bluuebunny/crossref_metadata_2025 huggingface dataset:
Managing Mortality and Aging Risks with a Time-Varying Lee–Carter Model
Authors: Chen Zhongwen , Shi Yanlin , Shu Ao
Published: March 2023

Influential existing research has suggested that rather than being static, mortality declines decelerate at young ages and accelerate at old ages. Without accounting for this feature, the forecast mortality rates of the popular Lee–Carter (LC) model are less reliable in the long run. To provide more accurate mortality forecasting, we introduce a time-varying coefficients extension of the LC model by adopting the effective kernel methods. With two frequently used kernel functions, Epanechnikov (LC-E) and Gaussian (LC-G), we demonstrate that the proposed extension is easy to implement, incorporates the rotating patterns of mortality decline and is straightforwardly extensible to multi-population cases. Using a large sample of 15 countries over 1950–2019, we show that LC-E and LC-G, as well as their multi-population counterparts, can consistently improve the forecasting accuracy of the competing LC and Li–Lee models in both single- and multi-population scenarios.
Comparison of Knee Muscular Strength Balance among Pre- and Post-Puberty Adolescent Swimmers: A Cross-Sectional Pilot Study
Authors: Amado Bruno Lombardi , De Lira Claudio Andre Barbosa , Vancini Rodrigo Luiz , Forte Pedro , Costa Taline , Weiss Katja , Knechtle Beat , Andrade Marilia Santos
Published: March 2023

Muscular weakness and strength imbalance between the thigh muscles are considered risk factors for knee injuries. Hormonal changes, characteristic of puberty, strongly affect muscle strength; however, it is unknown whether they affect muscular strength balance. The present study aimed to compare knee flexor strength, knee extensor strength, and strength balance ratio, called the conventional ratio (CR), between prepubertal and postpubertal swimmers of both sexes. A total of 56 boys and 22 girls aged between 10 and 20 years participated in the study. Peak torque, CR, and body composition were measured using an isokinetic dynamometer and dual-energy X-ray absorptiometry, respectively. The postpubertal boys group presented significantly higher fat-free mass (p < 0.001) and lower fat mass (p = 0.001) than the prepubertal group. There were no significant differences among the female swimmers. Peak torque for both flexor and extensor muscles was significantly greater in postpubertal male (p < 0.001, both) and female swimmers (p < 0.001 and p = 0.001, respectively) than in prepubertal swimmers. The CR did not differ between the pre- and postpubertal groups. However, the mean CR values were lower than the literature recommendations, which brings attention to a higher risk of knee injuries.
Dental Fear and Anxiety of Chinese Preschool Children in a School-Based Outreach Service Using Silver Diamine Fluoride for Caries Control: A Cross-Sectional Study
Authors: Sun Ivy Guofang , Chai Hollis Haotian , Lo Edward Chin Man , Chu Chun Hung , Duangthip Duangporn
Published: March 2023

Limited data are available regarding the patient-based outcomes of SDF therapy in the kindergarten setting. This study aims to evaluate the dental fear and anxiety (DFA) of preschool children after participating in a school-based outreach service using SDF to arrest early childhood caries (ECC). The study recruited 3- to 5-year-old children with untreated ECC. A trained dentist performed a dental examination and applied SDF therapy to the carious lesions. ECC experience was measured using the dmft index. Questionnaires for parents were used to collect the children’s demographic information and their dental treatment experiences. The children’s DFA before and immediately after SDF therapy was assessed using the self-reported Facial Image Scale (FIS) on a Likert scale of 1 (very happy) to 5 (very distressed). The association between the children’s DFA after SDF therapy and the potentially related factors, including demographic background, caries experience, and DFA before SDF therapy, were analysed using bivariate analysis. Three hundred and forty children (187 boys, 55%) joined this study. Their mean (SD) age and dmft scores were 4.8 (0.9) and 4.6 (3.6), respectively. Most of them (269/340, 79%) never had a dental visit. After SDF therapy, 86% (294/340) of the children exhibited no or low DFA (FIS ≤ 3), whereas 14% (46/340) reported high DFA (FIS > 3). No factor was associated with children’s DFA after SDF therapy (p > 0.05). This study showed most preschool children with ECC exhibited no or low DFA after SDF therapy in a school setting.
Summertime Characteristics of Atmospheric Polycyclic Aromatic Hydrocarbons in a Coastal City of Northern Poland
Authors: Siudek Patrycja
Published: March 2023

Parent polycyclic aromatic hydrocarbons (PAHs) in the gas and particle fraction were measured between May and August 2021 at a coastal urban site in Poland, to examine their chemical characteristics, distribution, sources, deposition fluxes and interactions with basic meteorological drivers. The mean concentration of PAHs in the gas phase was significantly higher (26.26 ± 15.83 ng m−3) than levels measured in the particle phase (1.77 ± 1.26 ng m−3). The highest concentration in the gas phase was found for phenanthrene (Phe), followed by fluoranthene (Flt), acenaphthene (Ace) and naphthalene (Naph). The contribution from each group of PAHs to the total particulate phase accounted for 50%, 25%, 14% and 12% for 3-, 4-, 5- and 6-ring compounds, respectively. The mean ΣPAH deposition flux was 59 ± 24 ng m−2 day−1. During the whole field campaign, the efficient removal of PM-bound PAHs was typically observed after precipitation events. Based on statistical analysis, it was found that 4-ring PAHs were less effectively removed (25%) by daily precipitation as compared to 5- and 6-ring components, whose fluxes decreased by 32% and 53%, respectively. This study revealed local urban sources such as vehicular emissions, coal-fired power plants, shipping activities, docks/ports infrastructure and municipal solid waste recycling units as predominant contributors to PM-bound and gas-phase PAHs.
Comparison of the Nasal Cavity Guidance Methods’ Effects during Nasotracheal Intubation Using a Preformed Nasotracheal Tube: A Prospective Randomized Controlled Trial
Authors: Kim Joungmin , Jang Eun-A , Kang Dongho , Moon Seonho , Bae Hong-Beom
Published: March 2023

Nasotracheal intubation is mainly performed to provide a safe airway during maxillofacial surgeries. Several guiding devices are suggested to facilitate nasotracheal intubation and reduce complications. We attempted to compare intubation conditions during nasotracheal intubation using a nasogastric tube and a suction catheter, which are readily available in operating rooms. In this study, 114 patients undergoing maxillofacial surgery were randomly divided into the nasogastric tube guidance group (NG group) and the suction catheter guidance group (SC group). The primary outcome was the total intubation time. Moreover, the incidence and degree of epistaxis, the position of the tube in the nasal cavity after intubation, and the number of manipulations during intubation in the nasal cavity were investigated. The insertion time from the nostril to the oral cavity and the total intubation time were significantly shorter in the SC group than in the NG group (p < 0.001). The incidence of epistaxis was lower at 35.1% in the NG group and 43.9% in the SC group than the previously reported 60–80%, but there was no statistical difference between the two groups. The use of a suction catheter aid during nasotracheal intubation can be used effectively because it shortens the intubation time and does not increase complications.
Can Green Credit Policies Accelerate the Realization of the Dual Carbon Goal in China? Examination Based on an Endogenous Financial CGE Model
Authors: Du Qianyi , Pan Haoran , Liang Shuang , Liu Xiaoxue
Published: March 2023

Green credit is an indispensable funding source through which China can achieve its carbon neutrality goal. This paper quantifies the influences of different green credit scales on energy structures, carbon reduction, the industrial economy, and the macroeconomy. It creates a green credit mechanism related to green technology innovation in a Chinese carbon neutrality computable general equilibrium (CGE) model and integrates energy, environmental, economic, and financial (3EF) systems. The green credit scale can influence green technology innovation and hence CO2 emissions. The results show that (1) green credit can accelerate China’s achievement of its carbon neutrality goal, and the larger the green credit scale, the less time it takes to achieve goals; (2) the influence of green credit scales confers marginal decreasing effects with realistic policy considerations; (3) using a cost–benefit perspective, 60% is the most appropriate green credit scale to use to achieve dual carbon goals in China; (4) the different green credit scales have a heterogeneous impact on the industry output, and high-carbon-emission producers from nonenergy industries need to pay attention to their green credit risk. This research provides a scientific reference for the policy design of China’s future green financial market development.
Evaluating Indirect Economic Losses from Flooding Using Input–Output Analysis: An Application to China’s Jiangxi Province
Authors: Lyu Yanfang , Xiang Yun , Wang Dong
Published: March 2023

Quantifying total economic impacts of flood disaster in a timely manner is essential for flood risk management and sustainable economic growth. This study takes the flood disaster in China’s Jiangxi province during the flood season in 2020 as an example, and exploits the input–output method to analyze indirect economic impacts caused by the agricultural direct economic loss. Based on regional IO data and MRIO data, a multi-dimensional econometric analysis was undertaken in terms of inter-regional, multi-regional, and structural decomposition of indirect economic losses. Our study reveals that the indirect economic losses caused by the agricultural sector in other sectors in Jiangxi province were 2.08 times the direct economic losses, of which the manufacturing sector suffered the worst, accounting for 70.11% of the total indirect economic losses. In addition, in terms of demand side and supply side indirect losses, the manufacturing and construction industries were found to be more vulnerable than other industries, and the flood disaster caused the largest indirect economic loss in eastern China. Besides, the supply side losses were significantly higher than the demand side losses, highlighting that the agricultural sector has strong spillover effects on the supply side. Moreover, based on the MRIO data of the years 2012 and 2015, dynamic structural decomposition analysis was undertaken, which showed that changes in the distributional structure appear to be influential in the evaluation of indirect economic losses. The findings highlight the spatial and sectoral heterogeneity of indirect economic losses caused by floods, and have significant implications for disaster mitigation and recovery strategies.
Diagnostic Performance of Immunohistochemistry Compared to Molecular Techniques for Microsatellite Instability and p53 Mutation Detection in Endometrial Cancer
Authors: Streel Sylvie , Salmon Alixe , Dheur Adriane , Bours Vincent , Leroi Natacha , Habran Lionel , Delbecque Katty , Goffin Frédéric , Pleyers Clémence , Kakkos Athanasios , Gonne Elodie , Seidel Laurence , Kridelka Frédéric , Gennigens Christine
Published: March 2023

Molecular algorithms may estimate the risk of recurrence and death for patients with endometrial cancer (EC) and may impact treatment decisions. To detect microsatellite instabilities (MSI) and p53 mutations, immunohistochemistry (IHC) and molecular techniques are used. To select the most appropriate method, and to have an accurate interpretation of their results, knowledge of the performance characteristics of these respective methods is essential. The objective of this study was to assess the diagnostic performance of IHC versus molecular techniques (gold standard). One hundred and thirty-two unselected EC patients were enrolled in this study. Agreement between the two diagnostic methods was assessed using Cohen’s kappa coefficient. Sensitivity, specificity, positive (PPV) and negative predictive values (NPV) of the IHC were calculated. For MSI status, the sensitivity, specificity, PPV and NPV were 89.3%, 87.3%, 78.1% and 94.1%, respectively. Cohen’s kappa coefficient was 0.74. For p53 status, the sensitivity, specificity, PPV, and NPV were 92.3%, 77.1%, 60.0% and 96.4%, respectively. Cohen’s kappa coefficient was 0.59. For MSI status, IHC presented a substantial agreement with the polymerase chain reaction (PCR) approach. For the p53 status, the moderate agreement observed between IHC and next generation sequencing (NGS) methods implies that they cannot be used interchangeably.
Peripubertal Alterations of Leptin Levels in Patients with Autism Spectrum Disorder and Elevated or Normal Body Weight
Authors: Skórzyńska-Dziduszko Katarzyna E. , Makarewicz Agata , Błażewicz Anna
Published: March 2023

Leptin, which plays a key role in energy homeostasis, is known as a neurotrophic factor possibly linking nutrition and neurodevelopment. Available data on the association between leptin and autism spectrum disorder (ASD) are confusing. The aim of this study was to explore whether plasma levels of leptin in pre- and post-pubertal children with ASD and/or overweightness/obesity differ from those of BMI- and age-matched healthy controls. Leptin levels were determined in 287 pre-pubertal children (mean age 8.09 years), classified as follows: ASD with overweightness/obesity (ASD+/Ob+); ASD without overweightness/obesity (ASD+/Ob−); non-ASD with overweightness/obesity (ASD−/Ob+); non-ASD without overweightness/obesity (ASD−/Ob−). The assessment was repeated in 258 of the children post-pubertally (mean age 14.26 years). There were no significant differences in leptin levels either before or after puberty between ASD+/Ob+ and ASD−/Ob+ or between ASD+/Ob− and ASD−/Ob−, although there was a strong trend toward significance for higher pre-pubertal leptin levels in ASD+/Ob− than in ASD−/Ob−. Post-pubertal leptin levels were significantly lower than pre-pubertal levels in ASD+/Ob+, ASD−/Ob+, and ASD+/Ob− and higher in ASD−/Ob−. Leptin levels, elevated pre-pubertally in the children with overweightness/obesity as well as in children with ASD and normal BMI, decrease with age, in contrast to the increasing leptin levels in healthy controls.
Translational Control of Metabolism and Cell Cycle Progression in Hepatocellular Carcinoma
Authors: Scagliola Alessandra , Miluzio Annarita , Biffo Stefano
Published: March 2023

The liver is a metabolic hub characterized by high levels of protein synthesis. Eukaryotic initiation factors, eIFs, control the first phase of translation, initiation. Initiation factors are essential for tumor progression and, since they regulate the translation of specific mRNAs downstream of oncogenic signaling cascades, may be druggable. In this review, we address the issue of whether the massive translational machinery of liver cells contributes to liver pathology and to the progression of hepatocellular carcinoma (HCC); it represents a valuable biomarker and druggable target. First, we observe that the common markers of HCC cells, such as phosphorylated ribosomal protein S6, belong to the ribosomal and translational apparatus. This fact is in agreement with observations that demonstrate a huge amplification of the ribosomal machinery during the progression to HCC. Some translation factors, such as eIF4E and eIF6, are then harnessed by oncogenic signaling. In particular, the action of eIF4E and eIF6 is particularly important in HCC when driven by fatty liver pathologies. Indeed, both eIF4E and eIF6 amplify at the translational level the production and accumulation of fatty acids. As it is evident that abnormal levels of these factors drive cancer, we discuss their therapeutic value.
Differential Modulation of Dorsal Raphe Serotonergic Activity in Rat Brain by the Infralimbic and Prelimbic Cortices
Authors: López-Terrones Elena , Paz Verónica , Campa Leticia , Conde-Berriozabal Sara , Masana Mercè , Artigas Francesc , Riga Maurizio S.
Published: March 2023

The reciprocal connectivity between the medial prefrontal cortex (mPFC) and the dorsal raphe nucleus (DR) is involved in mood control and resilience to stress. The infralimbic subdivision (IL) of the mPFC is the rodent equivalent of the ventral anterior cingulate cortex, which is intimately related to the pathophysiology/treatment of major depressive disorder (MDD). Boosting excitatory neurotransmission in the IL—but not in the prelimbic cortex, PrL—evokes depressive-like or antidepressant-like behaviors in rodents, which are associated with changes in serotonergic (5-HT) neurotransmission. We therefore examined the control of 5-HT activity by both of the mPFC subdivisions in anesthetized rats. The electrical stimulation of IL and PrL at 0.9 Hz comparably inhibited 5-HT neurons (53% vs. 48%, respectively). However, stimulation at higher frequencies (10–20 Hz) revealed a greater proportion of 5-HT neurons sensitive to IL than to PrL stimulation (86% vs. 59%, at 20 Hz, respectively), together with a differential involvement of GABAA (but not 5-HT1A) receptors. Likewise, electrical and optogenetic stimulation of IL and PrL enhanced 5-HT release in DR in a frequency-dependent manner, with greater elevations after IL stimulation at 20 Hz. Hence, IL and PrL differentially control serotonergic activity, with an apparent superior role of IL, an observation that may help to clarify the brain circuits involved in MDD.
Elevated Hippocampal CRMP5 Mediates Chronic Stress-Induced Cognitive Deficits by Disrupting Synaptic Plasticity, Hindering AMPAR Trafficking, and Triggering Cytokine Release
Authors: Lin Yu-Fen , Chen Ching-An , Hsu Fang-Yu , Hsiao Ya-Hsin
Published: March 2023

Chronic stress is a critical risk factor for developing depression, which can impair cognitive function. However, the underlying mechanisms involved in chronic stress-induced cognitive deficits remain unclear. Emerging evidence suggests that collapsin response mediator proteins (CRMPs) are implicated in the pathogenesis of psychiatric-related disorders. Thus, the study aims to examine whether CRMPs modulate chronic stress-induced cognitive impairment. We used the chronic unpredictable stress (CUS) paradigm to mimic stressful life situations in C57BL/6 mice. In this study, we found that CUS-treated mice exhibited cognitive decline and increased hippocampal CRMP2 and CRMP5 expression. In contrast to CRMP2, CRMP5 levels strongly correlated with the severity of cognitive impairment. Decreasing hippocampal CRMP5 levels through shRNA injection rescued CUS-induced cognitive impairment, whereas increasing CRMP5 levels in control mice exacerbated memory decline after subthreshold stress treatment. Mechanistically, hippocampal CRMP5 suppression by regulating glucocorticoid receptor phosphorylation alleviates chronic stress-induced synaptic atrophy, disruption of AMPA receptor trafficking, and cytokine storms. Our findings show that hippocampal CRMP5 accumulation through GR activation disrupts synaptic plasticity, impedes AMPAR trafficking, and triggers cytokine release, thus playing a critical role in chronic stress-induced cognitive deficits.
A Lattice-Based Certificateless Traceable Ring Signature Scheme
Authors: Liang Junbin , Huang Jianye , Huang Qiong , Lan Liantao , Au Man Ho Allen
Published: March 2023

A ring signature (RS) scheme enables a group member to sign messages on behalf of its group without revealing the definite signer identify, but this also leads to the abuse of anonymity by malicious signers, which can be prevented by traceable ring signatures (TRS). Up until that point, traceable ring signatures have been secure based on the difficult problem of number-theoretic (discrete logarithms or RSA), but since the advent of quantum computers, traditional traceable ring signatures may no longer be secure. Thus Feng proposed a lattice based TRS, which are resistant to attacks by quantum computers. However, that works did not tackle the certificate management problem. To close this gap, a quantum-resistant certificateless TRS scheme was proposed in the study. To the best of our knowledge, this is the first lattice based certificateless TRS. In detail, a specific TRS scheme was combined with the lattice-based certificateless signature technology to solve the certificate management problem while avoid key escrow problem. Additionally, a better zero-knowledge protocol is used to improve the computational efficiency of the scheme, and by reducing the soundness error of the zero-knowledge protocol, the number of runs of the zero-knowledge protocol is reduced, so that the communication overhead of the scheme is reduced. Under random oracle model, the proposed scheme satisfies tag-linkability, anonymity, exculpability and is secure based on the SIS problem and the DLWE problem. In conclusion, the proposed scheme is more practical and promising in e-voting.
Central Apnea in Patients with COVID-19 Infection
Authors: Puram Vikram Venkata , Sethi Anish , Epstein Olga , Ghannam Malik , Brown Kevin , Ashe James , Berry Brent
Published: March 2023

Background: The Coronavirus Disease 2019 (COVID-19) is a global pandemic that has killed over 1.5 million people worldwide. A constellation of multisystem involvement with SARS-CoV-2 has been reported. COVID-19 has been shown to affect the human nervous system, however, both the extent and severity of involvement have yet to be fully elucidated. In this manuscript, we aimed to better understand the effect of COVID-19 on neuro-respiratory status by studying COVID-19 patients who presented with central apnea. Methodology: We analyzed patient characteristics, clinical outcomes, laboratory results, and imaging results of three patients with symptomatic, PCR-proven COVID-19 and episodes of central apnea. Results: Of the three patients included in this study, two patients developed new central apnea, and one patient developed an exacerbation of underlying central apnea despite COVID-19 treatments with systemic steroids and remdesivir. All occurred, on average, 15 days after the onset of COVID-19 symptoms. At 1-year follow-up, all patients experienced complete resolution of apneic breathing. Conclusions: Physicians should be vigilant for the presentation of COVID-19 with central apnea. Central apnea may be a complication in patients with severe COVID-19 infection. More research is warranted to further understand this association.
Stress Experience, Depression and Neck Disability in Patients with Temporomandibular Disorder—Myofascial Pain with Referral
Authors: Szarejko Krzysztof , Gołębiewska Maria , Lukomska-Szymanska Monika , Kuć Joanna
Published: March 2023

The etiology of temporomandibular disorders (TMDs) is firmly anchored in the biopsychosocial model in which a special role is attributed to the stress, depression, somatic symptoms, and anxiety. The aim of the study was to assess the level of stress, depression and neck disability in patients with temporomandibular disorder—myofascial pain with referral. The study group enrolled 50 people (37 women and 13 men) with complete natural dentition. All the patients underwent a clinical examination according to the Diagnostic Criteria for Temporomandibular Disorders and were diagnosed as individuals with myofascial pain with referral. The questionnaires were associated with stress, depression, and neck disability; Perceived Stress Scale (PSS−10), Beck Depression Inventory(BDI), and Neck Disability Index (NDI) were evaluated. Of the individuals evaluated, 78% showed elevated levels of stress, and the average value of the PSS−10 in the study group was 18 points (Me = 17). Furthermore, 30% of the subjects presented depressive symptoms, with the average value of BDI was 8.94 points (Me = 8), and 82% of the subjects showed neck disability. The multiple linear regression model revealed that BDI and NDI allowed explanations for the 53% differentiation of PSS−10. In conclusion, stress, depression, and neck disability coexist with temporomandibular disorder—myofascial pain with referral.
Executive Functions and Psychopathology Dimensions in Deficit and Non-Deficit Schizophrenia
Authors: Bielecki Maksymilian , Tyburski Ernest , Plichta Piotr , Mak Monika , Kucharska-Mazur Jolanta , Podwalski Piotr , Rek-Owodziń Katarzyna , Waszczuk Katarzyna , Sagan Leszek , Mueller Shane , Michalczyk Anna , Misiak Błażej , Samochowiec Jerzy
Published: March 2023

This study: (a) compared executive functions between deficit (DS) and non-deficit schizophrenia (NDS) patients and healthy controls (HC), controlling premorbid IQ and level of education; (b) compared executive functions in DS and NDS patients, controlling premorbid IQ and psychopathological symptoms; and (c) estimated relationships between clinical factors, psychopathological symptoms, and executive functions using structural equation modelling. Participants were 29 DS patients, 44 NDS patients, and 39 HC. Executive functions were measured with the Mazes Subtest, Spatial Span Subtest, Letter Number Span Test, Color Trail Test, and Berg Card Sorting Test. Psychopathological symptoms were evaluated with the Positive and Negative Syndrome Scale, Brief Negative Symptom Scale, and Self-evaluation of Negative Symptoms. Compared to HC, both clinical groups performed poorer on cognitive flexibility, DS patients on verbal working memory, and NDS patients on planning. DS and NDS patients did not differ in executive functions, except planning, after controlling premorbid IQ and negative psychopathological symptoms. In DS patients, exacerbation had an effect on verbal working memory and cognitive planning; in NDS patients, positive symptoms had an effect on cognitive flexibility. Both DS and NDS patients presented deficits, affecting the former to a greater extent. Nonetheless, clinical variables appeared to significantly affect these deficits.
Outcomes of Intraductal Placement of Covered Metal Stents for Unresectable Distal Malignant Biliary Obstruction
Authors: Yamada Manabu , Takeda Tsuyoshi , Sasaki Takashi , Okamoto Takeshi , Hamada Tsuyoshi , Ishitsuka Takahiro , Nakagawa Hiroki , Mie Takafumi , Furukawa Takaaki , Kasuga Akiyoshi , Matsuyama Masato , Ozaka Masato , Kobara Hideki , Masaki Tsutomu , Sasahira Naoki
Published: March 2023

Intraductal self-expandable metal stent (SEMS) placement may prolong stent patency by reducing duodenobiliary reflux. This study aimed to evaluate the efficacy and safety of this biliary drainage method in patients with unresectable distal malignant biliary obstruction (MBO). Consecutive patients with unresectable MBO who underwent initial covered SEMS placement between 2015 and 2022 were retrospectively reviewed. We compared the causes of recurrent biliary obstruction (RBO), time to RBO (TRBO), adverse events (AEs), and reintervention rates between two biliary drainage methods (SEMSs placed above and across the papilla). A total of 86 patients were included (above: 38 and across: 48). Overall RBO rates (24% vs. 44%, p = 0.069) and median TRBO (11.6 months vs. 9.8 months, p = 0.189) were not significantly different between the two groups. The frequency of overall AEs was similar between the two groups in the entire cohort, but was significantly lower in patients with non-pancreatic cancer (6% vs. 44%, p = 0.035). Reintervention was successfully performed in the majority of patients in both groups. Intraductal SEMS placement was not associated with a prolonged TRBO in this study. Larger studies are warranted to further evaluate the benefit of intraductal SEMS placement.
Non-Invasive Neuromodulation Methods to Alleviate Symptoms of Huntington’s Disease: A Systematic Review of the Literature
Authors: Jose Lijin , Martins Lais , Cordeiro Thiago , Lee Keya , Diaz Alexandre , Ahn Hyochol , Teixeira Antonio
Published: March 2023

Huntington’s disease (HD) is a progressive and debilitating neurodegenerative disease. There is growing evidence for non-invasive neuromodulation tools as therapeutic strategies in neurodegenerative diseases. This systematic review aims to investigate the effectiveness of noninvasive neuromodulation in HD-associated motor, cognitive, and behavioral symptoms. A comprehensive literature search was conducted in Ovid MEDLINE, Cochrane Central Register of Clinical Trials, Embase, and PsycINFO from inception to 13 July 2021. Case reports, case series, and clinical trials were included while screening/diagnostic tests involving non-invasive neuromodulation, review papers, experimental studies on animal models, other systematic reviews, and meta-analyses were excluded. We have identified 19 studies in the literature investigating the use of ECT, TMS, and tDCS in the treatment of HD. Quality assessments were performed using Joanna Briggs Institute’s (JBI’s) critical appraisal tools. Eighteen studies showed improvement of HD symptoms, but the results were very heterogeneous considering different intervention techniques and protocols, and domains of symptoms. The most noticeable improvement involved depression and psychosis after ECT protocols. The impact on cognitive and motor symptoms is more controversial. Further investigations are required to determine the therapeutic role of distinct neuromodulation techniques for HD-related symptoms.
Insights into Mesalazine Use in Clinical Practice of Young Gastroenterologists
Authors: Nardone Olga Maria , Marasco Giovanni , Lopetuso Loris Riccardo , Mocci Giammarco , Pastorelli Luca , Petruzzellis Carlo , Scaldaferri Franco ,   on behalf of the Italian Association of Young Gastroenterologist and Endoscopist (AGGEI)
Published: March 2023

Background: Mesalazine is among the medications most prescribed by gastroenterologists, with variable and controversial use in different settings. We aimed to explore the use of mesalazine in the clinical practice of young gastroenterologists. Methods: A web-based electronic survey was distributed to all participants of the National Meeting of the Italian Young Gastroenterologist and Endoscopist Association. Results: A total of 101 participants took part in the survey, with a majority (54.4%) being aged >30 years, 63.4% of whom were trainees in academic hospitals, and 69.3% of whom were involved in the clinical management of inflammatory bowel disease (IBD). While both non-dedicated and IBD physicians generally agreed on the appropriate dose of mesalazine for mild ulcerative colitis (UC), significant differences were observed between the two groups for moderate-severe ulcerative colitis (UC). Additionally, in IBD patients who were starting immuno-modulators and/or biologics, 80% of IBD-dedicated physicians continued to prescribe mesalazine, compared to 45.2% of non-dedicated physicians (p = 0.002). Indeed, 48.4% of non-dedicated IBD physicians did not acknowledge mesalazine for colorectal cancer chemoprevention. With regards to Crohn’s disease, it is mainly used by 30.1% of IBD physicians for preventing postoperative recurrence of Crohn’s disease. Finally, 57.4% used mesalazine for symptomatic uncomplicated diverticular disease, and 84.2% did not recommend its use for irritable bowel syndrome. Conclusions: This survey showed heterogeneous behaviors in the daily use of mesalazine, mainly in the management of IBD. Educational programs and novel studies are needed to clarify its use.
Endometriosis in Adolescents with Obstructive Anomalies of the Reproductive Tract
Authors: Kapczuk Karina , Zajączkowska Weronika , Madziar Klaudyna , Kędzia Witold
Published: March 2023

Background: This study aimed to assess the prevalence and course of endometriosis in adolescents with obstructive Müllerian anomalies. Methods: The study group involved 50 adolescents undergoing surgeries (median age 13.5 (range 11.1–18.5)) for rare obstructive malformations of the genital tract: 15 girls had anomalies associated with cryptomenorrhea and 35 were menstruating. The median follow-up period was 2.4 (ranging from 0.1 to 9.5) years. Results: We diagnosed endometriosis in 23 of the 50 subjects (46%), including 10 of the 23 patients (43.5%) with obstructed hemivagina ipsilateral renal anomaly syndrome (OHVIRAS), six of eight patients (75%) with a unicornuate uterus with a non-communicating functional horn, two of three patients (66.7%) with distal vaginal aplasia, and five of five patients (100%) with cervicovaginal aplasia. Persistent dysmenorrhea, following treatment, affected 14 of the 50 adolescents (28%), including 8 of the 17 subjects (47.1%) diagnosed with endometriosis at the time of surgical correction and six adolescents diagnosed with endometriosis during the follow-up. Conclusions: Endometriosis affects about half of young adolescents undergoing surgical treatment of obstructive Müllerian anomalies after menarche. The incidence of endometriosis is highest in girls with cervical aplasia. The risk of developing endometriosis decreases after surgical correction of obstruction but is still significant in patients with uterine anomalies.
The Effect of Hematocrit on All-Cause Mortality in Geriatric Patients with Hip Fractures: A Prospective Cohort Study
Authors: Zhang Yu-Min , Li Kun , Cao Wen-Wen , Chen Shao-Hua , Zhang Bin-Fei
Published: March 2023

Objective: The present study aimed to evaluate the association between hematocrit (HCT) levels and all-cause mortality in geriatric hip fractures. Methods: Older adult patients with hip fractures were screened between January 2015 and September 2019. The demographic and clinical characteristics of these patients were collected. Linear and nonlinear multivariate Cox regression models were used to identify the association between HCT levels and mortality. Analyses were performed using EmpowerStats and the R software. Results: A total of 2589 patients were included in this study. The mean follow-up period was 38.94 months. Eight hundred and seventy-five (33.8%) patients died due to all-cause mortality. Linear multivariate Cox regression models showed that HCT level was associated with mortality (hazard ratio [HR] = 0.97, 95% confidence interval [CI]: 0.96–0.99, p = 0.0002) after adjusting for confounding factors. However, the linear association was unstable and nonlinearity was identified. A HCT level of 28% was the inflection point for prediction. A HCT level of <28% was associated with mortality (HR = 0.91, 95% CI: 0.87–0.95, p < 0.0001), whereas a HCT level > 28% was not a risk factor for mortality (HR = 0.99, 95% CI: 0.97–1.01, p = 0.3792). We found that the nonlinear association was very stable in the propensity score-matching sensitivity analysis. Conclusions: The HCT level was nonlinearly associated with mortality in geriatric hip fracture patients and could be considered a predictor of mortality in these patients. Registration: ChiCTR2200057323.
Sex-Specific Predictors of Long-Term Mortality in Elderly Patients with Ischemic Cardiomyopathy
Authors: Yoon Hyun Ju , Kim Kye Hun , Lee Nuri , Park Hyukjin , Kim Hyung Yoon , Cho Jae Yeong , Ahn Youngkeun , Jeong Myung Ho
Published: March 2023

Ischemic heart failure (HF) is one of the most common causes of morbidity and mortality in the world-wide, but sex-specific predictors of mortality in elderly patients with ischemic cardiomyopathy (ICMP) have been poorly studied. A total of 536 patients with ICMP over 65 years-old (77.8 ± 7.1 years, 283 males) were followed for a mean of 5.4 years. The development of death during clinical follow up was evaluated, and predictors of mortality were compared. Death was developed in 137 patients (25.6%); 64 females (25.3%) vs. 73 males (25.8%). Low-ejection fraction was only an independent predictor of mortality in ICMP, regardless of sex (HR 3.070 CI = 1.708–5.520 in female, HR 2.011, CI = 1.146–3.527 in male). Diabetes (HR 1.811, CI = 1.016–3.229), elevated e/e’ (HR 2.479, CI = 1.201–5.117), elevated pulmonary artery systolic pressure (HR 2.833, CI = 1.197–6.704), anemia (HR 1.860, CI = 1.025–3.373), beta blocker non-use (HR2.148, CI = 1.010–4.568), and angiotensin receptor blocker non-use (HR 2.100, CI = 1.137–3.881) were bad prognostic factors of long term mortality in female, whereas hypertension (HR 1.770, CI = 1.024–3.058), elevated Creatinine (HR 2.188, CI = 1.225–3.908), and statin non-use (HR 3.475, CI = 1.989–6.071) were predictors of mortality in males with ICMP independently. Systolic dysfunction in both sexes, diastolic dysfunction, beta blocker and angiotensin receptor blockers in female, and statins in males have important roles for long-term mortality in elderly patients with ICMP. For improving long-term survival in elderly patients with ICMP, it may be necessary to approach sex specifically.
Elective Ascending Aortic Aneurysm Surgery in the Elderly
Authors: Memis Feyza , Thijssen Carlijn G. E. , Gökalp Arjen L. , Notenboom Maximiliaan L. , Meccanici Frederike , Mokhles Mohammad Mostafa , van Kimmenade Roland R. J. , Veen Kevin M. , Geuzebroek Guillaume S. C. , Sjatskig Jelena , ter Woorst Franciscus J. , Bekkers Jos A. , Takkenberg Johanna J. M. , Roos-Hesselink Jolien W.
Published: March 2023

Background. No clear guidelines exist for performing preventive surgery for ascending aortic (AA) aneurysm in elderly patients. This study aims to provide insights by: (1) evaluating patient and procedural characteristics and (2) comparing early outcomes and long-term mortality after surgery between elderly and non-elderly patients. Methods. A multicenter retrospective observational cohort-study was performed. Data was collected on patients who underwent elective AA surgery in three institutions (2006–2017). Clinical presentation, outcomes, and mortality were compared between elderly (≥70 years) and non-elderly patients. Results. In total, 724 non-elderly and 231 elderly patients were operated upon. Elderly patients had larger aortic diameters (57.0 mm (IQR 53–63) vs. 53.0 mm (IQR 49–58), p < 0.001) and more cardiovascular risk factors at the time of surgery than non-elderly patients. Elderly females had significantly larger aortic diameters than elderly males (59.5 mm (55–65) vs. 56.0 mm (51–60), p < 0.001). Short-term mortality was comparable between elderly and non-elderly patients (3.0% vs. 1.5%, p = 0.16). Five-year survival was 93.9% in non-elderly patients and 81.4% in elderly patients (p < 0.001), which are both lower than that of the age-matched general Dutch population. Conclusion. This study showed that in elderly patients, a higher threshold exists to undergo surgery, especially in elderly females. Despite these differences, short-term outcomes were comparable between ‘relatively healthy’ elderly and non-elderly patients.
High Plasma tPAPAI-1C Levels May Be Related to a Poor Prognosis in Patients with Severe or Critical COVID-19: A Single-Center Retrospective Study
Authors: Shirai Kunihiro , Ishikawa Michiko , Kobayashi Tomoyuki , Sato Kiyoko , Murakami Hiromoto , Kohama Keisuke , Manbo Naomi , Hasegawa Kana , Hirata Junichi
Published: March 2023

Severe novel coronavirus disease 2019 (COVID-19) patients have a high incidence of thrombotic complications and mortality. The pathophysiology of coagulopathy involves fibrinolytic system impairment and vascular endothelial damage. This study examined coagulation and fibrinolytic markers as outcome predictors. In an observational study of 164 COVID-19 patients admitted to our emergency intensive care unit, hematological parameters on days 1, 3, 5, and 7 were retrospectively compared between survivors and nonsurvivors. Nonsurvivors had a higher APACHE II score, SOFA score, and age than survivors. Nonsurvivors also had a significantly lower platelet count and significantly higher plasmin/α2plasmin inhibitor complex (PIC), tissue plasminogen activator/plasminogen activator inhibitor-1 complex (tPAPAI-1C), D-dimer, and fibrin/fibrinogen degradation product (FDP) levels than survivors throughout the measurement period. The 7-day maximum or minimum values of the tPAPAI-1C, FDP, and D-dimer levels were significantly higher in nonsurvivors. A multivariate logistic regression analysis showed that the maximum tPAPAI-1C (OR = 1.034; 95% CI,1.014–1.061; p = 0.0041) was an independent factor affecting mortality, with an area under the curve (AUC) of 0.713 (optimum cut-off of 51 ng/mL; sensitivity, 69.2%; and specificity, 68.4%). COVID-19 patients with poor outcomes exhibit exacerbated coagulopathy with fibrinolysis inhibition and endothelial damage. Consequently, plasma tPAPAI-1C might be a useful predictor of the prognosis in patients with severe or critical COVID-19.
Performance of High-Strength Concrete with the Effects of Seashell Powder as Binder Replacement and Waste Glass Powder as Fine Aggregate
Authors: Shetty Prathibha P. , Rao Asha U. , Pai B. H. V. , Kamath Muralidhar V.
Published: March 2023

Seashell powder (SSP) is a waste from aquatic life that is generally available near the coastal region. Due to its high calcium content, SSP can be utilized as a supplementary cementitious binder. SSP can be used as a sustainable binder to replace ordinary Portland cement (OPC) and significantly reduce the carbon footprint. The present study investigates the effects of SSP and waste glass powder (WGP) on the fresh, mechanical, and microstructure properties of high-strength concrete (HSC). The SSP utilized in this research was varied, with 5%, 10%, and 15% cement replacement levels. The impact of WGP was also observed with two replacement levels, 5% and 10%, replacing natural sand. The slump flow of all the HSC mixes varied between 700 and 785 mm. A maximum compressive strength of 112.91 MPa was found for the C75SSP5 mix at 56 days. The split tensile strength values of all the HSC mixes were found in a range from 5.45 to 10.56 MPa. The modulus of elasticity values of all the HSC mixes were found to lie between 40.2 and 46.8 GPa. The lowest water absorption was observed in the mix containing 5% SSP. The SEM image of the HSC with increased SSP showed that it was denser and had fewer unreacted particles. XRD and EDS showed the presence of various gels, such as calcium silicate hydrates (CSHs), ettringite, calcium hydroxide (CH), and calcium carbonate (CC). The predicted equations for its split tensile strength, flexural strength, modulus of elasticity, and water absorption were also carried out in the present research.
Development of Chitosan/Whey Protein Hydrolysate Composite Films for Food Packaging Application
Authors: Al-Hilifi Sawsan A. , Al-Ibresam Orass T. , Al-Hatim Raqad R. , Al-Ali Rawdah M. , Maslekar Namrata , Yao Yin , Agarwal Vipul
Published: March 2023

There is a significant drive towards the development of edible biocompatible films for food packaging application due to the environmental and health impacts of synthetic packaging materials. This has inspired the exploration of biodegradable natural polymers as packaging materials. To address the instant water disintegration of most natural polymers, polymers with conditional water solubility, such as chitosan (needing acidic conditions for dissolution in water), have gained significant research attention. To this end, chitosan has been blended with different natural proteins, including whey protein isolates, to prepare edible food films. However, consumption of whey protein isolates in their natural form has been proposed in the literature to prolong processing (digestion) time upon consumption. To circumvent this limitation, here we report the development of chitosan/whey protein hydrolysate-based edible films with additional antioxidant properties. The developed films revealed that the inclusion of whey protein hydrolysate improved physicochemical properties and mechanical strength of the films with tensile strength of 26.3 MPa at 1 wt% WPH loading compared to 10.9 MPa in control neat chitosan films (0 wt% WPH). Furthermore, chitosan/whey protein hydrolysate exhibited a significant (whey protein hydrolysate) dose-dependent antioxidant response with a maximum value of 83% DPPH in chitosan/WPH (1 wt%) films assessed using two different antioxidant assays. Based on the results from this study, we envisage the exploration of whey protein hydrolysate-based films for commercial food packaging application in future.
Physical Match Demands of International Women’s Rugby Union: A Three-Year Longitudinal Analysis of a Team Competing in The Women’s Six Nations Championship
Authors: Nolan David , Curran Orlaith , Brady Aidan J. , Egan Brendan
Published: March 2023

There is a paucity of studies describing the physical match demands of elite international women’s rugby union, which limits coaches’ ability to effectively prepare players for the physical demands required to compete at the elite level. Global positioning system technologies were used to measure the physical match demands of 53 international female rugby union players during three consecutive Women’s Six Nations Championships (2020–2022), resulting in 260 individual match performances. Mixed-linear modelling was used to investigate differences in physical match demands between positions. Significant effects (p < 0.05) of the position were observed for all variables, with the exception of relative distances (m.min−1) at velocities of 1.01–3.00 m·s−1 (p = 0.094) and 3.01–5.00 m·s−1 (p = 0.216). This study provides valuable data on the physical match demands of elite international women’s rugby union match play that may aid practitioners in the physical preparation of players to compete at this level. Training methodologies for elite-level female rugby union players should consider the unique demands across positional groups with specific considerations of high-velocity running and collision frequency.
Assessment of Using Artificial Neural Network and Support Vector Machine Techniques for Predicting Wave-Overtopping Discharges at Coastal Structures
Authors: Alshahri Abdullah H. , Elbisy Moussa S.
Published: March 2023

Coastal defence structures play a crucial role in protecting coastal communities against extreme weather and flooding. This study investigates artificial neural network-based approaches, such as multilayer perceptron neural network (MPNN), cascade correlation neural network (CCNN), general regression neural network (GRNN), and support vector machine (SVM) with radial-bias function for estimating the wave-overtopping discharge at coastal structures featuring a straight slope ‘without a berm’. The newly developed EurOtop database was used for this study. Discriminant analysis was performed using the principal component analysis method, and Taylor diagram visualisation and other statistical analyses were performed to evaluate the models. For predicting wave-overtopping discharge, the GRNN yielded highly accurate results. As compared to the other models, the scatter index of the GRNN (0.353) was lower than that of the SVM (0.585), CCNN (0.791), and MPNN (1.068) models. In terms of the R-index, the GRNN (0.991) was superior to the SVM (0.981), CCNN (0.958), and MPNN (0.922). The GRNN results were compared with those of the previous models. An in-depth sensitivity analysis was conducted to determine the significance of each predictive variable. Furthermore, sensitivity analysis was conducted to select the optimal validation method for the GRNN model. The results revealed that both the validation methods were highly accurate, with the leave-one-out validation method outperforming the cross-validation method by only a small margin.