bluuebunny/crossref_metadata_2025 huggingface dataset:
A Thermophile-Fermented Compost Modulates Intestinal Cations and the Expression of a Juvenile Hormone-Binding Protein Gene in the Female Larvae of Hercules Beetle Dynastes hercules (Coleoptera: Scarabaeidae)
Authors: Asano Futo , Miyahara Taira , Miyamoto Hirokuni , Kodama Hiroaki
Published: November 2023

The Hercules beetle larvae grow by feeding on humus, and adding a thermophile-fermented compost to the humus can upregulate the growth of female larvae. In this study, the effects of compost on the intestinal environment, including pH, cation concentrations, and organic acid concentrations of intestinal fluids, were investigated, and the RNA profile of the fat body was determined. Although the total intestinal potassium ions were similar between the larvae grown without compost (control larvae) and those with compost (compost larvae), the proportion of potassium ions in the midgut of the compost larvae drastically increased. In the midgut, an unidentified organic acid was the most abundant, and its concentration increased in the compost larvae. Transcriptome analysis showed that a gene encoding hemolymph juvenile-binding protein (JHBP) was expressed in the compost female larvae and not in the control female larvae. Expression of many genes involved in the defensive system was decreased in the compost female larvae. These results suggest that the female-specific enhancement of larval growth by compost was associated with the increased JHBP expression under conditions in which the availability of nutrition from the humus was improved by an increase in potassium ions in the midgut.
Trehalose and Dry Eye Disease: A Comprehensive Systematic Review of Randomized Controlled Trials
Authors: Ballesteros-Sánchez Antonio , Martinez-Perez Clara , Alvarez-Peregrina Cristina , Sánchez-Tena Miguel Ángel , De-Hita-Cantalejo Concepción , Sánchez-González María Carmen , Sánchez-González José-María
Published: November 2023

The purpose of the research project was to extensively review the efficacy and safety of a trehalose tear-substitute treatment in cases of dry eye disease (DED). A systematic review that included only full-length randomized controlled studies (RCTs) reporting the effects of trehalose tear-substitute treatment in three databases, PubMed, Scopus and Web of Science, was performed according to the PRISMA statement. The search period included papers published before 8 August 2023. The Cochrane risk-of-bias tool was used to analyze the quality of the studies selected. A total of 10 RCTs were included in this systematic review. Trehalose tear-substitute treatments achieved a higher improvement than did control group interventions in all reported variables. The mean differences between both groups were in favor of trehalose, and were as follows: ocular surface disease index (OSDI) questionnaire score of −8.5 ± 7 points, tear film breakup time (TBUT) of 1.9 ± 1 s, tear film thickness (TFT) of 0.25 ± 0.1 μm, tear meniscus height (TMH) of 0.02 ± 0.02 mm, Schirmer test (ST) of 0.8 ± 1.4 mm, corneal fluorescein staining (CFS) of −0.7 ± 0.1 points and visual acuity (VA) of 0.3 ± 2.1 letters. No adverse events after trehalose tear-substitute treatments were reported. Trehalose tear substitutes are a safe and effective treatment for DED. Therefore, trehalose tear substitutes should be recommended for patients with dry eye disease. In addition, there is specific evidence to support its use in the preoperative cataract surgery period.
Oxidative Stress: The Role of Estrogen and Progesterone
Authors: Cagnacci Angelo , Gazzo Irene , Stigliani Sara , Paoletti Anna Maria , Anserini Paola , Londero Ambrogio Pietro , Xholli Anjeza
Published: November 2023

The effect of estrogen and progesterone on oxidative status is not yet very clear, improvements and detrimental effects having been reported with the use of menopausal hormone therapy or hormonal contraceptives, respectively. In this study, we evaluated the role played by estrogen and progesterone separately, on the oxidative status of 32 women, 18 to 43 years old, by inducing high levels of estrogen and then adding high levels of progesterone. During a cycle of in vitro fertilization, blood samples were collected prior to gonadotrophin stimulation (low estradiol levels), on the day of oocyte retrieval (high levels of estrogen), and on the day of embryo transfer (high levels of estrogen and progesterone). Total blood levels of oxidants (FORT), antioxidants (FORD), and their ratio FORT/FORD were measured using a colorimetric method based on the Fenton reaction. Seven women measured their early morning body temperature at the same time points. FORT significantly decreased from the low- to the high-estrogen phase (p = 0.023) and increased from the high-estrogen to the high-estrogen–progesterone phase (p = 0.006). FORD showed an opposite but non-significant trend. The FORT/FORD ratio decreased from the low- to the high-estrogen phase (p = 0.0104) and increased from the high-estrogen to the high-estrogen –progesterone phase (p = 0.004). Body temperature (n = 7) decreased in the high-estrogen phase (p = 0.001) and increased from the high-estrogen to the high-estrogen–progesterone phase (p = 0.001). In the seven women, FORT (p = 0.009) and FORT/FORD (p = 0.0056) were linearly related to body temperature values. Our data show opposite effects of estrogen and progesterone on oxidative status. These effects seem to be related to the effect exerted on body temperature regulation.
A Long-Term Follow-Up Study in Immune-Mediated Thrombotic Thrombocytopenic Purpura: What Are the Outcomes?
Authors: Bonifacio Maria Addolorata , Roselli Daniele , Schifone Claudia Pia , Ricco Alessandra , Vitucci Angelantonio , Aprile Lara , Mariggiò Maria Addolorata , Ranieri Prudenza
Published: November 2023

Endothelium damage triggers the multimeric protein von Willebrand factor (VWF) release and subsequent binding to platelets, which are recruited at sites of vascular injury. A complex and fragile equilibrium between circulating levels of von Willebrand factor and its metalloprotease, ADAMTS13, is responsible for the hemostatic balance. However, the presence of autoantibodies targeting ADAMTS13 results in an increase in von Willebrand factor, mainly in its ultra-large multimers. The latter lead to platelet aggregation, the formation of thrombi and microangiopathic hemolytic anemia. This pathologic condition, known as immune-mediated thrombotic thrombocytopenic purpura (iTTP), occurs with high morbidity and a high rate of relapses. In this work, the long-term follow-up of 40 patients with iTTP is reported. We assessed ADAMTS13 activity, plasmatic VWF levels and the ADAMTS13/VWF ratio, comparing iTTP relapsing patients with remitting ones. A decrease in the ADAMTS13/VWF ratio, along with a reduced ADAMTS13 activity, could serve as predictive and sensitive biomarkers of incoming relapses.
Remimazolam Pilot for Office-Based Dental Sedation: Adverse Events, Awareness and Outcomes
Authors: Swart Rudi , Maes Sabine S. A. , Cavanaugh David , Mason Keira P.
Published: November 2023

In recent years, remimazolam has gained approval for use in adult procedural sedation in both the United Kingdom and the United States, potentially offering an alternative to conventional sedatives like propofol and midazolam for procedural sedation. However, there is a limited body of literature that systematically reviews the outcomes of a remimazolam-alfentanil combination protocol for routine office-based dental procedures. The primary objective of this pilot study was to assess the occurrence of significant adverse events associated with the use of a remimazolam-alfentanil sedation protocol for adult dental procedures. Secondary outcomes included evaluating physiological responses, sedation effectiveness, patient and clinician satisfaction and the incidence of intraprocedural awareness. Notably, no significant adverse events were reported among the 25 adult subjects who received remimazolam and alfentanil, and all dental procedures were successfully completed. Patients and clinicians expressed high levels of satisfaction, and patients did not report any distressing memories associated with the dental procedure. These findings suggest that in a limited cohort, the remimazolam-alfentanil regimen appears to be well tolerated and effective for office-based dental procedures in adult patients, with a low risk of adverse events, acceptable hemodynamic effects, rapid onset and recovery and minimal intraoperative awareness. This study provides valuable insights into the potential use of the remimazolam-alfentanil combination in dental sedation practice.
Comparison of Remimazolam–Flumazenil versus Propofol for Recovery from General Anesthesia: A Systematic Review and Meta-Analysis
Authors: Wu Quantong , Xu Fuchao , Wang Jie , Jiang Ming
Published: November 2023

(1) Purpose: to systematically evaluate the recovery following sedation and anesthesia with remimazolam combined with flumazenil in comparison to propofol. (2) Methods: Electronic databases, including PubMed, Embase, Web of Science, and the Cochrane Library, were systematically searched from their inception up to 22 October 2023. Included in this analysis were randomized controlled trials (RCT) that compared remimazolam–flumazenil with propofol for the recovery from sedation and anesthesia in adults. The risk of bias was assessed using the Cochrane risk of bias tool. Pooled risk ratios (RR) or mean differences (MD) along with their corresponding 95% confidence intervals (CI) were calculated using either fixed-effects or random-effects models, and the results were visualized in forest plots. (3) Results: Nine RCTs involving 745 patients who underwent general anesthesia in three different countries were included. Compared to propofol, the remimazolam–flumazenil combination shortened the emergence time (MD = −4.34 min, 95% CI = [−6.88, −1.81], p = 0.0008, low certainty), extubation time (MD = −4.26 min, 95% CI = [−6.81, −1.7], p = 0.0011, low certainty), and the post-anesthesia care unit (PACU) stay (MD = −4.42 min, 95% CI = [−7.45, −1.38], p = 0.0044, low certainty), while reducing the incidence of respiratory depression (RR = 0.2, 95% CI = [0.04, 0.89], p = 0.03, high certainty) after general anesthesia. However, this combination was associated with a higher incidence of re-sedation (RR = 4.15, 95% CI = [1.31, 13.13], p = 0.01, moderate certainty). (4) Conclusions: Based on the existing evidence, the combination of remimazolam and flumazenil accelerates recovery from general anesthesia and lowers the risk of respiratory depression compared to propofol. However, it is important to consider the higher risk of re-sedation when using this combination in clinical practice. Due to limitations in the quality of the evidence, it is advisable to interpret the results of meta-analyses with caution.
Efficacy of Human Papillomavirus Vaccines for Recalcitrant Anogenital and Oral Warts
Authors: Ciccarese Giulia , Herzum Astrid , Serviddio Gaetano , Occella Corrado , Parodi Aurora , Drago Francesco
Published: November 2023

Human papillomavirus (HPV) vaccines are preventive measures to decrease HPV infection rates. Knowledge of their efficacy as treatment options for anogenital warts (AGWs) and oral warts (OWs) is limited. To evaluate the efficacy of HPV vaccinations in recalcitrant AGWs and OWs (lesions persisting more than 6 months despite conventional treatments), we compared a group of patients treated with standard therapies plus an HPV vaccine with a group of patients treated with standard therapies only. The response to treatment (in terms of the number of lesions) in the two groups was compared. Data were analyzed with the χ2 test and p values < 0.05 were considered to be statistically significant. The study included 14 patients (group A = cases) who received 3 doses of an intramuscular HPV vaccine (Gardasil 4 or Gardasil 9) in addition to the standard treatments for AGWs and OWs, and 15 age- and sex-matched patients (group B = controls) with an analogous number of lesions to group A who received only standard therapies. After 12 months, 85% of patients of group A versus 33% of group B had positive clinical outcomes (0.004). Our findings suggest a possible therapeutic role of HPV vaccines in addition to standard treatments for AGWs/OWs. Preventive vaccines, blocking the viral entry through the induction of L1-specific antibodies, can prevent autologous reinfections (through auto-inoculation) and favor the elimination of the virus.
CT Attenuation of Hepatic Pancreatic Cancer Metastases Correlates with Prognostically Detrimental Metastatic Necrosis
Authors: Reischl Stefan , Ziegelmayer Sebastian , Graf Markus , Gawlitza Joshua , Sauter Andreas Philipp , Steinhardt Manuel , Weber Marie-Christin , Neumann Philipp-Alexander , Makowski Marcus Richard , Lohöfer Fabian Karl , Mogler Carolin , Braren Rickmer Früdd
Published: November 2023

Percutaneous CT-guided biopsy is a frequently performed procedure for the confirmation and molecular workup of hepatic metastases of pancreatic ductal adenocarcinoma (PDAC). Tumor necrosis of primary PDAC has shown a negative prognostic impact in recent studies. This study aims to examine predictability in CT scans and the prognostic impact of necrosis in hepatic metastases of PDAC. In this tertiary-center retrospective cohort study, we included 36 patients with hepatic metastases of PDAC who underwent CT-guided hepatic biopsies. Normalized attenuation of the biopsied metastasis was determined in venous phase contrast-enhanced planning scans obtained prior to biopsy by automatic, threshold-based 3D segmentation and manual, blinded 2D segmentation. A board-certified pathologist specialized in hepatic pathology histologically quantified the tumor necrosis and cellularity of the biopsy cylinders. We found a significant inverse-linear correlation between normalized attenuation and the fraction of necrosis (Pearson’s r = 0.51, p < 0.001 for automatic 3D segmentation or Pearson’s r = 0.52, p < 0.001 for manual 2D segmentation), whereas no correlation was found with tumor cellularity. Additionally, we discovered that patients with a fraction of necrosis ≥ 20% in metastases had a significantly shorter overall survival (p < 0.035). In summary, tumor necrosis of PDAC metastases can be estimated from contrast-enhanced CT scans, which could help to improve biopsy sample pattern planning. In addition, liver metastatic necrosis may serve as a prognostic biomarker in PDAC.
Sex-Related Differences in the Prevalence of Classical, Non-Classical Risk Factors and Management of the Chronic Coronary Syndrome
Authors: Muszyński Paweł , Pawluczuk Elżbieta , Pasławska Marta , Kowalczuk Maciej , Kozakiewicz Julia , Sot-Muszyńska Natalia , Kożuch Marcin , Dobrzycki Sławomir
Published: November 2023

(1) Background: Coronary artery disease (CAD) remains the leading cause of death in both sexes. The male sex is considered a classical atherosclerosis risk factor, whereas females should be protected by hormonal effects until menopause. Although there are known differences in the development, type, and prognosis of chronic coronary syndrome (CCS) between both sexes, there are no differences in approach in the guidelines. (2) Methods: The sex-related differences in CAD risk factors, treatment, echocardiographic, and angiographic results were assessed among 3291 patients with CCS. (3) Results: Women were older and had a higher prevalence of hypertension, dyslipidaemia, and diabetes mellitus than men. Women were more often treated conservatively than men. There was no difference in the use of beta-blockers and statins among the sexes. The LDL cholesterol goal was less frequently reached by women. Women were treated less often with aspirin than men, but they were treated more often with angiotensin receptor blockers than men. The left ventricle ejection fraction was higher among females. The number of obstructed vessels was higher in men. (4) Conclusions: Women may be more exposed to the risk factors of CAD than men. Men are diagnosed with CAD earlier, and their prevention and therapy are more efficient.
Intra-Assessment Resting Metabolic Rate Variability Is Associated with Cardiometabolic Risk Factors in Middle-Aged Adults
Authors: Alcantara Juan M. A. , Osuna-Prieto Francisco J. , Castillo Manuel J. , Plaza-Florido Abel , Amaro-Gahete Francisco J.
Published: November 2023

The intra-assessment resting metabolic rate variability is related to cardiometabolic health, as suggested by previous literature. We studied whether that variability (expressed as coefficient of variation [CV; %]) for oxygen consumption (VO2), carbon dioxide production (VCO2), respiratory exchange ratio (RER), and resting energy expenditure (REE) is similar between men and women, and if is similarly associated with cardiometabolic risk factors. Gas exchange in 72 middle-aged adults was measured by indirect calorimetry. Anthropometrics and body composition, cardiorespiratory fitness, circulating cardiometabolic risk factors, and heart rhythm parameters were also determined. Men and women presented similar intra-assessment resting metabolic rate variability (all p > 0.05). Notably, in men, CV for RER was positively associated with BMI and adiposity (both standardized β = 0.35, Ps ≤ 0.048), while CVs for VO2, VCO2, and REE were negatively associated (standardized β ranged from −0.37 to −0.46, all p ≤ 0.036) with cardiometabolic risk factors. In women, CVs for VCO2 and REE were negatively associated with adiposity (both standardized β = −0.36, Ps ≤ 0.041) and cardiometabolic risk Z-score (standardized β = −0.40 and −0.38, respectively, Ps ≤ 0.05). In conclusion, intra-assessment resting metabolic rate variability could be considered an indicator of cardiometabolic health in middle-aged adults.
A Modified Technique for Two-Stage Revision in Knee PJI Treatment
Authors: Iorio Raffaele , Iannotti Ferdinando , Previ Leonardo , Viglietta Edoardo , Gugliotta Yuri , Corsetti Federico , Fenucci Simone , De Carli Angelo , Indelli Pier Francesco , Redler Andrea
Published: November 2023

Knee PJIs represent one of the most important complications after joint replacement surgery. If the prerequisites for implant retention do not subsist, the surgical treatment of these conditions is performed using one-stage and two-stage revision techniques. In this study, an implemented two-stage revision technique was performed, adopting antibiotic calcium sulfate beads and tumor-like debridement guided by methylene blue, such as described for the DAPRI technique. The aim of the present study is to compare the implemented two-stage revision technique with the standard technique in order to assess its effectiveness. Methods. Twenty patients affected by knee PJIs were prospectively enrolled in the study and underwent an implemented two-stage revision technique (Group A). Data collected and clinical results were compared with a matched control group treated with a standard two-stage technique (Group B). For each patient, the time of the reimplantation and length of antibiotic systemic therapy were recorded. Each patient underwent routine laboratory tests, including inflammatory markers. Results. In Group A and in Group B, inflammatory markers normalized at 6.5 ± 1.1. weeks and 11.1 ± 2.3 weeks, respectively (p < 0.05). Also, the difference in length of antibiotic therapy and time to reimplantation were significantly shorter in Group A (p < 0.05). No recurrence of infection was found in Group A at the last follow-up. Discussion. The implemented two-stage revision technique demonstrated a faster normalization of inflammatory markers, as well as a decrease in reimplantation time and duration of antibiotic therapy, compared to the traditional technique. The use of calcium sulfate antibiotic beads and tumor-like debridement seems to improve the results and reduce the time of healing. Conclusion. The implemented two-stage revision technique seems to improve the results and reduce the time of healing. This leads to a more rapid and less stressful course for the patient, as well as a reduction in health care costs.
Percutaneous Deep Venous Arterialization for Limb Salvage in No Option Patients with Chronic Limb-Threatening Ischemia
Authors: Spiliopoulos Stavros , Davoutis Efstathia , Arkoudis Nikolaos-Achilleas , Sritharan Kaji , Lechareas Symeon
Published: November 2023

An endovascular approach is often considered the first line treatment option for lower limb chronic limb-threatening ischemia (CLTI), which is defined by the presence of ischemic rest pain and severe tissue loss, such as ulcers or gangrene. Although the technical success rate of endovascular revascularization is high, in specific patients with advanced infrapopliteal disease and the absence of run-off tibial vessels, the so-called ‘desert foot’, the chance of successful endovascular revascularization is minimal. In order to avoid primary amputation, several treatment options are currently being investigated, including gene therapy and deep venous arterialization. This review focuses on the percutaneous deep venous arterialization technique as a promising, minimally invasive treatment option for limb salvage in CLTI patients presenting with a ‘desert foot’.
Grossly Bloody Colostrum—The Need for Staff Education and Maternal Support
Authors: Wszołek Katarzyna , Przewoźny Stanisław , Nowek Adrianna , Odor Angelika , Małyszka (Hoffmann) Paulina , Przybylski Marcin , Żurawski Jakub , Pięt Małgorzata , Wilczak Maciej
Published: November 2023

Background: Grossly bloody colostrum is defined as the presence of brownish or bloody-colored colostrum. The frequency is determined to be 0.1% of all births, and no predisposing factor for its occurrence was determined. The purpose of this study was to find factors that increase the probability of the syndrome and the possible influence of the presence of erythrocytes (red blood cells—RBCs) in breast milk on the symptoms of maternal milk intolerance in newborns. Methods: Here, 2 mL of colostrum was collected from 137 participants on postpartum days 1–3, separately from each breast, and transferred to the laboratory. For microscopic analysis, 0.5 mL of colostrum was centrifuged and then stained using the May–Grünwald–Giemsa method. Using an Olympus BX 43 light microscope at 400× total magnification, samples were visually assessed for the presence of RBCs. Additionally, the participants completed a questionnaire regarding their health status, observation of feeding tolerance of the newborn, observed milk color and other factors. Results: The number of RBCs in the yellow or white colostrum samples ranged from 8 to 1000 RBCs/mL and was found in 24.8% of cases. Regardless of the number of RBCs, the color of the milk was white (28.5%) or yellow (66.4%). Only one participant (0.7%) presented classical bloody-stained colostrum with visible bloody-milk colorization. We did not observe the influence of any analyzed factor as the reason for the increased number of RBCs in the colostrum. Conclusions: The presence of RBCs in breast milk did not cause milk intolerance among newborns and was independent of the analyzed factors. Mothers should be supported, and in view of the overall composition of breast milk, especially the content of immune cells in colostrum, even a temporary interruption in breast milk feeding in the case of grossly bloody colostrum is not recommended.
Comparative Study of the Efficacy of Anti-CGRP mAbs on Migraineurs: Analysis of the First Year of Therapy, 1-Month Suspension Period, and Reprisal
Authors: Tereshko Yan , Dal Bello Simone , Pez Sara , Belgrado Enrico , Lettieri Christian , Ercole Bruno Hector , Cellante Giulia , Del Regno Caterina , Sportelli Giuseppe , Ermanis Giovanni , Versace Salvatore , Merlino Giovanni , Gigli Gian Luigi , Valente Mariarosaria
Published: November 2023

Background: Few studies compare the clinical effectiveness of the three anti-CGRP mAbs. Moreover, no studies compare their efficacy during suspension and reprisal. Our study aimed to compare the efficacy of migraine frequency, intensity, and symptomatic medication intake during the first year of therapy, a 1-month suspension period, and a 3-month drug reprisal. Methods: A total of 160 migraineurs (chronic and high-frequency episodic) were treated with anti-CGRP mAbs (49 with fremanezumab, 55 with erenumab, and 55 with galcanezumab) for 12 months. They discontinued the therapy for 1 month and then reprised the therapy. In the three groups, we analyzed and compared the migraine days per month, migraine intensity, and symptomatic medication intake per month at baseline, 3-month, 6-month, and 12-month follow-up. We also compared these variables during the 1-month suspension and 3 months after the reprisal of the therapy. We compared the data and evaluated the response rate (>50% reduction in migraine days per month) at different follow-ups. This comparison was also performed separately for chronic and high-frequency episodic migraineurs. Results: There was no statistical difference in monthly migraine days, intensity, or symptomatic medication intake per month at the different follow-ups. Moreover, there was no difference in the response rate overall. However, in chronic migraineurs treated with galcanezumab, the response rate was higher during the 1-month suspension when compared to fremanezumab and erenumab. In high-frequency episodic migraineurs, fremanezumab had a higher response rate at 12-month follow-up when compared to galcanezumab and erenumab. Conclusions: In our study, the three anti-CGRP mAbs presented a similar response, with no significant differences, during the first year of therapy, the suspension period, and 3 months after the drug reprisal. The response rate during the 1-month suspension period in chronic migraineurs may be higher with galcanezumab.
How Refined Surgical Technical Solutions Can Make Bentall Operation a Low-Risk Procedure: 20-Year Personal Experience at the “Root” of the Aortic Diseases—It Is Time to Change Surgical Guidelines
Authors: Ruvolo Giovanni , Altieri Claudia , Bassano Carlo , Buioni Dario , Nardi Paolo , Pisano Calogera
Published: November 2023

(1) Objective: Twenty years’ experience of Bentall–De Bono operations by one surgeon. (2) Methods: From January 2003 to September 2023, four-hundred-and-two patients aged 65.9 ± 15 years underwent a Bentall operation. The EuroScore-2 was 5.0% ± 3.8%. Associated procedures were performed on 113 patients (28.1%). Results: Operative mortality was 1.2% (n = 5), in particular 0.69% (n = 2/289) for isolated Bentall operation, 2.65% (n = 3/113) for combined procedures (p < 0.05). Postoperative acute heart failure occurred in 38 patients (9.45%). Preoperative pulmonary hypertension (44 ± 14 vs. 33 ± 7 mmHg), cardiopulmonary bypass time (169 ± 61 min. vs. 124 ± 42 min.) and aortic cross-clamp time (133 ± 45 min. vs. 107 ± 34 min.) have been recognized as independent predictors of mortality and cardiac complications (p < 0.05). Conclusions: In our experience, the Bentall operation was associated with low operative mortality and low rate of complications. For this reason, in agreement with the patients, we have modified surgical indication for ascending aortic aneurysms and now we think that it is time to change surgical guidelines.
Maternal Stress, Anxiety, Well-Being, and Sleep Quality in Pregnant Women throughout Gestation
Authors: Pascal Rosalia , Casas Irene , Genero Mariona , Nakaki Ayako , Youssef Lina , Larroya Marta , Benitez Leticia , Gomez Yvan , Martinez-Aran Anabel , Morilla Ivette , Oller-Guzmán Teresa M. , Martín-Asuero Andrés , Vieta Eduard , Crispi Fàtima , Gratacos Eduard , Gomez-Roig María Dolores , Crovetto Francesca
Published: November 2023

Background: Maternal stress, anxiety, well-being, and sleep quality during pregnancy have been described as influencing factors during pregnancy. Aim: We aimed to describe maternal stress, anxiety, well-being, and sleep quality in pregnant women throughout gestation and their related factors. Methods: A prospective study including pregnant women attending BCNatal, in Barcelona, Spain (n = 630). Maternal stress and anxiety were assessed by the Perceived Stress Scale (PSS) and State-Trait Anxiety Inventory (STAI)-validated questionnaires. Maternal well-being was assessed using the World Health Organization Well-Being Index Questionnaire (WHO-5), and sleep quality was assessed using the Pittsburgh Sleep Quality Index Questionnaire (PSQI). All questionnaires were obtained twice during the second and third trimester of pregnancy. A multivariate analysis was conducted to assess factors related to higher maternal stress and anxiety and worse well-being and sleep quality. Results: High levels of maternal stress were reported in 23.1% of participants at the end of pregnancy, with maternal age <40 years (OR 2.02; 95% CI 1.08–3.81, p = 0.03), non-white ethnicity (OR 2.09; 95% CI 1.19–4.02, p = 0.01), and non-university studies (OR 1.86; 95% CI 1.08–3.19, p = 0.02) being the parameters mostly associated with it. A total of 20.7% of women had high levels of anxiety in the third trimester and the presence of psychiatric disorders (OR 3.62; 95% CI 1.34–9.78, p = 0.01) and non-university studies (OR 1.70; 95% CI 1.11–2.59, p = 0.01) provided a significant contribution to high anxiety at multivariate analysis. Poor maternal well-being was observed in 26.5% of women and a significant contribution was provided by the presence of psychiatric disorders (OR 2.96; 95% CI 1.07–8.25, p = 0.04) and non-university studies (OR 1.74; 95% CI 1.10–2.74, p = 0.02). Finally, less sleep quality was observed at the end of pregnancy (p < 0.001), with 81.1% of women reporting poor sleep quality. Conclusion: Maternal stress and anxiety, compromised maternal well-being, and sleep quality disturbances are prevalent throughout pregnancy. Anxiety and compromised sleep quality may increase over gestation. The screening of these conditions at different stages of pregnancy and awareness of the associated risk factors can help to identify women at potential risk.
Changes in Gait Parameters and the Podal System Depending on the Presence of a Specific Malocclusion Type in School-Age Children
Authors: Różańska-Perlińska Dorota , Jaszczur-Nowicki Jarosław , Rydzik Łukasz , Perliński Jacek , Bukowska Joanna M.
Published: November 2023

Background: The correspondence between various aspects of human postural parameters and the spatial relation of the jaws is of increasing interest among scientists. Emerging research suggests that the stomatognathic system and posture play, in a broad sense, significant roles. Objectives: The aim of the study was to analyze the relationship between various malocclusion types and gait parameters, the distribution of foot pressure on the ground, and body balance. Methods: The study involved 155 patients aged 12-16. The subjects were divided into groups according to their malocclusion—Angle’s class II (n = 32), Canine class II (n = 31), and Overbite (n = 46). The control group (n = 46) comprised children not demonstrating any defects. The study data were collected by direct observation of the oral cavity. Gait analysis was carried out using the Wiva® Science sensor, and the distribution of foot forces on the ground and body balance was determined via the E.P.S R/1 pedobarographic mat. The non-parametric Mann–Whitney U test was applied for statistical analysis. Results: Analysis of the results obtained showed statistically significant differences in left step duration (p = 0.042) and the duration of the right step (p = 0.021), as well as the projection of the body’s center of gravity on the left foot (p = 0.027). Conclusions: Distoocclusion in the anterior part of the mandible may cause different positioning of the head and neck, as well as varying tension of the muscles, further leading to balance disorders while walking.
A Novel Model to Predict Inadequate Bowel Preparation Prior to Colonoscopy Incorporating Patients’ Reactions to Drinking the Laxative
Authors: Malkin Daniela , Cohen Daniel L. , Richter Vered , Ariam Eran , Vosko Sergei , Shirin Haim , Bermont Anton
Published: November 2023

Background and Aims: Prior studies have identified predictors of inadequate preparation with limited success. We aimed to build a model that could predict the likelihood of inadequate preparation by also including factors related to the patient’s reaction to drinking the laxative preparation. Methods: Demographic, clinical, and preparation-related data were prospectively collected on patients undergoing colonoscopy. An inadequate preparation was defined as a Boston Bowel Preparation Scale < 6. Statistical analyses were performed to identify predictors of inadequate preparation and create a predictive model. Results: 324 patients were included (age 67 +/− 14 years, 52% male). 77 (23.7%) had inadequate preparations. Diabetes (p < 0.001), cerebrovascular accident (CVA) (p < 0.001), incomplete prep consumption (p = 0.007), high school level education and above (p < 0.001), use of Bisacodyl (p = 0.005), >10 bowel movements (p = 0.02), and use of Sodium Picosulfate or low-volume polyethylene glycol (PEG) solution (2L) compared to PEG 3L (p < 0.001) were significant variables. In a multivariate analysis, prior CVA increased the risk for inadequate preparation (OR = 4.8, CI 1.6–14.5), whereas high school level education and above (OR = 0.4, CI 0.2–0.8), consumption of Bisacodyl (OR = 0.4, CI 0.2–0.8), >10 bowel movements (OR = 0.5, CI 0.3–0.9), and use of Sodium Picosulfate (OR = 0.5, CI 0.3–0.9) decreased the risk for inadequate prep. Using these, a predictive model for patients likely to have an inadequate colon preparation was created with an area under the curve of 0.74 (35% sensitivity, 90% specificity at a cutoff point of 39%). Conclusion: Given the low sensitivity, this predictive model does not appear ready for clinical use. However, due to its high specificity, it may be helpful in high-risk, sicker populations by preventing inadequately prepped procedures.
Intracerebral Hemorrhage Caused by the Rupture of a Traumatic Pseudoaneurysm in the Middle Meningeal Artery
Authors: Kim Myoung Soo , Kim Younghwan
Published: November 2023

Hematomas caused by the rupture of a pseudoaneurysm in the middle meningeal artery (MMA) after trauma usually present as epidural hematomas. Intracerebral hemorrhage (ICH) is extremely rare. We reviewed ICH due to the rupture of MMA pseudoaneurysms. We found that in cases of acute ICH, a pseudoaneurysm was attached to the outer surface of the dura mater and associated with dura tear. In patients with acute ICH, the intraoperative rupture of a pseudoaneurysm developed just after bone flap removal. In cases of delayed ICH, pseudoaneurysms adhered to the inner surface of the dura mater. In patients with delayed ICH, the intraoperative rupture of a pseudoaneurysm developed during dura opening and hematoma removal. In situations of dura tear after trauma, the rupture of pseudoaneurysms might lead to ICH via a dura tear. Pseudoaneurysms that develop in the MMA after trauma may exert pressure and result in the thinning of the dura mater. In this case, pseudoaneurysms will adhere to the inner surface of the dura mater after several days or weeks. ICH might develop through both acute and delayed mechanisms following the development of pseudoaneurysms in the MMA. Clinicians should pay attention to the timing of such ruptures during operations for both acute and delayed ICH.
Predicting Genitourinary Injuries in Polytraumatized Patients—Development of the GUIPP Scoring System
Authors: Mair Olivia , Müller Michael , Rittstieg Philipp , Zehnder Philipp , Lefering Rolf , Biberthaler Peter , Wenk Maren J. , Hanschen Marc ,   The TraumaRegister DGU
Published: November 2023

Background: The genitourinary system is not as commonly affected as many other organ systems in severely injured patients. Although a delayed and missed diagnosis of genitourinary injuries (GUIs) can severely compromise long-term outcomes, these injuries are frequently overlooked. Therefore, we present a scoring system designed to assist emergency physicians in diagnosing GUIs in severely injured patients. Methods: The data were obtained from the TraumaRegister DGU® from the years 2015–2021. All severely injured patients (ISS ≥ 16) ≥16 years of age and treated in Germany, Austria, or Switzerland were included in this study. We excluded patients who were transferred out early (48 h), and all patients with isolated traumatic brain injury. After the univariate analysis of the relevant predictive factors, we developed a scoring system using a binary logistic regression model. Results: A total of 70,467 patients were included in this study, of which 4760 (6.8%) sustained a GUI. Male patients (OR: 1.31, 95% CI [1.22, 1.41]) injured in motorcycle accidents (OR: 1.70, 95% CI [1.55, 1.87]), who were under 60 years of age (OR: 1.59, 95% CI [1.49, 1.71]) and had sustained injuries in multiple body regions (OR: 6.63, 95% CI [5.88, 7.47]), and suffered severe pelvic girdle injuries (OR: 2.58, 95% CI [2.29, 2.91]) had the highest odds of sustaining a GUI. With these predictive factors combined, a novel scoring system, the GUIPP score, was developed. It showed good validity, with an AUC of 0.722 (95% CI [0.71; 0.73]). Conclusion: Predicting GUI in severely injured patients remains a challenge for treating physicians, but is extremely important to prevent poor outcomes for affected patients. The GUIPP score can be utilized to initiate appropriate diagnostic steps early on in order to reduce the delayed and missed diagnosis of GUI, with scores ≥ 9 points making GUIs very likely.
Monitoring of Inflammatory Bowel Disease in Pregnancy: A Review of the Different Modalities
Authors: Al-jabri Reem , Wetwittayakhlang Panu , Lakatos Peter L.
Published: November 2023

Inflammatory Bowel Disease (IBD) significantly affects women in their reproductive years. Understanding the relationship between IBD and pregnancy is crucial, given its impact across pre-gestational, gestational, and postpartum phases. Monitoring IBD activity during pregnancy involves various modalities. This review discusses these modalities, focusing on the efficacy and safety of Small Intestine Ultrasound (IUS) as a noninvasive and reliable option. While IUS has gained popularity, its technique-sensitive nature necessitates trained staff for optimal usage.
Clinical Characterisation and Comorbidities of Acquired Generalised Lipodystrophy: A 14-Year Follow-Up Study
Authors: Fernandez-Pombo Antia , Prado-Moraña Teresa , Diaz-Lopez Everardo Josue , Sanchez-Iglesias Sofia , Castro Ana I. , Cobelo-Gomez Silvia , Araujo-Vilar David
Published: November 2023

Acquired generalised lipodystrophy (AGL) is a rare disorder characterised by the gradual loss of fat that tends to generalise over time, the origin of which is still not fully clarified. The aim of this study was to offer a detailed description of seven patients with AGL (five women, 33.8 ± 18.6 years of age), evaluated over the last 14 years, in order to augment the knowledge of this disorder. The onset of the phenotype occurred during childhood and adolescence in five cases, and in adulthood in two cases. Three patients reported infections or vaccine administration prior to the development of lipodystrophy, and two subjects reported nodular swelling. The most frequent physical features were phlebomegaly, umbilical protrusion/hernia, and acanthosis nigricans. Skinfolds and body composition analysis showed the generalised absence of fat, with the exception of one patient in whom fat loss was spared in the trunk. The loss of fat in the palms/soles was observed in five subjects. Regarding metabolic comorbidities, throughout follow-up, two patients developed type 1 diabetes and one type 2 diabetes; three also presented hypertriglyceridaemia, one of whom developed acute pancreatitis, and no macrovascular complications were observed. Only one patient showed decreased complement C4. Autoimmunity was present in all cases, and six patients manifested Hashimoto’s thyroiditis, type 1 diabetes, autoimmune hepatitis, and/or celiac disease. Thus, there are certain clinical characteristics of AGL that may be considered important diagnostic criteria to differentiate this disorder from other lipodystrophy subtypes.
Expired Platelet Concentrate Up-Cycling: Growth Factor-Rich Bioproduct Preparation for FBS Substitute
Authors: Lee Eun Hye , Chun So Young , Yoon Bo Hyun , Jeon Minji , Ha Yun-Sok , Chung Jae-Wook , Kwon Joonbeom , Kim Jeongshik , Hwan Kim Dae , Park Sang-Joon , Kwon Tae Gyun , Kim Bum Soo , Kim Hyun Tae
Published: November 2023

Due to the short storage period, large quantities of platelet concentrate (PC) are expiring. The expired PC cannot be injected into a blood vessel, but the activity of bioactive molecules, especially growth factors, is still preserved. In this paper, we organized a process to obtain a growth factor-rich bioproduct for use as a supplement in human cell culture by optimizing freezing, thawing, and sterilization conditions. Each unit of PC displayed visual differences, diverse biochemical values, and growth factor concentrations. To minimize lot-to-lot variation, we pooled a minimum of 10 PC units. The concentrations of growth factors were maximized through five freeze–thaw cycles for 12 h at −80 °C for freezing and for 5 min at 36 °C for thawing. We used a cell strainer with 40 µm pores, followed by a 0.45 μm filter and a 0.22 μm filter sequentially to sterilize the bioproduct with minimizing loss. The obtained growth factors remained stable for 4–6 h at room temperature (23 °C), 24 h at 4 °C, and 12 months at −80 °C. Cellular responses to the growth factor-rich bioproduct were tested with primary human renal proximal tubule epithelial cells. The cells exhibited a significantly increased growth rate, compared to the fetal bovine serum (FBS)-treated control group. The cells maintained their characteristic cuboidal shape, and stem cells and renal progenitor cells also preserved their genetic characteristics during culture. Therefore, the growth factor-rich bioproduct isolated from expired PC through our process can be used as a medium supplement to replace FBS in human cell culture for clinical application.
Assessment of Isokinetics and Range of Motion of the Shoulder in Patients after Reverse Shoulder Arthroplasty in the Late Follow-Up Period
Authors: Ogrodzka-Ciechanowicz Katarzyna , Kurzeja Piotr , Sorysz Tomasz
Published: November 2023

(1) Background: The aim of the study was to evaluate the peak torque (PT) in isokinetic conditions and the range of motion of the shoulder joint in patients after reverse total shoulder arthroplasty in the late treatment period. (2) Methods: The study included fifteen patients aged 60–70 years (13 women and 2 men). The comparison group consisted of 15 healthy subjects (12 women and 3 men) aged 60–69 years. The study included measurement of peak torque (PT) and the range of motion of the shoulder joint, assessed using the Biodex System 4 Pro set, and an electronic goniometer. We conducted tests at two different angular velocities (60°/s and 90°/s), taking into account the operated and non-operated limb and comparing the results to healthy subjects. The average time from surgery to functional examination was 16 months. (3) Results: The non-operated limb generated significantly higher PT values than the operated limb (p < 0.001). The healthy limb of patients from the comparison group generated significantly higher PT values than the operated limb of patients from the study group (p < 0.001). A significant improvement (p < 0.001) in the range of motion in the operated limb was achieved after rTSA. (4) Conclusions: In patients 18 months after the rTSA, the non-operated upper limb has significantly greater muscle strength in flexion/extension and abduction/adduction movements compared to the operated limb. The non-operated limb also has a significantly greater range of motion compared to the operated limb.
Applications of Sustainable Hybrid Energy Harvesting: A Review
Authors: Shaukat Hamna , Ali Ahsan , Ali Shaukat , Altabey Wael A. , Noori Mohammad , Kouritem Sallam A.
Published: November 2023

This paper provides a short review of sustainable hybrid energy harvesting and its applications. The potential usage of self-powered wireless sensor (WSN) systems has recently drawn a lot of attention to sustainable energy harvesting. The objective of this research is to determine the potential of hybrid energy harvesters to help single energy harvesters overcome their energy deficiency problems. The major findings of the study demonstrate how hybrid energy harvesting, which integrates various energy conversion technologies, may increase power outputs, and improve space utilization efficiency. Hybrid energy harvesting involves collecting energy from multiple sources and converting it into electrical energy using various transduction mechanisms. By properly integrating different energy conversion technologies, hybridization can significantly increase power outputs and improve space utilization efficiency. Here, we present a review of recent progress in hybrid energy-harvesting systems for sustainable green energy harvesting and their applications in different fields. This paper starts with an introduction to hybrid energy harvesting, showing different hybrid energy harvester configurations, i.e., the integration of piezoelectric and electromagnetic energy harvesters; the integration of piezoelectric and triboelectric energy harvesters; the integration of piezoelectric, triboelectric, and electromagnetic energy harvesters; and others. The output performance of common hybrid systems that are reported in the literature is also outlined in this review. Afterwards, various potential applications of hybrid energy harvesting are discussed, showing the practical attainability of the technology. Finally, this paper concludes by making recommendations for future research to overcome the difficulties in developing hybrid energy harvesters. The recommendations revolve around improving energy conversion efficiency, developing advanced integration techniques, and investigating new hybrid configurations. Overall, this study offers insightful information on sustainable hybrid energy harvesting together with quantitative information, numerical findings, and useful research recommendations that progress and promote the use of this technology.
Surface Characteristics and Residual Stress Variation in Semi-Deep Hole Machining of Ti6Al4V ELI with Low-Frequency Vibration-Assisted Drilling
Authors: Choe Joon-Hyeok , Ha Ju Hyung , Kim Jisoo , Kim Dong Min
Published: November 2023

This study examined the impact of vibration-assisted drilling (VAD) on hole quality and residual stress in Ti-6Al-4V ELI (Extra Low Interstitials) material. Ti-6Al-4V ELI possesses excellent mechanical properties but presents challenges in machining, including chip evacuation, burr formation, and elevated cutting temperatures. VAD, particularly low-frequency vibration-assisted drilling (LF-VAD), has been explored as a potential solution to address these issues. The research compares LF-VAD with conventional drilling (CD) under various cutting and cooling conditions. LF-VAD exhibits higher maximum thrust forces under specific conditions, which result in accelerated tool wear. However, it also demonstrates lower RMS (root mean square) forces compared to CD, offering better control over chip formation, reduced burr formation, and improved surface roughness within the hole. Furthermore, LF-VAD generates greater compressive residual stresses on the hole’s inner surface compared to CD, suggesting enhanced fatigue performance. These findings indicate that LF-VAD holds promise for improving the hole’s surface characteristics, fatigue life, and overall component durability in Ti-6Al-4V machining applications.