bluuebunny/crossref_metadata_2025 huggingface dataset:
Biodiversity in and around Greenhouses: Benefits and Potential Risks for Pest Management
Authors: Messelink Gerben J. , Lambion Jérôme , Janssen Arne , van Rijn Paul C. J.
Published: October 2021

One of the ecosystem services of biodiversity is the contribution to pest control through conservation and stimulation of natural enemies. However, whether plant diversity around greenhouses is beneficial or a potential risk is heavily debated. In this review, we argue that most greenhouse pests in temperate climates are of exotic origin and infest greenhouses mainly through transportation of plant material. For indigenous pests, we discuss the potential ways in which plant diversity around greenhouses can facilitate or prevent pest migrations into greenhouses. As shown in several studies, an important benefit of increased plant diversity around greenhouses is the stimulation of indigenous natural enemies that migrate to greenhouses, where they suppress both indigenous and exotic pests. How this influx can be supported by specific plant communities, plant characteristics, and habitats while minimising risks of increasing greenhouse pest densities, virus transmission, or hyperparasitism needs further studies. It also requires a better understanding of the underlying processes that link biodiversity with pest management. Inside greenhouses, plant biodiversity can also support biological control. We summarise general methods that growers can use to enhance pest control with functional biodiversity and suggest that it is particularly important to study how biodiversity inside and outside greenhouses can be linked to enhancement of biological pest control with both released and naturally occurring species of natural enemies.
Radio Wave Attenuation Measurement System Based on RSSI for Precision Agriculture: Application to Tomato Greenhouses
Authors: Cama-Pinto Dora , Holgado-Terriza Juan Antonio , Damas-Hermoso Miguel , Gómez-Mula Francisco , Cama-Pinto Alejandro
Published: October 2021

Precision agriculture and smart farming are concepts that are acquiring an important boom due to their relationship with the Internet of Things (IoT), especially in the search for new mechanisms and procedures that allow for sustainable and efficient agriculture to meet future demand from an increasing population. Both concepts require the deployment of sensor networks that monitor agricultural variables for the integration of spatial and temporal agricultural data. This paper presents a system that has been developed to measure the attenuation of radio waves in the 2.4 GHz free band (ISM- Industrial, Scientific and Medical) when propagating inside a tomato greenhouse based on the received signal strength indicator (RSSI), and a procedure for using the system to measure RSSI at different distances and heights. The system is based on Zolertia Re-Mote nodes with the Contiki operating system and a Raspberry Pi to record the data obtained. The receiver node records the RSSI at different locations in the greenhouse with the transmitter node and at different heights. In addition, a study of the radio wave attenuation was measured in a tomato greenhouse, and we publish the corresponding obtained dataset in order to share with the research community.
Real-Life Impact of Glucocorticoid Treatment in COVID-19 Mortality: A Multicenter Retrospective Study
Authors: Muñoz-Gómez Ana , Fernández-Cruz Ana , Lavilla-Olleros Cristina , Giner-Galvañ Vicente , Ausín-García Cristina , Wikman Philip , Bendala-Estrada Alejandro D. , Vargas Juan A. , Rubio-Rivas Manuel , Laureiro Jaime , Fernández-Bermúdez Daniel , Buonaiuto Verónica A. , Arenas de Larriva Antonio P. , Pascual-Pérez María de los Reyes , Alcalá-Pedrajas José N. , Labirua-Iturburu Ruiz Ane , Hernández-Milián Almudena , Gómez del Mazo Marta , Antequera Beatriz , Mella-Pérez Carmen , Navas-Alcántara María de la Sierra , Soto-Delgado Juan F. , Gámez-Mancera Rosa M. , Sardiña-González Cristina , Meijide-Míguez Héctor , Ramos-Rincón José M. , Gómez-Huelgas Ricardo ,   on behalf of the SEMI-COVID-19 Network
Published: October 2021

We aimed to determine the impact of steroid use in COVID-19 in-hospital mortality, in a retrospective cohort study of the SEMICOVID19 database of admitted patients with SARS-CoV-2 laboratory-confirmed pneumonia from 131 Spanish hospitals. Patients treated with corticosteroids were compared to patients not treated with corticosteroids; and adjusted using a propensity-score for steroid treatment. From March–July 2020, 5.262 (35.26%) were treated with corticosteroids and 9.659 (64.73%) were not. In-hospital mortality overall was 20.50%; it was higher in patients treated with corticosteroids than in controls (28.5% versus 16.2%, OR 2.068 [95% confidence interval; 1.908 to 2.242]; p = 0.0001); however, when adjusting by occurrence of ARDS, mortality was significantly lower in the steroid group (43.4% versus 57.6%; OR 0.564 [95% confidence interval; 0.503 to 0.633]; p = 0.0001). Moreover, the greater the respiratory failure, the greater the impact on mortality of the steroid treatment. When adjusting these results including the propensity score as a covariate, in-hospital mortality remained significantly lower in the steroid group (OR 0.774 [0.660 to 0.907], p = 0.002). Steroid treatment reduced mortality by 24% relative to no steroid treatment (RRR 0.24). These results support the use of glucocorticoids in COVID-19 in this subgroup of patients.
Adequacy of Anesthesia and Pupillometry for Endoscopic Sinus Surgery
Authors: Stasiowski Michał Jan , Szumera Izabela , Wardas Piotr , Król Seweryn , Żak Jakub , Missir Anna , Pluta Aleksandra , Niewiadomska Ewa , Krawczyk Lech , Jałowiecki Przemysław , Grabarek Beniamin Oskar
Published: October 2021

Inadequate intraoperative analgesia causes the deterioration of the condition of the surgical field (CSF) as a result of hemodynamic instability. Analgesia monitors are used to guide remifentanil) infusion to optimize intraoperative analgesia. The main aim of the current randomized controlled trial was to investigate the potential advantages of intraoperative analgesia monitoring using surgical Pleth index (SPI)- or pupillometry (PRD)-guided remifentanil administration for managing the volume of total intraoperative blood loss (TEIBL), CSF, and length of operation (LOP) in comparison with the standard practice in patients undergoing endoscopic sinus surgery (ESS). The 89 patients in our study were grouped as follows: 30 patients were assigned to the general analgesia (GA) group, 31 patients were assigned to the SPI group, and 28 patients were assigned to the PRD group. The speed of remifentanil infusion was accelerated by 50% when SPI, PRD, or BSS were increased by >15 points, >5%, or >2, respectively, in adjacent groups until their normalization. The SPI group showed significantly lower TEIBL in comparison to the GA group (165.2 ± 100.2 vs. 283.3 ± 193.5 mL; p < 0.05) and a higher mean arterial pressure (MAP; 73.9 ± 8 vs. 69.2 ± 6.8 mmHg; p < 0.05). In the PRD group, a shorter LOP compared with the GA group was observed (63.1 ± 26.7 min vs. 82.6 ± 33.1 min; p < 0.05). It was noted that the PRD group had a lower total remifentanil consumption than the SPI group (1.3 ± 1.4 vs. 1.8 ± 0.9 mg; p < 0.05). In ASA I-III patients undergoing ESS, intraoperative monitoring based on state entropy and SPI values can optimize the CSF and reduce TEIBL, whereas monitoring based on state entropy and PRD measurements can optimize the cost effectiveness of anesthetic drugs and the use of the operation room.
Cardiac Arrest Occurring in High-Rise Buildings: A Scoping Review
Authors: Han Ming Xuan , Yeo Amelia Natasha Wen Ting , Ong Marcus Eng Hock , Smith Karen , Lim Yu Liang , Lin Norman Huangyu , Tan Bobo , Arulanandam Shalini , Ho Andrew Fu Wah , Ng Qin Xiang
Published: October 2021

Out-of-hospital cardiac arrests (OHCAs) occurring in high-rise buildings are a challenge to Emergency Medical Services (EMS). Contemporary EMS guidelines lack specific recommendations for systems and practitioners regarding the approach to these patients. This scoping review aimed to map the body of literature pertaining to OHCAs in high-rise settings in order to clarify concepts and understanding and to identify knowledge gaps. Databases were searched from inception through to 6 May 2021 including OVID Medline, PubMed, Embase, CINAHL, and Scopus. Twenty-three articles were reviewed, comprising 8 manikin trials, 14 observational studies, and 1 mathematical modelling study. High-rise settings commonly have lower availability of bystanders and automatic external defibrillators (AEDs), while height constraints often lead to delays in EMS interventions and suboptimal cardiopulmonary resuscitation (CPR), scene access, and extrication. Four studies found return of spontaneous circulation (ROSC) rates to be significantly poorer, while seven studies found rates of survival-to-hospital discharge (n = 3) and neurologically favourable survival (n = 4) to be significantly lower in multistorey settings. Mechanical chest compression devices, transfer sheets, and strategic defibrillator placement were suggested as approaches to high-rise OHCA management. A shift to maximising on-scene treatment time, along with bundling novel prehospital interventions, could ameliorate some of these difficulties and improve clinical outcomes for patients.
Good to Excellent Functional Outcome and High Return to Sports Rate after Operative Treatment of Unstable Lateral Clavicle Fractures: Comparison of Two Coracoclavicular Button Fixation Techniques
Authors: Wurm Markus , Zyskowski Michael , Pesch Sebastian , Biberthaler Peter , Kirchhoff Chlodwig , Beirer Marc
Published: October 2021

Purpose: Operative therapy for unstable lateral clavicle fractures is necessary to reduce the risk of bony non-union. Irritation and restriction during sportive activities due to the implanted materials are a common reason for impaired function and implant removal. The aim of this study was to gain information on functional outcome and time until return to sport (RTS) after surgical treatment of unstable lateral clavicle fractures, comparing two coracoclavicular button techniques. Methods: A retrospective chart review of patients who were consecutively treated for unstable lateral clavicle fractures at our level one trauma center from 2014 to 2018 was conducted. Two different surgical techniques were evaluated and compared. Group 1 was treated using a locking compression plate and knotted DogBone™ Button, while group 2 received an LCP and knotless DogBone™ Button. Functional outcome (ASES (American Shoulder and Elbow Score), Constant-Score, DASH (Disability of Arm, Shoulder and Hand), MSQ (Munich Shoulder Questionnaire) and SPADI (Shoulder Pain and Disability Index) and time until RTS were investigated and compared between both groups, 1 year postoperatively. Results: A total of 56 patients (n = 35 group 1, n = 21 group 2) with a mean age of 45.1 ± 14.6 years met the inclusion criteria. Functional outcome reached good to excellent results (ASES 94.7 ± 9.8, Constant Score 85.1 ± 8.1, DASH 5.5 ± 8.4, MSQ 90.9 ± 7.2, SPADI 96.1 ± 5.7). Implant removal rates were higher in group 1 (48.3% vs. 35.3%) yet without statistical significance (p = 0.122). All patients returned to sports postoperatively with a mean time period until return to sport of 4.6 (3–9) months. Conclusion: Locking compression plating and coracoclavicular fixation using a knotless Dogbone™ technique provides good to excellent functional outcomes, a high and fast rate of return to sport and lower irritation rates compared to the knotted DogBone™ technique.
Aging with Down Syndrome—Where Are We Now and Where Are We Going?
Authors: Alldred Melissa J. , Martini Alessandra C. , Patterson David , Hendrix James , Granholm Ann-Charlotte
Published: October 2021

Down syndrome (DS) is a form of accelerated aging, and people with DS are highly prone to aging-related conditions that include vascular and neurological disorders. Due to the overexpression of several genes on Chromosome 21, for example genes encoding amyloid precursor protein (APP), superoxide dismutase (SOD), and some of the interferon receptors, those with DS exhibit significant accumulation of amyloid, phospho-tau, oxidative stress, neuronal loss, and neuroinflammation in the brain as they age. In this review, we will summarize the major strides in this research field that have been made in the last few decades, as well as discuss where we are now, and which research areas are considered essential for the field in the future. We examine the scientific history of DS bridging these milestones in research to current efforts in the field. We extrapolate on comorbidities associated with this phenotype and highlight clinical networks in the USA and Europe pursuing clinical research, concluding with funding efforts and recent recommendations to the NIH regarding DS research.
Gender Differences among Sardinians with Alcohol Use Disorder
Authors: Agabio Roberta , Pisanu Claudia , Minerba Luigi , Gessa Gian Luigi , Franconi Flavia
Published: October 2021

Sardinia is an Italian island in the Mediterranean characterized by secular isolation and the singular genetic characteristics of its inhabitants. Findings obtained in populations with diverse genetic make-up and cultural background indicate gender differences and/or similarities in drinking characteristics of patients with alcohol use disorder (AUD). Knowledge of these characteristics in AUD patients is useful to improve access to treatments. This paper investigated the drinking characteristics of 66 female and 282 male outpatients with AUD, born from 1937 to 1991, living in Sardinia, and compared their characteristics with those of AUD patients living in other countries. Most Sardinian patients were men, approximately 3 years younger than women; women consumed lower amounts of alcohol than men but did not differ from men in the severity of AUD. Men were more often single than women, while a higher proportion of women reported that their mother or spouse was affected by AUD. Anxiety and depression were more prevalent among women while a higher proportion of men were affected by substance use disorders. Women were older than men at the age of first drink, regular drinking, and onset of AUD, and progressed faster than men from regular use to AUD onset. Women did not differ from men in age at first request for care, and in the lapse from AUD onset to first request for care. Women and men waited for more than 8 and 9 years, respectively, before receiving medical treatment. Gender differences progressively decreased among younger patients. Although the scarce number of women in some cohorts limits the strength of these findings, drinking characteristics of Sardinian patients did not vary significantly from those of AUD patients living in other countries. These results suggest that the number of Sardinian women with AUD is increasing and services for treatment of AUD should (a) consider women’s specific needs, and (b) realize effective policies to reduce latency prior to accessing medical treatment for both men and women with AUD.
Effect of Endoscopic Sinus Surgery on Eustachian Tube Function in Adult Sinusitis Patients: A Prospective Case-Control Study
Authors: Choi Kyu Young , Jang Sookyung , Seo Ganghyeon , Park Su-Kyoung
Published: October 2021

The eustachian tube (E-tube) function is known to be related with sinusitis; however, the effect of endoscopic sinus surgery (ESS) on E-tube function is not clearly documented. This study aimed to prospectively evaluate the function of the E-tube by using both subjective and objective tests in adult chronic sinusitis patients undergoing ESS, and to compare with those of the patients without sinusitis. Thirty adult patients who underwent ESS for treatment of chronic sinusitis and another thirty patients without sinusitis who underwent other nasal surgeries (septoplasty, rhinoplasty, or closed reduction) were evaluated and compared for E-tube function before and after three months of their surgeries. The E-tube function tests included the seven-item eustachian tube dysfunction questionnaire (ETDQ-7), Valsalva test, and inflation-deflation test that were compared preoperatively and postoperatively in both groups. Compared with the group without sinusitis, the ESS group showed significant improvement of E-tube function after surgery in the ETDQ-7 (p = 0.002), right Valsalva test (p = 0.015), right deflation test (p = 0.005), and left deflation test (p = 0.006). A binary logistic regression analysis revealed that ESS significantly improved E-tube function in the right Valsalva test in a univariate (p = 0.021) and multivariate analysis (p = 0.008), and E-tube function in the left deflation test in a univariate (p = 0.021) and multivariate analysis (p = 0.039). These findings indicate that E-tube function is significantly improved after ESS in adult sinusitis patients, and that the presence of sinusitis and implementation of ESS should be considered (if sinusitis is present) in managing patients with ear diseases that are affected by E-tube function.
A Review of the Impact of Alterations in Gut Microbiome on the Immunopathogenesis of Ocular Diseases
Authors: Bu Yashan , Chan Yau-Kei , Wong Ho-Lam , Poon Stephanie Hiu-Ling , Lo Amy Cheuk-Yin , Shih Kendrick Co , Tong Louis
Published: October 2021

Recent studies have highlighted the association between ocular diseases and microbiota profiles of the host intestinal tract and oral cavity. There is mounting evidence supporting the existence of a ‘gut–eye axis’, whereby changes in gut microbiome alter host immunity, with consequential implications for ocular health and disease. In this review, we examined recent published findings on the association between gut microbiome and ocular morbidity, based on 25 original articles published between 2011 to 2020. The review included both clinical and in vivo animal studies, with particular focus on the influence of the microbiome on host immunity and metabolism. Significant associations between altered intestinal microbiome and specific ocular diseases and pathological processes, including Behçet’s syndrome, autoimmune uveitis, age-related macular degeneration, choroidal neovascularization, bacterial keratitis, and Sjögren-like lacrimal keratoconjunctivitis have been demonstrated. Furthermore, alterations in the gut microbiome resulted in quantifiable changes in the host immune response, suggesting immunopathogenesis as the basis for the link between intestinal dysbiosis and ocular disease. We also examined and compared different techniques used in the identification and quantification of gut microorganisms. With our enhanced understanding of the potential role of gut commensals in ophthalmic disease, the stage is set for further studies on the underlying mechanisms linking the gut microbiome, the host immune response, and the pathogenesis of ophthalmic disease.
Long-Term Efficacy and Impact on Mortality of Remote Magnetic Navigation Guided Catheter Ablation of Ventricular Arrhythmias
Authors: Guckel Denise , Niemann Sarah , Ditzhaus Marc , Molatta Stephan , Bergau Leonard , Fink Thomas , Sciacca Vanessa , El Hamriti Mustapha , Imnadze Guram , Steinhauer Philipp , Braun Martin , Khalaph Moneeb , Nölker Georg , Sommer Philipp , Sohns Christian
Published: October 2021

Remote magnetic navigation (RMN) facilitates ventricular arrhythmia (VA) ablation. This study aimed to evaluate the long-term efficacy of RMN-guided ablation for ventricular tachycardia (VT) and premature ventricular contractions (PVC). A total of 176 consecutive patients (mean age 53.23 ± 17.55 years, 37% female) underwent VA ablation for PVC (132 patients, 75%) or VT (44 patients, 25%). The cohort consisted of 119 patients (68%) with idiopathic VA, 31 (18%) with ischemic (ICM), and 26 (15%) with dilated cardiomyopathy (DCM). VA recurrence was observed in 69 patients (39%, mean age 51.71 ± 19.91 years, 23% female) during a follow-up period of 5.48 years (first quartile 770.50 days, second quartile 1101.50 days, third quartile 1615.50 days). Left ventricular ejection fraction <40% lead to a significantly increased risk for VA (p = 0.031*). Multivariate analyses found DCM to be an independent predictor (IP) for VA recurrence (p < 0.001*, hazard ratio (HR) 3.74, confidence interval (CI) 1.58–8.88). ICM resulted in a lower increase in VA recurrence (p = 0.221, HR 1.49, CI 0.79–2.81). Class I/III/IV antiarrhythmic drug therapy (AADs) was also identified as IP for recurrence (p = 0.030*, HR 2.48, CI 1.11–5.68). A total of 16 patients (9%) died within the observational period. RMN-guided ablation of VA lead to acceptable long-term results. An impaired LV function, DCM, and AADs were associated with a significant risk for VA recurrence. Personalized paths are needed to improve efficacy and outcome.
Effect of Physical Therapy Modalities on Quality of Life of Head and Neck Cancer Survivors: A Systematic Review with Meta-Analysis
Authors: Burgos-Mansilla Barbara , Galiano-Castillo Noelia , Lozano-Lozano Mario , Fernández-Lao Carolina , Lopez-Garzon Maria , Arroyo-Morales Manuel
Published: October 2021

The objective was to describe the effectiveness of different physical therapy modalities to improve Quality of Life (QoL) in Head and Neck Cancer (HNC) survivors. PubMed, Scopus, Web of Science, CINAHL and Cochrane Library were searched for randomized clinical controlled trials published until 30 April 2020. Risk of bias assessment and meta-analysis were conducted using the Cochrane tools. A total of 251 records were retrieved, and 10 met the inclusion criteria. Interventions whose parameters focus on a 12-week exercise programs of aerobic activity (walking) or Progressive Resistance Training (PRT) for the whole body are effective and safe modalities improving QoL in HNC survivors. Electrophysical agents did not show significant results between groups. As for the assessment of methodological quality, 4 of the 10 articles included had a high risk of overall bias. Only five articles provided sufficient information to conduct a meta-analysis for exercise program intervention on QoL, showing a tendency in favor of intervention group, even when the global results did not show statistically significant improvements (pooled Cohen’s d 0.11; 95% CI: −0.27 to 0.50; I2 42.68%; p heterogeneity = 0.12). The present review and meta-analysis identified meaningful benefits of exercise on QoL of HNC survivors; this has been confirmed in a meta-analysis. This review adds evidence supporting exercise interventions on Head and Neck Cancer population whose opportunities for successful recovery after medical treatment are more limited.
Hyaluronic Acid/Trehalose Ophthalmic Solution in Reducing Post-Cataract Surgery Dry Eye Signs and Symptoms: A Prospective, Interventional, Randomized, Open-Label Study
Authors: Mencucci Rita , Favuzza Eleonora , Decandia Giulia , Cennamo Michela , Giansanti Fabrizio
Published: October 2021

The purpose of this prospective study was to evaluate the efficacy of the perioperative use of a hyaluronic acid (HA) and trehalose ophthalmic solution (Thealoz® Duo) in reducing post-cataract surgery dry eye signs and symptoms in patients with mild/moderate dry eye disease (DED). One hundred and twenty patients, scheduled for unilateral cataract surgery, were randomized into three groups: (1) group A: HA/trehalose three times/day in the preoperative week and for 5 postoperative weeks; (2) group B: HA/trehalose for only 5 postoperative weeks; (3) group C: no artificial tears. In groups A and B, OSDI (Ocular Surface Disease Index) questionnaire scores were significantly lower than group C at all the postoperative visits; in group A they were significantly lower than group B on the day of surgery, with similar results in the first and fifth weeks after surgery. In groups A and B, break-up time (BUT) was significantly higher than group C during the postoperative period (p ≤ 0.001). In comparison to the preoperative values, BUT in group A remained stable 7 days after surgery; however, in groups B and C, it significantly decreased. In conclusion, the HA/trehalose ophthalmic solution effectively reduced post-cataract surgery DED signs and symptoms in patients with mild/moderate DED, particularly if also administered in the preoperative period.
Do Age and Sex Play a Role in the Intraocular Pressure Changes after Acrobatic Gymnastics?
Authors: Gene-Morales Javier , Gené-Sampedro Andrés , Martín-Portugués Alba , Bueno-Gimeno Inmaculada
Published: October 2021

To evaluate the effects of an acrobatic gymnastics (AG) training session on intraocular pressure (IOP), a familiarization session was employed to confirm the participant’s suitability for the study. Forty-nine gymnasts (63.27% females, 18–40 years old) voluntarily agreed to participate. As age, sex, baseline IOP, and central corneal thickness (CCT) were considered as potential predictors of the IOP variations, in the second session measurements of the above parameters were taken before and after 90 min of AG. A mixed-factorial analysis of variance evaluated differences. Linear regression was conducted to potentially predict the IOP variation with the exercise. After the scheduled exercise, highly significant (p < 0.001, effect size: 0.73) reductions in IOP, but no significant changes in CCT (p = 0.229), were observed. IOP was significantly modified in males, older than 25 years, and subjects with baseline IOP > 14 mmHg (p ≤ 0.001, effect sizes: 0.57–1.02). In contrast, the IOP of females, younger participants, and subjects with baseline IOP ≤ 14 mmHg was not significantly modified (p = 0.114). With the regression analyses, we concluded that both sex and baseline IOP levels were significant predictors of the IOP fluctuation with AG. These findings could be of interest for gymnasts, coaches, ophthalmologists, and/or optometrists in the prevention and control of risk factors associated with glaucoma.
Fecal Levels of Lactic, Succinic and Short-Chain Fatty Acids in Patients with Ulcerative Colitis and Crohn Disease: A Pilot Study
Authors: Kaczmarczyk Olga , Dąbek-Drobny Agnieszka , Woźniakiewicz Michał , Paśko Paweł , Dobrowolska-Iwanek Justyna , Woźniakiewicz Aneta , Piątek-Guziewicz Agnieszka , Zagrodzki Paweł , Mach Tomasz , Zwolińska-Wcisło Małgorzata
Published: October 2021

Intestinal dysbiosis plays a crucial role in the development of inflammatory bowel disease (IBD), including Crohn’s disease (CD) and ulcerative colitis (UC). The importance of bacterial metabolites, such as short-chain fatty acids (SCFAs), succinic and lactic acids, as well as environmental factors that affect their production in the course of IBD, remains unclear. The aim of this study was to evaluate a profile of organic acids in the stool of CD and UC patients with different disease activity. We assessed a correlation between used medications, patient’s diet, and SCFA levels. A total of 35 adult patients were included in the study. We did not observe significant differences in the levels of organic acids between the CD and UC groups, irrespective of disease activity, and a control group. However, propionic acid levels were higher in IBD patients who received trimebutine vs. those who did not (p = 0.031). Higher isobutyric acid levels were observed in patients treated with biological drugs compared with those without such treatment (p = 0.014). No significant correlations were found between organic acid levels and the frequency of dietary fiber consumption. Our results reveal a new link between medication use and organic acid levels in patients with IBD.
Assessment of MRI-Linac Economics under the RO-APM
Authors: Palm Russell F. , Eicher Kurt G. , Sim Austin J. , Peneguy Susan , Rosenberg Stephen A. , Wasserman Stuart , Johnstone Peter A. S.
Published: October 2021

The implementation of the radiation oncology alternative payment model (RO-APM) has raised concerns regarding the development of MRI-guided adaptive radiotherapy (MRgART). We sought to compare technical fee reimbursement under Fee-For-Service (FFS) to the proposed RO-APM for a typical MRI-Linac (MRL) patient load and distribution of 200 patients. In an exploratory aim, a modifier was added to the RO-APM (mRO-APM) to account for the resources necessary to provide this care. Traditional Medicare FFS reimbursement rates were compared to the diagnosis-based reimbursement in the RO-APM. Reimbursement for all selected diagnoses were lower in the RO-APM compared to FFS, with the largest differences in the adaptive treatments for lung cancer (−89%) and pancreatic cancer (−83%). The total annual reimbursement discrepancy amounted to −78%. Without implementation of adaptive replanning there was no difference in reimbursement in breast, colorectal and prostate cancer between RO-APM and mRO-APM. Accommodating online adaptive treatments in the mRO-APM would result in a reimbursement difference from the FFS model of −47% for lung cancer and −46% for pancreatic cancer, mitigating the overall annual reimbursement difference to −54%. Even with adjustment, the implementation of MRgART as a new treatment strategy is susceptible under the RO-APM.
Coronary Artery Disease in Patients Older than 35 and Eligible for Cardiovascular Secondary Prevention: An Italian Retrospective Observational Analysis of Healthcare Administrative Databases
Authors: Calabria Silvia , Ronconi Giulia , Dondi Letizia , Piccinni Carlo , Cinconze Enrico , Pedrini Antonella , Esposito Immacolata , Addesi Alice , Martini Nello , Maggioni Aldo Pietro
Published: October 2021

Background: This study describes patients with coronary artery disease (CAD) who are eligible for secondary prevention and assesses their healthcare consumption and costs from the perspective of the Italian National Health Service (INHS). Methods: From the Fondazione Ricerca e Salute’s database, which collects Italian healthcare administrative data, all patients aged ≥ 35, with ≥1 primary in-hospital CAD diagnosis and/or procedure on the coronary arteries, or with the specific disease exemption code, and who are suitable for long-term secondary prevention treatments, were identified in 2018 and analyzed. Demographics, comorbidities, one-year supplied drugs, hospitalizations, and costs were analyzed. Results: From >3 million inhabitants aged ≥ 35, 46,063 (1.3%) were identified (72.1% males, mean age 70 ± 12; approximately 50% with ≥3 comorbidities). During a one-year follow-up, 96.4% were treated with ≥1 drug for secondary prevention (mainly antiplatelets and lipid lowering agents), 69.4% with ≥1 concomitant cardiovascular drug, and 95.8% with ≥1 concomitant non-cardiovascular therapy. Within one year, 30.6% of patients were hospitalized at least once, mostly due to non-cardiovascular events. Calculated by mean, the INHS paid EUR 6078 per patient. Conclusions: This analysis confirms the relevant burden of CAD for patients with many comorbidities and who are frequently hospitalized, and the burden on the INHS. A multidisciplinary healthcare approach is encouraged to improve patients’ outcomes and reduce costs for the INHS.
Sleep Disturbances and Phenoconversion in Patients with REM Sleep Behavior Disorder
Authors: Jo Hyunjin , Kim Dongyeop , Song Jooyeon , Choi Sujung , Joo Eunyeon
Published: October 2021

Objective: We aimed to investigate relationships between sleep disturbances and phenoconversion to neurodegenerative diseases in patients with REM sleep behavior disorder (RBD). Method: Using a comprehensive sleep database in a university-affiliated hospital between December 2014 and March 2021, we reviewed the data of 226 patients with RBD (182 patients with idiopathic RBD (iRBD) and 44 patients with symptomatic RBD (sRBD) with a neurodegenerative disease). Results: Among 226 patients with RBD (male, 61.5%), the mean age at RBD onset and mean disease duration were 59.4 ± 10.5 and 5.9 ± 5.6 years, respectively. Further, 111 (49.1%) patients had periodic limb movements during sleep (PLMS, PLM index ≥ 15/h), while 110 patients (48.7%) had comorbid obstructive sleep apnea (OSA, respiratory disturbance index ≥ 15/h). There was a positive correlation between age at RBD onset and the apnea-hypopnea index and Pittsburgh Sleep Quality Index. Compared to patients with iRBD, patients with sRBD showed a lower N3 sleep (3.3 ± 5.0 vs. 1.6 ± 3.1%, p = 0.004) and higher periodic limb movement index (36.3 ± 31.8 vs. 56.9 ± 47.5/h, p = 0.021) at the baseline. Among the 186 patients with iRBD, 18 (8.0%) developed neurodegenerative diseases (converters, mean follow-up duration: 2.5 ± 1.6 years) and 164 did not (non-converters, mean follow-up 2.4 ± 2.2 years). There was no significant between-group difference in the demographics and baseline clinical features. Continuous positive airway pressure (CPAP) therapy was prescribed in 101 patients with OSA; among them, 71 (70%) patients agreed to use it. CPAP improved dream enactment behaviors. Conclusion: In our study, 8.0% of patients with iRBD showed phenoconversion within a mean follow-up duration of 2.5 years. Polysomnographic parameters could not predict phenoconversion to neurodegenerative disease. However, approximately half of the patients with RBD presented with significant sleep disorders, including OSA or PLMS. CPAP therapy may alleviate RBD symptoms in patients with RBD-OSA.
First Census of Patients with Hereditary Angioedema in the Canary Islands
Authors: Mendoza-Alvarez Alejandro , Marcelino-Rodriguez Itahisa , Almeida-Quintana Lourdes , Martin-Fernandez Elena , Martinez-Beltran Dara , Almeida-Sanchez Zulay , Cruz-Niesvara David , Hernández-Santana Guacimara , Garcia-Robaina Jose C. , Flores Carlos , Callero Ariel
Published: October 2021

Hereditary angioedema (HAE) is a rare genetic condition whose main symptoms are recurrent swelling in the skin, mucosa, and internal organs. Recent studies suggested that the regulation of the inflammatory response and the complement cascade are two of the pathways significantly enriched in the Canary Islands, Spain. Here, we describe the first HAE patient series in this region. Forty-one patients (33 F, 8 M) and nine healthy relatives belonging to twenty-nine families were recruited for this study, obtaining their clinical and demographic features using a data collection form, as well as blood samples for biochemical analysis. The mean age of patients was 36.8 years (ranging from 4 to 72 years). Positive family history of HAE was reported in 13 patients (32.5%), and a mean diagnosis delay of 7.9 (±12.5) years was estimated, ranging from months to 50 years. Cutaneous edema was the most common symptom (53.6%), while airway symptoms was present in 11 patients. Prophylactic treatment was indicated for 23 patients, while 14 also require on-demand rescue treatment. We estimate a minimum prevalence of 1.25:100,000 for HAE due to C1-INH deficiency or dysfunction in the Canary Islands, which is higher than the estimates for mainland Spanish populations. HAE continues to be a disease poorly recognized by health care professionals due to its confusing symptoms, leading to longer diagnosis delay. Altogether, the evidence reinforces the need for a rapid and accurate diagnosis and precision medicine-based studies to improve the patient’s quality of life.
Non-Invasive Evaluation of Patients Undergoing Percutaneous Coronary Intervention for Chronic Total Occlusion
Authors: Nakachi Tatsuya , Kato Shingo , Saito Naka , Fukui Kazuki , Iwasawa Tae , Endo Tsutomu , Kosuge Masami , Utsunomiya Daisuke , Kimura Kazuo , Tamura Kouichi
Published: October 2021

Background: As percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) gains wider acceptance as a therapeutic option for coronary artery disease, the importance of appropriate patient selection has increased. Although cardiovascular magnetic resonance imaging (MRI) allows segmental and quantitative analyses of myocardial ischemia and scar transmurality, it has limitations, including contraindications, cost, and accessibility. This study established a non-invasive method to evaluate patients undergoing CTO-PCI using two-dimensional speckle-tracking echocardiography (2D-STE). Methods: Overall, we studied 55 patients who underwent successful CTO-PCI. Cardiovascular MRI and 2D-STE were performed before and 8 ± 2 months after CTO-PCI. Segmental findings of strain parameters were compared with those obtained with late gadolinium enhancement and stress-perfusion MRI. Results: With a cutoff of −10.7, pre-procedural circumferential strain (CS) showed reasonable sensitivity (71%) and specificity (73%) for detecting segments with transmural scar. The discriminatory ability of longitudinal strain (LS) for segments with transmural scar significantly improved during follow-up after successful CTO-PCI in the territory of the recanalized artery (area under the curve (AUC) 0.70 vs. 0.80, p < 0.001). LS accuracy was lower than that of CS at baseline (AUC 0.70 vs. 0.79, p = 0.048), and was increased at follow-up (AUC 0.80 vs. 0.82, p = 0.81). Changes in myocardial perfusion reserve from baseline to follow-up were significantly associated with those in LS but not in CS. Conclusions: Use of 2D-STE may allow the non-invasive evaluation of patients undergoing CTO-PCI to assess the indication before the procedure and treatment effects at follow-up.
The Contribution of Complement to the Pathogenesis of IgA Nephropathy: Are Complement-Targeted Therapies Moving from Rare Disorders to More Common Diseases?
Authors: Poppelaars Felix , Faria Bernardo , Schwaeble Wilhelm , Daha Mohamed R.
Published: October 2021

Primary IgA nephropathy (IgAN) is a leading cause of chronic kidney disease and kidney failure for which there is no disease-specific treatment. However, this could change, since novel therapeutic approaches are currently being assessed in clinical trials, including complement-targeting therapies. An improved understanding of the role of the lectin and the alternative pathway of complement in the pathophysiology of IgAN has led to the development of these treatment strategies. Recently, in a phase 2 trial, treatment with a blocking antibody against mannose-binding protein-associated serine protease 2 (MASP-2, a crucial enzyme of the lectin pathway) was suggested to have a potential benefit for IgAN. Now in a phase 3 study, this MASP-2 inhibitor for the treatment of IgAN could mark the start of a new era of complement therapeutics where common diseases can be treated with these drugs. The clinical development of complement inhibitors requires a better understanding by physicians of the biology of complement, the pathogenic role of complement in IgAN, and complement-targeted therapies. The purpose of this review is to provide an overview of the role of complement in IgAN, including the recent discovery of new mechanisms of complement activation and opportunities for complement inhibitors as the treatment of IgAN.
Strain-Mediated Magneto-Electric Effects in Coaxial Nanofibers of Y/W-Type Hexagonal Ferrites and Ferroelectrics
Authors: Liu Ying , Zhou Peng , Ge Bingfeng , Liu Jiahui , Zhang Jitao , Zhang Wei , Zhang Tianjing , Srinivasan Gopalan
Published: October 2021

Nanofibers of Y- or W-type hexagonal ferrites and core–shell fibers of hexagonal ferrites and ferroelectric lead zirconate titanate (PZT) or barium titanate (BTO) were synthesized by electrospinning. The fibers were found to be free of impurity phases, and the core–shell structure was confirmed by electron and scanning probe microscopy. The values of magnetization of pure hexagonal ferrite fibers compared well with bulk ferrite values. The coaxial fibers showed good ferroelectric polarization, with a maximum value of 0.85 μC/cm2 and 2.44 μC/cm2 for fibers with BTO core–Co2W shell and PZT core–Ni2Y shell structures, respectively. The magnetization, however, was much smaller than that for bulk hexaferrites. Magneto-electric (ME) coupling strength was characterized by measuring the ME voltage coefficient (MEVC) for magnetic field-assembled films of coaxial fibers. Among the fibers with Y-type, films with Zn2Y showed a higher MEVC than films with Ni2Y, and fibers with Co2W had a higher MEVC than that of those with Zn2W. The highest MEVC of 20.3 mV/cm Oe was measured for Co2W–PZT fibers. A very large ME response was measured in all of the films, even in the absence of an external magnetic bias field. The fibers studied here have the potential for use in magnetic sensors and high-frequency device applications.
Effects of Resin/Filler Adhesion on the Thermal and Electrical Conductivity of Polyimide Nanocomposites
Authors: Ohki Yoshimichi , Hirai Naoshi
Published: October 2021

With an aim to develop a good coil winding insulation film, fillers of boehmite alumina in the shape of a roughly rectangular plate were added with ratios of 10 and 20 wt% to polyimide. The filler surface was untreated or treated with a methacrylic or an epoxy silane coupling agent. Such prepared polyimide nanocomposites were subjected to various tests to measure the tensile strength, elastic modulus, complex permittivity, and thermal conductivity. It was found that samples with fillers treated using the methacrylic silane coupling agent have the strongest adhesion at the filler/polyimide interfaces and the lowest dielectric loss factor at high temperatures. A positive relationship between the filler/polyimide adhesion and the thermal conductivity is also indicated. These findings are significant since they indicate that the adhesion status at the filler/polymer interface exerts a strong influence on the thermal and electrical conduction processes in the polymer.
Study on Hydrodynamic Coefficients of a Submarine Piggyback Pipeline under the Action of Waves and Current
Authors: Cheng Xiaofei , Yang Jun , Xu Tiaojian , Xu Qianyuan
Published: October 2021

In this study, physical model tests are used to investigate the effects of a varying number of wave and current parameters, the gap ratios between the pipeline and seabed, the spacing ratios between the two pipelines and the diameter ratios on the hydrodynamic coefficients of the large, small pipeline and pipeline system (bundle) in a piggyback configuration under the combined action of waves and current. The results show that, compared with the pure wave field, the existence of the steady current will lead to a decrease in hydrodynamic coefficients. In addition, the results indicate clear differences between the hydrodynamic coefficients of the large pipeline, small pipeline and piggyback pipeline system. The experimental results on hydrodynamic coefficients can be used as an important basis for the safety design of a submarine piggyback pipeline.
Non-Indigenous Species on Artificial Coastal Environments: Experimental Comparison between Aquaculture Farms and Recreational Marinas
Authors: Png-Gonzalez Lydia , Ramalhosa Patrício , Gestoso Ignacio , Álvarez Soledad , Nogueira Natacha
Published: October 2021

Globally, there is growing concern regarding the effects of the increasing anthropogenic pressures in marine communities. Artificial structures such as marinas and aquaculture facilities serve as invasion hotspots; hence, monitoring fouling communities on these structures can be valuable for detecting new invasions. In the current study, 24 settlement PVC plates were deployed for three months to compare the recruitment ability of these two artificial environments along the south coast of the offshore island of Madeira (NE Atlantic). The results showed higher variations in the species richness between regions (SW vs. SE) than between artificial habitats (sea-cages vs. marinas), although the community composition differed. Cnidaria and Bryozoa were the most representative groups in the aquaculture systems, while Bryozoa and Chordata were in the marinas. A sum of 18 NIS was recorded for the study, accounting for between 21.88% and 54.84% of the total number of species in the aquaculture facilities and marinas, respectively. The higher NIS percentage from the marinas was even more explicit in the SE coast, where Cradoscrupocellaria bertholletii, Parasmittina alba, and Botrylloides niger distinctly dominated fouling populations. The results suggest that at least some particular NIS previously reported in the studied marinas successfully colonized sea-cages. Future assessments need to address the potential role of aquaculture facilities as drivers for the secondary spread of NIS. Additionally, two new records are considered for Madeira: Eudendrium capillare and Ericthonius punctatus.
Genetic Analyses of Amphotericin B Susceptibility in Aspergillus fumigatus
Authors: Fan Yuying , Korfanty Gregory A. , Xu Jianping
Published: October 2021

Aspergillus fumigatus is a ubiquitous saprophytic mold that can cause a range of clinical syndromes, from allergic reactions to invasive infections. Amphotericin B (AMB) is a polyene antifungal drug that has been used to treat a broad range of systemic mycoses since 1958, including as a primary treatment option against invasive aspergillosis in regions with high rates (≥10%) of environmental triazole resistance. However, cases of AMB-resistant A. fumigatus strains have been increasingly documented over the years, and high resistance rates were recently reported in Brazil and Canada. The objective of this study is to identify candidate mutations associated with AMB susceptibility using a genome-wide association analysis of natural strains, and to further investigate a subset of the mutations in their putative associations with differences in AMB minimum inhibitory concentration (MIC) and in growths at different AMB concentrations through the analysis of progeny from a laboratory genetic cross. Together, our results identified a total of 34 candidate single-nucleotide polymorphisms (SNPs) associated with AMB MIC differences—comprising 18 intergenic variants, 14 missense variants, one synonymous variant, and one non-coding transcript variant. Importantly, progeny from the genetic cross allowed us to identify putative SNP–SNP interactions impacting progeny growth at different AMB concentrations.
Strain Degeneration in Pleurotus ostreatus: A Genotype Dependent Oxidative Stress Process Which Triggers Oxidative Stress, Cellular Detoxifying and Cell Wall Reshaping Genes
Authors: Pérez Gumer , Lopez-Moya Federico , Chuina Emilia , Ibañez-Vea María , Garde Edurne , López-Llorca Luis V. , Pisabarro Antonio G. , Ramírez Lucía
Published: October 2021

Strain degeneration has been defined as a decrease or loss in the yield of important commercial traits resulting from subsequent culture, which ultimately leads to Reactive Oxygen Species (ROS) production. Pleurotus ostreatus is a lignin-producing nematophagous edible mushroom. Mycelia for mushroom production are usually maintained in subsequent culture in solid media and frequently show symptoms of strain degeneration. The dikaryotic strain P. ostreatus (DkN001) has been used in our lab as a model organism for different purposes. Hence, different tools have been developed to uncover genetic and molecular aspects of this fungus. In this work, strain degeneration was studied in a full-sib monokaryotic progeny of the DkN001 strain with fast (F) and slow (S) growth rates by using different experimental approaches (light microscopy, malondialdehyde levels, whole-genome transcriptome analysis, and chitosan effect on monokaryotic mycelia). The results obtained showed that: (i) strain degeneration in P. ostreatus is linked to oxidative stress, (ii) the oxidative stress response in monokaryons is genotype dependent, (iii) stress and detoxifying genes are highly expressed in S monokaryons with symptoms of strain degeneration, (iv) chitosan addition to F and S monokaryons uncovered the constitutive expression of both oxidative stress and cellular detoxifying genes in S monokaryon strains which suggest their adaptation to oxidative stress, and (v) the overexpression of the cell wall genes, Uap1 and Cda1, in S monokaryons with strain degeneration phenotype indicates cell wall reshaping and the activation of High Osmolarity Glycerol (HOG) and Cell Wall Integrity (CWI) pathways. These results could constitute a hallmark for mushroom producers to distinguish strain degeneration in commercial mushrooms.