bluuebunny/crossref_metadata_2025 huggingface dataset:
Considerations on the Setting of Cervantes’s Captivity Narratives
Authors: Chang Jae Won
Published: August 2024

This study aims to explore the issues of Islamophobia and Christian ideology prevalent in Spanish society in the 16th and early 17th centuries by examining the slave trade conducted by Barbary corsairs and the hard lives of Christian captives depicted in the literary works of Miguel de Cervantes, and to highlight his efforts to overcome the clash of civilizations between Christianity and Islam. To achieve this goal, first, the study delves into the historical context of the clash between Spain and Islam in the Mediterranean during the 16th century. Cervantes, who took part in the Battle of Lepanto in 1571, was captured by Barbary corsairs on his return from military service and spent five years as a captive in the Bagnio of Algiers. The painful experience left indelible marks on his works. This study focuses on the dual meaning of Orientalism in his works. One prevalent form of Orientalism in Spain and Europe during that period portrayed Muslims as barbaric and anti-Christian. However, Cervantes presented an alternative Orientalism to propose a pathway to co-existence, rather than conflict, between civilizations and religions. Therefore, this study explores how Cervantes, even though he himself was a victim of the clash of civilizations, sought to overcome the confrontations and conflicts in his works, rather than perpetuating the prevalent Islamophobia of his time.
Assessing the Association of Healthcare Resource Utilization and Patient-Reported Outcomes on Shared Decision-Making among Multimorbid Individuals
Authors: Zaidi Syeda Hina , Axon David Rhys
Published: August 2024

Shared decision-making (SDM) is an essential component of patient-centered healthcare and disease management. However, the association of SDM with healthcare resource utilization and patient-reported outcomes among multimorbid individuals is not well understood. This study sought to evaluate the association of SDM with healthcare resource utilization and patient-reported outcomes among United States (US) adults with multimorbidity. Data were collected from the 2020 Medical Expenditure Panel Survey (MEPS) for this cross-sectional study. Eligible participants were US adults with two or more comorbidities. The predictor variable was SDM (optimal versus not optimal). The outcome variables were healthcare resource utilization and patient-reported outcomes. Logistic regression models, adjusted for demographic characteristics, assessed associations with SDM for each healthcare resource utilization and patient-reported outcome variable. The analysis maintained the complex survey data and was weighted to produce nationally representative estimates. Individuals who reported optimal SDM in adjusted analyses utilized more healthcare resources compared to those who reported not optimal SDM. Individuals with optimal SDM had more than one outpatient visit (odds ratio OR = 1.23, 95% CI = 1.03–1.47), emergency room visit (OR = 1.55, 95% CI = 1.17–2.06), and inpatient discharge (OR = 1.44, 95% CI = 1.05–1.96). Additionally, these individuals had higher odds of reporting limitations in their ability to work or engage in other activities due to their physical health in the past four weeks (OR = 1.27, 95% CI = 1.01–1.60). This study indicated evidence of increased healthcare resource utilization among patients who participate in SDM with their providers, which should be explored in future studies.
Perioperative Management and Outcomes after Endovascular Mechanical Thrombectomy in Patients with Submassive (Intermediate-Risk) Pulmonary Embolism: A Retrospective Observational Cohort Study
Authors: Merren Michael P. , Padkins Mitchell R. , Cajigas Hector R. , Neidert Newton B. , Abcejo Arnoley S. , Elmadhoun Omar
Published: August 2024

Pulmonary embolism (PE) embodies a large healthcare burden globally and is the third leading cause of morbidity and mortality worldwide. Submassive (intermediate-risk) PE accounts for 40% of this burden. However, the optimal treatment pathway for this population remains complex and ill-defined. Catheter-directed interventions (CDIs) have shown promise in directly impacting morbidity and mortality while demonstrating a favorable success rate, safety profile, and decreased length of stay (LOS) in the intensive care unit and hospital. This retrospective review included 22 patients (50% female) with submassive PE who underwent mechanical thrombectomy (MT). A total of 45% had a contraindication to thrombolytics, the mean pulmonary embolism severity index was 127, 36% had saddle PE, the average decrease in mean pulmonary artery pressure (PAP) was 7.2 mmHg following MT, the average LOS was 6.9 days, the 30-day mortality rate was 9%, the major adverse event (MAE) rate was 9%, and the readmission rate was 13.6%. A total of 82% had successful removal of thrombus during MT with no major bleeding complications, intracranial hemorrhage events, or device-related deaths. Acknowledging the limitation of our small sample size, our data indicate that MT in the intermediate-high-risk submassive pulmonary embolism (PE) cohort resulted in a decreased hospital length of stay (LOS) and in-hospital mortality compared to standard anticoagulation therapy alone.
Pan-Genome Analysis of TRM Gene Family and Their Expression Pattern under Abiotic and Biotic Stresses in Cucumber
Authors: Zhao Lili , Wang Ke , Wang Zimo , Chu Shunpeng , Chen Chunhua , Wang Lina , Ren Zhonghai
Published: August 2024

Cucumber (Cucumis sativus L.) is a vital economic vegetable crop, and the TONNEAU1 Recruiting Motif (TRM) gene plays a key role in cucumber organ growth. However, the pan-genomic characteristics of the TRM gene family and their expression patterns under different stresses have not been reported in cucumber. In this study, we identified 29 CsTRMs from the pan-genomes of 13 cucumber accessions, with CsTRM29 existing only in PI183967. Most CsTRM proteins exhibited differences in sequence length, except five CsTRMs having consistent protein sequence lengths among the 13 accessions. All CsTRM proteins showed amino acid variations. An analysis of CsTRM gene expression patterns revealed that six CsTRM genes strongly changed in short-fruited lines compared with long-fruited lines. And four CsTRM genes strongly responded to salt and heat stress, while CsTRM14 showed responses to salt stress, powdery mildew, gray mold, and downy mildew. Some CsTRM genes were induced or suppressed at different treatment timepoints, suggesting that cucumber TRM genes may play different roles in responses to different stresses, with expression patterns varying with stress changes. Remarkably, the expression of CsTRM21 showed considerable change between long and short fruits and in responses to abiotic stresses (salt stress and heat stress), as well as biotic stresses (powdery mildew and gray mold), suggesting a dual role of CsTRM21 in both fruit shape determination and stress resistance. Collectively, this study provided a base for the further functional identification of CsTRM genes in cucumber plant growth and stress resistance.
Yield Performance and Quality Assessment of Brazilian Hybrid Grapes Influenced by Rootstocks and Training Systems
Authors: Domingues Neto Francisco José , Tecchio Marco Antonio , Borges Cristine Vanz , Rodrigues João Domingos , Ono Elizabeth Orika , Lima Giuseppina Pace Pereira , Moura Mara Fernandes , Hernandes José Luiz , Silva Marcelo de Souza , Leonel Magali
Published: August 2024

The choice of training system impacts the architecture and physiological characteristics of grapevines, affecting grape production and quality. Continuous studies are necessary to optimize viticulture production in Brazil. This study aimed to evaluate the effects of rootstocks and different training systems on the production and quality of ‘IAC 138-22 Máximo’ and ‘BRS Violeta’ grapevines for juice and wine. The experiment was conducted over two productive cycles (2019/2020 and 2020/2021) in an experimental vineyard at the Advanced Center for Fruit Research as part of the Agronomic Institute (IAC), in Jundiaí, São Paulo, Brazil (23°06′ S, 46°55′ W, and 745 m altitude). For each cultivar, a randomized block design in a 2 × 2 factorial scheme was used, with two rootstocks (‘IAC 766 Campinas’ and 106-8 ‘Mgt’) and two training systems (low and high trellises), with five blocks of three plants per experimental plot. In both cycles, the gas exchange and grapevine production, the chemical characteristics of the grape juice (must), and the chemical compounds in the berry skins were evaluated. The rootstocks and training systems influenced the variables evaluated in both cultivars, with the high trellis system providing the best results. This approach increased the photosynthetic rate, improved water-use efficiency, elevated grapevine production, and enhanced fruit quality. Therefore, its use is recommended for training grapevines. Regarding rootstocks, the best scion–rootstock affinity was found between hybrid grapevines and ‘IAC 766 Campinas’.
Genome-Wide Identification of the Class III Peroxidase Gene Family in Ginger and Expression Analysis under High Temperature and Intense Light Stress
Authors: Gong Min , Jiang Yajun , Tang Shihao , Xing Haitao , Li Hui , Gu Jiajia , Mao Minmin , Wang Wei , Xia Maoqin , Li Hong-Lei
Published: August 2024

Ginger, valued for its medicinal properties and economic significance, is vulnerable to environmental stressors such as intense light and high temperatures, which can hinder its growth and development. Class III peroxidases (PRXs) are plant-specific oxidoreductases essential for plant development, growth, and stress responses. Despite their importance, there is limited information available on the function of the class III peroxidase gene family in ginger (ZoPRX). In this study, 103 ZoPRX members within the ginger genome were identified, unevenly distributed across 11 chromosomes. The identified ZoPRX members were categorized into five subfamilies based on gene structures, protein motifs, and phylogenetic analysis. Gene duplication analysis revealed that ZoPRX has primarily undergone segmental duplication. Interspecies homology analysis between ginger and Arabidopsis thaliana, Oryza sativa, and Musa acuminata suggested most ZoPRXs in ginger originated after the divergence of dicotyledon and monocotyledon. Analysis of promoter cis-acting elements identified defense and stress response elements in 39 genes and hormone response elements in 95 genes, indicating their potential roles in responding to environmental stresses. Quantitative Real-Time PCR (qRT-PCR) analysis confirmed that the majority of ZoPRX members are responsive to high temperature and intense light stress. This study provides a comprehensive understanding of the PRX family in ginger, thereby laying the groundwork for future investigations into the functional role of ZoPRX genes under high-temperature and intense light-stress conditions.
Geo-Referenced Databases and SWOT Analysis for Assessing Flood Protection Structures, Measures, and Works at a River Basin Scale
Authors: Tzanou Eleni , Skoulikaris Charalampos
Published: August 2024

This research aims to evaluate the operational effectiveness of current flood protection infrastructure and measures in a flood-prone area using geo-referenced information systems and SWOT analysis. To achieve this, all existing flood protection measures and works in the case study basin, namely Strymonas River basin in Greece, were mapped and recorded. These data, along with water-related spatial information, were stored in a geo-referenced database created within an open-source GIS environment. Additionally, the system was populated with the basin’s recorded historic floods, derived from the European Union’s Floods Directive implementation process. The outputs of the research, which include a spatial comparison of flood protection measures and works with flood event occurrences as well as analyses of the figures, density, and locations of flood protection works, were evaluated as an integrated system and further processed using SWOT analysis. The latter was informed by questionnaire results, and the identified strengths and weaknesses of the flood protection infrastructure were used to explore potential opportunities and threats, which could respectively reinforce or jeopardize the basin’s capacity to effectively respond to future floods. The research framework can be applied to any river basin and could provide important assets in flood protection planning at a basin scale.
Uncovering Gaps in Knowledge: A Survey of Belgian General Practitioners’ Awareness of Legionnaires’ Disease Diagnostic Testing
Authors: Moretti Marco , Van Nedervelde Julien , Vanstokstraeten Robin , Seyler Lucie , Echahidi Fedoua , Prevost Benoit , Martiny Delphine , Wybo Ingrid , Michel Charlotte
Published: August 2024

Background: The incidence of Legionnaires’ disease (LD) is increasing steadily in Europe. Its early diagnosis by general practitioners (GPs) is crucial for better patient outcomes. Study objectives: This study assessed Belgian GPs’ knowledge about LD and the accessibility of diagnostic tests in their practices. Methods: A specifically designed questionnaire was distributed to actively practicing GPs, including primary care trainees, between 31 January 2022 and 13 March 2022. This survey targeted approximately 4200 GPs with an estimated population catchment of 30% of the actively working Belgian GPs. Results: The response rate was estimated at 3%. Over 70% of the GPs correctly identified the LD occurrence peak, major risk factors, and clinical manifestations. While 62% of participants preferred the Legionella pneumophila urinary antigen test (UAT) as a primary diagnostic method, 75% were unsure about its availability within their laboratories and 82% had not prescribed it in the last year. Finally, 76% expressed a desire for additional information on this topic. Conclusions: Belgian GPs should evaluate the possibility of conducting UAT testing in their laboratories to enhance LD case management and improve their preparedness. Furthermore, initiatives should be implemented to improve communication between specialists and GPs and develop educational programs directed at Belgian GPs.
Wearable Technology and Its Influence on Motor Development and Biomechanical Analysis
Authors: Morouço Pedro
Published: August 2024

The convergence among biomechanics, motor development, and wearable technology redefines our understanding of human movement. These technologies allow for the continuous monitoring of motor development and the state of motor abilities from infancy to old age, enabling early and personalized interventions to promote healthy motor skills. For athletes, they offer valuable insights to optimize technique and prevent injuries, while in old age, they help maintain mobility and prevent falls. Integration with artificial intelligence further extends these capabilities, enabling sophisticated data analysis. Wearable technology is transforming the way we approach motor development and maintenance of motor skills, offering unprecedented possibilities for improving health, performance, and quality of life at every stage of life. The promising future of these technologies paves the way for an era of more personalized and effective healthcare, driven by innovation and interdisciplinary collaboration.
Perceptions Matter! Active Physical Recreation Participation of Children with High and Low Actual and Perceived Physical Competence
Authors: Field Stephanie C. , Foley John T. , Naylor Patti-Jean , Temple Viviene A.
Published: August 2024

Emerging evidence suggests that the accuracy of a child’s perceived physical competence (PPC) impacts participation in physical activity. We examined differences in active physical recreation (APR) participation based on clusters of high and low motor competence and perceptions from grades 3–5. Participants were a longitudinal sample (n = 155; 85 girls) of grade three, four, and five children. Fundamental motor skills (FMSs) were assessed using the TGMD-2, perceptions were assessed using the Self-Perception Profile for Children, and APR was measured using the Children’s Assessment of Participation and Enjoyment. K-means cluster analysis was used to create four clusters per grade based on participants’ FMSs and PPC z-scores. Differences in FMSs, PPC, and APR with cluster group as a factor were examined using a series of factorial ANOVAs. In each grade, participants in the high–high cluster participated in significantly more APR than those in the low–low cluster (p = 0.002 in grades three and four; p < 0.001 in grade five). Among the less accurate clusters (e.g., low FMSs with high PPC) was a trend toward positive FMSs growth among the children with higher perceptions. Results show that combinations of FMSs and PPC influence patterns of engagement or disengagement in active physical recreation persistently across middle childhood.
“They Can’t Possibly Understand What I’m Going Through”: Female Farmers’ Perspectives on Barriers to Care in Georgia
Authors: Hopkins Noah , Griffeth Lauren Ledbetter , Reece Chase , Proctor Christina
Published: August 2024

The purpose of this study was to explore female farmers’ perspectives on barriers to engaging with resources for physical and mental healthcare faced by agriculture producers in the state of Georgia. In-depth interviews were conducted with female farm owners and managers (n = 16) across the state. Interviews were recorded and transcribed, and researchers coded interviews separately before thematic analysis was used to identify common themes. Three primary themes were identified: (i) formal healthcare challenges, (ii) stigma, and (iii) cultural norms. Formal healthcare challenges included time constraints, healthcare costs, and a lack of cultural competence from healthcare providers. Both community and self-stigma were identified as barriers to engaging with mental health resources. Cultural norms that acted as a barrier to care included the prioritization of farm operations, self-reliance, pride, and the minimization of health concerns. Interviewees identified gender differences in the impact of stigma and cultural norms, reporting that these sociocultural barriers were more prominent among older, male producers. Central to many of these barriers is the concept of ‘farm identity’, where farmers’ commitment to their operations consistently trumped concerns about physical or mental health. Future efforts to improve health outcomes among farmers should utilize the concept of farm identity as a guide for tailoring interventions and improving cultural competence among rural healthcare providers.
Effective Messages to Reduce Stigma among People Newly Diagnosed with HIV during Rapid ART Initiation
Authors: Campbell Chadwick K. , Koester Kimberly A. , Erguera Xavier A. , Moran Lissa , LeTourneau Noelle , Broussard Janessa , Crouch Pierre-Cédric , Lynch Elizabeth , Camp Christy , Torres Sandra , Schneider John , VanderZanden Lyndon , Coffey Susa , Christopoulos Katerina A.
Published: August 2024

HIV stigma has a negative influence on antiretroviral therapy (ART) initiation and persistence and viral suppression. Immediate access to ART (RAPID ART) has been shown to accelerate viral suppression (VS) that is sustained up to one year after HIV diagnosis. Little is known about the role of RAPID ART in reducing individual-level stigma. We explored how stigma manifests in RAPID ART encounters and whether RAPID ART interventions influence individual-level HIV stigma during and in the time immediately after the diagnosis experience. We conducted in-depth interviews with 58 RAPID ART patients from three health clinics in San Francisco, CA, and Chicago, IL. Interviews were transcribed, coded, and thematically analyzed. In the results, we discuss three main themes. First, Pre-Diagnosis HIV Beliefs, which included three sub-themes: HIV is “gross” and only happens to other people; HIV (Mis)education; and People are “living long and strong” with HIV. Second, Positive and Reassuring Messages During the RAPID Experience, which included two sub-themes: Correcting Misinformation and Early Interactions with People Living with HIV. Third, The RAPID ART Process Can Disrupt Stigma. RAPID ART encounters served as a potent mechanism to disrupt internalized stigma by providing accurate information and dispelling unhelpful myths through verbal and nonverbal messages. Reducing internalized stigma and misinformation about HIV at this early stage has the potential to reduce the effect of HIV stigma on ART initiation and adherence over time.
Immune Response and Exhaled Breath Profile Changes after Initiation of CFTR Modulator Therapy in Children with CF
Authors: van Aerde Koen J. , Ferwerda Gerben , Smolinska Agnieszka , Dompeling Edward , Roukema Jolt
Published: August 2024

Background: In recent years, cystic fibrosis transmembrane regulator (CFTR) modulating therapy has made it possible to treat the underlying pathophysiological defect in children with cystic fibrosis (CF). Response to therapy varies among patients. We investigated the immune responses and exhaled breath profile changes after the initiation of CFTR modulator therapy to explore their potential as markers of therapy response. Methods: We performed a prospective, longitudinal proof-of-principle study, investigating immune responses and exhaled breath volatile organic component (VOC) profiles prior to and during the initiation of therapy with Lumacaftor/Ivacaftor in a cohort of 17 patients with CF aged 2 to 6 years old. Response to therapy was assessed based on clinical markers and the decrease in sweat chloride. Whole blood stimulation assays were performed at t = 0, 6 and 18 weeks, while VOC analysis was performed at t = 0 and 18 weeks. Results: A pattern of immune reconstitution was found in the first 4 months of therapy. The same pattern was found in responders and non-responders. Exhaled breath VOC profiles were significantly affected by therapy. A trend toward a significant difference was found between responders and non-responders. Conclusions: Pediatric CF patients show a pattern of immune reconstitution after the initiation of CFTR modulating therapy. We hypothesize that this could be explained by the need for a pro-inflammatory profile for a more effective clearance of latent airway pathogens in the initial phase. The exhaled breath profile also clearly changes after the initiation of therapy, indicating the therapy’s influence on airway inflammation and oxidative stress; thus, it might predict the response to therapy.
Combined Toxic Effects of Lead and Glyphosate on Apis cerana cerana
Authors: Xue Yunfei , Zhao Wenzheng , Meng Qingxin , Yang Linfu , Zhi Dandan , Guo Yulong , Yue Dan , Tian Yakai , Dong Kun
Published: August 2024

Glyphosate (GY) is the most widely used herbicide in agriculture worldwide. Lead is a common heavy metal in the natural environment. Honeybees, as pollinators, are exposed to these pollutants. So far, few reports have evaluated the toxic effects of GY mixed with heavy metals on honeybees (Apis cerana cerana). This study found that the acute toxicity of lead (LC50 = 1083 mg/L) is much greater than that of GY (LC50 = 4764 mg/L) at 96 h. The acute toxicities of the mixed substances were as follows: LC50 = 621 mg/L of lead and LC50 = 946 mg/L of GY. The combination of lead and GY was more toxic than either of the individual substances alone. Compared to the individual toxicity, combined treatment significantly affected the bees’ learning and cognitive abilities and changed the relative expression of genes related to immune defense and detoxification metabolism in A. c. cerana. The combination of lead and GY seriously affected the behavior and physiology of the studied honeybees. This study provides basic data for further research on the combined effects of GY and heavy metals on bee health. It also serves as a reference for effective colony protection.
Tubal Cancer Clinical Management: Two Exceptional Scenarios and a Review of the Literature
Authors: Colombi Irene , D’Indinosante Marco , Lazzeri Lucia , Zupi Errico , Pisaneschi Silvia , Giusti Marco , Mattei Alberto , Debonis Elisa Valentina , Cassisa Angelo , Cavaliere Anna Franca , Perelli Federica
Published: August 2024

This article provides a literature review on tubal carcinoma to offer an updated insight into its preventative strategies, diagnosis, treatment and oncological surveillance. In addition to the search string utilized, the authors’ focus extended to key scientific studies, consensus statements, guidelines and relevant case reports essential for the proper clinical management of the disease, providing a methodologically well-structured literature review combined with practical expertise in the oncological field. This article also includes two special clinical cases that emphasize the importance of understanding the physiopathology and the current state of the art in the anatomopathological advancements in tubal/ovarian/peritoneal carcinoma, often assimilated into a single clinical entity and to which many of the concepts extracted from the literature can apply.
Longitudinal Impact of Disordered Eating Attitudes on Depression, Anxiety, and Somatization in Young Women with Anorexia and Bulimia
Authors: Skalski-Bednarz Sebastian Binyamin , Hillert Andreas , Surzykiewicz Janusz , Riedl Elisabeth , Harder Jean-Pierre , Hillert Sophia Magdalena , Adamczyk Marta , Uram Patrycja , Konaszewski Karol , Rydygel Martin , Maier Kathrin , Dobrakowski Paweł
Published: August 2024

Background/Objectives: Eating disorders, characterized by severe disturbances in eating behavior, are a public health concern, particularly among young women. This longitudinal study aimed to investigate the relationship between disordered eating attitudes and mental health outcomes, including depression, anxiety, and somatization, among individuals with eating disorders. Methods: A total of 471 young German women hospitalized with anorexia nervosa or bulimia nervosa participated in this study. Assessments were conducted at two points over a two-month interval using the Eating Disorder Inventory-2 (EDI-2) and the Patient Health Questionnaire. Regression analyses were performed to determine predictors of depression, anxiety, and somatization. The study controlled for socio-demographic segmentation using Sinus-Milieus, a social classification system, as a covariate. Results: Regression analyses revealed that interpersonal distrust and impulse regulation were significant predictors of subsequent depression. Impulse regulation strongly predicted subsequent anxiety, while both impulse regulation and social insecurity were strong predictors of subsequent somatization. The Neo-Ecological Milieu emerged as the most prevalent socio-demographic group (34.4% of participants). The Sinus-Milieus segmentation, however, did not significantly impact the health outcomes, suggesting consistent mental health issues across socio-demographic groups. Conclusions: This study’s findings underscored the role of disordered eating attitudes in predicting mental health outcomes among young women with eating disorders. Addressing these attitudes in therapeutic settings may help mitigate symptoms of not only the primary condition but also depression, anxiety, and somatization.
Development and Validation of Artificial Intelligence Models for Prognosis Prediction of Juvenile Myoclonic Epilepsy with Clinical and Radiological Features
Authors: Kim Kyung Min , Choi Bo Kyu , Ha Woo-Seok , Cho Soomi , Chu Min Kyung , Heo Kyoung , Kim Won-Joo
Published: August 2024

Background: Juvenile myoclonic epilepsy (JME) is a common adolescent epilepsy characterized by myoclonic, generalized tonic–clonic, and sometimes absence seizures. Prognosis varies, with many patients experiencing relapse despite pharmacological treatment. Recent advances in imaging and artificial intelligence suggest that combining microstructural brain changes with traditional clinical variables can enhance potential prognostic biomarkers identification. Methods: A retrospective study was conducted on patients with JME at the Severance Hospital, analyzing clinical variables and magnetic resonance imaging (MRI) data. Machine learning models were developed to predict prognosis using clinical and radiological features. Results: The study utilized six machine learning models, with the XGBoost model demonstrating the highest predictive accuracy (AUROC 0.700). Combining clinical and MRI data outperformed models using either type of data alone. The key features identified through a Shapley additive explanation analysis included the volumes of the left cerebellum white matter, right thalamus, and left globus pallidus. Conclusions: This study demonstrated that integrating clinical and radiological data enhances the predictive accuracy of JME prognosis. Combining these neuroanatomical features with clinical variables provided a robust prediction of JME prognosis, highlighting the importance of integrating multimodal data for accurate prognosis.
Predicting Quality of Life in Parkinson’s Disease: A Machine Learning Approach Employing Common Clinical Variables
Authors: Magano Daniel , Taveira-Gomes Tiago , Massano João , Barros António S.
Published: August 2024

Background: Parkinson’s Disease significantly impacts health-related quality of life, with the Parkinson’s Disease Questionnaire-39 extensively used for its assessment. However, predicting such outcomes remains a challenge due to the subjective nature and variability in patient experiences. This study develops a machine learning model using accessible clinical data to enable predictions of life-quality outcomes in Parkinson’s Disease and utilizes explainable machine learning techniques to identify key influencing factors, offering actionable insights for clinicians. Methods: Data from the Parkinson’s Real-world Impact Assessment study (PRISM), involving 861 patients across six European countries, were analyzed. After excluding incomplete data, 627 complete observations were used for the analysis. An ensemble machine learning model was developed with a 90% training and 10% validation split. Results: The model demonstrated a Mean Absolute Error of 4.82, a Root Mean Squared Error of 8.09, and an R2 of 0.75 in the training set, indicating a strong model fit. In the validation set, the model achieved a Mean Absolute Error of 11.22, a Root Mean Squared Error of 13.99, and an R2 of 0.36, showcasing moderate variation. Key predictors such as age at diagnosis, patient’s country, dementia, and patient’s age were identified, providing insights into the model’s decision-making process. Conclusions: This study presents a robust model capable of predicting the impact of Parkinson’s Disease on patients’ quality of life using common clinical variables. These results demonstrate the potential of machine learning to enhance clinical decision-making and patient care, suggesting directions for future research to improve model generalizability and applicability.
Use of Traditional Japanese Herbal Medicine Daikenchuto for the Treatment of Abdominal Distention in Very-Low-Birth-Weight Infants
Authors: Iijima Shigeo
Published: August 2024

Background: Very-low-birth-weight (VLBW) infants often experience feeding intolerance owing to organ immaturity, and the most frequent sign is the presence of abdominal distention. Daikenchuto (DKT), a traditional Japanese herbal medicine, is used to improve gastrointestinal function, particularly in adults. The aim of this study was to investigate the effectiveness of DKT in reducing abdominal distention and intestinal gas in VLBW infants. Methods: This study involved a retrospective chart review of 24 VLBW infants treated with DKT at Hamamatsu University Hospital between April 2016 and March 2021. The effects of DKT treatment at a dose of 0.3 g/kg/day were evaluated through clinical parameters and abdominal radiography. Results: Before treatment, marked abdominal distention was observed in 46% of the infants, which reduced to 4% within a week of DKT administration. The gas volume score (GVS) decreased in 92% of the patients within the first week of treatment and markedly decreased by ≥20% in 46% of the patients. The effects of improving abdominal distention and decreasing the GVS on radiography persisted for 1–2 weeks after treatment initiation. No clinical parameters affecting a GVS reduction of ≥20% and no notable adverse effects were observed. Conclusions: While the preliminary findings suggest that DKT may help manage abdominal distention in VLBW infants, further studies with placebo-controlled trials, larger sample sizes, use of advanced image processing software, and consideration of additional influencing factors are required to substantiate these results and identify predictors of treatment response.
Maternal and Perinatal Outcomes in Pregnant Women with Heart Disease: A Case—Control Study
Authors: Aracil Moreno Irene , Prieto-Arévalo Raquel , Ortega-Abad Virginia , Martín-Manzano Virginia , Pérez-Burrel Laura , Fraile-López Andrea , Devesa-Cordero Carolina , Yllana-Pérez Fátima , Ortega Miguel A. , De León-Luis Juan A.
Published: August 2024

Objective: We analyzed the obstetric and cardiac characteristics and results of pregnant women with heart disease (HD) and compared their results with those of healthy controls. Methods: In this retrospective single-center case–control study, women with HD attended between 2010 and 2018 were matched at a 1:2 ratio (according to date of delivery, parity, and singleton or twin pregnancy) with controls without heart disease treated in the same referral center. Results: We identified 141 pregnant women with HD, of whom 132 reached 22 weeks of gestation and were paired with 264 healthy controls, for a total of 396 participants and 408 newborns. Most common HDs were congenital HD (53 women), arrhythmia (46), valvular HD (35), and cardiomyopathy (16), having women with more than one coexisting HD. During pregnancy or the puerperium, 19.9% of mothers experienced a major adverse cardiac event (MACE), with 5% requiring intensive care unit (ICU) admission. The rates of cesarean section were 37.1% in the case group and 18.2% in the control group, with an odds ratio (OR) of 2.66 (95% CI = 1.66–4.26, p < 0.001). We also found a higher use of general anesthesia, with an OR of 10.73 (95% CI = 2.32–49.75, p = 0.002); more prolonged hospitalizations, with an OR of 2.91 (95% CI 1.02–8.35, p = 0.023); and a higher incidence of low neonatal weight, with an OR of 1.96 (95% CI 1.09–3.52, p = 0.012). There were no differences between groups in terms of gestational age at delivery; however, we observed greater prematurity in women with HD, without reaching statistical significance. The rate of congenital heart disease among the newborns of mothers with HD was 13.2%. Conclusions: HD increases maternal morbidity during pregnancy and it is associated with higher rates of cesarean section and low birth weight.
Association Analysis between Cognitive Function Score and Inner Macular Thickness/Visual Field Sensitivity in Glaucoma Patients
Authors: Shimomine Soichiro , Kubota Suguru , Kadoh Yoichi , Tanito Masaki
Published: August 2024

(1) Background: Previous research has investigated the relationship between cognitive impairment, optical coherence tomography (OCT), visual fields (VF), and VF reliability in smaller patient samples using various cognitive assessment tools. This study analyzed the relationship between cognitive function scores using the Mini-Cog test and inner macular thickness (IMT) and VF sensitivity in glaucoma patients. (2) Methods: A retrospective analysis was conducted on 984 patients with 1897 eyes. Assessments included age, sex, intraocular pressure (IOP), and Mini-Cog test scores. Abnormal Mini-Cog scores were observed in 89 patients (9%). Using a mixed-effects model adjusted for background factors, the association between Mini-Cog scores and IMT, parafoveal (PF)-IMT, mean deviation (MD), pattern standard deviation, fixation losses (FL), false negatives (FN), and false positives (FP) was analyzed. (3) Results: Abnormal Mini-Cog scores (≤2) were associated with thinning of the IMT and PF-IMT, worse MDs, and higher FN and FP rates but not with PSD or FL. (4) Conclusions: Glaucoma patients with low cognitive function scores exhibited more advanced glaucoma-related changes in VF testing and morphological tests. Further longitudinal studies are needed to explore the relationship between glaucoma and cognitive impairment.
Low-Frequency Ventilation May Facilitate Weaning in Acute Respiratory Distress Syndrome Treated with Extracorporeal Membrane Oxygenation: A Randomized Controlled Trial
Authors: Hermann Martina , König Sebastian , Laxar Daniel , Krall Christoph , Kraft Felix , Krenn Katharina , Baumgartner Clemens , Tretter Verena , Maleczek Mathias , Hermann Alexander , Fraunschiel Melanie , Ullrich Roman
Published: August 2024

Although extracorporeal membrane ventilation offers the possibility for low-frequency ventilation, protocols commonly used in patients with acute respiratory distress syndrome (ARDS) and treated with extracorporeal membrane oxygenation (ECMO) vary largely. Whether strict adherence to low-frequency ventilation offers benefit on important outcome measures is poorly understood. Background/Objectives: This pilot clinical study investigated the efficacy of low-frequency ventilation on ventilator-free days (VFDs) in patients suffering from ARDS who were treated with ECMO therapy. Methods: In this single-center randomized controlled trial, 44 (70% male) successive ARDS patients treated with ECMO (aged 56 ± 12 years, SAPS III 64 (SD ± 14)) were randomly assigned 1:1 to the control group (conventional ventilation) or the treatment group (low-frequency ventilation during first 72 h on ECMO: respiratory rate 4–5/min; PEEP 14–16 cm H2O; plateau pressure 23–25 cm H2O, tidal volume: <4 mL/kg). The primary endpoint was VFDs at day 28 after starting ECMO treatment. The major secondary endpoint was ICU mortality, 28-day mortality and 90-day mortality. Results: Twenty-three (52%) patients were successfully weaned from ECMO and were discharged from the intensive care unit (ICU). Twelve patients in the treatment group and five patients in the control group showed more than one VFD at day 28 of ECMO treatment. VFDs were 3.0 (SD ± 5.5) days in the control group and 5.4 (SD ± 6) days in the treatment group (p = 0.117). Until day 28 of ECMO initiation, patients in the treatment group could be successfully weaned off of the ventilator more often (OR of 0.164 of 0 VFDs at day 28 after ECMO start; 95% CI 0.036–0.758; p = 0.021). ICU mortality did not differ significantly (36% in treatment group and 59% in control group; p = 0.227). Conclusions: Low-frequency ventilation is comparable to conventional protective ventilation in patients with ARDS who have been treated with ECMO. However, low-frequency ventilation may support weaning from invasive mechanical ventilation in patients suffering from ARDS and treated with ECMO therapy.
Development of an Energy-Efficient Method of Obtaining Polymer-Modified Bitumen with High Operational Characteristics via Polymer–Bitumen Concentrate Application
Authors: Akimov Andrey Evgenevich , Yadykina Valentina Vasilevna , Lebedev Mikhail Sergeevich , Denisov Vasilij Petrovich , Inozemtcev Sergei Sergeevich , Inozemtcev Aleksandr Sergeevich , Korshunov Andrey Vladimirovich , Pilipenko Anton Sergeevich
Published: August 2024

New requirements for the operational reliability of roads make the utilization of polymer-modified bitumen (PMB) more common in road construction. The application of polymer-modified bitumen based on traditional technology for the production of asphalt mixtures is associated with technological and economic difficulties and does not provide proper adhesion to the mixture’s mineral components. In addition, the method of producing a binder over a long time at high process temperatures leads to increased aging, which significantly reduces the service life of the material in the pavement. This paper presents the results of studies on the effect of polymer–bitumen concentrate (PBC) consisting of styrene–butadiene–styrene, plasticizer, and surfactant on the bitumen characteristics. It has been established that the use of PBC in the bitumen binder leads to an increase in the temperature range of plasticity, softening temperature, elasticity, and cohesive strength with a decrease in the viscosity of the modified bitumen. With a complex modifier rational content of 8% by weight of bitumen, the temperature range of plasticity is 79 °C, and elasticity is 82%, which exceeds the parameters of the factory PMB-60 based on SBS polymer. Tests of binders using the Superpave method allow classifying the modified binder to the PG 64-28, which shows an increase in the temperature range of viscoelastic properties by 6 °C compared with the binder produced by traditional methods. Thus, the expediency of using a complex additive containing a polymer and surface-active substances (surfactants) that can be distributed in bitumen without the use of a colloid agitator and plasticizer has been proven to improve the quality of an organic binder.
Optimization of Material Utilization by Developing a Reliable Design Criterion for Tool Construction in Cross-Wedge Rolling
Authors: Kramer Patrick , Karaman Abdulkerim , Marré Michael
Published: August 2024

The massive forming industry in Germany produces around 1.4 million tons of parts every year, which are mainly used in safety-relevant areas such as the automotive industry. The production of these parts requires a considerable amount of energy, much of which remains unused and causes high CO2 emissions. An efficient approach to reduce these emissions and improve material utilization is cross-wedge rolling, which enables efficient material utilization but is limited by the so-called Mannesmann effect, which leads to unwanted material defects. This paper describes the development and validation of a safe design criterion for cross-wedge rolling tools in order to avoid material damage caused by the Mannesmann effect and thus increase resource efficiency in forging. Based on simulation-supported investigations and experimental tests, process maps are created for various materials. The validation is carried out both in an experimental test facility with real tools and in an industrial production facility, which leads to a significant reduction in excess material and CO2 emissions. The results show that the full resource potential of cross-wedge rolling can be exploited by optimizing process parameters and tool geometries.
Control of Peach Brown Rot Disease Produced by Monilinia fructicola and Monilinia laxa Using Benzylidene-Cycloalkanones
Authors: Madrid Alejandro , Silva Valentina , Reyes Constanza , Werner Enrique , Besoain Ximena , Montenegro Iván , Muñoz Evelyn , Díaz Katy
Published: August 2024

Fruit rots caused by filamentous fungi such as Monilinia fructicola and Monilinia laxa have a strong impact on crop yield and fruit commercialization, especially as they affect a wide variety of stone fruits. The antifungal efficacy of benzylidene-cycloalkanones has been previously described in in vitro assays against M. fructicola; so, this study aims to evaluate the in vivo inhibitory potential of these hybrids on fruits that have been inoculated with M. fructicola, and use molecular docking to visualize the main interactions of these molecules in the active site of the enzyme succinate dehydrogenase (SDH). The results indicate that compound C achieves the highest inhibition of both Monilinia species (15.7–31.4 µg/mL), spore germination in vitro (<10 µg/mL), and has promising results in vivo, without causing phytotoxicity in fruits. The results from molecular docking suggest that hydroxyl groups play a crucial role in enhancing the binding of compound C to SDH and contribute to the formation of hydrogen bonds with amino acid residues on the enzyme active site.
Novel Technique for Simultaneous Ethylene Glycol and Its Metabolites Determination in Human Whole Blood and Urine Samples Using GC–QqQ–MS/MS
Authors: Tusiewicz Kaja , Wachełko Olga , Zawadzki Marcin , Szpot Paweł
Published: August 2024

Toxicological analyses often necessitate the identification of compounds belonging to diverse functional groups. For GC–MS analyses, derivatization of compounds belonging to different functional groups can pose a challenge and requires the development of comprehensive methods of analysis. One example could be ethylene glycol, whose widespread use is related to possible unintentional or suicidal intoxications. This fact clearly indicates the need to develop sensitive methods for the determination of ethylene glycol and its metabolites in biological material, as only such complex analysis allows for proper toxicological expertise. A simultaneous GC–QqQ–MS/MS method for the determination of ethylene glycol together with its metabolites, glyoxal and glycolic acid, as well as the detection of glyoxylic acid and oxalic acid, was developed and fully validated. A novel approach for simultaneous derivatization of substances from different groups (alcohols, aldehydes, and carboxylic acids) was established. Sample preparation included the addition of three internal standards (BHB-d4, ethylene glycol-d4 and methylglyoxal), precipitation with acetonitrile and subsequent derivatization with N-tert-butyldimethylsilyl-N-methyltrifluoroacetamide (MTBSTFA), as well as pentafluorophenylhydrazine (PFPH). Detection was carried out with the use of triple quadrupole mass spectrometer. The ionization method was electron impact, and quantitative analysis was carried out in multiple reaction monitoring mode. The lower limit of quantification was 1 μg/mL, 0.1 μg/mL, and 500 μg/mL for ethylene glycol, glyoxal, and glycolic acid, respectively. The presented method was applied in three authentic postmortem cases of ethylene glycol intoxication.
Effect of Age, Gender, Food Intake, Obesity, and Smoking on Serum Levels of Prolactin in Healthy Adults
Authors: Momani Munther S. , Al Tarawni Ahmad , Momani Yazan M. , Rahhal Sara , Elhaj Ibrahim , Al-Halhouli Dania , Alhawari Hussam
Published: August 2024

Objective: The objective of this study was to investigate the effect of age, gender, body mass index (BMI), food intake, and smoking on serum prolactin (PRL) levels among healthy adults. Methods: In total, 100 healthy adults (46 males and 54 females) aged ≥18 years were recruited. Serum PRL levels were measured after a 9 h overnight fast, 1 h postprandially (early), and 3 h postprandially (late). Results: Mean PRL levels were significantly higher in females than males in the fasting, early, and late postprandial states. PRL levels were suppressed significantly after food intake in both genders. Mean PRL levels were significantly higher in younger individuals (<30 years) in the fasting and the early postprandial states compared to older individuals (≥30 years) and suppressed significantly after food intake in younger individuals only. Mean PRL levels were not significantly different between individuals with a normal BMI (<25 kg/m2) compared to those overweight and with obesity (BMI ≥ 25 kg/m2); however, PRL levels were significantly suppressed after food intake only in subjects with a normal BMI. Mean PRL levels did not differ significantly according to smoking status. PRL levels were suppressed significantly after food intake in nonsmokers only. Conclusion: Our data suggest that age, gender, and food intake should be considered when the serum PRL level is measured in clinical practice.