Background: Complex arrhythmias often arise from the left side of the heart, necessitating established electrophysiological (EP) procedures like 3D-mapping-assisted radiofrequency (RF) ablations or pulmonary vein isolation (PVI). These procedures typically require transseptal access, emphasizing the critical role of achieving an optimal catheter position through a precise transseptal puncture (TSP). Commonly employed imaging methods for TSP guidance include fluoroscopy and interventional echocardiography. Despite their routine use, there is limited evidence on which imaging modality offers superior catheter positioning for EP procedures, and safety concerns regarding transseptal punctures with imaging remain underexplored. This study aims to systematically evaluate the feasibility, safety, and accuracy of echo-guided TSP compared to fluoroscopy-guided TSP. Methods: In this prospective study, 150 consecutive patients undergoing left atrial EP procedures were enrolled between October 2023 and February 2024 at the Ulm University Heart Center. Following optimal fluoroscopy-guided transseptal needle positioning at the interatrial septum, the catheter placement was further verified using transesophageal echocardiography (TEE). Adjustments were made in cases of suboptimal needle positioning observed in TEE. The fluoroscopically achieved septal positions were categorized based on TEE images as optimal, suboptimal, poor, or dangerous. Results: Among the 150 patients included (58.0% male), fluoroscopy achieved optimal, suboptimal, and poor/dangerous positions in 32.7%, 43.3%, and 24.0%, respectively. After TEE-guided adjustments, optimal and suboptimal positions were achieved in 59.3% and 40.7% of patients, respectively. No instances of poor or dangerous transseptal needle positions were observed under TEE guidance. Conclusions: TEE-guided TSP emerges as a feasible, more accurate, and safer imaging method for transseptal punctures in EP procedures. Full article

As usually presented, octagons of opposition are rather complex objects and can be difficult to assimilate at a glance. We show how, under suitable conditions that are satisfied by most historical examples, different display conventions can simplify the diagrams, making them easier for readers to grasp without the loss of information. Moreover, those conditions help reveal the conceptual structure behind the visual display. Full article

Titanium with apatite-forming ability as well as antibacterial activity is useful as a component of antibacterial dental implants. When Ti was subjected to hydrogen peroxide (H₂O₂), copper acetate (Cu(OAc)₂), and heat (H₂O₂-Cu(OAc)₂-heat) treatments, a network structure of anatase and rutile titanium dioxide (TiO₂) and fine copper oxide (CuO) particles was formed on the Ti surface. The resulting samples accumulated a dense and uniform apatite layer on the surface when incubated in simulated body fluid and showed enhanced antibacterial activity against Escherichia coli and Staphylococcus aureus under visible-light irradiation. Electron spin resonance spectra of H₂O₂-Cu(OAc)₂-heat-treated samples showed that hydroxyl radicals (·OH) were generated from the samples, and the concentration of ·OH increased with increasing Cu concentration of the Cu(OAc)₂ solution. The enhanced antibacterial activity of these samples under visible-light irradiation may be attributable to the generation of ·OH from samples. These results suggest that Ti implants obtained using H₂O₂-Cu(OAc)₂-heat treatments and subjected to regular or on-demand visible-light irradiation may provide a decreased risk of peri-implantitis. Full article

Background: Anterior cruciate ligament (ACL) tears account for 40% to 50% of all ligamentous knee injuries. Most patients with ACL ruptures undergo surgical treatment. There is currently no objective, well-documented, repeatable, and standardized nonsurgical method for ACL tear treatment. This study aimed to investigate ACL outcomes in patients who underwent a novel nanosurgery and bioengineering treatment (NSBT) for an ACL tear. Methods: This was a double-blind randomized trial including 44 patients with a history of traumatic knee injury and a confirmed ACL tear. The final sample comprised 40 patients who met all the eligibility criteria. The patients were divided into two groups: the treatment group (n = 30) and the control group (n = 10). The treatment group underwent nanosurgery with an ultrasound-guided injection of modified platelet-rich plasma (PRP) using human cell memory (RP-hCM). The control group was treated with an ultrasound-guided PRP injection into the joint capsule. At baseline and post-treatment, all patients underwent both ultrasonography and magnetic resonance imaging (MRI), and the following clinical variables were assessed: the WOMAC score, the Lysholm knee score, the visual analog scale score, and knee instability. In most patients, the clinical outcome was verified using nanoscopy. Results: The median WOMAC, VAS, and LKS scores, as well as knee instability, improved significantly 12 weeks after the procedure in the treatment group (p < 0.001). We found a significantly larger improvement in the assessed parameters in the treatment group compared to the control group (p < 0.001). In the treatment group, all the patients had good and very good clinical outcomes, while 90% of the patients had a normal ACL signal in a follow-up MRI scan. In the control group, a physical examination revealed no changes in knee stability after treatment. Conclusions: This study showed that there is a significant difference in patient experience and the duration of recovery for patients with ACL tears treated with NSBT. The novel nonsurgical method was shown to be repeatable, objective, well documented, standardized, and highly effective. Full article

Inherited optic neuropathies (IONs) are rare genetic diseases characterized by progressive visual loss due the atrophy of optic nerves. The standard diagnostic workup involving next-generation sequencing panels has a diagnostic yield of about forty percent. In the other 60% of the patients with a clinical diagnosis of ION, the underlying genetic variants remain unknown. In this case study, we describe a potentially new disease-associated gene, NSUN3, for IONs. The proband was a young woman with consanguineous parents. She presented with bilateral optic atrophy and nystagmus at the age of seven years. Genetic testing revealed the homozygous variant c.349_352dup p.(Ala118Glufs*45) in NSUN3, with a segregation in the family compatible with autosomal recessive inheritance. Additional functional analysis showed decreased NSUN3 mRNA levels, slightly diminished mitochondrial complex IV levels, and decreased cell respiration rates in patient fibroblasts compared to healthy controls. In conclusion, pathogenic variants in NSUN3 can cause optic neuropathy. Trio whole-exome sequencing should be considered as a diagnostic strategy in ION cases where standard diagnostic analysis does not reveal disease-causing variants. Full article

The integration of wireless sensors with artificial intelligence could represent a transformative approach in restorative dentistry, offering a sophisticated means to enhance diagnostic precision, treatment planning, and patient outcomes. This systematic review was conducted to pinpoint and assess the efficacy of wireless sensors in restorative dentistry. The search methodology followed the guidelines outlined by PRISMA and involved the utilization of prominent scientific databases. Following the final phase of evaluating eligibility, the systematic review included six papers. Five experiments were conducted in vitro, while one was a randomized clinical trial. The investigations focused on wireless sensors for cavity diagnosis, toothbrush forces, facial mask applications, and physiological parameter detection from dental implants. All wireless sensors demonstrated efficacy in achieving the objectives established by each study and showed the validity, accuracy, and reproducibility of this device. The investigations examined in this systematic review illustrate the potential of wireless sensors in restorative dentistry, especially in the areas of caries detection, dental implant systems, face masks, and power brushes. These technologies hold promise for enhancing patient outcomes and alleviating the workload of dental practitioners. Full article

The objective of this study was to investigate how nitrogen and slow-release fertilizers affect the traits of leaf senescence and quinoa production in order to explore the optimal slow-release fertilizer and nitrogen fertilizer ratios suitable for quinoa production, as well as to provide theoretical references for the planting of quinoa fertilization methods and fertilizer amount. In this experiment, the main local strain Quinoa 77 was selected as the experimental material, and six treatments were set up: CK: no nitrogen fertilizer; T₁: 100% urea (N); T₂: 100% slow-release fertilizer (C); T₃: 5:5 (C₅N₅); T₄: 3:7 (C₃N₇); and T₅: 7:3 (C₇N₃). This was done in order to investigate how various treatments affect the activities of catalase (CAT), peroxidase (POD), and superoxide dismutase (SOD); malondialdehyde (MDA) content; and yield of quinoa leaves. The findings revealed the following: (1) As the reproductive period progressed, the activities of CAT, POD, and SOD in quinoa leaves treated differently showed a tendency to increase and subsequently decrease, and they reached the peak value at the early stage of filling. The activity of CAT, POD, and SOD in the T₃ treatment was the highest, and the average activities were 3148.74 U·g⁻¹, 2197.84 U·g⁻¹, and 118.51 U·g⁻¹, respectively, which increased by 78.90%, 101.99%, and 108.14%, respectively, compared with CK. The content of MDA continued to increase with the progress of fertility. The average T₃ treatment was 36.41 nmol·g⁻¹, which was 46.87% lower than that of CK. (2) Out of all the treatments, T₃ had the highest yield with an average of 3829.43 kg·hm⁻², T₅ the second with an average of 3313.52 kg·hm⁻², and T₄ the third with 2847.47 kg·hm⁻², which increased yields by 96.18%, 69.75%, and 45.87%, respectively, compared with CK. (3) Yield was highly significantly and positively correlated with thousand kernel weight; number of grains per spike per plant; and the early filling stages of CAT, POD, and SOD sports, and it had a negative, extremely significant correlation with MDA content. Comprehensive analysis showed that slow-release fertilizer and nitrogen fertilizer can improve the antioxidant enzyme activity of quinoa leaves, inhibit MDA content, improve the physiological characteristics of quinoa, and delay the purpose of leaf senescence, with a better effect of yield and income, of which the T₃ treatment had the high-quality impact of increasing yields and was a more scientific and reasonable fertilization method. Full article

This study aimed to assess the impact of palm oil deodorizer distillate (POD) on the ruminal environment, including (i) microbial community, (ii) ruminal degradability, and (iii) apparent digestibility in sheep. The data used were derived from twenty rumen-cannulated sheep fed five isoproteic and isofiber diets based on elephant grass (Pennisetum purpureum Schum. cv. Roxo) silage supplemented with 0, 25, 50, 75, or 100 g kg⁻¹ POD on a dry matter (DM) basis. Rumen fluid samples were collected three hours after feeding directly from the ventral sac of the rumen via a cannula and then subjected to DNA extraction, which was subsequently used for 16S rDNA amplification, followed by sequencing and diversity analysis. In this study, the microbial diversity was dominated by Bacteroidetes and Firmicutes, followed by Euryarchaetoa, Actinobacteria, and Tenericutes, in the ruminal environment, and was slightly modified when supplemented with the POD up to 100 g/kg (10%), leading to only a slight decrease in the diversity index. The ruminal degradability, ruminal fermentation parameters, and apparent digestibility were slightly compromised by the inclusion of up to 25 g of POD per kg of DM, and larger inclusions interfered with the ruminal degradability of fibrous fractions and the apparent digestibility of dry matter. This lipid supplement showed good results for feeding sheep and is an inexpensive and abundant alternative in the regional market. Full article

Accurate prediction of the Remaining Useful Life (RUL) of lithium-ion batteries is crucial for reducing battery usage risks and ensuring the safe operation of systems. Addressing the impact of noise and capacity regeneration-induced nonlinear features on RUL prediction accuracy, this paper proposes a predictive model based on Complete Ensemble Empirical Mode Decomposition with Adaptive Noise (CEEMDAN) data preprocessing and IHSSA-LSTM-TCN. Firstly, CEEMDAN is used to decompose lithium-ion battery capacity data into high-frequency and low-frequency components. Subsequently, for the high-frequency component, a Temporal Convolutional Network (TCN) prediction model is employed. For the low-frequency component, an Improved Sparrow Search Algorithm (IHSSA) is utilized, which incorporates iterative chaotic mapping and a variable spiral coefficient to optimize the hyperparameters of Long Short-Term Memory (LSTM). The IHSSA-LSTM prediction model is obtained and used for prediction. Finally, the predicted values of the sub-models are combined to obtain the final RUL result. The proposed model is validated using the publicly available NASA dataset and CALCE dataset. The results demonstrate that this model outperforms other models, indicating good predictive performance and robustness. Full article

Water pollution by organic dyes represents a major health and environmental issue. Despite the fact that peptide-based hydrogels are considered to be optimal absorbents for removing such contaminants, hydrogel systems often suffer from a lack of mechanical stability and complex recovery. Recently, we developed an enzymatic approach for the preparation of a new peptide-based magnetogel containing polyacrylic acid-modified γ-Fe₂O₃ nanoparticles (γ-Fe₂O₃NPs) that showed the promising ability to remove cationic metal ions from aqueous phases. In the present work, we tested the ability of the magnetogel formulation to remove three model organic dyes: methyl orange, methylene blue, and rhodamine 6G. Three different hydrogel-based systems were studied, including: (1) Fmoc-Phe₃ hydrogel; (2) γ-Fe₂O₃NPs dispersed in the peptide-based gel (Fe₂O₃NPs@gel); and (3) Fe₂O₃NPs@gel with the application of a magnetic field. The removal efficiencies of such adsorbents were evaluated using two different experimental set-ups, by placing the hydrogel sample inside cuvettes or, alternatively, by placing them inside syringes. The obtained peptide magnetogel formulation could represent a valuable and environmentally friendly alternative to currently employed adsorbents. Full article

Background: It has recently been shown that cardiac-specific troponin I concentrations in first morning urine samples can be measured with commercially available tests. Due to their accumulation in the first morning urine, scientific papers indicate a potential predictive value for cardiovascular diseases. Therefore, the aim of this study was to compare the concentration of cardiac troponin I in the first morning urine in patients with severe aortic stenosis and the healthy population. Patients and Methods: Blood and first morning urine samples were collected from 34 healthy individuals (17 female) at University Hospital Merkur and 25 patients with severe aortic stenosis (14 female) before surgical treatment at University Hospital Dubrava. Cardiac troponin I and T values were determined using high-sensitivity assays using commercially available Abbott and Roche tests. Results: Patients with severe aortic stenosis had significantly lower troponin I concentrations in the first morning urine samples (0.3 ng/L (0.1–0.6)) as compared to the healthy population (15.2 ng/L (8.4–19.9)) (p < 0.001). There was no statistically significant difference in troponin T concentrations between healthy individuals and patients with severe aortic stenosis. In parallel, both I and T plasma troponin concentrations were significantly higher in patients with severe aortic stenosis. Conclusions: In patients with severe aortic stenosis, cardiac troponin I values in the first morning urine are significantly lower than in healthy subjects. Full article

Background: Dry eye disease (DED) stands out as one of the most common eye conditions encountered in clinical settings. This study aimed to determine the diagnostic ability and feasibility of post-blink blur time (PBBT) in detecting patients with DED symptoms. Methods: The study included 200 subjects, 100 with and 100 without DED symptoms defined by the Schein questionnaire, who underwent assessment of DED signs [visual acuity, PBBT, conjunctival hyperemia, lid-parallel conjunctival folds—LIPCOF, tear film break-up time—TBUT, fluorescein corneal staining, and meibum score]. Results: DED subjects had a lower PBBT than controls (p < 0.001), with subjective (6 (1–45) s vs. 8 (1–70) s) and objective (6 (2–33) s vs. 8 (2–50) s) PBBT measurements being similar between repeats. The correlations between subjective and objective PBBT measurements were significantly positive (R = 0.873, p < 0.001). Subjective PBBT was negatively related to the Schein questionnaire (R = −0.217, p = 0.002), conjunctival hyperemia (R = −0.105, p = 0.035), and corneal staining (R = −0.153, p = 0.031), while positively related to the TBUT (R = 0.382, p < 0.001) and meibum score (R = 0.106, p = 0.033). Logistic regression analysis showed DED symptoms were significantly associated with subjective PBBT (AOR 0.91, p = 0.001), TBUT (AOR 0.79, p < 0.001), meibum score (AOR 0.65, p = 0.008), LIPCOF (AOR 1.18, p = 0.002) and corneal staining (AOR 1.14, p = 0.028). Conclusions: Subjective self-reported PBBT is a reliable and non-invasive screening test for evaluating time-wise changes in visual acuity and detecting a tear film dysfunction. Full article

With the development of biometric identification technology, finger vein identification has received more and more widespread attention for its security, efficiency, and stability. However, because of the performance of the current standard finger vein image acquisition device and the complex internal organization of the finger, the acquired images are often heavily degraded and have lost their texture characteristics. This makes the topology of the finger veins inconspicuous or even difficult to distinguish, greatly affecting the identification accuracy. Therefore, this paper proposes a finger vein image recovery and enhancement algorithm using atmospheric scattering theory. Firstly, to normalize the local over-bright and over-dark regions of finger vein images within a certain threshold, the Gamma transform method is improved in this paper to correct and measure the gray value of a given image. Then, we reconstruct the image based on atmospheric scattering theory and design a pixel mutation filter to segment the venous and non-venous contact zones. Finally, the degraded finger vein images are recovered and enhanced by global image gray value normalization. Experiments on SDUMLA-HMT and ZJ-UVM datasets show that our proposed method effectively achieves the recovery and enhancement of degraded finger vein images. The image restoration and enhancement algorithm proposed in this paper performs well in finger vein recognition using traditional methods, machine learning, and deep learning. The recognition accuracy of the processed image is improved by more than 10% compared to the original image. Full article

(1) Background: The objective of this in vitro study was to evaluate the impact of different etching times and ethanol pre-treatments on the immediate bond strength of a hydrophilic multi-mode universal adhesive (Clearfil Universal Bond Quick, Kuraray, UBQ) and on the consequent gelatinolytic activity of metalloproteinases (MMPs) on radicular dentin. (2) Methods: Sixty single-root teeth were selected and divided into four groups according to the adhesive protocol applied for fiber post cementation: (G1) 15 s H₃PO₄ application + UBQ; (G2) 30 s H₃PO₄ application + UBQ; (G3) 15 s H₃PO₄ application + ethanol pre-treatment + UBQ; (G4) 30 s H₃PO₄ + ethanol pre-treatment + UBQ. After adhesive procedures, fiber posts were luted into the post space with a dual-curing cement (DC Core, Kuraray) and light-cured for 40 s. To perform the push-out test and nanoleakage analyses for both coronal end apical areas, 1 mm slices were prepared, following a 24 h storage period in artificial saliva. Additionally, an in situ zymographic assay was conducted to explore endogenous MMP activity within the radicular layer. Results were statistically analyzed with ANOVA and Tukey post hoc tests. Statistical significance was set at p < 0.05. (3) Result: ANOVA revealed a statistically significant difference in push-out bond strength related to the pre-treatment variable but did not highlight any significance of etching time. Specimens pre-treated with ethanol wet bond application showed higher bond strength (p < 0.01). In situ zymography quantification analyses revealed that all tested groups, independently of etching time end ethanol pre-treatment, activated MMP gelatinolytic activity. A significant increase in MMP activity was detected for the 30 s etching time. However, ETOH pre-treatment significantly reduced MMP activity within the adhesive interface (p < 0.01). (4) Conclusions: The tested adhesive showed similar results regardless of the etching time protocol. The gelatinolytic activity of MMPs was observed in all the groups. Further investigations and extended follow-ups are required to validate the results of the present study in vivo. Full article

In this study, S-doped graphitic carbon nitride (S-C₃N₄) was prepared using the high-temperature polymerization method, and then S-C₃N₄/AgCdS heterojunction photocatalyst was obtained using the chemical deposition method through loading Ag-doped CdS nanoparticles (AgCdS NPs) on the surface of S-C₃N₄. Experimental results show that the AgCdS NPs were evenly dispersed on the surface of S-C₃N₄, indicating that a good heterojunction structure was formed. Compared to S-C₃N₄, CdS, AgCdS and S-C₃N₄/CdS, the photocatalytic performance of S-C₃N₄/AgCdS has been significantly improved, and exhibits excellent photocatalytic degradation performance of Rhodamine B and methyl orange. The doping of Ag in collaboration with the construction of a Z-scheme heterojunction system promoted the effective separation and transport of the photogenerated carriers in S-C₃N₄/AgCdS, significantly accelerated its photocatalytic reaction process, and thus improved its photocatalytic performance. Full article

In our case, the malformation was diagnosed prenatally at 40 weeks of gestation, and at the age of 14 days, the malformation was removed combined with a segmentectomy of the sixth segment of the left lung. Preoperative diagnostics focus on 3D-CT reconstruction and detailing of the anatomical variations of all arterial and venous vessels, as evident from our case. Treatment includes surgical removal or a minimally invasive interventional approach through the embolization of the vessel afferent to the malformation. After the operation, the child was discharged on the 30th day after birth in good condition and is developing normally. Early operative intervention is of great importance for the favorable outcome of the condition. In our case, this was hypoxemia with a saturation of 70-75%. The rare and often missed prenatal diagnosis of fetal AV malformation is significant for the adequate postnatal treatment and development of affected children. Full article

This essay explores the notion of Mitsprechen or “with-speaking” in Paul Celan’s poetry. “With-speaking” supposes that voices in the poems actively participate and engage in a dialogue that goes beyond traditional hermeneutic frameworks. Celan’s notion of col-loquy, distinct from the conventional sense of dialogue, challenges the separation between author and interpreter, rendering the traditional concept of intertextuality inadequate. The poems, according to Celan, give voice to human destinies, making texts audible as the voices of others. This vocal dimension of Celan’s poetry has prompted extensive discussion among philosophers, particularly in France. Levinas, Blanchot, and Derrida, influenced by German phenomenology and hermeneutics, critically examine the ethical implications of speaking “about” the other. They challenge traditional hermeneutical practices, emphasizing the responsibility of interpreters to respect the unique and untranslatable character of individual voices. This critique extends to Protestant categories of interpretation, drawing on alternative Jewish perspectives on being-in-the-world and alterity. The text explores the tensions inherent in speaking “for” or “in the name of” others, especially in the context of interpreting Celan’s work, raising questions about maintaining the fundamental difference and distance that otherness implies. The discussion concludes by highlighting Werner Hamacher’s formulation of a new philology that disrupts hermeneutical violence, influenced by the critiques of Blanchot, Levinas, and Derrida, and offering an alternative way of addressing the particular challenges posed by Celan’s poetry. Full article

Background and objectives: Gastroesophageal reflux disease (GERD) is a common disease affecting approximately 20% of the adult population. This study aimed to compare the results of laparoscopic Nissen fundoplication (LNF) in the treatment of GERD in patients of different age groups. Materials and Methods: A retrospective analysis was performed on patients who underwent LNF in one surgical department between 2014 and 2018. Patients were divided into three groups based on age: under 40 years of age, 40–65 years of age, and over 65 years of age. Results: A total of 111 patients (44.1% women) were analyzed in this study. The mean age was 50.2 ±15 years, and the mean follow-up was 50 months ± 16.6 months. Recurrence of symptoms occurred in 23%, 20%, and 23% in each age group, respectively (p = 0.13), and 85%, 89%, and 80% of patients from the respective groups reported that they would recommend the surgery to their relatives (p = 0.66). Furthermore, 83%, 92%, and 73% of patients from the respective age groups reported that they would undergo the surgery again with the knowledge they now had (p = 0.16). Conclusions: Given these results and observations, LNF has been shown to be a good method of treatment for GERD in every age group. In our study, there were no differences found in terms of satisfaction with surgery and associated recommendations between the studied age groups. Full article

Reliability and efficiency of valves are necessary for precise control and sufficient heat-flow to heat application plants for the integrated energy systems of nuclear power plants (NPPs). Strategic Management Analysis Requirement and Technology (SMART) valves’ ability to control flow and assess environmental parameters stands out for these requirements. Their ability to sustain the downstream flow rate, prevent reverse flow, and maintain pressure in the heat transport loop is much more efficient with the integration of sensors and intelligent algorithms. For assessing valve performance and monitoring, mechanical design and operating conditions are two important parameters. In this study, the butterfly valves of three different sizes are simulated with water and steam using STAR-CCM+ in various flow regimes and positions to analyze performance parameters to strategize an automated control system for efficiently balancing the heat–transport network. Also, flow behavior is studied using velocity and pressure fields for valve–body geometry optimization. It can be observed, through performance parameters, that the valves are suitable for operation between 30° and 90° positions with significantly low loss coefficients and high flow coefficients, and the performance parameters follow a certain pattern in both water and steam flow in each scenario. Full article