key parameters in power consumption and deploying renewable energies (rather than electricity and infrastructure prices, which are beyond the scope of this study) to assess their impact on the port’s overall emissions profile. Through sensitivity analysis, policymakers and managers discover each scenario’s efficacy and find the best decarbonization strategies. After thoroughly examining four realistic scenarios, our research findings show that each scenario’s emission reduction share and sensitivity are practical and feasible. It becomes clear that gradually replacing traditional fossil fuels for electricity generation with renewables is a reasonable and realistic option for emissions reduction. The results demonstrate that focusing on reasonable targets, such as replacing 30% and 50% of electricity generation with renewables, is more achievable and beneficial in the medium term than ambitious goals, like replacing all electricity with renewable energy. This research contributes to reducing emissions of the Port of Valencia by using data-driven sensitivity analysis to find practical renewable energy strategies. It provides actionable insights for managers and policymakers to implement feasible decarbonization plans, emphasizing gradual adoption of renewables over ambitious goals, thus supporting sustainable maritime operations.
Enhancing Efficiency in Hybrid Marine Vessels through a Multi-Layer Optimization Energy Management System
Authors: Truong Hoai Vu Anh , Do Tri Cuong , Dang Tri Dung
Published: July 2024

Configuring green power transmissions for heavy-industry marines is treated as a crucial request in an era of global energy and pollution crises. Following up on this hotspot trend, this paper examines the effectiveness of a modified optimization-based energy management strategy (OpEMS) for a dual proton exchange membrane fuel cells (dPEMFCs)-battery-ultra-capacitors (UCs)-driven hybrid electric vessels (HEVs). At first, the summed power of the dual PEMFCs is defined by using the equivalent consumption minimum strategy (ECMS). Accordingly, a map search engine (MSE) is proposed to appropriately split power for each FC stack and maximize its total efficiency. The remaining power is then distributed to each battery and UC using an adaptive co-state, timely determined based on the state of charge (SOC) of each device. Due to the strict constraint of the energy storage devices’ (ESDs) SOC, one fine-corrected layer is suggested to enhance the SOC regulations. With the comparative simulations with a specific rule-based EMS and other approaches for splitting power to each PEMFC unit, the effectiveness of the proposed topology is eventually verified with the highest efficiency, approximately about 0.505, and well-regulated ESDs’ SOCs are obtained.