bluuebunny/crossref_metadata_2025 huggingface dataset:
Intraoral Approach Through the Nasal Floor for Surgical Removal of Inverted Mesiodens: Protocol and Case Series
Authors: Urechescu Horatiu , Banu Ancuta , Streian Felicia , Urtila Florin , Cuzic Cristiana , Dinu Stefania , Pricop Marius
Published: December 2024

Background/Objectives: The most common form of supernumerary teeth is represented by the mesiodens. Very often, they are impacted, usually palatially, but can be found buccally or between the roots of the permanent central incisors. Their position can be normal, inclined, or inverted. In the possible case where the impacted mesiodens crown is oriented upwards towards the nasal cavity, they are called inverted mesiodens. The inverted mesiodens are mainly asymptomatic, and the main diagnostic methods are radiological, especially CBCT. Methods: This paper presents the intraoral approach through the nasal floor as a very reliable method for the surgical removal of inverted mesiodens. We report a protocol, including the diagnosis process, criteria for choosing this surgical approach, and description of the surgical procedure. Preoperative CBCT is mandatory for diagnosis and choice of the surgical approach. This is chosen based on measurements on the cross-sectional view of the CBCT investigation and is in compliance with our criteria related to the appropriate surgical approach. Results: Using this approach, the mesiodens were extracted without intraoperative or postoperative complications or accidents, and operating times were relatively short. Conclusions: The intraoral approach through the nasal floor for surgical removal of inverted mesiodens satisfies all the conditions to be a predictable, safe, and time-efficient technique. It has its limitations, mainly regarding the surgical skills of the operating team. The cone–beam computed tomography (CBCT) has a fundamental role in the diagnosis and treatment of included mesiodens.
Metabolic Disturbances Associated with In-Hospital Complication and Mortality in Different Types of Pneumonia
Authors: Făgărășan Iulia , Rusu Adriana , Comșa Horațiu , Cristea Maria , Motoc Nicoleta-Ștefania , Cristea Ciprian , Budin Corina Eugenia , Râjnoveanu Ruxandra-Mioara , Todea Doina Adina
Published: December 2024

Bakground: The mortality rate from community-acquired pneumonia (CAP) or coronavirus disease 19 (COVID-19) is high, especially in hospitalized patients. This study aimed to assess the disturbances of glucose and lipid metabolism with in-hospital complications and short-term outcomes for patients with pneumonia with different etiologies. Methods: This observational study comprised 398 patients divided as follows: 155 with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia, 129 participants with viral CAP, and 114 with bacterial pneumonia. Results: Fasting plasma glucose (FPG) at admission and glycemic variation during hospitalization was linked with acute kidney injury (AKI) in bacterial CAP. Compared with a value <110 mg/dL for FPG at admission, levels between 110 and 126 mg/dL are associated with mortality in both COVID-19 (OR = 3.462, 95% CI: 1.275–9.398, p = 0.015) and bacterial CAP participants (OR = 0.254; 95% CI: 0.069–0.935, p = 0.039), while a value ≥126 mg/dL was linked with mortality only in patients with SARS-CoV-2 (OR = 3.577, 95% CI: 1.166–10.976, p = 0.026). No relation between lipid biomarkers and complications or in-hospital outcomes was observed in all three participant groups. Conclusions: Patients with bacterial CAP are more prone to developing AKI due to increased FBG at admission and glycemic variations during hospitalization, while elevated FBG values at admission are associated with mortality in both COVID-19 and bacterial CAP.
AI in Hepatology: Revolutionizing the Diagnosis and Management of Liver Disease
Authors: Malik Sheza , Das Rishi , Thongtan Thanita , Thompson Kathryn , Dbouk Nader
Published: December 2024

The integration of artificial intelligence (AI) into hepatology is revolutionizing the diagnosis and management of liver diseases amidst a rising global burden of conditions like metabolic-associated steatotic liver disease (MASLD). AI harnesses vast datasets and complex algorithms to enhance clinical decision making and patient outcomes. AI’s applications in hepatology span a variety of conditions, including autoimmune hepatitis, primary biliary cholangitis, primary sclerosing cholangitis, MASLD, hepatitis B, and hepatocellular carcinoma. It enables early detection, predicts disease progression, and supports more precise treatment strategies. Despite its transformative potential, challenges remain, including data integration, algorithm transparency, and computational demands. This review examines the current state of AI in hepatology, exploring its applications, limitations, and the opportunities it presents to enhance liver health and care delivery.
Results of Modified Minimally Invasive Hallux Valgus Surgery, Factors for the First Metatarsal Shortening, and Patients’ Satisfaction
Authors: Hwang Jihyun , Cho Jung-Ah , Choi Go Woon , Song Si Young , Lee Collin , Kim Sung Jae
Published: December 2024

Background: Hallux valgus is a prevalent foot deformity conventionally treated with open surgical techniques, which carry risk of complications due to extensive soft tissue dissection. Minimally invasive surgeries (MISs) as alternatives offer comparable outcomes, reduced pain, and faster recovery; however, their challenges include the risk of shortening of the first metatarsal. This study aimed to assess the efficacy of our modified MIS hallux valgus correction technique and investigate the factors that affect first metatarsal shortening. Methods: Twenty-nine feet treated with modified MIS hallux valgus surgery between 2017 and 2022 were included with an average follow-up of 29 months. Clinical outcomes were evaluated with the Manchester–Oxford Foot Questionnaire (MOXFQ), Foot Function Index (FFI), and visual analog scale for pain. Radiographic evaluations included the intermetatarsal angle (IMA), hallux valgus angle (HVA), distal metatarsal articular angle (DMAA), first metatarsal length, and sesamoid grade. Results: Functional and radiographic outcomes were significantly improved (p < 0.0001 and p < 0.001, respectively). Significant correlations between patient satisfaction and the MOXFQ, FFI, and VAS scores were found, with no significant correlations between patient satisfaction and radiographic outcomes. Non-purchasing of the lateral cortex of the proximal osteotomy site was identified to increase risk of first metatarsal shortening (odds ratio [OR] = 22.09, p = 0.0064). Conclusions: Our modified MIS for hallux valgus correction showed favorable radiographic and functional outcomes. Proximal lateral cortex purchasing should be targeted to reduce postoperative shortening of the first metatarsal.
A Smartphone App for the Management of Postoperative Home Recovery After Thoracic Surgery Procedures: A Pilot Study Using the Care4Today™ App
Authors: Bertoglio Pietro , Garelli Elena , Bonucchi Silvia , Brandolini Jury , Kawamukai Kenji , Antonacci Filippo , Forti Parri Sergio Nicola , Bonfanti Barbara , Lai Giulia , De Leonibus Lisa , Solli Piergiorgio
Published: December 2024

Background/Objectives: In recent years, the use of smartphones has significantly increased among populations of almost every age. The aim of our work is to analyze the impact of an application (app) that follows up with the progress of a patient who underwent a thoracic surgery procedure in the first 30 days after discharge. Methods: We prospectively analyzed all the patients included in the pilot study from March 2023 to September 2023. The Care4Today™ app was downloaded and activated by the patient preoperatively. From the day of discharge, the app sent questions related to pain perception, breathing capacity, general clinical conditions, problems with surgical wound and quality of life. In the case of negative responses, clinical staff received an email with an orange (medium problem) or red (serious problem) alert. Results: Among the 96 patients who were included, 82 eventually downloaded and used the app. The mean age of the patients was 60.7 years (range 19–80), and 43 (52.4%) were female. Minimally invasive techniques (VATS or RATS) were used in 76 cases (92.7%). The mean length of in-hospital stay was 5.3 days. Malignancy was the reason for surgery in 66 cases (80.5%). The answer rate was 75.8%. A total of 698 orange alerts and 52 red alerts were sent by the app. Re-hospitalization was needed in two cases (only one case related to our surgical procedure). The app was globally judged as useful in the management of convalescence (with an average rating of 7.4 out of 10). Age was not related to the completion rate of answers. Conclusions: The use of the app Care4Today could prevent unexpected re-hospitalization and possible complications. The patients appreciated the use of this tool, and they found it useful for safer postoperative recovery. No difference according to the patients’ age was found regarding the use of the app.
Factors Associated with In-Hospital Mortality in Adult Patients with Bacterial Meningitis
Authors: Makowiecki Michał , Paciorek Marcin , Bednarska Agnieszka , Krogulec Dominika , Porowski Dawid , Bursa Dominik , Skrzat-Klapaczyńska Agata , Bieńkowski Carlo , Kowalska Justyna D. , Zielenkiewicz Magdalena , Horban Andrzej , Laskus Tomasz
Published: December 2024

Background/Objectives: The aim of this study was to evaluate the association between various clinical and laboratory findings and in-hospital mortality in community-acquired bacterial meningitis (BM). Methods: We retrospectively analyzed 339 adult (≥18 years old) patients with bacterial meningitis who were admitted to the Hospital for Infectious Diseases in Warsaw between January 2010 and December 2017. Results: Altogether, 56 patients (16.5%) died during hospitalization. On admission, the non-survivors scored lower on the Glasgow Coma Scale (GCS) (median 7 vs. 13, p < 0.001) and higher on the Sequential Organ Failure Assessment (SOFA) score (median 6 vs. 2, p < 0.001) and were less likely to complain about headaches (18.75% vs. 54.21%, p < 0.001) and nausea and/or vomiting (1.89% vs. 36.2%, p < 0.001), but were more likely to manifest peripheral nerve palsies (21.43% vs. 9.61%, p = 0.02). The patients who died were also more likely to be immunocompromised (53.57% vs. 34.28%, p = 0.01), have Streptococcus pneumoniae etiology (35.71% vs. 16.25%, p = 0.001), higher concentrations of procalcitonin (median 5.035 ng/mL vs. 2.245 ng/mL, p = 0.003) and urea (median 10.7 mmol/L vs. 5.865 mmol/L, p < 0.001) in the blood and higher protein (median 4.57 g/L vs. 2.605 g/L, p = 0.014) and lower glucose levels (median 0.765 mmol/L vs. 1.89 mmol/L, p = 0.006) in the cerebrospinal fluid (CSF). In a multiple logistic regression analysis, which was conducted separately for the GCS and SOFA, both scoring systems (OR = 0.67, OR 95% CI 0.59–0.75, p < 0.001 for GCS and OR = 1.42, OR 95% CI 1.29–1.60, p < 0.001 for SOFA) as well as an age over 70 years (OR = 3.99, OR 95% CI 1.39–12.93, p = 0.014) and Streptococcus pneumoniae etiology (OR = 2.38, OR 95% CI 1.12–4.99, p = 0.022) were associated with in-hospital deaths. Conclusions: The survivors and non-survivors with BM differed with respect to a number of signs and symptoms, etiology, the results of blood and CSF laboratory tests, and the immune deficiency status, as well as the GCS and SOFA scores. In the multiple logistic regression analysis, both of the GCS and SOFA scoring systems, age and Streptococcus pneumoniae etiology showed high associations with the in-hospital deaths.
Advances in Atrial Fibrillation Management: A Guide for General Internists
Authors: Pham Hoang Nhat , Ibrahim Ramzi , Truong Hong Hieu , Sainbayar Enkhtsogt , Tran Viet Nghi , Abdelnabi Mahmoud , Kanaan Christopher , Sridharan Aadhavi
Published: December 2024

Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia, impacting approximately 6.1 million adults in the United States, with projections to increase two-fold by 2030. AF significantly increases the risk of stroke and other adverse cardiovascular events, leading to increased morbidity and mortality. The 2023 ACC/AHA/ACCP/HRS guidelines present a paradigm shift in AF management, moving from a duration-based classification to a more comprehensive, patient-centered approach. This includes a novel AF classification system that emphasizes early detection and intervention, including risk factors and lifestyle modification tailored to each patient’s risk profile. Moreover, the recommendations advocate for a multidisciplinary care model, ensuring coordinated management involving primary care providers and specialists. Primary care providers play a crucial role in initiating risk factor management and lifestyle interventions, even before the development of AF. This review aims to thoroughly examine the guidelines for the diagnosis and management of AF and equip general internists with the necessary insights to navigate the evolving landscape of AF care effectively.
Effects on Posture of a Two-Diopter Horizontal Prism Base Out on the Non-Dominant Eye
Authors: Marini Davide , Rubegni Giovanni , Sarti Lorenzo , Rufa Alessandra , Mandalà Marco , Ferretti Fabio , Tosi Gian Marco , Fruschelli Mario
Published: December 2024

Background/Objectives: Ocular proprioception is implicated in balance control and heterophoria is associated with abnormal posture, though previous research focused mainly on the role of vertical phoria and the use of vertical prisms. This study aims to evaluate whether ocular misalignment and prismatic correction of horizontal phoria affect posture. Methods: Sixty-nine (N = 69) young healthy subjects were included and equally divided by horizontal distance phoria: orthophoria (n = 23), esophoria (n = 23) and exophoria (n = 23). A prism of low power (two-diopter) was placed base out on the non-dominant eye, reducing misalignment in esophorics and increasing it in exophorics more than in orthophorics. Dynamic computerized posturography was performed with the sensory organization test protocol (SOT) of the EquiTest® NeuroCom® version 8 platform both without and with prism, always maintaining subjects unaware of prism use. A mixed model for repeated measures analysis of variance was run to evaluate the main effect of prism and the interaction effect of prism with baseline phoria. Results: Composite movement strategy score without prism was 88.1 ± 2.8% (ankle-dominant strategy) and slightly increased to 89.0 ± 3.1% with prism insertion (p = 0.004), further shifting toward ankle strategy. Composite equilibrium score without prism was 80.3 ± 6.5% and remained stable with prism insertion (81.3 ± 8.2%, p = 0.117), medio-lateral and antero-posterior projection of center of gravity did not displace significantly under prism insertion (p = 0.652 and p = 0.270, respectively). At baseline, posturographic parameters were statistically independent of individual phoria, and no significant interaction between prism insertion and individual phoria was documented for any parameters (p > 0.05 for all). Secondary analysis and pairwise comparisons confirmed that the effect of prism was strongly selective on condition SOT 5 (eyes-closed, platform sway-referenced) with improvement of equilibrium (70.4 ± 9.7% with prism vs. 65.7 ± 11.6% without) and more use of ankle strategy (81.6 ± 5.3% with prism vs. 78.2 ± 6.0% without), without any interaction of phoria and ocular dominance, while the other conditions were comparable with and without prism. Conclusions: A two-diopter prism base out on the non-dominant eye induces the body to use the ankle joint more independently of individual phoria, suggesting a small improvement in postural control, while maintaining oscillations of the center of gravity unaltered. Prism seems to enhance the function of vestibular system selectively. Phoria adjustments with prismatic correction enable intervention in postural behavior. Extraocular muscles could act as proprioceptors influencing postural stability.
Novel Functional Polycaprolactone/Hematite Composites with Improved Mechanical, Thermal, UV-Protective and Barrier Properties
Authors: Krehula Ljerka Kratofil , Peršić Ana , Popov Nina , Krehula Stjepko
Published: December 2024

The need for materials with advanced properties finds the candidates among modified polymers—for instance, polymer composites. Furthermore, the stated environmental concerns dictate the use of biodegradable polymers. This work studies the properties of polycaprolactone/hematite composites prepared by the incorporation of laboratory-synthesized hematite (α-Fe2O3) particles of different sizes into the polycaprolactone (PCL) matrix. PCL is a biodegradable, biocompatible and non-toxic polymer, while hematite is a thermally stable, corrosion-resistant, non-toxic and low-cost iron oxide. To avoid harmful solvents, PCL/hematite composites were prepared by melt mixing. PCL and PCL/hematite composites were studied by thermogravimetric analysis (TGA), FTIR and UV–Vis–NIR spectroscopy. The mechanical and barrier properties were also studied. The results indicate the influence of hematite particles on the enhancement of PCL properties, especially using the smaller hematite particles (average diameter of about 100 or 170 nm). An improvement of thermal stability, UV absorption and mechanical properties was observed. The composites prepared with the larger hematite particles (average diameter of about 1 or 2 µm) act as a significantly better barrier to water loss than pure PCL. Therefore, PCL/hematite composites can be used as novel functional materials, with enhanced mechanical, thermal, barrier and UV-protective properties, for packaging or biomedical purposes.
Decellularized Green and Brown Macroalgae as Cellulose Matrices for Tissue Engineering
Authors: Berry-Kilgour Caitlin , Oey Indrawati , Cabral Jaydee , Dowd Georgina , Wise Lyn
Published: December 2024

Scaffolds resembling the extracellular matrix (ECM) provide structural support for cells in the engineering of tissue constructs. Various material sources and fabrication techniques have been employed in scaffold production. Cellulose-based matrices are of interest due to their abundant supply, hydrophilicity, mechanical strength, and biological inertness. Terrestrial and marine plants offer diverse morphologies that can replicate the ECM of various tissues and be isolated through decellularization protocols. In this study, three marine macroalgae species—namely Durvillaea poha, Ulva lactuca, and Ecklonia radiata—were selected for their morphological variation. Low-intensity, chemical treatments were developed for each species to maintain native cellulose structures within the matrices while facilitating the clearance of DNA and pigment. Scaffolds generated from each seaweed species were non-toxic for human dermal fibroblasts but only the fibrous inner layer of those derived from E. radiata supported cell attachment and maturation over the seven days of culture. These findings demonstrate the potential of E. radiata-derived cellulose scaffolds for skin tissue engineering and highlight the influence of macroalgae ECM structures on decellularization efficiency, cellulose matrix properties, and scaffold utility.
A Vessel Position Precision Analysis Based on a Two-Star Combined Approach
Authors: Wu Yulin , Zhuo Chao , He Tao , Liu Gangjun , Liu Qingqing
Published: December 2024

Traditional celestial navigation mainly utilized the sextant to measure the attitude and the position contour method to calculate and resolve the vessel’s positioning problem, but these methods are not rigorous, having major deficiencies in the positioning accuracy. Currently, the small field-of-view star sensor is becoming the main attitude measurement equipment on vessels, and its measurement accuracy directly affects the vessel positioning results. Aiming at this problem, this research provides a model of small field-of-view star sensor positioning accuracy based on the two-star combination method, and numerical solutions are given. In addition, it focuses on the influence of the measurement error of the star sensor, especially the elevation angle error, on the positioning accuracy of the vessel and gives the star selection strategy for practical application. In particular, the star selection strategy is also applicable to other two-star positioning methods. The results show that the analytical solution is computationally simple and real-time, and the effect of measurement errors on positioning can be minimized by the star selection strategy. This study reveals the error influence mechanism based on the dual-star combination approach, which has significant implications for practical vessel navigation using small-field-of-view star sensors.
Research on Fault Diagnosis Method for Marine Diesel Engines Based on Multi-Scale Attention Mechanism Transformer
Authors: Chen Manyi , Gan Huibing , Wu Hangjie
Published: December 2024

In modern intelligent shipping, ensuring the stable and reliable technical condition of marine diesel engines is critical for safe and efficient vessel operations. Conventional fault diagnosis approaches and many existing Transformer-based methods often focus on single-scale features, potentially overlooking subtle fault indicators and reducing diagnostic accuracy under complex working conditions. To address these limitations, this paper proposes a Multi-Scale Attention Transformer (MSAT) model that integrates both high- and low-resolution attention mechanisms. This multi-scale strategy enhances the extraction of detailed and coarse-grained features, improving the model’s capacity to detect and characterize complex diesel engine faults. Additionally, an optimized Nadam optimizer is employed to refine convergence speed and accuracy, surpassing the Adam-based baseline by 0.71%. Rigorous testing on a publicly available diesel engine fault dataset demonstrates that the MSAT model achieves a diagnostic accuracy of 99.86% at a 60 dB signal-to-noise ratio (SNR), outperforming established models such as GRU and LSTM by more than 1%. Even under severe noise interference (0 dB SNR), the model maintains a high accuracy of 96.86%, highlighting its robustness and suitability for real-time monitoring in challenging marine environments. By quantitatively validating these improvements in diagnostic accuracy and noise resistance, this work offers a novel and effective solution for predictive maintenance and operational condition assessment of marine diesel engines, contributing to the reliability and safety of intelligent shipping systems.
Simulation Study on Detection and Localization of a Moving Target Under Reverberation in Deep Water
Authors: Dun Jincong , Zhou Shihong , Qi Yubo , Liu Changpeng
Published: December 2024

Deep-water reverberation caused by multiple reflections from the seafloor and sea surface can affect the performance of active sonars. To detect a moving target under reverberation conditions, a reverberation suppression method using multipath Doppler shift in deep water and wideband ambiguity function (WAF) is proposed. Firstly, the multipath Doppler factors in the deep-water direct zone are analyzed, and they are introduced into the target scattered sound field to obtain the echo of the moving target. The mesh method is used to simulate the deep-water reverberation waveform in time domain. Then, a simulation model for an active sonar based on the source and short vertical line array is established. Reverberation and target echo in the received signal can be separated in the Doppler shift domain of the WAF. The multipath Doppler shifts in the echo are used to estimate the multipath arrival angles, which can be used for target localization. The simulation model and the reverberation suppression detection method can provide theoretical support and a technical reference for the active detection of moving targets in deep water.
Practical Fixed-Time Robust Containment Control of Multi-ASVs with Collision Avoidance
Authors: Wu Tao , Liu Zhengjiang , Shi Guoyou
Published: December 2024

A practical fixed-time robust containment control method for multiple autonomous surface vehicles (multi-ASVs) is proposed in this study. This method addresses the containment control problem of multi-ASVs, considering both collision risks and external disturbances. This control scheme improves the cooperative performance of the formation and guarantees safe collision avoidance behavior. First, to enable the online estimation of unknown time-varying disturbances from the external environment, a fixed-time disturbance observer (FNDO) is designed based on fixed-time control theory. Second, the distributed kinematic controller is modified to include the partial derivatives of the artificial potential energy function (APEF), thereby preventing collisions among multi-ASVs. Third, by applying fixed-time theory, graph theory, and fixed-time dynamic surface control techniques, a practical fixed-time robust containment controller for multi-ASVs is proposed. Additionally, the entire closed-loop control system is guaranteed to be practical and fixed-time stable through stability analysis. Finally, the proposed control strategy has been validated by simulation results.
Multivariate, Automatic Diagnostics Based on Insights into Sensor Technology
Authors: Skålvik Astrid Marie , Bjørk Ranveig N. , Martínez Enoc , Frøysa Kjell-Eivind , Saetre Camilla
Published: December 2024

With the rapid development of smart sensor technology and the Internet of things, ensuring data accuracy and system reliability is paramount. As the number of sensors increases with demand for high-resolution, high-quality input to decision-making systems, models and digital twins, manual quality control of sensor data is no longer an option. In this paper, we leverage insights into sensor technology, environmental dynamics and the correlation between data from different sensors for automatic diagnostics of a sensor node. We propose a method for combining results of automatic quality control of individual sensors with tests for detecting simultaneous anomalies across sensors. Building on both sensor and application knowledge, we develop a diagnostic logic that can automatically explain and diagnose instead of just labeling the individual sensor data as “good” or “bad”. This approach enables us to provide diagnostics that offer a deeper understanding of the data and their quality and of the health and reliability of the measurement system. Our algorithms are adapted for real time and in situ operation on the sensor node. We demonstrate the diagnostic power of the algorithms on high-resolution measurements of temperature and conductivity from the OBSEA observatory about 50 km south of Barcelona, Spain.
Long-Term Outcome of Elderly Patients with Severe Aortic Stenosis Undergoing a Tailored Interventional Treatment Using Frailty-Based Management: Beyond the Five-Year Horizon
Authors: Esposito Augusto , Foffa Ilenia , Quadrelli Paola , Bastiani Luca , Vecoli Cecilia , Del Turco Serena , Berti Sergio , Mazzone Annamaria
Published: December 2024

Background: Elderly patients with severe aortic stenosis (AS) need individualized decision-making in their management in order to benefit in terms of survival and improvement of quality of life. Frailty, a common condition in elderly patients, needs to be considered when weighing treatment options. Aim: We aimed to evaluate outcomes including survival and functional parameters according to disability criteria at six years of follow-up in an older population treated for severe AS using a frailty-based management. Methods: We evaluated data derived from a pilot clinical project involving elderly patients with severe AS referred to a tailored management based on classification by Fried’s score into pre-frail, early frail, and frail and a multidimensional geriatric assessment. A Frailty, Inflammation, Malnutrition, and Sarcopenia (FIMS) score was used to predict the risk of mortality at six years of follow-up. Functional status was evaluated by telephonic interview. Results: At six years of follow-up, we found a survival rate of 40%. It was higher in the pre-frail patients (long rank < 0.001) and in the patients who underwent TAVR treatment (long rank < 0.001). The cut-off FIMS score value of ≥1.28 was an independent determinant associated with a higher risk of mortality at six years of follow-up (HR 2.91; CI 95% 1.7–5.1; p-value 0.001). We found a moderate increase of disability levels, malnutrition status, comorbidities, and number of drugs, but none of them self-reported advanced NYHA class III–IV heart failure. Conclusion: An accurate clinical–instrumental and functional geriatric evaluation in an elderly population with AS is required for a non-futile interventional treatment in terms of survival and functional status even in long-term follow-up.
Post-Operative Outcome Predictions in Vestibular Schwannoma Using Machine Learning Algorithms
Authors: Dichter Abigail , Bhatt Khushi , Liu Mohan , Park Timothy , Djalilian Hamid R. , Abouzari Mehdi
Published: December 2024

Background/Objectives: This study aimed to develop a machine learning (ML) algorithm that can predict unplanned reoperations and surgical/medical complications after vestibular schwannoma (VS) surgery. Methods: All pre- and peri-operative variables available in the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database (n = 110), except those directly related to our outcome variables, were used as input variables. A deep neural network model consisting of seven layers was developed using the Keras open-source library, with a 70:30 breakdown for training and testing. The feature importance of input variables was measured to elucidate their relative permutation effect in the ML model. Results: Of the 1783 patients with VS undergoing surgery, unplanned reoperation, surgical complications, and medical complications were seen in 8.5%, 5.2%, and 6.2% of patients, respectively. The deep neural network model had area under the curve of receiver operating characteristics (ROC-AUC) of 0.6315 (reoperation), 0.7939 (medical complications), and 0.719 (surgical complications). Accuracy, specificity, and negative predictive values of the model for all outcome variables ranged from 82.1 to 96.6%, while positive predictive values and sensitivity ranged from 16.7 to 51.5%. Variables such as the length of stay post-operation until discharge, days from operation to discharge, and the total hospital length of stay had the highest permutation importance. Conclusions: We developed an effective ML algorithm predicting unplanned reoperation and surgical/medical complications post-VS surgery. This may offer physicians guidance into potential post-surgical outcomes to allow for personalized medical care plans for VS patients.
Financial Performance of the Target Companies: Before and After Acquisitions
Authors: Dogan Burak , Ugurlu Umut
Published: December 2024

This study investigates the financial performance of target companies involved in mergers and acquisitions (M&As), aiming to reveal the dynamics affecting these organizations pre- and post-transaction. Utilizing a comprehensive dataset, we analyze the financial outcomes of M&A deals globally, spanning from 2010 to 2019. Employing various financial ratios, such as liquidity ratios, profitability measures, leverage ratios, asset management ratios, and market valuation metrics, this research provides an understanding of how M&As influence the financial performance of target companies. The key findings suggest that target companies experience significant changes in their financial ratios post-acquisition, with liquidity and profitability ratios showing marked fluctuations. The study shows that the method of payment (cash vs. non-cash) and the size of the deal significantly influence the post-acquisition financial performance of target companies. Cash-based and lower-valued deals are found to have a more positive impact on financial stability and growth metrics. This research contributes to the existing body of knowledge by highlighting the marginal effects of acquisition strategies on target companies’ financial performance. Our findings provide practical insights for potential acquirers, suggesting that the choice of acquisition method and deal size can significantly affect the financial outcomes of M&A activities.
Contextualizing UNESCO’s Historic Urban Landscape Approach: A Framework for Identifying Modern Heritage in Post-Blast Beirut
Authors: Makhzoumi Jala , Al-Harithy Howayda , Bazzi Mariam
Published: December 2024

This paper reflects on the application and adaptation of the Historic Urban Landscape (HUL) approach in Beirut, Lebanon, in post-disaster conditions. Adopted by UNESCO in 2005, the HUL approach marked a shift in addressing urban heritage, echoing an evolution in theory. However, contextualizing the HUL approach to address distinct local, geographic, and cultural conditions and reframing its scale and scope of operation remains a challenge. This paper uses a case-study-based methodology as it reflects on the application of the Historic Urban Landscape approach in the post-blast context of Beirut. Commissioned by UNESCO, an interdisciplinary team at the Beirut Urban Lab used the HUL approach to identify modern heritage in Beirut after adapting it to the post-colonial and Mediterranean context of the city. This study contextualized modern heritage definitions, proposed a periodization of modern built and landscape heritage, and designated modern heritage based on its formal/spatial, urban/landscape, socio-cultural, and environmental values. This paper argues that the study contributes to the advancement of the Historic Urban Landscape approach by operationalizing it into an applicable heritage framework, employing a transdisciplinary model that involves local people at the institutional and community levels, and serving as a basis for generating conservation strategies responsive to place and culture. This study also pioneered a comprehensive, integrative, and transdisciplinary reading of modern heritage in Beirut, breaking the professional silos between disciplines and bringing landscape into the identification of heritage in Lebanon.
Prioritizing Urban River Restoration Management Practices: A Cross-Evaluation Using the Criticality Index for Watershed Restoration (CIWR) and Opportunity Layers
Authors: Lima Andressa Ferreira , Ferreira Giulia Figueiredo , Veról Aline Pires , Miguez Marcelo Gomes
Published: December 2024

Urbanization exerts significant stress on urban river ecosystems, leading to their degradation and the loss of environmental functions. Several studies have focused on restoring these urban rivers to enhance environmental quality and contribute to overall city well-being. However, such restoration efforts encounter economic, environmental, and social challenges. This study proposes a methodological framework to aid public managers in prioritizing areas for urban river restoration. The approach integrates the concept of environmental services with urban development opportunities to address these dual demands. Central to this framework is the introduction of the criticality index for watershed restoration (CIWR), which categorizes watershed areas based on environmental quality indicators, using river restoration as a guiding principle. Additionally, legally protected environmental areas were considered as opportunity layers. This study used geographic information systems (GIS) to manage and overlay datasets for a case study in the João Mendes Watershed in Niterói, southeast Brazil, which illustrated the use of the CIWR. By intersecting this framework with the opportunity layers, priority locations were identified for potential river restoration management practices. The results indicated that the overall criticality condition of this watershed for river restoration is low. The study further discusses potential measures for river restoration in the identified priority areas, underscoring the importance of strategic planning in urban environmental management. The CIWR proved to be an easily applicable and replicable management decision tool for comparing watersheds and assessing deficient environmental services, with both numerical and spatial results. Its use, combined with the “opportunity” layer, enables public managers to define priority areas for river restoration practices based on clear and objective criteria.
Landscape Metrics as Ecological Indicators for PM10 Prediction in European Cities
Authors: Sohrab Seyedehmehrmanzar , Csikós Nándor , Szilassi Péter
Published: December 2024

Despite significant progress in recent decades, air pollution remains the leading environmental cause of premature death in Europe. Urban populations are particularly exposed to high concentrations of air pollutants, such as particulate matter smaller than 10 µm (PM10). Understanding the spatiotemporal variations of PM10 is essential for developing effective control strategies. This study aimed to enhance PM10 prediction models by integrating landscape metrics as ecological indicators into our previous models, assessing their significance in monthly average PM10 concentrations, and analyzing their correlations with PM10 air pollution across European urban landscapes during heating (cold) and non-heating (warm) seasons. In our previous research, we only calculated the proportion of land uses (PLANDs), but according to our current research hypothesis, landscape metrics have a significant impact on PM10 air quality. Therefore, we expanded our independent variables by incorporating landscape metrics that capture compositional heterogeneity, including the Shannon diversity index (SHDI), as well as metrics that reflect configurational heterogeneity in urban landscapes, such as the Mean Patch Area (MPA) and Shape Index (SHI). Considering data from 1216 European air quality (AQ) stations, we applied the Random Forest model using cross-validation to discover patterns and complex relationships. Climatological factors, such as monthly average temperature, wind speed, precipitation, and mean sea level air pressure, emerged as key predictors, particularly during the heating season when the impact of temperature on PM10 prediction increased from 5.80% to 22.46% at 3 km. Landscape metrics, including the SHDI, MPA, and SHI, were significantly related to the monthly average PM10 concentration. The SHDI was negatively correlated with PM10 levels, suggesting that heterogeneous landscapes could help mitigate pollution. Our enhanced model achieved an R² of 0.58 in the 1000 m buffer zone and 0.66 in the 3000 m buffer zone, underscoring the utility of these variables in improving PM10 predictions. Our findings suggest that increased urban landscape complexity, smaller patch sizes, and more fragmented land uses associated with PM10 sources such as built-up areas, along with larger and more evenly distributed green spaces, can contribute to the control and reduction of PM10 pollution.
Digital Characteristics of Spatial Layout in Urban Park Scene Space: Spatial Classification, Quantitative Indicators, and Design Applications Based on Completed Park Cases
Authors: Fan Boqing , Gu Jia , Ai Shucheng , Chen Xi , Du Siying , Cheng Yuning
Published: December 2024

Urban parks are important components of the urban green space system, providing residents with a variety of leisure options. The design’s focal point is the spatial layout of the different use scenarios within these parks. Previous studies have largely concentrated on the scene and macro layout of urban public spaces but have not thoroughly investigated the digital characteristics and corresponding parametric methods for the layout of different internal use scenes in urban green spaces. This research selected 18 urban parks from various global regions as case samples and categorized eight typical park scene space types based on common activity scene requirements in park design using AutoCAD to identify vector boundaries in each sample. To examine the digital characteristics of these scene space types, a quantitative index system was established, including spatial density and scale indicators, spatial connection relationship indicators, and spatial unit morphology indicators. The analysis of these indicators across the samples shows that the number of scene spaces is positively correlated with the total park area, while natural experience scenes constitute the largest proportion of urban parks. Different scene types exhibit distinct spatial layouts; for example, circulation spaces demonstrate high connectivity due to their role in directing visitor flow. Some spaces exhibit a more fixed scale and size, while others vary considerably. Finally, this research develops a parametric design framework using the Grasshopper platform. By taking a park in Nanjing as a case study, this paper illustrates how to utilize digital layout features to generate scene space layouts, offering insights into intelligent generative design. This approach provides a structured method to enhance urban park design through the application of digital and parametric tools, contributing to the broader field of urban park design.
Rewilding Landscape Creation in Country Parks Based on Wilderness Thinking—Taking Shanghai Heqing Country Park as an Example
Authors: Li Jing , Zhu Yi , Yu Haoran , Zhang Lang
Published: December 2024

In recent years, rapid urbanization in China has driven cities to expand uncontrollably into surrounding rural areas. Within the global context of ecological restoration, protecting and rehabilitating natural spaces have become key issues in landscape design. The concept of rewilding, rooted in wilderness philosophy, has gained significant attention. This article explores the background, significance, and theoretical foundations of rewilding urban ecological spaces using the woodland area of Heqing Country Park in Shanghai as a case study. It examines the feasibility, methods, and strategies for implementing rewilding in urban settings, considering both natural and human-influenced activities, with a focus on minimizing human intervention. This approach enhances biodiversity, promotes the sustainable development of ecosystems, and helps the park maintain its rural character despite its tourist appeal. Four years after the project’s implementation, research data show that the richness of native plant species, the diversity of bird species, and insect populations have exceeded those of the previously maintained forest. Moreover, the rewilding landscapes have supported the natural succession of habitat communities, leading to a stable and revitalized ecosystem. The landscape improvements and visitor experiences have been highly positive. The reconstruction strategy developed in this project is expected to inform future ecological initiatives, such as country parks, promoting the harmonious development of human and natural environments and serving as a model for creating urban ecosystems where both can coexist sustainably.
The Acquisition of Branching Onsets in Simultaneous French–Portuguese Bilingual Children: The Effect of Age, Language, Cluster Type, and Dominance
Authors: Almeida Letícia , Possidónio Margarida , Castro Mariana
Published: December 2024

The literature on bilingual language development often reports cases of cross-linguistic interaction of the two languages being acquired. In this paper, we investigate possible cross-linguistic interaction outputs in the development of branching onsets in the bilingual acquisition of French and Portuguese. Thirty French–Portuguese bilingual children, aged between 3;6 and 6;1, participated in our study. Their elicited productions were collected using two picture naming tasks containing 29 clusters in French and 57 clusters in Portuguese. Almost all the children acquire branching onsets earlier in French than in Portuguese, independently of the quality of cluster type (Consonant + Rhotic (Cr) clusters vs. Consonant + Lateral (Cl) clusters). Epenthesis is more present in Portuguese than in French. Shared structures in both languages are not acquired at the same time. These results show that bilingual children follow separate patterns of development, close to the ones reported for monolinguals, during the acquisition of their two languages. Moreover, the bilingual children show higher rates of development of clusters in Portuguese than the ones reported for monolinguals, suggesting an accelerated acquisition of clusters in Portuguese due to a positive influence of French.
Something That Looks Like Money: Ethnopragmatic Analysis of Wealth-Related Title Names Among Young Igbo Businessmen
Authors: Etu Mercy Runyi , Offong Imeobong John , Eyakndue Idongesit Imohowo
Published: December 2024

African anthroponyms are a rich repository of the socio-cultural materials of ethnolinguistic groups. They reveal speakers’ collective beliefs, norms, traditions, practices, philosophies and worldview. Among other things, literature on Igbo personal names show current trends in contemporary naming and the reasons for this, the social structure of their society. Igbo names also provide insight into what speakers value and uphold. This includes ideas they have about concepts such as wealth, which has also been interrogated. It has been discovered that titles also capture the ways wealth is viewed by Igbo-speaking people. This is obvious in the informal titles held by young businessmen of this ethnolinguistic group. This paper examines title names which are conferred informally by young Igbo businessmen. It particularly investigates the value holders place on wealth, which are captured by these names. While it explicates the identity that holders create for themselves when they have attained a certain level of financial success, it draws attention to the importance placed on wealth possession as a fundamental index for attaining high social status in Igbo land. The ethnopragmatic framework was employed to explain wealth-related title naming as a speech practice, which is different from the traditional order of this community of speakers. It is chosen for its emphasis on the understanding of speakers’ cultural nuances for the use of language, one of which is naming. Using ethnographic tools such as semi-structured interviews, passive participation and participant observation, information on forty-one such title names have been elicited. Questions asked included the semantic interpretation of the names, what circumstances inform the choice of the names and the importance bearers place on wealth. It is revealed that, for young Igbo businessmen, being wealthy is equated with the possession of money. The values they place on money are highly influenced by the capacity it gives to bearers, its usefulness in defending oneself and attacking adversaries and the provision of succor to those in need.