bluuebunny/crossref_metadata_2025 huggingface dataset:
Excessive Noise in Neonatal Units and the Occupational Stress Experienced by Healthcare Professionals: An Assessment of Burnout and Measurement of Cortisol Levels
Authors: Bringel Jocélia Maria de Azevedo , Abreu Isabel , Muniz Maria-Cláudia Mendes Caminha , de Almeida Paulo César , Silva Maria-Raquel G.
Published: July 2023

Excessive noise in the work environment has been associated with extra-auditory symptoms, which can have harmful long-term effects on individuals. The purpose of this study was to identify noise levels in neonatal intensive care units and investigate their impact on the occurrence of stress among healthcare professionals, using cortisol levels as a biomarker for Burnout Syndrome. This descriptive, observational, and cross-sectional study was conducted in four public teaching hospitals in Fortaleza, Ceará, Brazil. Sound pressure levels in the environment were measured, and questionnaires were administered to collect sociodemographic data and assess perceptions of the work environment and Burnout symptoms. Saliva samples were collected at the beginning and end of work shifts for cortisol quantification. The average sound pressure ranged from 59.9 to 66.4 dB(A), exceeding the recommended levels set by Brazilian and international legislation. Among the 256 participants, the average age was 39.4 years, with 95% being female. The majority (70.9%) were nurses, and 22.7% were physicians. There was no significant association found between noise and Burnout Syndrome, nor with changes in cortisol levels. However, a significant association was observed between the perception of excessive noise and the sensation of a stressful work shift (p = 0.012). All evaluated professionals displayed symptoms of Burnout. The high sound pressure levels indicated that the assessed environments did not meet the recommended standards for acoustic comfort, and this was associated with the participants’ perception of stressful work shifts. While Burnout symptoms were evident in our participants, it was not possible to confirm a correlation with high noise levels.
Advancements in Lily Viruses Management: Challenges and Solutions in Elimination and Detection
Authors: Gong Huiling , Dusengemungu Leonce , Lv Peng , Igiraneza Clement
Published: July 2023

Lilies are important crops that are commonly used as cut flowers (Lilium spp.) and edible bulb crops (Lilium davidii var. unicolor). However, virus infections can significantly impact the quantity and quality of lily production. Various methods have been developed to eliminate viruses in lilies, including in vitro culture and virus detection techniques. Meristem culture is the most effective method, which can be combined with other techniques such as thermotherapy and chemotherapy. Nonetheless, virus elimination is affected by several factors, including cultivar, explants used, virus type, and duration of treatments. Efficient diagnostic methods, such as serological and molecular techniques, have been developed to detect viral infections in lilies, including enzyme-linked immunosorbent assay (ELISA) and real-time reverse transcriptase polymerase chain reaction (real-time RT-PCR). However, cross-contamination and multiple-virus contamination can lead to unreliable results, and more sophisticated protocols and systems have been developed to address these issues. The objective of this review is to provide a comprehensive overview of the development of lily virus eradication, detection strategies, challenges, and solutions associated with these procedures, and how more sophisticated approaches such as multiplex RT-PCR, indirect ELISA (ID-ELISA), immunocapture RT-PCR (IC-RT-PCR), and immunochromatographic test strips (ICSs) can alleviate some of these setbacks.
Engineered Human Dendritic Cell Exosomes as Effective Delivery System for Immune Modulation
Authors: Elsayed Ranya , Elashiry Mahmoud , Tran Cathy , Yang Tigerwin , Carroll Angelica , Liu Yutao , Hamrick Mark , Cutler Christopher W.
Published: July 2023

Exosomes (exos) contain molecular cargo of therapeutic and diagnostic value for cancers and other inflammatory diseases, but their therapeutic potential for periodontitis (PD) remains unclear. Dendritic cells (DCs) are the directors of immune response and have been extensively used in immune therapy. We previously reported in a mouse model of PD that custom murine DC-derived exo subtypes could reprogram the immune response toward a bone-sparing or bone-loss phenotype, depending on immune profile. Further advancement of this technology requires the testing of human DC-based exos with human target cells. Our main objective in this study is to test the hypothesis that human monocyte-derived dendritic cell (MoDC)-derived exos constitute a well-tolerated and effective immune therapeutic approach to modulate human target DC and T cell immune responses in vitro. MoDC subtypes were generated with TGFb/IL-10 (regulatory (reg) MoDCs, CD86lowHLA-DRlowPDL1high), E. coli LPS (stimulatory (stim) MoDCs, CD86highHLA-DRhighPDL1low) and buffer (immature (i) MoDCs, CD86lowHLA-DRmedPDL1low). Exosomes were isolated from different MoDC subtypes and characterized. Once released from the secreting cell into the surrounding environment, exosomes protect their prepackaged molecular cargo and deliver it to bystander cells. This modulates the functions of these cells, depending on the cargo content. RegMoDCexos were internalized by recipient MoDCs and induced upregulation of PDL1 and downregulation of costimulatory molecules CD86, HLADR, and CD80, while stimMoDCexos had the opposite influence. RegMoDCexos induced CD25+Foxp3+ Tregs, which expressed CTLA4 and PD1 but not IL-17A. In contrast, T cells treated with stimMoDCexos induced IL-17A+ Th17 T cells, which were negative for immunoregulatory CTLA4 and PD1. T cells and DCs treated with iMoDCexos were immune ‘neutral’, equivalent to controls. In conclusion, human DC exos present an effective delivery system to modulate human DC and T cell immune responses in vitro. Thus, MoDC exos may present a viable immunotherapeutic agent for modulating immune response in the gingival tissue to inhibit bone loss in periodontal disease.
Global Protein Profiling in Processed Immunohistochemistry Tissue Sections
Authors: Venz Simone , von Bohlen und Halbach Viola , Hentschker Christian , Junker Heike , Kuss Andreas Walter , Sura Thomas , Krüger Elke , Völker Uwe , von Bohlen und Halbach Oliver , Jensen Lars Riff , Hammer Elke
Published: July 2023

Tissue sections, which are widely used in research and diagnostic laboratories and have already been examined by immunohistochemistry (IHC), may subsequently provide a resource for proteomic studies, even though only small amount of protein is available. Therefore, we established a workflow for tandem mass spectrometry-based protein profiling of IHC specimens and characterized defined brain area sections. We investigated the CA1 region of the hippocampus dissected from brain slices of adult C57BL/6J mice. The workflow contains detailed information on sample preparation from brain slices, including removal of antibodies and cover matrices, dissection of region(s) of interest, protein extraction and digestion, mass spectrometry measurement, and data analysis. The Gene Ontology (GO) knowledge base was used for further annotation. Literature searches and Gene Ontology annotation of the detected proteins verify the applicability of this method for global protein profiling using formalin-fixed and embedded material and previously used IHC slides.
In Silico Comparative Genomic Analysis Revealed a Highly Conserved Proteolytic System in Lactobacillus delbrueckii
Authors: Elean Mariano , Albarracin Leonardo , Villena Julio , Kitazawa Haruki , Saavedra Lucila , Hebert Elvira M.
Published: July 2023

Lactobacillus delbrueckii, the type species of the genus Lactobacillus, is widely recognized as the primary starter culture in the dairy industry due to its proteolytic activity, which enables it to growth in milk. In this study, a comprehensive genomic analysis of the proteolytic system was conducted on L. delbrueckii strains. The analysis included 27 genomes of L. delbrueckii, with a specific focus on the key enzyme involved in this system, the cell envelope-associated proteinase (CEP). The amino acid sequences, as well as the protein-structure prediction of the CEPs, were compared. Additionally, syntenic analysis of the genomic locus related to the CEPs revealed high conservation in L. delbrueckii subsp. bulgaricus strains, while L. delbrueckii subsp. lactis strains exhibited greater variability, including the presence of insertion sequences, deletions, and rearrangements. Finally, the CEP promoter region and putative regulatory elements responsible for controlling the expression of the proteolytic system in lactobacilli were investigated. Our genomic analysis and in silico characterization of the CEPs contribute to our understanding of proteolytic activity and the potential applications of these lactic acid bacteria in the dairy industry. Further research in this area will expand our knowledge and potential practical uses of these findings.
Translating Molecular Biology Discoveries to Develop Targeted Cancer Interception in Barrett’s Esophagus
Authors: Samaddar Sohini , Buckles Daniel , Saha Souvik , Zhang Qiuyang , Bansal Ajay
Published: July 2023

Esophageal adenocarcinoma (EAC) is a rapidly increasing lethal tumor. It commonly arises from a metaplastic segment known as Barrett’s esophagus (BE), which delineates the at-risk population. Ample research has elucidated the pathogenesis of BE and its progression from metaplasia to invasive carcinoma; and multiple molecular pathways have been implicated in this process, presenting several points of cancer interception. Here, we explore the mechanisms of action of various agents, including proton pump inhibitors, non-steroidal anti-inflammatory drugs, metformin, and statins, and explain their roles in cancer interception. Data from the recent AspECT trial are discussed to determine how viable a multipronged approach to cancer chemoprevention would be. Further, novel concepts, such as the repurposing of chemotherapeutic drugs like dasatinib and the prevention of post-ablation BE recurrence using itraconazole, are discussed.
Transcriptome-Wide Identification and Response Pattern Analysis of the Salix integra NAC Transcription Factor in Response to Pb Stress
Authors: Xin Yue , Huang Ruifang , Xu Meng , Xu Li’an
Published: July 2023

The NAC (NAM-ATAF1/2-CUC) transcription factor family is one of the largest plant-specific transcription factor families, playing an important role in plant growth and development and abiotic stress response. As a short-rotation woody plant, Salix integra (S. integra) has high lead (Pb) phytoremediation potential. To understand the role of NAC in S. integra Pb tolerance, 53 SiNAC transcripts were identified using third-generation and next-generation transcriptomic data from S. integra exposed to Pb stress, and a phylogenetic analysis revealed 11 subfamilies. A sequence alignment showed that multiple subfamilies represented by TIP and ATAF had a gene that produced more than one transcript under Pb stress, and different transcripts had different responses to Pb. By analyzing the expression profiles of SiNACs at 9 Pb stress time points, 41 of 53 SiNACs were found to be significantly responsive to Pb. Short time-series expression miner (STEM) analysis revealed that 41 SiNACs had two significant Pb positive response patterns (early and late), both containing 10 SiNACs. The SiNACs with the most significant Pb response were mainly from the ATAF and NAP subfamilies. Therefore, 4 and 3 SiNACs from the ATAF and NAP subfamilies, respectively, were selected as candidate Pb-responsive SiNACs for further structural and functional analysis. The RT-qPCR results of 7 transcripts also confirmed the different Pb response patterns of the ATAF and NAP subfamilies. SiNAC004 and SiNAC120, which were randomly selected from two subfamilies, were confirmed to be nuclear localization proteins by subcellular localization experiments. Functional prediction analysis of the associated transcripts of seven candidate SiNACs showed that the target pathways of ATAF subfamily SiNACs were “sulfur metabolism” and “glutathione metabolism”, and the target pathways of NAP subfamily SiNACs were “ribosome” and “phenylpropanoid biosynthesis”. This study not only identified two NAC subfamilies with different Pb response patterns but also identified Pb-responsive SiNACs that could provide a basis for subsequent gene function verification.
Theme Mapping and Bibliometric Analysis of Two Decades of Smart Farming
Authors: Kushartadi Tri , Mulyono Aditya Eka , Al Hamdi Azhari Haris , Rizki Muhammad Afif , Sadat Faidar Muhammad Anwar , Harsanto Wirawan Dwi , Suryanegara Muhammad , Asvial Muhamad
Published: July 2023

The estimated global population for 2050 is 9 billion, which implies an increase in food demand. Agriculture is the primary source of food production worldwide, and improving its efficiency and productivity through an integration with information and communication technology system, so-called “smart farming”, is a promising approach to optimizing food supply. This research employed bibliometric analysis techniques to investigate smart farming trends, identify their potential benefits, and analyze their research insight. Data were collected from 1141 publications in the Scopus database in the period 1997–2021 and were extracted using VOS Viewer, which quantified the connections between the articles using the co-citation unit, resulting in a mapping of 10 clusters, ranging from agriculture to soil moisture. Finally, the analysis further focuses on the three major themes of smart farming, namely the IoT; blockchain and agricultural robots; and smart agriculture, crops, and irrigation.
Quality and Content Concordance of International Clinical Guidelines on Hypertensive Disorders of Pregnancy Using the AGREE II Instrument: An Updated Systematic Review
Authors: Bazzano Alessandra N. , Keenan Alexandra , Woltz Sara , Subramanian Advaith , Akpogheneta Onome , Coronado Daza Jorge , Bazzano Lydia A. L.
Published: July 2023

Utilization of high-quality clinical practice guidelines has the potential to positively impact health outcomes. This study aimed to assess the quality and content concordance of national and international recommendations on hypertensive disorders of pregnancy (HDPs). Searches were conducted of the MEDLINE database and reference lists generated from national and international agencies. Covidence software was used for the management of the systematic review process, the Appraisal of Guidelines for Research and Evaluation II (AGREE II) tool was used to assess guidelines for quality, and three reviewers independently screened records. The research team identified and screened a total of 399 records of which 10 were deemed high quality. Guidelines were assessed and compared regarding the treatment, prevention, and categorization of disorders. The quality of guidelines varied across different domains, with significant variation in domain scores even within individual guidelines. Not all recommendations showed a high level of methodologic rigor, and the highest-rated guidelines were from the American Heart Association, the World Health Organization, and South Africa national guidelines. Classification of hypertension differed among the guidelines, particularly in defining chronic hypertension, severe hypertension, and preeclampsia. Prevention modalities varied across guidelines, with recommendations for aspirin, calcium supplementation, and against the use of certain approaches. Treatment modalities highlighted the importance of delivery as the definitive way to terminate hypertensive disorders of pregnancy, with other management strategies provided for symptom control. The variability in guidelines and consensus statements across different contexts may reflect regional differences in healthcare practices, available resources, and research evidence. There is potential to harmonize guidelines for HDP globally while considering the unique needs of individual countries. Where guidelines may be synthesized and condensed into an accessible format, doing so could improve their use in clinical decision-making.
Do Non-Functional Adrenal Adenomas Affect Metabolic Profile and Carotid Intima-Media Thickness? A Single Centre Study from Poland
Authors: Szychlińska Magdalena , Rzeczkowska Magdalena , Gontarz-Nowak Katarzyna , Matuszewski Wojciech , Bandurska-Stankiewicz Elżbieta
Published: July 2023

Background: Compared to the general population, among people with adrenal incidentalomas (AIs) the diagnosis of obesity, hypertension, impaired carbohydrate and lipid metabolism is more common. The aformentioned disorders represent typical cardiovascular remodeling risk factors. The study was designed to assess the association between NFAIs, metabolic profile and carotid intima-media thickness (CIMT) as the predictive factor of atherosclerosis. Material: The study included 48 patients with NFAI (16 men, 32 women, mean age 58.6 +/− 9 years) and 44 control participants (15 men, 29 women, mean age 57 +/− 7 years). Both groups were matched for age, gender and BMI. Subjects with history of myocardial infarction, stroke or diabetes mellitus (DM) were excluded. Participants underwent adrenal imaging, biochemical evaluation, and measurement of CIMT. Hormonal evaluation was conducted in AI patients. Results: The NFAI group had significantly higher waist circumference (p < 0.01), higher systolic (p < 0.01) and diastolic blood pressure (p < 0.01), fasting insulin (p = 0.03) and glucose in the 2 h OGTT (p = 0.04) as well as higher CIMT (p < 0.01). Hypertension (p < 0.01) and IGT (p = 0.026) were more common in this group as well. There was a positive correlation between CIMT and cortisol levels in 1 mg dexamethasone suppression test (r = 0.33, p = 0.02). Conclusions: Patients diagnosed with NFAIs, despite normal cortisol inhibition in the 1 mg dexamethasone test, still presented a number of metabolic abnormalities. The assessment of IMT may proove valuable in indicate the presence of early vascular remodelling in asymptomatic patients. The underlying mechanisms of these findings are still unknown, hence further studies are required.
Expression of Interleukin 17A and 17B in Gingival Tissue in Patients with Periodontitis
Authors: Mazurek-Mochol Małgorzata , Serwin Karol , Bonsmann Tobias , Kozak Małgorzata , Piotrowska Katarzyna , Czerewaty Michał , Safranow Krzysztof , Pawlik Andrzej
Published: July 2023

Periodontitis (PD) is a chronic inflammatory disease that is initiated by oral microorganisms. The pathogens induce the production of cytokines, such as interleukin (IL)-17, which enhances the inflammatory response and progression of the disease. The aim of this study was to examine the expression and localization in gingival tissue of IL-17A and IL-17B in patients with periodontitis. This study included 14 patients with periodontal disease and 14 healthy subjects without periodontal disease as a control group. There were no statistically significant differences in the expression of IL-17A mRNA between patients with periodontitis and control subjects. The expression of IL-17B mRNA was statistically significantly lower in patients with periodontitis in comparison with healthy subjects (p < 0.048). The expression of IL-17A correlated significantly with the approximal plaque index. The IL-17B expression in gingival tissue correlated with the clinical attachment level. This correlation reached borderline statistical significance (p = 0.06). In immunohistochemical analysis, we have shown the highest expression of IL-17 protein in inflamed connective tissue, epithelium, and granulation tissue from gingival biopsy specimens from patients with periodontitis. In biopsy specimens from healthy individuals, no IL-17 was found in the epithelium, while an expression of IL-17 was found in the connective tissue. The results of our study confirm the involvement of IL-17 in the pathogenesis of periodontitis. Our results suggest that an increase in IL-17 protein expression in the gingival tissue of patients with periodontitis occurs at the post-translational stage.
The Immunoseasonal Theory of Psychiatric Disorders
Authors: Waszkiewicz Napoleon
Published: July 2023

Although the influence of the weather on the well-being and mental health of psychiatric patients has been widely seen, the relationships between various seasonal weather factors and depressive, manic, anxiety, and psychotic states have not been systematized in the literature. The current article describes the seasonal changes in weather-related immune responses and their impact on the development of episodes of depression, mania, psychosis, and anxiety, highlighting the T-helper 1 (Th1) and Th2 immune balance as their potential trigger. In autumn–winter depression, the hyperactivation of the Th1 system, possibly by microbial/airborne pathogens, may lead to the inflammatory inhibition of prefrontal activity and the subcortical centers responsible for mood, drive, and motivation. Depressive mood periods are present in most people suffering from schizophrenia. In the spring and summertime, when the compensating anti-Th1 property of the Th2 immune system is activated, it decreases the Th1 response. In individuals immunogenetically susceptible to psychosis and mania, the inhibition of Th1 by the Th2 system may be excessive and lead to Th2-related frontal and subcortical hyperactivation and subsequent psychosis. In people suffering from bipolar disorder, hyperintense changes in white matter may be responsible for the partial activation of subcortical areas, preventing full paranoid psychosis. Thus, psychosis may be mood-congruent in affective disorders.
Depressive Symptoms and Their Impact on Quality of Life in Parkinson’s Disease: An Exploratory Network Analysis Approach
Authors: Heimrich Konstantin , Mendorf Sarah , Schönenberg Aline , Santos-García Diego , Mir Pablo , COPPADIS Study Group  , Prell Tino
Published: July 2023

The clinical presentation of Parkinson’s disease (PD) is often dominated by depressive symptoms, which can significantly impact the patients’ quality of life (QoL). However, it is not clear how these depressive symptoms are interconnected, or if some symptoms are more influential in affecting QoL. In the Cohort of Patients with Parkinson’s Disease in Spain (COPPADIS) study, 686 patients with PD were analyzed using network analyses. The patients completed the Beck Depression Inventory II (BDI-II) and provided their overall QoL (EUROHIS-QOL) at the beginning of the study. The study used centrality measures such as Expected Influence and Bridge Expected Influence to identify depressive symptoms that had the greatest impact on overall QoL. The results of exploratory network analyses indicate that the BDI-II items related to loss of energy, past failure, and tiredness or fatigue have the greatest impact on overall QoL as measured by the EUROHIS-QOL 8-item index. The loss of energy and tiredness or fatigue BDI-II items are also strongly associated with a number of different EUROHIS-QOL items, according to Bridge Expected Influences. For individuals suffering from PD, network analysis can aid in identifying significant non-motor symptoms that impact their QoL, thus paving the way for potential improvements.
Safety Issues in the Development of an Innovative Medical Parallel Robot Used in Renal Single-Incision Laparoscopic Surgery
Authors: Pisla Doina , Crisan Nicolae , Gherman Bogdan , Andras Iulia , Tucan Paul , Radu Corina , Pusca Alexandru , Vaida Calin , Al Hajjar Nadim
Published: July 2023

Robotic-assisted single-incision laparoscopic surgery (SILS) is becoming an increasingly widespread field worldwide due to the benefits it brings to both the patient and the surgeon. The goal of this study is to develop a secure robotic solution for SILS, focusing specifically on urology, by identifying and addressing various safety concerns from an early design stage. Starting with the medical tasks and protocols, the technical specifications of the robotic system as well as potential; hazards have been identified. By employing competitive engineering design methods such as Analytic Hierarchy Process (AHP), Risk assessment, and Failure Mode and Effects Analysis (FMEA), a safe design solution is proposed. A set of experiments is conducted to validate the proposed concept, and the results strongly support the development of the experimental model. The Finite Element Analysis (FEA) method is applied to validate the mechanical architecture within a set of simulations, demonstrating the compliance of the robotic system with the proposed technical specifications and its capability to safely perform SILS procedures.
The Role of Intracoronary Imaging for the Management of Calcified Lesions
Authors: Petousis Stylianos , Skalidis Emmanouil , Zacharis Evangelos , Kochiadakis George , Hamilos Michalis
Published: July 2023

Interventional cardiologists in everyday practice are often confronted with calcified coronary lesions indicated for percutaneous transluminal coronary angioplasty (PTCA). PTCA of calcified lesions is associated with diverse technical challenges resulting in suboptimal coronary stenting and adverse long-term clinical outcomes. Angiography itself offers limited information regarding coronary calcification, and the adjuvant use of intracoronary imaging such as intravascular ultrasound (IVUS) and Optical Coherence Tomography (OCT) can guide the treatment of calcified coronary lesions, optimizing the different stages of the procedure. This review offers a description of why, when, and how to use intracoronary imaging for PTCA of calcified coronary lesions in order to obtain the most favorable results. We used the PubMed and Google Scholar databases to search for relevant articles. Keywords were calcified coronary lesions, intracoronary imaging, IVUS, OCT, coronary calcium modification techniques, PTCA, and artificial intelligence in intracoronary imaging. A total of 192 articles were identified. Ninety-one were excluded because of repetitive or non-important information.
Manual and Device-Assisted Hamstring Autograft Tensioning Yield Similar Outcomes following ACL Reconstruction
Authors: Piskopakis Andreas , Totlis Trifon , Achlatis Vlasios , Zampeli Frantzeska , Georgoulis Jim Dimitris , Hantes Michael , Piskopakis Nikolaos , Vekris Marios
Published: July 2023

The optimal initial graft tension during ACL reconstruction is still a matter of debate. Manual tension is commonly applied to the graft during tibial fixation. However, this has been associated with a greater graft failure rate than that associated with device-assisted tensioning. This study aims to compare the clinical outcomes between the application of manual tension and the use of the ConMed Linvatec SE™ Graft Tensioning System during graft fixation while performing anatomic single-bundle ACL reconstruction. Methods: A prospective comparative study was conducted between September 2015 and May 2017. Sixty-four patients (mean age 29.3 years, range 14–45) with isolated ACL injuries (and who would be subjected to ACL reconstruction with a quadruple hamstring tendon graft) were divided into two groups. In Group A (n = 29), common tension was applied manually to both grafts. In Group B (n = 35), specific tension was applied to the grafts with the use of a tensioner device (ConMed Linvatec SE™ (Stress Equalization) Graft Tensioning System). A total of 60 N was applied to the semitendinosus, and 40 N was applied to the gracilis. Clinical outcomes were assessed at 6, 12, and 24 months. Results: There were no significant differences between the baseline demographic and clinical data among the patients of the two groups (all p > 0.05). The patients were followed up for a minimum of 24 months (mean ± SD). There were no significant differences in the side-to-side anterior knee laxity, the IKDC, the Lysholm Knee, and the Tegner Activity Scale scores for up to 24 months after operation. The pivot shift test was negative in all cases, and no graft failure was reported at a 2-year follow-up. Conclusion: No significant differences were found with respect to postoperative anterior knee laxity, clinical outcomes, activity level, and patient satisfaction between the application of manual tension and the use of the graft-tensioning system during tibial fixation while performing anatomic single-bundle ACL reconstruction with a quadruple hamstring tendon graft. Further high-quality clinical studies are required to elucidate whether device-assisted tension is superior to manual tension.
Incidence and Predictors of Ventricular Arrhythmias in Transthyretin Amyloid Cardiomyopathy
Authors: Knoll Katharina , Fuchs Patrick , Weidmann Isabel , Altunkas Fatih , Voss Stephanie , Lennerz Carsten , Kolb Christof , Kessler Thorsten , Schunkert Heribert , Reinhard Wibke , Groß Stefan , Trenkwalder Teresa
Published: July 2023

Background: Wild-type transthyretin amyloid cardiomyopathy (wtATTR-CM) is characterized by heart failure, conduction abnormalities and arrhythmias. The incidence of ventricular arrhythmias, particularly ventricular tachycardias (VTs), in wtATTR-CM is unclear. With the development of targeted therapies and improved overall prognosis, there is an unmet need to identify patients at high risk for VTs who might benefit from ICD therapy. Methods: Between 2017 and 2022, 72 patients diagnosed with wtATTR-CM were prospectively evaluated for the presence of ventricular arrhythmias using a Holter ECG. VTs were defined as >3 consecutive beats with a heart rate > 100 beats per minute originating from a ventricle. Results: The incidence of VTs was 44% (n = 32/72) in unselected wtATTR-CM patients. Patients with VT showed significantly more severe left ventricular (LV) hypertrophy (septum diameter 21 ± 2.6 vs. 19 ± 3.0 mm, p = 0.006), reduced LV ejection fraction (47 ± 8 vs. 52 ± 8%, p = 0.014) and larger left atria (32 ± 7 vs. 28 ± 6 mm2, p = 0.020), but no differences in cardiac markers such as NTproBNP and troponin. In a multivariable model, LV hypertrophy (LV mass indexed, OR = 1.02 [1.00–1.03], p = 0.031), LV end-diastolic diameter (OR = 0.85 [0.74–0.98], p = 0.021) and LV end-systolic diameter (OR = 1.19 [1.03–1.349], p = 0.092) were predictive for VT occurrence with an area under the receiver operating characteristic of 0.76 [0.65–0.87]. Conclusions: The incidence of ventricular arrhythmia in wtATTR-CM is high and is associated with an advanced stage of left ventricular disease. Further studies are needed evaluating the role of VTs in predicting sudden cardiac death and the benefit of ICD therapy in wtATTR-CM.
Magnetic Resonance Imaging in Clinical Trials of Diabetic Kidney Disease
Authors: Friedli Iris , Baid-Agrawal Seema , Unwin Robert , Morell Arvid , Johansson Lars , Hockings Paul D.
Published: July 2023

Chronic kidney disease (CKD) associated with diabetes mellitus (DM) (known as diabetic kidney disease, DKD) is a serious and growing healthcare problem worldwide. In DM patients, DKD is generally diagnosed based on the presence of albuminuria and a reduced glomerular filtration rate. Diagnosis rarely includes an invasive kidney biopsy, although DKD has some characteristic histological features, and kidney fibrosis and nephron loss cause disease progression that eventually ends in kidney failure. Alternative sensitive and reliable non-invasive biomarkers are needed for DKD (and CKD in general) to improve timely diagnosis and aid disease monitoring without the need for a kidney biopsy. Such biomarkers may also serve as endpoints in clinical trials of new treatments. Non-invasive magnetic resonance imaging (MRI), particularly multiparametric MRI, may achieve these goals. In this article, we review emerging data on MRI techniques and their scientific, clinical, and economic value in DKD/CKD for diagnosis, assessment of disease pathogenesis and progression, and as potential biomarkers for clinical trial use that may also increase our understanding of the efficacy and mode(s) of action of potential DKD therapeutic interventions. We also consider how multi-site MRI studies are conducted and the challenges that should be addressed to increase wider application of MRI in DKD.
Histomorphometry of the Sural Nerve for Use as a CFNG in Facial Reanimation Procedures
Authors: Kehrer Andreas , Hollmann Katharina S. , Klein Silvan M. , Anker Alexandra M. , Tamm Ernst R. , Prantl Lukas , Engelmann Simon , Knoedler Samuel , Knoedler Leonard , Ruewe Marc
Published: July 2023

Facial palsy (FP) is a debilitating nerve pathology. Cross Face Nerve Grafting (CFNG) describes a surgical technique that uses nerve grafts to reanimate the paralyzed face. The sural nerve has been shown to be a reliable nerve graft with little donor side morbidity. Therefore, we aimed to investigate the microanatomy of the sural nerve. Biopsies were obtained from 15 FP patients who underwent CFNG using sural nerve grafts. Histological cross-sections were fixated, stained with PPD, and digitized. Histomorphometry and a validated software-based axon quantification were conducted. The median age of the operated patients was 37 years (5–62 years). There was a significant difference in axonal capacity decrease towards the periphery when comparing proximal vs. distal biopsies (p = 0.047), while the side of nerve harvest showed no significant differences in nerve caliber (proximal p = 0.253, distal p = 0.506) and axonal capacity for proximal and distal biopsies (proximal p = 0.414, distal p = 0.922). Age did not correlate with axonal capacity (proximal: R = −0.201, p = 0.603; distal: R = 0.317, p = 0.292). These novel insights into the microanatomy of the sural nerve may help refine CFNG techniques and individualize FP patient treatment plans, ultimately improving overall patient outcomes.
A Potential Effect of Circadian Rhythm in the Delivery/Therapeutic Performance of Paclitaxel–Dendrimer Nanosystems
Authors: Albuquerque Tânia , Neves Ana Raquel , Paul Milan , Biswas Swati , Vuelta Elena , García-Tuñón Ignacio , Sánchez-Martin Manuel , Quintela Telma , Costa Diana
Published: July 2023

The circadian clock controls behavior and physiology. Presently, there is clear evidence of a connection between this timing system and cancer development/progression. Moreover, circadian rhythm consideration in the therapeutic action of anticancer drugs can enhance the effectiveness of cancer therapy. Nanosized drug delivery systems (DDS) have been demonstrated to be suitable engineered platforms for drug targeted/sustained release. The investigation of the chronobiology-nanotechnology relationship, i.e., timing DDS performance according to a patient’s circadian rhythm, may greatly improve cancer clinical outcomes. In the present work, we synthesized nanosystems based on an octa-arginine (R8)-modified poly(amidoamine) dendrimer conjugated with the anticancer drug paclitaxel (PTX), G4-PTX-R8, and its physicochemical properties were revealed to be appropriate for in vitro delivery. The influence of the circadian rhythm on its cellular internalization efficiency and potential therapeutic effect on human cervical cancer cells (HeLa) was studied. Cell-internalized PTX and caspase activity, as a measure of induced apoptosis, were monitored for six time points. Higher levels of PTX and caspase-3/9 were detected at T8, suggesting that the internalization of G4-PTX-R8 into HeLa cells and apoptosis are time-specific/-regulated phenomena. For a deeper understanding, the clock protein Bmal1—the main regulator of rhythmic activity, was silenced by Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR) technology. Bmal1 silencing was revealed to have an impact on both PTX release and caspase activity, evidencing a potential role for circadian rhythm on drug delivery/therapeutic effect mediated by G4-PTX-R8.
High Boron Content Enhances Bioactive Glass Biodegradation
Authors: Gharbi Amina , Oudadesse Hassane , el Feki Hafedh , Cheikhrouhou-Koubaa Wissem , Chatzistavrou Xanthippi , V. Rau Julietta , Heinämäki Jyrki , Antoniac Iulian , Ashammakhi Nureddin , Derbel Nabil
Published: July 2023

Derived Hench bioactive glass (BaG) containing boron (B) is explored in this work as it plays an important role in bone development and regeneration. B was also found to enhance BaG dissociation. However, it is only possible to incorporate a limited amount of B. To increase the amount of B in BaG, bioactive borosilicate glasses (BaG-Bx) were fabricated based on the use of the solution-gelation process (sol-gel). In this work, a high B content (20 wt.%) in BaG, respecting the conditions of bioactivity and biodegradability required by Hench, was achieved for the first time. The capability of BaG-Bx to form an apatite phase was assessed in vitro by immersion in simulated body fluid (SBF). Then, the chemical structure and the morphological changes in the fabricated BaG-Bx (x = 0, 5, 10 and 20) were studied. The formation of hydroxyapatite (HAp) layer was observed with X-ray diffraction (XRD) and infrared (IR) spectroscopy. The presence of HAp layer was confirmed using scanning electron microscopy (SEM) and transmission electron microscopy (TEM). Enhanced bioactivity and chemical stability of BaG-Bx were evaluated with an ion exchange study based on Inductively Coupled Plasma–Optical Emission Spectrometry (ICP-OES) and energy dispersive spectroscopy (EDS). Results indicate that by increasing the concentration of B in BaG-Bx, the crystallization rate and the quality of the newly formed HAp layer on BaG-Bx surfaces can be improved. The presence of B also leads to enhanced degradation of BaGs in SBF. Accordingly, BAG-Bx can be used for bone regeneration, especially in children, because of its faster degradation as compared to B-free glass.
Hydrodynamics Analysis of an Underwater Foldable Arm
Authors: Wang Jiayue , Shen Shengnan , Wei Wei , Hou Yuqing , Huang Yicang
Published: July 2023

Improved designs for underwater manipulators are becoming increasingly important due to their utility in academic and industrial applications. In this work, an experiment was conducted in conjunction with a numerical simulation to investigate the hydrodynamic performance and structural reliability of the proposed foldable arm during the unfolding process at various movement velocities. A large-scale geometric model of the foldable arm with a single degree of freedom (DOF) was constructed. The distribution of the flow field, the movement stability and the equivalent stress of the foldable arm were quantitatively analyzed with a designed tank experiment and the Computational Fluid Dynamics (CFD) simulation. Simulation results show that the maximum deviation of the resistance and torque is 8.04% and 5.73%, respectively, compared with the experimental results of static postures. Comparison results prove the reliability of the numerical model. The results of transient simulation demonstrate that the optimal speed of the foldable arm is 3 Kn and the pressure distribution on the surface of foldable arm is relatively regular. Furthermore, a fluid–structure interaction (FSI) validation study of the foldable arm was presented. For the coupling between the fluid and structural mechanics domains, a nonmatching discretization approach was adopted. The results show that the directional deformation (Z axis) of the foldable arm is less than 0.50 mm. The proposed foldable arm has a large angle of rotation and high stability compared to the existing manipulators.
Optimal Control Strategy for Ship Cabin’s Active Chilled Beam System Using Improved Multi-Objective Salp Swarm Algorithm
Authors: Liu Chenyu , Su Yixin , Zhang Danhong
Published: July 2023

Heating, ventilation, and air conditioning (HVAC) systems are the second largest energy consumers on cruise ships after the propulsion system. As a kind of HVAC system, active chilled beam (ACB) systems have been widely used for cabin service due to their performance of energy efficiency and good thermal comfort. However, conventional control strategies for ships’ ACB systems are not intelligent enough and cannot balance energy consumption and cabin comfort during the voyages of ships. This study developed an optimal control strategy for cabins’ ACB systems. First, a simulation environment considering dynamic conditions is established in TRNSYS. Second, an artificial neural network model is utilized to predict the energy consumption of the ACB system, while the predicted percentage dissatisfied is adopted to represent cabins’ thermal discomfort. Third, an improved multi-objective salp swarm algorithm is proposed to dynamically minimize both energy consumption and thermal discomfort. A TRNSYS–MATLAB co-simulation testbed is established to simulate the cabins served by an ACB system on a small cruise ship navigating from Hong Kong to Shanghai for validation tests and a comparison study. Compared to the conventional strategies, the proposed strategy can achieve a maximum energy savings of 12% while maintaining a predicted mean vote index less than 0.5, meeting the comfort requirements set by ASHRAE.
Ship Autonomous Berthing Simulation Based on Covariance Matrix Adaptation Evolution Strategy
Authors: Chen Guoquan , Yin Jian , Yang Shenhua
Published: July 2023

Existing research on auto-berthing of ships has mainly focused on the design and implementation of controllers for automatic berthing. For the real automatic docking processes, not only do external environmental perturbations need to be taken into account but also motion paths, docking strategies and ship mechanical constraints, which are important influential factors to measure autonomous docking methods. Through a literature review of ship path planning and motion control for automatic berthing, it is found that many studies ignore the interference of the actual navigational environment, especially for ships sailing at slow speed when berthing, or do not consider the physical constraints of the steering gear and the main engine. In this paper, we propose a hybrid approach for autonomous berthing control systems based on a Linear Quadratic Regulator (LQR) and Covariance Matrix Adaptation Evolution Strategy (CMA-ES), which systematically addresses the problems involved in the berthing process, such as path planning, optimal control, adaptive berthing strategies, dynamic environmental perturbations and physically enforced structural constraints. The berthing control system based on the LQR and modified LQR-CMA-ES have been validated by simulation work. The simulation results show that the proposed method is able to achieve the automatic docking of the ship well and the system is robust and well adapted to environmental disturbances at slow speed when docking.
The Dynamics of Buoyant Microplastic in the Ocean Forced by Unsteady Insolation
Authors: Kreczak Hannah , Higgins Rosie , Willmott Andrew J.
Published: July 2023

Building on the deterministic mathematical models of Kooi et al. (Environ. Sci. Technol. 51, 2017) and Kreczak et al. (Limnol. Oceanogr. 66, 2021), this study investigates the trajectories of biofouled microplastic particles forced by unsteady insolation. A new, non-dimensional system of governing equations is derived to predict the particle trajectory in a stratified, quiescent ocean subject to unsteady insolation. In the absence of stratification, unsteady insolation drives surface-to-depth oscillations with amplitude varying seasonally, attaining a maximum/minimum in the summer/winter, respectively. At high latitudes, a particle spends an increasing length of time floating on the sea surface in the winter when biofilm production is minimal or absent altogether. We demonstrate that, at 70N, the oscillations are modulated; in summer they are briefly subsurface, while in spring/fall they reach the sea surface and exhibit the largest amplitude throughout the year. In contrast, forcing the particle motion with constant, annually averaged insolation, at any given latitude, always generates persistent surface-to-depth periodic oscillations. In a stratified ocean, the previously reported persistence of subsurface particle oscillations forced by constant insolation is no longer exhibited for unsteady solar forcing. At lower latitudes, surface-to-depth oscillations with seasonally varying amplitude occur in a stratified ocean. In polar latitudes, the particle dynamics displays three regimes: (i) floating at the sea surface in winter, (ii) surface-to-depth oscillations in spring/fall with time-varying amplitude, (iii) subsurface oscillations around the compensation depth, where biofilm production and mortality rates balance. Decreasing the particle size leads to longer oscillation periods, and at high latitudes the particle either floats or performs subsurface oscillations with seasonally varying amplitude about the compensation depth.
Prediction of Suitable Habitat Distribution of Cryptosphaeria pullmanensis in the World and China under Climate Change
Authors: Yan Chengcai , Hao Haiting , Wang Zhe , Sha Shuaishuai , Zhang Yiwen , Wang Qingpeng , Kang Zhensheng , Huang Lili , Wang Lan , Feng Hongzu
Published: July 2023

Years of outbreaks of woody canker (Cryptosphaeria pullmanensis) in the United States, Iran, and China have resulted in massive economic losses to biological forests and fruit trees. However, only limited information is available on their distribution, and their habitat requirements have not been well evaluated due to a lack of research. In recent years, scientists have utilized the MaxEnt model to estimate the effect of global temperature and specific environmental conditions on species distribution. Using occurrence and high resolution ecological data, we predicted the spatiotemporal distribution of C. pullmanensis under twelve climate change scenarios by applying the MaxEnt model. We identified climatic factors, geography, soil, and land cover that shape their distribution range and determined shifts in their habitat range. Then, we measured the suitable habitat area, the ratio of change in the area of suitable habitat, the expansion and shrinkage of maps under climate change, the direction and distance of range changes from the present to the end of the twenty-first century, and the effect of environmental variables. C. pullmanensis is mostly widespread in high-suitability regions in northwestern China, the majority of Iran, Afghanistan, and Turkey, northern Chile, southwestern Argentina, and the west coast of California in the United States. Under future climatic conditions, climate changes of varied intensities favored the expansion of suitable habitats for C. pullmanensis in China. However, appropriate land areas are diminishing globally. The trend in migration is toward latitudes and elevations that are higher. The estimated area of possible suitability shifted eastward in China. The results of the present study are valuable not only for countries such as Morocco, Spain, Chile, Turkey, Kazakhstan, etc., where the infection has not yet fully spread or been established, but also for nations where the species has been discovered. Authorities should take steps to reduce greenhouse gas emissions in order to restrict the spread of C. pullmanensis. Countries with highly appropriate locations should increase their surveillance, risk assessment, and response capabilities.