bluuebunny/crossref_metadata_2025 huggingface dataset:
Histopathologic Aspects of Malignancy-Associated Granuloma Annulare: A Single Institution Experience
Authors: Bagci Buket , Karakas Cansu , Kaur Harsimran , Smoller Bruce R.
Published: March 2023

Granuloma annulare (GA) is a benign, self-limiting granulomatous inflammatory disease that exhibits different histologic patterns. Infrequently, granuloma annulare can be associated with malignancy, the so-called malignancy-associated granuloma annulare (MGA). In this study, we aimed to compare the clinical and histopathological differences between GA and MGA. We retrospectively reviewed patient charts and identified 35 patients diagnosed with GA and concurrent hematological or solid organ malignancies as a case group. Additionally, we identified 33 patients without any known solid organ or hematological malignancy as a control group. MGA is commonly seen in the seventh decade of life, while GA affects the younger population. MGA is most commonly presented in the extremities of the body. The most common malignancy associated with MGA was chronic lymphocytic leukemia. Prostate cancer was the most common type of solid organ malignancy that was associated with MGA. The most common histopathological pattern seen in MGA was interstitial, comprising half of the cases. Multinucleated giant cells were present in half of the MGA cases and in most of the control group. In the literature, there are no established features that distinguish MGA from GA. Although MGA and GA have overlapping features, in our series, we found that the interstitial pattern was more common in MGA, while the necrobiotic pattern was more common in GA.
Negative Samples for Improving Object Detection—A Case Study in AI-Assisted Colonoscopy for Polyp Detection
Authors: Nogueira-Rodríguez Alba , Glez-Peña Daniel , Reboiro-Jato Miguel , López-Fernández Hugo
Published: March 2023

Deep learning object-detection models are being successfully applied to develop computer-aided diagnosis systems for aiding polyp detection during colonoscopies. Here, we evidence the need to include negative samples for both (i) reducing false positives during the polyp-finding phase, by including images with artifacts that may confuse the detection models (e.g., medical instruments, water jets, feces, blood, excessive proximity of the camera to the colon wall, blurred images, etc.) that are usually not included in model development datasets, and (ii) correctly estimating a more realistic performance of the models. By retraining our previously developed YOLOv3-based detection model with a dataset that includes 15% of additional not-polyp images with a variety of artifacts, we were able to generally improve its F1 performance in our internal test datasets (from an average F1 of 0.869 to 0.893), which now include such type of images, as well as in four public datasets that include not-polyp images (from an average F1 of 0.695 to 0.722).
Role of Machine Learning-Based CT Body Composition in Risk Prediction and Prognostication: Current State and Future Directions
Authors: Elhakim Tarig , Trinh Kelly , Mansur Arian , Bridge Christopher , Daye Dania
Published: March 2023

CT body composition analysis has been shown to play an important role in predicting health and has the potential to improve patient outcomes if implemented clinically. Recent advances in artificial intelligence and machine learning have led to high speed and accuracy for extracting body composition metrics from CT scans. These may inform preoperative interventions and guide treatment planning. This review aims to discuss the clinical applications of CT body composition in clinical practice, as it moves towards widespread clinical implementation.
Evaluation of the Diagnostic Performance of a SARS-CoV-2 and Influenza A/B Combo Rapid Antigen Test in Respiratory Samples
Authors: Dinç Harika , Karabulut Nuran , Alaçam Sema , Uysal Hayriye , Daşdemir Ferhat , Önel Mustafa , Tuyji Tok Yeşim , Sirekbasan Serhat , Agacfidan Ali , Gareayaghi Nesrin , Çakan Hüseyin , Eryiğit Önder , Kocazeybek Bekir
Published: March 2023

This study aimed to evaluate the performance characteristics of a rapid antigen test developed to detect SARS-CoV-2 (COVID-19), influenza A virus (IAV), and influenza B virus (IBV) (flu) compared with those of the real-time reverse transcription-polymerase chain reaction (rRT-PCR) method. One hundred SARS-CoV-2, one hundred IAV, and twenty-four IBV patients whose diagnoses were confirmed by clinical and laboratory methods were included in the patient group. Seventy-six patients, who were negative for all respiratory tract viruses, were included as the control group. The Panbio™ COVID-19/Flu A&B Rapid Panel test kit was used in the assays. The sensitivity values of the kit were 97.5%, 97.9%, and 33.33% for SARS-CoV-2, IAV, and IBV, respectively, in samples with a viral load below 20 Ct values. The sensitivity values of the kit were 16.7%, 36.5%, and 11.11% for SARS-CoV-2, IAV, and IBV, respectively, in samples with a viral load above 20 Ct. The kit’s specificity was 100%. In conclusion, this kit demonstrated high sensitivity to SARS-CoV-2 and IAV for viral loads below 20 Ct values, but the sensitivity values were not compatible with PCR positivity for lower viral loads over 20 Ct values. Rapid antigen tests may be preferred as a routine screening tool in communal environments, especially in symptomatic individuals, when diagnosing SARS-CoV-2, IAV, and IBV with high caution.
The Use of Visual Analysis for Gait and Foot Posture in Children with Developmental Dysplasia of the Hip
Authors: Vasilcova Veronika , AlHarthi Moqfa , Jawadi Ayman H. , Zvonař Martin
Published: March 2023

Background: Developmental dysplasia of the hip (DDH) is recognized as a leading cause of significant long-term complications, including inaccurate gait patterns, persistent pain, and early regressive joint disorder, and it can influence families functionally, socially, and psychologically. Methods: This study aimed to determine foot posture and gait analysis across patients with developmental hip dysplasia. We retrospectively reviewed participants referred to the pediatric rehabilitation department of KASCH from the orthopedic clinic between 2016 and 2022 (patients born 2016–2022) with DDH for conservative brace treatment. Results: The foot postural index for the right foot showed a mean of 5.89 (n = 203, SD 4.15) and the left food showed a mean of 5.94 (n = 203, SD 4.19). The gait analysis mean was 6.44 (n = 406, SD 3.84). The right lower limb mean was 6.41 (n = 203, SD 3.78), and the left lower limb mean was 6.47 (n = 203, SD 3.91). The correlation for general gait analysis was r = 0.93, presenting the very high impact of DDH on gait. Significant correlation results were found between the right (r = 0.97) and left (r = 0.25) lower limbs. Variation between the right and left lower limb p-values was 0.88 (p < 0.05). DDH affects the left lower limb more than the right during gait. Conclusion: We conclude that there is a higher risk of developing foot pronation on the left side, which is altered by DDH. Gait analysis has shown that DDH affects the right lower limb more than the left. The results of the gait analysis showed gait deviation in the sagittal mid- and late stance phases.
Implementation of GAN-Based, Synthetic T2-Weighted Fat Saturated Images in the Routine Radiological Workflow Improves Spinal Pathology Detection
Authors: Schlaeger Sarah , Drummer Katharina , Husseini Malek El , Kofler Florian , Sollmann Nico , Schramm Severin , Zimmer Claus , Kirschke Jan S. , Wiestler Benedikt
Published: March 2023

(1) Background and Purpose: In magnetic resonance imaging (MRI) of the spine, T2-weighted (T2-w) fat-saturated (fs) images improve the diagnostic assessment of pathologies. However, in the daily clinical setting, additional T2-w fs images are frequently missing due to time constraints or motion artifacts. Generative adversarial networks (GANs) can generate synthetic T2-w fs images in a clinically feasible time. Therefore, by simulating the radiological workflow with a heterogenous dataset, this study’s purpose was to evaluate the diagnostic value of additional synthetic, GAN-based T2-w fs images in the clinical routine. (2) Methods: 174 patients with MRI of the spine were retrospectively identified. A GAN was trained to synthesize T2-w fs images from T1-w, and non-fs T2-w images of 73 patients scanned in our institution. Subsequently, the GAN was used to create synthetic T2-w fs images for the previously unseen 101 patients from multiple institutions. In this test dataset, the additional diagnostic value of synthetic T2-w fs images was assessed in six pathologies by two neuroradiologists. Pathologies were first graded on T1-w and non-fs T2-w images only, then synthetic T2-w fs images were added, and pathologies were graded again. Evaluation of the additional diagnostic value of the synthetic protocol was performed by calculation of Cohen’s ĸ and accuracy in comparison to a ground truth (GT) grading based on real T2-w fs images, pre- or follow-up scans, other imaging modalities, and clinical information. (3) Results: The addition of the synthetic T2-w fs to the imaging protocol led to a more precise grading of abnormalities than when grading was based on T1-w and non-fs T2-w images only (mean ĸ GT versus synthetic protocol = 0.65; mean ĸ GT versus T1/T2 = 0.56; p = 0.043). (4) Conclusions: The implementation of synthetic T2-w fs images in the radiological workflow significantly improves the overall assessment of spine pathologies. Thereby, high-quality, synthetic T2-w fs images can be virtually generated by a GAN from heterogeneous, multicenter T1-w and non-fs T2-w contrasts in a clinically feasible time, which underlines the reproducibility and generalizability of our approach.
Models and Algorithms for the Refinement of Therapeutic Approaches for Retinal Diseases
Authors: Friedmann Elfriede , Dörsam Simon , Auffarth Gerd U.
Published: March 2023

We are developing a Virtual Eye for in silico therapies to accelerate research and drug development. In this paper, we present a model for drug distribution in the vitreous body that enables personalized therapy in ophthalmology. The standard treatment for age-related macular degeneration is anti-vascular endothelial growth factor (VEGF) drugs administered by repeated injections. The treatment is risky, unpopular with patients, and some of them are unresponsive with no alternative treatment. Much attention is paid to the efficacy of these drugs, and many efforts are being made to improve them. We are designing a mathematical model and performing long-term three-dimensional Finite Element simulations for drug distribution in the human eye to gain new insights in the underlying processes using computational experiments. The underlying model consists of a time-dependent convection-diffusion equation for the drug coupled with a steady-state Darcy equation describing the flow of aqueous humor through the vitreous medium. The influence of collagen fibers in the vitreous on drug distribution is included by anisotropic diffusion and the gravity via an additional transport term. The resulting coupled model was solved in a decoupled way: first the Darcy equation with mixed finite elements, then the convection-diffusion equation with trilinear Lagrange elements. Krylov subspace methods are used to solve the resulting algebraic system. To cope with the large time steps resulting from the simulations over 30 days (operation time of 1 anti-VEGF injection), we apply the strong A-stable fractional step theta scheme. Using this strategy, we compute a good approximation to the solution that converges quadratically in both time and space. The developed simulations were used for the therapy optimization, for which specific output functionals are evaluated. We show that the effect of gravity on drug distribution is negligible, that the optimal pair of injection angles is (50∘,50∘), that larger angles can result in 38% less drug at the macula, and that in the best case only 40% of the drug reaches the macula while the rest escapes, e.g., through the retina, that by using heavier drug molecules, more of the drug concentration reaches the macula in an average of 30 days. As a refined therapy, we have found that for longer-acting drugs, the injection should be made in the center of the vitreous, and for more intensive initial treatment, the drug should be injected even closer to the macula. In this way, we can perform accurate and efficient treatment testing, calculate the optimal injection position, perform drug comparison, and quantify the effectiveness of the therapy using the developed functionals. We describe the first steps towards virtual exploration and improvement of therapy for retinal diseases such as age-related macular degeneration.
Multisystem Inflammatory Syndrome in Adults Associated with Recent Infection with COVID-19
Authors: Zahornacky Ondrej , Porubčin Štefan , Rovnakova Alena , Jarcuska Pavol
Published: March 2023

Multisystem inflammatory syndrome in adults (MIS-A) is an uncommon but severe and still understudied post-infectious complication of COVID-19. Clinically, the disease manifests itself most often 2–6 weeks after overcoming the infection. Young and middle-aged patients are especially affected. The clinical picture of the disease is very diverse. The dominant symptoms are mainly fever and myalgia, usually accompanied by various, especially extrapulmonary, manifestations. Cardiac damage (often in the form of cardiogenic shock) and significantly increased inflammatory parameters are often associated with MIS-A, while respiratory symptoms, including hypoxia, are less frequent. Due to the seriousness of the disease and the possibility of rapid progression, the basis of a successful treatment of the patient is early diagnosis, based mainly on anamnesis (overcoming the disease of COVID-19 in the recent past) and clinical symptoms, which often imitate other severe conditions such as, e.g., sepsis, septic shock, or toxic shock syndrome. Because of the danger of missing the treatment, it is necessary to initiate it immediately after the suspicion of MIS-A is expressed, without waiting for the results of microbiological and serological examinations. The cornerstone of pharmacological therapy is the administration of corticosteroids and intravenous immunoglobulins, to which the majority of patients clinically react. In this article, the authors describe the case report of a 21-year-old patient admitted to the Clinic of Infectology and Travel Medicine for febrility up to 40.5 °C, myalgia, arthralgia, headache, vomiting, and diarrhea three weeks after overcoming COVID-19. However, as part of the routine differential diagnosis of fevers (imaging and laboratory examinations), their cause was not clarified. Due to the overall worsening of the condition, the patient was transferred to the ICU with suspicion of developing MIS-A (he met all clinical and laboratory criteria). Given the above, reserve antibiotics, intravenous corticosteroids, and immunoglobulins were added to the treatment due to the risk of missing them, with a good clinical and laboratory effect. After stabilizing the condition and adjusting the laboratory parameters, the patient was transferred to a standard bed and sent home.
CD24 Gene Expression as a Risk Factor for Non-Alcoholic Fatty Liver Disease
Authors: Amin Mona A. , Ragab Halla M. , Abd El Maksoud Nabila , Elaziz Wafaa Abd
Published: March 2023

In light of increasing NAFLD prevalence, early detection and diagnosis are needed for decision-making in clinical practice and could be helpful in the management of patients with NAFLD. The goal of this study was to evaluate the diagnostic accuracy of CD24 gene expression as a non-invasive tool to detect hepatic steatosis for diagnosis of NAFLD at early stage. These findings will aid in the creation of a viable diagnostic approach. Methods: This study enrolled eighty individuals divided into two groups; a study group included forty cases with bright liver and a group of healthy subjects with normal liver. Steatosis was quantified by CAP. Fibrosis assessment was performed by FIB-4, NFS, Fast-score, and Fibroscan. Liver enzymes, lipid profile, and CBC were evaluated. Utilizing RNA extracted from whole blood, the CD24 gene expression was detected using real-time PCR technique. Results: It was detected that expression of CD24 was significantly higher in patients with NAFLD than healthy controls. The median fold change was 6.56 higher in NAFLD cases compared to control subjects. Additionally, CD24 expression was higher in cases with fibrosis stage F1 compared to those with fibrosis stage F0, as the mean expression level of CD24 was 7.19 in F0 cases as compared to 8.65 in F1 patients but without significant difference (p = 0.588). ROC curve analysis showed that CD24 ∆CT had significant diagnostic accuracy in the diagnosis of NAFLD (p = 0.034). The optimum cutoff for CD24 was 1.83 for distinguishing patients with NAFLD from healthy control with sensitivity 55% and specificity 74.4%; and an area under the ROC curve (AUROC) of 0.638 (95% CI: 0.514–0.763) was determined. Conclusion: In the present study, CD24 gene expression was up-regulated in fatty liver. Further studies are required to confer its diagnostic and prognostic value in the detection of NAFLD, clarify its role in the progression of hepatocyte steatosis, and to elucidate the mechanism of this biomarker in the progression of disease.
Differentiating Fordyce Spots from Their Common Simulators Using Ultraviolet-Induced Fluorescence Dermatoscopy—Retrospective Study
Authors: Pietkiewicz Paweł , Navarrete-Dechent Cristian , Goldust Mohamad , Korecka Katarzyna , Todorovska Verce , Errichetti Enzo
Published: March 2023

Fordyce spots (FS) are heterotopic sebaceous glands affecting mostly oral and genital mucosa, commonly misdiagnosed with sexually transmitted infections. In a single-center retrospective study, we aimed to assess the ultraviolet-induced fluorescencedermatoscopy (UVFD) clues of Fordyce spots and their common clinical simulants: molluscum contagiosum, penile pearly papules, human papillomavirus warts, genital lichen planus, and genital porokeratosis. Analyzed documentation included patients’ medical records (1 September–30 October 2022) and photodocumentation, which included clinical images as well as polarized, non-polarized, and UVFD images. Twelve FS patients were included in the study group and fourteen patients in the control group. A novel and seemingly specific UVFD pattern of FS was described: regularly distributed bright dots over yellowish-greenish clods. Even though, in the majority of instances, the diagnosis of FS does not require more than naked eye examination, UVFD is a fast, easy-to-apply, and low-cost modality that can further increase the diagnostic confidence and rule out selected infectious and non-infectious differential diagnoses if added to conventional dermatoscopic diagnosis.
A High-Efficiency Consultation Improves Urological Diagnosis in Patients with Complex LUTS—A Pilot Study
Authors: Ciudin Alexandru , Padulles Bernat , Manasia Pasqualino , Alcoberro Josep , Ounia Sanae , Lopez Maria , Allue Natalia , Ferrer Joan Maria , Duran Jaume , Aguilar Antonio
Published: March 2023

(1) Background: The diagnosis of moderate-severe lower urinary tract symptoms (LUTS) is not easy due to the complexity of the micturition act. Sequential diagnostic tests can be time consuming due to waiting lists. Thus, we developed a diagnostic model combining all the tests in a single one-stop consultation. (2) Methods: In a prospective pilot study in patients with complex LUTS, they received all diagnostic tests (ultrasound, uroflowmetry, cystoscopy, pressure-flow study) in a single consultation and by the same doctor. Patients’ results were compared with those from a 2021 paired cohort that underwent the classical sequential diagnostic pathway. (3) Results: Per patient, the high-efficiency consultation saved: 175 days of waiting, 60 min doctor time and 120 nursing assistant time and over 300 euros on average. The intervention also saved 120 patient journeys to the hospital, lowering the total carbon footprint by 145.86 kg CO2. In one-third of the patients, performing all the tests within the same consultation contributed to reaching a more appropriate diagnosis and thus more effective treatment. Patients’ satisfaction was high, with good tolerability. (4) Conclusions: The high-efficiency urology consultation improves waiting times, therapeutic decisions and the degree of patient satisfaction while optimizing the use of resources and generating savings for the health system.
Outpatient Hysteroscopic Polypectomy—A Retrospective Study Comparing Rigid and Semirigid Office Hysteroscopes
Authors: Chiofalo Benito , Calandra Mauro , Bruno Valentina , Tarantino Vincenzo , Esposito Giovanni , Vizza Enrico , Corrado Giacomo , Scambia Giovanni , Catena Ursula
Published: March 2023

Endometrial polyps are one of the most common pathological conditions in gynecology. Hysteroscopy is the gold standard for the diagnosis and treatment of endometrial polyps. The purpose of this multicenter, retrospective study was to compare patients’ pain perception during an operative hysteroscopic endometrial polypectomy in an outpatient setting with two different hysteroscopes (rigid and semirigid) and to identify some clinical and intraoperative characteristics that are related to worsening pain during the procedure. We included women that underwent, at the same time as an diagnostic hysteroscopy, the complete removal of an endometrial polyp (using the see-and-treat strategy) without any kind of analgesia. A total of 166 patients were enrolled, of which 102 patients underwent a polypectomy with a semirigid hysteroscope and 64 patients underwent the procedure with a rigid hysteroscope. No differences were found during the diagnostic step; on the contrary, after the operative procedure, a statistically significant greater degree of pain was reported when the semirigid hysteroscope was used. Cervical stenosis and menopausal status were risk factors for pain both in the diagnostic step and in the operative one. Our results confirm that operative hysteroscopic endometrial polypectomy in an outpatient setting is an effective, safe, and well-tolerated procedure and indicate that it might be better tolerated if a rigid rather than semirigid instrument is used.
Advanced Imaging for Robotic Bronchoscopy: A Review
Authors: Ravikumar Nakul , Ho Elliot , Wagh Ajay , Murgu Septimiu
Published: March 2023

Recent advances in navigational platforms have led bronchoscopists to make major strides in diagnostic interventions for pulmonary parenchymal lesions. Over the last decade, multiple platforms including electromagnetic navigation and robotic bronchoscopy have allowed bronchoscopists to safely navigate farther into the lung parenchyma with increased stability and accuracy. Limitations persist, even with these newer technologies, in achieving a similar or higher diagnostic yield when compared to the transthoracic computed tomography (CT) guided needle approach. One of the major limitations to this effect is due to CT-to-body divergence. Real-time feedback that better defines the tool–lesion relationship is vital and can be obtained with additional imaging using radial endobronchial ultrasound, C-arm based tomosynthesis, cone-beam CT (fixed or mobile), and O-arm CT. Herein, we describe the role of this adjunct imaging with robotic bronchoscopy for diagnostic purposes, describe potential strategies to counteract the CT-to-body divergence phenomenon, and address the potential role of advanced imaging for lung tumor ablation.
Secondary Breast Malignancy from Renal Cell Carcinoma: Challenges in Diagnosis and Treatment—Case Report
Authors: Spasic Marko , Zaric Dusan , Mitrovic Minja , Milojevic Sanja , Nedovic Nikola , Sekulic Marija , Stojanovic Bojan , Vulovic Dejan , Milosevic Bojan , Milutinovic Filip , Milosavljevic Neda
Published: March 2023

Renal cell carcinoma represents about 2% of all malignant tumours in adults. Metastases of the primary tumour in the breast make up to about 0.5–2% of the cases. Renal cell carcinoma metastases in the breast are extremely rare and have been sporadically recorded in the literature. In this paper, we present the case of a patient with breast metastasis of renal cell carcinoma 11 years after primary treatment. Case presentation: An 82-year-old female who had right nephrectomy due to renal cancer in 2010 felt a lump in her right breast in August 2021, whereby a clinical examination revealed a tumour at the junction of the upper quadrants of her right breast, about 2 cm, movable toward the base, vaguely limited, and with a rough surface. The axillae were without palpable lymph nodes. Mammography showed a circular and relatively clearly contoured lesion in the right breast. Ultrasound showed an oval lobulated lesion of 19 × 18 mm at the upper quadrants, with strong vascularisation and without posterior acoustic phenomena. A core needle biopsy was performed, and the histopathological findings and obtained immunophenotype indicated a metastatic clear cell carcinoma of renal origin. A metastasectomy was performed. Histopathologically, the tumour was without desmoplastic stroma, comprising predominantly solid-type alveolar arrangements of large moderately polymorphic cells, bright and abundant cytoplasm, and round vesicular cores with focally prominent nuclei. Immunohistochemically, tumour cells were diffusely positive for CD10, EMA, and vimentin, and negative for CK7, TTF-1, renal cell antigen, and E-cadherin. With a normal postoperative course, the patient was discharged on the third postoperative day. After 17 months, there were no new signs of the underlying disease spreading at regular follow-ups. Conclusion: Metastatic involvement of the breast is relatively rare and should be suspected in patients with a prior history of other cancers. Core needle biopsy and pathohistological analysis are required for the diagnosis of breast tumours.
Ultrasonic Diagnosis of Intestinal Obstruction in Neonates-Original Article
Authors: Guo Binbin , Pang Lin , Liu Chang , Chen Xiaoya , Qiao Qiang , Zhang Cong
Published: March 2023

Background: Intestinal obstruction in neonates is a common problem that requires prompt diagnosis and treatment, and ultrasound could be a potential tool for it. The purpose of this study was to investigate the accuracy of ultrasonography in diagnosing and identifying the cause of intestinal obstruction in neonates, the corresponding ultrasonic manifestations, as well as to utilize the diagnostic method. Methods: We conducted a retrospective study of all neonatal intestinal obstruction in our institute between 2009 and 2022. The accuracy of ultrasonography in the diagnosis of intestinal obstruction and the identification of its etiology was compared with the results of operation as the gold standard. Results: The accuracy of the ultrasonic diagnosis of intestinal obstruction was 91%, and the accuracy of the ultrasonic etiological diagnosis of intestinal obstruction was 84%. The main ultrasound findings for the neonatal intestinal obstruction were dilation and high tension of the proximal bowel and collapse of the distal intestinal. Other major manifestations were the presence of corresponding diseases causing intestinal obstruction at the junction of the dilated and collapsed bowel. Conclusions: Ultrasound has the advantages of being a flexible multi-section dynamic evaluation and a valuable tool to diagnose and identify the cause of intestinal obstruction in neonates.
Association of Vitamin D Deficiency and Insufficiency with Pathology in Hospitalized Patients
Authors: Bucurica Sandica , Prodan Ioana , Pavalean Mihaela , Taubner Corina , Bucurica Ana , Socol Calin , Calin Roxana , Ionita-Radu Florentina , Jinga Mariana
Published: March 2023

Vitamin D deficiency is one of the most common medical conditions, with approximately one billion people having low vitamin D levels. Vitamin D is associated with a pleiotropic effect (immunomodulatory, anti-inflammatory and antiviral), which can be essential for a better immune response. The aim of this research was to evaluate the prevalence of vitamin D deficiency/insufficiency in hospitalized patients focusing on demographic parameters as well as assessing the possibility of its associations with different comorbidities. Of 11,182 Romanian patients evaluated in the study over 2 years, 28.83% had vitamin D deficiency, 32.11% insufficiency and 39.05% had optimal vitamin D levels. The vitamin D deficiency was associated with cardiovascular disorders, malignancies, dysmetabolic disorders and SARS-CoV2 infection, older age and the male sex. Vitamin D deficiency was prevalent and showed pathology association, while insufficiency of vitamin D (20–30 ng/mL) had lower statistical relevance and represents a grey zone in vitamin D status. Guidelines and recommendations are necessary for homogeneity of the monitoring and management of inadequately vitamin D status in the risk categories.
The Prevalence and Risk Factors of Chronic Heart Failure in the Mongolian Population
Authors: Sukhbaatar Pagmadulam , Bayartsogt Batzorig , Ulziisaikhan Ganchimeg , Byambatsogt Bolortuul , Khorloo Chingerel , Badrakh Burmaa , Tserendavaa Sumiya , Sodovsuren Naranchimeg , Dagva Mungunchimeg , Khurelbaatar Mungun-Ulzii , Tsedensodnom Sodchimeg , Nyamsuren Bat-Erdene , Myagmardorj Rinchyenkhand , Unurjargal Tsolmon
Published: March 2023

Background: The prevalence of heart failure in the Mongolian population is unknown. Thus, in this study, we aimed to define the prevalence of heart failure in the Mongolian population and to identify significant risk factors for heart failure among Mongolian adults. Methods: This population-based study included individuals 20 years and older from seven provinces as well as six districts of the capital city of Mongolia. The prevalence of heart failure was based on the European Society of Cardiology diagnostic criteria. Results: In total, 3480 participants were enrolled, of which 1345 (38.6%) participants were males, and the median age was 41.0 years (IQR 30–54 years). The overall prevalence of heart failure was 4.94%. Patients with heart failure had significantly higher body mass index, heart rate, oxygen saturation, respiratory rate, and systolic/diastolic blood pressure than patients without heart failure. In the logistic regression analysis, hypertension (OR 4.855, 95% CI 3.127–7.538), previous myocardial infarction (OR 5.117, 95% CI 3.040–9.350), and valvular heart disease (OR 3.872, 95% CI 2.112–7.099) were significantly correlated with heart failure. Conclusions: This is the first report on the prevalence of heart failure in the Mongolian population. Among the cardiovascular diseases, hypertension, old myocardial infarction, and valvular heart disease were identified as the three foremost risk factors in the development of heart failure.
Acute Traumatic Pain in the Emergency Department
Authors: Zanza Christian , Romenskaya Tatsiana , Zuliani Marta , Piccolella Fabio , Bottinelli Maria , Caputo Giorgia , Rocca Eduardo , Maconi Antonio , Savioli Gabriele , Longhitano Yaroslava
Published: March 2023

Trauma is a major cause of mortality throughout the world. Traumatic pain—acute, sudden, or chronic—is defined as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage”. Patients’ perceptions of pain assessment and management have become an important criterion and relevant outcome measure for healthcare institutions. Several studies show that 60–70% of ER patients experience pain, and more than half of them express a feeling of sorrow, which can be moderate or severe, at triage. The few studies that have analyzed how pain is assessed and managed in these departments agree that approximately 70% of patients receive no analgesia or receive it with remarkable delay. Specifically, less than half of the patients receive treatment for pain during admission and 60% of discharged patients have higher intensity pain than at admission. Trauma patients are also the ones who most commonly report low satisfaction with pain management. Associated with this lack of satisfaction, we can describe the poor use of tools for measuring and recording pain, poor communication among caregivers, inadequate training in pain assessment and management, and widespread misconceptions among nurses about the reliability of patients’ estimation of pain. The aim of this article is to review the scientific literature to explore the methodologies of pain management in trauma patients attending the emergency room and analyzing their weaknesses as a starting point to improve the approach to this, unfortunately too often, underestimated issue. A literature search was performed using the major databases to identify relevant studies in indexed scientific journals. The literature showed that the multimodal approach in trauma patients is the best approach to pain management. It is becoming increasingly crucial to manage the patient on multiple fronts. Drugs acting on different pathways can be administered together at lower doses, minimizing risks. Every emergency department must have staff trained in the assessment and immediate management of pain symptoms as this allows the reduction of mortality and morbidity and shortens hospital stays, contributing to early mobilization, reduced hospital costs, and enhanced patient satisfaction and quality of life.
Health Coaching-Based Interventions for Oral Health Promotion: A Scoping Review
Authors: Chunda Remus , Mossey Peter , Freeman Ruth , Yuan Siyang
Published: March 2023

Background: Health coaching-based interventions can support behaviour change to improve oral health. This scoping review aims to identify key characteristics of health coaching-based interventions for oral health promotion. Methods: The Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews checklist and the Joanna Briggs Institute manual for evidence synthesis were used in this review. A search strategy using medical subject heading terms and keywords was developed and applied to search the following databases: CINAHL, Ovid, PubMed, Cochrane Library and Scopus. Thematic analysis was used to synthesise the data. Results: Twenty-three studies met the inclusion criteria and were included in this review. These studies were predominantly based on health coaching and motivational interviewing interventions applied to oral health promotion. The following are the characteristics of health coaching-based interventions extracted from themes of the included studies: (a) Health professionals should be trained on the usage of motivational interviewing/health coaching interventions; (b) oral health professionals should acquire motivational techniques in their practice to engage patients and avoid criticisms during the behaviour change process; (c) routine brief motivational interviewing/health coaching intervention sessions should be introduced in dental clinics; (d) traditional oral health education methods should be supplemented with individually tailored communication; and (e) for cost-effectiveness purposes, motivational interviewing/health coaching strategies should be considered. Conclusions: This scoping review reveals that health coaching-based techniques of health coaching and motivational interviewing can significantly impact oral health outcomes and behaviour change and can improve oral health professional–patient communication. This calls for the use of health coaching-based techniques by dental teams in community and clinical settings. This review highlights gaps in the literature, suggesting the need for more research on health coaching-based intervention strategies for oral health promotion.
Estuary Stingray (Dasyatis fluviorum) Behaviour Does Not Change in Response to Drone Altitude
Authors: Bourke Emily , Raoult Vincent , Williamson Jane E. , Gaston Troy F.
Published: March 2023

The use of drones to study the behaviours of marine animals is increasing, yet the potential effects of drones on natural behaviours are poorly understood. Here, we assessed if a small consumer drone produced behavioural changes in a ray common to New South Wales, Australia, the estuary stingray (Dasyatis fluviorum). A drone was flown directly above a total of 50 individual stingrays, the altitude above that ray was progressively reduced, and any behavioural changes were recorded. While stingrays demonstrated a range of behaviours, these behaviours rarely changed during drone observations (n = 6 or 12% of flights), and no change in the type of behaviour or number of behavioural changes was observed as the altitude decreased. These results suggest that consumer drones have little visible impact on stingray behaviour but do not exclude potential physiological responses. As a result, we recommend that when conducting drone-based stingray research, operators fly at the highest altitude possible that allows monitoring of features of interest, and we conclude that drones are effective tools for assessing natural stingray behaviours.
Non-Euclidean Graph-Convolution Virtual Network Embedding for Space–Air–Ground Integrated Networks
Authors: Chen Ning , Shen Shigen , Duan Youxiang , Huang Siyu , Zhang Wei , Tan Lizhuang
Published: March 2023

For achieving seamless global coverage and real-time communications while providing intelligent applications with increased quality of service (QoS), AI-enabled space–air–ground integrated networks (SAGINs) have attracted widespread attention from all walks of life. However, high-intensity interactions pose fundamental challenges for resource orchestration and security issues. Meanwhile, virtual network embedding (VNE) is applied to the function decoupling of various physical networks due to its flexibility. Inspired by the above, for SAGINs with non-Euclidean structures, we propose a graph-convolution virtual network embedding algorithm. Specifically, based on the excellent decision-making properties of deep reinforcement learning (DRL), we design an orchestration network combined with graph convolution to calculate the embedding probability of nodes. It fuses the information of the neighborhood structure, fully fits the original characteristics of the physical network, and utilizes the specified reward mechanism to guide positive learning. Moreover, by imposing security-level constraints on physical nodes, it restricts resource access. All-around and rigorous experiments are carried out in a simulation environment. Finally, results on long-term average revenue, VNR acceptance ratio, and long-term revenue–cost ratio show that the proposed algorithm outperforms advanced baselines.
A Weakly Supervised Approach for Disease Segmentation of Maize Northern Leaf Blight from UAV Images
Authors: Chen Shuo , Zhang Kefei , Wu Suqin , Tang Ziqian , Zhao Yindi , Sun Yaqin , Shi Zhongchao
Published: March 2023

The segmentation of crop disease zones is an important task of image processing since the knowledge of the growth status of crops is critical for agricultural management. Nowadays, images taken by unmanned aerial vehicles (UAVs) have been widely used in the segmentation of crop diseases, and almost all current studies use the study paradigm of full supervision, which needs a large amount of manually labelled data. In this study, a weakly supervised method for disease segmentation of UAV images is proposed. In this method, auxiliary branch block (ABB) and feature reuse module (FRM) were developed. The method was tested using UAV images of maize northern leaf blight (NLB) based on image-level labels only, i.e., only the information as to whether NBL occurs is given. The quality (intersection over union (IoU) values) of the pseudo-labels in the validation dataset achieved 43% and the F1 score reached 58%. In addition, the new method took 0.08 s to generate one pseudo-label, which is highly efficient in generating pseudo-labels. When pseudo-labels from the train dataset were used in the training of segmentation models, the IoU values of disease in the test dataset reached 50%. These accuracies outperformed the benchmarks of the ACoL (45.5%), RCA (36.5%), and MDC (34.0%) models. The segmented NLB zones from the proposed method were more complete and the boundaries were more clear. The effectiveness of ABB and FRM was also explored. This study is the first time supervised segmentation of UAV images of maize NLB using only image-level data was applied, and the above test results confirm the effectiveness of the proposed method.
Coordinated Vision-Based Tracking by Multiple Unmanned Vehicles
Authors: Cichella Venanzio , Kaminer Isaac
Published: March 2023

We address the problem of coordinated vision-based tracking of a moving target using multiple unmanned vehicles that exchange information over a supporting time-varying network. The objective of this work is to formulate decentralized control algorithms that enable multiple vehicles to follow the target while coordinating their phase separation. A typical scenario involves multiple unmanned aerial vehicles that are required to monitor a moving ground object (target tracking) while maintaining a desired inter-vehicle separation (coordination). To solve the vision-based tracking problem, the yaw rate of each vehicle is used as the control input, while the speeds of the vehicles are adjusted to achieve coordination. It is assumed that the vehicles are equipped with an internal autopilot, which is able to track yaw rate and speed commands. The performance of the coordinated vision-based tracking algorithm is evaluated as a function of the target’s velocity, tracking performance of the onboard autopilot, and the quality of service of the communication network.
Characterization of a Driven Two-Level Quantum System by Supervised Learning
Authors: Couturier Raphaël , Dionis Etienne , Guérin Stéphane , Guyeux Christophe , Sugny Dominique
Published: March 2023

We investigate the extent to which a two-level quantum system subjected to an external time-dependent drive can be characterized by supervised learning. We apply this approach to the case of bang-bang control and the estimation of the offset and the final distance to a given target state. For any control protocol, the goal is to find the mapping between the offset and the distance. This mapping is interpolated using a neural network. The estimate is global in the sense that no a priori knowledge is required on the relation to be determined. Different neural network algorithms are tested on a series of data sets. We show that the mapping can be reproduced with very high precision in the direct case when the offset is known, while obstacles appear in the indirect case starting from the distance to the target. We point out the limits of the estimation procedure with respect to the properties of the mapping to be interpolated. We discuss the physical relevance of the different results.
A Robust Hierarchical Estimation Scheme for Vehicle State Based on Maximum Correntropy Square-Root Cubature Kalman Filter
Authors: Qi Dengliang , Feng Jingan , Li Yongbin , Wang Lei , Song Bao
Published: March 2023

Accurate acquisition of vehicle dynamics state information is essential for vehicle active safety control systems. However, these states cannot be easily measured, and the measurement is expensive. Conventional Kalman filters perform well for vehicle state estimation in Gaussian environments but exhibit low accuracy and robustness under practical non-Gaussian noise. Vehicle model parameter ingestion, inaccurate tire force calculation, and non-Gaussian noise from on-board sensors cause great challenges to the estimation of vehicle driving states. Therefore, this paper presents a robust hierarchical estimation scheme for vehicle driving state based on the maximum correntropy square-root cubature Kalman filter (MCSCKF) using easily measurable on-board sensor information. First, the vehicle mass is dynamically updated based on the recursive least squares (FRLS) method with a forgetting factor. Then, an adaptive sliding mode observer (ASMO) is designed to estimate the longitudinal and lateral tire forces. Ultimately, the vehicle states are estimated based on the MCSCKF under non-Gaussian noise. Two typical operating situations are carried out to verify the validity of the proposed estimation scheme. The results prove that the proposed estimation scheme can estimate the vehicle’s driving state accurately compared to other common methods. And the MCSCKF algorithm has better accuracy and robustness than the traditional Kalman filters for vehicle state estimation in non-Gaussian situations.
Energy Diversification and Security in the EU: Comparative Assessment in Different EU Regions
Authors: Streimikiene Dalia , Siksnelyte-Butkiene Indre , Lekavicius Vidas
Published: March 2023

Various methods and tools have been developed to quantify energy supply security; however, there is no ideal framework to measure energy security, as the concept is multifaceted and context dependent. Energy supply security has always been an extremely important issue for European Union (EU) countries due to high import dependency, and recent events linked to the COVID-19 pandemic and the Russian invasion of Ukraine have made it exceptionally important to reconsider this problem to identify the crucial issues and address contemporary policy needs. This study endeavours to systematise the primary energy security indicators in terms of policy relevance and develop an energy security assessment framework to examine energy import dependency and diversification for the EU in view of recent problems. This study introduces an energy import diversification and security index which enables measurement of a country’s energy security level for comparison with other countries and identifies primary areas for improvement. The proposed framework is then applied to a case study of selected EU countries to examine regional differences and identify potential improvements.
Use of Technological Resources for the Development of Computational Thinking Following the Steps of Solving Problems in Engineering Students Recently Entering College
Authors: Paucar-Curasma Ronald , Villalba-Condori Klinge Orlando , Mamani-Calcina Jorge , Rondon David , Berrios-Espezúa Mario Gustavo , Acra-Despradel Claudia
Published: March 2023

In this work, the authors propose the use of technological resources to develop computational thinking following the steps or phases of problem-solving for first-year students. During the development of the activities using technological resources (Arduino board, sensors, electronic devices, and mBlock) the students carried out activities, such as algorithm development and programming of the Arduino board and sensors from a friendly and playful interface such as the mBlock, as well as the debugging of programs until obtaining the expected results. These activities had an impact on the cognitive processes, practices, and technological perspectives of the students. Causality has been shown to exist between computational thinking skills and problem-solving phases in an environment of engineering students entering college. For the analysis of the relationship between computational thinking skills and problem-solving, Pearson’s statistical correlation test was used through SPSS software.
Preface of Special Issue “21st Century Health Communication Challenges: Public Health Emergencies”
Authors: Ruíz-Núñez Carlos , Herrera-Peco Ivan
Published: March 2023

Over recent years, the tendency to seek health information has increased exponentially worldwide [...]