bluuebunny/crossref_metadata_2025 huggingface dataset:
Behavioural Interventions in People with Oropharyngeal Dysphagia: A Systematic Review and Meta-Analysis of Randomised Clinical Trials
Authors: Speyer Renée , Cordier Reinie , Sutt Anna-Liisa , Remijn Lianne , Heijnen Bas Joris , Balaguer Mathieu , Pommée Timothy , McInerney Michelle , Bergström Liza
Published: January 2022

Objective: To determine the effects of behavioural interventions in people with oropharyngeal dysphagia. Methods: Systematic literature searches were conducted to retrieve randomized controlled trials in four different databases (CINAHL, Embase, PsycINFO, and PubMed). The methodological quality of eligible articles was assessed using the Revised Cochrane risk-of-bias tool for randomised trials (RoB 2), after which meta-analyses were performed using a random-effects model. Results: A total of 37 studies were included. Overall, a significant, large pre-post interventions effect size was found. To compare different types of interventions, all behavioural interventions and conventional dysphagia treatment comparison groups were categorised into compensatory, rehabilitative, and combined compensatory and rehabilitative interventions. Overall, significant treatment effects were identified favouring behavioural interventions. In particular, large effect sizes were found when comparing rehabilitative interventions with no dysphagia treatment, and combined interventions with compensatory conventional dysphagia treatment. When comparing selected interventions versus conventional dysphagia treatment, significant, large effect sizes were found in favour of Shaker exercise, chin tuck against resistance exercise, and expiratory muscle strength training. Conclusions: Behavioural interventions show promising effects in people with oropharyngeal dysphagia. However, due to high heterogeneity between studies, generalisations of meta-analyses need to be interpreted with care.
Effectiveness of Lifestyle Modification vs. Therapeutic, Preventative Strategies for Reducing Cardiovascular Risk in Primary Prevention—A Cohort Study
Authors: Chlabicz Małgorzata , Jamiołkowski Jacek , Łaguna Wojciech , Dubatówka Marlena , Sowa Paweł , Łapińska Magda , Szpakowicz Anna , Zieleniewska Natalia , Zalewska Magdalena , Raczkowski Andrzej , Kamiński Karol A.
Published: January 2022

Background: Cardiovascular diseases (CVD) are still the leading cause of death in developed countries. The aim of this study was to calculate the potential for CV risk reduction when using three different prevention strategies to evaluate the effect of primary prevention. Methods: A total of 931 individuals aged 20–79 years old from the Bialystok PLUS Study were analyzed. The study population was divided into CV risk classes. The Systematic Coronary Risk Estimation (SCORE), Framingham Risk Score (FRS), and LIFE-CVD were used to assess CV risk. The optimal prevention strategy assumed the attainment of therapeutic goals according to the European guidelines. The moderate strategy assumed therapeutic goals in participants with increased risk factors: a reduction in systolic blood pressure by 10 mmHg when it was above 140 mmHg, a reduction in total cholesterol by 25% when it was above 190 mg/dL, and a reduction in body mass index below 30. The minimal prevention strategy assumed that CV risk would be lowered by lifestyle modifications. The greatest CV risk reduction was achieved in the optimal model and then in the minimal model, and the lowest risk reduction was achieved in the moderate model, e.g., using the optimal model of prevention (Model 1). In the total population, we achieved a reduction of −1.74% in the 10-year risk of CVD death (SCORE) in relation to the baseline model, a −0.85% reduction when using the moderate prevention model (Model 2), and a −1.11% reduction when using the minimal prevention model (Model 3). However, in the low CV risk class, the best model was the minimal one (risk reduction of −0.72%), which showed even better results than the optimal one (reduction of −0.69%) using the FRS. Conclusion: A strategy based on lifestyle modifications in a population without established CVD could be more effective than the moderate strategy used in the present study. Moreover, applying a minimal strategy to the low CV risk class population may even be beneficial for an optimal model.
Long Term Prognostic Value of Contractile Reserve Assessed by Global Longitudinal Strain in Patients with Asymptomatic Severe Aortic Stenosis
Authors: Arbucci Rosina , Lowenstein Haber Diego M. , Rousse María Graciela , Saad Ariel K. , Martínez Golleti Liliana , Gastaldello Natalio , Amor Miguel , Caniggia Cristian , Merlo Pablo , Zambrana Gustavo , Galello Marcela , Clos Esteban , Mora Vicente , Lowenstein Jorge A.
Published: January 2022

Background. Left ventricle (LV) global longitudinal strain (GLS) at rest has shown prognostic value in patients (pts) with severe aortic stenosis (SAS). Contractile reserve (CR) during exercise stress echo (ESE) estimated via GLS (CR-GLS) could better stratify the asymptomatic patients who could benefit from early intervention. Aims. To determine the long-term prognostic value of CR-GLS in patients with asymptomatic SAS with an ESE without inducible ischemia. Additionally, to compare the prognostic value of CR assessed via ejection fraction (CR-EF) and CR-GLS. Methods. In a prospective, single-center, observational study between 2013 and 2019, 101 pts with asymptomatic SAS and preserved left ventricular ejection fraction (LVEF) > 55% were enrolled. CR was considered present with an exercise-rest increase in LVEF (Simpson’s rule) ≥ 5 points and > 2 absolute points in GLS. Patients were assigned to 2 groups (G): G1: 56 patients with CR-GLS present; and G2: 45 patients CR-GLS absent. All patients were followed up. Results. G2 Patients were older, with lower exercise capability, less aortic valve area (AVA), a higher peak aortic gradient, and less LVEF (71.5% ± 5.9 vs. 66.8% ± 7.9; p = 0.002) and GLS (%) at exercise (G1: −22.2 ± 2.8 vs. G2: −18.45 ± 2.4; p = 0.001). During mean follow-up of 46.6 ± 3.4 months, events occurred in 45 pts., with higher incidence in G2 (G2 = 57.8% vs. G1 = 42.2%, p < 0.01). At Cox regression analysis, CR-GLS was an independent predictor of major cardiovascular events (HR: 1.98, 95% CI 1.09–3.58, p = 0.025). Event-free survival was lower for patients with CR-GLS absent (log rank test p = 0.022). CR-EF was not outcome predictive (log rank test p 0.095). Conclusions: In patients with asymptomatic SAS, the absence of CR-GLS during ESE is associated with worse prognosis. Additionally, CR-GLS was a better predictor of events than CR-EF.
Accuracy of Deep Learning Echocardiographic View Classification in Patients with Congenital or Structural Heart Disease: Importance of Specific Datasets
Authors: Wegner Felix , Benesch Vidal Maria , Niehues Philipp , Willy Kevin , Radke Robert , Garthe Philipp , Eckardt Lars , Baumgartner Helmut , Diller Gerhard-Paul , Orwat Stefan
Published: January 2022

Introduction: Automated echocardiography image interpretation has the potential to transform clinical practice. However, neural networks developed in general cohorts may underperform in the setting of altered cardiac anatomy. Methods: Consecutive echocardiographic studies of patients with congenital or structural heart disease (C/SHD) were used to validate an existing convolutional neural network trained on 14,035 echocardiograms for automated view classification. In addition, a new convolutional neural network for view classification was trained and tested specifically in patients with C/SHD. Results: Overall, 9793 imaging files from 262 patients with C/SHD (mean age 49 years, 60% male) and 62 normal controls (mean age 45 years, 50.0% male) were included. Congenital diagnoses included among others, tetralogy of Fallot (30), Ebstein anomaly (18) and transposition of the great arteries (TGA, 48). Assessing correct view classification based on 284,250 individual frames revealed that the non-congenital model had an overall accuracy of 48.3% for correct view classification in patients with C/SHD compared to 66.7% in patients without cardiac disease. Our newly trained convolutional network for echocardiographic view detection based on over 139,910 frames and tested on 35,614 frames from C/SHD patients achieved an accuracy of 76.1% in detecting the correct echocardiographic view. Conclusions: The current study is the first to validate view classification by neural networks in C/SHD patients. While generic models have acceptable accuracy in general cardiology patients, the quality of image classification is only modest in patients with C/SHD. In contrast, our model trained in C/SHD achieved a considerably increased accuracy in this particular cohort.
Safety and Long-Term Immunogenicity of BNT162b2 Vaccine in Individuals with Down Syndrome
Authors: Valentini Diletta , Cotugno Nicola , Scoppola Vittorio , Di Camillo Chiara , Colagrossi Luna , Manno Emma Concetta , Perno Carlo Federico , Russo Cristina , Palma Paolo , Rossi Paolo , Villani Alberto
Published: January 2022

We aimed to evaluate the safety and immunogenicity of the BNT162b2 vaccine in young people with Down syndrome (DS), and to compare their humoral immune response with those of the healthy controls (HC). Individuals with DS and HC received the BNT162b2 vaccine. Longitudinal blood samples were collected on the day of vaccination, twenty-one days after the first dose, seven days after the second dose, and six months after the first dose. Both the local and systemic adverse events reported by participants were mild. Pain at the injection site was the most reported local adverse event, while fever was the systemic adverse event. Humoral responses showed a significant increase of anti-S and anti-S trimeric antibody (Ab) levels after both doses of vaccine in both groups. In comparison with HC, Ab levels in individuals with DS were similar at T21, but significantly lower, both in terms anti-S and anti-S trimeric, at T28 (respectively p = 0.0003 and p = 0.0001). At T180 both groups showed a significant reduction of anti-S trimeric Ab levels compared to T28 (p = 0.0004 and p < 0.0001 for DS and HC, respectively). Individuals with DS exhibit a good humoral response to the BNT162b2 vaccine; however, similarly to in HC, the immune response wanes over time.
Living Kidney Donor Knowledge of Provided Information and Informed Consent: The PRINCE Study
Authors: Spoon Emerentia Q. W. , Kortram Kirsten , Ismail Sohal Y. , Nieboer Daan , d’Ancona Frank C. H. , Christiaans Maarten H. L. , Dam Ruth E. , Hofker Hendrik Sijbrand , Hoksbergen Arjan W. J. , van der Pant Karlijn Ami , Toorop Raechel J. , van de Wetering Jacqueline , Ijzermans Jan N. M. , Dor Frank J. M. F. ,   on behalf of the Dutch Working Group Informed Consent for Live Donor Nephrectomy (“PRINCE”)
Published: January 2022

Background: Informed consent for living kidney donation is paramount, as donors are healthy individuals undergoing surgery for the benefit of others. The informed consent process for living kidney donors is heterogenous, and the question concerns how well they are actually informed. Knowledge assessments, before and after donor education, can form the basis for a standardized informed consent procedure for live kidney donation. Methods: In this prospective, a multicenter national cohort study conducted in all eight kidney transplant centers in The Netherlands, we assessed the current status of the informed consent practice for live donor nephrectomy. All of the potential living kidney donors in the participating centers were invited to participate. They completed a pop quiz during their first outpatient appointment (Cohort A). Living kidney donors completed the same pop quiz upon admission for donor nephrectomy (Cohort B). Results: In total, 656 pop quizzes were completed (417 in Cohort A, and 239 in Cohort B). The average donor knowledge score was 7.0/25.0 (±3.9, range 0–18) in Cohort A, and 10.5/25.0 (±2.8, range 0–17.5) in Cohort B. Cohort B scored significantly higher on overall knowledge, preparedness, and the individual item scores (p < 0.0001), except for the long-term complications (p = 0.91). Conclusions: Donor knowledge generally improves during the live donor workup, but it is still quite disappointing. Long-term complications, especially, deserve more attention during living kidney donor education.
Pregnant and Postpartum Women Requiring Intensive Care Treatment for COVID-19—First Data from the CRONOS-Registry
Authors: Sitter Magdalena , Pecks Ulrich , Rüdiger Mario , Friedrich Sabine , Fill Malfertheiner Sara , Hein Alexander , Königbauer Josefine T. , Becke-Jakob Karin , Zöllkau Janine , Ramsauer Babett , Rathberger Katharina , Pontones Constanza A. , Kraft Katrina , Meybohm Patrick , Härtel Christoph , Kranke Peter ,   CRONOS Network
Published: January 2022

(1) Background: Data on coronavirus 2 infection during pregnancy vary. We aimed to describe maternal characteristics and clinical presentation of SARS-CoV-2 positive women requiring intensive care treatment for COVID-19 during pregnancy and postpartum period based on data of a comprehensive German surveillance system in obstetric patients. (2) Methods: Data from COVID-19 Related Obstetric and Neonatal Outcome Study (CRONOS), a prospective multicenter registry for SARS-CoV-2 positive pregnant women, was analyzed with respect to ICU treatment. All women requiring intensive care treatment for COVID-19 were included and compared regarding maternal characteristics, course of disease, as well as maternal and neonatal outcomes. (3) Results: Of 2650 cases in CRONOS, 101 women (4%) had a documented ICU stay. Median maternal age was 33 (IQR, 30–36) years. COVID-19 was diagnosed at a median gestational age of 33 (IQR, 28–35) weeks. As the most invasive form of COVID-19 treatment interventions, patients received either continuous monitoring of vital signs without further treatment requirement (n = 6), insufflation of oxygen (n = 30), non-invasive ventilation (n = 22), invasive ventilation (n = 28), or escalation to extracorporeal membrane oxygenation (n = 15). No significant clinical differences were identified between patients receiving different forms of ventilatory support for COVID-19. Prevalence of preterm delivery was significantly higher in women receiving invasive respiratory treatments. Four women died of COVID-19 and six fetuses were stillborn. (4) Conclusions: Our cohort shows that progression of COVID-19 is rare in pregnant and postpartum women treated in the ICU. Preterm birth rate is high and COVID-19 requiring respiratory support increases the risk of poor maternal and neonatal outcome.
Clinical Course and Outcome of Non-Immune Fetal Hydrops in Singleton Pregnancies
Authors: Reischer Theresa , Muth Bernadette , Catic Anja , Monod Cécile , Linder Tina , Göbl Christian , Yerlikaya-Schatten Gülen
Published: January 2022

Nonimmune fetal hydrops is a condition defined by abnormal fluid accumulation in two or more body compartments. The aim is to evaluate factors associated with adverse outcome in diagnosed fetal hydrops and to investigate the aspects for the decision making in the case of termination of pregnancy. Therefore, a retrospective data analysis of pregnancies complicated by non-immune hydrops fetalis between 2004 and 2018 was performed in a single tertiary referral center. Of 361 pregnancies with diagnosed fetal hydrops, in 183 cases (50.7%), the parents decided to terminate the pregnancy. A strong relationship between etiology and termination of pregnancy was demonstrated, whereas the highest rates of termination of pregnancy were found if a chromosomal aberration was diagnosed. Of the remaining 178 cases, 51 cases (28.7%) had a miscarriage, 33 cases (18.5%) had an intrauterine fetal death, and 94 cases (52.8%) were live born, whereas 26 (27.7%) of these offspring died within the first week of life. The risk of an adverse outcome increased with lower gestational age at diagnosis (p < 0.001). A nuchal translucency thickness greater than 2.5 mm was associated with an adverse outcome (p < 0.01). Furthermore, pregnancies with adverse outcome had significantly more affected compartments (median: 3; IQR 2), compared with live born cases (median: 2; IQR 1; p < 0.01). In conclusion, adverse outcome in pregnancies with fetal hydrops was associated with a lower gestational age at diagnosis, nuchal translucency greater than 2.5 mm and a higher count of affected compartments. These results confirm that a precise clinical workup to identify the underlying etiology of non-immune fetal hydrops is essential for a better prognostic assessment and accurate counselling of parents.
Physical Activity in High-Risk Pregnancies
Authors: Sitzberger Christina , Hansl Juliane , Felberbaum Ricardo , Brössner Anke , Oberhoffer-Fritz Renate , Wacker-Gussmann Annette
Published: January 2022

It is known that physical activity before and during pregnancy is associated with health benefits for both the mother and fetus. The WHO recommends a minimum of 150 min per week of moderate-intensity aerobic physical activity for pregnant women. However, the majority of pregnant woman seem not to be physically active in pregnancy as recommended. In addition, the WHO recommendations do not include information on physical activity (PA) for specific target groups. This might be particularly problematic in women with assisted reproduction technologies (ART) or those who have received the fetal diagnosis of congenital heart defects (CHD). The aim of our study was to elaborate on whether assisted reproduction technologies (ART) and/or the diagnosis of fetal congenital heart defects (CHD) influence the level of PA in pregnant women, and to determine if there is a difference between PA behavior before and during pregnancy. In addition, we will evaluate whether high-risk pregnant women also reach the WHO recommendations. A non-interventional, cross-sectional, monocentric study based on two standardized questionnaires on physical activity was conducted. In total, n = 158 pregnant women were included. All of the participants were recruited from the outpatient clinics of the German Heart Center, Munich, and the Klinikverbund Kempten-Oberallgäu, Germany. Pregnant women after ART (n = 18), with fetal CHD (n = 25) and with both ART and CHD (n = 8) could be included. A total of 107 pregnant women served as healthy controls. Women, after ART, showed a significantly reduced level of physical activity (p = 0.014) during pregnancy compared to women who became pregnant naturally. Additionally, less (p < 0.001) and lighter (p = 0.002) physical activity was observed in all groups during pregnancy compared to those before pregnancy. An increase in maternal age increases the likelihood of CHD (p < 0.001) and decreases the level of physical activity before pregnancy (p = 0.012). The overall level of physical activity decreased in healthy and high-risk pregnancies, and only a quarter (26.49%) of all pregnant women reached the WHO recommendations. Further research for the specific target groups is highly recommended in order to promote and increase physical activity in ART and CHD pregnancies.
“Heart in DRESS”: Cardiac Manifestations, Treatment and Outcome of Patients with Drug Reaction with Eosinophilia and Systemic Symptoms Syndrome: A Systematic Review
Authors: Radovanovic Milan , Jevtic Djordje , Calvin Andrew D. , Petrovic Marija , Paulson Margaret , Rueda Prada Libardo , Sprecher Lawrence , Savic Ivana , Dumic Igor
Published: January 2022

Cardiac involvement in drug reaction with eosinophilia and systemic symptoms (DS) is rare but associated with high mortality. The aim of this research was to systematically review case reports by PRISMA guidelines in order to synthetize the knowledge of cardiac manifestations of DS. We identified 42 cases from 36 case reports. Women were two times more affected than men. Two-thirds of patients had cardiac manifestation in the initial phase of the disease, while in one-third of cases cardiac manifestations developed later (mean time of 70 ± 63 days). The most common inciting medications were minocycline (19%) and allopurinol (12%). In 17% of patients, the heart was the only internal organ affected, while the majority (83%) had at least one additional organ involved, most commonly the liver and the kidneys. Dyspnea (55%), cardiogenic shock (43%), chest pain (38%), and tachycardia (33%) were the most common cardiac signs and symptoms reported. Patients frequently had an abnormal ECG (71.4%), and a decrease in left ventricular ejection fraction was the most common echocardiographic finding (45%). Endomyocardial biopsy or histological examination at autopsy was performed in 52.4%, with the predominant finding being fulminant eosinophilic myocarditis with acute necrosis in 70% of those biopsied. All patients received immunosuppressive therapy with intravenous steroids, while non-responders were more likely to have received IVIG, cyclosporine, mycophenolate, and other steroid-sparing agents (60%). Gender and degree of left ventricular systolic dysfunction were not associated with outcomes, but short latency between drug exposure and the first DRESS symptom onset (<15 days) and older age (above 65 years) was associated with death. This underscores the potential importance of heightened awareness and early treatment.
Hematopoiesis, Inflammation and Aging—The Biological Background and Clinical Impact of Anemia and Increased C-Reactive Protein Levels on Elderly Individuals
Authors: Bruserud Øystein , Vo Anh Khoi , Rekvam Håkon
Published: January 2022

Anemia and systemic signs of inflammation are common in elderly individuals and are associated with decreased survival. The common biological context for these two states is then the hallmarks of aging, i.e., genomic instability, telomere shortening, epigenetic alterations, loss of proteostasis, deregulated nutrient sensing, mitochondrial dysfunction, cellular senescence, stem cell exhaustion and altered intercellular communication. Such aging-associated alterations of hematopoietic stem cells are probably caused by complex mechanisms and depend on both the aging of hematopoietic (stem) cells and on the supporting stromal cells. The function of inflammatory or immunocompetent cells is also altered by aging. The intracellular signaling initiated by soluble proinflammatory mediators (e.g., IL1, IL6 and TNFα) is altered during aging and contributes to the development of both the inhibition of erythropoiesis with anemia as well as to the development of the acute-phase reaction as a systemic sign of inflammation with increased CRP levels. Both anemia and increased CRP levels are associated with decreased overall survival and increased cardiovascular mortality. The handling of elderly patients with inflammation and/or anemia should in our opinion be individualized; all of them should have a limited evaluation with regard to the cause of the abnormalities, but the extent of additional and especially invasive diagnostic evaluation should be based on an overall clinical evaluation and the possible therapeutic consequences.
Surgical Management of Hemorrhoidal Disease in Inflammatory Bowel Disease: A Systematic Review with Proportional Meta-Analysis
Authors: Grossi Ugo , Gallo Gaetano , Di Tanna Gian Luca , Bracale Umberto , Ballo Mattia , Galasso Elisa , Kazemi Nava Andrea , Zucchella Martino , Cinetto Francesco , Rattazzi Marcello , Felice Carla , Zanus Giacomo
Published: January 2022

Surgical treatment of hemorrhoidal disease (HD) in inflammatory bowel disease (IBD) has been considered to be potentially harmful, but the evidence for this is poor. Therefore, a systematic review of the literature was undertaken to reappraise the safety and effectiveness of surgical treatments in this special circumstance. A MEDLINE, Web of Science, Scopus, and Cochrane Library search was performed to retrieve studies reporting the outcomes of surgical treatment of HD in patients with Crohn’s disease (CD) and ulcerative colitis (UC). From a total of 2072 citations, 10 retrospective studies including 222 (range, 2–70) patients were identified. Of these, 119 (54%) had CD and 103 (46%) UC. Mean age was between 41 and 49 years (range 14–77). Most studies lacked information on the interval between surgery and the onset of complications. Operative treatments included open or closed hemorrhoidectomy (n = 156 patients (70%)), rubber band ligation (n = 39 (18%)), excision or incision of thrombosed hemorrhoid (n = 14 (6%)), and doppler-guided hemorrhoidal artery ligation (DG-HAL, n = 13 (6%)). In total, 23 patients developed a complication (pooled prevalence, 9%; (95%CI, 3–16%)), with a more than two-fold higher rate in patients with CD compared to UC (11% (5–16%) vs. 5% (0–13%), respectively). Despite the low quality evidence, surgical management of HD in IBD and particularly in CD patients who have failed nonoperative therapy should still be performed with caution and limited to inactive disease. Further studies should determine whether advantages in terms of safety and effectiveness with the use of non-excisional techniques (e.g., DG-HAL) can be obtained in this patient population.
Assessment of the Risk of Nodal Involvement in Rectal Neuroendocrine Neoplasms: The NOVARA Score, a Multicentre Retrospective Study
Authors: Ricci Angela Dalia , Pusceddu Sara , Panzuto Francesco , Gelsomino Fabio , Massironi Sara , De Angelis Claudio Giovanni , Modica Roberta , Ricco Gianluca , Torchio Martina , Rinzivillo Maria , Prinzi Natalie , Rizzi Felice , Lamberti Giuseppe , Campana Davide
Published: January 2022

Rectal neuroendocrine tumors (r-NETs) are rare tumors with overall good prognosis after complete resection. However, there is no consensus on the extension of lymphadenectomy or regarding contraindications to extensive resection. In this study, we aim to identify predictive factors that correlate with nodal metastasis in patients affected by G1–G2 r-NETs. A retrospective analysis of G1–G2 r-NETs patients from eight tertiary Italian centers was performed. From January 1990 to January 2020, 210 patients were considered and 199 were included in the analysis. The data for nodal status were available for 159 cases. The nodal involvement rate was 9%. A receiver operating characteristic (ROC) curve analysis was performed to identify the diameter (>11.5 mm) and Ki-67 (3.5%), respectively, as cutoff values to predict nodal involvement. In a multivariate analysis, diameter > 11.5 mm and vascular infiltration were independently correlated with nodal involvement. A risk scoring system was constructed using these two predictive factors. Tumor size and vascular invasion are predictors of nodal involvement. In addition, tumor size > 11.5 mm is used as a driving parameter of better-tailored treatment during pre-operative assessment. Data from prospective studies are needed to validate these results and to guide decision-making in r-NETs patients in clinical practice.
Influence of Thoracic Trauma on Fracture Healing in Long Bones—A Retrospective Analysis
Authors: Timm Karsten , Walter Nike , Heinrich Martin , Knapp Gero , Thormann Ulrich , El Khassawna Thaqif , Alt Volker , Heiss Christian , Rupp Markus
Published: January 2022

Purpose: Pre-clinical studies indicate that concomitant thoracic trauma impairs fracture healing of long bones and reduces callus formation. The aim of this study was to investigate whether patients with accompanying chest trauma suffer from delayed fracture healing of long bones in comparison with patients with fractures of two long bones or isolated fractures. Patients and Methods: This is a clinical retrospective study from a level I trauma center. The patients were divided into three groups: (1) thoracic trauma and fracture of a long bone, (2) fractures of two long bones, (3) isolated fracture of a long bone. The fracture consolidation was defined using the radiographic union scale in tibial fractures (RUST). A RUST value of ≥10 six-to-eight months after definitive operative intervention represented complete fracture healing. Results: In the first group 19 (43.2%) fractures did not show full consolidation, in the second group 14 (45.2%) and 13 (41.9%) and in the third group 14 (36.8%). The analysis revealed no statistically significant differences between the groups regarding consolidation of the fractures six-to-eight months after definitive operative intervention (p = 0.84). Conclusions: Unlike previously reported pre-clinical data, this study did not demonstrate a negative effect on fracture consolidation in long bones when accompanied by thoracic trauma. Furthermore, the results demonstrated that concomitant fractures of two long bones does not have a negative effect on fracture consolidation.
Multiple Aerial Targets Re-Identification by 2D- and 3D- Kinematics-Based Matching
Authors: Seah Shao Xuan , Lau Yan Han , Srigrarom Sutthiphong
Published: January 2022

This paper presents two techniques in the matching and re-identification of multiple aerial target detections from multiple electro-optical devices: 2-dimensional and 3-dimensional kinematics-based matching. The main advantage of these methods over traditional image-based methods is that no prior image-based training is required; instead, relatively simpler graph matching algorithms are used. The first 2-dimensional method relies solely on the kinematic and geometric projections of the detected targets onto the images captured by the various cameras. Matching and re-identification across frames were performed using a series of correlation-based methods. This method is suitable for all targets with distinct motion observed by the camera. The second 3-dimensional method relies on the change in the size of detected targets to estimate motion in the focal axis by constructing an instantaneous direction vector in 3D space that is independent of camera pose. Matching and re-identification were achieved by directly comparing these vectors across frames under a global coordinate system. Such a method is suitable for targets in near to medium range where changes in detection sizes may be observed. While no overlapping field of view requirements were explicitly imposed, it is necessary for the aerial target to be detected in both cameras before matching can be carried out. Preliminary flight tests were conducted using 2–3 drones at varying ranges, and the effectiveness of these techniques was tested and compared. Using these proposed techniques, an MOTA score of more than 80% was achieved.
A Priori Information Based Time-Resolved 3D Analysis of the Trajectory and Spatial Orientation of Fast-Moving Objects Using High-Speed Flash X-ray Imaging
Authors: Langkemper Ralph , Moser Stefan , Büttner Markus , Rakus Dominik , Sättler Axel , Nau Siegfried
Published: January 2022

This paper shows that the X-ray analysis method known from the medical field, using a priori information, can provide a lot more information than the common analysis for high-speed experiments. Via spatial registration of known 3D shapes with the help of 2D X-ray images, it is possible to derive the spatial position and orientation of the examined parts. The method was demonstrated on the example of the sabot discard of a subcaliber projectile. The velocity of the examined object amounts up to 1600 m/s. As a priori information, the geometry of the experimental setup and the shape of the projectile and sabot parts were used. The setup includes four different positions or points in time to examine the behavior over time. It was possible to place the parts within a spatial accuracy of 0.85 mm (standard deviation), respectively 1.7 mm for 95% of the errors within this range. The error is mainly influenced by the accuracy of the experimental setup and the tagging of the feature points on the X-ray images.
Serological Changes in Anti-Aspergillus IgG Antibody and Development of Chronic Pulmonary Aspergillosis in Patients Treated for Pulmonary Tuberculosis
Authors: Kim Changwhan , Moon Jin-Wook , Park Yong-Bum , Ko Yousang
Published: January 2022

Chronic pulmonary aspergillosis (CPA) is an important infection to understand in survivors of pulmonary tuberculosis (PTB). However, limited data are available regarding CPA development and its predisposing factors following PTB. We investigated the development of, and the predisposing factors for, CPA following the completion of PTB treatment. A total of 345 patients, with newly diagnosed culture-positive PTB (between January 2015 and December 2018), were included. Enrolled cases were categorized into four groups (persistently seronegative, seroconversion, seroreversion, and persistently seropositive) according to serological changes in their anti-Aspergillus IgG antibodies before and after PTB treatment. The patients were followed up for a median of 25.8 months. Ten (10/345, 2.9%) patients developed CPA at a median of 13.5 months after treatment completion, including seven (7/24, 29.2%) and three (3/73, 4.1%) in the seroconversion and persistently seropositive groups, respectively. Upon multivariate analysis, seroconversion of anti-Aspergillus IgG antibody (adjusted hazard ratio [HR], 25.21; 95% confidence interval [CI], 6.11–103.99; p < 0.001) and diabetic status (adjusted HR, 7.54; 95% CI, 1.93–29.50; p = 0.004) were independently associated with CPA development. The development of CPA in patients with PTB was observed in 2.9% of patients during post-treatment follow-up, and this was significantly associated with both the seroconversion of anti-Aspergillus IgG antibody and diabetes characteristics.
Biological Control and Plant Growth Promotion by Volatile Organic Compounds of Trichoderma koningiopsis T-51
Authors: You Jiaqi , Li Guoqing , Li Chaohan , Zhu Lihua , Yang Hongjuan , Song Ronghao , Gu Weihong
Published: January 2022

Trichoderma spp. are widely used in plant disease control and growth promotion due to their high efficacy and multiple biocontrol mechanisms. Trichoderma koningiopsis T-51 is an effective biocontrol agent against gray mold disease by direct contact. However, the indirect physical contact biocontrol potential of Trichoderma spp. is not clear. In this study, the volatile organic compounds (VOCs) produced by T-51 showed high inhibitory activity against plant pathogenic fungi Botrytis cinerea and Fusarium oxysporum. The percentage of B. cinerea and F. oxysporum mycelial growth inhibition by T-51 VOCs was 73.78% and 43.68%, respectively. In both B. cinerea and F. oxysporum, conidial germination was delayed, and germ tube elongation was suppressed when exposed to T-51 VOCs, and the final conidial germination rate of B. cinerea decreased significantly after T-51 treatment. The VOCs from T-51 reduced the Botrytis fruit rot of tomato compared with that noted when using the control. Moreover, the T-51 VOCs significantly increased the size and weight of Arabidopsis thaliana seedlings. Twenty-four possible compounds, which were identified as alkenes, alkanes, and esters, were detected in VOCs of T-51. These results indicate that T. koningiopsis T-51 can exert biological control by integrating actions to suppress plant disease and promote plant growth.
Assessment of Visual Diagnosis by Podiatrists for HPV and Onychomycosis: The Need for Complementary Tests
Authors: Aldana-Caballero Alberto , Mayordomo Raquel , Marcos-Tejedor Félix
Published: January 2022

Onychomycosis and human papillomavirus (HPV) plantar warts are common in clinical practice. Clinical diagnosis is based on searching for pathognomonic signs and symptoms. However, due to misdiagnosis, podiatrists may unnecessarily prescribe antifungal treatments or burn lesions with chemical agents. The objective of this study was to assess podiatrists’ visual diagnosis of these infections and their willingness to use complementary tests. A 12-item questionnaire was developed to assess visual diagnostic ability. The diagnoses of all lesions were verified before the questionnaire was sent out. The respondents were 415 podiatrists with a range of years of experience. While 86.3% of podiatrists considered complementary tests for onychomycosis necessary, only 21.4% used them regularly. As many as 60.2% would leave a distal subungual onychomycosis untreated based on visual diagnosis. In the case of HPV, only 14.5% of respondents considered complementary tests necessary, although 76.6% would treat a non-HPV lesion with regular chemical agents. Years of experience did not affect the percentage of misdiagnoses. Complementary tests are needed in clinical practice to avoid unnecessary treatments. Podiatrists easily identify clear signs and symptoms but have difficulty making differential diagnoses. Research should focus on ensuring complementary tests are available to health professionals.
MicroRNA Alterations Induced in Human Skin by Diesel Fumes, Ozone, and UV Radiation
Authors: Valacchi Giuseppe , Pambianchi Erika , Coco Simona , Pulliero Alessandra , Izzotti Alberto
Published: January 2022

Epigenetic alterations are a driving force of the carcinogenesis process. MicroRNAs play a role in silencing mutated oncogenes, thus defending the cell against the adverse consequences of genotoxic damages induced by environmental pollutants. These processes have been well investigated in lungs; however, although skin is directly exposed to a great variety of environmental pollutants, more research is needed to better understand the effect on cutaneous tissue. Therefore, we investigated microRNA alteration in human skin biopsies exposed to diesel fumes, ozone, and UV light for over 24 h of exposure. UV and ozone-induced microRNA alteration right after exposure, while the peak of their deregulations induced by diesel fumes was reached only at the end of the 24 h. Diesel fumes mainly altered microRNAs involved in the carcinogenesis process, ozone in apoptosis, and UV in DNA repair. Accordingly, each tested pollutant induced a specific pattern of microRNA alteration in skin related to the intrinsic mechanisms activated by the specific pollutant. These alterations, over a short time basis, reflect adaptive events aimed at defending the tissue against damages. Conversely, whenever environmental exposure lasts for a long time, the irreversible alteration of the microRNA machinery results in epigenetic damage contributing to the pathogenesis of inflammation, dysplasia, and cancer induced by environmental pollutants.
Effect of Pillbox Organizers with Alarms on Adherence to Pharmacotherapy in Parkinson Disease Patients Taking Three and More Daily Doses of Dopaminergic Medications
Authors: Straka Igor , Minar Michal , Grofik Milan , Skorvanek Matej , Bolekova Veronika , Gazova Andrea , Kyselovic Jan , Valkovic Peter
Published: January 2022

Improvement of adherence to pharmacotherapy in patients with Parkinson’s disease (PD) is a challenge in routine clinical practice. Our study was aimed at the effect of pillbox organizers with alarms improving adherence to pharmacotherapy and its impact on clinical outcomes. Forty nonadherent patients with PD being treated with ≥ 3 daily doses of levodopa and/or dopamine agonists were pseudorandomized and consecutively ranked to groups A (early-start intervention) and B (delayed-start intervention). We used the following validated diagnostic instruments: MMAS-8 (adherence), PDQ-8 (quality of life, QoL), GDS (depression), NMSS (non-motor symptoms), MDS-UPDRS III (motor involvement), MDS-UPDRS IV, and WOQ-9 (motor and non-motor fluctuations and dyskinesias). We proved a significantly improved rate of adherence with the use of pillbox organizers with alarms. Moreover, after only four weeks of using the pillbox organizer, we detected an improvement in QoL scores, motor involvement, motor-, and non-motor fluctuations. Our study showed that pillbox organizers with alarms are efficient in improving adherence to pharmacotherapy in PD. It also could contribute to better motor states, less severe fluctuations, and improved QoL.
Nursing Students’ Perceptions on Healthcare-Associated Infection Control and Prevention Teaching and Learning Experience in Portugal
Authors: Parreira Pedro , Santos-Costa Paulo , Pardal João , Neves Teresa , Bernardes Rafael A. , Serambeque Beatriz , Sousa Liliana B. , Graveto João , Silén-Lipponen Marja , Korhonen Ulla , Koponen Leena , Myllymäki Mikko , Yurrebaso Macho Amaia , Mayens Alexander L. Ward , Picado Valverde Eva Maria , Guzmán Ordaz Raquel , Juanes Méndez Juan Antonio , Iglesias Jose Luis Pérez , Canelo José Antonio Mirón , Jankowiak-Bernaciak Aleksandra , Patrzała Amelia , Bączyk Grażyna , Basa Anna , do Sacramento Costa Reis Alcinda Maria , Simões Joaquim Augusto , Torres Ana Luísa , do Rosário Pinto Maria , Salgueiro-Oliveira Anabela
Published: January 2022

Healthcare-associated infections (HAI) are one of the major concerns worldwide, posing significant challenges to healthcare professionals’ education and training. This study intended to measure nursing students’ perceptions regarding their learning experiences on HAI prevention and control. In the first phase of the study, a cross-sectional and descriptive study with a convenience sample composed of undergraduate nursing students from Portugal, Spain, Poland, and Finland was conducted to develop the InovSafeCare questionnaire. In the second phase, we applied the InovSafeCare scale in a sample of nursing students from two Portuguese higher education institutions to explore which factors impact nursing students’ adherence to HAI prevention and control measures in clinical settings. In phase one, the InovSafeCare questionnaire was applied to 1326 students internationally, with the instrument presenting adequate psychometric qualities with reliability results in 14 dimensions. During phase two, the findings supported that Portuguese nursing students’ adherence to HAI prevention and control measures is influenced not only by the curricular offerings and resources available in academic settings, but also by the standards conveyed by nursing tutors during clinical placements. Our findings support the need for a dedicated curricular focus on HAI prevention and control learning, not only through specific classroom modules, innovative resources, and pedagogical approaches, but also through a complementary and coordinated liaison between teachers and tutors in academic and clinical settings.
Presence of Helicobacter Species in Gastric Mucosa of Human Patients and Outcome of Helicobacter Eradication Treatment
Authors: Matos Rita , Taillieu Emily , De Bruyckere Sofie , De Witte Chloë , Rêma Alexandra , Santos-Sousa Hugo , Nogueiro Jorge , Reis Celso A. , Carneiro Fátima , Haesebrouck Freddy , Amorim Irina , Gärtner Fátima
Published: January 2022

The genus Helicobacter is composed of bacteria that colonize both the human and animal gastrointestinal tract. Helicobacter pylori infects half of the world’s population, causing various disorders, such as gastritis, duodenitis and gastric cancer. Additionally, non-Helicobacter pylori Helicobacter species (NHPH) are commonly found in the stomach of pigs, dogs and cats. Most of these species have zoonotic potential and prevalence rates of 0.2–6.0%, and have been described in human patients suffering from gastric disorders undergoing a gastric biopsy. The aim of this study was to determine the occurrence of Helicobacter spp. in the stomach of patients with gastric cancer (n = 17) and obese (n = 63) patients. Furthermore, the outcome of the Helicobacter eradication treatment and the current infection status was evaluated. Overall, based on the genus-specific PCR followed by sequencing, DNA from Helicobacter spp. was detected in 46.3% of the patients, including single infections with H. pylori in 43.8% of the patients and mixed infections with H. pylori and canine- or feline-associated H. felis in 2.5%. About 32.5% of the patients had been subjected to previous Helicobacter eradication therapy and the triple standard therapy was the most frequent scheme (42.3%). In 48.0% of the patients who received eradication treatment, bacteria were still detected, including one mixed infection. In 23.1% of the patients who reported that a subsequent test had been performed to confirm the elimination of the bacteria, Helicobacter were still detected. In conclusion, although in a smaller percentage, NHPH may also be present in the human stomach. Thus, specific NHPH screening should be included in the diagnostic routine. The continued presence of H. pylori in the stomach of patients recently subjected to eradication schemes raises questions about the efficacy of the current Helicobacter treatments.
SARS-CoV-2 mRNA Vaccine Immunogenicity in Hemodialysis Patients: Promising Vaccine Protection That May Be Hindered by Fluid Overload
Authors: Hebibi Hedia , Edeas Marvin , Cornillac Laure , Beaudreuil Severine , Achiche Jedjiga , Attaf David , Saibi Samah , Chazot Charles , Ouaaz Fatah , Canaud Bernard
Published: January 2022

Background: Due to their immunocompromised conditions, hemodialysis (HD) patients are at high risk of being infected with SARS-CoV-2 with poor clinical outcomes. We explored safety, efficacy and variability factors associated with vaccine immune response in these patients. Methods: From 18 January to 30 April 2021, 87 HD patients were enrolled in this study and subdivided in two sub-groups: SARS-CoV-2 positive prior to vaccination and naïve patients. The vaccination protocol included two intramuscular shots of the mRNA vaccine at a 28-day interval. The vaccine response was evaluated one month after the first and second shots by measuring anti-S antibody titers. Findings: 44% of the patients studied, were women; median age was 58 years. One month after the first shot, 64.3% of patients had anti-S antibody titers < 50 U/mL while 96.5% had anti-S antibody titers > 250 U/mL one month after the second shot. We show that the anti-SARS-CoV-2 spike mRNA vaccine elicits a great tolerability in HD patients. Importantlly, the vaccine response is characterized by a higher rate of seroconversion than conventional vaccination, as we have shown for the hepatitis B vaccine. We highlight two major factors of variability of the vaccine response. First, pre-exposure to SARS-CoV-2 boosts humoral response, as 95% of SARS-CoV-2 positive patients developed anti-S antibody titers > 250 U/L just after the first shot. Secondly, on the contrary fluid overload strikingly appears, limiting the vaccine response, as 84% of HD patients with fluid overload elicit lower anti-S antibody titers after the first shot. Interpretation: Our findings show that the immunogenic profile induced by mRNA vaccines in HD patients represents a promising a protective strategy that is associated with greater tolerability. Fluid overload may be considered as a novel factor that hinders the immune response in HD patients and further studies will be needed to investigate this working hypothesis.
Él Code-Switches More Than tú y yo: New Data for the Subject Pronoun-Verb Switch Constraint
Authors: Bellamy Kate , Stadthagen-Gonzalez Hans , Parafita Couto M. Carmen
Published: January 2022

In early studies, code-switches between a subject pronoun and a finite verb were considered highly dispreferred or even impossible. However, naturalistic data from several language pairs has since highlighted that such switches are possible, although their grammaticality is constrained by the typology of the pronouns involved. In this study, we test the switching constraints postulated for subject pronouns-verbs among P’urhepecha-Spanish bilinguals (n = 12) from Michoacán, western Mexico. Using a two-alternative forced-choice acceptability judgement task (2AFC), we found that, contrary to expectations, switches between a third person singular pronoun and a verb were considered the most acceptable, followed by the coordinated ‘you and I’ second person, then the first person singular. The same order was found for both switch directions, despite third-person pronouns in P’urhepecha having a stronger typological profile. Building on the results of previous studies, we suggest that the lack of preference for a single switch direction is evidence for language-specific code-switching patterns, as well as possible differences in productive vs. receptive language. Additionally, we highlight the probative value of judgement data, particularly those emerging from 2AFC tasks, as a means of expanding our understanding of grammaticality in code-switching.