bluuebunny/crossref_metadata_2025 huggingface dataset:
Projections of standardised energy indices in future climate scenarios
Authors: Dolores-Tesillos Edgar , Otero Noelia , Allen Sam
Published: December 2024

Renewable energy is becoming an increasingly important component of energy systems. However, renewable energy production is heavily dependent on the prevailing weather conditions, which are changing as a result of climate change. It is therefore necessary to build energy systems that are robust to energy shortages caused by weather-dependent changes to energy demand and renewable energy production. To design such systems, we must monitor how changes in the climate are expected to influence future energy production and demand; this is important for policymakers to decide when, where, and by how much renewable energy installed capacities should be increased, for example. In this paper, we study the behaviour of standardised energy indices in future European climate projections, and use this to monitor how characteristics of energy production droughts in Europe are expected to change in the future. We use these results to make suggestions regarding how the energy mix should be adapted in the future to decrease the risk of energy production droughts.
Simulation analysis of the internal flow field in single screw compressor using local re-meshing method
Authors: Wu W , Zhang P , Wang Q , Huang L , Sun Y , Feng T
Published: December 2024

The single screw compressor (SSC) is considered an excellent competitor to the twin screw compressor due to its symmetrical structure and balanced gas forces on the screw rotor. To enhance the performance of SSC, it is crucial to have a thorough understanding of the internal flow field, particularly in the leakage channels. Nevertheless, the vertical relationship between the star wheel axis and the screw axis leads to mesh distortion, which presents technical challenges for mesh division in CFD simulations. In this paper, the method of local re-meshing is employed to simulate the comprehensive flow field using the Forte software. The mesh is regenerated near the motion boundary, while the mesh in the remaining areas remains unchanged. The pressure and temperature distribution of the internal flow field of the compressor are obtained, as well as its variation during operation. The results indicate a noticeable pressure gradient change in the leakage gap. The pressure and temperature of gas gradually increase along the axis direction of the screw, reaching the maximum value in the exhaust channel. The research can provide support for the future optimization design of the SSC.
A lattice-mechanical metamaterial with tunable two-step deformation, tunable stiffness, tunable energy absorption and programmable properties
Authors: Liu Chenyang , Gao Zexin , Chang Jiahui , Zhao Jianan , Qiu Song , Yu Peiran , Zhang Xi
Published: December 2024

Mechanical metamaterials have attracted much attention in recent years because of excellent properties. However, most mechanical metamaterials have only a relatively fixed and single deformation mode. Although some multi-step deformation metamaterials have been proposed, their rich static and dynamic mechanical properties have yet to be studied in depth. Therefore, a lattice-mechanical metamaterial is introduced in this study. Under vertical compression, different unit cells under the same architecture can achieve two or three steps of deformation, respectively. Metamaterials built from these unit cells can also achieve the same properties. These properties can exist in multiple directions and are not affected by the number of unit cells. In addition, this metamaterial not only has adjustable two-step deformation, adjustable stiffness, and adjustable energy absorption properties but it can also be spatially programmed by changing geometric parameters and tessellation. Finally, a 3D design version of the metamaterial is provided, and its conceptual application is briefly demonstrated. The developed metamaterial can achieve more static and dynamic mechanical properties while taking into account two-step deformation. This can provide richer content for the development of mechanical metamaterials and also provide new perspectives for the application of energy absorbers, aerospace, and industrial products.
Optical and photoelectric properties of nanostructured SnS films obtained by spraying ink using a nanoparticle suspension
Authors: Gnatenko Yu P , Bukivskii A P , Yevdokymenko V Yu , Opanasyuk A S , Bukivskij P M , Iliash S A , Vertegel I G , Ovcharenko O I , Gamernyk R V
Published: December 2024

In this work, SnS films were prepared using spraying ink with a nanoparticle suspension. The average size of the synthesized nanoparticles was (18–20) nm. The structural, optical and photoelectric properties of SnS films were investigated using different characterization techniques. XRD and EDX results show that the investigated films exhibited an orthorhombic SnS phase with a composition close to the stoichiometry (C
S

/C

Sn
= 0.99) and low level of microdeformation (ε = 1.8 × 10−3). In addition, the hexagonal SnS2 and tetragonal SnO2 phases were also observed. The presence of SnS and SnS2 phases is confirmed by Raman characteristics. The band gap of the SnS, SnS2, and SnO2 phases was determined using the novel ACFD method based on the analysis of the spectra of the first derivative of the absorption coefficient, which directly determines the energy of both band-to-band optical transitions and transitions involving defect’s levels. These results correlate very well with data obtained using photoconductivity spectra. The nature of the electronic optical transitions as well as the type and energy position of various defect levels were established. It was shown that the energy of direct and indirect band-to-band optical transitions of SnS compound correspond to 1.72 eV and 1.16 eV, respectively. At the same time, the band gap of SnS2 phase equal to 2.05 eV. The ionization energy of the acceptor (233 meV) and donor (100 meV) levels that determine the p- and n-type conductivity of SnS and SnS2 compounds, respectively were defined. Due to its properties, SnS films may be suitable for the development of novel effective solar cells with SnS absorber layers.
Experimental study of physical, mechanical and tribological behaviour of polyester/kota stone dust composite
Authors: Awasthi Tanmay , Bharti Manish Singh , Agrawal Alok , Gupta Gaurav
Published: December 2024

In the industry of Kota stone, a significant amount of waste material is produced at the time of manufacturing. This waste is typically discarded on the local site, which is then carried away by rainwater and air, leading to environmental deterioration. The current study focuses on utilizing the waste i.e. Kota stone dust (KSD) as the filler in the polyester resin for the development of a polymeric composite. Various composite sets with different micro-particulate contents through open moulding technique are prepared and its characterization is reported. The density and void percentage of polyester increase with KSD loading. The hardness and compressive strength increased to 83.7 Shore-D number and 102.7 MPa respectively, at 40 wt% KSD. A tensile and flexural modulus also increases with KSD loading showing an improvement of 72.8% and 64.1% respectively. Contrary to that, the highest tensile and flexural strength was recorded at 25 wt% and 30 wt% KSD loading respectively, which is 29.2% and 28.8% higher than unfilled polyester. Sliding wear tests were conducted following Taguchi’s experimental design. The experiments revealed that the filler content had the most significant impact on the specific rate. The study of surface morphology of the worn surfaces provided an insight into the wear mechanisms of the composites such as craters, cracks, wear debris, and wear track formation at different sliding conditions. The composites’ wear response prediction for various test conditions within and beyond the experimental boundary was conducted by successfully implementing a model based on artificial neural networks.
Early knee osteoarthritis classification using distributed explainable convolutional neural network with local interpretable model-agnostic explanations
Authors: Ganesh Kumar M , Gumma Lakshmi Narayana , Neelam Saikiran , Yaswanth Narikamalli , Yedukondalu Jammisetty
Published: December 2024

Knee Osteoarthritis (KOA) is a type of Knee Arthritis (KA) that causes pain, swelling, and other discomforts to the knee joints, which is quite complicated to classify using previous methods due to its various limitations such as computational cost, over-fitting issues, less reliability and so on. In this research, the classification using a distributed explainable convolutional neural network with local interpretable model-agnostic explanations (LExNN) model is proposed for knee Osteoarthritis. The distributed LExNN model is an ensemble with a distributed mechanism, in which the input vectors are distributed to two explainable CNNs which makes it quite easier for classification and grading. The distributed concepts are blown up with several advantages such as high computation efficiency with less training time, reliability, and develop an efficient model for classification. In addition, the local interpretable model-agnostic explanations (LIME) technique interprets important information from the image and classifies the severity based on two grades namely high and low. This technique provides significant, simple, and understandable information, which is quite reliable for KOA classification. The supremacy of the model can be determined by measuring several parameters such as accuracy, precision, recall, and f1 score that gives 99.25%, 99.25%, 98.42%, and 98.83% compared to other state-of-the-art methods.
Thickness dependence of the mechanical properties of piezoelectric high-Qm nanomechanical resonators made from aluminium nitride
Authors: Ciers Anastasiia , Jung Alexander , Ciers Joachim , Radit Nindito Laurentius , Pfeifer Hannes , Dadgar Armin , Bläsing Jürgen , Strittmatter André , Wieczorek Witlef
Published: December 2024

Nanomechanical resonators with high quality factors (Q
m) enable mechanics-based quantum technologies, in particular quantum sensing and quantum transduction. High-Q
m nanomechanical resonators in the kHz to MHz frequency range can be realized in tensile-strained thin films that allow the use of dissipation dilution techniques to drastically increase Q
m. In our work, we study the material properties of tensile-strained piezoelectric films made from aluminium nitride (AlN). We characterize crystalline AlN films with a thickness ranging from 45 nm to 295 nm, which are directly grown on Si(111) by metal–organic vapour-phase epitaxy. We report on the crystal quality and surface roughness, the piezoelectric response, and the residual and released stress of the AlN thin films. Importantly, we determine the intrinsic quality factor of the films at room temperature in high vacuum. We fabricate and characterize AlN nanomechanical resonators that exploit dissipation dilution to enhance the intrinsic quality factor by utilizing the tensile strain in the film. We find that AlN nanomechanical resonators below 200 nm thickness exhibit the highest

Q
m

×

f
m

-product, on the order of 1012 Hz. We discuss possible strategies to optimize the material growth that should lead to devices that reach even higher

Q
m

×

f
m

-products. This will pave the way for future advancements of optoelectromechanical quantum devices made from tensile-strained piezoelectric AlN.
Distinguishing short-term and long-term climate impacts in damage functions
Authors: Wang Tianpeng
Published: December 2024

Climate change presents substantial challenges to global economic stability, with damage functions widely applied to evaluate its potential impacts. However, differing assumptions within damage functions lead to significant variability in estimated climate damages, with limited quantitative investigation into the reasons for these discrepancies. This study addresses this gap by distinguishing between short-term and long-term climate impacts in damage assessments, using the Dynamic Integrated Climate-Economy (DICE) model as a case study, alongside other assessments. Short-term impacts capture immediate economic disruptions, whereas long-term impacts encompass enduring effects on economic growth, such as reductions in capital stock. The results demonstrate that accounting for long-term impacts increases estimated damages by approximately 30% in the DICE model. Comparative analysis across multiple models reveals that different treatments of short-term and long-term climate impacts contribute significantly to variations in projected economic damages. This study emphasizes the urgent need for future damage functions to clarify both long-term and short-term climate damages to inform robust climate policies.
Four decades of research on multiword expressions: A bibliometric analysis
Authors: Yi Wei , Zhao Yihan , Wang Wanxin
Published: December 2024

Multiword expressions have been a prominent research topic in applied linguistics and second language acquisition. However, no bibliometric analysis has been conducted to examine the landscape of this field. Using CiteSpace, we analyzed 1,302 research articles published from 1983 to 2024, retrieved from the Web of Science database. We performed various bibliometric analyses based on citation, co-citation information, and keywords from the publications to identify the most influential authors, scholarly documents, and journals in the field. We also visualized collaboration networks between authors, research institutions, and countries. Additionally, we identified the key research areas and the most frequently discussed topics over different time periods. By tracking and visualizing the patterns in research on multiword expressions over the past four decades, our study offers insights into the intellectual structure and dynamics of this field, thereby guiding future research on larger-than-word units.
Techno-economic assessment and multi-objective optimization of CO2 hydrogenation via geothermal energy storage using synthetic natural gas, refrigeration, and freshwater production
Authors: Hai Tao , Seger Abdullah Ali , El-Shafay A S , Agarwal Diwakar , Al-Yasiri Ahmed Jassim , Rajab Husam , Darweesh Moustafa S , Kolsi Lioua , Maatki Chemseddine , Singh Narinderjit Singh Sawaran
Published: December 2024

This study addresses the challenge of sustainable, multi-generational energy production by introducing an innovative geothermal-powered system for simultaneous methane, electricity, cooling, and freshwater generation. The configuration integrates a flash-binary geothermal power setup with an Organic Rankine Cycle, dual-effect absorption cooling, multi-stage flash desalination, and a solid oxide electrolyzer cell (SOEC) linked to a Sabatier reactor for CO2 hydrogenation. Financial analysis reveals annual revenue of $63.6 million, with operating expenses of $54.8 million and labor costs of $5.81 million, leading to a 7.3-year return on investment period. Optimized SOEC operation, including higher working temperatures, reduces voltage losses, improving energy efficiency.
Fungal trunk pathogens of fruit and nut tree crops: identification, characterization, detection and perspectives for a critical global issue
Authors: Martino Ilaria , Spadaro Davide , Guarnaccia Vladimiro
Published: December 2024

Fungal trunk pathogens are a growing global issue, significantly affecting fruit and nut tree crop cultivation. These pathogens, mainly ascomycetes, belong to several families including Botryosphaeriaceae, Calosphaeriaceae, Cytosporaceae, Diaporthaceae, Diatrypaceae, Nectriaceae and Togniniaceae. The large number of species involved represent a challenge in clarifying the etiology of trunk diseases, further complicated by frequent co-infections of different fungi. Typically, these pathogens enter plants through wounds and natural openings, and some can persist in a latent phase, switching to pathogenicity under favorable conditions. This aspect represents a significant concern for both nurseries and orchards. Moreover, the current climatic conditions and the intensification of cropping systems are likely exacerbating the spread and development of these pathogens, making their management more difficult. This review provides an overview of the main ascomycetes causing trunk diseases, discussing their identification, characterization, and detection methods. Accurate identification and characterization are crucial to increase the knowledge on these pathogens and to develop effective management strategies. An insight on the current preventive and curative strategies is provided as well to explore sustainable crop protection strategies, including agronomic practices, biological control, the use of new active ingredients and tolerant and/or resistant cultivars, to address this escalating problem.
Identification of Two Novel Recombinant Types of Potato Virus Y from Solanum tuberosum Plants in Southern Region of Russia
Authors: Samarskaya Viktoriya , Kuznetsova Maria , Gryzunov Nikita , Spechenkova Nadezhda , Bagdasarova Polina , Ryabov Eugene , Taliansky Michael , Kalinina Natalia O.
Published: December 2024

Potato virus Y (PVY, genus Potyvirus, family Potyviridae) is one of the most devastating and economically important potato pathogens. Members of the Potyviridae family demonstrate high recombination rates. In nature, 5 major parental variants of PVY were identified with at least 35 recombinants. In this study we report two novel PVY recombinants discovered in the sprouts of potato tubers produced in field conditions in Astrakhan region of Russia in 2021 using high-throughput sequencing and de novo genome assembly. These recombinants, which were named Ast-A-I and Ast-A-II, have previously unknown arrangements of genome sections derived from PVYO and PVYN with a novel recombination junction at the position 7850 nt of the PVY genome, in the middle part of the RNA-dependent RNA polymerase (NIb) gene, with PVYO-type sequence at the 5’-end of this junction and PVYN-type at the 3’-end. Other recombinant junctions in the novel PVY variants were previously found in PVYNTNa and PVYNTNb. This includes those at the positions 2390 and 9200 (PVYN at the 5’-end and PVYO at the 3’-end) which were present in both novel recombinants, and at the position 500 (PVYO at the 5’-end and PVYN at the 3’-end) which present in Ast-A-II. The presence of PVY variants with novel recombinant point is verified by Sanger sequencing. Phylogenetic analysis of genomic RNA showed that the sequences of these recombinants form a separate branch which do not cluster with previously described PVY strains.
Circulating DKK1 levels are significantly elevated in obese individuals and are associated with insulin resistance and oxidative stress
Authors: Yang Qiyu , Qiu Sheng , Li Shenbing , Li Ling , Yang Gangyi , Yang Mengliu
Published: December 2024

Dickkopf‐1 (DKK1) is reportedly involved in various biological functions of the human body. However, the relationship between DKK1 and obesity in humans remains unknown. Bioinformatics analysis was performed to investigate the associations between DKK1 and metabolism‐related genes and signaling pathways. EHC and OGTT were performed on all individuals. Serum DKK1 concentrations were measured by an ELISA kit. DKK1 expression was measured by qRT‐PCR and Western blotting. We found that circulating DKK1 levels in overweight/obese (OW/OB) individuals were significantly elevated and were associated with parameters of glucose/lipid metabolism and IR, including BMI, WHR, fat%, TC, TG, FBG, 2 h‐BG, FIns, 2 h‐Ins, LDL‐C, HbA1c, HOMA‐IR, AUCi, AUCg, BAI, and VAI. The circulating DKK1 concentration was not affected by blood glucose or serum insulin levels. Bioinformatics analysis suggested that DKK1 may be associated with glucose/lipid metabolism and oxidative stress. At the cellular level, we found that DKK1 promoted oxidative stress and inhibited insulin signaling. Circulating DKK1 may be a biomarker for obesity and IR.
Effect of sodium butyrate on kidney and liver mitochondrial dysfunction in a lipopolysaccharide mouse model
Authors: Khan Muznah , Farooqi Sumera , Mitchell Katherine L. , Chowdhury Subir Kumar Roy , Cabrera‐Ayala Marian , Huang Jessica , Wallace Douglas C. , Weiss Scott L.
Published: December 2024

Sodium butyrate can reduce inflammation, but it is not known if butyrate can improve mitochondrial dysfunction during sepsis. We tested butyrate to prevent or reverse lipopolysaccharide (LPS)‐induced mitochondrial dysfunction in murine kidney and liver. C57BL/6 mice were grouped as control (n = 9), intraperitoneal (IP) LPS (n = 8), pretreatment with IP butyrate 600 (n = 3) or 1200 mg/kg (n = 8) followed 2 h later by LPS, posttreatment with IP butyrate 600 (n = 3) or 1200 mg/kg (n = 7) 1 h after LPS, or butyrate 1200 mg/kg only (n = 8). Kidney and liver tissue were collected at 24 h to measure mitochondrial respiration, electron transport system (ETS) complex activity and subunit expression, and content (citrate synthase [CS] activity and mtDNA/nDNA). Kidney mitochondrial respiration was decreased after LPS compared to controls. Pretreatment with butyrate 1200 mg/kg increased kidney OXPHOSCI+II, ETSCI+II, ETSCII, and CIV respiration compared to LPS; posttreatment did not achieve significant increases except for OXPHOSCI. Liver mitochondrial respiration exhibited a similar pattern as in kidney, but differences were not significant. ETS complex and CS activity did not differ between groups, but CI and CII subunit expression trended higher with butyrate in kidney. Changes in mtDNA/nDNA followed a similar pattern as respiration in kidney and liver with a decrease after LPS that was not present with butyrate pretreatment. These data show that butyrate can prevent—but not significantly reverse—the LPS‐induced decrease in kidney mitochondrial respiration without a clear effect in liver. Mitochondrial protection was not attributable to changes in ETS complex activity but may reflect maintenance of ETS subunit expression.
Ischemic Placental Disease: Epidemiology and Impact on Maternal and Offspring Health Along the Life Course
Authors: Daggett Emily E. , Ananth Cande V.
Published: December 2024

Ischemic placental disease (IPD) is a constellation of obstetrical complications that include preeclampsia, placental abruption, and fetal growth restriction and affects 12% to 15% of pregnancies. The unifying pathophysiological mechanism that precedes all 3 complications is uteroplacental ischemia as a consequence of inadequate (or failure of) physiological transformation of the maternal uterine spiral arteries, endothelial cell dysfunction, and increased oxidative stress. This review summarizes the IPD literature, focusing on the epidemiology and risk factors, the effects of IPD on short and long-term maternal complications, and the association of IPD with perinatal, childhood, and long-term complications in offspring.
Effect of single-pill versus free equivalent combinations on persistence and major adverse cardiovascular events in hypertension: a real-world analysis
Authors: Simonyi Gábor , Burnier Michel , Narkiewicz Krzysztof , Rokszin György , Abonyi-Tóth Zsolt , Kovács Gábor , Potukuchi Praveen Kumar , Abdel-Moneim Mohamed , Farsang Csaba
Published: December 2024

Objectives:

Hypertension guidelines recommend the use of single-pill combinations (SPCs) of antihypertensive drugs to improve treatment persistence and blood pressure control. This study aimed to investigate the long-term effects of ramipril/amlodipine (R/A) SPC versus free equivalent dose combinations (FEC) on cardiovascular outcomes and treatment persistence.

Methods:

This retrospective, observational study analysed the database of the Hungarian National Health Insurance Fund. The study included patients with hypertension aged at least 18 years who were initiated on R/A SPC or FEC of different dose combinations (R/A 5/5, 5/10, 10/5 and 10/10 mg) between 2012 and 2018, with follow-up for up to 60 months. Imbalances in baseline characteristics were reduced with propensity score-based sub-classification. All analyses were performed with Cox proportional hazard model and propensity score sub-classification to adjust the imbalances in baseline characteristics. Drug persistence and MACEs were the primary and secondary endpoints, respectively.

Results:

Overall, 104 882 patients with SPC and 68 324 patients with FEC-treated hypertension were included. The R/A 5/5 mg combination represented the largest proportion (62%). The nonpersistence rate was significantly lower with SPC than with FEC from month 1 to month 24 in the R/A 5/5 mg combination (P < 0.001) and during the entire observation period in the remaining combinations. The MACE rate was significantly reduced with all R/A SPCs versus FECs. No effects on age and sex on both endpoints were noted.

Conclusion:

This study further supports the beneficial effects of the use of SPC on 60-month persistence and MACEs in hypertension.
Kahook Dual Blade Goniotomy Versus iStent Implantation Combined With Phacoemulsification: A Systematic Review and Meta-Analysis
Authors: Guedes Jaime , Amaral Dillan Cunha , de Oliveira Caneca Karina , Cassins Aguiar Eduardo Henrique , de Oliveira Lucas Neves , Mora-Paez Denisse J. , Cyrino Laura Goldfarb , Louzada Ricardo Noguera , Moster Marlene R. , Myers Jonathan S. , Schuman Joel S. , Shukla Aakriti Garg , Shalaby Wesam Shamseldin
Published: December 2024

Précis:

In this meta-analysis, Kahook dual blade (KDB) goniotomy achieved higher rates of surgical success compared with iStent/iStent inject implantation combined with phacoemulsification. KDB goniotomy demonstrated better intraocular pressure (IOP) reduction at month 6 compared with the stent group.

Objective:

To compare the outcomes of phacoemulsification combined with either KDB goniotomy (phaco-KDB) or trabecular microbypass stent (iStent and iStent inject) implantation (phaco-Stent).

Methods:

A literature search was performed on PubMed, Embase, Web of Science, and Cochrane Library from inception to April 2024. Randomized clinical trials and observational studies that compared KDB goniotomy to the first or second-generation iStent combined with phacoemulsification were included. The main outcome measures were surgical success, mean change in IOP and medication number, and complication rates. Mean differences (MDs) and pooled odds ratios were used to analyze continuous and binary outcomes, respectively.

Results:

Fourteen studies were included with a total of 1959 eyes (958 phaco-KDB, and 1000 phaco-Stent including 753 phaco-iStent and 207 phaco-iStent inject). The combined findings showed significantly higher rates of surgical success in the phaco-KDB group versus the phaco-Stent group (odds ratio: 0.68; 95% CI: 0.50 to 0.92; P = 0.01; I
2= 40%), and greater IOP reduction in the phaco-KDB group versus the phaco-Stent group at month 6 (MD: 1.13 mm Hg; 95% CI: 0.43 to 1.83; P = 0.002; I
2= 51%). By month 12, both groups demonstrated similar IOP reduction. Subgroup analysis at month 12 showed greater IOP reduction in the phaco-KDB group versus the phaco-iStent group (MD: 1.69 mm Hg; 95% CI: 0.44 to 2.95; P = 0.008; I
2= 74%). However, compared with the phaco-iStent inject group, there was no significant difference in IOP reduction (MD: −0.72 mm Hg; 95% CI: −3.69 to 2.24; P = 0.63; I
2= 64%). Medication reduction and the incidence of adverse events were comparable between groups.

Conclusion:

KDB goniotomy may offer better surgical success compared with Stent implantation when used in combination with phacoemulsification. KDB goniotomy demonstrated better IOP reduction at month 12 compared with iStent. However, iStent inject showed a similar IOP reduction to KDB.
Predicting Health Access During Critical Public Health Crises
Authors: Zhong Nancy , Wohlars Kirsten , Lee-Wong Mary , Promisloff Robert , Mirsaidi Niloofar , Amsel Lawrence , Szema Anthony
Published: December 2024

Objectives

This study explores how ambulatory medical practices adapted their policies in response to the global COVID-19 crisis. Practice and provider characteristics were used to build an artificial intelligence model that predicts future medical practice closures during critical events.

Methods

We surveyed 261 outpatient medical practices and collected information on clinician age, gender, the protective measures implemented, closure status, and utilization of telemedicine services. These data were used to build an artificial intelligence model that predicts practice closure in future critical public health events.

Results

Responses varied by specialty, location, and physician characteristics. These factors predicted closure status in 85.45% of test cases.

Conclusions

This paper demonstrates that practice characteristics can assist in predicting medical practice responses to public health events.
Simplified ischemia-free liver transplantation by providing alternating flow of the portal vein and hepatic artery: Applicability, efficiency, and safety
Authors: Li Jiahao , Qin Meiting , Tang Yunhua , Dan Jia , Chen Honghui , Chen Huadi , Huang Jinbo , Yang Yongqi , Wang Tielong , Li Yefu , Chen Maogen , Ju Weiqiang , Wang Dongping , Guo Zhiyong , Tan Haidong , He Xiaoshun , Zhao Qiang
Published: December 2024

Conventional ischemia-free liver transplantation (CIFLT) represents a pioneering procedure that circumvents ischemia-reperfusion injury to livers throughout the transplant procedure. However, its complexity has limited its widespread adoption. This study introduced a simplified ischemia-free liver transplantation (SIFLT) technique by providing an alternating flow of the portal vein and hepatic artery, demonstrating its efficacy and safety. In this retrospective study, 32 patients who received SIFLT and 32 who received CIFLT were included between January 2021 and January 2024. The intraoperative and postoperative outcomes were collected and elevated. Patients who underwent SIFLT had a shorter anhepatic phase (44.0±2.4 vs. 51.6±2.4 min, p=0.03), along with a comparatively reduced intraoperative blood loss compared to those who underwent CIFLT. Furthermore, the SIFLT group exhibited significantly lower peak AST levels within postoperative 7 days (413.1±62.6 vs. 707.5±110.7 U/L, p=0.02). The incidence of early allograft dysfunction, primary nonfunction, and transplant-related complications were similar across both groups. There were no significant differences in the number of Clavien-Dindo classification of surgical complications and comprehensive complication index at 3 months after transplantation. Kaplan-Meier analysis confirmed similar patient and graft survival rates. The subgroup analysis of extended criteria donor demonstrated that SIFLT can effectively reduce anhepatic phase and intraoperative blood loss and can achieve a clinical prognosis similar to CIFLT. Additionally, histological analysis revealed that both groups demonstrated well-preserved livers and bile ducts. The SIFLT simplifies the intricate surgical procedure while ensuring the protection of livers from ischemia-reperfusion injury. This technique holds promise for enabling patients to achieve clinical outcomes comparable to those of CIFLT.
Activity-related dyspnea and exercise intolerance in chronic obstructive pulmonary disease: recent insights
Authors: James Matthew D. , Berton Danilo C. , Neder J. Alberto
Published: December 2024

Purpose of review

Exertional dyspnea and exercise intolerance remain key patient-related outcomes in chronic obstructive pulmonary disease (COPD). Improvement in treatment strategies is pendant further understand of their underpinnings across the spectrum of disease severity.

Recent findings

Emerging literature has been reviewed based on a conceptual framework that relates ventilatory demand to capacity under the modulating influence of sub-cortical and cortical centers (symptom perception and affective interpretation). Evidence supporting these fundamental tenets is critically appraised, focusing on mechanistic and interventional studies that shed novel light on the sources of heightened and/or mechanically constrained ventilation. Mechanistic studies using proxies of the inspiratory neural drive (e.g., diaphragm electromyography) were particularly informative, as well as interventional trials aimed at decreasing afferent stimulation and/or symptom perception via pharmacological (e.g., low-dose opiates in selected patients, high flow oxygen, oral nitrate) and nonpharmacological (e.g., novel exercise training paradigms, inspiratory muscle training, breathing techniques) interventions.

Therapeutic and rehabilitative strategies to lessen dyspnea's devastating impact on quality of life should minimize demand in the setting of reduced capacity and increased sensation awareness in COPD. The most successful attempts so far have amalgamated pharmacological and nonpharmacological approaches tailored to the main underlying mechanisms on an individual basis.
Effect of the allelic background on the phenotype of primary hyperoxaluria type I
Authors: Mandrile Giorgia , Cellini Barbara , Ferraro Pietro Manuel
Published: December 2024

Purpose of review

Primary hyperoxaluria type 1 (PH1) is an autosomal recessive disorder of hepatic glyoxylate metabolism leading to nephrolithiasis and kidney failure. PH1 is caused by mutations on the AGXT gene encoding alanine:glyoxylate aminotransferase (AGT). The AGXT gene has two haplotypes, the major (Ma) and the minor (mi) alleles. This review summarizes the role of the minor allele on the molecular pathogenesis and the clinical manifestations of PH1.

Recent findings

PH1 shows high genetic variability and significant interindividual variability. Although the minor haplotype is not pathogenic on its own, it may be crucial for the pathogenicity of some mutations or amplify the effect of others, thus affecting both symptoms and responsiveness to Vitamin B6, the only pharmacological treatment effective in a selected group of PH1 patients.

In the last years, new drugs based on RNA-interference are available for patients nonresponsive to Vitamin B6, but no specific biomarkers are available to predict disease course and severity. Therefore, a clinical assessment of PH1 taking into account molecular analysis of the mutations and the allelic background and the possible synergism among polymorphic and pathogenic variants should be encouraged to promote approaches of personalized medicine that improve the management of available resources.
The Impact of Hospice Care on the Prognosis, Quality of Life, and Emotional Well-being of Patients With Chronic Heart Failure
Authors: Liu Ping , Liao Xueyan
Published: December 2024

Chronic heart failure (CHF) represents a substantial public health challenge, impacting patients’ emotional well-being, quality of life, and overall prognosis. Palliative care and hospice services are increasingly recognized in managing advanced CHF, yet their evidence-based benefits remain underexplored. This study aimed to assess the influence of hospice care on CHF patient outcomes. A total of 120 inpatients with CHF were randomly assigned to receive either hospice care in addition to standard treatment (experimental group) or standard care alone (control group). Patient assessments included heart function classification, activities of daily living, Minnesota Living With Heart Failure Questionnaire, anxiety scale, and pain assessment. Results demonstrated significant improvements in cardiac function, activities of daily living, anxiety levels, pain scores, and heart failure–related quality of life in the experimental group compared with controls. Reduced anxiety, enhanced emotional well-being, and overall health status improvements were particularly notable postintervention. Hospice care was associated with enhanced functional abilities, emotional well-being, pain management, and overall quality of life for CHF patients. In conclusion, this study underscores hospice care’s positive impact on prognosis, quality of life, and emotional well-being in CHF, emphasizing its potential as a critical component in comprehensive CHF management strategies.
Virtual Reality as Active Distraction in Laceration Repair
Authors: McEvoy Anne O. , Vincent Olivia B. , Vazifedan Turaj , Chang Todd P. , Clingenpeel Joel M. , Kapoor Rupa
Published: December 2024

Objectives:

We conducted an unblinded, randomized control trial to determine if immersive virtual reality (VR) goggles decrease pain and fear scores in children undergoing laceration repair in the pediatric emergency department (PED) compared to the standard of care. Secondary outcomes included duration of procedure, physical holding, anxiolytic usage, and desire to use VR goggles again.

Methods:

Ninety-one patients aged 6-17 years in a PED with simple lacerations sutured by PED staff completed surveys. Eligible patients were randomized to receive either VR or standard of care. Guardians and providers also completed surveys. Self-reported pain scores were assessed by the Wong-Baker Faces Pain Scale and fear scores by Children's Fear Scale.

Results:

There were significant reductions in pain and fear scores for VR goggles compared to standard of care. Patients rated their mean pain score as 3.7 in controls and 2.3 in the VR group, and mean fear score of 3.0 and 2.2. The likelihood of physical holding was significantly lower among those who used VR goggles (adjusted odds ratio = 0.34, 95% confidence interval [0.13–0.92], P = 0.033). The likelihood of receiving anxiolytics was lower among the 12- to 17-year-olds (adjusted odds ratio = 0.27, 95% confidence interval [0.11–0.69], P = 0.006). There was no significant difference in the procedure duration (P = 0.06). A total of 97.9% of parents, 93.6% of patients, and 95.7% of providers would use VR again.

Conclusion:

Virtual reality goggles are an effective tool for distraction for simple laceration repairs. Their use leads to decreased pain and fear. Children who used VR goggles did not require to be held as often for sutures. There was no significant difference in anxiolytics or duration of procedure.
The impact of stroke impairment and phases in daily steps of stroke survivors living in community: a systematic review with meta-analysis
Authors: Guediri Amine , Mandigout Stéphane , Agbohessou Kokouvi Geovani , Daviet Jean-Christophe , Compagnat Maxence
Published: December 2024

Objectives

to provide detailed information about the number of steps taken by stroke survivors based on their level of impairment in order to guide recommendations for PA.

Design

A meta-analysis was conducted, including studies that assessed daily steps and stroke impairment in community-dwelling stroke patients. Participants were categorized into three groups based on stroke impairment severity (minor, minor and moderate, moderate and severe) and into two groups based on stroke phase (subacute and chronic).

Results

A total of 47 studies were included, encompassing 1749 participants. There were 494 in the minor stroke group, 1097 in the minor and moderate group, and 158 in the moderate and severe group. A significant difference in daily steps was observed across these groups (P < 0.01), with the first group averaging 4645 steps/day, the second 3610 steps/day, and the third 1990 steps/day. No significant difference was found between the subacute and chronic groups in terms of daily steps (3839 vs 3783 steps/day).

Conclusion

The study highlights the significant impact of stroke impairment on daily step count. We recommend implementing targeted interventions, particularly during the chronic phase, to increase PA levels in stroke survivors, tailored to the specific impairments of each patient.
Risk factors for cognitive decline in persons with HIV
Authors: Henderson Merle , Winston Alan
Published: December 2024

Purpose of review

Cognitive disorders persist in persons with HIV, despite virologically suppressive antiretroviral therapy. We summarize the current evidence on risk factors for cognitive decline in persons with HIV in the modern antiretroviral therapy-era.

Recent findings

Recent consensus recommendations have proposed a new approach for defining cognitive impairment in persons with HIV, which distinguishes true cognitive impairment from low cognitive performance alone and considers both HIV and non-HIV-associated causes of brain injury. Adverse mental health, risks associated with substance misuse, and an increasing burden of age-related comorbidities have been highlighted as important contributors toward cognitive decline in this population. Aging may potentiate these risk factors through polypharmacy and drug-drug interactions.

Cognitive decline in persons with HIV is likely multifactorial, with contributions from both HIV and non-HIV-associated mechanisms, particularly age-related comorbidities. With an aging community of persons with HIV, screening for risk factors associated with cognitive decline may be crucial to implement appropriate risk reduction strategies.
Early Detection of Basal Cell Carcinoma of Skin From Medical History
Authors: Lin Yili
Published: December 2024

Background and Objectives:

Basal cell carcinoma (BCC) is the most common form of skin cancer, originating from basal cells in the skin’s outer layer. It frequently arises from prolonged exposure to ultraviolet (UV) radiation from the sun or tanning beds. Although BCC rarely metastasizes, it can cause significant local tissue damage if left untreated. Early detection is essential to prevent extensive damage and potential disfigurement. The United States Preventive Services Task Force (USPSTF) currently remains uncertain about the benefits and potential harms of routine skin cancer screenings in asymptomatic individuals. This paper evaluates the accuracy of predicting BCC using patients’ medical histories to address this uncertainty and support early detection efforts.

Methods:

We analyzed the medical histories of 405,608 patients, including 7733 with BCC. We categorized 25,154 diagnoses into 16 body systems based on the hierarchy in the Systematized Nomenclature of Medicine (SNOMED) ontology. For each body system, we identified the most severe condition present. Logistic Least Absolute Shrinkage and Selection Operator (LASSO) regression was then employed to predict BCC, using demographic information, body systems, and pairwise and triple combinations of body systems, as well as missing value indicators. The dataset was split into 90% for training and 10% for validation. Model performance was evaluated using McFadden’s R2, Percentage Deviance Explained (PDE), and cross-validated with the area under the receiver operating characteristic curve (AUC).

Results:

Diagnoses related to the Integument system showed an 8-fold higher likelihood of being associated with BCC compared to diagnoses related to other systems. Older (age from 60 to 69) white individuals were more likely to receive a BCC diagnosis. After training the model, it achieved a McFadden’s R2 of 0.286, an AUC of 0.912, and a PDE of 28.390%, reflecting a high level of explained variance and prediction accuracy.

Conclusions:

This study underscores the potential of LASSO Regression models to enhance early identification of BCC. Extant medical history of patients, available in electronic health records, can accurately predict the risk of BCC. Integrating such predictive models into clinical practice could significantly improve early detection and intervention.
Point of Care Ultrasonography for the Evaluation of Ocular Emergencies
Authors: Gonzalez Juan Manuel , Ortega Johis , Snowden Kenya , Larrieu-Jimenez Patricia , Crenshaw Nichole , Nadeau Catherine , McGhee Stephen
Published: December 2024

Ocular point-of-care ultrasound (POCUS) has emerged as a pivotal tool in evaluating ocular emergencies in the emergency department (ED), addressing millions of annual visits for eye complaints in the United States. Compared to traditional imaging methods, ocular POCUS’s advantages include efficiency, repeatability, and safety. Adequate patient preparation, positioning, and transducer selection are essential for obtaining high-quality images. Ocular POCUS offers static and dynamic imaging,aiding in diagnosing conditions like retinal detachment and increased intracranial pressure. Emergency nurse practitioners (ENPs) can use ocular POCUS to expedite diagnosis and interventions, improving patient outcomes. Overall, ocular POCUS represents a rapid, non-invasive, and effective means of evaluating ocular emergencies in the ED, promising improved diagnostic accuracy, treatment initiation, and, ultimately, enhanced patient care.
A Study Analysing the Distribution and Determinants of Diabetic Macular Edema in a Tertiary Care Center
Authors: Priethikka M. S. , Chandrasekaran B. , Subha L , Chellakumar Vikram , Balakrishnan M , Solasa Deepthi
Published: December 2024

AIM

This study aims to examine the correlation between the specific type of diabetic macular edema (DME) identified using Optical Coherence Tomography (OCT) and various factors, including patient age, gender, diabetic profile (fasting blood sugars, postprandial blood sugars, and HbA1c), duration of Type 2 Diabetes Mellitus, and central macular thickness on OCT.

OBJECTIVE

The study intends to investigate the relationships between the age of patients and DME type, gender prevalence in DME, duration of Type 2 Diabetes Mellitus and DME type, diabetic profiles and DME type, central macular thickness and DME type, and severity of diabetic retinopathy and DME type.

Introduction

Diabetic maculopathy is a major cause of vision impairment in diabetic retinopathy. This study explores the relationship between DME types as determined by OCT and factors such as age, gender, diabetic profile, and diabetes duration.

Materials and Methods

Conducted over one year at a tertiary health care center, the study evaluated 95 patients with diabetic maculopathy through comprehensive clinical assessments including OCT classification of DME types.

Results

The findings indicated a higher prevalence of DME among males, predominantly in the 61- 70 age group. A significant association was found between diabetes duration and mixed-type DME. However, no significant correlations were observed between glycemic control measures (FBS, PPBS, HbA1c) and DME types.

Conclusion

The study underscores the importance of demographic and clinical factors in understanding variations in DME types, highlighting the need for tailored management strategies to reduce vision loss risk in diabetic patients.