bluuebunny/crossref_metadata_2025 huggingface dataset:
Infective Pleural Effusions—A Comprehensive Narrative Review Article
Authors: Abdulelah Mohammad , Abu Hishmeh Mohammad
Published: May 2024

Infective pleural effusions are mainly represented by parapneumonic effusions and empyema. These conditions are a spectrum of pleural diseases that are commonly encountered and carry significant mortality and morbidity rates reaching upwards of 50%. The causative etiology is usually an underlying bacterial pneumonia with the subsequent seeding of the infectious culprit and inflammatory agents to the pleural space leading to an inflammatory response and fibrin deposition. Radiographical evaluation through a CT scan or ultrasound yields high specificity and sensitivity, with features such as septations or pleural thickening indicating worse outcomes. Although microbiological yields from pleural studies are around 56% only, fluid analysis assists in both diagnosis and prognosis by evaluating pH, glucose, and other biomarkers such as lactate dehydrogenase. Management centers around antibiotic therapy for 2–6 weeks and the drainage of the infected pleural space when the effusion is complicated through tube thoracostomies or surgical intervention. Intrapleural enzymatic therapy, used to increase drainage, significantly decreases treatment failure rates, length of hospital stay, and surgical referrals but carries a risk of pleural hemorrhage. This comprehensive review article aims to define and delineate the progression of parapneumonic effusions and empyema as well as discuss pathophysiology, diagnostic, and treatment modalities with aims of broadening the generalist’s understanding of such complex disease by reviewing the most recent and relevant high-quality evidence.
Safety and Efficacy of Very Early Conversion to Belatacept in Pediatric Kidney Transplantation with Transplant-Associated Thrombotic Microangiopathy: Case Study and Review of Literature
Authors: Acharya Ratna , Clapp William , Upadhyay Kiran
Published: May 2024

The inhibition of co-stimulation during T-cell activation has been shown to provide effective immunosuppression in kidney transplantation (KT). Hence, the conversion from calcineurin inhibitor (CNI) to belatacept is emerging as a potential alternate maintenance immunosuppressive therapy in those with transplant-associated thrombotic microangiopathy (TA-TMA) or in the prevention of TA-TMA. We present a 17-year-old male who presented with biopsy-proven CNI-associated TA-TMA immediately post-KT. The administration of eculizumab led to the reversal of TMA. Tacrolimus was converted to belatacept with excellent efficacy and safety during a short-term follow-up of one year. Further larger controlled studies are required to demonstrate the efficacy of this approach in children who present with early-onset TMA post-KT.
First-Principles and Experimental Study of Ge, V, Ta-Doped AgNi Electrical Contact Materials
Authors: Wang Jingqin , Zhang Yixuan , Wang Menghan , Chen Jing , Huang Guanglin
Published: May 2024

To explore the stability, electrical, and mechanical characteristics of undoped AgNi alongside AgNi doped with elemental Ge, V, and Ta, we performed calculations on their electronic structures using density functional theory from first-principles. We also prepared AgNi(17) and AgNi-x(Ge, V, Ta) electrical contact materials using the powder metallurgy technique, and they were subsequently assessed experimentally. The electrical properties of these materials were evaluated under a 24 V/15 A DC-resistive load using the JF04D contact material testing system. A three-dimensional morphology scanner was employed to examine the contact surface and investigate the erosion patterns of the materials. Our findings indicate that doping with metal elements significantly enhanced the mechanical properties of electrical contacts, including conductivity and hardness, and optimizes arc parameters while improving resistance to arc erosion. Notably, AgNi-Ge demonstrated superior conductivity and arc erosion resistance, showing significant improvements over the undoped AgNi contacts. This research provides a theoretical foundation for selecting doping elements aimed at enhancing the performance of AgNi electrical contact materials.
Mineralization of Octacalcium Phosphate under Magnetic Field
Authors: He Wenhao , Xue Bingyu , Qian Qi , Chen Shenye , Fu Zhengyi , Wang Kun
Published: May 2024

The mineralization of octacalcium phosphate (OCP) crystals in gel media was studied in the presence of a magnetic field. OCP crystal growth was found to be dependent on mineralization temperature, mineralization time, and the magnetic field. Higher temperatures significantly reduced the mineralization time, which is crucial for directional growth of OCP crystals. The growth of OCP crystals was accelerated by the applied magnetic field, while OCP crystals generated in the presence of a magnetic field exhibited increased length and width of oriented growth. This study provides valuable insights into the influence of mineralization factors in bioprocessing-inspired manufacturing processes.
Comprehensive Two-Dimensional Pediatric Echocardiographic Nomograms for Coronary Artery Sizes in Caucasian Children and Comparison among Major Nomograms
Authors: Cantinotti Massimiliano , Scalese Marco , Contini Francesca Valeria , Franchi Eliana , Viacava Cecilia , Corana Giulia , Pizzuto Alessandra , Pietro Marchese , Santoro Giuseppe , Assanta Nadia
Published: May 2024

Background: Although coronary artery nomograms in children have been published, data on Caucasian children are lacking. The aim of this study is to provide: (i) a full dataset of coronary artery diameters in healthy children and (ii) a comparison among major previous nomograms. Materials and Methods: We prospectively evaluated 606 healthy subjects (age range, 1 days–<18 years; median age 8.7 years; 62.5% male). Coronary artery measurements in a short-axis view were performed. Age, heart rate, and body surface area (BSA) were used as independent variables in different analyses to predict the mean values of each measurement. To assess the accuracy of the predictive models of different studies, a Z-score calculator was created using Lopez’s nomograms for comparison. Results: The association with BSA was found to be stronger, and was used for normalization of our data. The best-fit models, satisfying the assumption of homoscedasticity and normality of residuals and showing the highest R2 scores, were logarithmic (ln[y] = a + b*ln[x]). Predicted values and Z-score boundaries by BSA are provided. Our ranges of normality are slightly lower than those, diverging from −0.22 to −0.59 Z-scores for the left main coronary artery and from −0.23 to −0.3 Z-scores for the right coronary artery. Conclusions: We report a complete dataset of normal echocardiography coronary artery diameter (including new measures of the proximal origin) values in a large population of healthy children. Our data were statistically like those of north American nomograms.
Orally Derived Stem Cell-Based Therapy in Periodontal Regeneration: A Systematic Review and Meta-Analysis of Randomized Clinical Studies
Authors: Campagna Alessandro , Baima Giacomo , Romano Federica , Amoroso Federico , Mussano Federico , Oteri Giacomo , Aimetti Mario , Peditto Matteo
Published: May 2024

The present systematic review was performed to assess the application of orally derived stem cells in periodontal regenerative therapy, and because of this, the following PICO question was proposed: “In patients with periodontitis, can the adjunctive use of orally derived stem cells provide additional clinical and radiographic benefits for periodontal regeneration?”. Randomized clinical studies were electronically and manually searched up until December 2023. Quantitative analyses were performed with the aim of evaluating the mean differences (MDs) between the treatment and control groups in terms of clinical attachment level (CAL) gain, probing pocket depth (PPD) reduction, gingival recession (GR), and radiographic bone gain (RBG) using random effect models. A total of seven studies were selected for the systematic review. Meta-analyses excluding studies with a high risk of bias highlighted a non-statistically significant result for the use of stem cells when compared to the control groups in terms of CAL gain [MD = 1.05; 95% CI (−0.88, 2.97) p = 0.29] and PPD reduction [MD = 1.32; 95% CI (−0.25, 2.88) p = 0.10]. The same also applied to GR [MD = −0.08; 95% CI (−0.79, 0.63) p = 0.83] and RBG [MD = 0.50; 95% CI (−0.88, 1.88) p = 0.48]. Based on the high heterogeneity, there is not enough evidence to consider the adjunctive application of orally derived mesenchymal stem cells as a preferential approach for periodontal regenerative treatment, as compared to standard procedures.
Fault Diagnosis Method for Space Fluid Loop Systems Based on Improved Evidence Theory
Authors: Liu Yue , Li Zhenxiang , Zhang Lu , Fu Hongyong
Published: May 2024

Addressing the challenges posed by the complexity of the structure and the multitude of sensor types installed in space application fluid loop systems, this paper proposes a fault diagnosis method based on an improved D-S evidence theory. The method first employs the Gaussian affiliation function to convert the information acquired by sensors into BPA functions. Subsequently, it utilizes a pignistic probability transformation to convert the multiple subset focal elements into single subset focal elements. Finally, it comprehensively evaluates the credibility and uncertainty factors between evidences, introducing Bray–Curtis dissimilarity and belief entropy to achieve the fusion of conflicting evidence. The proposed method is initially validated on the classic Iris dataset, demonstrating its reliability. Furthermore, when applied to fault diagnosis in space application fluid circuit loop pumps, the results indicate that the method can effectively fuse multiple sensors and accurately identify faults.
Factors Determining the Average Price Level: A Combined Microeconomic and Macroeconomic Approach
Authors: Todorova Tamara Peneva , Myftarallari Brikena
Published: May 2024

We analyze various determinants of the average price level using a strictly mathematical approach. Starting with the microeconomic perspective, we review the effect of demand shifters such as consumer income and the level of advertising on the average price level in a simple partial market equilibrium model. Then, we discuss the effect of supply shifters such as the exogenous tax level, worker wage, rental rate, and technology. We use implicit differentiation and Jacobian determinants. While government spending triggers inflation, taxes have the opposite effect. This is consistent with Keynesian theory. Money supply increases national income and prices while reducing the equilibrium interest rate. Therefore, money supply has pro-inflationary effects. The effect of money demand is the opposite—it increases the equilibrium interest rate, thereby lowering national income and prices. Augmenting the model to the level of international trade, we find that exports raise national income, the interest rate, and the average price level, while the effect of imports is just the opposite. Government spending raises the exchange rate while continuous inflation lowers it.
Policy Instrument Preferences and Optimization Strategies: Based Text Analysis of Provincial-Level Education Digitalization Policy from China
Authors: Cao Jing , Yu Chunmei , Wu Yan
Published: May 2024

In the context of world education digitalization, the Chinese government has formulated China’s education digitalization strategy. The education digitalization policy tools of provincial governments are an important factor affecting the effectiveness of education digitalization policies. In this study, a text quantification and content analysis is conducted on educational digital policy documents released by eight provinces of China during the 14th Five-Year Plan period in China. This is based on a two-dimensional analysis framework of “instruments-value” using instrument types and policy principles, and NVivo software. The research outcomes reveal the following: (1) The distribution of educational digital policy instrument types is uneven, with an excess of supply-side instruments and a noticeable shortage of demand-side instruments. (2) Different policy instruments exhibit varying degrees of preference in implementing policy principles. There is a stronger emphasis on technology application and balanced development, while the emphasis on service principles promoting diverse participation is relatively weaker. (3) The policy instruments that facilitate interaction between policymakers and educational entities require further strengthening. In light of these findings, local governments in China should strengthen the use of demand-side policy instruments to achieve comprehensiveness and sustainability in educational digitalization. Policymakers should pay more attention to the demands of educational entities to shift educational digitalization from being technology driven to being demand driven. Furthermore, policy instrument selection should adhere to the value of serving and supporting individuals and reinforce the concept of multi-participation in their development, ultimately improving the precision and coordination of policies, and achieving a harmonious integration of technological and value aspects of policy instruments.
A Cost-Effective Current-Limiting Hybrid DC Circuit Breaker Based on Hybrid Semiconductors
Authors: Liu Siyuan , Yuan Ziao , Chen Jinchao , Chen Yifan , Yu Mengze , Liu Zhiyuan , Geng Yingsan
Published: May 2024

DC circuit breakers (DCCBs) are the key equipment to rapidly interrupt the fault current in high-voltage DC power grids and ensure the safe operation of the system. However, most DCCBs do not take current-limiting measures and rely solely on current-limiting reactors in the system to limit the rate of current rise during the interruption process. The extensive use of fully controlled power electronic devices in circuit breakers (CBs) results in high costs. To address the issues above, this paper proposes a DCCB topology with a current-limiting function based on thyristors and diodes, which can reduce the cost of CB while ensuring reliable interruption. The impact of various parameters on CB performance is analyzed using numerical calculations to optimize the parameters. Then, a simulation model of a 500 kV/16 kA DCCB is built in PSCAD/EMTDC, and the performance of the proposed CB topology is compared with the other CB topologies. By comparison, the proposed DCCB topology can reliably isolate fault currents and reduce the amplitude of fault currents and the cost of CBs. Significantly, the energy absorbed by the metal oxide varistor (MOV) during the interruption process decreases by 64.2%, reducing the cost and volume of the MOV. Finally, the feasibility of the CB is further verified in the ±500 kV 4-terminal high-voltage DC power grid simulation model. The results show that the proposed DCCB topology can limit the fault current rise rate, interrupt and isolate the fault reliably, and reduce the cost.
Evaluation of a Simplified Modeling Approach for SEE Cross-Section Prediction: A Case Study of SEU on 6T SRAM Cells
Authors: Marques Cleiton M. , Wrobel Frédéric , Aguiar Ygor Q. , Michez Alain , Saigné Frédéric , Boch Jérôme , Dilillo Luigi , García Alía Rubén
Published: May 2024

Electrical models play a crucial role in assessing the radiation sensitivity of devices. However, since they are usually not provided for end users, it is essential to have alternative modeling approaches to optimize circuit design before irradiation tests, and to support the understanding of post-irradiation data. This work proposes a novel simplified methodology to evaluate the single-event effects (SEEs) cross-section. To validate the proposed approach, we consider the 6T SRAM cell a case study in four technological nodes. The modeling considers layout features and the doping profile, presenting ways to estimate unknown parameters. The accuracy and limitations are determined by comparing our simulations with actual experimental data. The results demonstrated a strong correlation with irradiation data, without requiring any fitting of the simulation results or access to process design kit (PDK) data. This proves that our approach is a reliable method for calculating the single-event upset (SEU) cross-section for heavy-ion irradiation.
Development of Grid-Forming and Grid-Following Inverter Control in Microgrid Network Ensuring Grid Stability and Frequency Response
Authors: Babu V. Vignesh , Roselyn J. Preetha , Nithya C. , Sundaravadivel Prabha
Published: May 2024

This paper proposes a control strategy for grid-following inverter control and grid-forming inverter control developed for a Solar Photovoltaic (PV)–battery-integrated microgrid network. A grid-following (GFL) inverter with real and reactive power control in a solar PV-fed system is developed; it uses a Phase Lock Loop (PLL) to track the phase angle of the voltages at the PCC and adopts a vector control strategy to adjust the active and reactive currents that are injected into the power grid. The drawback of a GFL inverter is that it lacks the capability to operate independently when the utility grid is down due to outages or disturbances. The proposed grid-forming (GFM) inverter control with a virtual synchronous machine provides inertia to the grid, generates a stable grid-like voltage and frequency and enables the integration of the grid. The proposed system incorporates a battery energy storage system (BESS) which has inherent energy storage capability and is independent of geographical areas. The GFM control includes voltage and frequency control, enhanced islanding and black start capability and the maintenance of the stability of the grid-integrated system. The proposed model is validated under varying irradiance conditions, load switching, grid outages and temporary faults with fault ride-through (FRT) capability, and fast frequency response and stability are achieved. The proposed model is validated under varying irradiance conditions, load switching, grid outages and line faults incorporating fault ride-through capability in GFM-based control. The proposed controller was simulated in a 100 MW solar PV system and 60 MW BESS using the MATLAB/Simulink 2023 tool, and the experimental setup was validated in a 1 kW grid-connected system. The percentage improvement of the system frequency and voltage with FRT-capable GFM control is 69.3% and 70%, respectively, and the percentage improvement is only 3% for system frequency and 52% for grid voltage in the case of an FRT-capable GFL controller. The simulation and experimental results prove that GFM-based inverter control achieves fast frequency response, and grid stability is also ensured.
PDPHE: Personal Data Protection for Trans-Border Transmission Based on Homomorphic Encryption
Authors: Liu Yan , Yang Changshui , Liu Qiang , Xu Mudi , Zhang Chi , Cheng Lihong , Wang Wenyong
Published: May 2024

In the digital age, data transmission has become a key component of globalization and international cooperation. However, it faces several challenges in protecting the privacy and security of data, such as the risk of information disclosure on third-party platforms. Moreover, there are few solutions for personal data protection in cross-border transmission scenarios due to the difficulty of handling sensitive information between different countries and regions. In this paper, we propose an approach, personal data protection based on homomorphic encryption (PDPHE), to creatively apply the privacy computing technology homomorphic encryption (HE) to cross-border personal data protection. Specifically, PDPHE reconstructs the classical full homomorphic encryption (FHE) algorithm, DGHV, by adding support for multi-bit encryption and security level classification to ensure consistency with current data protection regulations. Then, PDPHE applies the reconstructed algorithm to the novel cross-border data protection scenario. To evaluate PDPHE in actual cross-border data transfer scenarios, we construct a prototype model based on PDPHE and manually construct a data corpus called PDPBench. Our evaluation results on PDPBench demonstrate that PDPHE cannot only effectively solve privacy protection issues in cross-border data transmission but also promote international data exchange and cooperation, bringing significant improvements for personal data protection during cross-border data sharing.
Methodology for Selecting a Location for a Photovoltaic Farm on the Example of Poland
Authors: Stala-Szlugaj Katarzyna , Olczak Piotr , Kulpa Jaroslaw , Soltysik Maciej
Published: May 2024

As the LCOE for photovoltaics has decreased several times, it is once again gaining popularity. The intensification of the development of PV installations is contributing to the duck curve phenomenon in an increasing number of countries and, consequently, affecting current electricity prices. Decisions on new investments in large-scale PV sources are driven by potential economic and environmental effects, and these, in turn, are subject to locational considerations, both as to the country and its region. In calculating the economic impact of locating a 1 MWp PV farm, it was assumed that the electricity generated by the farm would be fed into the national grid, and that the life of the PV farm would be 20 years. Poland was considered as an example country for the placement of a photovoltaic farm. The authors of this paper proposed that the main verification parameter is the availability of connection capacities to feed the produced electricity into the country’s electricity grid. The methodology proposed by the authors for the selection of the location of a PV farm consists of four steps: step (i) identification and selection of the administrative division of a given country; step (ii) verification of available connection capacities; step (iii) (two stages) verification of other factors related to the location of the PV farm (e.g., information on land availability and the distance of the land from the substation), and analysis of productivity at each potential location and electricity prices achieved on the power exchange; step (iv) economic analysis of the investment—analyses of PV farm energy productivity in monetary terms on an annual basis, cost analysis (CAPEX, OPEX) and evaluation of economic efficiency (DPP, NPV, IRR). The greatest impact on the economic efficiency of a PV project is shown by the value of land (as part of CAPEX), which is specific to a given location, and revenues from energy sales, which are pretty similar for all locations.
New Advances in Materials, Applications, and Design Optimization of Thermocline Heat Storage: Comprehensive Review
Authors: Zhang Yunshen , Guo Yun , Zhu Jiaao , Yuan Weijian , Zhao Feng
Published: May 2024

To achieve sustainable development goals and meet the demand for clean and efficient energy utilization, it is imperative to advance the penetration of renewable energy in various sectors. Energy storage systems can mitigate the intermittent issues of renewable energy and enhance the efficiency and economic viability of existing energy facilities. Among various energy storage technologies, thermocline heat storage (THS) has garnered widespread attention from researchers due to its stability and economic advantages. Currently, there are only a few review articles focusing on THS, and there is a gap in the literature regarding the optimization design of THS systems. Therefore, this paper provides a comprehensive review of the recent research progress in THS, elucidating its principles, thermal storage materials, applications, and optimization designs. The novelty of this work lies in the detailed classification and analysis of various optimization designs for THS, including tank shape, aspect ratio, inlet/outlet configuration, thermal energy storage materials arrangement, operating strategies, and numerical model optimization approaches. The limitations of existing research are also identified, and future perspectives are proposed, aiming to provide recommendations for THS research and contribute to the development and promotion of THS technology.
Photoperiod-Dependent Nutrient Accumulation in Rice Cultivated in Plant Factories: A Comparative Metabolomic Analysis
Authors: Yu Jingyao , Yang Yu , Luo Lanjun , Feng Fang , Saeed Sana , Luo Jie , Fang Chuanying , Zhou Junjie , Li Kang
Published: May 2024

Plant factories offer a promising solution to some of the challenges facing traditional agriculture, allowing for year-round rapid production of plant-derived foods. However, the effects of conditions in plant factories on metabolic nutrients remain to be explored. In this study, we used three rice accessions (KongYu131, HuangHuaZhan, and Kam Sweet Rice) as objectives, which were planted in a plant factory with strict photoperiods that are long-day (12 h light/12 h dark) or short-day (8 h light/16 h dark). A total of 438 metabolites were detected in the harvested rice grains. The difference in photoperiod leads to a different accumulation of metabolites in rice grains. Most metabolites accumulated significantly higher levels under the short-day condition than the long-day condition. Differentially accumulated metabolites were enriched in the amino acids and vitamin B6 pathway. Asparagine, pyridoxamine, and pyridoxine are key metabolites that accumulate at higher levels in rice grains harvested from the short-day photoperiod. This study reveals the photoperiod-dependent metabolomic differences in rice cultivated in plant factories, especially the metabolic profiling of taste- and nutrition-related compounds.
In Vitro Characterization of Polysaccharides from Fresh Tea Leaves in Simulated Gastrointestinal Digestion and Gut Microbiome Fermentation
Authors: Zhou Qiaoyi , Gao Jinjing , Sun Xueyan , Liang Yicheng , Ye Minqi , Liang Dongxia , Ling Caijin , Fang Binghu
Published: May 2024

Tea plants have a long cultivation history in the world, but there are few studies on polysaccharides from fresh tea leaves. In this study, tea polysaccharides (TPSs) were isolated from fresh tea leaves. Then, we investigated the characteristics of TPSs during in vitro simulated digestion and fermentation; moreover, the effects of TPSs on gut microbiota were explored. The results revealed that saliva did not significantly affect TPSs’ molecular weight, monosaccharide composition, and reducing sugar content, indicating that TPSs cannot be digested in the oral cavity. However, TPSs were partially decomposed in the gastrointestinal tract after gastric and intestinal digestion, resulting in the release of a small amount of free glucose monosaccharides. Our in vitro fermentation experiments demonstrated that TPSs are degraded by gut microbiota, leading to short-chain fatty acid (SCFA) production and pH reduction. Moreover, TPSs increased the abundance of Bacteroides, Lactobacillus, and Bifidobacterium but reduced that of Escherichia, Shigella, and Enterococcus, demonstrating that TPSs can regulate the gut microbiome. In conclusion, TPSs are partially decomposed by gut microbiota, resulting in the production of SCFAs and the regulation of gut microbiota composition and function. Therefore, TPSs may be used to develop a prebiotic supplement to regulate the gut microbiome and improve host health.
Chemical and Physical Architecture of Macromolecular Gels for Fracturing Fluid Applications in the Oil and Gas Industry; Current Status, Challenges, and Prospects
Authors: Khan Majad
Published: May 2024

Hydraulic fracturing is vital in recovering hydrocarbons from oil and gas reservoirs. It involves injecting a fluid under high pressure into reservoir rock. A significant part of fracturing fluids is the addition of polymers that become gels or gel-like under reservoir conditions. Polymers are employed as viscosifiers and friction reducers to provide proppants in fracturing fluids as a transport medium. There are numerous systems for fracturing fluids based on macromolecules. The employment of natural and man-made linear polymers, and also, to a lesser extent, synthetic hyperbranched polymers, as additives in fracturing fluids in the past one to two decades has shown great promise in enhancing the stability of fracturing fluids under various challenging reservoir conditions. Modern innovations demonstrate the importance of developing chemical structures and properties to improve performance. Key challenges include maintaining viscosity under reservoir conditions and achieving suitable shear-thinning behavior. The physical architecture of macromolecules and novel crosslinking processes are essential in addressing these issues. The effect of macromolecule interactions on reservoir conditions is very critical in regard to efficient fluid qualities and successful fracturing operations. In future, there is the potential for ongoing studies to produce specialized macromolecular solutions for increased efficiency and sustainability in oil and gas applications.
Elucidating Cancer Subtypes by Using the Relationship between DNA Methylation and Gene Expression
Authors: Jilani Muneeba , Degras David , Haspel Nurit
Published: May 2024

Advancements in the field of next generation sequencing (NGS) have generated vast amounts of data for the same set of subjects. The challenge that arises is how to combine and reconcile results from different omics studies, such as epigenome and transcriptome, to improve the classification of disease subtypes. In this study, we introduce sCClust (sparse canonical correlation analysis with clustering), a technique to combine high-dimensional omics data using sparse canonical correlation analysis (sCCA), such that the correlation between datasets is maximized. This stage is followed by clustering the integrated data in a lower-dimensional space. We apply sCClust to gene expression and DNA methylation data for three cancer genomics datasets from the Cancer Genome Atlas (TCGA) to distinguish between underlying subtypes. We evaluate the identified subtypes using Kaplan–Meier plots and hazard ratio analysis on the three types of cancer—GBM (glioblastoma multiform), lung cancer and colon cancer. Comparison with subtypes identified by both single- and multi-omics studies implies improved clinical association. We also perform pathway over-representation analysis in order to identify up-regulated and down-regulated genes as tentative drug targets. The main goal of the paper is twofold: the integration of epigenomic and transcriptomic datasets followed by elucidating subtypes in the latent space. The significance of this study lies in the enhanced categorization of cancer data, which is crucial to precision medicine.
Are the Head and Tail Domains of Intermediate Filaments Really Unstructured Regions?
Authors: Tsilafakis Konstantinos , Mavroidis Manolis
Published: May 2024

Intermediate filaments (IFs) are integral components of the cytoskeleton which provide cells with tissue-specific mechanical properties and are involved in a plethora of cellular processes. Unfortunately, due to their intricate architecture, the 3D structure of the complete molecule of IFs has remained unresolved. Even though most of the rod domain structure has been revealed by means of crystallographic analyses, the flanked head and tail domains are still mostly unknown. Only recently have studies shed light on head or tail domains of IFs, revealing certainsecondary structures and conformational changes during IF assembly. Thus, a deeper understanding of their structure could provide insights into their function.
Relationship between Spinal Range of Motion and Functional Tests in University Students: The Role of Demographic Factors
Authors: Balint Nela Tatiana , Antohe Bogdan Alexandru , Uysal Huseyin Sahin , Cristuță Alina Mihaela , Rață Marinela
Published: May 2024

Spinal disorders are some of the most prevalent health concerns, especially among students. Based on student demographics, this cross-sectional study evaluated the correlation between functional tests (FTs) and spinal range of motion (ROM). This study included 206 students (age = 19.85 ± 1.80 years) from the Vasile Alecsandri University of Bacău. Participants’ assessments were conducted using the following tests: (i) Ott, (ii) Schober, (iii) Stibor, (iv) finger-to-floor distance, (v) lateral flexion of the cervical and lumbar spine, and (vi) flexion of the cervical spine. Correlation analyses were evaluated using the Spearman correlation coefficient analysis. The results indicated a very strong relationship between lateral flexion of the lumbar spine on the left (LFLSL) and right (LFLSR) for all departments (r = 0.85 to 0.97, p < 0.05). There was a stronger relationship between FT results and spinal ROM for physical-education-department students compared to students from other departments (n = 17, r = −0.38 to 0.93, p < 0.05). There was no statistically significant correlation between FTs and spinal ROM based on age (p > 0.05). The study results provide evidence of the primary risk factors that predispose students to postural deviations. Practitioners and physiotherapists can utilize these values as a reference for potential therapeutic interventions.
Current Status and Barriers of Exercise in Individuals with Spinal Cord Injuries in Korea: A Survey
Authors: Kim Yuna , Ko Sung-Hwa , Lee Jung-Lim , Huh Sungchul
Published: May 2024

This study investigated exercise participation, health status, and barriers to exercise in 109 individuals with spinal cord injury (SCI) using a self-report questionnaire. The responses of the exercise and non-exercise groups were statistically analyzed using t-tests or Fisher’s exact test. Significant differences were observed in the cause of injury and the American Spinal Injury Association Impairment Scale between the groups. The non-exercise group had a higher incidence of traumatic and complete injuries. Demographic factors such as gender, age, income level, and marital status did not significantly influence exercise participation. The exercise group reported lower pain scores, less inconvenience from complications, and higher activity and participation scores. However, less than half of the individuals with SCI met the recommended exercise intensity, and community facility usage was low. Barriers to exercise participation included severe disabilities, lack of time, insufficient exercise information, and lack of facility accessibility. To enhance exercise among individuals with SCI, it is essential to develop and extend exercise programs tailored to individual physical factors and a comprehensive understanding of barriers. Prioritizing community-based data management, alongside developing social systems and health policies, is crucial to overcome barriers to exercise participation for individuals with SCI.
The Effect of Different Electric Toothbrush Technologies on Interdental Plaque Removal: A Systematic Review with a Meta-Analysis
Authors: Lewis Robert David , Kanagasingam Shalini , Cook Neil , Krysmann Marta , Taylor Kathryn , Pisani Flavio
Published: May 2024

The removal of dental plaque from the gingival margins of the teeth is essential to maintaining periodontal health. Whilst it has been established that electric toothbrushes demonstrate a greater ability to remove plaque, no systematic review has specifically investigated which technology is better for removing plaque from the interdental tooth surfaces, where plaque control may be more difficult. Three databases were searched until October 2023: MEDLINE and DOSSS via EBSCOhost and Embase. Data extraction was carried out on studies which met the inclusion criteria, and a risk of bias assessment was completed. The study findings were combined via a narrative synthesis and a meta-analysis where appropriate. A total of 77 studies were found, out of which 14 were selected and included in the analysis. The mean difference in interproximal plaque reduction, measured using the Rustogi Modified Naval Plaque Index (RMNPI) at 8 weeks, was 0.09 (p < 0.00001) in favor of the oscillating–rotating toothbrush. At 6 and 12 weeks, the mean difference in plaque reduction (RMNPI) was 0.05 (p = 0.0008) and 0.04 (p = 0.0001) in favor of the oscillating–rotating toothbrush, respectively. The studies show a tendency for oscillating–rotating toothbrushes to remove more interproximal plaque than oscillating toothbrushes, especially in a short time (8 weeks).
Intrapartum Quality of Care among Healthy Women: A Population-Based Cohort Study in an Italian Region
Authors: Fumagalli Simona , Nespoli Antonella , Panzeri Maria , Pellegrini Edda , Ercolanoni Michele , Vrabie Paul Stefan , Leoni Olivia , Locatelli Anna
Published: May 2024

Although the quality of care during childbirth is a maternity service’s goal, less is known about the impact of the birth setting dimension on provision of care, defined as evidence-based intrapartum midwifery practices. This study’s aim was to investigate the impact of hospital birth volume (≥1000 vs. <1000 births/year) on intrapartum midwifery care and perinatal outcomes. We conducted a population-based cohort study on healthy pregnant women who gave birth between 2018 and 2022 in Lombardy, Italy. A total of 145,224 (41.14%) women were selected from nationally linked databases. To achieve the primary aim, log-binomial regression models were constructed. More than 70% of healthy pregnant women gave birth in hospitals (≥1000 births/year) where there was lower use of nonpharmacological coping strategies, higher likelihood of epidural analgesia, episiotomy, birth companion’s presence at birth, skin-to-skin contact, and first breastfeeding within 1 h (p-value < 0.001). Midwives attended almost all the births regardless of birth volume (98.80%), while gynecologists and pediatricians were more frequently present in smaller hospitals. There were no significant differences in perinatal outcomes. Our findings highlighted the impact of the birth setting dimension on the provision of care to healthy pregnant women.
Systematic Review of Genetic Modifiers Associated with the Development and/or Progression of Nephropathy in Patients with Sickle Cell Disease
Authors: Labarque Veerle , Okocha Emmanuel Chide
Published: May 2024

Sickle cell nephropathy (SCN) is a common complication of sickle cell disease (SCD) that significantly contributes to morbidity and mortality. In addition to clinical and life-style factors, genetic variants influence this risk. We performed a systematic review, searching five databases. Studies evaluating the effect of genetic modifiers on SCN were eligible. Twenty-eight studies (fair-to-good quality) were included: one genome-wide association study, twenty-six case-control studies, and one article combining both approaches. APOL1 was significantly associated with albuminuria and hyperfiltration in children and with worse glomerular filtration in adults. On the other hand, alpha-thalassemia protected patients against albuminuria and hyperfiltration, while BCL11A variants were protective against albuminuria alone. The HMOX1 long GT-tandem repeat polymorphism led to a lower glomerular filtration rate. No modifiers for the risk of hyposthenuria were identified. A genome-wide association approach identified three new loci for proteinuria (CRYL1, VWF, and ADAMTS7) and nine loci were linked with eGFR (PKD1L2, TOR2A, CUBN, AGGF1, CYP4B1, CD163, LRP1B, linc02288, and FPGT-TNNI3K/TNNI3K). In conclusion, this systematic review supports the role of genetic modifiers in influencing the risk and progression of SCN. Incorporating and expanding this knowledge is crucial to improving the management and clinical outcomes of patients at risk.
Assessment of the Effect on Periodontitis of Antibiotic Therapy and Bacterial Lysate Treatment
Authors: Ancuţa Diana Larisa , Alexandru Diana Mihaela , Muselin Florin , Cristina Romeo Teodor , Coman Cristin
Published: May 2024

Periodontitis is an inflammatory process that starts with soft tissue inflammation caused by the intervention of oral bacteria. By modulating local immunity, it is possible to supplement or replace current therapeutic methods. The aim of this study was to compare the effects of an immunostimulatory treatment with the antibiotherapy usually applied to periodontitis patients. On a model of periodontitis induced in 30 rats (divided into three equal groups) with bacterial strains selected from the human oral microbiome (Aggregatibacter actinomycetemcomitans, Fusobacterium nucleatum and Streptococcus oralis), we administered antibiotics, bacterial lysates and saline for 10 days. Clinically, no significant lesions were observed between the groups, but hematologically, we detected a decrease in lymphocyte and neutrophil counts in both the antibiotic and lysate-treated groups. Immunologically, IL-6 remained elevated compared to the saline group, denoting the body’s effort to compensate for bone loss due to bacterial action. Histopathologically, the results show more pronounced oral tissue regeneration in the antibiotic group and a reduced inflammatory reaction in the lysate group. We can conclude that the proposed bacterial lysate has similar effects to antibiotic therapy and can be considered an option in treating periodontitis, thus eliminating the unnecessary use of antibiotics.
Genome-Wide DNA Methylation in Early-Onset-Dementia Patients Brain Tissue and Lymphoblastoid Cell Lines
Authors: Ramos-Campoy Oscar , Comas-Albertí Aina , Hervás David , Borrego-Écija Sergi , Bosch Beatriz , Sandoval Juan , Fort-Aznar Laura , Moreno-Izco Fermín , Fernández-Villullas Guadalupe , Molina-Porcel Laura , Balasa Mircea , Lladó Albert , Sánchez-Valle Raquel , Antonell Anna
Published: May 2024

Epigenetics, a potential underlying pathogenic mechanism of neurodegenerative diseases, has been in the scope of several studies performed so far. However, there is a gap in regard to analyzing different forms of early-onset dementia and the use of Lymphoblastoid cell lines (LCLs). We performed a genome-wide DNA methylation analysis on sixty-four samples (from the prefrontal cortex and LCLs) including those taken from patients with early-onset forms of Alzheimer’s disease (AD) and frontotemporal dementia (FTD) and healthy controls. A beta regression model and adjusted p-values were used to obtain differentially methylated positions (DMPs) via pairwise comparisons. A correlation analysis of DMP levels with Clariom D array gene expression data from the same cohort was also performed. The results showed hypermethylation as the most frequent finding in both tissues studied in the patient groups. Biological significance analysis revealed common pathways altered in AD and FTD patients, affecting neuron development, metabolism, signal transduction, and immune system pathways. These alterations were also found in LCL samples, suggesting the epigenetic changes might not be limited to the central nervous system. In the brain, CpG methylation presented an inverse correlation with gene expression, while in LCLs, we observed mainly a positive correlation. This study enhances our understanding of the biological pathways that are associated with neurodegeneration, describes differential methylation patterns, and suggests LCLs are a potential cell model for studying neurodegenerative diseases in earlier clinical phases than brain tissue.
Investigating User Experience of VR Art Exhibitions: The Impact of Immersion, Satisfaction, and Expectation Confirmation
Authors: Cheng Lin , Xu Junping , Pan Younghwan
Published: May 2024

As an innovative form in the digital age, VR art exhibitions have attracted increasing attention. This study aims to explore the key factors that influence visitors’ continuance intention to VR art exhibitions using the expectation confirmation model and experience economy theory and to explore ways to enhance visitor immersion in virtual environments. We conducted a quantitative study of 235 art professionals and enthusiasts, conducted using the partial least squares structural equation modeling (PLS-SEM), to examine the complex relationship between confirmation (CON), Perceived Usefulness (PU), Aesthetic Experiences (AE), Escapist Experiences (EE), Satisfaction (SAT), and Continuance Intention (CI). The results show that confirmation plays a key role in shaping PU, AE, and EE, which in turn positively affect visitors’ SAT. Among these factors, AE positively impacts PU, but EE have no impact. A comprehensive theoretical model was then constructed based on the findings. This research provides empirical support for designing and improving VR art exhibitions. It also sheds light on the application of expectation confirmation theory and experience economy theory in the art field to improve user experience and provides theoretical guidance for the sustainable development of virtual digital art environment.
Machine Learning Modeling to Predict Atrial Fibrillation Detection in Embolic Stroke of Undetermined Source Patients
Authors: Ming Chua , Lee Geraldine J. W. , Teo Yao Hao , Teo Yao Neng , Toh Emma M. S. , Li Tony Y. W. , Guo Chloe Yitian , Ding Jiayan , Zhou Xinyan , Teoh Hock Luen , Seow Swee-Chong , Yeo Leonard L. L. , Sia Ching-Hui , Lip Gregory Y. H. , Motani Mehul , Tan Benjamin YQ
Published: May 2024

Background: In patients with embolic stroke of undetermined source (ESUS), occult atrial fibrillation (AF) has been implicated as a key source of cardioembolism. However, only a minority acquire implantable cardiac loop recorders (ILRs) to detect occult paroxysmal AF, partly due to financial cost and procedural inconvenience. Without the initiation of appropriate anticoagulation, these patients are at risk of increased ischemic stroke recurrence. Hence, cost-effective and accurate methods of predicting AF in ESUS patients are highly sought after. Objective: We aimed to incorporate clinical and echocardiography data into machine learning (ML) algorithms for AF prediction on ILRs in ESUS. Methods: This was a single-center cohort study that included 157 consecutive patients diagnosed with ESUS from October 2014 to October 2017 who had ILR evaluation. We developed four ML models, with hyperparameters tuned, to predict AF detection on an ILR. Results: The median age of the cohort was 67 (IQR 59–74) years old and the median monitoring duration was 1051 (IQR 478–1287) days. Of the 157 patients, 32 (20.4%) had occult AF detected on the ILR. Support vector machine predicted for AF with a 95% confidence interval area under the receiver operating characteristic curve (AUC) of 0.736–0.737, multilayer perceptron with an AUC of 0.697–0.708, XGBoost with an AUC of 0.697–0.697, and random forest with an AUC of 0.663–0.674. ML feature importance found that age, HDL-C, and admitting heart rate were important non-echocardiography variables, while peak mitral A-wave velocity and left atrial volume were important echocardiography parameters aiding this prediction. Conclusion: Machine learning modeling incorporating clinical and echocardiographic variables predicted AF in ESUS patients with moderate accuracy.