bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparing Light—Emitting—Diodes Light Traps for Catching Anopheles Mosquitoes in a Forest Setting, Western Thailand
Authors: Jhaiaun Pairpailin , Panthawong Amonrat , Saeung Manop , Sumarnrote Anchana , Kongmee Monthathip , Ngoen-Klan Ratchadawan , Chareonviriyaphap Theeraphap
Published: December 2021

Light traps are a common method for attracting and collecting arthropods, including disease vectors such as mosquitoes. Various types of traps have been used to monitor mosquitoes in a forest in Western Thailand. In this study, four Light Emitting Diodes (LED) light sources (UV, blue, green, and red) and two fluorescent lights (white and UV) were used to trap nocturnal adult mosquitoes. These traps were used with light alone and not any additional attractant. The experiment was conducted from 18:00 to 06:00 h. on six consecutive nights, every two months, across dry, wet, and cold seasons. All specimens were first identified by morphological features and subsequently confirmed by using PCR. We collected a total of 873 specimens of 31 species in four genera, Anopheles, Aedes, Culex, and Armigeres. Anopheles harrisoni was the predominant species, followed by Aedes albopictus, Culex brevipalpis, Culex nitropunctatus, and Armigeres (Leicesteria) longipalpis. UV fluorescent light was the most effective light source for capturing forest mosquitoes, followed by UV LED, blue LED, green LED, white fluorescent, and red LED. The optimal times for collection were from 21:00 to 03:00 h in the dry season. Our results demonstrate that appropriate sampling times and light sources should be selected for optimal efficiency in vector surveillance programs.
Virulence of Beauveria bassiana Strains Isolated from Cadavers of Colorado Potato Beetle, Leptinotarsa decemlineata
Authors: Zemek Rostislav , Konopická Jana , Jozová Eva , Skoková Habuštová Oxana
Published: December 2021

The Colorado potato beetle, Leptinotarsa decemlineata (Say), is a serious, widely distributed pest of potato and other crops. This pest is able to defoliate the host plant and cause severe yield loss. Moreover, the pest quickly becomes resistant to many chemical pesticides. Therefore, the development of novel biopesticides targeting this pest is urgently needed. The purpose of this study was to obtain new strains of the entomopathogenic fungus Beauveria bassiana and assess their efficacy against L. decemlineata adults under laboratory conditions. Twelve strains were isolated from cadavers of Colorado potato beetles collected in potato fields in the Czech Republic. Test beetles were treated by suspensions of conidia at the concentration of 1 × 107 spores per milliliter and their survival was recorded daily for three weeks. The results of the bioassays revealed that all new native strains were pathogenic to L. decemlineata adults and caused mortality up to 100% at the end of the trial period with an LT50 of about 7 days. These strains were more virulent than a reference strain GHA and some of them can be recommended for the development of a new mycoinsecticide against L. decemlineata. Our findings also highlight the importance of searching for perspective strains of entomopathogenic fungi among naturally infected hosts.
Population Dynamics and Yield Loss Assessment for Pea Aphid, Acyrthosiphon pisum (Harris) (Homoptera: Aphididae), on Lentil in Morocco
Authors: El Fakhouri Karim , Sabraoui Abdelhadi , Kehel Zakaria , El Bouhssini Mustapha
Published: December 2021

Pea aphid (Acyrthosiphon pisum Harris) is the major insect pest of lentil in Morocco. We investigated pea aphid mean numbers and yield losses on three lentil varieties at one location during three successive cropping seasons during 2015–2018. The effects of several weather factors on pea aphid population dynamics were investigated. Population density increased in early spring followed by several peaks during March–April and then steeply declined during the late spring. Aphid populations peaked at different times during the three years of the study. In 2016, higher populations occurred during the second and third weeks of April for Abda and Zaria varieties with averages of 27 and 28 aphids/20 twigs, respectively. In 2017, higher populations occurred on the 12th and 13th standard meteorological weeks (SMWs) for Zaria with averages of 24.7 and 27.03 aphids/20 twigs, respectively. In 2018, the population peaked for all varieties at three different times, 11th, 13th, and 17th SMW, with the highest for Zaria being 26.00, 47.41, and 32.33 aphids/20 twigs. Pea aphid population dynamics changed with weather conditions. The number of aphids significantly and positively correlated with maximum temperature, but significantly negatively correlated with relative humidity and wind speed. The minimum temperature and rainfall had non-significant correlations. Pea aphid infestation resulted in losses of total seed weight for all lentil varieties, with the highest avoidable losses for Bakria being 12.51% followed by Zaria with 7.72% and Abda with 4.56%. These losses may justify the development of integrated management options for control of this pest.
First Proof-of-Concept Prototype of an Additive Manufactured Radio Frequency Quadrupole
Authors: Torims Toms , Pikurs Guntis , Gruber Samira , Vretenar Maurizio , Ratkus Andris , Vedani Maurizio , López Elena , Brückner Frank
Published: December 2021

Continuous developments in additive manufacturing (AM) technology are opening up opportunities in novel machining, and improving design alternatives for modern particle accelerator components. One of the most critical, complex, and delicate accelerator elements to manufacture and assemble is the radio frequency quadrupole (RFQ) linear accelerator, which is used as an injector for all large modern proton and ion accelerator systems. For this reason, the RFQ has been selected by a wide European collaboration participating in the AM developments of the I.FAST (Innovation Fostering in Accelerator Science and Technology) Horizon 2020 project. The RFQ is as an excellent candidate to show how sophisticated pure copper accelerator components can be manufactured by AM and how their functionalities can be boosted by this evolving technology. To show the feasibility of the AM process, a prototype RFQ section has been designed, corresponding to one-quarter of a 750 MHz 4-vane RFQ, which was optimised for production with state-of-the-art laser powder bed fusion (L-PBF) technology, and then manufactured in pure copper. To the best of the authors’ knowledge, this is the first RFQ section manufactured in the world by AM. Subsequently, geometrical precision and surface roughness of the prototype were measured. The results obtained are encouraging and confirm the feasibility of AM manufactured high-tech accelerator components. It has been also confirmed that the RFQ geometry, particularly the critical electrode modulation and the complex cooling channels, can be successfully realised thanks to the opportunities provided by the AM technology. Further prototypes will aim to improve surface roughness and to test vacuum properties. In parallel, laboratory measurements will start to test and improve the voltage holding properties of AM manufactured electrode samples.
Observational Study of Hand Hygiene Compliance at a Trauma Hospital in Iraqi Kurdistan
Authors: Moued Ines , Haweizy Rawand M. , Miran Lawand S. , Mohammed Mustafa G. , von Schreeb Johan , Älgå Andreas
Published: December 2021

Healthcare-associated infections, commonly caused by poor hand hygiene, represent a significant source of disease and economic burden for healthcare systems, especially those in resource-limited settings. The few existing studies on hand hygiene compliance in resource-limited hospital settings suggest that compliance is insufficient. The difference in compliance rates between units in resource-limited trauma hospitals is largely unknown. We aimed to assess hand hygiene compliance rates among healthcare workers at a trauma hospital in Iraqi Kurdistan and compare the levels of compliance between the emergency room (ER), the intensive care unit (ICU), and the acute care ward (ACW). We carried out overt observations in 2018 using the validated World Health Organization ‘five moments for hand hygiene’ observational tool. We observed a total of 622 hand hygiene opportunities performed by 149 healthcare workers. Hand hygiene compliance was defined as handwashing with soap and water or the use of alcohol-based hand rub, in accordance with the ‘five moments for hand hygiene’ concept. Overall, the hand hygiene compliance rate was found to be 6.8% (95% confidence interval 5.0–9.1). Compliance was significantly lower in the ER (1.0%), compared with the ICU (8.1%) (p = 0.0012), and the ACW (11.1%) (p < 0.0001). In all three units, the availability of alcohol-based hand rub and handwashing sinks was insufficient in relation to the number of patient beds. We conclude that the overall level of hand hygiene compliance was low, with the lowest level of compliance in the ER. Our findings call for improved resource allocation and strengthened hand hygiene routines. These relatively simple measures could potentially lower the incidence of healthcare-associated infections and improve the mortality and morbidity of patients in already overburdened healthcare systems.
Search for Multi-Coincidence Cosmic Ray Events over Large Distances with the EEE MRPC Telescopes
Authors: Abbrescia Marcello , Avanzini Carlo , Baldini Luca , Baldini Ferroli Rinaldo , Batignani Giovanni , Battaglieri Marco , Boi Stefano , Bossini Edoardo , Carnesecchi Francesca , Cicalò Corrado , Cifarelli Luisa , Coccetti Fabrizio , Coccia Eugenio , Corvaglia Alessandro , De Gruttola Daniele , De Pasquale Salvatore , Fabbri Franco , Galante Lorenzo , Garbini Marco , Gemme Gianluca , Gnesi Ivan , Grazzi Stefano , Hatzifotiadou Despina , La Rocca Paola , Liu Zhang , Mandaglio Giuseppe , Maron Gaetano , Mazziotta Mario Nicola , Mulliri Alice , Nania Rosario , Noferini Francesco , Nozzoli Francesco , Palmonari Federico , Panareo Marco , Panetta Maria Paola , Paoletti Riccardo , Pellegrino Carmelo , Pinazza Ombretta , Pinto Chiara , Pisano Silvia , Riggi Francesco , Righini Giancarlo , Ripoli Cristina , Rizzi Matteo , Sartorelli Gabriella , Scapparone Eugenio , Schioppa Marco , Scribano Angelo , Selvi Marco , Serri Gabriella , Squarcia Sandro , Taiuti Marco , Terreni Giuseppe , Trifirò Antonio , Trimarchi Marina , Vistoli Cristina , Votano Lucia , Williams Crispin , Zichichi Antonino , Zuyeuski Roman
Published: December 2021

The existence of independent, yet time correlated, Extensive Air Showers (EAS) has been discussed over the past years, with emphasis on possible physical mechanisms that could justify their observation. The detector network of the Extreme Energy Events (EEE) Collaboration, with its approximately 60 cosmic ray telescopes deployed over the Italian territory, has the potential to search for such events, employing different analysis strategies. In this paper, we have analyzed a set of EEE data, corresponding to an approximately five month observation period, searching for multi-coincidence events among several far telescopes, within a time window of 1 ms. Events with up to 12 coincident telescopes have been observed. Results were compared to expectations from a random distribution of events and discussed with reference to the relativistic dust grain hypothesis.
Heparin-Induced Thrombocytopenia under Mechanical Circulatory Support by Large Impella for Acute Cardiogenic Shock
Authors: Sugimura Yukiharu , Bauer Sebastian , Immohr Moritz Benjamin , Hermsen Derik Franz , Westenfeld Ralf , Boeken Udo , Aubin Hug , Tudorache Igor , Lichtenberg Artur , Akhyari Payam
Published: December 2021

Despite the critical feature of heparin-induced thrombocytopenia (HIT) for patients on mechanical circulatory support, reports on its incidence and outcome are still scarce. Thus, we report on clinical features of HIT in patients under Impella 5.0 or 5.5 (Abiomed Inc., Danvers, MA, USA) (Impella 5+) support for acute cardiogenic shock (CS) by focusing on observed thrombotic events. Between November 2018 and December 2020, a total of 56 consecutive patients were enrolled in a single-center retrospective study. A total of 21 patients (37.5%) were tested for HIT, and 6 (10.7%) proved positive for HIT at 10.5 ± 2.89 days after the first heparin administration during current admission. Interestingly, thrombocyte counts dropped under Impella support in all groups (all cases, no HIT test, and HIT negative group: p < 0.001, HIT-positive group: p = 0.001). All HIT-positive patients were switched from heparin to argatroban. HIT-associated thrombotic events were observed in two cases resulting in Impella dysfunction due to pump thrombosis (n = 1) and left ventricular (LV) thrombus formation (n = 1). Under large Impella support, the prevalence of HIT was relatively high. Further, thrombocytopenia does not deliver a high specificity in the setting of Impella 5+ support. Considering HIT manifestation, a routine HIT test may be considered to avoid critical thrombotic adverse events.
Intraoperative Assessment of Coronary Resistances: A New Quality Marker and Potential Tool to Predict Early Graft Failure after Coronary Artery Bypass Grafting?
Authors: Rubino Antonino Salvatore , Ceresa Fabrizio , Mammana Liborio , Vite Giuseppe , Cullurà Gianluca , Palermo Augusto , Leonardi Aurora , De Donno Bruna Filomena , Patanè Francesco
Published: December 2021

Intraoperative assessment of graft patency is pivotal for successful coronary revascularization. In the present study we aimed to propose a new, easy to perform tool to assess anastomotic quality intraoperatively, and to investigate its potential reliability in predicting early graft failure. Intraoperative graft flowmetry of 63 consecutive patients undergoing CABG were prospectively collected. Transit time flowmetry and its derivatives were recorded. Coronary resistances were calculated according to Hagen–Poiseuille equation both during cardioplegic arrest and after withdrawal from cardiopulmonary bypass. Angiographic evidence of graft occlusion at follow-up was cross-checked with intraoperative recordings. After a mean follow-up of 10.4 ± 6.0 months, 22 grafts were studied, and occlusion was documented in five (22.7%). Occluded grafts showed lower flows and higher resistances recorded during aortic cross-clamping. Coronary resistances, recorded during aortic cross-clamping, greater than 2.0 mmHg/mL/min, showed a sensitivity of 80% and a specificity of 100% to predict graft failure. We propose the routine recording of coronary resistances during aortic cross-clamping as an additional tool to overcome the acknowledged limitation of TTF to predict graft occlusion at 1 year.
Effects of Supervised Cardiac Rehabilitation Programmes on Quality of Life among Myocardial Infarction Patients: A Systematic Review and Meta-Analysis
Authors: Mansilla-Chacón María , Gómez-Urquiza José L. , Martos-Cabrera María Begoña , Albendín-García Luis , Romero-Béjar José L. , Cañadas-De La Fuente Guillermo A. , Suleiman-Martos Nora
Published: December 2021

Coronary heart disease is the leading cause of death and disability worldwide. Traditionally, cardiac rehabilitation programmes are offered after cardiac events to aid recovery, improve quality of life, and reduce adverse events. The objective of this review was to assess the health-related quality of life, after a supervised cardiac rehabilitation programme, of patients who suffered a myocardial infarction. A systematic review was carried out in the CINAHL, Cochrane, LILACS, Medline, Scopus, and SciELO databases, according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. Randomised controlled trials were selected. Meta-analyses were performed for the Short Form Health Survey SF-36, Myocardial Infarction Dimensional Assessment Scale (MIDAS), MacNew Heart Disease-Health-Related Quality of Life (HRQL) questionnaire, and European Quality of Life-Visual Analogue Scale (EuroQol-VAS) with the software Cochrane RevMan Web. Ten articles were found covering a total of 3577 patients. In the meta-analysis, the effect size of the cardiac rehabilitation programme was statistically significant in the intervention group for physical activity, emotional reaction, and dependency dimensions of the MIDAS questionnaire. For the control group, the score improved for SF-36 physical functioning, and body pain dimensions. The mean difference between the control and intervention group was not significant for the remaining dimensions, and neither for the MacNew Heart Disease-HRQL and EuroQol-VAS questionnaires. Supervised cardiac rehabilitation programmes were effective in improving health-related quality of life, however, there was a potential variability in the interventions; therefore, the results should be interpreted with caution. This study supports the importance of providing care and evaluating interventions via the supervision of trained health professionals, and further randomised clinical trials are needed to analyse the positive changes in mental and physical health outcomes.
A Population-Based Registry Analysis on Hospitalized COVID-19 Patients with Previous Cardiovascular Disease: Clinical Profile, Treatment, and Predictors of Death
Authors: Gutiérrez-Abejón Eduardo , Herrera-Gómez Francisco , Martín-García Débora , Tamayo Eduardo , Álvarez Francisco Javier
Published: December 2021

A high percentage of patients with COVID-19 (coronavirus disease 2019) have previous cardiovascular disease (CVD). The findings presented here came from an epidemiological population-based registry study (real-world data) that enrolled all in-hospital COVID-19 patients with previous CVD from 1 March to 31 May 2020. Death, other comorbidities, hospital stay variables, ventilation type, and main clinical outcomes were evaluated. In Castile and Leon, 35.83% of the 7307 in-hospital COVID-19 patients who participated in this study had previous CVD, particularly arrhythmias (48.97%), cerebrovascular disease (25.02%), ischemic heart disease (22.8%), and chronic heart failure (20.82%). Of the patients, 21.36% were men and more than 90% were over 65 years of age, and the mortality rate achieved 32.93%. The most used medicines were antibiotics (91.41%), antimalarials (73.3%), steroids (46.64%), and antivirals (43.16%). The main predictors of death were age over 65 years (OR: 5), ventilation needs (OR: 2.81), treatment with anti-SIRS (systemic inflammatory response syndrome) medicines (OR: 1.97), antivirals (OR: 1.74) or steroids (OR: 1.68), SIRS (OR: 5.75), SARS (severe acute respiratory syndrome) (OR: 2.44), or AKI (acute kidney injury) (OR: 1.63) occurrence. Chronic heart failure and cerebrovascular disease were associated with a worse clinical course of COVID-19, especially in men older than 65 years with diabetes who developed SIRS, SARS, or AKI.
Plasma Levels and Diagnostic Utility of VEGF in a Three-Year Follow-Up of Patients with Breast Cancer
Authors: Będkowska Grażyna E. , Gacuta Ewa , Zbucka-Krętowska Monika , Ławicki Paweł , Szmitkowski Maciej , Lemancewicz Adam , Motyka Joanna , Kobus Agnieszka , Chorąży Monika , Paniczko Marlena , Ławicki Sławomir
Published: December 2021

Breast cancer is the most common malignancy in women globally. The increasing worldwide incidence of this type of cancer illustrates the challenge it represents for healthcare providers. Therefore, new tumor markers are constantly being sought. The aim of this study was to assess plasma concentrations and the diagnostic power of VEGF in 100 patients with early-stage breast cancer, both before and after surgical treatment and during a three-year follow-up. The control groups included 50 subjects with benign breast tumors (fibroadenoma) and 50 healthy women. The VEGF concentration was determined using enzyme-linked immunosorbent assay (ELISA) and the CA 15-3 concentration was determined by chemiluminescent microparticle immunoassay (CMIA). We observed significantly higher preoperative plasma concentrations of VEGF and CA 15-3 in patients with breast cancer. VEGF, similar to CA 15-3, demonstrated high diagnostic utility in the assessment of the long-term efficacy of surgical removal of the tumor. Determinations of VEGF had the highest diagnostic usefulness in the detection of breast cancer recurrence (SE 40%, SP 92%, PPV 67%, NPV 79%). Additionally, the highest values of SE, NPV and AUC were observed during the combined analysis with CA 15-3 (60%; 84%; 0.7074, respectively). Our study suggests a promising diagnostic utility of VEGF in the early stages of breast cancer and in the evaluation of the efficacy of the surgical treatment of breast cancer as well as the detection of breast cancer recurrence, particularly in a combined analysis with CA 15-3 as a new diagnostic panel.
Unbiased Metabolomics Links Fatty Acid Pathways to Psychiatric Symptoms in People Living with HIV
Authors: Meeder Elise , Matzaraki Vasiliki , Vadaq Nadira , van de Wijer Lisa , van der Ven André , Schellekens Arnt
Published: December 2021

Psychiatric symptoms are prevalent in people living with HIV (PLWH), especially depression, anxiety, impulsivity, and substance use. Various biological mechanisms might play a role in the occurrence of psychiatric symptoms in this population. A hypothesis free, data-driven metabolomics approach can further our understanding of these mechanisms. In this study, we identified metabolic pathways associated with impulsivity, depression and substance use in 157 PLWH. First, Spearman’s rank correlations between metabolite feature intensities and psychiatric symptom levels were calculated, while controlling for age, gender and body mass index. Subsequently, a mummichog pathway analysis was performed. Finally, we analyzed which individual metabolites drove the observed effects. In our cohort of PLWH, fatty acid-related pathways were associated with both depressive as well as impulsive symptomatology. Substance use showed most extensive metabolic associations, and was positively associated with short chain fatty acids (SCFA’s), and negatively associated with glutamate levels. These findings suggest that PUFA metabolism might be associated with both internalising and externalising symptomatology in PLWH. Furthermore, glutamate and SCFA’s—microbiome derivatives with known neuroactive properties—might be involved in substance use in these patients. Future studies should explore potential causal mechanisms involved and whether these findings are HIV-specific.
Serum from Patients with Severe Alcoholic Liver Cirrhosis Inhibits Proliferation and Migration of Human Coronary Artery Smooth Muscle Cells
Authors: Mechelinck Mare , Peschel Miriam , Habigt Moriz A. , Kroy Daniela , Lehrke Michael , Helmedag Marius J. , Rossaint Rolf , Barton Matthias , Hein Marc
Published: December 2021

Liver cirrhosis has been associated with an increased risk of coronary artery disease and clinical complications following percutaneous coronary revascularization. The present study is based on the hypothesis that cirrhosis may influence intimal hyperplasia following PCI. Sera from 10 patients with alcoholic liver cirrhosis and 10 age-matched healthy controls were used to stimulate cultured human coronary artery smooth muscle cells (HCASMC) for 48 h. HCASMC proliferation, migration, gene expression and apoptosis were investigated. Serum concentrations of growth factors and markers of liver function were also determined in patients and healthy controls. Treatment of HCASMC with patient sera reduced cell proliferation and migration (p < 0.05 vs. healthy controls), whereas apoptosis was unaffected (p = 0.160). Expression of genes associated with a synthetic vascular smooth muscle cell phenotype was decreased in cells stimulated with serum from cirrhotic patients (RBP1, p = 0.001; SPP1, p = 0.003; KLF4, p = 0.004). Platelet-derived growth factor-BB serum concentrations were lower in patients (p = 0.001 vs. controls). The results suggest the presence of circulating factors in patients with alcoholic liver cirrhosis affecting coronary smooth muscle cell growth. These findings may have implications for clinical outcomes following percutaneous coronary revascularization in these patients.
Optimization of RAASi Therapy with New Potassium Binders for Patients with Heart Failure and Hyperkalemia: Rapid Review and Meta-Analysis
Authors: Montagnani Andrea , Frasson Stefania , Gussoni Gualberto , Manfellotto Dario
Published: December 2021

(1) Background: The objective of this rapid review is to assess whether new potassium binders (NPBs) could enable the optimization of RAASi therapy more than usual care or placebo in patients with or at risk of heart failure and hyperkalemia. (2) Methods: We searched for RCTs that included patients with or at risk of hyperkalemia and patients treated with Patiromer or sodium zirconium cyclosilicate (ZSC). The comparators were placebo, usual care, and potassium binders with different doses or different treatment protocols. We searched the Cochrane CENTRAL, MEDLINE, and ClinicalTrials.gov databases. The risk of bias was assessed using the Cochrane risk of bias tool for RCTs. Data were pooled using the random effects model, and the fixed effects model was used for sensitivity analysis. (3) Results: We included 12 studies with 2800 enrolled patients. Only three of these trials (412 patients) were included in the meta-analysis. NPBs seemed to have an effect on the optimization of MRA therapy, with an RR (95% CI) of 1.24 (1.09, 1.42) (moderate certainty evidence); Patiromer seemed to have an effect on MRA optimization, with an RR (95% CI) or 1.25 (1.08, 1.45) (high certainty evidence). ZSC seemed to have no effect on enabling MRA therapy, with an RR (95% CI) of 1.19 (0.89, 1.59) (low certainty evidence). The AEs in HF patients with hyperkalemia treated with Patiromer were GI disorders and hypomagnesemia. ZSC The AEs included chronic cardiac failure, hypokalemia, and edema. (4) Conclusions: This meta-analysis included three studies with a small number of patients and a short follow-up period (1–3 months). The evidence of the effect of NPBs on MRA optimization had a moderate certainty for imprecision. Data on the effect on MRA optimization and less severe AEs in long-term treatment seem to suggest the use of Patiromer for the optimization of MRA therapy in patients with or at risk of heart failure and hyperkalemia. Future adequately powered RCTs are needed to assess the benefits and potential harms of potassium binders.
Applicability of the Geographic Tongue Area and Severity Index among Healthcare Professionals: A Cross-Sectional Clinical Validation of a Newly Developed Geographic Tongue Scoring System
Authors: Picciani Bruna Lavinas Sayed , Santos Lílian Rocha , Amin Thaylla Núñez , Rocha Santos Jonatas Daniel , Carneiro Sueli , Neffa Pinto Jane Marcy , Regazzi Avelleira Joao Carlos , Azulay David Rubem , de Sousa Gonzaga Heron Fernando , Luiz Ronir Raggio , Dziedzic Arkadiusz
Published: December 2021

Geographic tongue (GT) is a chronic condition of unknown aetiology, with no defined parameters to establish the protocol for evidence-based management. Validation of a newly developed and proposed clinical index to assess the severity of GT could assist in its diagnosis, especially in cases associated with systemic dermatological diseases in the form of psoriasis. Objective: To verify the applicability of the geographic tongue area and severity index (GTASI). This involved healthcare professionals from different specialties to evaluate the usefulness of the GTASI in supporting GT classification, as well as the follow-up process. Methods: One hundred cases of previously diagnosed GT were initially evaluated by three independent, experienced researchers/clinicians to obtain a standardised classification baseline. Subsequently, nine cases of GT were selected, three cases for each category—mild, moderate and severe. These stages were professionally evaluated by 51 healthcare professionals from three groups: 17 dentists (33%), 22 oral medicine specialists (43%) and 12 specialist dermatologists (24%) during a cross-sectional survey. Results: The quantitative and qualitative assessment based on experts’ opinions in the cross-sectional survey demonstrated an acceptable, similar level of GT clinical diagnosis (p > 0.05), with coherence between the various groups of professionals critically appraising the GTASI. An apparent divergence was observed for the moderate GT category, as well as in the group of less experienced evaluators. Conclusion: Whilst the validation of GTASI applicability was successfully executed, the general dental practitioners, specialists in oral medicine and dermatologists were equally capable of correct GT diagnosis and appropriately rating its severity. These coherent results were especially replicated among the experienced clinicians. The validation of the newly proposed index confirmed its reliability as a feasible instrument in oral medicine, with the prospect of its wider implementation in clinical practice.
Association of C-Reactive Protein Velocity with Early Left Ventricular Dysfunction in Patients with First ST-Elevation Myocardial Infarction
Authors: Holzknecht Magdalena , Tiller Christina , Reindl Martin , Lechner Ivan , Fink Priscilla , Lunger Patrick , Mayr Agnes , Henninger Benjamin , Brenner Christoph , Klug Gert , Bauer Axel , Metzler Bernhard , Reinstadler Sebastian Johannes
Published: December 2021

C-reactive protein velocity (CRPv) has been proposed as a very early and sensitive risk predictor in patients with ST-elevation myocardial infarction (STEMI). However, the association of CRPv with early left ventricular (LV) dysfunction after STEMI is unknown. The aim of this study was to investigate the relationship between CRPv and early LV dysfunction, either before or at hospital discharge, in patients with first STEMI. This analysis evaluated 432 STEMI patients that were included in the prospective MARINA-STEMI (Magnetic Resonance Imaging In Acute ST-elevation Myocardial Infarction. ClinicalTrials.gov Identifier: NCT04113356) cohort study. The difference of CRP 24 ± 8 h and CRP at hospital admission divided by the time (in h) that elapsed during the two examinations was defined as CRPv. Cardiac magnetic resonance (CMR) imaging was conducted at a median of 3 (IQR 2–4) days after primary percutaneous coronary intervention (PCI) for the determination of LV function and myocardial infarct characteristics. The association of CRPv with the CMR-derived LV ejection fraction (LVEF) was investigated. The median CRPv was 0.42 (IQR 0.21–0.76) mg/l/h and was correlated with LVEF (rS = −0.397, p < 0.001). In multivariable linear as well as binary logistic regression analysis (adjustment for biomarkers and clinical and angiographical parameters), CRPv was independently associated with LVEF (β: 0.161, p = 0.004) and LVEF ≤ 40% (OR: 1.71, 95% CI: 1.19–2.45; p = 0.004), respectively. The combined predictive value of peak cardiac troponin T (cTnT) and CRPv for LVEF ≤ 40% (AUC: 0.81, 95% CI 0.77–0.85, p < 0.001) was higher than it was for peak cTnT alone (AUC difference: 0.04, p = 0.009). CRPv was independently associated with early LV dysfunction, as measured by the CMR-determined LVEF, revealing an additive predictive value over cTnT after acute STEMI treated with primary PCI.
Bendamustine-Based Regimens as Salvage Therapy in Refractory/Relapsed Multiple Myeloma Patients: A Retrospective Real-Life Analysis by the Polish Myeloma Group
Authors: Grzasko Norbert , Charlinski Grzegorz , Morawska Marta , Kicinski Pawel , Waszczuk-Gajda Anna , Drozd-Sokolowska Joanna , Subocz Edyta , Blonska Danuta , Razny Malgorzata , Druzd-Sitek Agnieszka , Holojda Jadwiga , Swiderska Alina , Usnarska-Zubkiewicz Lidia , Masternak Anna , Giannopoulos Krzysztof
Published: December 2021

Multiple myeloma (MM) is an incurable disease and patients become refractory to the treatment in the course of the disease. Bendamustine-based regimens containing steroids and other agents are among the therapeutic options offered to MM patients. Here, we investigated the safety and the efficacy of bendamustine used in patients with refractory/relapsed MM (RRMM). The patients were treated with bendamustine and steroids (n = 52) or bendamustine, steroids and immunomodulatory agents or proteasome inhibitors (n = 53). Response rates, progression-free survival (PFS), overall survival (OS) and frequency of adverse events were compared between both study groups. Most efficacy measurements were better in patients treated with three-drug regimens: overall response rate (55% versus 37%, p = 0.062), median PFS (9 months versus 4 months, p < 0.001), median OS survival (18 months versus 12 months, p = 0.679). The benefit from combining bendamustine and steroids with an additional agent was found in subgroups previously treated with both lenalidmide and bortezomib, with stem cell transplant and with more than two previous therapy lines. Toxicity was similar in both study groups and bendamustine-based therapies were generally well-tolerated. Our study suggests that bendamustine may be an effective treatment for patients with RRMM. Three-drug regimens containing bendamustine, steroids and novel agents produced better outcomes and had acceptable toxicity. The efficacy of bendamustine combined with steroids was limited.
Revisited Upper Reference Limits for Highly Sensitive Cardiac Troponin T in Relation to Age, Sex, and Renal Function
Authors: Gärtner Christiane , Langhammer Romy , Schmidt Maria , Federbusch Martin , Wirkner Kerstin , Löffler Markus , Isermann Berend , Laufs Ulrich , Wachter Rolf , Kaiser Thorsten
Published: December 2021

(1) Background: Highly sensitive cardiac troponin T (hs-cTnT) plays an essential role in the diagnosis of myocardial injury. The upper reference limit of the respective assay is generally applied, irrespective of age, renal function, or sex. We aimed to identify age-adjusted and sex-adjusted upper reference limits in relation to renal function in a large population-based cohort without cardiac diseases. (2) Methods: We included 5428 subjects of the population-based LIFE-Adult cohort, free of diagnosed cardiac diseases. Sex-adjusted and age-adjusted 99th percentiles for hs-cTnT in subjects with preserved renal function were obtained. (3) Results: The hs-cTnT values were higher in men of all age groups. In both sexes, an increasing age positively correlated with higher hs-cTnT values. Hs-cTnT weakly correlated with serum creatinine. The three-dimensional analysis of age, creatinine, and hs-cTnT showed no relevant additional effect of creatinine on hs-cTnT. In men aged above 60 and women above 70, the calculated 99th percentiles clearly exceeded the commonly applied thresholds. (4) Conclusion: Age and sex have a major impact on the serum concentration of hs-cTnT, while renal function does not. We propose to consider age-adjusted and sex-adjusted reference values.
Predictors of Tumour Growth and Autonomous Cortisol Secretion Development during Follow-Up in Non-Functioning Adrenal Incidentalomas
Authors: Araujo-Castro Marta , Parra Ramírez Paola , Robles Lázaro Cristina , García Centeno Rogelio , Gracia Gimeno Paola , Fernández-Ladreda Mariana Tomé , Sampedro Núñez Miguel Antonio , Marazuela Mónica , Escobar-Morreale Héctor F. , Valderrabano Pablo
Published: December 2021

Purpose: To assess the risk of developing autonomous cortisol secretion (ACS) and tumour growth in non-functioning adrenal incidentalomas (NFAIs). Methods: Multicentre retrospective observational study of patients with NFAIs. ACS was defined as serum cortisol >1.8 µg/dL after 1 mg-dexamethasone suppression test (DST) without specific data on Cushing’s syndrome. Tumour growth was defined as an increase in maximum tumour diameter >20% from baseline; and of at least 5 mm. Results: Of 654 subjects with NFAIs included in the study, both tumour diameter and DST were re-evaluated during a follow-up longer than 12 months in 305 patients. After a median follow-up of 41.3 (IQR 24.7–63.1) months, 10.5% of NFAIs developed ACS. The risk for developing ACS was higher in patients with higher serum cortisol post-DST levels (HR 6.45 for each µg/dL, p = 0.001) at diagnosis. Significant tumour growth was observed in 5.2% of cases. The risk of tumour growth was higher in females (HR 10.7, p = 0.004). Conclusions: The frequency of re-evaluation with DST in NFAIs during the initial 5 years from diagnosis can probably be tailored to the serum cortisol post-DST level at presentation. Re-evaluation of NFAIs with imaging studies, on the other hand, seems unnecessary in most cases, particularly if the initial imaging demonstrates features specific to typical adenoma, given the low rate of significant tumour growth.
Molecular Imaging of Vulnerable Coronary Plaque with Radiolabeled Somatostatin Receptors (SSTR)
Authors: Anzola Luz Kelly , Rivera Jose Nelson , Ramirez Juan Carlos , Signore Alberto , Mut Fernando
Published: December 2021

Atherosclerosis is responsible for the majority of heart attacks and is characterized by several modifications of the arterial wall including an inflammatory reaction. The silent course of atherosclerosis has made it necessary to develop predictors of disease complications before symptomatic lesions occur. Vulnerable to rupture atherosclerotic plaques are the target for molecular imaging. To this aim, different radiopharmaceuticals for PET/CT have emerged for the identification of high-risk plaques, with high specificity for the identification of the cellular components and pathophysiological status of plaques. By targeting specific receptors on activated macrophages in high-risk plaques, radiolabelled somatostatin analogues such as 68Ga-DOTA-TOC, TATE,0 or NOC have shown high relevance to detect vulnerable, atherosclerotic plaques. This PET radiopharmaceutical has been tested in several pre-clinical and clinical studies, as reviewed here, showing an important correlation with other risk factors.
Procedure Increasing the Accuracy of Modelling and the Manufacturing of Surgical Templates with the Use of 3D Printing Techniques, Applied in Planning the Procedures of Reconstruction of the Mandible
Authors: Turek Paweł , Pakla Paweł , Budzik Grzegorz , Lewandowski Bogumił , Przeszłowski Łukasz , Dziubek Tomasz , Wolski Sławomir , Frańczak Jan
Published: December 2021

The application of anatomical models and surgical templates in maxillofacial surgery allows, among other benefits, the increase of precision and the shortening of the operation time. Insufficiently precise anastomosis of the broken parts of the mandible may adversely affect the functioning of this organ. Applying the modern mechanical engineering methods, including computer-aided design methods (CAD), reverse engineering (RE), and rapid prototyping (RP), a procedure used to shorten the data processing time and increase the accuracy of modelling anatomical structures and the surgical templates with the use of 3D printing techniques was developed. The basis for developing and testing this procedure was the medical imaging data DICOM of patients treated at the Maxillofacial Surgery Clinic of the Fryderyk Chopin Provincial Clinical Hospital in Rzeszów. The patients were operated on because of malignant tumours of the floor of the oral cavity and the necrosis of the mandibular corpus, requiring an extensive resection of the soft tissues and resection of the mandible. Familiarity with and the implementation of the developed procedure allowed doctors to plan the operation precisely and prepare the surgical templates and tools in terms of the expected accuracy of the procedures. The models obtained based on this procedure shortened the operation time and increased the accuracy of performance, which accelerated the patient’s rehabilitation in the further course of events.
Malignant Pleural Effusions—A Review of Current Guidelines and Practices
Authors: Kulandaisamy Prarthna Chandar , Kulandaisamy Sakthidev , Kramer Daniel , Mcgrath Christopher
Published: December 2021

Malignant pleural effusion (MPE) occurs in 15% of all cancer patients and usually portends poor prognosis while also serving to limit the patient’s quality of life. Palliation of symptoms has been the goal for the management of these effusions while keeping the patient’s hospital stay to a minimum. Traditionally, this has been achieved by chest tube drainage followed by the instillation of sclerosing agents, such as talc, in the pleural space. A recent increase in evidence for the effectiveness and convenience of indwelling pleural catheters has changed the management of MPE, which is reflected in the guidelines released by the American Thoracic Society as well their European Counterpart (ERS/BTS). In this article, we aim to review the current management practices and guidelines for MPE.
Arterial Hypertension in Aortic Valve Stenosis: A Critical Update
Authors: Basile Christian , Fucile Ilaria , Lembo Maria , Manzi Maria Virginia , Ilardi Federica , Franzone Anna , Mancusi Costantino
Published: December 2021

Aortic stenosis (AS) is a very common valve disease and is associated with high mortality once it becomes symptomatic. Arterial hypertension (HT) has a high prevalence among patients with AS leading to worse left ventricle remodeling and faster degeneration of the valve. HT also interferes with the assessment of the severity of AS, leading to an underestimation of the real degree of stenosis. Treatment of HT in AS has not historically been pursued due to the fear of excess reduction in afterload without a possibility of increasing stroke volume due to the fixed aortic valve, but most recent evidence shows that several drugs are safe and effective in reducing BP in patients with HT and AS. RAAS inhibitors and beta-blockers provide benefit in selected populations based on their profile of pharmacokinetics and pharmacodynamics. Different drugs, on the other hand, have proved to be unsafe, such as calcium channel blockers, or simply not easy enough to handle to be recommended in clinical practice, such as PDE5i, MRA or sodium nitroprusside. The present review highlights all available studies on HT and AS to guide antihypertensive treatment.
Elderly People’s Access to Emergency Departments during the COVID-19 Pandemic: Results from a Large Population-Based Study in Italy
Authors: Bardin Andrea , Buja Alessandra , Barbiellini Amidei Claudio , Paganini Matteo , Favaro Andrea , Saia Mario , Baldo Vincenzo
Published: December 2021

Across the world, people have avoided seeking medical attention during the coronavirus pandemic, resulting in a marked reduction in emergency department (ED) visits. This retrospective cohort study examines in detail how the present pandemic affects ED use by the elderly. The regional database on ED visits in Veneto (northeastern Italy) was consulted to extract anonymous data on all ED visits during 2019 and 2020, along with details concerning patients’ characteristics (access mode, triage code, chief complaint, and outcome). A year-on-year comparison was drawn between 2019 and 2020. There was a 25.3% decrease in ED visits in 2020 compared to the previous year. The decrease ranged from −52.4% in March to −18.4% in September when comparing the same months in the two years. This decrease started in late February 2020, with the lowest numbers of visits recorded in March and April 2020 (during the “first wave” of the COVID-19 pandemic in Italy), and in the autumn (during the “second wave”). The proportion of visits to the ED by ambulance has increased sharply since March 2020, and patients arrived more frequently with severe conditions (red or yellow triage tags) that often required a hospitalization. The greatest decrease was in fact observed for non-urgent complaints. This decreased concerned a wide range of conditions, including chest pain and abdominal pain. The sharp reduction observed in the present study is unlikely to be attributed entirely to the effect of lockdown measures. Individual psychological and media-induced fear of contagion most likely played a relevant role in leading people to avoid seeking medical attention.
Prevention, Diagnosis and Management of Post-Surgical Mediastinitis in Adults Consensus Guidelines of the Spanish Society of Cardiovascular Infections (SEICAV), the Spanish Society of Thoracic and Cardiovascular Surgery (SECTCV) and the Biomedical Research Centre Network for Respiratory Diseases (CIBERES)
Authors: Bouza Emilio , de Alarcón Arístides , Fariñas María Carmen , Gálvez Juan , Goenaga Miguel Ángel , Gutiérrez-Díez Francisco , Hortal Javier , Lasso José , Mestres Carlos A. , Miró José M. , Navas Enrique , Nieto Mercedes , Parra Antonio , Pérez de la Sota Enrique , Rodríguez-Abella Hugo , Rodríguez-Créixems Marta , Rodríguez-Roda Jorge , Sánchez Espín Gemma , Sousa Dolores , Velasco García de Sierra Carlos , Muñoz Patricia , Kestler Martha
Published: December 2021

This is a consensus document of the Spanish Society of Cardiovascular Infections (SEICAV), the Spanish Society of Thoracic and Cardiovascular Surgery (SECTCV) and the Biomedical Research Centre Network for Respiratory Diseases (CIBERES). These three entities have brought together a multidisciplinary group of experts that includes anaesthesiologists, cardiac and cardiothoracic surgeons, clinical microbiologists, infectious diseases and intensive care specialists, internal medicine doctors and radiologists. Despite the clinical and economic consequences of sternal wound infections, to date, there are no specific guidelines for the prevention, diagnosis and management of mediastinitis based on a multidisciplinary consensus. The purpose of the present document is to provide evidence-based guidance on the most effective diagnosis and management of patients who have experienced or are at risk of developing a post-surgical mediastinitis infection in order to optimise patient outcomes and the process of care. The intended users of the document are health care providers who help patients make decisions regarding their treatment, aiming to optimise the benefits and minimise any harm as well as the workload.
Effects of a Single Application of ScenarTM, a Low-Frequency Modulated Electric Current Therapy, for Pain Relief in Patients with Low Back and Neck Pain: A Randomized Single Blinded Trial
Authors: Michel-Cherqui Mireille , Guirimand Avit , Szekely Barbara , Kennel Titouan , Fischler Marc , Le Guen Morgan
Published: December 2021

We aimed to demonstrate the antalgic effectiveness of ScenarTM (Self-Controlled Electro Neuro Adaptative Regulation) in patients experiencing low back and neck pain. Sixty patients were included and equally assigned by randomization to a Scenar-On group and to a Scenar-Off group (sham group). All patients received a 20 min application of ScenarTM on the area where they experienced pain. The pain at rest and during movement and the sensation of stiffness were assessed using a numeric rating scale at baseline, immediately after the session and 24 h after the session. The patients’ characteristics at entry were similar between groups. The pain at rest decreased after the session in both groups (from 8 (4) to 5.0 (3) in the Scenar-Off group, p = 0.0001, and from 7 (3) to 4 (4) in the Scenar-On group, p < 0.0001). The difference was not statistically significant for the groups (p = 0.22). Similar results were observed during movement, but the sensation of stiffness was not modified. Such beneficial results did not last until the next day. No undesirable major effects were noticed. Our study does not support the fact that one ScenarTM session improves low back and neck pain better than a sham session.