bluuebunny/crossref_metadata_2025 huggingface dataset:
Combined Use of Phenotypic Screening and of a Novel Commercial Assay (REALQUALITY Carba-Screen) for the Rapid Molecular Detection of Carbapenemases: A Single-Center Experience
Authors: Novazzi Federica , Arcari Gabriele , Drago Ferrante Francesca , Boutahar Sara , Genoni Angelo Paolo , Carcione Davide , Cassani Gianluca , Gigante Paolo , Carbotti Mattia , Capuano Riccardo , Pasciuta Renée , Mancini Nicasio
Published: July 2024

Carbapenem resistance is a serious public health threat, causing numerous deaths annually primarily due to healthcare-associated infections. To face this menace, surveillance programs in high-risk patients are becoming a widespread practice. Here we report the performance of the combined use of a recently approved commercial multiplex real-time PCR assay (REALQUALITY Carba-Screen kit) with conventional phenotypic screening. In this three-month study, 479 rectal swabs from 309 patients across high-risk units were evaluated by combining the two approaches. Although the molecular assay showed a higher positivity rate than phenotypic screening (7.1% vs. 5%), it should be noted that the molecular method alone would have missed eight carbapenem-resistant isolates, while using only phenotypic screening would not have detected sixteen isolates. This demonstrates the complementary strengths of each method. Our study confirms the need for a combined approach to maximize the possible clinical impact of this kind of screening, ensuring a more comprehensive detection of resistant strains.
Improving Lesion Location Reproducibility in Handheld Breast Ultrasound
Authors: Chiu James , Bova Davide , Spear Georgia , Ecanow Jacob , Choate Alyssa , Besson Pierre , Caluser Calin
Published: July 2024

Interoperator variability in the reproducibility of breast lesions found by handheld ultrasound (HHUS) can significantly interfere with clinical care. This study analyzed the features associated with breast mass position differences during HHUS. The ability of operators to reproduce the position of small masses and the time required to generate annotations with and without a computer-assisted scanning device (DEVICE) were also evaluated. This prospective study included 28 patients with 34 benign or probably benign small breast masses. Two operators generated manual and automated position annotations for each mass. The probe and body positions were systematically varied during scanning with the DEVICE, and the features describing mass movement were used in three logistic regression models trained to discriminate small from large breast mass displacements (cutoff: 10 mm). All models successfully discriminated small from large breast mass displacements (areas under the curve: 0.78 to 0.82). The interoperator localization precision was 6.6 ± 2.8 mm with DEVICE guidance and 19.9 ± 16.1 mm with manual annotations. Computer-assisted scanning reduced the time to annotate and reidentify a mass by 33 and 46 s on average, respectively. The results demonstrated that breast mass location reproducibility and exam efficiency improved by controlling operator actionable features with computer-assisted HHUS.
Alterations in Intestinal Mucosal Barrier Visualized by Confocal Laser Endomicroscopy in Liver Cirrhosis: A Pilot Trial (AMBIC)
Authors: Rusticeanu Monica Alexandrina , Zimmer Vincent
Published: July 2024

Background: Chronic liver disease occurs throughout the world irrespective of region, age, sex, or race, and it is caused by a variety of liver conditions. One of the most frequent infectious complications in liver cirrhosis that severely reduces the median survival is spontaneous bacterial peritonitis. Current guidelines recommend a paracentesis before starting an antibiotic prophylaxis for this complication. Methods: Selective intestinal decontamination significantly lowers the rate of first or recurrent SBP in cirrhotic patients, so in this study we aimed to investigate and quantify the intestinal integrity of patients with liver cirrhosis and correlate a pathologically increased permeability with the incidence of SPB. We included 14 patients who met the inclusion criteria. No patient was excluded. For the CLE investigation, we use probe based confocal laser endomicroscopy techniques from Mauna Kea (Cellvizio), enabling in vivo surface imaging. The images (optical biopsies) were analyzed for functional and structural barrier defects after the procedure using Mauna Kea software (version 1.0.09). Results: Because of the small number of included patients and healthy controls, most results are lacking statistical relevance. We found that the CLE investigation showed an increased intestinal permeability in patients with liver cirrhosis, in concordance with previous published data, based on other assessment methods. Conclusions: This study confirms that previously published permeability scores can be applied for patients with liver cirrhosis and is, to our knowledge, the first to investigate the intestinal permeability in vivo in patients with liver cirrhosis. Further data are needed to identify patients at risk and help develop new and less invasive diagnostic criteria for cirrhotic patients who may profit from a prophylactic antibiotic treatment.
Biparametric vs. Multiparametric MRI in the Detection of Cancer in Transperineal Targeted-Biopsy-Proven Peripheral Prostate Cancer Lesions Classified as PI-RADS Score 3 or 3+1: The Added Value of ADC Quantification
Authors: Bertelli Elena , Vizzi Michele , Marzi Chiara , Pastacaldi Sandro , Cinelli Alberto , Legato Martina , Ruzga Ron , Bardazzi Federico , Valoriani Vittoria , Loverre Francesco , Impagliazzo Francesco , Cozzi Diletta , Nardoni Samuele , Facchiano Davide , Serni Sergio , Masieri Lorenzo , Minervini Andrea , Agostini Simone , Miele Vittorio
Published: July 2024

Background: Biparametric MRI (bpMRI) has an important role in the diagnosis of prostate cancer (PCa), by reducing the cost and duration of the procedure and adverse reactions. We assess the additional benefit of the ADC map in detecting prostate cancer (PCa). Additionally, we examine whether the ADC value correlates with the presence of clinically significant tumors (csPCa). Methods: 104 peripheral lesions classified as PI-RADS v2.1 score 3 or 3+1 at the mpMRI underwent transperineal MRI/US fusion-guided targeted biopsy. Results: The lesions were classified as PI-RADS 3 or 3+1; at histopathology, 30 were adenocarcinomas, 21 of which were classified as csPCa. The ADC threshold that maximized the Youden index in order to predict the presence of a tumor was 1103 (95% CI (990, 1243)), with a sensitivity of 0.8 and a specificity of 0.59; both values were greater than those found using the contrast medium, which were 0.5 and 0.54, respectively. Similar results were also found with csPCa, where the optimal ADC threshold was 1096 (95% CI (988, 1096)), with a sensitivity of 0.86 and specificity of 0.59, compared to 0.49 and 0.59 observed in the mpMRI. Conclusions: Our study confirms the possible use of a quantitative parameter (ADC value) in the risk stratification of csPCa, by reducing the number of biopsies and, therefore, the number of unwarranted diagnoses of PCa and the risk of overtreatment.
Enhanced Optimization Techniques for Parameter Estimation of Single-Diode PV Modules
Authors: Kumar Madhav , Panda Kaibalya Prasad , Naayagi Ramasamy T. , Thakur Ritula , Panda Gayadhar
Published: July 2024

Renewable energy sources such as solar are becoming increasingly popular worldwide. Mathematical derivation is used to show the structural framework of PV cells and their models with a single-diode configuration. This paper proposed a two-step optimization technique for extracting the unknown parameters of solar PV cells and modules. The implementation of the proposed techniques is to find the unknown parameters of the PV module from Kyocera (KC200GT). First, we configured the single-diode configuration of the PV equation in terms of five unknown parameters (Iph, I0, Vt, Rs, and Rsh) and in terms of two unknown parameters (Rs and Vt). After that, we implemented the proposed two-step optimization techniques for extracting the unknown parameters (Iph, I0, Vt, Rs, and Rsh) of the PV module Kyocera (KC200GT). Also, we used the genetic algorithm (GA) and particle swarm optimization (PSO) techniques to find the unknown parameters (Iph, I0, Vt, Rs, and Rsh) of the PV module from Kyocera (KC200GT). The performance of the proposed two-step optimization techniques was compared with the traditional single-stage optimization techniques: particle swarm optimization (PSO), genetic algorithms (GAs), grey wolf optimization (GWO), Villalva’s method, Accarino’s method, Iterative method, and Silva’s method. The test results and the output P–V waveform indicate that the proposed method is more efficient and has a greater impact than the standard techniques.
Research on a Three-Phase Soft-Switching Inverter Based on a Simple Auxiliary Snubber Circuit
Authors: Dai Dawei , Zheng Hua
Published: July 2024

This study presents a novel soft-switching inverter distinguished by a simplified topology and an innovative modulation approach. The design aims to optimize the energy conversion processes commonly found in auxiliary snubber circuits. By minimizing the number of auxiliary switches, the control method is streamlined, thereby enhancing system reliability and cost-efficiency. The principles of operation and conditions for soft-switching are thoroughly analyzed using equivalent circuit models. A 3 kW/16 kHz inverter prototype was constructed, and the experimental results confirm the effectiveness and benefits of the proposed inverter.
Glycine Betaine Enhances Poplar Cultivar (Populus deltoides × Populus euramericana) Tolerance to Confront NaCl Stress
Authors: Chen Feiyan , Movahedi Ali , Wei Hui , Zhuge Qiang , Sun Weibo
Published: July 2024

Glycine betaine (GB) serves as a compatible solute crucial for stress tolerance across numerous plant species. Populus trichocarpa grows along coastal regions and often suffers from salt stress. In this study, we explored the effects of foliar spraying of GB on the growth, physicochemical indexes, gene expression, and stress tolerance of poplar under salt stress. To achieve this, poplar plants (Populus deltoides × Populus euramericana “Nanlin 895”) were grown under four NaCl concentrations: 0, 50, 100, and 150 mM. Additionally, they were treated with 0, 5, 15, and 25 mM GB. The degree of effect on potted poplars was observed after 8 weeks. A GB treatment of about 15 mM significantly reduced the impact of salt stress and photosynthetic pigments and caused an improvement in the activity of the antioxidant enzymes peroxidase (POD) and superoxide dismutase (SOD). Moreover, GB-treated poplars had significantly more malonaldehyde (MDA) than the control lines. This study indicated that GB treatment reduces salt stress symptoms in poplars. This research helps to develop safe levels of endogenous GB, which will make poplars more resistant to environmental stresses.
Predicting Potential Suitable Areas of Dendrocalamus brandisii under Global Climate Change
Authors: Tao Hang , Kingston Kate , Xu Zhihong , Hosseini Bai Shahla , Guo Lei , Liu Guanglu , Hui Chaomao , Liu Weiyi
Published: July 2024

Climate change restricts and alters the distribution range of plant species. Predicting potential distribution and population dynamics is crucial to understanding species’ geographical distribution characteristics to harness their economic and ecological benefits. This study uses Dendrocalamus brandisii as the research subject, aiming to accurately reveal the impact of climate change on this plant. The findings offer important insights for developing practical conservation and utilization strategies, and guidance for future introduction and cultivation. The MaxEnt model was optimized using regularization multiplier (RM) and feature combination (FC) from the ‘Kuenm’ package in R language, coupled with ArcGIS for modeling 142 distribution points and 29 environmental factors of D. brandisii. This article explored the key environmental factors influencing the potential suitable regions for D. brandisii, and predicted trends in habitat changes under SSPs2.6 and SSPs8.5 climate scenarios for the current era, the 2050s, 2070s, and 2090s. (1) The results show that when FC = QPH and RM = 1, the AUC = 0.989, indicating that the model prediction is accurate with the lowest complexity and overfitting. The key environmental factors affecting its primary suitable distribution, determined by jackknife training gain and single-factor response curve, are the precipitation of warmest quarter (bio18), the temperature seasonality (bio4), the minimum average monthly radiation (uvb-4), and elevation (Elev), contributing 93.6% collectively. It was established that the optimal range for D. brandisii is precipitation of warmest quarter of between 657 and 999 mm, temperature seasonality from 351% to 442%, minimum average monthly radiation from 2420 to 2786 J/m2/day, at elevation from 1099 to 2217 m. (2) The current potential habitat distribution is somewhat fragmented, covering an area of 92.17 × 104 km2, mainly located in southwest, south, and southeast China, central Nepal, southern Bhutan, eastern India, northwestern Myanmar, northern Laos, and northern Vietnam. (3) In future periods, under different climate scenario models, the potential habitat of D. brandisii will change in varying degrees to become more fragmented, with its distribution center generally shifting westward. The SSP8.5 scenario is not as favorable for the growth of D. brandisii as the SSPs2.6. Central Nepal, southern Bhutan, and the southeastern coastal areas of China have the potential to become another significant cultivation region for D. brandisii. The results provide a scientific basis for the planning of priority planting locations for potential introduction of D. brandisii in consideration of its cultivation ranges.
A Three-Level Model System of Biomass and Carbon Storage for All Forest Types in China
Authors: Zeng Weisheng , Zou Wentao , Chen Xinyun , Yang Xueyun
Published: July 2024

Forest biomass and carbon storage models are crucial for inventorying, monitoring, and assessing forest resources. This study develops models specific to China’s diverse forests, offering a methodological foundation for national carbon storage estimation and a quantitative basis for national, regional, and global carbon sequestration projections. Utilizing data from 52,700 permanent plots obtained during China’s 9th national forest inventory, we calculated biomass and carbon storage per hectare for 35 tree species groups using respective individual tree biomass models and carbon factors. We then constructed a three-level volume-based model system for forest biomass and carbon storage, applying weighted regression, dummy variable modeling, and simultaneous equations with error-in-variables. This system encompasses one population of forests, three forest categories (level I), 20 forest types (level II), and 74 forest sub-types (level III). Finally, the assessment of these models was carried out with six evaluation indices, and comparative analyses with previously established biomass models of three major forest types were conducted. Determination coefficients (R2) for the population average model, and three dummy models on levels I, II, and III, exceed 0.78, 0.85, 0.92, and 0.95, respectively, with corresponding mean prediction errors (MPEs) of 0.42%, 0.34%, 0.24%, and 0.19%, and mean percent standard errors (MPSEs) of approximately 22%, 21%, 15%, and 12%. Models for 20 forest types and 74 sub-types yield R2 values above 0.87 and 0.85, with MPE values below 3% and 5%, respectively. Notably, the estimates of previous biomass models of three major forest types demonstrated considerable uncertainty, with TRE ranging from −20% to 74%. However, accuracy has improved with larger sample sizes. In total biomass and carbon storage estimations, the R2 values of dummy models for levels I, II, and III progressively increase and MPSE and MPE values decrease, whereas TRE approximates zero. The tiered model system of simultaneous equations developed herein offers a quantitative framework for precise evaluations of biomass and carbon storage on different scales. For enhanced accuracy in such estimations, applying level III models is recommended whenever feasible, especially for national estimation.
Experimental Study on the Effect of Root Content on the Shear Strength of Root–Soil Composite with Thick and Fine Roots of Cryptomeria japonica (Thunb. ex L.f.) D.Don
Authors: Liu Jianping , Tang Yusha , Jiang Yulin , Luo Shixin , Wu Kai , Peng Xingxin , Pan Yucong
Published: July 2024

The current research on slope protection with plants mainly focuses on herbs and shrubs. In order to investigate the difference in shear strength of root–soil composite with thick and fine roots under different root content conditions, Cryptomeria japonica (Thunb. ex L.f.) D.Don was selected as the research object, and the distribution characteristics of its roots with the increase of buried depth were studied using the longitudinal profile method. Based on the distribution range of root area ratio (RAR) in field investigation, the modified large-scale direct shear tests were executed on the root–soil composite samples with thick and fine roots of five RAR grades under four normal stress levels, and the variation rule of the shear strength of the root–soil composites with thick and fine roots under different root contents was analyzed. The influence mechanism of RAR was briefly discussed. The results show that the RAR of Cryptomeria japonica (Thunb. ex L.f.) D.Don increases first and then decreases with the increase of buried depth, and decreases with the increase of horizontal distance from the excavation point to the trunk. Both the thick and fine roots can increase the soil shear strength, but the effect of thick roots is greater than that of fine roots. The shear strengths of root–soil composites with thick and fine roots both increase first and then decrease with the increase of RAR, which means that there exists the optimal root content for the roots with the best reinforcement effect on soil, and the optimal RAR is 0.1% and 0.2%, respectively. The cohesive and internal friction angle of the root–soil composite can be improved by the roots of Cryptomeria japonica (Thunb. ex L.f.) D.Don, and the thick root is better than the fine root. Meanwhile, the enhancement effect on the cohesion is greater than that on the internal friction angle. The results are of great significance for understanding the effect of roots on soil shear strength and enriching the existing theory of slope protection with arbors.
A Novel Deep Learning Framework for Intrusion Detection Systems in Wireless Network
Authors: Nguyen Dang Khoa Dinh , Fazio Peppino , Voznak Miroslav
Published: July 2024

In modern network security setups, Intrusion Detection Systems (IDS) are crucial elements that play a key role in protecting against unauthorized access, malicious actions, and policy breaches. Despite significant progress in IDS technology, two of the most major obstacles remain: how to avoid false alarms due to imbalanced data and accurately forecast the precise type of attacks before they even happen to minimize the damage caused. To deal with two problems in the most optimized way possible, we propose a two-task regression and classification strategy called Hybrid Regression–Classification (HRC), a deep learning-based strategy for developing an intrusion detection system (IDS) that can minimize the false alarm rate and detect and predict potential cyber-attacks before they occur to help the current wireless network in dealing with the attacks more efficiently and precisely. The experimental results show that our HRC strategy accurately predicts the incoming behavior of the IP data traffic in two different datasets. This can help the IDS to detect potential attacks sooner with high accuracy so that they can have enough reaction time to deal with the attack. Furthermore, our proposed strategy can also deal with imbalanced data. Even when the imbalance is large between categories. This will help significantly reduce the false alarm rate of IDS in practice. These strengths combined will benefit the IDS by making it more active in defense and help deal with the intrusion detection problem more effectively.
Identification of KSR2 Variants in Pediatric Patients with Severe Early-Onset Obesity from Qatar
Authors: Abu-Rub Lubna I. , Al-Barazenji Tara , Abiib Sumaya , Hammad Ayat S , Abbas Alaa , Hussain Khalid , Al-Shafai Mashael
Published: July 2024

The kinase suppressor of Ras 2 (KSR2) gene is associated with monogenic obesity, and loss-of-function variants in KSR2 have been identified in individuals with severe early-onset obesity. This study investigated KSR2 variants in 9 pediatric patients with severe early-onset obesity in Qatar using whole genome sequencing among a cohort of 240 individuals. We focused on KSR2 variants with a minor allele frequency (MAF) below 1% and a Combined Annotation Dependent Depletion (CADD) score above 13 to identify potential causative variants. Our analysis identified four KSR2 variants: one intronic (c.1765-8G>A) and three missense variants (c.1057G>A, c.1673G>A, and c.923T>C) in nine patients. The intronic variant c.1765-8G>A was the most frequent (seen in six individuals) and had a CADD score of 21.10, suggesting possible pathogenicity. This variant showed a significantly higher allele frequency in the Qatari population compared to the Genome Aggregation Database (gnomAD), indicating a possible founder effect. Molecular modeling of the missense variants revealed structural changes in the protein structure. The study concludes that these four KSR2 variants are associated with monogenic obesity, with an autosomal dominant inheritance pattern. The c.1765-8G>A variant’s prevalence in Qatar underscores its importance in genetic screening for severe obesity. This research advances the understanding of genetic factors in severe early-onset obesity and may inform better management strategies.
In Silico Analysis of the Missense Variants of Uncertain Significance of CTNNB1 Gene Reported in GnomAD Database
Authors: Caballero-Avendaño Arturo , Gutiérrez-Angulo Melva , Ayala-Madrigal María de la Luz , Moreno-Ortiz José Miguel , González-Mercado Anahí , Peregrina-Sandoval Jorge
Published: July 2024

CTNNB1 pathogenic variants are related to the improper functioning of the WNT/β-catenin pathway, promoting the development of different types of cancer of somatic origin. Bioinformatics analyses of genetic variation are a great tool to understand the possible consequences of these variants on protein structure and function and their probable implication in pathologies. The objective of this study is to describe the impact of the missense variants of uncertain significance (VUS) of the CTNNB1 gene on structure and function of the β-catenin protein. The CTNNB1 variants were obtained from the GnomAD v2.1.1 database; subsequently, a bioinformatic analysis was performed using the VarSome, UCSC Genome Browser, UniProt, the Kinase Library database, and DynaMut2 platforms to evaluate clinical significance, gene conservation, consensus sites for post-translational modifications, and the dynamics and stability of proteins. The GnomAD v2.1.1 database included 826 variants of the CTNNB1 gene, of which 385 were in exons and exon/intron boundaries. Among these variants, 214 were identified as missense, of which 146 were classified as VUS. Notably, 12 variants were in proximity to consensus sites for post-translational modifications (PTMs). The in silico analysis showed a slight tendency towards probably pathogenic for c.59C>T (p.Ala20Val) and c.983T>C (p.Met328Thr) missense VUS. These findings provide possible functional implications of these variants in some types of cancer.
Auditory and Language Abilities in Children with Takenouchi–Kosaki Syndrome: A Systematic Review
Authors: Caragli Valeria , Genovese Elisabetta , Parretta Sara , Pellegrino Michele , Ciorba Andrea
Published: July 2024

Takenouchi–Kosaki syndrome (TKS) is a rare congenital disease caused by a de novo mutation in the Cell Division Cycle 42 (CDC42) gene. Patients with TKS present facial and body dysmorphisms, hematologic and immune dysregulation, intellectual disability, neurodevelopmental delay and hearing loss. The aim of this study is to review the literature, focusing on hearing and language abilities in children with TKS. A systematic search on PubMed, Scopus and Web of Science databases was performed, including twelve studies for a total of 13 patients. Hearing loss (HL) occurs in a great percentage of patients (84.6%); nonetheless, auditory threshold, severity of HL and language abilities were reported in a few cases. In two studies, auditory rehabilitation strategies were described. Although several studies have investigated the hematological features of TKS, still only a few authors have focused on the audiological and language abilities of these children. Given the fact that HL has a significant impact on behaviors, communications skills, and quality of life, it is important to adequately assess and rehabilitate patients early with this syndrome. Further studies are needed to improve the knowledge about this topic and improve the quality of life of patients with TKS.
Dynamic Evolution Model of Internet Financial Public Opinion
Authors: Yu Chao , He Jianmin , Ma Qianting , Liu Xinyu
Published: July 2024

In the context of global economic digitalization, financial information is highly susceptible to internet financial public opinion due to the overwhelming and misleading nature of information on internet platforms. This paper delves into the core entities in the diffusion process of internet financial public opinions, including financial institutions, governments, media, and investors, and models the behavioral characteristics of these entities in the diffusion process. On this basis, we comprehensively use the multi-agent model and the SIR model to construct a dynamic evolution model of internet financial public opinion. We conduct a simulation analysis of the impact effects and interaction mechanisms of multi-agent behaviors in the financial market on the evolution of internet financial public opinion. The research results are as follows. Firstly, the financial institutions’ digitalization levels, government guidance, and the media authority positively promote the diffusion of internet financial public opinion. Secondly, the improvement of investors’ financial literacy can inhibit the diffusion of internet financial public opinion. Thirdly, under the interaction of multi-agent behaviors in the financial market, the effects of financial institutions’ digitalization level and investors’ financial literacy are more significant, while the effects of government guidance and media authority tend to converge.
Myocardial Mechanics and Valvular and Vascular Abnormalities in Cardiac Amyloidosis
Authors: Nemes Attila
Published: July 2024

Cardiac amyloidosis is an infiltrative disease primarily caused by extracellular tissue deposition of amyloid fibrils in the myocardial interstitium. The aim of the present review was to summarize findings regarding changes in myocardial mechanics, valvular abnormalities, and vascular remodeling detected in patients with cardiac amyloidosis.
Setting Up an Ambulatory GI Endoscopy Suite in the USA—Anesthesia and Sedation Challenges
Authors: Goudra Basavana
Published: July 2024

Gastrointestinal endoscopy units, both freestanding and associated with ambulatory surgical centers, are on the increase, and the trend is likely to continue. The concept is relatively new, and there are insufficient guidelines and a general dearth of information for prospective planners and physicians. Debate continues in areas such as the selection of patients, appropriateness of procedures, and access to tertiary care. Leaders often scramble to address both critical and non-critical issues, often after the center has opened to the public. They often encounter issues which were not anticipated. In this review, we have provided comprehensive and concise information on the various aspects of starting and running an endoscopy unit. Some of the areas considered are referral and recruitment systems, determination of the need and site selection, layout and regulations, aspects related to drugs, equipment, medical emergencies, and emergency room transfers, discharge criteria, post-discharge follow-up, and finally, we have addressed issues related to avoiding and managing cancelations. It is assumed that a majority of the procedures are performed with predominantly propofol-induced deep sedation.
Navigating the Metaverse: A New Virtual Tool with Promising Real Benefits for Breast Cancer Patients
Authors: Żydowicz Weronika Magdalena , Skokowski Jaroslaw , Marano Luigi , Polom Karol
Published: July 2024

BC, affecting both women and men, is a complex disease where early diagnosis plays a crucial role in successful treatment and enhances patient survival rates. The Metaverse, a virtual world, may offer new, personalized approaches to diagnosing and treating BC. Although Artificial Intelligence (AI) is still in its early stages, its rapid advancement indicates potential applications within the healthcare sector, including consolidating patient information in one accessible location. This could provide physicians with more comprehensive insights into disease details. Leveraging the Metaverse could facilitate clinical data analysis and improve the precision of diagnosis, potentially allowing for more tailored treatments for BC patients. However, while this article highlights the possible transformative impacts of virtual technologies on BC treatment, it is important to approach these developments with cautious optimism, recognizing the need for further research and validation to ensure enhanced patient care with greater accuracy and efficiency.
Charting Proficiency: The Learning Curve in Robotic Hysterectomy for Large Uteri Exceeding 1000 g
Authors: Lee Jihyun , Kim Seongmin
Published: July 2024

Background/Objectives: This study evaluates the safety and surgical outcomes of performing robotic hysterectomy on uteri weighing over 1000 g, with a focus on the surgeon’s learning curve. Methods: A retrospective analysis was conducted on 44 patients who underwent hysterectomy by a single surgeon from January 2020 to February 2024 using the DaVinci Xi System. Surgical procedures included total hysterectomy with bilateral salpingectomy, and specimens were removed via transvaginal manual morcellation. Operative times were segmented into docking, console, morcellation, and conversion times. Results: Results indicated an inflection point in the 20th case, suggesting proficiency after 20 surgeries. Comparison between early (Group A, cases 1–20) and later cases (Group B, cases 21–44) showed significant reductions in console time (CT) and morcellation time (MT) in Group B, leading to a shorter overall operative time (OT). Although estimated blood loss was higher in Group A, it was not statistically significant. Hemoglobin differences were significantly higher in Group B. No significant differences were observed in transfusion rates, postoperative analgesic usage, or complications between the groups. Conclusions: The study concludes that robotic hysterectomy for large uteri is safe and that surgical proficiency improves significantly after 20 cases, enhancing overall outcomes.
Usefulness of Elastic Bandage Compression Compared to Calf Massage to Prevent Venous Thromboembolism—A Retrospective Evaluation
Authors: Kimura Keishi , Imai Norio , Nozaki Asami , Horigome Yoji , Suzuki Hayato , Kawashima Hiroyuki
Published: July 2024

Background: Manual calf massage and passive ankle motion (CaM) can reduce the incidence of venous thromboembolism (VTE) after total hip arthroplasty (THA). However, these methods cannot be used in all patients; thus, elastic bandage (EB) compression is an alternative method. The efficacy of EB compression in preventing VTE has not yet been investigated; thus, this study aimed to compare the effects of EB compression and manual calf massage. Methods: Of the 363 patients who underwent unilateral primary THA at our hospital between 1 August 2018 and 31 October 2023, CaM without anticoagulation therapy was administered to 206 patients (CaM group) and 157 patients underwent EB without anticoagulation therapy (EB group). Duplex ultrasonography was performed 7 days postoperatively to check for deep vein thrombosis (DVT) in both legs. Results: The surgical time (122.2 min vs. 155.5 min), the incidence of DVT (4.5% vs. 4.8%) and pulmonary thromboembolism (PTE) (0% vs. 0.7%), intraoperative bleeding (305.4 mL vs. 301 mL), and estimated actual blood loss (846.6 mL vs. 811.6 mL) were not significantly different between the CaM and EB group. However, there was one case of symptomatic PTE in the EB group. Conclusions: The incidences of DVT, PTE, and intraoperative bleeding were not significantly different between the groups. Moreover, EB can be administered to patients with DVT and is considered to be a DVT prophylaxis method that can be used in a larger number of patients. Therefore, we recommend that EB be performed in all the patients undergoing THA.
Exploring Non-Modifiable and Modifiable Determinants of Vision-Related Quality of Life in Central Serous Chorioretinopathy
Authors: Künzel Steffen E. , Kabiri Payam , zur Bonsen Lynn , Frentzel Dominik P. , Böker Alexander , Joussen Antonia M. , Zeitz Oliver
Published: July 2024

Background: To longitudinally investigate the impact of best-corrected visual acuity (BCVA), non-modifiable risk factors, modifiable habits, and disease course on the vision-related quality of life (VRQOL) of patients with central serous chorioretinopathy (CSCR). Methods: We longitudinally enrolled 109 CSCR patients and 42 non-diseased control participants from our clinic. In addition to clinical examination, the National Eye Institute Visual Function Questionnaire (NEI-VFQ-39) was employed for assessments, along with questions pertaining to various aspects of lifestyle habits. Alongside the cross-sectional analyses, the VRQOL of CSCR patients was tracked longitudinally over one year. Results: Consistent with prior studies, CSCR patients reported a lower VRQOL compared to non-diseased participants (79.3 ± 14.1 for CSCR and 92.6 ± 7.6 for CTRL; p < 0.0001), but fared better than those with other ocular conditions. No significant associations were observed between BCVA, any non-modifiable risk factors, or interventions, and VRQOL, both in cross-sectional and longitudinal contexts (cross-sectional BCVA with VRQOL: Pearson r correlation 0.173, p = 0.072). Among modifiable habits, sleep duration (p = 0.036), perceived quality of sleep rhythm (p = 0.006), hours of physical activity (p = 0.036), and the presence of non-ocular conditions (p = 0.001) were significantly correlated with VRQOL. Notably, enhanced sleep duration (+4.232 vs. −0.041 non-enhanced at 3 months, p = 0.033) and higher perceived quality of sleep rhythm (+6.248 vs. +0.094 non-higher, p = 0.009) showed a positive correlation with improved VRQOL over time. Conclusions: The study reveals that VRQOL has minimal dependence on BCVA or other clinical factors, suggesting that patient-reported outcome measures (PROMs) could serve as alternative endpoints in clinical studies for more holistic patient welfare assessment. Furthermore, the strong correlations between VRQOL and modifiable lifestyle habits indicate potential therapeutic value in targeting these areas for intervention.
Impact of High Risk of Obstructive Sleep Apnea on Health-Related Quality of Life: The Korean National Health and Nutrition Survey 2019–2021
Authors: Chang Min-Seok , Park Sunmin , Lim Jihye , Lee Ji-Ho
Published: July 2024

Background/Objectives: Obstructive sleep apnea (OSA) impairs quality of life (QoL). However, its disease burden in the general population remains unknown. We aimed to investigate the association between OSA and health-related QoL in the general Korean population. Methods: This study analyzed cross-sectional datasets of adults (≥40 years) in the Korean National Health and Nutrition Examination Survey 2019–2021. QoL was assessed using the 3-level EuroQoL 5-dimension component (EQ-5D-3L). The high risk of OSA was determined using the STOP-Bang questionnaire (score ≥ 3). Demographic and clinical factors were included in linear regression analyses to identify the factors associated with EQ-5D-3L. Results: Of the 8966 total participants, 6792 (75.8%) and 2174 (24.2%) were classified as having a low risk and high risk of OSA, respectively. The high risk OSA group showed significantly lower QoL scores when compared with the low risk OSA group (0.939 ± 0.003 vs. 0.951 ± 0.002, p < 0.001). However, the mean difference was within the minimal clinically important difference (MCID) of EQ-5D-3L. Only females exceeded the MCID for the EQ-5D-3L. Elderly females with a high risk of OSA showed the lowest QoL. The regression coefficient of high risk OSA in the multivariate model was −0.018 (95% CI: −0.025–−0.01, p < 0.001). Patient demographics and comorbidities also showed significant associations with the EQ-5D-3L. Their regression coefficient was higher than that of high risk OSA. Conclusions: The impact of high risk OSA on QoL manifested differently according to age and sex. The impact of comorbidities on QoL was greater than that of high risk OSA, highlighting the important role of comorbidities and the need for their adjustment in the assessment of QoL.
Chronic Exposure to Both Electronic and Conventional Cigarettes Alters Ileum and Colon Turnover, Immune Function, and Barrier Integrity in Mice
Authors: Djouina Madjid , Ollivier Anaïs , Waxin Christophe , Kervoaze Gwenola , Pichavant Muriel , Caboche Ségolène , Achour Djamal , Grare Céline , Beury Delphine , Hot David , Anthérieu Sébastien , Lo-Guidice Jean-Marc , Dubuquoy Laurent , Launay David , Vignal Cécile , Gosset Philippe , Body-Malapel Mathilde
Published: July 2024

Although the effects of cigarette smoke (CS) on the development of several intestinal diseases is well documented, the impact of e-cigarette aerosol (e-cig) on digestive health is largely unknown. To compare the effects of e-cig and CS on mouse ileum and colon, animals were chronically exposed for 6 months by nose-only inhalation to e-cig at 18 or 30 W power, or to 3R4F CS. Results showed that e-cig exposure decreased colon cell proliferation. Several other proliferative defects were observed in response to both e-cig and CS exposure, including up- and down-regulation of cyclin D1 protein levels in the ileum and colon, respectively. E-cig and CS exposure reduced myeloperoxidase activity in the ileum. In the colon, both exposures disrupted gene expression of cytokines and T cell transcription factors. For tight junction genes, ZO-1- and occludin-protein expression levels were reduced in the ileum and colon, respectively, by e-cig and CS exposure. The 16S sequencing of microbiota showed specific mild dysbiosis, according to the type of exposure. Overall, e-cig exposure led to altered proliferation, inflammation, and barrier function in both the ileum and colon, and therefore may be a gut hazard on par with conventional CS.
The Role of Service Quality Attributes and Perceived Value in US Consumers’ Impulsive Buying Intentions for Fresh Food E-Commerce
Authors: Kang Jee-Won , Namkung Young
Published: July 2024

Given the widespread adoption of fresh food e-commerce, this study aimed to explore the service quality attributes influencing utilitarian value, hedonic value, and impulsive buying behavior. A survey was conducted with 263 participants who had experience in purchasing fresh food online. Their responses were analyzed to test hypotheses using structural equation modeling. The findings reveal significant influences of information quality, ease of use, and problem resolution on utilitarian value. Additionally, ease of use, problem resolution, and trendiness were found to impact hedonic value. Problem resolution was a quality factor that affected both practical value and hedonic value, and its influence was found to be greater than that of other service quality factors. Hedonic value was also found to significantly affect impulsive buying behavior; however, utilitarian value did not exhibit a significant impact on impulsive buying behavior. The results provide useful theoretical and managerial implications in the field of fresh food e-commerce business.
Von Willebrand Factor Dynamics in Patients with Aortic Stenosis Undergoing Surgical and Transcatheter Valve Replacement
Authors: Grigorescu Andrei Emanuel , Anghel Andrei , Koch Claudia , Horhat Florin George , Savescu Delia , Feier Horea
Published: July 2024

Aortic stenosis (AS) is a prevalent valvular disorder that poses a significant burden on healthcare systems due to its debilitating symptoms and high mortality rates if left untreated. Surgical aortic valve replacement (SAVR) and transcatheter aortic valve replacement (TAVR) are the primary interventions for severe AS, but perioperative complications such as bleeding remain a concern. Von Willebrand factor (VWF), a crucial player in hemostasis, is known to be altered in AS and may contribute to the hemostatic imbalance observed in these patients. This prospective study aimed to investigate the association between prosthetic valve type, size, and postprocedural VWF levels in patients undergoing aortic valve replacement (AVR) for severe AS. This study involved 39 consecutive patients diagnosed with severe AS who underwent SAVR or TAVR. By elucidating the VWF dynamics associated with different prosthetic valves, this study sought to provide valuable insights into personalized valve selection and perioperative management strategies.
Research on Microstructure, Mechanical Properties, and High-Temperature Stability of Hot-Rolled Tungsten Hafnium Alloy
Authors: Yin Yi , Wang Tiejun , Qin Sigui , Wang Wanjing , Shi Yingli , Yu Hongxin
Published: July 2024

W-(0, 0.1, 0.3, 0.5) wt.% Hf (mass fraction, wt.%) materials were fabricated by the powder metallurgy method and hot rolling. The microstructure, mechanical properties, and high-temperature stability of alloys with varying compositions were systematically studied. The active element Hf can react with the impurity O segregated at the grain boundary to form fine dispersed HfO2 particles, refining the grains and purifies and strengthening the grain boundary. The average size of the sub-grains in the W-0.3 wt.% Hf alloy is 4.32 μm, and the number density of the in situ-formed second phase is 6.4 × 1017 m−3. The W-0.3 wt.% Hf alloy has excellent mechanical properties in all compositions of alloys. The ultimate tensile strength (UTS) is 1048 ± 17.02 MPa at 100 °C, the ductile fracture occurs at 150 °C, and the total elongation (TE) is 5.91 ± 0.41%. The UTS of the tensile test at 500 °C is 614 ± 7.55 MPa, and the elongation is as high as 43.77 ± 1.54%. However, more Hf addition will increase the size of the second-phase particles and reduce the number density of the second-phase particles, resulting in a decrease in the mechanical properties of the tungsten alloy. The isochronal annealing test shows that the recrystallization temperature of W-Hf alloy is 1400 °C, which is 200 °C higher than rolling pure tungsten.
The Identification of Leidenfrost Phenomenon Formation on TiO2-Coated Surfaces and the Modelling of Heat Transfer Processes
Authors: Maziukienė Monika , Striūgas Nerijus , Vorotinskienė Lina , Skvorčinskienė Raminta , Urbonavičius Marius
Published: July 2024

Experiments on specimen cooling dynamics and possible film boiling around a body are very important in various industrial applications, such as nucleate boiling, to decrease drag reduction or achieve better surface properties in coating technologies. The objective of this study was to investigate the interaction between the heat transfer processes and cooling dynamics of a sample in different boundary conditions. This article presents new experimental data on specimens coated with Al–TiO2 film and Leidenfrost phenomenon (LP) formation on the film’s surface. Furthermore, this manuscript presents numerical heat and mass transfer parameter results. The comparative analysis of new experiments on Al–TiO2 film specimens and other coatings such as polished aluminium, Al–MgO, Al–MgH2 and Al–TiH2 provides further detail on oxide and hydride materials. In the experimental cooling dynamics experiments, specimens were heated up to 450 °C, while the sub-cooling water temperatures were 14*‒20 °C (room temperature), 40 °C and 60 °C. The specimens’ cooling dynamics were calculated by applying Newton’s cooling law, and heat transfer was estimated by calculating the heat flux q transferred from the specimens’ surface and the Bi parameter. The metadata results from the performed experiments were used to numerically model the cooling dynamics curves for different material specimens. Approximated polynomial equations are proposed for the polished aluminium, Al–TiO2, Al–MgO, Al–MgH2 and Al–TiH2 materials. The provided comparative analysis makes it possible to see the differences between oxides and hydrides and to choose materials for practical application in the industrial sector. The presented results could also be used in software packages to model heat transfer processes.
Effects of Different Austenitising Conditions on the Strength–Ductility Balance in a High-Strength Low-Alloy Steel
Authors: Luo Liang , Dong Duyu , Jiang Zheng , Chen Tao , Li Yimin
Published: July 2024

With the addition of microalloy elements to a high-strength low-alloy (HSLA) steel, various fine particles of carbides and nitrides are formed, which increase the matrix strength. These precipitates play a crucial role in precipitation strengthening. However, the role of precipitates in microstructural refinement is frequently overlooked. In this study, a series of hot-rolled HSLA steel samples were reheated to different temperatures above the austenite transformation point for a specified period to refine austenite grains via precipitation, then cooled to a dual-phase (austenitic/ferritic) region, and finally air-cooled to room temperature. The influences of different austenitising conditions on the microstructure and mechanical properties of the HSLA steel were examined. When a hot-rolled sample was reheated to 15 °C above the austenitic transition temperature for 20 min and then cooled to 25 °C below the austenitic transition temperature for 25 min, the most low-angle boundaries were formed, and the smallest effective grain size was achieved. Meanwhile, compared with the hot-rolled sample, the tensile and yield strengths of the reheated sample increased by 12.3% and 3.4%, respectively, while the elongation increased by 162.5%, exhibiting a good strength–ductility balance. By adopting an appropriate austenitising process, precipitates can refine the crystalline grains during austenitisation, thereby enhancing the comprehensive mechanical properties of the steel. Meanwhile, excessively high austenitising temperatures lead to the coarsening of the steel microstructure, decreasing the microstructural refinement efficiency via precipitation and consequently degrading the comprehensive mechanical properties of the steel. The findings provide valuable insights into the preparation process design of such steels or other steels with similar microstructures.