bluuebunny/crossref_metadata_2025 huggingface dataset:
A Real-Life Study of Prolonged Meropenem Infusion in Neonates and Children Admitted to Intensive Care Units: Are Three Hours Long Enough?
Authors: Mariani Marcello , Scaglione Marco , Russo Chiara , Rainelli Andrea , Mesini Alessio , Saffioti Carolina , Ricci Erica , Cafaro Alessia , Cangemi Giuliana , Bavastro Martina , Bellini Tommaso , Brisca Giacomo , Moscatelli Andrea , Castagnola Elio
Published: February 2025

Background/Objectives: Meropenem is a broad-spectrum antibiotic essential for treating resistant Gram-negative infections in pediatric patients. Current dosing recommendations may not consistently achieve optimal pharmacokinetic (PK) targets, especially in critically ill children. Methods: We conducted a retrospective cohort study at IRCCS Istituto Giannina Gaslini, analyzing 97 plasma levels from 86 pediatric patients (<18 years) hospitalized between January 2020 and December 2023 in the neonatal and pediatric intensive care unit. Patients receiving meropenem for proven or suspected infections were included. Demographic, clinical, and PK parameters were assessed, with a focus on trough concentrations (Ctrough). Results: The median age was 25 months, with neonates representing 15.5% of cases. The median Ctrough was 2.8 mg/L and was significantly higher in neonates (8.9 mg/L) compared to older patients (2.2 mg/L, p < 0.001). Only 27.8% of patients achieved the target Ctrough of >8 mg/L, with estimated glomerular filtration rate (eGFR) being the primary factor influencing these levels. Patients with Ctrough > 8 mg/L had a significantly lower eGFR (61 mL/min/1.73 m2) compared to those below this threshold (131 mL/min/1.73 m2, p = 0.001). Conclusions: The current meropenem dosing regimen may not reliably meet PK targets in critically ill pediatric patients, particularly those with augmented renal clearance or when treating pathogens with increased meropenem MIC. Our findings suggest that increased dosages and prolonged infusion times may be necessary to optimize therapeutic efficacy against resistant Gram-negative bacteria in this vulnerable population. Further studies are needed to refine dosing strategies and improve patient outcomes.
Evaluating the Effectiveness of Radiofrequency in Multimodal Physiotherapy for Postpartum Pelvic Pain: The RASDOP Protocol—A Mixed-Methods Study
Authors: Navarro-Brazález Beatriz , Lorenzo-Gallego Laura , Rangel-de la Mata Paula , Torres-Lacomba María , Vergara-Pérez Fernando , Sánchez-Sánchez Beatriz , Izquierdo-Méndez Nuria
Published: February 2025

Background/Objectives: Approximately 30% of women experience pelvic pain one year after vaginal delivery, and this increases to 50% during vaginal intercourse. Multimodal physiotherapy is the first-line treatment for myofascial pain of the pelvic floor muscles (PFM), often incorporating emerging technologies like radiofrequency, despite limited evidence supporting its use. The RASDOP study aims to (i) evaluate the effectiveness of multimodal physiotherapy combining therapeutic education, PFM training, and myofascial pain syndrome (MPS) management with or without radiofrequency, in reducing pain and improving sexual function postpartum; and (ii) explore the barriers and facilitators influencing adherence and perceived self-efficacy towards physiotherapy treatment in women with postpartum pelvic pain. Methods: This study employs a randomized clinical trial with a blinded examiner and two parallel groups, followed by a qualitative phenomenological study. A total of 124 postpartum women with pelvic pain (≥4 cm on the visual analogue scale) will be randomized into two groups: a multimodal physiotherapy group (therapeutic education, MPS treatment, and PFM training) and a radiofrequency + multimodal physiotherapy group (same treatment with additional non-ablative radiofrequency). Both groups will receive 12 supervised individual sessions. Assessments will be conducted pre- and post-intervention, and at 3-, 6-, and 12-month stages post-treatment. Primary outcomes include pain intensity and sexual function, while secondary outcomes involve PFM tone, strength, MPS presence, levator ani length, and distress caused by pelvic floor dysfunction. The qualitative study will utilize semi-structured interviews and focus groups analyzed thematically. Results: Radiofrequency is expected to enhance pain relief, sexual function, and PFM relaxation. Insights into adherence and barriers will aid in personalizing physiotherapy interventions. Conclusions: The RASDOP study will provide evidence on the safety and efficacy of radiofrequency in postpartum pelvic pain treatment and shed light on women’s experiences to improve therapeutic outcomes.
Advances in Managing Pelvic Fractures in Polytrauma: A Comprehensive Review
Authors: Dabetic Uros , Grupkovic Jovana , Zagorac Slavisa , Aleksandric Dejan , Bogosavljevic Nikola , Tulic Goran
Published: February 2025

Background: Pelvic fractures are among the most complex and life-threatening injuries encountered in trauma and orthopedic surgery, often resulting from high-energy trauma and leading to severe complications. This review synthesizes recent advancements in pelvic trauma care, with a focus on comparing damage control orthopedics (DCO) and early total care (ETC) strategies, operative versus nonoperative management, and outcomes of minimally invasive versus traditional ORIF techniques. Results: Our comparative analysis highlights that DCO remains the preferred approach for hemodynamically unstable patients, prioritizing rapid stabilization and reducing mortality from hemorrhage. In contrast, ETC has demonstrated superior functional recovery outcomes in stable polytrauma patients, with a 30–40% reduction in pulmonary complications and shorter ICU stays when performed within 24–48 h post-injury. Additionally, percutaneous fixation reduces soft tissue trauma and infection risk but increases the likelihood of malunion, while ORIF provides superior anatomical restoration with a higher risk of postoperative infections. Hybrid approaches, integrating percutaneous techniques with limited open reduction, show promise in minimizing operative time and complications while achieving stable fixation. Conclusions: These findings reinforce the importance of tailoring surgical strategies to patient physiology and injury patterns. DCO and ETC have distinct but complementary roles, and emerging hybrid techniques offer a middle ground that balances stability with reduced morbidity. A precision medicine approach, integrating AI-driven predictive modeling and real-world clinical data, is essential for optimizing outcomes and developing evidence-based treatment protocols. Large-scale, multicenter trials are needed to validate these approaches and establish standardized guidelines for pelvic fracture management.
Evaluating Oral Health Status in Incarcerated Women: A Systematic Review
Authors: Fiegler-Rudol Jakub , Tysiąc-Miśta Monika , Kasperczyk Janusz
Published: February 2025

Background: Oral health is crucial to overall well-being but is significantly neglected among incarcerated women, who face higher rates of dental caries, periodontal disease, and edentulism due to systemic barriers, behavioral risks, and socio-demographic vulnerabilities. Objective: This review evaluates the oral health status of incarcerated women, identifying key determinants and assessing intervention effectiveness. Methods: A systematic search of PubMed, Scopus, Embase, and Cochrane Library databases was conducted as per PRISMA 2020 guidelines. Studies published in English in the last 15 years on adult incarcerated women were included. Data on oral health outcomes, risk factors, and interventions were extracted and analyzed. Results: Ten studies revealed significantly higher rates of oral diseases among incarcerated women compared to the general population. Behavioral factors such as smoking and poor diet, combined with inadequate access to care, are major contributors. Pregnant inmates face compounded risks, with poor oral health linked to adverse maternal and infant outcomes. Conclusions: Incarcerated women experience severe oral health disparities requiring gender-responsive, interdisciplinary interventions, including preventive care, education, and integrated correctional policies. Future research should focus on longitudinal studies and effective intervention strategies.
The Influence of Social Determinants of Health on the Survival of Heart Transplants in the Pediatric Age: An Analysis of a Mexican Cohort and Its Comparison with Latin America and the Caribbean
Authors: Márquez-González Horacio , Bolio-Cerdán Alejandro , Ruiz-González Sergio , Erdmenger-Orellana Julio , Alcántara-Noguez Carlos , Romero-Cárdenas Ma Pueblito Patricia , Avila-Montiel Diana , Koretzky Solange Gabriela
Published: February 2025

Background/Objectives: A heart transplantation (HT) is the definitive treatment for heart failure. There is a difference in the success between national HT programs in developed countries and those in Central America, South America, and the Caribbean (LAC), and social determinants of health (SDHs) can directly influence this. The objectives of this study were to describe the survival since the beginning of the HT program of a national pediatric institute in Mexico City and to compare it with the results of a systematic review of LAC. Methods: A cohort study of a pediatric hospital (which performed 42% of the pediatric HTs in Mexico) was performed since the beginning of the HTs program in 2001. Clinical variables related to the transplants were identified, and the SDHs were divided into three categories: personal, family, and community. A systematic literature review was performed using keywords and a search in the medical indexes of LAC countries. The statistical analysis included descriptive statistics and a bivariate survival analysis. A risk calculation was estimated using the hazard ratio (HR) of the SDHs. Results: A total of 38 HTs were performed, the median age was 7 (4–16) years, and 22 (58%) were men. The leading cause was cardiomyopathy in 20 (53%) cases. The first-year survival rate was 76.3 per 100 HTs. The SDHs that increased the risk of death were suboptimal immunosuppression, the persistence of malnutrition, parental education, the distance from the center, the socioeconomic level, and the absence of transitional care. Conclusions: This cohort of pediatric patients with HTs resulted in the identification of risk variables of personal and community SDHs for mortality in the first and fifth years. Chronic rejection occurred in 50%, and the absence of transitional care to adulthood was the variable with the highest risk. The systematic review identified Mexico as the country with the second-highest frequency of HTs, and our cohort represented 42% of the total number of transplants in the country. Numerically, LAC has a lower frequency of transplants and survival in the first year compared to other developed countries, possibly due to a gap associated with organizational justice.
Effects of Normobaric Hypoxia of Varying Severity on Metabolic and Hormonal Responses Following Resistance Exercise in Men and Women
Authors: Foltyn Jakub , Płoszczyca Kamila , Czuba Miłosz , Niemaszyk Adam , Langfort Józef , Gajda Robert
Published: February 2025

Background/Objectives: Resistance exercise under hypoxic conditions induces various metabolic and hormonal responses, yet the relationship between hypoxia severity and anabolic hormone responses remains unclear. This study aimed to assess the effects of a single bout of resistance exercise on metabolic and hormonal responses in normoxia and three levels of hypoxia in both men and women. Methods: The study involved 16 physically active individuals with at least two years of experience in recreational resistance training. The participants completed resistance exercise sessions in normoxia and normobaric hypoxia at simulated altitudes of 3000 m (H3000), 4000 m (H4000), and 5000 m (H5000). Blood levels of total testosterone (T), cortisol (C), growth hormone (GH), and metabolic variables were measured before and after exercise. Results: In women, severe hypoxia (H4000 and H5000) was found to significantly enhance post-exercise increases in T and GH compared to H3000 (p < 0.05), without affecting C levels. In men, hypoxia (regardless of intensity) did not significantly augment post-exercise changes in T and GH compared to normoxia. In H4000 conditions, an increase in C levels was observed (p < 0.05), leading to an unfavorable reduction in the T/C ratio. Additionally, a reduction in the total number of repetitions performed during the training session and a weakened metabolic response (lactate and creatine kinase) were observed in men at H5000. Conclusions: In women, severe hypoxia (H5000) was found to induce a pronounced hormonal response, particularly in GH levels. The use of severe hypoxia during resistance exercise appears unfavorable in men due to a reduced metabolic response, and diminished exercise capacity, coupled with a failure to induce more favorable changes in the secretion of anabolic hormones than in normoxic conditions.
Synergic Efficacy of a Multicomponent Nutraceutical Add-On Therapy in Seasonal Allergic Rhinitis in Children: A Prospective, Randomized, Parallel-Group Study
Authors: Gori Alessandra , Brindisi Giulia , Anania Caterina , Spalice Alberto , Zicari Anna Maria
Published: February 2025

Background: Emerging evidence suggests that nutraceuticals, alongside standard therapy, may benefit children with allergic rhinitis (AR). This study aimed to compare the efficacy of Quertal® (Neopharmed Gentili S.p.A., Milano, Italy), a nutraceutical supplement based on Perilla frutescens, Quercetin, and vitamin D3, combined antihistamines per os versus antihistamines alone, in improving AR symptoms considering respiratory functional and laboratory biomarkers in pediatric age. Materials and Method: This study included 100 children, 50 in the case group (Quertal® plus antihistamines) and 50 in the control group (antihistamines alone), with mild/moderate AR sensitized to grass pollens. They underwent assessments of respiratory function (rhinomanometry-AAR, spirometry), inflammation markers (Nasal Nitric Oxide [nFeNO]; exhaled Nitric Oxide [eFeNO]; nasal cytology), and laboratory assays (blood eosinophils, total IgE and specific IgE to Phl p1). Results: After three months of treatment, the case group showed statistically significant improvement in nFeNO and eFeNO values compared to controls (p < 0.001), as well as a reduction in nasal eosinophils (p < 0.001). Conclusions: Adding Quertal® to standard antihistamine therapy may reduce nasal inflammation and improve AR symptoms in pediatric patients. This combination therapy shows promise as a practical, well-tolerated approach to managing AR and may have broader implications for enhancing long-term outcomes.
Minimally Invasive vs. Open Synovectomy in Rheumatoid Arthritis: Insights into Clinical Recovery, Systemic Inflammation, and Economic Impact
Authors: Blajovan Marc-Dan , Abu-Awwad Ahmed , Pop Daniel-Laurentiu , Abu-Awwad Simona-Alina , Tudoran Cristina , Gurgus Daniela , Timircan Madalina Otilia , Dinu Anca , Faur Cosmin Ioan
Published: February 2025

Background: Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by persistent synovial inflammation, leading to joint destruction and disability. Synovectomy, the surgical removal of inflamed synovial tissue, is performed when pharmacological treatments are insufficient. This study compares the clinical efficacy, systemic inflammatory response, and cost-effectiveness of minimally invasive arthroscopic synovectomy versus traditional open synovectomy in RA patients. Methods: A comparative observational study was conducted on 53 RA patients undergoing either arthroscopic (n = 30) or open synovectomy (n = 23) at “Pius Brînzeu” Timișoara County Emergency Clinical Hospital over nine years. Clinical outcomes, including pain relief (VAS), functional improvement (HAQ), complication rates, and recovery times, were assessed at baseline, 1, 3, 6, and 12 months postoperatively. Systemic inflammatory markers (CRP, IL-6, TNF-α, ESR, and fibrinogen) were measured preoperatively, at 48 h and 30 days postoperatively. A cost-effectiveness analysis evaluated direct and indirect healthcare costs. Results: Arthroscopic synovectomy demonstrated significantly faster pain reduction and functional recovery within the first three months (p < 0.001), shorter hospital stays (3.1 vs. 6.4 days, p < 0.001), and quicker returns to daily activities (14.5 vs. 22.3 days, p < 0.001) compared to open synovectomy. Inflammatory markers were significantly lower postoperatively in the arthroscopic group (p < 0.01), indicating reduced systemic inflammation. Complication rates were markedly lower in the arthroscopic group (26.66% vs. 82.60%, p < 0.001). Despite higher procedural costs, arthroscopic synovectomy proved more cost-effective due to reduced hospitalization and faster recovery. Conclusions: Arthroscopic synovectomy offers superior early postoperative outcomes, reduced systemic inflammation, and greater cost-effectiveness compared to open synovectomy, with comparable long-term joint stability. These findings support its preference as the surgical technique of choice for RA patients requiring synovectomy.
A Machine Learning Approach for the Clustering and Classification of Geothermal Reservoirs in the Ying-Qiong Basin
Authors: Duan Yujing , Liang Yuan , Ji Qingyun , Wang Zhong
Published: February 2025

The exploration and development of marine geothermal energy is a field with significant potential, but it is also one that presents considerable challenges and costs. The assessment of marine geothermal reservoir potential is currently based on subjective analysis, and this study proposes an innovative clustering-based method to classify marine geothermal reservoirs systematically. The Yingqiong Basin was analysed to develop a machine learning framework to predict the potential of marine geothermal reservoirs (CPPOGR). The study integrated eight key geothermal features into a unified dataset, employing dimensionality reduction techniques (principal component analysis and sparse autoencoder) and SMOTE to balance the sample size. Machine learning classifiers, including XGBoost, BP Neural Networks, Support Vector Machines, K-Nearest Neighbours, and Random Forests, were utilised for prediction. The experimental results demonstrate that XGBoost is the most suitable classifier, achieving an excellent performance of 0.96 precision, 0.9556 recall, 0.9528 F1 score, and 0.9623 accuracy. These results demonstrate the effectiveness of the proposed CPPOGR in accurately classifying marine geothermal reservoirs based on intrinsic features. This study underscores the potential of integrating cluster analysis with machine learning for efficient reservoir characterisation, thereby offering a novel approach for marine geothermal resource assessment.
Extraction of Tsunami Signals from Coupled Seismic and Tsunami Waves
Authors: Song Linjian , An Chao
Published: February 2025

The generation of an earthquake and a tsunami is a coupled process of radiating seismic waves and exciting tsunamis, and the two types of waves are simultaneously recorded by ocean-bottom pressure sensors. In order to constrain the earthquake source and evaluate the tsunami hazards, it is necessary to separate the tsunami waves. It is traditional to apply a low-pass filter such that the seismic waves are filtered and the tsunami waves remain. However, filtering may also cause distortion of the tsunami waves. In this study, we first use the finite-element method to simulate the generation of seismic and tsunami waves and show that the coupling is a linear superposition of the two waves. We then propose a new method to extract the tsunami waves. First, a low-pass filter with relatively high cutoff frequency that does not affect the tsunami waves is adopted, so that only tsunami waves and low-frequency seismic waves remain. The low-frequency seismic waves satisfy a theoretical equation p=ρha (p pressure, ρ water density, h water depth, and a seafloor vertical acceleration), and they can be predicted and removed by utilizing the records of ocean-bottom acceleration. We demonstrate the procedure by numerical simulations and show that the method successfully extracts clean tsunami signals, which is important for earthquake source characterization and tsunami hazard assessment.
Risk Assessment and Spatial Zoning of Rainstorm and Flood Hazards in Mountainous Cities Using the Random Forest Algorithm and the SCS Model
Authors: Xie Zixin , Shu Bo
Published: February 2025

China has a vast land area, with mountains accounting for 1/3 of the country’s land area. Flooding in these areas can cause significant damage to human life and property. Therefore, rainstorms and flood hazards in Huangshan City should be accurately assessed and effectively managed to improve urban resilience, promote green and low-carbon development, and ensure socio-economic stability. Through the Random Forest (RF) algorithm and the Soil Conservation Service (SCS) model, this study aimed to assess and demarcate rainstorm and flood hazard risks in Huangshan City. Specifically, Driving forces-Pressure-State-Impact-Response (DPSIR)’s framework was applied to examine the main influencing factors. Subsequently, the RF algorithm was employed to select 11 major indicators and establish a comprehensive risk assessment model integrating four factors: hazard, exposure, vulnerability, and adaptive capacity. Additionally, a flood hazard risk zoning map of Huangshan City was generated by combining the SCS model with a Geographic Information System (GIS)-based spatial analysis. The assessment results reveal significant spatial heterogeneity in rainstorm and flood risks, with higher risks concentrated in low-lying areas and urban fringes. In addition, precipitation during the flood season and economic losses were identified as key contributors to flood risk. Furthermore, flood risks in certain areas have intensified with ongoing urbanization. The evaluation model was validated by the 7 July 2020 flood event, suggesting that Huangshan District, Huizhou District, and northern Shexian County suffered the most severe economic losses. This confirms the reliability of the model. Finally, targeted flood disaster prevention and mitigation strategies were proposed for Huangshan City, particularly in the context of carbon neutrality and green urbanization, providing decision-making support for disaster prevention and emergency management. These recommendations will contribute to enhancing the city’s disaster resilience and promoting sustainable urban development.
How Can the Capability Approach Contribute to a New Perspective on the Value of Cropland Ecosystem Services?
Authors: Tang Yi , Liu Junzhu , Chen Zhoupeng
Published: February 2025

Cultivated land ecosystems are complex systems that integrate human activities with natural environments, playing a critical role in both ecological and socio-economic processes. These ecosystems face significant challenges, including land degradation, soil erosion, and biodiversity loss. Despite their importance, there is currently no standardized conceptual framework or unified approach for valuing cultivated land ecosystems and their ecosystem services. This paper aims to address this gap by developing a comprehensive framework that incorporates the unique characteristics of cultivated land ecosystems, with particular focus on the relationship between ecosystem services and human well-being. It introduces a novel theoretical approach for evaluating these services through the capability approach, emphasizing the integration of key concepts, the clarification of ecosystem service definitions, and the classification of their functions. Furthermore, the study explores the practical applications of this framework for the management and valuation of cultivated land ecosystems. The capability approach, as an innovative solution, is utilized to support and enhance the ecosystem services and benefits provided by cultivated land ecosystems, ultimately contributing to improved social well-being. The findings of this research are crucial for promoting sustainable management practices and advancing the implementation of ecological compensation strategies within the context of cultivated land.
How Does Land Finance Influence Vegetation Dynamics in China?
Authors: Yan Siqi , Wang Jian
Published: February 2025

Land-based financing plays an essential role in urbanization in the developing world, and it is widely recognized to have profound environmental effects. However, there have been relatively few research endeavors on the impact of land finance on vegetation dynamics. This study applies fixed effects models and an instrumental variable approach to examine the impact of land finance on vegetation status and mechanisms of influence, using data for 286 Chinese cities between 2011 and 2022. The nonlinear relationship between land finance and vegetation conditions at different levels of economic development is investigated by estimating panel threshold models. The findings show that land finance exerts an inhibiting impact on vegetation conditions. The restraining effect of land finance on vegetation status tends to be more pronounced in western China or in secondary industry-led cities. The analysis of mechanisms of influence indicates that land finance negatively affects vegetation conditions by speeding up urban expansion, suppressing innovation, reducing land use efficiency, and distorting the fiscal expenditure structure. The analysis of the threshold effect suggests that land finance exerts a stronger curbing effect on vegetation status as the economic development level rises. The findings have significant policy implications for deepening reform of the fiscal system and promoting vegetation protection and restoration.
Comparative Evaluation Methods of Comprehensive Soil Fertility in Jiangsu’s Coastal Saline–Alkali Land
Authors: Wang Zhiwang , Wang Shihang , Xu Lingying , Guo Qiankun , Chen Yuqi , Qiu Weiwen , Sun Jiabei
Published: February 2025

In coastal saline–alkali regions, the intrusion of saline water exacerbates the nutrient depletion in the plow layer, posing a significant challenge to agricultural productivity. Given the limited understanding of soil fertility in these areas and the inconsistent results among different assessment methods, this study aims to develop a more accurate and reliable soil fertility evaluation system. To achieve this objective, 108 topsoil samples were systematically collected from saline–alkali lands in Jiangsu Province. Several key soil fertility indicators, including soil pH, total salinity (TS), soil organic matter (SOM), total nitrogen (TN), total phosphorus (TP), total potassium (TK), alkaline-hydrolyzable nitrogen (AN), available phosphorus (AP), and available potassium (AK), were comprehensively evaluated. Four advanced methods, namely principal component analysis indexing–linear scoring (SQIPCAL), principal component analysis indexing–nonlinear scoring (SQIPCANL), modified Nemerow–linear scoring (SQINemeroL), and modified Nemerow indexing–nonlinear scoring (SQINemeroNL), were employed to conduct a multi-dimensional examination of soil fertility. Additionally, principal component analysis (PCA) was utilized to establish a minimum data set (MDS), which was then compared with the total data set (TDS) for a more precise assessment of soil fertility. Linear scoring methods (SQIPCAL and SQINemeroL) had higher semi-variogram R2 values compared to nonlinear methods. Moreover, under the SQIPCAL and SQINemeroL evaluation methods, a strong correlation was observed between the TDS and MDS, with R2 values reaching 0.63 and 0.65, respectively. Based on these findings, the SQINemeroL method, integrated with MDS, is recommended as an effective approach for soil fertility assessments in coastal saline–alkali regions in Jiangsu Province. This research not only enriches the theoretical understanding of soil fertility in such regions but also provides practical insights for sustainable agricultural management.
Brain Magnetic Resonance Imaging Radiomic Signature and Machine Learning Model Prediction of Hepatic Encephalopathy in Adult Cirrhotic Patients
Authors: Sparacia Gianvincenzo , Colelli Giulia , Parla Giuseppe , Mamone Giuseppe , Maruzzelli Luigi , Lo Re Vincenzina , Avorio Federica , Miraglia Roberto , Pichiecchio Anna
Published: February 2025

Background: Hepatic encephalopathy (HE) may arise as a possible consequence of cirrhosis. Magnetic resonance imaging (MRI) may reveal a T1-weighted hyperintensity in the globi pallidi, indicating the deposition of paramagnetic substances. The objective of this research was to implement a machine learning-based radiomic model to predict the diagnosis and severity of chronic hepatic encephalopathy in adult patients with cirrhosis. Methods: Between October 2018 and February 2020, brain magnetic resonance imaging (MRI) was conducted on adult patients, both with and without cirrhosis. The control population consisted of individuals who did not have a previous medical record of chronic liver disease. The grade of hepatic encephalopathy (HE) was determined by considering factors such as the presence of underlying liver disease, the severity of clinical symptoms, and the frequency of encephalopathic episodes. Radiomic texture analysis based on five machine learning algorithms was applied to axial T1-weighted MR images of bilateral lentiform nuclei. Using the area under the receiver operating characteristics curve, we determined the accuracy of the five machine learning-based algorithms in predicting the presence of HE and the HE grading. Results: The ultimate research cohort included 124 individuals, with 70 being cirrhotic patients and 54 being non-cirrhotic controls. Of the total number of patients, 38 had a previous occurrence of HE and, among them, 22 had a grade of HE greater than 1. The multilayer perceptron algorithm classified patients versus controls with an accuracy of 100%. The k-nearest neighbor (KNN) algorithm classified patients with or without HE with an accuracy of 76.5%. The multilayer perceptron algorithm classified HE grade (HE grade 1, HE grade ≥ 2) with an accuracy of 94.1%. Conclusions: The machine learning algorithms implemented provide a robust modeling technique for deriving valuable insights from brain MR images in cirrhotic patients and this can serve as an imaging tool valuable for the assessment of the burden of hepatic encephalopathy.
Exploration of Suitable Conditions for Shoot Proliferation and Rooting of Quercus robur L. in Plant Tissue Culture Technology
Authors: Wang Ting , Li Hao , Zhao Jiujiu , Huang Jinliang , Zhong Yu , Xu Zhenfeng , He Fang
Published: February 2025

Quercus robur L., also referred to as “summer oak” or “English oak”, is an esthetically pleasing species, making it an excellent choice for street trees and gardens. Raising Quercus presents several challenges, including its long growth period, delayed germination, and inconsistent emergence. The shoot proliferation and adventitious root formation of Q. robur are crucial for establishing a tissue culture regeneration system and are vital for the successful transplantation of seedlings. To address this, experiments were conducted to assess shoot proliferation and adventitious root formation in Q. robur using various media. The shoot proliferation time, shoot proliferation coefficient, number of rooting strips, and length indicators of roots were recorded. The results indicated that a combination of 0.3 mg/L 6-Benzylaminopurine (6-BA) and 100 mg/L cefotaxime (Cef) was optimal for shoot propagation, while a solution of 0.1 mg/L 1-Naphthaleneacetic acid (NAA) and 1/2 Murashige and Skoog Medium (1/2MS) medium was most effective for root induction. This study has identified the optimal conditions for adventitious root formation and shoot proliferation in Q. robur, providing a basis for further research into propagation, germplasm conservation and genetic transformation techniques.
Serum Levels of IL-6 and TNF-α, Salivary Morning Cortisol and Intensity of Psychological Stress in Patients with Allergic Contact Hand Dermatitis and Healthy Subjects
Authors: Pondeljak Nives , Lugović-Mihić Liborija , Davidović Blaženka Ladika , Karlović Dalibor , Hanžek Milena , Neuberg Marijana
Published: February 2025

Introduction: Allergic contact dermatitis (ACD) is a form of late hypersensitivity reaction of skin contact with allergens. As an inflammatory skin disease, ACD has a negative impact on the quality of life and there is a need to elucidate the etiopathogenetic factors of the disease, whereby using the psychoneuroimmunological (PNI) approach can be helpful. Psychological stress (PS), as a component of PNI, leads to aggravation of the contact hypersensitivity reaction. In response to the perception of PS, cortisol secretion is enhanced by activation of the hypothalamic–pituitary–adrenal (HPA) axis. Furthermore, the pro-inflammatory cytokines interleukin 6 (IL-6) and tumor necrosis factor alpha (TNF-α) play a role in activating the HPA axis as well as initiating and maintaining inflammatory responses. Recent studies show that IL-6, IL-1, and TNF-α values are increased in the serum of patients with contact dermatitis, as well as in keratinocyte cell culture. Methods: The study examined the association of PNI factors (serum IL-6 and TNF-α, stress intensity with a Perceived Stress Scale (PSS) questionnaire, quality of life of dermatology patients with a Dermatology Life Quality Index (DLQI)) with the disease severity evaluated using the Hand Eczema Extent Score (HEES) and the duration of disease in hand ACD patients. Results: Patients with hand ACD had higher PSS (p = 0.001) than healthy people, with no difference in IL-6 and TNF-α. Higher DLQI was associated with higher HEES and PSS (p = 0.002 and p < 0.001) and these were the only predictors of DLQI. The duration of the disease was not related to the investigated factors. Conclusion: This study is the first so far, to our knowledge, in which a detailed analysis of PNI factors in patients with hand ACD was conducted. The results show that patients with ACD have higher PS intensity, which can chronically indicate changes in the balance of the HPA axis and indirectly affect the quality of life and disease severity of this disease. The results of the research provide more knowledge about hand ACD and contribute to and emphasize the importance of a multidisciplinary approach to treatment, thus improving the quality of life of these patients.
Life Cycle Assessment of Polyphenolic Extracts Derived from Pine By-Products
Authors: Baquero Grau , Sorolla Sílvia , Casas Concepció , Bacardit Anna
Published: February 2025

Forestry and wood-processing by-products, such as pine bark, offer promising opportunities for sustainable resource utilization within a circular economy. This study aimed to assess the environmental impact of an aqueous extraction process for polyphenolic compounds from various pine residues, including bark, cones, and pruning, using life cycle assessment (LCA). The analysis revealed that ground and sieved pine bark powder had the lowest environmental impact, attributed to its simpler extraction process without chemical modifications and reduced energy consumption compared to other pine-derived products. Electricity and natural gas were identified as the primary drivers of environmental impacts across all categories. Sensitivity analyses demonstrated that increasing the tannin concentration in pine-derived products and integrating renewable energy sources could further improve environmental performance. These findings highlight the potential of utilizing underutilized pine residues as sustainable feedstock for producing valuable polyphenolic extracts with a relatively low environmental footprint. The insights gained from this LCA study provide a comprehensive foundation for advancing sustainable extraction technologies. They emphasize the critical role of energy efficiency, tannin concentration, and renewable energy integration in minimizing environmental impacts. Furthermore, these findings offer actionable guidance for optimizing resource recovery from forestry by-products, enhancing their viability as eco-friendly alternatives to conventional tannin sources.
Virtual Prototyping of a Novel Manipulator for Efficient Laser Processing of Complex Large Parts
Authors: Pandolfi Antonio , Ferrarini Sergio , Bilancia Pietro , Pellicciari Marcello
Published: February 2025

Traditional industrial robots offer significant operational flexibility and adapt well to reconfigurable production systems, although they face limitations in applications demanding high motion performance and spatial positional accuracy. While novel manufacturing solutions supporting small batch productions of custom products are widely researched, they are not yet fully available at industrial level. With the aim to advance in this domain, the present work, conducted in the context of the EU project OPeraTIC, reports the development of a novel manipulator for advanced three-dimensional laser surface treatment of large industrial components. The proposed robotic platform presents a decoupled kinematic architecture, with direct drive actuation in all axes. Its open control ensures adaptability to diverse manufacturing scenarios, making it a versatile tool for modern production lines. Starting from the description of its embodiment design and mechanical layout, the paper delves into robot virtual prototyping focusing on kinematic and dynamics aspects. In particular, a detailed behavioral model covering direct and inverse kinematic calculations, also allowing the precise evaluation of all actuation forces/torques, has been developed using analytical approaches. The model is validated with a commercial solver imposing different spatial motions. The generated performance maps illustrate the robot operational capabilities across a range of work scenarios.
Effect of Baffle on Heat Transfer Performance of Turbine Blade Composite Cooling Channel Based on Latticework
Authors: Li Minlong , Yang Ke , Wang Huishe , Yu Rongguo , Tong Jingze
Published: February 2025

Using the numerical simulation of the Reynolds-averaged Navier–Stokes method, the effects of two new baffle structures on the heat transfer performance of a composite cooling structure based on latticework in the leading-edge region and the mid-chord region of the turbine blade were studied. Further, the heat transfer performance of the composite cooling structure caused by the difference between the rectangular channel and the wedge channel is compared. The application potential of the new baffle is comprehensively evaluated, which provides design experience for the application of the baffle in the composite cooling structure of the leading-edge region and the mid-chord region of the turbine blade. It is found that the baffle significantly improves the comprehensive heat transfer capacity and flow rate in the leading-edge channel region and the mid-chord channel non-transition region. The baffle increases the comprehensive heat transfer coefficient of the leading-edge channel by 26.5% and the flow rate by 14.5%. The baffle leads to an increase in the comprehensive heat transfer coefficient and flow rate in the mid-chord channel non-transition region by 39.5% and 6.5%, respectively. However, the baffle significantly restrains the heat transfer in the mid-chord channel transition region, resulting in an average decrease of 16.5% in the flow rate in this region. The comprehensive heat transfer performance of the continuous baffle is 4.7% higher than that of the discontinuous baffle, and the heat transfer uniformity of the composite channel based on the continuous baffle is better. Compared with the rectangular channel, the baffle increases the difference in flow distribution in each region of the wedge channel, but the effect of the baffle on the heat transfer performance parameters of the wedge channel is weakened, and the heat transfer distribution is more uniform.
A Self-Normalized Online Monitoring Method Based on the Characteristic Function
Authors: Wang Yang , Yang Baoying
Published: February 2025

The goal of nonparametric online monitoring methods is to quickly detect structural changes in the distribution of a data stream. This work is concerned with a nonparametric self-normalized monitoring method based on the difference of empirical characteristic functions. This method introduces an additional self-normalization factor, which enables effective control the Type I error. We theoretically investigate the asymptotic properties of the monitoring method under the null hypothesis as well as the alternative hypothesis. Since the asymptotic distribution under the null hypothesis is quite complicated, we apply the multivariate stationary bootstrap method to estimate the critical value of the sequential test. Numerical simulations and a real-world application demonstrate the usefulness of the proposed method.
Effects of Sugammadex on the Coagulation Profile of Living Liver Donors Undergoing Hepatectomy: A Case-Control Study
Authors: Demiroz Duygu , Colak Yusuf Ziya , Akbulut Sami , Ozdes Oya Olcay , Ucar Muharrem , Erdogan Mehmet Ali , Karakas Serdar , Gulhas Nurcin
Published: February 2025

Background: The most important concern regarding living donor liver transplantation is the safety of living liver donors, of which anesthesia management is an important part. Sugammadex, which has recently been used frequently for the reversal of neuromuscular blockade, is known to cause adverse effects on the coagulation profile. This study seeks to assess the impact of neostigmine and sugammadex on coagulation parameters in living liver donors following hepatectomy. Methods: We compared the demographic, clinical, and coagulation parameters of 209 living liver donors who received sugammadex (2 mg/kg) for neuromuscular blockade reversal during donor hepatectomy procedures from January 2018 to July 2022, with 209 patients who received neostigmine (50 g/kg) for the same purpose during the same timeframe. We compared the following parameters: age, gender, prothrombin time (PT), partial thromboplastin time (PTT), international normalized ratio (INR), hemoglobin (Hb), platelet count, ICU stay, hospital stay, and relaparotomy for bleeding and other causes. Results: Demographic data and preoperative biochemical values were similar in both groups. PT (p = 0.004) and aPTT (p < 0.001) values were significantly longer in the postoperative period in both groups; the difference between preoperative and postoperative PT (p = 0.009) and aPTT (p < 0.001) was significantly higher in the sugammadex group. However, neither group showed any elongation beyond the reference range. The sugammadex group had an elevated postoperative platelet count (p = 0.040). The duration of patients’ stay in the ICU was significantly shorter in the sugammadex group (p < 0.001). Conclusion: The prolonged aPTT and PT associated with sugammadex did not lead to any postoperative bleeding complications. The sugammadex group significantly reduced the duration of ICU stays, while the hospital stays remained comparable. Further multicentric prospective randomized studies should support our study’s findings, which demonstrate the safe use of low-dose sugammadex.
Prognostic and Predictive Value of Systemic Inflammatory Markers in Epithelial Ovarian Cancer
Authors: İdrisoğlu Cem , Muğlu Harun , Hamdard Jamshid , Açıkgöz Özgür , Olmusçelik Oktay , Müezzinoğlu Bahar , Ölmez Ömer Fatih , Yıldız Özcan , Bilici Ahmet
Published: February 2025

Background and Objectives: Epithelial ovarian cancer (EOC) remains a significant global health challenge. While traditional prognostic factors are well established, emerging biomarkers continue to gain attention. Materials and Methods: This retrospective study evaluated the impact of systemic inflammatory markers on progression-free survival (PFS) and overall survival (OS) in 154 EOC patients. Pre-treatment neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and systemic inflammatory index (SII) were calculated and categorized into low and high groups. Univariate and multivariate analyses were conducted to identify independent prognostic factors, while logistic regression analysis was used to determine predictors of platinum resistance. Results: In the univariate analysis, elevated NLR and PLR were associated with poorer PFS and OS. However, these markers did not maintain statistical significance in the multivariate analysis. Although SII demonstrated a trend toward worse outcomes, it did not reach statistical significance. Histopathological type, PLR, and surgical approach were identified as independent predictors of platinum resistance. Conclusions: Our findings indicate that systemic inflammatory markers may hold prognostic value in EOC; however, further validation through larger prospective studies is necessary.
The Management of Cardiometabolic Risk in MAFLD: Therapeutic Strategies to Modulate Deranged Metabolism and Cholesterol Levels
Authors: Pezzoli Annalisa , Abenavoli Ludovico , Scarcella Marialaura , Rasetti Carlo , Svegliati Baroni Gianluca , Tack Jan , Scarpellini Emidio
Published: February 2025

Background and Objectives: Fatty Liver Disease is a major health problem worldwide. We can distinguish liver steatosis as non-associated or associated with chronic/acute alcohol consumption. These two entities share similar stages ranging from hepatic fat storage (namely, steatosis) to inflammation, necrosis, and fibrosis until hepatocellular carcinoma (HCC). Over time, “Metabolic Associated Fatty Liver Disease” (MAFLD) has replaced nonalcoholic fatty liver disease (NAFLD) nomenclature and has included cardiometabolic criteria in these patients definition. Thus, obesity, type 2 diabetes mellitus (T2DM), hypertension, and dyslipidemia are MAFLD features and are of the metabolic syndrome. Importantly, there is not a specific treatment for MAFLD, but there are therapeutic strategies that act on metabolic dysfunction related to MAFLD. They can reduce the progression of liver fibrosis and its complications. Materials and Methods: For all these reasons, we conducted a narrative review of the literature, and we focused on metabolic dysfunction related to MAFLD, with a special regard for cholesterol metabolism. Results: MAFLD is a recently redefined condition that better describes the metabolism derangement responsible for fatty liver disease. This distinguishes MAFLD from NAFLD. In fact, the diagnostic criteria for MAFLD require the presence of liver steatosis together with at least one of the following: obesity, T2DM, or evidence of metabolic disorder such as hypertriglyceridemia, low high-density lipoprotein cholesterol, or hypertension. As a result, MAFLD is closely linked to an increased cardiometabolic risk. Current therapeutic approaches can be used to reduce this risk, focusing on lifestyle interventions and pharmacological strategies. Several treatments in patients diagnosed with MAFLD are mainly cholesterol-lowering remedies. Among these, Pro-protein Convertase Subtilisin/Kexin type 9 inhibitors (PCSK9i) show the most promising efficacy profile but data on liver fibrosis are lacking. Agonists of GLP-1 receptor, Sodium-glucose cotransporter-2 inhibitors (SGLT2i) and Dipeptidyl Peptidase-4 inhibitors (DPP-4i) have a “ multi-hit “ action allowing their use also in diabetic patients with MAFLD. Conclusions: Lifestyle modifications, some nutraceuticals, statins, incretins, and PCSK9i have changed the natural course and significantly improved the cardiometabolic outcomes of MAFLD. Emerging cholesterol-lowering drugs, such as Bempedoic acid, can overcome low compliance to statins’ use and their controversial effect on liver fibrosis. Finally, medications targeting insulin resistance allow for strategic interventions of the convoluted pathophysiology of MAFLD in multiple steps, with the potential to reduce liver steatosis, inflammation, and necrosis and, sometimes even to reverse liver fibrosis.