bluuebunny/crossref_metadata_2025 huggingface dataset:
Can Gastric Juice Analysis with EndoFaster® Reduce the Environmental Impact of Upper Endoscopy?
Authors: Zullo Angelo , Chiovelli Federica , Esposito Enrica , Hassan Cesare , Casini Beatrice
Published: December 2023

Gastrointestinal (GI) endoscopy services are in third place as major contributors to CO2 emissions among healthcare facilities, especially due to their massive waste production. One of the measures suggested to reduce this environmental impact is a reduction in histological examinations performed on biopsy specimens taken during endoscopy. A reliable candidate to reduce the rate of biopsies and, consequently, the impact of CO2 emissions could be EndoFaster®, an innovative medical device that allows one to suspect or rule out both H. pylori infection and precancerous lesions on the gastric mucosa by analyzing a small amount of gastric juice aspirated during endoscopy in real time. In the present study, we investigated the ability of EndoFaster® to reduce the environmental impact of upper endoscopy, comparing the CO2 production of standard biopsy sampling as suggested in guidelines and biopsies guided by real-time EndoFaster® results during endoscopy. By estimating an overall 90% rate of biopsies according to standard guidelines and a reduction of 50% of gastric biopsies based on EndoFaster® results, we calculated a 44% overall reduction in CO2 emissions, demonstrating that by using this tool, it is possible to distinctly reduce the contribution of upper endoscopy to global warming.
Exploring Vulnerability Indicators: Tourist Impact on Cultural Heritage Sites in High Arctic Svalbard
Authors: Flyen Anne Cathrine , Flyen Cecilie , Hegnes Atle Wehn
Published: December 2023

This article reports findings from two research projects that aimed to understand the vulnerabilities of cultural heritage sites in Svalbard and investigated factors that influence tourism-induced pressures and site degradation. It draws upon fieldwork conducted at ten selected historic locations, including interviews with tourists and guides, consultations with regional and central cultural heritage management authorities, on-site observations, and condition assessments. The primary goal was to explore indicators rendering cultural heritage sites susceptible to the impacts of tourism and human visitors. These indicators were common denominators and encompassed the sites’ physical state/degree of decay, legibility, accessibility, and quantity and quality of objects at the sites. This article seeks to enhance the understanding of these sites’ vulnerabilities and provide insights for effective heritage site management and sustainable tourism development. The principal findings highlight key factors contributing to cultural heritage sites’ vulnerability. These factors encompass intensity and frequency of visitor traffic, suboptimal visitor management strategies, tourists’ limited awareness of proper site behaviour and conservation practices, and restricted resources for site maintenance and protection. These findings can guide policymakers, site managers, and tourism stakeholders in formulating strategies to balance tourism promotion with site conservation, ensuring the long-term preservation of cultural heritage in this unique and vulnerable environment.
Predicted Dynamic of Biodeterioration in Cultural Heritage Stones Due to Climate Changes in Humid Tropical Regions—A Case Study on the Rhodotorula sp. Yeast
Authors: Sitzia Fabio , Lisci Carla , Pires Vera , Dias Luís , Mirão José , Caldeira Ana Teresa
Published: December 2023

The recent global warming started at the end of the 19th century, causing an increase in the average temperature of Earth and posing environmental, social, economic, and cultural repercussions. Much tangible cultural heritage is composed of natural stones, which decay due to the combination of chemical, physical, and biological factors. Biodeterioration leads to a loss of the performance requirements and socio-economic value of stone building materials. In the future, the dynamics of biodeterioration will hypothetically vary. This study aims to shed light on this variation by comparing biodeterioration under historical climatic conditions (1995–2014) with a future scenario defined by the IPCC SSP5-8.5 for the reference period 2080–2099. The material tested is Pedra de Ançã (PA), a candidate for World Heritage Stone. Climatic chambers were used to simulate the historical and predicted environmental conditions. The scope of this investigation is to understand the growth dynamic of the biodeteriogen Rhodotorula sp. and to study the morphological and aesthetic variations of stone surfaces. Biochemical and micro-topographic analyses highlighted the metabolic activity of the population proliferating under distinct environmental conditions, revealing better adaptability of Rhodotorula sp. and higher biocorrosion in the historical climate status with respect to the future.
Addressing Sustainability in Portuguese Museums and Heritage: The Role of Cultural Policies
Authors: Carvalho Ana , Camacho Clara Frayão
Published: December 2023

The Future Museums Project Group was created under the Portuguese Ministry of Culture with the mission of proposing recommendations for a 10-year public policy for museums, palaces, and monuments, considering sustainability, accessibility, and innovation issues and their relevance in society. Against this background, museums were understood as agents of change with a role to play in achieving a more sustainable future, and culture as a fundamental pillar for democracy and sustainable development. This study discusses the findings of the project, focusing on three features that highlight the approach adopted to sustainability, which included collections management, participation, and mediation. Drawn from empirical research, a series of concrete recommendations, both for policy makers and museums, are discussed. The study concludes by arguing that cultural policies must place sustainability at the core of their strategy in order to function as a framework to drive and implement sustainable development practices in museums and heritage. Furthermore, within the scope of post-pandemic recovery plans, climate emergency, and the energy crisis, it is even more pressing that cultural policies provide support for museums and heritage and ensure that they have the conditions and resources to be able to move forward in a more integrated manner, thus contributing to a sustainable future.
Persisting Shadows: Unraveling the Impact of Long COVID-19 on Respiratory, Cardiovascular, and Nervous Systems
Authors: Sideratou Christina-Michailia , Papaneophytou Christos
Published: December 2023

The coronavirus disease 2019 (COVID-19), instigated by the zoonotic Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), rapidly transformed from an outbreak in Wuhan, China, into a widespread global pandemic. A significant post-infection condition, known as ‘long- COVID-19′ (or simply ‘long- COVID’), emerges in a substantial subset of patients, manifesting with a constellation of over 200 reported symptoms that span multiple organ systems. This condition, also known as ‘post-acute sequelae of SARS-CoV-2 infection’ (PASC), presents a perplexing clinical picture with far-reaching implications, often persisting long after the acute phase. While initial research focused on the immediate pulmonary impact of the virus, the recognition of COVID-19 as a multiorgan disruptor has unveiled a gamut of protracted and severe health issues. This review summarizes the primary effects of long COVID on the respiratory, cardiovascular, and nervous systems. It also delves into the mechanisms underlying these impacts and underscores the critical need for a comprehensive understanding of long COVID’s pathogenesis.
Prevalence of Postural Changes and Musculoskeletal Disorders in Young Adults
Authors: Pacheco Maria Paula , Carvalho Paulo José , Cavalheiro Luís , Sousa Filipa Manuel
Published: December 2023

Background: Postural changes are considered a public health problem, especially those that affect the spine, as they may predispose to degenerative conditions of the spine in adulthood. Musculoskeletal disorders are the main cause of chronic pain, illness, reduced educational performance, productivity, and quality of life, and are responsible for increased absenteeism, which could compromise the future career of students. The purpose of this study was to identify the prevalence of postural changes and the occurrence of musculoskeletal disorders in different anatomical regions in the 12 months prior and 7 days prior to the application of the questionnaire and the number of affected anatomical regions. Methods: This is an observational, descriptive, cross-sectional study. It included 508 students selected by a stratified random sample. Our outcomes were the Portuguese version of the Standardized Nordic Musculoskeletal Questionnaire, the Adam’s test, a scoliometer, and the visual analog pain scale associated with the Nordic Musculoskeletal Questionnaire. Results: In total, 79.3% of the students tested positive with the Adam’s test. The neck, shoulder, lumbar region, and knee stood out in all of the temporal references, the 12 months prior (44.3%; 35.2%, 50.2%, 34.1%) and the 7 days prior (16.5%, 16.9%; 28.9%, 17.5%), and even in the restriction of activity due to painful symptoms in the 12 months prior (4.3%, 5.3%, 10.6%, 8.5%). Conclusions: Out of 497 students, 403 were identified with postural changes. The high prevalence rate of identified musculoskeletal symptoms in the anatomical regions of the neck, lumbar region, and shoulder raises the need for intervention in students. Gender appears to generate differences between men and women. Pain from multiple body sites is frequent among young adults.
Cognitive Patterns and Problematic Use of Video Games in Adolescents: A Cluster Analysis
Authors: Fernández-Arias Ignacio , Labrador Marta , Bernaldo-de-Quirós Mónica , Estupiñá Francisco J. , Vallejo-Achón Marina , Sanchez-Iglesias Iván , González-Álvarez María , Labrador Francisco J.
Published: December 2023

Background: Video game playing (VGP) is an increasingly common leisure activity among children and adolescents, although in some cases, it is accompanied by problems due to misuse. Method: A sample of 2884 children and adolescents aged between 12 and 20, representative of the Community of Madrid (Spain), were studied using a cluster analysis to explore the existence of cognitive patterns associated with engagement, attitudes, and concurrent cognitions. We also explored the relationship between these patterns and problematic VGP, using the 2173 gamers as a reference. Results: The concurrent cognitions were not qualitatively different between the problematic users and the others. High engagement and high activation of concurrent cognitions (intensity and frequency) showed the greatest relationship with problematic VGP. Conclusions: The results suggest the existence of different groups of gamers and the relevance to include psycho-educational aspects in intervention programs, as well as the training of specific skills, especially those related with the control of activation. Limitations related to the sample size and potential supplementary analyses are acknowledged.
Hyperspectral Image Classification Network Based on 3D Octave Convolution and Multiscale Depthwise Separable Convolution
Authors: Hong Qingqing , Zhong Xinyi , Chen Weitong , Zhang Zhenghua , Li Bin
Published: December 2023

Hyperspectral images (HSIs) are pivotal in various fields due to their rich spectral–spatial information. While convolutional neural networks (CNNs) have notably enhanced HSI classification, they often generate redundant spatial features. To address this, we introduce a novel HSI classification method, OMDSC, employing 3D Octave convolution combined with multiscale depthwise separable convolutional networks. This method initially utilizes 3D Octave convolution for efficient spectral–spatial feature extraction from HSIs, thereby reducing spatial redundancy. Subsequently, multiscale depthwise separable convolution is used to further improve the extraction of spatial features. Finally, the HSI classification results are output by softmax classifier. This work compares the method with other methods on three publicly available datasets in order to confirm its efficacy. The outcomes show that the method performs better in terms of classification.
Tailored Water-Soluble Covalent Organic Cages for Encapsulation of Pyrene and Information Encryption
Authors: Song Haixin , Guo Yujing , Zhang Guorui , Shi Linlin
Published: December 2023

Forming pyridine salts to construct covalent organic cages is an effective strategy for constructing covalent cage compounds. Covalent organic cages based on pyridine salt structures are prone to form water-soluble supramolecular compounds. Herein, we designed and synthesized a triangular prism-shaped hexagonal cage with a larger cavity and relatively flexible conformation. The supramolecular cage structure was also applied to the encapsulation of pyrene and information encryption.
Combined BSA-Seq and RNA-Seq Reveal Genes Associated with the Visual Stay-Green of Maize (Zea mays L.)
Authors: Zheng Ran , Deng Min , Lv Dan , Tong Bo , Liu Yuqing , Luo Hongbing
Published: December 2023

Maize has become one of the most widely grown grains in the world, and the stay-green mutant allows these plants to maintain their green leaves and photosynthetic potential for longer following anthesis than in non-mutated plants. As a result, stay-green plants have a higher production rate than non-stay-green varieties due to their prolonged grain-filling period. In this study, the candidate genes related to the visual stay-green at the maturation stage of maize were investigated. The F2 population was derived from the T01 (stay-green) and the Xin3 (non-stay-green) cross. Two bulked segregant analysis pools were constructed. According to the method of combining ED (Euclidean distance), Ridit (relative to an identified distribution unit), SmoothG, and SNP algorithms, a region containing 778 genes on chromosome 9 was recognized as the candidate region associated with the visual stay-green in maize. A total of eight modules were identified using WGCNA (weighted correlation network analysis), of which green, brown, pink, and salmon modules were significantly correlated with visual stay-green. BSA, combined with the annotation function, discovered 7 potential candidate genes, while WGCNA discovered 11 stay-green potential candidate genes. The candidate range was further reduced due through association analysis of BSA-seq and RNA-seq. We identified Zm00001eb378880, Zm00001eb383680, and Zm00001eb384100 to be the most likely candidate genes. Our results provide valuable insights into this new germplasm resource with reference to increasing the yield for maize.
Chronic Inhibition of Nitric Oxide Synthases Impairs Spatiotemporal Learning and Memory to a Similar Extent in C57BL/6 and hAPP23+/− Mice
Authors: Hendrickx Jhana O. , Calus Elke , De Deyn Peter Paul , Van Dam Debby , De Meyer Guido R. Y.
Published: December 2023

Due to global population growth, age-related disorders like cardiovascular disease and dementia are anticipated to increase. Recent data suggests a connection between cardiovascular disease and neurodegeneration, especially focusing on arterial stiffness (AS) and Alzheimer’s disease (AD). In light of this, we conducted a study to explore the impact of long-term nitric oxide synthase (NOS) isoform inhibition, which leads to AS, on neurobehavioral performance. We also compared these effects in an AD model and control mice. C57BL/6 and hAPP23+/− mice (an established AD model) were given 0.5 mg/mL N(G)-Nitro-L-Arginine Methyl Ester (L-NAME) in their drinking water for 16 weeks. Our findings indicate that chronic non-selective NOS inhibition increased AS and reduced spatiotemporal learning and memory in both C57BL/6 and hAPP23+/− mice. These effects were consistent across both groups, emphasizing the role of neuronal NOS (nNOS) in cognitive aging, regardless of genetic predisposition to AD.
A Comparison of Steam Turbine Control Valve Geometries and Their Dynamic Behavior at Part Load
Authors: Windemuth Christian , Lange Martin , Mailach Ronald
Published: December 2023

A growing significance of flexible steam turbine operation challenges the control of turbines, as part load operation using control valves can be accompanied by highly unsteady flow conditions. The increased dynamic load induced by pressure forces can reduce the reliable operating range, weaken the valve, and lead to mechanical failures. The geometry of the valve plays a major role in the reduction of dynamic forces. Using a scaled control valve, experiments were conducted with a focus on the dynamic behavior of the valve head. A spherical valve shape favoring unstable operation was used as a reference case, and the desired instability was proven by measurements. Different modified valve geometries based on literature featuring separation edges were then tested against the spherical shape. Results indicate the improved stability of the modified geometries over the reference geometry. For most of the operating range, vibrations were drastically reduced, and the overall flow stabilized.
Indexing the Maintenance Priority of Road Safety Barriers in Urban and Peri-Urban Contexts: Application of a Ranking Methodology in Bologna, Italy
Authors: Nalin Alessandro , Simone Andrea , Lantieri Claudio , Rosatella Umberto , Dondi Giulio , Vignali Valeria
Published: December 2023

The need for clear and updated information is pivotal when authorities plan and perform routinary, periodic and emergency maintenance of both road network and their roadside assets, e.g., curbs, signals, and barriers. With particular regard to road barriers, the development of remote sensing technologies, such as Laser Imaging Detection and Ranging (LiDAR), has played a disruptive role in acquiring information, so the surveys today are predominantly automatic, faster, and less biased than the traditional (i.e., visual and manual) inventorying methodologies. However, even though they are accurate, these emerging procedures usually focus only on the surveyed elements and do not provide any other information about the surrounding environment or about the qualitative degradation of the elements. The primary objective of this research effort was to present a ranking methodology for enhancing road safety in urban contexts. Due to an innovative synthetic index which takes into account both the deterioration and the location of the surveyed elements, maintenance priority of road barriers was outlined in Bologna, Italy. All the collected information was georeferenced in a Geographic Information System (GIS) environment and hence plotted in thematic maps for an easier analysis. In addition, compliance to the norm was verified. The research was tested to provide public authorities with an effective tool in the evaluation of maintenance activities and road safety policies.
The Clinical Relevance of Diabetes Distress versus Major Depression in Type 2 Diabetes: A Latent Class Analysis from the Fremantle Diabetes Study Phase II
Authors: Davis Wendy A. , Bruce David G. , Davis Timothy M. E. , Starkstein Sergio E.
Published: December 2023

Background: The nosological position and clinical relevance of the concept of diabetes distress (DD) are uncertain. The aim of this study was to use latent class analysis (LCA) to categorise classes of people with type 2 diabetes and to compare their characteristics. Methods: Data from 662 participants in the longitudinal observational Fremantle Diabetes Study Phase II were analysed. LCA identified latent subgroups based on individual responses to the Patient Health Questionnaire-9, the Generalised Anxiety Disorder Scale, and the 5-item Problem Areas in Diabetes Scale. Results: Four classes were identified: Class 1 (65.7%, no symptoms), Class 2 (14.0%, DD), Class 3 (12.6%, subsyndromal depression (SSD)), and Class 4 (7.6%, major depression (MD)). Multinomial regression analysis with Class 1 as reference showed significant associations between the DD class and Southern European and Asian ethnic background, HbA1c, and BMI. The SSD class was significantly associated with HbA1c, cerebrovascular disease, and coronary heart disease (CHD). The MD class had significant associations with age (inversely), Southern European ethnic background, HbA1c, BMI, and CHD. In conclusion, LCA identified a pure DD group comprising 14.0% of participants. The only variable uniquely associated with the DD class was Asian ethnic background. Conclusion: Although identification of DD may have some utility in assessing the psychological wellbeing of individuals with type 2 diabetes, it adds little to the assessment of depressive disorder and its significant clinical sequalae.
Association between Subretinal Drusenoid Deposits and Age-Related Macular Degeneration in Multimodal Retinal Imaging
Authors: Krytkowska Elżbieta , Olejnik-Wojciechowska Joanna , Grabowicz Aleksandra , Safranow Krzysztof , Machalińska Anna
Published: December 2023

Multimodal retinal imaging enables the detection of subretinal drusenoid deposits (SDD) with significantly greater accuracy compared to fundus photography. The study aimed to analyze a relationship between the presence of SDD, the clinical picture of AMD, and disease progression in a 3 year follow-up. A total of 602 eyes of 339 patients with a diagnosis of AMD, of which 121 (55%) had SDD confirmed in multimodal retinal imaging, were enrolled in the study. SDD was related to a more advanced stage of AMD (p = 0.008), especially with the presence of geographic atrophy (OR = 4.11, 95% CI 2.02–8.38, p < 0.001). Eyes with SDD presented significantly lower choroidal and retinal thickness (ATC: 210.5 μm, CRT: 277 μm, respectively) and volume (AVC: 0.17 mm3, CRV: 8.29 mm3, p < 0.001, respectively) compared to SDD-negative eyes (ATC: 203 μm, CRT: 277 μm; AVC: 7.08 mm3, 8.54 mm3, p < 0.001). Accordingly, the prevalence of pachychoroids and pachyvessels was significantly lower in the SDD present group than in eyes without SDD (p = 0.004; p = 0.04, respectively). Neither demographic factors, lipid profile, genetic predisposition, systemic vascular disease comorbidities, nor parameters of retinal vessels were affected by the presence of SDD. We found no effect of SDD presence on AMD progression (p = 0.12). The presence of SDD appeared to be related to local rather than systemic factors.
Principal Component Analysis Applied to Radiomics Data: Added Value for Separating Benign from Malignant Solitary Pulmonary Nodules
Authors: Bomhals Birte , Cossement Lara , Maes Alex , Sathekge Mike , Mokoala Kgomotso M. G. , Sathekge Chabi , Ghysen Katrien , Van de Wiele Christophe
Published: December 2023

Here, we report on the added value of principal component analysis applied to a dataset of texture features derived from 39 solitary pulmonary lung nodule (SPN) lesions for the purpose of differentiating benign from malignant lesions, as compared to the use of SUVmax alone. Texture features were derived using the LIFEx software. The eight best-performing first-, second-, and higher-order features for separating benign from malignant nodules, in addition to SUVmax (MaximumGreyLevelSUVbwIBSI184IY), were included for PCA. Two principal components (PCs) were retained, of which the contributions to the total variance were, respectively, 87.6% and 10.8%. When included in a logistic binomial regression analysis, including age and gender as covariates, both PCs proved to be significant predictors for the underlying benign or malignant character of the lesions under study (p = 0.009 for the first PC and 0.020 for the second PC). As opposed to SUVmax alone, which allowed for the accurate classification of 69% of the lesions, the regression model including both PCs allowed for the accurate classification of 77% of the lesions. PCs derived from PCA applied on selected texture features may allow for more accurate characterization of SPN when compared to SUVmax alone.
Complement and Non-Complement Binding Anti-HLA Antibodies Are Differentially Detected with Different Antigen Bead Assays in Renal Transplant Recipients
Authors: Ouranos Konstantinos , Panteli Manolis , Petasis Georgios , Papachristou Marianthi , Iosifidou Artemis Maria , Iosifidou Myrto Aikaterini , Anastasiou Aikaterini , Samali Margarita , Stangou Maria , Theodorou Ioannis , Lioulios Georgios , Fylaktou Asimina
Published: December 2023

Two semi-quantitative, Luminex-based, single-antigen bead (SAB) assays are available to detect anti-HLA antibodies and evaluate their reactivity with complement binding. Sera from 97 patients with positive panel reactive antibody tests (>5%) were analyzed with two SAB tests, Immucor (IC) and One-Lambda (OL), for anti-HLA antibody detection and the evaluation of their complement-binding capacity. IC detected 1608/8148 (mean fluorescent intensity (MFI) 4195 (1995–11,272)) and 1136/7275 (MFI 6706 (2647–13,184)) positive anti-HLA class I and II specificities, respectively. Accordingly, OL detected 1942/8148 (MFI 6185 (2855–12,099)) and 1247/7275 (MFI 9498 (3630–17,702)) positive anti-HLA class I and II specificities, respectively. For the IC assay, 428/1608 (MFI 13,900 (9540–17,999)) and 409/1136 (MFI 11,832 (7128–16,531)) positive class I and II specificities bound C3d, respectively. Similarly, OL detected 485/1942 (MFI 15,452 (9369–23,095)) and 298/1247 (MFI18,852 (14,415–24,707)) C1q-binding class I and II specificities. OL was more sensitive in detecting class I and II anti-HLA antibodies than IC was, although there was no significant difference in the number of class II specificities per case. MFI was higher for complement vs. non-complement-binding anti-HLA antibodies in both assays. Both methods were equal in detecting complement-binding anti-HLA class I antibodies, whereas the C3d assay was more sensitive in detecting complement-binding anti-HLA class II antibodies.
Value of Post-/Pre-Procedural Aortic Regurgitation Ratio vs. Pre-Procedural Aortic Valve Calcium Score to Predict Moderate to Severe Paravalvular Leak Requiring Post-Dilation after Transcatheter Aortic Valve Implantation
Authors: Uebelacker Roman , Martin Simon S. , Vasa-Nicotera Mariuca , Mas-Peiro Silvia
Published: December 2023

Background and aim: Tools that assist interventionists in selecting patients for post-dilation (PD) are needed. We aimed to assess whether pre-interventional aortic valve calcium (AVC) or the peri-interventional aortic regurgitation (ARI) ratio is a better predictor for a more than mild paravalvular leak (PVL) requiring PD after TAVI. Methods: Patients undergoing TAVI with available data on AVC derived from MSCTs and the ARI ratio derived from peri-interventional hemodynamic curves were studied. The main outcome was moderate-to-severe PVL requiring PD. Results: In 237 patients, more than mild PVL after valve deployment was present in 25.7%. PD was performed in 65 patients. The median (IQR) total AVC was 390.5 (211.5–665.4) mm3. All calcification values were significantly higher in patients who underwent PD. The median (IQR) individual threshold was 600 (550–685) Hus. The overall ARI ratio was 0.78 (0.61–0.96), with values being significantly lower in patients who underwent PD: 0.61 (0.49–0.80) vs. 0.82 (0.69–0.99) (p < 0.001). Both the ARI ratio (OR [95%CI] 0.053 [0.014–0.203]; p < 0.001) and AVC (1.01 [1.000–1.002]; p = 0.015) predicted PD need. ROC curves showed higher discrimination for the ARI ratio (AUC 0.73) than for any calcification parameter (all AUCs ≤ 0.62). Conclusions: The ARI ratio provides interventionists with a powerful predictive tool for PVL requiring PD after TAVI that is beyond the predictive value of pre-procedural valve calcification derived from MSCT.
Survival and Results after Resection and Reconstruction with Megaprosthesis at the Hip in Octogenarians
Authors: Scoccianti Guido , Innocenti Matteo , Scanferla Roberto , Scolari Federico , Muratori Francesco , Ungar Andrea , Rostagno Carlo , Campanacci Domenico Andrea
Published: December 2023

Few data are available about results after procedures of resection and megaprosthesis at the hip in very elderly patients. The aim of our study was to ascertain survival and complications in patients aged 80 or older undergoing these major orthopedic procedures. A consecutive series of 27 procedures in 26 patients aged 80–93 years was evaluated. In total, 15 procedures were performed due to oncological diseases, 6 were performed following joint arthroplasty failures or periprosthetic fractures, and 6 were performed after trauma or trauma sequelae. Survival of the patients ranged from 0 to 122 months. Overall survival was 56% at 3 years, 24% at 5 years, and 16% at 8 years. An early postoperative death during the first 3 months occurred in five patients (18.5%). The only preoperative parameter negatively affecting survival was preoperative hemoglobin lower than 11 g/dL. Local complications were similar to reported rates in all-age patients’ series. In our experience, resection and megaprosthetic reconstruction can also be a valid choice in very elderly patients, with 56% of patients living more than two years from surgery and 24% more than five. Nevertheless, early postoperative deaths are frequent. A multidisciplinary evaluation of frailty of the patient must be accomplished, and patients and relatives must be informed about the risks of the procedure.
Outcomes of Secondary Intracapsular Intraocular Lens Implantation in Patients following Rhegmatogenous Retinal Detachment
Authors: Wu Kaicheng , Shi Jiemei , Zong Yuan , Xu Gezhi , Zhu Haohao , Jiang Chunhui
Published: December 2023

This study reports the outcomes of a secondary IOL implantation technique in patients that suffered from rhegmatogenous retinal detachment combined with a cataract, which included reopening the capsular bag, enabling secondary intracapsular intraocular lens (IOL) implantation. We included consecutive cases with rhegmatogenous retinal detachment (RRD) treated with vitrectomy and silicone oil tamponade, and subsequent secondary IOL implantation during silicone oil removal between September 2019 and June 2022. Demographics, pre- and postoperative clinical data, and complications were collected. Visual and refractive outcomes and IOL position were evaluated. Thirty eyes were included and followed up for a mean of 24.2 ± 5.06 months. Compared with the preoperative values, no significant changes were observed in the intraocular pressure (p = 0.170) and endothelial cell density (p = 0.336); however, the best-corrected visual acuity (Snellen: 20/83 vs. 20/38; logMAR: 0.66 ± 0.23 vs. 0.37 ± 0.32; p < 0.001) and spherical equivalent (p < 0.001) improved significantly. The mean prediction error (ME) was −0.45 ± 0.68 D (−1.9–0.54 D), and the mean absolute prediction error (MAE) was 0.62 ± 0.52 D (0.01–1.9 D). The macula-on subgroup demonstrated significantly better refractive outcomes than the macula-off subgroup (ME, p = 0.046; MAE, p = 0.008). The IOL was well positioned, with a mean horizontal and vertical tilt and decentration of 0.53 ± 0.49° and 0.21 ± 0.16 mm, and 0.54 ± 0.45° and 0.22 ± 0.16 mm, respectively. Secondary intracapsular IOL implantation provided a good and stable IOL position and satisfactory refractive outcomes, and is a feasible treatment option for patients with RRD.
Clinical Features and Response to Treatment in Elderly Subjects Affected by Hidradenitis Suppurativa: A Cohort Study
Authors: Antonelli Flaminia , Ippoliti Elena , Rosi Elia , Moltrasio Chiara , Malvaso Dalma , Botti Elisabetta , Abeni Damiano , Dini Valentina , Cannizzaro Maria Vittoria , Bruni Manfredo , Di Nardo Lucia , Fargnoli Maria Concetta , Romanelli Marco , Fania Luca , Bianchi Luca , Marzano Angelo Valerio , Prignano Francesca , Peris Ketty , Chiricozzi Andrea
Published: December 2023

Hidradenitis suppurativa (HS) is a chronic-relapsing inflammatory skin disease. It usually appears in the second and third decades, but a smaller proportion of patients develop late-onset HS. Geriatric HS, defined as the persistence or the development of HS after the age of 65 years, has been poorly explored. This study aimed to investigate the clinical features, treatment management and response to therapies of HS elderly subjects (≥65 years old). We designed a multicentric observational study, gathering data from seven Italian university hospitals. Demographic and clinical data of HS patients aged over 65 years were collected at baseline, week 12 and week 24. Overall, 57 elderly subjects suffering from HS were enrolled. At baseline, disease severity was predominantly moderate-to-severe, with 45.6% of patients classified as Hurley III. The gluteal phenotype was the most frequently observed; it also appeared to affect patients’ quality of life more than other phenotypes. Gluteal involvement was detected in about half (49.1%) of cases and associated with severe stages of the disease. In terms of therapeutic response, Hurley III patients showed the persistency of higher values of mean IHS4, DLQI, itch- and pain-NRS scores compared to Hurley I/II. In conclusion, disease severity in this subpopulation appears high and treatment is often challenging.
Mechanical Support Strategies for High-Risk Procedures in the Invasive Cardiac Catheterization Laboratory: A State-of-the-Art Review
Authors: Groeneveld Niels T. A. , Swier Carolien E. L. , Montero-Cabezas Jose , Elzo Kraemer Carlos V. , Klok Frederikus A. , van den Brink Floris S.
Published: December 2023

Thanks to advancements in percutaneous cardiac interventions, an expanding patient population now qualifies for treatment through percutaneous endovascular procedures. High-risk interventions far exceed coronary interventions and include transcatheter aortic valve replacement, endovascular management of acute pulmonary embolism and ventricular tachycardia ablation. Given the frequent impairment of ventricular function in these patients, frequently deteriorating during percutaneous interventions, it is hypothesized that mechanical ventricular support may improve periprocedural survival and subsequently patient outcome. In this narrative review, we aimed to provide the relevant evidence found for the clinical use of percutaneous mechanical circulatory support (pMCS). We searched the Pubmed database for articles related to pMCS and to pMCS and invasive cath lab procedures. The articles and their references were evaluated for relevance. We provide an overview of the clinically relevant evidence for intra-aortic balloon pump, Impella, TandemHeart and ECMO and their role as pMCS in high-risk percutaneous coronary intervention, transcatheter valvular procedures, ablations and high-risk pulmonary embolism. We found that the right choice of periprocedural pMCS could provide a solution for the hemodynamic challenges during these procedures. However, to enhance the understanding of the safety and effectiveness of pMCS devices in an often high-risk population, more randomized research is needed.
Surgically Resected Cardiac Angiosarcoma: Survival Analysis from the National Cancer Database
Authors: Rahouma Mohamed , Baudo Massimo , Khairallah Sherif , Lau Christopher , Gaudino Mario , El-Sayed Ahmed Magdy M. , Kumar Akshay , Lorusso Roberto , Mick Stephanie L.
Published: December 2023

Angiosarcoma is a rare type of soft-tissue sarcoma arising from endothelial cells. It is considered ‘high-grade’ by definition, reflecting its aggressive behavior. We sought to investigate the role of surgery in cardiac angiosarcoma, identify late mortality predictors, and identify interactions with other modalities in its treatment using a national dataset. The 2004–2017 National Cancer Database was reviewed for patients with primary cardiac angiosarcoma. Late mortality predictors were evaluated with Kaplan–Meier curves and Cox regression analysis. Surgery in primary cardiac angiosarcoma was performed in 130 patients (median age 50.5 years; female sex 36.9%). The median follow up was 72.02 months, with a median overall survival (OS) of 14.32 months. In patients treated with surgery in combination with other modalities compared with those treated with surgery alone, median OSs were 17.28 and 2.88 months, respectively (log-rank = 0.018). Older patients (age > 57 years) experienced lower OS compared to those with an age < 57 (log-rank = 0.012). This may be partially explained by the difference in treatment strategies among age groups: those with increasing age, less surgery (p = 0.037), and less chemotherapy (p < 0.001) were chosen. With multivariable Cox regression analysis, age and race other than white or black were identified to be significant independent predictors of late mortality. Cardiac angiosarcoma has poor overall survival, and our findings should further encourage the use of surgery in combination with other therapeutic modalities in treating such an aggressive disease whenever possible.
Structural Formation and Properties of Eco-Friendly Foam Concrete Modified with Coal Dust
Authors: Stel’makh Sergey A. , Shcherban’ Evgenii M. , Beskopylny Alexey N. , Mailyan Levon R. , Meskhi Besarion , Shilov Alexandr A. , Mailyan Alexander L. , Zakieva Nadezhda I. , Chernil’nik Andrei , El’shaeva Diana
Published: December 2023

Foam concrete is a popular energy-efficient construction material with a fairly wide range of usage in buildings and structures. Increasing ecological efficiency and reducing construction costs by the application of different types of industrial waste in the manufacturing technology of this composite is a promising direction. The main goal of this study is to investigate the possibility of coal dust (CD) waste inclusion in the technology of energy-efficient cellular concrete produced by foam concrete technology. Test samples of foam concrete were made using coal dust by partially replacing cement in the range of 0–10% in increments of 2%. The following primary characteristics of foam concrete were studied: fluidity of mixtures; compressive strength; density; thermal conductivity of foam concrete. An X-ray diffraction analysis of foam concrete composites was performed, which showed changes in their phase composition when using coal dust as a modifier. Coal dust in rational quantities from 2% to 6% improves the physical and mechanical characteristics of foam concrete and increases the structure uniformity. The optimal values of the foam concrete characteristics were recorded at a dosage of coal dust of 6%. At the same time, the density decreased by 2.3%, the compressive strength increased by 15.6%, and the thermal conductivity coefficient decreased by 8.9% compared to the ordinary composition. The use of the resulting foam concrete is advisable in enclosing structures to create high energy efficiency of buildings and structures due to the improved structure and properties.
Enhancing COVID-19 CT Image Segmentation: A Comparative Study of Attention and Recurrence in UNet Models
Authors: Buongiorno Rossana , Del Corso Giulio , Germanese Danila , Colligiani Leonardo , Python Lorenzo , Romei Chiara , Colantonio Sara
Published: December 2023

Imaging plays a key role in the clinical management of Coronavirus disease 2019 (COVID-19) as the imaging findings reflect the pathological process in the lungs. The visual analysis of High-Resolution Computed Tomography of the chest allows for the differentiation of parenchymal abnormalities of COVID-19, which are crucial to be detected and quantified in order to obtain an accurate disease stratification and prognosis. However, visual assessment and quantification represent a time-consuming task for radiologists. In this regard, tools for semi-automatic segmentation, such as those based on Convolutional Neural Networks, can facilitate the detection of pathological lesions by delineating their contour. In this work, we compared four state-of-the-art Convolutional Neural Networks based on the encoder–decoder paradigm for the binary segmentation of COVID-19 infections after training and testing them on 90 HRCT volumetric scans of patients diagnosed with COVID-19 collected from the database of the Pisa University Hospital. More precisely, we started from a basic model, the well-known UNet, then we added an attention mechanism to obtain an Attention-UNet, and finally we employed a recurrence paradigm to create a Recurrent–Residual UNet (R2-UNet). In the latter case, we also added attention gates to the decoding path of an R2-UNet, thus designing an R2-Attention UNet so as to make the feature representation and accumulation more effective. We compared them to gain understanding of both the cognitive mechanism that can lead a neural model to the best performance for this task and the good compromise between the amount of data, time, and computational resources required. We set up a five-fold cross-validation and assessed the strengths and limitations of these models by evaluating the performances in terms of Dice score, Precision, and Recall defined both on 2D images and on the entire 3D volume. From the results of the analysis, it can be concluded that Attention-UNet outperforms the other models by achieving the best performance of 81.93%, in terms of 2D Dice score, on the test set. Additionally, we conducted statistical analysis to assess the performance differences among the models. Our findings suggest that integrating the recurrence mechanism within the UNet architecture leads to a decline in the model’s effectiveness for our particular application.
The Impact of Anthropogenic Pollution on Tidal Water Quality in Mangrove Wetlands
Authors: Lam Kit-Ling , Lam Yu-Hin , Ng Angie Ying-Sim , So Ken Kwok-Yin , Tam Nora Fung-Yee , Lee Fred Wang-Fat , Mo Wing-Yin
Published: December 2023

Mangrove wetlands are vulnerable coastal ecosystems that provide critical habitats for aquatic life. Tai O is a popular tourist village on Lantau Island, Hong Kong, which is surrounded by mangrove wetlands with rich biodiversity; and this village is also famous for its traditional stilt houses. However, the untreated municipal sewage from some stilt houses is directly discharged into nearby tidal channels, potentially threatening health of the adjacent mangrove wetlands. In order to evaluate the anthropogenic impact on these wetlands and identify the potential sources of their pollution, this study aimed to evaluate spatial (at the sampling points) and temporal (during weekdays and weekends) differences in the quality of their tidal water, and examine relationships between the water quality and the density of the stilt houses. The results indicated that the water quality was worse during weekends. The ammonia concentrations in most samples exceeded the limits of the Hong Kong Water Quality Objectives, China’s Sea Water Quality Standards, and even the U.S. EPA criterion for fish reproduction. This high ammonia input could potentially adversely affect the mangrove ecosystem, underscoring the need for further comprehensive studies. Moreover, some of the weekend water samples had lower dissolved oxygen levels and were polluted by phosphate. Our Principal Component Analysis revealed that water quality was correlated with stilt house density, suggesting that anthropogenic inputs of untreated sewage was the major source of pollution. These findings highlight that nutrients released from human activities, particularly ammonia and phosphate, must be controlled for a better protection of mangrove wetland ecosystems.
A Four-Year Video Monitoring Analysis of the Posidonia oceanica Banquette Dynamic: A Case Study from an Urban Microtidal Mediterranean Beach (Poetto Beach, Southern Sardinia, Italy)
Authors: Trogu Daniele , Simeone Simone , Ruju Andrea , Porta Marco , Ibba Angelo , DeMuro Sandro
Published: December 2023

This paper investigates the dynamics of the cross-shore extensions of banquettes, a sedimentary structure mostly made by rests of Posidonia oceanica (L.) Delile, in a sandy urban beach located in the Gulf of Cagliari, Italy, western Mediterranean. A video monitoring station was installed above the promontory south of the beach. We analysed a four-year image database and related these dynamics to wave and wind parameters (obtained from the Copernicus and ERA5 databases) from September 2016 to September 2020. Our results showed that banquette deposition occurred in concomitance with the presence of leaf litter in the surf zone associated with mild storm events. Erosion of the banquettes occurred during more intense storms. When leaf litter was not present in the surf zone, banquettes were not deposited even with mild storms. Wind can influence the banquette dynamics: under certain conditions of speed intensity, the banquettes may be removed offshore, supplying litter in the surf zone, or they may be covered by sediment. The permanence of the banquettes on the beaches also depended on their composition: when the banquettes were intertwined with reeds, their removal by the waves did not occur even during intense storms, and this sedimentary structure can protect the beach from flooding.
An Analytical Model for Estimating Ship-Related Emissions in Port Areas
Authors: Bojić Filip , Gudelj Anita , Bošnjak Rino
Published: December 2023

Intensive shipping activity in port areas is considered one of the leading problems in the maritime sector, which has a negative effect on climate change and local air quality. The compilation of detailed inventories of combustion gases released by ships should therefore provide a more accurate overview of emission levels, which can serve as a basis for analysing impacts on the port community and lead to the establishment of better environmental measures. Thus, the aim of this study was to develop an adaptable and relevant analytical model capable of integrating a comprehensive methodology with large databases of ship movements and technical details to provide clear ship-related emission estimates in large port areas. Considering the lack of research in Croatia that includes the mentioned approach and the insufficient monitoring of air pollutants in ports, the model was used to produce an initial overall emissions inventory for the Port of Split, the busiest passenger port in Croatia. In the model, bottom-up logic with an energy-based method was applied to detailed technical and near-real-time shipping data from AIS, creating the first high-density spatial and temporal overview of shipping emissions in the City port basin. The results showed strong seasonal fluctuations and large discrepancies in the quantities emitted between different ship types and operating modes. The analysis therefore raised the question of the need for the future development and implementation of a scalable system that would provide a more transparent and efficient overview of the important characteristics of air pollution from ships and port areas.
Re-Distribution of Welding Residual Stress in Fatigue Crack Propagation Considering Elastic–Plastic Behavior
Authors: Xia Yuxuan , Yue Jingxia , Lei Jiankang , Yang Ke , Garbatov Yordan
Published: December 2023

The welding residual stress re-distribution behavior during fatigue crack propagation in butt-welded high-strength steel plates for ship construction is investigated based on experimental test results and numerical analyses. The specimens’ initial welding residual stresses are obtained from X-ray for middle tensile (MT) specimens cut from butt-welded high-strength steel plates. Then, fatigue crack propagation experiments on MT specimens are conducted, and a strain gauge is used to measure the residual stress re-distribution field around cracks. A practical fatigue crack propagation simulation procedure is developed with a dynamic update of in-situ welding residual stress, where the residual stress intensity factor Kres of the MT specimen is deduced. The stress ratio effect on Kres during fatigue crack propagation is analyzed and a good agreement between experimental and numerical results is achieved.