bluuebunny/crossref_metadata_2025 huggingface dataset:
Determining an Optimal Oxygen Saturation Target Range Based on Neonatal Maturity: Demonstration of a Decision Tree Analytic
Authors: Bachman Thomas E. , Iyer Narayan P. , Newth Christopher J. L. , LeMoyne Robert
Published: October 2023

The utility of decision tree machine learning in exploring the interactions among the SpO2 target range, neonatal maturity, and oxemic-risk is demonstrated. METHODS: This observational study used 3 years of paired age-SpO2-PaO2 data from a neonatal ICU. The CHAID decision tree method was used to explore the interaction of postmenstrual age (PMA) on the risk of extreme arterial oxygen levels at six different potential SpO2 target ranges (88–92%, 89–93%, 90–94%, 91–95%, 92–96% and 93–97%). Risk was calculated using a severity-weighted average of arterial oxygen outside the normal range for neonates (50–80 mmHg). RESULTS: In total, 7500 paired data points within the potential target range envelope were analyzed. The two lowest target ranges were associated with the highest risk, and the ranges of 91–95% and 92–96% were associated with the lowest risk. There were shifts in the risk associated with PMA. All the target ranges showed the lowest risk at ≥42 weeks PMA. The lowest risk for preterm infants was within a target range of 92–96% with a PMA of ≤34 weeks. CONCLUSIONS: This study demonstrates the utility of decision tree analytics. These results suggest that SpO2 target ranges that are different from typical range might reduce morbidity and mortality. Further research, including prospective randomized trials, is warranted.
Computed Tomography-Based Coronary Artery Calcium Score Calculation at a Reduced Tube Voltage Utilizing Iterative Reconstruction and Threshold Modification Techniques: A Feasibility Study
Authors: Habibi Shirin , Akbarnejad Mohammad , Rezaeian Nahid , Salmanipour Alireza , Mohammadzadeh Ali , Rezaei-Kalantari Kiara , Chalian Hamid , Asadian Sanaz
Published: October 2023

Background: The coronary artery calcium score (CACS) indicates cardiovascular health. A concern in this regard is the ionizing radiation from computed tomography (CT). Recent studies have tried to introduce low-dose CT techniques to assess CACS. We aimed to investigate the accuracy of iterative reconstruction (IR) and threshold modification while applying low tube voltage in coronary artery calcium imaging. Methods: The study population consisted of 107 patients. Each subject underwent an electrocardiogram-gated CT twice, once with a standard voltage of 120 kVp and then a reduced voltage of 80 kVp. The standard filtered back projection (FBP) reconstruction was applied in both voltages. Considering Hounsfield unit (HU) thresholds other than 130 (150, 170, and 190), CACS was calculated using the FBP-reconstructed 80 kVp images. Moreover, the 80 kVp images were reconstructed utilizing IR at different strength levels. CACS was measured in each set of images. The intraclass correlation coefficient (ICC) was used to compare the CACSs. Results: A 64% reduction in the effective dose was observed in the 80 kVp protocol compared to the 120 kVp protocol. Excellent agreement existed between CACS at high-level (strength level = 5) IR in low-kVp images and the standard CACS protocol in scores ≥ 11 (ICC > 0.9 and p < 0.05). Increasing the threshold density to 190 HU in FBP-reconstructed low-kVp images yielded excellent agreement with the standard protocol in scores ≥ 11 (ICC > 0.9 and p < 0.05) and good agreement in score zero (ICC = 0.84 and p = 0.02). Conclusions: The modification of the density threshold and IR provides an accurate calculation of CACS in low-voltage CT with the potential to decrease patient radiation exposure.
Prerequisites of Good Cooperation between Teachers and School Psychologists: A Qualitative Analysis
Authors: Müllerová Zuzana , Šmahaj Jan
Published: October 2023

The aim of this study was to determine what kinds of factors play a role in the formation of relationships and cooperation between teachers and school psychologists in Czech schools and the ways in which these factors operate. We used a qualitative methodological design with data collection conducted in the form of semi-structured interviews with eight teachers and ten school psychologists. Subsequent analysis was performed using the grounded theory method. The results indicated the central importance of how a given teacher views the school psychologist, which further determines which factors will influence the degree to which the psychologist is accepted. The following factors were shown to be important in the relationship between a psychologist and a teacher’s neutral attitude toward them: the characteristics of the teacher and the psychologist, the role of school management, the role of school focus and the degree to which the psychologist’s role is understood. The discrepancy between the actual role of the school psychologist and how their role is perceived by the teachers can be a source of issues in cooperation and trust between the two.
Image Composition Method Based on a Spatial Position Analysis Network
Authors: Li Xiang , Teng Guowei , An Ping , Yao Haiyan
Published: October 2023

Realistic image composition aims to composite new images by fusing a source object into a target image. It is a challenging problem due to the complex multi-task framework, including sensible object placement, appearance consistency, shadow generation, etc. Most existing researchers attempt to address one of the issues. Especially before compositing, there is no matching assignment between the source object and target image, which often leads to unreasonable results. To address the issues above, we consider image composition as an image generation problem and propose a deep adversarial learning network via spatial position analysis. We target the analysis network segment and classify the objects in target images. A spatial alignment network matches the segmented objects with the source objects, and predicts a sensible placement position, and an adversarial network generates a realistic composite image with the shadow and reflection of the source object. Furthermore, we use the classification information of target objects to filter out unreasonable image compositing. Moreover, we introduce a new test set to evaluate the network generalization for our multi-task image composition dataset. Extensive experimental results of the SHU (Shanghai University) dataset demonstrate that our deep spatial position analysis network remarkably enhances the compositing performance in realistic, shadow, and reflection generations.
Tikhonov-Tuned Sliding Neural Network Decoupling Control for an Inverted Pendulum
Authors: Mon Yi-Jen
Published: October 2023

This paper introduces the concept of intelligent control using Tikhonov regularization for nonlinear coupled systems. This research is driven by the increasing demand for advanced control techniques and aims to explore the impact of Tikhonov regularization on these systems. The primary objective is to determine the optimal regularization term and its integration with other control methods to enhance intelligent control for nonlinear coupled systems. Tikhonov regularization is a technique employed to adjust neural network weights and prevent overfitting. Additionally, the incorporation of ReLU activation function in the neural network simplifies thearchitecture, avoiding issues like gradient explosion, and optimizes controller performance. Furthermore, sliding surfaces are designed to improve control system stability and robustness. The proposed Tikhonov-tuned sliding neural network (TSN) controller ensures both stability and superior system performance. The methodology emphasizes the importance of determining optimal neural network weights and regularization terms to prevent overfitting, facilitating accurate predictions in inverted pendulum control system applications. To assess the functionality and stability of TSN, this paper employs simulations and experimental implementations to control both the rotary inverted pendulum and the arm-driven inverted pendulum. The results indicate that the proposed TSN methodologies are effective and feasible.
A Comparative Review of Three Different Power Inverters for DC–AC Applications
Authors: Abdel-Aziz Ali , Elgenedy Mohamed A. , Williams Barry
Published: October 2023

This paper presents a comparative review of three different widely used power inverters, namely the conventional six-switch inverter; the reduced switch count four-switch inverter; and the eight-switch inverter. The later inverter can be reconfigured as a neutral-point diode-clamped inverter at the failure of one inverter leg. The three power inverters are compared and discussed with respect to cost, complexity, losses, common mode voltage, and control techniques. The paper is intended to serve as a guide regarding selecting the appropriate inverter for each specific application. Simulation results are presented to demonstrate the performance of the three power inverters, followed by a comprehensive comparison between the three power inverters.
Design of Thermoelectric Generators and Maximum Electrical Power Using Reduced Variables and Machine Learning Approaches
Authors: Vargas-Almeida Alexander , Olivares-Robles Miguel Angel , Andrade-Vallejo Andres Alfonso
Published: October 2023

This work aims to contribute to studies on the geometric optimization of thermoelectric generators (TEGs) through a combination of the reduced variables technique and supervised machine learning. The architecture of the thermoelectric generators studied, one conventional and the other segmented, was determined by calculating the cross-sectional area and length of the legs, and applying reduced variables approximation. With the help of a supervised machine learning algorithm, the values of the thermoelectric properties were predicted, as were those of the maximum electrical power for the other temperature values. This characteristic was an advantage that allowed us to obtain approximate results for the electrical power, adjusting the design of the TEGs when experimental values were not known. The proposed method also made it possible to determine the optimal values of various parameters of the legs, which were the ratio of the cross-sectional areas (Ap/An), the length of the legs (l), and the space between the legs (H). Aspects such as temperature-dependent thermoelectric properties (Seebeck coefficient, electrical resistivity, and thermal conductivity) and the metallic bridge that connects the legs were considered in the calculations for the design of the TEGs, obtaining more realistic models. In the training phase, the algorithm received the parameter (H) and an operating temperature value as input data, to predict the corresponding value of the maximum power produced. This calculation was performed for conventional and segmented systems. Recent advances have opened up the possibility of applying an algorithm for designing conventional and segmented thermocouples based on the reduced variables approach and incorporating a supervised machine learning computational technique.
Modeling Vehicle Fuel Consumption Using a Low-Cost OBD-II Interface
Authors: Rykała Magdalena , Grzelak Małgorzata , Rykała Łukasz , Voicu Daniela , Stoica Ramona-Monica
Published: October 2023

As a result of ever-growing energy demands, motor vehicles are among the largest contributors to overall energy consumption. This has led researchers to focus on fuel consumption, which has important implications for the environment, the economy, and geopolitical stability. This article presents a comprehensive analysis of various fuel consumption modeling methods, with the aim of identifying parameters that significantly influence fuel consumption. The scientific novelty of this article lies in its use of low-cost technology, i.e., an OBD-II interface paired with a mobile phone, combined with modern mathematical modeling methods to create an accurate model of the fuel consumption of a vehicle. A vehicle test drive was performed, during which variations in selected parameters were recorded. Based on the obtained data, a model of the vehicle’s fuel consumption was built using three forecasting methods: a multivariate regression model, decision trees, and neural networks. The results show that the multivariate regression model obtained the lowest MSE, MAR, and MRSE coefficients, indicating that this was the best forecasting method among those tested. Sufficient forecast error results were obtained using neural networks, with increases of approximately 73%, 10%, and 131% in MSE, MAE, and MRAE, respectively, compared to regression results. The worst results were obtained with the decision tree model, with increases of approximately 163%, 21%, and 92% in MSE, MAE, and MRAE compared to the regression results.
Hierarchical Operation Optimization for Regenerative Braking Energy Utilizing in Urban Rail Traction Power Supply System
Authors: Zhang Hao , Zhang Jian , Zhou Linjie , Xiong Peng , Zhao Zhuofan
Published: October 2023

The energy feedback system (EFS) is widely accepted to utilize the regenerative braking energy (RBE) in an urban rail traction power supply system (TPSS). However, the sharing relationship of RBE between EFS, traction trains and on-board braking resistors is not clear. In addition, the impact of EFS operation on the sharing of RBE has been rarely studied. This paper proposed a hierarchical operation optimization method for improving the utilization of shared RBE in TPSS through the EFS. An optimizing model for the dynamic start-up voltage threshold of EFS is established, with the objective of minimizing TPSS power consumption. A fast prediction model of train operation information is developed to analyze the steady-state power flow in advance. The optimal solution is searched using a salp swarm algorithm (SSA) on a per second basis. A microsystem of three traction stations and two trains is analyzed. Compared to the conventional constant voltage operation scheme, the optimal solution achieves a maximum additional energy-saving efficiency improvement of 2.44%. Efficient sharing of RBE is identified as the key to achieving energy savings. Regarding the local control part, system stability analysis is verified. Real-time simulation results indicate that the dynamic operating mode of EFS efficiently distributes RBE.
Assessment of the Full Density Curve in Stand Density Management Diagrams for Hinoki (Chamaecyparis obtusa) in Kyushu Island, Japan: Implications for Forest Management
Authors: Kondoh Hiroshi
Published: October 2023

Accurate forest information on tree species, stand age, tree density, and stand volume is required to ensure effective forest management practices. In Japan, forest information is consolidated in forest yield tables and stand density management diagrams (SDMDs) that are specifically designed for major forest plantation species. In this study, we analyzed whether the current full density curve in the SDMD of Hinoki (Chamaecyparis obtusa) plantation stands in Kyushu Island aligns with the characteristics of the existing stands. Data from 18 Hinoki forests were used to measure tree heights, diameters, and densities. Equations were developed to establish relationships between stand factors, and various curves were derived for average height, competition ratio, full density, yield ratio, average diameter, and natural mortality. The results showed that the current full density curve in the SDMD for Hinoki plantation stands did not completely align with the characteristics of the existing Hinoki plantation stands in Kyushu Island. Thus, the full density curve in the SDMD for the Hinoki stands in this region should be significantly adjusted. These results can enhance forest management in Japan and advance SDMD modeling and its application in forest planning and management.
Study on Single-Tree Segmentation of Chinese Fir Plantations Using Coupled Local Maximum and Height-Weighted Improved K-Means Algorithm
Authors: Chen Xiangyu , Yu Kunyong , Yu Shuhan , Hu Zhongyang , Tan Hongru , Chen Yichen , Huang Xiang , Liu Jian
Published: October 2023

Chinese fir (Cunninghamia lanceolata) is a major timber species in China, and obtaining and monitoring the parameters of Chinese fir plantations is of great practical significance. With the help of the K-means algorithm and UAV-LiDAR data, the efficiency of forestry surveys can be greatly improved. Considering that the traditional K-means algorithm is susceptible to the influence of initial cluster centers and outliers during the process of individual tree segmentation, it may result in incorrect segmentation. Therefore, this study proposes an improved K-means algorithm that uses the methods of local maxima and height weighting to optimize and improve the algorithm. The research results are as follows: (1) Compared to the traditional K-means algorithm, the producer accuracy and user accuracy of this research algorithm have imsproved by 10.72% and 11.46%, respectively, with significant differences (p < 0.05). (2) The research algorithm proposed in this study can adapt to Chinese fir plantations of different age groups, with average producer accuracy and user accuracy reaching 78.48% and 83.72%, respectively. In summary, this algorithm can be effectively applied to the forest parameter estimation of Chinese fir plantations and is of great significance for sustainable forest management.
Scenario Simulation of Land Use and Cover under Safeguarding Ecological Security: A Case Study of Chang-Zhu-Tan Metropolitan Area, China
Authors: Deng Zhiwei , Quan Bin , Zhang Haibo , Xie Hongqun , Zhou Ze
Published: October 2023

Scenario-based simulation in land use and cover change (LUCC) is a practical approach to maintaining ecological security. Many studies generally set constraints of LUCC utilizing ecological patches but without consideration of corridors connecting these patches. Here, we constructed a framework to balance urban growth and ecological security by integrating ecological security patterns (ESPs) into the PLUS model. This study selected Chang-Zhu-Tan Metropolitan Area (CZTMA) in central China as a typical case. Specifically, coupling quantitative demand with spatial constraints of multiple levels of ESPs, this study designed four scenarios, including historical tendency (HT), urban growth (UG), ecological conservation (EC), and coordinating city development and ecological protection (CCE). Then, the transformations and landscape patterns of LUCC were analyzed to evaluate the future land change from 2020 to 2050. The results show sixty-one key ecological sources in the CZTMA, mainly in higher-elevation forested areas. Forty-six ecological corridors were estimated using circuit theory. The building expansion was driven by accessibility to transportation and government locations and will contribute to the loss of forest and cropland in the future. The feature of different scenarios in alleviating the increasing fragmentation of patches and reducing the loss amount of ecological land showed EC > CCE > HT > UG. This study developed the ESP-PLUS framework and its modeling idea, which has the potential to be applied in other regions. This extension would assist decision-makers and urban planners in formulating sustainable land strategies that effectively reconcile eco-environmental conservation with robust economic growth, achieving a mutually beneficial outcome.
Understanding the Contribution of Co-Fermenting Non-Saccharomyces and Saccharomyces Yeasts to Aroma Precursor Degradation and Formation of Sensory Profiles in Wine Using a Model System
Authors: Schober Doreen , Wacker Michael , Schmarr Hans-Georg , Fischer Ulrich
Published: October 2023

Comprehensive yeast strain characterization is an important issue for the wine industry as market demands require controlled production of distinctive high-quality wines. Glycosides form an important reservoir of varietal grape wine aroma, and their hydrolysis into olfactory-active compounds essentially depends on the fermenting yeast genera and strains. Among the 14 Metschnikowia, Pichia, Torulaspora and 18 Saccharomyces spp., rapid screenings by agar plate and activity assay, including the substrates arbutin, cellobiose and p-nitrophenol-β-D-glucopyranoside, revealed the most glycosidase-active strains. In the novel co-fermentation setups, five selected non-Saccharomyces and a Saccharomyces strain were separated by a 14 kDa cut-off membrane, allowing respective viable cell counts but facilitating metabolite transfer. Chemical analysis focused on aroma glycosides, with extensive quantification by GC-MS with SIDA on the extracted and hydrolyzed compounds. Olfactory profiles obtained for the non-Saccharomyces wines demonstrated a significant impact of these yeasts, albeit mainly correlated with increased hydrolysis of monoterpene glycosides, and surpassed by a technical Aspergillus niger enzyme. While screenings of non-Saccharomyces strains indicated enhanced glucosidase activity under winemaking conditions, their effect was lower than expected and dominated by ester formation. Interestingly, Saccharomyces yeast cell vitality was increased via in co-fermentation, and non-Saccharomyces strains displayed extended viabilities with high ethanol tolerances.
New RFI Model for Behavioral Audience Segmentation in Wi-Fi Advertising System
Authors: Lim Shueh-Ting , Ong Lee-Yeng , Leow Meng-Chew
Published: October 2023

In this technological era, businesses tend to place advertisements via the medium of Wi-Fi advertising to expose their brands and products to the public. Wi-Fi advertising offers a platform for businesses to leverage their marketing strategies to achieve desired goals, provided they have a thorough understanding of their audience’s behaviors. This paper aims to formulate a new RFI (recency, frequency, and interest) model that is able to analyze the behavior of the audience towards the advertisement. The audience’s interest is measured based on the relationship between their total view duration on an advertisement and its corresponding overall click received. With the help of a clustering algorithm to perform the dynamic segmentation, the patterns of the audience behaviors are then being interpreted by segmenting the audience based on their engagement behaviors. In the experiments, two different Wi-Fi advertising attributes are tested to prove the new RFI model is applicable to effectively interpret the audience engagement behaviors with the proposed dynamic characteristics range table. The weak and strongly engaged behavioral characteristics of the segmented behavioral patterns of the audience, such as in a one-time audience, are interpreted successfully with the dynamic-characteristics range table.
Optimization of the Monitoring of Coal Spontaneous Combustion Degree Using a Distributed Fiber Optic Temperature Measurement System: Field Application and Evaluation
Authors: Zhang Fengjie , Han Dongyang , Qin Yueping , Peng Shiyang , Zhong Dawei , Tang Fei , Xiang Zhencai , Xu Hao
Published: October 2023

Coal spontaneous combustion (CSC) in gob not only leads to wasted resources and casualties, but also produces a lot of waste gas that pollutes the underground environment. Mastering the degree of CSC helps ensure that timely and effective control measures are taken. The real-time and accurate monitoring of temperature, as the primary indicator of the extent of CSC, is difficult due to the harsh and hidden environment of gob, resulting in a reduced ability to anticipate and prevent CSC. In this work, a complete distributed optical fiber temperature sensing system (DTSS) set with strong anti-damage ability was developed. The optical cable is protected by internal parallel steel cables and external protective pipes, which greatly improve the system’s reliability and integrity when used in gob. During its application in the Wangyun Coal Mine, an abnormal temperature rise in gob was discovered in time, and the effect of inhibitor spraying was monitored and evaluated. The degree of CSC in the gob was accurately identified, which shows that the work of coal mining can be targeted. This work is expected to improve early warning capability to prevent the risk of CSC in gob, and has promising applications.
Effect of Blending Dimethyl Carbonate and Ethanol with Gasoline on Combustion Characteristics
Authors: Suzuki Shunsuke , Takahashi Eiichi , Oguma Mitsuharu , Akihama Kazuhiro
Published: October 2023

We investigated the effects of blending dimethyl carbonate (DMC) and ethanol with commercial gasoline on combustion characteristics. Our experimental approach involved using a rapid compression and expansion machine (RCEM) to achieve elevated temperatures and pressures. The fuels containing different volumes of oxygenated hydrocarbons were burned at equivalence ratios of 1.0 or 0.7, an initial temperature of 340 K, and initial pressures of 0.10 or 0.05 MPa. To simulate knocking phenomena, we installed a rectangular channel in the combustion chamber of the RCEM and measured the pressure history inside the chamber. By analyzing the pressure history resulting from the end-gas autoignition, we evaluated the combustion duration and maximum pressure amplitude. Blending both oxygenated fuels with gasoline effectively reduced the maximum-pressure amplitude in the end-gas autoignition, with ethanol exhibiting a more pronounced suppression effect compared to DMC in the same volumetric mixing ratio. At an initial pressure of 0.10 MPa, the combustion durations of DMC/gasoline blends showed non-linear behavior, being shorter than those of pure gasoline and DMC and comparable to those of the ethanol/gasoline blends. However, the blending effect of DMC on combustion durations was greatly mitigated when the initial pressure was reduced to 0.05 MPa. Conversely, the combustion durations for ethanol/gasoline blends showed a nearly monotonic reduction with an increase in the ethanol blending ratio at both initial pressures of 0.10 and 0.05 MPa. Finally, we discussed the differential impact of the blending effect of oxygenated hydrocarbons on combustion characteristics.
Predisposition of the Common MC4R rs17782313 Female Carriers to Elevated Obesity and Interaction with Eating Habits
Authors: Chermon Danyel , Birk Ruth
Published: October 2023

The global rise in obesity is attributed to genetic predisposition interaction with an obesogenic environment. Melanocortin 4 receptor (MC4R) rs17782313 polymorphism has been linked to common obesity with varying influence across different populations. MC4R is a crucial player in the leptin proopiomelanocortin pathway that regulates weight hemostasis. We aimed to study MC4R rs17782313 and its interaction with eating behaviors on obesity predisposition in the Israeli population. Adults’ (n = 5785, >18 y) genotype and anthropometric and demographic data were analyzed using logistic regression models adjusting for age, sex, T1DM, and T2DM. MC4R rs17782313 significantly predisposes to elevated obesity risk under the recessive and additive models (OR = 1.38, 95% CI: 1.1–1.72, p = 0.005 and OR = 1.1, 95% CI: 1.01–1.2, p = 0.03, respectively) adjusted for confounders (age, sex, T1DM, and T2DM). Stratification by sex demonstrated that carrying the common MC4R rs17782313 is significantly associated with an elevated predisposition to obesity under the recessive model among females only (OR = 1.41, 95% CI: 1.09–1.82, p = 0.01), with an average of 0.85 BMI increment compared with wild type and one risk allele carriers. MC4R rs17782313 significantly interacted with several eating behaviors to enhance the risk of obesity. Our findings demonstrate that MC4R rs17782313 homozygous female carriers are significantly predisposed to obesity amplified by eating behaviors.
The Nutriepigenome
Authors: Mirisola Mario G.
Published: October 2023

Unlike genetic changes, epigenetics modulates gene expression without stable modification of the genome. Even though all cells, including sperm and egg, have an epigenome pattern, most of these modifications occur during lifetime and interestingly, some of them, are reversible. Lifestyle and especially nutrients as well as diet regimens are presently gaining importance due to their ability to affect the epigenome. On the other hand, since the epigenome profoundly affects gene expression profile it can be speculated that the epigenome could modulate individual response to nutrients. Recent years have thus seen growing interest on nutrients, macronutrients ratio and diet regimens capable to affect the epigenetic pattern. In fact, while genetic alterations are mostly detrimental at the individual level, reshaping the epigenome may be a feasible strategy to positively counteract the detrimental effect of aging. Here, I review nutrient consumption and diet regimens as a possible strategy to counteract aging-driven epigenome derangement.
Agent-Based Modeling of Tsunami Evacuation at Figueirinha Beach, Setubal, Portugal
Authors: Santos Angela , David Nuno , Perdigão Nelson , Cândido Eduardo
Published: October 2023

Previous tsunami numerical model results show that the 1755 tsunami reached the Figueirinha beach 35 min after the earthquake, resulting in the inundation of the beach, the parking lot, and two sections of the road on the beach. Thus, an effective evacuation plan for the beach must be identified. However, conducting drills and evacuation exercises is costly and time-consuming. As an alternative, this study develops an agent-based model (ABM) to simulate the evacuation of beach users. The findings from this study reveal that, across the six considered scenarios, it is not feasible to evacuate all beach users in less than 35 min. The results also show there are only two routes available for evacuation—the left and right sides—with the left side offering a shorter evacuation time. However, both evacuation options come with advantages and disadvantages. The results of this study will be disseminated to local stakeholders.
The Perception of the Quality of Professional Healthcare Assistance for the Management of Endometriosis: Findings from a National Survey in Italy
Authors: Cofini Vincenza , Muselli Mario , Limoncin Erika , Lolli Chiara , Pelaccia Erika , Guido Maurizio , Fabiani Leila , Necozione Stefano
Published: October 2023

(1) Background: endometriosis is included in the list of chronic and disabling pathologies. This study aimed to examine patients’ points of view about the quality of care for endometriosis during the COVID-19 pandemic; (2) Methods: we conducted a survey on knowledge about endometriosis, management of endometriosis, perceived mental and physical well-being, and perceived changes in the quality of care during the pandemic; (3) Results: out of 1065 participants, 875 were included in the analysis, with an average age of 34. Overall, patients had positive perceptions of care accessibility and cleanliness (95%), but less satisfaction with visit hours (86%). Those with better physical and psychological health were more satisfied with service hours, while those treated at specialised centres were more content with cleanliness. Satisfaction with clarity was linked to specialist treatment, and perceived availability to listen correlated with age, complications, and overall health status; (4) Conclusions: patients’ perspectives are crucial for patient education and advocate for specialised interdisciplinary networks to support endometriosis management and patients’ well-being. These findings highlight the importance of considering patient viewpoints, particularly in the context of the COVID-19 pandemic’s impact on healthcare systems and suggest a need for further research from the patient’s perspective.
Protective Effects of Rhamnetin in Carbapenem-Resistant Acinetobacter baumannii-Induced Sepsis Model and the Underlying Mechanism
Authors: Kim Minju , Chaudhary Shubhash Chandra , Kim Byeongkwon , Kim Yangmee
Published: October 2023

Carbapenem-resistant Acinetobacter baumannii (CRAB) is a well-known harmful bacterium that causes severe health disorders and dysregulates the host immune response associated with inflammation. Upon examining the suppressive activity of natural flavonoid rhamnetin on various pro-inflammatory cytokines in a CRAB-induced septic shock mouse model, we found that rhamnetin inhibited the production of IL-1β and IL-18, two pro-inflammatory cytokines associated with pyroptotic cell death, a process dependent on caspase-1. In this study, we investigated the antioxidant and anti-apoptotic activities of rhamnetin and the underlying mechanism of action in a CRAB infection. In the CRAB-induced septic shock mouse model, rhamnetin reduced the level of lipopolysaccharide (LPS) in lung lysates, resulting in the inhibition of TLR4-mediated inflammatory signaling. Notably, rhamnetin reduced intracellular reactive oxygen species (ROS) generation in macrophages and inhibited apoptotic and pyroptotic cell injury induced by CRAB infection. Therefore, rhamnetin inhibited LPS-induced pro-inflammatory mediators, hindering apoptotic and pyroptotic processes and contributing to a recovery effect in CRAB-induced sepsis mice by suppressing oxidative stress. Taken together, our study presents the potential role of rhamnetin in protecting against oxidative damage induced by CRAB infection through a TLR4 and ROS-mediated pyroptotic pathway, showing an alternative mechanism for sepsis prevention. Therefore, rhamnetin is a promising therapeutic candidate for treating CRAB-induced sepsis.
Breeding Cultivars for Resistance to the African Sweetpotato Weevils, Cylas puncticollis and Cylas brunneus, in Uganda: A Review of the Current Progress
Authors: Yada Benard , Musana Paul , Chelangat Doreen , Osaru Florence , Anyanga Milton , Katungisa Arnold , Oloka Bonny , Ssali Reuben , Mugisa Immaculate
Published: October 2023

In sub-Saharan Africa, sweetpotato weevils are the major pests of cultivated sweetpotato, causing estimated losses of between 60% and 100%, primarily during dry spells. The predominantly cryptic feeding behavior of Cylas spp. within their roots makes their control difficult, thus, host plant resistance is one of the most promising lines of protection against these pests. However, limited progress has been made in cultivar breeding for weevil resistance, partly due to the complex hexaploid genome of sweetpotato, which complicates conventional breeding, in addition to the limited number of genotypes with significant levels of resistance for use as sources of resistance. Pollen sterility, cross incompatibility, and poor seed set and germination in sweetpotato are also common challenges in improving weevil resistance. The accurate phenotyping of sweetpotato weevil resistance to enhance the efficiency of selection has been equally difficult. Genomics-assisted breeding, though in its infancy stages in sweetpotato, has a potential application in overcoming some of these barriers. However, it will require the development of more genomic infrastructure, particularly single-nucleotide polymorphism markers (SNPs) and robust next-generation sequencing platforms, together with relevant statistical procedures for analyses. With the recent advances in genomics, we anticipate that genomic breeding for sweetpotato weevil resistance will be expedited in the coming years. This review sheds light on Uganda’s efforts, to date, to breed against the Cylas puncticollis (Boheman) and Cylas brunneus (Fabricius) species of African sweetpotato weevil.
How Effective Are Non-Frictional Techniques Compared to Sliding Techniques in the Retraction of Upper Anterior Teeth When Using Buccal Fixed-Appliance Therapy? A Systematic Review
Authors: Kheshfeh Mohammad Naem , Hajeer Mohammad Younis , Al Hinnawi Mhd. Firas , Awawdeh Mohammed Adel , Aljhani Ali S. , Alhazmi Nora
Published: October 2023

Methods for retracting the anterior teeth are divided into frictional methods and non-frictional methods. However, evidence regarding the superiority of one technique over the other is still lacking in the available literature. Therefore, we aimed to evaluate the current evidence regarding the effectiveness of frictional methods of anterior teeth retraction compared to the non-frictional ones. The extracted data included the mechanism of application of the retraction force and its intensity, the observation period, follow-up records, and outcome measures. Ten studies were included in this review; the results did not favor a specific technique regarding the rate of orthodontic tooth movement and loss of anchorage during canine retraction, although a preference was shown for the sliding technique in the rate of en-masse retraction (0.74 versus 0.39 mm/month) and the anchorage control during the retraction of the incisors (0.5 versus 0.1 mm/month). The control of the incisor’s torque during the en-masse retraction was higher when frictionless techniques were used (−12° versus −7°). Regarding the rate of orthodontic tooth movement, the non-frictional technique is characterized by a high sensitivity to the quality of the design, and the sliding technique was generally effective. As for controlling the torque of the incisors, the preference is for the non-frictional technique. Overall, there is a need to conduct more studies with an appropriate design.
The Importance of Subjectivity in Assessing the Efficiency of Surgery for Obstructive Sleep Apnea. Comment on Kuik et al. Subjective Efficiency Evaluation after Maxillomandibular Advancement Surgery in Obstructive Sleep Apnea Patients. J. Clin. Med. 2023, 12, 4023
Authors: Maniaci Antonino , Cocuzza Salvatore , Cammaroto Giovanni , Vicini Claudio , La Via Luigi
Published: October 2023

We recently read with interest the study by Kuik et al. [...]
Diagnostic Accuracy of Abdominal CT for Locally Advanced Colon Tumors: Can We Really Entrust Certain Decisions to the Reliability of CT?
Authors: García del Álamo Hernández Yaiza , Cano-Valderrama Óscar , Cerdán-Santacruz Carlos , Pereira Pérez Fernando , Aldrey Cao Inés , Núñez Fernández Sandra , Álvarez Sarrado Eduardo , Obregón Reina Rosángela , Dujovne Lindenbaum Paula , Taboada Ameneiro María , Ambrona Zafra David , Pérez Farré Silvia , Pascual Damieta Marta , Frago Montanuy Ricardo , Flor Lorente Blas , Biondo Sebastiano ,   Collaborative Group for the Study of Metachronous Peritoneal Metastases of pT4 Colon Cancer
Published: October 2023

Many different options of neoadjuvant treatments for advanced colon cancer are emerging. An accurate preoperative staging is crucial to select the most appropriate treatment option. A retrospective study was carried out on a national series of operated patients with T4 tumors. Considering the anatomo-pathological analysis of the surgical specimen as the gold standard, a diagnostic accuracy study was carried out on the variables T and N staging and the presence of peritoneal metastases (M1c). The parameters calculated were sensitivity, specificity, positive and negative predictive values, and positive and negative likelihood ratios, as well as the overall accuracy. A total of 50 centers participated in the study in which 1950 patients were analyzed. The sensitivity of CT for correct staging of T4 colon tumors was 57%. Regarding N staging, the overall accuracy was 63%, with a sensitivity of 64% and a specificity of 62%; however, the positive and negative likelihood ratios were 1.7 and 0.58, respectively. For the diagnosis of peritoneal metastases, the accuracy was 94.8%, with a sensitivity of 40% and specificity of 98%; in the case of peritoneal metastases, the positive and negative likelihood ratios were 24.4 and 0.61, respectively. The diagnostic accuracy of CT in the setting of advanced colon cancer still has some shortcomings for accurate diagnosis of stage T4, correct classification of lymph nodes, and preoperative detection of peritoneal metastases.
Does the “Obesity Paradox” Have an Expiration Date? A Retrospective Cohort Study
Authors: Elkan Matan , Kofman Natalia , Minha Sa’ar , Rappoport Nadav , Zaidenstein Ronit , Koren Ronit
Published: October 2023

(1) Background: The “obesity paradox” refers to a protective effect of higher body mass index (BMI) on mortality in acute infectious disease patients. However, the long-term impact of this paradox remains uncertain. (2) Methods: A retrospective study of patients diagnosed with community-acquired acute infectious diseases at Shamir Medical Center, Israel (2010–2020) was conducted. Patients were grouped by BMI: underweight, normal weight, overweight, and obesity classes I–III. Short- and long-term mortality rates were compared across these groups. (3) Results: Of the 25,226 patients, diverse demographics and comorbidities were observed across BMI categories. Short-term (90-day) and long-term (one-year) mortality rates were notably higher in underweight and normal-weight groups compared to others. Specifically, 90-day mortality was 22% and 13.2% for underweight and normal weight respectively, versus 7–9% for others (p < 0.001). Multivariate time series analysis revealed underweight individuals had a significantly higher 5-year mortality risk (HR 1.41 (95% CI 1.27–1.58, p < 0.001)), while overweight and obese categories had a reduced risk (overweight—HR 0.76 (95% CI 0.72–0.80, p < 0.001), obesity class I—HR 0.71 (95% CI 0.66–0.76, p < 0.001), obesity class II—HR 0.77 (95% CI 0.70–0.85, p < 0.001), and obesity class III—HR 0.79 (95% CI 0.67–0.92, p = 0.003)). (4) Conclusions: In this comprehensive study, obesity was independently associated with decreased short- and long-term mortality. These unexpected results prompt further exploration of this counterintuitive phenomenon.
Gestational Weight Gain Is Associated with the Expression of Genes Involved in Inflammation in Maternal Visceral Adipose Tissue and Offspring Anthropometric Measures
Authors: Saucedo Renata , Peña-Cano María Isabel , Díaz-Velázquez Mary Flor , Ferreira-Hermosillo Aldo , Solis-Paredes Juan Mario , Camacho-Arroyo Ignacio , Valencia-Ortega Jorge
Published: October 2023

Background: Adequate gestational weight gain (GWG) is essential for maternal and fetal health. GWG may be a sign of higher visceral adipose tissue (VAT) accretion. A higher proportion of VAT is associated with an inflammatory process that may play a role in the fetal programming of obesity. This study aimed to (1) compare the expression of genes involved in inflammatory responses (TLR2, TLR4, NFκB, IKKβ, IL-1RA, IL-1β, IL-6, IL-10, TNF-α) in the VAT of pregnant women according to GWG and (2) explore whether VAT inflammation and GWG are related to offspring anthropometric measures. Material and methods: 50 women scheduled for cesarean section who delivered term infants were included in the study. We collected maternal omental VAT, and the expression of genes was examined with RT-qPCR. Results: Women with excessive and with adequate GWG had significantly higher expressions of most inflammatory genes than women with insufficient GWG. Neonates from mothers with excessive GWG had greater birth weight and chest circumference than those from mothers with insufficient GWG. GWG was positively correlated with fetal birth weight. Conclusions: The VAT expression of most genes associated with inflammatory pathways was higher in excessive and adequate GWG than in pregnant women with insufficient GWG. Moreover, GWG was found to be positively associated with newborn weight.
Biweekly Versus Monthly Hyperimmune Globulin Therapy for Primary Cytomegalovirus Infection in Pregnancy
Authors: Schirwani-Hartl Nawa , Palmrich Pilar , Haberl Christina , Perkmann-Nagele Nicole , Kiss Herbert , Berger Angelika , Rittenschober-Böhm Judith , Kasprian Gregor , Kienast Patric , Khalil Asma , Binder Julia
Published: October 2023

Primary cytomegalovirus (CMV) infection during pregnancy is associated with an increased risk of congenital CMV (cCMV). Hyperimmune globulin (HIG) therapy has been proposed as a potential prophylaxis to reduce maternal–fetal transmission. Data on whether the administration of HIG every 2 weeks offers benefits over HIG administration every 4 weeks are lacking. This was a retrospective analysis including pregnant women with primary CMV infection diagnosed in the first or early second trimester between 2010 and 2022 treated with HIG every 4 weeks (300 IE HIG per kg) or every 2 weeks (200 IE HIG per kg), respectively. In total, 36 women (4 weeks: n = 26; 2 weeks: n = 10) and 39 newborns (4 weeks: n = 29; 2 weeks: n = 10) were included. The median gestational age at the first HIG administration was 13.1 weeks. There was no significant difference in the cCMV rates between the women who received HIG every 4 versus every 2 weeks (n = 8/24 [33.3%] vs. 3/10 [30.0%]; p = 0.850). An abnormal fetal ultrasound was present in three fetuses and fetal magnetic resonance imaging (MRI) anomalies in four fetuses were related to cCMV infection, with no significant difference in the frequency between the two groups. A larger study will be needed to determine whether HIG administration every 2 instead of every 4 weeks improves the maternal–fetal transmission rates.
Optimal Lymphadenectomy in Patients with Well-Differentiated Nonfunctioning Pancreatic Neuroendocrine Neoplasms
Authors: Shintakuya Ryuta , Uemura Kenichiro , Sumiyoshi Tatsuaki , Okada Kenjiro , Baba Kenta , Harada Takumi , Murakami Yoshiaki , Serikawa Masahiro , Ishii Yasutaka , Arihiro Koji , Takahashi Shinya
Published: October 2023

This study aimed to evaluate the optimal extent of lymphadenectomy in patients with nonfunctioning pancreatic neuroendocrine neoplasms. We retrospectively analyzed the clinicopathological data of patients with nonfunctioning pancreatic neuroendocrine neoplasms who underwent surgical resection. We investigated the frequency of metastases at each lymph node station according to tumor location and analyzed the factors contributing to poor overall survival (OS) and disease-free survival (DFS). Overall, data of 84 patients were analyzed. Among patients with pancreatic head tumors, metastases at stations 8, 13, and 17 were found in one (3.1%), four (12.5%), and three (9.3%) patients, respectively. However, none of the other stations showed metastases. For pancreatic body and tail tumors, metastases only at station 11 were found in two (5.1%) patients. Additionally, multivariate DFS and OS analyses showed that lymph node metastasis was the only independent prognostic factor. In conclusion, lymph node metastasis near the primary tumor was the only independent factor of poor prognosis in patients with nonfunctioning pancreatic neuroendocrine neoplasms after undergoing curative surgery. Peri-pancreatic lymphadenectomy might be recommended for nonfunctioning pancreatic neuroendocrine neoplasms.