bluuebunny/crossref_metadata_2025 huggingface dataset:
High-Dimensional Chaotic Lorenz System: Numerical Treatment Using Changhee Polynomials of the Appell Type
Authors: Adel Mohamed , Khader Mohamed M. , Algelany Salman
Published: May 2023

Presenting and simulating the numerical treatment of the nine-dimensional fractional chaotic Lorenz system is the goal of this work. The spectral collocation method (SCM), which makes use of Changhee polynomials of the Appell type, is the suggested approximation technique to achieve this goal. A rough formula for the Caputo fractional derivative is first derived, and it is used to build the numerical strategy for the suggested model’s solution. This procedure creates a system of algebraic equations from the model that was provided. We validate the effectiveness and precision of the provided approach by evaluating the residual error function (REF). We compare the results obtained with the fourth-order Runge–Kutta technique and other existing published work. The outcomes demonstrate that the technique used is a simple and effective tool for simulating such models.
Invasion of Optimal Social Contracts
Authors: Lütz Alessandra F. , Amaral Marco Antonio , Braga Ian , Wardil Lucas
Published: May 2023

The stag-hunt game is a prototype for social contracts. Adopting a new and better social contract is usually challenging because the current one is already well established and stable due to sanctions imposed on non-conforming members. Thus, how does a population shift from the current social contract to a better one? In other words, how can a social system leave a locally optimum configuration to achieve a globally optimum state? Here, we investigate the effect of promoting diversity on the evolution of social contracts. We consider group-structured populations where individuals play the stag-hunt game in all groups. We model the diversity incentive as a snowdrift game played in a single focus group where the individual is more prone to adopting a deviant norm. We show that a moderate diversity incentive is sufficient to change the system dynamics, driving the population over the stag-hunt invasion barrier that prevents the global optimum being reached. Thus, an initial fraction of adopters of the new, better norm can drive the system toward the optimum social contract. If the diversity incentive is not too large, the better social contract is the new equilibrium and remains stable even if the incentive is turned off. However, if the incentive is large, the population is trapped in a mixed equilibrium and the better social norm can only be reached if the incentive is turned off after the equilibrium is reached. The results are obtained using Monte Carlo simulations and analytical approximation methods.
A LC-QTOF Method for the Determination of PEGDE Residues in Dermal Fillers
Authors: Alonci Giuseppe , Boussard Anna , Savona Martina , Cordella Fabiana , Angelici Gaetano , Mocchi Roberto , Sommatis Sabrina , Monticelli Damiano
Published: May 2023

Hyaluronic acid is one of the most important ingredients in dermal fillers, where it is often cross-linked to gain more favorable rheological properties and to improve the implant duration. Poly(ethylene glycol) diglycidyl ether (PEGDE) has been recently introduced as a crosslinker because of its very similar chemical reactivity with the most-used crosslinker BDDE, while giving special rheological properties. Monitoring the amount of the crosslinker residues in the final device is always necessary, but in the case of PEGDE, no methods are available in literature. Here, we present an HPLC-QTOF method, validated according to the guidelines of the International Council on Harmonization, which enables the efficient routine examination of the PEGDE content in HA hydrogels.
Netherton Syndrome Caused by Heterozygous Frameshift Mutation Combined with Homozygous c.1258A>G Polymorphism in SPINK5 Gene
Authors: Moltrasio Chiara , Romagnuolo Maurizio , Riva Davide , Colavito Davide , Ferrucci Silvia , Marzano Angelo , Tadini Gianluca , Brena Michela
Published: May 2023

Netherton syndrome (NS) is a rare autosomal recessive disorder caused by SPINK5 mutations, resulting in a deficiency in its processed protein LEKTI. It is clinically characterized by the triad of congenital ichthyosis, atopic diathesis, and hair shaft abnormalities. The SPINK5 (NM_006846.4): c.1258A>G polymorphism (rs2303067) shows a significant association with atopy and atopic dermatitis (AD), which share several clinical features with NS. We describe an NS patient, initially misdiagnosed with severe AD, who carried the heterozygous frameshift (null) mutation (NM_006846.4): c.957_960dup combined with homozygous rs2303067 in the SPINK5 gene. Histopathological examination confirmed the diagnosis, whereas an immunohistochemical study showed normal epidermal expression of LEKTI, despite the genetic findings. Our results corroborate the hypothesis that haploinsufficiency of SPINK5, in the presence of a SPINK5 null heterozygous mutation in combination with homozygous SPINK5 rs2303067 polymorphism, can be causative of an NS phenotype, impairing the function of LEKTI despite its normal expression. Due to the clinical overlap between NS and AD, we suggest performing SPINK5 genetic testing to search for the SPINK5 (NM_006846.4): c.1258A>G polymorphism (rs2303067) and ensure a correct diagnosis, mainly in doubtful cases.
Towards a Hybrid Design Approach of Anchored Drapery Systems
Authors: Marchelli Maddalena , Pol Antonio , Peila Daniele , Gabrieli Fabio
Published: May 2023

Anchored drapery meshes represent a worldwide adopted protective solution against rockfall. The mechanical performance of a wire mesh is evaluated through laboratory procedures in which the boundary conditions strongly differ from the ones typical of field applications. This shows that the laboratory characterization is, in general, not representative of the field behavior. In this work, referring to a double-twisted wire mesh, a simple approach allowing the extension of the laboratory characteristic values to field conditions is proposed. The approach is based on the definition of analytical relations for evaluating the effects of both the mesh’s system geometry and the loading condition on the force–displacement response. These relations are derived from previously calibrated laboratory tests and are extended to different configurations on the basis of a large number of discrete element simulations. A master curve allowing the prediction of the entire force–displacement response of a general configuration of the drapery system is then defined. The results of this study can provide useful information for designing anchored drapery systems and can be easily associated with standard limit equilibrium calculations to move toward a hybrid design approach that couples forces with mesh deformations.
Understanding the Role of Children’s Footwear on Children’s Feet and Gait Development: A Systematic Scoping Review
Authors: Wang Yuan , Jiang Hanhui , Yu Lin , Gao Zixiang , Liu Wei , Mei Qichang , Gu Yaodong
Published: May 2023

Children’s footwear plays an important role in the healthy growth of foot and gait development during the growing stage. This review aims to synthesize findings of previous investigations and to explore the biomechanical influences of different types of children’s footwear on foot health and gait development, thus guiding the healthy and safe growth of children’s feet and gait. Online databases were searched for potential eligible articles, including Web of Science, Google Scholar, and PubMed. In total, nineteen articles were identified after searching based on the inclusion requirements. The following five aspects of biomechanical parameters were identified in the literature, including spatiotemporal, kinematics, kinetics, electromyography (EMG), and plantar pressure distribution. Children’s footwear can affect their foot health and gait performance. In addition, children’s shoes with different flexibility and sole hardness have different effects on children’s feet and gait development. Compared to barefoot, the stride length, step length, stride time, and step time were increased, but cadence was decreased with wearing shoes. Furthermore, the support base and toe-off time increased. Double support time and stance time increased, but single support time decreased. The hip, knee, and ankle joints showed increased range of motion in children with the rear-foot strike with larger ground reaction force as well. Future studies may need to evaluate the influence of footwear types on gait performance of children in different age groups. Findings in this study may provide recommendations for suitable footwear types for different ages, achieving the aim of growth and development in a healthy and safe manner.
Satisfaction of Online University Education during the COVID-19 Pandemic
Authors: Ortega-Donaire Lucía , Bailén-Expósito Jessica , Álvarez-García Cristina , López-Medina Isabel M. , Álvarez-Nieto Carmen , Sanz-Martos Sebastián
Published: May 2023

The rapid global spread of the coronavirus disease affected the education sector, which had to adapt its teaching methodology to an online scenario to curb the increase in infections. This study aimed to determine the satisfaction level of university students regarding the online education they received during the COVID-19 pandemic. A descriptive cross-sectional study was carried out with nursing degree students. Convenience sampling was used because of the accessibility of the sample, estimating 168 as the minimum sample size needed. The satisfaction level was measured using the “Questionnaire on Satisfaction of University Students with Online Training” (CUSAUF). The sample consisted of 215 participants. The overall level of satisfaction was high. Subject content and teaching methodology were the most highly rated aspects, while aspects related to lecturer-student communication and communication among students were rated the worst. The Cronbach’s α for the satisfaction scale was 0.94, showing high internal consistency and reliability of the sample. Online education could be considered an alternative methodology for teaching learning modules or complementing face-to-face training in future training programs.
Health-Related Quality of Life in Pregnant Women during the First Trimester in Northern Spain: A Descriptive Cross-Sectional Study
Authors: Martín-Vázquez Cristian , García-Fernández Rubén , Calvo-Ayuso Natalia , Martínez-Fernández María Cristina , Liébana-Presa Cristina , Urchaga-Litago José David
Published: May 2023

Background: Achieving the optimal quality of life is currently a health challenge for the world’s population. Pregnancy is a stressful period of life that affects women’s quality of life. Aims: This study aimed to describe and analyse the health-related quality of life in pregnant women during their first trimester in a health area in the north of Spain. Methods: A cross-sectional descriptive study was carried out. A total of 359 women completed the 36-Item Short-Form Health Survey. Results: The sample consisted of 57.9% primiparous women, 30% had experienced a previous abortion, and 7.2% were foreign women. The mean age was 33.53 years. The sum of the physical and mental component values was below 50 points. Notably, 4.17% of women reported a worsening of their health in the last year, and 28.69% had an increased depression risk. Conclusion: Being a foreigner, prenatal abortion, previous caesarean section, previous children, or assisted reproduction techniques are the variables that have a negative association with some dimensions of quality of life in pregnant women.
Trends in the Consumption of Antidepressant Drugs before and during the COVID-19 Pandemic in the Canary Islands, Spain: The Case of the Province of Las Palmas
Authors: Moreno Vanessa , Dévora Sandra , Abdala-Kuri Susana , Oliva Alexis
Published: May 2023

The use of antidepressants (ADs) has increased significantly as a result of COVID-19 and its consequences. However, there are some notable differences in the relative levels of use between geographical areas and population groups. The aim of this work is to assess the impact of COVID-19 on the consumption of ADs in the Canary Islands, focusing on the islands of Gran Canaria, Fuerteventura and Lanzarote, by analyzing the trends in prescriptions of ADs during the pandemic period (2020) compared to the pre-pandemic period (2016–2020). Data were extracted from the community pharmacy wholesaler at a population level. Consumption patterns are expressed as the number of defined daily doses per 1000 inhabitant/day. The overall consumption of DIDs was higher in Gran Canaria, mainly in urban areas and the capital. It was similar in both Lanzarote and Fuerteventura, but particularly localized in the capital, which are considered semi-urban areas. Lanzarote and Fuerteventura present the same pattern of prescription ADs use, whereas Gran Canaria is notably different. This finding was also observed in the more consumed active pharmaceutical ingredients, although small inter-island variations in the ranking and percentages were observed. Sertraline and escitalopram are two of the most prescribed N06AB ADs, whereas the most recent N06AX ADs such as venlafaxine, mirtazapine and desvenlafaxine are more commonly prescribed. These differences in prescription ADs can be explained by demographical characteristics, population size, the fact of living in an urban area and general medical practice. In this context, the COVID-19 pandemic did not have an impact on the overall trend of the use of ADs between 2016 and 2020 in the islands under study.
Deteriorated Characters Restoration for Early Japanese Books Using Enhanced CycleGAN
Authors: Kaneko Hayata , Ishibashi Ryuto , Meng Lin
Published: May 2023

Early Japanese books, classical humanities resources in Japan, have great historical and cultural value. However, Kuzushi-ji, the old character in early Japanese books, is scratched, faded ink, and lost due to weathering and deterioration over the years. The restoration of deteriorated early Japanese books has tremendous significance in cultural revitalization. In this paper, we introduce augmented identity loss and propose enhanced CycleGAN for deteriorated character restoration, which combines domain discriminators and augmented identity loss. This enhanced CycleGAN makes it possible to restore multiple levels of deterioration in the early Japanese books. It obtains the high readability of the actual deteriorated characters, which is proved by higher structural similarity(SSIM) and accuracy of deep learning models than standard CycleGAN and traditional image processing. In particular, SSIM increases by 8.72%, and the accuracy of ResNet50 for damaged characters improves by 1.1% compared with the competitive CycleGAN. Moreover, we realize the automatic restoration of pages of early Japanese books written about 300 years ago.
Isolation of FLOWERING LOCUS C and Preliminary Characterization in the Floral Transition of Xinjiang Precocious Walnut
Authors: Jin Qiang , Zhang Rui , Chen Liping , Luo Zhengrong
Published: May 2023

Walnut (Juglans regia L.) plants typically flower after eight to ten years of juvenile growth. Precocious germplasm, also known as early-flowering or early-mature genotypes, have shortened juvenile phases of one to two years and are therefore crucial for enhancing breeding efficiency. However, such precocious germplasms are very limited. Here, we isolated and characterized the key flowering-time gene FLOWERING LOCUS C (FLC) in the precocious walnuts of the Xinjiang Uygur Autonomous Region. Sequence alignment showed that Juglans regia FLC (JrFLC)contained a conserved MINICHROMOSOME MAINTENANCE 1 (MCM1), AGAMOUS (AG), DEFICIENS (DEF), and SERUM RESPONSE FACTOR (SRF) (MADS)-box domain. Analysis of an FLC–green fluorescent protein (GFP) fusion protein revealed that JrFLC was localized to the nucleus. Gene expression analysis showed that JrFLC was specifically expressed during the bud dormancy stage of precocious walnut, and that expression levels gradually decreased as the ambient temperature warmed. Exogenous JrFLC overexpression in Arabidopsis thaliana delayed flowering and increased the total leaf number, suggesting a similar function of JrFLC as a floral repressor in walnut and in other plants. Together, these results showed that JrFLC played an important role in regulating the floral transition of Xinjiang precocious walnut. Further studies, including a detailed characterization of JrFLC, are expected to validate JrFLC as a strong target for genetic improvement in flowering time in walnut.
Extending the Design Life of the Palm Jumeirah Revetment Considering Climate Change Effects
Authors: Elkersh Khaled , Atabay Serter , Yilmaz Abdullah Gokhan , Morad Yomna , Nouar Nour
Published: May 2023

This paper presents potential upgrades to the Palm Jumeirah Island’s outer revetment to extend its design life for 50 years, considering the sea level rise (SLR) associated with climate change. The paper proposes several upgrade options to ensure that the hydraulic stability and wave overtopping discharges of the Palm Jumeirah revetment comply with the recommended design criteria based on industry guidelines. The performance of the existing revetment, in terms of the hydraulic stability and wave overtopping discharge criteria, is assessed using design wave heights (1- and 100-year events) extracted from an extreme wave analysis study on the Dubai coast. The results show that, based on the new design conditions, the existing structure should be upgraded to meet the armor stability criteria and recommended overtopping discharge values. Three different upgrade solutions are designed and analyzed to satisfy the required hydraulic stability and overtopping conditions. The suggested upgrade options are an extra armor layer, a flat berm, and a submerged breakwater offshore. The proposed upgrade solutions are preliminary designs that would require verification in terms of their geotechnical stability and physical model testing to evaluate their performance.
Efficacy of a Short-Term Lifestyle Change Intervention in Healthy Young Men: The FASt Randomized Controlled Trial
Authors: Donato Francesco , Ceretti Elisabetta , Viola Gaia Claudia Viviana , Marullo Monica , Zani Danilo , Ubaldi Stefania , Sieri Sabina , Lorenzetti Stefano , Montano Luigi
Published: May 2023

The aim of this study was to investigate the impact of dietary habits and physical activity intervention on lifestyle behavior as a prevention tool supported also by personalized motivational counseling. A two-arm randomized controlled trial was carried out. A sample of 18–22-year-old students was randomly assigned to a four-month intervention based on the Mediterranean diet and moderate physical activity program (N = 66) or to a control group (N = 63). The outcomes were adherence to the Mediterranean diet, physical activity level, and nutrients intake, assessed at enrollment (t0), end of intervention (t4, 4 months after the start), and end of follow-up (t8, 8 months after the start). Adherence to the Mediterranean diet increased from t0 to t4 and t8, more in the intervention (6.83, 9.85, and 9.12, respectively) than in the control group (6.73, 7.00, 7.69, respectively) (p < 0.001). Physical activity showed a moderate increase from t0 to t4 and t8 in both groups, without significant differences between them. Significant differences were seen between the two groups in food intake changes, from t0 to t4 and t8. This randomized controlled trial showed that a moderate short-term intervention based on the Mediterranean diet and regular physical activity determined a positive change in the lifestyle of healthy, normal-weight, young men.
Effects of a Primary Care-Based Intervention on the Identification and Management of Patients with Coronary Heart Disease and Mental or Cognitive Comorbidity—A Study Protocol
Authors: Sannemann Lena , Bach Lisa , Hower Kira Isabel , Ihle Peter , Keller Kai , Leikert Charlotte , Leminski Christin , Meixner Adriana , Meyer Ingo , Nordmeyer Laura , Peltzer Samia , Peter Sophie , Werner Belinda , Kuntz Ludwig , Pfaff Holger , Schulz-Nieswandt Frank , Albus Christian , Jessen Frank ,   on behalf of the CoRe-Net Study Group
Published: May 2023

Mental and cognitive disorders (MCD) negatively affect the incidence and prognosis of coronary heart disease (CHD). Medical guidelines recommend the appropriate management of comorbid MCD in patients with CHD, yet there is evidence that the implementation in primary care is not always adequate. We present the protocol for a pilot study that aims to develop a minimally invasive intervention and evaluate its feasibility in the primary care setting to improve the identification and management of comorbid MCD in patients with CHD. The study consists of two consecutive parts and will be carried out in Cologne, Germany. Part 1 comprises the development and tailoring of the intervention, which is guided by qualitative interviews with primary care physicians (PCPs, n = 10), patients with CHD and MCD and patient representatives (n = 10). Part II focuses on the implementation and evaluation of the intervention in n = 10 PCP offices. Changes in PCP behaviour will be analysed by comparing routine data in the practice management system six months before and six months after study participation. In addition, we will explore the influence of organisational characteristics and perform a socio-economic impact assessment. The outcomes of this mixed-method study will inform the feasibility of a PCP-based intervention to improve quality of care in patients with CHD and comorbid MCD.
“Follow the Musical Road”: Selecting Appropriate Music Experiences for People with Dementia Living in the Community
Authors: Kelly Lisa , Clements-Cortés Amy , Ahessy Bill , Richardson Ita , Moss Hilary
Published: May 2023

There are many music experiences for people with dementia and their caregivers including but not limited to individualized playlists, music and singing groups, dementia-inclusive choirs and concerts, and music therapy. While the benefits of these music experiences have been well documented, an understanding of the differences between them is often absent. However, knowledge of and distinction between these experiences are crucial to people with dementia and their family members, caregivers, and health practitioners to ensure a comprehensive music approach to dementia care is provided. Considering the array of music experiences available, choosing the most appropriate music experience can be challenging. This is an exploratory phenomenological study with significant Public and Patient Involvement (PPI). Through consultation with PPI contributors with dementia via an online focus group and senior music therapists working in dementia care via online semi-structured interviews, this paper aims to identify these distinctions and to address this challenge by providing a visual step-by-step guide. This guide can be consulted when choosing an appropriate music experience for a person with dementia living in the community.
Hemodynamic and Electrophysiological Biomarkers of Interpersonal Tuning during Interoceptive Synchronization
Authors: Balconi Michela , Angioletti Laura
Published: May 2023

This research explored the influence of interoception and social frame on the coherence of inter-brain electrophysiological (EEG) and hemodynamic (collected by functional Near Infrared Spectroscopy, fNIRS) functional connectivity during a motor synchronization task. Fourteen dyads executed a motor synchronization task with the presence and absence of interoceptive focus. Moreover, the motor task was socially or not-socially framed by enhancing the shared intentionality. During the experiment, delta, theta, alpha, and beta frequency bands, and oxygenated and de-oxygenated hemoglobin (O2Hb and HHb) were collected through an EEG-fNIRS hyperscanning paradigm. Inter-brain coherence indices were computed for the two neurophysiological signals and then they were correlated to explore the reciprocal coherence of the functional connectivity EEG-fNIRS in the dyads. Findings showed significant higher correlational values between delta and O2Hb, theta and O2Hb, and alpha and O2Hb for the left hemisphere in the focus compared to the no focus condition and to the right hemisphere (both during focus and no focus condition). Additionally, greater correlational values between delta and O2Hb, and theta and O2Hb were observed in the left hemisphere for the focus condition when the task was socially compared to non-socially framed. This study showed that the focus on the breath and shared intentionality activate coherently the same left frontal areas in dyads performing a joint motor task.
Allelochemical Interactions in the Trophic System «Henosepilachna vigintioctomaculata Motschulsky—Solanum tuberosum Linneus»
Authors: Matsishina Nathalia Valerievna , Ermak Marina Vladimirovna , Kim Irina Vyacheslavovna , Fisenko Petr Viktorovich , Sobko Olga Abdulalievna , Klykov Alexey Grigorievich , Emel’yanov Alexey Nikolaevich
Published: May 2023

Henosepilachna vigintioctomaculata is an intrinsic element in the agroecosystem of potato fields. The issues of relationships in the system “potato ladybird beetle—potato plant” have not yet been studied. To study the effect of potato varieties on the potato ladybird beetle, only hatched and active larvae with a hatching rate close to 100% were selected from a laboratory colony. Larvae of the first summer generation collected in potato fields were used in our study to determine the level of adrenaline in the bodies of insects, fresh potato leaves were used to study the content of glycoalkaloids, the content and activity of proteinase inhibitors. The larvae that fed on plants of varieties Belmonda, Queen Anne, Lilly, Dachny, Kazachok, Yubilyar, and Avgustin demonstrated the highest level of stress while the stress level in those that fed on variety Smak was the lowest. The damage inflicted by potato ladybird beetles on leaves of some studied potato varieties led to a progressive increase in the content of glycoalkaloids already within 24 h after the phytophages had been transferred. In most cases, the content of glycoalkoloids increased by 20% within five days. Potato ladybird beetles feeding on plants of different potato varieties caused a progressive increase in proteinase inhibitors (% of the control). Plants of variety Smak did not show a significant increase in the content of alkaloids in the herbage in response to the damage. A correlation was established between the mortality rate, the activity of proteinase inhibitors, the dynamics of glycoalkaloids, and the level of adrenaline, which could be formulated as follows: the higher the content of glycoalkaloids and the activity of proteinase inhibitors in the tissues of potato plants, the higher the level of stress in the potato ladybird beetles that feed on them.
Four Most Pathogenic Superfamilies of Insect Pests of Suborder Sternorrhyncha: Invisible Superplunderers of Plant Vitality
Authors: Oberemok Volodymyr V. , Gal’chinsky Nikita V. , Useinov Refat Z. , Novikov Ilya A. , Puzanova Yelizaveta V. , Filatov Roman I. , Kouakou Nanan J. , Kouame Kra F. , Kra Kouadio D. , Laikova Kateryna V.
Published: May 2023

Sternorrhyncha representatives are serious pests of agriculture and forestry all over the world, primarily causing damage to woody plants. Sternorrhyncha members are vectors for the transfer of a large number of viral diseases, and subsequently, the host plant weakens. Additionally, many are inherent in the release of honeydew, on which fungal diseases develop. Today, an innovative approach is needed to create new and effective ways to control the number of these insects based on environmentally friendly insecticides. Of particular relevance to such developments is the need to take into account the large number of organisms living together with insect pests in this group, including beneficial insects. Practically without changing their location on their host plant, they adopted to be more invisible and protected due to their small size, symbiosis with ants, the ability to camouflage with a leaf, and moderately deplete plants and others, rarely leading them to death but still causing substantial economic loss in the subtropics and tropics. Due to the lack of presence in the literature, this review fills in this pesky spot by examining (on the example of distinct species from four superfamilies) the characteristic adaptations for this suborder and the chemical methods of combating these insects that allow them to survive in various environmental conditions, suggesting new and highly promising ways of using olinscides for plant protection against Sternorrhyncha members.
Management of the Sickle Cell Trait: An Opinion by Expert Panel Members
Authors: Pinto Valeria Maria , De Franceschi Lucia , Gianesin Barbara , Gigante Antonia , Graziadei Giovanna , Lombardini Letizia , Palazzi Giovanni , Quota Alessandra , Russo Rodolfo , Sainati Laura , Venturelli Donatella , Forni Gian Luca , Origa Raffaella
Published: May 2023

The number of individuals with the sickle cell trait exceeds 300 million worldwide, making sickle cell disease one of the most common monogenetic diseases globally. Because of the high frequency of sickle cell disease, reproductive counseling is of crucial importance. In addition, unlike other carrier states, Sickle Cell Trait (SCT) seems to be a risk factor for several clinical complications, such as extreme exertional injury, chronic kidney disease, and complications during pregnancy and surgery. This expert panel believes that increasing knowledge about these clinical manifestations and their prevention and management can be a useful tool for all healthcare providers involved in this issue.
Diclofenac Sodium for Fever Control in Neurocritical Care: A Systematic Review
Authors: Rochat Negro Tommaso , Watchi Michael , Wozniak Hannah , Pugin Jerome , Quintard Herve
Published: May 2023

Background: Fever is extremely common in neurocritical care patients and is independently associated with a worse outcome. Non-steroidal anti-inflammatory drugs (NSAIDs) lower the hypothalamic set point temperature through the inhibition of prostaglandin E2 synthesis, and they constitute a second line of pharmacological treatment for temperature control. This systematic review aims to evaluate the effectiveness of DCF in reducing body temperature and its effects on brain parameters. Methods: A comprehensive search of several databases was run in November 2022 in Ovid EBM (Evidence Based Medicine) Reviews, Cochrane library, Ovid Medline and Scopus (1980 onward). The outcome of interest included DCF control of body temperature and its impact on cerebral parameters. Results: A total of 113 titles were identified as potentially relevant. Six articles met eligible criteria and were reviewed. DCF induce a reduction in body temperature (MD, 1.10 [0.72, 1.49], p < 0.00001), a slight decrease in ICP (MD, 2.22 [−0.25, 4.68] IC 95%; p < 0.08) as well as in CPP and MAP (MD, 5.58 [0.43, 10.74] IC 95%; p < 0.03). The significant heterogeneity and possibility of publication bias reduces the strength of the available evidence. Conclusions: Diclofenac sodium is effective in reducing body temperature in patients with brain injury, but data in the literature are scarce and further studies are needed to evaluate the benefits of DCF.
Radiologically Defined Sarcopenia as a Biomarker for Frailty and Malnutrition in Head and Neck Skin Cancer Patients
Authors: Zwart Aniek T. , Kok Laurence M. C. , de Vries Julius , van Kester Marloes S. , Dierckx Rudi A. J. O. , de Bock Geertruida H. , van der Hoorn Anouk , Halmos Gyorgy B.
Published: May 2023

The aim of this study was to evaluate whether radiologically defined sarcopenia, or a low skeletal muscle index (SMI), could be used as a practical biomarker for frailty and postoperative complications (POC) in patients with head and neck skin cancer (HNSC). This was a retrospective study on prospectively collected data. The L3 SMI (cm2/m2) was calculated with use of baseline CT or MRI neck scans and low SMIs were defined using sex-specific cut-off values. A geriatric assessment with a broad range of validated tools was performed at baseline. POC was graded with the Clavien–Dindo Classification (with a grade of > II as the cut-off). Univariate and multivariable regression analyses were performed with low SMIs and POC as the endpoints. The patients’ (n = 57) mean age was 77.0 ± 9 years, 68.4% were male, and 50.9% had stage III–IV cancer. Frailty was determined according to Geriatric 8 (G8) score (OR 7.68, 95% CI 1.19–49.66, p = 0.032) and the risk of malnutrition was determined according to the Malnutrition Universal Screening Tool (OR 9.55, 95% CI 1.19–76.94, p = 0.034), and these were independently related to low SMIs. Frailty based on G8 score (OR 5.42, 95% CI 1.25–23.49, p = 0.024) was the only variable related to POC. However, POC was more prevalent in patients with low SMIs (∆ 19%, OR 1.8, 95% CI 0.5–6.0, p = 0.356).To conclude, a low SMI is a practical biomarker for frailty and malnutrition in HNSC. Future research should be focused on interventions based on low SMI scores and assess the effect of the intervention on SMI, frailty, malnutrition, and POC.
Deep Learning Methods for Interpretation of Pulmonary CT and X-ray Images in Patients with COVID-19-Related Lung Involvement: A Systematic Review
Authors: Lee Min-Ho , Shomanov Adai , Kudaibergenova Madina , Viderman Dmitriy
Published: May 2023

SARS-CoV-2 is a novel virus that has been affecting the global population by spreading rapidly and causing severe complications, which require prompt and elaborate emergency treatment. Automatic tools to diagnose COVID-19 could potentially be an important and useful aid. Radiologists and clinicians could potentially rely on interpretable AI technologies to address the diagnosis and monitoring of COVID-19 patients. This paper aims to provide a comprehensive analysis of the state-of-the-art deep learning techniques for COVID-19 classification. The previous studies are methodically evaluated, and a summary of the proposed convolutional neural network (CNN)-based classification approaches is presented. The reviewed papers have presented a variety of CNN models and architectures that were developed to provide an accurate and quick automatic tool to diagnose the COVID-19 virus based on presented CT scan or X-ray images. In this systematic review, we focused on the critical components of the deep learning approach, such as network architecture, model complexity, parameter optimization, explainability, and dataset/code availability. The literature search yielded a large number of studies over the past period of the virus spread, and we summarized their past efforts. State-of-the-art CNN architectures, with their strengths and weaknesses, are discussed with respect to diverse technical and clinical evaluation metrics to safely implement current AI studies in medical practice.
Prognostic Role of Serum Albumin in Predicting 30-Day Mortality in Patients with Infections in Emergency Department: A Prospective Study
Authors: Turcato Gianni , Zaboli Arian , Sibilio Serena , Fanni Canelles Massimiliano Fanni , Rella Eleonora , Giudiceandrea Alberto , Pfeifer Norbert , Brigo Francesco
Published: May 2023

Background: Infections in emergency departments (EDs) are insidious clinical conditions characterised by high rates of hospitalisation and mortality in the short-to-medium term. The serum albumin, recently demonstrated as a prognostic biomarker in septic patients in intensive care units, could be an early marker of severity upon arrival of infected patients in the ED. Aim: To confirm the possible prognostic role of the albumin concentration recorded upon arrival of patients with infection. Methods: A prospective single-centre study was performed in the ED of the General Hospital of Merano, Italy, between 1 January 2021 and 31 December 2021. All enrolled patients with infection were tested for serum albumin concentration. The primary outcome measure was 30-day mortality. The predictive role of albumin was assessed by logistic regression and decision tree analysis adjusted for Charlson comorbidity index, national early warning score, and sequential organ failure assessment (SOFA) score. Results: 962 patients with confirmed infection were enrolled. The median SOFA score was 1 (0–3) and the mean serum albumin level was 3.7 g/dL (SD 0.6). Moreover, 8.9% (86/962) of patients died within 30 days. Albumin was an independent risk factor for 30-day mortality with an adjusted hazard ratio of 3.767 (95% CI 2.192–6.437), p < 0.001. Decision tree analysis indicated that at low SOFA scores, albumin had a good predictive ability, indicating a progressive mortality risk reduction in concentrations above 2.75 g/dL (5.2%) and 3.52 g/dL (2%). Conclusions: Serum albumin levels at ED admission are predictive of 30-day mortality in infected patients, showing better predictive abilities in patients with low-to-medium SOFA scores.
Measuring Fatigue and Fatigability in Spinal Muscular Atrophy (SMA): Challenges and Opportunities
Authors: Rodriguez-Torres Rafael S. , Uher David , Gay Emma L. , Coratti Giorgia , Dunaway Young Sally , Rohwer Annemarie , Muni Lofra Robert , De Vivo Darryl C. , Hirano Michio , Glynn Nancy W. , Montes Jacqueline
Published: May 2023

Fatigue, a common symptom, together with the characteristic of performance fatigability, are well-documented features of SMA that impact quality of life and function. Importantly, establishing associations between multidimensional self-reported fatigue scales and patient performance has proven difficult. This review was conducted to evaluate the various patient-reported fatigue scales applied in SMA, with the objective of considering the limitations and advantages of each measure. Variable use of fatigue-related nomenclature, including conflicting terminology interpretation, has affected assessment of physical fatigue attributes, specifically perceived fatigability. This review encourages the development of original patient-reported scales to enable perceived fatigability assessment, providing a potential complementary method of evaluating treatment response.
Circulating Extracellular Vesicle Levels in Patients with Coronavirus Disease 2019 Coagulopathy: A Prospective Cohort Study
Authors: Iwasaki Yudai , Takei Yusuke , Yamada Mitsuhiro , Sugino Shigekazu , Saito Koji , Aoyagi Tetsuji , Oshima Kengo , Kanamori Hajime , Baba Hiroaki , Takei Kentarou , Tokuda Koichi , Kodama Eichi N. , Kamo Tetsuro , Kamio Tadashi , Kasai Takehiko , Ogawa Satoru , Yamauchi Masanori
Published: May 2023

Coronavirus disease 2019 (COVID-19) is associated with coagulopathy. However, the underlying mechanisms are not completely understood. We evaluated the association between COVID-19 coagulopathy and extracellular vesicle (EV) levels. We hypothesized that several EV levels would be higher in COVID-19 coagulopathy patients than in non-coagulopathy patients. This prospective observational study was conducted in four tertiary care faculties in Japan. We enrolled 99 COVID-19 patients (48 with coagulopathy and 51 without coagulopathy) aged ≥20 years who required hospitalization, and 10 healthy volunteers; we divided the patients into coagulopathy and non-coagulopathy groups according to the D-dimer levels (≥1 μg/mL and <1 μg/mL, respectively). We used flow cytometry to measure the tissue-factor-bearing, endothelium-derived, platelet-derived, monocyte-derived, and neutrophil-derived EV levels in platelet-free plasma. The EV levels were compared between the two COVID-19 groups as well as among the coagulopathy patients, non-coagulopathy patients, and healthy volunteers. No significant difference was found in EV levels between the two groups. Meanwhile, the cluster of differentiation (CD) 41 + EV levels were significantly higher in COVID-19 coagulopathy patients than in healthy volunteers (549.90 [255.05–984.65] vs. 184.3 [150.1–254.1] counts/µL, p = 0.011). Therefore, CD41+ EVs might play an essential role in COVID-19 coagulopathy development.
Observations on the Present and the Future of Hip Surgery
Authors: Di Martino Alberto
Published: May 2023

Each period in history has its own peculiar fashions and trends, and contemporary research on hip surgery is no exception [...]
Retrospective In-Hospital Mortality Analysis of GeriatricPatients Treated in a Level 1 Trauma Center
Authors: Höller Sebastian , Wübbeke Lina , Apel Jamina , Hawellek Thelonius , Sehmisch Stephan , Wiedenhöft John , Lehmann Wolfgang , Hoffmann Daniel
Published: May 2023

The aim of this study is to determine the critical time intervals and influencing covariates for in-hospital mortality in geriatric trauma and orthopedic patients. During a period of five years, we retrospectively review patients aged > 60 years who were hospitalized at the Department of Trauma, Orthopedic, and Plastic Surgery. The primary outcome is the mean time to death. Survival analysis is performed using an accelerated failure time model. A total of 5388 patients are included in the analysis. Two-thirds underwent surgery (n = 3497, 65%) and one-third were conservatively treated (n = 1891, 35%). The in-hospital mortality rate is 3.1% (n = 168; surgery, n = 112; conservative, n = 56). The mean time to death is 23.3 days (±18.8) after admission in the surgery group and 11.3 days (±12.5) in the conservative treatment group. The greatest accelerating effect on mortality is found in the intensive care unit (16.52, p < 0.001). We are able to identify a critical time interval for in-hospital mortality between days 11 and 23. The day of death on weekend days/holidays, hospitalization for conservative treatment, and treatment at the intensive care unit significantly increase the risk of in-hospital mortality. Early mobilization and a short hospitalization duration seem to be of major importance in fragile patients.
An Overview of Enhancing the Performance of Medical Implants with Nanocomposites
Authors: Ramezani Maziar , Ripin Zaidi Mohd
Published: May 2023

Medical implants are essential tools for treating chronic illnesses, restoring physical function, and improving the quality of life for millions of patients worldwide. However, implant failures due to infection, mechanical wear, corrosion, and tissue rejection continue to be a major challenge. Nanocomposites, composed of nanoparticles or nanofillers dispersed in a matrix material, have shown promising results in enhancing implant performance. This paper provides an overview of the current state of research on the use of nanocomposites for medical implants. We discuss the types of nanocomposites being developed, including polymer-, metal-, and ceramic-based materials, and their advantages/disadvantages for medical implant applications. Strategies for improving implant performance using nanocomposites, such as improving biocompatibility and mechanical properties and reducing wear and corrosion, are also examined. Challenges to the widespread use of nanocomposites in medical implants are discussed, such as biocompatibility, toxicity, long-term stability, standardisation, and quality control. Finally, we discuss future directions for research, including the use of advanced fabrication techniques and the development of novel nanocomposite materials. The use of nanocomposites in medical implants has the potential to improve patient outcomes and advance healthcare, but continued research and development will be required to overcome the challenges associated with their use.
The Role of Natural Compounds in Optimizing Contemporary Dental Treatment—Current Status and Future Trends
Authors: Budala Dana Gabriela , Martu Maria-Alexandra , Maftei George-Alexandru , Diaconu-Popa Diana Antonela , Danila Vlad , Luchian Ionut
Published: May 2023

For a long period of time, natural remedies were the only ailment available for a multitude of diseases, and they have proven effective even after the emergence of modern medicine. Due to their extremely high prevalence, oral and dental disorders and anomalies are recognized as major public health concerns. Herbal medicine is the practice of using plants with therapeutic characteristics for the purpose of disease prevention and treatment. Herbal agents have made a significant entry into oral care products in recent years, complementing traditional treatment procedures due to their intriguing physicochemical and therapeutic properties. There has been a resurgence of interest in natural products because of recent updates, technological advancements, and unmet expectations from current strategies. Approximately eighty percent of the world’s population uses natural remedies, especially in poorer nations. When conventional treatments have failed, it may make sense to use natural drugs for the treatment of pathologic oral dental disorders, as they are readily available, inexpensive, and have few negative effects. The purpose of this article is to provide a comprehensive analysis of the benefits and applications of natural biomaterials in dentistry, to gather relevant information from the medical literature with an eye toward its practical applicability, and make suggestions for the directions for future study.
Assessing the Design of Interactive Radial Data Visualizations for Mobile Devices
Authors: Svalina Ana , Pibernik Jesenka , Dolić Jurica , Mandić Lidija
Published: May 2023

The growing use of mobile devices in daily life has led to an increased demand for the display of large amounts of data. In response, radial visualizations have emerged as a popular type of visualization in mobile applications due to their visual appeal. However, previous research has highlighted issues with these visualizations, namely misinterpretation due to their column length and angles. This study aims to provide guidelines for designing interactive visualizations on mobile devices and new evaluation methods based on the results of an empirical study. The perception of four types of circular visualizations on mobile devices was assessed through user interaction. All four types of circular visualizations were found to be suitable for use within mobile activity tracking applications, with no statistically significant difference in responses by type of visualization or interaction. However, distinguishing characteristics of each visualization type were revealed depending on the category that is in focus (memorability, readability, understanding, enjoyment, and engagement). The research outcomes provide guidelines for designing interactive radial visualizations on mobile devices, enhance the user experience, and introduce new evaluation methods. The study’s results have significant implications for the design of visualizations on mobile devices, particularly in activity tracking applications.
Working Memory Constrains Long-Term Memory in Children and Adults: Memory of Objects and Bindings
Authors: Forsberg Alicia , Guitard Dominic , Adams Eryn J. , Pattanakul Duangporn , Cowan Nelson
Published: May 2023

We explored how individual and age-related differences in working memory (WM) capacity affected subsequent long-term memory (LTM) retrieval. Unlike past studies, we tested WM and LTM not only for items, but also for item–color bindings. Our sample included 82 elementary school children and 42 young adults. The participants performed a WM task with images of unique everyday items presented sequentially at varying set sizes in different colors. Later, we tested LTM for items and item–color bindings from the WM task. The WM load during encoding constrained LTM, and participants with a higher WM capacity retrieved more items in the LTM test. Even when accounting for young children’s poor item memory by considering only the items that they did remember, they exhibited an exacerbated difficulty with remembering item–color bindings in WM. Their LTM binding performance, however, as a proportion of remembered objects, was comparable to that of older children and adults. The WM binding performance was better during sub-span encoding loads, but with no clear transfer of this benefit to LTM. Overall, LTM item memory performance was constrained by individual and age-related WM limitations, but with mixed consequences for binding. We discuss the theoretical, practical, and developmental implications of this WM-to-LTM bottleneck.