bluuebunny/crossref_metadata_2025 huggingface dataset:
CBF-IDS: Addressing Class Imbalance Using CNN-BiLSTM with Focal Loss in Network Intrusion Detection System
Authors: Peng Haonan , Wu Chunming , Xiao Yanfeng
Published: October 2023

The importance of network security has become increasingly prominent due to the rapid development of network technology. Network intrusion detection systems (NIDSs) play a crucial role in safeguarding networks from malicious attacks and intrusions. However, the issue of class imbalance in the dataset presents a significant challenge to NIDSs. In order to address this concern, this paper proposes a new NIDS called CBF-IDS, which combines convolutional neural networks (CNNs) and bidirectional long short-term memory networks (BiLSTMs) while employing the focal loss function. By utilizing CBF-IDS, spatial and temporal features can be extracted from network traffic. Moreover, during model training, CBF-IDS applies the focal loss function to give more weight to minority class samples, thereby mitigating the impact of class imbalance on model performance. In order to evaluate the effectiveness of CBF-IDS, experiments were conducted on three benchmark datasets: NSL-KDD, UNSW-NB15, and CIC-IDS2017. The experimental results demonstrate that CBF-IDS outperforms other classification models, achieving superior detection performance.
Radiation Pattern Synthesis Using Constraint Convex Optimization Algorithm for Conformal Antenna Array
Authors: Khan Taimur Ahmed , Khattak Muhammad Irfan , Basit Abdul , AlQahtani Salman A. , Alawwad Abdulaziz M. , Alotaibi Abdullilah A.
Published: October 2023

In this paper, a model based on constraint convex optimization is proposed for the radiation pattern synthesis in cylindrical and spherical microstrip conformal array antennas. The optimization algorithm is modeled to decrease the Euclidean distance between the obtained radiation pattern of the deformed array and the desired radiation pattern of the planar array by calculating the suitable amplitude and phase values for the individual array patches. Four prototypes of 2×2, 3×3, 4×4, and 5×5 microstrip patch array antenna are used as the radiating elements which are deformed from planar arrangement and placed on the faces of prescribed spherical and cylindrical shapes with various radii of curvatures. The results reveal that the performance of optimization algorithm performs better in 5×5 array, followed by 4×4 array, 3×3 array, and 2×2 array. However, 5×5 array provides more degrees of freedom for tuning the radiation pattern in desired form. The 5×5 array computes suitable amplitude and phase values for the radiating elements of the array, which restore the radiation pattern in terms of mainlobe reconstruction, null locations, sidelobe levels, up to the deformation of 20 cm in both spherical and cylindrical configurations of conformal array. The proposed optimization technique when applied to conformal antenna array offers fast computational speed and good convergence accuracy for radiation pattern synthesis, which can be useful for various engineering applications.
Utilizing Multivariate Adaptive Regression Splines (MARS) for Precise Estimation of Soil Compaction Parameters
Authors: Abed Musaab Sabah , Kadhim Firas Jawad , Almusawi Jwad K. , Imran Hamza , Bernardo Luís Filipe Almeida , Henedy Sadiq N.
Published: October 2023

Traditional laboratory methods for estimating soil compaction parameters, such as the Proctor test, have been recognized as time-consuming and labor-intensive. Given the increasing need for the rapid and accurate estimation of soil compaction parameters for a range of geotechnical applications, the application of machine learning models offers a promising alternative. This study focuses on employing the multivariate adaptive regression splines (MARS) model algorithm, a machine learning method that presents a significant advantage over other models through generating human-understandable piecewise linear equations. The MARS model was trained and tested on a comprehensive dataset to predict essential soil compaction parameters, including optimum water content (wopt) and maximum dry density (ρdmax). The performance of the model was evaluated using coefficient of determination (R2) and root mean square error (RMSE) values. Remarkably, the MARS models showed excellent predictive ability with high R2 and low RMSE, MAE, and relative error values, indicating its robustness and reliability in predicting soil compaction parameters. Through rigorous five-fold cross-validation, the model’s predictions for wopt returned an RMSE of 1.948%, an R2 of 0.893, and an MAE of 1.498%. For ρdmax, the results showcased an RMSE of 0.064 Mg/m3, an R2 of 0.899, and an MAE of 0.050 Mg/m3. When evaluated on unseen data, the model’s performance for wopt prediction was marked with an MAE of 1.276%, RMSE of 1.577%, and R2 of 0.948. Similarly, for ρdmax, the predictions were characterized by an MAE of 0.047 Mg/m3, RMSE of 0.062 Mg/m3, and R2 of 0.919. The results also indicated that the MARS model outperformed previously developed machine learning models, suggesting its potential to replace conventional testing methods. The successful application of the MARS model could revolutionize the geotechnical field through providing quick and reliable predictions of soil compaction parameters, improving efficiency for construction projects. Lastly, a variable importance analysis was performed on the model to assess how input variables affect its outcomes. It was found that fine content (Cf) and plastic limit (PL) have the greatest impact on compaction parameters.
Vibration Velocity Prediction with Regression and Forecasting Techniques for Axial Piston Pump
Authors: Fic Paweł , Czornik Adam , Rosikowski Piotr
Published: October 2023

Measuring vibration velocity is one of the most common techniques to estimate the condition of industrial machines. At a constant operating point, as the vibration velocity value increases, the machine’s condition worsens. However, there are no precise thresholds that indicate the condition of a machine at different operating points. Also, the axial piston pump, which is the subject of the article, is a device that generates stronger vibrations by design and cannot be enclosed in general vibration norms. Due to different use cases and work regimes of axial piston pumps, the need to determine whether the device is working correctly for a broad spectra of operating points emerges. This article aims to present and compare different methods for vibration velocity prediction for axial piston pumps with use of neural networks including dense networks, variants of recurrent neural networks, and ensemble methods. The result of this research consists of models that have performance metrics that clearly indicate whether the monitored pump has malfunctioned or not across a wide variety of operating points, working conditions, and in case of reassembling. A detailed analysis of the influence of available measured variables on the performance of models is also provided. The conclusion is that the application of commercial implementation of developed models is reasonable in the context of both performance quality and costs of sensors needed to provide the necessary data.
Comparison of the Bioactive and Bacteriostatic Performance of Different Alginate-Based Dental Prosthetic Impression Materials with and without Zirconium Phosphate-Based Ion Exchange Resin Containing Silver: An In Vitro Study
Authors: Raszewski Zbigniew , Mikulewicz Marcin , Brząkalski Dariusz , Pakuła Daria , Przekop Robert E.
Published: October 2023

Disinfection of alginate impressions used in dental prosthetics is a very problematic procedure, during which the dimensions of the obtained model can change, and it can be easily mechanically damaged. Therefore, it would be beneficial to create a material with bacteriostatic properties for this application. In this work, we investigated alginate materials with the addition of 0.25–1.0 wt% of zirconium phosphate-based ion exchange resin containing silver and compared them with commercial alginate impression products. The obtained materials passed the normative requirements of ISO 21563:2021 (setting time, elastic recovery, strain in compression, compatibility with gypsum, detail reproduction, tearing strength, and linear dimensional change) as well as bacteriostatic properties in relation to Streptococcus mutans. The newly developed alginate materials met all the properties required by the standards. Their setting time was comparable to the commercial materials, and their 24 h contraction did not exceed 1.3%. Furthermore, the tearing strength was 0.42–0.48 MPa, less than that of the comparative commercial materials (0.52–0.56 MPa). From the point of view of clinical practice, it will be possible to create an alginate material with bacteriostatic properties that will prevent the transmission of cross-infections.
Dopaminergic Input Regulates the Sensitivity of Indirect Pathway Striatal Spiny Neurons to Brain-Derived Neurotrophic Factor
Authors: Ayon-Olivas Maurilyn , Wolf Daniel , Andreska Thomas , Granado Noelia , Lüningschrör Patrick , Ip Chi Wang , Moratalla Rosario , Sendtner Michael
Published: October 2023

Motor dysfunction in Parkinson’s disease (PD) is closely linked to the dopaminergic depletion of striatal neurons and altered synaptic plasticity at corticostriatal synapses. Dopamine receptor D1 (DRD1) stimulation is a crucial step in the formation of long-term potentiation (LTP), whereas dopamine receptor D2 (DRD2) stimulation is needed for the formation of long-term depression (LTD) in striatal spiny projection neurons (SPNs). Tropomyosin receptor kinase B (TrkB) and its ligand brain-derived neurotrophic factor (BDNF) are centrally involved in plasticity regulation at the corticostriatal synapses. DRD1 activation enhances TrkB’s sensitivity for BDNF in direct pathway spiny projection neurons (dSPNs). In this study, we showed that the activation of DRD2 in cultured striatal indirect pathway spiny projection neurons (iSPNs) and cholinergic interneurons causes the retraction of TrkB from the plasma membrane. This provides an explanation for the opposing synaptic plasticity changes observed upon DRD1 or DRD2 stimulation. In addition, TrkB was found within intracellular structures in dSPNs and iSPNs from Pitx3−/− mice, a genetic model of PD with early onset dopaminergic depletion in the dorsolateral striatum (DLS). This dysregulated BDNF/TrkB signaling might contribute to the pathophysiology of direct and indirect pathway striatal projection neurons in PD.
Biogenic Selenium Nanoparticles: Anticancer, Antimicrobial, Insecticidal Properties and Their Impact on Soybean (Glycine max L.) Seed Germination and Seedling Growth
Authors: Abdelsalam Asmaa , El-Sayed Heba , Hamama Heba M. , Morad Mostafa Y. , Aloufi Abeer S. , Abd El-Hameed Rehab M.
Published: October 2023

Selenium nanoparticles (SeNPs) have demonstrated significant potential in a variety of disciplines, making them an extremely desirable subject of research. This study investigated the anticancer and antibacterial properties of my-co-fabricated selenium SeNPs, as well as their effects on soybean (Glycine max L.) seeds, seedling growth, cotton leafworm (Spodoptera littoralis) combat, and plant pathogenic fungi inhibition. SeNPs showed anticancer activity with an IC50 value of 1.95 µg/mL against MCF-7 breast adenocarcinoma cells. The myco-synthesized SeNPs exhibited an antibacterial effect against Proteus mirabilis and Klebsiella pneumoniae at 20 mg/mL. The use of 1 µM SeNPs improved soybean seed germination (93%), germination energy (76.5%), germination rate (19.0), and mean germination time (4.3 days). At 0.5 and 1.0 µM SeNPs, the growth parameters of seedlings improved. SeNPs increased the 4th instar larval mortality of cotton leafworm compared to control, with a median lethal concentration of 23.08 mg/mL. They inhibited the growth of Fusarium oxysporum, Rhizoctonia solani, and Fusarium solani. These findings demonstrate that biogenic SeNPs represent a promising approach to achieving sustainable progress in the fields of agriculture, cancer therapy, and infection control.
Neuroinflammation in Alzheimer’s Disease: A Potential Role of Nose-Picking in Pathogen Entry via the Olfactory System?
Authors: Zhou Xian , Kumar Paayal , Bhuyan Deep J. , Jensen Slade O. , Roberts Tara L. , Münch Gerald W.
Published: October 2023

Alzheimer’s disease (AD) is a complex neurodegenerative disorder characterized by progressive cognitive decline and memory impairment. Many possible factors might contribute to the development of AD, including amyloid peptide and tau deposition, but more recent evidence suggests that neuroinflammation may also play an—at least partial—role in its pathogenesis. In recent years, emerging research has explored the possible involvement of external, invading pathogens in starting or accelerating the neuroinflammatory processes in AD. In this narrative review, we advance the hypothesis that neuroinflammation in AD might be partially caused by viral, bacterial, and fungal pathogens entering the brain through the nose and the olfactory system. The olfactory system represents a plausible route for pathogen entry, given its direct anatomical connection to the brain and its involvement in the early stages of AD. We discuss the potential mechanisms through which pathogens may exploit the olfactory pathway to initiate neuroinflammation, one of them being accidental exposure of the olfactory mucosa to hands contaminated with soil and feces when picking one’s nose.
Radicalization Processes and Transitional Phases in Female and Male Detainees Residing in Dutch Terrorism Wings
Authors: Thijssen Gaby , Sijtsema Jelle , Bogaerts Stefan , Voorde Lys van de , Masthoff Erik
Published: October 2023

Background: Radicalization, violent extremism, and terrorism are risks to societal security. Although research on terrorism-related behaviors is increasing, thorough empirical studies are rare. Methods: This study investigates radicalization processes and transitions in a matched sample of female and male terrorist suspects and convicts (N = 26) residing in Dutch penitentiary terrorism wings. Results: Results show that both men and women often experienced discrimination. A subgroup of women grew up in a stressful family environment and lacked emotional support from their family, whereas the other women did not experience such circumstances. The majority of the study sample was susceptible to connecting with radicalized friends or family members. Interestingly, factors that initially led to radicalization (e.g., a utopian image of the Islamic State) could later turn out to be factors associated with abandoning extremism. Conclusions: In this study, differences in radicalization processes and transitional phases between women and men emerged. Men more often had police contact prior to a terrorism-related offense. Making an effort to right old mistakes seemed important in the radicalization processes of men, whereas women had a stronger desire for emotional support and were more driven by experienced trauma and feelings of loneliness. This study provides input for gender-specific prevention and disengagement interventions.
Coping with the Stress through Individual and Contextual Resilient Factors in Primary School Settings
Authors: Flores-Buils Raquel , Andrés-Roqueta Clara
Published: October 2023

Children face school stress as students through all educational stages. A negative association between resilience and stress has been demonstrated by many authors, but most of these studies have been carried out in higher educational stages. So, the aim of the present study is, on the one hand, to find out the level of stress of primary school children and also the types of stressful situations in school settings, and on the other hand, to analyze the effect of individual and contextually resilient factors on their level of school stress. The study involved 427 children between 6 and 12 years of age, who were administered the IECI school stress scale and the RES-PRIM Resilience questionnaire for children. Descriptive analyses, correlations, and regression analyses were performed on the data. Results showed an average level of school stress, with the most stressful situations being: participating in too many activities, concentration problems, and nervousness when being asked by the teacher in class. Predictive analysis showed that part of the school stress could be explained by both individual factors (self-esteem, introspection, future purpose, and social skills) and resilient contextual factors (teacher support, parental support, and peer support). It is concluded that it is necessary to pay more attention to the transitions between different educational stages with programs that reinforce academic information and encourage the development of individual resilient skills, stressing the importance of the role of teachers, peers, and parents as support groups.
Mechanistic Details of the Titanium-Mediated Polycondensation Reaction of Polyesters: A DFT Study
Authors: Guan Zhenyu , Zhang Jialong , Zhou Wenle , Zhu Youcai , Liu Zhen , Zhang Yumei , Zhang Yue
Published: October 2023

In this work, the mechanism of polyester polycondensation catalysed by titanium catalysts was investigated using density functional theory (DFT). Three polyester polycondensation reaction mechanisms, including the Lewis acid mechanism (M1), the coordination of the ester alkoxy oxygen mechanism (M2) and the coordination of the carboxy oxygen mechanism (M3), were investigated. Three reaction mechanisms for the polycondensation reaction of diethyl terephthalate (DET) were investigated using Ti(OEt)4 and cationic Ti(OEt)3+ as the catalyst. The results show that the polycondensation reaction of the Lewis acid mechanism exhibits similar energy barriers to the catalyst-free condition (42.6 kcal/mol vs. 47.6 kcal/mol). Mechanism M3 gives the lowest energy barrier of 17.5 kcal/mol, indicating that Ti(OEt)4 is the active centre for the polycondensation reaction. The catalytic efficiency of Ti(OEt)3+ is lower than that of Ti(OEt)4 catalysts due to its higher DET distortion energy (67.6 kcal/mol vs. 37.4 kcal/mol) by distortion–interaction analysis.
Age-Related Changes in the Temperature of the Lumbar Spine Measured by Passive Microwave Radiometry (MWR)
Authors: Tarakanov Alexander V. , Tarakanov Alexander A. , Skorodumova Elizaveta G. , Roberts Neil , Kobayshi Toshi , Vesnin Sergey G. , Zelman Vladimir , Goryanin Igor
Published: October 2023

A study was conducted to determine the age dependence of the temperature of the low back in the region of the five lumbar vertebrae by using passive microwave radiometry (MWR). The rationale for the study is that the infrared brightness on which the temperature measurement is based will be dependent upon blood circulation and thus on metabolic, vascular, and other regulatory factors. The brightness and infrared temperatures were determined in five zones above each of the medial, left, and right lateral projections of the vertebrae. A total of 115 healthy subjects were recruited, aged between 18 and 84 years. No significant differences in infrared temperature were detected. As predicted, brightness temperature increased until 25 years old and then gradually decreased. In subjects over 70 years of age, compared with those aged 60–70 years, there is a significant increase in brightness temperature at the level of 3–5 lumbar vertebrae by 0.3–0.7 °C. This is interpreted as indicating that individuals who have lived to an advanced age successfully maintain metabolic and regenerative processes. The benchmark data that has been obtained can be usefully employed in future studies of the aetiology of low back pain. In particular, the prospect exists for the technology to be used to provide a non-invasive biomarker to evaluate the effectiveness of antiaging therapies.
Advances in Biomarkers for Diagnosis and Treatment of ARDS
Authors: Ge Ruiqi , Wang Fengyun , Peng Zhiyong
Published: October 2023

Acute respiratory distress syndrome (ARDS) is a common and fatal disease, characterized by lung inflammation, edema, poor oxygenation, and the need for mechanical ventilation, or even extracorporeal membrane oxygenation if the patient is unresponsive to routine treatment. In this review, we aim to explore advances in biomarkers for the diagnosis and treatment of ARDS. In viewing the distinct characteristics of each biomarker, we classified the biomarkers into the following six categories: inflammatory, alveolar epithelial injury, endothelial injury, coagulation/fibrinolysis, extracellular matrix turnover, and oxidative stress biomarkers. In addition, we discussed the potential role of machine learning in identifying and utilizing these biomarkers and reviewed its clinical application. Despite the tremendous progress in biomarker research, there remain nonnegligible gaps between biomarker discovery and clinical utility. The challenges and future directions in ARDS research concern investigators as well as clinicians, underscoring the essentiality of continued investigation to improve diagnosis and treatment.
Elementary Teachers’ Perceptions and Enactment of Supplemental, Game-Enhanced Fraction Intervention
Authors: Hunt Jessica , Taub Michelle , Duarte Alejandra , Bentley Brianna , Womack-Adams Kelly , Marino Matthew , Holman Kenneth , Kuhlman Adrian
Published: October 2023

Curricula enhanced through the use of digital games can benefit students in their interest and learning of Science, Technology, Engineering, and Mathematics (STEM) concepts. Elementary teachers’ likelihood to embrace and use game-enhanced instructional approaches with integrity in mathematics has not been extensively studied. In this study, a sequential mixed methods design was employed to investigate the feasibility of a game-enhanced supplemental fraction curriculum in elementary classrooms, including how teachers implemented the curriculum, their perspectives and experiences as they used it, and their students’ resulting fraction learning and STEM interest. Teachers implemented the supplemental curriculum with varying adherence but had common experiences throughout their implementation. Teachers expressed experiences related to (1) time, (2) curriculum being too different, and (3) too difficult for students. Their strategies to handle those phenomena varied. Teachers that demonstrated higher adherence to the game-enhanced supplemental fraction curriculum had students that displayed higher STEM interest and fraction learning. While this study helps to better understand elementary teachers’ experiences with game-enhanced mathematics curricula, implications for further research and program development are also discussed.
Wideband Millimeter-Wave MIMO Antenna with a Loaded Dielectric Cover for High-Gain Broadside Radiation
Authors: Chen Zhijiao , Song Wei , Wang Wensong
Published: October 2023

In a millimeter-wave terminal device, the use of a radome degrades the radiating performance of the broadside antenna, especially for the MIMO antenna system. In this study, a dielectric cover is de-signed and investigated to enhance the broadside gain of a millimeter-wave MIMO antenna, while keeping its wideband and high isolation performance. Firstly, a compact wideband ladder-shaped slot antenna is proposed with 21.9% bandwidth. The effectiveness of the dielectric cover design criteria over the wideband antenna is investigated. Then, this wideband antenna element is expanded to a 2 × 2 MIMO antenna by forming a center-symmetric structure and isolating it via the inserted metal vias. By loading the dielectric cover, this millimeter-wave MIMO antenna is verified with enhanced broadside gain for more than 2.1 dB. With the measured impedance bandwidth of 21.9% (57.0–71.0 GHz), peak broadside gain of 12.3 dBi, and high isolation over 15 dB, the proposed MIMO antenna is suitable for wireless gigabit terminal devices.
Specific Absorption Rate and Temperature Distributions in the Human Head with Implanted Deep Brain Stimulation Subjected to Mobile Phone Electromagnetic Radiation
Authors: Tian Rui , Wu Yu-Qin , Lu Mai , Miao Xin-Fa
Published: October 2023

Deep Brain Stimulation (DBS), also known as the brain pacemaker, has gradually evolved from a scientific experiment into an effective clinical treatment for movement disorders as a method of improving movement disorders. At present, there are few studies on the effects of 5G mobile phone antenna radiation on the heads of adult patients implanted with DBS. In this study, COMSOL Multiphysics was used to establish a mobile phone model with a 5G/4G patch antenna, a real human head, and the DBS models. Then, we calculated the specific absorption rate (SAR) of various layers of the head tissues with the mobile phone at different distances from the human head, as well as the temperature change rule of the head and the DBS irradiated by the antenna for 30 min. The simulation results showed that when the frequency is 3500 MHz, the electromagnetic radiation of the phone to the patient’s head is generally greater than that of the 2400 MHz. When at 3500 MHz, the distance between the phone and the head is inversely proportional to the SAR value; thus, when the distance between the phone and the head is 1 cm, the maximum SAR value—which is 1.132 W/kg—appeared in the skin layer of the head with implanted DBS. But it is worth noting that the largest temperature rise appeared in the brain layer at 2400 MHz and at a distance of 1 cm, which is 0.2148 °C. Although the SAR values and temperature rise obtained from all simulations are below the limits of 2 W/kg and +1 °C specified by the International Commission on Non-Ionizing Radiation Protection (ICNIRP), we still recommend that patients with implanted DBS maintain a distance when using the phones.
A Novel Standardized Collaborative Online Model for Processing and Analyzing Remotely Sensed Images in Geographic Problems
Authors: Zhang Xueshen , Wu Qiulan , Zhang Feng , Sun Xiang , Wu Huarui , Wu Shumin , Chen Xuefei
Published: October 2023

In recent years, remote sensing image processing technology has developed rapidly, and the variety of remote sensing images has increased. Solving a geographic problem often requires multiple remote sensing images to be used together. For an image processing analyst, it is difficult to become proficient in the image processing of multiple types of remote sensing images. Therefore, it is necessary to have multiple image processing analysts collaborate to solve geographic problems. However, as a result of the naturally large volumes of data and the computer resources they consume for analysis, remote sensing images present a barrier in the collaboration of multidisciplinary remote sensing undertakings and analysts. As a result, during the development of the collaborative analysis process, it is necessary to achieve the online processing and analysis of remote sensing images, as well as to standardize the online remote sensing image collaborative analysis process. To address the above issues, a hierarchical collaborative online processing and analysis framework was developed in this paper. This framework defined a clear collaborative analysis structure, and it identifies what kinds of online image processing and analysis activities participants can engage in to successfully conduct collaborative processes. In addition, a collaborative process construction model and an online remote sensing image processing analysis model were developed to assist participants in creating a standard collaborative online image processing and analysis process. In order to demonstrate the feasibility and effectiveness of the framework and model, this paper developed a collaborative online post-disaster assessment process that utilizes radar images and optical remote sensing images for a real forest fire event. This process was based on the BPMN2.0 and OGC dual standards. Based on the results, the proposed framework provides a hierarchical collaborative remote sensing image processing and analysis process with well-defined stages and activities to guide the participants’ mutual collaboration. Additionally, the proposed model can help participants to develop a standardized collaborative online image processing process in terms of process structure and information interactions.
Pulmonary Function in Pulmonary Sarcoidosis
Authors: Yao Qian , Ji Qiuliang , Zhou Ying
Published: October 2023

The pulmonary function test (PFT) has been widely used in sarcoidosis. It may vary due to the severity, extent, and the presence of complications of the disease. Although the PFT of most sarcoidosis patients is normal, there are still 10–30% of cases who may experience a decrease in the PFT, with a progressive involvement of lungs. Restrictive ventilatory impairment due to parenchymal involvement has been commonly reported, and an obstructive pattern can also be present related to airway involvement. The PFT may influence treatment decisions. A diffusing capacity for carbon monoxide (DLCO) < 60% as well as a forced vital capacity (FVC) < 70% portends clinically significant pulmonary sarcoidosis pathology and warrants treatment. During follow-up, a 5% decline in FVC from baseline or a 10% decline in DLCO has been considered significant and reflects the disease progression. FVC has been recommended as the favored objective endpoint for monitoring the response to therapy, and an improvement in predicted FVC percentage of more than 5% is considered effective.
Allergic Disease with Selective IgA Deficiency. Comment on Cinicola et al. The Allergic Phenotype of Children and Adolescents with Selective IgA Deficiency: A Longitudinal Monocentric Study. J. Clin. Med. 2022, 11, 5705
Authors: Özdemir Öner
Published: October 2023

I read the article titled ‘The Allergic Phenotype of Children and Adolescents with Selective IgA Deficiency: A Longitudinal Monocentric Study’ by Cinicola et al. with great interest [...]
Which of the 37 Plates Is the Most Mechanically Appropriate for a Low-Neck Fracture of the Mandibular Condyle? A Strength Testing
Authors: Okulski Jakub , Kozakiewicz Marcin , Krasowski Michał , Zieliński Rafał , Wach Tomasz
Published: October 2023

(1) Background: The mandible is the most frequently injured component of the facial skeleton, with 25–45% of mandibular fractures involving the condylar process. This study aims to mechanically compare which plates are most suitable for use in low-neck fractures of the condyle. (2) Methods: Polyurethane mandibular models with simulated low-neck fractures were tested using 37 distinct plate designs. These plates were fabricated from 1 mm thick, grade 23 titanium sheets. The models were then subjected to force tests on a strength machine, and the correlation between applied force and fracture displacement was recorded. (3) Results: For low-neck fractures, XCP side-dedicated 3+5 and ACP-T plates demonstrated strength comparable to that of two straight plates, the current gold standard in osteosynthesis. (4) Conclusions: The Mechanical Excellence Factor (MEF) introduced by the authors provides a more accurate metric for theoretically predicting a plate’s mechanical strength compared to the Plate Design Factor (PDF). Eight plate characteristics were utilized to calculate the MEF. Employing the MEF allows for rapid, preliminary validation before undertaking strength tests. Furthermore, the findings of this study can guide the selection of the most durable plate designs for subsequent fatigue testing.
Aortic Valve Replacement: Understanding Predictors for the Optimal Ministernotomy Approach
Authors: Irace Francesco Giosuè , Chirichilli Ilaria , Russo Marco , Ranocchi Federico , Bergonzini Marcello , Lio Antonio , Nicolò Francesca , Musumeci Francesco
Published: October 2023

Introduction. The most common minimally invasive approach for aortic valve replacement (AVR) is the partial upper mini-sternotomy. The aim of this study is to understand which preoperative computed tomography (CT) features are predictive of longer operations in terms of cardio-pulmonary bypass timesand cross-clamp times. Methods. From 2011 to 2022, we retrospectively selected 246 patients which underwent isolated AVR and had a preoperative ECG-gated CT scan. On these patients, we analysed the baseline anthropometric characteristics and the following CT scan parameters: aortic annular dimensions, valve calcium score, ascending aorta length, ascending aorta inclination and aorta–sternum distance. Results. We identified augmented body surface area (>1.9 m2), augmented annular diameter (>23 mm), high calcium score (>2500 Agatson score) and increased aorta–sternum distance (>30 mm) as independent predictors of elongated operation times (more than two-fold). Conclusions. Identifying the preoperative predictive factors of longer operations can help surgeons select cases suitable for minimally invasive approaches, especially in a teaching context.
Doppler-Guided Second-Look Endoscopy in Peptic Ulcer Bleeding: A Randomised Controlled Trial
Authors: Nielsen Michael Milek , Schaffalitzky de Muckadell Ove B , Laursen Stig Borbjerg
Published: October 2023

Background: Endoscopic treatment guided by Doppler endoscopic probes (DEPs) during index endoscopy may be associated with improved outcome in patients with peptic ulcer bleeding (PUB). As competencies for DEP evaluation are not always available for index endoscopy, we examined the outcome associated with DEP evaluation at second-look endoscopy. Methods: The study was designed as a non-blinded, parallel group, randomised controlled trial. Patients admitted with PUB from Forrest Ia-IIb ulcers, controlled by endoscopic therapy, were randomised (1:1 ratio) to second-look endoscopy <24 h with DEP evaluation of the bleeding ulcer or continued standard treatment. Patients were followed up for 30 days. The primary outcome was rebleeding. Secondary outcomes included the number of transfusions, length of hospital stay, and 30-day mortality. Results: A total of 62 patients were included. At second-look endoscopy, 91% (29/32) of patients had a positive DEP signal at the ulcer base and were treated with contact thermal therapy (n = 29), injection of diluted adrenaline (n = 23), and haemoclips (n = 7). Among the 32 patients treated with DEP evaluation, only one rebled (3%) compared to four patients (13%) in the control group (p = 0.20). There were no differences in the secondary outcomes between groups, and there were no complications related to DEP evaluation. Conclusions: Second-look endoscopy with DEP-guided evaluation and treatment is safe and associated with a very low risk of rebleeding (3%) in patients with PUB. Second-look endoscopy with DEP evaluation may be considered in selected PUB patients at high risk of rebleeding, and may represent an alternative to the use of DEP for index endoscopy. Nevertheless, we did not find that second-look endoscopy with DEP evaluation significantly improved patient outcome compared to standard treatment.
Updated Adjuvant Chemotherapy for Gastric Cancer
Authors: Takayama Toshizo , Tsuji Yasushi
Published: October 2023

Surgical resection is currently the best curative approach for gastric cancer (GC); however, the prognosis of patients with advanced GC remains poor even with curative resection. For this reason, perioperative chemotherapy has been combined with surgery to reduce the risk of postoperative recurrence. Standard perioperative chemotherapy for resectable advanced GC varies from region to region. Postoperative S-1 therapy was standardized via the ACTS-GC study in East Asia, perioperative ECF (Epirubicin + Cisplatin + Fluorouracil) was standardized via the MAGIC study in Europe, and postoperative chemoradiotherapy was standardized via the US intergroup study in North America. Since then, more intensive regimens have been developed. In recent years, perioperative therapy using novel agents, such as molecular-targeted drugs and immune checkpoint inhibitors (ICIs), has also been tested and evaluated in the three major regions (East Asia, Europe, and North America) with promising results. Perioperative chemotherapy has become an integral part of many treatment strategies and requires continued research and evaluation.
Effectiveness and Safety of an Outpatient Program for Percutaneous Left Atrial Appendage Occlusion
Authors: Blanco-Fernández Fabián , Antúnez-Muiños Pablo J. , Núñez-García Jean C. , López-Tejero Sergio , Barreira-de Sousa Gilles J. , García-Monsalvo Mónica , Antúnez-Ballesteros Milena , Maree Andrew , González-Calle David , Rodríguez-Collado Javier , Barreiro-Pérez Manuel , Díaz-Peláez Elena , Pérez del Villar-Moro María C. , Sánchez-Fernández Pedro L. , Cruz-González Ignacio
Published: October 2023

Background: Left atrial appendage occlusion (LAAO) is a safe and effective alternative to oral anticoagulation for thromboprophylaxis in patients with nonvalvular atrial fibrillation. Technological development in devices and imaging techniques, as well as accumulated experience, have increased procedural success rates and decreased complications. Same-day discharge protocols have been proposed in the field of structural heart disease, but this approach has not been studied in detail for the LAAO procedure. Aim: The aim of this study is to assess the safety and efficacy of an outpatient program for LAAO when compared to the conventional treatment approach. Methods: We present a retrospective, non-randomized single-center study of 262 consecutive patients undergoing LAAO. Patients were divided into two groups, the first (n = 131) followed a conventional protocol (CP), and the second (n = 131) an outpatient protocol (OP). The primary composite endpoint comprised MACCE (death, stroke, and bleeding), cardiac tamponade, vascular complication, or attendance in the emergency department after hospital discharge at 30 days. Results: The overall success rate was 99.6%, with a periprocedural complication rate of 2.29%. With regards to the CP versus OP group, there were no differences between incidences of the primary composite endpoint (6.1% PC vs. 3.0% PA, p = 0.24), or after an analysis, with propensity score matching. No differences were observed in the individual endpoints. There was a decrease in hospital length of stay in the same-day discharge group (p < 0.01). Conclusions: A same-day discharge LAAO program is safe, effective, and feasible when compared to the conventional strategy. Moreover, it reduces hospital length of stay, which might have clinical and economic benefits.
Sustainable Management for Healthy and Productive Watersheds in Indonesia
Authors: Supangat Agung Budi , Basuki Tyas Mutiara , Indrajaya Yonky , Setiawan Ogi , Wahyuningrum Nining , Purwanto  , Putra Pamungkas Buana , Savitri Endang , Indrawati Dewi Retna , Auliyani Diah , Nandini Ryke , Pramono Irfan Budi , Nugroho Agung Wahyu , Wuryanta Agus , Adi Rahardyan Nugroho , Harjadi Beny , Cahyono Sigit Andy , Lastiantoro C. Yudi , Handayani Wuri , Pratiwi Dian , Nada Firda Maftukhakh Hilmya , Hanindityasari Luthfi , Ismanto Agus , Riyanto Heru Dwi , Samawandana Gipi , Simarmata Daniel Pandapotan , Anggraeni Illa
Published: October 2023

Indonesian watershed management continues to struggle with various problems caused by natural disasters, particularly hydrometeorological disasters, which are worsened by the effects of climate change. Coordinating and synchronizing the interest of many parties in watershed management with various scenarios of natural conditions is a big challenge in the creation of a healthy and productive watershed. Multiple initiatives have been undertaken, from establishing rules and policies to implementing them and assessing the effects, leading to various lessons being learned for better management. This article presents a study on watershed management in Indonesia and recommends alternative improvements toward healthy and productive watershed management. A combination of a descriptive qualitative analysis of the authors’ experience in various research activities and a critical analysis is used to examine existing conditions and to formulate recommendations for better sustainable management toward a healthy and productive watershed. Most Indonesian watersheds are susceptible to degradation due to numerous threats. The challenges in Indonesian watershed management, including land degradation and climate-induced disasters, lack of synchronization and coordination, limited resources, and anthropogenic factors, have led to decreased watershed health and productivity and hindered effective management. Integrated management, especially at the micro-watershed level, addresses these challenges. Successful integrated watershed management requires community involvement, appropriate management action for specific locations, technological support, regulatory alignment, and stakeholder collaboration to ensure a healthy, productive, and sustainable watershed for present and future generations.
A Modified NAR Scoring Model Incorporating Immune Infiltration Characteristics to Better Predict Long-Term Survival Following Neoadjuvant Radiotherapy in Rectal Cancer
Authors: Zhang Xueqing , Zeng Yibin , Li Hui , Zhuang Qingyang , Tang Lirui , Wu Junxin , Li Jinluan
Published: October 2023

(1) Background: The neoadjuvant rectal (NAR) score has been developed as a prognostic tool for survival in locally advanced rectal cancer (LARC). However, the NAR score only incorporates weighted cT, ypT, and ypN categories. This long-term follow-up study aims to modify a novel prognostic scoring model and identify a short-term endpoint for survival. (2) Methods: The prognostic factors for overall survival (OS) were explored through univariate and multivariate analyses. Based on Cox regression modeling, nomogram plots were constructed. Area under the curve (AUC) and concordance indices were used to evaluate the performance of the nomogram. Receiver operating characteristic (ROC) analysis was conducted to compare the efficiency of the nomogram with other prognostic factors. (3) Results: After a long-term follow-up, the 5-year OS was 67.1%. The mean NAR score was 20.4 ± 16.3. Multivariate analysis indicated that CD8+ T-cell, lymphovascular invasion, and the NAR score were independent predictors of OS. The modified NAR scoring model, incorporating immune infiltration characteristics, exhibited a high C-index of 0.739 for 5-year OS, significantly outperforming any individual factor. Moreover, the predictive value of the nomogram was superior to the AJCC stage and pathological complete regression at 3-year, 5-year, and 10-year time points, respectively. Over time, the model’s predictions of long-term survival remained consistent and improved in accuracy. (4) Conclusions: The modified NAR scoring model, incorporating immune infiltration characteristics, demonstrates high accuracy and consistency in predicting OS.
Cyclic Stability of Locking Plate Augmented with Intramedullary Polymethyl Methacrylate (PMMA) Strut Fixation for Osteoporotic Humeral Fractures: A Biomechanical Study
Authors: Hsiao Chih-Kun , Chiu Yen-Wei , Hsiao Hao-Yuan , Tsai Yi-Jung , Lee Cheng-Hung , Yen Cheng-Yo , Tu Yuan-Kun
Published: October 2023

The locking plate may provide improved fixation in osteoporotic bone; however, it has been reported to fail due to varus collapse or screw perforation of the articular surface, especially in osteoporotic bone with medial cortex comminution. Using bone graft as an intramedullary strut together with plate fixation may result in a stronger construct. However, the drawbacks of bone grafts include limited supply, high cost, and infection risk. PMMA (so-called bone cement) has been widely used for implant fixation due to its good mechanical properties, fabricability, and biocompatibility. The risk of donor-site infection and the drawbacks of allografting may be overcome by considering PMMA struts as alternatives to fibular grafts for humeral intramedullary grafting surgeries. However, the potential effects of intramedullary PMMA strut on the dynamic behaviour of osteoporotic humerus fractures remain unclear. This study aimed to investigate the influence of an intramedullary PMMA strut on the stability of unstable proximal humeral fractures in an osteoporotic synthetic model. Two fixation techniques, a locking plate alone (non-strut group) and the same fixation augmented with an intramedullary PMMA strut (with-strut group), were cyclically tested in 20 artificial humeral models. Axially cyclic testing was performed to 450 N for 10,000 cycles, intercyclic motion, cumulated fragment migration, and residual deformation of the constructs were determined at periodic cyclic intervals, and the groups were compared. Results showed that adding an intramedullary PMMA strut could decrease 1.6 times intercyclic motion, 2 times cumulated fracture gap migration, and 1.8 times residual deformation from non-strut fixation. During cycling, neither screw pull-out, cut-through, nor implant failure was observed in the strut-augmented group. We concluded that the plate-strut mechanism could enhance the cyclic stability of the fixation and minimize the residual displacement of the fragment in treating osteoporotic proximal humeral unstable fractures. The PMMA strut has the potential to substitute donor bone and serve as an intramedullary support when used in combination with locking plate fixation. The intramedullary support with bone cement can be considered a solution in the treatment of osteoporotic proximal humeral fractures, especially when there is medial comminution.
Microcatheter-Directed Thrombolysis Using Recombinant Tissue Plasminogen Activator for the Treatment of Acute Superior Mesenteric Artery Embolism: A Case Report
Authors: Kim Yang-Won , Choi Ho-Cheol , Yang Won-Jeong , Koo Byeong-Ju , Ahn Jae-Kyeong , Lee Jeong-Pyo , Na Jae-Bum , Jo Sa-Hong , Park Sung-Eun , Won Jung-Ho
Published: October 2023

Background: Acute mesenteric ischemia (AMI) is a life-threatening condition, and in 50% of patients, AMI is caused by acute superior mesenteric artery (SMA) embolism. Endovascular treatment is increasingly being considered the primary modality in selected cases. Many studies have reported that percutaneous aspiration embolectomy using a guiding catheter and thrombolysis with recombinant tissue plasminogen activator (rtPA) are effective in treating SMA embolism. However, no reports on treating SMA embolism using rtPA administered via a microcatheter exist. Case presentation: A 64-year-old man with underlying atrial fibrillation presented with acute SMA embolism revealed using computed tomography (CT). rtPA (total 3 mg) was carefully administered into the occluded SMA through a microcatheter. No complications occurred, and complete revascularization of the SMA was revealed on follow-up CT. Conclusions: Compared with previous reports, this case report reveals that successful revascularization can be achieved using rtPA administered via a microcatheter, with a low dose of rtPA and a short duration of thrombolysis.
Surface Properties and Cavitation Erosion Resistance of Cast Iron Subjected to Laser Cavitation Treatment
Authors: Luo Chunhui , Gu Jiayang
Published: October 2023

Laser cavitation is a novel surface modification technology using the impact of bubble collapse and laser-induced plasma to induce plastic deformation and produce compressive residual stress on material surfaces. The effects of laser cavitation on surface properties and the cavitation erosion resistance of cast iron were studied. In this work, three-dimensional morphology and residual stress distribution of the laser cavitation area under different laser parameters was obtained, the variation regularities of the topographic range and impact depth of the affected area was discussed, and the weight loss rate of cast iron under different defocusing amounts was studied. It was found that laser cavitation can effectively improve the anti-cavitation erosion property of the cast iron surface, and the optimal value was reached when the defocusing amount was H = 1 mm. Combined with the various defocusing amounts and the variation trend of the weight loss rate of cavitation erosion, the cavitation erosion time corresponding to each stage of the cast iron (incubation, rise, decay, and stability) was obtained.