bluuebunny/crossref_metadata_2025 huggingface dataset:
A Microscopic Experimental Study on the Dominant Flow Channels of Water Flooding in Ultra-High Water Cut Reservoirs
Authors: Yu Chunlei , Zhang Min , Chen Wenbin , Zhang Shiming , Wang Shuoliang
Published: November 2024

The water drive reservoir in Shengli Oilfield has entered a stage of ultra-high water cut development, forming an advantageous flow channel for the water drive, resulting in the inefficient and ineffective circulation of injected water. Therefore, the distribution characteristics of water drive flow channels and their controlled residual oil in ultra-high water cut reservoirs are of great significance for treating water drive dominant flow channels and utilizing discontinuous residual oil. Through microscopic physical simulation of water flooding, color mixing recognition and image analysis technology were used to visualize the evolution characteristics of water flooding seepage channels and their changes during the control process. Research has shown that during the ultra-high water content period, the shrinkage of the water drive seepage channel forms a dominant seepage channel, forming a “seepage barrier” at the boundary of the dominant seepage channel, and dividing the affected area into the water drive dominant seepage zone and the seepage stagnation zone. The advantage of water flooding is that the oil displacement efficiency in the permeable zone is as high as 80.5%, and the remaining oil is highly dispersed. The water phase is almost a single-phase flow, revealing the reason for high water consumption in this stage. The remaining oil outside the affected area and within the stagnant flow zone accounts for 89.8% of the remaining oil, which has the potential to further improve oil recovery in the later stage of ultra-high water cut. For the first time, the redundancy index was proposed to quantitatively evaluate the control effect of liquid extraction and liquid flow direction on the dominant flow channels in water flooding. Experimental data showed that both liquid extraction and liquid flow direction can regulate the dominant flow channels in water flooding and improve oil recovery under certain conditions. Microscopic physical simulation experiments were conducted through the transformation of well network form in the later stage of ultra-high water content, which showed that the synergistic effect of liquid extraction and liquid flow direction can significantly improve the oil recovery effect, with an oil recovery rate of 68.02%, deepening the understanding of improving oil recovery rate in the later stage of ultra-high water content.
Master–Slave Game Optimization Scheduling of Multi-Microgrid Integrated Energy System Considering Comprehensive Demand Response and Wind and Storage Combination
Authors: Sun Hongbin , Zou Hongyu , Jia Jianfeng , Shen Qiuzhen , Duan Zhenyu , Tang Xi
Published: November 2024

This paper addresses the critical challenge of scheduling optimization in regional integrated energy systems, characterized by the coupling of multiple physical energy streams (electricity, heat, and cooling) and the participation of various stakeholders. To tackle this, a novel multi-load and multi-type integrated demand response model is proposed, which fully accounts for the heterogeneous characteristics of energy demands in different campus environments. A leader–follower two-layer game equilibrium model is introduced, where the system operator acts as the leader, and campus load aggregators, energy storage plants, and wind farm operators serve as followers. The layer employs an enhanced particle swarm optimization (PSO) algorithm to iteratively adjust energy sales prices and response compensation unit prices, influencing the user response plan through the demand response model. In the lower layer, the charging and discharging schedules of energy storage plants, wind farm energy supply, and outputs of energy conversion devices are optimized to guide system operation. The novelty of this approach lies in the integration of a game-theoretic framework with advanced optimization techniques to balance the interests of all participants and enhance system coordination. A case study is conducted to evaluate the effectiveness of the proposed strategy, demonstrating significant economic benefits. The results show that the model encourages stakeholders to invest in energy infrastructure and actively participate in coordinated dispatch, leading to improved overall system efficiency and comprehensive revenue enhancement for the multi-agent energy system.
Beyond Lithium: Future Battery Technologies for Sustainable Energy Storage
Authors: Tan Alan K. X. , Paul Shiladitya
Published: November 2024

Known for their high energy density, lithium-ion batteries have become ubiquitous in today’s technology landscape. However, they face critical challenges in terms of safety, availability, and sustainability. With the increasing global demand for energy, there is a growing need for alternative, efficient, and sustainable energy storage solutions. This is driving research into non-lithium battery systems. This paper presents a comprehensive literature review on recent advancements in non-lithium battery technologies, specifically sodium-ion, potassium-ion, magnesium-ion, aluminium-ion, zinc-ion, and calcium-ion batteries. By consulting recent peer-reviewed articles and reviews, we examine the key electrochemical properties and underlying chemistry of each battery system. Additionally, we evaluate their safety considerations, environmental sustainability, and recyclability. The reviewed literature highlights the promising potential of non-lithium batteries to address the limitations of lithium-ion batteries, likely to facilitate sustainable and scalable energy storage solutions across diverse applications.
Innovative Approaches to Windcatcher Design: A Review on Balancing Tradition Sustainability and Modern Technologies for Enhanced Performance
Authors: Sirror Hala
Published: November 2024

This review investigates the role of windcatchers in modern architecture, exploring their optimization through the integration of traditional designs with contemporary technologies. Historically utilized in hot and arid climates for passive cooling, windcatchers offer energy-efficient solutions for improving indoor air quality (IAQ). This study examines the sustainability of traditional windcatcher designs and their relevance in preserving heritage structures. Using advanced tools like computational fluid dynamics (CFD) modeling, modern adaptations of windcatchers can be optimized for urban environments. This review also explores hybrid systems, combining windcatchers with solar chimneys, evaporative cooling, or heat pumps, to enhance performance in low-wind conditions by balancing natural and mechanical ventilation. Additionally, it addresses the role of artificial intelligence (AI) in heritage planning, facilitating the design and integration of windcatchers into contemporary architecture. The findings suggest that windcatchers, combined with modern design strategies and hybrid systems, continue to be viable and sustainable solutions for passive cooling, contributing to energy-efficient and climate-resilient buildings across different environmental and urban contexts.
Amended Calculation of Solar Heat Gain Coefficient Based on the Escape of Incident Solar Radiation
Authors: Lu Shunyao , Yang Dongfang , Huang Xiaoqing , Chen Tao , Wang Zhengzhi
Published: November 2024

The solar heat gain is an important component of building cooling load, and its magnitude affects building energy consumption directly. In buildings with glass curtain walls, the window to wall rate is close to 1, so the amount of solar heat gain is huge, which directly determines the energy consumption level of a building’s air conditioning system. In fact, incident solar radiation can escape to the exterior through the transparent envelope, which cannot be ignored in buildings with glass curtain walls. This will cause changes in solar heat gain, so the solar heat gain coefficient (SHGC) needs to be corrected. In this paper, the heat transfer process of solar radiation in window shading systems is analyzed, and an amended calculation model for the SHGC is established. Multiple forms of windows and shading systems are selected and their SHGC-amended factor for rooms with different orientations under different standard calculation conditions in various countries is calculated. As the number of glass layers increases, the transmittance of the window gradually decreases, the reflectance and absorbance gradually increase, and the SHGC value decreases. The SHGC-amended factor decreases with an increasing escape rate, and the two can be approximated as a linear correlation. The weakening effect of shading on the solar heat gain of the buildings is overestimated. The SHGC-amended factor proposed in this paper can calculate building solar heat gain more accurately.
Yield and Survival of 19 Cultivars of Willow (Salix spp.) Biomass Crops over Eight Rotations
Authors: Santucci Shane , Eisenbies Mark , Volk Timothy
Published: November 2024

This study reveals patterns of yield and survival of short-rotation coppice (SRC) willow cultivars over eight rotations (1993–2019). Cultivars fell into four broad categories: commercial, released, stable, and decline. SV1, the singular cultivar that advanced to commercial deployments, had first-rotation yields of 8.9 Mg ha−1 a−1, peaking at 15.2 Mg ha−1 a−1 by the fourth. Mean yields from rotations 2–8 were still 36% above first-rotation yields, confirming the commercial potential for this cultivar over 26 years. The released group (four cultivars) had stable yields over six rotations (approximately 3 to 7 Mg ha−1 a−1), rising to match commercial yields (10 Mg ha−1 a−1) between the sixth and eighth rotation. Most of the cultivars were in the stable group that had relatively consistent yields over time. First-rotation yields in this group were approximately 5 Mg ha−1 a−1, and average yield increased by 23% for rotations 2–8. The two cultivars in the decline group were impacted by disease and browsing that lowered survival and growth. These findings are crucial for understanding willow systems’ potential over their full lifespan as a bioenergy crop, which is a crucial input into yield, economic, and environmental models.
Identification of Key Soil Quality Indicators for Predicting Mean Annual Increment in Pinus patula Forest Plantations in Tanzania
Authors: Maguzu Joshua , Maliondo Salim M. , Ulrik Ilstedt , Katani Josiah Zephaniah
Published: November 2024

There is an unexplored knowledge gap regarding the relationship between soil quality and mean annual increment (MAI) in forest plantations in Tanzania. Therefore, this study aimed to identify soil quality indicators and their impact on the mean annual increment (MAI) of Pinus patula at Sao Hill (SHFP) and Shume forest plantations (SFP) in Tanzania. The forests were stratified into four site classes based on management records. Tree growth data were collected from 3 quadrat plots at each site, resulting in 12 plots in each plantation, while soil samples were taken from 0 to 40 cm soil depth. Analysis of variance examined the variation in soil quality indicators between site classes at two P. patula plantation sites. Covariance analysis assessed the differences in MAI and stand variables across various site classes, taking into account the differing ages of some stands, with stand age serving as a covariate. Linear regression models explored the relationship between soil quality indicators and MAI, while partial least squares regression predicted MAI using soil quality indicators. The results showed that, at SHFP, sand, organic carbon (OC), cation exchange capacity, calcium (Ca), magnesium (Mg), and available P varied significantly between site classes, while silt, clay, and available P varied significantly at SFP. At SHFP, sand and clay content were positively correlated with MAI, while at SFP, silt content, available P (Avail P), potassium (K), Ca, and Mg showed significant positive correlations. Soil quality indicators, including physical and chemical properties (porosity, clay percentages, sand content, and OC) and only chemical (K, Mg, Avail P, and soil pH) properties were better predictors of the forest mean annual increment at SHFP and SFP, respectively. This study underscores the importance of monitoring the quality of soils in enhancing MAI and developing soil management strategies for long-term sustainability in forests production.
Enhanced CRC Growth in Iron-Rich Environment, Facts and Speculations
Authors: Chieppa Marcello , Kashyrina Marianna , Miraglia Alessandro , Vardanyan Diana
Published: November 2024

The contribution of nutritional factors to disease development has been demonstrated for several chronic conditions including obesity, type 2 diabetes, metabolic syndrome, and about 30 percent of cancers. Nutrients include macronutrients and micronutrients, which are required in large and trace quantities, respectively. Macronutrients, which include protein, carbohydrates, and lipids, are mainly involved in energy production and biomolecule synthesis; micronutrients include vitamins and minerals, which are mainly involved in immune functions, enzymatic reactions, blood clotting, and gene transcription. Among the numerous micronutrients potentially involved in disease development, the present review will focus on iron and its relation to tumor development. Recent advances in the understanding of iron-related proteins accumulating in the tumor microenvironment shed light on the pivotal role of iron availability in sustaining pathological tumor hallmarks, including cell cycle regulation, angiogenesis, and metastasis.
Genomic Insights into Tibetan Sheep Adaptation to Different Altitude Environments
Authors: Zhang Wentao , Yuan Chao , An Xuejiao , Guo Tingting , Wei Caihong , Lu Zengkui , Liu Jianbin
Published: November 2024

In recent years, research has gradually uncovered the mechanisms of animal adaptation to hypoxic conditions in different altitude environments, particularly at the genomic level. However, past genomic studies on high-altitude adaptation have often not delved deeply into the differences between varying altitude levels. This study conducted whole-genome sequencing on 60 Tibetan sheep (Medium Altitude Group (MA): 20 Tao sheep (TS) at 2887 m, High Altitude Group (HA): 20 OuLa sheep (OL) at 3501 m, and Ultra-High Altitude Group (UA): 20 AWang sheep (AW) at 4643 m) from different regions of the Tibetan Plateau in China to assess their responses under varying conditions. Population genetic structure analysis revealed that the three groups are genetically independent, but the TS and OL groups have experienced gene flow with other northern Chinese sheep due to geographical factors. Selection signal analysis identified FGF10, MMP14, SLC25A51, NDUFB8, ALAS1, PRMT1, PRMT5, and HIF1AN as genes associated with ultra-high-altitude hypoxia adaptation, while HMOX2, SEMA4G, SLC16A2, SLC22A17, and BCL2L2 were linked to high-altitude hypoxia adaptation. Functional analysis showed that ultra-high-altitude adaptation genes tend to influence physiological mechanisms directly affecting oxygen uptake, such as lung development, angiogenesis, and red blood cell formation. In contrast, high-altitude adaptation genes are more inclined to regulate mitochondrial DNA replication, iron homeostasis, and calcium signaling pathways to maintain cellular function. Additionally, the functions of shared genes further support the adaptive capacity of Tibetan sheep across a broad geographic range, indicating that these genes offer significant selective advantages in coping with oxygen scarcity. In summary, this study not only reveals the genetic basis of Tibetan sheep adaptation to different altitudinal conditions but also highlights the differences in gene regulation between ultra-high- and high-altitude adaptations. These findings offer new insights into the adaptive evolution of animals in extreme environments and provide a reference for exploring adaptation mechanisms in other species under hypoxic conditions.
Rhodanine–Piperazine Hybrids as Potential VEGFR, EGFR, and HER2 Targeting Anti-Breast Cancer Agents
Authors: Szczepański Jacek , Khylyuk Dmytro , Korga-Plewko Agnieszka , Michalczuk Mariola , Mańdziuk Sławomir , Iwan Magdalena , Trotsko Nazar
Published: November 2024

Breast cancer is one of the most common malignancies affecting women worldwide, with a significant need for novel therapeutic agents to target specific molecular pathways involved in tumor progression. In this study, a series of rhodanine–piperazine hybrids were designed, synthesized, and evaluated for their anticancer activity, targeting key tyrosine kinases such as VEGFR, EGFR, and HER2. Biological screening against breast cancer cell lines (MCF-7, MDA-MB-231, T47D, and MDA-MB-468) revealed 3 of the 13 tested compounds as the most potent, with 5-({4-[bis(4-fluorophenyl)methyl]piperazin-1-yl}methylidene)-2-thioxo-1,3-thiazolidin-4-one (12) showing the strongest activity, particularly against the MCF-7 and MDA-MB-468 cell lines. Molecular docking studies indicated favorable binding interactions of compound 12 and its 3-phenyl-2-thioxo-1,3-thiazolidin-4-one analogue (15) with HER2, VEGFR, and EGFR, and molecular dynamics simulations further confirmed their stable binding to HER2. These findings highlight the potential of rhodanine–piperazine hybrids as promising leads for developing new anticancer agents targeting breast cancer, particularly HER2-positive subtypes. Further structural optimization could enhance their efficacy and therapeutic profile.
Secreted Phospholipases A2: Drivers of Inflammation and Cancer
Authors: Hidalgo Ivan , Sorolla Maria Alba , Sorolla Anabel , Salud Antonieta , Parisi Eva
Published: November 2024

Secreted phospholipase 2 (sPLA2) is the largest family of phospholipase A2 (PLA2) enzymes with 11 mammalian isoforms. Each sPLA2 exhibits different localizations and specific properties, being involved in a very wide spectrum of biological processes. The enzymatic activity of sPLA2 has been well described; however, recent findings have shown that they could regulate different signaling pathways by acting directly as ligands. Arachidonic acid (AA) and its derivatives are produced by sPLA2 in collaboration with other molecules in the extracellular space, making important impacts on the cellular environment, being especially relevant in the contexts of immunity and cancer. For these reasons, this review focuses on sPLA2 functions in processes such as the promotion of EMT, angiogenesis, and immunomodulation in the context of tumor initiation and progression. Finally, we will also describe how this knowledge has been applied in the search for new sPLA2 inhibitory compounds that can be used for cancer treatment.
Characterization of Antimicrobial Properties of Copper-Doped Graphitic Nanoplatelets
Authors: Kang Jun-Kyu , Yoon Seo Jeong , Park Honghyun , Lee Seung-Jae , Baek Jaehoon , Jeon In-Yup , Gwak So-Jung
Published: November 2024

Recent clinical outbreaks of infectious diseases caused by pathogenic microorganisms, such as viruses, bacteria, and fungi, along with the emergence of unwanted microorganisms in industrial settings, have significantly reduced efficiency. Graphene has recently attracted significant attention as a potential antimicrobial agent because of its low toxicity, ease of production and functionalization, and high solubility in water. The presence of oxygen functional groups allows the interaction of the compound with bacteria and other biomolecules, making it an interesting candidate for antimicrobial therapy. Moreover, integrating graphene into copper coatings has been shown to enhance their antimicrobial properties. However, the implementation of copper–graphene composite coatings is currently limited by the difficulty of uniformly distributing graphene within the copper matrix. Copper (Cu)-doped graphitic nanoplatelets (CuGnPs), one option to overcome this challenge, are made via a mechanochemical reaction between solid graphite and Cu powder. The configuration of C–Cu bonds within CuGnPs can be identified using a range of analytical techniques, including transmission electron microscopy, X-ray photoelectron spectroscopy, energy-dispersive X-ray spectroscopy, scanning electron microscopy, and time-of-flight secondary ion mass spectrometry. To evaluate the antibacterial activity of the Cu-GnPs, we employed Escherichia coli or Staphylococcus aureus. Various amounts (250, 500, 750, and 1000 μg/mL) of prepared CuGnP samples were incubated in a bacterial suspension for 3 or 6 h at 150 rpm and 37 °C for a colony-forming unit assay. Three hours and six hours of treatment of the bacteria with CuGnPs led to a significant difference in bacterial survival compared with that of the control. It was observed that CuGnPs, with copper bound to graphene oxide, more effectively inhibited the proliferation of E. coli compared with nanoplatelets containing graphene oxide alone. These findings suggest that the unique properties of CuGnPs, such as C–Cu bonds, high surface area, and the coexistence of micropores and mesopores, are valuable for exerting strong antimicrobial effects making CuGnPs effective at preventing bacterial colonization on industrial surfaces.
Magnesium-Doped Hydroxyapatite Nanofibers for Medicine Applications: Characterization, Antimicrobial Activity, and Cytotoxicity Study
Authors: Alanis-Gómez Ricardo Pascual , Hernández-Rosas Fabiola , Olivares-Hernández Juan David , Rivera-Muñoz Eric Mauricio , Zapatero-Gutiérrez Araceli , Méndez-Lozano Néstor , Alanis-Gómez José Rafael , Velázquez-Castillo Rodrigo
Published: November 2024

Magnesium-doped hydroxyapatite (HAp-Mg) nanofibers show promise for medical applications due to their structural similarity to bone minerals and enhanced biological properties, such as improved biocompatibility and antimicrobial activity. This study synthesized HAp-Mg nanofibers using a microwave-assisted hydrothermal method (MAHM) to evaluate their cytotoxicity, biocompatibility, and antimicrobial efficacy compared to commercial hydroxyapatite (HAp). Characterization through X-ray diffraction (XRD), scanning electron microscopy (SEM), Transmission Electron Microscopy (TEM), energy-dispersive X-ray spectroscopy (EDS), and Fourier transform infrared spectroscopy (FTIR) confirmed the successful incorporation of magnesium, producing high-purity, crystalline nanofibers with hexagonal morphology. Rietveld refinement showed slight lattice parameter shortening, indicating Mg2+ ion integration. Cell viability assays (MTT and AlamarBlue) revealed a significant increase in fibroblast proliferation with 2% and 5% HAp-Mg concentrations compared to controls (p < 0.05), demonstrating non-cytotoxicity and enhanced biocompatibility. Antimicrobial tests (disk diffusion method, 100 µg/mL) showed that HAp-Mg had strong antibacterial effects against Gram-positive and Gram-negative bacteria and moderate antifungal activity against Candida albicans. In contrast, commercial HAp showed no antimicrobial effects. These results suggest HAp-Mg nanofibers have significant advantages as biomaterials for medical applications, particularly in preventing implant-related infections and supporting further clinical development.
LGFA-MTKD: Enhancing Multi-Teacher Knowledge Distillation with Local and Global Frequency Attention
Authors: Cheng Xin , Zhou Jinjia
Published: November 2024

Transferring the extensive and varied knowledge contained within multiple complex models into a more compact student model poses significant challenges in multi-teacher knowledge distillation. Traditional distillation approaches often fall short in this context, as they struggle to fully capture and integrate the wide range of valuable information from each teacher. The variation in the knowledge offered by various teacher models complicates the student model’s ability to learn effectively and generalize well, ultimately resulting in subpar results. To overcome these constraints, We introduce an innovative method that integrates both localized and globalized frequency attention techniques, aiming to substantially enhance the distillation process. By simultaneously focusing on fine-grained local details and broad global patterns, our approach allows the student model to more effectively grasp the complex and diverse information provided by each teacher, therefore enhancing its learning capability. This dual-attention mechanism allows for a more balanced assimilation of specific details and generalized concepts, resulting in a more robust and accurate student model. Extensive experimental evaluations on standard benchmarks demonstrate that our methodology reliably exceeds the performance of current multi-teacher distillation methods, yielding outstanding outcomes regarding both performance and robustness. Specifically, our approach achieves an average performance improvement of 0.55% over CA-MKD, with a 1.05% gain in optimal conditions. These findings suggest that frequency-based attention mechanisms can unlock new potential in knowledge distillation, model compression, and transfer learning.
PLC-Fusion: Perspective-Based Hierarchical and Deep LiDAR Camera Fusion for 3D Object Detection in Autonomous Vehicles
Authors: Mushtaq Husnain , Deng Xiaoheng , Azhar Fizza , Ali Mubashir , Raza Sherazi Hafiz Husnain
Published: November 2024

Accurate 3D object detection is essential for autonomous driving, yet traditional LiDAR models often struggle with sparse point clouds. We propose perspective-aware hierarchical vision transformer-based LiDAR-camera fusion (PLC-Fusion) for 3D object detection to address this. This efficient, multi-modal 3D object detection framework integrates LiDAR and camera data for improved performance. First, our method enhances LiDAR data by projecting them onto a 2D plane, enabling the extraction of object perspective features from a probability map via the Object Perspective Sampling (OPS) module. It incorporates a lightweight perspective detector, consisting of interconnected 2D and monocular 3D sub-networks, to extract image features and generate object perspective proposals by predicting and refining top-scored 3D candidates. Second, it leverages two independent transformers—CamViT for 2D image features and LidViT for 3D point cloud features. These ViT-based representations are fused via the Cross-Fusion module for hierarchical and deep representation learning, improving performance and computational efficiency. These mechanisms enhance the utilization of semantic features in a region of interest (ROI) to obtain more representative point features, leading to a more effective fusion of information from both LiDAR and camera sources. PLC-Fusion outperforms existing methods, achieving a mean average precision (mAP) of 83.52% and 90.37% for 3D and BEV detection, respectively. Moreover, PLC-Fusion maintains a competitive inference time of 0.18 s. Our model addresses computational bottlenecks by eliminating the need for dense BEV searches and global attention mechanisms while improving detection range and precision.
Understanding Surgeons’ Reluctance to Adopt Intraoperative Coronary Graft Verification Procedures: A Literature Review Combined to AI-Driven Insights Under Human Supervision
Authors: Di Giammarco Gabriele , Cammertoni Federico , Testa Nicola , Massetti Massimo
Published: November 2024

Background: Intraoperative graft verification in coronary surgery is accepted worldwidand equally discussed. In spite of multiple sources of evidence published up to now in favor of clinical benefits following the use of the procedure, there is a persistent skepticism in adopting the available technologies. The object of the present review is to analyze the reluctance of surgeons toward the adoption of assessment methods. Materials and Method: A thorough literature review was carried out on Google Scholar based on the results obtained from AI’s answer to the question about the reasons for that reluctance. We took advantage of using ChatGPT-4 since the research based on PubMed Central alone was not able to return a detailed response, maybe because the reasons for the reluctance are veiled in the text of the published papers. Through the items suggested by AI and taken from the literature, we deepened the research, pointing attention to the issues published so far about the various technologies. Results: There are many convincing pieces of evidence about the utility of intraoperative graft control in coronary surgery, involving improved clinical outcome, efficacy and safety, and social cost saving. The opinion that arose through this analysis is that, beyond the objective difficulties in utilizing some technologies and the equally objective limitations of an economic and organizational nature, the reluctance is the result of a real unwillingness based on the various implications that the discovery of the technical error entails. Conclusions: This negative attitude, in light of the convincing scientific and clinical evidence published up to now, appears to overwhelm the benefits for patients.
Relationship Between Ultrasound Diagnosis, Symptoms and Pain Scale Score on Examination in Patients with Uterosacral Ligament Endometriosis
Authors: Maple Shae , Bezak Eva , Chalmers K. Jane , Parange Nayana
Published: November 2024

Background/Objectives: This study investigated patient pain descriptors for transvaginal ultrasound (TVS) diagnostic evaluation of endometriosis for uterosacral ligaments (USLs), including correlation between USL thickness and site-specific tenderness (SST). It further investigated if SST could positively assist diagnosing endometriosis on TVS. Methods: TVS images and SST pain descriptors were collected from 42 patients. SST was evaluated by applying sonopalpation during TVS. The images were presented to six observers for diagnosis based on established USL criteria. Following this, they were given the SST pain scores and asked to reevaluate their diagnosis to assess if the pain scores impacted their decision. Results: An independent t-test showed that the patients with an endometriosis history had higher pain scores overall (7.2 ± 0.59) compared to the patients with no history (0.34 ± 0.12), t (40) = 8.8673. Spearman’s correlation showed a strong correlation to the pain scale score for clinical symptoms (r = 0.74), endometriosis diagnosis (r = 0.78), USL thickness (r = 0.74), and when USL nodules were identified (r = 0.70). Paired t-tests showed that the observers demonstrated a higher ability to correctly identify endometriosis with the pain scale information (33 ± 8.83) as opposed to not having this information (29.67 ± 6.31), which was a statistically significant change of 3.33, t (5) = 2.7735. Conclusions: Patients with an endometriosis history have significantly higher pain scores on TVS compared to patients with no endometriosis history. A strong correlation was shown between SST pain scores and patient symptoms, USL thickness, and USL nodules. Inclusion of SST alongside TVS imaging shows promise, with these results demonstrating a higher ability to diagnose endometriosis with additional SST pain scale information.
Ophthalmic Formulations for the Treatment of Allergic Conjunctivitis and Their Effect on the Ocular Surface: A Review of Safety and Tolerability Assessments in Clinical Trials
Authors: Suárez-Cortés Tatiana , Gonzalo Ana , Arana Eider , Guillén Virginia , Andollo Noelia
Published: November 2024

Allergic conjunctivitis (AC) is the most common allergic eye disorder. Antiallergic eyedrops are the first line of pharmacological treatment. However, the application of antiallergic eyedrops can potentially alter tear homeostasis and affect the ocular surface, which may result in iatrogenic diseases such as dye eye disease (DED). Long-term treatment of AC with eyedrops containing preservatives and other components may increase the risk of DED and ocular surface damage. Here, we examined 20 clinical trials published during the past ten years with antihistamine ophthalmic formulations in the treatment of AC, to evaluate the extent of evidence about their safety and tolerability. Remarkably, we find that most trials lack an evaluation of the critical ocular surface parameters, such as tear film break-up time, tear volume, corneal and conjunctival damage, and inflammation, to properly assess the state of the ocular surface state after prolonged treatment. There is a need to increase awareness of the use of specific formulations that do not increase the risk of iatrogenic DED.
Hugo™ Versus daVinci™ Robot-Assisted Radical Prostatectomy: 1-Year Propensity Score-Matched Comparison of Functional and Oncological Outcomes
Authors: Gandi Carlo , Marino Filippo , Totaro Angelo , Scarciglia Eros , Presutti Simona , Bellavia Fabrizio , Bientinesi Riccardo , Gavi Filippo , Rossi Francesco , Moosavi Seyed Koosha , Palermo Giuseppe , Racioppi Marco , Lentini Nicolò , Pastorino Roberta , Sacco Emilio
Published: November 2024

Background/Objectives: A comprehensive comparison of intraoperative, oncological, and functional outcomes of RARP performed with different robotic surgical platforms is critically needed. Our aim is to compare the oncological and functional outcomes of RARP performed using the novel Hugo™ RAS system with those from the daVinci system, the reference standard, at a high-volume robotic center, with an extended follow-up period (one year). Methods: We analyzed the data of 400 patients undergoing RARP ± pelvic lymph node dissection between 2021 and 2023, using propensity score (PS) matching to correct for treatment selection bias. All procedures were performed by three surgeons with HugoTM RAS or daVinci. This analysis extends the follow-up period to 1 year, focusing on specific functional and oncological outcomes, building on our previous 3-month evaluation of perioperative outcomes. The primary outcome was the trifecta rate, defined as freedom from biochemical recurrence, continence, and erectile function recovery. Secondary outcomes included detailed assessments of oncological outcomes (PSA levels) and functional outcomes (continence and erectile function). Results: The propensity score-matched cohort included 99 matched pairs (198 patients), balanced for all covariates. No significant differences were found in trifecta rates between the two platforms at 1-year follow-up (Hugo: 25.25%, daVinci: 27.27%, p = 0.743). Both groups showed improved trifecta rates when considering only nerve-sparing procedures (Hugo: 36.84%, daVinci: 35.59%, p = 0.889). Continence rates were similar (Hugo: 87.9%, daVinci: 89.9%, p = 0.327), as were the undetectable PSA rates (Hugo: 92.9%, daVinci: 88.8%, p = 0.158). Also, the erectile function recovery rate did not differ significantly between the groups. Conclusions: This is the first study comparing 1-year functional and oncological outcomes of RARP performed with Hugo™ RAS and daVinci surgical robotic systems using PS matching. Functional and oncological outcomes of RARP were comparable between the two robotic platforms. These findings confirm that the transition to the Hugo™ platform does not compromise surgical proficiency or patient outcomes, even if further long-term studies are necessary to confirm these results.
Cardiovascular Magnetic Resonance Reveals Cardiac Inflammation and Fibrosis in Symptomatic Patients with Post-COVID-19 Syndrome: Findings from the INSPIRE-CMR Multicenter Study
Authors: Markousis-Mavrogenis George , Vartela Vasiliki , Pepe Alessia , Sierra-Galan Lilia , Androulakis Emmanouil , Perazzolo Anna , Christidi Aikaterini , Belegrinos Antonios , Giannakopoulou Aikaterini , Bonou Maria , Vrettou Agathi-Rosa , Lazarioti Fotini , Skantzos  Vasilios , Quaia Emilio , Mohiaddin Raad , Mavrogeni Sophie I.
Published: November 2024

Introduction. Post-coronavirus disease-2019 (COVID-19) patients may develop cardiac symptoms. We hypothesized that cardiovascular magnetic resonance (CMR) can assess the background of post-COVID-19 cardiac symptoms using multi-parametric evaluation. We aimed to conduct an investigation of symptomatic patients with post-COVID-19 syndrome using CMR (INSPIRE-CMR). Methods. INSIPRE-CMR is a retrospective multicenter study including 174 patients from five centers referred for CMR due to cardiac symptoms. CMR was performed using 3.0 T/1.5 T system (24%/76%, respectively). Myocardial inflammation was determined by the updated Lake Louise criteria. Results. Further, 174 patients with median age of 40 years (IQR: 26–54), 72 (41%) were women, and 17 (9.7%) had a history of autoimmune disease, muscular dystrophy, or cancer. In total, 149 (86%) patients were late gadolinium enhanced (LGE)-positive with a non-ischemic pattern, and of those evaluated with the updated Lake Louise criteria, 141/145 (97%) had ≥1 pathologic T1 index. Based on the T2-criterion, 62/173 (36%) patients had ≥1 pathologic T2 index. Collectively, 48/145 (33%) patients had both positive T1- and T2-criterion. A positive T2-criterion or a combination of a positive T1- and T2-criterion were significantly more common amongst patients with severe COVID-19 [45 (31%) vs. 17 (65%), p = 0.001 and 32 (27%) vs. 16 (64%), p < 0.001, respectively]. During the one-year evaluation, available for 65/174 patients, shortness of breath, chest pain, and arrhythmia were identified in 7 (4%), 15 (8.6%), and 43 (24.7%), respectively. CMR evaluation, available in a minority of them, showed mildly reduced LVEF, while nat T1 mapping and EVC remained at levels higher than the normal values of the local MRI units. Conclusions. The majority of post-COVID-19 patients with cardiac symptoms presented non-ischemic LGE and abnormalities in T1 and T2-based indices. Multi-parametric CMR reveals important information on post-COVID-19 patients, supporting its role in short/long-term evaluation.
Brain Ultrasonography in Critically Ill Septic Patients: A Scoping Review
Authors: Cucciolini Giada , Corda Irene , Forfori Francesco , Corradi Francesco
Published: November 2024

Sepsis-associated encephalopathy (SAE) is linked to high mortality and impaired neurologic outcome. Brain ultrasonography (US) is a non-invasive tool for cerebral monitoring. A scoping review of the literature in three databases was performed to answer if brain perfusion is altered in sepsis, to determine the role of brain US in guiding resuscitation and its ability to predict the outcome. Randomized controlled trials, clinical trials, observational studies, and systematic reviews on adults with sepsis or septic shock in the ICU were included. A total of 625 articles were screened, and 34 included. There were 85% observational studies and 15% systematic reviews with or without meta-analysis. The majority of studies had a small sample size and used different metrics. The studies focused on cerebral blood flow (CBF) alterations reporting variable results (CBF increased, normal, or decreased). The findings showed a variable rate of cerebral autoregulation (CAR) impairment, with higher incidence in the early stages of sepsis and associations with poor neurological outcomes. However, the impact of CAR and CBF alterations on neurological outcomes and mortality was not clear. Very few studies were found on resuscitation. In conclusion, brain US can identify cerebral perfusions alterations and its usage in sepsis is promising. However, the current body of evidence for its usage is poor and lacks standardization.
Retinopathy of Prematurity: Incidence, Risk Factors, and Treatment Outcomes in a Tertiary Care Center
Authors: Blazon Mara Nike , Rezar-Dreindl Sandra , Wassermann Lorenz , Neumayer Thomas , Berger Angelika , Stifter Eva
Published: November 2024

Retinopathy of prematurity (ROP) remains a major cause of childhood blindness. Its pooled prevalence worldwide is 31.9%, and that of severe ROP is 7.5% among prematurely born babies. Investigating risk factors is essential for improving early detection and treatment outcomes. Purpose: To determine the frequency and stages of ROP cases and evaluate the treatment methods for premature infants at the Medical University of Vienna. Methods: In this retrospective study, 352 children who underwent ROP screening between 2018 and 2021 with a gestational age (GA) ≤ 32 weeks and/or a birth weight (BW) ≤ 1500 g were included. Results: ROP was found in 144 (40.9%) of the 352 screened premature infants, with 17 (4.8%) requiring treatment. Significant risk factors included GA and BW, while sex and pregnancy type were not significant. The mean GA was 27.7 ± 2.5 weeks, and the mean BW was 989.1 ± 359.7 g. Infants with ROP had a lower GA (25.9 ± 1.7 weeks) and BW (778.6 ± 262.4 g) than those without ROP (28.9 ± 2.2 weeks; 1134.9 ± 345.9 g). GA and BW were significantly lower in infants developing ROP (p < 0.001). Stage 2 ROP was the most common severity in 74 children (51.4%). Laser therapy was the most common first-line treatment, used in 11 infants (64.7%), followed by anti-VEGF therapy, used in 6 infants (35.3%). Children were treated within 1.0 ± 0.6 days on average. Of the 17 infants treated, 14 (82.4%) showed initial regression. Three infants (17.6%) required re-treatment: two with initial anti-VEGF therapy and one after laser therapy. Conclusions: The findings provide insights into ROP’s prevalence and treatment preferences at a university tertiary care center. GA and BW were confirmed to be significant predictors, aiding in early detection and informing treatment decisions. These insights will enable comparisons with similar studies and contribute to improved patient care.
The Hypothesis of Trace Elements Involvement in the Coronary Arteries Atherosclerotic Plaques’ Location
Authors: Urbanowicz Tomasz , Hanć Anetta , Frąckowiak Julia , Piecek Jakub , Spasenenko Ievgen , Olasińska-Wiśniewska Anna , Krasińska Beata , Tykarski Andrzej
Published: November 2024

Background: Coronary artery disease (CAD) is a chronic inflammatory disease with multiple well-known risk factors. Although epidemiological studies report improvements in classical CAD risk-factor control, except for diabetes and obesity, cardiovascular diseases remain the leading causes of morbidity and mortality in the current population. The question regarding the atherosclerotic plaque location in particular arteries remains unanswered. Research on novel possible aspects that could help to properly understand atherosclerosis pathophysiology is essential. This study was based on a body trace-elements analysis, measured in scalp hair samples, as possible co-factors of various enzymes that may be crucial for CAD development. Methods: A total of 133 consecutive male patients with a median age of 71 (65–75) years, who presented with anginal symptoms of CCS class 2.0 (0.3) without previous heart-related interventions, were included in the analysis. The results of the cine-angiography were compared with the demographical, clinical, and laboratory results, followed by scalp-hair trace analysis. The possible predictors for coronary disease locations in the left descending artery (LAD), the circumflex artery (Cx), and the right coronary artery (RCA) were the subjects of this study. Results: Statistically significant differences in the scalp-hair trace elements concentration between the CAD and normal angiogram groups were noticed for magnesium (p = 0.003), calcium (p < 0.001), chromium (p = 0.011), and copper (p = 0.043). The multivariable analysis for epicardial atherosclerotic disease revealed the co-existence of diabetes mellitus (OR: 2.94, 95% CI: 1.27–6.79, p = 0.012) as a possible causative factor for the LAD location. The multivariable analysis for the atherosclerosis location in the Cx artery presented scalp-hair magnesium as a possible predictive factor (OR: 0.98, 95% CI: 0.96–1.00, p = 0.024). The multivariable model for the RCA location of atherosclerotic plaque indicated scalp-hair Zn concentration (0.99, 95% CI: 0.98–1.00, p = 0.002) and serum HDL (OR: 0.61, 95% CI: 0.04–0.09, p = 0.016). Conclusions: Possible hypothetical distinctive pathomechanisms, in particular, coronary artery involvement, in atherosclerosis processes are presented in the male group. Diabetes mellitus was found to be the primary factor for left descending artery disease. The low scalp-hair magnesium concentration was found to be a possible risk factor involved in the circumflex artery atherosclerotic plaque location. The inverse relation between serum high-density lipoprotein, the scalp hair zinc concentration, and right coronary disease was noticed.
The EUPEMEN (EUropean PErioperative MEdical Networking) Protocol for Acute Appendicitis: Recommendations for Perioperative Care
Authors: Ioannidis Orestis , Anestiadou Elissavet , Ramirez Jose M. , Fabbri Nicolò , Ubieto Javier Martínez , Feo Carlo Vittorio , Pesce Antonio , Rosetzka Kristyna , Arroyo Antonio , Kocián Petr , Sánchez-Guillén Luis , Bellosta Ana Pascual , Whitley Adam , Enguita Alejandro Bona , Teresa-Fernandéz Marta , Bitsianis Stefanos , Symeonidis Savvas
Published: November 2024

Background/Objectives: Acute appendicitis (AA) is one of the most common causes of emergency department visits due to acute abdominal pain, with a lifetime risk of 7–8%. Managing AA presents significant challenges, particularly among vulnerable patient groups, due to its association with substantial morbidity and mortality. Methods: The EUPEMEN (European PErioperative MEdical Networking) project aims to optimize perioperative care for AA by developing multidisciplinary guidelines that integrate theoretical knowledge and clinical expertise from five European countries. This study presents the key elements of the EUPEMEN protocol, which focuses on reducing surgical stress, optimizing perioperative care, and enhancing postoperative recovery. Results: Through this standardized approach, the protocol aims to lower postoperative morbidity and mortality, shorten hospital stays, and improve overall patient outcomes. The recommendations are tailored to address the variability in clinical practice across Europe and are designed to be widely implementable in diverse healthcare settings. Conclusions: The conclusions drawn from this study highlight the potential for the EUPEMEN protocol to significantly improve perioperative care standards for AA, demonstrating its value as a practical, adaptable tool for clinicians.
Impact of Pulmonary Ligament Resection in Upper Lobectomies: A Multicenter Matched Cohort Study
Authors: Campisi Alessio , Dell’Amore Andrea , Fang Wentao , Roca Gabriella , Silvestrin Stefano , Nicotra Samuele , Chen Yang , Gabryel Piotr , Sielewicz Magdalena , Piwkowski Cezary , Rocca Eleonora La , Patirelis Alexandro , Ambrogi Vincenzo , Giovannetti Riccardo , Rea Federico , Infante Maurizio
Published: November 2024

Background: Division of the pulmonary ligament is standard in lower lobectomies, but its application in upper lobectomies remains controversial due to potential complications like atelectasis and bronchial kinking. This retrospective matched cohort study aimed to evaluate the efficacy and safety of ligament resection in upper lobectomies for oncological purposes. Methods: From January 2015 to December 2020, 988 patients who underwent minimally invasive upper lobectomies across multiple centers were identified. They were categorized into ligament resection and no ligament resection groups, with propensity score matching (PSM) to minimize confounding factors. Endpoints included operative time, pleural effusion, complications (frequency and Clavien–Dindo scores), chest drainage removal, length of stay, pleural space, collapse rate, and bronchial kinking. Results: Following PSM, 276 patients were included in each group, with no significant differences in baseline characteristics. Ligament resection correlated with longer operative times, increased lymphadenectomy sampling at station #9 (p < 0.001), and a bigger change in the bronchial angle (p < 0.001). No statistically significant differences were observed for the other endpoints. Conclusions: Ligament resection during upper lobectomy may impact the bronchial angle without immediate postoperative outcome changes. Further research is necessary to comprehensively assess the risks and benefits of ligament resection in upper lobectomies for neoplastic disease.