Search Results (20)

Background/Objectives: The increased accessibility of information has resulted in a rise in patients trying to self-diagnose and opting for self-medication, either as a primary treatment or as a supplement to medical care. Our objective was to evaluate the reliability, comprehensibility, and readability of the responses provided by ChatGPT 4.0 when queried about the most prevalent orthopaedic problems, thus ascertaining the occurrence of misguidance and the necessity for an audit of the disseminated information. Methods: ChatGPT 4.0 was presented with 26 open-ended questions. The responses were evaluated by two observers using a Likert scale in the categories of diagnosis, recommendation, and referral. The scores from the responses were subjected to subgroup analysis according to the area of interest (AoI) and anatomical region. The readability and comprehensibility of the chatbot’s responses were analyzed using the Flesch–Kincaid Reading Ease Score (FRES) and Flesch–Kincaid Grade Level (FKGL). Results: The majority of the responses were rated as either ‘adequate’ or ‘excellent’. However, in the diagnosis category, a significant difference was found in the evaluation made according to the AoI (p = 0.007), which is attributed to trauma-related questions. No significant difference was identified in any other category. The mean FKGL score was 7.8 ± 1.267, and the mean FRES was 52.68 ± 8.6. The average estimated reading level required to understand the text was considered as “high school”. Conclusions: ChatGPT 4.0 facilitates the self-diagnosis and self-treatment tendencies of patients with musculoskeletal disorders. However, it is imperative for patients to have a robust understanding of the limitations of chatbot-generated advice, particularly in trauma-related conditions. Full article

Background and Objective: Using echocardiogram data for cardiovascular disease (CVD) can lead to difficulties due to imbalanced datasets, leading to biased predictions. Machine learning models can enhance prognosis accuracy, but their effectiveness is influenced by optimal feature selection and robust classification techniques. This study introduces an event-based self-similarity approach to enhance automatic feature selection approach for imbalanced echocardiogram data. Critical features correlated with disease progression were identified by leveraging self-similarity patterns. This study used an echocardiogram dataset, visual presentations of high-frequency sound wave signals, and data of patients with heart disease who are treated using three treatment methods: catheter ablation, ventricular defibrillator, and drug control—over the course of three years. Methods: The dataset was classified into nine categories and Recursive Feature Elimination (RFE) was applied to identify the most relevant features, reducing model complexity while maintaining diagnostic accuracy. Machine learning classification models, including XGBoost and CATBoost, were trained and evaluated. Results: Both models achieved comparable accuracy values, 84.3% and 88.4%, respectively, under different normalization techniques. To further optimize performance, the models were combined into a voting ensemble, improving feature selection and predictive accuracy. Four essential features—age, aorta (AO), left ventricular (LV), and left atrium (LA)—were identified as critical for prognosis and were found in Random Forest (RF)-voting ensemble classifier. The results underscore the importance of feature selection techniques in handling imbalanced datasets, improving classification robustness, and reducing bias in automated prognosis systems. Conclusions: Our findings highlight the potential of machine learning-driven echocardiogram analysis to enhance patient care by providing accurate, data-driven assessments. Full article

Background/Objectives: The aim of the study was to determine the frequency of occurrence of a significant health problem—abdominal obesity (AO)—in children and adolescents with intellectual disability (ID) compared to children and adolescents without disabilities, examined in the period 2013–2014. Methods: The study group included 568 students with various ID degrees (n = 265 mild; n = 249 moderate; n = 54 severe) (age range 7–18 years) attending care and educational facilities. The comparison group (non-ID) was randomly selected based on the principle of matching the group (age and sex) among students without ID. Anthropometric measurements were taken: waist circumference (WC), height, and body mass. To classify WC and BMI values, percentile charts developed within the OLAF project were used. Analyses were performed using the independence chi-square test, odds ratio (95% confidence interval) and logistic regression for multivariate analysis. The level of significance was assumed as α = 0.05. Results: The prevalence of AO in the ID group was not statistically significant (OR = 1.31; p = 0.056). The risk in the study group was significantly higher in the older age category (OR = 1.88; p < 0.001) and increased with the level of intellectual disability, amounting (OR = 3.71; p < 0.001) to moderate ID and (OR = 5.62; p < 0.001) for profound ID, respectively. Conclusions: Consideration should be given to the extension of preventive and therapeutic measures to defined subgroups of children and adolescents with intellectual disabilities, who are particularly vulnerable to AO. Full article

Introduction: Various classifications for osteoporotic vertebral fractures (OVFs) have been introduced to enhance patient care and facilitate clinical communication. However, there is limited evidence of their effectiveness in predicting vertebral collapse, and very few studies have compared this association across different classification systems. This study aims to investigate the association between OVF categories, according to the most widely used classification systems, and vertebral collapse. Patients and Methods: A retrospective single-center study was conducted involving patients diagnosed with acute OVFs at the emergency department of a tertiary-level academic hospital with a minimum follow-up of 6 months. Vertebral fractures were independently classified by two radiologists according to several classification systems, including those proposed by Genant, Sugita, the German Society for Orthopedics and Trauma (DGOU), and the AO Spine. Associations between vertebral collapse and OVF classification systems were analyzed using bivariate and logistic regression analyses. Results: This study included 208 patients (82.7% females; mean age of 72.6 ± 9.2 years). The median follow-up time was 15 months, with L1 being the most common fracture site (47.6%). The most frequent OVF types observed, according to Genant’s morphological, Genant’s quantitative, Sugita ’s, DGOU’s, and AO Spine’s classifications, were biconcave (50%), grade 0.5 (47.6%), bow-shaped (61.5%), OF2 (74%), and A1 (61.5%), respectively. All classifications, except for Genant’s quantitative system, were significantly associated with vertebral collapse in bivariate analyses. Logistic regression analyses showed a significant association (p = 0.002) between the AO Spine classification and vertebral collapse, with 85.7% of A4 fractures developing collapse on follow-up. Conclusions: The AO Spine classification showed the highest predictive capacity for vertebral collapse. Specifically, A4 fracture types showed a very high risk of vertebral collapse, confirming the need for non-conservative management of these fractures. Further multicentric and prospective studies are warranted to confirm these findings. Full article

This article contributes the first corpus-based study of possession in Māori, the indigenous language of Aotearoa New Zealand. Like most Polynesian languages, Māori has a dual possessive system involving a choice between the so-called A and O categories. While Māori grammars describe these categories in terms of the inherent semantic relationship between the possessum and possessor, there have been no large-scale corpus analyses demonstrating their use in natural contexts. Social media provide invaluable opportunities for such linguistic studies, capturing contemporary language use while alleviating the burden of gathering data through traditional means. We operationalise semantic distinctions to investigate possession in Māori-language tweets, focusing on the [possessum a/o possessor] construction (e.g., te tīmatanga o te wiki ‘the beginning of the week’). In our corpus comprising 2500 tweets produced by more than 200 individuals, we find that users leverage a wide array of noun types encompassing many different semantic relationships. We observe not only the expected predominance of the O category, but also a tendency for examples described by Māori grammars as A-marked to instead be O-marked (59%). Although the A category persists in the corpus, our findings suggest that language change could be underway. Our primary dataset can be explored interactively online. Full article

The recent dominance of Adelphocoris suturalis Jakovlev as the primary cotton field pest in Bt-cotton-cultivated areas has generated significant interest in cotton pest control research. This study addresses the limited understanding of cotton defense mechanisms triggered by A. suturalis feeding. Utilizing LC-QTOF-MS, we analyzed cotton metabolomic changes induced by A. suturalis, and identified 496 differential positive ions (374 upregulated, 122 downregulated) across 11 categories, such as terpenoids, alkaloids, phenylpropanoids, flavonoids, isoflavones, etc. Subsequent iTRAQ-LC-MS/MS analysis of the cotton proteome revealed 1569 differential proteins enriched in 35 metabolic pathways. Integrated metabolome and proteome analysis highlighted significant upregulation of 17 (89%) proteases in the α-linolenic acid (ALA) metabolism pathway, concomitant with a significant increase in 14 (88%) associated metabolites. Conversely, 19 (73%) proteases in the fructose and mannose biosynthesis pathway were downregulated, with 7 (27%) upregulated proteases corresponding to the downregulation of 8 pathway-associated metabolites. Expression analysis of key regulators in the ALA pathway, including allene oxidase synthase (AOS), phospholipase A (PLA), allene oxidative cyclase (AOC), and 12-oxophytodienoate reductase3 (OPR3), demonstrated significant responses to A. suturalis feeding. Finally, this study pioneers the exploration of molecular mechanisms in the plant–insect relationship, thereby offering insights into potential novel control strategies against this cotton pest. Full article

This paper explores the diachrony of the Portuguese contrastive connective ao passo que (‘whereas’). First, we describe its syntactic and semantic properties in present-day European Portuguese. With this contemporary analysis in mind, we explore the semantic and syntactic changes from the PP ao passo que (lit. ‘at the step/pace that’) into first a temporal connective of simultaneity (‘at the same time as’) and, ultimately, a contrastive expression. The evolution of expressions with temporal meanings into contrastive ones has been documented in many languages. In our paper, we show that another related meaning, that of the gradual development of events that are temporally simultaneous, may also evolve into a contrastive meaning. We also examine the role of the syntax and semantics of the noun passo in this process. Furthermore, we discuss the internal analyzability of the connective and provide evidence for the retention of some internal syntax, which has implications for current theories on the nature of complex categories. Full article

Researchers have explored multiple Wi-Fi features to estimate user locations in indoor environments in the past decade, such as Received Signal Strength Indication (RSSI), Channel State Information (CSI), Time of Arrival (TOA), and Angle of Arrive (AoA). Fine Time Measurement (FTM) is a protocol standardized by IEEE 802.11-2016, which can estimate the distance between the initiator and the station using Wi-Fi Round-Trip Time (RTT). Promoted by Google, such a protocol has been explored in many mobile localization algorithms, which can provide meter-level positioning accuracy between Wi-Fi RTT-enabled smartphones and access points (APs). However, previous studies have shown that the Wi-Fi RTT measurements are sensitive to environmental changes, which leads to significant errors in the localization algorithms. Such an error usually varies according to different environments and settings. Therefore, this paper investigates the error in Wi-Fi RTT distance measurements by setting multiple experiments with different hardware, motion status, and signal path loss conditions. The experiment results show that four categories of errors are found in RTT distance measurements, including hardware-dependent bias, blocker-dependent bias, fluctuations, and outliers. Comparison and analysis are carried out to illustrate the impact of the different errors on Wi-Fi RTT distance. Full article

Previous studies have shown the efficacy of foot–ankle exercises in people with diabetic peripheral neuropathy (DPN), but the quality of evidence is still low. This proof-of-concept study pursues preliminary evidence for potential clinical and gait biomechanical benefits from an internet-based foot–ankle therapeutic exercise program for people with DPN. We randomized 30 individuals with DPN (IWGDF risk category 1 or 2) into either the control group (CG) receiving the usual care or the intervention group (IG) receiving the usual care plus an internet-based foot–ankle exercise program, fully guided by the Sistema de Orientação ao Pé Diabético (SOPeD; translation: Diabetic Foot Guidance System) three times per week for 12 weeks. We assessed face-to-face clinical and biomechanical outcomes at baseline, 12 weeks, and 24 weeks (follow up). Participants had good adherence to the proposed intervention and it led to only mild adverse events. The IG showed improvements in the ankle and first metatarsophalangeal joint motion after 12 and 24 weeks, changed forefoot load absorption during foot rollover during gait after 24 weeks, reduced foot pain after 12 weeks, and improved foot function after 24 weeks. A 12-week internet-based foot–ankle exercise program using the SOPeD software (version 1.0) has the potential to reduce foot pain, improve foot function, and modify some important foot–ankle kinematic outcomes in people with DPN. Full article

Site characterization of metropolitan areas, especially after an earthquake, is of paramount importance for interpretation of spatial damage distribution and taking measures that assure realistic design actions to strengthen existing constructions and create new ones. Such a case is the city of Durres, Albania, that was hit by the disastrous earthquake of 26 November 2019 (M6.4). Significant differences in structural damage were observed throughout the city, despite its uniform epicentral distance (approximately 15 km); this could be either due to varying vulnerability of the affected constructions and/or to spatial variation of strong ground motion in the city, resulting from local site effects; the latter factor was investigated in this study. This was achieved by taking single station ambient noise measurements throughout the city, at approximately 80 sites. Ambient noise measurements are favorable, as acquiring ambient noise data is an easy and effective noninvasive approach within urban environments. Measurements were processed using the widely applied Horizontal-to-Vertical Spectral Ratio (HVSR) method, following the SESAME project (2004) guidelines. Their fundamental and dominant frequencies, f_o and f_d, respectively, were calculated and related to the iso-depth contours of the investigated area, as well as their corresponding amplitudes, A_o, and A_d. These experimental parameters and the HVSR curves were used to group all examined sites into classes with similar properties. This clustering provided a zonation map with four categories consisting of similar shapes and amplitudes, applicable to the city of Durres. This map can be utilized as a first level zonation of local site effects for the city. In addition, dynamic properties of soil profiles in selected sites were investigated and tested using 1D synthetic ambient noise data, based on the Hisada (1994, 1995) simulation method, and compared to experimental HVSRs in proximity to the selected sites. A comparison of the proposed four categories zonation map to the observed damage of the 26 November 2019, mainshock is attempted and evaluated. The four categories zonation map with similar expected local site effects proposed in this study can be used as a first level seismic microzonation of Durres. Undoubtedly, corrections for 2D/3D effects on ground shaking must be applied to sites lying in the edges of the Durres basin. Full article

Both members of the aldo-keto reductases (AKRs) family, AKR1B1 and AKR1B10, are over-expressed in various type of cancer, making them potential targets for inflammation-mediated cancers such as colon, lung, breast, and prostate cancers. This is the first comprehensive study which focused on the identification of phenylcarbamoylazinane-1, 2,4-triazole amides (7a–o) as the inhibitors of aldo-keto reductases (AKR1B1, AKR1B10) via detailed computational analysis. Firstly, the stability and reactivity of compounds were determined by using the Guassian09 programme in which the density functional theory (DFT) calculations were performed by using the B3LYP/SVP level. Among all the derivatives, the 7d, 7e, 7f, 7h, 7j, 7k, and 7m were found chemically reactive. Then the binding interactions of the optimized compounds within the active pocket of the selected targets were carried out by using molecular docking software: AutoDock tools and Molecular operation environment (MOE) software, and during analysis, the Autodock (academic software) results were found to be reproducible, suggesting this software is best over the MOE (commercial software). The results were found in correlation with the DFT results, suggesting 7d as the best inhibitor of AKR1B1 with the energy value of −49.40 kJ/mol and 7f as the best inhibitor of AKR1B10 with the energy value of −52.84 kJ/mol. The other potent compounds also showed comparable binding energies. The best inhibitors of both targets were validated by the molecular dynamics simulation studies where the root mean square value of <2 along with the other physicochemical properties, hydrogen bond interactions, and binding energies were observed. Furthermore, the anticancer potential of the potent compounds was confirmed by cell viability (MTT) assay. The studied compounds fall into the category of drug-like properties and also supported by physicochemical and pharmacological ADMET properties. It can be suggested that the further synthesis of derivatives of 7d and 7f may lead to the potential drug-like molecules for the treatment of colon cancer associated with the aberrant expression of either AKR1B1 or AKR1B10 and other associated malignancies. Full article

With the launch of the Sentinel-1 satellites, it becomes easy to obtain long time-series dual-pol (i.e., VV and VH channels) SAR images over most areas of the world. By combining the information from both VV and VH channels, the polarimetric persistent scatterer interferometry (PolPSI) techniques is supposed to achieve better ground deformation monitoring results than conventional PSI techniques (using only VV channel) with Sentinel-1 data. According to the quality metric used for polarimetric optimizations, the most commonly used PolPSI techniques can be categorized into three main categories. They are PolPSI-ADI (amplitude dispersion index as the phase quality metric), PolPSI-COH (coherence as the phase quality metric), and PolPSI-AOS (taking adaptive optimization strategies). Different categories of PolPSI techniques are suitable for different study areas and with different performances. However, the study that simultaneously applies all the three types of PolPSI techniques on Sentinel-1 PolSAR images is rare. Moreover, there has been little discussion about different characteristics of the three types of PolPSI techniques and how to use them with Sentinel-1 data. To this end, in this study, three data sets in China have been used to evaluate the three types of PolPSI techniques’ performances. Based on results obtained, the different characteristics of PolPSI techniques have been discussed. The results show that all three PolPSI techniques can improve the phase quality of interferograms. Thus, more qualified pixels can be used for ground deformation estimation by PolPSI methods with respect to the PSI technique. Specifically, this pixel density improvement is 50%, 12%, and 348% for the PolPSI-ADI, PolPSI-COH, and POlPSI-AOS, respectively. PolPSI-ADI is the most efficient method, and it is the first choice for the area with abundant deterministic scatterers (e.g., urban areas). Benefitting from its adaptive optimization strategy, PolPSI-AOS has the best performances at the price of highest computation cost, which is suitable for rural area applications. On the other hand, limited by the medium resolution of Sentinel-1 PolSAR images, PolPSI-COH’s improvement with respect to conventional PSI is relatively insignificant. Full article

Clinical pathways (CPs) are multidisciplinary clinical governance tools necessary for the care management of the patients, whose aim is to outline the best practicable path within a health organization related to an illness or to a complex clinical situation. The COVID-19 pandemic emergency has created the need for an organizational renewal of care pathways based on the principles of “primary health care” recommended by the WHO. In Italy, the Hospitals and Local Health Authorities (ASL) have tried to guarantee the continuity of non-deferrable treatments and the maximum safety of both patients and health professionals. This study analyzes the organizational and managerial responses adopted in pathology-specific care pathways to assess how CPs as diagnostic tools responded to the COVID-19 pandemic in the first two waves. Twenty-four referents of Operational Units (UU OO) from Hospitals (AO) and Local Health Authorities (ASL) of the Lazio Region (Central Italy) that apply four different CPs responded to a survey, which analyzes the managerial and organizational responses of CPs in regard to different contexts. Results show that the structural and organizational adjustments of the CPs have made it possible to maintain an adequate level of care for specific treatment processes, with some common critical aspects that require improvement actions. The adjustments found could be useful for dealing with new outbreaks and/or new epidemics in order to try to mitigate the potential negative impact, especially on the most vulnerable patient categories. Full article

Several pesticides and pharmaceuticals (PP) have been detected in the effluent of a full-scale Portuguese Wastewater Treatment Plant (WWTP). Their presence contributed to the environmental burdens associated with the existing treatment of the Municipal Wastewater (MWW) in the impact categories of Human Carcinogenicity, Non-Carcinogenicity, and Freshwater toxicities on average by 85%, 60%, and 90%, respectively (ReciPe2016 and USEtox methods). The environmental and economic assessment of the installation of an Anodic Oxidation (AO) unit for PPs’ removal was performed through Life Cycle and Economic Analysis, considering two types of anodes, the Boron-Doped Diamond (BDD) and the Mixed Metal Oxides (MMO). The operation of the AO unit increased the environmental burdens of the system by 95% on average (USEtox), but these impacts can be partially compensated by the avoided the production of non-renewable energy in the Portuguese electricity mix by biogas cogeneration at the WWTP. If the construction of the AO unit and the manufacturing of the electrodes are considered, the Human and Freshwater Toxicities are often higher than the environmental benefits derived from the PPs’ removal. On the economic side, the MMO configuration is clearly more advantageous, whereas BDD is environmentally more favorable. The issue of the presence of PP in MWW effluents has to be addressed as an integrated solution both improving upstream PP’s management and adopting PP’s removal technologies strongly supported by renewable energies. Further insights are needed for the assessment of fate and of the environmental effects of PP in the sludge. Full article

Background: Methicillin-resistant Staphylococcus aureus (MRSA) has emerged as a major threat to public health. This study investigated the occurrence of MRSA in humans, chickens, chicken meat and environmental samples within poultry farms and live bird markets in southwestern Nigeria. Methods: MRSA were isolated using selective culture and tested for antimicrobial susceptibility by broth microdilution. Selected isolates were characterized by whole genome sequencing (WGS). From WGS data, spa, dru, multilocus sequence typing (MLST) and SCCmec types, but also virulence and antimicrobial resistance genes, were identified. Results: Fifty-six MRSA isolates were detected in 734 samples. They showed resistance to β-lactams (100%), tetracycline (60.7%), ciprofloxacin (33.9%), erythromycin (28.6%), gentamicin (32.1%), and trimethoprim/sulfamethoxazole (10.7%). All 30 isolates investigated by WGS carried mecA, dfrG, and tet(38) genes. Other resistance genes detected were blaZ (83.3%), fosB (73.3%), tet(K) (60.0%), aacA-aphD (36.6%), aphA3 (33.3%), msr(A) (30.0%), mph(C) (30.0%), dfrS1 (3.3%), and sat4 (3.3%). Seven spa types (t091, t314, t657, t1476, t2331, t4690 and t12236), four known (dt9aw, dt10ao, dt10cj, and dt11a) and two novel (dt10dr and dt11dw) dru types, as well as five sequence types (ST8, ST121, ST152, ST772 and ST789) were found among the MRSA isolates. All ST121 isolates carried an SCCmec type IV cassette and were not dru-typeable. ST152 and ST121 were found only in specific sample categories within defined locations, while ST8 and ST772 were distributed across most sample categories and locations. Three SCCmec types, IVa, V and Vc, were identified. All MRSA isolates possessed virulence genes including aur, clpP, coa, fnbA, esaA, hly, hla, ica, isdA, srtB, sspA, and vWbp, among others. The toxic shock syndrome toxin gene (tst) was not detected in any isolate, whereas the Pantone–Valentine leukocidin genes lukF-PV/lukS-PV were present in all ST121, all ST772, and all but one ST152 isolates. Conclusion: The results of this study (i) showed that chicken meat is contaminated by MRSA and (ii) suggested that live bird markets may serve as focal points for the dissemination of MRSA within the community. Full article