bluuebunny/crossref_metadata_2025 huggingface dataset:
The Lesser Chestnut Weevil (Curculio sayi): Damage and Management with Biological Control Using Entomopathogenic Fungi and Entomopathogenic Nematodes
Authors: Filgueiras Camila C. , Willett Denis S.
Published: November 2022

The lesser chestnut weevil, Curculio sayi (Gyllenhal), can cause irreparable damage to chestnuts through direct consumption and/or introduction of secondary pathogens. With the resurgence of blight resistant American Chestnut plantings both for commercial production and for habitat restoration, C. sayi has become a similarly resurgence pest. Here, we investigated the nature and extent of C. sayi larval damage on individual nuts and collected harvests with an eye toward the quantifying impacts. Next, we explored management options using biological control including entomopathogenic fungi and entomopathogenic nematodes. Nut damage from C. sayi can be extensive with individual nuts hosting several larvae, larvae emerging from nuts several weeks post harvest, and nut weight loss even after C. sayi have emerged from the nut. Applications of entomopathogenic fungi reduced chances of chestnut infestation, while certain strains of entomopathogenic nematodes increased the probability of C. sayi larval mortality. Understanding C. sayi damage and exploring biological control management options could be a useful tool in the effective management of this resurgent pest.
New Mitogenome Features of Philopotamidae (Insecta: Trichoptera) with Two New Species of Gunungiella
Authors: Peng Lang , Ge Xinyu , Shi Faxian , Wang Le , Zang Haoming , Sun Changhai , Wang Beixin
Published: November 2022

A total of 14 individuals of Philopotamidae, from China, were examined. Six species in four genera, including two new species of the genus Gunungiella, were recognized. Their COI barcode sequences were extracted, mitogenomes were sequenced, assembled and analyzed. All of these sequences were used to further reveal the phylogenetic relationships of the family Philopotamidae. In addition, two new species: Gunungiella wangi n. sp., Gunungiella flabellata n. sp. were described and illustrated.
The First Study of Mating Mistakes in Stoneflies (Plecoptera) from China, with Remarks on Their Biological Implications
Authors: Huo Qing-Bo , Zhu Bin-Qing , Murányi Dávid , Tierno de Figueroa José Manuel , Zhao Meng-Yuan , Xiang Ya-Nan , Yang Yu-Ben , Du Yu-Zhou
Published: November 2022

Currently, information on the biology of Plecoptera from China is scarce, particularly on mating behavior. In this paper, the existence of mating mistakes (erroneous mating attempts) involving 13 Chinese stonefly species (belonging to nine genera and three families) is reported. These erroneous mating behaviors can be included into three different categories: mating attempts between conspecific males (including the formation of erroneous mating balls), mating attempts between different taxa (including displacement attempts during copulation), and mating-related behaviors with non-living objects. From these behaviors, some aspects of stoneflies during mating, such as the physical competition between males, the sensorial mechanisms implied in triggering a mating behavior, the conditions favoring the mating mistakes, and the possible consequences of interspecific mating in the hybrid production, are discussed.
Blockchain and 6G-Enabled IoT
Authors: Pajooh Houshyar Honar , Demidenko Serge , Aslam Saad , Harris Muhammad
Published: November 2022

Ubiquitous computing turns into a reality with the emergence of the Internet of Things (IoT) adopted to connect massive numbers of smart and autonomous devices for various applications. 6G-enabled IoT technology provides a platform for information collection and processing at high speed and with low latency. However, there are still issues that need to be addressed in an extended connectivity environment, particularly the security and privacy domain challenges. In addition, the traditional centralized architecture is often unable to address problems associated with access control management, interoperability of different devices, the possible existence of a single point of failure, and extensive computational overhead. Considering the evolution of decentralized access control mechanisms, it is necessary to provide robust security and privacy in various IoT-enabled industrial applications. The emergence of blockchain technology has changed the way information is shared. Blockchain can establish trust in a secure and distributed platform while eliminating the need for third-party authorities. We believe the coalition of 6G-enabled IoT and blockchain can potentially address many problems. This paper is dedicated to discussing the advantages, challenges, and future research directions of integrating 6G-enabled IoT and blockchain technology for various applications such as smart homes, smart cities, healthcare, supply chain, vehicle automation, etc.
A Fast and Cost-Effective (FACE) Instrument Setting to Construct Focus-Extended Images
Authors: Audira Gilbert , Hsu Ting-Wei , Chen Kelvin H.-C. , Huang Jong-Chin , Lin Ming-Der , Ger Tzong-Rong , Hsiao Chung-Der
Published: November 2022

Image stacking is a crucial method for micro or macro photography. It captures images at different focal planes and then merges them into a single, all-in-focus image with extended focus. This method has been extensively used for digital documentation by scientists working at museums or research institutions. However, the traditional image stacking method relies on expensive instruments to conduct precise image stacking using a computer-based stepper motor controller. In this study, we reported how to conduct image focus extensions with comparable quality to those done by a motorized stepper using a cost-effective instrument setting and an efficient manual stacking method. This method provides a shorter operation time and capability to capture images of living objects and high flexibility in obtaining the images of objects from cm to mm scale. However, it also has some limitations, including the inability to control aperture and exposure time, relatively short working distance at high magnification, requires additional steps to convert the video into images, and heavily relies on the user’s manual observation prior to a video recording. Nevertheless, the authors believe that the current method can be applied as an alternative method to conduct image stacking. The development of such an instrument and method offers a promising avenue for scientists to perform image stacking with greater flexibility and speed in macro photography.
Left Atrial Diameter and the Risk of Thromboembolism in Patients with Left Ventricular Noncompaction
Authors: Xu Wei , Yang Yanmin , Zhu Jun , Tan Jiangshan , Wang Jingyang , Wang Lulu
Published: November 2022

Aims: Patients with left ventricular noncompaction (LVNC) are at risk of thromboembolism. The relationship between left atrial diameter (LAD), a robust predictor for thrombosis, and LVNC is unclear. The purpose of this study was to explore the effect of LAD on the thrombotic risk in LVNC. Methods: In this retrospective cohort study, 320 patients with imaging characteristics of LVNC were included for statistical analysis. The primary endpoint was a composite event of intracardiac thrombi and stroke or transient ischemic attack (TIA). The secondary endpoints were intracardiac thrombi and stroke/TIA. Results: The 320 included patients (211 [65.9%] men, median age: 45 years [interquartile range: 30–57]) were divided into LAD1 (<43 mm, n = 157) and LAD2 (≥43 mm, n = 163) groups based on the median LAD. Throughout the median follow-up of 34 months, the incidence of thromboembolism among them was 7.2%: 11 (3.4%) patients had stroke/TIA and 14 (4.4%) had intracardiac thrombi. The rate of thromboembolism in the LAD2 group was higher than that of patients in the LAD1 group (11.0% vs. 3.2%, p = 0.007). Kaplan–Meier survival curves suggested that a LAD ≥ 43 mm was associated with a higher risk of thromboembolism and intracardiac thrombi (log-rank test, all p < 0.05). After adjusting for potential risk factors, LAD ≥ 43 mm was found to be an independent risk factor for thromboembolism (p = 0.013) and stroke (p = 0.024). The area under the receiver operating characteristic curve of LAD for predicting thromboembolism reached 0.696 at 1 year, 0.635 at 2 years, and 0.660 at 3 years. Conclusions: A larger LAD was related to a higher risk of thromboembolism in patients with LVNC. The LAD may be a useful predictor for thrombotic risk stratification among such patients.
Nasal Symptoms in Asthmatic Patients under Treatment with Anti-IL-5 Monoclonal Antibodies. A Real-Life Cohort Study
Authors: Maza-Solano Juan , Calvo-Henríquez Christian , Alobid Isam , Álvarez-Cendrero Marta , Palomares Óscar , Moreno-Luna Ramón , Santos-Perez Jaime , González-García Jaime , Sánchez-Gómez Serafín
Published: November 2022

Currently, some monoclonal antibodies (mAbs) are being studied for chronic rhinosinusitis with nasal polyps (CRSwNP). Three anti-IL-5 mAb: mepolizumab, reslizumab and benralizumab, have been tested through randomized clinical trials. In this real-life study, we aimed to describe the nasal effects of a cohort of asthmatic adults treated with anti-IL-5 mAb. Methods: We carried out an observational study in adults (≥18 years) on anti-IL-5 mAb treatment. Variables included ACT and SNOT−22 questionnaires, nasal polyps score, blood total IgE levels and blood eosinophil count. Results: Overall, 38 participants were included in the study; 19 patients received mepolizumab, 17 were treated with benralizumab and 2 patients were given reslizumab. There was a statistically significant difference in the ACT and SNOT−22 scores before and after mAb treatment. ACT score increased from 11.05 to 21.5 after treatment (p < 0.001). SNOT−22 decreased from 57 to 37.3 after treatment (p = 0.004). No statistically significant differences between mAb groups were observed regarding the ACT or the SNOT−22 (p = 0.775) response (p = 0.775). In addition, 60.53% of patients obtained a minimal clinically important difference (MCID) in SNOT−22. Conclusions: A significant clinical response based on SNOT−22 score evolution after anti-IL-5 mAb treatment was observed. This study also demonstrated that blood eosinophil count, rather than serum total IgE levels, is the best predictor of asthma symptom improvement, which was assessed through the ACT and SNOT−22 questionnaires.
Tumor Recurrence and Follow-Up Intervals in Oral Squamous Cell Carcinoma
Authors: Blatt Sebastian , Krüger Maximilian , Sagheb Kawe , Barth Marie , Kämmerer Peer W. , Al-Nawas Bilal , Sagheb Keyvan
Published: November 2022

Tumor recurrence in oral squamous cell carcinoma (OSCC) is frequent. However, no consensus about follow-up interval is available. The aim of this study was to analyze the recurrence pattern, detection method and associated parameters for possible risk stratification. Histopathological and epidemiological features were obtained retrospectively and correlated with tumor recurrence and overall survival, distant and lymph node metastases. A total of 760 patients were included, of which 216 patients showed tumor recurrence (mean after 24 ± 26 months). Within the first 12 months, 24% of the recurrences were detected. The primary detection method was clinical examination (n = 123, 57%). Tumor recurrence significantly correlated with advanced histopathological grading (G2/3 vs. G1, p < 0.000) and lymph node metastasis (p = 0.004). Tumor recurrence was frequent. Clinical examination was the primary detection method and manifestation within the first 6–12 months was high. The degree of histopathological grading may be useful for risk stratification.
Safe Service Delivery of a Complex Early Pregnancy Problem: Caesarean Scar Pregnancy
Authors: Fourie Hanine , El-Zibdeh Ahmad , Heppell Victoria , Granne Ingrid , Lim Lee Nai , Supramaniam Prasanna Raj
Published: November 2022

Caesarean Scar Pregnancy (CSP) is an ectopic pregnancy with implantation into the niche of the uterine scar. We aimed to describe the local management of consecutive cases of CSP to develop a standard operating procedure (SOP). Between December 2019 and June 2022, there were 19,100 maternities. Of these, 23 were CSPs in 19 patients. Median BMI was 29 (range 20.5–52), median number of Caesarean deliveries (CS) was 2 (range 1–4) and 7/23 (30%) were cigarette smokers. At diagnosis, 9/23 were live pregnancies, 3/23 were retained products of conception (RPOC), 9/23 were pregnancies of uncertain viability (PUV), and 2/23 were non-viable. In six, the initial management was expectant, surgical suction evacuation with transrectal ultrasound guidance in 16, and one had a hysterectomy. The median blood loss was 100 mL (range 50–2000 mL). Two patients (9%) required a blood transfusion. Median hospital stay was 1 day (range 0–4). At follow-up after 10 weeks, no patients had an ongoing haematoma, and one had significant RPOC electing hysterectomy. Eight women were known to have 9 subsequent pregnancies (recurrent CSP n = 4, livebirth n = 2, miscarriage n = 2, tubal ectopic n = 1). Outcomes as rated by low blood loss, short hospital stay, and rare need for further intervention were favorable. Factors associated included prompt ultrasonographic diagnosis, availability of transrectal ultrasound guided surgery, and specialist follow-up, which form the basis of the SOP.
Impact of Frailty Risk on Adverse Outcomes after Traumatic Brain Injury: A Historical Cohort Study
Authors: Yamamoto Yoshinori , Hori Shinsuke , Ushida Kenta , Shirai Yuka , Shimizu Miho , Kato Yuki , Shimizu Akio , Momosaki Ryo
Published: November 2022

We evaluated the utility of the Hospital Frailty Risk Score (HFRS) as a predictor of adverse events after hospitalization in a retrospective analysis of traumatic brain injury (TBI). This historical cohort study analyzed the data of patients hospitalized with TBI between April 2014 and August 2020 who were registered in the JMDC database. We used HFRS to classify the patients into the low- (HFRS < 5), intermediate- (HFRS5-15), and high- (HFRS > 15)-frailty risk groups. Outcomes were the length of hospital stay, the number of patients with Barthel Index score ≥ 95 on, Barthel Index gain, and in-hospital death. We used logistic and linear regression analyses to estimate the association between HFRS and outcome in TBI. We included 18,065 patients with TBI (mean age: 71.8 years). Among these patients, 10,139 (56.1%) were in the low-frailty risk group, 7388 (40.9%) were in the intermediate-frailty risk group, and 538 (3.0%) were in the high-frailty risk group. The intermediate- and high-frailty risk groups were characterized by longer hospital stays than the low-frailty risk group (intermediate-frailty risk group: coefficient 1.952, 95%; confidence interval (CI): 1.117–2.786; high-frailty risk group: coefficient 5.770; 95% CI: 3.160–8.379). The intermediate- and high-frailty risk groups were negatively associated with a Barthel Index score ≥ 95 on discharge (intermediate-frailty risk group: odds ratio 0.645; 95% CI: 0.595–0.699; high-frailty risk group: odds ratio 0.221; 95% CI: 0.157–0.311) and Barthel Index gain (intermediate-frailty risk group: coefficient −4.868, 95% CI: −5.599–−3.773; high-frailty risk group: coefficient −19.596, 95% CI: −22.242–−16.714). The intermediate- and high-frailty risk groups were not associated with in-hospital deaths (intermediate-frailty risk group: odds ratio 0.901; 95% CI: 0.766–1.061; high-frailty risk group: odds ratio 0.707; 95% CI: 0.459–1.091). We found that HFRS could predict adverse outcomes during hospitalization in TBI patients.
The Use of Aspirin Increases the Risk of Major Adverse Cardiac and Cerebrovascular Events in Hypertensive Patients with Obstructive Sleep Apnea for the Primary Prevention of Cardiovascular Disease: A Real-World Cohort Study
Authors: Li Nanfang , Wen Wen , Cai Xintian , Zhu Qing , Hu Junli , Heizhati Mulalibieke , Yuan Yujuan , Gan Lin , Dang Yujie , Yang Wenbo , Hong Jing , Zhang Xiangyang
Published: November 2022

(1) Background: Hypertensive patients with obstructive sleep apnea (OSA) are at high risk for cardiovascular diseases (CVDs), and the utility of aspirin for primary cardiovascular prevention in this population remains uncertain. (2) Methods: In this retrospective cohort study using data from the Urumchi Hypertension Database (UHDATA), hypertensive patients older than 18 years old with a first-time diagnosis of OSA were divided into three groups depending on aspirin history. Major adverse cardiac and cerebrovascular events (MACCE) were the primary outcome. Secondary outcomes included MACCE components, ischemic events, cardiac events, cerebrovascular events, and gastrointestinal bleeding risk. The inverse probability of treatment weighting (IPTW) method was used to balance the confounding factors among the groups, and the Cox proportional hazards model was used to calculate the hazard ratio (HR) and 95% confidence interval (CI). (3) Results: In persistent aspirin users, the risk of MACCE events (HR 2.11, 95%CI 1.23–3.63), ischemic events (HR 2.58, 95%CI 1.42–4.69), cerebrovascular events (HR 2.55, 95%CI 1.44–4.51), and non-fatal cerebral infarction (HR 3.14, 95%CI 1.69–5.84) was significantly elevated. (4) Conclusions: Continuous aspirin use increases the incidence of cardiovascular adverse events in hypertensive patients with OSA receiving aspirin for primary prevention of cardiovascular disease.
Combined Airway and Bariatric Surgery (CABS) for Obstructive Sleep Apnea Patients with Morbid Obesity: A Comprehensive Alternative Preliminary Study
Authors: Lin Chia-Chen , Liu Keng-Hao , Lee Li-Ang , Chuang Li-Pang , Lin Yu-Sheng , Hsin Li-Jen , Lin Wan-Ni , Chiang Yen-Ting , Cheng Wen-Nuan , Li Hsueh-Yu
Published: November 2022

Although continuous positive airway pressure is the gold standard for obstructive sleep apnea (OSA), it does not improve obesity. By contrast, bariatric surgery significantly improves obesity but with sustained OSA in the majority of patients. This study proposes a comprehensive technique—combined airway and bariatric surgery (CABS)—to improve both obesity and OSA. The aims of the study are to evaluate the feasibility, safety and efficacy of CABS in morbidly obese OSA patients. The retrospective study enrolled 20 morbidly obese OSA patients (13 males; median age, 44 years; median apnea–hypopnea index (AHI), 63.2 event/h; median body mass index (BMI), 41.4 kg/m2). The study population was divided into two groups based on patients’ volition after shared decision making. The bariatric surgery (BS) group included laparoscopic sleeve gastrectomy (LSG, n = 8) and laparoscopic Roux-en-Y gastric bypass (LRYGB, n = 2). CABS involved bariatric surgery—LSG (n = 8) and LRYGB (n = 2) in conjunction with airway surgery (concurrent nasal/palatal/lingual surgery [n = 8], concurrent palatal/lingual surgery [n = 2]). Patients received a home sleep apnea test at baseline and one year after surgery. The two patient groups were not different in age, sex, preoperative AHI or preoperative BMI. There was no airway compromise, wound bleeding or infection throughout the postoperative period. One year after surgery, patients in both groups achieved significant improvement in AHI and BMI. Furthermore, the improvement in AHI was significantly higher (p = 0.04) in the CABS group than in the BS group despite the insignificant change in BMI reduction (p = 0.63) between the two groups. In the CABS group, the BMI dropped from 40.4 to 28.4 kg/m2 (p < 0.0001) and the AHI decreased from 75.1 to 4.5 event/h (p = 0.0004). The classic success rate for OSA was 90% and the cure rate was 60% in the CABS group. A perioperative assessment of CABS group patients also revealed a significant improvement in the Epworth sleepiness scale, minimal O2 saturation, snoring index and heart rate. CABS is feasible and safe in treating OSA with morbid obesity. CABS achieves more reduction in AHI than BS alone with high success and cure rates for OSA. CABS can also significantly improve quality of life and general health and offers a comprehensive alternative for morbidly obese OSA patients.
Fractional Flow Reserve versus Angiography–Guided Management of Coronary Artery Disease: A Meta–Analysis of Contemporary Randomised Controlled Trials
Authors: Maznyczka Annette M. , Matthews Connor J. , Blaxill Jonathan M. , Greenwood John P. , Mozid Abdul M. , Rossington Jennifer A. , Veerasamy Murugapathy , Wheatcroft Stephen B. , Curzen Nick , Bulluck Heerajnarain
Published: November 2022

Background and Aims: Randomised controlled trials (RCTs) comparing outcomes after fractional flow reserve (FFR)-guided versus angiography-guided management for obstructive coronary artery disease (CAD) have produced conflicting results. We investigated the efficacy and safety of an FFR-guided versus angiography-guided management strategy among patients with obstructive CAD. Methods: A systematic electronic search of the major databases was performed from inception to September 2022. We included studies of patients presenting with angina or myocardial infarction (MI), managed with medications, percutaneous coronary intervention, or bypass graft surgery. A meta-analysis was performed by pooling the risk ratio (RR) using a random-effects model. The endpoints of interest were all-cause mortality, MI and unplanned revascularisation. Results: Eight RCTs, with outcome data from 5077 patients, were included. The weighted mean follow up was 22 months. When FFR-guided management was compared to angiography-guided management, there was no difference in all-cause mortality [3.5% vs. 3.7%, RR: 0.99 (95% confidence interval (CI) 0.62–1.60), p = 0.98, heterogeneity (I2) 43%], MI [5.3% vs. 5.9%, RR: 0.93 (95%CI 0.66–1.32), p = 0.69, I2 42%], or unplanned revascularisation [7.4% vs. 7.9%, RR: 0.92 (95%CI 0.76–1.11), p = 0.37, I2 0%]. However, the number patients undergoing planned revascularisation by either stent or surgery was significantly lower with an FFR-guided strategy [weighted mean difference: 14 (95% CI 3 to 25)%, p =< 0.001]. Conclusion: In patients with obstructive CAD, an FFR-guided management strategy did not impact on all-cause mortality, MI and unplanned revascularisation, when compared to an angiography-guided management strategy, but led to up to a quarter less patients needing revascularisation.
Veno-Arterial Extracorporeal Membrane Oxygenation as a Bridge to Heart Transplant—Change of Paradigm
Authors: Šipuš Dubravka , Krželj Kristina , Đurić Željko , Gašparović Hrvoje , Miličić Davor , Hanževački Jadranka Šeparović , Lovrić Daniel
Published: November 2022

Despite advances in medical therapy and mechanical circulatory support (MCS), heart transplant (HT) remains the gold standard therapy for end-stage heart failure. Patients in cardiogenic shock require prompt intervention to reverse hypoperfusion and end-organ damage. When medical therapy becomes insufficient, MCS should be considered. Historically, it has been reported that critically ill patients bridged with veno-arterial extracorporeal membrane oxygenation (VA-ECMO) directly to HT have worse outcomes. However, when the heart allocation system gives the highest priority to patients on VA-ECMO support, those patients have a higher incidence of HT and a lower incidence of death or removal from the transplant list. Moreover, patients with a short waiting time on VA-ECMO have a similar hazard of mortality to non-ECMO patients. According to the reported data, bridging with VA-ECMO directly to HT may be a solution in the selection of critically ill patients when the anticipated waiting list time is short. However, when a prolonged waiting time is expected, more durable MCS should be considered. Regardless of the favorable results of the direct bridging to HT with ECMO in selected patients, the superiority of this strategy compared to the bridge-to-bridge strategy (ECMO to durable MCS) has not been established and further studies are mandatory in order to clarify this issue.
Longitudinal Surveillance of Fetal Heart Failure Using Speckle Tracking Analysis
Authors: Murlewska Julia , Sylwestrzak Oskar , Respondek-Liberska Maria , Sklansky Mark , Devore Greggory
Published: November 2022

Long-term monitoring of a fetus with heart failure is an undeniable challenge for prenatal cardiology. Echocardiography is constrained by many fetal and maternal factors, and it is difficult to maintain the reproducibility of the measured and analyzed parameters. In our study, we presented the possibilities of using modern speckle tracking technology in combination with standard echocardiography parameters that may be insufficient or less sensitive in the context of monitoring life-threatening fetal conditions. Our analysis shows the superiority of the parameters used to assess fetal cardiac architecture, such as the GSI Global sphericity Index, and fetal cardiac function, such as the FAC fractional area change and the EF ejection fraction, which temporal change may indicate a worsening condition of the fetus with heart failure. The significant increase in the parameters of fetal heart size in speckle tracking allows for an improved echocardiographic diagnosis and monitoring of the fetus with heart failure and the prognostic conclusions about the clinical condition after birth. Significant decreases in FAC for the left and right ventricles and EF for the left ventricle may indicate an unfavourable prognosis for the monitored fetus due to heart failure.
Looking Back to Look Forward: What to Expect in a Redo Surgery for a Bioprosthesis Replacement
Authors: Giambuzzi Ilaria , Bonalumi Giorgia , Ballan Giulia , Messi Pietro , Bonomi Alice , Maggiore Analia , Esposito Giampiero , Di Mauro Michele , Alamanni Francesco , Zanobini Marco
Published: November 2022

Redo surgeries are becoming more common because of an increased rate of bioprosthesis implantation. We performed a retrospective study on patients who underwent redo replacement of an aortic and/or mitral bioprosthesis between 2005 and 2018 to evaluate intra-hospital mortality and morbidity. Univariate analysis was performed on the propensity score variables to determine predictors of mortality. A total of 180 patients were enrolled in the study: Group A (replacement of aortic bioprosthesis) with 136 patients (75.56%) and group B (replacement of mitral bioprosthesis ± aortic bioprosthesis) with 44 patients (24.44%). NYHA class ≥ 3 and female sex were significantly more common in group B. Cardiopulmonary-bypass time and aortic cross-clamping time in group A and group B were, respectively, 154.95 ± 74.35 and 190.25 ± 77.44 (p = 0.0005) and 115.99 ± 53.54 and 144.91 ± 52.53 (p = 0.0004). Overall mortality was 8.89%. After propensity score adjustment, Group B was confirmed to have an increased risk of death (OR 3.32 CI 95% 1.02–10.88 p < 0.0001), gastrointestinal complications (OR 7.784 CI 95% 1.005–60.282 p < 0.0002) and pulmonary complications (OR 2.381 CI 95% 1.038–5.46 p < 0.0001). At the univariate analysis, endocarditis, cardiopulmonary-bypass and aortic cross clamping time, NYHA class ≥ 3 and urgency setting were significantly associated to death. Intra-hospital outcomes were acceptable regarding mortality and complications. Patients who need redo surgery on mitral bioprosthesis have an increased risk of post-operative pulmonary and gastrointestinal complications and mortality. Therefore the choice of mitral bioprosthesis at time of first surgery should be carefully evaluated.
Applicability of Actigraphy for Assessing Sleep Behaviour in Children with Palliative Care Needs Benchmarked against the Gold Standard Polysomnography
Authors: Kubek Larissa Alice , Kutz Patrizia , Roll Claudia , Zernikow Boris , Wager Julia
Published: November 2022

In children with life-limiting conditions and severe neurological impairment receiving pediatric palliative care (PPC), the degree to which actigraphy generates meaningful sleep data is uncertain. Benchmarked against the gold standard polysomnography (PSG), the applicability of actigraphy in this complex population was to be assessed. An actigraph was placed on N = 8 PPC patients during one-night polysomnography measurement in a pediatric tertiary care hospital’s sleep laboratory. Patient characteristics, sleep phase data, and respiratory abnormalities are presented descriptively. Bland-Altman plots evaluated actigraphy’s validity regarding sleep onset, sleep offset, wake after sleep onset (WASO), number of wake phases, total sleep time (TST) and sleep efficiency compared to PSG. PSG revealed that children spent most of their time in sleep stage 2 (46.6%) and most frequently showed central apnea (28.7%) and irregular hypopnea (14.5%). Bland-Altman plots showed that actigraphy and PSG gave similar findings for sleep onset, sleep offset, wake after sleep onset (WASO), total sleep time (TST) and sleep efficiency. Actigraphy slightly overestimated TST and sleep efficiency while underestimating all other parameters. Generally, the Actiwatch 2 low and medium sensitivity levels showed the best approximation to the PSG values. Actigraphy seems to be a promising method for detecting sleep problems in severely ill children.
An Update on the Role of Anti-EGFR in the Treatment of Older Patients with Metastatic Colorectal Cancer
Authors: Rosati Gerardo , Montrone Michele , Pacilio Carmen , Colombo Alfredo , Cicero Giuseppe , Paragliola Fernando , Vaia Angelo , Annunziata Luigi , Bilancia Domenico
Published: November 2022

Although colorectal cancer is increasingly being diagnosed in older patients, their number is largely underrepresented in phase II or III clinical trials. Consequently, guidelines and the SIOG recommendations are not sufficiently clear regarding the treatment of these patients, particularly when chemotherapy is combined with monoclonal antibodies (bevacizumab, cetuximab, and panitumumab). Targeted therapy based on the use of anti-epidermal growth factor receptors (EGFRs) is conditioned by the potential for increased toxicity, making it more difficult to treat an older, rat sarcoma virus (RAS) and B rapidly accelerated fibrosarcoma (BRAF) wild-type patient. In light of a more detailed characterization of the older population, modernly differentiable between fit, vulnerable, or frail patients on the basis of the comprehensive geriatric assessment, and of the analysis of more recent studies, this review fully collects data from the literature, differentiating the results on functional status patients.
The Best Way to Deal Is with Cold Steel…Is It?—Ways of Dealing with Age and Ageing in Cardiac Surgery
Authors: Albes Johannes M.
Published: November 2022

Everyone knows from their own experience what ageing means [...]
Social Connectedness and Associations with Gambling Risk in New Zealand
Authors: Wang Grace Y. , Bellringer Maria E.
Published: November 2022

Multiple factors are associated with disordered gambling, with some populations having a greater risk for developing disordered gambling than others. The present study, utilising data previously collected for a New Zealand (NZ) national gambling survey, explored the associations of social connectedness and leisure activities with risky gambling behaviour and quality of life. Poorer social connectedness and leisure activities were found to be associated with increased gambling risk and poorer quality of life, respectively. Social connectedness and leisure activities strongly predicted type of gambling activities and quality of life. Furthermore, Māori (NZ’s indigenous population) had lower social connectedness and fewer leisure activities, and a greater gambling risk, as well as higher psychological distress, than the NZ European/Other population. These findings indicate that the risk of progressing from recreational gambling to risky gambling is relatively higher for Māori, and that social connectedness and leisure activities could be contributing factors for this increased risk. It is, therefore, important that social connectedness and leisure activities are seriously considered in public health and treatment efforts to reduce gambling harm for vulnerable populations.
A New Method to Speed Up Nannofossil Picking for Monospecific Geochemical Analyses
Authors: Bordiga Manuela , Lupi Claudia , Zanoni Mario , Bianco Stefania , Cabrini Marina , Fiorentino Giulia , Garagna Silvia , Zuccotti Maurizio , Di Giulio Andrea
Published: November 2022

Investigating the trace elements contained in the coccoliths, i.e., the carbonate exoskeleton, of unicellular marine phytoplankton called coccolithophores, is fundamental for calibrating environmental climate proxies, which are key tools for studying past and future climate changes. To date, lab-cultivated coccolithophores have been mainly used for measuring the elements retained within the coccoliths, whereas geochemical studies in fossil records have been limited by the difficulty in isolating monospecific samples from sediments containing highly diversified fossil assemblages. Since a comparison of the geochemical data collected from both fossil and living species is fundamental for calibrating the environmental proxies, an improvement of coccolith-picking methodology should be envisaged. Here, we present a significant advancement in the isolation of fossil species-specific coccolith achieved using a hydraulic micromanipulation system together with wet samples, never applied before on coccoliths. Our technique allows the picking of around 100 monospecific coccoliths per h, a number never achieved before with other isolation methodologies. This method opens up new possibilities in applying monospecific geochemical analyses to the fossil record not attainable before (e.g., the use of the mass spectrometer), leading to an increase in knowledge of environmental proxy calibration and coccolithophore element incorporation strategies.
Data-Driven Damage Quantification of Floating Offshore Wind Turbine Platforms Based on Multi-Scale Encoder–Decoder with Self-Attention Mechanism
Authors: Bashir Musa , Xu Zifei , Wang Jin , Guedes Soares C.
Published: November 2022

A Multi-Scale Convolutional Neural Network with Self Attention-based Auto Encoder–Decoder (MSCSA-AED), is a novel high-performance framework, presented here for the quantification of damage on a multibody floating offshore wind turbine (FOWT) structure. The model is equipped with similarity measurement to enhance its capability to accurately quantify damage effects from different scales of coded features using raw platform responses and without human intervention. Case studies using different damage magnitudes on tendons of a 10 MW multibody FOWT were used to examine the accuracy and reliability of the proposed model. The results showed that addition of Square Euclidean (SE) distance enhanced the MSCSA-AED model’s capability to suitably estimate the damage in structures operating in complex environments using only raw responses. Comparison of the model’s performance with other variants (DCN-AED and MSCNN-AED) used in the industry to extract the coded features from FOWT responses further demonstrated the superiority of MSCSA-AED in complex operating conditions, especially in low magnitude damage quantification, which is the hardest to quantify.
The Role of Microplastics in Marine Pathogen Transmission: Retrospective Regression Analysis, Experimental Design, and Disease Modelling
Authors: Bidegain Gorka , Sestelo Marta , Luque Patricia L. , Uriarte Ibon , Iriarte Arantza , Villate Fernando
Published: November 2022

Marine wildlife and aquaculture species can accumulate large amounts of marine microplastic debris (MMD) (<1 mm) carrying pathogens, thus threatening the health of marine ecosystems and posing a risk to food safety and human health. Here, we outline a theoretical three-perspective approach for studying the relationship between MMD and disease. First, we provide a framework for retrospective analysis of MMD and pathogen loads in marine animal tissues to assess the relationship between these and other environmental variables in order to decide whether a compound or pathogen should be considered an emerging substance or organism. Second, we describe an experimental design for testing the effects of a variety of microplastics on infection intensity in two model species (oysters and zebrafish). Finally, we create a theoretical susceptible–infected microplastic particle and pathogen transmission model for bivalves and fish. Overall, the experiments and models we propose will pave the way for future research designed to assess the role of MMD as a vector for marine and human pathogens. This multi-faceted approach needs to be an urgent priority of the EU Strategic Research Innovation Agenda for addressing marine disease challenges related to MMD.
Epidemiologic Aspects of Mycetoma in Africa
Authors: Develoux Michel
Published: November 2022

Mycetoma is a chronic, disabling infection caused by fungi or actinomycetes that affects the disadvantaged rural populations of arid tropical regions. The identification of etiological agents is long, difficult, and often imprecise or unsuccessful. Recently developed molecular methods can be used to identify causal agents at the species level. However, diagnosis can only be implemented in specialized laboratories. For these reasons, the distribution of causal agents in endemic African countries remains approximate. It is known that the pathogenic organisms of mycetoma are present in the environment, introduced as a result of injuries or trauma. There are still unknowns concerning the natural habitats of agents and the mode of infection. A potential association between mycetoma and acacia was uncovered in Sudan, allowing the elaboration of a risk map of the country. A new hypothesis for the mode of contamination involves the intervention of an intermediate host. The first surveys in Sudanese endemic villages gave a higher prevalence than the previous estimates, indicating that the prevalence of mycetoma in endemic African countries has previously been underestimated.
The Multifaceted Gene 275 Embedded in the PKS-PTS Gene Cluster Was Involved in the Regulation of Arthrobotrisin Biosynthesis, TCA Cycle, and Septa Formation in Nematode-Trapping Fungus Arthrobotrys oligospora
Authors: Zhou Jiao , Wu Qun-Fu , Li Shu-Hong , Yan Jun-Xian , Wu Li , Cheng Qian-Yi , He Zhi-Qiang , Yue Xu-Tong , Zhang Ke-Qin , Zhang Long-Long , Niu Xue-Mei
Published: November 2022

The predominant nematode-trapping fungus Arthrobotrys oligospora harbors a unique polyketide synthase-prenyltransferase (PKS-PTS) gene cluster AOL_s00215g responsible for the biosynthesis of sesquiterpenyl epoxy-cyclohexenoids (SECs) that are involved in the regulation of fungal growth, adhesive trap formation, antibacterial activity, and soil colonization. However, the function of one rare gene (AOL_s00215g275 (275)) embedded in the cluster has remained cryptic. Here, we constructed two mutants with the disruption of 275 and the overexpression of 275, respectively, and compared their fungal growth, morphology, resistance to chemical stress, nematicidal activity, transcriptomic and metabolic profiles, and infrastructures, together with binding affinity analysis. Both mutants displayed distinct differences in their TCA cycles, SEC biosynthesis, and endocytosis, combined with abnormal mitochondria, vacuoles, septa formation, and decreased nematicidal activity. Our results suggest that gene 275 might function as a separator and as an integrated gene with multiple potential functions related to three distinct genes encoding the retinoic acid induced-1, cortactin, and vacuolar iron transporter 1 proteins in this nematode-trapping fungus. Our unexpected findings provide insight into the intriguing organization and functions of a rare non-biosynthetic gene in a biosynthetic gene cluster.
Serum Beta-D-Glucan in the Diagnosis of Invasive Fungal Disease in Neonates, Children and Adolescents: A Critical Analysis of Current Data
Authors: Ferreras-Antolin Laura , Borman Andrew , Diederichs Antonia , Warris Adilia , Lehrnbecher Thomas
Published: November 2022

β-D-glucan (BDG) is a cell wall component of many pathogenic fungi. The detection of BDG as an assay is clinically broadly used as a diagnostic tool. However, the current data on BDG in paediatrics are limited, prompting specific considerations about when BDG can be used in neonates and children. We aimed to analyse the available data for the use of serum BDG in neonates and immunocompromised children and adolescents; as well as to understand the extent and characteristics of the use of BDG in children in Europe.
Validation of Pharmacogenomic Interaction Probability (PIP) Scores in Predicting Drug–Gene, Drug–Drug–Gene, and Drug–Gene–Gene Interaction Risks in a Large Patient Population
Authors: Ashcraft Kristine , Grande Kendra , Bristow Sara L. , Moyer Nicolas , Schmidlen Tara , Moretz Chad , Wick Jennifer A. , Blaxall Burns C.
Published: November 2022

Utilizing pharmacogenomic (PGx) testing and integrating evidence-based guidance in drug therapy enables an improved treatment response and decreases the occurrence of adverse drug events. We conducted a retrospective analysis to validate the YouScript® PGx interaction probability (PIP) algorithm, which predicts patients for whom PGx testing would identify one or more evidence-based, actionable drug–gene, drug–drug–gene, or drug–gene–gene interactions (EADGIs). PIP scores generated for 36,511 patients were assessed according to the results of PGx multigene panel testing. PIP scores versus the proportion of patients in whom at least one EADGI was found were 22.4% vs. 22.4% (p = 1.000), 23.5% vs. 23.4% (p = 0.6895), 30.9% vs. 29.4% (p = 0.0667), and 27.3% vs. 26.4% (p = 0.3583) for patients tested with a minimum of 3-, 5-, 14-, and 25-gene panels, respectively. These data suggest a striking concordance between the PIP scores and the EAGDIs found by gene panel testing. The ability to identify patients most likely to benefit from PGx testing has the potential to reduce health care costs, enable patient access to personalized medicine, and ultimately improve drug efficacy and safety.
A Data-Driven Strategy for Identifying Individuals Resistant to SARS-CoV-2 Virus under In-Household Exposure
Authors: Hen Gabzi Roni , Patalon Tal , Shomron Noam , Gazit Sivan
Published: November 2022

This report describes the development of a data-driven approach for identifying individuals who tested negative to a SARS-CoV-2 infection, despite their residence with individuals who had confirmed infections. Household studies have demonstrated efficiency in evaluating exposure to SARS-CoV-2. Leveraging earlier studies based on the household unit, our analysis utilized close contacts in order to trace chains of infection and to subsequently categorize TEFLONs, an acronym for Timely Exposed to Family members Leaving One Not infected. We used over one million anonymized electronic medical records, retrieved from Maccabi Healthcare Services’ centralized computerized database from March 2020 to March 2022. The analysis yielded 252 TEFLONs, who were probably at very high risk of infection and yet, demonstrated clinical resistance. The exposure extent in each household positively correlated with household size, reflecting the in-house rolling transmission event. Our approach can be easily implemented in other clinical fields and should spur further research of clinical resistance to various infections.
Exercise Modulates Brain Glucose Utilization Response to Acute Cocaine
Authors: Hanna Colin , Hamilton John , Blum Kenneth , Badgaiyan Rajendra D. , Thanos Panayotis K.
Published: November 2022

Exercise, a proven method of boosting health and wellness, is thought to act as a protective factor against many neurological and psychological diseases. Recent studies on exercise and drug exposure have pinpointed some of the neurological mechanisms that may characterize this protective factor. Using positron emission tomography (PET) imaging techniques and the glucose analog [18F]-Fluorodeoxyglucose (18F-FDG), our team sought to identify how chronic aerobic exercise modulates brain glucose metabolism (BGluM) after drug-naïve rats were exposed to an acute dose of cocaine. Using sedentary rats as a control group, we observed significant differences in regional BGluM. Chronic treadmill exercise treatment coupled with acute cocaine exposure induced responses in BGluM activity in the following brain regions: postsubiculum (Post), parasubiculum (PaS), granular and dysgranular insular cortex (GI and DI, respectively), substantia nigra reticular (SNR) and compact part dorsal tier (SNCD), temporal association cortex (TeA), entopenduncular nucleus (EP), and crus 1 of the ansiform lobule (crus 1). Inhibition, characterized by decreased responses due to our exercise, was found in the ventral endopiriform nucleus (VEn). These areas are associated with memory and various motor functions. They also include and share connections with densely dopaminergic areas of the mesolimbic system. In conclusion, these findings suggest that treadmill exercise in rats mediates brain glucose response to an acute dose of cocaine differently as compared to sedentary rats. The modulated brain glucose utilization occurs in brain regions responsible for memory and association, spatial navigation, and motor control as well as corticomesolimbic regions related to reward, emotion, and movement.
Cholesterol Management in Neurology: Time for Revised Strategies?
Authors: Andronie-Cioară Felicia Liana , Jurcău Anamaria , Jurcău Maria Carolina , Nistor-Cseppentö Delia Carmen , Simion Aurel
Published: November 2022

Statin therapy has been extensively evaluated and shown to reduce the incidence of new or recurrent vascular events, ischemic stroke included. As a consequence, each published guideline pushes for lower low-density cholesterol levels in the population at large, recommending increased statin doses and/or adding new cholesterol-lowering molecules. Neurologists find it sometimes difficult to apply these guidelines, having to confront situations such as (1) ischemic strokes, mainly cardioembolic ones, in patients with already low LDL-cholesterol levels; (2) myasthenic patients, whose lifespan has been extended by available treatment, and whose age and cholesterol levels put them at risk for ischemic stroke; (3) patients with myotonic dystrophy, whose disease often associates diabetes mellitus and heart conduction defects, and in whom blood cholesterol management is also not settled. As such, further trials are needed to address these issues.
Institutional Ownership and Firm Performance: Evidence from an Emerging Economy
Authors: Abedin Syeda Humayra , Haque Humaira , Shahjahan Tanjina , Kabir Md Nurul
Published: November 2022

Using the Ordinary Least Square (OLS) estimation technique based on a sample of 180 listed firms from 2008 to 2018, this study investigates the impact of institutional ownership on firm performance in the Bangladeshi setting. Consistent with the “active monitoring” view, the results indicate that both domestic and foreign institutional investors have a positive effect on firm performance measured by Tobin’s Q and Return on Asset (ROA). In addition, this study explores whether the other corporate governance attributes—board size and board independence—operate as mediators between institutional ownership and firm performance. Our findings indicate that both board size and board independence have a significant positive impact on the relationship between institutional ownership and firm performance.