bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical Impact of a Protocol Involving Cone-Beam CT (CBCT), Fusion Imaging and Ablation Volume Prediction in Percutaneous Image-Guided Microwave Ablation in Patients with Hepatocellular Carcinoma Unsuitable for Standard Ultrasound (US) Guidance
Authors: Biondetti Pierpaolo , Ierardi Anna Maria , Casiraghi Elena , Caruso Alessandro , Grillo Pasquale , Carriero Serena , Lanza Carolina , Angileri Salvatore Alessio , Sangiovanni Angelo , Iavarone Massimo , Guzzardi Giuseppe , Carrafiello Gianpaolo
Published: December 2023

Purpose: to evaluate the clinical impact of a protocol for the image-guided percutaneous microwave ablation (MWA) of hepatocellular carcinoma (HCC) that includes cone-beam computed tomography (CBCT), fusion imaging and ablation volume prediction in patients with hepatocellular carcinoma unsuitable for standard ultrasound (US) guidance. Materials and Methods: this study included all patients with HCC treated with MWA between January 2021 and June 2022 in a tertiary institution. Patients were divided into two groups: Group A, treated following the protocol, and Group B, treated with standard ultrasound (US) guidance. Follow-up images were reviewed to assess residual disease (RD), local tumor progression (LTP) and intrahepatic distant recurrence (IDR). Ablation response at 1 month was also evaluated according to mRECIST. Baseline variables and outcomes were compared between the groups. For 1-month RD, propensity score weighting (PSW) was performed. Results: 80 consecutive patients with 101 HCCs treated with MWA were divided into two groups. Group A had 41 HCCs in 37 patients, and Group B had 60 HCCs in 43 patients. Among all baseline variables, the groups differed regarding their age (mean of 72 years in Group A and 64 years in Group B, respectively), new vs. residual tumor rates (48% Group A vs. 25% Group B, p < 0.05) and number of subcapsular tumors (56.7% Group B vs. 31.7% Group A, p < 0.05) and perivascular tumors (51.7% Group B vs. 17.1% Group A, p < 0.05). The protocol led to repositioning the antenna in 49% of cases. There was a significant difference in 1-month local response between the groups measured as the RD rate and mRECIST outcomes. LTP rates at 3 and 6 months, and IDR rates at 1, 3 and 6 months, showed no significant differences. Among all variables, logistic regression after PSW demonstrated a protective effect of the protocol against 1-month RD. Conclusions: The use of CBCT, fusion imaging and ablation volume prediction during percutaneous MWA of HCCs provided a better 1-month tumor local control. Further studies with a larger population and longer follow-up are needed.
Early Initiation of Adalimumab Significantly Diminishes Postoperative Crohn’s Disease Endoscopic Recurrence and Is Superior to 6-Mercaptopurine Therapy: An Open-Label, Randomized Controlled Study
Authors: Hirsch Ayal , Scapa Erez , Fliss-Isakov Naomi , Tulchinsky Hagit , Itzkowitz Eran , Kariv Yehuda , Ron Yulia , Yanai Henit , White Ian , Yassin Sharief , Cohen Nathaniel Aviv , Brazovski Eli , Dotan Iris , Maharshak Nitsan
Published: December 2023

Postoperative recurrence (POR) is the rule in patients with Crohn’s disease (CD), mitigated with prophylactic therapy. The evidence for therapeutic choice and timing of intervention is lacking. We aimed to compare the rates of POR in patients treated early with prophylactic 6-mercaptopurine (6-MP) or adalimumab. We conducted a prospective single-center randomized open-label clinical study in which patients in surgical remission following their first ileocecectomy were randomized to receive early treatment with 6-MP or adalimumab. Patients were followed up clinically every 3 months and underwent endoscopy at weeks 32 and 58 postoperatively. The primary endpoint was endoscopic recurrence (ePOR) at 1 year (week 58), defined as a Rutgeerts score ≥ i2. We enrolled 35 patients (25 males, mean age 35 ± 1.4 years, median disease duration 5 ± 6.1 years) following ileocecectomy. Of these, seven (20%) were current smokers and nine (26%) biologics-experienced. Patients allocated to adalimumab had significantly less ePOR than patients treated with 6MP at week 32 (21% vs. 69%, p = 0.004) and 58 (47% vs. 75%), (p = 0.03, HR = 0.39, 95% CI = 0.16–0.93). POR was associated with an increased diameter of the resected small bowel surgical specimen, lower baseline body mass index (BMI), increased week 18 fecal calprotectin, increased week 18 serum alanine aminotransferase and decreased week 18 hemoglobin level. Adalimumab was more effective than 6-MP in preventing ePOR. Increased operative small bowel diameter and lower postoperative BMI were associated with ePOR. At eighteen weeks, serum hemoglobin, ALT and fecal calprotectin levels were predictive of endoscopic disease recurrence. (ClinicalTrials.gov ID NCT01629628).
Test Bench for Right Ventricular Failure Reversibility: The Hybrid BiVAD Concept
Authors: Tarzia Vincenzo , Ponzoni Matteo , Pittarello Demetrio , Gerosa Gino
Published: December 2023

Background: When heart transplantation and myocardial recovery are unlikely, patients presenting with biventricular cardiogenic shock initially treated with extracorporeal membrane oxygenation (ECMO) may benefit from a mechanical support upgrade. In this scenario, a micro-invasive approach is proposed: the combination of the double-lumen ProtekDuo cannula (Livanova, London, UK) and the Impella 5.5 (Abiomed, Danvers, MA) trans-aortic pump that translates into a hybrid BiVAD. Methods: All consecutive ECMO patients presenting with biventricular cardiogenic shock and ineligibility to heart transplantation from August 2022 were prospectively enrolled. The clinical course, procedural details, and in-hospital events were collected via electronic medical records. Results: A total of three patients, who were temporarily not eligible for heart transplantation or durable LVAD due to severe acute pneumonia and right ventricular (RV) dysfunction, were implanted with a hybrid BiVAD. This strategy provided high-flow biventricular support while pulmonary function ameliorated. Moreover, by differentially sustaining the systemic and pulmonary circulation, it allowed for a more adequate reassessment of RV function. All the patients were considered eligible for isolated durable LVAD and underwent less invasive LVAD implantation paired with a planned postoperative RVAD. In all cases, RV function gradually recovered and the RVAD was successfully removed. Conclusions: The Hybrid BiVAD represents an up-to-date micro-invasive mechanical treatment of acute biventricular failure beyond ECMO. Its rationale relies on more physiological circulation across the lungs, the complete biventricular unloading, and the possibility of including an oxygenator in the circuit. Finally, the independent and differential control of pulmonary and systemic flows allows for more accurate RV function evaluation for isolated durable LVAD eligibility reassessment.
Lights and Shadows of Clinical Applications of Cardiac Scintigraphy with Bone Tracers in Suspected Amyloidosis
Authors: Saro Riccardo , Pavan Daniela , Porcari Aldostefano , Sinagra Gianfranco , Mojoli Marco
Published: December 2023

Radionuclide bone scintigraphy is the cornerstone of an imaging-based algorithm for accurate non-invasive diagnosis of transthyretin cardiac amyloidosis (ATTR-CA). In patients with heart failure and suggestive echocardiographic and/or cardiac magnetic resonance imaging findings, the positive predictive value of Perugini grade 2 or 3 myocardial uptake on a radionuclide bone scan approaches 100% for the diagnosis of ATTR-CA as long as there is no biochemical evidence of a clonal dyscrasia. The technetium-labelled tracers that are currently validated for non-invasive diagnosis of ATTR-CA include pyrophosphate (99mTc-PYP); hydroxymethylene diphosphonate (99mTc-HMDP); and 3,3-diphosphono-1,2-propanodicarboxylate (99mTc-DPD). Although nuclear scintigraphy has transformed the contemporary diagnostic approach to ATTR-CA, a number of grey areas remains, including the mechanism for binding tracers to the infiltrated heart, differences in the kinetics and distribution of these radiotracers, differences in protocols of image acquisition worldwide, the clinical significance of extra-cardiac uptake, and the use of this technique for prognostic stratification, monitoring disease progression and assessing the response to disease-modifying treatments. This review will deal with the most relevant unmet needs and clinical questions concerning scintigraphy with bone tracers in ATTR-CA, providing expert opinions on possible future developments in the clinical application of these radiotracers in order to offer practical information for the interpretation of nuclear images by physicians involved in the care of patients with this ATTR-CA.
Modulating the Gut Microbiome in Multiple Sclerosis Management: A Systematic Review of Current Interventions
Authors: Tsogka Anthi , Kitsos Dimitrios K. , Stavrogianni Konstantina , Giannopapas Vasileios , Chasiotis Athanasios , Christouli Niki , Tsivgoulis Georgios , Tzartos John S. , Giannopoulos Sotirios
Published: December 2023

This review attempted to explore all recent clinical studies that have investigated the clinical and autoimmune impact of gut microbiota interventions in multiple sclerosis (MS), including dietary protocols, probiotics, fecal microbiota transplantation (FMT), and intermittent fasting (IF). Methods: Thirteen studies were held between 2011 and 2023 this demonstrated interventions in gut microbiome among patients with MS and their impact the clinical parameters of the disease. These included specialized dietary interventions, the supply of probiotic mixtures, FMT, and IF. Results: Dietary interventions positively affected various aspects of MS, including relapse rates, EDSS disability scores, MS-related fatigue, and metabolic features. Probiotic mixtures showed promising results on MS-related fatigue, EDSS parameters, inflammation; meanwhile, FMT—though a limited number of studies was included—indicated some clinical improvement in similar variables. IF showed reductions in EDSS scores and significant improvement in patients’ emotional statuses. Conclusions: In dietary protocols, clinical MS parameters, including relapse rate, EDSS, MFIS, FSS, and MSQoL54 scales, were significantly improved through the application of a specific diet each time. Probiotic nutritional mixtures promote a shift in inflammation towards an anti-inflammatory cytokine profile in patients with MS. The administration of such mixtures affected disability, mood levels, and quality of life among patients with MS. FMT protocols possibly demonstrate a therapeutic effect in some case reports. IF protocols were found to ameliorate EDSS and FAMS scores. All interventional means of gut microbiome modulation provided significant conclusions on several clinical aspects of MS and highlight the complexity in the relationship between MS and the gut microbiome.
Changes in Sleep in Children and Adults with Cystic Fibrosis and Primary Ciliary Dyskinesia over Time and after CFTR Modulator Therapy
Authors: Cohen-Cymberknoh Malena , Lehavi Maya , Gileles-Hillel Alex , Atia Ohad , Breuer Oded , Reiter Joel
Published: December 2023

Cystic fibrosis (CF) and primary ciliary dyskinesia (PCD) are associated with sleep disturbances affecting quality of life (QOL) in both children and adults. However, little is known about the progression of these complaints over time, and the effect of CFTR modulator (CFTRm) therapies. Participants completed sleep quality (SDSC, PSQI) and quality of life questionnaires (PedQL, QOL-BE) as well as the Epworth sleepiness scale (ESS) at baseline and after 4 years. Medical records were reviewed for clinical data and correlations were sought between sleep, QOL, and clinical parameters. A total of 67 patients (33 pediatric), 37 pancreatic insufficient CF (CF-PI), 15 pancreatic sufficient CF (CF-PS), and 15 PCD patients, completed the study. In adults, global sleep quality decreased from 85.8% (76.2–90.5) to 80.9% (71.4–85.7); (p = 0.009). Analysis by disease cohort showed a significant deterioration only in the CF-PS group. In adults off CFTRm, sleep quality decreased from 85.7% (78.6–88.2) to 80.9% (71.4–87.3); (p = 0.021) and from 85.8% (76.2–92.9) to 76.2% (71.4–85.8); (p = 0.078) in people on CFTRm. Changes in sleep quality and changes in QOL over time were strongly associated with each other. In conclusion sleep quality deteriorates over time, correlates with QOL, and is driven primarily by adults and CF-PS patients. CFTRm has a possible effect on sleep initiation; however, results are mixed, and further long-term studies are required.
Stepwise Approach for Transvenous Lead Extraction in a Large Single Centre Cohort
Authors: Kloppe Axel , Fischer Julian , Aweimer Assem , Schöne Dominik , El-Battrawy Ibrahim , Hanefeld Christoph , Mügge Andreas , Schiedat Fabian
Published: December 2023

Background: Infection, lead dysfunction and system upgrades are all reasons that transvenous lead extraction is being performed more frequently. Many centres focus on a single method for lead extraction, which can lead to either lower success rates or higher rates of major complications. We report our experience with a systematic approach from a less invasive to a more invasive strategy without the use of laser sheaths. Methods: Consecutive extraction procedures performed over a period of seven years in our electrophysiology laboratory were included. We performed a stepwise approach with careful traction, lead locking stylets (LLD), mechanical non-powered dilator sheaths, mechanical powered sheaths and, if needed, femoral snares. Results: In 463 patients (age 69.9 ± 12.3, 31.3% female) a total of 780 leads (244 ICD leads) with a mean lead dwelling time of 5.4 ± 4.9 years were identified for extraction. Success rates for simple traction, LLD, mechanical non-powered sheaths and mechanical powered sheaths were 31.5%, 42.7%, 84.1% and 92.6%, respectively. A snare was used for 40 cases (as the primary approach for 38 as the lead structure was not intact and stepwise approach was not feasible) and was successful for 36 leads (90.0% success rate). Total success rate was 93.1%, clinical success rate was 94.1%. Rate for procedural failure was 1.1%. Success for less invasive steps and overall success for extraction was associated with shorter lead dwelling time (p < 0.001). Major procedure associated complications occurred in two patients (0.4%), including one death (0.2%). A total of 36 minor procedure-associated complications occurred in 30 patients (6.5%). Pocket hematoma correlated significantly with uninterrupted dual antiplatelet therapy (p = 0.001). Pericardial effusion without need for intervention was associated with long lead dwelling time (p = 0.01) and uninterrupted acetylsalicylic acid (p < 0.05). Conclusion: A stepwise approach with a progressive invasive strategy is effective and safe for transvenous lead extraction.
CT Coronary Angiography: Technical Approach and Atherosclerotic Plaque Characterization
Authors: Dell’Aversana Serena , Ascione Raffaele , Vitale Raffaella Antonia , Cavaliere Fabrizia , Porcaro Piercarmine , Basile Luigi , Napolitano Giovanni , Boccalatte Marco , Sibilio Gerolamo , Esposito Giovanni , Franzone Anna , Di Costanzo Giuseppe , Muscogiuri Giuseppe , Sironi Sandro , Cuocolo Renato , Cavaglià Enrico , Ponsiglione Andrea , Imbriaco Massimo
Published: December 2023

Coronary computed tomography angiography (CCTA) currently represents a robust imaging technique for the detection, quantification and characterization of coronary atherosclerosis. However, CCTA remains a challenging task requiring both high spatial and temporal resolution to provide motion-free images of the coronary arteries. Several CCTA features, such as low attenuation, positive remodeling, spotty calcification, napkin-ring and high pericoronary fat attenuation index have been proved as associated to high-risk plaques. This review aims to explore the role of CCTA in the characterization of high-risk atherosclerotic plaque and the recent advancements in CCTA technologies with a focus on radiomics plaque analysis.
Understanding Post-Esophagectomy Complications and Their Management: The Early Complications
Authors: Edmondson Jenifer , Hunter John , Bakis Gennadiy , O’Connor Amber , Wood Stephanie , Qureshi Alia P.
Published: December 2023

Esophagectomy is a technically complex operation performed for both benign and malignant esophageal disease. Medical and surgical advancements have led to improved outcomes in esophagectomy patients over the past several decades; however, surgeons must remain vigilant as complications happen often and can be severe. Post-esophagectomy complications can be grouped into early and late categories. The aim of this review is to discuss the early complications of esophagectomy along with their risk factors, work-up, and management strategies with special attention given to anastomotic leaks.
Frailty in Traumatic Brain Injury—The Significance of Temporal Muscle Thickness
Authors: Dubinski Daniel , Won Sae-Yeon , Meyer-Wilmes Jonas , Trnovec Svorad , Rafaelian Artem , Behmanesh Bedjan , Cantré Daniel , Baumgarten Peter , Dinc Nazife , Konczalla Juergen , Wittstock Matthias , Bernstock Joshua D. , Freiman Thomas M. , Gessler Florian
Published: December 2023

Background: Temporal muscle thickness (TMT) on cranial CT scans has recently been identified as a prognostic imaging parameter for assessing a patient’s baseline frailty. Here, we analyzed whether TMT correlates with Traumatic brain injury (TBI) severity and whether it can be used to predict outcome(s) after TBI. Methods: We analyzed the radiological and clinical data sets of 193 patients with TBI who were admitted to our institution and correlated the radiological data with clinical outcomes after stratification for TMT. Results: Our analyses showed a significant association between high TMT and increased risk for intracranial hemorrhage (p = 0.0135) but improved mRS at 6 months (p = 0.001) as compared to patients with low TMT. Congruent with such findings, a lower TMT was associated with falls and reduced outcomes at 6 months (p < 0.0001 and p < 0.0001). Conclusion: High TMT was robustly associated with head trauma sequelae but was also associated with good clinical outcomes in TBI patients. These findings consolidate the significance of TMT as an objective marker of frailty in TBI patients; such measurements may ultimately be leveraged as prognostic indicators.
Somatotype Analysis of International Football Players with Cerebral Palsy: A Comparison with Non-Disabled Football Players
Authors: Doménech Carmen , Roche Enrique , Reina Raul , Sarabia José Manuel
Published: December 2023

Football for people with cerebral palsy is a para-sport involving ambulant athletes with impairments, such as hypertonia, ataxia, or athetosis. The objective of the present study was to describe the somatotype of a representative sample of international football players according to different functional profiles of cerebral palsy, including spastic diparesis, athetosis/ataxia, spastic hemiparesis, and minimum impairment criteria, and to compare it with non-disabled football players. A total of 144 international para-footballers and 39 non-disabled footballers participated in the study, and their somatotype was calculated using anthropometric measurements. A Kruskal–Wallis test was used to compare the groups to determine and assess the differences between the different functional profiles, and the analysis of anthropometric variables and body composition showed no differences. Regarding somatotype, a predominance of the mesomorphic component was observed in all subgroups, and differences in somatotype were also found between non-disabled footballers and para-footballers with spastic hemiparesis and minimum impairment criteria. This study suggests that there may be a degree of homogeneity in terms of somatotype among footballers with or without physical impairments, such as hypertonia, athetosis, or ataxia. Furthermore, it provides reference values of international-level para-football players for the different sport classes, which can help coaches and trainers monitor athletes’ physical conditions.
Small Microplastics: A yet Unknown Threat in the Svalbard (Norway) Region
Authors: Caruso Gabriella , Iannilli Valentina , Vitale Giulia , Vardè Massimiliano , Oliverio Marco , Bogialli Sara , Litti Lucio , Setini Andrea , Rosso Beatrice , Corami Fabiana
Published: December 2023

The Arctic Ocean is undergoing several transformations because of global climate change. Small microplastics (SMPs) or nanoplastics (NPs) carried by marine aerosols may settle in the land ice and be released to the waters, produced following its melting. As sea ice extent reduces and shipping and fishing activities increase, microplastics (MPs) may enter the region following ocean and maritime transports, with implications on Arctic biota, human health, and socioeconomic issues related to the exploitation of marine resources. First analyses on amphipods collected in Ny-Ålesund confirmed the presence of SMPs. Nevertheless, the threat posed by SMPs/NPs to polar biota and regional human health is not fully understood. This article addresses this issue and the need for organisms as potential bioindicators of plastic pollution, which is currently being carried out in the Svalbard region under the framework of the MICROTRACER project funded by the Italian Arctic Research Program (PRA, Call 2021). The outputs of this research are expected to contribute to deepening the current knowledge of SMPs in Svalbard, providing new insights on their occurrence, distribution, and transfer through the marine trophic web, to realize effective control and regulatory framework measures to implement an integrated multidisciplinary approach for monitoring and to reduce MPs pollution in this fragile polar environment.
Adaptive Fuzzy Quantized Control for a Cooperative USV-UAV System Based on Asynchronous Separate Guidance
Authors: Xing Yingshuo , Zhang Guoqing , Li Jiqiang
Published: December 2023

This paper focuses predominantly on the multi-tasks carried out by the cooperative unmanned surface vehicle-unmanned aerial vehicle (USV-UAV) system in which the input quantization is considered. The proposed cooperative scheme consists of the asynchronous separate guidance and adaptive fuzzy quantized control algorithm. The proposed guidance law takes full advantage of subsystems whilst considering the maneuverability of these subsystems in order to achieve the goal of executing multi-tasks. In contrast to previous guidance laws, although the same waypoint path is planned, the calculation for guidance law proposed is based on speed rather than time, which in reality is more relevant. As for the controls, an adaptive fuzzy quantized controller was developed to reduce undue exertion on the actuator. By fusing the dynamic surface control (DSC) and fuzzy logic system (FLS), a hysteresis quantizer has been introduced to reduce the transmission load. By properly adjusting the quantization density, the number of quantizations was reduced whilst maintaining a favorable control performance. All of the stated variables are semi-global uniform ultimate bounded (SGUUB) and the stability of the USV-UAV system is proofed through the Lyapunov theorem. Finally, the advantages of the proposed scheme are evaluated by two simulative experiments, exhibiting the favorable tracking accuracy and reduced wear on the actuators.
COLREGs-Based Path Planning for USVs Using the Deep Reinforcement Learning Strategy
Authors: Wen Naifeng , Long Yundong , Zhang Rubo , Liu Guanqun , Wan Wenjie , Jiao Dian
Published: December 2023

This research introduces a two-stage deep reinforcement learning approach for the cooperative path planning of unmanned surface vehicles (USVs). The method is designed to address cooperative collision-avoidance path planning while adhering to the International Regulations for Preventing Collisions at Sea (COLREGs) and considering the collision-avoidance problem within the USV fleet and between USVs and target ships (TSs). To achieve this, the study presents a dual COLREGs-compliant action-selection strategy to effectively manage the vessel-avoidance problem. Firstly, we construct a COLREGs-compliant action-evaluation network that utilizes a deep learning network trained on pre-recorded TS avoidance trajectories by USVs in compliance with COLREGs. Then, the COLREGs-compliant reward-function-based action-selection network is proposed by considering various TS encountering scenarios. Consequently, the results of the two networks are fused to select actions for cooperative path-planning processes. The path-planning model is established using the multi-agent proximal policy optimization (MAPPO) method. The action space, observation space, and reward function are tailored for the policy network. Additionally, a TS detection method is introduced to detect the motion intentions of TSs. The study conducted Monte Carlo simulations to demonstrate the strong performance of the planning method. Furthermore, experiments focusing on COLREGs-based TS avoidance were carried out to validate the feasibility of the approach. The proposed TS detection model exhibited robust performance within the defined task.
Numerical Study on the Responses of Suction Pile Foundations under Horizontal Cyclic Loading Considering the Soil Stiffness Degradation
Authors: Wang Yin , Qi Zhen , Wei Tongzhong , Bao Junji , Zhang Xun , Zhou Yansheng
Published: December 2023

This paper analyzes the deformation responses of single-cylinder and four-cylinder suction pile foundations in soft clay under horizontal cyclic loading. Based on the existing stiffness degradation model of soft clay, a more suitable model for marine soft clay is proposed by carrying out dynamic triaxial experiments under different stress levels. The stiffness degradation and cumulative displacement of soil under cyclic loading are implemented in ABAQUS by compiling a USDFLD subroutine. The rationality is verified by comparison with the displacement response of the pile measured by the centrifugal model test and the scaled model test reported in the literature. With the aid of the current model, the stress state and deformation of suction pile foundations under horizontal cyclic load are further analyzed. The numerical results reveal the path of soil stiffness degradation and the deformation response of foundations during horizontal cycling. The cumulative displacement generated by the cyclic load is quantitatively displayed. It is proved that this model has the capability to reflect the cumulative displacement under cyclic loading and shows promise in analyzing the long-term deformation response of offshore foundations.
A Study on the Vibration Analysis of Thick-Walled, Fluid-Conveying Pipelines with Internal Hydrostatic Pressure
Authors: Zhu Hongzhen , Wu Jianghai
Published: December 2023

Pipelines are designed to carry seawater with hydrostatic pressure below sea level in the ship industry. Previously conducted studies have established the FSI (Fluid–Structure Interaction) equations for thin-walled, fluid-filled pipelines based on the Timoshenko beam model; these equations now need to be modified for analyzing the vibration characteristics of thick-walled pipelines with hydrostatic pressure. The vibration of thick-walled pressurized pipes is studied in this paper. Effective and accurate numerical methods for solving vibration responses to either harmonic excitation or a random load have been developed using the spectral element method and pseudo-excitation method. It is found that the thick-walled theory and the thin-walled theory differ in axial wave transmissions. The internal pressure mainly affects the transverse vibration, which results in an increase in the natural frequencies in the lower frequency domain, an increase in the vibration transmission in the assembled pipeline, and an increase in the displacements when subjected to random loads. Using relatively thicker pipelines and introducing flexible pipes may reduce the vibration transmission when subjected to internal pressure.
Numerical and Experimental Investigation of the Dynamics of a U-Shaped Sloshing Tank to Increase the Performance of Wave Energy Converters
Authors: Fontana Marco , Giorgi Giuseppe , Accardi Massimiliano , Giorcelli Ermanno , Brizzolara Stefano , Sirigu Sergej Antonello
Published: December 2023

In this investigation, a comprehensive study was conducted on a U-shaped sloshing tank, based on reversing the classical treatment of such devices as motion stabilizers and using them instead to improve the performance of wave energy converters. The modeling encompasses a comparative analysis between a linear model and Computational Fluid Dynamics (CFD) simulations. The validation of the CFD methodology was rigorously executed via a series of experimental tests, subsequently enhancing the linear model. The refined linear model demonstrates a notable alignment with rigorously verified results, thus establishing itself as a reliable tool for advanced research, indicating promise for various applications. Furthermore, this novelty is addressed by simulating the integration of a U-tank device with a pitch-based wave energy converter, displaying a broadening of the operational bandwidth and a substantial performance improvement, raising the pitch motion of the floater to about 850% in correspondence with the new secondary peak over extended periods, effectively addressing previously identified limitations. This achievement contributes to the system’s practical relevance in marine energy conversion.
Artificial Intelligence in Scoliosis Classification: An Investigation of Language-Based Models
Authors: Fabijan Artur , Polis Bartosz , Fabijan Robert , Zakrzewski Krzysztof , Nowosławska Emilia , Zawadzka-Fabijan Agnieszka
Published: December 2023

Open-source artificial intelligence models are finding free application in various industries, including computer science and medicine. Their clinical potential, especially in assisting diagnosis and therapy, is the subject of increasingly intensive research. Due to the growing interest in AI for diagnostics, we conducted a study evaluating the abilities of AI models, including ChatGPT, Microsoft Bing, and Scholar AI, in classifying single-curve scoliosis based on radiological descriptions. Fifty-six posturographic images depicting single-curve scoliosis were selected and assessed by two independent neurosurgery specialists, who classified them as mild, moderate, or severe based on Cobb angles. Subsequently, descriptions were developed that accurately characterized the degree of spinal deformation, based on the measured values of Cobb angles. These descriptions were then provided to AI language models to assess their proficiency in diagnosing spinal pathologies. The artificial intelligence models conducted classification using the provided data. Our study also focused on identifying specific sources of information and criteria applied in their decision-making algorithms, aiming for a deeper understanding of the determinants influencing AI decision processes in scoliosis classification. The classification quality of the predictions was evaluated using performance evaluation metrics such as sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy, and balanced accuracy. Our study strongly supported our hypothesis, showing that among four AI models, ChatGPT 4 and Scholar AI Premium excelled in classifying single-curve scoliosis with perfect sensitivity and specificity. These models demonstrated unmatched rater concordance and excellent performance metrics. In comparing real and AI-generated scoliosis classifications, they showed impeccable precision in all posturographic images, indicating total accuracy (1.0, MAE = 0.0) and remarkable inter-rater agreement, with a perfect Fleiss’ Kappa score. This was consistent across scoliosis cases with a Cobb’s angle range of 11–92 degrees. Despite high accuracy in classification, each model used an incorrect angular range for the mild stage of scoliosis. Our findings highlight the immense potential of AI in analyzing medical data sets. However, the diversity in competencies of AI models indicates the need for their further development to more effectively meet specific needs in clinical practice.
Transcriptomic Analysis of Tight Junction Proteins Demonstrates the Aberrant Expression and Function of Zona Occludens 2 (ZO-2) Protein in Stanford Type A Aortic Dissection
Authors: Magouliotis Dimitrios E. , Arjomandi Rad Arian , Kourliouros Antonios , Viviano Alessandro , Koulouroudias Marinos , Salmasi Mohammad Yousuf , Briasoulis Alexandros , Triposkiadis Filippos , Skoularigis John , Athanasiou Thanos
Published: December 2023

Objective: Thoracic aortic aneurysm dissection (TAAD) represents a cardiac surgery emergency characterized by the disrupted integrity of the aortic wall and is associated with poor prognosis. In this context, the identification of biomarkers implicated in the pathobiology of TAAD is crucial. Our aim in the present original in silico study is to assess the differential gene expression profile of the tight junction proteins (TJPs) in patients with TAAD and to propose novel biomarkers for the diagnosis and prognosis of this disease. Methods: We implemented bioinformatics methodology in order to construct the gene network of the TJPs family, identify the differentially expressed genes (DEGs) in pathologic aortic tissue excised from patients with TAAD as compared to healthy aortic tissue, and assess the related biological functions and the associated miRNA families. Results: Data regarding the transcriptomic profile of selected genes were retrieved and incorporated from three microarray datasets, including 23 TAAD and 20 healthy control samples. A total of 32 TJPs were assessed. The zona occludens 2 (ZO-2) protein encoded by the gene TJP2 was significantly under-expressed in patients with TAAD compared to the control group (p = 0.009). ZO-2 was associated with fair discrimination and calibration traits in predicting the TAAD presentation. CpG islands of ZO-2 were demonstrated. No important difference was found regarding ZO-2 expression between aneurysmal non-dissected and healthy control aortic tissue. Finally, we performed gene set enrichment analysis (GSEA) and uncovered the major biological functions and miRNA families (hsa-miR-155-5p, hsa-miR-1-3p, hsa-miR-2118-5p, hsa-miR-4691-3p, and hsa-miR-1229-3p) relevant to ZO-2. Conclusions: These outcomes demonstrated the important role of ZO-2 in the pathobiology of TAAD.
REAC Reparative Treatment: A Promising Therapeutic Option for Alcoholic Cirrhosis of the Liver
Authors: Pereira Lizomar de Jesus Maués , Pereira José Alfredo Coelho , Fontani Vania , Rinaldi Salvatore
Published: December 2023

Alcoholic liver disease (ALD) is a significant global health concern associated with excessive alcohol consumption. ALD encompasses various liver conditions with complex pathogenesis and progression influenced by environmental, genetic, and epigenetic factors. Alcoholic cirrhosis of the liver (ALC) is particularly prevalent among socially disadvantaged individuals, and current pharmacotherapy options provide limited treatment. This study aims to explore the potential benefits of radio electric asymmetric conveyer (REAC) technology and its tissue optimization reparative treatment (TO-RPR) in managing ALC. The liver possesses remarkable regenerative capabilities closely tied to its bioelectrical properties. REAC TO-RPR is a novel biotechnological therapeutic approach that aims to enhance and expedite reparative processes in injured tissues by restoring disrupted cellular endogenous bioelectric fields. This study seeks to optimize understanding of REAC TO-RPR’s impact on liver function and clinical outcomes in ALC patients. By investigating the mechanisms underlying liver’s reparative abilities and evaluating the efficacy of REAC TO-RPR, this research aims to address the urgent need for improved interventions in managing ALC. The findings hold potential for developing innovative treatment approaches, improving patient outcomes, and reducing the societal and individual burden associated with ALC.
Do Aid for Trade Flows Affect Technology Licensing in Recipient Countries?
Authors: Gnangnon Sèna Kimm
Published: December 2023

There is an abundant literature on the economic (including trade) effects of Aid for Trade (AfT) flows. However, little attention has been devoted to the effect of AfT flows on demand for technology licensing. The present article aims to fill this void in the literature by investigating the effect of AfT flows on technology licensing in developing countries. The analysis has used an unbalanced panel dataset of 77 countries over the period from 2002 to 2019 and mainly the two-step generalized method of moments estimator. It has been established that AfT flows foster technology licensing in countries that experience lower trade costs. In addition, the analysis has revealed that adverse environmental and external (economic and financial) shocks significantly hamper innovation, including the demand for technology licensing, and that AfT flows promote technology licensing in countries that experience lower magnitudes of such shocks. Finally, AfT flows foster technology licensing in countries that diversify export products.
How Can Plants Help Restore Degraded Tropical Soils?
Authors: Massoukou Pamba Renaud , Poirier Vincent , Nguema Ndoutoumou Pamphile , Epule Terence Epule
Published: December 2023

In the tropics, anthropogenic activities can lead to water and wind erosion, a loss of biodiversity, and a reduction in sequestered carbon, fertility, and organic matter content in the soils concerned, potentially resulting in their degradation. This study therefore aims to identify the mechanisms used by plant species to restore degraded tropical soils and plant species characteristics that are best suited to achieve this through a critical scoping review of the peer-reviewed literature. Soil restoration leads to the re-establishment of ecosystem services and an increase in soil production potential, the regeneration of biodiversity, the stopping of organic matter losses, and the creation of favorable conditions for carbon sequestration and nitrogen fixation. The choice of appropriate plant species depends on the restoration objectives to be achieved. Five key mechanisms by which plant species contribute to restore degraded tropical soils include: (1) nitrogen fixation, (2) carbon sequestration, (3) organic matter addition, (4) structure stabilization, and (5) erosion control. The main characteristics of plant species and vegetation involved in these mechanisms are (a) the capacity to form symbiotic associations with N-fixing bacteria and mycorrhizae, (b) the production of abundant root biomass releasing litter and exudates, (c) roots having a high length density, branching intensity, and depth distribution, (d) the production of an abundant and easily decomposed above ground litter, (e) the production of a vast canopy, and (f) the presence of different vegetation strata. Targeting these characteristics will contribute to acting on several mechanisms simultaneously, which will increase the chance of success in tropical soil restoration.
Dynamic Impact of Urban Built Environment on Land Surface Temperature Considering Spatio-Temporal Heterogeneity: A Perspective of Local Climate Zone
Authors: Zhao Kaixu , Qi Mingyue , Yan Xi , Li Linyu , Huang Xiaojun
Published: December 2023

Thermal environment deterioration has seriously threatened urban habitat quality and urban sustainable development. The evolution of the urban built environment (UBE) is an important cause for urban thermal environment variation. However, the dynamic effect of the UBE on the land surface temperature (LST) is rarely studied by combining the local climate zone (LCZ) theory and spatio-temporal heterogeneity. Based on a case study of Beilin District in Xi’an, China, this paper identified LCZ types of Beilin District in 2010, 2015, and 2020 using the GIS method. It also analyzed the spatial–temporal characteristics of the LST in summer based on the remote sensing retrieval method and explored the effects of the built environment on the LST by Geodetector and geographically weighted regression (GWR). The results showed the following: (1) The area share of dense building zones in Beilin District was greater than that of open building zones and natural surface zones, while the share of mid- and high-rise dense building zones continued to increase and the share of low-rise dense building zones continued to decrease during the study period. (2) The LST of different LCZ types in Beilin District was obviously different, and the LST of dense building zones was generally higher than that of open building zones and natural surface zones. Meanwhile, the LST of mid- and low-rise dense building zones increased gradually, and the LST of high-rise open building zones decreased gradually, but the overall warming area was obviously more than the cooling area. (3) The effects of the UBE factors on the LST varied greatly, with their interaction having an enhancement effect. The direct and interactive influence of the two-dimensional (2D) UBE indicators on the LST were greater than those of the three-dimensional (3D) indicators, but there was a gradual decrease in the force of the 2D indicators and a simultaneous diminution, enhancement, and invariance of the force of the 3D indicators. (4) Vegetation cover (VC) and floor area ratio (FAR) acted negatively, and the building height (BH) was changing from a positive to a negative role, with the average action intensity of VC changing from −0.27 to −0.15, FAR from −0.20 to −0.16, and BH from 0.05 to −0.04. The impervious surface area (ISA), building area (BA), and space congestion (SC) acted positively, with the average action intensity of the ISA changing from 0.12 to 0.20, BA from 0.12 to 0.19, and SC was stable at 0.04. The framework enables a deeper portrayal of LST changes in different LCZs, reflecting the direct and interactive effects of different UBE indicators on LST, as well as local variations in the impact effects and provides a basis for urban managers or planners to improve urban heat resilience.
Antioxidant Activity and Anticarcinogenic Effect of Extracts from Bouvardia ternifolia (Cav.) Schltdl.
Authors: Valadez-Vega Carmen , Lugo-Magaña Olivia , Mendoza-Guzmán Lorenzo , Villagómez-Ibarra José Roberto , Velasco-Azorsa Raul , Bautista Mirandeli , Betanzos-Cabrera Gabriel , Morales-González José A. , Madrigal-Santillán Eduardo Osiris
Published: December 2023

According to the available ethnobotanical data, the Bouvardia ternifolia plant has long been used in Mexican traditional medicine to relieve the symptoms of inflammation. In the present study, the cytotoxic effect of extracts obtained from the flowers, leaves and stems of B. ternifolia using hexane, ethyl acetate (AcOEt) and methanol (MeOH) was evaluated by applying them to the SiHa and MDA-MB-231 cancer cell lines. An MTT reduction assay was carried out along with = biological activity assessments, and the content of total phenols, tannins, anthocyanins, betalains and saponins was quantified. According to the obtained results, nine extracts exhibited a cytotoxic effect against both the SiHa and MDA lines. The highest cytotoxicity was measured for leaves treated with the AcOEt (ID50 of 75 µg/mL was obtained for MDA and 58.75 µg/mL for SiHa) as well as inhibition on ABTS•+ against DPPH• radical, while MeOH treatment of stems and AcOEt of flowers yielded the most significant antioxidant capacity (90.29% and 90.11% ABTS•+ radical trapping). Moreover, the highest phenolic compound content was measured in the stems (134.971 ± 0.294 mg EAG/g), while tannins were more abundant in the leaves (257.646 mg eq cat/g) and saponins were most prevalent in the flowers (20 ± 0 HU/mg). Screening tests indicated the presence of flavonoids, steroids, terpenes and coumarins, as well as ursolic acid, in all the studied extracts. These results demonstrate the biological potential of B. ternifolia.
Intrauterine Fetal Death in Term Pregnancy—A Single Tertiary Clinic Study
Authors: Jovanovic Ivana , Ivanovic Katarina , Kostic Sanja , Tadic Jasmina , Dugalic Stefan , Petronijevic Milica , Gojnic Miroslava , Petronijevic Miloš , Vrzic-Petronijevic Svetlana
Published: December 2023

Introduction: Intrauterine fetal death (IUFD) is defined as death of the fetus after the 20th week of gestation. Despite regular monitoring the incidence of IUFD remains high. This study aims to assess the incidence and maternal conditions associated with IUFD over term pregnancies in a twelve-year period. Materials and Methods: A retrospective descriptive study was conducted on a population of women in whom IUFD was diagnosed in a term pregnancy during the period from January 2010 to December 2022. The study was at the Clinic for Obstetrics and Gynecology, University Clinic Centre of Serbia. The analyses included the number of deliveries, live births, and stillbirths, as well as maternal, fetal, and placental conditions associated with the risk of IUDF. The statistical analysis involved descriptive statistical methods and one sample proportion. Results: The average age of the patients was 30 years. Most patients had secondary and higher education, and 70% of patients had regular pregnancy monitoring; 53.33% were primiparous and pregnancies occurred spontaneously. IUFD mainly occurred in the 39th week of gestation. In total, 38.3% had one to two associated diseases, 5% more than three, and 58.33% were healthy. Recurrence of IUFD was reported by 10% of patients, while 8.33% had a history of spontaneous abortion. Over 80% of placental histopathological findings indicated some pathology (e.g., infarction, infections, placental abruption). Conclusions: The most significant risk factors for IUFD in term pregnancies in our population during the study period were hypertensive syndrome in pregnancy, obesity and gestational diabetes. Pathological findings on the placenta were more common in our study group than is usually reported with infractions of placental tissue being the most common, even in healthy women.
Can Isotopologues Be Used as Biosignature Gases in Exoplanet Atmospheres?
Authors: Glidden Ana , Seager Sara , Petkowski Janusz J. , Ono Shuhei
Published: December 2023

Isotopologue ratios are anticipated to be one of the most promising signs of life that can be observed remotely. On Earth, carbon isotopes have been used for decades as evidence of modern and early metabolic processes. In fact, carbon isotopes may be the oldest evidence for life on Earth, though there are alternative geological processes that can lead to the same magnitude of fractionation. However, using isotopologues as biosignature gases in exoplanet atmospheres presents several challenges. Most significantly, we will only have limited knowledge of the underlying abiotic carbon reservoir of an exoplanet. Atmospheric carbon isotope ratios will thus have to be compared against the local interstellar medium or, better yet, their host star. A further substantial complication is the limited precision of remote atmospheric measurements using spectroscopy. The various metabolic processes that cause isotope fractionation cause less fractionation than anticipated measurement precision (biological fractionation is typically 2 to 7%). While this level of precision is easily reachable in the laboratory or with special in situ instruments, it is out of reach of current telescope technology to measure isotope ratios for terrestrial exoplanet atmospheres. Thus, gas isotopologues are poor biosignatures for exoplanets given our current and foreseeable technological limitations.