bluuebunny/crossref_metadata_2025 huggingface dataset:
The Valorization of Wastes and Byproducts from Cruciferous Vegetables: A Review on the Potential Utilization of Cabbage, Cauliflower, and Broccoli Byproducts
Authors: Shinali Tharushi S. , Zhang Yiying , Altaf Moater , Nsabiyeze Assa , Han Zixin , Shi Shuyuan , Shang Nan
Published: April 2024

The management of vegetable waste and byproducts is a global challenge in the agricultural industry. As a commonly consumed vegetable crop, cruciferous vegetables marked higher amounts of wastage during their supply chain processes, with a significant contribution from cabbage, cauliflower, and broccoli. Therefore, the sustainable and resource-efficient utilization of discarded materials is crucial. This review explores potential applications of cruciferous vegetable waste and byproducts, spotlighting cabbage, cauliflower, and broccoli in food, medicinal, and other industries. Their significance of being utilized in value-added applications is addressed, emphasizing important biomolecules, technologies involved in the valorization process, and future aspects of practical applications. Cabbage, cauliflower, and broccoli generate waste and low-processing byproducts, including leaves, stems, stalks, and rot. Most of them contain high-value biomolecules, including bioactive proteins and phytochemicals, glucosinolates, flavonoids, anthocyanins, carotenoids, and tocopherols. Interestingly, isothiocyanates, derived from glucosinolates, exhibit strong anti-inflammatory and anticancer activity through various interactions with cellular molecules and the modulation of key signaling pathways in cells. Therefore, these cruciferous-based residues can be valorized efficiently through various innovative extraction and biotransformation techniques, as well as employing different biorefinery approaches. This not only minimizes environmental impact but also contributes to the development of high-value-added products for food, medicinal, and other related industries.
Distribution and Probabilistic Risk Assessment of Antibiotics, Illegal Drugs, and Toxic Elements in Gastropods from Southeast China
Authors: Shen Hai-Tao , Pan Xiao-Dong , Han Jian-Long
Published: April 2024

We investigated fourteen antibiotics, three illegal drugs, and two toxic elements in commercially available gastropods from southeast China. The data revealed high detection frequencies (DFs) for florfenicol (61.32%), florfenicol amine (47.33%), and thiamphenicol (39.88%), with maximum concentrations of 1110, 2222, and 136 μg/kg wet weight (ww), respectively. The DFs of illegal drugs were 3.54% for leucomalachite green and 0.3% for chloramphenicol. The average levels of Cd and As were 1.17 and 6.12 mg/kg ww, respectively. All chemicals presented diverse DFs in different sampling months. The highest DFs of florfenicol, florfenicol amine, and thiamphenicol were in July. The health risk assessment showed that targeted hazard quotients (THQs) of antibiotics, Cd, and As for children, teens, and adults were all less than one. Notably, the toxic elements (Cd and As) were identified as the primary health risk in gastropods, contributing to over 90% of the total THQs.
Nutritional Composition and Safety Aspects of Deep-Sea Whelks (Buccinum tenuissimum Kuroda)
Authors: Mansoor Sana , Lee Jin-Hwa , Bashir Khawaja Muhammad Imran , Sohn Jae-Hak , Choi Jae-Suk
Published: April 2024

The deep-sea whelk Buccinum tenuissimum Kuroda is highly sought-after as food in East Asian countries, notably, Korea and Japan. However, it lacks official recognition as a food product in Korea. This study aimed to assess its nutritional composition and safety for the potential development of seafood products. The nutritional analysis revealed high protein (13.54–20.47 g/100 g whelk), fat (0.85–8.59 g/100 g whelk), carbohydrate (1.55–12.81 g/100 g whelk), and dietary fiber (1.25–1.95 g/100 g whelk) contents in both muscle and gut samples, with energy contents ranging from 339.11 ± 1.64 to 692.00 ± 3.21 kJ/100 g. Key minerals, including iron, potassium, calcium, and sodium, and essential fatty acids, including eicosapentaenoic acid, docosahexaenoic acid, arachidonic acid, omega-3, and omega-6 fatty acids, were abundant, making it a potential supplementary food. Notably, heavy metal levels met the Korean standards for seafood safety. No trans fats, radioactivity concerning the radioactive isotopes 134Cs/137Cs and 131I, or pathogenic bacteria were detected. This confirms the safety and nutritional value of deep-sea whelks, suggesting their potential for developing seafood products rich in beneficial components, which could enhance nutrition and food security while contributing to economic growth.
A Gellan Gum, Polyethylene Glycol, Hydroxyapatite Composite Scaffold with the Addition of Ginseng Derived Compound K with Possible Applications in Bone Regeneration
Authors: Thangavelu Muthukumar , Kim Pil-Yun , Cho Hunhwi , Song Jeong-Eun , Park Sunjae , Bucciarelli Alessio , Khang Gilson
Published: April 2024

Engineered bone scaffolds should mimic the natural material to promote cell adhesion and regeneration. For this reason, natural biopolymers are becoming a gold standard in scaffold production. In this study, we proposed a hybrid scaffold produced using gellan gum, hydroxyapatite, and Poly (ethylene glycol) within the addition of the ginseng compound K (CK) as a candidate for bone regeneration. The fabricated scaffold was physiochemically characterized. The morphology studied by scanning electron microscopy (SEM) and image analysis revealed a pore distribution suitable for cells growth. The addition of CK further improved the biological activity of the hybrid scaffold as demonstrated by the MTT assay. The addition of CK influenced the scaffold morphology, decreasing the mean pore diameter. These findings can potentially help the development of a new generation of hybrid scaffolds to best mimic the natural tissue.
A Simplified Screening Model to Predict the Risk of Gestational Diabetes Mellitus in Caucasian and Latin American Pregnant Women
Authors: Arnoriaga-Rodríguez María , Serrano Irene , Paz Mateo , Barabash Ana , Valerio Johanna , del Valle Laura , O’Connors Rocio , Melero Verónica , de Miguel Paz , Diaz Ángel , Familiar Cristina , Moraga Inmaculada , Pazos-Guerra Mario , Martínez-Novillo Mercedes , Rubio Miguel A. , Marcuello Clara , Ramos-Leví Ana , Matia-Martín Pilar , Calle-Pascual Alfonso L.
Published: April 2024

The pathophysiology of gestational diabetes mellitus (GDM) comprises clinical and genetic factors. In fact, GDM is associated with several single nucleotide polymorphisms (SNPs). This study aimed to build a prediction model of GDM combining clinical and genetic risk factors. A total of 1588 pregnant women from the San Carlos Cohort participated in the present study, including 1069 (67.3%) Caucasian (CAU) and 519 (32.7%) Latin American (LAT) individuals, and 255 (16.1%) had GDM. The incidence of GDM was similar in both groups (16.1% CAU and 16.0% LAT). Genotyping was performed via IPLEX Mass ARRAY PCR, selecting 110 SNPs based on literature references. SNPs showing the strongest likelihood of developing GDM were rs10830963, rs7651090, and rs1371614 in CAU and rs1387153 and rs9368222 in LAT. Clinical variables, including age, pre-pregnancy body mass index, and fasting plasma glucose (FPG) at 12 gestational weeks, predicted the risk of GDM (AUC 0.648, 95% CI 0.601–0.695 in CAU; AUC 0.688, 95% CI 0.628–9.748 in LAT), and adding SNPs modestly improved prediction (AUC 0.722, 95%CI 0.680–0.764 in CAU; AUC 0.769, 95% CI 0.711–0.826 in LAT). In conclusion, adding genetic variants enhanced the prediction model of GDM risk in CAU and LAT pregnant women.
Satisfaction with Teleophthalmology Services: Insights from Remote Areas of Taiwan
Authors: Chen Nancy , Wang Jen-Hung , Chiu Cheng-Jen
Published: April 2024

During and after the COVID-19 pandemic, teleophthalmology provided access to eye care for rural populations. This study aimed to assess the efficacy of and satisfaction with an integrated real-time videoconferencing module. This project incorporated ophthalmic instruments and telecommunication devices and provided on-site consultations via videoconferencing. Both patients and healthcare providers completed satisfaction questionnaires. From May 2020 to May 2021, this project provided eye care services to 395 patients (aged 6–90 years). The most frequent eye condition was chronic conjunctivitis (n = 197), followed by senile cataract (n = 163), dry eye (n = 103), and refractive error (n = 95). Among them, 40 (10.1%) patients were referred to secondary or tertiary hospitals for further evaluation or treatment. In total, 181 recruited respondents provided good satisfaction scores in all dimensions, including quality of medical care (4.50 of 5.00), financial aspects of care (4.48), supportive attitude toward the project (4.47), quality of service (4.40), and quality of telecommunication (4.40). Women had a substantially more supportive attitude toward the project, and 25 healthcare providers provided low ratings in areas representing the quality of telecommunication (4.04) and user-friendliness of the instrument (4.00). This teleophthalmology system provided efficient and satisfactory eye care to participants in remote communities. However, better internet access and training in instrument use can reduce obstacles to the future implementation of the project.
Variations in Flower Color of Mutant Chrysanthemums
Authors: Haspolat Gulden
Published: April 2024

The induction of variation in chrysanthemums using gamma radiation under in vitro conditions is an effective technique in ornamental plants. The purpose of this study is to obtain new mutants by isolating desirable properties from the three-colored single chrysanthemum mutant using in vitro cultures. Bud explants were cultured four times, the plantlets were acclimatized, and 520 plants were planted in outdoor conditions. Observations of the mutants were collected during flowering time, and 97 of the mutants were compared to the control group. Plants with pink, white, and chimeric flowers were obtained. Mutant plants with white flowers constituted the majority of the population followed by plants with variegated flower colors. The population is divided into six clusters, based on the plant height, plant diameter, flower number, flower diameter, number of flower colors, ray flowers’ number, leaves’ number, stem weight, and lengths and widths of leaves. The population decreased in plant height, flower number, and stem weight, while other features increased compared to the control group. Thus, a new population with similar characteristics to the parent plant was obtained from a single mutant. Chrysanthemum plants exposed to mutagens showed major changes in flower parts as well as other parts of the plant.
Association of Combined Per- and Polyfluoroalkyl Substances and Metals with Chronic Kidney Disease
Authors: Haruna Issah , Obeng-Gyasi Emmanuel
Published: April 2024

Background: Exposure to environmental pollutants such as metals and Per- and Polyfluoroalkyl Substances (PFAS) has become common and increasingly associated with a decrease in the estimated Glomerular Filtration Rate (eGFR), which is a marker often used to measure chronic kidney disease (CKD). However, there are limited studies involving the use of both eGFR and the urine albumin creatinine ratio (uACR), which are more comprehensive markers to determine the presence of CKD and the complexity of pollutant exposures and response interactions, especially for combined metals and PFAS, which has not been comprehensively elucidated. Objective: This study aims to assess the individual and combined effects of perfluorooctanoic acid (PFOA), perfluorooctanesulfonic acid (PFOS), Cadmium (Cd), Mercury (Hg), and Lead (Pb) exposure on CKD using data from the National Health and Nutritional Examination Survey (NHANES) 2017–2018. Methods: We employed the use of bivariate logistic regression and Bayesian Kernel Machine Regression (BKMR) in our analysis of the data. Results: Logistic regression results revealed a positive association between PFOA and CKD. Our BKMR analysis revealed a non-linear and bi-phasic relationship between the metal exposures and CKD. In our univariate exposure–response function plot, Cd and Hg exhibited a U and N-shaped interaction, which indicated a non-linear and non-additive relationship with both low and high exposures associated with CKD. In addition, the bivariate exposure–response function between two exposures in a mixture revealed that Cd had a U-shaped relationship with CKD at different quantiles of Pb, Hg, PFOA, and PFOS, indicating that both low and high levels of Cd is associated with CKD, implying a non-linear and complex biological interaction. Hg’s interaction plot demonstrated a N-shaped association across all quantiles of Cd, with the 75th quantile of Pb and the 50th and 75th quantiles of PFOA and PFOS. Furthermore, the PIP results underscored Cd’s consistent association with CKD (PIP = 1.000) followed by Hg’s (PIP = 0.9984), then PFOA and PFOS with a closely related PIP of 0.7880 and 0.7604, respectively, and finally Pb (PIP = 0.6940), contributing the least among the five environmental pollutants on CKD, though significant. Conclusions: Our findings revealed that exposure to environmental pollutants, particularly Hg and Cd, are associated with CKD. These findings highlight the need for public health interventions and strategies to mitigate the cumulative effect of PFAS and metal exposure and elucidate the significance of utilizing advanced statistical methods and tools to understand the impact of environmental pollutants on human health. Further research is needed to understand the mechanistic pathways of PFAS and metal-induced kidney injury and CKD, and longitudinal studies are required to ascertain the long-term impact of these environmental exposures.
Glucosamine Enhancement of Learning and Memory Functions by Promoting Fibroblast Growth Factor 21 Production
Authors: Chao Yu-Ming , Wu Hon-Yen , Yeh Sin-Huei , Yang Ding-I , Her Lu-Shiun , Wu Yuh-Lin
Published: April 2024

Fibroblast growth factor 21 (FGF21) plays a crucial role in metabolism and brain function. Glucosamine (GLN) has been recognized for its diverse beneficial effects. This study aimed to elucidate the modulation of FGF21 production by GLN and its impact on learning and memory functions. Using both in vivo and in vitro models, we investigated the effects of GLN on mice fed with a normal diet or high-fat diet and on mouse HT22 hippocampal cells, STHdhQ7/Q7 striatal cells, and rat primary cortical neurons challenged with GLN. Our results indicated that GLN promotes learning and memory functions in mice and upregulates FGF21 expression in the hippocampus, cortex, and striatum, as well as in HT22 cells, STHdhQ7/Q7 cells, and cortical neurons. In animals receiving GLN together with an FGF21 receptor FGFR1 inhibitor (PD173074), the GLN-enhanced learning and memory functions and induction of FGF21 production in the hippocampus were significantly attenuated. While exploring the underlying molecular mechanisms, the potential involvement of NF-κB, Akt, p38, JNK, PKA, and PPARα in HT22 and NF-κB, Akt, p38, and PPARα in STHdhQ7/Q7 were noted; GLN was able to mediate the activation of p65, Akt, p38, and CREB in HT22 and p65, Akt, and p38 in STHdhQ7/Q7 cells. Our accumulated findings suggest that GLN may increase learning and memory functions by inducing FGF21 production in the brain. This induction appears to be mediated, at least in part, through GLN’s activation of the NF-κB, Akt, p38, and PKA/CREB pathways.
Diagnostic and Prognostic Value of Circulating DNA Fragments in Glioblastoma Multiforme Patients
Authors: Jarmuzek Pawel , Wawrzyniak-Gramacka Edyta , Morawin Barbara , Tylutka Anna , Zembron-Lacny Agnieszka
Published: April 2024

Novel blood-circulating molecules, as potential biomarkers for glioblastoma multiforme (GBM) diagnosis and monitoring, are attracting particular attention due to limitations of imaging modalities and invasive tissue biopsy procedures. This study aims to assess the diagnostic and prognostic values of circulating cell-free DNA (cfDNA) in relation to inflammatory status in GBM patients and to determine the concentration and average size of DNA fragments typical of tumour-derived DNA fractions. Preoperative plasma samples from 40 patients (GBM 65.0 ± 11.3 years) and 40 healthy controls (HC 70.4 ± 5.4 years) were compared. The cfDNA concentrations and lengths were measured using the electrophoresis platform, and inflammatory indices (NLR, PLR, LMR, and SII) were calculated from complete blood cell analysis. More fragmented cfDNA and 4-fold higher 50–700 bp cfDNA concentrations were detected in GBM patients than in healthy controls. The average cfDNA size in the GBM group was significantly longer (median 336 bp) than in the HC group (median 271 bp). Optimal threshold values were 1265 pg/μL for 50–700 bp cfDNA (AUC = 0.857) and 290 bp for average cfDNA size (AUC = 0.814). A Kaplan–Meier survival curves analysis also demonstrated a higher mortality risk in the GBM group with a cut-off >303 bp cfDNA. This study is the first to have revealed glioblastoma association with high levels of cfDNA > 1000 pg/μL of 50–700 bp in length, which can be aggravated by immunoinflammatory reactivity.
Loss of the Y Chromosome: A Review of Molecular Mechanisms, Age Inference, and Implications for Men’s Health
Authors: Gutiérrez-Hurtado Itzae Adonai , Sánchez-Méndez Astrid Desireé , Becerra-Loaiza Denisse Stephania , Rangel-Villalobos Héctor , Torres-Carrillo Norma , Gallegos-Arreola Martha Patricia , Aguilar-Velázquez José Alonso
Published: April 2024

Until a few years ago, it was believed that the gradual mosaic loss of the Y chromosome (mLOY) was a normal age-related process. However, it is now known that mLOY is associated with a wide variety of pathologies in men, such as cardiovascular diseases, neurodegenerative disorders, and many types of cancer. Nevertheless, the mechanisms that generate mLOY in men have not been studied so far. This task is of great importance because it will allow focusing on possible methods of prophylaxis or therapy for diseases associated with mLOY. On the other hand, it would allow better understanding of mLOY as a possible marker for inferring the age of male samples in cases of human identification. Due to the above, in this work, a comprehensive review of the literature was conducted, presenting the most relevant information on the possible molecular mechanisms by which mLOY is generated, as well as its implications for men’s health and its possible use as a marker to infer age.
LighterFace Model for Community Face Detection and Recognition
Authors: Shi Yuntao , Zhang Hongfei , Guo Wei , Zhou Meng , Li Shuqin , Li Jie , Ding Yu
Published: April 2024

This research proposes a face detection algorithm named LighterFace, which is aimed at enhancing detection speed to meet the demands of real-time community applications. Two pre-trained convolutional neural networks are combined, namely Cross Stage Partial Network (CSPNet), and ShuffleNetv2. Connecting the optimized network with Global Attention Mechanism (GAMAttention) extends the model to compensate for the accuracy loss caused by optimizing the network structure. Additionally, the learning rate of the detection model is dynamically updated using the cosine annealing method, which enhances the convergence speed of the model during training. This paper analyzes the training of the LighterFace model on the WiderFace dataset and a custom community dataset, aiming to classify faces in real-life community settings. Compared to the mainstream YOLOv5 model, LighterFace demonstrates a significant reduction in computational demands by 85.4% while achieving a 66.3% increase in detection speed and attaining a 90.6% accuracy in face detection. It is worth noting that LighterFace generates high-quality cropped face images, providing valuable inputs for subsequent face recognition models such as DeepID. Additionally, the LighterFace model is specifically designed to run on edge devices with lower computational capabilities. Its real-time performance on a Raspberry Pi 3B+ validates the results.
A Novel Interaction of Nesidiocoris tenuis (Hemiptera: Miridae) as a Biological Control Agent of Bactericera cockerelli (Hemiptera: Triozidae) in Potato
Authors: Esparza-Diaz Gabriela , Villanueva Raul T. , Badillo-Vargas Ismael E.
Published: April 2024

Nesidiocoris tenuis (Hemiptera: Miridae) is a generalist predator commonly used to control the whitefly Bemisia tabaci in Europe. This mirid has been found and established in South Texas, where it was initially observed feeding on nymphs of the psyllid Bactericera cockerelli (Hemiptera: Triozidae) in open tomato fields. B. cockerelli is the vector of the fastidious bacterium “Candidatus Liberibacter solanacearum” that causes diseases in several solanaceous crops, including zebra chip (ZC) disease in potatoes. There is a need to better understand how this predator impacts the control of important crop pests, such as potato psyllids. We assessed the interactions between N. tenuis and B. cockerelli in three different environmental settings. First, we estimated the numeric response of N. tenuis preying on B. cockerelli under laboratory and greenhouse conditions. Second, we evaluated the predator–prey interaction under controlled field cage conditions. Then, we exposed N. tenuis under controlled field release conditions to the natural occurrence of B. cockerelli. Finally, we assessed the compatibility between the use of N. tenuis as a biological control agent in a field study and its impact on ZC disease incidence, severity in potato tubers, and potato yield. Laboratory and greenhouse experiments resulted in diverse types of functional model responses, including exponential and linear mathematical models. Our findings revealed a significant predation effect exerted by N. tenuis, resulting in a reduction of more than fourfold in the number of B. cockerelli nymphs per cage. Specifically, the nymphal population decreased from 21 ± 3.2 in the absence of N. tenuis to 5 ± 1.6 when N. tenuis was present. Furthermore, the combination of N. tenuis with a reduced insecticide program increased potato yields, but only reduced ZC tuber incidence in one of two potato cultivars evaluated, and in one season. Findings from these studies indicate that N. tenuis could be effective as a biological control agent for B. cockerelli in potato production in South Texas. This is the first report of N. tenuis preying on immature stages of any psyllid species.
Trapeziometacarpal Dislocations in Pediatric Age, Is There a Better Treatment? Series of Cases and a Systematic Review
Authors: Martin-Diaz Pablo , Perez-Lopez Laura M. , Gutierrez-de la Iglesia Diego , Miron-Dominguez Beatriz , Domínguez Enric , Perez-Abad Miguel
Published: April 2024

(1) Background: Dislocations of the trapeziometacarpal joint (TMC) are uncommon in children and adolescents. Only a few isolated cases are reported in the literature. Therapeutic guidance is minimal and inconclusive. (2) Methods: The authors present four patients treated for this unusual lesion. We evaluated the evolution according to treatment, age, patient activity, and quickDASH. Despite the clear limitation of the small number of patients, it is relevant to try to better understand this lesion and its evolution. A systematic review of the literature was also conducted. (3) Results: This is the largest published series of TMC dislocations in children and adolescents. Patients included a 12-year-old girl treated conservatively with a poor quickDASH; a 9-year-old girl treated surgically with the Eaton–Littler technique for a new dislocation with a partially modified quickDASH; a 13-year-old boy with two necessary closed reductions for a new dislocation and a very good final quickDASH; and a 12-year-old boy treated with closed reduction and percutaneous fixation with excellent final results with quickDASH. (4) Conclusions: In the absence of scientific evidence, conservative treatment and ligament reconstruction did not provide good functionality. In contrast, closed reduction with percutaneous fixation provided excellent results. Therefore, the authors would recommend closed reduction and percutaneous needle fixation as an elective method to treat TMC dislocations in pediatric and adolescent patients.
In-Vitro Effects of Perfluorooctanoic Acid on Human Sperm Function: What Are the Clinical Consequences?
Authors: Alamo Angela , La Vignera Sandro , Mogioì Laura M. , Crafa Andrea , Barbagallo Federica , Cannarella Rossella , Aversa Antonio , Calogero Aldo E. , Condorelli Rosita A.
Published: April 2024

Background: Lifestyle and environmental pollution harm male fertility. Perfluoroalkyl substances (PFAS) are bio-accumulates in the environment as well as in several human tissues, and one of the most common PFAS is perfluorooctanoic acid (PFOA). Therefore, this study aimed to evaluate the in vitro effects of PFOA with hydrophobic and waterproofing properties on motility and bio-functional sperm parameters. Methods: To accomplish this, 50 healthy men with normozoospermia and not exposed to high doses of PFAS were enrolled. Their spermatozoa were incubated for 3 h with increasing concentrations of PFOA (0, 0.01, 0.1, and 1 mM) to evaluate its effects. In particular, we evaluated the effects of PFOA on total and progressive sperm motility and, by flow cytometry, on the following bio-functional sperm parameters: degree of chromatin compactness, viability, early and late apoptosis, mitochondrial membrane potential, the degree of lipoperoxidation, and concentrations of mitochondrial superoxide anion. Results: The results showed that PFOA decreased both total and progressive sperm motility, impaired chromatin compactness, and increased sperm lipid peroxidation and mitochondrial superoxide anion levels. Conclusions: This study showed that PFOA alters several sperm parameters and thus it may play a negative role in male fertility.
Impact of Self-Reported Loss of Balance and Gait Disturbance on Outcomes following Adult Spinal Deformity Surgery
Authors: Diebo Bassel G. , Alsoof Daniel , Lafage Renaud , Daher Mohammad , Balmaceno-Criss Mariah , Passias Peter G. , Ames Christopher P. , Shaffrey Christopher I. , Burton Douglas C. , Deviren Vedat , Line Breton G. , Soroceanu Alex , Hamilton David Kojo , Klineberg Eric O. , Mundis Gregory M. , Kim Han Jo , Gum Jeffrey L. , Smith Justin S. , Uribe Juan S. , Kebaish Khaled M. , Gupta Munish C. , Nunley Pierce D. , Eastlack Robert K. , Hostin Richard , Protopsaltis Themistocles S. , Lenke Lawrence G. , Hart Robert A. , Schwab Frank J. , Bess Shay , Lafage Virginie , Daniels Alan H.
Published: April 2024

Background: The objective of this study was to evaluate if imbalance influences complication rates, radiological outcomes, and patient-reported outcomes (PROMs) following adult spinal deformity (ASD) surgery. Methods: ASD patients with baseline and 2-year radiographic and PROMs were included. Patients were grouped according to whether they answered yes or no to a recent history of pre-operative loss of balance. The groups were propensity-matched by age, pelvic incidence–lumbar lordosis (PI-LL), and surgical invasiveness score. Results: In total, 212 patients were examined (106 in each group). Patients with gait imbalance had worse baseline PROM measures, including Oswestry disability index (45.2 vs. 36.6), SF-36 mental component score (44 vs. 51.8), and SF-36 physical component score (p < 0.001 for all). After 2 years, patients with gait imbalance had less pelvic tilt correction (−1.2 vs. −3.6°, p = 0.039) for a comparable PI-LL correction (−11.9 vs. −15.1°, p = 0.144). Gait imbalance patients had higher rates of radiographic proximal junctional kyphosis (PJK) (26.4% vs. 14.2%) and implant-related complications (47.2% vs. 34.0%). After controlling for age, baseline sagittal parameters, PI-LL correction, and comorbidities, patients with imbalance had 2.2-times-increased odds of PJK after 2 years. Conclusions: Patients with a self-reported loss of balance/unsteady gait have significantly worse PROMs and higher risk of PJK.
Measuring Cardiorespiratory Fitness without Exercise Testing: The Development and Validation of a New Tool for Spanish Adults
Authors: Schröder Helmut , Subirana Isaac , Elosua Roberto , Camps-Vilaró Anna , Tizón-Marcos Helena , Fitó Montserrat , Gómez Santiago F. , Dégano Irene R. , Marrugat Jaume
Published: April 2024

Background: Cardiorespiratory fitness (CRF) is an important component of overall physical fitness and is associated with numerous health benefits, including a reduced risk of heart disease, diabetes, and obesity. However, direct measurement of CRF is time-consuming and therefore not feasible for screening purposes. Methods: A maximal treadmill exercise test with the Bruce protocol was performed to estimate VO2max in 1047 Spanish men and women aged 17 to 62 years. Weight, height, and heart rate were measured. Leisure-time physical activity (LTPA) was recorded using the Minnesota Leisure Time Physical Activity Questionnaire. A multiple linear regression model was developed to predict exercise-based VO2max. The validity of the model was examined by correlation, concordance, Bland–Altman analysis, cross-validation, and construct validity analysis. Results: There was no significant difference between VO2max obtained by the Bruce protocol (43.56 mL/kg/min) or predicted by the equation (43.59 mL/kg/min), with R2 of 0.57, and a standard error of the estimate of 7.59 mL/kg/min. Pearson’s product–moment correlation and Lin’s concordance correlation between measured and predicted CRF values were 0.75 and 0.72, respectively. Bland–Altman analysis revealed a significant proportional bias of non-exercise eCRF, overestimating unfit and underestimating highly fit individuals. However, 64.3% of participants were correctly classified into CRF tertile categories, with an important 69.9% in the unfit category. Conclusions: The eCRF equation was associated with several cardiovascular risk factors in the anticipated directions, indicating good construct validity. In conclusion, the non-exercise eCRF showed a reasonable validity to estimate true VO2max, and it may be a useful tool for screening CRF.
Lupus Nephritis Outcomes after Stopping Immunosuppression
Authors: Alenzi Fahidah , Ateka-Barrutia Oier , Ken Cheah Chee , Khamashta Munther , Sangle Shirish R. , D’Cruz David P.
Published: April 2024

Background/Objectives: Immunosuppression (IS) is a standard therapy for lupus nephritis (LN). Data on the outcomes of patients with LN after the discontinuation of immunosuppression remain uncertain. This study aimed to evaluate the outcomes and results of patients with lupus nephritis (LN) who ceased immunosuppressive (IS) therapy. Methods: Records were obtained on the clinical and laboratory features of LN patients who were treated at our Lupus Unit. They included median values and ranges for various numerical variables such as patient age, disease duration, and treatment duration. Categorical variables such as gender, LN class, IS treatment type, and patient outcomes, which were categorized as either “stable” or “flare experienced”, were presented as percentages and frequencies. A flare in LN was characterized by a two-fold increase in serum creatinine levels and a rise in proteinuria following the cessation of IS medication. Results: Outcomes were assessed for 45 patients with LN who ceased IS therapy after achieving remission. The patients’ median age was 55 years (29–78). The median duration of treatment was 4 years (0.5–14). The LN histology distribution was class V = 24.4%, class IV = 17.8 %, class III = 17.8%, class III + IV = 15.6%, class III + V = 6.7%, class IV + V = 2.2%, and class II + IV and II = 2.2%. At the discontinuation of IS treatment, creatinine levels were elevated in 9/45 (20%) patients. Furthermore, 28.9% of patients relapsed after IS treatment discontinuation. Patients with anti-Smith antibodies (anti-Sm) were observed to have a higher occurrence of relapses, with six patients experiencing flare compared to four patients who remained stable (p = 0.03). Five (38.5%) of the patients with flares had high creatinine levels after IS discontinuation. Conclusions: Most of our patients maintained clinical remission and stable levels of LN parameters after IS treatment discontinuation. Those with a high serum creatinine level, ongoing proteinuria, depleted complement levels, and the presence of anti-Sm antibodies were more likely to experience flares after the discontinuation of IS therapy.
Edge AI Model Deployed for Real-Time Detection of Atrial Fibrillation Risk during Sinus Rhythm
Authors: Wu Hongmin , Sawada Takumi , Goto Takafumi , Yoneyama Tatsuya , Sasano Tetsuo , Asada Ken
Published: April 2024

Objectives: The study aimed to develop a deep learning-based edge AI model deployed on electrocardiograph (ECG) devices for the real-time detection of atrial fibrillation (AF) risk during sinus rhythm (SR) using standard 10 s, 12-lead electrocardiograms (ECGs). Methods: A novel approach was used to convert standard 12-lead ECGs into binary images for model input, and a lightweight convolutional neural network (CNN)-based model was trained using data collected by the Japan Agency for Medical and Research Development (AMED) between 2019 and 2022. Patients over 40 years old with digital, SR ECGs were retrospectively enrolled and divided into AF and non-AF groups. The data labeling was supervised by cardiologists. The dataset was randomly allocated into training, validation, and internal testing datasets. External testing was conducted on data collected from other hospitals. Results: The best-trained model achieved an AUC of 0.82 and 0.80, sensitivity of 79.5% and 72.3%, specificity of 77.8% and 77.7%, precision of 78.2% and 76.4%, and overall accuracy of 78.6% and 75.0% in the internal and external testing datasets, respectively. The deployed model and app package utilized 2.5 MB and 40 MB of the available ROM and RAM capacity on the edge ECG device, correspondingly. The processing time for AF risk detection was approximately 2 s. Conclusions: The model maintains comparable performance and improves its suitability for deployment on resource-constrained ECG devices, thereby expanding its potential impact to a wide range of healthcare settings. Its successful deployment enables real-time AF risk detection during SR, allowing for timely intervention to prevent AF-related serious consequences like stroke and premature death.
Biomechanical Effects of Ti-Base Abutment Height on the Dental Implant System: A Finite Element Analysis
Authors: Beltrán-Guijarro Miguel , Pérez-Pevida Esteban , Chávarri-Prado David , Estrada-Martínez Alejandro , Diéguez-Pereira Markel , Sánchez-Lasheras Fernando , Brizuela-Velasco Aritza
Published: April 2024

This study aims to analyse, using a finite element analysis, the effects of Ti-base abutment height on the distribution and magnitude of transferred load and the resulting bone microstrain in the bone-implant system. A three-dimensional bone model of the mandibular premolar section was created with an implant placed in a juxta-osseous position. Three prosthetic models were designed: a 1 mm-high titanium-base (Ti-base) abutment with an 8 mm-high cemented monolithic zirconia crown was designed for model A, a 2 mm-high Ti-base abutment with a 7 mm-high crown for model B, and a 3 mm-high abutment with a 6 mm-high crown for model C. A static load of 150 N was applied to the central fossa at a six-degree angle with respect to the axial axis of the implant to evaluate the magnitude and distribution of load transfer and microstrain. The results showed a trend towards a direct linear association between the increase in the height of the Ti-base abutments and the increase in the transferred stress and the resulting microstrain to both the prosthetic elements and the bone/implant system. An increase in transferred stress and deformation of all elements of the system, within physiological ranges, was observed as the size of the Ti-base abutment increased.
Subjective Straylight Index: A Visual Test for Retinal Contrast Assessment as a Function of Veiling Glare
Authors: Ávila Francisco J. , Casado Pilar , Marcellán Mª Concepción , Remón Laura , Ares Jorge , Collados Mª Victoria , Otín Sofía
Published: April 2024

Spatial aspects of visual performance are usually evaluated through visual acuity charts and contrast sensitivity (CS) tests. CS tests are generated by vanishing the contrast level of the visual charts. However, the quality of retinal images can be affected by both ocular aberrations and scattering effects and none of those factors are incorporated as parameters in visual tests in clinical practice. We propose a new computational methodology to generate visual acuity charts affected by ocular scattering effects. The generation of glare effects on the visual tests is reached by combining an ocular straylight meter methodology with the Commission Internationale de l’Eclairage’s (CIE) general disability glare formula. A new function for retinal contrast assessment is proposed, the subjective straylight function (SSF), which provides the maximum tolerance to the perception of straylight in an observed visual acuity test. Once the SSF is obtained, the subjective straylight index (SSI) is defined as the area under the SSF curve. Results report the normal values of the SSI in a population of 30 young healthy subjects (19 ± 1 years old), a peak centered at SSI = 0.46 of a normal distribution was found. SSI was also evaluated as a function of both spatial and temporal aspects of vision. Ocular wavefront measures revealed a statistical correlation of the SSI with defocus and trefoil terms. In addition, the time recovery (TR) after induced total disability glare and the SSI were related; in particular, the higher the RT, the greater the SSI value for high- and mid-contrast levels of the visual test. No relationships were found for low contrast visual targets. To conclude, a new computational method for retinal contrast assessment as a function of ocular straylight was proposed as a complementary subjective test for visual function performance.
Automated Landmark Annotation for Morphometric Analysis of Distal Femur and Proximal Tibia
Authors: Grammens Jonas , Van Haver Annemieke , Lumban-Gaol Imelda , Danckaers Femke , Verdonk Peter , Sijbers Jan
Published: April 2024

Manual anatomical landmarking for morphometric knee bone characterization in orthopedics is highly time-consuming and shows high operator variability. Therefore, automation could be a substantial improvement for diagnostics and personalized treatments relying on landmark-based methods. Applications include implant sizing and planning, meniscal allograft sizing, and morphological risk factor assessment. For twenty MRI-based 3D bone and cartilage models, anatomical landmarks were manually applied by three experts, and morphometric measurements for 3D characterization of the distal femur and proximal tibia were calculated from all observations. One expert performed the landmark annotations three times. Intra- and inter-observer variations were assessed for landmark position and measurements. The mean of the three expert annotations served as the ground truth. Next, automated landmark annotation was performed by elastic deformation of a template shape, followed by landmark optimization at extreme positions (highest/lowest/most medial/lateral point). The results of our automated annotation method were compared with ground truth, and percentages of landmarks and measurements adhering to different tolerances were calculated. Reliability was evaluated by the intraclass correlation coefficient (ICC). For the manual annotations, the inter-observer absolute difference was 1.53 ± 1.22 mm (mean ± SD) for the landmark positions and 0.56 ± 0.55 mm (mean ± SD) for the morphometric measurements. Automated versus manual landmark extraction differed by an average of 2.05 mm. The automated measurements demonstrated an absolute difference of 0.78 ± 0.60 mm (mean ± SD) from their manual counterparts. Overall, 92% of the automated landmarks were within 4 mm of the expert mean position, and 95% of all morphometric measurements were within 2 mm of the expert mean measurements. The ICC (manual versus automated) for automated morphometric measurements was between 0.926 and 1. Manual annotations required on average 18 min of operator interaction time, while automated annotations only needed 7 min of operator-independent computing time. Considering the time consumption and variability among observers, there is a clear need for a more efficient, standardized, and operator-independent algorithm. Our automated method demonstrated excellent accuracy and reliability for landmark positioning and morphometric measurements. Above all, this automated method will lead to a faster, scalable, and operator-independent morphometric analysis of the knee.
The Performance of a Survival Nomogram and Albumin–Bilirubin Grade as Prognostic Tools in Advanced Hepatocellular Carcinoma Treated with FOLFOX4
Authors: Wonglhow Jirapat , Sunpaweravong Patrapim , Sathitruangsak Chirawadee , Dechaphunkul Arunee
Published: April 2024

Background: The ability of the survival nomogram developed in the EACH study and albumin–bilirubin (ALBI) grade to predict the survival of advanced hepatocellular carcinoma (HCC) patients receiving oxaliplatin plus 5-fluorouracil/leucovorin (FOLFOX4) remains unvalidated. Here, we comprehensively evaluated these prognostic tools. Methods: The survival nomogram and ALBI grade of each patient were assessed, and the area under the receiver operating curve (AUROC) and Harrell’s C-index for the risk classification model were calculated. Results: Overall, 76 HCC patients who received FOLFOX4 between August 2017 and June 2023 were included. The survival nomogram classified patients into low-, intermediate-, and high-risk groups, with a median overall survival (OS) of 9.82, 10.64, and 3.70 months, respectively (p = 0.23). The AUROC was 0.621 and Harrell’s C-index was 0.589. However, the ALBI grade categorized all patients into grade 1, 2, and 3, with a median OS of 9.82, 6.83, and 1.58 months, respectively (p = 0.00024). The AUROC was 0.663 and Harrell’s C-index was 0.663. Conclusion: The ALBI grade can be a potential prognostic tool. However, the survival nomogram does not provide clear discrimination. Therefore, FOLFOX4 should be an option for patients with ALBI grade 1 who cannot receive immunotherapy or targeted therapy. Additional prospective studies with a larger cohort are warranted to validate the survival nomogram and ALBI grade as prognostic tools.
The Effect of Intermittent Pneumatic Compression on Hemodynamics and Regional Cerebral Oxygen Saturation in Laparoscopic Bariatric Surgery with Mild Hypercapnia in the Steep Reverse Trendelenburg Position
Authors: Jo Youn Yi , Kim Seong Min , Park Chun Gon , Kim Ji Woong , Kwak Hyun Jeong
Published: April 2024

Obesity negatively affects hemodynamics and cerebral physiology. We investigated the effect of the utilization of an intermittent pneumatic compression (IPC) device on hemodynamics and cerebral physiology in patients undergoing laparoscopic bariatric surgery under general anesthesia with lung-protective ventilation. Sixty-four patients (body mass index > 30 kg/m2) were randomly assigned to groups that received an IPC device (IPC group, n = 32) and did not (control group, n = 32). The mean arterial pressure (MAP), heart rate (HR), need for vasopressors, cerebral oxygen saturation (rSO2), and cerebral desaturation events were recorded. The incidence of intraoperative hypotension was not significantly different between groups (p = 0.153). Changes in MAP and HR over time were similar between groups (p = 0.196 and p = 0.705, respectively). The incidence of intraoperative cerebral desaturation was not significantly different between groups (p = 0.488). Changes in rSO2 over time were similar between the two groups (p = 0.190) during pneumoperitoneum. Applying IPC to patients with obesity in the steep reverse Trendelenburg position may not improve hemodynamic parameters, vasopressor requirements, or rSO2 values during pneumoperitoneum under lung-protective ventilation. During laparoscopic bariatric surgery, IPC alone has limitations in improving hemodynamics and cerebral physiology.
Role of Cardiovascular Magnetic Resonance in Cardiac Amyloidosis: A Narrative Review
Authors: Maggialetti Nicola , Torrente Andrea , Lorusso Giovanni , Villanova Ilaria , Ficco Michele , Gravina Matteo , Ferrari Cristina , Giordano Luca , Granata Vincenza , Rubini Dino , Lucarelli Nicola Maria , Stabile Ianora Amato Antonio , Scardapane Arnaldo
Published: April 2024

Amyloidosis is a rare infiltrative condition resulting from the extracellular accumulation of amyloid fibrils at the cardiac level. It can be an acquired condition or due to genetic mutations. With the progression of imaging technologies, a non-invasive diagnosis was proposed. In this study, we discuss the role of CMR in cardiac amyloidosis, focusing on the two most common subtypes (AL and ATTR), waiting for evidence-based guidelines to be published.
The Impact of the Digital Capability of College Students’ New Enterprises on Business Model Innovation Driven by the Digital Economy: The Mediating Effect of Digital Opportunity Discovery
Authors: Li Fengliang , Sukpasjaroen Khunanan
Published: April 2024

Based on the theoretical frameworks on dynamic capabilities and business model innovation, we conducted a comprehensive survey and analysis involving 451 Chinese university student enterprises. The primary objective was to investigate the synergistic mechanism between these two factors, assessing their impact on business model innovation and tracing the evolutionary path. The study revealed the following key findings: (1) positive correlations exist between digital capabilities and business model innovation; (2) entrepreneurial passion serves as a mediator in the positive relationship between digital capabilities and the discovery of digital opportunities; (3) digital opportunity discovery acts as a mediator in the relationship between digital capabilities and business model innovation; (4) under the mediation of dynamic capabilities, digital opportunity discovery significantly promotes business model innovation. Our research contributes to the empirical exploration of digitization in enterprises, shedding light on the collaborative influence of digital capabilities and digital opportunity discovery on business model innovation. Importantly, it elucidates the contextual boundaries that influence business model innovation through diverse pathways, enhancing our comprehensive understanding of the dynamic landscape in the evolution of digital business transformations.
Pyrolysis of Specific Non-Recyclable Waste Materials: Energy Recovery and Detailed Product Characteristics
Authors: Janáková Iva , Čech Martin , Grabovská Šárka , Šigut Oldřich , Sala Pavel , Kijo-Kleczkowska Agnieszka
Published: April 2024

This study explores the pyrolysis process applied to various non-utilized waste materials, specifically focusing on separated plastics from municipal waste, wood waste (including pallets and window frames), paper rejects, and automotive carpets. Different combinations of these waste materials were subjected to pyrolysis, a process involving high-temperature treatment (600 °C) in a nitrogen atmosphere. The resulting products, including biochar, gas, and liquid fractions, as well as the residual waste materials, underwent comprehensive analysis. The evaluation of pyrolysis products emphasizes their quality, energy content, and potential applications. Notably, the pyrolysis gas derived from the combination of separated municipal plastics and waste wood exhibited the highest calorific value at 49.45 MJ/m3. Additionally, Mixture 2, consisting of plastic and wood waste, demonstrated the highest calorific value for the pyrolysis condensate, reaching 30.62 MJ/kg. Moreover, Mixture 3, benefiting from biochar utilization as a sorbent, displayed the highest iodine value at 90.01 mg/g.