bluuebunny/crossref_metadata_2025 huggingface dataset:
Interrelations of the Factors Influencing the Whole-Life Cost Estimation of Buildings: A Systematic Literature Review
Authors: Samarasekara Herath Mudiyanselage Samadhi Nayanathara , Purushothaman Mahesh Babu , Rotimi Funmilayo Ebun
Published: March 2024

The global GDP has witnessed a significant upswing, majorly due to the growth of the construction industry. Embracing the whole-life costing (WLC) approach, the construction sector strategically manages expenses across a construction project’s life cycle. However, despite its widespread adoption, accurate cost forecasting remains a major challenge. The intricate interplay of various influencing factors has not been fully explored, leading to inaccurate cost estimations. A comprehensive understanding of specific factors and their interrelationships is crucial to address this issue. Therefore, it is imperative to conduct further research to identify and explore the subtle nuances of these factors that impact whole-life cost estimation. Our study fills this gap, analysing 51 factors from 84 papers across prominent repositories. We assess interrelationships using a systematic literature review and pairwise comparison as in the analytical hierarchy process. The International Construction Measurement Standards (ICMS) framework structures these relationships and is represented in the causal loop diagrams (CLDs). The pioneering CLDs are a notable contribution, illustrating interrelationships and polarities among the 51 WLC factors. Six reinforcing loops and one balancing loop provide valuable insights into their dynamic nature. Importantly, lower-level factors do not always directly connect with upper-level factors. Instead, they interact within the same level before linking to top-level factors. These findings are significant for professionals, such as cost estimators, quantity surveyors and scholars, offering a comprehensive understanding of the WLC system.
Statistical Evaluation of Sleeve Friction to Cone Resistance Ratio in Coarse-Grained Soils
Authors: Sližytė Danutė , Šalna Remigijus , Urbonas Kęstutis
Published: March 2024

The investigation of soil is a particularly important stage of structural design. Cone penetration tests (CPTs) are the most common soil investigation techniques. The results of these tests provide information about the values of cone resistance (qc) and sleeve friction (fs), which correspond to depth. Previous studies have shown that the ratio of sleeve friction to cone resistance depends on the particle size distribution in soil and its use for soil classification. Unfortunately, as an analysis of the literature shows, there is no such classification for coarse-grained soils. This paper presents statistically significant differences in the ratio of fs to qc in coarse-grained soils. Based on the research performed, the proposed coefficients depend on the classification of coarse-grained soils with respect to the size of the soil particles. The data investigated were obtained from study reports on 35 sites (5934 tests) at which the main type of soil was coarse-grained and contained different sizes of particles. Following a statistical analysis, five groups of tested coarse-grained soils, silty fine sand, clayey fine sand, fine sand, medium sand and gravelly coarse sand together with gravel, are derived. The analysed data show statistically significant differences in the ratio of fs to qc considering this particular type of soil. A ratio of fs to qc with a probability of 95% is proposed for sandy soils. The values for silty fine sand, clayey fine sand, fine sand, medium sand and gravelly coarse sand mixed with gravel are 0.009459, 0.010982, 0.009268, 0.008001 and 0.006741, respectively. A linear relationship between the fs and qc indexes is also suggested.
Experimental Study and Effectiveness Evaluation on the Rapid Antiquing of Red Sandstone in Ancient Buildings Restoration
Authors: Liu Dunwen , Meng Xianqing , Ao Tao , Cao Kunpeng
Published: March 2024

As there are few cases of red sandstone rapid antiquing in ancient buildings and as it is difficult to reproduce, this paper carried out an experimental study and effect evaluation assessment on red sandstone rapid antiquing in the restoration of ancient buildings, based on a restoration project of an ancient town in Ganzhou. The method and the implementation process of red sandstone rapid antiquing are proposed by starting from color antiquing and texture antiquing. By controlling the concentration of red mud, grass ash, and carbon black in color coatings as variables, using the HSV (hue, saturation, value) color space and Tamura texture features (roughness, contrast, orientation) to quantitatively analyze the antiquing effect, an analytical model for evaluating the red sandstone antiquing effect based on image processing was established. The results showed that among all the antiquing groups, the group that used white cement, green zeolite, imitation greenery, red clay, grass ash, and 5 mL/L carbon black liquid at the same time had the best effect, with a qualified rate of 90%. The analytical model can improve the evaluation efficiency of red sandstone antiquing and avoid errors caused by subjective factors. With feasibility and practicability, the model is conducive for new red sandstone to meet the requirements of ancient building restoration through rapid antiquing. It provides a scientific basis and technical reference for red sandstone antiquing in stone cultural relics and ancient building restoration.
A Review of Cooling and Heating Loads Predictions of Residential Buildings Using Data-Driven Techniques
Authors: Abdel-Jaber Fayez , Dirks Kim N.
Published: March 2024

Energy efficiency is currently a hot topic in engineering due to the monetary and environmental benefits it brings. One aspect of energy efficiency in particular, the prediction of thermal loads (specifically heating and cooling), plays a significant role in reducing the costs associated with energy use and in minimising the risks associated with climate change. Recently, data-driven approaches, such as artificial intelligence (AI) and machine learning (ML) techniques, have provided cost-effective and high-quality solutions for solving energy efficiency problems. This research investigates various ML methods for predicting energy efficiency in buildings, with a particular emphasis on heating and cooling loads. The review includes many ML techniques, including ensemble learning, support vector machines (SVM), artificial neural networks (ANN), statistical models, and probabilistic models. Existing studies are analysed and compared in terms of new criteria, including the datasets used, the associated platforms, and, more importantly, the interpretability of the models generated. The results show that, despite the problem under investigation being studied using a range of ML techniques, few have focused on developing interpretable classifiers that can be exploited by stakeholders to support the design of energy-efficient residential buildings for climate impact minimisation. Further research in this area is required.
Psychological and Visual Perception of Campus Lightscapes Based on Lightscape Walking Evaluation: A Case Study of Chongqing University in China
Authors: Huang Haijing , Zhang Binyue , Cheng Jingru , Sun Yue
Published: March 2024

The creation of lightscapes in colleges and universities are of great significance in enhancing the perception of the campus environment, improving physical and mental health, and shaping humanistic connotations. This research aims to examine lightscape perceptions and impacts of different campuses. At Chongqing University A and B Campuses, lightscape walking experiments, subjective questionnaires, objective luminance measurements, and HDR picture processing were used to examine lightscape perception and factors. The relevance and differences in the perception of circadian lightscapes in the two campuses were analyzed using SPSS software. The study found: (1) natural lightscapes such as sky light, cloud shadow, and lake water reflection were the most popular during the daytime, while artificial lightscapes, such as decorative lighting of buildings, were positively evaluated at night; (2) the frequency of visits by a crowd directly impacts the ambiance of the environmental area; (3) males showed strong emotional awareness and social interaction skills in daytime, leading to increased social activity and stronger emotional responses, but no differences in nighttime; (4) optimal nighttime luminance enhances the overall perception satisfaction of the illumination; (5) the amount and arrangement of outdoor space, vegetation, minor landscape design, and service facilities all affect the perception of circadian lightscapes. In conclusion, design concepts and proposals of landscapes were suggested to optimize college and university lightscapes.
Effect of Orientation and Skylight Area Ratio on Building Energy Efficiency in the Qinghai–Tibet Plateau
Authors: Wang Yingmei , Qin Haosen , Wang Yan , Chen Ji , Hou Xin , Rui Pengfei , Zhang Shouhong , Song Hanyu
Published: March 2024

The Qinghai–Tibet plateau, with an average altitude of over 4000 m, has low annual average temperatures and a high demand for building heating. This region’s abundant solar energy resources hold substantial practical significance for improving the indoor heat environment and reducing building energy consumption. This paper investigates the impact of orientation and skylight area ratio on building heat load and indoor temperature, using both actual measurement and simulation methods, with a case study of the comprehensive building at Beiluhe Observation and Research Station of Frozen Soil Engineering and Environment (Beiluhe Station), located in the Qinghai–Tibet Plateau region. Initially, a model was established using the EnergyPlus 9.4 software, with orientation variables set from east to west in 15° increments, to simulate the variations in building heat load resulting from orientation changes; simulations were then conducted for three different skylight area ratios under the optimal orientation to evaluate their influence on heat load and indoor temperature. The results show that for the architectural style examined in this paper, the optimal building orientation within the region is 30° south by east, with the optimal orientation range spanning from 45° south by east to due south. Heating load is negatively correlated with the skylight area ratio, and beyond a certain threshold, the rate of decrease in heat load diminishes or even stabilizes. The conclusions of this paper offer guidance for the orientation and skylight design of new buildings on the Qinghai–Tibet Plateau.
Effect of Silica Fume Concentration and Water–Cement Ratio on the Compressive Strength of Cement-Based Mortars
Authors: Badalyan Maria M. , Muradyan Nelli G. , Shainova Roza S. , Arzumanyan Avetik A. , Kalantaryan Marine A. , Sukiasyan Rafayel R. , Yeranosyan Mkrtich , Laroze David , Vardanyan Yeghiazar V. , Barseghyan Manuk G.
Published: March 2024

This study investigated how the water–cement ratio and silica fume concentration affect the compressive strength of cement mortars. This comprehensive study delved into the intricate interplay between water–cement ratio and silica fume concentration, examining their influence on cement-based mortars’ compressive strength and water absorption characteristics. The silica fume concentration was investigated, ranging from 5% to 15% of the cement weight. The investigation employed two distinct mixing techniques, mixing cement and silica fume, before extracting appropriate samples; alternatively, a magnetic stirrer was used to prepare samples by dissolving silica fume in water. The cement mortars were also prepared with three different water–cement ratios: 0.44, 0.47, and 0.5. The interesting findings of compressive tests illuminated a consistent trend across all curing days and mixing methods—a reduction in the water–cement ratio corresponded with a notable increase in compressive strength. However, it is essential to note that the influence of the mixing method on the compressive strength of cement-based mortars is based on the water–cement ratio. The results show that by using the suggested technological method, it was observed that samples prepared with water–cement ratios (W/C) of 0.47 and 0.44 exhibited higher compressive strengths compared to those prepared using the well-known standard mixing method. The compressive test results underscored that the water–cement ratio reduction consistently enhanced the compressive strength in every combination of curing days and mixing techniques. Furthermore, this reduction in the water–cement ratio was correlated with a decrease in water absorption of the mortar. Conversely, the water–cement ratio itself played a pivotal role in defining how the mixing technique affected the compressive strength and water absorption of cement-based mortars. This multifaceted exploration underscores the nuanced relationships between key variables, emphasizing the need for a comprehensive understanding of the intricate factors influencing the mechanical and absorptive properties of cement-based materials.
Machine Learning-Based Prediction of Glioma IDH Gene Mutation Status Using Physio-Metabolic MRI of Oxygen Metabolism and Neovascularization (A Bicenter Study)
Authors: Stadlbauer Andreas , Nikolic Katarina , Oberndorfer Stefan , Marhold Franz , Kinfe Thomas M. , Meyer-Bäse Anke , Bistrian Diana Alina , Schnell Oliver , Doerfler Arnd
Published: March 2024

The mutational status of the isocitrate dehydrogenase (IDH) gene plays a key role in the treatment of glioma patients because it is known to affect energy metabolism pathways relevant to glioma. Physio-metabolic magnetic resonance imaging (MRI) enables the non-invasive analysis of oxygen metabolism and tissue hypoxia as well as associated neovascularization and microvascular architecture. However, evaluating such complex neuroimaging data requires computational support. Traditional machine learning algorithms and simple deep learning models were trained with radiomic features from clinical MRI (cMRI) or physio-metabolic MRI data. A total of 215 patients (first center: 166 participants + 16 participants for independent internal testing of the algorithms versus second site: 33 participants for independent external testing) were enrolled using two different physio-metabolic MRI protocols. The algorithms trained with physio-metabolic data demonstrated the best classification performance in independent internal testing: precision, 91.7%; accuracy, 87.5%; area under the receiver operating curve (AUROC), 0.979. In external testing, traditional machine learning models trained with cMRI data exhibited the best IDH classification results: precision, 84.9%; accuracy, 81.8%; and AUROC, 0.879. The poor performance for the physio-metabolic MRI approach appears to be explainable by site-dependent differences in data acquisition methodologies. The physio-metabolic MRI approach potentially supports reliable classification of IDH gene status in the presurgical stage of glioma patients. However, non-standardized protocols limit the level of evidence and underlie the need for a reproducible framework of data acquisition techniques.
Cancer Risk in Patients with Down Syndrome—A Retrospective Cohort Study from Germany
Authors: Krieg Sarah , Krieg Andreas , Loosen Sven H. , Roderburg Christoph , Kostev Karel
Published: March 2024

Background: Individuals with Down syndrome are thought to have a unique tumor profile. Methods: Using the IQVIA Disease Analyzer database, patients aged ≥18 years diagnosed with Down syndrome in German general practices between 2005 and 2021 were compared with patients without Down syndrome for cancer incidence, adjusting for age, sex, average annual visit frequency, and comorbidity. The 5-year cumulative incidence of cancer overall and specific cancers was analyzed using Kaplan–Meier curves and compared using the log-rank test. In addition, univariable Cox regression analysis was performed. Results: A total of 2438 patients with Down syndrome and 12,190 patients without Down syndrome were included; 3.9% of patients without Down syndrome and 3.1% of patients with Down syndrome were diagnosed with cancer (p = 0.143). Regression analysis showed no significant association between Down syndrome and subsequent cancer in the total population (HR: 0.79; 95% CI: 0.57–1.09), in women (HR: 0.89; 95% CI: 0.56–1.37), or in men (HR: 0.69; 95% CI: 0.43–1.11). Analyses by cancer type and sex showed a strong but not significant negative association between Down syndrome and breast cancer in women (HR: 0.33; 95% CI: 0.12–0.93). Conclusions: Our results could form the basis for future studies to clarify whether and to what extent an adapted screening program needs to be modified for individuals with Down syndrome due to the particular cancer distribution pattern.
Malignant Brenner Tumor of the Ovary: A Systematic Review of the Literature
Authors: Koufopoulos Nektarios I. , Pouliakis Abraham , Samaras Menelaos G. , Kotanidis Christakis , Boutas Ioannis , Kontogeorgi Adamantia , Dimas Dionysios , Sitara Kyparissia , Zacharatou Andriani , Ieronimaki Argyro-Ioanna , Spathis Aris , Leventakou Danai , Zanelli Magda , Pateras Ioannis S. , Panayiotides Ioannis G. , Palicelli Andrea , Syrios John
Published: March 2024

Background: Malignant Brenner tumors are rare ovarian tumors, accounting for less than 1% of malignant ovarian neoplasms. The aim of this manuscript is to systematically review the current literature concerning malignant Brenner tumors. Methods: We searched three medical databases (PubMed, Scopus, and Web of Science) for relevant articles published until 15 September 2023. Results: After applying inclusion and exclusion criteria, 48 manuscripts describing 115 cases were included in this study from the English literature. Conclusions: We analyzed the demographic, clinical, pathological, and oncological characteristics of 115 patients with malignant Brenner tumors. The statistical analysis showed that recurrence was marginally statistically significantly related to tumor stage and was more common in patients with ascites and in women with abnormal CA-125 levels; patients that were treated with lymphadenectomy had better disease-specific survival.
Incidence and Predictors of Textbook Outcome after Minimally Invasive Esophagectomy for Cancer: A Two-Center Study
Authors: Tagkalos Evangelos , Grimminger Peter , Gao Xing , Chiu Chien-Hung , Uzun Eren , Lang Hauke , Wen Yu-Wen , Chao Yin-Kai
Published: March 2024

Purpose: The textbook outcome (TBO), a multidimensional indicator that reflects an optimal perioperative course, has emerged as a significant prognostic variable in surgical oncology. Our study aimed to assess the occurrence and determinants of TBO following minimally invasive esophagectomy (MIE) for cancer. Methods: A total of 945 patients who had undergone MIE at two high-volume centers between 2008 and 2022 were analyzed. Multivariable logistic regression analysis was applied to identify the independent predictors of TBO. The potential selection bias associated with choosing between different MIE techniques—namely, robotic esophagectomy (RE) and video-assisted thoracoscopic esophagectomy (VATE)—was addressed by applying inverse probability of treatment weighting (IPTW). Results: TBO was realized in 46.6% of cases (n = 440), correlating with markedly better overall and disease-free survival. Multivariable analysis showed that treatment with RE (odds ratio (OR) = 1.527; 95% confidence interval (CI) = 1.149–2.028) was associated with a higher likelihood of achieving TBO, whereas a Charlson Comorbidity Index (CCI) of 2 or higher showed an opposite association (CCI2: OR = 0.687, 95% CI = 0.483–0.977; CCI ≥ 3: OR = 0.604, 95% CI = 0.399–0.915). The advantage of RE in attaining a higher rate of TBO, compared to VATE, remained statistically significant after applying IPTW, with rates of 53.3% for RE and 42.2% for VATE. Notably, RE contributed to a greater probability of thorough lymph node dissection, resection with negative margins, and the avoidance of major complications. Conclusion: TBO was realized in 46.6% of the patients who underwent MIE for cancer. Patients with a lower CCI and those who received RE were more likely to achieve TBO.
Transoral Robotic Surgery for Oral Cancer: Evaluating Surgical Outcomes in the Presence of Trismus
Authors: Lin Ting-Shen , Luo Ci-Wen , Hsieh Tsai-Ling , Lin Frank Cheau-Feng , Tsai Stella Chin-Shaw
Published: March 2024

Trismus, defined as restricted mouth opening, is a common complication among Taiwanese oral cancer patients, especially those who chew betel quid. However, the impact of trismus on survival outcomes in oral cancer patients undergoing transoral robotic surgery (TORS) is unclear. This study aimed to investigate the associations between trismus and surgical outcomes in Taiwanese male oral cancer patients treated with TORS. We conducted a retrospective propensity score-matched cohort study of 40 Taiwanese male oral cancer patients who underwent TORS between 2016 and 2022. Overall, 20 patients with trismus were matched to 20 patients without trismus. TORS achieved similar operative and short-term clinical outcomes in trismus patients to non-trismus patients. There were no significant differences between groups in operation time, blood loss, margin status, flap reconstruction rates, duration of nasogastric tube feeding, or length of hospital stay. Kaplan–Meier and Cox proportional hazard regression analyses were performed to compare overall survival (OS) and disease-free survival (DFS) between the two groups. The overall survival (OS) rate at three years was significantly lower in patients with trismus than those without trismus (27.1% vs. 95.0%, log-rank p = 0.02). However, there was no significant difference in disease-free survival (DFS) rates between the trismus and non-trismus groups (36.6% vs. 62.7%, log-rank p = 0.87). After adjusting for confounders, trismus was independently associated with a 13-fold increased risk of mortality (adjusted HR 12.87, 95% CI 1.55–106.50, p < 0.05). In conclusion, trismus appears to be an independent prognostic factor for reduced long-term OS in Taiwanese male oral cancer patients undergoing TORS, though short-term surgical outcomes were non-inferior in the trismus patients. Further research is warranted to clarify the mechanisms linking trismus and survival in this population.
Exploring Genetic Determinants: A Comprehensive Analysis of Serpin B Family SNPs and Prognosis in Glioblastoma Multiforme Patients
Authors: Al-Khatib Sohaib M. , Al-Bzour Ayah N. , Al-Majali Mohammad N. , Sa’d Laila M. , Alramadneh Joud A. , Othman Nour R. , Al-Mistarehi Abdel-Hameed , Alomari Safwan
Published: March 2024

Serpins are serine proteinase inhibitors, with several serpins being overexpressed in cancer cells. Thus, we aim to analyze the single-nucleotide polymorphism (SNP) of Serpinb11 and its association with GBM survival. A cohort of 63 GBM patients recruited from King Abdullah University Hospital in Jordan underwent polymorphism analysis and overall survival (OS) assessments. The Cancer Genome Atlas (GBM) cohort was useful for validation. We constructed a risk score using the principal component analysis for the following Serpin genes: Serpinb3, Serpinb5, Serpinb6, Serpinb11, and Serpinb12, and patients were grouped into high- vs. low-risk groups based on the median cutoff. Univariable Cox models were used to study the survival outcomes. We identified a significant association between rs4940595 and survival. In the TCGA cohort, Serpinb3 alterations showed worse OS. Univariable Cox showed worse PFS outcomes with higher SERPINB5 and SERPINB6 expression. A Serpin B 5-gene risk score showed a trend towards worse PFS in the high-risk group. Upregulated DEGs showed GO enrichment in cytokine regulation and production, positive regulation of leukocyte activation, and the MAPK cascade. The high-risk group showed a significantly higher infiltration of M2 macrophages and activated mast cells. Our findings showed a significant role of the Serpin B family in GBM survival in the Jordanian population.
HER2-Positive Early Breast Cancer: Time for Ultimate De-Escalation?
Authors: Tauber Nikolas , Cirkel Christoph , Claussen Anna , Fick Franziska , Kontomanolis Emmanuel , Krawczyk Natalia , Rody Achim , Banys-Paluchowski Maggie
Published: March 2024

De-escalation is currently taking place in both the surgical and systemic treatment of breast cancer. The introduction of trastuzumab, the first monoclonal antibody against the HER2 receptor, over 20 years ago was a milestone in the treatment of HER2-positive breast cancer and marked the beginning of a new era in targeted tumor therapy. In the sense of de-escalation, omitting non-targeted cytotoxic chemotherapy altogether is often hailed as the ultimate goal of oncological research. Especially in cases of small, node-negative, HER2-positive early breast cancer, it remains a challenge for clinicians to establish the safest and most efficient treatment plan while considering the significant potential for toxic side effects associated with chemotherapy and HER2-targeted therapy, and the generally excellent prognosis. In this context, several ongoing studies are currently assessing chemotherapy-free regimens as part of strategies aimed at de-escalating therapy in the field of HER2-positive early breast cancer. Despite the promising early results of these studies, the combination of anti-HER2 treatment with a chemotherapy backbone remains the standard of care.
Recent Advances in Advanced Oxidation Processes for Degrading Pharmaceuticals in Wastewater—A Review
Authors: Roslan Nur Nabaahah , Lau Harry Lik Hock , Suhaimi Nurul Amanina A. , Shahri Nurulizzatul Ningsheh M. , Verinda Sera Budi , Nur Muhammad , Lim Jun-Wei , Usman Anwar
Published: March 2024

A large variety of pharmaceutical compounds have recently been detected in wastewater and natural water systems. This review highlighted the significance of removing pharmaceutical compounds, which are considered indispensable emerging contaminants, from wastewater and natural water systems. Various advanced oxidation processes (AOPs), including UV-H2O2, Fenton and photo-Fenton, ozone-based processes, photocatalysis, and physical processes, such as sonolysis, microwave, and electron beam irradiation, which are regarded as the most viable methods to eliminate different categories of pharmaceutical compounds, are discussed. All these AOPs exhibit great promising techniques, and the catalytic degradation process of the emerging contaminants, advantages, and disadvantages of each technique were deliberated. Heterogeneous photocatalysis employing metal oxides, particularly anatase TiO2 nanoparticles as catalysts activated by UV light irradiation, was reviewed in terms of the electron–hole separation, migration of the charge carriers to the catalyst surfaces, and redox potential of the charge carriers. This brief overview also emphasized that anatase TiO2 nanoparticles and TiO2-based nanomaterials are promising photocatalysts, and a combination of photocatalysis and other AOPs enhanced photocatalytic degradation efficiency. Finally, the challenges of applying anatase TiO2-based photocatalysis in environmental remediation and wastewater treatments to degrade pharmaceutical compounds, including mass spectroscopic analysis and a biological activity test of by-products of the emerging contaminants resulting from photocatalysis, are summarized.
Biotics and Children’s and Adolescents’ Health: A Narrative Review
Authors: Xenopoulou Evangelia , Kontele Ioanna , Sergentanis Theodoros N. , Grammatikopoulou Maria G. , Tzoutzou Milia , Kotrokois Konstantinos , Tsitsika Artemis Κ. , Vassilakou Tonia
Published: March 2024

Recently, there has been an increasing interest in the association of gut microbiota with health conditions and the potentially beneficial role of several types of biotics in several population groups, including children and adolescents. Children and adolescents comprise a unique population group due their rapid growth rates, high nutritional requirements, the immaturity of their immune system in early life, and their susceptibility to infectious diseases. The aim of the present study is to investigate the role and limitations of the administration of biotics in specific conditions affecting children and adolescents. A narrative review of related articles published on PubMed up to October 2023 was conducted. The administration of biotics has been evaluated in several health conditions among children and adolescents, such as the treatment and prevention of infectious diarrhea, the prevention of diarrhea after the use of antibiotics, the prevention of necrotizing enterocolitis, the treatment of functional gastrointestinal diseases, such as infant colic, functional abdominal pain, and irritable bowel syndrome, the eradication of H. pylori, the treatment of ulcerative colitis and pouchitis, and the prevention of atopic dermatitis, and the findings indicate improved symptoms and various beneficial health outcomes. However, some limitations have been identified regarding probiotics’ use. In conclusion, biotics may have a beneficial impact in several health conditions among children and adolescents. There is a need for additional randomized, controlled clinical studies on the effects of the administration of biotics in children and particularly in adolescents and young adults.
A Rule-Based Algorithm and Its Specializations for Measuring the Complexity of Software in Educational Digital Environments
Authors: Gorchakov Artyom V. , Demidova Liliya A. , Sovietov Peter N.
Published: March 2024

Modern software systems consist of many software components; the source code of modern software systems is hard to understand and maintain for new developers. Aiming to simplify the readability and understandability of source code, companies that specialize in software development adopt programming standards, software design patterns, and static analyzers with the aim of decreasing the complexity of software. Recent research introduced a number of code metrics allowing the numerical characterization of the maintainability of code snippets. Cyclomatic Complexity (CycC) is one widely used metric for measuring the complexity of software. The value of CycC is equal to the number of decision points in a program plus one. However, CycC does not take into account the nesting levels of the syntactic structures that break the linear control flow in a program. Aiming to resolve this, the Cognitive Complexity (CogC) metric was proposed as a successor to CycC. In this paper, we describe a rule-based algorithm and its specializations for measuring the complexity of programs. We express the CycC and CogC metrics by means of the described algorithm and propose a new complexity metric named Educational Complexity (EduC) for use in educational digital environments. EduC is at least as strict as CycC and CogC are and includes additional checks that are based on definition-use graph analysis of a program. We evaluate the CycC, CogC, and EduC metrics using the source code of programs submitted to a Digital Teaching Assistant (DTA) system that automates a university programming course. The obtained results confirm that EduC rejects more overcomplicated and difficult-to-understand programs in solving unique programming exercises generated by the DTA system when compared to CycC and CogC.
Peritoneal Metastatic Gastric Cancer: Local Treatment Options and Recommendations
Authors: Acs Miklos , Piso Pompiliu , Glockzin Gabriel
Published: March 2024

Peritoneal metastasis is a common finding in patients with advanced gastric cancer. Beyond systemic chemotherapy, additive local treatments such as cytoreductive surgery and intraperitoneal chemotherapy are considered an inherent part of different multimodal treatment concepts for selected patients with peritoneal metastatic gastric cancer. This review article discusses the role of cytoreductive surgery (CRS) and intraperitoneal chemotherapy, including HIPEC, NIPS, and PIPAC, as additive therapeutic options with curative and palliative intent.
Impact of Systemic Delays for Patient Access to Oncology Drugs on Clinical, Economic, and Quality of Life Outcomes in Canada: A Call to Action
Authors: Sehdev Sandeep , Gotfrit Joanna , Elias Martine , Stein Barry D.
Published: March 2024

Canada has one of the most complex and rigorous drug approval and public reimbursement processes and is, unfortunately, one of the countries with the longest delays in drug access. To assess the overall impact of systemic delays in access to cancer therapy, a targeted literature review (TLR) was performed to identify studies associated with the clinical, economic, and quality of life impacts of delayed access to oncology drugs. Using MEDLINE/PubMed databases and snowballing, four unique records met the eligibility criteria. Results revealed that clinical outcomes were the most impacted by systemic delays in access to oncology drugs (e.g., life years lost, overall survival, and progression-free survival). The four articles retrieved by the TLR specifically illustrated that a substantial number of life years could potentially be saved by increasing systemic efficiency regarding the development, approval, and reimbursement processes of new drugs for advanced malignancies. It is imperative that initiatives are put in place to improve the performance and speed of Canadian drug regulatory and health technology assessment (HTA) processes, especially for new cancer therapeutics. The proposed solutions in this paper include better coordination between HTA and Canadian payers to harmonize coverage decisions, international collaborations, information sharing, and national standards for timeliness in oncology drug access.
Whole Process of Standardization of Diffusion-Weighted Imaging: Phantom Validation and Clinical Application According to the QIBA Profile
Authors: Choi Se Jin , Kim Kyung Won , Ko Yousun , Cho Young Chul , Jang Ji Sung , Ahn Hyemin , Kim Dong Wook , Kim Mi Young
Published: March 2024

Background: To use the apparent diffusion coefficient (ADC) as reliable biomarkers, validation of MRI equipment performance and clinical acquisition protocols should be performed prior to application in patients. This study aims to validate various MRI equipment and clinical brain protocols for diffusion weighted imaging (DWI) using commercial phantom, and confirm the validated protocols in patients’ images. Methods: The performance of four different scanners and clinical brain protocols were validated using a Quantitative Imaging Biomarker Alliance (QIBA) diffusion phantom and cloud-based analysis tool. We evaluated the performance metrics regarding accuracy and repeatability of ADC measurement using QIBA profile. The validated clinical brain protocols were applied to 17 patients, and image quality and repeatability of ADC were assessed. Results: The MRI equipment performance of all four MRI scanners demonstrated high accuracy in ADC measurement (ADC bias, −2.3% to −0.4%), excellent linear correlation to the reference ADC value (slope, 0.9 to 1.0; R2, 0.999–1.000), and high short-term repeatability [within-subject-coefficient-of-variation (wCV), 0% to 0.3%]. The clinical protocols were also validated by fulfilling QIBA claims with high accuracy (ADC bias, −3.1% to −0.7%) and robust repeatability (wCV, 0% to 0.1%). Brain DWI acquired using the validated clinical protocols showed ideal image quality (mean score ≥ 2.9) and good repeatability (wCV, 1.8–2.2). Conclusions: The whole process of standardization of DWI demonstrated the robustness of ADC with high accuracy and repeatability across diverse MRI equipment and clinical protocols in accordance with the QIBA claims.
Current Trends and Applications of PET/MRI Hybrid Imaging in Neurodegenerative Diseases and Normal Aging
Authors: Lee Jonathan , Renslo Jonathan , Wong Kasen , Clifford Thomas G. , Beutler Bryce D. , Kim Paul E. , Gholamrezanezhad Ali
Published: March 2024

Dementia is a significant global health issue that is exacerbated by an aging population. Imaging plays an established role in the evaluation of patients with neurocognitive disorders such as dementia. In current clinical practice, magnetic resonance imaging (MRI) and positron emission tomography (PET) are primary imaging modalities used separately but in concert to help diagnose and classify dementia. The clinical applications of PET/MRI hybrid imaging in dementia are an active area of research, particularly given the continued emergence of functional MRI (fMRI) and amyloid PET tracers. This narrative review provides a comprehensive overview of the rationale and current evidence for PET/MRI hybrid dementia imaging from 2018 to 2023. Hybrid imaging offers advantages in the accuracy of characterizing neurodegenerative disorders, and future research will need to address the cost of integrated PET/MRI systems compared to stand-alone scanners, the development of new biomarkers, and image correction techniques.
Congenital Heart Defects in Patients with Molecularly Confirmed Sotos Syndrome
Authors: Calcagni Giulio , Ferrigno Federica , Franceschini Alessio , Dentici Maria Lisa , Capolino Rossella , Sinibaldi Lorenzo , Minotti Chiara , Micalizzi Alessia , Alesi Viola , Novelli Antonio , Baban Anwar , Parlapiano Giovanni , Coviello Domenico , Versacci Paolo , Putotto Carolina , Chinali Marcello , Drago Fabrizio , Bartuli Andrea , Marino Bruno , Digilio Maria Cristina
Published: March 2024

Sotos syndrome is an autosomal dominant condition characterized by overgrowth with advanced bone age, macrodolicocephaly, motor developmental delays and learning difficulties, and characteristic facial features caused by heterozygous pathogenetic variants in the NSD1 gene located on chromosome 5q35. The prevalence of heart defects (HDs) in individuals with Sotos syndrome is estimated to be around 15–40%. Septal defects and patent ductus arteriosus are the most commonly diagnosed malformations, but complex defects have also been reported. The aim of our study was to analyze the prevalence of HD, the anatomic types, and the genetic characteristics of 45 patients with Sotos syndrome carrying pathogenetic variants of NSD1 or a 5q35 deletion encompassing NSD1, who were followed at Bambino Gesù Children’s Hospital in Rome. Thirty-nine of the forty-five patients (86.7%) had a mutation in NSD1, while six of the forty-five (13.3%) had a deletion. Most of the patients (62.2%, 28/45) were male, with a mean age of 14 ± 7 years (range 0.2–37 years). A total of 27/45 (60.0%) of the patients had heart defects, isolated or combined with other defects, including septal defects (12 patients), aortic anomalies (9 patients), mitral valve and/or tricuspid valve dysplasia/insufficiency (1 patient), patent ductus arteriosus (3 patients), left ventricular non-compaction/hypertrabeculated left ventricle (LV) (4 patients), aortic coarctation (1 patient), aortopulmonary window (1 patient), and pulmonary valve anomalies (3 patients). The prevalences of HD in the two subgroups (deletion versus intragenic mutation) were similar (66.7% (4/6) in the deletion group versus 58.91% (23/39) in the intragenic variant group). Our results showed a higher prevalence of HD in patients with Sotos syndrome in comparison to that described in the literature, with similar distributions of patients with mutated and deleted genes. An accurate and detailed echocardiogram should be performed in patients with Sotos syndrome at diagnosis, and a specific cardiological follow-up program is needed.
Network Higher-Order Structure Dismantling
Authors: Peng Peng , Fan Tianlong , Lü Linyuan
Published: March 2024

Diverse higher-order structures, foundational for supporting a network’s “meta-functions”, play a vital role in structure, functionality, and the emergence of complex dynamics. Nevertheless, the problem of dismantling them has been consistently overlooked. In this paper, we introduce the concept of dismantling higher-order structures, with the objective of disrupting not only network connectivity but also eradicating all higher-order structures in each branch, thereby ensuring thorough functional paralysis. Given the diversity and unknown specifics of higher-order structures, identifying and targeting them individually is not practical or even feasible. Fortunately, their close association with k-cores arises from their internal high connectivity. Thus, we transform higher-order structure measurement into measurements on k-cores with corresponding orders. Furthermore, we propose the Belief Propagation-guided Higher-order Dismantling (BPHD) algorithm, minimizing dismantling costs while achieving maximal disruption to connectivity and higher-order structures, ultimately converting the network into a forest. BPHD exhibits the explosive vulnerability of network higher-order structures, counterintuitively showcasing decreasing dismantling costs with increasing structural complexity. Our findings offer a novel approach for dismantling malignant networks, emphasizing the substantial challenges inherent in safeguarding against such malicious attacks.
How Multiple Representations Using Cyber–Physical System to Teach Rectilinear Motion Improves Learning and Creativity
Authors: Guentulle Victoria , Muñoz Rodolfo , Nussbaum Miguel , Madariaga Leonardo
Published: March 2024

Learning physics can be seen by many as a problem, as the standard method of learning tends to focus on remembering and using concepts that fail to construct meaning. To overcome this problem in teaching rectilinear motion, we implemented multiple representations using a cyber–physical system that enables interaction between a physical model and the real world. We did so by using a microcomputer system housed inside a ball, including motion and force sensors. This system communicated with the teacher’s laptop in order to display the corresponding data via a projector. The study was conducted with 49 tenth-grade students across five sessions on rectilinear motion. Using a pre- and post-test, we observed that the experimental group performed significantly better than the control group, both in terms of learning as well as in the development of creativity (fluency and flexibility). With guidance from the teacher, the multiple representations allowed the students to improve their learning and creativity by connecting various forms of representation. In other words, the students were able to connect both abstract and concrete views through a real-world, physical experience. Our study reveals the potential of cyber–physical systems within the teaching–learning process for physics, specifically rectilinear motion, and how such a system supports multiple representations.
Special Education Teachers’ Perceptions of Parental Involvement in Inclusive Education
Authors: Hyassat Mizyed , Al-Bakar Asem , Al-Makahleh Ahmad , al-Zyoud Nawaf
Published: March 2024

(1) Background: It is widely agreed that mutual partnerships between school staff and parents of students are key to creating robust frameworks of inclusive education for students with disabilities. This study explores special education teachers’ perceptions of involving parents of students with disabilities in mainstream schools in Jordan. (2) Methods: This research employs a descriptive quantitative method in the form of a Google-Forms-based online questionnaire with closed-ended questions. (3) Results: The findings indicate that parents were moderately involved in the education of their disabled children; that these parents perceived teachers and school principal to be instrumental in encouraging their involvement in this respect; and that parents face many obstacles to such involvement in their children’s education. (4) Conclusions: The findings point to a need for policymakers to create legislation that enables and mandates the involvement of parents with children with disabilities in inclusive education settings in order to implement constructive models of parental involvement where parents can be treated as equal partners in the educational process.
EPFed: Achieving Optimal Balance between Privacy and Efficiency in Federated Learning
Authors: Mao Dong , Yang Qiongqian , Wang Hongkai , Chen Zuge , Li Chen , Song Yubo , Qin Zhongyuan
Published: March 2024

Federated learning (FL) is increasingly challenged by security and privacy concerns, particularly vulnerabilities exposed by malicious participants. There remains a gap in effectively countering threats such as model inversion and poisoning attacks in existing research. To address these challenges, this paper proposes the Effective Private-Protected Federated Learning Aggregation Algorithm (EPFed), a framework that utilizes a blockchain platform, homomorphic encryption, and secret sharing to fortify the data privacy and computational efficiency in a federated learning environment. EPFed works by establishing “trust groups” through the unique integration of a Chinese Remainder Theorem-based secret sharing scheme with Paillier homomorphic encryption, streamlining secure model parameter exchange and aggregation while minimizing the computational load. Our performance-driven aggregation strategy leverages local performance metrics to safeguard against malicious contributions, ensuring both the integrity and efficiency of the learning process. The evaluations demonstrate that EPFed achieves a remarkable accuracy rate of 92.5%, thereby confirming the advanced nature of the proposed solution in addressing the pressing challenges of FL.
Five-Port Isolated Bidirectional DC-DC Converter for Interfacing a Hybrid Photovoltaic–Fuel Cell–Battery System with Bipolar DC Microgrids
Authors: Koroglu Tahsin , Ekici Elanur , Savrun M. Mustafa
Published: March 2024

This paper introduces a novel five-port, three-input, dual-output isolated bidirectional dc-dc converter (FPIBC) topology with an effective controller for power-sharing and voltage-balancing in bipolar dc microgrids (BPDCMGs). The proposed converter acts as the interface for the integration of a hybrid generation system comprising a solid oxide fuel cell (SOFC), a photovoltaic (PV) system, and a battery into BPDCMGs. It employs a reduced number of circuit elements compared with similar multiport converter topologies suggested for BPDCMG applications. Symmetrical bipolar output voltages are ensured by a voltage-balancing circuit composed of a fully controlled switch and four diodes. The FPIBC is equipped with different controllers for output voltage regulation and balancing, power sharing, maximum power point tracking of the PV, the optimum operating region of the SOFC, and constant-current, constant-voltage charging of the battery. To verify the viability and effectiveness of the proposed system, a simulation model was developed with a 4.2 kW SOFC, a 3.7 kW PV, and a 140 V 10.8 Ah battery in MATLAB/Simulink. The performance of the FPIBC was evaluated through extensive case studies with different operational modes, including battery charge/discharge states and SOFC and PV parameter changes under varying load conditions. In addition, the proposed system was examined using a daily dynamic load profile. According to the simulation results, a peak efficiency of 97.28% is achieved and the voltage imbalance between the output ports is maintained below 0.5%. It is shown that the FPIBC has advantages over previous converters in terms of the number of ports, number of circuit elements, bipolar output voltage, bidirectional power flow, and efficiency.