bluuebunny/crossref_metadata_2025 huggingface dataset:
Operating Characteristics of a Wave-Driven Plasma Thruster for Cutting-Edge Low Earth Orbit Constellations
Authors: Andreescu Anna-Maria Theodora , Crunteanu Daniel Eugeniu , Teodorescu Maximilian Vlad , Danescu Simona Nicoleta , Stoicescu Adrian , Cancescu Alexandru , Paraschiv Alexandru
Published: September 2024

This paper outlines the development phases of a wave-driven Helicon Plasma Thruster for cutting-edge Low Earth Orbit (LEO) constellations. The two-stage ambipolar electric propulsion (EP) system combines the efficient ionization of an ultra-compact helicon reactor with plasma acceleration based on an ambipolar electric field provided by a magnetic nozzle. This paper reveals maturation challenges associated with an emerging EP system in the hundreds-watt class, followed by outlook strategies. A 3 cm diameter helicon reactor was operated using argon gas under a time-modulated RF power envelope ranging from 250 W to 500 W with a fixed magnetic field strength of 400 G. Magnetically enhanced inductively coupled plasma reactor characteristics based on half-wavelength right helical and Nagoya Type III antennas under capacitive (E-mode), inductive (W-mode), and wave coupling (W-mode) were systematically investigated based on Optical Emission Spectroscopy. The operation characteristics of a wave-heated reactor based on helicon configuration were investigated as a function of different operating parameters. This work demonstrates the ability of two-stage HPT using a compact helicon reactor and a cusped magnetic field to outperform today’s LEO spacecraft propulsion.
Power Distance and Indulgence Are Positively and Negatively Correlated with Ageism, Respectively: Evidence from 31 Countries
Authors: Kokubun Keisuke
Published: September 2024

As the aging of the world accelerates, clarifying the relationship between cultural differences and ageism is an urgent issue. Therefore, in this study, we conducted a correlation analysis between the six cultural scales of Hofstede et al. and the two ageism scales calculated from data on 35,232 people from 31 countries included in the World Values Survey Wave 6 (WVSW6) by Inglehart et al. The results of a partial correlation analysis controlling for economic and demographic factors showed that power distance (PDI) and indulgence versus restraint (IVR) are positively and negatively correlated with ageism, respectively. This is the first study to show that these two cultural scales, which previous studies have not paid much attention to, are related to ageism.
Nine Years of Continuous Flow LVAD (HeartMate 3): Survival and LVAD-Related Complications before and after Hospital Discharge
Authors: Boburg Rodrigo Sandoval , Marinos Spiros Lukas , Baumgaertner Michael , Rustenbach Christian Jörg , Salewski Christoph , Doll Isabelle , Berger Rafal , Schlensak Christian , Radwan Medhat
Published: September 2024

Background: End-stage heart failure is associated with high mortality. Recent developments such as the left ventricular assist device (LVAD) have improved patient outcomes. The HeartMate 3 LVAD is a novel centrifugal pump that was developed to provide hemodynamic support in heart failure patients, either as a bridge-to-transplant (BTT), myocardial recovery, or destination therapy (DT). Our objective was to evaluate the survival rates and LVAD-related complications of the HeartMate 3 LVAD before and after hospital discharge in our center. Methods: We retrospectively reviewed all patients implanted with the HeartMate 3 LVAD in our institute between September 2015 and June 2024. Patients who received a Heart Ware Ventricular Assist Device (HVAD) and HeartMate 2 LVAD devices were excluded. The primary endpoint was survival before and after hospital discharge. The secondary endpoints included an incidence of serious LVAD adverse events (bleeding, major infection, hemolysis, device thrombosis and malfunction, and neurological dysfunction) and the causes of re-admission along the follow-up period. Results: A total of 48 consecutive HeartMate 3 LVAD patients were enrolled in this study. The mean age was 56.1 ± 10.6 years. A total of 72.9% of patients received LVAD therapy as a BTT, 14.6% as DT, 10.4% as a bridge-to-decision, and 2.1% as a bridge-to-recovery. A total of 85.4% of patients were discharged after implantation. The main cause for in-hospital mortality was right ventricular failure (8.3%), followed by stroke, abdominal bleeding, and multi-organ failure (2.1% each). One patient (2.1%) had successful heart transplantation, 26 patients (63.4%) are still on LVAD support, and 11 (26.8%) patients have died during follow-up. The main cause of mortality after hospital discharge was sepsis, which occurred in 9.8% of patients, followed by right ventricular failure, non-LVAD-related causes, unknown causes with two (4.9%) cases each, and one case of fatal stroke (2.4%). During the follow-up, there was no need for LVAD replacement. Conclusions: HeartMate 3 LVAD is associated with excellent in-hospital survival rates in patients with end-stage heart failure. Right ventricular failure was the main cause of death before hospital discharge, whereas sepsis was the main cause of death after hospital discharge.
Drug-Related Pyroglutamic Acidosis: Systematic Literature Review
Authors: Scafetta Tessa , Kovacs Orsolya , Milani Gregorio P. , Bronz Gabriel , Lava Sebastiano A. G. , Betti Céline , Vanoni Federica , Bianchetti Mario G. , Faré Pietro B. , Camozzi Pietro
Published: September 2024

Background: Inborn errors of glutathione metabolism may cause high anion gap metabolic acidosis due to pyroglutamic acid accumulation. Since 1988, cases of this acidosis have been reported in individuals without these defects. Methods: Given the poorly characterized predisposing factors, presentation, management, and prognosis of acquired pyroglutamic acidosis, we conducted a systematic review using the National Library of Medicine, Excerpta Medica, Web of Science, and Google Scholar databases. Results: A total of 131 cases were found. Most patients were females (79%), adults (92%) aged 51 years or older (66%) with pre-existing conditions (74%) such as undernutrition, alcohol-use disorder, or kidney disease, and had an ongoing infection (69%). The clinical features included diminished consciousness (60%), Kussmaul breathing (56%), and nausea or vomiting (27%). At least 92% of patients were on paracetamol therapy for >10 days at an appropriate dose, 32% on a β-lactamase-resistant penicillin, and 2.3% on vigabatrin. Besides severe anion gap acidosis, patients also presented with hypokalemia (24%) and kidney function deterioration (41%). Management involved discontinuing the offending drug (100%), bicarbonate (63%), acetylcysteine (42%), and acute kidney replacement therapy (18%). The fatality rate was 18%, which was higher without acetylcysteine (24%) compared to with it (11%). Conclusions: Acquired pyroglutamic acidosis is a rare, potentially fatal metabolic derangement, which usually occurs after paracetamol use, frequently combined with a β-lactamase-resistant penicillin or vigabatrin. This condition predominantly affects adults, especially women with factors like undernutrition, alcohol-use disorder, or kidney disease, often during infection. Increased awareness of this rare condition is necessary.
Magnetic Resonance Imaging of Endometriosis: The Role of Advanced Techniques
Authors: Alonzo Laura , Cannella Roberto , Gullo Giuseppe , Piombo Giulia , Cicero Giuseppe , Lopez Alessandra , Billone Valentina , Andrisani Alessandra , Cucinella Gaspare , Lo Casto Antonio , Lo Re Giuseppe
Published: September 2024

Endometriosis is a chronic inflammatory disease that affects about 10% of women, and it is characterized by the presence of endometrial tissue outside the uterine cavity. Associated symptoms are dyspareunia, chronic pelvic pain, and infertility. The diagnosis of endometriosis can be challenging due to various clinical and imaging presentations. Laparoscopy is the gold standard for the diagnosis, but it is an invasive procedure. The literature has increasingly promoted a switch to less invasive imaging techniques, such as ultrasound and magnetic resonance imaging (MRI). The latter, also in relation to the latest technological advances, allows a comprehensive and accurate assessment of the pelvis and it can also identify sites of endometriosis that escape laparoscopic evaluation. Furthermore, MRI has been found to be more accurate than other imaging techniques in relation to its improved sensitivity and specificity in identifying disease sites, also due to the role of new emerging sequences. This article aims to review the current role of advanced MRI applications in the assessment of endometriosis.
Pulmonary Sequestration: A Monocentric Case Series Report
Authors: Galanis Michail , Sommer Estelle , Gioutsos Konstantinos , Nguyen Thanh-Long , Dorn Patrick
Published: September 2024

Purpose: Pulmonary sequestration is a rare pulmonary malformation that often necessitates surgical intervention due to potential complications such as recurrent infections or hemoptysis. This case series presents the clinical trajectory of four patients diagnosed with pulmonary sequestration, from initial diagnosis through postoperative care, with a specific focus on the limited arterial supply in two of the cases. Materials and Methods: We conducted a retrospective descriptive analysis of four patients diagnosed with pulmonary sequestration who underwent surgical treatment at our institution between January 2013 and November 2022. The affected lung segments were excised via either thoracoscopy or thoracotomy. We evaluated perioperative and postoperative complications, hospital stay duration, histological findings, and the vascular supply of the affected areas. Results: Thoracoscopic surgery was initially preferred for all patients, though one required conversion to an open procedure due to technical challenges. Perioperative complications included increased pain and atelectasis. Two patients developed pleural empyema postoperatively, necessitating additional surgical intervention. The overall outcomes were favorable, with appropriate management addressing the complications effectively. Conclusions: Pulmonary sequestration, despite its rarity, often requires surgical treatment. Both thoracoscopic and open surgical methods are effective, though thoracoscopic surgery is generally preferred when feasible. The findings underscore the importance of meticulous preoperative planning and vigilant postoperative care to manage and mitigate potential complications.
Orbital Hematoma Treatment—A Retrospective Study
Authors: Bielecki-Kowalski Bartosz , Bielecka-Kowalska Natalia , Jaxa-Kwiatkowski Marek , Osmola Krzysztof , Kozakiewicz Marcin
Published: September 2024

Background: Bleeding within the orbit in the form of a subperiosteal or retrobulbar hematoma is a relatively common complication of trauma and surgery. It affects up to 30% of patients fractures involving the orbital bones. Most cases do not require surgical intervention because they do not cause retinal ischemia or optic nerve neuropathy. The above symptoms occur in only 0.5–1% of patients developing Orbital Compartment Syndrome (OCS). Due to the short period (60–100 min) of time in which the optic nerve and retina can tolerate increased intraocular pressure, it seemed reasonable to evaluate and standardize the surgical management protocol for this rare complication. Objective: The aim of this retrospective study was to retrospectively analyze cases of inframammary haematomas with clinically relevant correlations. Methods: Eighteen patients treated at the Department of Maxillofacial Surgery due to OCS, in Lodz and Poznan, Poland, between 2009 and 2022, were included. APTT, INR, systemic diseases, cause, location and size of hematoma, presence and number of fractures, visual disturbances and pupillary response on the day after surgery and one month after, the type of intervention and time between admission to the hospital and surgery were evaluated. Results: Statistically significant correlations were obtained between the size of the hematoma and the patients’ age, the degree of visual disturbance and the weakening of pupillary constriction, severe initial symptoms and poor postoperative outcomes at both postoperative periods studied, immediate and distant poor outcome after decompression surgery and good postoperative outcome persisting one month after. Conclusions: The results obtained in the study and the surgical protocol proposed by the authors are in line with the current state of knowledge regarding orbital hematomas. Some of the correlations described in the literature (such as OCS and anticoagulant treatment) were not demonstrated, but this is probably due to the small study group. Maintaining the 100 min limit as a standard was possible only in early postoperative diagnoses (only 1 of the patients was operated on up to 100 min after the appearance of symptoms). In other cases, the specialized diagnosis took an average of 2785 ± 4020 min or 46 ± 67 h.
AFTER-CA: Autonomic Function Transformation and Evaluation Following Catheter Ablation in Atrial Fibrillation
Authors: Ferreira Monica , Cunha Pedro Silva , Felix Ana Clara , Fonseca Helena , Oliveira Mario , Laranjo Sergio , Rocha Isabel
Published: September 2024

Background: Catheter ablation (CA) is a well-established treatment for atrial fibrillation (AF). However, its effects on autonomic function and underlying mechanisms remain poorly understood. This study investigated autonomic and haemodynamic changes following CA and explored their potential implications for patient outcomes. Methods: Seventy-eight patients with AF underwent CA and were followed up at one, three, and six months. Autonomic function was assessed using a combination of head-up tilt (HUT), handgrip (HG), and deep breathing (DB) manoeuvres along with baroreflex sensitivity (BRS) and baroreflex effectiveness index (BEI) evaluation. Heart rate (HR), blood pressure (BP), and their variability were measured at each time point. Results: Significant autonomic alterations were observed after ablation, particularly at one month, with reductions in parasympathetic tone and baroreflex function. These changes gradually normalised by six months. Both pulmonary vein isolation (PVI) and cryoablation (CryO) had similar effects on autonomic regulation. Improvements in quality of life, measured by the AFEQT scores, were consistent with these physiological changes. Conclusions: CA for AF induces significant time-dependent autonomic and haemodynamic changes with recovery over six months. These findings underscore the need for ongoing monitoring and personalised post-ablation management. Further research is required to explore the mechanisms driving these alterations and their long-term impacts on patient outcomes.
Clinical and Sociodemographic Factors Related to Amyotrophic Lateral Sclerosis in Spain: A Pilot Study
Authors: Proaño Belén , Cuerda-Ballester María , Daroqui-Pajares Noelia , del Moral-López Noemí , Seguí-Sala Fiorella , Martí-Serer Laura , Calisaya Zambrana Carlen Khrisley , Benlloch María , de la Rubia Ortí Jose Enrique
Published: September 2024

Background: Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease of unknow etiology. Male sex is a well stablished risk factor, but other factors such as early and adult life expositions show contradictory evidence. Aim: to explore the link of clinical, sociodemographic, and occupational factors with ALS patients in Spain and the impact of these factors in functionality. Methods: A cross-sectional study was conducted with ALS patients and healthy controls. Registered variables were smoking, arterial hypertension, diabetes mellitus type 2, previous cancer to reproductive organs or breast, occupational exposure, and early life exposures. Functionality in ALS patients was compared according to each exposure. Results: The ALS group consisted of 59 participants and the control group of 90 participants. ALS patients showed a significant association with previous cancer (p = 0.011), occupational exposure (p < 0.001), and older siblings (p = 0.029). ALS patients presented significant differences in BMI according to hypertension and older-sibling factors. Moreover, respiratory function was affected in patients with previous cancer (p = 0.031). Conclusions: Occupational exposure and previous cancer to reproductive organs or breast could be linked to ALS patients. In addition, hypertension and previous cancer could affect their BMI and respiratory function. Other factors such as longer smoking periods and exposition to older siblings could also characterize ALS patients.
Is It Time for a New Algorithm for the Pharmacotherapy of Steroid-Induced Diabetes?
Authors: Ostrowska-Czyżewska Aleksandra , Zgliczyński Wojciech , Bednarek-Papierska Lucyna , Mrozikiewicz-Rakowska Beata
Published: September 2024

Glucocorticoids (GS) are widely used in multiple medical indications due to their anti-inflammatory, immunosuppressive, and antiproliferative effects. Despite their effectiveness in treating respiratory, skin, joint, renal, and neoplastic diseases, they dysregulate glucose metabolism, leading to steroid-induced diabetes (SID) or a significant increase of glycemia in people with previously diagnosed diabetes. The risk of adverse event development depends on the prior therapy, the duration of the treatment, the form of the drug, and individual factors, i.e., BMI, genetics, and age. Unfortunately, SID and steroid-induced hyperglycemia (SIH) are often overlooked, because the fasting blood glucose level, which is the most commonly used diagnostic test, is insufficient for excluding both conditions. The appropriate control of post-steroid hyperglycemia remains a major challenge in everyday clinical practice. Recently, the most frequently used antidiabetic strategies have been insulin therapy with isophane insulin or multiple injections in the basal–bolus regimen. Alternatively, in patients with lower glycemia, sulphonylureas or glinides were used. Taking into account the pathogenesis of post-steroid-induced hyperglycemia, the initiation of therapy with glucagon-like peptide 1 (GLP-1) analogs and dipeptidyl peptidase 4 (DPP-4) inhibitors should be considered. In this article, we present a universal practical diagnostic algorithm of SID/SIH in patients requiring steroids, in both acute and chronic conditions, and we present a new pharmacotherapy algorithm taking into account the use of all currently available antidiabetic drugs.
Urethral Bulking Agents for the Treatment of Urinary Incontinence: Efficacy, Safety, and Impact on the Overactive Bladder Symptoms with an Underlying Detrusor Overactivity
Authors: Serati Maurizio , Campitiello Maria Rosaria , Torella Marco , Mesiano Giada , Scancarello Chiara , Ghezzi Fabio , Papadia Andrea , Gamarra Elena , Caccia Giorgio , Braga Andrea
Published: September 2024

Background: Mixed urinary incontinence (MUI) has always represented a major therapeutic challenge and the management of this type of incontinence is often complicated by uncertain outcomes. Surgical options include interventions targeting both stress urinary incontinence (SUI) and urge urinary incontinence (UUI), although there are no international published guidelines that dictate whether it is better to start with surgical management to address the SUI or UUI component after the failure of conservative treatment. The aim of the present study is to evaluate the effectiveness of the Macroplastique (MPQ) procedure on overactive bladder (OAB) symptoms in women with MUI with a minimum follow-up of 1 year. Methods: A retrospective analysis of prospectively collected data was performed in two tertiary reference centers. We enrolled all women complaining of symptoms of SUI and OAB, dry or wet, with a urodynamically confirmed diagnosis of MUI [urodynamic stress incontinence (USI) with detrusor overactivity (DO)], who took a previous ineffective antimuscarinic treatment and underwent the MPQ procedure. We considered as objectively cured women who did not leak urine during the stress test and with a 1 h pad-test negative, while International Consultation on Incontinence Questionnaire–Short Form (ICIQ-SF), ICIQ-OAB, Patient Global Impression of Improvement (PGI-I) scale, and a Visual Analogue Scale (VAS) were used to assess subjective outcomes. Results: A total of forty-six patients who met the inclusion criteria and who underwent the MPQ procedure were considered for the analysis. At the 1-year mark of follow-up, 72% of patients were objectively cured at stress test and 65% were objectively cured at pad-test, while 72% of women declared themselves subjectively cured. OAB symptoms significantly improved after MPQ and a complete resolution of OAB was recorded in 35% of patients. Conclusions: This study demonstrated that MPQ is a safe and effective option for the treatment of female MUI. Furthermore, MPQ significantly improves the symptoms of OAB and is able to completely cure this condition in a relevant percentage of women with MUI when pharmacological treatment fails.
What Mattered Most: Personal, Work-Related, and Psychopathological Characteristics Associated with Healthcare Workers’ Impairment of Functioning during COVID-19
Authors: Gesi Camilla , Cafaro Rita , Cerioli Matteo , Achilli Francesco , Boscacci Maria , Cirnigliaro Giovanna , Dell’Osso Bernardo
Published: September 2024

Background: The COVID-19 pandemic greatly impacted healthcare workers (HWs) around the world. Italy was the first Western country hit by the pandemic, and several studies have been published targeting the mental health burden held by Italian HWs. Notwithstanding, only a few studies focused on the impact of COVID-19 on HWs’ levels of functioning. Methods: An online survey was distributed to HWs in Italy through physicians’ and nurses’ associations, social networks, and researchers’ direct contacts, between 4 April and 13 May 2020. Participants provided sociodemographic, work-related, and pandemic-related data and filled out a set of psychometric questionnaires (Patient Health Questionnaire-9—PHQ-9, General Anxiety Disorder-7—GAD-7, Impact of Event Scale—Revised—IES-R, and Work and Social Adjustment Scale—WSAS). Results: The final sample included 1041 HWs (mean age 45.01 ± 11.62, 63.9% females). In total, 58.1% of the subjects screened positive on the GAD-7, 27.5% on the PHQ-9, and 25.9% on the IES-R. Furthermore, 67.4% showed a significant level of impairment in functioning according to the WSAS, while 35.8% reached scores of moderate or worse impairment. In the multiple linear regressions, screening positive on any of the psychometric scales and being exposed to unusual suffering significantly predicted worse scores in all WSAS domains (p < 0.05). Having a history of mental disorders significantly predicted worse scores in the WSAS domain of work ability (p = 0.002), while being the parent of children younger than 18 years significantly predicted worse WSAS family functioning scores (p < 0.001). Conclusions: Our results corroborate extant data about the impact of the COVID-19 pandemic on HWs’ mental health and shed light on its detrimental effect on functioning. Tailored interventions should be designed in order to support HWs during times of crisis.
The Changing Landscape of Intravenous Thrombolysis for Acute Ischaemic Stroke
Authors: Donaldson Jack , Winders Joel , Alamri Yassar , Knight Dhara , Wu Teddy Y.
Published: September 2024

Intravenous thrombolysis remains the most accessible and effective reperfusion therapy available to patients with acute ischaemic stroke. Treatment with intravenous thrombolysis improves the odds of favourable functional outcome with the unacceptably low risk of haemorrhagic complications. Even in the current era of endovascular thrombectomy, intravenous thrombolysis remains the backbone of acute stroke treatment due to its accessibility and relative ease of administration. Since intravenous alteplase was first approved for acute ischaemic stroke in the mid 1990s, there have been significant advances in expanding the indication and time window for treatment, in addition to transitioning towards tenecteplase use for stroke thrombolysis. In this review, we will provide a narrative on the use of thrombolysis in acute ischaemic stroke including an up-to-date discussion on recent advances in thrombolytic therapy.
IL-8, TNF-α, and IL-17 in the Development of Erosive Esophagitis and Symptom Perception in Gastroesophageal Reflux Disease (GERD)
Authors: Sugihartono Titong , Hidayat Amal Arifi , Alfaray Ricky Indra , Lusida Michael Austin Pradipta , Mahmudah Isna , Aftab Hafeza , Vilaichone Ratha-Korn , Yamaoka Yoshio , Malaty Hoda M. , Miftahussurur Muhammad
Published: September 2024

Background: The diverse clinical characteristics of erosive esophagitis (EE) and symptom perception in patients with gastroesophageal reflux disease (GERD) remain a major challenge in understanding their underlying pathogenesis. This study aimed to investigate the association between the levels of IL-8, TNF-α, and IL-17 in serum and the presence of erosive esophagitis and symptoms related to GERD. Method: We enrolled 65 subjects presenting with GERD symptoms. Based on the findings of upper endoscopy, the subjects were categorized into two groups: (1) erosive esophagitis (EE LA grades B-D) and (2) non-erosive esophagitis (normal-EE LA grade A). Symptom perception was assessed via GERD questionnaire (GERD-Q) and the frequency scale for the symptoms of GERD (FSSG). The enzyme-linked immunosorbent assay (ELISA) method was used to analyze serum levels of IL-8, TNF-α, and IL-17. Analysis of cytokine levels between different symptoms severity was performed using the Kruskal-Wallis H test. Results: Median serum IL-8 levels were significantly higher in the erosive esophagitis group compared to those with non-erosive esophagitis (20.2 (IQR 16.9–32.2) vs. 17.7 (IQR 15.2–19.6), p < 0.05). The study found a significant association between IL-8 levels and the presence of globus symptoms (median IL8 level 46.961 (38.622–92.644) in subjects with globus vs. 18.06 (16.68–20.49) in those without globus; p < 0.05). Similarly, TNF-α levels were associated with the frequency of regurgitation symptoms (H index = 10.748; dr = 3; p < 0.05). We observed a significant correlation between IL-17 levels and the frequency of heartburn and early satiety symptoms. Conclusions: IL-8 may play a role in the development of mucosal erosion in GERD. IL-8, TNF- α, and IL-17 might be involved in the development of globus symptoms, the frequency of regurgitation, and the frequency of heartburn and early satiety, respectively. The diverse symptom phenotypes observed in patients with GERD symptoms may be mediated by distinct profiles of proinflammatory cytokines.
Coronary Artery Disease, Family History, and Screening Perspectives: An Up-to-Date Review
Authors: Di Lenarda Francesca , Balestrucci Angela , Terzi Riccardo , Lopes Pedro , Ciliberti Giuseppe , Marchetti Davide , Schillaci Matteo , Doldi Marco , Melotti Eleonora , Ratti Angelo , Provera Andrea , Paolisso Pasquale , Andreini Daniele , Conte Edoardo
Published: September 2024

Family history for CAD (coronary artery disease) is an established cardiovascular (CV) risk factor and it is progressively acquiring importance in patients’ CV risk stratification. Numerous studies have demonstrated that individuals with a first-degree relative affected by CAD have a significantly higher risk of developing the condition themselves; in particular, when CAD occurs at an early age in relatives. Indeed, recently published CCS (chronic coronary syndrome) ESC (European Society of Cardiology) guidelines include family history (FH) as a risk factor to consider when calculating pre-test risk for CAD. ESC guidelines on preventive cardiology (2021) only suggested CV risk assessment in the presence of a positive FH for CV disease, not considering it in the actual risk scores. Evidence suggests that positive anamnesis for relatives affected by CAD correlates with ACS (acute coronary syndrome) and CAD, with slight differences in relative risk as far as the degree of kinship is concerned. Genetic factors contribute to this correlation by influencing key processes that affect heart health, such as cholesterol metabolism, blood pressure regulation, and inflammatory responses. New technologies in the genetics field are increasing the availability of genome sequencing, and new polymorphism panels are being tested as predictive for CAD, objectifying familiarity. Advances in imaging techniques allow the assessment of coronary atherosclerosis and its composition, and these are acquiring strength in evidence and recommendations in ESC guidelines as a way to define coronary disease in low and low-to-intermediate risk patients and to guide medical therapy and interventional procedures. Use of these emerging tools to guide screening is likely to be extended, beyond high CV risk patients, to individuals with FH for early CAD and/or specific genetic profiles, as recent evidence in the literature is suggesting.
Towards a Better Prognosis in Patients with Systemic Sclerosis-Related Pulmonary Arterial Hypertension: Recent Developments and Perspectives
Authors: Boutel Maria , Dara Athanasia , Arvanitaki Alexandra , Deuteraiou Cleopatra , Mytilinaiou Maria , Dimitroulas Theodoros
Published: September 2024

Precapillary pulmonary hypertension (PH) is a significant complication of systemic sclerosis (SSc). It represents one of the leading causes of morbidity and mortality, correlating with a significantly dismal prognosis and quality of life. Despite advancements in the management of patients with pulmonary arterial hypertension associated with SSc (SSc-PAH), no significant improvement has been reported in survival of patients with precapillary SSc-PH associated with extensive lung parenchyma disease. International expert consensus and guidelines for the management of PH recommend annual screening of SSc patients for early detection of pre-capillary PH. The implementation of screening algorithms capable of identifying patients with a high likelihood of developing PH could help limit unnecessary right-heart catheterization procedures and prevent significant delay in diagnosis. Furthermore, early initiation of up-front combination targeted therapy in patients with PAH has shown increase in survival rates, indicating that timely and aggressive medical therapy is key for stabilizing and even improving functional class, hemodynamic parameters and 6 min walking distance (6MWD) in this population. Further research is warranted into the benefit of PAH-targeted therapies in patients with PH associated with lung disease. Lastly, we discuss the potential role of immunosuppression using biologic agents in the therapeutic management of precapillary PH in SSc patients.
Image-Guided Superficial Radiation Therapy for Basal and Squamous Cell Carcinomas Produces Excellent Freedom from Recurrence Independent of Risk Factors
Authors: Agha Rania , Heysek Randy V. , Vasily David B. , Rowe Russell , McClure Erin M. , O’Reilly Kathryn , Finkelstein Steven Eric , Farberg Aaron S.
Published: September 2024

Background/Objectives: Basal cell carcinomas (BCCs) and squamous cell carcinomas (SCCs) are non-melanoma skin cancers (NMSCs) and the most prevalent cancers in the United States. Image-guided superficial radiotherapy (IGSRT) is a relatively new treatment option that uses high-resolution dermal ultrasound integrated with superficial radiotherapy to improve tumor visualization. IGSRT is a clinically equivalent non-surgical alternative to Mohs micrographic surgery at 2 years of follow-up in early-stage NMSC, but larger cohort studies with longer follow-up periods that allow for analysis of patient outcomes by demographic and disease characteristics are needed. Methods: This large, retrospective cohort study was conducted to determine the effect of risk factors (tumor location, tumor stage, and sex) on 2-, 4-, and 6-year freedom from recurrence rates in 19,988 NMSC lesions treated with IGSRT, including lesions with complete treatment courses. Results: Overall freedom from recurrence rates were 99.68% at 2 years, 99.54% at 4 years, and 99.54% at 6 years; rates did not differ significantly by tumor location (head/neck versus other locations, p = 0.9) or sex (male versus female, p = 0.4). In contrast, there was a significant difference in freedom from recurrence rates when analyzed by tumor stage (p = 0.004). Conclusions: There was no significant effect of tumor location or sex on freedom from recurrence in IGSRT-treated NMSC. Although there was a significant difference according to tumor stage, freedom from recurrence rates exceeded 99% at all stages.
Significance as a Prognostic Factor of Eosinophil Count in Nasal Polyp Tissue in Patients with Chronic Rhinosinusitis Accompanied by Asthma
Authors: Kim Moo Keon , Cho Seok Hyun , Lee Ha Na , Jung Seon Min , Jeong Jin Hyeok
Published: September 2024

Background/Objectives: Patients with chronic rhinosinusitis (CRS) accompanied by asthma often show poor prognoses and require continuous management. This study aimed to assess the prognostic value of eosinophil counts in nasal polyp tissue for selecting individuals who would benefit from ongoing management in CRS patients with asthma. Methods: Patients with asthma who underwent endoscopic sinus surgery for CRS with nasal polyps were included in the study. Eosinophil counts in nasal polyp tissues were quantified, and retrospective data were collected from laboratory and clinical findings, including endoscopic examinations, CT scans, and Japan Endoscopic Sinus Surgery Rating and Evaluation Committee (JESREC) scores. Disease control status was evaluated through endoscopic examination 6 months post-surgery. Results: A total of 42 patients were divided into two groups based on their disease management status 6 months post-operation: the well-control group (24 patients, 57.14%) and the poor-control group (18 patients, 42.86%). Demographics and laboratory findings did not show significant differences between the groups. However, the JESREC score (p = 0.04) and tissue eosinophil count (p = 0.02) were significantly different. Multivariate analysis identified tissue eosinophil count as the only risk factor associated with prognosis, with a cut-off value of 90/HPF. Conclusions: In CRS patients with asthma, high tissue eosinophil counts in nasal polyps were associated with poor disease control, which is the most potent predictor of prognosis. The assessment of eosinophil counts in nasal polyp tissue could aid in identifying patients who would benefit from continuous management and tailored interventions for improved outcomes.
Visual and Refractive Outcomes after Phacoemulsification Cataract Surgery in Nanophthalmic Eyes
Authors: Lai Tracy H. T. , Tse Jeffrey Y. T. , Chan Jacqueline W. T. , Li Kenneth K. W.
Published: September 2024

Background/Objectives: The aim of this study was to report the visual and refractive outcomes of nanophthalmic eyes undergoing phacoemulsification at a tertiary cataract center. Methods: This is a prospective consecutive case series. Patients with an axial length of ≤20.5 mm who underwent phacoemulsification at a tertiary cataract center in Hong Kong were included. Eyes undergoing extracapsular cataract extraction or with a previous history of intraocular surgery including trabeculectomy were excluded. The outcome measures were the corrected distance visual acuity (CDVA) and refractive status at four months post-operation. Different intraocular lens formulas were used to compare the refractive outcomes. Results: Out of 22,847 cataract surgeries performed from May 2011 to March 2020, 14 eyes (0.06%) of 10 patients had axial lengths of ≤20.5 mm and underwent phacoemulsification. The mean axial length was 20.13 ± 0.44 mm. Out of these fourteen eyes, three (21%) had postoperative myopic shift with spherical equivalent refraction of more than or equal to 1D compared to the original target. Eleven eyes (79%) had postoperative refraction within 0.5D compared to the original target. Nine out of fourteen eyes (64%) had improvements in postoperative vision. There were no intraoperative complications. When comparing the Hoffer Q, Holladay 1, Holladay 2, Haigis and Hill-RBF 2.0 formulas, there was no significant difference in the absolute errors between the five formulas (p = 0.072). Conclusions: There was no significant difference in the mean absolute errors between the Hoffer Q, Holladay 1, Holladay 2, Haigis and Hill-RBF 2.0 formulas. Myopic shift was not uncommon, and more studies on intraocular lens (IOL) power calculation for short eyes are warranted.
The Impact of 3D Printing Technology on the Improvement of External Wall Thermal Efficiency—An Experimental Study
Authors: Anwajler Beata , Szulc Piotr
Published: September 2024

Three-dimensional printing technology continues to evolve, enabling new applications in manufacturing. Extensive research in the field of biomimetics underscores the significant impact of the internal geometry of building envelopes on their thermal performance. Although 3D printing holds great promise for improving thermal efficiency in construction, its full potential has yet to be realized, and the thermal performance of printed building components remains unexplored. The aim of this paper is to experimentally examine the thermal insulation characteristics of prototype cellular materials created using 3D additive manufacturing technologies (SLS and DLP). This study concentrates on exploring advanced thermal insulation solutions that could enhance the energy efficiency of buildings, cooling systems, appliances, or equipment. To this end, virtual models of sandwich composites with an open-cell foam core modeled after a Kelvin cell were created. They were characterized by a constant porosity of 0.95 and a pore diameter of the inner core of the composites of 6 mm. The independent variables included the different material from which the composites were made, the non-uniform number of layers in the composite (one, two, three, and five layers) and the total thickness of the composite (20, 40, 60, 80, and 100 mm). The impact of three independent parameters defining the prototype composite on its thermal insulation properties was assessed, including the heat flux (q) and the heat transfer coefficient (U). According to the experimental tests, a five-layer composite with a thickness of 100 mm made of soybean oil-based resin obtained the lowest coefficient with a value of U = 0.147 W/m2·K.
Tensile Properties and Weibull Modulus of Polymeric-Fiber-Reinforced Epoxy-Impregnated Bundle Composites
Authors: Naito Kimiyoshi , Nagai Chiemi , Kawasaki Shota
Published: September 2024

The tensile properties and the Weibull statistical distributions of the tensile strength of poly-(para-phenylene-2,6-benzobisoxazole) (PBO), poly-(para-phenylene terephthalamide) (PPTA), copoly-(para-phenylene-3,4′-oxydiphenylene terephthalamide (PPODTA), polyarylate (PAR), and polyethylene (PE) polymeric fiber epoxy-impregnated bundle composites have been investigated. The results show that the Weibull modulus decreases as the tensile modulus, strength, and inverse of the failure strain increase. The interfacial shear properties were also examined using the microdroplet composite. For the lower interfacial shear strength of polymeric fibers, the Weibull modulus decreases as interfacial shear strength increases. Conversely, for the higher interfacial shear strength of polymeric fibers, the Weibull modulus increases as interfacial shear strength increases. Interestingly, these inflection points were also observed for the 20–30 MPa interfacial shear strength.
The Influence of the Rolling Direction on the Mechanical Properties of the Al-Alloy EN AW-5454-D
Authors: Balant Matjaž , Vuherer Tomaž , Majerič Peter , Rudolf Rebeka
Published: September 2024

A complementary characterisation of the Al-alloy EN AW-5454 was carried out, intended for obtaining the laser hybrid welding parameters of subassemblies in the automotive industry. The investigation included a microstructural examination and the determination of the alloy’s properties using several analytical methods (HV5 hardness measurement, tensile test, Charpy impact toughness, fracture mechanics analysis). Samples were prepared in the longitudinal and transverse directions of a cold-rolled sheet of EN AW-5454 with thicknesses of 3.5 mm and 4 mm. The measured hardness on the thinner sheet was 5% higher than on the thicker sheet. The tensile and yield strength were nominal, while the elongations were smaller by 2.2–3.2% for the longitudinal samples and by 2.7–13.7% for the transverse samples. The smaller deviations from the nominal values are for the thinner sheet metal. A precise topographical analysis showed the brittle fractures of the samples. The Charpy impact toughness results on the thicker plate showed a 20% greater work needed to break it in the longitudinal direction than in the transverse direction. With the thinner sheet metal, 40% greater work was needed. SEM (scanning electron microscope) analysis has shown that the intermetallic Al6(Mn,Fe) particles in the longitudinal samples were mostly intact, with evidence of tough areas on the upper part of the fracture, indicating a better toughness than the specimens in the transverse direction. More crushed intermetallic particles were observed at the fractures of the transverse samples, and their distribution appeared to be more oriented in the direction of rolling. Fracture mechanics SENB (single edge notch bending) tests and their analysis showed that the resistance of the material to crack propagation in the longitudinal sample was about 50% greater than that in the transverse sample. SEM analysis of the fractures showed that the state of the intermetallic particles in the fracture mechanics testing and the fracture mechanism differed from the one in the Charpy fractures.
Risk Identification and Safety Evaluation of Offshore Wind Power Submarine Cable Construction
Authors: Huang Hui , Zhang Qiang , Xu Hao , Li Zhenming , Tian Xinjiao , Fang Shuhao , Zheng Juan , Zhang Enna , Yang Dingding
Published: September 2024

To mitigate accidents in submarine cable construction within the rapidly expanding offshore wind power sector, this study employed the analytic hierarchy process (AHP) and risk matrix method (LS) to assess the risks associated with identified factors. Based on project research and expert consultations, five primary and twenty-two secondary risk factors were identified. AHP was utilized to rank the primary risk factors by severity, probability, and detection difficulty, with the highest risk being the environmental impact, followed by third-party destruction and worker error. LS was applied to rank the secondary risk factors by likelihood and severity, with the highest risks being complex submarine topography, low underwater visibility, and fishing operations. The study proposes risk reduction measures based on these evaluations and offers methodological guidance for improving construction safety in similar enterprises.
An Intelligent Decision-Making Approach for Multi-Ship Traffic Conflict Mitigation from the Perspective of Maritime Surveillance
Authors: Wang Shaobo , Zou Yiyang , Wang Xiaohui
Published: September 2024

Potential multi-ship conflict situations in coastal or near-shore port areas have always been one of the important factors affecting ship navigation safety and a key target of maritime traffic regulatory authorities. In recent years, with the continuous development and integration of various emerging technologies in the maritime field, maritime traffic supervision has also shown a trend of intelligent and autonomous development. The traditional supervision method dominated by human experience is evolving towards data and model-driven practices. In order to solve the problem of ship navigation safety supervision under multi-ship conflict scenarios, it is urgent to build an intelligent conflict mitigation decision-making model. Therefore, this paper designs a novel risk mitigation decision-making model for multi-ship conflict scenarios from the perspective of maritime supervision. The model proposed in this paper first extracts high-density ship clusters based on AIS (Automatic Identification System) data and uses the MCD (Mean Core Density) and PRM (Proportion of Relative Motion) as feature indicators to further mine potential multi-ship conflict scenarios. Finally, a global optimization decision-making model is constructed to effectively mitigate conflict risks. Experimental verification shows that the intelligent decision-making model for the mitigation of maritime traffic conflict proposed in this paper can autonomously identify conflict scenarios and make reasonable decisions in real time. It can effectively ensure the navigation safety of ships in multi-ship conflict scenarios and further improve the supervision level of maritime departments.
Exploring the Synergistic Secretome: Insights from Co-Cultivation of Aspergillus brasiliensis and Trichoderma reesei RUT-C30
Authors: Sperandio Guilherme Bento , Melo Reynaldo Magalhães , Gomes Taísa Godoy , Miller Robert Neil Gerard , do Vale Luis Henrique Ferreira , Sousa Marcelo Valle de , Ricart Carlos André Ornelas , Filho Edivaldo Ximenes Ferreira
Published: September 2024

The spectrum of enzymes required for complete lignocellulosic waste hydrolysis is too diverse to be secreted by a single organism. An alternative is to employ fungal co-cultures to obtain more diverse and complete enzymatic cocktails without the need to mix enzymes during downstream processing. This study evaluated the co-cultivation of Aspergillus brasiliensis and Trichoderma reesei RUT-C30 in different conditions using sugarcane bagasse as the carbon source. The resulting enzymatic cocktails were characterized according to the impact of strain inoculation time on enzymatic activities and proteome composition. Data revealed that the profile of each enzymatic extract was highly dependent on the order in which the participating fungi were inoculated. Some of the co-cultures exhibited higher enzyme activities compared to their respective monocultures for enzymes such as CMCase, pectinase, β-glucosidase, and β-xylosidase. Analysis of the T. reesei RUT-C30 and A. brasiliensis co-culture secretome resulted in the identification of 167 proteins, with 78 from T. reesei and 89 from A. brasiliensis. In agreement with the enzymatic results, proteome analysis also revealed that the timing of inoculation greatly influences the overall secretome, with a predominance of T. reesei RUT-C30 proteins when first inoculated or in simultaneous inoculation.