bluuebunny/crossref_metadata_2025 huggingface dataset:
Left Atrium Reverse Remodeling in Fusion CRT Pacing: Implications in Cardiac Resynchronization Response and Atrial Fibrillation Incidence
Authors: Văcărescu Cristina , Cozma Dragoș , Crișan Simina , Gaiță Dan , Anutoni Debora-Delia , Margan Mădălin-Marius , Faur-Grigori Adelina-Andreea , Roteliuc Romina , Luca Silvia-Ana , Lazăr Mihai-Andrei , Pătru Oana , Cirin Liviu , Baneu Petru , Luca Constantin-Tudor
Published: August 2024

Background: When compared to biventricular pacing, fusion CRT pacing was linked to a decreased incidence of atrial fibrillation (AF). There is a gap in the knowledge regarding exclusive fusion CRT without interference with RV pacing, and all the current data are based on populations of patients with intermittent fusion pacing. Purpose: To assess left atrium remodeling and AF incidence in a real-life population of permanent fusion CRT-P. Methods: Retrospective data were analyzed from a cohort of patients with exclusive fusion CRT-P. Device interrogation, exercise testing, transthoracic echocardiography (TE), and customized medication optimization were all part of the six-monthly individual follow-up. Results: Study population: 73 patients (38 males) with non-ischemic dilated cardiomyopathy aged 63.7 ± 9.3 y.o. Baseline characteristic: QRS 159.8 ± 18.2 ms; EF 27.9 ± 5.1%; mitral regurgitation was severe in 38% of patients, moderate in 47% of patients, and mild in 15% of patients; 43% had type III diastolic dysfunction (DD), 49% had type II DD, 8% had type I DD. Average follow-up was 6.4 years ± 27 months: 93% of patients were responders (including 31% super-responders); EF increased to 40.4 ± 8.5%; mitral regurgitation decreased in 69% of patients; diastolic profile improved in 64% of patients. Paroxysmal and persistent AF incidence was 11%, with only 2% of patients developing permanent AF. Regarding LA volume, statistically significant LA reverse remodeling was observed. Conclusions: Exclusive fusion CRT-P was associated with important LA reverse remodeling and a low incidence of AF.
Mutational Landscapes of Normal Skin and Their Potential Implications in the Development of Skin Cancer: A Comprehensive Narrative Review
Authors: Riew Tae-Ryong , Kim Yoon-Seob
Published: August 2024

Recent evidence suggests that physiologically normal skin harbors pervasive mutant clones with cancer drivers. Normal skin has the highest burden of somatic mutations due to persistent ultraviolet exposure throughout life. The mutation burden exponentially increases with age and is further modified by skin site, sun-damage history, and skin phototype. Driver gene profiles in normal skin are similar to those in cutaneous squamous cell carcinoma where NOTCH family, FAT family, and TP53 are consistently reported, while other reported profiles include PPM1D, KMT2D, ASXL1, and RBM10. Normal skin seldom harbors canonical hotspot mutations with therapeutic relevance. The pathologic role of mutant clones with cancer drivers in normal skin is classically considered precursors for skin cancer; however, recent evidence also suggests their putative cancer-protective role. Copy number alterations and other structural variants are rare in normal skin with loss in 9q region encompassing NOTCH1 being the most common. Study methodologies should be carefully designed to obtain an adequate number of cells for sequencing, and a comparable number of cells and read depth across samples. In conclusion, this review provides mutational landscapes of normal skin and discusses their potential implications in the development of skin cancer, highlighting the role of driver genes in early malignant progression.
The Impact of Laparoscopic Surgery on Fertility Outcomes in Patients with Minimal/Mild Endometriosis
Authors: Grigoriadis Georgios , Roman Horace , Gkrozou Fani , Daniilidis Angelos
Published: August 2024

Minimal/mild endometriosis (MME) is independently associated with reduced fecundity rates. In this review article, we discuss the role of laparoscopic surgery in enhancing the fertility outcomes of patients with MME. Laparoscopic management of MME enhances fecundity and increases the chances of spontaneous conception in appropriately selected cases. However, laparoscopy cannot be routinely recommended in asymptomatic patients with the sole purpose of diagnosing and treating potentially present MME. Equally, and based on existing information, the laparoscopic management of MME cannot be routinely recommended prior to in vitro fertilisation (IVF) attempts due to the lack of robust and beneficial evidence. Because an overlap between unexplained infertility and MME cases likely exists, the development of reliable, widely available, non-invasive tests for the diagnosis of MME may revolutionise the management of cases currently classified as unexplained infertility. In a disease as diverse as endometriosis, management decisions should be based on a multitude of factors. Future studies should focus on reporting the outcomes of interventions for MME on fertility and obstetric outcomes, clearly differentiating between disease stages and phenotypes.
Sleep Quality and Bariatric Surgery—Can We Treat Sleep Disturbances and Insomnia in Patients with Obesity with Laparoscopic Sleeve Gastrectomy?
Authors: Wyszomirski Krzysztof , Ślubowska Antonina , Dębski Jan , Skibiak Klaudia , Przybyłowski Józef , Czerwińska Maria , Walędziak Maciej , Różańska-Walędziak Anna
Published: August 2024

Introduction: Bariatric surgery is the mainstay of treatment of obesity, with a proven, long-lasting effect on body weight reduction and remission of co-morbidities. Sleep disorders, including insomnia, and deteriorated sleep quality and duration are associated with obesity, and a reduction in body weight can be associated with a reduction in prevalence of sleep disorders. The purpose of this study was to assess the influence of laparoscopic sleeve gastrectomy (LSG) on the prevalence and intensity of different sleep disturbances. Methods: This observational prospective study included 80 patients qualified for bariatric surgery who filled in a questionnaire with a set of structured questions about different sleep disturbances, such as difficulties in falling asleep, night awakenings, early morning awakenings, snoring, and nightmares, as well as eating at night and daytime dysfunction, supplemented with Athens Insomnia Scale (AIS), before and 6 months after bariatric surgery. Results: There was a statistically significant reduction in incidence of night awakenings, with 40.00% of participants reporting night awakenings before surgery and, respectively, 25.00% after surgery. A significant reduction was also observed in the rate of patients who reported snoring, with 60.00% before the surgery and 38.75% after the surgery (p < 0.05). There was a correlation present between estimated weight loss % (EWL%) and reduction in snoring (p < 0.05). The mean total AIS score before surgery was 7.21 and 5.99 after surgery, and the change was statistically significant (p < 0.05). A total AIS score of 8 or more, the cutoff score for insomnia diagnosis according to the Polish validation of the Athens Insomnia Scale, was present in 44.16% of cases before surgery and in 38.00% after surgery (p = 0.52). There was a significant difference in the incidence of awakening during the night score before and after surgery (p < 0.05; CI 0.022–0.341), sleep quality (p < 0.05; CI 0.0105–0.4311), well-being during the day (p < 0.05; CI 0.0273–0.4143), and sleepiness during the day (p < 0.05; CI 0.101–0.444). Conclusions: LSG is observed to have a positive effect on selected sleep disturbances and insomnia remission in patients with obesity, measured by a significant reduction in Athens Insomnia Scale scores in follow-up 6 months after surgery. Additionally, patients after bariatric surgery reported less night awakenings and there was a lower rate of snoring. Therefore, LSG can be considered an effective therapeutic tool for insomnia in patients with obesity.
Surgical Treatment Strategies for Severe and Neglected Spinal Deformities in Children and Adolescents without the Use of Radical Three-Column Osteotomies
Authors: Grabala Pawel , Gregorczyk Jerzy , Fani Negin , Galgano Michael A. , Grabala Michał
Published: August 2024

Background: Severe spinal deformity manifests as a pronounced deviation from the normal curvature of the spine in the frontal, sagittal, and horizontal planes, where the coronal plane curvature exceeds 90 degrees and may coincide with hyperkyphotic deformity. The most severe deformities exhibit rigidity, with flexibility below 30%. If left untreated or improperly treated, these deformities can result in serious complications associated with progression of the curvature. A combination of surgical techniques is frequently employed to attain optimal outcomes and minimize the risk of complications. The overall medical condition of the patient, their capacity to endure extensive procedures, the expertise of the surgeon, and the resources available all play significant roles in determining the course of management. A systematic and thorough review of the relevant literature was conducted utilizing a variety of electronic databases. The primary objective of this study was to scrutinize the surgical techniques commonly employed in complex spine surgeries for the management of severe scoliosis without resection vertebral body techniques, with higher potential risk of major complications, including permanent neurological deficit. Conclusions: Halo-gravity traction, halo femoral traction, and all techniques for releases of the spine (anterior, posterior, or combine), as well as thoracoplasty, have demonstrated significant effectiveness in managing severe and rigid idiopathic scoliosis. The combination of several of these methods can lead to optimal alignment correction without the need to perform high-risk techniques involving three-column osteotomies. Surgeons must customize the indications based on factors such as available resources, characteristics of the deformity, and the patient’s individual profile. Surgical correction of severe scoliosis without vertebral body resection surgeries decreases the potential risks related to neurological and pulmonary complications while providing significant clinical improvement outcomes. The powerful Ponte osteotomy is indicated for severe scoliosis, curves with poor flexibility, for better restoration of hypokyphosis, and decrease of hyperkyphosis. These corrective techniques combined with HGT or temporary internal distraction rods are recommended as viable options for managing individuals with severe rigid spine deformity characteristics. Therefore, they also should be considered and performed by a proficient surgical team. The presence of neuromonitoring is crucial throughout these procedures.
Differentiation of Post-Polio Syndrome from Prior Poliomyelitis Sequela by Assessing Paraspinal Muscle Involvement in Magnetic Resonance Imaging
Authors: Topaloglu Mahir , Sarikaya Deniz , Peker Ahmet , Senturk Yunus Emre , Terlemez Rana , Cetin Burak Ugur , Oge Ali Emre , Ketenci Aysegul
Published: August 2024

Background/Objectives: Post-polio syndrome (PPS) affects former polio patients, manifesting decades after initial infection with progressive symptoms like pain, fatigue, and muscle weakness. Diagnosis relies on the clinical criteria and exclusion of other probable causes. The purpose of this study is to determine the scope and new diagnostic value of magnetic resonance imaging (MRI) in identifying muscle involvement in PPS and distinguishing it from prior poliomyelitis (PPM). Methods: This study was approved by the Koç University Ethics Committee with Approval No. 2023.409.IRB2.090. Electronic medical archives from two academic institutions were searched for records tagged with ICD code B-91 for poliomyelitis sequalae. The resulting search query of 291 records was manually sorted for PPS and PPM, medical history, clinical examination findings, and lumbar MR images down to 32 patients. Two independent radiologists evaluated the paraspinal musculature in the MRIs using the Mercuri scale. Inter-rater agreement, comparison of the paraspinal musculatures between groups, and their relationship to leg involvement were assessed with the resulting data. Results: Inter-rater agreement was found to be almost perfect across all muscles, except for the multifidus muscle. When clinical examination findings were included for these muscles, quadratus lumborum (QL) degradation was found in both right-side (p = 0.017) and left-side (p = 0.002) leg involvement. Conclusions: QL muscle deterioration may serve as a diagnostic marker for PPS, potentially guiding lumbar pain treatment through rehabilitation.
Diabetes Management Based on the Phenotype and Stage of the Disease: An Expert Proposal from the AGORA Diabetes Collaborative Group
Authors: Gómez-Peralta Fernando , Pinés-Corrales Pedro J. , Santos Estefanía , Cuesta Martín , González-Albarrán Olga , Azriel Sharona ,   on behalf the AGORA Diabetes Collaborative Group
Published: August 2024

Diabetes is a complex and rapidly growing disease with heterogeneous clinical presentations. Recent advances in molecular and genetic technologies have led to the identification of various subtypes of diabetes. These advancements offer the potential for a more precise, individualized approach to treatment, known as precision medicine. Recognizing high-risk phenotypes and intervening early and intensively is crucial. A staging system for type 1 diabetes has been proposed and accepted globally. In this article, we will explore the different methods for categorizing and classifying type 2 diabetes (T2D) based on clinical characteristics, progression patterns, risk of complications, and the use of molecular techniques for patient grouping. We, as a team of experts, will also present an easy-to-follow treatment plan and guidance for non-specialists, particularly primary care physicians, that integrates the classification and staging of diabetes. This will help ensure that the most suitable therapy is applied to the different types of T2D at each stage of the disease’s progression.
Review of Advancements in Managing Cardiogenic Shock: From Emergency Care Protocols to Long-Term Therapeutic Strategies
Authors: Martínez León Amaia , Bazal Chacón Pablo , Herrador Galindo Lorena , Ugarriza Ortueta Julene , Plaza Martín María , Pastor Pueyo Pablo , Alonso Salinas Gonzalo Luis
Published: August 2024

Cardiogenic shock (CS) is a complex multifactorial clinical syndrome of end-organ hypoperfusion that could be associated with multisystem organ failure, presenting a diverse range of causes and symptoms. Despite improving survival in recent years due to new advancements, CS still carries a high risk of severe morbidity and mortality. Recent research has focused on improving early detection and understanding of CS through standardized team approaches, detailed hemodynamic assessment, and selective use of temporary mechanical circulatory support devices, leading to better patient outcomes. This review examines CS pathophysiology, emerging classifications, current drug and device therapies, standardized team management strategies, and regionalized care systems aimed at optimizing shock outcomes. Furthermore, we identify gaps in knowledge and outline future research needs.
Clavicle Shaft Non-Unions–Do We Even Need Bone Grafts?
Authors: Mühlenfeld Nils , Wagner Ferdinand C. , Hupperich Andreas , Heykendorf Lukas , Frodl Andreas , Obid Peter , Kühle Jan , Schmal Hagen , Erdle Benjamin , Jaeger Martin
Published: August 2024

Background: The surgical treatment of bony non-unions is traditionally performed with additional bone grafts when atrophic and/or stronger implants when hypertrophic. In the case of the clavicle shaft, however, in our experience, a more controversial method where no additional bone graft is needed leads to equally good consolidation rates, independent of the non-union morphology. This method requires the meticulous anatomical reconstruction of the initial fracture and fixation according to the AO principle of relative stability. Methods: A retrospective review following the STROBE guidelines was performed on a consecutive cohort of all patients who received surgical treatment of a midshaft clavicle non-union at the Medical Center of the University of Freiburg between January 2003 and December 2023. Patients were identified using a retrospective systematical query in the Hospital Information System (HIS) using the International Statistical Classification of Diseases and Related Health Problems Version 10 (ICD-10) codes of the German Diagnosis Related Groups (G-DRG). Two groups were formed to compare the consolidation rates of patients who received additional bone grafting from the iliac crest with those of patients who did not. A 3.5 mm reconstruction LCP plate was used in all patients. Consolidation rates were evaluated using follow-up radiographs and outcomes after material removal with a mean follow-up of 31.5 ± 44.3 months (range 0–196). Results: Final data included 50 patients, predominantly male (29:21); age: 46.0 ± 13.0 years, BMI 26.1 ± 3.7. Autologous bone grafts from the iliac crest were used in 38.0% (n = 19), while no bone addition was used in 62.0% (n = 30). Six patients were lost to follow-up. Radiological consolidation was documented after a mean of 15.1 ± 8.0 months for the remaining 44 patients. Consolidation rates were 94.4% (n = 17) in patients for whom additional bone grafting was used and 96.2% (n = 25) in patients for whom no graft was used. There was no relevant difference in the percentage of atrophic or hypertrophic non-unions between both groups (p = 0.2425). Differences between groups in the rate of consolidation were not significant (p = 0.7890). The complication rate was low, with 4.5% (n = 2). Conclusions: Independent of the non-union morphology, non-unions of the clavicle midshaft can be treated successfully with 3.5 mm locking reconstruction plates without the use of additional bone grafting in most cases.
Clinical Characteristics and Audiological Profiles of Patients with Pathogenic Variants of WFS1
Authors: Jung Joonho , Jang Seung Hyun , Won Dongju , Gee Heon Yung , Choi Jae Young , Jung Jinsei
Published: August 2024

Background: Mutations in Wolfram syndrome 1 (WFS1) cause Wolfram syndrome and autosomal dominant non-syndromic hearing loss DFNA6/14/38. To date, more than 300 pathogenic variants of WFS1 have been identified. Generally, the audiological phenotype of Wolfram syndrome or DFNA6/14/38 is characterized by low-frequency hearing loss; however, this phenotype is largely variable. Hence, there is a need to better understand the diversity in audiological and vestibular profiles associated with WFS1 variants, as this can have significant implications for diagnosis and management. This study aims to investigate the clinical characteristics, audiological phenotypes, and vestibular function in patients with DFNA6/14/38. Methods: Whole-exome or targeted deafness gene panel sequencing was performed to confirm the pathogenic variants in patients with genetic hearing loss. Results: We identified nine independent families with affected individuals who carried a heterozygous pathogenic variant of WFS1. The onset of hearing loss varied from the first to the fifth decade. On a pure-tone audiogram, hearing loss was symmetrical, and the severity ranged from mild to severe. Notably, either both low-frequency and high-frequency or all-frequency-specific hearing loss was observed. However, hearing loss was non-progressive in all types. In addition, vestibular impairment was identified in patients with DFNA6/14/38, indicating that impaired WFS1 may also affect the vestibular organs. Conclusions: Diverse audiological and vestibular profiles were observed in patients with pathogenic variants of WFS1. These findings highlight the importance of comprehensive audiological and vestibular assessments in patients with WFS1 mutations for accurate diagnosis and management.
Additive Friction Stir Deposition of a Tantalum–Tungsten Refractory Alloy
Authors: Griffiths R. Joey , Wilson-Heid Alexander E. , Linne Marissa A. , Garza Eleanna V. , Wright Arnold , Martin Aiden A.
Published: August 2024

Additive friction stir deposition (AFSD) is a solid-state metal additive manufacturing technique, which utilizes frictional heating and plastic deformation to create large deposits and parts. Much like its cousin processes, friction stir welding and friction stir processing, AFSD has seen the most compatibility and use with lower-temperature metals, such as aluminum; however, there is growing interest in higher-temperature materials, such as titanium and steel alloys. In this work, we explore the deposition of an ultrahigh-temperature refractory material, specifically, a tantalum–tungsten (TaW) alloy. The solid-state nature of AFSD means refractory process temperatures are significantly lower than those for melt-based additive manufacturing techniques; however, they still pose difficult challenges, especially in regards to AFSD tooling. In this study, we perform initial deposition trials of TaW using twin-rod-style AFSD with a high-temperature tungsten–rhenium-based tool. Many challenges arise because of the high temperatures of the process and high mechanical demand on AFSD machine hardware to process the strong refractory alloy. Despite these challenges, successful deposits of the material were produced and characterized. Mechanical testing of the deposited material shows improved yield strength over that of the annealed reference material, and this strengthening is mostly attributed to the refined recrystallized microstructure typical of AFSD. These findings highlight the opportunities and challenges associated with ultrahigh-temperature AFSD, as well as provide some of the first published insights into twin-rod-style AFSD process behaviors.
Diabetic Foot and Fungal Infections: Etiology and Management from a Dermatologic Perspective
Authors: Gupta Aditya K. , Shemer Avner , Economopoulos Vasiliki , Talukder Mesbah
Published: August 2024

Diabetes Mellitus (DM) is a significant global concern. Many diabetic patients will experience complications due to angiopathy, neuropathy, and immune dysfunction, namely diabetic foot ulcers (DFU) and diabetic foot infections (DFI), which can result in lower limb amputation and potentially death. The prevalence of common superficial fungal infections, such as tinea pedis and onychomycosis, can directly increase a diabetic patient’s risk of developing both DFU and DFI. In this review article, we discuss the etiology of diabetic foot complications as well as considerations for both screening and management. We also discuss the role of the dermatologist within a multidisciplinary care team in prescribing and managing treatments for tinea pedis and onychomycosis infections within this patient population. We believe that reducing the burden of these fungal infections in the context of the diabetic foot will help reduce DFU and DFI complications and their associated morbidity and mortality.
Germline RAD51C and RAD51D Mutations in High-Risk Chinese Breast and/or Ovarian Cancer Patients and Families
Authors: Kwong Ava , Ho Cecilia Yuen Sze , Au Chun Hang , Tey Sze Keong , Ma Edmond Shiu Kwan
Published: August 2024

Background: RAD51C and RAD51D are crucial in homologous recombination (HR) DNA repair. The prevalence of the RAD51C and RAD51D mutations in breast cancer varies across ethnic groups. Associations of RAD51C and RAD51D germline pathogenic variants (GPVs) with breast and ovarian cancer predisposition have been recently reported and are of interest. Methods: We performed multi-gene panel sequencing to study the prevalence of RAD51C and RAD51D germline mutations among 3728 patients with hereditary breast and/or ovarian cancer (HBOC). Results: We identified 18 pathogenic RAD51C and RAD51D mutation carriers, with a mutation frequency of 0.13% (5/3728) and 0.35% (13/3728), respectively. The most common recurrent mutation was RAD51D c.270_271dupTA; p.(Lys91Ilefs*13), with a mutation frequency of 0.30% (11/3728), which was also commonly identified in Asians. Only four out of six cases (66.7%) of this common mutation tested positive for homologous recombination deficiency (HRD). Conclusions: Taking the family studies in our registry and tumor molecular pathology together, we concluded that this relatively common RAD51D variant showed incomplete penetrance in our local Chinese community. Personalized genetic counseling emphasizing family history for families with this variant, as suggested at the UK Cancer Genetics Group (UKCGG) Consensus meeting, would also be appropriate in Chinese families.
Does Corporate Governance and Earning Quality Mitigate Idiosyncratic Risk? Evidence from an Emerging Economy
Authors: Rahman Habib Ur , Ali Asif , Arian Adam , Sands John
Published: August 2024

This study investigates evolving corporate governance mechanisms within the context of an emerging economy. Addressing a literature gap, this study analyses the influence of corporate governance and earnings quality on idiosyncratic risk in an emerging economy. In particular, this research explores the impact of corporate governance practices and earnings quality on idiosyncratic risk. For this purpose, this research utilises a sample of 75 non-financial firms listed on the Pakistani equity market over nine years from 2010 to 2018. Employing the generalised method of moments, the findings of our empirical analysis reveal that firms with robust governance mechanisms and higher earnings quality experience minimal idiosyncratic risk. These outcomes provide valuable insights for standard setters, regulatory authorities, policymakers, and other stakeholders, emphasising the importance of governance mechanisms and earnings management in mitigating idiosyncratic return volatility.
Reevaluating Bank Price-to-Book Ratios: An In-Depth Analysis of Equity Components across Economic Cycles
Authors: Martínez Fernando García , Jiménez Juan Domínguez , Matas Ricardo Queralt Sánchez de las
Published: August 2024

This study explores the evolution of price-to-book (P/B) ratios among European banks from 2005 to 2020, a period where most banks in different countries had a P/B ratio below 1. By dissecting banks’ accounting equity into investor contributions and earnings-derived components, this research aims to evaluate how each component of equity affects these ratios and investigates whether their dynamics shifted during the period. We address a gap in prior research that has not extensively examined how individual equity components affect the overall P/B ratio. This aspect is crucial, especially in scenarios where the increase of specific components compensates for declines in others, thereby stabilizing total equity values. Our methodology involves regression analyses using a panel data model with random effects. The findings reveal that earnings-related equity components significantly influence P/B ratios. In contrast, investor contributions, which strengthen the solvency of the entity, appear to have a minimal impact. Additionally, our analysis highlights a significant quadratic relationship between the P/B ratios and both the profit or loss reported on Income Statements and distributed dividends.
Machine Learning for Criteria Weighting in GIS-Based Multi-Criteria Evaluation: A Case Study of Urban Suitability Analysis
Authors: Zhao Lan Qing , van Duynhoven Alysha , Dragićević Suzana
Published: August 2024

Geographic Information System-based Multi-Criteria Evaluation (GIS-MCE) methods are designed to assist in various spatial decision-making problems using spatial data. Deriving criteria weights is an important component of GIS-MCE, typically relying on stakeholders’ opinions or mathematical methods. These approaches can be costly, time-consuming, and prone to subjectivity or bias. Therefore, the main objective of this study is to investigate the use of Machine Learning (ML) techniques to support criteria weight derivation within GIS-MCE. The proposed ML-MCE method is explored in a case study of urban development suitability analysis of the City of Kelowna, Canada. Feature importance values drawn from three ML techniques–Random Forest (RF), Extreme Gradient Boosting (XGB), and Support Vector Machine (SVM)–are used to derive criteria weights. The suitability scores obtained using the ML-MCE methodology are compared with Equal-Weights (EW) and the Analytical Hierarchy Process (AHP) approach for criteria weighting. The results indicate that ML-derived criteria weights can be used in GIS-MCE, where RF and XGB techniques provide more similar values for criteria weights than those derived from SVM. The similarities and differences are confirmed with Kappa indices obtained from comparing pairs of suitability maps. The proposed new ML-MCE methodology can support various decision-making processes in urban land-use planning.
Spatial and Temporal Analysis of Water Resources in the Olive-Growing Areas of Extremadura, Southwestern Spain
Authors: Moral Francisco J. , Rebollo Francisco J. , García-Martín Abelardo , Paniagua Luis L. , Honorio Fulgencio
Published: August 2024

The increasing variability of precipitation, higher temperatures, and recurring droughts in the semi-arid regions due to climate change are leading to increased aridity, resulting in scarcer water resources for crops. The present study aimed to analyse the spatial distribution of climate variables related to water resources in the olive-growing areas throughout Extremadura, southwestern Spain. To perform this task, three climate variables were used: the potential evapotranspiration of the crop, the FAO aridity index, and the annual water requirement. Considering data from 58 weather stations located throughout Extremadura and 17 along boundaries with at least a 30-year length (within the 1991–2021 period), each variable was computed at each station. After calculating some descriptive statistics, a multivariate geostatistical (regression-kriging) algorithm, incorporating secondary information on elevation and latitude, was used to accurately map each climate variable. Later, temporal trends and their magnitude were analysed using the Mann–Kendall test and the Sen’s estimator, respectively. The highest evapotranspiration and water requirements are located in the southern part of the region, which has large areas dedicated to olive cultivation. In the northern part of the region, there is greater spatial variability in evapotranspiration and, consequently, in water requirements for olive groves due to the more rugged topography. Similarly, the olive-growing areas with the highest aridity are also in the south of Extremadura. In most areas of Extremadura, olive cultivation requires appropriate irrigation for optimal productivity. According to evapotranspiration trends, the water requirements will become greater in the future. However, it is not guaranteed that the water supply will be sufficient in olive-growing areas where aridity is higher and water resources are scarce. The results of this study are very important for evaluating water deficit and water resources in vulnerable olive-growing areas throughout Extremadura.
The Setting of the Null Subject Parameters across (Non-)Null-Subject Languages
Authors: Bertolino Karina
Published: August 2024

This article explores a learning model for acquiring a variety of null and non-null-subject languages (i.e., consistent, partial, semi and non-null-subject languages). This model builds upon a version of the Null Subject Parameter(s) based on the “Borer-Chomsky Conjecture” (BCC), which assumes that the presence or absence of a D(definiteness)-feature in different functional heads, together with EPP (Extended projection principle) related features, account for the distributions of null subjects in a complex typology of (non-)null-subject languages. This BCC-based learning model assumes the hypothesis that children, in order to learn the pattern of null subjects in their language, need to look at the morphology of functional elements. By reviewing acquisition studies, I examine whether the model is compatible with the data. I argue that there is no evidence of parameter missetting in any of the languages examined, and that children’s early sensitivity to functional elements suggests that the BCC-based learning model is a suitable theory for the acquisition of null subjects.
Effects of Exercise on Cancer-Related Fatigue in Breast Cancer Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Authors: Zhou Runyu , Chen Zhuying , Zhang Shiyan , Wang Yushu , Zhang Chiyang , Lv Yuanyuan , Yu Laikang
Published: August 2024

The primary objective of this study was to assess the influence of exercise interventions on cancer-related fatigue (CRF), specifically in breast cancer patients, with the ultimate goal of establishing an optimal exercise prescription for breast cancer patients. A comprehensive search was undertaken across multiple databases, including Embase, PubMed, Cochrane Library, Web of Science, and Scopus, covering data published up to 1 September 2023. A meta-analysis was conducted to calculate the standardized mean difference (SMD) along with its corresponding 95% confidence interval (CI), thereby quantifying the effectiveness of exercise in alleviating CRF in the breast cancer patient population. Twenty-six studies met the inclusion criteria. Aerobic exercise (SMD, −0.17, p = 0.02), resistance exercise (SMD, −0.37, p = 0.0009), and combined exercise (SMD, −0.53, p < 0.0001) significantly improved CRF in breast cancer patients. In addition, exercise intervention conducted ≥3 times per week (SMD, −0.47, p = 0.0001) for >60 min per session (SMD, −0.63, p < 0.0001) and ≥180 min per week (SMD, −0.79, p < 0.0001) had greater effects on improving CRF in breast cancer patients, especially middle-aged patients (SMD, −0.42, p < 0.0001). Exercise is an effective approach to improving CRF in breast cancer patients. When devising an exercise program, the primary consideration should be the incorporation of combined exercise as the principal intervention. This entails ensuring that participants engage in the program at least three times weekly, with each session lasting for more than 60 min. The ultimate aim is to achieve a total weekly exercise duration of 180 min by progressively increasing the frequency of exercise sessions.
Role of Non-Residential Larval Habitats in Aedes Spatiotemporal Egg Production
Authors: Soto-López Julio D. , Barrios-Izás Manuel A. , Vieira Lista María Carmen , Muro Antonio
Published: August 2024

Aedes mosquitoes play a pivotal role as vectors of several arboviral diseases, presenting significant public health challenges worldwide. Their invasive success in tropical regions has raised substantial medical concerns. In Guatemala, Aedes mosquitoes are widely distributed and are the primary vectors of the dengue virus. Efforts to control and monitor Aedes populations have evolved over time, incorporating strategies such as spatial repellents, larvicides, genetic modifications, and targeted interventions. Previous research has shown the heterogeneous spatial-temporal distribution of these mosquitoes within each season, influenced by temperature variations and favorable environmental conditions for breeding. This study analyzed hot-spot patterns of spatiotemporal egg density in Santa Elena de la Cruz, Petén, Guatemala, from March to September 2022. The aim was to determine whether these patterns were influenced by non-residential larval habitats with plant cover that are not treated by healthcare entities, as well as the proximity between such habitats. Our findings include the collection and registration of over 16,000 Aedes eggs during the study period. Local analyses revealed hot-spot patterns in egg densities associated with non-residential larval habitats and their proximity. These insights highlight critical focal points where targeted interventions could be implemented more effectively, resulting in cost-efficient mosquito vector control.
A Comparative Analysis between Enhanced Recovery after Surgery and Traditional Care in the Management of Obstructive Colorectal Cancer
Authors: Mihăilescu Alexandra-Ana , Onisâi Minodora , Alexandru Adrian , Teodorescu Matei , Aliuș Cătălin , Blendea Corneliu-Dan , Neagu Ștefan-Ilie , Șerban Dragoș , Grădinaru Sebastian
Published: August 2024

Enhanced Recovery After Surgery (ERAS) represents evidence-based transformation in perioperative care, which has been demonstrated to reduce both recovery times and postoperative complication rates. The aim of the present study was to evaluate the clinical significance of the ERAS program in comparison with conventional postoperative care. This longitudinal cohort observational study enrolled 120 consecutive patients diagnosed with intestinal obstruction caused by colorectal cancers, with 40 patients in the ERAS group and 80 patients receiving conventional postoperative care forming the non-ERAS group. Our study compares the effectiveness of ERAS protocols to non-ERAS methods, focusing on the time to first flatus, defecation, the resumption of normal diet, and early mobilization. The main endpoints are morbidity and hospitalization length. The results showed that despite a longer admission-to-surgery interval in the ERAS group, median hospitalization was significantly shorter compared to the non-ERAS group (p = 0.0002). The ERAS group showed a tendency towards a lower incidence of overall postoperative complications, indicating that implementing the ERAS protocol does not increase the risk of postoperative complications, ensuring the safety of enhanced recovery strategies for patients. Also, ERAS patients had notably fewer stomas than those in the non-ERAS group, indicating the potential effectiveness of reducing stoma necessity. This study shows that ERAS surpasses conventional care for colonic or rectal surgery patients, reducing hospital stays and costs while enhancing recovery. This highlights the comprehensive advantages of adopting ERAS in surgical settings.
dmPINNs: An Integrated Data-Driven and Mechanism-Based Method for Endpoint Carbon Prediction in BOF
Authors: Xia Yijie , Wang Hongbing , Xu Anjun
Published: August 2024

Accurate prediction of endpoint carbon at the dynamic control stage in the converter is crucial for achieving smelting targets. Currently, there are two main methods for converter endpoint prediction: the data-driven method and the mechanism-based method. Data-driven methods exhibit high accuracy but are vulnerable to data quality variations and lack interpretability. Mechanism-based methods provide great interpretability but face challenges in precisely identifying key parameters in the mechanism formula. Inspired by the design concept of physics-informed neural networks (PINNs), an integrated data-driven and mechanism-based method for endpoint carbon prediction in BOF (dmPINNs, data-driven and mechanism-based physics-informed neural networks) is proposed, which has four parts: feature extraction, mechanism-based calculation, data-driven prediction, and integrated prediction. We identify key parameters of the mechanism formula through the neural network to obtain the specified formula for each heat and supervise the training process of the neural network through the mechanism formula to ensure interpretability. Experimental results show that, within the ±0.012% error range, the hit rate of endpoint carbon content using dmPINNs improved by 5.23% compared with the traditional data-driven method and has greater robustness with the supervision of the mechanism formula.
Yttrium Separation from Phosphorite Extract Using Liquid Extraction with Room Temperature Ionic Liquids Followed by Electrochemical Reduction
Authors: Jürjo Silvester , Oll Ove , Lust Enn
Published: August 2024

The combined chemical extraction of rare earth elements from acid solutions and electrochemical separation of yttrium by electrodeposition from Estonian phosphorite ore samples containing rare earth elements has been conducted using ionic liquids at room temperature. It is shown that bis(2-ethylhexyl) phosphate can be used to selectively extract yttrium from other low rare earth elements, constituting the basis for further extraction. Electrochemical deposition can then be applied to the concentrated extraction product to separate valuable Y from the more abundant elements, such as Ca, from the natural sample. The addition of Bi salt to the working solution significantly aids REE’s deposition. It is shown that this extraction method can be highly efficient as well as selective when well-controlled different electrodeposition conditions are applied.
Hybridization of Principal Component Analysis-Entropy-TOPSIS Techniques for Minimization of Angular Deviation in Gas Metal Arc Welded Stainless Steel Plates
Authors: Eazhil Kuluthupalayam Maruthavanan , Sudhakaran Ranganathan , Aabid Abdul , Ahmed Omar Shabbir
Published: August 2024

The current study involves optimizing gas metal arc welding input parameters by hybridization techniques such as principal component analysis, entropy, and TOPSIS for minimizing the angular distortion resulting from the welding process. Structural steel has been considered as the research material by varying the process parameters such as electrode angle with workpiece, time gap between passes, wire feed rate, and welding speed, each varying with five levels. Experimental layout has been prepared through response surface methodology with 125 experimental trials combining different parameters. The measured angular distortion of the welded plates has been considered for multi-criteria decision making to find the optimal parameter combination for reducing the angular distortion. The optimal combination comprising 110 degrees of electrode to workpiece angle, 25 min time gap, 5.75 mm/min wire feed rate, and 10.8 cm/min welding speed is found to hold top ranking (A2B2C1D2) from both PCA and entropy weighted values through TOPSIS technique. The closeness coefficient value has been trained and tested through supervised ML techniques. AdaBoost algorithm outperformed other regression algorithms with excellent evaluation scores. The microstructure analysis of the welded plates reveals the presence of coarse and fine structures in the welded area.
Tolerance Mechanisms and Removal Efficiency of Chlorella pyrenoidosa in Treating 3-Fluorophenol Pollution
Authors: Li Min , Shang Zhenfang , Ma Yonglan , Zhao Huijun , Ni Zhijing , Wei Zhaojun , Zhang Xiu
Published: August 2024

This study investigates the growth tolerance mechanisms of Chlorella pyrenoidosa to 3-fluorophenol and its removal efficiency by algal cells. Our results indicate that C. pyrenoidosa can tolerate up to 100 mg/L of 3-fluorophenol, exhibiting a significant hormesis effect characterized by initial inhibition followed by promotion of growth. In C. pyrenoidosa cells, the activities of superoxide dismutase (SOD) and catalase (CAT), as well as the levels of malondialdehyde (MDA) and reactive oxygen species (ROS), were higher than or comparable to the control group. Metabolic analysis revealed that the 3-fluorophenol treatment activated pathways, such as glycerol phospholipid metabolism, autophagy, glycosylphosphatidylinositol (GPI)-anchored protein biosynthesis, and phenylpropanoid biosynthesis, contributed to the stabilization of cell membrane structures and enhanced cell repair capacity. After 240 h of treatment, over 50% of 3-fluorophenol was removed by algal cells, primarily through adsorption. Thus, C. pyrenoidosa shows potential as an effective biosorbent for the bioremediation of 3-fluorophenol.
Development of a Microbioreactor for Bacillus subtilis Biofilm Cultivation
Authors: Seručnik Mojca , Dogsa Iztok , Zadravec Lan Julij , Mandic-Mulec Ines , Žnidaršič-Plazl Polona
Published: August 2024

To improve our understanding of Bacillus subtilis growth and biofilm formation under different environmental conditions, two versions of a microfluidic reactor with two channels separated by a polydimethylsiloxane (PDMS) membrane were developed. The gas phase was introduced into the channel above the membrane, and oxygen transfer from the gas phase through the membrane was assessed by measuring the dissolved oxygen concentration in the liquid phase using a miniaturized optical sensor and oxygen-sensitive nanoparticles. B. subtilis biofilm formation was monitored in the growth channels of the microbioreactors, which were designed in two shapes: one with circular extensions and one without. The volumes of these microbioreactors were (17 ± 4) μL for the reactors without extensions and (28 ± 4) μL for those with extensions. The effect of microbioreactor geometry and aeration on B. subtilis biofilm growth was evaluated by digital image analysis. In both microbioreactor geometries, stable B. subtilis biofilm formation was achieved after 72 h of incubation at a growth medium flow rate of 1 μL/min. The amount of oxygen significantly influenced biofilm formation. When the culture was cultivated with a continuous air supply, biofilm surface coverage and biomass concentration were higher than in cultivations without aeration or with a 100% oxygen supply. The channel geometry with circular extensions did not lead to a higher total biomass in the microbioreactor compared to the geometry without extensions.
Chemical Diversity of Ketosteroids as Potential Therapeutic Agents
Authors: Dembitsky Valery M.
Published: August 2024

This article presents a comprehensive overview of recent discoveries and advancements in the field of steroid chemistry, highlighting the isolation and characterization of various steroidal compounds from natural sources. This paper discusses a wide range of steroids, including pregnane steroids, steroidal alkaloids, ketosteroids, and novel triterpenoids, derived from marine organisms, fungi, and plants. Significant findings include the isolation of bioactive compounds such as the cytotoxic erectsterates from microorganisms, soft corals, the unusual tetracyclic steroid penicillitone from a fungal culture, and innovative steroidal derivatives with potential anti-inflammatory and anticancer activities. The synthesis of steroids from microorganisms as a tool for pharmaceutical development is also explored, showcasing the role of microbial biotransformation in generating steroidal drugs. Additionally, this paper emphasizes the ecological and medicinal relevance of these compounds, which are often used in traditional medicine and have potential therapeutic applications in treating diseases like cancer and microbial infections. This article serves as a vital resource for researchers interested in the chemical diversity of steroids and their applications in drug discovery and development.
The Impact of Non-Dysentery Shigella Infection on the Growth and Health of Children over Time (INSIGHT)—A Prospective Case–Control Study Protocol
Authors: Chakraborty Subhra , Dash Sampa , Antara Nowrin Akbar , Roy Bharati Rani , Mamun Shamim Al , Ali Mohammad , Naz Farina , Johura Fatema-Tuz , Lewis Jade , Afroze Farzana , Hasan ABM Ali , Sack David A. , Ram Malathi , Tofail Fahmida , Ahmed Tahmeed , Faruque A. S. G.
Published: August 2024

(1) Shigella spp. (Shigella) is known for causing dysentery with blood in stool, but most children infected with Shigella have non-dysentery Shigella-associated diarrhea (NDSD). The World Health Organization recommends the use of antibiotics when diarrhea is bloody, leaving most NDSD cases untreated. The absence of dysentery may not indicate a low risk of death and severe morbidity. Rapid diagnosis and treatment of shigellosis in vulnerable, young children may be lifesaving. INSIGHT aims to determine the potential benefit of identifying NDSD cases (n = 296) and their outcomes compared to cases of Shigella dysentery [DS (n = 148)] and non-Shigella watery diarrhea [WD (n = 148)]. (2) Children seeking care at hospitals in Bangladesh will be enrolled and followed for 1 year (NDSD and DS) or 90 days (WD). We will determine the impact of NDSD on morbidity, mortality, gut health, nutritional status, and cognitive development compared to DS and WD in children and whether the simple “Rapid LAMP-based Diagnostic Test (RLDT)” can accelerate the detection and treatment of shigellosis in the clinical settings of rural Bangladesh. (3) INSIGHT will determine the impact of NDSD in children and determine if the treatment guidelines of shigellosis need to be revisited to improve clinical outcomes and the development of these children.