bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of high-intensity interval training in physiotherapy primary care for patients with inflammatory arthritis: the ExeHeart randomised controlled trial
Authors: Nordén Kristine Røren , Semb Anne Grete , Dagfinrud Hanne , Hisdal Jonny , Sexton Joseph , Fongen Camilla , Bakke Emilie , Ødegård Sigrid , Skandsen Jon , Blanck Thalita , Metsios George S , Tveter Anne Therese 
Published: January 2024

ObjectivesTo assess the effect of high-intensity interval training (HIIT) delivered in physiotherapy primary care on the primary outcome of cardiorespiratory fitness (CRF) in patients with inflammatory arthritis (IA). Additionally, to explore the effects of HIIT on secondary outcomes, including cardiovascular disease (CVD) risk factors and disease activity.MethodsSingle-blinded randomised controlled trial with 60 patients randomly assigned to either a control group receiving usual care or an exercise group receiving usual care and 12 weeks of individualised HIIT at 90%–95% peak heart rate. Outcomes were assessed at baseline, 3 months and 6 months post baseline and included CRF measured as peak oxygen uptake (VO2peak), classic CVD risk factors, disease activity, anthropometry and patient-reported physical activity, pain, fatigue, disease impact and exercise beliefs and self-efficacy.ResultsIntention-to-treat analysis demonstrated a significant between-group difference in VO2peakat 3 months (2.5 mL/kg/min, 95% CI 0.9 to 4.0) and 6 months (2.6 mL/kg/min, 95% CI 0.8 to 4.3) in favour of the exercise group. A beneficial change in self-reported physical activity in favour of the exercise group was observed at 3 and 6 months. The HIIT intervention was well-tolerated with minimal adverse events and no apparent impact on disease activity. Differences in secondary outcomes related to CVD risk factors, disease impact, pain, fatigue and exercise beliefs and self-efficacy were generally small and non-significant.ConclusionAfter 12 weeks of supervised HIIT delivered in physiotherapy primary care, patients with IA demonstrated a favourable improvement in CRF, with sustained effects at 6-month follow-up.Trial registration numberNCT04922840.
Patterns of comorbidities differentially affect long-term functional evolution and disease activity in patients with ‘difficult to treat’ rheumatoid arthritis
Authors: Bertsias Antonios , Flouri Irini D , Repa Argyro , Avgoustidis Nestor , Kalogiannaki Eleni , Pitsigavdaki Sofia , Bertsias George , Sidiropoulos Prodromos 
Published: January 2024

BackgroundCharacterisation of the long-term outcome of patients with ‘difficult to treat’ (D2T) rheumatoid arthritis and factors contributing to its evolution are unknown. Herein, we explored the heterogeneity and contributing factors of D2T long-term outcome.MethodsPatients included from a prospective single centre cohort study. The EULAR definition of D2T was applied. Longitudinal clustering of functional status (modified Health Assessment Questionnaire (mHAQ)) and disease activity (Disease Activity Score-28 (DAS28)) were assessed using latent-class trajectory analysis. Multiple linear mixed models were used to examine the impact of comorbidities and their clusters on the long-term outcome.Results251 out of 1264 patients (19.9%) were identified as D2T. Younger age, fibromyalgia, osteoarthritis, DAS28-erythrocyte sedimentation rate (ESR) at first biological or targeted synthetic disease-modifying antirheumatic drug (b/ts-DMARD) initiation and failure to reduce DAS28-ESR scores within the first 6 months of b/ts-DMARD therapy were significant predictors of patients becoming D2T. Long-term follow-up (total of 5872 person-years) revealed four groups of functional status evolution: 18.2% had stable, mildly compromised mHAQ (mean 0.41), 39.9% had gradual improvement (1.21–0.87) and two groups had either slow deterioration or stable significant functional impairment (HAQ>1). Similarly, four distinct groups of disease activity evolution were identified. Among the different clusters of comorbidities assessed, presence of ‘mental-health and pain-related illnesses’ or ‘metabolic diseases’ had significant contribution to mHAQ worsening (p<0.0001 for both) and DAS28 evolution (p<0.0001 and p=0.018, respectively).ConclusionD2T patients represent a heterogeneous group in terms of long-term disease course. Mental-health/pain-related illnesses as well as metabolic diseases contribute to long-term adverse outcomes and should be targeted in order to optimise the prognosis of this subset of rheumatoid arthritis.
Upadacitinib therapy in refractory inflammatory myositis: a case series of 10 patients
Authors: Beckett Madelaine , Dutz Jan , Huang Kun 
Published: January 2024

ObjectivesTo evaluate the effectiveness and safety of upadacitinib in treatment-refractory inflammatory myositis.MethodsPatients with refractory inflammatory myositis treated with upadacitinib from a single urban centre in Vancouver, British Columbia, Canada, were included from September 2020 to June 2023. The medical records of these patients were retrospectively reviewed.Results10 total patients were identified for review, including 5 classic dermatomyositis (DM), 3 amyopathic DM (ADM) and 2 antisynthetase syndrome. The patients failed an average of four immunosuppressants before initiation of upadacitinib. Three had prior Janus kinase inhibitor therapy with tofacitinib. In the classic DM and ADM aggregate group, upadacitinib offered clinically and statistically significant cutaneous improvement. Lack of active muscle disease at baseline precluded analysis of the effect of upadacitinib on muscle weakness. Nine patients remained on upadacitinib at the end of the study period. One patient discontinued upadacitinib due to severe facial acne.ConclusionUpadacitinib appears to be effective in targeting cutaneous manifestations of refractory inflammatory DM. Further research is still needed to validate its efficacy on a broader population scale.
Impact of regulatory tightening of the Hungarian tobacco retail market on availability, access and cigarette smoking prevalence of adolescents
Authors: Joó Tamás , Foley Kristie , Brys Zoltán , Rogers Todd , Szócska Miklós , Bodrogi József , Gaál Péter , Pénzes Melinda 
Published: January 2024

IntroductionPolicies that reduce tobacco retail density to decrease tobacco use among the youth are critical for the tobacco endgame. This paper reviews a Hungarian tobacco regulatory measure, which, since 2013, has confined the sale of tobacco products exclusively to so-called National Tobacco Shops, summarises the changes in the national tobacco retail marketplace and reports on analyses of the impact of this intervention on illegal sales to minors and adolescent smoking behaviour.MethodsWe reviewed the available national statistical data on the structure and dynamics of the tobacco retail market. Changes in lifetime and current (past 30 days) use of cigarettes among Hungarian adolescents aged 13–17 years were assessed using data from international youth surveys on health behaviours collected in 2010–2020.ResultsSince the start of policy implementation, the density of tobacco shops in Hungary decreased by 85%, from 4.1 to 0.6 per 1000 persons. The prevalence of lifetime and current cigarette smoking among adolescents declined by 13–24 percentage points (pp) and by 4.8–15 pp, respectively. The rate of illegal sales of tobacco products to minors decreased by 27.6 pp, although the prevalence of compensatory access strategies, especially asking others to buy cigarettes for minors, increased.ConclusionsAfter a significant decrease in the nationwide availability of licensed tobacco retailers, Hungary experienced short-term reductions in youth smoking prevalence. However, the sporadic implementation of complementary, evidence-based tobacco control strategies might limit further declines in youth smoking initiation and tobacco product use.
A survey of preoperative surgical nutrition practices, opinions, and barriers across Canada
Authors: Bellafronte Natalia Tomborelli , Nasser Roseann , Gramlich Leah , Carli Francesco , Liberman Sender , Santa Mina Daniel , Schierbeck Geoff , Ljungqvist Olle , Gillis Chelsia 
Published: January 2024

Malnutrition is prevalent among surgical candidates and associated with adverse outcomes. Despite being potentially modifiable, malnutrition risk screening is not a standard preoperative practice. We conducted a cross-sectional survey to understand healthcare professionals’ (HCPs) opinions and barriers regarding screening and treatment of malnutrition. HCPs working with adult surgical patients in Canada were invited to complete an online survey. Barriers to preoperative malnutrition screening were assessed using the Capability Opportunity Motivation-Behaviour model. Quantitative data were analyzed using descriptive statistics and qualitative data were analyzed using summative content analysis. Of the 225 HCPs surveyed ( n = 111 dietitians, n = 72 physicians, n = 42 allied HCPs), 96%–100% agreed that preoperative malnutrition is a modifiable risk factor associated with worse surgical outcomes and is a treatment priority. Yet, 65% ( n = 142/220; dietitians: 88% vs. physicians: 40%) reported screening for malnutrition, which mostly occured in the postoperative period ( n = 117) by dietitians ( n = 94). Just 42% (48/113) of non-dietitian respondents referred positively screened patients to a dietitian for further assessment and treatment. The most prevalent barriers for malnutrition screening were related to opportunity, including availability of resources (57%, n = 121/212), time (40%, n = 84/212) and support from others (38%, n = 80/212). In conclusion, there is a gap between opinion and practice among surgical HCPs pertaining to malnutrition. Although HCPs agreed malnutrition is a surgical priority, the opportunity to screen for nutrition risk was a great barrier.
Effect of flyash addition to flocculation and freezing and thawing treatment on consolidation of oil sands fluid fine tailings
Authors: Kabwe L.K. , Beier N.A. , Wilson G.W. , Rima U. , Scott J.D. 
Published: January 2024

The total volume of fluid fine tailings (FFT), reached 1,270 Mm3 in 2019. Extensive research is underway by a number of operators to develop dewatering technologies for oil sand tailings reclamation to comply with Directive 085 issued by the Alberta Energy Regulator. A promising technology for the disposal of FFT is to add flocculents and then use thickeners or centrifuges to decrease the water content. Following this treatment, freezing/thawing processes can then be utilized to further dewater the tailings. The effect of flocculation/flyash addition and thickening coupled with freezing/thawing treatments on FFT was investigated by performing large-strain consolidation and shear strength tests on the treated flocculated TTs. It was found that flocculation and thickening treatment increases the hydraulic conductivity of the treated TT which will result in the TT consolidating much faster than the untreated TT. The most important benefit of the flyash addition is the increase in shear strength and hydraulic conductivity of the flyash-treated TTs. The benefit of the freezing/thawing treatment processes coupled with flyash treatment is the increase in the compressibility and hydraulic conductivity at effective stresses lower than 100 kPa and void ratios greater than 1.2, respectively. This will facilitate earlier progressive reclamation required to support hydraulic sand capping.
Towards sustainable manufacturing: Multiple optimization of surface roughness Ra, flank wear Vb in MQL-assisted milling of Titanium Alloy Ti-6Al-4V
Authors: Nguyen Van-Canh , Tien Dung Hoang , Pham Van Hung , Nguyen Thuy Duong 
Published: January 2024

This research focuses on the sustainable optimization of the milling process for Titanium Alloy Ti-6Al-4V using Minimum Quantity Lubrication (MQL) assistance. This experimental research investigates the effects of cutting parameters and lubrication conditions on the surface roughness ([Formula: see text]) and flank wear ([Formula: see text]) in the milling process of Titanium Alloy Ti-6Al-4V. The study aims to evaluate the influence of cutting speed ([Formula: see text]), feed rate ([Formula: see text]) and depth of cut ([Formula: see text]) on the selected machining performance indicators. The experiments were carried out using a DMG Mori Seiki DMU50 CNC center, and the workpiece samples were measured at [Formula: see text]. Three different lubrication conditions were employed, including dry machining, conventional flood cooling and Minimum Quantity Lubrication (MQL) using peanut oil. The cutting parameters were varied based on a Taguchi L9 orthogonal array design to explore the main effects of each parameter on [Formula: see text] and [Formula: see text]. The results reveal that cutting speed ([Formula: see text]) has the most significant influence on surface roughness, followed by feed rate ([Formula: see text]), while the impact of depth of cut ([Formula: see text] is negligible in comparison. Conversely, the coolant mode has the most significant impact on flank wear ([Formula: see text]), followed by feed rate ([Formula: see text]) and depth of cut ([Formula: see text]), while the influence of cutting speed ([Formula: see text] is relatively minor. Under the same cutting parameters, transitioning from dry machining to MQL led to a sharp decrease in [Formula: see text] from 170 to 100[Formula: see text][Formula: see text]m, and it increased to approximately 145[Formula: see text][Formula: see text]m when switching to flood cooling. Additionally, increasing the feed rate from 0.02 to 0.06[Formula: see text]mm/tooth reduced [Formula: see text] from around 135 to 120[Formula: see text][Formula: see text]m, but it significantly rose to approximately 165[Formula: see text][Formula: see text]m when the feed rate was further increased. Furthermore, the application of MQL with peanut oil as a lubricant and coolant demonstrated improvements in surface finish and reduced tool wear compared to dry and conventional flood cooling. The MQL approach led to better machining performance with lower [Formula: see text] and [Formula: see text] values. Overall, this study provides valuable insights into the effects of cutting parameters and lubrication conditions on surface roughness and flank wear in the milling process of Titanium Alloy Ti-6Al-4V. The findings offer practical guidelines for optimizing machining conditions to achieve desired surface quality and extend tool life while considering the environmental benefits of employing MQL in the manufacturing process.
Using the geoheritage framework to explore the intersection of diverse legacies at Grand Caverns, Virginia, USA
Authors: Garcia Ángel A. , Shank Austin 
Published: January 2024

Abstract
Grand Caverns is the oldest show cave in continuous operation in the contiguous United States. Discovered in 1804, Grand Caverns has been offering at least one tour per year continuously from 1806 until now. For more than two centuries Grand Caverns – which is host to diverse and uncommon solution cave speleothems, such as cave shields – has served as the centre for multidisciplinary research related to limestones in Virginia and has accrued historical accounts relevant to the Shenandoah Valley (nestled between the Blue Ridge Mountains to the east and the Allegheny Mountains to the west) in the Commonwealth of Virginia. In this article, we explore the geological, historical, mapping and geotourism legacies of Grand Caverns, using its geoheritage as a narrative framework. In addition, we discuss the intersection of historical and diverse concurrent heritages at Grand Caverns and their relevance for understanding national show caves and cave development processes, and we share ongoing efforts towards the construction of a proposal to elevate Grand Caverns to the United Nations Educational, Scientific and Cultural Organization World Heritage list.
Cyclic Fasting–Mimicking Diet Plus Bortezomib and Rituximab Is an Effective Treatment for Chronic Lymphocytic Leukemia
Authors: Raucci Franca , Vernieri Claudio , Di Tano Maira , Ligorio Francesca , Blaževitš Olga , Lazzeri Samuel , Shmahala Anastasiya , Fragale Giuseppe , Salvadori Giulia , Varano Gabriele , Casola Stefano , Buono Roberta , Visco Euplio , de Braud Filippo , Longo Valter D. 
Published: January 2024

Abstract

Cyclic fasting–mimicking diet (FMD) is an experimental nutritional intervention with potent antitumor activity in preclinical models of solid malignancies. FMD cycles are also safe and active metabolically and immunologically in cancer patients. Here, we reported on the outcome of FMD cycles in two patients with chronic lymphocytic leukemia (CLL) and investigated the effects of fasting and FMD cycles in preclinical CLL models. Fasting-mimicking conditions in murine CLL models had mild cytotoxic effects, which resulted in apoptosis activation mediated in part by lowered insulin and IGF1 concentrations. In CLL cells, fasting conditions promoted an increase in proteasome activity that served as a starvation escape pathway. Pharmacologic inhibition of this escape mechanism with the proteasome inhibitor bortezomib resulted in a strong enhancement of the proapoptotic effects of starvation conditions in vitro. In mouse CLL models, combining cyclic fasting/FMD with bortezomib and rituximab, an anti-CD20 antibody, delayed CLL progression and resulted in significant prolongation of mouse survival. Overall, the effect of proteasome inhibition in combination with FMD cycles in promoting CLL death supports the targeting of starvation escape pathways as an effective treatment strategy that should be tested in clinical trials.

Significance:
Chronic lymphocytic leukemia cells resist fasting-mimicking diet by inducing proteasome activation to escape starvation, which can be targeted using proteasome inhibition by bortezomib treatment to impede leukemia progression and prolong survival.
Security enhancement of cyber-physical system using modified encryption AESGNRSA technique
Authors: Rameshwar Saraf Kundankumar , Malathi P. 
Published: January 2024

<span>A cyber-physical system (CPS) is a combination of physical components with computational elements to interact with the physical world. The integration of these two systems has led to an increase in security concerns. Traditional encryption algorithms designed for general-purpose computing environments may not adequately address the distinct challenges of CPS, such as limited processing power, delay, and resource-constrained hardware. Therefore, there is a pressing need to develop an encryption algorithm that is optimized for CPS security without compromising the critical real-time aspects of these systems. This research has designed a modified encryption technique named the advanced encryption standard in galois counter mode with nonce and rivest-shamir-adleman algorithm (AESGNRSA). A smart medical system is designed to monitor the health of remotely located patients. The AESGNRSA algorithm is applied to the three servers of this system. The data of 1.5 lakh patients is fed to this system to verify the effectiveness of the AESGNRSA algorithm. The performance parameters like encryption and decryption time, encryption and decryption throughput, and encrypted file size are calculated for the AESGNRSA algorithm. The comparative analysis proved that AESGNRSA has the highest performance as compared to other algorithms and it can protect CPS against many cyber-attacks.</span>
Multimodal approach for early prediction of COVID-19 disease using convolutional neural network
Authors: Ankleshwar Milind , Chavan Pramod , Chavan Pratibha , K. Ambhore Sushil 
Published: January 2024

<p><span>The latest human coronavirus is COVID-19. Chest radiography imaging is essential for screening, early detection, and monitoring COVID-19 infections since the virus resides in the lungs. Classical real time reverse transcriptase polymerase chain reaction (RT-PCR) data and chest X-ray pictures will become more important for COVID-19 identification as the pandemic spreads due to their affordability, wide availability, and infection control benefits, which reduce cross-contamination. This work presents multi-modal hybrid automated approaches to classify COVID-19 illness into three clinical categories: normal, pathogenic, and COVID-19 utilising RT-PCR test data and online chest X-ray datasets. The RT-PCR and chest X-ray image datasets were processed using supervised machine learning and convolutional neural networks (CNN). Together, these measures help us separate COVID-19 patients, those with similar symptoms, and healthy persons. The author improved detection times and classification accuracy with extra tree classifier’s feature selection and openCV’s image sharpening. The proposed approaches were tested using a research dataset. The proposed methods allowed reliable COVID-19 disease categorization for clinical decision-making, with random forest (RF) classifier global precision values of 91.58% on the RT-PCR dataset and CNN model accuracy of 95.46% on improved sharpened images.</span></p>
Characteristics of symmetrical components for high impedance faults in distribution networks with photovoltaic inverters
Authors: Yamashika Herris , Syafii Syafii 
Published: January 2024

This work models a photovoltaic (PV) inverter connected to an IEC microgrid system. The purpose of this study was to find the characteristics of symmetrical components before and after a high impedance single phase short-circuit fault. The IEC microgrid system is tailored to the distribution system in Indonesia, where the applied voltage is 20 kV. Only parameters related to the short-circuit study are included in the model. A second-order generalized integrator frequency-locked-loop is utilized to represent the 3-phase PV inverter. The inverter model, previously treated as an ideal current source, and positive sequence current are no longer employed, as they fail to depict the characteristics of symmetric components during a phase-to-ground short-circuit fault. The IEC microgrid system connected to the PV inverter is simulated using ATPDraw-electro magnetic transient program (EMTP). Simulation results reveal that the changes in the symmetric component values of current after a fault experience a very insignificant increase. Meanwhile, the positive sequence voltage values following the short-circuit fault exhibit a negligible decrease. In contrast, the negative sequence and zero sequence voltage components after the short-circuit fault undergo a significant increase.