The 2023 MDPI Annual Report has
been released!
 
13 pages, 1031 KiB  
Article
CA-125 KELIM as an Alternative Predictive Tool to Identify Which Patients Can Benefit from PARPi in High-Grade Serous Advanced Ovarian Cancer: A Retrospective Pilot Diagnostic Accuracy Study
by Dimitrios Zouzoulas, Dimitrios Tsolakidis, Panagiotis Tzitzis, Kimon Chatzistamatiou, Vasilis Theodoulidis, Iliana Sofianou, Grigoris Grimbizis and Eleni Timotheadou
Int. J. Mol. Sci. 2024, 25(10), 5230; https://doi.org/10.3390/ijms25105230 (registering DOI) - 11 May 2024
Abstract
BRCA mutation and homologous recombination deficiency (HRD) are the criteria for the administration of PARP inhibitor (PARPi) maintenance therapy. It is known that PARPi efficacy is related to platinum sensitivity and that the latter can be demonstrated from the CA-125 elimination rate constant [...] Read more.
BRCA mutation and homologous recombination deficiency (HRD) are the criteria for the administration of PARP inhibitor (PARPi) maintenance therapy. It is known that PARPi efficacy is related to platinum sensitivity and that the latter can be demonstrated from the CA-125 elimination rate constant (KELIM). This study aims to investigate if KELIM can be another tool in the identification of patients that could be benefit from PARPi therapy. Retrospective analysis of patients with high-grade serous advanced ovarian cancer that underwent cytoreduction and was further tested for HRD status. The HRD status was tested either by myChoice HRD CDx assay or by RediScore assay. KELIM score was measured in both neoadjuvant and adjuvant settings with the online tool biomarker-kinetics.org. A total of 39 patients had available data for estimating both HRD status and KELIM score. When assuming KELIM as a binary index test with the value 1 as the cut-off point, the sensitivity was 0.86, 95% CI (0.64–0.97) and the specificity was 0.83, 95% CI (0.59–0.96). On the other hand, when assuming KELIM as a continuous index test, the area under the curve (AUC) was 81% and the optimal threshold, using the Youden index, was identified as 1.03 with a sensitivity of 85.7% and a specificity of 83.3%. KELIM score seems to be a new, cheaper, and faster tool to identify patients that can benefit from PARPi maintenance therapy. Full article
(This article belongs to the Special Issue Advances in Gynecological Cancers 2.0)
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16 pages, 6773 KiB  
Article
Quantitative Relationship of Plant Height and Leaf Area Index of Spring Maize under Different Water and Nitrogen Treatments Based on Effective Accumulated Temperature
by Tingrui Yang, Jinghua Zhao and Qiuping Fu
Agronomy 2024, 14(5), 1018; https://doi.org/10.3390/agronomy14051018 (registering DOI) - 11 May 2024
Abstract
To optimize the growth management of spring maize, it is essential to understand the dynamics of plant height and leaf area index (LAI) under controlled water and nitrogen supply. This study conducted two-year field experiments (2022–2023) in Karamay, Xinjiang. Three irrigation levels (75%, [...] Read more.
To optimize the growth management of spring maize, it is essential to understand the dynamics of plant height and leaf area index (LAI) under controlled water and nitrogen supply. This study conducted two-year field experiments (2022–2023) in Karamay, Xinjiang. Three irrigation levels (75%, 100%, and 125% of Crop Evapotranspiration (ETc)) and four nitrogen application rates (0, 93, 186, and 279 kg N/ha) were set. A logistic growth model was fitted using accumulated effective temperature as the independent variable to analyze the growth and development characteristics of spring maize under various water and nitrogen conditions. The results demonstrated that the logistic models, based on relative effective accumulated temperature, had a determination coefficient (R2) of over 0.99 and a Normalized Root Mean Square Error (NRMSE) of less than 10%. Irrigation extended the rapid growth phase of plant height, whereas nitrogen application shortened the time to enter this rapid growth phase and prolonged its duration. Irrigation increased the maximum LAI growth rate and shortened and prolonged the rapid growth phase, while nitrogen extended the duration of the rapid growth phase for LAI. The W2N2 treatment, consisting of 100% ETc irrigation and 186 kg N/ha, was identified as the optimal drip irrigation water–nitrogen combination for spring maize in the study area. Under optimal water and nitrogen supply, both the maximum growth rate and the average growth rate during the rapid growth phase were higher, requiring accumulated effective temperatures of 825.16–845.74 °C·d and 856.68–890.00 °C·d, respectively, to reach these rates. The appropriate water and nitrogen supply significantly enhanced the synergistic promotion of growth and development in spring maize. This study provides a theoretical basis for the quantitative analysis of growth dynamics in summer maize using effective accumulated temperature. Full article
(This article belongs to the Section Water Use and Irrigation)
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19 pages, 2164 KiB  
Article
Value-Based Health Care for Prostate Cancer Centers by Implementing Specific Key Performance Indicators Using a Balanced Score Card
by Jan Philipp Radtke, Peter Albers, Boris A. Hadaschik, Markus Graefen, Christian P. Meyer, Björn Behr and Stephan Nüesch
Healthcare 2024, 12(10), 991; https://doi.org/10.3390/healthcare12100991 (registering DOI) - 11 May 2024
Abstract
Background: Prostate cancer (PC) is the most common cancer in men in 112 countries, and accounts for 15% of cancers. Because it cannot be prevented, the rise in cases is inevitable, and improvements in diagnostic pathways and treatments are needed, as there is [...] Read more.
Background: Prostate cancer (PC) is the most common cancer in men in 112 countries, and accounts for 15% of cancers. Because it cannot be prevented, the rise in cases is inevitable, and improvements in diagnostic pathways and treatments are needed, as there is still a shortage of cost-effective diagnostics and widespread oncologically safe treatment options with measurable quality. As part of the implementation of a Full Cycle of Care, instruments have been developed to achieve value-based medicine, such as consistent commitment to measurability. One of these instruments is the Balanced Scorecard (BSC). Here, we propose the first BSC for prostate cancer (PC) treatment. Methods: BSCs are used to assess performance in healthcare organizations across four dimensions: financial, patient and referrer, process, and learning and development. This study aimed to identify Key Performance Indicators (KPIs) for each perspective. A systematic literature search was conducted according to PRISMA guidelines using multiple databases and specific search terms to identify KPIs for PC care, excluding case reports and conference abstracts. In total, 44 reports were included in analyses and development of the PC-specific BSC. Results: In the present study, a PC-specific BSC and KPIs were defined for the four classic perspectives, as well as for a newly developed PC-Specific Disease and Outcome perspective, including patient-related parameters from the German Cancer Society and the International Consortium for Health Outcomes Measurement. In addition, the Process perspective includes KPIs of fulfillment of continuing education of residents and the metrics of structured training of the radical prostatectomy procedure in the Learning and Development perspective. Conclusions: The developed BSC provides a comprehensive set of perspectives for an Integrated Practice Unit or center in PC care, ensuring that the indicators remain manageable and applicable. The BSC facilitates value creation in line with Porter’s Full Cycle of Care by systematically collecting and providing economic, personnel, and medical results, actions, and indicators. In particular, this BSC includes KPIs of structured training of practitioners and metrics of the German Cancer Society, that recently proved to improve PC patients outcomes. Full article
(This article belongs to the Section Health Assessments)
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13 pages, 5642 KiB  
Article
Risk of Atrial Fibrillation in Patients with Different Cancer Types in Taiwan
by Kuang-Ming Liao, Chia-Hung Yu, Yu-Cih Wu, Jhi-Joung Wang, Fu-Wen Liang and Chung-Han Ho
Life 2024, 14(5), 621; https://doi.org/10.3390/life14050621 (registering DOI) - 11 May 2024
Abstract
Atrial fibrillation (AF) commonly occurs in approximately 2% of cancer patients, and the incidence of AF among cancer patients is greater than in the general population. This observational study presented the incidence risk of AF among cancer patients, including specific cancer types, using [...] Read more.
Atrial fibrillation (AF) commonly occurs in approximately 2% of cancer patients, and the incidence of AF among cancer patients is greater than in the general population. This observational study presented the incidence risk of AF among cancer patients, including specific cancer types, using a population database. The Taiwan Cancer Registry was used to identify cancer patients between 2008 and 2017. The diagnosis of AF was based on the International Classification of Diseases codes (ICD-9-CM: 427.31 or ICD-10-CM: I48.0, I48.1, I48.2, and I48.91) in Taiwan national health insurance research datasets. The incidence of developing AF in the cancer population was calculated as the number of new-onset AF cases per person-year of follow-up during the study period. The overall incidence of AF among cancer patients was 50.99 per 100,000 person-years. Patients aged older than 65 years and males had higher AF incidence rates. Lung cancer males and esophageal cancer females showed the highest AF incidence risk (185.02 and 150.30 per 100,000 person-years, respectively). Our findings identified esophageal, lung, and gallbladder cancers as the top three cancers associated with a higher incidence of AF. Careful monitoring and management of patients with these cancers are crucial for early detection and intervention of AF. Full article
(This article belongs to the Section Epidemiology)
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24 pages, 7830 KiB  
Article
Novel Learning of Bathymetry from Landsat 9 Imagery Using Machine Learning, Feature Extraction and Meta-Heuristic Optimization in a Shallow Turbid Lagoon
by Hang Thi Thuy Tran, Quang Hao Nguyen, Ty Huu Pham, Giang Thi Huong Ngo, Nho Tran Dinh Pham, Tung Gia Pham, Chau Thi Minh Tran and Thang Nam Ha
Geosciences 2024, 14(5), 130; https://doi.org/10.3390/geosciences14050130 (registering DOI) - 11 May 2024
Abstract
Bathymetry data is indispensable for a variety of aquatic field studies and benthic resource inventories. Determining water depth can be accomplished through an echo sounding system or remote estimation utilizing space-borne and air-borne data across diverse environments, such as lakes, rivers, seas, or [...] Read more.
Bathymetry data is indispensable for a variety of aquatic field studies and benthic resource inventories. Determining water depth can be accomplished through an echo sounding system or remote estimation utilizing space-borne and air-borne data across diverse environments, such as lakes, rivers, seas, or lagoons. Despite being a common option for bathymetry mapping, the use of satellite imagery faces challenges due to the complex inherent optical properties of water bodies (e.g., turbid water), satellite spatial resolution limitations, and constraints in the performance of retrieval models. This study focuses on advancing the remote sensing based method by harnessing the non-linear learning capabilities of the machine learning (ML) model, employing advanced feature selection through a meta-heuristic algorithm, and using image extraction techniques (i.e., band ratio, gray scale morphological operation, and morphological multi-scale decomposition). Herein, we validate the predictive capabilities of six ML models: Random Forest (RF), Support Vector Machine (SVM), CatBoost (CB), Extreme Gradient Boost (XGB), Light Gradient Boosting Machine (LGBM), and KTBoost (KTB) models, both with and without the application of meta-heuristic optimization (i.e., Dragon Fly, Particle Swarm Optimization, and Grey Wolf Optimization), to accurately ascertain water depth. This is achieved using a diverse input dataset derived from multi-spectral Landsat 9 imagery captured on a cloud-free day (19 September 2023) in a shallow, turbid lagoon. Our findings indicate the superior performance of LGBM coupled with Particle Swamp Optimization (R2 = 0.908, RMSE = 0.31 m), affirming the consistency and reliability of the feature extraction and selection-based framework, while offering novel insights into the expansion of bathymetric mapping in complex aquatic environments. Full article
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8 pages, 2052 KiB  
Brief Report
Parkinson’s Kinetigraph for Wearable Sensor Detection of Clinically Unrecognized Early-Morning Akinesia in Parkinson’s Disease: A Case Report-Based Observation
by Karolina Poplawska-Domaszewicz, Naomi Limbachiya, Yue Hui Lau and Kallol Ray Chaudhuri
Sensors 2024, 24(10), 3045; https://doi.org/10.3390/s24103045 (registering DOI) - 11 May 2024
Abstract
Early-morning off periods, causing early-morning akinesia, can lead to significant motor and nonmotor morbidity in levodopa-treated fluctuating Parkinson’s disease (PD) cases. Despite validated bedside scales in clinical practice, such early-morning off periods may remain undetected unless specific wearable technologies, such as the Parkinson’s [...] Read more.
Early-morning off periods, causing early-morning akinesia, can lead to significant motor and nonmotor morbidity in levodopa-treated fluctuating Parkinson’s disease (PD) cases. Despite validated bedside scales in clinical practice, such early-morning off periods may remain undetected unless specific wearable technologies, such as the Parkinson’s KinetiGraph™ (PKG) watch, are used. We report five PD cases for whom the PKG detected early-morning off periods that were initially clinically undetected and as such, untreated. These five cases serve as exemplars of this clinical gap in care. Post-PKG assessment, clinicians were alerted and targeted therapies helped abolish the early-morning off periods. Full article
(This article belongs to the Section Biomedical Sensors)
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20 pages, 10466 KiB  
Article
Manufacturing of TiO2, Al2O3 and Y2O3 Ceramic Nanotubes for Application as Electrodes for Printable Electrochemical Sensors
by Alexandru Florentin Trandabat, Romeo Cristian Ciobanu, Oliver Daniel Schreiner, Mihaela Aradoaei and Sebastian Teodor Aradoaei
Crystals 2024, 14(5), 454; https://doi.org/10.3390/cryst14050454 (registering DOI) - 11 May 2024
Abstract
This paper describes the process to obtain ceramic nanotubes from titanium dioxide, alumina and yttrium oxide by a feasible, replicable and reliable technology, including three stages, starting from an electrospinning process of poly(methyl methacrylate) solutions. A minimum diameter of 0.3 μm was considered [...] Read more.
This paper describes the process to obtain ceramic nanotubes from titanium dioxide, alumina and yttrium oxide by a feasible, replicable and reliable technology, including three stages, starting from an electrospinning process of poly(methyl methacrylate) solutions. A minimum diameter of 0.3 μm was considered optimal for PMMA nanofibers in order to maintain the structural stability of covered fibers, which, after ceramic film deposition, leads to a fiber diameter of 0.5–0.6 μm. After a chemical and physical analysis of the stages of obtaining ceramic nanotubes, in all cases, uniform deposition of a ceramic film on PMMA fibers and, finally, a uniform structure of ceramic nanotubes were noted. The technological purpose was to use such nanotubes as ingredients in screen-printing inks for electrochemical sensors, because no study directly targeted the subject of ceramic nanotube applications for printed electronics to date. The printing technology was analyzed in terms of the ink deposition process, printed electrode roughness vs. type of ceramic nanotubes, derived inks, thermal curing of the electrodes and the conductivity of electrodes on different support (rigid and flexible) at different curing temperatures. The experimental inks containing ceramic nanotubes can be considered feasible for printed electronics, because they offer fast curing at low temperatures, reasonable conductivity vs. electrode length, good printability on both ceramic or plastic (flexible) supports and good adhesion to surface after curing. Full article
(This article belongs to the Special Issue Metal Oxide Thin Films, Nanomaterials and Nanostructures)
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18 pages, 63940 KiB  
Article
Tomographic Background-Oriented Schlieren for Axisymmetric and Weakly Non-Axisymmetric Supersonic Jets
by Tong Jia, Jiawei Li, Jie Wu and Yuan Xiong
Symmetry 2024, 16(5), 596; https://doi.org/10.3390/sym16050596 (registering DOI) - 11 May 2024
Abstract
The Schlieren technique is widely adopted for visualizing supersonic jets owing to its non-invasiveness to the flow field. However, extending the classical Schlieren method for quantitative refractive index measurements is cumbersome, especially for three-dimensional supersonic flows. Background-oriented Schlieren has gained increasing popularity owing [...] Read more.
The Schlieren technique is widely adopted for visualizing supersonic jets owing to its non-invasiveness to the flow field. However, extending the classical Schlieren method for quantitative refractive index measurements is cumbersome, especially for three-dimensional supersonic flows. Background-oriented Schlieren has gained increasing popularity owing to its ease of implementation and calibration. This study utilizes multi-view-based tomographic background-oriented Schlieren (TBOS) to reconstruct axisymmetric and weakly non-axisymmetric supersonic jets, highlighting the impact of flow axisymmetry breaking on TBOS reconstructions. Several classical TBOS reconstruction algorithms, including FDK, SART, SIRT, and CGLS, are compared quantitatively regarding reconstruction quality. View spareness is identified to be the main cause of degraded reconstruction quality when the flow experiences axisymmetry breaking. The classic visual hull approach is explored to improve reconstruction quality. Together with the CGLS tomographic algorithm, we successfully reconstruct the weakly non-axisymmetric supersonic jet structures and confirm that increasing the nozzle bevel angle leads to wider jet spreads. Full article
(This article belongs to the Special Issue Applications Based on Symmetry/Asymmetry in Fluid Mechanics)
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9 pages, 4379 KiB  
Communication
Gain−Switched Er−Doped Fluoride Fiber Laser at ~3.75 μm
by Lu Zhang, Shijie Fu, Quan Sheng, Xuewen Luo, Junxiang Zhang, Wei Shi, Qiang Fang and Jianquan Yao
Photonics 2024, 11(5), 449; https://doi.org/10.3390/photonics11050449 (registering DOI) - 11 May 2024
Abstract
We demonstrate a pulsed Er−doped ZBLAN fiber laser operating at 3.75 μm based on the gain−switching scheme. A diffraction grating is introduced as a wavelength selection component to enable stable lasing in this long−wavelength region that deviates from the emission peak of 4 [...] Read more.
We demonstrate a pulsed Er−doped ZBLAN fiber laser operating at 3.75 μm based on the gain−switching scheme. A diffraction grating is introduced as a wavelength selection component to enable stable lasing in this long−wavelength region that deviates from the emission peak of 4F9/24I9/2 transition in Er3+. Different from the conventional gain−switching behavior where the pulse repetition frequency of the output laser is same as the that of the pump, the gain−switched laser demonstrated here shows a variable pulse repetition frequency, which accounts for 1/n (n = 4, 3, 2) of the pump pulse repetition frequency, in response to the 1950 nm pump power. The output pulse characteristics, including average output power, repetition frequency, pulse duration, and peak power, are investigated in detail. Over 200 mW average output power at 3.75 μm was obtained at 12 W of 1950 nm pump power. This work demonstrates that the Er−doped ZBLAN fiber laser, in combination with gain−switched scheme, is a feasible and promising approach to generate powerful pulsed emission > 3.7 μm. Full article
(This article belongs to the Special Issue Research on Rare-Earth-Doped Fiber Lasers)
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8 pages, 832 KiB  
Article
Clinical Results of the MINIject Implant for Suprachoroidal Drainage
by Timothy Gläser, Daniel Böhringer, Charlotte Evers, Philip Keye, Thomas Reinhard and Jan Lübke
J. Clin. Med. 2024, 13(10), 2831; https://doi.org/10.3390/jcm13102831 (registering DOI) - 11 May 2024
Abstract
Objective: This retrospective study evaluated the safety and efficacy of the new minimally invasive MINIject implant placed in the suprachoroidal space. The aim was to assess its impact on intraocular pressure (IOP) reduction and complication rate. Methods: 18 eyes from 18 patients with [...] Read more.
Objective: This retrospective study evaluated the safety and efficacy of the new minimally invasive MINIject implant placed in the suprachoroidal space. The aim was to assess its impact on intraocular pressure (IOP) reduction and complication rate. Methods: 18 eyes from 18 patients with insufficiently controlled glaucoma received the implant using topical medications. Outcomes were changes in IOP, change in IOP medication, need for other glaucoma surgery, and rate of adverse events. Results: IOP reduced by 15% (p < 0.05) following MINIject implantation. IOP medication decreased from 3 to 1 agent (p < 0.05). Four patients (22%) required other glaucoma surgery while we did not observe any clinically relevant adverse event. Conclusions: This retrospective study indicates that MINIject implants may be a safe and effective means of reducing IOP together with a reduction in IOP medications in most patients. Larger prospective studies with longer follow-ups are necessary to confirm our results, though. Full article
(This article belongs to the Special Issue Advances in Glaucoma Surgery: 2nd Edition)
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20 pages, 5668 KiB  
Article
Beyond Frequency Bands: Complementary-Ensemble-Empirical-Mode-Decomposition-Enhanced Microstate Sequence Non-Randomness Analysis for Aiding Diagnosis and Cognitive Prediction of Dementia
by Wang Wan, Zhongze Gu, Chung-Kang Peng and Xingran Cui
Brain Sci. 2024, 14(5), 487; https://doi.org/10.3390/brainsci14050487 (registering DOI) - 11 May 2024
Abstract
Exploring the spatiotemporal dynamic patterns of multi-channel electroencephalography (EEG) is crucial for interpreting dementia and related cognitive decline. Spatiotemporal patterns of EEG can be described through microstate analysis, which provides a discrete approximation of the continuous electric field patterns generated by the brain [...] Read more.
Exploring the spatiotemporal dynamic patterns of multi-channel electroencephalography (EEG) is crucial for interpreting dementia and related cognitive decline. Spatiotemporal patterns of EEG can be described through microstate analysis, which provides a discrete approximation of the continuous electric field patterns generated by the brain cortex. Here, we propose a novel microstate spatiotemporal dynamic indicator, termed the microstate sequence non-randomness index (MSNRI). The essence of the method lies in initially generating a sequence of microstate transition patterns through state space compression of EEG data using microstate analysis. Following this, we assess the non-randomness of these microstate patterns using information-based similarity analysis. The results suggest that this MSNRI metric is a potential marker for distinguishing between health control (HC) and frontotemporal dementia (FTD) (HC vs. FTD: 6.958 vs. 5.756, p < 0.01), as well as between HC and populations with Alzheimer’s disease (AD) (HC vs. AD: 6.958 vs. 5.462, p < 0.001). Healthy individuals exhibit more complex macroscopic structures and non-random spatiotemporal patterns of microstates, whereas dementia disorders lead to more random spatiotemporal patterns. Additionally, we extend the proposed method by integrating the Complementary Ensemble Empirical Mode Decomposition (CEEMD) method to explore spatiotemporal dynamic patterns of microstates at specific frequency scales. Moreover, we assessed the effectiveness of this innovative method in predicting cognitive scores. The results demonstrate that the incorporation of CEEMD-enhanced microstate dynamic indicators significantly improved the prediction accuracy of Mini-Mental State Examination (MMSE) scores (R2 = 0.940). The CEEMD-enhanced MSNRI method not only aids in the exploration of large-scale neural changes in populations with dementia but also offers a robust tool for characterizing the dynamics of EEG microstate transitions and their impact on cognitive function. Full article
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16 pages, 953 KiB  
Review
Intracellular Host Restriction of Hepatitis B Virus Replication
by Prakriti Sinha, Chloe L. Thio and Ashwin Balagopal
Viruses 2024, 16(5), 764; https://doi.org/10.3390/v16050764 (registering DOI) - 11 May 2024
Abstract
The hepatitis B virus (HBV) infects hepatocytes and hijacks host cellular mechanisms for its replication. Host proteins can be frontline effectors of the cell’s defense and restrict viral replication by impeding multiple steps during its intracellular lifecycle. This review summarizes many of the [...] Read more.
The hepatitis B virus (HBV) infects hepatocytes and hijacks host cellular mechanisms for its replication. Host proteins can be frontline effectors of the cell’s defense and restrict viral replication by impeding multiple steps during its intracellular lifecycle. This review summarizes many of the well-described restriction factors, their mechanisms of restriction, and counteractive measures of HBV, with a special focus on viral transcription. We discuss some of the limitations and knowledge gaps about the restriction factors, highlighting how these factors may be harnessed to facilitate therapeutic strategies against HBV. Full article
(This article belongs to the Special Issue HBV Transcriptional and Post-transcriptional Regulation)
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10 pages, 813 KiB  
Article
Association between Bone Quality and Physical Activity in Community-Dwelling Older Adults
by Koki Akai, Koutatsu Nagai, Shotaro Tsuji, Katsuyoshi Hirose, Daisuke Maruyama, Ryota Matsuzawa, Kayoko Tamaki, Hiroshi Kusunoki, Yosuke Wada and Ken Shinmura
Geriatrics 2024, 9(3), 62; https://doi.org/10.3390/geriatrics9030062 (registering DOI) - 11 May 2024
Abstract
Bone quality is an essential factor determining bone strength. However, the relationship between physical activity (PA) and bone quality remains unclear. This study aimed to ascertain the relationship between bone quality and PA using a cortical bone quantitative ultrasound device that measures components [...] Read more.
Bone quality is an essential factor determining bone strength. However, the relationship between physical activity (PA) and bone quality remains unclear. This study aimed to ascertain the relationship between bone quality and PA using a cortical bone quantitative ultrasound device that measures components of bone quality. In this cross-sectional study, bone quality was assessed in community-dwelling older adults by measuring the cortical speed of sound (cSOS) at the mid-tibia using a quantitative ultrasound device. Using a wrist-worn accelerometer, we calculated the daily duration of moderate-to-vigorous physical activity (MVPA) and light physical activity (LPA) based on estimated METs from the accelerometer data, without differentiating between types of activities. A multiple regression analysis was performed to examine the association between PA and the cSOS. The participants’ physical activity averaged 42.0 min/day for MVPA and 483.6 min/day for LPA. No significant association was observed between PA and bone quality in either men or women in the crude models. Furthermore, PA was not significantly correlated with the cSOS in the models adjusted for age, body mass index, nutrient intake, number of medications, and kidney disease. This study was a cross-sectional study which focused on the association between bone quality in older adults and their current amount of PA. The cSOS, as a measure of bone quality, was not associated with PA in men or women. Higher amounts of daily PA, as estimated from metabolic equivalents with an accelerometer, may not necessarily maintain or improve bone quality in older adults. This study does not rule out the potential for a positive association between PA levels or types and bone quality in younger or middle-aged individuals. It was specifically targeted at older adults, and its findings should not be generalized to younger populations. Further longitudinal studies are required to better understand the relationship between PA and bone quality. Full article
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15 pages, 451 KiB  
Article
Empathy and Coping Strategies Predict Quality of Life in Japanese Healthcare Professionals
by Kotaro Shoji, Norihito Noguchi, Fumiko Waki, Taku Saito, Masato Kitano, Naoki Edo, Minori Koga, Hiroyuki Toda, Nobuhisa Kobayashi, Takehito Sawamura and Masanori Nagamine
Behav. Sci. 2024, 14(5), 400; https://doi.org/10.3390/bs14050400 (registering DOI) - 11 May 2024
Abstract
Burnout and secondary traumatic stress (STS), also referred to as compassion fatigue, are undeniable negative consequences experienced by healthcare professionals when working with patients. As frontline healthcare professionals are essential to communities, it is crucial to understand their mental health and how they [...] Read more.
Burnout and secondary traumatic stress (STS), also referred to as compassion fatigue, are undeniable negative consequences experienced by healthcare professionals when working with patients. As frontline healthcare professionals are essential to communities, it is crucial to understand their mental health and how they cope with negative psychological responses. This study investigated the relationships between burnout, STS, compassion satisfaction, dispositional empathy, and stress management among Japanese healthcare professionals and students taking care of patients in clinical practice. The participants were 506 Japanese healthcare professionals and students (doctors, nurses, medical students, and nursing students) affiliated with Japanese Ministry of Defense Hospitals. The data were collected from March 2020 to May 2021. We assessed burnout, STS, and compassion satisfaction using the Professional Quality of Life Scale, dispositional empathy using the Interpersonal Reactivity Index, and coping with stress using the Coping Orientation to Problems Experienced Inventory (Brief-COPE). Exploratory factor analysis of the Brief-COPE yielded three factors: active coping; support-seeking; and indirect coping. Personal distress, a self-oriented emotional empathy index, was related to higher burnout and STS scores and lower compassion satisfaction. Empathic concern, an other-oriented emotional empathy index, was associated with lower burnout and higher compassion satisfaction. Active coping strategies were associated with lower burnout and higher compassion satisfaction, whereas indirect coping strategies were associated with higher burnout and STS scores. In a comparison of empathy in professional categories, nurses presented higher personal distress than nursing students, and medical doctors showed lower fantasy tendencies than medical students. These results imply the complex relationships between empathy, coping strategies, and psychological responses among healthcare professionals. Further longitudinal study is needed to explore these complex relationships and to develop more precise and effective psycho-educational interventions to prevent burnout and STS. Full article
(This article belongs to the Special Issue Trauma, Resilience and Mental Health)
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16 pages, 258 KiB  
Article
Understanding and Classifying Permanent Denial-of-Service Attacks
by Stanislav Abaimov
J. Cybersecur. Priv. 2024, 4(2), 324-339; https://doi.org/10.3390/jcp4020016 (registering DOI) - 11 May 2024
Abstract
In the evolving landscape of cybersecurity threats, permanent denial-of-service (PDoS) attacks have emerged as a particularly damaging form of cyber aggression. Unlike the more well-known denial-of-service (DoS) attacks, which disrupt services temporarily, PDoS attacks aim to inflict irreversible damage to systems, often resulting [...] Read more.
In the evolving landscape of cybersecurity threats, permanent denial-of-service (PDoS) attacks have emerged as a particularly damaging form of cyber aggression. Unlike the more well-known denial-of-service (DoS) attacks, which disrupt services temporarily, PDoS attacks aim to inflict irreversible damage to systems, often resulting in significant system overhauls and requiring hardware replacement. To enable the development of effective security measures, but also to address the knowledge gaps, this paper presents an in-depth exploration of PDoS attacks, emphasizing their distinguishing characteristics, underlying mechanisms, and potential further development. Through a comprehensive case study, this research highlights diverse tactics and strategies employed by attackers, from targeting IoT devices to manipulating boot processes and exploiting firmware vulnerabilities. A novel classification of PDoS attack vectors is proposed that also explains the ways in which the systems can be compromised. The findings confirm the pressing need for adaptive and robust defense mechanisms to mitigate the threats posed by PDoS attacks in our interconnected digital world. Full article
(This article belongs to the Topic Trends and Prospects in Security, Encryption and Encoding)
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11 pages, 4421 KiB  
Article
The Deterioration of Sarcopenia Post-Transarterial Radioembolization with Holmium-166 Serves as a Predictor for Disease Progression at 3 Months in Patients with Advanced Hepatocellular Carcinoma: A Pilot Study
by Claudio Trobiani, Nicolò Ubaldi, Leonardo Teodoli, Marcello Andrea Tipaldi, Federico Cappelli, Sara Ungania and Giulio Vallati
J. Pers. Med. 2024, 14(5), 511; https://doi.org/10.3390/jpm14050511 (registering DOI) - 11 May 2024
Abstract
Purpose: The aim of this pilot study is to explore the relationship between changes in sarcopenia before and after one to three months of Transarterial Radioembolization (TARE) treatment with Holmium-166 (166Ho) and its effect on the rate of local response. Our primary objective [...] Read more.
Purpose: The aim of this pilot study is to explore the relationship between changes in sarcopenia before and after one to three months of Transarterial Radioembolization (TARE) treatment with Holmium-166 (166Ho) and its effect on the rate of local response. Our primary objective is to assess whether the worsening of sarcopenia can function as an early indicator of a subgroup of patients at increased risk of disease progression in cases of hepatocellular carcinoma (HCC). Methods: A single-center retrospective analysis was performed on 25 patients with HCC who underwent 166Ho-TARE. Sarcopenia status was defined according to the measurement of the psoas muscle index (PMI) at baseline, one month, and three months after TARE. Radiological response according to mRECIST criteria was assessed and patients were grouped into responders and non-responders. The loco-regional response rate was evaluated for all patients before and after treatment, and was compared with sarcopenia status to identify any potential correlation. Results: A total of 20 patients were analyzed. According to the sarcopenia status at 1 month and 3 months, two groups were defined as follows: patients in which the deltaPMI was stable or increased (No-Sarcopenia group; n = 12) vs. patients in which the deltaPMI decreased (Sarcopenia group; n = 8). Three months after TARE, a significant difference in sarcopenia status was noted (p = 0.041) between the responders and non-responders, with the non-responder group showing a decrease in the sarcopenia values with a median deltaPMI of −0.57, compared to a median deltaPMI of 0.12 in the responder group. Therefore, deltaPMI measured three months post-TARE can be considered as a predictive biomarker for the local response rate (p = 0.028). Lastly, a minor deltaPMI variation (>−0.293) was found to be indicative of positive treatment outcomes (p = 0.0001). Conclusion: The decline in sarcopenia three months post-TARE with Holmium-166 is a reliable predictor of worse loco-regional response rate, as evaluated radiologically, in patients with HCC. Sarcopenia measurement has the potential to be a valuable assessment tool in the management of HCC patients undergoing TARE. However, further prospective and randomized studies involving larger cohorts are necessary to confirm and validate these findings. Full article
(This article belongs to the Special Issue Interventional Radiology: Towards Personalized Medicine)
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13 pages, 6382 KiB  
Article
Lateral Humeral Condyle Fracture in Childhood: Results of a New Surgical Technique
by Giulia Masci, Luca Basiglini, Carlotta Giusti, Angelo Gabriele Aulisa and Francesco Falciglia
J. Clin. Med. 2024, 13(10), 2830; https://doi.org/10.3390/jcm13102830 (registering DOI) - 11 May 2024
Abstract
Fractures of the lateral condyle of the humerus are one of the most common fractures in children, accounting for between 10% and 20% of fractures involving the elbow, with a peak incidence at 6 years of age. Treatment is often surgical for displaced [...] Read more.
Fractures of the lateral condyle of the humerus are one of the most common fractures in children, accounting for between 10% and 20% of fractures involving the elbow, with a peak incidence at 6 years of age. Treatment is often surgical for displaced fractures > 2 mm, according to Milch and Jakob classification. There is no consensus in the literature about the appropriate surgical management of these fractures. Objectives: The aim of this study is to describe, propose, and evaluate outcomes and complications of the surgical technique of reduction and osteosynthesis using trans-bone suture with resorbable threads. Methods: Patients with lateral condyle fractures treated with this surgical technique from 2015 to 2019 were included in this retrospective study, with a minimum follow-up of 24 months. For clinical and functional assessment of the elbow, Mayo Elbow Scores were recorded; we assessed the time of fracture healing, carrying angles, and Baumann angle of the affected limb compared to the healthy contralateral elbow for radiographic data. Complications have also been described. Results: We achieved satisfactory results; 36 patients with lateral condyle fractures were included in this study. Radiological healing was achieved in all cases. There was only one complication. No cases required additional surgical procedures. Almost all patients achieved a complete flexion of 110 degrees or more and complete extension. Conclusions: This surgical technique has good functional outcomes and fracture healing, a lower incidence of complications when compared to other surgical techniques, and no mechanical failure with good clinical and radiological results. Full article
(This article belongs to the Section Orthopedics)
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12 pages, 1826 KiB  
Systematic Review
Prognostic Significance of the Royal Marsden Hospital (RMH) Score in Patients with Cancer: A Systematic Review and Meta-Analysis
by Taha Koray Sahin, Alessandro Rizzo, Sercan Aksoy and Deniz Can Guven
Cancers 2024, 16(10), 1835; https://doi.org/10.3390/cancers16101835 (registering DOI) - 11 May 2024
Abstract
Background: Cancer remains a leading cause of death globally, necessitating the identification of prognostic biomarkers to guide treatment decisions. The Royal Marsden Hospital (RMH) score, based on readily available blood tests and clinical features, has emerged as a prognostic tool, although its performance [...] Read more.
Background: Cancer remains a leading cause of death globally, necessitating the identification of prognostic biomarkers to guide treatment decisions. The Royal Marsden Hospital (RMH) score, based on readily available blood tests and clinical features, has emerged as a prognostic tool, although its performance across variable clinical scenarios is not thoroughly delineated. Therefore, we aimed to systematically assess the association between RMH score and survival in cancer patients. Methods: We conducted a systematic literature search across Pubmed, Scopus, and Web of Science databases for studies published up to 15 February 2024. We performed a meta-analysis with the generic inverse variance method with a random-effects model and reported hazard ratios (HR) with 95% confidence intervals (CI). Results: Nineteen studies encompassing 127,230 patients were included. A higher RMH score was significantly associated with worse overall survival (OS) (HR: 2.09, 95% CI: 1.87–2.33, p < 0.001) and progression-free survival (PFS) (HR: 1.80, 95% CI: 1.48–2.18, p < 0.001). This association was consistent across various subgroups, including study population (clinical trial vs. real-world cohort), geographic region, and tumor type. Conclusion: This meta-analysis, including over a hundred thousand patients, demonstrates a negative association between a higher RMH score and survival in cancer patients. The RMH score holds promise as a readily available prognostic tool across diverse cancer types and clinical settings. Future research should focus on validating and refining this score to aid clinical decision-making. Full article
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19 pages, 349 KiB  
Article
Sampling-Based Machine Learning Models for Intrusion Detection in Imbalanced Dataset
by Zongwen Fan, Shaleeza Sohail, Fariza Sabrina and Xin Gu
Electronics 2024, 13(10), 1878; https://doi.org/10.3390/electronics13101878 (registering DOI) - 11 May 2024
Abstract
Cybersecurity is one of the important considerations when adopting IoT devices in smart applications. Even though a huge volume of data is available, data related to attacks are generally in a significantly smaller proportion. Although machine learning models have been successfully applied for [...] Read more.
Cybersecurity is one of the important considerations when adopting IoT devices in smart applications. Even though a huge volume of data is available, data related to attacks are generally in a significantly smaller proportion. Although machine learning models have been successfully applied for detecting security attacks on smart applications, their performance is affected by the problem of such data imbalance. In this case, the prediction model is preferable to the majority class, while the performance for predicting the minority class is poor. To address such problems, we apply two oversampling techniques and two undersampling techniques to balance the data in different categories. To verify their performance, five machine learning models, namely the decision tree, multi-layer perception, random forest, XGBoost, and CatBoost, are used in the experiments based on the grid search with 10-fold cross-validation for parameter tuning. The results show that both the oversampling and undersampling techniques can improve the performance of the prediction models used. Based on the results, the XGBoost model based on the SMOTE has the best performance in terms of accuracy at 75%, weighted average precision at 82%, weighted average recall at 75%, weighted average F1 score at 78%, and Matthews correlation coefficient at 72%. This indicates that this oversampling technique is effective for multi-attack prediction under a data imbalance scenario. Full article
(This article belongs to the Special Issue Machine Learning for Cybersecurity: Threat Detection and Mitigation)
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1 pages, 133 KiB  
Editorial
Publisher’s Note: Therapeutics as a Spin-Off Journal of Medicines
by Shu-Kun Lin
Therapeutics 2024, 1(1), 1; https://doi.org/10.3390/therapeutics1010001 (registering DOI) - 11 May 2024
Abstract
We are publishing volume 11 of Medicines in 2024 [...] Full article
22 pages, 1864 KiB  
Article
Metaheuristic and Heuristic Algorithms-Based Identification Parameters of a Direct Current Motor
by David M. Munciño, Emily A. Damian-Ramírez, Mayra Cruz-Fernández, Luis A. Montoya-Santiyanes and Juvenal Rodríguez-Reséndiz
Algorithms 2024, 17(5), 209; https://doi.org/10.3390/a17050209 (registering DOI) - 11 May 2024
Abstract
Direct current motors are widely used in industry applications, and it has become necessary to carry out studies and experiments for their optimization. In this manuscript, a comparison between heuristic and metaheuristic algorithms is presented, specifically, the Steiglitz–McBride, Jaya, Genetic Algorithm (GA), and [...] Read more.
Direct current motors are widely used in industry applications, and it has become necessary to carry out studies and experiments for their optimization. In this manuscript, a comparison between heuristic and metaheuristic algorithms is presented, specifically, the Steiglitz–McBride, Jaya, Genetic Algorithm (GA), and Grey Wolf Optimizer (GWO) algorithms. They were used to estimate the parameters of a dynamic model that approximates the actual responses of current and angular velocity of a DC motor. The inverse of the Euclidean distance between the current and velocity errors was defined as the fitness function for the metaheuristic algorithms. For a more comprehensive comparison between algorithms, other indicators such as mean squared error (MSE), standard deviation, computation time, and key points of the current and velocity responses were used. Simulations were performed with MATLAB/Simulink 2010 using the estimated parameters and compared to the experiments. The results showed that Steiglitz–McBride and GWO are better parametric estimators, performing better than Jaya and GA in real signals and nominal parameters. Indicators say that GWO is more accurate for parametric estimation, with an average MSE of 0.43%, but it requires a high computational cost. On the contrary, Steiglitz–McBride performed with an average MSE of 3.32% but required a much lower computational cost. The GWO presented an error of 1% in the dynamic response using the corresponding indicators. If a more accurate parametric estimation is required, it is recommended to use GWO; however, the heuristic algorithm performed better overall. The performance of the algorithms presented in this paper may change if different error functions are used. Full article
(This article belongs to the Special Issue Metaheuristic Algorithms in Optimal Design of Engineering Problems)
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13 pages, 2691 KiB  
Article
Influence of an Organic Fertilizer on Agronomic Characteristics and Herbaceous Plant Diversity in a Greek Ecosystem: The Case of Cretan Dittany (Origanum dictamnus L.)
by Aikaterini Molla, Alexandra D. Solomou, Anastasia Fountouli, Evaggelia Chatzikirou, Emmanouil Stamatakis, Petros Stamatakis and Elpiniki Skoufogianni
Nitrogen 2024, 5(2), 426-438; https://doi.org/10.3390/nitrogen5020027 (registering DOI) - 11 May 2024
Abstract
In recent years, there has been a growing tendency towards using organic fertilizers instead of chemical ones. This study aimed to evaluate the influence of the organic fertilizer, Prima Humica, on agronomic characteristics and herbaceous plant diversity on Origanum dictamnus (Dittany) cultivation. A [...] Read more.
In recent years, there has been a growing tendency towards using organic fertilizers instead of chemical ones. This study aimed to evaluate the influence of the organic fertilizer, Prima Humica, on agronomic characteristics and herbaceous plant diversity on Origanum dictamnus (Dittany) cultivation. A field experiment was carried out in Kalo Xorio (Lasithi, Crete) and included three different nitrogen organic fertilization schemes: 0 g/plant (T0—unfertilized), 300 g/plot (T1), and 600 g/plot (T2). Plant height, fresh and dry weight, Leaf Area Index (LAI), and plant diversity during the growing season were measured. The results showed that when the T2 treatment was compared with the unfertilized and the T1 fertilizer, the increase in plant height ranged between 9.18% and 40.61%. Moreover, the total fresh and dry weight were positively affected by the T2 treatment. The total fresh and dry weight varied from 111.6 to 239.8 g per plant and from 36.7 to 77.6 g per plant, respectively. Furthermore, LAI was ameliorated using the T2 fertilizer scheme. Concerning plant diversity, a key finding in this study is that the O. dictamnus ecosystem favors herbaceous plant species richness and Shannon’s diversity index. In total, 18 plant species in the O. dictamnus ecosystem were recorded in the study area. The most frequently occurring plants were Anthemis arvensis L. and Piptatherum miliaceum (L.) Coss. Finally, the highest Shannon’s diversity index of herbaceous plants was detected using the T2 fertilizer scheme. Full article
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14 pages, 3287 KiB  
Article
The Changes of Amino-Acid Metabolism between Wheat and Rice during Early Growth under Flooding Stress
by Setsuko Komatsu, Mayu Egishi and Toshihisa Ohno
Int. J. Mol. Sci. 2024, 25(10), 5229; https://doi.org/10.3390/ijms25105229 (registering DOI) - 11 May 2024
Abstract
Floods induce hypoxic stress and reduce wheat growth. On the other hand, rice is a semi-aquatic plant and usually grows even when partially submerged. To clarify the dynamic differences in the cellular mechanism between rice and wheat under flooding stress, morphological and biochemical [...] Read more.
Floods induce hypoxic stress and reduce wheat growth. On the other hand, rice is a semi-aquatic plant and usually grows even when partially submerged. To clarify the dynamic differences in the cellular mechanism between rice and wheat under flooding stress, morphological and biochemical analyses were performed. Although the growth of wheat in the early stage was significantly suppressed due to flooding stress, rice was hardly affected. Amino-acid analysis revealed significant changes in amino acids involved in the gamma-aminobutyric acid (GABA) shunt and anaerobic/aerobic metabolism. Flood stress significantly increased the contents of GABA and glutamate in wheat compared with rice, though the abundances of glutamate decarboxylase and succinyl semialdehyde dehydrogenase did not change. The abundance of alcohol dehydrogenase and pyruvate carboxylase increased in wheat and rice, respectively. The contents of aspartic acid and pyruvic acid increased in rice root but remained unchanged in wheat; however, the abundance of aspartate aminotransferase increased in wheat root. These results suggest that flooding stress significantly inhibits wheat growth through upregulating amino-acid metabolism and increasing the alcohol-fermentation system compared to rice. When plant growth is inhibited by flooding stress and the aerobic-metabolic system is activated, GABA content increases. Full article
(This article belongs to the Section Molecular Plant Sciences)
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