bluuebunny/crossref_metadata_2025 huggingface dataset:
A Performance-Based Design Framework for Enhanced Asphalt Concrete in the Caribbean Region
Authors: Leon Lee P. , Roopnarine Karishma , Azamathulla Hazi Mohammad , Chadee Aaron Anil , Rathnayake Upaka
Published: June 2023

The majority of recent research in has been focused on the introduction, development, and evaluation of performance-based specifications for the design of asphalt concrete mixtures. In the Caribbean, most laboratories only use the Volumetric Marshall Mix design methodology. Road designers, engineers, consultants, and contractors have all highlighted the many shortcomings and inadequacies of the volumetric design mix selection process. The consensus is that there is a need to a develop process that addresses the service’s performance and common distress on asphalt pavements through performance-based mix design. Performance-Based Mix Design (PBMD) has been used as a practical alternative to the volumetric mix design technique in evaluating pavement distresses by incorporating performance testing in conjunction with volumetric parameters into the mix design process. This study describes the findings of our comprehensive laboratory research, which was conduced to facilitate the development of a Performance-Based Mix Design framework for asphalt concrete mixtures. The research methodology involved the collection and integration of qualitative and quantitative data through case studies and experimental work. Two control and two PBMD mixtures were designed to evaluate both the volumetric and performance properties that address distresses of permanent deformation (rutting), fatigue cracking, stiffness, and moisture susceptibility. The PBMD framework led to the development of performance test criteria for permanent deformation, stiffness modulus, fatigue cracking, and an acceptable tensile strength ratio. The development and implementation of the PMBD framework for the Caribbean region could exemplify a significant step towards achieving sustainable asphalt pavements in the region. The framework, which incorporates best-practice solutions, is anticipated to increase awareness about the variables that affect the performance of asphalt mixtures.
A Novel Data-Driven Model for the Effect of Mood State on Thermal Sensation
Authors: Turhan Cihan , Özbey Mehmet Furkan , Çeter Aydın Ege , Akkurt Gulden Gokcen
Published: June 2023

Thermal comfort has an important role in human life, considering that people spend most of their lives in indoor environments. However, the necessity of ensuring the thermal comfort of these people presents an important problem, calculating the thermal comfort accurately. The assessment of thermal comfort has always been problematic, from past to present, and the studies conducted in this field have indicated that there is a gap between thermal comfort and thermal sensation. Although recent studies have shown an effort to take human psychology into account more extensively, these studies just focused on the physiological responses of the human body under psychological disturbances. On the other hand, the mood state of people is one of the most significant parameters of human psychology. Thus, this paper investigated the effect of occupants’ mood states on thermal sensation; furthermore, it introduced a novel “Mood State Correction Factor” (MSCF) to the existing thermal comfort model. To this aim, experiments were conducted at a mixed-mode building in a university between 15 August 2021 and 15 August 2022. Actual Mean Vote (AMV) and Profile of Mood States (POMS) were used to examine the effect of mood state on thermal sensation. The outcomes of this study showed that in the mood states of very pessimistic and very optimistic, the occupants felt warmer than the calculated one and the MSCFs are calculated as −0.125 and −0.114 for the very pessimistic and very optimistic mood states, respectively. It is worth our time to note that the experiments in this study were conducted during the COVID-19 Global Pandemic and the results of this study could differ in different cultural backgrounds.
Toward the Sustainable and Efficient Use of External Thermal Insulation Composite Systems (ETICS): A Comprehensive Review of Anomalies, Performance Parameters, Requirements and Durability
Authors: Parracha João L. , Veiga Rosário , Flores-Colen Inês , Nunes Lina
Published: June 2023

The identification of the main degradation agents and knowledge of the degradation mechanisms and long-term performance of ETICSs are of fundamental importance for the sustainable and efficient use of these systems. This review article presents the state of the art related to the durability of ETICSs, defining the required bases for their sustainable and efficient use. The aim is to identify the most common anomalies detected on ETICS façades and their causes, to overview the performance of ETICS, their performance parameters and requirements and to identify the most significant degradation mechanisms and the related failure modes. The results show that ETICS application is a key aspect in the performance and durability of the system, since most of the anomalies can be prevented with proper design, execution and appropriate assembly of the system components. The greatest drawbacks lie in dealing with enhancing the water resistance over time, which leads to extensive cases of anomalies, and improving the mechanical and thermal performance during the life cycle. Further research is needed to evaluate the synergistic effect of several degradation agents and mechanisms toward a development in optimized durability assessment methodologies for ETICSs.
Improving the Seismic Performance of Steel Frames under Mainshock–Aftershock Using Post-Tensioned Connections
Authors: Torres José R. , Bojórquez Edén , Bojórquez Juan , Leyva Herian , Ruiz Sonia E. , Reyes-Salazar Alfredo , Palemón-Arcos Leonardo , Rivera J. Luz , Carvajal Joel , Reyes Henry E.
Published: June 2023

In this study, the seismic responses of moment-resisting steel frames (MRSFs) with welded and post-tensioned connections under 28 artificial seismic sequences (mainshock–aftershock) are compared. For this aim, the mainshock are scaled at different ground motion intensity levels as a function of the spectral pseudo-acceleration corresponding to the fundamental period of vibration of the structure Sa(T1), whereas different intensity levels of the aftershocks are used for a percentage of the peak maximum acceleration of the mainshock. The seismic performance comparison of both structural systems is computed for the maximum, residual inter-story drift and hysteretic energy demands. The results show that post-tensioned frames significantly reduce the structural demands, especially in the case of residual inter-story drifts and hysteretic energy in comparison with moment-resisting steel frames with welded connections. The reductions in the structural response tend to be larger as the intensity of the aftershock tends to increase. Therefore, it is concluded that the use of post-tensioned connections is a great alternative to mitigate the seismic response of buildings subjected to seismic sequences.
Pricing and Coordination for the Leasing and Recycling of Construction Machinery in a Supply Chain Based on Industrial Internet Platform
Authors: Yin Jing , Fang Yifan , Zhang Hengxi , Wang Tingting
Published: June 2023

Leasing and recycling are important methods for developing the low-carbon sustainability of the construction machinery industry. However, there are some dilemmas caused by the extreme limitations of product service life. There has been little research on construction machinery leasing thus far and a lack of description of its unique characteristics in previous models. Focusing on the problem of pricing and coordination, a two-stage model of a leasing closed-loop supply chain based on the practical application of an Industrial Internet platform was proposed. Under centralized and decentralized decision-making scenarios, the prices of leasing and selling, maintenance effort, and recovery rate were calculated, respectively. By using the Shapley value method to optimize the selling price, and the two-part pricing contract to calculate the compensation fee, global profits can be reasonably distributed, while the supply chain can be improved. The effects of different contracts on the improvement of supply chain profit were investigated. Additionally, the correlation among parameters was explored via sensitivity analysis and numerical simulation. The findings show that the maintenance and recycling of construction machinery can be improved by using an Industrial Internet platform while achieving supply chain coordination via contracts. The enhancement of maintenance effort can decrease remanufacturing costs, which are positively correlated with the selling price and leasing price of products, further promoting the recovery rate of used products. The findings of this paper show that manufacturers can take advantage of the Industrial Internet platform to improve recycling efficiency as well as to decrease product prices and remanufacturing costs by promoting remanufacturing technologies. On the other hand, leasers need to enhance the maintenance of construction machinery. Strengthening cooperation via contracts can jointly promote leasing and recycling in the construction machinery industry and help achieve low-carbon sustainable development.
Impact Performance of RC Beams Reinforced by Engineered Cementitious Composite
Authors: Wu Jiehao
Published: June 2023

To mitigate potential damage to RC structures subjected to impact load—especially spalling damage—engineered cementitious composite (ECC) is applied, with the aim of reinforcing the RC members, so as to improve their impact performance. In the present study, the response of beams, with and without ECC reinforcement, to impact loading was investigated. Firstly, the mechanical properties of the ECC were characterized by quasi-static compression and tension tests, as well as by dynamic direct tension tests. Then, the K&C model (Karagozian and Case Concrete Model) was employed to delineate the ECC behavior, whose parameters were calibrated using the test data. Subsequently, models of RC beams with and without ECC reinforcement, validated using the drop weight test, were established to investigate the impact response. The numerical results suggested that the performance of the impact resistance of the ECC-reinforced RC beams was significantly improved. The damage degree of the ECC-reinforced members was effectively reduced, the degree of deformation was effectively controlled, and the energy consumption capacity was significantly increased while the impact load and transferred load increased. In particular, the method of multiple separate layers as reinforcement, proposed in this study, was found to reduce effectively the response and damage extent, improve the energy dissipation, and control the impact load and transferred load within certain levels. In addition, the multiple separate ECC layers effectively prevented the crack propagation caused by the cracking of the member, ensured the residual integrity of the member, and further improved the performance of the impact resistance of the member comprehensively.
The Impact of PSMA PET/CT on Modern Prostate Cancer Management and Decision Making—The Urological Perspective
Authors: Hoffman Azik , Amiel Gilad E.
Published: June 2023

Prostate-specific membrane antigen (PSMA) PET use in prostate cancer treatment has recently become a routinely used imaging modality by urologists. New, established data regarding its performance in different stages of prostate cancer, as well as gaining clinical knowledge with new tracers, drives the need for urologists and other clinicians to improve the utilization of this tool. While the use of PSMA PET/CT is more common in metastatic disease, in which it outperforms classical imaging modalities and drives treatment decisions and adjustments, recently, it gained ground in localized prostate cancer as well, especially in high-risk disease. Still, PSMA PET/CT might reveal lesions within the prostate or possibly locoregional or metastatic disease, not always representing true cancer when utilized in earlier stages of the disease, potentially adding diagnostic burden and changing treatment decisions. As urological treatment options advance toward focal treatments in localized organ-confined prostate cancer, recent reports suggest the utilization of PSMA PET/CT in treatment planning and follow-up and even when choosing active surveillance. This review aims to reveal the current perspective of urologists regarding its daily use.
Electron Regulation in Pt-M (M = Cu, Co, and Ni) Decorated WO3 Thin Films for Photocatalytic Degradation Performance
Authors: Pan Jinkang , Zhang Lihua , Wang Cunxia , Gao Kangjie , Dong Pengyu
Published: June 2023

In this study, Pt-M/WO3 (M = Cu, Co, and Ni) thin films are effectively synthesized by preparing homogeneous precursor sols, spin-coating, toluene-etching, and calcination. Furthermore, the microstructural, chemical, and electrochemical properties of the WO3, Pt-Cu/WO3, Pt-Co/WO3, and Pt-Ni/WO3 thin films are also systematically compared. The results demonstrate that when compared to the WO3 thin film, the photocatalytic capability for methylene blue (MB) solution degradation is greatly increased in the Pt-M/WO3 thin films. Transfer routes for photogenerated charges and an improved photocatalytic process are suggested based on the experimental results. Due to the large difference in the work function (Φ) between the bimetallic alloy Pt-M and WO3, a bending of the energy bands at the Pt-M/WO3 interface is presented. Furthermore, the introduction of transition metals such as Cu, Co, or Ni modifies the electronic structure of Pt-M/WO3 thin films, facilitating the separation and migration of electrons and holes. Specifically, the photogenerated electrons migrate from the CB of WO3 to Pt-Co or Pt-Ni nanoparticles in the samples of Pt-Co/WO3 or Pt-Ni/WO3 thin films, while the hot electrons from the localized surface plasmon resonance (LSPR) effect of Cu could transfer to the conduction band (CB) of WO3 and other electrons generated from the photoexcitation of the WO3 semiconductor itself in the sample of the Pt-Cu/WO3 thin film. In summary, this work proposes a unique strategy for creating electron regulation in Pt-M decorated WO3 thin films for photocatalytic application.
Recent Advances in Photoredox-Catalyzed Difunctionalization of Alkenes
Authors: Liu Yong , Liu Huan , Liu Xiao , Chen Zhangpei
Published: June 2023

Alkenes and their related analogs are ideal starting materials for organic synthesis, and the selective difunctionalization of alkenes, which allows the simultaneous introduction of two neighboring bonds, has gained considerable attention in recent years. In particular, the photoredox-catalyzed difunctionalization of alkenes has also been accomplished, which has been regarded as an increasingly powerful tool for the synthesis of miscellaneous interesting molecular scaffolds in an environmentally benign and economical manner. Several exquisite strategies have been developed to facilitate this transformation, such as photosensitizer-catalyzed redox reactions, electron donor-acceptor (EDA) complexes-mediated photoreactions, and atom transfer radical addition (ATRA) reactions. This literature review briefly describes the most recent key progress on the photoredox-catalyzed 1,2-difunctionalization of various structurally diverse alkenes, including 1,2-dicarbofunctionalization, 1,2-carboheterofunctionalization, and 1,2-diheterofunctionalization, with a special emphasis on the mechanistic details.
Deficiency of Adipose Aryl Hydrocarbon Receptor Protects against Diet-Induced Metabolic Dysfunction through Sexually Dimorphic Mechanisms
Authors: Haque Nazmul , Ojo Emmanuel S. , Krager Stacey L. , Tischkau Shelley A.
Published: June 2023

The molecular mechanisms underlying diet-induced obesity are complex and remain unclear. The activation of the aryl hydrocarbon receptor (AhR), a xenobiotic sensor, by obesogens may contribute to diet-induced obesity through influences on lipid metabolism and insulin resistance acting at various sites, including adipose tissue. Thus, our hypothesis was that conditional AhR depletion, specifically from mature adipose tissue (CadKO), would improve high-fat diet (HFD)-induced metabolic dysfunction. CadKO protects mice from HFD-induced weight gain. CadKO females eat fewer calories, leading to increased energy expenditure (EE) and improved glucose tolerance on HFD. Our exploration of adipose tissue biology suggests that the depletion of AhR from adipocytes provides female mice with an increased capacity for adipogenesis and lipolysis, allowing for the maintenance of a healthy adipocyte phenotype. The HFD-induced leptin rise was reduced in CadKO females, but the hypothalamic leptin receptor (LepR) was increased in the energy regulatory regions of the hypothalamus, suggesting an increased sensitivity to leptin. The estrogen receptor α (ERα) was higher in CadKO female adipose tissue and the hypothalamus. CadKO males displayed a delayed progression of obesity and insulin resistance. In males, CadKO ameliorated proinflammatory adipocytokine secretion (such as TNFα, IL1β, IL6) and displayed reduced inflammatory macrophage infiltration into adipose depots. Overall, CadKO improves weight control and systemic glucose homeostasis under HFD challenge but to a more profound extent in females. CadKO facilitates a lean phenotype in females and mediates healthy adipose–hypothalamic crosstalk. In males, adipose-specific AhR depletion delays the development of obesity and insulin resistance through the maintenance of healthy crosstalk between adipocytes and immune cells.
Retinal Injury Activates Complement Expression in Müller Cells Leading to Neuroinflammation and Photoreceptor Cell Death
Authors: Tabor Steven J. , Yuda Kentaro , Deck Jonathan , Gnanaguru Gopalan , Connor Kip M.
Published: June 2023

Retinal detachment (RD) is a neurodegenerative blinding disease caused by plethora of clinical conditions. RD is characterized by the physical separation of retina from the underlying retinal pigment epithelium (RPE), eventually leading to photoreceptor cell death, inflammation, and vision loss. Albeit the activation of complement plays a critical role in the pathogenesis of RD, the retinal cellular source for complement production remains elusive. Here, using C3 tdTomato reporter mice we show that retinal injury upregulates C3 expression, specifically in Müller cells. Activation of the complement cascade results in the generation of proinflammatory cleaved products, C3a and C5a, that bind C3aR and C5aR1, respectively. Our flow cytometry data show that retinal injury significantly upregulated C3aR and C5aR1 in microglia and resulted in the infiltration of peripheral immune cells. Loss of C3, C5, C3aR or C5aR1 reduced photoreceptor cell death and infiltration of microglia and peripheral immune cells into the sub-retinal space. These results indicate that C3/C3aR and C5/C5aR1 play a crucial role in eliciting photoreceptor degeneration and inflammatory responses in RD.
Who Is Best Placed to Support Cyber Responsibilized UK Parents?
Authors: Prior Suzanne , Renaud Karen
Published: June 2023

The UK government responsibilizes its citizens when it comes to their cyber security, as do other countries. Governments provide excellent advice online, but do not provide any other direct support. Responsibilization is viable when: (1) risk management activities require only ubiquitous skills, (2) a failure to manage the risk does not affect others in the person’s community. Cybersecurity fails on both counts. Consider that parents and carers are effectively being responsibilized to educate their children about cybersecurity, given that young children cannot be expected to consult and act upon government advice. Previous research suggests that UK parents embrace this responsibility but need help in keeping up to date with cybersecurity ‘best practice’. In this paper, we consider a number of possible sources of parental advice, and conclude that support workers would be best placed to support parents in this domain. We then carried out a study to gauge the acceptability of this source of help. We find that parents would be willing to accept advice from this source, and suggest that cybersecurity academics be recruited to train support workers to ensure that they have current ‘best practice’ cybersecurity knowledge to impart to parents.
Fetal Congenital Complete Heart Block: A Rare Case with an Extremely Low Ventricular Rate and Review of Current Management Strategies
Authors: Samples Stefani , Fitt Catherine , Satzer Michael , Wakai Ronald , Strasburger Janette , Patel Sheetal
Published: June 2023

Congenital complete heart block (CCHB) is associated with high intrauterine and post-natal mortality. Prenatal detection and management, as well as appropriate delivery planning, may improve the outcomes in CCHB. We describe a rare case of CCHB that initially presented with fetal ascites and high-grade second-degree heart block noted on fetal echocardiography. The mother was noted to be positive for anti-SSA antibodies, and treatment with maternal steroids was started in an effort to reverse the fetal cardiac conduction abnormality. However, the fetal cardiac rhythm progressed to complete heart block by the follow up evaluation and the fetus had a continual declination of heart rate throughout the pregnancy to a low fetal heart rate of 25 beats per minute (bpm). This case demonstrates the lowest fetal ventricular rate documented in the literature and illustrates a severe presentation of a rare disease process. An overview of the existing knowledge related to etiology, prenatal evaluation with fetal echocardiography and fetal magnetocardiography, prenatal management, and delivery planning in fetuses with prenatally detected CCHB is included.
How Czech Adolescents Perceive Their Physical Activity
Authors: Salonna Ferdinand , Vorlíček Michal , Rubín Lukáš , Vašíčková Jana , Mitáš Josef
Published: June 2023

Adolescence is a critical stage in the development of an individual’s physical activity (PA) habits and preferences. Adolescents’ perceptions of PA can influence their motivation to engage in PA and, consequently, their overall level of PA. Thus, our primary aim was to investigate whether Czech adolescents misperceive their peers’ PA. Our dataset comprised cross-sectional data on 1289 adolescents aged 11–15 years. PA was measured using self-reported items used in the HBSC study. To describe the gender and school grade differences in VPA, independent samples T, ANOVA, Mann–Whitney U, and Kruskal–Wallis H tests were performed. To analyze the effect of gender, school grade, school, and participants’ own PA on the underestimation of PA, binomial regression models were used. Our study points out that there is a discrepancy between self-perceived levels of PA and the perceived descriptive norms of peers’ PA. Adolescents underestimate the prevalence of sufficient PA, and thus perceived descriptive norms in PA as being worse than levels of own PA. These findings indicate room for targeted interventions based on social-norms-based approaches to increase the PA of adolescents or at least strengthen their actual positive behavior.
Diagnostics and Management of Pediatric Headache: An Exploratory Study among Dutch Physical Therapists
Authors: Bot Maria N. , van der Meer Hedwig A. , Meurs de Vries Marloes , Bronkhorst Ewald M. , Kalaykova Stanimira I. , Creugers Nico H. J.
Published: June 2023

Physiotherapists are often part of a multidisciplinary treatment plan for children with headaches. The literature on physical therapeutic diagnostics and management of headaches is often focused on adults. To gain insight, identify knowledge gaps, and increase the evidence needed for clinical physical therapeutic practice with children with headaches, an exploratory method is warranted. The purpose of this study was to describe the views, beliefs, and experiences of physical therapists regarding diagnostics and treatment options for children with headaches. The method consisted of a survey and two peer consultation group meetings. A total of 195 individual surveys were returned and 31 out of 47 peer consultation groups participated. Most participants were specialized in pediatric physical therapy (93.3%). They use the 4P-factor model (predisposing, precipitating, perpetuating, and protective factors) as a guiding principle in the diagnostic and therapeutic process in children with headaches. This model helps to organize and to understand how a variety of factors interact in a biopsychosocial relationship. Pediatric physical therapists focus their treatments on factors interfering with movement and functional abilities of the child with headaches. Knowledge of how temporomandibular disfunction can relate to headaches is currently insufficient for pediatric physical therapists.
The Audiological Follow-Up of Children with Symptomatic Congenital Cytomegalovirus Infection: An Experience in Two Italian Centers
Authors: Palma Silvia , Forli Francesca , Rossi Cecilia , Filice Riccardo , D’adamo Concetta , Roversi Maria Federica , Monzani Daniele , Lorenzoni Francesca , Botti Cecilia , Berrettini Stefano , Bruschini Luca , Berardi Alberto , Genovese Elisabetta , Canelli Rachele
Published: June 2023

Background: Congenital cytomegalovirus (cCMV) infection is the leading cause of non-hereditary sensorineural hearing loss in children. While about 10% of children reportedly display symptoms at birth, 85–90% of cCMV infection cases are asymptomatic. However, 10–15% of these asymptomatic infants may later develop hearing, visual, or neurodevelopmental impairments. This study aimed to evaluate the impact of cCMV infection on newborns’ hearing function with a particular emphasis on progressive and late-onset cases. Methods: This study is a retrospective chart analysis with longitudinal character and was conducted in two Italian centers: Center 1 (from 1 November 2007 to 31 December 2021) and Center 2 (from 1 January 2012 to 31 December 2021). Data collected included newborn hearing screening results, characterization of hearing loss (unilateral/bilateral, degree of impairment), and audiological follow-up. Results: The cohort consisted of 103 children (42% males, 58% females). In total, 28 children presented with hearing impairment; 71.4% (20 out of 28) of the cases of hearing loss were severe/profound, with 35.7% of the cases due to unilateral hearing loss. Out of twenty-eight, six experienced progression of hearing loss and four had late-onset hearing loss. Conclusions: In the absence of universal cCMV screening, hearing screening at birth for cCMV remains a critical factor for early diagnosis. A significant percentage of children affected by cCMV with normal audiological evaluations at birth is easily lost to follow-up. Close collaboration between neonatologists, pediatricians, and audiological services is fundamental to ensure timely diagnosis and treatment of cCMV-related hearing loss.
Sedoanalgesia in the Debridement of Pediatric Burns in the Emergency Department: Is It Effective and Safe?
Authors: Delgado-Miguel Carlos , Miguel-Ferrero Miriam , Ezquerra Andrea , Díaz Mercedes , De Ceano-Vivas María , López-Gutiérrez Juan Carlos
Published: June 2023

Background: The routine use of sedoanalgesia has increased the number of potential minor surgical procedures that can be performed in the Emergency Department (ED) without requiring general anesthesia and, thus, hospital admission. Our aim is to analyze the effectiveness and safety of the use of sedoanalgesia in childhood burns treated in the ED. Methods: A retrospective study was conducted in burned children in whom burn debridement was performed under sedoanalgesia in the ED between 2017 and 2021 in a tertiary referral center for burns. We collected demographic variables, burn features and the type of sedoanalgesia performed in each case, including its effectiveness and associated adverse effects. Results: A total of 227 patients (118 males, 109 females) were included, with a median age of 25 months. In total, 99.2% of the burns were thermal (69.2% scald burns), with a mean total body surface area (TBSA) burned of 4%. The most commonly used drugs were intravenous ketamine (35.7%), intravenous ketamine + midazolam (15.4%), intranasal fentanyl + midazolam (14.1%) and intranasal fentanyl (10.6%). The effectiveness of sedoanalgesia was considered satisfactory in 95.2% of the cases, with an adverse effect rate of 7.5%, without severe adverse effects reported. Conclusions: The use of sedoanalgesia in the ED in the early treatment of childhood burns achieves high effectiveness and safety. It is postulated as a quality indicator; thus, it should be known by all pediatric healthcare practitioners.
Responses to Sensory Events in Daily Life in Children with Cerebral Palsy from a Parent Reported Perspective and in a Swedish Context
Authors: Ericson Annika , Bartonek Åsa , Tedroff Kristina , Lidbeck Cecilia
Published: June 2023

The motor disorders of cerebral palsy (CP) are often accompanied by sensory disturbances, but knowledge of their relationship to motor functioning is sparse. This study explored responses to sensory events in relation to spastic subtype and motor functioning in children with CP. Parents of 60 children with CP (unilateral: 18, bilateral: 42) with GMFCS levels I:29, II:13, III:15 and IV:3 of mean age 12.3 years (3.7 SD) participated. The parents (n = 55) rated their children´s responses with the norm-referenced questionnaire Child Sensory Profile-2© (CSP-2©), Swedish version, incorporating nine sections and four sensory processing patterns/quadrants, and replied (n = 57) to two additional questions. On the CSP-2©, thirty (55%) of the children were reported to have responses “much more than others“ (>2 SD) in one or more of the sections and/or quadrants and 22 (40%) in the section of Body Position, overrepresented by the children with bilateral CP. The additional questions revealed that a greater proportion of children at GMFCS levels III-IV compared to level I frequently were requested to sit/stand up straight (14/17 versus 6/26, p < 0.001) and were sound sensitive at a younger age (14/17 versus 10/26, p = 0.005). The findings of this study highlight the sensory aspects of motor functioning in children with spastic CP.
Is the Frequency of Postpartum Breastfeeding Counseling Associated with Exclusive Breastfeeding at Six Months? An Analytical Cross-Sectional Study
Authors: Hassounah Marwah , Dabbagh Rufaidah , Younis Afnan
Published: June 2023

Breastfeeding counseling is an essential public health tool in postpartum maternal and infant health. In this study, we aimed to explore the relationship between the frequency of postpartum breastfeeding counseling and the type of feeding outcome at six months. The study design was an analytical, cross-sectional study on mothers of 6–24-month-old children living in Riyadh, Saudi Arabia. We conducted an analysis with descriptive statistics as well as logistic regression models. The findings from our study can be summarized in the following points: First, only 31.9% of the women in our study received postnatal breastfeeding counseling in the first six months after delivery, with the majority receiving fewer than four sessions. Second, there seemed to be a drop in exclusive breastfeeding with time: from 35.3% in the first two months to 29.7% in the second two months and then 20.7% in the final two months. Third, previous exclusive breastfeeding increased the odds of exclusive breastfeeding in the proceeding delivery. Finally, exposure to one or more postnatal breastfeeding counseling sessions increased the odds of exclusive or predominant breastfeeding in the first six months. This study helps to guide decision makers in planning maternal child health services and relevant community-based efforts.
Development of Clause Complexity in Children with Specific Language Impairment/Language Development Disorder: A Longitudinal Study
Authors: Araya Claudia , Coloma Carmen Julia , Quezada Camilo , Benavente Paula
Published: June 2023

This paper addresses the grammatical challenges associated with the development of clause complexity, focusing on the performance of a group of monolingual Spanish-speaking schoolchildren with Specific Language Impairment/Developmental Language Disorder (SLI/DLD) in a longitudinal corpus of oral narrative samples. The study examines the presence of interclause relations of subordination and equivalence (hypotaxis and parataxis) in language samples of two groups: an experimental group made up of 24 schoolchildren with SLI/DLD and a control group made up of 24 schoolchildren with typical development (TD). The results show that while both groups use parataxis as the most common relation between clauses in all school grades, there is a significant decrease in paratactic relations and a significant increase in hypotactic relations from first to fourth grade of primary education. Although the development patterns are highly similar, the SLI/DLD group shows greater difficulties in mastering more complex (hypotactic) relations in fourth grade compared to the control group, indicating that it is less sophisticated in the use of these types of complex relations. These findings suggest that focused support on the most complex structures is needed towards the fourth grade of primary education, given the demands of the school academic register from 6 and 7 years of age and the potential problems that the development of clause complexity can cause in school-age children.
Adequate Nutrition in Early Childhood
Authors: Kozioł-Kozakowska Agnieszka
Published: June 2023

For children, receiving adequate nutrition in their first 1000 days of life is vital to ensuring their appropriate growth and preventing the future development of diseases [...]
Microbial Community Responses to Alterations in Historical Fire Regimes in Montane Grasslands
Authors: Gokul Jarishma K. , Matcher Gwynneth , Dames Joanna , Nkangala Kuhle , Gordijn Paul J. , Barker Nigel P.
Published: June 2023

The influence of fire regimes on soil microbial diversity in montane grasslands is a relatively unexplored area of interest. Understanding the belowground diversity is a crucial stepping-stone toward unravelling community dynamics, nutrient sequestration, and overall ecosystem stability. In this study, metabarcoding was used to unravel the impact of fire disturbance regimes on bacterial and arbuscular mycorrhizal fungal community structures in South African montane grasslands that have been subjected to an intermediate (up to five years) term experimental fire-return interval gradient. Bacterial communities in this study exhibited a shift in composition in soils subjected to annual and biennial fires compared to the controls, with carbon and nitrogen identified as significant potential chemical drivers of bacterial communities. Shifts in relative abundances of dominant fungal operational taxonomic units were noted, with Glomeromycota as the dominant arbuscular mycorrhiza observed across the fire-return gradient. A reduction in mycorrhizal root colonisation was also observed in frequently burnt autumnal grassland plots in this study. Furthermore, evidence of significant mutualistic interactions between bacteria and fungi that may act as drivers of the observed community structure were detected. Through this pilot study, we can show that fire regime strongly impacts bacterial and fungal communities in southern African montane grasslands, and that changes to their usually resilient structure are mediated by seasonal burn patterns, chemical drivers, and mutualistic interactions between these two groups.
Binary Integer Formulations for Task Allocation and Optimal Labor Cost in Small and Medium Apparel Manufacturing
Authors: Nguyen Vi , Tran Quyen , Altarazi Faisal , Tran Thanh
Published: June 2023

In small apparel manufacturing, unit price determination is often based on production duration given by customers and design complexity rather than information relating to internal labor resources. However, labor expertise and skills are critical factors that outweigh the machinery and technology in small and medium apparel companies. The quality of the product greatly depends on the experience and delicacy of the tailors. Using data on labor skill and wage levels in the planning process will benefit human resource utilization, increasing productivity, and profits effectively. This paper proposes a general mathematical model for task allocation and cost optimization for small and medium apparel companies. The model handles task allocation and cost minimization problems that must ensure processing time requirements and balance workloads for operators. The developed model tests two case studies in a published paper. The results prove that although the proposed model is simple, it has high applicability and efficiency in solving allocation optimization problems. The authors then integrate the formulations into a Standalone desktop app in the MATLAB “App designer” module. With a standalone desktop app, end users can enjoy the application. This app has a user-friendly design. Users unfamiliar with computers or planners with no background in programming can use the app to tackle similar optimization problems. The proposed mathematical model can further expand to include more complex issues in apparel companies and can also be a good reference for other fields.
Lung Cancer Screening with Low-Dose CT: What We Have Learned in Two Decades of ITALUNG and What Is Yet to Be Addressed
Authors: Mascalchi Mario , Picozzi Giulia , Puliti Donella , Diciotti Stefano , Deliperi Annalisa , Romei Chiara , Falaschi Fabio , Pistelli Francesco , Grazzini Michela , Vannucchi Letizia , Bisanzi Simonetta , Zappa Marco , Gorini Giuseppe , Carozzi Francesca Maria , Carrozzi Laura , Paci Eugenio
Published: June 2023

The ITALUNG trial started in 2004 and compared lung cancer (LC) and other-causes mortality in 55–69 years-aged smokers and ex-smokers who were randomized to four annual chest low-dose CT (LDCT) or usual care. ITALUNG showed a lower LC and cardiovascular mortality in the screened subjects after 13 years of follow-up, especially in women, and produced many ancillary studies. They included recruitment results of a population-based mimicking approach, development of software for computer-aided diagnosis (CAD) and lung nodules volumetry, LDCT assessment of pulmonary emphysema and coronary artery calcifications (CAC) and their relevance to long-term mortality, results of a smoking-cessation intervention, assessment of the radiations dose associated with screening LDCT, and the results of biomarkers assays. Moreover, ITALUNG data indicated that screen-detected LCs are mostly already present at baseline LDCT, can present as lung cancer associated with cystic airspaces, and can be multiple. However, several issues of LC screening are still unaddressed. They include the annual vs. biennial pace of LDCT, choice between opportunistic or population-based recruitment. and between uni or multi-centre screening, implementation of CAD-assisted reading, containment of false positive and negative LDCT results, incorporation of emphysema. and CAC quantification in models of personalized LC and mortality risk, validation of ultra-LDCT acquisitions, optimization of the smoking-cessation intervention. and prospective validation of the biomarkers.
Inflammatory Biomarkers Affecting Survival Prognosis in Patients Receiving Veno-Venous ECMO for Severe COVID-19 Pneumonia
Authors: Drmić Željka , Bandić Ivan , Hleb Sonja , Kukoč Andrea , Sakan Sanja , Sojčić Nataša , Kristović Darko , Mikecin Verica , Presečki Ivana , Oremuš Zrinka Šafarić , Bradić Nikola , Peršec Jasminka , Šribar Andrej
Published: June 2023

Severe COVID-19 pneumonia in which mechanical ventilation is unable to achieve adequate gas exchange can be treated with veno-venous ECMO, eliminating the need for aggressive mechanical ventilation which might promote ventilator-induced lung injury and increase mortality. In this retrospective observational study, 18 critically ill COVID-19 patients who were treated using V-V ECMO during an 11-month period in a tertiary COVID-19 hospital were analyzed. Biomarkers of inflammation and clinical features were compared between survivors and non-survivors. Survival rates were compared between patients receiving ECMO and propensity matched mechanically ventilated controls. There were 7 survivors and 11 non-survivors. The survivors were significantly younger, with a higher proportion of females, higher serum procalcitonin at ICU admission, and before initiation of ECMO they had significantly lower Murray scores, PaCO2, WBC counts, serum ferritin levels, and higher glomerular filtration rates. No significant difference in mortality was found between patients treated with ECMO compared to patients treated using conventional lung protective ventilation. Hypercapnia, leukocytosis, reduced glomerular filtration rate, and increased serum ferritin levels prior to initiation of V-V ECMO in patients with severe COVID-19 pneumonia may be early warning signs of reduced chance of survival. Further multicentric studies are needed to confirm these findings.
Advancing HIV Drug Resistance Technologies and Strategies: Insights from South Africa’s Experience and Future Directions for Resource-Limited Settings
Authors: Steegen Kim , van Zyl Gert U. , Claassen Mathilda , Khan Aabida , Pillay Melendhran , Govender Subitha , Bester Phillip A. , van Straaten Johanna M. , Kana Vibha , Cutler Ewaldé , Kalimashe Monalisa N. , Lebelo Ramokone L. , Moloi Mokopi B. H. , Hans Lucia
Published: June 2023

Monitoring of HIV drug resistance (HIVDR) remains critical for ensuring countries attain and sustain the global goals for ending HIV as a public health threat by 2030. On an individual patient level, drug resistance results assist in ensuring unnecessary treatment switches are avoided and subsequent regimens are tailored on a case-by-case basis, should resistance be detected. Although there is a disparity in access to HIVDR testing in high-income countries compared to low- and middle-income countries (LMICS), more LMICs have now included HIVDR testing for individual patient management in some groups of patients. In this review, we describe different strategies for surveillance as well as where HIVDR testing can be implemented for individual patient management. In addition, we briefly review available technologies for HIVDR testing in LMICs, including Sanger sequencing, next-generation sequencing, and some point-of-care options. Finally, we describe how South Africa has implemented HIVDR testing in the public sector.
Morphological Changes in the Myocardium of Patients with Post-Acute Coronavirus Syndrome: A Study of Endomyocardial Biopsies
Authors: Makarov Igor , Mayrina Sofya , Makarova Taiana , Karonova Tatiana , Starshinova Anna , Kudlay Dmitry , Mitrofanova Lubov
Published: June 2023

The clinical manifestation study of post-acute sequelae of SARS-CoV-2 infection (PASC) has shown a lack of knowledge regarding its morphology and pathogenesis. The aim of this research was to investigate morphological manifestations of PASC in the myocardium. Materials and Methods: The study included 38 patients requiring endomyocardial biopsy (EMB) during the post-acute phase of coronavirus infection and a control group including patients requiring EMB prior to the SARS-CoV-2 pandemic. The patients’ clinical and laboratory data were analyzed. Histological examination and immunohistochemistry (IHC) of the myocardial tissue was conducted with antibodies to CD3, CD68, HLA-DR, MHC1, C1q, VP1 enteroviruses, spike protein SARS-CoV-2, Ang1, von Willebrand factor (VWF), and VEGF. The morphometric analysis included counting the mean number of inflammatory infiltrate cells per mm2 and evaluating the expression of SARS-CoV-2 spike protein, HLA-DR, MHC1, C1q, Ang1, VWF, and VEGF using a scoring system. If the expression of SARS-CoV-2 spike protein was >3 points, an additional IHC test with antibodies to ACE2, CD16 as well as RT-PCR testing of the myocardial tissue were performed. For two patients, immunofluorescence tests of the myocardial tissue were performed using antibody cocktails to SARS-CoV-2 spike protein/CD16, SARS-CoV-2 spike protein/CD68, CD80/CD163. The statistical data analysis was carried out using the Python programming language and libraries such as NumPy, SciPy, Pandas, and Matplotlib. Results: The study demonstrated a significant increase in the number of CD68+ macrophages in the myocardium of PASC patients compared to patients who did not have a history of COVID-19 (p = 0.014 and p = 0.007 for patients with and without myocarditis, respectively), predominantly due to M2 macrophages. An increase in the number of CD68+ macrophages was more frequently observed in patients with shorter intervals between the most recent positive SARS-CoV-2 PCR test and the time of performing the EMB (r = −0.33 and r = −0.61 for patients with and without myocarditis, respectively). The expression scores of Ang1, VEGF, VWF, and C1q in PASC patients did not significantly differ from those in EMB samples taken before 2019. Conclusion: The myocardium of PASC patients demonstrated a significant increase in the number of CD68+ macrophages and a decrease in the expression of markers associated with angiopathy. No evidence of coronavirus-associated myocarditis was observed in any PASC patient.
Synthetic Attenuation Correction Maps for SPECT Imaging Using Deep Learning: A Study on Myocardial Perfusion Imaging
Authors: Prieto Canalejo Mariana , Palau San Pedro Aley , Geronazzo Ricardo , Minsky Daniel , Juárez-Orozco Luis , Namías Mauro
Published: June 2023

(1) Background: The CT-based attenuation correction of SPECT images is essential for obtaining accurate quantitative images in cardiovascular imaging. However, there are still many SPECT cameras without associated CT scanners throughout the world, especially in developing countries. Performing additional CT scans implies troublesome planning logistics and larger radiation doses for patients, making it a suboptimal solution. Deep learning (DL) offers a revolutionary way to generate complementary images for individual patients at a large scale. Hence, we aimed to generate linear attenuation coefficient maps from SPECT emission images reconstructed without attenuation correction using deep learning. (2) Methods: A total of 384 SPECT myocardial perfusion studies that used 99mTc-sestamibi were included. A DL model based on a 2D U-Net architecture was trained using information from 312 patients. The quality of the generated synthetic attenuation correction maps (ACMs) and reconstructed emission values were evaluated using three metrics and compared to standard-of-care data using Bland–Altman plots. Finally, a quantitative evaluation of myocardial uptake was performed, followed by a semi-quantitative evaluation of myocardial perfusion. (3) Results: In a test set of 66 test patients, the ACM quality metrics were MSSIM = 0.97 ± 0.001 and NMAE = 3.08 ± 1.26 (%), and the reconstructed emission quality metrics were MSSIM = 0.99 ± 0.003 and NMAE = 0.23 ± 0.13 (%). The 95% limits of agreement (LoAs) at the voxel level for reconstructed SPECT images were: [−9.04; 9.00]%, and for the segment level, they were [−11; 10]%. The 95% LoAs for the Summed Stress Score values between the images reconstructed were [−2.8, 3.0]. When global perfusion scores were assessed, only 2 out of 66 patients showed changes in perfusion categories. (4) Conclusion: Deep learning can generate accurate attenuation correction maps from non-attenuation-corrected cardiac SPECT images. These high-quality attenuation maps are suitable for attenuation correction in myocardial perfusion SPECT imaging and could obviate the need for additional imaging in standalone SPECT scanners.