Shoulder arthroplasty has significantly gained popularity in orthopedic surgery, driven by progress in prosthesis design and surgical techniques. This study explored the epidemiology of shoulder arthroplasty, analyzing healthcare data from 2012 to 2022 for primary osteoarthritis of the shoulder. The data included patient demographics and types of surgical procedures. Data analysis indicates a higher utilization rate of reverse total shoulder arthroplasty (RTSA; n = 41,251) over total- (TSA; n = 18,679) and hemiarthroplasty (HSA; n = 12,827) for primary shoulder osteoarthritis. Overall, a significant increase in RTSA procedures from n = 2237 (2012) to n = 5415 (2022) was observed, representing more than a two-fold increase of 121.1%. The relative proportion of RTSA among all types of shoulder arthroplasty increased from 39% (2012) to 68.6% (2022), while HSA decreased and TSA essentially remained constant. Age analysis identified the following peaks: RTSA, 77 ± 7 y; HSA, 68 ± 12 y; and TSA, 67 ± 10 y. Among the over 60s, significantly more women were treated with any type of prosthesis, whereas in young patients (45 to 59 y), more men received HSA or TSA. Our study confirms that RTSA has become the preferred choice for elderly patients in Germany, reflecting the prevailing preference despite varying patient ages and conditions, with a noted difference in sex in treatment prevalence. Full article

People living with HIV (PLWH) face a growing burden of chronic diseases, owing to the combinations of aging, environmental triggers, lifestyle choices, and virus-induced chronic inflammation. The rising incidence of pulmonary vascular diseases represents a major concern for PLWH. The study of HIV-associated pulmonary vascular complications ideally requires a strong understanding of pulmonary vascular cell biology and HIV pathogenesis at the molecular level for effective applications in infectious diseases and vascular medicine. Active HIV infection and/or HIV proteins disturb the delicate balance between vascular tone and constriction, which is pivotal for maintaining pulmonary vascular health. One of the defining features of HIV is its high genetic diversity owing to several factors including its high mutation rate, recombination between viral strains, immune selective pressures, or even geographical factors. The intrinsic HIV genetic diversity has several important implications for pathogenic outcomes of infection and the overall battle to combat HIV. Challenges in the field present themselves from two sides of the same coin: those imposed by the virus itself and those stemming from the host. The field may be advanced by further developing in vivo and in vitro models that are well described for both pulmonary vascular diseases and HIV for mechanistic studies. In essence, the study of HIV-associated pulmonary vascular complications requires a multidisciplinary approach, drawing upon insights from both infectious diseases and vascular medicine. In this review article, we discuss the fundamentals of HIV virology and their impact on pulmonary disease, aiming to enhance the understanding of either area or both simultaneously. Bridging the gap between preclinical research findings and clinical practice is essential for improving patient care. Addressing these knowledge gaps requires interdisciplinary collaborations, innovative research approaches, and dedicated efforts to prioritize HIV-related pulmonary complications on the global research agenda. Full article

Understanding the emotional states of animals is a long-standing research endeavour that has clear applications in animal welfare. Vocalisations are emerging as a promising way to assess both positive and negative emotional states. However, the vocal expression of emotions in birds is a relatively unexplored research area. The goal of this study was to develop an interactive feeding system that would elicit positive and negative emotional states, and collect recordings of the vocal expression of these emotions without human interference. In this paper, the mechatronic design and development of the feeder is described. Design choices were motivated by the desire for the hens to voluntarily interact with the feeder and experience the different stimuli that were designed to induce (1) positive low-arousal, (2) positive high-arousal, (3) negative low-arousal, and (4) negative high-arousal states. The results showed that hens were motivated to engage with the feeder despite the risk of receiving negative stimuli and that this motivation was sustained for at least 1 week. The potential of using the interactive feeder to analyse chicken vocalisations related to emotional valence and arousal is being explored, offering a novel proof of concept in animal welfare research. Preliminary findings suggest that hens vocalised in response to all four stimulus types, with the number of vocalisations, but not the probability of vocalising, distinguishing between low- and high-arousal states. Thus, the proposed animal–computer interaction design has potential to be used as an enrichment device and for future experiments on vocal emotions in birds. Full article

Context modeling has always been the groundwork for the dialogue response generation task, yet it presents challenges due to the loose context relations among open-domain dialogue sentences. Introducing simulated dialogue futures has been proposed as a solution to mitigate the problem of low history–response relevance. However, these approaches simply assume that the history and future of a dialogue have the same effect on response generation. In reality, the coherence between dialogue sentences varies, and thus, history and the future are not uniformly helpful in response prediction. Consequently, determining and leveraging the relevance between history–response and response–future to aid in response prediction emerges as a pivotal concern. This paper addresses this concern by initially establishing three context relations of response and its context (history and future), reflecting the relevance between the response and preceding and following sentences. Subsequently, we annotate response contextual relation labels on a large-scale dataset, DailyDialog (DD). Leveraging these relation labels, we propose a response generation model that adaptively integrates contributions from preceding and succeeding sentences guided by explicit relation labels. This approach mitigates the impact in cases of lower relevance and amplifies contributions in cases of higher relevance, thus improving the capability of context modeling. Experimental results on public dataset DD demonstrate that our response generation model significantly enhances coherence by 3.02% in long sequences (4-gram) and augments bi-gram diversity by 17.67%, surpassing the performance of previous models. Full article

Benign and malignant mediastinal lesions are not infrequently encountered in clinical practice. Mediastinoscopy has long been considered the gold standard in evaluating mediastinal pathology. Since its introduction into clinical practice, endobronchial-ultrasonography-guided transbronchial fine needle aspiration (EBUS-TBNA) has replaced mediastinoscopy as the initial procedure of choice to evaluate mediastinal lesions and to stage lung cancer. Its diagnostic yield in benign mediastinal lesions and less common malignancies, however, has remained limited. This has led different proceduralists to investigate additional procedures to improve the diagnostic yield of EBUS-TBNA. In recent years, different published reports concluded that the addition of EBUS-guided intranodal forceps biopsy (IFB) and transbronchial cryobiopsy (TBCB) to EBUS-TBNA increases the diagnostic yield especially in benign mediastinal lesions and uncommon mediastinal malignancies. The purpose of this review is to describe how EBUS-IFB and EBUS-TBCB are performed, to compare their diagnostic yields, and to discuss their limitations and their potential complications. In addition, the review will conclude with a proposed algorithm on how to incorporate EBUS-IFB and EBUS-TBCB into clinical practice. Full article

Introduction: This paper explores the potential influence of a single nucleotide variant in the ANK-2 gene on COVID-19 myocarditis-related ventricular tachycardia. Case Description: A 53-year-old female with a history of Crohn’s disease and asthma developed COVID-19. Shortly after infection, she experienced symptoms of chest pressure, palpitations, and shortness of breath, leading to the eventual diagnosis of myocarditis complicated by recurrent ventricular tachycardia. Treatment with mechanistically driven anti-arrhythmic therapy and beta-blockers suppressed this highly symptomatic ventricular tachycardia. Genetic testing to further risk stratify and influence long term care identified a single nucleotide variant in the ANK-2 gene, which is known to be associated with arrhythmic risk. Discussion: This case study highlights the use of rationally selected anti-arrhythmic therapy, mexiletine, in the management of ventricular tachycardia associated with COVID-19 myocarditis and the presence of a single nucleotide variant in ANK-2, raising the possibility of its contribution to VT susceptibility and severity. Our patient demonstrated significant improvement with administered therapeutics, including the resolution of myocarditis and ventricular tachycardia. The normalization of the QT interval during the resolution phase further supports the potential influence of the genetic variant in ANK-2 on potassium channel activity. Full article

Stress distribution and its magnitude during loading heavily influence the osseointegration of dental implants. Currently, no high-resolution, three-dimensional method of directly measuring these biomechanical processes in the peri-implant bone is available. The aim of this study was to measure the influence of different implant materials on stress distribution in the peri-implant bone. Using the three-dimensional ARAMIS camera system, surface strain in the peri-implant bone area was compared under simulated masticatory forces of 300 N in axial and non-axial directions for titanium implants and zirconia implants. The investigated titanium implants led to a more homogeneous stress distribution than the investigated zirconia implants. Non-axial forces led to greater surface strain on the peri-implant bone than axial forces. Thus, the implant material, implant system, and direction of force could have a significant influence on biomechanical processes and osseointegration within the peri-implant bone. Full article

The determination of misconceptions among students is a prerequisite to driving conceptual, procedural, and attitudinal changes. This study aimed to investigate the causes and effects that misconceptions generate in the learning of natural sciences, as well as the basic categories of misconceptions in the learning of physics held by high school students. Under the PRISMA guidelines, the research consisted of a systematic literature review in three databases: Scopus, WoS, and Dimensions. Data visualization and analysis were supported by the following tools: VOSviewer, Bibliometrix, and ATLAS.ti. It was concluded that misconceptions do not solely depend on students’ behavior; teacher training and preparation also have a direct influence on this issue. The main factors include persistent use of the didactic model of transmission–reception, the influences of students’ daily experiences, decontextualization of the addressed content, limited development of research skills, usage of inadequate teaching methods, texts full of formulas, and exaggerated schemas. Physics stands out as the most studied discipline, in terms of misconceptions. Several topics were identified that contained misconceptions grouped into four main subject areas: thermodynamics, waves and sound, mechanics, and radiation and light. Full article

The aim of this study was to examine the long-term prognostic value of changes in the cardio-ankle vascular index (CAVI) within a year after coronary artery bypass grafting (CABG). Methods. Patients with coronary artery disease (n = 251) in whom CAVI was assessed using the VaSera VS-1000 device before and one year after CABG. Groups with improved CAVI or worsened CAVI were identified. We assessed the following events at follow-up: all-causes death, myocardial infarction, and stroke/transient ischemic attack. Results. All-causes death was significantly more common in the group with worsened CAVI (27.6%) than in the group with CAVI improvement (14.8%; p = 0.029). Patients with worsened CAVI were more likely to have MACE, accounting for 42.2% cases, compared with patients with CAVI improvement, who accounted for 24.5%; p = 0.008. Worsened CAVI (p = 0.024), number of shunts (p = 0.006), and the presence of carotid stenosis (p = 0.051) were independent predictors of death from all causes at 10-year follow-up after CABG. The presence of carotid stenosis (p = 0.002) and the group with worsened CAVI after a year (p = 0.008) were independent predictors of the development of the combined endpoint during long-term follow-up. Conclusions. Patients with worsening CAVI one year after CABG have a poorer prognosis at long-term follow-up than patients with improved CAVI. Future research would be useful to identify the most effective interventions to improve CAVI and correspondingly improve prognosis. Full article

Clinical trials of chronic kidney disease (CKD) in children have important implications for the early identification and management of CKD. The selection of clinical trial outcomes is critical for assessing the effectiveness of interventions in pediatric CKD clinical trials. This review systematically examines the spectrum of outcome measures deployed in pediatric CKD clinical trials, which includes clinical and alternative outcomes, patient-reported outcome measures (PROMs), and safety indicators. Alternative outcome measures were stratified into four levels of evidence strength: convincing, probable, suggestive, and inconclusive. Consequently, the selection of outcome measures for pediatric CKD clinical trials mandates careful consideration of both their methodological feasibility and the robustness of their evidence base. Moreover, the burgeoning field of PROMs warrants integration into the design of future pediatric clinical trials to enrich the relevance and impact of research findings. Full article

From 2016 to 2020, the “PraeRi” study, conducted by three German veterinary universities, was aimed at enhancing animal health and welfare in dairy farms. With 765 dairy farms visited and 101,307 animals examined, this study provided a basis for improving animal health and welfare. The study population comprised three different regions representing a broad variety of characteristics. To ensure representative estimates, a sample size of 250 farms was determined for each region, employing a stratified sampling plan based on farm size. According to the information provided by the farmers, the most commonly occurring disease in their herds was mastitis without general disorder (14.2% to 16.3% of the herd—depending on the region). For most disorders, prevalence data were lowest for the region South compared with the two remaining regions. Multivariable regression analyses were performed to identify risk factors for various target variables, and the results were communicated through individual reports and benchmarking flyers to participating farmers. The authors encountered challenges in management and communication due to the project’s size in terms of personnel, data, and farms examined. Harmonizing data management and hypothesis testing across all involved parties added complexity. Full article

Meldonium, a promising pharmacological agent initially developed for cardiovascular indications, has sparked considerable interest in recent years due to its potential performance-enhancing effects. This review manuscript delves into the multifaceted roles of meldonium, examining its pharmacological mechanisms, therapeutic applications, and controversial implications in medicine. Beyond its cardiovascular applications, emerging research has shed light on meldonium’s neuroprotective properties and its potential for mitigating various psychiatric conditions. Moreover, recent investigations have explored meldonium’s potential in treating neurodegenerative disorders, alcohol use disorder, and even enhancing cognitive function. However, meldonium’s journey extends beyond the realm of medicine, as its use among athletes has stirred debates surrounding performance enhancement and fair competition. The substance’s inclusion in the World Anti-Doping Agency’s (WADA) prohibited list has intensified scrutiny and raised ethical considerations regarding its use in sports. This manuscript aims to provide a comprehensive resource for researchers, clinicians, and enthusiasts alike, fostering a deeper understanding of meldonium’s complex biological interactions and its potential contributions to psychiatry. Full article

Water resource management has emerged as a pivotal concern within arid regions in recent times. The water footprint (WFP) index stands out as a principal gauge for facilitating comprehensive watershed management. This study endeavors to compute the WFP of diverse agricultural products encompassing major crops, orchards, cucurbits, and medicinal plants across arid regions. This research focuses on three distinct climate scenarios: the Shazand Plain with a semidry climate, the Khomein Plain characterized by a dry climate, and the Saveh Plain exhibiting a very dry climate. This study also seeks to ascertain the climate most conducive to cultivating crops from a WFP (green, blue, and gray) perspective. To achieve these objectives, this study employed the CropWat family software to determine crop water requirements, as well as considering crop yield and relevant parameters for calculations. The findings of the investigation unveiled that the cultivated areas in the respective climates amounted to 19,479 ha (semidry), 18,166 ha (dry), and 41,682 ha (very dry). These areas were allocated as follows: 88%, 85%, and 55% for crops; 11%, 13%, and 40% for orchards; and 1%, 2%, and 5% for cucurbit crops. Importantly, the very dry climate was predisposed to allocating more land for low-water-demand orchards. Among the major crops, wheat occupied 44%, 39%, and 43% of the total areas in the semidry, dry, and very dry climates, respectively. Analyzing the overall agricultural output in these climates, it was revealed that over 79%, 69%, and 66% of production correlated with crops; 17%, 19%, and 22% with orchards; and 4%, 12%, and 12% with cucurbits, respectively. In terms of water consumption, maize and apples emerged as the highest performers, with varying consumption patterns across different crops. Interestingly, canola exhibited a substantially higher WFP, surpassing wheat and barley by 56.48% and 58.85%, respectively, in dry climates. Cucurbit crops, on the other hand, displayed a lower WFP in dry climates, which could potentially encourage their cultivation. The influence of climate warming on canola’s WFP_gray introduced complexity, challenging the conventional correlation between WFP and yields. Medicinal plants consistently demonstrated lower WFP values, underscoring the need for deliberate and considerate cultivation decisions in this regard. Full article

In this article, the practical issues connected with guided wave measurement are studied: (1) the influence of gluing of PZT plate actuators (NAC2013) on generated elastic wave propagation, (2) the repeatability of PZT transducers attachment, and (3) the assessment of the possibility of comparing the results of Laser Doppler Vibrometry (LDV) measurement performed on different 2D samples. The consideration of these questions is crucial in the context of the assessment of the possibility of the application of the guided wave phenomenon to structural health-monitoring systems, e.g., in civil engineering. In the examination, laboratory tests on the web of steel I-section specimens were conducted. The size and shape of the specimens were developed in such a way that they were similar to the elements typically used in civil engineering structures. It was proved that the highest amplitude of the generated wave was obtained when the exciters were glued using wax. The repeatability and durability of this connection type were the weakest. Due to this reason, it was not suitable for practical use outside the laboratory. The permanent glue application gave a stable connection between the exciter and the specimen, but the generated signal had the lowest amplitude. In the paper, the new procedure dedicated to objective analysis and comparison of the elastic waves propagating on the surface of different specimens was proposed. In this procedure, the genetic algorithms help with the determination of a new coordinate system, in which the assessment of the quality of wave propagation in different directions is possible. Full article

Gastric cancer has been demonstrating a reduction in the number of cases over the past decades, largely attributed to advancements in public health practices and increased accessibility to educational initiatives for the general population. Nevertheless, it persists as the third leading cause of mortality globally among both men and women. These fatalities are typically associated with delayed disease detection. The current study assessed the levels of homocysteine, vitamin B12, and folic acid as a means of establishing a screening biomarker profile that could be integrated into routine testing protocols to facilitate swift diagnosis of the illness. A total of 207 control subjects and 207 individuals with gastric cancer were scrutinized, with biochemical measurements conducted using chemiluminescence for homocysteine, folic acid, and vitamin B12. The two groups were matched based on age, tumor location, subtype, tumor classification, presence of Epstein-Barr Virus infection (EBV), and Helicobacter pylori (H. pylori). Significant statistical variances were identified in the mean levels of the triad of substances among cancer patients when compared to the control group for all corresponding variables. In conclusion, our study indicated that analyzing the triad of homocysteine, vitamin B12, and folic acid holds diagnostic value for gastric cancer and could potentially serve as an effective screening marker for this type of cancer in the future. Full article

IL-36 cytokines are emerging as beneficial in immunity against pathogens and cancers but can also be detrimental when dysregulated in autoimmune and autoinflammatory conditions. Interest in targeting IL-36 activity for therapeutic purposes is rapidly growing, yet many unknowns about the functions of these cytokines remain. Thus, the availability of robust research tools is essential for both fundamental basic science and pre-clinical studies to fully access outcomes of any manipulation of the system. For this purpose, a floxed Il1rl2, the gene encoding the IL-36 receptor, mouse strain was developed to facilitate the generation of conditional knockout mice. The targeted locus was engineered to contain an inverted mCherry reporter sequence that upon Cre-mediated recombination will be flipped and expressed under the control of the endogenous Il1rl2 promoter. This feature can be used to confirm knockout in individual cells but also as a reporter to determine which cells express the IL-36 receptor IL-1RL2. The locus was confirmed to function as intended and further used to demonstrate the expression of IL-1RL2 in barrier tissues. Il1rl2 expression was detected in leukocytes in all barrier tissues. Interestingly, strong expression was observed in epithelial cells at locations in direct contact with the environment such as the skin, oral mucosa, the esophagus, and the upper airways, but almost absent from epithelial cells at more inward facing sites, including lung alveoli, the small intestine, and the colon. These findings suggest specialized functions of IL-1RL2 in outward facing epithelial tissues and cells. The generated mouse model should prove valuable in defining such functions and may also facilitate basic and translational research. Full article

Informal English learning plays a crucial role in vocabulary learning, yet few scholars have explored the use of large language models for this purpose. In light of this, our study, integrating Self-Determination Theory (SDT) and the Unified Theory of Acceptance and Use of Technology (UTAUT), employed Structural Equation Modeling (SEM) to investigate factors influencing 568 Chinese English learners’ use of large language models for vocabulary learning. Our findings identified six significant factors from those models—perceived autonomy, perceived competence, perceived relatedness, performance expectancy, effort expectancy, and social influence—that significantly shape learners’ intentions and behaviors towards utilizing large language models for vocabulary learning. Notably, effort expectancy emerged as the most influential factor, while facilitating conditions did not significantly impact usage intentions. This research offers insights for future curriculum design and policy formulation, highlighting the importance of understanding learners’ perspectives on technology use in education. Full article

Adult-onset diabetes increases one’s risk of neurodegenerative disease including Alzheimer’s disease (AD); however, the risk associated with youth-onset diabetes (Y-DM) remains underexplored. We quantified plasma biomarkers of neurodegeneration and AD in participants with Y-DM from the SEARCH cohort at adolescence and young adulthood (Type 1, n = 25; Type 2, n = 25; 59% female; adolescence, age = 15 y/o [2.6]; adulthood, age = 27.4 y/o [2.2]), comparing them with controls (adolescence, n = 25, age = 14.8 y/o [2.7]; adulthood, n = 21, age = 24.9 y/o [2.8]). Plasma biomarkers, including glial fibrillary acidic protein (GFAP), neurofilament light chain protein (NfL), phosphorylated tau-181 (pTau181), and amyloid beta (Aβ40, Aβ42), were measured via Simoa. A subset of participants (n = 7; age = 27.5 y/o [5.7]) and six controls (age = 25.1 y/o [4.5]) underwent PET scans to quantify brain amyloid and tau densities in AD sensitive brain regions. Y-DM adolescents exhibited lower plasma levels of Aβ40, Aβ42, and GFAP, and higher pTau181 compared to controls (p < 0.05), a pattern persisting into adulthood (p < 0.001). All biomarkers showed significant increases from adolescence to adulthood in Y-DM (p < 0.01), though no significant differences in brain amyloid or tau were noted between Y-DM and controls in adulthood. Preliminary evidence suggests that preclinical AD neuropathology is present in young people with Y-DM, indicating a potential increased risk of neurodegenerative diseases. Full article

Manganese oxide-cerium oxide supported on titanate nanotubes (i.e., MnCe/TiNTs) were prepared and their catalytic activities towards NH₃-SCR of NO were tested. The results indicated that the MnCe/TiNT catalyst can achieve a high NO removal efficiency above 95% within the temperature range of 150–350 °C. Even after exposure to a HCl-containing atmosphere for 2 h, the NO removal efficiency of the MnCe/TiNT catalyst maintains at approximately 90% at 150 °C. This is attributed to the large specific surface area as well as the unique hollow tubular structure of TiNTs that exposes more Ce atoms, which preferentially react with HCl and thus protect the active Mn atoms. Moreover, the abundant OH groups on TiNTs serve as Brønsted acid sites and provide H protons to expel Cl atom from the catalyst surface. The irreversible deactivation caused by HCl can be alleviated by H₂O. That is because the dissociated adsorption of H₂O on TiNTs forms additional OH groups and relieves HCl poisoning. Full article

Flood hazards present a significant risk to the UK, with homes, businesses and critical infrastructure exposed to a mixture of fluvial, surface water and coastal flooding. Climate change is expected to influence river flows, changing the frequency and magnitude of future flood events. Flood hazard assessments are used by decision-makers to implement policies and engineering interventions to reduce the impacts of these flood events. Probabilistic flood modelling can explore input and parameter uncertainties in flood models to fully quantify inundation uncertainty. However, probabilistic methods require large computational costs—limiting their application. This paper investigates a range of advanced uncertainty quantification methods (traditional Monte Carlo (FMC), Kriging and multi-fidelity Monte Carlo (MFMC)) to reduce the dichotomy between accuracy and costs. Results suggest that Kriging can reduce computational costs by 99.9% over FMC. The significantly increased efficiency has the potential to improve future policy and engineering decisions, reducing the impacts of future flood events. Full article

The calculation of land surface temperatures (LSTs) via low-altitude thermal infrared remote (TIR) sensing images at a block scale is gaining attention. However, the accurate calculation of LSTs requires a precise determination of the range of various underlying surfaces in the TIR images, and existing approaches face challenges in effectively segmenting the underlying surfaces in the TIR images. To address this challenge, this study proposes a deep learning (DL) methodology to complete the instance segmentation and quantification of underlying surfaces through the low-altitude TIR image dataset. Mask region-based convolutional neural networks were utilized for pixel-level classification and segmentation with an image dataset of 1350 annotated TIR images of an urban rail transit hub with a complex distribution of underlying surfaces. Subsequently, the hyper-parameters and architecture were optimized for the precise classification of the underlying surfaces. The algorithms were validated using 150 new TIR images, and four evaluation indictors demonstrated that the optimized algorithm outperformed the other algorithms. High-quality segmented masks of the underlying surfaces were generated, and the area of each instance was obtained by counting the true-positive pixels with values of 1. This research promotes the accurate calculation of LSTs based on the low-altitude TIR sensing images. Full article