bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluating the Impact of Inulin Addition before Solar Drying on the Characteristics of Sour Cassava Starch as a Food Ingredient
Authors: Díaz Andrea , Dini Cecilia , García María Alejandra
Published: April 2024

Sour cassava starch is obtained by spontaneous fermentation of the starch cake immediately after being extracted, followed by sun‐drying, where oxidation reactions take place that are essential for the enhanced baking expansion of this starch. The aim of this work is to evaluate the influence of adding a different polysaccharide to the starch cake before sun‐drying in the characteristics of the obtained product. Inulin is chosen for being a soluble prebiotic fiber that may improve the nutritional quality of the starch. Inulin modifies the oxidation of the fermented starch during sun‐drying, and forms a film around the granules that hinder their swelling and water retention capacity. The crystallinity of the inulin is increased by hydration and sun‐drying. Adding inulin to the fermented starch before sun‐drying reduces its expansion capacity, but in a lower rate than when inulin is added after sun‐drying. The fermented starch sun‐dried with inulin produces a baked snack with similar texture to that of the sour starch alone, and softer than that from the native starch.
Fractional‐Order Kinetics Modeling of Starch Thermal Degradation
Authors: Roldan‐Cruz César , García‐Hernandez Angeles , Fonseca‐Florido Heidi Andrea , Vernon‐Carter Eduardo Jaime , Alvarez‐Ramirez Jose
Published: April 2024

The thermal decomposition modeling of starch granules (rice, maize, and potato) is investigated in this work. Thermogravimetric analysis (TGA) under nitrogen conditions and different heating rates is carried out. First, a model‐free analysis is carried out to determine the variability of the activation energy with the relative conversion. The results reveal that the sequence of activation energy is rice > maize > potato. In turn, the activation energy is positively correlated (ρ  =  0.98) with the relative crystallinity determined by X‐ray diffraction (XRD) analysis. Then, a fractional‐order version of the Sestak–Berggren equation is used to model the starch thermal decomposition. A least‐squares approach is used to estimate the underlying parameters by fitting non‐isothermal TGA curves. The results show that the parameters depend on the heating rate, but more strongly on the XRD relative crystallinity. Overall, the results reported in this study indicate that fractional‐order kinetics models provide an accurate description of the starch thermal degradation, without the use of the traditional TGA heuristic methods used for parameter estimation.
Using a smartphone‐based digital fundus camera for screening of retinal and optic nerve diseases in veterinary medicine: A preliminary investigation
Authors: Sebbag Lionel , Ofri Ron , Arad Dikla , Handel Karin W. , Pe'er Oren
Published: April 2024

Background

Ophthalmoscopy is a valuable tool in clinical practice. We report the use of a novel smartphone‐based handheld device for visualisation and photo‐documentation of the ocular fundus in veterinary medicine.

Methods

Selected veterinary patients of a referral ophthalmology service were included if one or both eyes had clear ocular media, allowing for examination of the fundus. Following pharmacological mydriasis, fundic images were obtained with a handheld fundus camera (Volk VistaView). For comparison, the fundus of a subset of animals was also imaged with a veterinary‐specific fundus camera (Optomed Smartscope VET2).

Results

The large field of view achieved by the Volk VistaView allowed for rapid and thorough observation of the ocular fundus in animals, providing a tool to visualise and record common pathologies of the posterior segment. Captured fundic images were sometimes overexposed, with the tapetal fundus artificially appearing hyperreflective when using the Volk VistaView camera, a finding that was less frequent when activating a ‘veterinary mode’ that reduced the sensitivity of the camera's sensor. The Volk VistaView compared well with the Optomed Smartscope VET2.

Limitation

The main study limitation was the small sample size.

Conclusions

The Volk VistaView camera was easy to use and provided good‐quality fundic images in veterinary patients with healthy or diseased eyes, offering a wide field of view that was ideal for screening purposes.
Temperature dependence investigations of molecular interactions and excess thermodynamic parameters of binary mixtures of ionic liquids and water using Flory's statistical theory
Authors: Sirohi Archana , Upmanyu Arun , Dhiman Monika , Kumar Pankaj , Singh Devinder Pal
Published: April 2024

Flory's Statistical Theory (FST) has been applied to investigate excess thermodynamical parameters viz., excess enthalpy, excess entropy, and excess Gibbs free energy for eight binary mixtures of ionic liquids and water at different concentration and temperatures. The concentration and temperature dependent variations of excess enthalpy suggest that ionic liquid mixtures exhibit an endothermic nature and the presence of weak dispersive forces among their constituents. The positive excess Gibbs free energy of mixing points out that the pure components do not mix thoroughly for the systems under study. Overall, these binary systems are thermodynamically unfavorable suggesting that the mixing of ionic liquids and water is not energetically favored or spontaneous. Experimental molar volumes are compared with those calculated using FST and these values show excellent agreement. It affirms the validity of FST's application to these systems. Additionally, some partial properties have also been determined to explore the solute‐solvent interactions. The Redlich‐Kister (R‐K) polynomial model has been applied to excess thermodynamical parameters The high R2 values and low standard deviation values confirm the validity of fitting the RK polynomial model to the functions obtained using FST of liquids for these systems within the given temperature range.
Microwave‐assisted green synthesized TiO2 mediated nano photocatalytic degradation of prulifloxacin: A mechanistic study
Authors: Ahmad Waseem , Arora Anshika , Rana Rinku
Published: April 2024

The present investigation reports an effective, environmentally benevolent method for the removal of pharmaceutical waste from the contaminated water. Popular fluoroquinolone antibiotic prulifloxacin residue was taken as a sample of contaminant. Different irradiation conditions were used to explore the ability of TiO2 nanoparticles in the photodegradation of prulifloxacin. Aqueous lichen extract was used to fabricate the TiO2 nanoparticles. The assessment of the physical and chemical properties of the fabricated materials was examined by using well‐established analytical methodologies. The UV–vis spectra depicted the surface plasmon resonance peak at 282 nm. The XRD spectra revealed the particle nature of the developed nanomaterials and the result of the XRD spectrum depicted that the average diameter of the fabricated materials was found to be in the range of 20–30 nm. The FTIR spectra depicted the characteristic band at 750 cm−1, which corresponded to the Ti─O stretching mode of vibration. The SEM micrograph of the developed nanoparticles exhibited the irregular morphology of the developed nanoparticles. The present report critically analyzes the possible route of the degradation of prulifloxacin in the presence of microwave‐assisted green synthesized TiO2 NPs. The photodegradation of the prulifloxacin was not notably influenced by reactive oxygen species. Diverse analytical techniques were utilized to perform the structural analysis of the photoproduct. Results of the proposed investigation indicate that the rate of the photodegradation of prulifloxcin is highest when the drug is irradiated at 310 nm light in the presence of TiO2 NPs.
Degradation of several chlorophenols using advanced oxidative processes: Major and minor products
Authors: Lebedeva Olga E. , Buchelnikov Anatoly S. , Kalashnikova Yulia V. , Ustinova Maria N. , Solovyeva Anna A. , Gudkova Elena A.
Published: April 2024

This study focuses on finding direct evidence of oxidative degradation of chlorophenols. The aim of the study was distinguishing major and minor degradation products. Several chlorophenols with different numbers of chloride substituents (2‐chlorophenol, 2,4‐dichlorophenol, and 2,4,5‐trichlorophenol) were chosen for a thorough study. UV photolysis, Fenton, and photo‐Fenton processes were tested as advanced oxidative processes. Photo‐Fenton appeared to result in higher conversions of mono‐ and dichlorophenols. Conversions of trichlorophenol were comparable for all the processes under this study. Formic and acetic acids were shown to be the major products. Their formation was confirmed by 1H NMR spectroscopy. Other possible products are minor and are formed in negligible concentrations. The degradation methods can be considered harmless techniques of inactivating the chlorophenols, leading to the formation of products of low toxicity.
Impact of water‐in‐diesel emulsion on compression ignition engine's emissions and its challenges—A detailed review
Authors: Onuoha Chiamaka Prisca , Etim Ini‐ibehe Nabuk , Oguzie Emeka Emmanuel
Published: April 2024

Compression ignition engines/diesel engines release greenhouse gases like particulate matter (PM), carbon monoxide (CO), nitrogen oxides (NOx), and, unburnt hydrocarbons which pose environmental and human health risks. Water‐in‐diesel emulsion (WiDE) has emerged as a cost‐effective alternative fuel for reducing the emission of these gases in diesel engines. This paper reviews the effectiveness of using emulsion fuel in engines to reduce harmful emissions as well as the challenges associated with WiDE, which include emulsion stability and corrosion. The review is based on available experimental results from various studies in the literature. While there are a few conflicting outcomes among researchers, the majority of results support the benefits of using WiDE in a compression engine as the PM and NOx emissions, significantly decreased. The decrease in NOx is a result of the flame reaching a lower peak temperature during combustion. The reduction in PM occurs as a result of the micro‐explosion process, which enhances combustion efficiency. Even though WiDE significantly reduces the environmental impact of diesel engines, this study also shows that WiDE faces stability problems and enhances the corrosion of materials. The development of a systematic methodology that can accurately measure emulsion stability, the in‐depth study of the impacts of surfactant dosage, water content and temperature on the corrosion behavior of metals in WiDE and also the development of anti‐corrosion intervention suggestions have been suggested based on the analysis of earlier research.
Removal of antiretroviral drugs from wastewater using activated macadamia nutshells: Adsorption kinetics, adsorption isotherms, and thermodynamic studies
Authors: Simelane Lindokuhle , Mahlambi Precious , Rochat Sebastien , Baker Ben
Published: April 2024

Antiretroviral drugs (ARVDs) have been extensively employed in health care to improve the quality of life and lifecycle longevity. However, overuse and improper disposal of ARVDs have been recognized as an emerging concern whereby wastewater treatment major recipients. Therefore, in this work, the activated macadamia nutshells (MCNs) were explored as low‐cost adsorbents for the removal of ARVDs in wastewater samples. Fourier transform infrared spectroscopy (FTIR), Scanning Electron microscopy (SEM), Brunauer–Emmet–Teller (BET), and Powder X‐ray diffraction (PXRD). The highest removal efficiency (R.E) was above 86% for the selected analytes nevirapine, abacavir, and efavirenz. The maximum adsorption capacity of the functionalized MCN adsorbent was 10.79, 27.44, and 38.17 mg/g for nevirapine, abacavir, and efavirenz for HCl‐modified adsorbent. In contrast, NaOH modified had adsorption capacities of 13.67, 14.25, and 20.79 mg/g. The FTIR showed distinct functional groups OH and CO, which facilitate the removal of selected ARVDs. From studying kinetics parameters, the pseudo‐second‐order (R2 = 0.990–0.996) was more dominant than the pseudo‐first‐order (R2 = 0.872–0.994). The experimental data was most fitted in the Freundlich model with (R2 close to 1). The thermodynamic parameters indicated that the adsorption process was spontaneous and exothermic. The study indicated that MCNs are an eco‐friendly, low‐cost, and effective adsorbent for the removal of nevirapine, abacavir, and efavirenz.

Practitioner Points

Modification macadamia nutshell with HCl and NaOH improved physio‐chemical properties that yielded high removal efficiency compared with raw macadamia nutshells.

Modification of macadamia by HCl showed high removal efficiency, which could be attributed to high interaction such as H‐bonding that improves adsorption.

The macadamia nutshell as an adsorbent showed so much robustness with regeneration studies yielding to about 69.64% of selected compounds.
Polynomial stability for Lord–Shulman porous elasticity with microtemperature and strong time delay
Authors: Ramos Anderson J. A. , Araujo Anderson L. A. , Freitas Mirelson M. , Santos Manoel J. Dos , Noé Alberto S.
Published: April 2024

In this paper, we study a porous thermoelastic system with microtemperature and strong time delay acting on the volume fraction equation. The thermal effect of microtemperature is based on the Lord–Shulman theory (J Mech Phys Solids. 15(5) (1967), 299–309.), while the strong delay is motivated by Makheloufi's et al. recent work (Math Meth Appl Sci. 44 (2021), 6301–6317.). To prove the well‐posedness of the system, lack of exponential stability and the polynomial decay with optimal rate, we use the semigroup theory of linear operators.
Investment Arbitration, Corruption and Illegality: South Korea
Authors: Kim Joongi
Published: April 2024

This chapter provides an overview of Korea’s investment treaty regime and its provisions and practice concerning corruption and illegality. It further analyzes how these issues have featured in cases related to Korea and Korean investors. Korea has become a leading exporter and significant importer of foreign direct investment. To protect and promote inbound and outbound investment, Korea has established one of the most wide-ranging and extensive regimes of international investment agreements in the world, primarily through an array of bilateral investment treaties and free trade agreements with investment chapters. However, their provisions related to corruption and illegality are generally not developed. For instance, most of Korea’s treaties do not include an explicit requirement for the host states to take measures against corruption. Korean treaties also vary in terms of how they require foreign investments to be made in accordance with host state laws. Korea’s passivity regarding such provisions seems unaffected by foreign investors increasingly commencing arbitrations against the country recently and Korean investors also becoming more active in bringing outbound claims. While the extent that corruption or illegality features in cases brought by Korean investors remain largely unknown, some of the cases against Korea have corruption and illegality related elements. There is no indication that Korea may become more proactive in terms of corruption provisions, but there are some signs it is pursuing more and clearer legality provisions. Nevertheless, it is foreseeable that Korea might become more proactive in promoting both types of provisions in future treaties as part of its commitment to transparency.
Does Corruption Hinder Foreign Direct Investment and Growth in Asia and Beyond? The Grabbing Versus the Helping Hand Revisited
Authors: Khalid Ahmed M.
Published: April 2024

Corruption is considered a major issue globally, particularly for developing countries, as it takes away important resources resulting in huge costs to the economy. This is especially true in the case of attracting foreign direct investment (FDI) in the host country. However, the theoretical literature contains counter-arguments, with some scholars agreeing with the above argument while others suggest that, in some cases, corrupt practices facilitate business transactions, thus helping to attract FDI. This chapter further explores this literature. It first provides a review of the theoretical and empirical literature on corruption–growth and corruption–investment relationships. This is followed by some interesting details on the cost of corruption. Subsequently, some econometric analysis is performed to verify the ‘grabbing hand’ and ‘helping hand’ views on the impact of corruption. The empirical findings of this chapter support a grabbing hand view for the top 20 (least corrupt) countries while the evidence suggests a helping hand view for the bottom 20 (most corrupt) countries. The author also finds evidence supporting a non-linearcorruption–growth and corruption–investment relationship for the sample of the 20 most corrupt countries. He believes that these are interesting findings and could have important policy implications.
Multi-Tiered International Anti-Corruption Cooperation in Asia: A Review of Treaties and Prospects
Authors: Yan Yueming , Liu Tianyu
Published: April 2024

Effective international cooperation is essential for combating the pervasive and far-reaching problem of transnational corruption. This chapter focuses on the anti-corruption commitments and cooperation among Asian countries in the context of international investment. It firstly examines the legal framework against corruption in Asia at both the international and regional levels, encompassing both ‘hard law’ and ‘soft law’ instruments. In addition, the chapter presents a comprehensive analysis of the anti-corruption provisions in international investment agreements concluded by Asian countries. The review of these agreements reveals that provisions of direct anti-corruption obligations imposed on investors are still elusive among Asian investment agreements, whereas provisions that demonstrate states’ general commitments to combatting corruption are more common. The chapter highlights the importance of more nuanced treaty-making practices in addressing corruption, as well as the need to align commitments made under investment agreements with those of other international instruments aimed at tackling corruption.
Rebalancing Asymmetries Between Host States and Investors in Asian Investor–State Dispute Settlement: An Exception for Systemic Corruption
Authors: Jarrett Martin
Published: April 2024

Consider the following case. An investor is building an apartment complex. Halfway into developing this multi-million-ducat investment, a government department starts demanding bribes, which is business as usual for it. The investor initially resists, but eventually caves in. Years later, the host state seeks to use the investor’s participation in this corruption against it in an investment-treaty arbitration. The applicable investment treaty stipulates that only lawfully made investments are protected, with the result that the investor must fail. Any arbitral tribunal would be uncomfortable with this outcome. The degree of wrongfulness of the investor’s conduct pales in comparison to the host state's, noting that the host state has let many of its governmental departments become dens of corruption. But the arbitral tribunal’s hands are apparently tied. The terms of the applicable investment treaty are clear: the investor's claim must be denied, with an asymmetric outcome that effectively benefits the state. This chapter unties arbitral tribunals’ hands. It lays down another path for these tribunals to follow in such cases, one which avoids this outcome, yet remains honest to the tenets of international investment law.
Dark Matter searches with photons at the LHC
Authors: Roy Subhojit , Wagner Carlos E. M.
Published: April 2024

Abstract

We unveil blind spot regions in dark matter (DM) direct detection (DMDD), for weakly interacting massive particles with a mass around a few hundred GeV that may reveal interesting photon signals at the LHC. We explore a scenario where the DM primarily originates from the singlet sector within the Z3-symmetric Next-to-Minimal Supersymmetric Standard Model (NMSSM). A novel DMDD spin-independent blind spot condition is revealed for singlino-dominated DM, in cases where the mass parameters of the higgsino and the singlino-dominated lightest supersymmetric particle (LSP) exhibit opposite relative signs (i.e., κ < 0), emphasizing the role of nearby bino and higgsino-like states in tempering the singlino-dominated LSP. Additionally, proximate bino and/or higgsino states can act as co-annihilation partner(s) for singlino-dominated DM, ensuring agreement with the observed relic abundance of DM. Remarkably, in scenarios involving singlino-higgsino co-annihilation, higgsino-like neutralinos can distinctly favor radiative decay modes into the singlino-dominated LSP and a photon, as opposed to decays into leptons/hadrons. In exploring this region of parameter space within the singlino-higgsino compressed scenario, we study the signal associated with at least one relatively soft photon alongside a lepton, accompanied by substantial missing transverse energy (ɆT) and a hard initial state radiation jet at the LHC. In the context of singlino-bino co-annihilation, the bino state, as the next-to-LSP, exhibits significant radiative decay into a soft photon and the LSP, enabling the possible exploration at the LHC through the triggering of this soft photon alongside large ɆT and relatively hard leptons/jets resulting from the decay of heavier higgsino-like states.
Hebammen als Influencer bei der Hautpflege atopisch prädisponierter Neugeborener
Authors: Staubach-Renz Petra , Schulz Sara , Weyer-Elberich Veronika , Peveling-Oberhag Adriane , Zimmer Sebastian , Wegner Joanna , Sohn Anna , Mann Caroline , Lang Berenice M.
Published: April 2024

Einleitung

Die Prävalenz atopischer Erkrankungen ist weiterhin hoch. Erste Studien deuten darauf hin, dass die Primärprävention mit regelmäßiger Basispflege das Auftreten von atopischer Dermatitis bei Säuglingen beeinflussen könnte, allerdings ist die Datenlage nicht ganz eindeutig. Hebammen spielen eine wichtige Rolle bei der Betreuung von Frauen in der Peripartalzeit und damit auch in der Beratung zu Themen wie Hautpflege, Stillen und Ernährung des Neugeborenen und jungen Säuglings. Ziel dieser Studie war es, die Pflegeempfehlungen für Neugeborene durch Hebammen zu ermitteln.

Methoden

Wir führten eine Querschnittsbefragung unter deutschen Hebammen mittels Fragebogen zum Thema Hautpflege von Neugeborenen durch.

Ergebnisse

Es wurden 128 Fragebögen ausgewertet. Die häufigsten Empfehlungen waren pflanzliche Externa auf öliger Basis (34,9 %) und klares Wasser (34,0 %). Etwa 70 % der Hebammen gaben an, verschiedene Optionen zu empfehlen, wenn in der Familie eine atopische Diathese bekannt ist. Bemerkenswert war, dass die meisten Empfehlungen der Hebammen unabhängig vom Vorliegen einer atopischen Diathese dennoch identisch waren. Substanzielle Pflegeprodukte werden nur „bei Bedarf“ verwendet.

Schlussfolgerung

Schulungsprogramme für Hebammen zum Thema „Pflege und Stärkung der Hautbarriere“ unter Berücksichtigung der geltenden Leitlinien zur Allergieprävention sollten durchgeführt werden.
Breaking barriers in electrochemical biosensing using bioinspired peptide and phage probes
Authors: Campuzano Susana , Pedrero María , Barderas Rodrigo , Pingarrón José M.
Published: April 2024

Electrochemical biosensing continues to advance tirelessly, overcoming barriers that have kept it from leaving research laboratories for many years. Among them, its compromised performance in complex biological matrices due to fouling or receptor stability issues, the limitations in determining toxic and small analytes, and its use, conditioned to the commercial availability of commercial receptors and the exploration of natural molecular interactions, deserved to be highlighted. To address these challenges, in addition to the intrinsic properties of electrochemical biosensing, its coupling with biomimetic materials has played a fundamental role, among which bioinspired phage and peptide probes stand out. The versatility in design and employment of these probes has opened an unimaginable plethora of possibilities for electrochemical biosensing, improving their performance far beyond the development of highly sensitive and selective devices. The state of the art offers robust electroanalytical biotools, capable of operating in complex samples and with exciting opportunities to discover and determine targets regardless of their toxicity and size, the commercial availability of bioreceptors, and prior knowledge of molecular interactions. With all this in mind, this review offers a panoramic, novel, and updated vision of both the tremendous advances and opportunities offered by the combination of electrochemical biosensors with bioinspired phage and peptide probes and the challenges and research efforts that are envisioned in the immediate future.

Graphical Abstract
Transseptal coronary artery—a pictorial review
Authors: Maller Vijetha V , Johnson Jason N. , Boston Umar , Knott-Craig Christopher
Published: April 2024

A transseptal coronary artery course, also known as a transconal course, is an anomalous course of the left main coronary artery (LMCA) or the left anterior descending artery (LAD) through the conal septal myocardium. The conal septal myocardium is the posterior wall of the right ventricular outflow tract (RVOT), acting as a dividing myocardial wall between the subaortic and subpulmonary outflow tracts. The initial segment of a transseptal coronary artery has an extraconal course between the aorta and the RVOT cranial to the true intramyocardial segment. The transseptal coronary artery then emerges out of the conal septal myocardium at the epicardial surface on the lateral aspect of the RVOT. Many consider the transseptal coronary artery to be a benign entity. However, there are few case reports of severe cardiac symptoms such as myocardial ischemia, arrhythmia, and even sudden cardiac deaths due to potential coronary artery compression in the systolic phase.​ In this article, we seek to describe the imaging findings of transseptal coronary artery course on coronary computed tomography angiography (CTA), discuss their clinical analysis, and briefly discuss the management of these lesions.

Graphical abstract
Gn protein expressed in plants for diagnosis of severe fever with thrombocytopenia syndrome virus
Authors: Chang Yu-Chih , Shimoda Hiroshi , Jiang Min-chao , Hsu Yau-Heiu , Maeda Ken , Yamada Yumiko , Hsu Wei-Li
Published: April 2024

Severe fever with thrombocytopenia syndrome virus (SFTSV) causes the highly fatal disease in humans. To facilitate diagnosis, the native form of subunit glycoprotein (Gn), a prime target for potential vaccines and therapies, was produced in Nicotiana benthamiana using a Bamboo mosaic virus-based vector system. By fusion with secretory signal tags, SSExt, derived from the extension protein, and the (SP)10 motif, the yield of the recombinant Gn (rGn) was remarkably increased to approximately 7 mg/kg infiltrated leaves. Ultimately, an rGn-based ELISA was successfully established for the detection of SFTSV-specific antibodies in serum samples from naturally infected monkeys. As validated with the reference method, the specificity and sensitivity of rGn-ELISA were 94% and 96%, respectively. In conclusion, utilizing well-suited fusion tags facilitates rGn production and purification in substantial quantities while preserving its antigenic properties. The rGn-ELISA, characterized by its commendable sensitivity and specificity could serve as a viable alternative diagnostic method for assessing SFTSV seroprevalence.

Key points

• SFTSV Gn, fused with secretory signal tags, was expressed by the BaMV-based vector.

• The plant fusion tags increased expression levels and eased the purification of rGn.

• The rGn-ELISA was established and validated; its specificity and sensitivity > 94%.
Intravenous Opioid Medication with Piritramide Reduces the Risk of Pneumothorax During CT-Guided Percutaneous Core Biopsy of the Lung
Authors: Goetz Andrea , Poschenrieder Florian , Steer Frederike Georgine , Zeman Florian , Lange Tobias J. , Thurn Sylvia , Greiner Barbara , Stroszczynski Christian , Uller Wibke , Hamer Okka , Hammer Simone
Published: April 2024

Purpose

CT-guided percutaneous core biopsy of the lung is usually performed under local anesthesia, but can also be conducted under additional systemic opioid medication. The purpose of this retrospective study was to assess the effect of intravenous piritramide application on the pneumothorax rate and to identify risk factors for post-biopsy pneumothorax.

Materials and Methods

One hundred and seventy-one core biopsies of the lung were included in this retrospective single center study. The incidence of pneumothorax and chest tube placement was evaluated. Patient-, procedure- and target-related variables were analyzed by univariate and multivariable logistic regression analysis.

Results

The overall incidence of pneumothorax was 39.2% (67/171). The pneumothorax rate was 31.5% (29/92) in patients who received intravenous piritramide and 48.1% (38/79) in patients who did not receive piritramide. In multivariable logistic regression analysis periinterventional piritramide application proved to be the only independent factor to reduce the risk of pneumothorax (odds ratio 0.46, 95%-confidence interval 0.24, 0.88; p = 0.018). Two or more pleura passages (odds ratio 3.38, 95%-confidence interval: 1.15, 9.87; p = 0.026) and prone position of the patient (odds ratio 2.27, 95%-confidence interval: 1.04, 4.94; p = 0.039) were independent risk factors for a higher pneumothorax rate.

Conclusion

Procedural opioid medication with piritramide proved to be a previously undisclosed factor decreasing the risk of pneumothorax associated with CT-guided percutaneous core biopsy of the lung.

Level of Evidence 4

small study cohort.

Graphic Abstract
Comparison of Clinical and Radiological Outcomes Between Different (Balloon) Guide Catheter With and Without Inflated Balloon in Acute Ischemic Stroke Patients: A MaSQ-Registry Study
Authors: Knapen R. R. M. M. , Celen M. , Pinckaers F. M. E. , Wagemans B. A. J. M. , van Zwam W. H. , van Oostenbrugge R. J. , van der Leij C.
Published: April 2024

Purpose

Balloon guide catheters (BGCs) are used in endovascular treatment (EVT) for ischemic stroke. Previous literature did not distinguish between BGC use with and without inflated balloon. This study aims to compare outcomes between non-BCG and BGC use with and without inflated balloon during EVT.

Methods

Patients who underwent EVT for anterior circulation ischemic stroke between September 2020 and February 2023 were analyzed. Patients were divided into three groups: non-BGC, BGC with inflated balloon, or BGC without inflated balloon. The primary outcome was the ordinal modified Rankin Scale (mRS) at 90-day follow-up. Secondary outcomes included expanded Thrombolysis In Cerebral Ischemia score (eTICI) and periprocedural complications. Regression analyses with BGC with inflated balloon as comparator were performed with adjustments. Subgroup analyses were conducted based on first-line thrombectomy technique.

Results

Out of 511 patients, 428 patients were included. Compared to BCG with inflated balloon, the mRS at 90 days did not differ in the group without inflated balloon (adjusted common [ac]OR: 1.07, 95%CI 0.67–1.73) or non-BGC (acOR: 1.42, 95%CI 0.83–2.42). Compared to patients treated with a BGC with inflated balloon, those treated with BGC without inflated balloon had lower eTICI scores (acOR: 0.59, 95%CI 0.37–0.94), and patients treated with non-BGC had lower chances of periprocedural complications (aOR: 0.41, 95%CI 0.20–0.86).

Conclusions

This study shows no clinical differences in ischemic stroke patients treated with BGC with inflated balloon compared to non-BGC and BGC without inflated balloon, despite lower periprocedural complication rates in the non-BGC group and lower eTICI scores in the BGC without inflated balloon group.

Level of Evidence

Level 3, non-controlled retrospective cohort study.

Graphical Abstract
Einfluss des Verhältnisses von Transplantatgröße zu Hornhautgröße auf Immunreaktion, Re-Bubbling-Rate und postoperativen Endothelzellverlust bei 457 Augen nach Descemet-Membrane-Endothelial-Keratoplastik (DMEK)
Authors: Reinert Ursula , Seitz Berthold , Munteanu Cristian , Daas Loay
Published: April 2024

Hintergrund

Ziel dieser Studie war es, den Einfluss des Verhältnisses von Transplantatgröße zu Hornhautgröße auf postoperative Komplikationen (endotheliale Immunreaktion [IR], Re-Bubbling-Rate und Endothelzellverlust [ECL]) nach Descemet-Membrane-Endothelial-Keratoplastik (DMEK) zu untersuchen.

Patienten und Methoden

Retrospektiv eingeschlossen wurden 457 Patientenaugen mit den Diagnosen Fuchs-Endotheldystrophie (n = 431), pseudophake bullöse Keratopathie (n = 9) und andere Diagnosen (n = 17), welche zwischen 2016 und 2019 in der Klinik für Augenheilkunde am Universitätsklinikum des Saarlandes (UKS) in Homburg/Saar mittels DMEK (n = 270) bzw. Triple-DMEK (n = 187) operiert wurden. Der Nachbeobachtungszeitraum erstreckte sich bis Ende 2020. Die untersuchten Zielgrößen waren: Auftreten einer endothelialen IR, eines Re-Bubblings und die Größe des postoperativen ECL (6 Wochen, 6 Monate, 1 Jahr) in Abhängigkeit des Verhältnisses von Transplantat- zu Hornhautgröße (VTH).

Ergebnisse

Das VTH in dieser Studie schwankte von 0,35 bis 0,62 (0,46 ± 0,04). Es traten 33 (7,2 %) postoperative IR auf (DMEK n = 25; Triple-DMEK n = 8). Das durchschnittliche VTH war ohne IR (0,46 ± 0,04) signifikant (p = 0,038) kleiner als in der Gruppe mit IR (0,47 ± 0,05). Ein Re-Bubbling war bei 159 von 457 Patientenaugen nötig (34,8 %). Das VTH der Augen mit Re-Bubbling (0,47 ± 0,04) war signifikant (p = 0,014) größer als das VTH der Augen ohne Re-Bubbling (0,45 ± 0,04). Die durchschnittliche präoperative Endothelzellzahl (ECD) betrug 2603 ± 251 Zellen/mm2 (Min: 2161, Max: 3500 Zellen/mm2). Ein größerer VTH hatte keinen positiven Einfluss auf den Endothelzellverlust (r = 0,001; p = 0,974).

Schlussfolgerung

Unsere Ergebnisse deuten an, dass ein größerer Transplantatdurchmesser im Vergleich zu Hornhautgröße mit einer erhöhten Rate von IR und Re-Bubblings nach DMEK einhergeht. Dagegen hatte das VTH keinen Einfluss auf den Endothelzellverlust nach DMEK. Aus diesem Grund sollte der Transplantatdurchmesser für DMEK gerade bei der Fuchs-Dystrophie nicht unnötig groß gewählt werden.
On a Class of Elliptic Orthogonal Polynomials and their Integrability
Authors: Desiraju Harini , Latimer Tomas Lasic , Roffelsen Pieter
Published: April 2024

Building upon the recent works of Bertola; Fasondini, Olver and Xu, we define a class of orthogonal polynomials on elliptic curves and establish a corresponding Riemann–Hilbert framework. We then focus on the special case, defined by a constant weight function, and use the Riemann–Hilbert problem to derive recurrence relations and differential equations for the orthogonal polynomials. We further show that the sub-class of even polynomials is associated to the elliptic form of Painlevé VI, with the tau function given by the Hankel determinant of even moments, up to a scaling factor. The first iteration of these even polynomials relates to the special case of Painlevé VI studied by Hitchin in relation to self-dual Einstein metrics.
Assessment of olfactory recovery after COVID-19: cross-sectional study
Authors: Zaid Ehab Abou , Eltelety Ahmad Mohamed , Azooz Khaled Omar , Ragab Gouda , Nassar Ahmed Amin
Published: April 2024

Objective

This study aimed to evaluate recovery patterns of olfactory dysfunction among recovered COVID-19 patients, both subjective and objective, and correlate this recovery to the severity of the disease.

Methods

The study recruited 200 patients and assigned them to two equal groups, one of them was a control group. The olfactory function of the study group was assessed via subjective and objective methods at baseline and then monthly for three months, with changes in smell function reported at each visit. These patients underwent chemosensory testing using the Sniffin’ Sticks test and completed the validated Arabic version of the Questionnaire of Olfactory Disorders-Negative Statements (QOD-NS).

Results

Olfactory dysfunction occurred on the first day of COVID-19 symptoms in 37% of participants. Subjective reports suggested smell recovery in 55% after 3 months, but Sniffin' Sticks showed only 1% with normal function, indicating persistent deficits in others. This study revealed smell recovery for 93% of participants (median 14 days), with most (58%) recovering within 2 weeks. No significant links were found between demographics, COVID-smell loss timing, and recovery speed.

Conclusion

Three months after COVID-19, many patients perceive smell recovery, but objective tests reveal shockingly high rates of persistent dysfunction. Further follow-up with objective tests is vital to assess the true burden and potential long-term effects of smell loss.
Search engine optimization and its association with readability and accessibility of diabetic retinopathy websites
Authors: Lam Matthew R. , Manion Garrett N. , Young Benjamin K.
Published: April 2024

Purpose

This study investigated whether websites regarding diabetic retinopathy are readable for patients, and adequately designed to be found by search engines.

Methods

The term “diabetic retinopathy” was queried in the Google search engine. Patient-oriented websites from the first 10 pages were categorized by search result page number and website organization type. Metrics of search engine optimization (SEO) and readability were then calculated.

Results

Among the 71 sites meeting inclusion criteria, informational and organizational sites were best optimized for search engines, and informational sites were the most visited. Better optimization as measured by authority score was correlated with lower Flesch Kincaid Grade Level (r = 0.267, P = 0.024). There was a significant increase in Flesch Kincaid Grade Level with successive search result pages (r = 0.275, P = 0.020). Only 2 sites met the 6th grade reading level AMA recommendation by Flesch Kincaid Grade Level; the average reading level was 10.5. There was no significant difference in readability between website categories.

Conclusion

While the readability of diabetic retinopathy patient information was poor, better readability was correlated to better SEO metrics. While we cannot assess causality, we recommend websites improve their readability, which may increase uptake of their resources.
Child participation during outpatient consultations: a mixed methods study
Authors: Koenis Maud M. , Vroman Heleen , Brand Paul L. P. , van Woerden Christiaan S.
Published: April 2024

Although children wish to be included in their own healthcare, they recognize a gap between their right to be heard and their ability to become involved. Despite adaptation of medical consultation styles which suit a more patient-centered approach, data on the current state of child participation in clinical encounters are missing. We aimed to assess actual child participation in a Dutch pediatric clinic. Children aged 4–18 years visiting a pediatric outpatient clinic for consultation after general practitioner’s referral were included. Sixteen consultations of six pediatricians were recorded and transcribed verbatim. Quantitative measurement included word count and speech turn; conversation analysis with qualitative appraisal provided data on participatory behavior. Quantitative child participation equaled parent participation in turns (28% vs 29%, respectively), but remained limited in words (relative contribution 11% for child, 23% for parent and 66% for pediatrician). Children spoke on average six words per speech turn. Child age correlated positively with participation in words (p = 0.022, r = 0.566) and turns (p =  < 0.001, r = 0.746). Children were mostly involved during social history taking, introduction, and physical examination but did not actively speak during the decision-making process. Children took an active role by instigating talks. Qualitative facilitators included appropriate language and verbal or non-verbal child allocated turns. Adults involved children by asking them questions and verifying their opinions or plans with the child. Teenagers participated most during the entire consultation, while younger children were more likely to lose their focus by the end of the conversation.

Conclusion: Despite increased turn taking, children’s verbal participation remains low in pediatric consultations. If pediatricians and parents maintain a triadic conversation style throughout every stage of the medical encounter, child participation may increase.

What is Known:• Verbal child participation varies between 4 and 17%, measured in turns, words, speech time, or utterances.• Child participation is limited to social talk, laughter, and providing medical information.

What is New:• Child speech turns equal parental speech turns (28%), but average relative word count remains low (11%).• Three percent of the children’s turns are defined a “contributing in decision making, giving their opinion or give consent,” which equals three turns per consultation.
Clozapintherapie bei Wirkverlust einer antipsychotischen Einstellung nach Lebertransplantation
Authors: Sommer Lea , Weber Sabine , Listabarth Stephan , Trojer Armin , Groemer Magdalena , König Daniel
Published: April 2024

Nach schrittweiser Umstellung der psychopharmakologischen Therapie konnte bei einem Patienten mit vorbekannter paranoider Schizophrenie Clozapin etabliert werden, nachdem es bei St. p. Lebertransplantation und laufender Immunsuppression mit Tacrolimus zu einer Exazerbation psychotischer Symptomatik gekommen war. Bisherige Therapieversuche mit Risperidon, Paliperidon, Quetiapin und Olanzapin hatten zu keiner wesentlichen Besserung geführt. In dem hier beschriebenen Zeitraum von ca. 20 Wochen fanden wöchentliche Termine und Blutbildkontrollen statt sowie regelmäßige Laborkontrollen der Leber- und Nierenfunktionsparameter, metabolischen Parameter und Medikamentenspiegel. Schwankungen im Clozapinspiegel waren wahrscheinlich auf starke Änderungen des Nikotinkonsums zurückzuführen. Nach der Etablierung von Clozapin kam es insgesamt zu einer deutlichen Verbesserung des Allgemeinzustandes des Patienten.

Die Verschlechterung des psychopathologischen Zustandes nach Transplantation könnte rückblickend mit möglichen unerwünschten neuropsychiatrischen Effekten von Tacrolimus in Zusammenhang stehen. Zwischenzeitlich traten Bewegungsstörungen auf, welche am ehesten auf den antipsychotischen Therapieversuch mit Paliperidon zurückgeführt wurden und mit Biperiden akut und erfolgreich behandelt werden konnten. Es kam im weiteren Verlauf nach Clozapinetablierung zu einer Hypersalivation, was von dem Patienten allerdings im Rahmen des gebesserten Allgemeinzustandes toleriert wurde. Die Fortsetzung regelmäßiger multidisziplinärer Kontrollen inklusive entsprechender Laboruntersuchungen waren weiterhin vorgesehen.
Effect of material composition and thickness of orthodontic aligners on the transmission and distribution of forces: an in vitro study
Authors: Elshazly Tarek M. , Bourauel Christoph , Ismail Ahmed , Ghoraba Omar , Aldesoki Mostafa , Salvatori Damiano , Elattar Hanaa , Alhotan Abdulaziz , Alkabani Yasmine
Published: April 2024

Objectives

To investigate the effects of material type and thickness on force generation and distribution by aligners.

Materials and methods

Sixty aligners were divided into six groups (n = 10): one group with a thickness of 0.89 mm using Zendura Viva (Multi-layer), four groups with a thickness of 0.75 mm using Zendura FLX (Multi-layer), CA Pro (Multi-layer), Zendura (Single-layer), and Duran (Single-layer) sheets, and one group with a thickness of 0.50 mm using Duran sheets. Force measurements were conducted using Fuji® pressure-sensitive films.

Results

The lowest force values, both active and passive, were recorded for the multi-layered sheets: CA Pro (83.1 N, 50.5 N), Zendura FLX (88.9 N, 60.7 N), and Zendura Viva (92.5 N, 68.5 N). Conversely, the highest values were recorded for the single-layered sheets: Duran (131.9 N, 71.8 N) and Zendura (149.7 N, 89.8 N). The highest force was recorded at the middle third of the aligner, followed by the incisal third, and then the cervical third. The net force between the incisal and cervical thirds (FI-FC) showed insignificant difference across different materials. However, when comparing the incisal and middle thirds, the net force (FI-FM) was higher with single-layered materials. Both overall force and net force (FI-FM) were significantly higher with 0.75 mm compared to those with a thickness of 0.50 mm.

Conclusions

Multi-layered aligner materials exert lower forces compared to their single-layered counterparts. Additionally, increased thickness in aligners results in enhanced retention and greater force generation. For effective bodily tooth movement, thicker and single-layered rigid materials are preferred.

Clinical relevance

This research provides valuable insights into the biomechanics of orthodontic aligners, which could have significant clinical implications for orthodontists. Orthodontists might use this information to more effectively tailor aligner treatments, considering the specific tooth movement required for each individual patient. In light of these findings, an exchangeable protocol for aligner treatment is suggested, which however needs to be proven clinically. This protocol proposes alternating between multi-layered and single-layered materials within the same treatment phase. This strategy is suggested to optimize treatment outcomes, particularly when planning for a bodily tooth movement.
Assessing the progress of internal instability of fill dam material in South Korea through long-term seepage tests
Authors: Lee Hee-Jun , Kim Inhyun , Chung Choong-Ki
Published: April 2024

Several studies investigating the internal instability of well-graded soils have suggested that well-graded soils show characteristics and developments different from those of gap-graded soils. Moreover, the cause and progression of long-term internal instability in well-graded soils have not yet been established. This study aimed to address this knowledge gap by conducting long-term seepage tests to analyze the progress and cause of the internal instability of well-graded soils generally utilized in fill dams in South Korea. The test results revealed that well-graded soils in internally stable conditions exhibited clogging due to fine particles, reducing overall permeability. A similar phenomenon was identified under internally unstable conditions. The subsequent unclogging process resulted in a rapid increase in permeability and erosion rate with the collapse of the soil structure. Consequently, the internal instabilities of well-graded soils progress through suffosion. Based on the test results, the mechanism of internal instability and its progression in well-graded soils were proposed.