bluuebunny/crossref_metadata_2025 huggingface dataset:
Peri-conception human papillomavirus vaccination exposure and risk of birth defects: a population-based retrospective cohort study
Authors: Guo Jin , Xiong Yiquan , Zhao Peng , Liu Chunrong , Liao Mingyu , Chen Jingwen , Ren Yan , Yao Guanhua , Qian Yongyao , Rong Biao , Qi Huanyang , Chen Moliang , Zou Kang , Sun Xin , Tan Jing
Published: November 2024

Background
With the global push for human papillomavirus (HPV) vaccination, many women of childbearing age may receive this vaccine around the time of conception. Previous studies have clarified the association between Peri-conception HPV vaccination and several adverse pregnancy outcomes (e.g., spontaneous abortion). However, the risk for birth defects remains controversial due to limited large-scale studies. This study aims to investigate whether peri-conception HPV vaccination is associated with an increased risk of birth defects.
Methods
This population-based retrospective cohort study included 177,574 pregnancies conceived between March 2018 and December 2021 in Xiamen, China. Peri-conception HPV exposure was defined as vaccination occurring from 90 days before the LMP to the end of the first trimester (i.e.,13+ 6 gestational weeks, approximately 97 days after the LMP). Propensity score matching (PSM) based Poisson regression was used to estimate the adjusted relative risk (aRR) of HPV vaccine exposure for total birth defects, excluding chromosomal abnormalities and 10 organ system-specific birth defects. Two subgroup analyses, including different exposure windows (pre-30 days [30 days preceding the LMP to 97 days after the LMP] vs. first trimester) and vaccine valences (quadrivalent vs. 9-valent), six sensitivity analyses, and a negative control analysis were performed.
Results
A total of 177,574 pregnancies were included, of which 566 were exposed to the HPV vaccine during the Peri-conception period. The rate of Peri-conception vaccine exposure increased from 0.10% in 2018 to 0.58% in 2021. After 1:4 PSM, Peri-conception HPV vaccination was not associated with an increased risk of total birth defects (2.22% vs. 2.88%; aRR 0.77, 95% confidence interval [CI] 0.42–1.42). Similarly, no significant association was found between HPV vaccination and the risk of 10 organ system-specific birth defects. In subgroup analyses, exposure during pre-30 days (aRR 0.59, 95% CI 0.23–1.48) and the first trimester (aRR 0.61, 95% CI 0.14–2.69) and exposure to the 4vHPV (aRR 1.25, 95% CI 0.62–2.51) and 9vHPV (aRR 0.57, 95% CI 0.13–2.49) vaccines were not associated with a higher risk of total birth defects. All sensitivity and negative control analyses demonstrated the robustness of the results.
Conclusions
Our evidence suggests that exposure to the HPV vaccine before and during early pregnancy does not increase the risk of birth defects. This conclusion helps increase the willingness of women of childbearing age to receive HPV vaccination.
Trial registration:
This population-based retrospective cohort study was registered at ClinicalTrials.gov (NCT06180447, December 21, 2023).
Spatiotemporal evolution characteristics and trend prediction of the fertility level of women of childbearing age in China
Authors: Hua Yiwei , Wang Lin , Wang Wenzhen , Wen Yaling , Liu Xiaochun
Published: November 2024

Objective
The purpose of this study is to understand the temporal trends and spatial distribution characteristics of the fertility rate of women of childbearing age in China and 31 provincial-level administrative regions from 2008 to 2022, and to make projections of future trends in the fertility rate.
Methods
Statistical data related to fertility were collected from 2008 to 2022 for China and 31 provincial administrative regions (except Hong Kong, Macao and Taiwan). Statistical descriptions of the fertility situation were made in both spatial and temporal dimensions to understand its spatial and temporal distribution; the future trend of fertility was predicted by using the ARIMA projection model of time series analysis, and the spatial autocorrelation analysis was used to explore its spatial aggregation characteristics.
Results
From 2008 to 2022, the fertility level of women of childbearing age in China has been in a long-term depression and there is a trend of continued decline, with the phenomenon of delayed childbearing evident in the population of childbearing age. The spatial pattern shows a gradual decrease from south to north.China, as well as the three major regions of the East, Centre and West, will reach their lowest point in 2023, followed by a slow recovery and a gradual stabilisation in the following decade, but will still be at a relatively low level of fertility as a whole;while in the Northeast, fertility levels will continue to decline and will be in a state of negative growth in 2036. There is a positive spatial autocorrelation of fertility levels across provinces,and the characteristics of the spatial agglomeration of fertility levels vary from region to region.
Conclusion
The results of this study show that the fertility level of women of childbearing age in China continues to be low, and is expected to remain at a very low fertility level for a long time to come. Individualised recommendations are made for future development trends in different regions to create a fertility-friendly social environment and promote long-term balanced population development.
The depth of arterial supply of forehead, Meta-Analysis
Authors: Trzeciak Mateusz , Gładysz Tomasz , Przybycień Wojciech , Bartoszcze Jędrzej , Pisarek Julia , Mordarski Michał , Iwanaga Joe , Koziej Mateusz , Walocha Jerzy
Published: November 2024

Introduction: Botulinum toxin injections effectively smooth dynamic forehead wrinkles by temporarily relaxing the underlying muscles, creating rejuvenated appearance. Complications may range from minor issues, such as transient swelling and bruising, to severe adverse events, including vascular occlusion leading to tissue necrosis and vision loss. The knowledge about the depth and morphology of the frontal area vessels may aid in reducing the number of complications. Materials and methods: Five research papers were included in the meta-analysis. The analyses were performed in two distinctive places bilaterally: at the level of the glabella and above the eyebrow. Results: A total of 201 SOA arteries and 282 STA arteries were analysed at the following horizontal levels, respectively: at the level of the glabella and above the eyebrow. The final results were as follows: 5.68 mm, 95% CI (4.58–6.78) for SOA at the glabella, 5.53 mm, 95% CI (4.79–6.28) for SOA above the eyebrow, 4.45 mm, 95% CI (3.43–5.47) for STA at the glabella, and 3.53 mm, 95% CI (3.21–3.85) for STA above the eyebrow. Conclusions: The supratrochlear artery tends to become more superficial along its path, while the supraorbital artery remains at a consistent depth across various anatomical levels. For injections in the medial part of the forehead, it is advisable to place the needle up to 2.5 mm deep or laterally to the artery's path. In contrast, injections in the lateral part of the forehead can be administered at slightly deeper depths, up to 3.5 mm. To minimise the risk of complications, performing a high-resolution linear ultrasonography (USG) exam prior to injection is recommended, allowing for needle placement either laterally or medially to the vessels.
Impact of Choroid Plexus Coagulation on the Success of Endoscopic Third Ventriculostomy in Children with Hydrocephalus: A Preliminary Comparative Study
Authors: Cunha Artur Henrique Galvão Bruno Da , Guerra Pedro Lucas Negromonte , Silva Inaê Carolline Silveira da
Published: November 2024

Introduction.
Hydrocephalus is a common condition in childhood, often treated with ventriculoperitoneal shunts (VPS). Endoscopic third ventriculostomy (ETV) has emerged as an effective alternative, and the addition of choroid plexus coagulation (CPC) is believed to enhance its success, particularly in children under six months.
Methods.
In this observational study, a retrospective analysis was conducted on 167 pediatric patients who underwent ETV, with and without CPC, at the Hospital da Restauração in Pernambuco. The primary outcome was to evaluate the success rates of ETV and ETV+CPC at immediate postoperative and six-month follow-up. Statistical analyses, including chi-square, univariate, and multivariate logistic regression, were employed to assess correlations between dependent and independent variables.
Results.
ETV+CPC showed a significantly higher success rate in the immediate postoperative period (91%) compared to ETV alone (75%) (p=0.007). After six months, success rates were similar for both groups (67% for ETV+CPC and 66% for ETV), with no significant difference (p=0.855). Univariate and multivariate analysis revealed that the type of surgery (ETV+CPC vs. ETV) was a significant predictor of immediate postoperative success (OR 2.81, 95% CI 1.18-6.72, p=0.020). Age and sex did not correlate significantly with surgical outcomes.
Conclusion.
The addition of CPC to ETV significantly enhances immediate postoperative success in young children with hydrocephalus. Although long-term outcomes equalized, these findings suggest that CPC can be a valuable adjunct in optimizing short-term results.
Multi-Response Optimization and the Effect of Parameters in Turning of AISI 4140 Steel using (Al2O3+CuO) Hybrid Nanofluid under MQL Approach
Authors: Merga Alemu , Gutema Endalkachew Mosisa , GOPAL MAHESH
Published: November 2024

Machining of AISI 4140 high-strength steel produces more heat in the tool and work part, which degrades the product's surface quality, damages cutting tools, and requires a significant cutting force. The use of traditional cutting fluids such as mineral oils, water, ethylene glycol, and vegetable oils for lubrication in machining harms both human health and the environment. The current study aims to assess the effectiveness of hybrid nanofluids used for lubrication purposes, as well as to investigate the effects of process parameters such as cutting speed, feed rate and depth of cut. Moreover, the study aims to asses nanoparticle concentration on turning performance characteristics such as surface roughness, temperature, and material removal rate when Al2O3-CuO hybrid nanofluids are used as cutting fluid in the MQL during the turning of AISI-4140 steel using carbide inserts as cutting tool. The experiment was designed using RSM of CCD using Design Expert 13 software. The results revealed that Al2O3-CuO hybrid nanofluids improved surface quality while lowering cutting zone temperature. The ANOVA results show that the interaction between depth of cut and nanoparticle concentration was the most significant factor impacting surface quality (21.62%), followed by depth of cut (45.57% for MRR) and nanoparticle concentration (45.63% for cutting zone temperature). A desirability function analysis was carried out to predict the responses. The highest possible overall desirability value is 0.693, similar to the target response.
Pen Direct Writing of Multiplex-LFIA for Detection of Thiamphenicol and Tylosin in Milk
Authors: Russo Alida , Cavalera Simone , Murray Richard , Quinn Aidan J. , Anfossi Laura , Iacopino Daniela
Published: November 2024

Therapeutic and misuse of veterinary drugs, such as antibiotics, can increase the potential risk of residue contamination in animal-derived food products. For milk, these residual antibiotics can have an impact on efficiency in dairy processing factories, as well as economic loss, and can also cause side effects on consumer health. Lateral flow immunoassays (LFIAs) are gaining popularity for their ease of use, low cost and their fulfilment to the REASSURED (real time connection/monitoring, easy sampling, affordable, specific, user-friendly, rapid/robust, equipment free, deliverable to end user) criteria. At the same time, direct writing of functional materials has been recently used for facile applications on point-of-care test (POCT) fabrication.
Herein, a novel multiplex-LFIA has been developed for the simultaneous detection of two antibiotics in milk: thiamphenicol and tylosin. In contrast to the traditional automated dispensers, a direct pen writing method was used to deposit control and test lines. The response of each antibiotic was tested, as well as the selectivity of the test during cross-testing. For both antibiotics, the test was successful in distinguishing between safe and unsafe milk samples, according to the maximum residue limits (MRLs) set for both antibiotics. The visual LOD obtained was 100 ppb for the two antibiotics and the IC50 were lower than the set maximum residue limits (MRLs).
Leisure Time Physical Activity and Reported Impairments: a Cross- Sectional, Population-based Study in the City of São Paulo
Authors: Figueiredo Tatiane Kosimenko Ferrari , Bassichetto Katia Cristina , Goldbaum Moisés , Castro Shamyr Sulyvan , Santos Edige Felipe Sousa , Cesar Chester Luiz Galvão
Published: November 2024

Background
For people with impairments, physical activity is also a mechanism that facilitates autonomy in activities of daily living and inclusion in society. In addition to sociodemographic inequalities related to impairments, evidence shows that some population strata also have greater opportunities for physical activity. However, studies of physical activity in this population specifically are scarce. So, the purpose of the study was to describe and compare leisure time physical activity among people with and without impairments in the city of São Paulo, measuring the magnitude of inequalities and associated factors according to selected sociodemographic variables.
Methods
Data from the 3rd edition of the ISA-Capital, a population-based cross-sectional study of the population in the city of São Paulo, was used. People included were classified as people with and without - visual, hearing, physical or intellectual impairments. Leisure time physical activity was assessed using the IPAQ, classifying as leisure-time active those who met the recommendation from WHO. Prevalence estimates and 95% confidence intervals were calculated. Poisson regression models were used.
Results
When comparing the prevalence of physically active people without impairments (22.4%) and those with impairments, no statistically significant differences were found for visual (17.8%), hearing (20.3%) and intellectual impairment (17.7%). Physically active people with physical impairments prevalence were 40.0% lower than those without impairments (10.9%), 60.0% lower in older people (5.9%) and 50% lower in males (9.8%).
Conclusion
Combination of public policies, right environment, awareness and knowledge of the recommendations and benefits of practicing physical activity during leisure time are essential for people with impairments to engage in a physical activity program.
Improving Falling Film Evaporator: Insights from Heat and Mass Transfer and CFD Simulations
Authors: Dolgun Ekin Can , Karaca Gülşah , Aktaş Mustafa
Published: November 2024

This study presents a mathematical relationship linking effective flow distribution with heat and mass transfer for a falling film evaporator with a capacity of 10,000 kg/h and an evaporation capacity of 2,000 kg/h. While previous research has focused on optimizing falling film evaporators primarily through heat and mass transfer approaches, they often assume fully homogeneous liquid distribution within the heating tubes, highlighting a notable gap in the literature. This study validates the performance of an optimized design through computational fluid dynamics (CFD) analysis, utilizing milk as the working fluid. Heat transfer calculations were conducted across four heating tube diameters (26, 32, 38, and 50 mm), considering the required heating surface area, total heat transfer coefficient, discharge flowrate, and retention time. Key parameters included the distribution hole diameter (5–6 mm), distribution plate thickness (0–15 mm), and fluid accumulation height (15–30 mm). The optimal heating tube diameter was found to be 26 mm, yielding a total heat transfer coefficient of 2001 W/m²K with a wetting rate of 0.161 kg/ms. Results indicate that increasing heating tube diameter decreased the total heat transfer coefficient and necessitated a larger heating surface area. Furthermore, this study also emphasizes the influence of distribution plate thickness and hole diameter on discharge flowrates, revealing that a 5% change in plate thickness affects flowrate by 9.4%. Moreover, CFD simulations were conducted to refine design geometries for homogeneous fluid distribution, concluding that reduced hydraulic jet height (15 mm) and smaller heating tube diameters enhance performance.
Brain Iron Accumulation in Neurodegenerative Disorders: Does Air Pollution Play a Role?
Authors: George Jithin V. , Hornburg Kathryn J. , Merrill Alyssa , Marvin Elena , Conrad Katherine , Welle Kevin , Gelein Robert , Chalupa David , Graham Uschi , Oberdörster Günter , Johnson G. Allan , Cory-Slechta Deborah A. , Sobolewski Marissa
Published: November 2024

Background
Both excess brain Fe and air pollution (AP) exposures are associated with increased risk for multiple neurodegenerative disorders. Fe is a redox-active metal that is abundant in AP from traffic and industrial sources and in U.S. subway systems. Exposures to AP and associated contaminants, such as Fe, are lifelong and could therefore contribute to elevated brain Fe observed in neurodegenerative diseases, particularly via nasal olfactory uptake of ultrafine particle AP. These studies tested the hypotheses that exogenously generated Fe oxide nanoparticles could reach brain following inhalational exposures and produce neurotoxic effects consistent with neurodegenerative diseases and disorders in adult C57/Bl6J mice exposed by inhalation to Fe nanoparticles at a concentration similar to those found in underground subway systems (~ 150 ug/m3) for 20 days. Olfactory bulb sections and exposure chamber TEM grids were analyzed for Fe speciation. Measures included brain volumetric and diffusivity changes, levels of striatal and cerebellar neurotransmitters and trans-sulfuration markers, quantification of frontal cortical and hippocampal Aβ42, total tau and phosphorylated tau and behavioral alterations in locomotor activity and memory.
Results
Particle speciation confirmed similarity of Fe oxides (mostly magnetite) found on chamber TEM grids and in olfactory bulb. Alzheimer’s disease (AD) like characteristics were seen in Fe-exposed females including increased olfactory bulb diffusivity, impaired memory and increased accumulation of total and phosphorylated tau, with total hippocampal tau levels significantly correlated with increased errors in the radial arm maze. Fe-exposed males showed increased volume of the substantia nigra pars compacta, a region critical to the motor impairments seen in Parkinson’s disease (PD), in conjunction with reduced volume of the trigeminal nerve and optic tract and chiasm.
Conclusions
Inhaled Fe oxide nanoparticles appeared to lead to olfactory bulb uptake. Further, these exposures reproduced characteristic features of neurodegenerative diseases in a sex-dependent manner, with females evidencing features similar to those seen in AD and effects in regions in males associated with PD. As such, prolonged inhaled Fe exposure via AP may be a risk factor for neurodegenerative diseases, and regulation of air Fe levels in enclosed areas like subway stations may have broad public health protective effects. More research is needed to improve our translation from these rodent studies to human exposures. We suggest, prolonged inhaled FE exposure via AP is a suggested risk factor for neurodegenerative changes in mice and given the similarities of these changes to changes observed in human AD, these data may have broad public health protections effects.
FDA-approved Secukinumab alleviates glial activation and immune cell infiltration in MPTP-induced mouse model of Parkinson's disease
Authors: Li Qi , Han Xiaoxuan , Dong Mengmeng , Bai Lipeng , Zhang Wei , Liu Wei , Wang Fei , Zhu Xiaodong
Published: November 2024

Background: The negative role of interleukin-IL-17A (IL-17A) in neurodegeneration diseases such as Alzheimer's disease (AD) and Parkinson's disease (PD) has been investigated. The effect of FDA-approval Secukinumab (SEC), which selectively targets IL‐17A, on the modification of PD remains unclear. This study investigated the protective effect of SEC in MPTP mice and explored its potential mechanism.
Methods: We explored the neuroprotective effect of SEC by evaluating the loss of dopaminergic neurons, the activation of glial cells and the infiltration of immune cells in 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-induced mouse model of PD.
Results: We found that the treatment of SEC alleviated the loss of dopaminergic neurons and reversed behavioral deficits in MPTP mice. SEC treatment reduced the infiltration of peripheral leukocytes into the brain, especially CD4+T cells, NK cells and monocyte-macrophages, attenuated the activation of glial cells and the expression of pro-inflammatory cytokines in MPTP mice. In addition, we found that the release of corresponding chemokines (CCL2, CXCL9), which recruit peripheral immune cells into the brain, was reduced.
Conclusion: These results suggest that Secukinumab protects dopaminergic neurons and attenuates neuroinflammation in MPTP-induced model. SEC treatment in PD might be an effective therapeutic approach for clinical application in the future.
Identifying Anxiety, Social Support and Spiritual Well-Being States of Patients Experiencing Cerebrovascular Event: A cross-sectional descriptive study
Authors: Oner Ugur , Erol Ahmet , Utli Hediye , Dinc Mahmut
Published: November 2024

Background: It has been observed to play an important role in providing holistic care by considering anxiety, social support and spiritual well-being in the care of patients. The present study aimed to determine the anxiety, social support and spiritual well-being states of patients who experience a cerebrovascular event.
Methods: The descriptive and cross-sectional study was completed with 231 cerebrovascular patients. The data were collected using the “Patient Information Form”, “Multidimensional Scale of Perceived Social Support”, “Beck Anxiety Inventory” and “Spiritual Well-Being Scale”.
Results: The mean age of the patients participating in the study was 60.62±10.44, with 52.4% being female. The patients were seen to obtain 63.09±12.45 points over the Multidimensional Scale of Perceived Social Support, indicating a moderate level of perceived social support.
It was found that the total score of the patients was 53.59±11.50 points on the Beck Anxiety Inventory, which showed high levels of anxiety. The patients scores an average of 43.62±8.65 points on the Spiritual Well-Being Scale, indicating a moderate level of spiritual well-being. A positive significant correlation was found between the perceived social support and spiritual well-being levels of the patients.
Conclusion: As a result of the present study, it was found that the patients had a moderate level of perceived social support, high level of anxiety and moderate level of spiritual well-being. A positive relationship was found between the patients’ perceived social support and anxiety levels. A positive relationship was determined between the patients’ age and spiritual well-being levels.
Dispensing Hope: Leveraging Distribution Boxes to Enhance Low-Barrier Access to Naloxone in Healthcare Settings
Authors: Kothe Nycole , Gray Angela , Guthrie Sarah , Londner Michael
Published: November 2024

Background: West Virginia, often regarded as the epicenter of the opioid epidemic, has consistently recorded the nation's highest rates of opioid overdose deaths. The Eastern Panhandle, including Berkeley, Morgan, and Jefferson counties, mirrors this trend, with Berkeley County's overdose death rate in 2020 exceeding triple the national average. Recent data, however, indicates a promising 25% decrease in overdose deaths in Berkeley County over a 12-month period ending September 2023, contrasting with a statewide increase. This decline is suspected to be attributed to enhanced access to naloxone and medications for opioid use disorder, supported by community collaboration. Despite these gains, barriers persist for at-risk populations, necessitating strategies such as over-the-counter naloxone availability.
Methods: The implementation of naloxone distribution boxes in healthcare settings, initiated in Berkeley Medical Center's emergency department, marks a significant advancement. These boxes, accessible at all times and stocked with OTC (over the counter) naloxone kits, were placed in visible areas of the building vestibule to increase community access to naloxone. Results: Over a six-month period, these boxes distributed 2,383 naloxone kits, significantly surpassing physician-ordered distributions of 17 kits over the same period.
Conclusion: Distribution boxes allowed for delivery of large volumes of naloxone compared to the physician-ordered distributions. Future efforts aim to expand naloxone availability in community settings to sustain and further reduce overdose fatalities.
Petrography and Geotechnical Properties Sakessar Limestone, Nammal Gorgue in District Mainwali Punjab, Pakistan
Authors: Ayaz Hassan , Xu Jiancong , Ahmad Sohail , Asalam Muhammad Usama
Published: November 2024

This study evaluates the petrographic and geo-mechanical properties of the Sakessar Limestone in the Nammal Gorge, District Mianwali, Punjab, Pakistan, to evaluate its suitability for construction applications. The limestone, exposed in the western Salt Range near Nammal Dam, features an approximate thickness of 18 meters and displays an off-white to grey coloration, primarily consisting of fractured limestone with chert nodules. Geotechnical tests conducted include unconfined compressive strength (UCS), water absorption, specific gravity, porosity, unconfined tensile strength (UTS), soundness, Schmidt hammer, and point load tests. Results indicate water absorption values between 0.21% and 0.37%, specific gravity ranging from 2.607 to 2.670, and porosity from 0.5–0.97%. UCS values of 19.2 to 59.7 MPa suggest moderate to high strength, with UTS values ranging from 4.44 to 9.51 MPa and UCS/UTS ratios from 2.4646 to 8.243. Soundness tests using sodium sulfate yielded a value of 1.2%. Petrographic analysis classifies the limestone as Wackestone, containing over 30% grains, less than 5% cement, and a significant matrix component. Overall, the physical, mechanical, and petrographic properties indicate that Sakessar limestone is suitable for use as a construction material.
Design and Mechanical Analysis of a Novel Modular Bionic Earthworm Robot with Upright Functionality
Authors: Tang Shufeng , Yao Jianan , Yu Yue
Published: November 2024

With the escalating demand for exploration within confined spaces, bionic design methodologies have attracted considerable attention from researchers, primarily due to the intrinsic limitations of human access to hazardous environments. However, contemporary bionic robots primarily attain linear motion through the axial radial deformation of their body segments, thereby lacking the upright functionality that is characteristic of these organisms. In response to the limitations associated with current bionic earthworm robots concerning upright capability and stiffness modulation, we propose an innovative bionic robot that incorporates upright functionality and programmable stiffness. Initially, we present a bionic robot unit module that is capable of attaining an upright posture. A mechanical model is established in accordance with the principle of minimum potential energy to facilitate various compression and deflection functionalities. Through comprehensive simulation and experimental studies, we validate the model's high precision in predicting compression and deformation behaviors. Furthermore, the effects of varying spring stiffness values (k) on device performance are systematically investigated, thereby enabling tailored stiffness adjustments for each module. This programmability empowers the robot to adapt to a broader spectrum of environmental demands. Ultimately, we construct a multi-module robot and successfully evaluate its upright functionality under diverse compression and deformation conditions. The proposed bionic structure, characterized by its enhanced ease of control and programmable stiffness, exhibits considerable potential for applications in complex and unstructured environments.
How to handle parameter uncertainty in green roof model?
Authors: Hégo Axelle , Collin Floriane , Limon Merlin , Claverie Rémy
Published: November 2024

Green roofs have become a very important component of sustainable urban development. The hydric performances of a green roof are characterized by the water content inside the different layers of the roof. The models describing the water content involve soil, vegetation and weather parameters which may be difficult to determine and thus are considered uncertain. It would be desirable to quantify the uncertainty features of the green roof performance so that a more comprehensive assessment or design can be made. This paper provides a methodology to handle the sensitivity analysis of complex model involving time-varying uncertain parameters and time-varying output. It focuses on an original approach based on the data statistical analysis and on Iman and Conover procedure to generate consistent random samples which are independent but following a prescribed time correlation matrix. Furthermore, the sensitivity is computed at each time instant to better understand the behavior of the green roof according to the season and the different rain events. This study points out the parameters that influence the water content during dry and wet periods in one year.
TROJAN-MDR: In vitro activity of cefiderocol and comparators against multidrug-resistant Enterobacterales and Pseudomonas aeruginosa strains in Southern France, evaluation of available testing methods performances
Authors: BENYAHIA Massinissa , MAGNAN Chloé , JEAN-PIERRE Vincent , LARCHER Romaric , BOUTET-DUBOIS Adeline , GAILLARD Marie , MARCHANDIN Hélène , GENIEYZ Stéphanie , MORSLI Madjid , LAVIGNE Jean-Philippe , PANTEL Alix
Published: November 2024

Background
Cefiderocol, a newly introduced siderophore cephalosporin, exhibits activity against various multidrug-resistant (MDR) Gram-negative bacilli (GNB), including producers of Ambler class A, B and D carbapenemases. The TROJAN-MDR study aimed to i) compare the in vitro activity of cefiderocol with other last-resort antibiotics against a well-characterized collection of Enterobacterales and Pseudomonas aeruginosa strains from Southern France, and ii) assess the performance of available cefiderocol antimicrobial susceptibility testing (AST) methods.
Methods
The collection comprised 127 Enterobacterales from various clones, including 119 carbapenemase producers (93.7%), and 53 MDR P. aeruginosa. The minimum inhibitory concentrations (MICs) of cefiderocol were determined using the UMIC® broth microdilution method (BMD) as the reference. Comparators MICs were measured using Sensititre™ EUMDRXXF plates and Liofilchem strips for aztreonam-avibactam. Results were interpreted according to EUCAST breakpoints, with CLSI breakpoints also used for cefiderocol. The performance of the ComASP® BMD and disk diffusion on two different Mueller-Hinton media (Bio-Rad and BD) were evaluated according to ISO 20776-2:2007 and 2021.
Results
Cefiderocol demonstrated potent activity on Enterobacterales (81.9% susceptible) and P. aeruginosa (84.9%) using EUCAST breakpoints. Among Enterobacterales, the most effective comparators were colistin, aztreonam-avibactam, meropenem-vaborbactam, and amikacin, with susceptibility rates of 99.2%, 98.4%, 85%, and 76.4%, respectively. For P. aeruginosa, only colistin exhibited better activity (100%). The disk diffusion method showed superior performance on BD medium compared to Bio-Rad. The ComASP® method did not provide sufficient performance to be considered reliable.
Conclusions
Cefiderocol was highly active against a large collection of MDR GNB, including high-risk clones. It is crucial to assess susceptibility to this last-resort antibiotic using a validated method when considering clinical use.
An Experimental Investigation on the Effect of Laser Energy Deposition in an Over-expanded Jet
Authors: Syam S , Jassal Gauresh Raj , Schmidt Bryan E
Published: November 2024

This experimental investigation focuses on understanding the influence of perturbations due to short-duration energy deposition on the shock train structure and flow dynamics in an axisymmetric over-expanded Mach 2.52 jet. The flow is perturbed by localized laser-induced breakdown at various locations within the jet, creating a shock wave and a high-temperature plasma zone in the shock train. A high-speed self-aligning focusing schlieren system is used to visualize the flow structure variations by measuring the distance to the first shock reflection point to characterize the shock train dynamics and the flow structure recovery process. The response of the jet flow is similar for cases with the perturbation at the nozzle exit and the pre-reflection point across a range of jet total pressures but the response is qualitatively different when the perturbation occurs downstream of the first shock reflection in the jet, with the flow structures being forced upstream towards the nozzle. The frequency of the oscillations of the shock height is found to be the same for all cases, approximately 10 kHz, independent of the jet total pressure, laser energy, and deposition location. The oscillations reduce in magnitude over time, and the damping ratio for cases with the energy deposition at the pre-reflection point and nozzle exit is found to be nearly constant with respect to jet total pressure and deposition energy, whereas it is dependent on the jet chamber pressure for the post-reflection case.
Urbanization, digital systems adoption and environmental integration in the Euro-Mediterranean region: Is the IT transition green?
Authors: Iormom Bruce Iortile , Iorember Paul Terhemba , Diyoke Kenneth , Abbas Jaffar
Published: November 2024

This study characterized the link between urbanization, digital system adoption and environmental integration among the Euro-Mediterranean countries (from 2000–2019). Environmental integration proxied by load capacity factor was found to be decreasing with increased digital systems adoption. While load capacity factor decreased with increased GDP, it however increased with increased GDP2. The study found evidence invalidating the Green IT proposition while validating the load capacity curve hypothesis for the Euro-Mediterranean countries.
WITHDRAWN: Trends in Leadership Styles, Employee Engagement, and Employee Performance: A Comprehensive Review and Bibliometric Analysis Using Scopus and WOS Data (2010–2023)
Authors: Mohammad AL Montaser , Menhat Masha , Shafi Sujana , Husseind Alhareth Mohammed Abu
Published: November 2024

Purpose
There has been growing interest in the impact of results that need to be more varied and conclusive. This article aims to comprehensively define employee performance, develop a holistic understanding of how employee engagement and leadership styles are related to employee performance, identify knowledge gaps, and propose a research direction for the future.
Design/methodology/approach
A methodical examination and bibliometric analysis were conducted on 52 articles about leadership styles, employee engagement, employee performance, and the obstacles and catalysts associated with these approaches.
Findings
Research focusing on these variables has expanded significantly over the past decade. A total of 52 articles were reviewed. The review shows that organisations could achieve enhanced employee performance through effective leadership and outstanding managerial commitment. These actions would realise a company's vision and enable it to achieve its goals.
Research limitations/implications
This paper is limited explicitly to examining academic articles sourced from online databases. Other literary sources, such as unpublished works, concept papers, and reviews, were excluded from the study. This literature review and bibliometric analysis highlight essential knowledge gaps that should be explored.
Originality/value
To the best of the authors' knowledge, this study represents the first attempt to conduct a bibliometric analysis of leadership styles, employee engagement, and employee performance. This research is an initial reference for scholars seeking insights into the correlation between leadership, employee engagement, and performance.
Rezension zu: Ronald A. Bleeker, Aspar and the Struggle for the Eastern Roman Empire, AD 421-71
Authors: Michel Christian
Published: November 2024

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Women With Breast Cancer in Malaysia: Social Work Perspectives on the Challenges and Social Support
Authors:   Department of Malaysian Studies, Faculty of Human Sciences, Universiti Pendidikan Sultan Idris, Tanjung Malim, Perak, Malaysia, Nordin Ashiqin , Mohammad Taufik ,   Independent researcher, Selangor, Malaysia
Published: November 2024

It has been reported that breast cancer is the most common type of cancer affecting women in Malaysia. A diagnosis of breast cancer will usually bring upon a set of issues and challenges affecting the well-being of these women. The aim of this article is to provide a literature review regarding the biopsychosocial issues, challenges, social support and adaptation process experienced by women with breast cancer, with an application to the Malaysian setting focusing on the Malaysian sociocultural backgrounds. The discussion of this article focuses on the importance of social support in adaptation process such as from immediate family members, support group and the medical team following the challenges faced by the patients such as ones stemming from their cultural background, their biological issues and their refusal to seek treatments. The overall review of the literature is aligned with the social work values in addressing human wellbeing, including the recognition of the psychosocial and sociocultural backgrounds as powerful components of health in practice and policies. Finally, this article will provide insights for the helping profession in the country such as medical social workers in providing social work assessments and interventions suitable for Asian women with breast cancer.
“Air Laut Macam Daun Pandan” (The Sea is Like Pandan Leaf): Pulau Pinang Fishing Communities, Contested Development and “Anti-Politics”
Authors:   School of Social Sciences, Universiti Sains Malaysia, Pulau Pinang, Malaysia, Soon Chuan Yean
Published: November 2024

This study identifies the developmental pathway that is taking place in the state of Pulau Pinang. The focus is on the responses of the ordinary people, namely fishing communities to the development pace of Pulau Pinang (island), the contestation on “developmental” discourses with the state (namely Pulau Pinang State Government, PSG), and the ways in which state institutions and communities construct the narrative of “development”. Through participant observation in the field sites with the fishing community and secondary resources analysis, the article showcases the contested meaning of “development”. The research findings are on the one hand by the PSG, which is underpinned by neoliberal economic principles, on the other hand, by the communities at large, which is multifaceted in nature.
Phenotype of a patient with arterial hypertension for therapy with candesartan and its combinations with a diuretic or calcium antagonist
Authors: Sergey S. V. , Bolotova S. L. , Bychkova O. I. , Vlasov D. S. , Ledyaeva A. A. , Salasyuk A. S. , Tsoma V. V.
Published: November 2024

The article provides a review on the efficacy and safety of the use of candesartan in hypertension through the lens of current clinical guidelines, and considers updated data on the efficacy and metabolic effects of different candesartan-based combinations. A clear phenotype of a patient with hypertension who can be selected for the prescription of candesartan has been built-up, and the principles of differentiated approach to prescribing candesartan-based combinations for the treatment of hypertension have been outlined, taking into account metabolic effects and impact on the end points. It has been shown  that candesartan is more effective than irbesartan, valsartan and losartan in lowering blood pressure, can reduce the risk of hypertension in people with normal high blood pressure or in young people with familial risks, and has the largest and most diverse evidence in the treatment of chronic heart failure, and significantly reduces the risk of cardiovascular complications as well as restrains the progression rates of diabetic retinopathy. The patient’s phenotype for the candesartan and amlodipine combination suggests that the presence of one or more of the following conditions: metabolic syndrome (particularly with impaired glucose tolerance and hypertriglyceridemia), the need for targeted angioprotection, hyperuricemia, hypokalemia tendency, or the necessity to replace other angiotensin II receptor blockers with candesartan-based combinations. The candesartan and hydrochlorothiazide combination is preferable for HOPE-3-like patients, patients with a history of strokes or transient ischemic attacks, as well as recurrent strokes, the presence of hypervolemia (obesity, perimenopause), the need for treatment or prevention of chronic heart failure, replacement of other angiotensin II receptor blockers with candesartan-based combinations. The prescription of the candesartan and hydrochlorothiazide combination using the 24-hour blood pressure monitoring in a patient requires to exclude the 24-hour night-picker or non-dipper profile and the morning blood pressure surge, as the effect of hydrochlorothiazide does not exceed 12 hours. Both combinations have also been shown to improve cognitive function.
Long-term effects of metformin on fat depots and insulin-glucose parameters in patients with prediabetes and chronic heart failure
Authors: Tsygankova O. V. , Apartseva N. E. , Latyntseva L. D. , Ryabikov A. N. , Kashtanova E. V.
Published: November 2024

Introduction. Chronic heart failure with preserved ejection fraction (CHpEF) is a heterogeneous syndrome with a variety of pathophysiological factors, including obesity and impaired carbohydrate metabolism associated with an increase in visceral adipose tissue. Due to the positive effect of metformin on weight loss, in recent years special attention has been paid to its effect on fat depots.

Aim. To study the effects of metformin XR after 12 months of administration on various fat depots and glucose metabolism parameters in patients with CHpEF, prediabetes and abdominal obesity (AO).

Materials and methods. A single-center open-label randomized prospective controlled trial included 64 people (50% men, median age 58 [55.25; 59.75] years) with CHpEF, prediabetes and AO. All patients (groups A and B) received optimal CHpEF therapy. In group A (n = 32), metformin XR 1000–1500 mg/day was additionally prescribed. All patients underwent general clinical examination, calculation of  insulin resistance indices, ultrasound lipometry with determination of  the size of  epicardial, preperitoneal and subcutaneous fat, in addition, the thickness of epicardial fat was assessed using magnetic resonance imaging (MRI) of the heart.

Results. In group A, after 12 months of the study, fasting plasma glucose levels decreased from baseline by 7.7% (p < 0.0001), glycated hemoglobin by 3.3% (p = 0.008), fasting insulin by 20% (p = 0.004) and HOMA-IR and FIRI indices by 25.3% (p = 0.001). In the control group, on the contrary, the values of glycated hemoglobin increased by 3.4% (p = 0.021), fasting insulin by 45% (p = 0.031), HOMA-IR and FIRI by 52.4% (p = 0.020). In group A, the thickness of epicardial fat decreased by 6.1% (p = 0.020) according to ultrasound and MRI lipometry by 16.7% (p = 0.029), preperitoneal fat by 3.0% (p = 0.009), subcutaneous fat by 11.2% (p = 0.001).

Conclusion. Metformin XR therapy for 12 months in patients with prediabetes, CHpEF and AO against the background of optimal basic CHpEF therapy had a beneficial effect on glucose metabolism (decrease in fasting plasma glucose and insulin, glycated hemoglobin, insulin resistance indices HOMA-IR, FIRI) and on subcutaneous and visceral adipose tissue depots: epicardial and preperitoneal.
Differential diagnosis of acute coronary syndrome without ST-segment elevation in a middle-aged patient
Authors: Chernikov A. O. , Chernyshova V. A. , Konstantinova E. V. , Velikotsky A. A. , Ploshchenkov E. V.
Published: November 2024

Acute Coronary Syndrome (ACS) is an initial diagnosis, which is transformed into the diagnosis of “myocardial infarction”, “unstable angina” or other diagnosis during the diagnostic process. If a patient meets the criteria for myocardial infarction (according to the Fourth Universal Definition of Myocardial Infarction), in the presence of atherothrombosis in the infarct-related coronary artery, Type 1 myocardial infarction is diagnosed. In most of the remaining cases Type 2 myocardial infarction is diagnosed. Acute myocardial injury due to various conditions is separately classified. In the presented case, a 54-year-old patient with a history of arterial hypertension and diabetes mellitus, not adherent to treatment and suffering from obesity, a smoker, was hospitalized with typical new-onset angina pectoris and ischemic changes on the ECG, by ambulance, with the initial diagnosis of “ACS without ST-segment elevation”. The diagnosis changed several times during the examination: “ACS without ST-segment elevation”, “CAD: myocardial infarction without ST-segment elevation”, “Myocardial infarction with non-obstructive coronary arteries (MINOCA)”, “Severe calcified aortic stenosis. Anemia. Type 2 myocardial infarction”. The peculiarity of this case is the debut of high-gradient aortic stenosis in a middle-aged man with clinical manifestations of ACS and high blood troponin level. Causes of severe aortic stenosis manifestation as myocardial infarction with elevation of cardiac-specific troponin in the blood, despite intact coronary vessels, are discussed in this article. The differential diagnosis of myocardial injury is discussed, as the correct diagnostic judgment directly determines the patient’s management strategy.
Cardiovascular profile drugs and the state of periodontal tissues
Authors: Sabirova A. I. , Karshina O. O. , Sabirov I. S.
Published: November 2024

People with CVD, mostly over 50 years of age, regularly take medications such as beta-blockers (BBs), angiotensin-converting enzyme inhibitors (ACEIs), calcium channel blockers (CCBs), angiotensin II receptor blockers (ARBs), statins and acetylsalicylic acid (ASA). Periodontal tissue disease (PTD) occurs in the age group 35–44 years in 60% of cases, in the group of people 65–74 years – about 70%, that is, in that period of life when cardiovascular disease (CVD) begins to develop and progress. Some cardioprotective drugs, such as antihypertensives, cause xerostomia. Medication-induced xerostomia is one of the common causes of oral health problems in older adults who are on long-term drug therapy. Xerostomia is a common debilitating condition that causes problems such as dysphagia, loss of taste, and oral pain, as well as increasing the risk of tooth decay and oral infections. Drug-induced gingival overgrowth is an abnormal hypertrophy of the gingiva that can be caused by a number of medications, including calcium channel blockers. Drug-induced gingival overgrowth is characterized by the accumulation of connective tissue that primarily affects the anterior regions of the upper and lower jaw, and also causes problems with oral hygiene, which leads to susceptibility to infections and periodontal disease and can lead to tooth loss. Anticoagulants used in CVD due to the risk of bleeding require special approaches in the prevention and therapy of periodontal tissue disease. The possibilities of using statins in PTD due to their pleiotropic properties, independent of hypolipidemic action. The review article is devoted to the influence of drugs of cardiovascular profile on the state of periodontal tissues and mechanisms of development of side effects, as well as the possibilities of using statins taking into account their pleiotropic effects.