Search Results (5,446)

Background/Objectives: Pleural effusions may be seen in patients with severe AS complicated by hemodynamically significant heart failure. However, there are no data on the association between pleural effusion and long-term mortality in patients undergoing transcatheter aortic valve implantation (TAVI). This study aimed to assess the impact of pre-procedural pleural effusion on long-term mortality in these patients. Methods: A retrospective, single-center analysis was conducted on 401 patients who underwent TAVI between January 2010 and December 2023. The patients were categorized into two groups based on the presence of pleural effusion, which was assessed via pre-procedural imaging using thoracic computed tomography (CT). Results: Pleural effusion was present in 158 patients (39.4%). The patients with pleural effusion had significantly higher long-term mortality rates compared to those without pleural effusion (46.2% vs. 24.3%, p < 0.001). Multivariate analysis identified pleural effusion as an independent predictor of long-term mortality (HR: 1.568, 95% CI: 1.065–2.308, p = 0.023). Also, the patients with pleural effusions had a higher long-term mortality rate compared with those without pleural effusions (log-rank p < 0.001). Conclusions: Pre-procedural pleural effusion is independently associated with increased long-term mortality in TAVI patients. Early recognition and management of pleural effusion are critical for optimizing outcomes in this high-risk population. Full article

A critical review of studies concerning the attribution of the provenance of marble from the Apuan Alps (Italy) (AAM) used for historical–monumental buildings and artefacts is proposed based on its O/C isotopic and EPR signature. First, a summary of the geological origin of AAM and its geo-structural evolution and setting is presented. A review of the exploitation history of AAM is then discussed. This geological and historical information is used as categorical information to better constrain the literature multimethodic database, containing numerous data, including O/C isotopic and EPR spectroscopic parameters. A robust multivariate statistical analysis of the combination of all these data is performed. The results point to the fact that the O/C isotopic and EPR signature can help in attributing an analysed AAM sample to a marble extraction district, and to a certain extent also to a site, whereas the discrimination of the individual quarry appears to not yet be achievable. Full article

The lithofacies of a reservoir contain key information such as rock lithology, sedimentary structures, and mineral composition. Accurate prediction of shale reservoir lithofacies is crucial for identifying sweet spots for oil and gas development. However, obtaining shale lithofacies through core sampling during drilling is challenging, and the accuracy of traditional logging curve intersection methods is insufficient. To efficiently and accurately predict shale lithofacies, this study proposes a hybrid model called Stacking, which combines four classifiers: Random Forest, HistGradient Boosting, Extreme Gradient Boosting, and Categorical Boosting. The model employs the Grid Search Method to automatically search for optimal hyperparameters, using the four classifiers as base learners. The predictions from these base learners are then used as new features, and a Logistic Regression model serves as the final meta-classifier for prediction. A total of 3323 data points were collected from six wells to train and test the model, with the final performance evaluated on two blind wells that were not involved in the training process. The results indicate that the stacking model accurately predicts shale lithofacies, achieving an Accuracy, Recall, Precision, and F1 Score of 0.9587, 0.959, 0.9587, and 0.9587, respectively, on the training set. This achievement provides technical support for reservoir evaluation and sweet spot prediction in oil and gas exploration. Full article

Background/Objectives: Falls are the most common adverse in-hospital event, resulting in a considerable social and economic burden on individuals, their families, and the healthcare system. This study aims to develop and implement an automatic coding system using large language models (LLMs) to extract and categorize free-text information (including the location of the fall and any resulting injury) from in-hospital fall records. Methods: The study used the narrative description of the falls reported through the Incident Reporting system to the Risk Management Service of an Italian Local Health Authority in Italy (name not disclosed as per research agreement). The OpenAI application programming interface (API) was used to access the generative pre-trained transformers (GPT) models, extract data from the narrative description of the falls, and perform the classification task. The GPT-4-turbo models were used for the classification task. Two independent reviewers manually coded the information, representing the gold standard for the classification task. Sensitivity, specificity, and accuracy were calculated to evaluate the performance of the task. Results: The analysis included 187 fall records with free-text event descriptions detailing the location of the fall and 93 records providing information about the presence or absence of an injury. GPT-4-turbo showed excellent performance, with specificity, sensitivity, and accuracy values of at least 0.913 for detecting the location and 0.953 for detecting the injury. Conclusions: The GPT models effectively extracted and categorized the information, even though the text was not optimized for GPT-based analysis. This shows their potential for the use of LLMs in clinical risk management research. Full article

Chinese named entity recognition (NER) is a fundamental natural language processing (NLP) task that involves identifying and categorizing entities in text. It plays a crucial role in applications such as information extraction, machine translation, and question-answering systems, enhancing the efficiency and accuracy of text processing and language understanding. However, existing methods for Chinese NER face challenges due to the disruption of character-level semantics in traditional data augmentation, leading to misaligned entity labels and reduced prediction accuracy. Moreover, the reliance on English-centric fine-grained annotated datasets and the simplistic concatenation of label semantic embeddings with original samples limits their effectiveness, particularly in addressing class imbalances in low-resource scenarios. To address these issues, we propose a novel Chinese NER model, LGDA, which leverages Label-Guided Data Augmentation to mitigate entity label misalignment and sample distribution imbalances. The LGDA model consists of three key components: a data augmentation module, a label semantic fusion module, and an optimized loss function. It operates in two stages: (1) the enhancement of data with a masked entity generation model and (2) the integration of label annotations to refine entity recognition. By employing twin encoders and a cross-attention mechanism, the model fuses sample and label semantics, while the optimized loss function adapts to class imbalances. Extensive experiments on two public datasets, OntoNotes 4.0 (Chinese) and MSRA, demonstrate the effectiveness of LGDA, achieving significant performance improvements over baseline models. Notably, the data augmentation module proves particularly effective in few-shot settings. Full article

Background and Objectives: Regular exercise is known to induce cardiovascular adaptations collectively referred to as “athlete’s heart”. While previous research has explored the morphological and functional cardiac adaptations in athletes, the relationship between vitamin D (25-hydroxyvitamin D [25(OH)D]) levels and echocardiographic parameters remains underexplored. This study aims to assess the association between 25(OH)D levels and structural and functional cardiac parameters using electrocardiographic (ECG) and echocardiographic evaluations in athletes. Materials and Methods: This case–control study included 93 male athletes, categorized into professional (n = 68) and recreational (n = 25) groups. Professional athletes were further divided into football (n = 19), weightlifting (n = 22), and running (n = 27) subgroups. Serum 25(OH)D levels were measured using high-performance liquid chromatography–tandem mass spectrometry (LC-MS/MS). Standard 12-lead ECG and transthoracic echocardiography were performed to assess cardiac structure and function. Data were analyzed using statistical tests that were appropriate for normal and non-normal distributions, with a significance level set at p < 0.05. Results: Athletes exhibited higher left ventricular interventricular septum (IVS) thickness and left ventricular posterior wall thickness (LVPWd) compared to the control group. Significant differences in diastolic function parameters, including early (E) and late (A) diastolic filling velocities and the E/A ratio, were observed among athlete subgroups. The weightlifting group showed lower end-systolic diameter (ESD) values than the football group. However, no statistically significant relationship was found between 25(OH)D levels and echocardiographic diastolic parameters. While more than half of the athletes had insufficient 25(OH)D levels (<30 ng/mL), their average values were higher than those reported in previous studies. Conclusions: This study demonstrates that 25(OH)D levels do not significantly influence echocardiographic diastolic parameters in athletes. However, notable differences in structural and functional cardiac findings were observed among different sports disciplines. These findings contribute to the understanding of cardiac adaptations in athletes and suggest that 25(OH)D may not play a crucial role in diastolic function. Further research is needed to explore the long-term effects of vitamin D on athletic cardiac performance. Full article

In soccer players, ankle injuries are a common issue that may increase lower limb imbalance. Therefore, this study investigates the relationship between the range of motion of the knee and ankle joints and lower limb imbalance in soccer players with and without ankle injuries. We recruited 50 male university soccer athletes, who were categorized into an injury group (21 players) and a non-injury group (29 players). Prior to the experimental tests, basic data were collected through a self-reported questionnaire. During the experiment, participants sequentially completed a passive knee flexion test, a passive knee extension test, an active ankle plantarflexion test, and an active ankle dorsiflexion test. The results indicated that there were significant differences in the imbalance in knee and ankle range of motion between injured and non-injured athletes. Additionally, there was a significant negative correlation between right passive knee flexion range of motion, right active ankle plantarflexion range of motion, and ankle injuries. Full article

Purpose: The objective of this study was to determine the prevalence of exostosis in the Mississippi population. Methods: The patient archives of the UMMC School of Dentistry between January 2018 and May 2021 were examined. Patients with exostosis were included in the study based on the findings from intraoral photographs, full-moth series (FMS), panoramic radiographs, and cone-beam computerized tomography (CBCT) images of the patients. Patients were excluded from the study if they did not have maxillary or mandibular exostosis. In addition, each patient’s age, gender, and ethnic origins, such as Caucasian, African-American, or Asian, were recorded. All data regarding exostosis were evaluated and categorized according to age, gender, and ethnicity. Multiple logistic regression analysis was performed for more detailed statistical analysis. Results: A total of 1242 patients were examined for the presence of maxillary and mandibular tori. In total, 303 patients were diagnosed with maxillary and/or mandibular tori among the Mississippi population, with a prevalence rate of 24.4%. Exostosis was seen more in females (57.4%) compared to males (42.6%). The highest prevalence of exostosis was seen in Caucasians (71.3%), followed by African-Americans (23.8%) and Asians (5%). Conclusions: High prevalence of exostosis was seen in the Mississippi population. Our findings will help clinicians to be more aware of these bony protuberances and, thus, better at diagnosing them. This may specifically help oral surgeons, periodontists, and prosthodontists in pre-prosthodontic surgery and denture fabrication. Full article

At present, China is facing a serious aging problem. Although community daycare centers have been built, they generally have problems such as inadequate facilities, single-service provision, and insufficient environmental design. These problems make it impossible to meet the multifaceted needs of the elderly in their old age, enhance their sense of wellbeing, and achieve sustainable development. Therefore, relevant policies indicate that the elderly service model of community day care centers should be actively constructed and upgraded. However, most of the existing research focuses on service models or single-design practice studies, and there are relatively few studies that address the integration of restorative environmental design and sustainability. Therefore, this paper systematically explores the current research status of restorative environmental design in daycare centers for the elderly through macro quantitative bibliometric analysis and micro qualitative content analysis based on Web of Science (WOS) data, then proposes design practice strategies, implementation paths, and evaluation methods to enhance wellbeing. Through keyword network visualization analysis, this paper identifies eight main clusters: physical literacy, public preschool services, social support, elderly day care centers, hospice use, designing leisure products, risk factors, and communicative skills. The high-frequency keywords “health”, “elderly”, “cultural diversity”, “children”, and “quality of life” are further categorized into “caregiving”, “Alzheimer’s disease”, “adult day care”, and “daycare centers”, with the latter split into three further categories: design strategy, implementation approach, and evaluation. In addition, this paper combines SDG3 goals such as reducing premature mortality from non-communicable diseases, achieving universal health coverage, etc., in order to explore the potential of resilience-based environmental design to promote the sustainable development of elderly daycare centers. This study not only complements the research related to restorative environmental design in daycare centers for the elderly but also provides specific guidelines and references for future environmental design, policy planning, and elderly service practices. Full article

Objective: This systematic literature review aimed to summarize the economic burden of lung cancer in Greece, identify current data gaps, and support the design of future real-world studies. Methods: A systematic search of studies published in English on the cost of lung cancer was performed in MEDLINE-(PubMed), Scopus, and ScienceDirect. The databases were searched until September 2024, and records were screened based on our eligibility criteria. After conducting the initial literature search, the abstracts and full texts of the identified studies were reviewed and evaluated for inclusion based on predefined criteria. Data from the selected studies were then extracted into a standardized form and subsequently synthesized. Results: Seven studies were included in this review. The reported burden was sourced from hospital data and categorized as direct and indirect costs. Most studies (n = 6) reported direct costs, with one study reporting both direct and indirect costs. The total direct medical cost per patient increased from approximately EUR 16,000 in 2015 to EUR 58,974 in 2023, with drug acquisition costs being the key driver of the total direct cost. Additionally, the cost of end-of-life care during the final six months of a patient’s life was estimated to range from EUR 6786 to EUR 7665 per patient, with pharmaceutical costs comprising the largest proportion of the total cost. One study also reported that indirect costs were considerably higher for patients than for family caregivers. Conclusion: The economic burden of lung cancer has increased substantially over the past decade in Greece. The present systematic review emphasizes the critical need for comprehensive real-world studies on the economic burden of lung cancer in Greece. Addressing the current gaps holistically will yield invaluable insights for policymakers and stakeholders. Full article

Background: The 2011 Very Early Diagnosis of Systemic Sclerosis (VEDOSS) criteria include both patients at risk of progression and those with mild non-progressive forms of SSc. Early diastolic and systolic dysfunction can indicate myocardial fibrosis in SSc patients, yet data on myocardial impairment in the VEDOSS population are limited. Objectives: This study aimed to identify subclinical echocardiographic changes and predictive markers of cardiac dysfunction in both very early and mild-longstanding forms of VEDOSS. Methods: We conducted a cross-sectional observational study involving 61 patients meeting VEDOSS criteria followed up regularly within our Scleroderma referral center. Patients were categorized as early VEDOSS (e-VEDOSS) or mild-longstanding VEDOSS (ml-VEDOSS) based on disease duration (≥10 years). We analyzed clinical and demographic data, focusing on echocardiographic parameters such as the E/A ratio and left ventricular (LV) thickness. Statistical analyses included chi-square, Fischer exact, and student’s t tests, with a significance threshold of p < 0.05. Results: ml-VEDOSS patients were older and reported a higher burden of comorbidities. Autoantibody-positive patients exhibited lower E/A ratios and increased left atrial size. Late nailfold videocapillaroscopic pattern patients exhibited increased PWED thickening and aortic valve insufficiency. Notably, patients undergoing vasodilators experienced larger right atrial volume, while patients receiving Renin-Angiotensin-Aldosterone System (RAAS) inhibitors reported reduced E/A ratio. Multivariable analysis confirmed DLCO% as the sole predictor of both diastolic and systolic impairment in VEDOSS population. Conclusions: Careful monitoring of cardiac function in VEDOSS patients is crucial as subclinical alterations may occur even in the absence of symptoms. DLCO% emerged as an important predictor of LV diastolic dysfunction. Full article

Manufacturing-as-a-service consists of an Industry 4.0 innovation and has been a focal point of research and business attention in recent years. MaaS provides a matching connection between manufacturing resources or capabilities as service and organizations that need to utilize them, via a digital thread. Through this approach, not all companies have to invest in heavy capital, which allows them to focus on other critical capacities. This review provides bibliometric insights, such as quantitative results regarding the annual trends, dominant publications, journals, institutions, and VOS-viewer-software-extracted networks that highlight co-occurrence of keywords and journal co-citations. Moreover, the publications are presented concisely and are critically evaluated and categorized in pilar categories based on their core concept. The current limitations and future trends in the MaaS field are identified as well. Even though it is an established, important Industry 4.0 innovation, the available literature may not provide such a holistic, comprehensive overview of MaaS. The current study not only presents critical observations of contemporary and distinguished scientific papers but also guides researchers in a systematic examination of MaaS theoretically, architecturally represented, or regarding its data-driven opportunities. Full article

Heavy rainfall significantly impacts agriculture by damaging crops and causing substantial economic losses. The Paravanar River Basin, a coastal river basin in India, experiences heavy rainfall during the monsoon season. This study analyzed both ground-level rainfall measurements and farmers’ experiences to understand the effects of heavy rainfall on agriculture. Rainfall data from nine rain gauge locations were analyzed across three cropping seasons: Kharif 1 (June to August), Kharif 2 (September to November), and Rabi (December to May). To determine the frequency of heavy rainfall events, a detailed analysis was conducted based on the standards set by the India Meteorological Department (IMD). Villages near stations showing increasing rainfall trends and a higher frequency of heavy rainfall events were classified as vulnerable. The primary crops cultivated in these vulnerable areas were identified through a questionnaire survey with local farmers. A detailed analysis of these crops was conducted to determine the cropping season most affected by heavy rainfall events. The impacts of heavy rainfall on the primary crops were assessed using the Delphi technique, a score-based crop risk assessment method. These impacts were categorized into eight distinct types. Among them, yield reduction, waterlogging, crop damage, soil erosion, and crop failure emerged as the most significant challenges in the study area. Additional impacts included nutrient loss, disrupted microbial activity, and disease outbreaks. Based on this evaluation, risks were classified into five categories: low risk, moderate risk, high risk, very high risk, and extreme risk. This categorization offers a framework for understanding potential consequences and making informed decisions. To address these challenges, the study recommended mitigation measures such as crop management, soil management, and drainage management. Farmers were also encouraged to conduct a cause-and-effect analysis. This bottom-up approach raised awareness among farmers and provided practical solutions to reduce crop losses and mitigate the effects of heavy rainfall. Full article

Background: B3 lesions of the breast, for which vacuum-assisted biopsy (VABB) represents the standard tissue sampling approach, have different risks of upgrade to malignancy at surgery and/or follow-up. This study aimed to investigate if complete or partial lesion removal during VABB of B3 lesions presenting as microcalcifications influences their subsequent upgrade rate. Methods: For this retrospective single-center study, we retrieved 165 lesions diagnosed as B3 at VABB that presented solely as microcalcifications categorized as Breast Imaging Reporting & Data System (BI-RADS) 4 or 5 at mammography between January 2016 and December 2020. Surgical pathology or at least 3-year follow-up were obtained to determine potential lesion upgrade to malignancy. χ², Fisher’s, and Mantel–Haenszel tests were performed to assess if complete lesion removal influenced upgrade rates overall and among different B3 subtypes. Results: Complete lesion removal was achieved in 99/165 cases (60.0%) and did not differ among B3 subtypes (p = 0.092). The overall upgrade rate was 8.5% (95% confidence interval [CI] 5.1–13.7%, 14/165), without statistically significant differences among B3 subtypes (p = 0.562). Conversely, completely removed lesions (4.0%, 95% CI 1.6–9.9%) had a statistically significant lower upgrade rate compared to partially removed lesions (15.2%, 95% CI 8.4–25.7%, p = 0.019). According to stratified analysis according to B3 subtypes, the odds ratio of upgrade among completely and partially removed flat epithelial atypia (0.13, 95% CI 0.00–1.45) was lower (Mantel-Haenszel test p = 0.016) than those of atypical ductal hyperplasia (0.31, 95% CI 0.02–3.17) and of lobular neoplasia (0.73, 95% CI 0.01–60.62). Conclusions: The upgrade rate of B3 lesions is significantly influenced by complete lesion removal, both overall and among different B3 subtypes. Full article

Background/Objectives: Heart failure (HF) can damage organs because of poor perfusion and/or congestion. The interactions between HF and other organs have recently been studied; however, data on the interaction between HF and pancreatic exocrine function, which may affect fat and protein absorption and malnutrition, are scarce. We previously showed that the serum levels of pancreatic exocrine enzymes, as suggestive of pancreatic exocrine function, were low and associated with malnutrition or congestion in hospitalized patients with acute decompensated HF (ADHF). This study investigated the relationship between the serum levels of pancreatic exocrine enzymes and long-term outcomes in patients with ADHF. Methods: We collected serum levels of pancreatic exocrine enzymes (amylase and lipase) from patients who were admitted to the cardiac intensive care unit due to ADHF. Patients undergoing dialysis and those with neoplasms were excluded. Patients were categorized as having high or low pancreatic exocrine enzyme levels in the first quartile upon admission. The association between low serum pancreatic exocrine enzyme levels at admission and the composite of death and ADHF readmission was assessed. Results: Of the 146 patients, 37 (25.3%) and 36 (24.7%) had low amylase and lipase levels, respectively. Patients with low lipase levels showed worse cumulative event-free survival than those with high lipase levels (p < 0.001). A low lipase level was associated with worse outcomes (hazard ratio: 1.96; p = 0.012). Conclusions: These findings suggest that low serum lipase levels may be a predictor of long-term outcomes in patients with ADHF. Full article