bluuebunny/crossref_metadata_2025 huggingface dataset:
Incident Cardiometabolic Comorbidities in Smokers with/Without Chronic Obstructive Pulmonary Disease: A Long-Term Cohort Study
Authors: Herrero-Cortina Beatriz , Maldonado-Guaje Aura , Rodriguez-Sanz Jorge , Boldova-Loscertales Ana , Cubero-Marin Pablo , Marin-Oto Marta , Sanz-Rubio David , Marin Jose M.
Published: December 2024

Backgrounds: Despite the significant global health impact of cardiometabolic multimorbidity (CMM), our understanding of potential predictors associated with its development in smokers, remains limited. Objective: This study aimed to investigate whether a new COPD diagnosis and the rate of lung function decline serve as predictors for incident CMM (defined as having at least two of the following comorbidities: cerebro-cardiovascular diseases, hypertension, dyslipidemia, and diabetes mellitus) in smokers. Methods: An observational longitudinal analysis of prospectively collected data was conducted, including smokers without a previous COPD diagnosis and any cardiometabolic conditions. Sociodemographic and clinical data (body mass index, smoking history, respiratory symptoms, and hospital admissions) were collected at baseline. Lung function tests were performed at baseline and at the end of the follow-up period. The incidence of CMM, a new positive diagnosis of COPD, and the forced expiratory volume in 1 s (FEV1) annual rate of decline were prospectively registered. Adjusted Cox proportional hazard models were adopted to explore risk factors associated with the incidence of CMM. Results: From the 391 smokers included in the study, 207 (53%) were newly diagnosed with COPD, and 184 had a preserved spirometry at baseline (non-COPD group). After nearly a decade of follow-up, 34% (n = 133) of smokers developed CMM. This group was characterized by male predominance, older age, higher BMI and pack-years of smoking, lower post-FEV1, baseline COPD diagnosis, and a history of hospital admission. A positive diagnosis of COPD at baseline and a greater rate of lung function decline (ΔFEV1 ≥ 40 mL/year) were independent predictors for developing CMM. Conclusions: A new COPD diagnosis and an accelerated decline in lung function are significantly associated with the development of CMM in smokers.
Utility of Simultaneous Left Atrial Strain–Volume Relationship During Passive Leg Lift to Identify Elevated Left Ventricular Filling Pressure—A Proof-of-Concept Study
Authors: Venkateshvaran Ashwin , Wiklund Urban , Lindqvist Per , Lindow Thomas
Published: December 2024

Background: The assessment of left ventricular (LV) filling pressure in heart failure (HF) poses a diagnostic challenge, as HF patients may have normal LV filling pressures at rest but often display elevated LV filling pressures during exercise. Rapid preload increase during passive leg lift (PLL) may unmask HF in such challenging scenarios. We explored the dynamic interplay between simultaneous left atrial (LA) function and volume using LA strain/volume loops during rest and PLL and compared its diagnostic performance with conventional echocardiographic surrogates to detect elevated LV filling pressure. Methods: We retrospectively reviewed 35 patients with clinical HF who underwent simultaneous echocardiography and right heart catheterization before and immediately after PLL. Patients with atrial fibrillation (n = 4) were excluded. Twenty age-matched, healthy controls were added as controls. LA reservoir strain (LASr) was analyzed using speckle-tracking echocardiography. LA strain–volume loops were generated, including the best-fit linear regression line employing simultaneous LASr and LA volume. Results: LA strain–volume slope was lower for HF patients when compared with controls (0.71 vs. 1.22%/mL, p < 0.001). During PLL, the LA strain–volume slope displayed a moderately strong negative correlation with invasive pulmonary arterial wedge pressure (PAWP) (r = −0.71, p < 0.001). At a 0.74%/mL cut-off, the LA strain–volume slope displayed 88% sensitivity and 86% specificity to identify elevated PAWP (AUC 0.89 [0.76–1.00]). In comparison, LASr demonstrated strong but numerically lower diagnostic performance (AUC 0.82 [0.67–0.98]), and mitral E/e’ showed poor performance (AUC 0.57 [0.32–0.82]). Conclusions: In this proof-of-concept study, LA strain–volume characteristics provide incremental diagnostic value over conventional echocardiographic measures in the identification of elevated LV filling pressure.
Objective Voice Analysis in Partial Deafness: Comparison of Multi-Dimensional Voice Program (MDVP) and VOXplot Results
Authors: Myszel Karol
Published: December 2024

Acoustic analysis of voice enables objective assessment of voice to diagnose changes in voice characteristics, and track the progress of therapy. In contrast to subjective assessment, objective measurements provide mathematical results referring to specific parameters and can be analyzed statistically. Changes in the voice of patients with partial deafness (PD) were not widely described in the literature, and recent studies referred to the voice parameters measured in this group of patients only using the multi-dimensional voice program (MDVP) by Kay Pentax. This paper describes the results of acoustic analysis of voice in patients with PD using VOXplot, and compares the results with those achieved with MDVP. Background/Objectives: The purpose of this study was a VOXplot objective analysis of voice in individuals with PD and to assess consistency with results obtained using MDVP and with perceptual assessment. Methods: Voice samples from 22 post-lingual PD individuals were recorded. They included continuous speech (cs) and sustained vowels (sv). The control group consisted of 22 healthy individuals with no history of voice or hearing dysfunction. The samples were analyzed with MDVP followed by VOXplot version 2.0.0 Beta. Statistical analysis was performed using a t-test paired with two samples for means. All individuals were also subjected to a perceptual voice assessment using the GRBAS by Hirano. Results: Differences were observed in 13 VOXplot parameters measured in voice samples of adults with PD compared with those in the control group. Both multiparametric indices, AVQI and ABI, showed a statistical increase. When it comes to MDVP parameters correlating with breathiness, all of them (shim dB, APQ, NHR, SPI, and NSH) increased in patients with partial deafness, reflecting a breathy voice. Only one increase in the SPI was not statistically significant. Seven MDVP parameters correlating with hoarseness were elevated, and five (Jitt%, vF0, Shim dB, APQ, and NHR) showed a statistically significant increase. Correlations were found of VOXplot and MDVP parameters with perceptual voice assessment. Conclusions: Both programs for objective assessment showed voice abnormalities in patients with PD compared with the control groups. There was a poor to moderate level of consistency in the results achieved using both systems. Correlations were also found with GRBAS assessment results.
A Practical Clinical Approach to Navigate Pulmonary Embolism Management: A Primer and Narrative Review of the Evolving Landscape
Authors: Benavente Kevin , Fujiuchi Bradley , Virk Hafeez Ul Hassan , Kavali Pavan K. , Ageno Walter , Barnes Geoffrey D. , Righini Marc , Alam Mahboob , Rosovsky Rachel P. , Krittanawong Chayakrit
Published: December 2024

Advances in imaging, pharmacological, and procedural technologies have rapidly expanded the care of pulmonary embolism. Earlier, more accurate identification and quantification has enhanced risk stratification across the spectrum of the disease process, with a number of clinical tools available to prognosticate outcomes and guide treatment. Direct oral anticoagulants have enabled a consistent and more convenient long-term therapeutic option, with a greater shift toward outpatient treatment for a select group of low-risk patients. The array of catheter-directed therapies now available has contributed to a more versatile and nuanced armamentarium of treatment options, including ultrasound-facilitated thrombolysis and mechanical thrombectomy. Research into supportive care for pulmonary embolism have explored the optimal use of vasopressors and volume resuscitation, as well as utilization of various devices, including right ventricular mechanical support and extracorporeal membrane oxygenation. Even in the realm of surgery, outcomes have steadily improved in experienced centers. This rapid expansion in diagnostic and therapeutic data has necessitated implementation of pulmonary embolism response teams to better interpret the available evidence, manage the utilization of advanced therapies, and coordinate multidisciplinary care. We provide a narrative review of the risk stratification and management of pulmonary embolism, with a focus on structuralizing the multidisciplinary approach and organizing the literature on new and emerging therapies.
Comparison of the Effects of Oral Hygiene Instruction Methods on Oral Hygiene and Self-Perception in Older Adults: A Randomized Controlled Trial
Authors: Santos Inês Caetano , Colaço Catarina , Canales Giancarlo De la Torre , Proença Luís , Polido Mário , Mendes José João , Canhão Helena , Manso Ana Cristina
Published: December 2024

Background: Age-related conditions, such as being misinformed, having limited oral health literacy, and the loss of manual dexterity, autonomy, or visual acuity, may act as barriers to oral health. The aim of this study was to evaluate the effectiveness of two different oral hygiene instruction methods on oral hygiene and the self-perception of oral health in older adults. Methods: This randomized controlled trial included participants aged 65 and older who completed a questionnaire on socio-economic factors, self-perceived oral health, and oral hygiene behaviours. Oral hygiene status was assessed using the Oral Hygiene Index—Simplified (OHI-S). Participants were randomly allocated into two different groups, according to the method of oral hygiene instruction: a “General Approach” (GA) (n = 28) and a “Personalized Technique” (PT) (n = 26). After two months, a follow-up session was conducted. Data were analysed using descriptive and inferential methodologies. Results: The GA and PT methods were effective in promoting oral hygiene behaviours, with a significant increase in the use of interdental devices, but no significant differences were found between the two methods. Self-perceived oral health did not change significantly, neither after the instruction nor between methods. Significant improvements were achieved with both methods for the OHI-S, with significant differences between the two methods for the Calculus Index, where the PT achieved better results. Conclusions: Oral hygiene education leads to improvements in the adoption of oral hygiene behaviours and clinical indicators. Furthermore, a personalized approach promoted better results in clinical indicators.
Left Atrial Functional and Structural Characteristics in Patients After Total and Bicaval Orthotopic Heart Transplantation
Authors: Obremska Marta , Przybylski Roman , Sokolski Mateusz , Przewłocka-Kosmala Monika , Rakowski Mateusz , Ptak Jakub , Sareło Przemysław , Zakliczyński Michał , Kosmala Wojciech
Published: December 2024

Background/Objectives: Currently, the most popular techniques for orthotopic heart transplantation (OHTx) are bicaval and total OHTx. Although bicaval OHTx has shown advantages over the biatrial approach, comparisons between bicaval and total OHTx reain limited. To compare the functional and morphological characteristics of the left atrium (LA) in patients after bicaval and total OHTx. Methods: Sixty-six patients (age 51.2 ± 10.5 years) after total OHTx (33 patients) and bicaval OHTx (33 patients) were included in this case–control study. Recipients were matched for sex, age, and time from transplantation and absence of severe graft rejection based on routine endomyocardial biopsies (EMB) performed during follow-up. Echocardiography included standard measurements along with a speckle-tracking assessment of LA strain. Results: Compared with the bicaval OHTx, the total OHTx group showed higher atrial mitral inflow velocity, resulting in a lower E/A ratio, lower LA volume index, and higher LA emptying fraction. Both the reservoir and contraction components of LA function, as assessed by LA deformation, were found to show more favorable profiles in the total OHTx group than in the bicaval group (26.5 ± 6.9 vs. 17.4 ± 4.7, p < 0.001 and 14.8 ± 5.8 vs. 6.0 ± 4.5, p < 0.001, respectively). Multivariable analysis identified surgical technique, left ventricular global longitudinal strain, and the presence of diabetes in the recipient as independent determinants of LA strain. Conclusions: Total OHTx is associated with better LA morphology and function than bicaval OHTx. This may provide better conditions for LA-LV coupling in transplanted hearts and contribute to a more stable electrophysiological environment in atrial tissue.
Cross-Sectional Analysis of Hypoxia-Regulated miRNA-181a, miRNA-199a, HIF-1α, and SIRT1 in the Development of Type 2 Diabetes in Patients with Obstructive Sleep Apnea—Preliminary Study
Authors: Karuga Filip Franciszek , Kaczmarski Piotr , Sochal Marcin , Szmyd Bartosz , Białasiewicz Piotr , Gabryelska Agata
Published: December 2024

Introduction: Obstructive sleep apnea (OSA) is recognized as an independent risk factor for diabetes mellitus type 2 (T2DM) development, which is twice as common in patients with OSA compared to non-OSA patients. Objectives: This study aimed to investigate changes in oxygen metabolism and their role in T2DM development among OSA patients through epigenetic processes via miRNA-181a, miRNA-199a, and enzymatic processes via SIRT1 and HIF-1α. Methods: Based on polysomnography, apnea–hypopnea index and the presence of T2DM patients were divided into three groups: control group (n = 17), OSA group (n = 11), OSA&T2DM (n = 20) group. Total RNA was extracted from the buffy coat. Moreover, HOMA-IR (Homeostatic Model Assessment for Insulin Resistance) was counted. Results: Morning miRNA-181a expression was significantly higher in the OSA&T2DM group than in the control group: 67.618 vs. 32.685 (p = 0.036). Evening miRNA-199a expression was significantly higher in the OSA group than in the control group: 5.043 vs. 2.081 (p = 0.042), while its morning expression was significantly higher in the OSA&T2DM group when compared to the control: 4.065 vs. 1.605 (p = 0.036). MiRNA-181a evening expression revealed a negative correlation with the SIRT1 evening and morning expressions (R = −0.367, p = 0.010 and R = −0.405, p = 0.004, respectively). Moreover, morning miRNA-181a was positively correlated with HOMA-IR (R = 0.321, p = 0.034). MiRNA-199a evening expression presented a moderate positive correlation with the SIRT1 morning expressions (R = 0.48, p < 0.001) and HOMA-IR (R = 0.35, p = 0.02). Conclusions: Patients suffering from OSA and T2DM had an increased expression of miRNA-181a. Moreover, a negative correlation between miRNA-181a and SIRT1 expression was observed, while a correlation between miRNA-181a and insulin resistance was positive. This phenomenon might suggest a possible epigenetic pathway for an increased incidence of T2DM in OSA patients however further research is needed.
Put Down the ACE: Low Clinical Utility for Angiotensin-Converting Enzyme Levels in Sarcoidosis: A Single-Center Retrospective Cohort Study
Authors: Druyan Amit , Shuv Noam , Lidar Merav
Published: December 2024

Background/Objectives: ACE (angiotensin-converting enzyme) is considered a serological marker of sarcoidosis as elevated levels have been reported in 30–80% of patients. However, elevated ACE levels are also encountered in other medical conditions, and the clinical correlation between ACE levels and disease activity in sarcoidosis is disputable as well. To determine the significance of elevated ACE levels in the diagnosis and follow-up of sarcoidosis patients. Methods: All electronic patient records in which an ACE level was recorded in a large tertiary hospital were identified using a computerized algorithm. Medical diagnoses, ACE numerical values, and clinical data were also automatically extracted. Furthermore, all records with a diagnosis of sarcoidosis were manually reviewed for ascertainment of the diagnosis and searched for additional clinical manifestations and treatment responses. Results: A total of 1416 records with a documented ACE level were found in the database, and 146 of the records had a diagnosis of sarcoidosis in the medical record. However, the diagnosis was excluded in 27 of these cases after a manual review of the records. Elevated ACE levels were most commonly encountered among patients with sarcoidosis, non-Hodgkin’s lymphoma, cirrhosis, and interstitial lung disease. Elevated ACE levels had a positive predictive value of 12.76% and a negative predictive value of 94.6% for the diagnosis of sarcoidosis in our cohort, with a sensitivity of 63.5% and a specificity of 59.5%. Among patients with sarcoidosis, ACE levels around the time of diagnosis were higher than ACE levels in remission. However, a paired analysis did not find a statistically significant difference in ACE levels between the two timepoints. A positive correlation between lack of cardiac involvement and elevated ACE levels was found on multivariate analysis. Conclusions: ACE levels are a non-specific serological marker with low specificity and sensitivity for sarcoidosis and a poor positive predictive value, but with a negative predictive value of 94.6%. Furthermore, elevated ACE levels correlated poorly with disease activity in our cohort.
Subclinical Detection of Hydroxychloroquine-Induced Retinopathy in Patients with Systemic Lupus Erythematous Using Multifocal Electroretinography and Optical Coherence Tomography
Authors: Jung Suk Hoon , Park Young-Hoon , Park Young Gun
Published: December 2024

Background/Objectives: Although hydroxychloroquine (HCQ) is used to treat systemic lupus erythematosus (SLE), it is associated with retinal toxicity. Early diagnosis can prevent the further progression of HCQ-associated retinopathy by discontinuing HCQ treatments. This study aimed to evaluate the early diagnostic parameters in patients with SLE treated with HCQ and identify the best approach using multifocal electroretinography (mfERG) and swept-source optical coherence tomography (SS-OCT) to reflect subclinical retinal toxicity. Methods: Thirty-eight patients with SLE (76 eyes) and 18 healthy controls (36 eyes) were enrolled. They were referred for HCQ retinopathy screening without visual field defects. The patients were tested using a standard 61-hexagon mfERG stimulus and SS-OCT. Ten groups of the mfERG responses from the sectors were averaged to compare the quadrants, hemiretinal areas, consecutive ring amplitudes, and ring ratios (R1/R2–R5) from the center to the periphery. Additionally, the ganglion cell complex (GCC) analyses were performed using SS-OCT. Results: No difference was observed in GCC thickness on the OCT images, in the P1 amplitudes, and in the implicit time of mfERG. However, the R1/Rx ring ratios, except the R1/R2 ratio, showed significant differences among the three groups (p = 0.759, 0.018, 0.029, and 0.029, respectively). The R1/R3, R1/R4, and R1/R5 ring ratios demonstrated a correlation with the duration of HCQ therapy (r = −0.303, −0.279, and −0.266; p = 0.003, 0.006, and 0.009). The areas under the receiver operating characteristic curve of the ring ratios R1/R3–R5 were 0.730, 0.702, and 0.724, respectively (p = 0.004, 0.012, and 0.006), indicating the likelihood of being categorized as a high-risk group for subclinical HCQ retinopathy. Conclusions: The ring ratio of mfERG reflects the subclinical electrophysiological alterations induced by HCQ and can become more clinically useful by simplifying screening examinations.
Predictive and Prognostic Values of Glycoprotein 96, Androgen Receptors, and Extranodal Extension in Sentinel Lymph Node-Positive Breast Cancer: An Immunohistochemical Retrospective Study
Authors: Klarica Gembić Tihana , Grebić Damir , Gulić Tamara , Golemac Mijo , Avirović Manuela
Published: December 2024

Objectives: In this paper, we investigate the association of glycoprotein 96 (GP96) and androgen receptor (AR) expression with clinicopathological factors, additional axillary lymph node burden, and their potential role in predicting 5-year overall survival (OS) and disease-free survival (DFS) in breast cancer (BC) patients with sentinel lymph node (SLN) involvement. We also explore the prognostic value of the presence of extranodal extension (ENE) in SLN. Methods: We retrospectively enrolled 107 female patients with cT1-T2 invasive BC and positive SLN biopsy. GP96 and AR expression were immunohistochemically evaluated on tissue microarrays constructed from two 2 mm diameter cores of formalin-fixed paraffin-embedded tumor tissues from each patient. ENE in SLN was measured in the highest (HD-ENE) and widest diameter (WD-ENE). Relative GP96 gene expression was determined using real-time quantitative PCR. Results: The analysis revealed ENE in SLN as the strongest predictive factor for non-SLN metastases. Patients with WD-ENE > HD-ENE had a higher risk of non-SLN metastases and worse DFS compared to those with WD-ENE ≤ HD-ENE. High GP96 expression was associated with a greater relative risk for locoregional recurrence but showed no significant impact on OS or DFS. Histological grade 3, extensive intraductal component (EIC), higher lymph node ratio (LNR), and negative AR were associated with worse DFS, while age, histological grade 3, EIC, and higher LNR were independent predictors of OS. GP96 mRNA levels were elevated in BC tissue compared to normal breast tissue. Conclusions: ENE in SLN is the strongest predictor of non-SLN involvement and could also have prognostic significance. While GP96 expression does not influence survival outcomes, AR expression could be used as a valuable biomarker in the follow-up of BC patients.
Risk of Surgical Site Infection in Posterior Spine Surgery Using Different Closing Techniques: A Retrospective Study of Two Neurosurgical Centers
Authors: Molliqaj Granit , Lener Sara , Da Broi Michele , Nouri Aria , Silva Baticam Nalla , Schaller Karl , Thomé Claudius , Girod Pierre-Pascal , Tessitore Enrico
Published: December 2024

Objectives: To determine whether a closed dressing protocol reduces the surgical site infections (SSI) rate compared to conventional closing techniques. Methods: Patients who underwent lumbar spine surgery at two neurosurgical centers were retrospectively included from June 2015 to December 2019. Data on patients, general risk factors, and surgical risk factors for SSI were collected. Patients were subdivided into two groups: a Closed Protocol where the Dermabond® ± Prineo® dressing system was used, and a Conventional Protocol, namely sutures or staples. Statistical analysis was undertaken to compare the infection rates among the different closure techniques. Results: Altogether, 672 patients were included. In the whole cohort, 157 (23.36%) underwent skin closure with staples, 122 (18.15%) with sutures, 98 (14.58%) with intracutaneous sutures, 78 (11.61%) with Dermabond®, and 217 (32.29%) with Demabond® + Prineo®. The overall infection rate was 2.23% (n = 15). Skin suture had the highest infection rate (4.10%), while the lowest was Dermabond® (1.28%) and Dermabond® + Prineo® (1.4%), though the difference was not significant. Risk factors for SSI included higher BMI (29.46 kg/m2 vs. 26.96 kg/m2, p = 0.044), other sites infection (20.00% vs. 2.38%, p = 0.004), and a higher national nosocomial infections surveillance score (p = 0.003). Conclusions: This study showed that a closed protocol with the use of adhesive dressing with or without mesh had a slight tendency to lower infection rates compared to conventional protocol with sutures or staples, although no statistically significant difference was found between the closure techniques. Larger randomized studies are needed to investigate this potential benefit avoiding selection bias.
Lymph Node Dissection of Choice in Older Adult Patients with Gastric Cancer: A Systematic Review and Meta-Analysis
Authors: Ramírez-Giraldo Camilo , Avendaño-Morales Violeta , Van-Londoño Isabella , Melo-Leal Daniela , Camargo-Areyanes María Isabel , Venegas-Sanabria Luis Carlos , Vargas Juan Pablo Vargas , Aguirre-Salamanca Edgar Javier , Isaza-Restrepo Andrés
Published: December 2024

Background: Although the current literature has shown an increasing interest in surgical treatment of gastric cancer (GC) in older adults in recent years, there is still no consensus on proper management in this subgroup of patients. This study was designed with the objective of evaluating the current evidence that compares limited lymph node dissection with extended lymph node dissection in older adult patients (≥65 years) coursing with resectable GC. Methods: A systematic review of PubMed, Cochrane library, and ScienceDirect was performed according to PRISMA guidelines. All studies before 2018 were selected using a systematic review by Mogal et al. Studies were eligible for this meta-analysis if they were randomized controlled trials or non-randomized comparative studies comparing limited lymph node dissection versus extended lymph node dissection in patients with resectable GC taken to gastrectomy. Results: Seventeen studies and a total of 5056 patients were included. There were not any statistically significant differences in OS (HR = 1.04, CI95% = 0.72–1.51), RFS (HR = 0.92, CI95% = 0.62–1.38), or CSS (HR = 1.24, CI95% = 0.74–2.10) between older adult patients taken to limited and extended lymphadenectomy in addition to gastrectomy as the current surgical treatment for GC. Although a higher rate of major complications was observed in the extended lymphadenectomy group, this difference was not statistically significant in incidence between both groups of patients (OR = 1.92, CI95% = 0.75–4.91). Conclusions: Limited lymphadenectomy must be considered as the better recommendation for surgical treatment for GC in older adult patients, considering the oncological outcomes and lower rates of complications compared with more radical lymph node dissections.
Association Between Temperature, Sunlight Hours, and Daily Steps in School-Aged Children over a 35-Week Period
Authors: Rodríguez-Gutiérrez Eva , Torres-Costoso Ana , Jiménez-López Estela , Mesas Arthur Eumann , Díaz-Goñi Valentina , Guzmán-Pavón María José , Beneit Nuria , Martínez-Vizcaíno Vicente
Published: December 2024

Objective: To examine the associations between gradients of average daily temperature and sunlight hours with daily steps over a 35-week period in school-aged children and to evaluate whether there were differences by sex. Methods: We conducted a follow-up study involving 655 children (50.8% girls, mean age 10.45 ± 0.95 years) from six public primary schools in Cuenca, Spain. We measured daily steps using Xiaomi Mi Band 3 Smart Bracelets (Xiaomi Corporation, Beijing, China) from October 2022 to June 2023 (over 35 weeks). We collected the average daily temperature from the local weather station in Cuenca and the sunlight hours during the same period. We used ANCOVA models and LOESS regression to examine the associations between gradients of average daily temperature and daily hours of sunlight with daily steps. Additionally, we performed a multiple linear regression model. Results: Our findings revealed significant variations in daily steps across the 35 weeks. The relationship between environmental factors and daily steps was non-linear in both girls and boys. The optimal values for higher activity levels were an average temperature of 14 °C and 13 h of sunlight. Furthermore, a 1 °C increase in temperature was associated with an increase of 74 ± 130 steps/day, while an increase of one hour of sunlight was associated with an increase of 315 ± 237 steps/day. However, the sunlight hours may act as a moderating factor. Conclusions: Our study showed a non-linear association between average daily temperature and the sunlight hours with daily steps over a 35-week period. Appropriate strategies may be needed to promote physical activity during periods of extreme temperatures or sunlight exposure.
Patients’ Acceptance of Psoriasis Depends on Disease Severity, Itch Intensity, and the Patients’ Quality of Life: A Cross-Sectional Study
Authors: Bień Beata , Krajewski Piotr K. , Szepietowski Jacek C.
Published: December 2024

Background/Objectives: Psoriasis is a chronic skin disorder affecting over 60 million people worldwide, with both physical and psychological impacts due to the visible lesions and associated somatic symptoms. This study aimed to assess disease acceptance among psoriasis patients and to explore its correlation with disease severity, itch intensity, and quality of life (QoL) Methods: The study included 166 psoriasis patients, comprising 101 men and 65 women, all with a disease duration of at least one year. Clinical and psychological aspects of psoriasis were comprehensively assessed using various standardized tools, along with a demographic questionnaire. Results: The study found that psoriasis patients had a mean illness acceptance score of 25.1 points, with most respondents (44%) exhibiting a moderate level of acceptance. A high level of acceptance was observed in 28% of participants, while an equal proportion of patients (28%) demonstrating low acceptance, with no significant gender-based differences. Acceptance was negatively correlated with disease severity (PASI score), quality of life impairment (DLQI), and itch intensity (NRS), indicating that lower acceptance was linked to more severe symptoms. Additionally, a slight negative correlation was observed between acceptance and disease duration, while acceptance levels were unaffected by factors such as education, relationship status, or age of disease onset. Conclusions: A comprehensive approach to psoriasis treatment should address not only the physical aspects but also the psychological challenges faced by patients, with a particular focus on improving disease acceptance as a coping strategy. Reducing itch intensity may contribute to better disease acceptance.
Advanced Speckle-Tracking Echocardiography Could Play a Crucial Role in the Diagnosis of Post-Implanted Cardiomyopathy Associated with a Leadless Pacemaker System
Authors: Wabich Elżbieta , Daniłowicz-Szymanowicz Ludmiła , Budrejko Szymon , Kochańska Anna , Kozłowski Dariusz , Kempa Maciej
Published: December 2024

Background: A leadless pacemaker (LP) is a modern alternative to a transvenous pacemaker, allowing certain complications to be avoided; however, some cannot be eliminated. Aim: To highlight the essential role of advanced speckle-tracking echocardiography (STE) in diagnosing pacing-induced cardiomyopathy (PICM) caused by an LP. Clinical case: A 79-year-old male, after LP implantation a year earlier, was admitted due to heart failure (HF). Left ventricular ejection fraction (LVEF) was 40%, global longitudinal strain (GLS) was −10%, and interventricular mechanical delay (IVMD) was 42 ms. All these parameters were significantly better before the operation. Myocardial work indices confirmed dyssynchrony due to the right ventricular (RV) stimulation pattern, and PICM was considered. To verify the impact of RV pacing on the LV, measurements were taken after restoring the native rhythm, showing an improvement in LVEF (45%), GLS (−13%), IVMD (7 ms), and myocardial work indices. After the next HF exacerbation with further deterioration of the LV function, a decision to convert the LP to a standard CRT-P system was made, with immediate relief in clinical symptoms and improved echocardiographic parameters. Conclusions: This case highlights the essential role of STE echocardiography in identifying the detrimental impact of RV pacing, diagnosing PICM, and selecting the appropriate treatment for patients with LPs.
Meta-Analysis of MINIject vs. Two iStents as Standalone Treatment for Glaucoma with 24 Months of Follow-Up
Authors: Tan Jeremy C. K. , Agar Ashish , Rao Harsha L. , Awad Katherin , Mansouri Kaweh
Published: December 2024

Background: This study compares the long-term intraocular pressure (IOP)-lowering efficacy of standalone MINIject (iSTAR Medical, Belgium) suprachoroidal implantation and two iStent (Glaukos, CA, USA) trabecular bypass implantation using a systematic review and meta-analysis. Methods: Systematic review of standalone implantation of MINIject or iStent inject with at least 24 months of follow up. The mean and standard deviation of IOP and the number of IOP-lowering medications at baseline and at 24 months were extracted. Weighted estimates of the outcome variables were calculated using random-effects meta-analysis models. Heterogeneity in the outcome measures among the studies was quantified using I². Results: Seven studies (three studies for MINIject and four for iStent) comprising 280 eyes were included. At 24 months, there was a greater reduction in IOP from baseline in the MINIject vs. two iStent cohorts (−9.57 vs. −4.92 mmHg, p = 0.03). The change from baseline in mean medication use was −1.00 with MINIject and −0.56 medications with iStent (p = 0.26). The mean percentage IOP reduction at 24 months ranged from 36.3−42.2% with MINIject compared to 5.2−40.7% with iStent, with greater variability in mean change from baseline in IOP observed in the iStent group (I2 = 96.5% vs. 0%). The most frequent adverse events for MINIject were anterior chamber inflammation, best-corrected visual acuity (BCVA) loss, hyphema, and conjunctival hemorrhage, and for iStent, these were device obstruction, BCVA loss, IOP spike, and cataract progression. Conclusions: While both MINIject and iStent inject devices resulted in significant reductions in IOP and IOP medication use, standalone MINIject may provide a greater and more consistent reduction in IOP.
The Role of Transcranial Ultrasound Imaging in Intensive Care Treatment of Decompressive Hemicraniectomy Patients: A Retrospective Single-Center Analysis
Authors: Petkov Martin , Becker Ralf , Schneider Max , Hlavac Michal , Knoll Andreas , Wirtz Christian Rainer , König Ralph , Pala Andrej
Published: December 2024

Background: Post-hemicraniectomy patients often need extended intensive care treatment. While computed tomography (CT) is considered the gold standard for regular imaging, its frequent use could be linked to adverse clinical outcomes. This study aimed to assess bedside transcranial ultrasound (TUS) to capture intracranial anatomical structures and pathologies. Methods: We analyzed 19 patients treated in our neurosurgical ICU from 1 January 2023 to 1 February 2024. Six physicians from our unit (three residents and three attending physicians) conducted a retrospective evaluation. A total of 158 sessions, including multiple freeze frames and video footage, were analyzed, including 7 imaging categories, using a Likert scale. Subsequently, correlation between CT and TUS was evaluated for midline (ML) shift, subdural space, lateral ventricular width (LVW), and extent of intracerebral hematoma using the Pearson’s correlation coefficient (r). Results: TUS was performed on average on 8.32/19.53 days (mean inpatient stay). It provided the lowest Likert scores for the imaging categories ventricular system, midline, subdural space, intraventricular catheter placement, and cortical gyration. Residents reported slightly inferior assessability, resulting in higher scores on the Likert scale (0.02–0.93 mean difference compared with attending physicians). A high correlation was shown in terms of ML shift, LVW, and intracerebral hematomas. No relevant correlation was shown in subdural space. Conclusions: TUS is a safe, cost-, and time-efficient method, potentially gaining relevance for imaging post-hemicraniectomy patients. In our setting, the method seemed effective in depicting intraventricular catheter placement, hydrocephalus, ML shift, and space-occupying lesions. Further improvement in image quality could potentially reduce the overall number of indicated CT scans.
Positive Results Using Variable Fixation in Medial Opening Wedge High Tibial Osteotomies in Patients with Unilateral Knee Osteoarthritis: An Observational Clinical Investigation
Authors: Colcuc Christian , Vordemvenne Thomas , Beyer Georg , Leimkühler Philipp , Wähnert Dirk
Published: December 2024

Background: Medial opening wedge high tibial osteotomy (HTO) treats medial knee osteoarthritis by realigning the knee joint, though it still carries quite a high risk of complications. A new Variable Fixation Locking Screw technology, designed to gradually reduce construct stiffness and promote bone healing, aims to address these issues. This observational study evaluates the safety and effectiveness of this innovative approach in improving clinical outcomes. Methods: Data were prospectively collected on a cohort of the first ten consecutive patients (over 18 years of age) who underwent corrective medial opening wedge high tibial osteotomy using Variable Fixation Locking Screws (VFLSs). The procedure followed the standard surgical technique, with osteotomies stabilized using a Tomofix plate and a combination of standard locking screws and VFLSs. This study aimed to evaluate outcomes such as fracture healing, patient safety, and procedural success at 6 and 12 weeks and at 6 months. Results: No complications, side effects, or need for implant removal were observed. By six months, 70% of patients showed radiographic and clinical healing, and 100% of patients achieved full functional recovery without any issues like length discrepancy, instability, pain, or joint stiffness. Conclusions: This first clinical observation study indicates that Variable Fixation Locking Screws are safe and effective for medial opening wedge high tibial osteotomies, showing promising results in reducing the risk of delayed closure or non-closure of the wedge. Further studies with a larger patient population are needed to confirm their effectiveness.
Multi-Criteria Optimization of Wind Turbines in an Offshore Wind Farm with Monopile Foundation Considering Structural Integrity and Energy Generation
Authors: Ali Sajid , Park Hongbae , Lee Daeyong
Published: December 2024

Offshore wind energy plays a crucial role in achieving renewable energy targets, with OWFs facing unique environmental challenges that impact turbine performance and structural demands. This study develops an advanced optimization methodology to identify the most effective layout configurations for offshore wind farms (OWFs) with monopile foundations, focusing on enhancing structural integrity and energy generation efficiency. Using a multi-criteria optimization approach, the effects of wind turbine spacing, angular orientation, and height on energy yield and monopile loading were evaluated. Based on a seven-year dataset from the Ouido site in South Korea, where the mean wind speed is 6.95 m/s at a 150 m hub height, optimized configurations were determined. For average wind conditions, a turbine spacing of 250 m, a hub height of 148 m, and an orientation angle of 36.87° minimized wake losses and distributed structural loads effectively. Under rated wind speeds of 10.59 m/s, a spacing of 282 m, a hub height of 155 m, and an orientation angle of 45° further enhanced performance. These designs reduced wake interference by 25%, decreased monopile fatigue loads by 18%, and lowered the levelized cost of electricity (LCOE) by up to 15%. This study’s findings provide a robust framework for optimizing OWFs to increase energy yield, improve operational efficiency, and ensure economic viability.
Vessel Type Recognition Using a Multi-Graph Fusion Method Integrating Vessel Trajectory Sequence and Dependency Relations
Authors: Ye Lin , Chen Xiaohui , Liu Haiyan , Zhang Ran , Zhang Bing , Zhao Yunpeng , Zhou Dewei
Published: December 2024

In the field of research into vessel type recognition utilizing trajectory data, researchers have primarily concentrated on developing models based on trajectory sequences to extract the relevant information. However, this approach often overlooks the crucial significance of the spatial dependency relationships among trajectory points, posing challenges for comprehensively capturing the intricate features of vessel travel patterns. To address this limitation, our study introduces a novel multi-graph fusion representation method that integrates both trajectory sequences and dependency relationships to optimize the task of vessel type recognition. The proposed method initially extracts the spatiotemporal features and behavioral semantic features from vessel trajectories. By utilizing these behavioral semantic features, the key nodes within the trajectory that exhibit dependencies are identified. Subsequently, graph structures are constructed to represent the intricate dependencies between these nodes and the sequences of trajectory points. These graph structures are then processed through graph convolutional networks (GCNs), which integrate various sources of information within the graphs to obtain behavioral representations of vessel trajectories. Finally, these representations are applied to the task of vessel type recognition for experimental validation. The experimental results indicate that this method significantly enhances vessel type recognition performance when compared to other baseline methods. Additionally, ablation experiments have been conducted to validate the effectiveness of each component of the method. This innovative approach not only delves deeply into the behavioral representations of vessel trajectories but also contributes to advancements in intelligent water traffic control.
A Predictive Analysis of Beach Susceptibility to Jellyfish Arrivals in Costa del Sol
Authors: de la Fuente Roselló Ana , Perles Roselló María Jesús , Cantarero Prados Francisco José
Published: December 2024

This study investigates the susceptibility of beaches to jellyfish arrivals, focusing on the summer seasons from 2015 to 2020. The objective was to develop a predictive model that identifies the characteristics of beaches prone to higher jellyfish presence. This research utilized data from the Infomedusa application, with a focus on key structural and circumstantial variables, such as beach orientation, coastal currents, and morphology. Binomial logistic regression was applied to two models to assess the influence of these variables on jellyfish occurrence. The results showed that beaches oriented toward the east and south, with protection from natural or artificial barriers, and those with limited open sea exposure are more likely to experience jellyfish arrivals. Conversely, beaches facing southwest, with opposing currents and freshwater inflows, tend to have lower risks. Although the models’ predictive capacity was moderate, with a 76% validation rate against empirical data, they provided valuable insights for coastal management and risk prevention. The findings highlight the importance of beach-specific characteristics in forecasting jellyfish presence, contributing to more effective coastal protection strategies.
Are Social Media-Based Marketing Strategies the New Mechanisms for Attracting Consumers? A Quantitative Method-Based Approach
Authors: Islam Maidul , Sheikh Shabnam A.
Published: December 2024

This research used a quantitative approach to explore the impact of social media marketing on consumer purchase intention. Due to the technological development of social media platforms in the recent past, as well as the addition of several functionalities to these platforms, the way that consumers and firms engage has changed dramatically in the current competitive market. To understand the influence of social media marketing and the important role of influencer marketing in consumer purchase intention, a cross-sectional analysis was performed. Data from 210 participants were used for this study. Furthermore, a comprehensive and critical analysis of the existing research on social media marketing was also undertaken. The results reveal that there is a significant positive relationship between social media marketing and purchase intention.
Harnessing the Power of Mechanization: A Multivalued Treatment Effect Analysis on Productivity for Chinese Smallholders
Authors: Ma Zhenbang , Sun Huichun
Published: December 2024

Developing countries, in their pursuit of the Sustainable Development Goals, are intensifying their efforts to promote agricultural mechanization, with China at the forefront, through comprehensive policy revisions aimed at enhancing mechanization levels. This study employs multivalued treatment effect (MVTE) and quantile treatment effect (QTE) methodologies to assess the impact of agricultural mechanization on labor and land productivity while also examining the seffects across different farm sizes and moderating influences. Leveraging data from the 2016 China Labor-force Dynamics Survey, the findings indicate that semi-mechanized and full-mechanized farming, compared to no-mechanized farming, significantly boost labor and land productivity for both average and lower-to-mid-level productivity farmers. Disaggregated analysis by farm size shows that larger farms benefit significantly from semi-mechanized and full-mechanized farming in terms of increased labor and land productivity. However, the incremental benefits of varying levels of mechanization on productivity are observed only in labor productivity for farmers with mid- and upper-level productivity and for those in the largest farm size group. Additionally, land transfer status, government subsidies, and the intensity of clan culture are found to significantly influence the productivity effects of agricultural mechanization in China. Consequently, it is imperative to reorient agricultural policies towards enhancing the efficiency and cost-effectiveness of mechanization, especially considering the constraints on labor and land availability and the need to minimize the environmental impact of agricultural production. In light of these discussions, this paper presents policy implications for sustainable agricultural mechanization.
Electrical Conductivity in Graphite Foils Produced by Rolling and Pressing
Authors: Morozov Nikolai S. , Shulyak Vladimir A. , Isaenkova Margarita G. , Krymskaya Olga A. , Fesenko Vladimir A. , Chebotarev Sergei N. , Avdeev Victor V.
Published: December 2024

In this research paper, the factors impacting electrical conductivity of the flexible graphite foils (GFs) produced by different forming processes, namely, either by rolling or pressing, were studied. The relationship between electrical conductivity and texture and structure that formed when producing the material was examined. Correlation was determined between the texture sharpness and anisotropy of electrical conductivity, as well as the extent of impact from the substructural characteristics on the properties’ values. Besides, it was demonstrated that the higher values of micro-strains, as well as the secondary phase substructure, reduced conductivity in foils. Electrical conductivity calculation was optimized for different directions in foils using the Kearns texture parameters and taking into consideration the foil structural characteristics.