Soil heavy metal contamination poses a significant threat to both environmental health and ecological safety. To investigate the influencing factors, ecological hazards, and sources analysis of heavy metals in purple soil, 27 sets of soil samples were collected from varying genetic horizons within Guang’an City, and the contents of As, Cd, Cu, Cr, Hg, Ni, Pb, and Zn were analyzed. The results indicated higher concentrations of heavy metals in soil A horizon, compared to that of C horizon. The relevance analysis indicated that the soil’s heavy metals were strongly correlated with the soil’s physicochemical properties. The enrichment factor, pollution load index, and potential risk index highlighted slightly to severely polluted levels of soil Cd and Hg, which significantly contribute to the ecological hazards posed by soil heavy metals. The potential source of heavy metals analyzed using the APCS-MLR model identified both anthropogenic inputs and natural sources as primary contributors to heavy metal presence in soils. The Cu, Cr, Ni, Pb, and Zn contents in the samples from different genetic horizons were chiefly influenced by natural sources, such as soil matrix erosion and weathering, while the concentrations of Cd and Hg were largely affected by anthropogenic activities, specifically coal combustion and agriculture. Conversely, the As content was found to be influenced by a combination of both factors. Anthropogenic activities greatly impacted soil heavy metals at various depths within the study area, thereby underscoring the importance of monitoring these heavy metals. The findings gained from this research can give a scientific basis for the potential utilization of purple soil. Full article

The assessment of antibody response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is of critical importance to verify the protective efficacy of available vaccines. Hospital healthcare workers play an essential role in the care and treatment of patients and were particularly at risk of contracting the SARS-CoV-2 infection during the pandemic. The vaccination protocol introduced in our hospital protected the workers and contributed to the containment of the infection’ s spread and transmission, although a reduction in vaccine efficacy against symptomatic and breakthrough infections in vaccinated individuals was observed over time. Here, we present the results of a longitudinal and prospective analysis of the anti-SARS-CoV-2 antibodies at multiple time points over a 17-month period to determine how circulating antibody levels change over time following natural infection and vaccination for SARS-CoV-2 before (T0–T4) and after the spread of the omicron variant (T5–T6), analyzing the antibody response of 232 healthy workers at the Pio XI hospital in Desio. A General Estimating Equation model indicated a significant association of the antibody response with time intervals and hospital area, independent of age and sex. Specifically, a similar pattern of antibody response was observed between the surgery and administrative departments, and a different pattern with higher peaks of average antibody response was observed in the emergency and medical departments. Furthermore, using a logistic model, we found no differences in contracting SARS-CoV-2 after the third dose based on the hospital department. Finally, analysis of antibody distribution following the spread of the omicron variant, subdividing the cohort of positive individuals into centiles, highlighted a cut-off of 550 BAU/mL and showed that subjects with antibodies below this are more susceptible to infection than those with a concentration above the established cut-off value. Full article

The demand for digitizing manufacturing and controlling processes has been steadily increasing in recent years. Digitization relies on different techniques and equipment, which produces various data types and further influences the process of space understanding and area recognition. This paper provides an updated view of these data structures and high-level categories of techniques and methods leading to indoor environment segmentation and the discovery of its semantic meaning. To achieve this, we followed the Systematic Literature Review (SLR) methodology and covered a wide range of solutions, from floor plan understanding through 3D model reconstruction and scene recognition to indoor navigation. Based on the obtained SLR results, we identified three different taxonomies (the taxonomy of underlying data type, of performed analysis process, and of accomplished task), which constitute different perspectives we can adopt to study the existing works in the field of space understanding. Our investigations clearly show that the progress of works in this field is accelerating, leading to more sophisticated techniques that rely on multidimensional structures and complex representations, while the processing itself has become focused on artificial intelligence-based methods. Full article

Plant fibers have been studied as sources of nanocellulose due to their sustainable features. This study investigated the effects of acid hydrolysis parameters, reaction temperature, and acid concentration on nanocellulose yield from maguey (Agave cantala) fiber. Nanocellulose was produced from the fibers via the removal of non-cellulosic components through alkali treatment and bleaching, followed by strong acid hydrolysis for 45 min using sulfuric acid (H₂SO₄). The temperature during acid hydrolysis was 30, 40, 50, and 60 °C, and the H₂SO₄ concentration was 40, 50, and 60 wt. % H₂SO₄. Results showed that 53.56% of raw maguey fibers were isolated as cellulose, that is, 89.45% was α-cellulose. The highest nanocellulose yield of 81.58 ± 0.36% was achieved from acid hydrolysis at 50 °C using 50 wt. % H₂SO₄, producing nanocellulose measuring 8–75 nm in diameter and 72–866 nm in length, as confirmed via field emission scanning electron microscopy (FESEM) and transmission electron microscopy (TEM) analysis. Fourier-transform infrared spectroscopy (FTIR) analysis indicated the chemical transformation of fibers throughout the nanocellulose production process. The zeta potential analysis showed that the nanocellulose had excellent colloidal stability with a highly negative surface charge of −37.3 mV. Meanwhile, X-ray diffraction (XRD) analysis validated the crystallinity of nanocellulose with a crystallinity index of 74.80%. Lastly, thermogravimetric analysis (TGA) demonstrated that the inflection point attributed to the cellulose degradation of the produced nanocellulose is 311.41 °C. Full article

Background: This study aimed to investigate the relationship between the Curve of Spee (COS) depth and malocclusion characteristics in a population from Sibiu County, Romania. The research sought to understand how the COS’s anatomical dimensions correlate with different classes of malocclusion and the position of the frontal teeth. Methods: A total of 265 participants from the Dentistry Ambulatory of the Military Hospital of Sibiu were included in this study. It employed digital intraoral scanning technology to measure the COS, overjet, and overbite, with malocclusion classification. Statistical analyses, including correlation and regression, were conducted to examine the relationships between COS depth, frontal teeth position, and malocclusion characteristics. Results: The average COS depth measured was 1.0564 mm, presenting variability when compared to existing literature. Most of the study participants had Class I malocclusion. A significant positive correlation between COS depth and overjet was identified, with no notable gender-based differences in these occlusal parameters. Conclusions: The findings affirm the integral role of COS in occlusal dynamics and malocclusion diagnosis. The COS measurement of a mean of 1.0564 mm, when compared to other results emphasizes the differences in occlusal curvature among various populations. The results contribute to a refined understanding of occlusal relationships, supporting the need for personalized orthodontic and prosthetic treatments based on precise anatomical measurements. Full article

Wine grape quality heavily influences the price received for a product. Hyperspectral imaging has the potential to provide a non-destructive technique for predicting various enological parameters. This study aims to explore the feasibility of applying hyperspectral imaging to measure the total soluble solids (TSS) and titratable acidity (TA) in wine grape berries. A normalized difference spectral index (NDSI) spectral preprocessing method was built and compared with the conventional preprocessing method: multiplicative scatter correction and Savitzky–Golay smoothing (MSC+SG). Different machine learning models were built to examine the performance of the preprocessing methods. The results show that the NDSI preprocessing method demonstrated better performance than the MSC+SG preprocessing method in different classification models, with the best model correctly classifying 93.8% of the TSS and 84.4% of the TA. In addition, the TSS can be predicted with moderate performance using support vector regression (SVR) and MSC+SG preprocessing with a root mean squared error (RMSE) of 0.523 °Brix and a coefficient of determination (R²) of 0.622, and the TA can be predicted with moderate performance using SVR and NDSI preprocessing (RMSE = 0.19%, R² = 0.525). This study demonstrates that hyperspectral imaging data and NDSI preprocessing have the potential to be a method for grading wine grapes for producing quality wines. Full article

Placenta Accreta Spectrum (PAS) is a life-threatening condition in which placental trophoblastic cells abnormally invade the uterus, often up to the uterine serosa and, in extreme cases, tissues beyond the uterine wall. Currently, there is no clinical assay for the non-invasive detection of PAS, and only ultrasound and MRI can be used for its diagnosis. Considering the subjectivity of visual assessment, the detection of PAS necessitates a high degree of expertise and, in some instances, can lead to its misdiagnosis. In clinical practice, up to 50% of pregnancies with PAS remain undiagnosed until delivery, and it is associated with increased risk of morbidity/mortality. Although many studies have evaluated the potential of fetal biomarkers circulating in maternal blood, very few studies have evaluated the potential of circulating placental extracellular vesicles (EVs) and their miRNA contents for molecular detection of PAS. Thus, to purify placental EVs from maternal blood, we customized our robust ultra-sensitive immuno-purification assay, termed EV-CATCHER, with a monoclonal antibody targeting the membrane Placental Alkaline Phosphatase (PLAP) protein, which is unique to the placenta and present on the surface of placental EVs. Then, as a pilot evaluation, we compared the miRNA expression profiles of placental EVs purified from the maternal plasma of women diagnosed with placenta previa (controls, n = 16); placenta lying low in uterus but not invasive) to those of placental EVs purified from the plasma of women with placenta percreta (cases, n = 16), PAS with the highest level of invasiveness. Our analyses reveal that miRNA profiling of PLAP⁺ EVs purified from maternal plasma identified 40 differentially expressed miRNAs when comparing these two placental pathologies. Preliminary miRNA pathway enrichment and gene ontology analysis of the top 14 upregulated and top nine downregulated miRNAs in PLAP⁺ EVs, purified from the plasma of women diagnosed with placenta percreta versus those diagnosed with placenta previa, suggests a potential role in control of cellular invasion and motility that will require further investigation. Full article

It is well known that if a poset satisfies Property A and its dual form, then the o-convergence and $o_2$-convergence in the poset are equivalent. In this paper, we supply an example to illustrate that a poset in which the o-convergence and $o_2$-convergence are equivalent may not satisfy Property A or its dual form, and carry out some further investigations on the equivalence of the o-convergence and $o_2$-convergence. By introducing the concept of the local Frink ideals (the dually local Frink ideals) and establishing the correspondence between ID-pairs and nets in a poset, we prove that the o-convergence and $o_2$-convergence of nets in a poset are equivalent if and only if the poset is ID-doubly continuous. This result gives a complete solution to the problem of E.S. Wolk in two modes of order convergence, which states under what conditions for a poset the o-convergence and $o_2$-convergence in the poset are equivalent. Full article

Van der Waals heterostructures with incommensurate contact interfaces show excellent tribological performance, which provides solutions for the development of new solid lubricants. In this paper, a facile electrostatic layer-by-layer self-assembly (LBL) technique was proposed to prepare multi-layer van der Waals heterostructures tungsten disulfide/hexagonal boron nitride (vdWH WS₂/h-BN). The h-BN and WS₂ were modified with poly (diallyldimethylammonium chloride) (PDDA) and sodium dodecyl benzene sulfonate (SDBS) to obtain the positively charged PDDA@h-BN and the negatively charged SDBS@WS₂, respectively. When the mass ratio of PDDA to h-BN and SDBS to WS₂ were both 1:1 and the pH was 3, the zeta potential of PDDA@h-BN and SDBS@WS₂ were 60.0 mV and −50.1 mV, respectively. Under the electrostatic interaction, the PDDA@h-BN and SDBS@WS₂ attracted each other and stacked alternately along the (002) crystal plane forming the multi-layer (four-layer) vdWH WS₂/h-BN. The addition of the multi-layer vdWH WS₂/h-BN (1.0 wt%) to the base oil resulted in a significant reduction of 33.8% in the friction coefficient (0.104) and 16.8% in the wear rate (4.43 × 10⁻⁵ mm³/(N·m)). The excellent tribological property of the multi-layer vdWH WS₂/h-BN arose from the lattice mismatch (26.0%), a 15-fold higher interlayer slip possibility, and the formation of transfer film at the contact interface. This study provided an easily accessible method for the multi-layer vdWH with excellent tribological properties. Full article

Sacran is a supergiant cyanobacterial polysaccharide that forms mesogenic supercoil rods that exhibit liquid crystalline (LC) gels at deficient concentrations of around 0.5 wt%, and has several bioactive stimuli-responsive functions. Here, we attempted to form oriented microfibers of sacran by electrospinning, following structural analyses of the sacran rods. A heterogeneous acid-hydrolysis method using a protonated cation-exchange resin was adopted to examine the short-time exposition of concentrated acid to sacran rods. From the supernatant, the oligomeric fraction that was soluble in water and methanol was isolated. The oligomeric fraction had a main sugar ratio of α-Glc:β-Glc:α-Xyl:β-Xyl:α-Rha of 2:5:1.5:1.5:4 (Glc:Xyl:Rha = 7 (=4 + 3):3:4), and it was speculated that the sacran structure includes rhamnoglucan and xyloglucan (4:3), which are generally rigid enough to exhibit LC. To make oriented microfibers of LC sacran, solubility testing was performed on sacran to find good new solvents of polyhydroxy alcohols such as ethylene glycol, 1,2-propanediol, and glycerol. The oriented film was prepared from a sacran aqueous solution where calcium compound particles deposited on the film are different from polyhydroxy alcohol solutions. Although sacran could not form microfibers by itself, polymer composite microfibers of sacran with poly(vinyl alcohol) were prepared by electrospinning. Cross-polarizing microscopy revealed the molecular orientation of the microfibers. Full article

Virtual reality (VR) enables the development of virtual training frameworks suitable for various domains, especially when real-world conditions may be hazardous or impossible to replicate because of unique additional resources (e.g., equipment, infrastructure, people, locations). Although VR technology has significantly advanced in recent years, methods for evaluating immersion (i.e., the extent to which the user is engaged with the sensory information from the virtual environment or is invested in the intended task) continue to rely on self-reported questionnaires, which are often administered after using the virtual scenario. Having an objective method to measure immersion is particularly important when using VR for training, education, and applications that promote the development, fine-tuning, or maintenance of skills. The level of immersion may impact performance and the translation of knowledge and skills to the real-world. This is particularly important in tasks where motor skills are combined with complex decision making, such as surgical procedures. Efforts to better measure immersion have included the use of physiological measurements including heart rate and skin response, but so far they do not offer robust metrics that provide the sensitivity to discriminate different states (idle, easy, and hard), which is critical when using VR for training to determine how successful the training is in engaging the user’s senses and challenging their cognitive capabilities. In this study, electroencephalography (EEG) data were collected from 14 participants who completed VR jigsaw puzzles with two different levels of task difficulty. Machine learning was able to accurately classify the EEG data collected during three different states, obtaining accuracy rates of 86% and 97% for differentiating easy versus hard difficulty states and baseline vs. VR states. Building on these results may enable the identification of robust biomarkers of immersion in VR, enabling real-time recognition of the level of immersion that can be used to design more effective and translative VR-based training. This method has the potential to adjust aspects of VR related to task difficulty to ensure that participants are immersed in VR. Full article

Plastic production, which exceeds one million tons per year, is of global concern. The constituent low-density polymers enable spread over large distances and micro/nano particles (MNPLs) induce organ toxicity via digestion, inhalation, and skin contact. Particles have been documented in all human tissues including breast milk. MNPLs, especially weathered particles, can breach the blood–brain barrier, inducing neurotoxicity. This has been documented in non-human species, and in human-induced pluripotent stem cell lines. Within the brain, MNPLs initiate an inflammatory response with pro-inflammatory cytokine production, oxidative stress with generation of reactive oxygen species, and mitochondrial dysfunction. Glutamate and GABA neurotransmitter dysfunction also ensues with alteration of excitatory/inhibitory balance in favor of reduced inhibition and resultant neuro-excitation. Inflammation and cortical hyperexcitability are key abnormalities involved in the pathogenic cascade of amyotrophic lateral sclerosis (ALS) and are intricately related to the mislocalization and aggregation of TDP-43, a hallmark of ALS. Water and many foods contain MNPLs and in humans, ingestion is the main form of exposure. Digestion of plastics within the gut can alter their properties, rendering them more toxic, and they cause gut microbiome dysbiosis and a dysfunctional gut–brain axis. This is recognized as a trigger and/or aggravating factor for ALS. ALS is associated with a long (years or decades) preclinical period and neonates and infants are exposed to MNPLs through breast milk, milk substitutes, and toys. This endangers a time of intense neurogenesis and establishment of neuronal circuitry, setting the stage for development of neurodegeneration in later life. MNPL neurotoxicity should be considered as a yet unrecognized risk factor for ALS and related diseases. Full article

Obstructive sleep apnea (OSA) is a prevalent yet underdiagnosed condition in pregnancy, associated with various maternal and fetal complications. This review synthesizes the current evidence on the epidemiology, pathophysiology, and neurological consequences of OSA in pregnancy, along with the potential management strategies. Articles were sourced from the PubMed, EMBASE, and Cochrane databases until 2023. Our comprehensive review highlights that the incidence of OSA increases during pregnancy due to physiological changes such as weight gain and hormonal fluctuations. OSA in pregnancy is linked with gestational hypertension, pre-eclampsia, gestational diabetes, and potential adverse fetal outcomes such as intrauterine growth restriction and preterm birth. Continuous positive airway pressure (CPAP) therapy remains the most effective management strategy for pregnant women with OSA. However, adherence to CPAP therapy is often suboptimal. This comprehensive review underscores the importance of the early recognition, timely diagnosis, and effective management of OSA in pregnancy to improve both maternal and fetal outcomes. Future research should focus on enhancing screening strategies and improving adherence to CPAP therapy in this population. Full article

Sporting events are drivers of urban life and have the potential to bring substantial short-term economic benefits to the host region by attracting visitor spending. This study has analyzed the impact generated by the 2021 Senior and Elite Badminton World Championships that took place in Huelva, Spain. The objectives are (i) determine the economic impact and determining factors; and (ii) the impact on the development of badminton in the region. For this purpose, the study used the Cost-Benefit Analysis approach to estimate the cashflows through a survey applied to both events. The results reflect a direct positive impact on the region’s economy, although the results are not as satisfactory at the sporting level. The article contributes to the few mid-range event studies on a minority sport in a city with a highly developed tourism sector. Full article

Rheumatoid arthritis (RA) is a chronic and debilitating condition that affects a significant number of individuals worldwide. Unfortunately, the currently available therapeutic approaches often yield unsatisfactory results and may be accompanied by harmful side effects. A medicinal plant called Psidium glaziovianum Kiaersk has potential benefits in the treatment of this condition due to its anti-inflammatory and analgesic properties. In this study, our objective was to investigate the potential therapeutic effects of P. glaziovianum essential oil (PgEO) in alleviating arthritis symptoms in mice induced by Complete Freund’s Adjuvant (CFA). The effect of P. glaziovianum essential oil was evaluated in mice with Complete Freund’s Adjuvant (CFA)-induced arthritis. Edema sizes, macroscopic and radiographic images, cytokine levels, and oxidative stress were evaluated. Administration of PgEO at dosages of 50 and 100 mg/kg effectively prevented CFA-induced osteoarticular changes in arthritic mice, resulting in a significant reduction in joint damage. Additionally, the PgEO treatment exhibited the ability to minimize edema, a common symptom associated with arthritis. Furthermore, PgEO can modulate the levels of pro-inflammatory cytokines and oxidative stress, both of which play crucial roles in the progression of the disease. In conclusion, our study suggests that PgEO holds great potential as a natural therapeutic agent for rheumatoid arthritis. Full article

Protein kinase C-iota (PKC-ι) is an oncogene overexpressed in many cancer cells including prostate, breast, ovarian, melanoma, and glioma cells. Previous in vitro studies have shown that 5-amino-1-((1R,2S,3R,4R)-2-3-dihydroxy-4-(hydroxymethyl)cyclopentyl)-1H-imidazole-4-carboxamide (ICA-1S), a PKC-ι-specific inhibitor, has low toxicity in both acute and sub-acute mouse model toxicological testing and is an effective therapeutic against several cancer cell lines showing significant reductions in tumor growth when treating athymic nude mice with xenografted carcinoma cell lines. To further assess ICA-1S as a possible therapeutic agent, chronic mouse model toxicological testing was performed in vivo to provide inferences concerning the long-term effects and possible health hazards from repeated exposure over a substantial part of the animal’s lifespan. Subjects survived well after 30, 60, and 90 days of doses ranging from 50 mg/kg to 100 mg/kg. Heart, liver, kidney, and brain tissues were then analyzed for accumulations of ICA-1S including the measured assessment of aspartate transaminase (AST), alkaline phosphatase (ALK-P), gamma-glutamyl transferase (GGT), troponin, and C-reactive protein (CRP) serum levels to assess organ function. Predictive in vitro/in silico methods were used to predict compound-induced direct hepatocyte toxicity or renal proximal tubular cell (PTC) toxicity in humans based on the high-content imaging (HCI) of compound-treated cells in combination with phenotypic profiling. In conclusion, ICA-1S shows low toxicity in both acute and chronic toxicology studies, and shows promise as a potential therapeutic. Full article

Microplastics are tangible particles of less than 0.2 inches in diameter that are ubiquitously distributed in the biosphere and accumulate in water bodies. During the east-coast hot summers (23–29 °C) of 2021 and 2022, June through September, we captured copious amounts of the jellyfish Chrysaora chesapeakei, a predominant species found in the Patuxent River of the Chesapeake Bay in Maryland on the United States East Coast. We determined that their gelatinous bodies trapped many microplastics through fluorescent microscopy studies using Rhodamine B staining and Raman Spectroscopy. The chemical nature of the microplastics was detected using gas chromatography–mass spectroscopy headspace (SPME-GC-MS) and solvent extraction (GC-MS) methods through a professional commercial materials evaluation laboratory. Numerous plastic-affiliated volatile organic compounds (VOCs) from diverse chemical origins and their functional groups (alkanes, alkenes, acids, aldehydes, ketones, ethers, esters, and alcohols) along with other non-microplastic volatile organic compounds were observed. Our findings corroborate data in the available scientific literature, distinguishing our finding’s suitability. Full article

The long-term goal of this research is the development of a stand-alone tactile device for the communication of speech for persons with profound sensory deficits as well as for applications for persons with intact hearing and vision. Studies were conducted with a phoneme-based tactile display of speech consisting of a 4-by-6 array of tactors worn on the dorsal and ventral surfaces of the forearm. Unique tactile signals were assigned to the 39 English phonemes. Study I consisted of training and testing on the identification of 4-phoneme words. Performance on a trained set of 100 words averaged 87% across the three participants and generalized well to a novel set of words (77%). Study II consisted of two-way messaging between two users of TAPS (TActile Phonemic Sleeve) for 13 h over 45 days. The participants conversed with each other by inputting text that was translated into tactile phonemes sent over the device. Messages were identified with an accuracy of 73% correct in conjunction with 82% of the words. Although rates of communication were slow (roughly 1 message per minute), the results obtained with this ecologically valid procedure represent progress toward the goal of a stand-alone tactile device for speech communication. Full article

Obesity is considered an important risk factor for the onset of asthma, playing a key role in enhancing the disease’s severity. However, there is increasing evidence linking not only obesity but also overweight with a higher risk of asthma. Although the correlation between obesity and asthma has already been reported, several aspects are still not fully elucidated, mainly about the inflammatory processes underlying both diseases. It is well known that Western-type calorically rich diets and overfeeding can act as triggers of chronic metabolic inflammation, but few studies have examined associations between ultra-processed foods (UPFs) intake, despite its positive correlation with obesity, and biomarkers of inflammation. In addition to their nutrient composition, UPF may have chemical additives and contaminants from packaging, whose effects on health and food addiction are still under research. In this review, we provide an overview of the current data that identify the associations between the obese asthma phenotype and UPF consumption, highlighting the potential central role played by the intestinal microbiota. Full article

Population-based databases in Nordic countries offer unique opportunities for large-scale population-based epidemiological studies. The personal identity number enables researchers to link different registers at the individual level, which can be used for large-scale epidemiological population-based studies. This review outlines how these opportunities have been used so far in the field of gout research, as well as the potential challenges and limitations. Their major advantage is that they cover the entire population, minimizing problems such as selection bias and loss to follow-up. This has enabled us to provide information on gout regarding risk factors; occurrence; association with comorbidities in relation to gout onset; treatment patterns; as well as its effect on other outcomes, such as sick leave and mortality. Validity issues, missing data, and legal issues are some of the challenges that researchers need to deal with. Choosing the most appropriate combination of databases to use for a specific question is crucial in order to maximize validity and adjust for confounders. Despite challenges and potential limitations, the Swedish registers have provided valuable epidemiological results and will continue to play an important role in the years to come. Full article

Numerous real-world applications apply categorical data clustering to find hidden patterns in the data. The K-modes-based algorithm is a popular algorithm for solving common issues in categorical data, from outlier and noise sensitivity to local optima, utilizing metaheuristic methods. Many studies have focused on increasing clustering performance, with new methods now outperforming the traditional K-modes algorithm. It is important to investigate this evolution to help scholars understand how the existing algorithms overcome the common issues of categorical data. Using a research-area-based bibliometric analysis, this study retrieved articles from the Web of Science (WoS) Core Collection published between 2014 and 2023. This study presents a deep analysis of 64 articles to develop a new taxonomy of categorical data clustering algorithms. This study also discusses the potential challenges and opportunities in possible alternative solutions to categorical data clustering. Full article

Background: Carotid body tumors (CBTs) are rare benign tumors that arise from the chemoreceptor tissue located at the carotid bifurcation that require excision if symptomatic. Depending on the size and location of the tumor, the carotid artery may need to be repaired after resection. This study aims to assess whether CBT excision with artery resection had higher rates of 30-day postoperative outcomes compared with CBT excision without artery resection. Methods: This is a retrospective cohort study. Patients were identified in the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) registry from 2005 to 2017. They were divided into two groups, based on Current Procedural Terminology (CPT^®) codes: group A had CBT excision without carotid artery excision (CPT code 60600) and group B with carotid artery excision (CPT code 60605). Patient demographic characteristics, co-morbidities, and 30-days postoperative outcomes were compared between the two groups. Categorical data were analyzed using Pearson’s X² or Fisher exact tests and presented as proportions (percentages). Continuous data were analyzed using parametric or non-parametric tests as appropriate. Statistical significance was defined as p < 0.05. Statistical analysis was performed using the SPSS statistical software package. Results: A total of 463 patients were identified, 410 (88.4%) in group A and 53 (11.4%) in group B. Overall, there were 291 (62.9%) women. A higher proportion of women underwent CBT excision only, compared to men (91.1% [265/291] vs. 84.3% [145/172], p < 0.0001). Demographics and comorbidities were similar between groups. There was no significant difference in the 30-day postoperative outcomes. The reoperation rate was higher in group B (3.8% vs. 1.5%, p = 0.334), while the readmission rate was higher in group A (3.2% vs. 0% p = 0.269), and both were not significantly different. Overall morbidity and serious morbidity were higher in group B (7.5% vs. 5.9%, p = 0.626) and lower in group A (5.7% vs. 3.9%, p = 0.544), respectively, but were not significantly different. Operative time (mean, SD) was higher in group B (187 ± 107 vs. 138 ± 66 min, p < 0.001). However, the median (IQR) of hospital length of stay (LOS) was similar (2 [1, 4] vs. 2 [1, 3] days, p = 0.134). Conclusions: Overall, no difference was noted in the 30-day postoperative outcome between the two surgical approaches of CBT. However, operative time was longer when artery resection was performed. Further research to determine the factors predicting the need for carotid artery resection among patient gender is needed. Full article