bluuebunny/crossref_metadata_2025 huggingface dataset:
Diaphyseal Femur Fractures in Children and Adolescents—Opportunities and Limitations of the ESIN Technique
Authors: Kalbitz Miriam , Fischer Andreas , Weber Birte , Mayer Benjamin , Lackner Ina , Pressmar Jochen
Published: December 2022

Background: Elastic stable intramedullary nailing (ESIN) is the gold standard for non-overweight children aged 6–12 years. However, the complication rate using elastic stable intramedullary nailing is considerably high. Nevertheless, the question arises of whether the indication for elastic stable intramedullary nailing therapy can be extended and which factors must be taken into account when determining the indication. Methods: A retrospective chart review of patients <18 years admitted with diaphyseal femur fracture at a Level I Trauma Center in Germany between 2005 and 2017 was performed. In total, 118 patients were included. For the classification of femur fractures in children, the AO Pediatric Comprehensive Classification of Long-Bone Fractures (AO-PCCF) was applied. Results: Simple oblique fractures (32-D/5.1) occurred in most of the patients. Patients with simple oblique fractures were significantly younger compared to patients with simple transverse (32-D/4.1) or multifragmentary (32-D/5.2) fracture type according to the AO Pediatric Comprehensive Classification of Long-Bone Fractures. Most patients were treated with elastic stable intramedullary nailing (68 patients, 58%). Although children treated with elastic stable intramedullary nailing were older than those treated conservatively (25%, n = 29, mean age 1.5, median age 1.0), the children in the elastic stable intramedullary nailing group were comparatively young (range 1–12 years, mean age 5.4, median age 5). A total of 32 children below the age of 6 years were treated with elastic stable intramedullary nailing. Complications were more frequent in patients with overhead extension (50%) compared to conservative treatment with a spica cast (17%) or elastic stable intramedullary nailing (15%). Conclusions: Elastic stable intramedullary nailing therapy was associated with a low complication rate and was, therefore, a safe and frequently used treatment strategy in diaphyseal femur fractures with satisfactory results, even though the age groups were expanded in favor of younger patients.
Lactose-Containing Dry-Powder Inhalers for Patients with Cow’s Milk Protein Allergy—The Conundrum; A National Survey of Pediatric Pulmonologists and Allergologists
Authors: Bar-On Ophir , Levine Hagit , Stafler Patrick , Shmueli Einat , Jacobi Eyal , Goldberg Ori , Steuer Guy , Prais Dario , Mei-Zahav Meir
Published: December 2022

Introduction: Several dry-powder inhalers (DPIs) contain lactose which may be contaminated with milk proteins. Confusion exists pertaining to DPI use in patients with cow’s milk protein allergy (CMPA). Methods: A computerized survey sent via e-mail to pediatric pulmonologists and allergologists. Results: A total of 77 out of 232 (33.2%) doctors replied, of whom 80.5% were pediatric pulmonologists. A total of 69 of 77 (89.6%) were specialists, 37.6% with more than 15 years of experience. The most commonly used DPIs were formoterol + budesonide and vilanterol + fluticasone. A total of 62 out of 77 (80.5%) responders knew these DPIs contained lactose. A total of 35 out of 77 (45.5%) doctors who replied did not know that DPI leaflets list CMPA as a contra-indication to DPI administration. Of these, 4 (11.4%) stated that they would instruct patients with CMPA to stop DPIs, and 7 (20%) would avoid recommending DPIs. A total of 42 out of 77 (54.5%) responders were aware of this warning, yet 13 of these 42 (30.9%) continued to recommend lactose-containing DPIs without hesitation and 18 of these 42 (42.8%) responders prescribed DPIs but considered allergy severity. Conclusions: Almost half of certified, experienced pediatric pulmonologists and allergologists were unaware of the warning to administer DPIs to patients with CMPA. Most doctors who do know of this warning still continue to prescribe these DPIs.
Impact of COVID-19 Diagnosis on Mortality in Patients with ST-Elevation Myocardial Infarction Hospitalized during the National Outbreak in Italy
Authors: De Luca Leonardo , Rosato Stefano , D’Errigo Paola , Giordani Barbara , Mureddu Gian , Badoni Gabriella , Seccareccia Fulvia , Baglio Giovanni
Published: December 2022

Background. We sought to assess the clinical impact of COVID-19 infection on mortality in patients with ST-elevation myocardial infarction (STEMI) admitted during the national outbreak in Italy. Methods. We analysed a nationwide, comprehensive, and universal administrative database of consecutive STEMI patients admitted during lockdown for COVID-19 infection (11 March–3 May 2020) and the equivalent periods of the previous 5 years in Italy. The observed rate of 30-day and 6-month all-cause mortality of STEMI patients with and without COVID-19 infection during the lockdown was compared with the expected rate of death, according to the trend of the previous 5 years. Results. During the study period, 32.910 STEMI hospitalizations occurred in Italy. Among these, 4048 STEMI patients were admitted during the 2020 outbreak: 170 (4.2%) with and 3878 (95.8%) without a COVID-19 diagnosis. According to the 5-year trend, the 2020 expected rates of 30-day and 6-month all-cause mortality were 9.2% and 12.6%, while the observed incidences of death were 10.8% (p = 0.016) and 14.4% (p = 0.017), respectively. Excluding STEMI patients with a COVID-19 diagnosis, the mortality rate resulted in accordance with the prior 5-year trend. After multiple corrections, the presence of COVID-19 diagnosis was an independent predictor of all-cause mortality at 30 days [adjusted odds ratio (OR) 4.5; 95% confidence intervals (CI) 3.09–6.45; p < 0.0001] and 6 months (adjusted OR 3.6; 95% CI: 2.47–5.12; p < 0.0001). Conclusions.During the 2020 national outbreak in Italy, COVID-19 infection significantly increased the mortality trend in patients with STEMI.
Clinicopathological Features of Intrathoracic Liposarcoma—A Systematic Review with an Illustrative Case
Authors: Kiełbowski Kajetan , Ruszel Nikola , Skrzyniarz Seweryn Adam , Wojtyś Małgorzata Edyta , Becht Rafał , Ptaszyński Konrad , Gajić Darko , Wójcik Janusz
Published: December 2022

Background: Liposarcoma (LPS) is one of the most common soft-tissue sarcomas. However, intrathoracic LPS is rare, as only 1% of all LPS cases are found in the thorax. Methods: A systematic literature review through PubMed and Embase databases was performed. Only eligible case reports and case series reporting intrathoracic LPS in adult patients were included. Kaplan–Meier curves were calculated to evaluate the survival rate of included patients based on the histological subtype of LPS. Results: 123 studies reporting 197 patients were included. We added a case of a 69-year-old female patient with recurrent giant intrathoracic LPS. The primary tumor measured 15.1cm × 22.9 cm × 21.9 cm and weighed 3100 g. Six months later, the patient was admitted to the hospital with another intrathoracic tumor measuring 9.5 cm × 9 cm× 1.4 cm. The immunohistochemical studies showed expression of murine double minute 2 (MDM2) antigen in both primary and recurrent tumor cells. Conclusions: Dyspnea, chest pain, and cough were the most common symptoms reported in included studies. Overall, the 5-year survival rate was 62%. The highest survival was observed in well-differentiated LPS patients (80%) and the lowest in myxoid LPS (31%).
Long-Term Outcome of Infective Endocarditis Involving Cardiac Implantable Electronic Devices: Impact of Comorbidities and Lead Extraction
Authors: Durante-Mangoni Emanuele , Ursi Maria Paola , Andini Roberto , Mattucci Irene , Della Ratta Ester E. , Iossa Domenico , Bertolino Lorenzo , De Vivo Stefano , Manduca Sabrina , Torella Michele , De Feo Marisa , Zampino Rosa ,   The Monaldi Hospital Cardiovascular Infection Study Group
Published: December 2022

(1) Background: Management of cardiac implantable electronic device-related infective endocarditis (CIED-IE) hinges on complete hardware removal. We assessed whether long-term prognosis is affected by device removal, considering baseline patient comorbid conditions; (2) Methods: A total of 125 consecutive patients hospitalized for CIED-IE were included in this retrospective analysis. Outcomes were in-hospital, one-year, and long-term mortality. There were 109 patients who underwent device removal, 91 by transvenous lead extraction (TLE) and 18 by open heart surgery (OHS); (3) Results: TLE translated into lower hospital mortality (4.4% vs. 22.5% with OHS; p = 0.03). Septic pulmonary embolism was the only independent predictor of in-hospital mortality (OR:7.38 [1.49–36.6], p = 0.013). One-year mortality was in contrast independently associated to tricuspid valve involvement (p = 0.01) and Charlson comorbidity index (CCI, p = 0.039), but not the hardware removal modality. After a median follow-up of 41 months, mortality rose to 24%, and was significantly influenced only by CCI. Specifically, patients with a higher CCI who were also treated with TLE showed a survival rate not significantly different from those managed with medical therapy only; (4) Conclusions: In CIED-IE, TLE is the strategy of choice for hardware removal, improving early outcomes. Long-term benefits of TLE are lessened by comorbidities. In cases of CIED-IE with high CCI, a more conservative approach might be an option.
Association of Potassium Level at Discharge with Long-Term Mortality in Hospitalized Patients with Heart Failure
Authors: Miura Yusuke , Higuchi Satoshi , Kohno Takashi , Shiraishi Yasuyuki , Kitamura Mitsunobu , Nagatomo Yuji , Takei Makoto , Nakano Shintaro , Goda Ayumi , Soejima Kyoko , Kohsaka Shun , Yoshikawa Tsutomu
Published: December 2022

Dyskalemia (hypokalemia and hyperkalemia) is a common comorbidity of heart failure (HF). Although dyskalemia is associated with poor prognosis, different prognostic impacts of hypo- and hyperkalemia remain vastly unclear. This study investigated the association of dyskalemia with prognosis in HF patients, especially the mode of death and left ventricular ejection fraction (LVEF). The multicenter study included 3398 patients hospitalized for HF. Patients were divided into three groups based on serum potassium levels at discharge: hypokalemia (<3.5 mEq/L; n = 115 (3.4%)), normokalemia (3.5–5.0 mEq/L; n = 2960 (87.1%)), and hyperkalemia (≥5.0 mEq/L; n = 323 (9.5%)). Two-year all-cause, cardiac, and non-cardiac mortality was evaluated. Association of serum potassium with two-year mortality demonstrated a U-shaped curve, with a worse prognosis for patients with hypokalemia. All-cause mortality at two-years did not differ among the three groups. Hypokalemia was associated with 2-year cardiac death (adjusted hazard ratio (HR), 2.60; 95% confidence interval (CI), 1.20–5.64) in HF with reduced ejection fraction (HFrEF; LVEF < 40%), but not in non-HFrEF. Regardless of LVEF, hyperkalemia was not independently associated with any mortality. Hypokalemia was independently associated with cardiac death, particularly in HFrEF patients. Such an association was not observed in hyperkalemia regardless of LVEF.
30-Day Postoperative Outcomes in Adults with Obstructive Sleep Apnea Undergoing Upper Airway Surgery
Authors: Knoedler Samuel , Knoedler Leonard , Baecher Helena , Kauke-Navarro Martin , Obed Doha , Hoch Cosima C. , Diehm Yannick F. , Vosler Peter S. , Harréus Ulrich , Kneser Ulrich , Panayi Adriana C.
Published: December 2022

Background: Obstructive sleep apnea (OSA) is a chronic disorder of the upper airway. OSA surgery has oftentimes been researched based on the outcomes of single-institutional facilities. We retrospectively analyzed a multi-institutional national database to investigate the outcomes of OSA surgery and identify risk factors for complications. Methods: We reviewed the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database (2008–2020) to identify patients who underwent OSA surgery. The postoperative outcomes of interest included 30-day surgical and medical complications, reoperation, readmission, and mortality. Additionally, we assessed risk-associated factors for complications, including comorbidities and preoperative blood values. Results: The study population included 4662 patients. Obesity (n = 2909; 63%) and hypertension (n = 1435; 31%) were the most frequent comorbidities. While two (0.04%) deaths were reported within the 30-day postoperative period, the total complication rate was 6.3% (n = 292). Increased BMI (p = 0.01), male sex (p = 0.03), history of diabetes (p = 0.002), hypertension requiring treatment (p = 0.03), inpatient setting (p < 0.0001), and American Society of Anesthesiology (ASA) physical status classification scores ≥ 4 (p < 0.0001) were identified as risk-associated factors for any postoperative complications. Increased alkaline phosphatase (ALP) was identified as a risk-associated factor for the occurrence of any complications (p = 0.02) and medical complications (p = 0.001). Conclusions: OSA surgery outcomes were analyzed at the national level, with complications shown to depend on AP levels, male gender, extreme BMI, and diabetes mellitus. While OSA surgery has demonstrated an overall positive safety profile, the implementation of these novel risk-associated variables into the perioperative workflow may further enhance patient care.
The Development of the Chimaeroid Pelvic Skeleton and the Evolution of Chondrichthyan Pelvic Fins
Authors: Pears Jacob B. , Tillett Carley , Tahara Rui , Larsson Hans C. E. , Trinajstic Kate , Boisvert Catherine A.
Published: December 2022

Pelvic girdles, fins and claspers are evolutionary novelties first recorded in jawed vertebrates. Over the course of the evolution of chondrichthyans (cartilaginous fish) two trends in the morphology of the pelvic skeleton have been suggested to have occurred. These evolutionary shifts involved both an enlargement of the metapterygium (basipterygium) and a transition of fin radial articulation from the pelvic girdle to the metapterygium. To determine how these changes in morphology have occurred it is essential to understand the development of extant taxa as this can indicate potential developmental mechanisms that may have been responsible for these changes. The study of the morphology of the appendicular skeleton across development in chondrichthyans is almost entirely restricted to the historical literature with little contemporary research. Here, we have examined the morphology and development of the pelvic skeleton of a holocephalan chondrichthyan, the elephant shark (Callorhinchus milii), through a combination of dissections, histology, and nanoCT imaging and redescribed the pelvic skeleton of Cladoselache kepleri (NHMUK PV P 9269), a stem holocephalan. To put our findings in their evolutionary context we compare them with the fossil record of chondrichthyans and the literature on pelvic development in elasmobranchs from the late 19th century. Our findings demonstrate that the pelvic skeleton of C. milii initially forms as a single mesenchymal condensation, consisting of the pelvic girdle and a series of fin rays, which fuse to form the basipterygium. The girdle and fin skeleton subsequently segment into distinct components whilst chondrifying. This confirms descriptions of the early pelvic development in Scyliorhinid sharks from the historical literature and suggests that chimaeras and elasmobranchs share common developmental patterns in their pelvic anatomy. Alterations in the location and degree of radial fusion during early development may be the mechanism responsible for changes in pelvic fin morphology over the course of the evolution of both elasmobranchs and holocephalans, which appears to be an example of parallel evolution.
TM-Net: A Neural Net Architecture for Tone Mapping
Authors: Finlayson Graham , McVey Jake
Published: December 2022

Tone mapping functions are applied to images to compress the dynamic range of an image, to make image details more conspicuous, and most importantly, to produce a pleasing reproduction. Contrast Limited Histogram Equalization (CLHE) is one of the simplest and most widely deployed tone mapping algorithms. CLHE works by iteratively refining an input histogram (to meet certain conditions) until convergence, then the cumulative histogram of the result is used to define the tone map that is used to enhance the image. This paper makes three contributions. First, we show that CLHE can be exactly formulated as a deep tone mapping neural network (which we call the TM-Net). The TM-Net has as many layers as there are refinements in CLHE (i.e., 60+ layers since CLHE can take up to 60 refinements to converge). Second, we show that we can train a fixed 2-layer TM-Net to compute CLHE, thereby making CLHE up to 30× faster to compute. Thirdly, we take a more complex tone-mapper (that uses quadratic programming) and show that it too can also be implemented — without loss of visual accuracy—using a bespoke trained 2-layer TM-Net. Experiments on a large corpus of 40,000+ images validate our methods.
Laser-Based Additive Manufacturing of Magnesium Alloys for Bone Tissue Engineering Applications: From Chemistry to Clinic
Authors: Fard Mohammad Ghasemian , Sharifianjazi Fariborz , Kazemi Sanam Sadat , Rostamani Hosein , Bathaei Masoud Soroush
Published: December 2022

Metallic biomedical implants are made from materials such as stainless steel, titanium, magnesium, and cobalt-based alloys. As a degradable biometal, magnesium (Mg) and its alloys are becoming more popular for applications in bone tissue engineering. Mg-based alloys have been found to be biocompatible, bioabsorbable, and bioactive, allowing them to be used as orthopedic implants with a low Young’s modulus. Computer-aided design can be used to design scaffolds with intricate porous structures based on patient-specific anatomical data. These models can be materialized rapidly and with reasonably acceptable dimensional accuracy by additive manufacturing (AM) techniques. It is known that lasers are the most widely investigated energy source for AM’ed Mg, as they offer some distinct advantages over other forms of energy. Recent studies have focused on developing biodegradable Mg scaffolds by using laser-based AM techniques. In this paper, we aim to review the recent progress of laser-based AM for Mg alloys and survey challenges in the research and future development of AM’ed Mg scaffolds for clinical applications.
Intertwining Neuropathogenic Impacts of Aberrant Circadian Rhythm and Impaired Neuroregenerative Plasticity in Huntington’s Disease: Neurotherapeutic Significance of Chemogenetics
Authors: Ravichandran Sowbarnika , Suhasini Ramalingam , Madheswaran Deepa Sudhiksha , Selvaraj Divya Bharathi , Vergil Andrews Jemi Feiona , Thiagarajan Viruthachalam , Kandasamy Mahesh
Published: December 2022

Huntington’s disease (HD) is a progressive neurodegenerative disorder characterized by abnormal progressive involuntary movements, cognitive deficits, sleep disturbances, and psychiatric symptoms. The onset and progression of the clinical symptoms have been linked to impaired adult neurogenesis in the brains of subjects with HD, due to the reduced neurogenic potential of neural stem cells (NSCs). Among various pathogenic determinants, an altered clock pathway appears to induce the dysregulation of neurogenesis in neurodegenerative disorders. Notably, gamma-aminobutyric acid (GABA)-ergic neurons that express the vasoactive intestinal peptide (VIP) in the brain play a key role in the regulation of circadian rhythm and neuroplasticity. While an abnormal clock gene pathway has been associated with the inactivation of GABAergic VIP neurons, recent studies suggest the activation of this neuronal population in the brain positively contributes to neuroplasticity. Thus, the activation of GABAergic VIP neurons in the brain might help rectify the irregular circadian rhythm in HD. Chemogenetics refers to the incorporation of genetically engineered receptors or ion channels into a specific cell population followed by its activation using desired chemical ligands. The recent advancement of chemogenetic-based approaches represents a potential scientific tool to rectify the aberrant circadian clock pathways. Considering the facts, the defects in the circadian rhythm can be rectified by the activation of VIP-expressing GABAergic neurons using chemogenetics approaches. Thus, the chemogenetic-based rectification of an abnormal circadian rhythm may facilitate the neurogenic potentials of NSCs to restore the neuroregenerative plasticity in HD. Eventually, the increased neurogenesis in the brain can be expected to mitigate neuronal loss and functional deficits.
Failure Rate Assessment for Onshore and Floating Offshore Wind Turbines
Authors: Li He , Peng Weiwen , Huang Cheng-Geng , Guedes Soares C.
Published: December 2022

A detailed analysis is performed on a dataset of failure and maintenance records from various onshore wind farms located in different geographical areas for the safety, risk, reliability, availability, and maintainability characterization of wind turbines. Specifically, characteristics related to failures, including the criticality of failure modes, failure frequencies, failure rates, and lifetime distributions of components, are analyzed to support the failure identification and failure prevention of wind turbines. Additionally, characteristics of maintenance, including typical maintenance measures of failures, policies for spare components, delayed maintenance, as well as related times such as reaction time, travelling time, and mean time to repair, are provided to support the maintenance management of wind farms. Based on the operational data analysis results, a reliability influence factor-based failure data correction approach is presented to transfer the onshore data to floating offshore turbines by modeling the differences in failure occurrences based on experts’ judgment. A comprehensive comparison with existing studies validates the performance of the proposed approach.
Investigation of a Cabin Suspended and Articulated Rescue Vessel in Terms of Motion Reduction
Authors: Li Jiong , Bai Xuesong , Li Yang , Du Hongwang , Fan Fangtao , Li Shuaixian , Li Zhi , Xiong Wei
Published: December 2022

To solve the problem that small rescue vessels are seriously affected by waves when working at sea, which causes damage to the crew and equipment, a catamaran with a suspended and articulated cabin is designed. The multi-body dynamic model of the whole vessel based on SimMechanics is built, and the prototype is tested on the water. The correctness of the model is verified based on the three aspects of the roll motion, pitch motion, and heave motion of the rescue platform. The motion of the rescue platform is simulated under the conditions of bow waves and large heave waves, and the RMS value of the vertical acceleration of the rescue platform is taken as the response target to analyze the influence of the suspension system parameters of the whole vessel. The suspension system has good buffering and motion reduction effects under various working conditions, and it has an obvious reduction effect on the vertical acceleration at the rescue platform. The larger the amplitude of the wave impact, the more obvious the effect. The articulated system reduces the roll angle and the heave amplitude under the conditions of bow waves.
Description of the Joint Probability of Significant Wave Height and Mean Wave Period
Authors: Zhao Mingwen , Deng Xiaodong , Wang Jichao
Published: December 2022

The bivariate probability distribution of significant wave heights and mean wave periods has an indispensable guiding role in the implementation of offshore engineering, which has attracted great attention. This work gives a new bivariate method to describe the bivariate distribution of significant wave height and mean wave period at the NanJi, BeiShuang, and XiaoMaiDao stations from 2018 to 2020. A mixed lognormal distribution is used for univariate probability analysis of wave data, and the method of connecting two mixed lognormal distributions with copula functions is applied to construct bivariate distribution. The results show that compared with Weibull and lognormal distributions, the mixed lognormal distribution shows good performance in fitting marginal distributions. In the bivariate probability analysis, the conditional model overestimates the probability of lower wave heights, and the bivariate function model has a poor fitting effect in the region with larger periods. In contrast, the copula model based on mixed lognormal distribution is more suited to describe the joint distribution of significant wave height and mean wave period.
Optimal Scheduling of an Electric Propulsion Tugboat Considering Various Operating Conditions and Navigation Uncertainties
Authors: Gao Jingjie , Lan Hai , Cheng Peng , Hong Ying-Yi , Yin He
Published: December 2022

The operating conditions of all-electric tugboats are flexible and changeable. They are more complicated than conventional vessels in terms of joint voyages and power generation scheduling. To guarantee the reliable operation of the ship, a new coordinated optimization scheme that combines economy and operational reliability is proposed. It is based on the various operating conditions of the tugboat during its voyage, taking into account the random outages of equipment and load fluctuations due to speed and wave uncertainties. Due to the difficulty of implementing a stochastic sampling method with space-time coupling constraints (e.g., the voyage is related to propulsion load), an analytical approach is needed to transform the model into a readily solvable mixed-integer linear program (MINP) which attributes risk scenarios to load fluctuations under various conditional probabilities. In addition, this paper proposes an improved piecewise linearization method based on a differential evolutionary algorithm to speed up the solution process and improve computational accuracy. Meanwhile, the energy storage loss cost due to battery degradation is added to the optimization target. The battery’s cycle life is extended by rational scheduling of charging and discharging. Simulations validate this paper’s joint scheduling optimization scheme in multiple comparison experiments. The results show that it can effectively balance the economic and reliability levels under various risk scenarios and improve the environmental energy efficiency indicators.
Characterization of Intertidal Macrofaunal Communities of Two Sandy Beaches under Different Anthropogenic Pressures
Authors: Di Camillo Cristina Gioia , Luzi Giorgia , Danial Afghan , Di Florio Luciano , Calcinai Barbara , Lo Brutto Sabrina , de Oliveira Jéssica Luana Santana Mendonça , Fumanti Agnese , Cerrano Carlo
Published: December 2022

The macrofauna in the intertidal zone of sandy beaches provides the trophic connectivity between land and sea, by linking microbiome, meiofauna, and megafauna, representing a food source for several terrestrial animals, including shorebirds and mammals. However, the macrozoobenthos in urbanised beaches is subjected to intense disturbances, such as breakwater barriers and tourism, which limit or impede the energy transfer from the marine to the terrestrial habitats. Because the information about diversity and abundance of the macrozoobenthos of the intertidal zone on the Mediterranean sandy coasts is scant, the main objective of this study is to increase the knowledge on the macrofauna living in this habitat and to identify taxa sensitive to cumulative human-induced stresses. To achieve this purpose, the structure and dynamics of macrozoobenthic communities from (1) a highly frequented beach characterized by breakwater barriers and (2) a marine protected area (MPA) in the Adriatic Sea were compared. The hypotheses that macrofauna composition and abundance changed in the two sites and over time were tested. Results highlighted that the macrozoobenthos in the MPA is mainly dominated by juvenile bivalves, which peaked from autumn to winter, and to a lesser extent by ostracods and mysids. Conversely, ostracods and the bivalve Lentidium mediterraneum (O. G. Costa, 1830) are particularly abundant in the highly disturbed beach, while the gastropod Tritia neritea (Linnaeus, 1758) increased only during summer. A possible combined effect of breakwater barriers and intense trampling has been theorized to explain the main differences between the two sites especially in the summer.
Heterologous Expression of CFL1 Confers Flocculating Ability to Cutaneotrichosporon oleaginosus Lipid-Rich Cells
Authors: Donzella Silvia , Compagno Concetta
Published: December 2022

Lipid extraction from microbial and microalgae biomass requires the separation of oil-rich cells from the production media. This downstream procedure represents a major bottleneck in biodiesel production, increasing the cost of the final product. Flocculation is a rapid and cheap system for removing solid particles from a suspension. This natural characteristic is displayed by some microorganisms due to the presence of lectin-like proteins (called flocculins/adhesins) in the cell wall. In this work, we showed, for the first time, that the heterologous expression of the adhesin Cfl1p endows the oleaginous species Cutaneotrichosporon oleaginosus with the capacity of cell flocculation. We used Helm’s test to demonstrate that the acquisition of this trait allows for reducing the time required for the separation of lipid-rich cells from liquid culture by centrifugation without altering the productivity. This improves the lipid production process remarkably by providing a more efficient downstream.
Liver Tumor Markers, HALP Score, and NLR: Simple, Cost-Effective, Easily Accessible Indexes for Predicting Prognosis in ICC Patients after Surgery
Authors: Zhang Deyao , Zeng Huilan , Pan Yangxun , Zhao Yumo , Wang Xin , Chen Jinbin , Wang Juncheng , Zhang Yaojun , Zhou Zhongguo , Xu Li , Chen Minshan , Hu Dandan
Published: December 2022

Introduction: To investigate the prognostic significance of liver tumor markers, the hemoglobin, albumin, lymphocyte, and platelet (HALP) score; neutrophil-to-lymphocyte ratio (NLR); and platelet-to-lymphocyte ratio (PLR), for predicting the specific site of recurrence or metastasis after surgery in patients with intrahepatic cholangiocarcinoma (ICC). Methods: In total, 162 patients with pathologically proven ICC who underwent curative surgery at Sun Yat-sen University Cancer Center between April 2016 and April 2020 were analyzed. Clinicopathological characteristics were collected retrospectively. The Kaplan–Meier method was used to analyze the overall survival (OS) and recurrence-free survival (RFS). Significant clinical factors were examined by univariate analysis and multivariate analysis and analyzed by receiver operating characteristic (ROC) curve analysis. Results: The cutoff values for the HALP score, NLR, and PLR were determined to be 43.63, 3.73, and 76.51, respectively, using the surv_cutpoint function of survminer using RFS as the target variable. In multivariate analysis, vascular invasion, pathology nerve tract invasion, and carbohydrate antigen 19-9 (CA19-9) levels were independent prognostic factors of OS, whereas the tumor number, pathology microvascular invasion, pathology differentiation, CA19-9 levels, and NLR were independent prognostic factors of RFS. For the whole recurrence analysis, the carcinoembryonic antigen (CEA) index exhibited the largest ROC curve area of all (AUC = 0.590), and the alpha-fetoprotein (AFP) index exhibited the smallest ROC curve area (AUC = 0.530). The HALP score exhibited the largest ROC curve area of all in predicting intrahepatic recurrence (AUC = 0.588), the NLR showed the best predictive value in predicting lymph node metastasis (AUC = 0.703), and the AUC of the CA19-9 index was the largest of all variables in predicting distant metastasis (AUC = 0.619). Conclusions: Our study showed that CA19-9, CEA, HALP score, and NLR are easily accessible, reliable, cost-effective indexes for predicting the specific site of recurrence or metastasis after surgery in ICC patients. Patients with high HALP scores and NLR have a higher risk of intrahepatic and lymph node metastasis recurrence.
Atraumatic Acromioclavicular Joint Dislocation: A Case Report Treated with Excision of the Distal Clavicle Margin and Button Slide System with Allograft Tendon Reinforcement at Coracoclavicular and Acromioclavicular Joint
Authors: León Alejandro , Chavez Sergio , Garcia-Medrano Belén , García-Fraile Rubén , de Heredia Pablo Beltrán , Palencia Jesús , Caballero-García Alberto , Córdova Alfredo , Gonzalez David Noriega
Published: December 2022

Although acromioclavicular joint (ACJ) dislocation is a common injury following trauma involving the shoulder, it is rare in the absence of trauma. In this manuscript, we describe a case of ACJ in a 15-year-old girl who presented a painful dislocation with spontaneous shortening of the right acromioclavicular joint that forced her to temporarily abandon her sports career. After failure of conservative physiotherapy treatment, surgical intervention was proposed by performing an arthroscopic-assisted button slide combined with augmented hamstring allograft reconstruction. After the intervention and the subsequent recovery period, the athlete was able to return to her semi-professional training. The follow-up of the patient is 5.5 years post-surgery. The result obtained could help in planning the treatment of future cases.
Individual Influence of Trochlear Dysplasia on Patellofemoral Kinematics after Isolated MPFL Reconstruction
Authors: Frodl Andreas , Lange Thomas , Siegel Markus , Meine Hans , Taghizadeh Elham , Schmal Hagen , Izadpanah Kaywan
Published: December 2022

Introduction: The influence of the MPFL graft in cases of patella instability with dysplastic trochlea is a controversial topic. The effect of the MPFL reconstruction as single therapy is under investigation, especially with severely dysplastic trochlea (Dejour types C and D). The purpose of this study was to evaluate the impact of trochlear dysplasia on patellar kinematics in patients suffering from low flexion patellar instability under weight-bearing conditions after isolated MPFL reconstruction. Material and Methods: Thirteen patients were included in this study, among them were eight patients with mild dysplasia (Dejour type A and B) and five patients with severe dysplasia (Dejour type C and D). By performing a knee MRI with in situ loading, patella kinematics and the patellofemoral cartilage contact area could be measured under the activation of the quadriceps musculature in knee flexion angles of 0°, 15° and 30°. To mitigate MRI motion artefacts, prospective motion correction based on optical tracking was applied. Bone and cartilage segmentation were performed semi-automatically for further data analysis. Cartilage contact area (CCA) and patella tilt were the main outcome measures for this study. Pre- and post-surgery measures were compared for each group. Results: Data visualized a trending lower patella tilt after MPFL graft installation in both groups and flexion angles of the knee. There were no significant changes in patella tilt at 0° (unloaded pre-surgery: 22.6 ± 15.2; post-surgery: 17.7 ± 14.3; p = 0.110) and unloaded 15° flexion (pre-surgery: 18.9 ± 12.7; post-surgery: 12.2 ± 13.0; p = 0.052) of the knee in patients with mild dysplasia, whereas in patients with severe dysplasia of the trochlea the results happened not to be significant in the same angles with loading of 5 kg (0° flexion pre-surgery: 34.4 ± 12.1; post-surgery: 31.2 ± 16.1; p = 0.5; 15° flexion pre-surgery: 33.3 ± 6.1; post-surgery: 23.4 ± 8.6; p = 0.068). CCA increased in every flexion angle and group, but significant increase was seen only between 0°–15° (unloaded and loaded) in mild dysplasia of the trochlea, where significant increase in Dejour type C and D group was seen with unloaded full extension of the knee (0° flexion) and 30° flexion (unloaded and loaded). Conclusion: This study proves a significant effect of the MPFL graft to cartilage contact area, as well as an improvement of the patella tilt in patients with mild dysplasia of the trochlea. Thus, the MPFL can be used as a single treatment for patient with Dejour type A and B dysplasia. However, in patients with severe dysplasia the MPFL graft alone does not significantly increase CCA.
Devascularized Bone Surface Culture: A Novel Strategy for Identifying Osteomyelitis-Related Pathogens
Authors: Chen Peng , Lin Qing-rong , Huang Mou-Zhang , Zhang Xin , Hu Yan-jun , Chen Jing , Jiang Nan , Yu Bin
Published: December 2022

The gold standard for identifying pathogens causing osteomyelitis (OM) is intraoperative tissue sampling culture (TSC). However, its positive rate remains inadequate. Here, we evaluated the efficiency of a novel strategy, known as devitalized bone surface culture (BSC), for detecting OM-related microorganisms and compared it to TSC. Between December 2021 and July 2022, patients diagnosed with OM and received both methods for bacterial identification were screened for analysis. In total, 51 cases were finally recruited for analysis. The mean age was 43.6 years, with the tibia as the top infection site. The positive rate of BSC was relatively higher than that of TSC (74.5% vs. 58.8%, p = 0.093), though no statistical difference was achieved. Both BSC and TSC detected definite pathogens in 29 patients, and their results were in accordance with each other. The most frequent microorganism identified by the BSC method was Staphylococcus aureus. Moreover, BSC took a significantly shorter median culture time than TSC (1.0 days vs. 3.0 days, p < 0.001). In summary, BSC may be superior to TSC for identifying OM-associated pathogens, with a higher detectable rate and a shorter culture time.
Politicians’ Personal Legacies from Olympic Bids and Referenda—An Analysis of Individual Risks and Opportunities
Authors: Könecke Thomas , de Nooij Michiel
Published: December 2022

The popularity of staging Olympic Games has dropped in democratic countries as a series of failed referenda and withdrawn bids as well as protests against mega sport events have shown in recent years. Nevertheless, the there still are democratically elected office-holders willing to become involved in an Olympic bid despite the high probability of public opposition and the threat of an almost unwinnable referendum. This conceptual study analyses the individual risk management that these politicians have to concern themselves with because of their involvement in Olympic bids and referenda. It does so by looking at possible ‘personal legacies’ the politicians can obtain. It is interesting to note that although the size of such legacies will vary, they can result irrespective of the outcome of a bid or a referendum and can have positive, negative, or neutral effects for the politician(s) in question. As will be shown, personal legacies can also be obtained by opponents of Olympic bidding ambitions, which is not the only finding that is problematic particularly for the IOC and National Olympic Committees interested in hosting Olympic Games or other sport events.
Google Street View and Machine Learning—Useful Tools for a Street-Level Remote Survey: A Case Study in Ho Chi Minh, Vietnam and Ichikawa, Japan
Authors: Ta Duy Thong , Furuya Katsunori
Published: December 2022

This study takes one step further to complement the application of a method for mapping informal green spaces (IGSs) using an efficient combination of open-source data with simple tools and algorithms. IGSs are unofficially recognized by the government as vegetation spaces designed for recreation, gardening, and forestry in urban areas. Due to the economic crisis, many formal green spaces such as urban parks and garden projects have been postponed, while IGSs have significant potential as green space retrofits. However, because they are small and spatially continuous and cannot be fully detected via airborne surveys, they are surveyed in small areas and neglected by government and city planners. Therefore, in this research, we combined the use of Google Street View (GSV) data with machine learning to develop a survey method that can be used to survey a wide area at once. Deeplab V3+ was used to segment the semantics based on the model created using 1000 labelled photos, with an accuracy rate of nearly 65%. Applying this method gave high accuracy in Ichikawa, Japan, with 3029 photos, and matched the results of a field survey in a previous study. In contrast, low accuracy was seen in Ho Chi Minh City, with 204 photos, where the quality of the GSV data was considerably lower.
How Does Change in Rural Residential Land Affect Cultivated Land Use Efficiency? An Empirical Study Based on 42 Cities in the Middle Reaches of the Yangtze River
Authors: Tang Houtian , Wu Yuanlai , Chen Jinxiu , Deng Liuxin , Zeng Minjie
Published: December 2022

The growth of rural residential land (RRL) areas has led to the encroachment of cultivated land, which has seriously reduced cultivated land use efficiency (CLUE). This paper takes 42 cities in the middle reaches of the Yangtze River (MRYR) as an example, using the kernel density estimation method, the Super-SBM model, and mediating effect test methods to explore the impact of RRL change on CLUE during 2000–2020. Specifically, based on the analysis of the spatiotemporal distribution characteristics of RRL and CLUE, this paper attempts to further explore the influence path of RRL change on CLUE and test whether there is a mediating effect. The results show that (1) the overall RRL area increased by 30,386.34 hm2, except for the decrease in RRL area in a few regions of Hunan Province, and the RRL area in other regions increased. (2) The hot-spot and sub-hot-spot regions of CLUE in the MRYR were mainly concentrated in northwestern Hubei Province and eastern Hunan Province, and the hot-spot and sub-hot-spot regions in Hunan Province are the highest among the three provinces. (3) Under the control of socioeconomic variables, the change in RRL has a significant negative impact on CLUE. (4) The area of cultivated land occupied by rural residential land (CLRRL) has a mediating role during 2000–2020, while the per capita cultivated land area (PCLA) and the rural permanent population (RPP) only have a mediating role during 2000–2010. In the future, the government should strictly prohibit the occupation of cultivated land by RRL and to improve the CLUE.
Assessment of the Terraced Landscapes’ Integrity: A GIS-Based Approach in a Potential GIAHS-FAO Site (Northwest Piedmont, Italy)
Authors: Pomatto Enrico , Devecchi Marco , Larcher Federica
Published: December 2022

The GIAHS-FAO program enhances the agricultural systems coevolved with humans through their dynamic conservation to guarantee the livelihood of future generations. The aim of this research was to assess, with a dynamic perspective, the terraced landscape’s integrity in a potential GIAHS-FAO site (Northwest Piedmont, Italy, 545 ha) characterized by a pergola caremiese vine-breeding technique. We developed a GIS-based approach to explore the main features that can affect the landscape’s integrity, starting from the changes of the land use. The aerial IGMI images (1954–1968) and the AGEA (2018) orthophoto were photo-interpreted using QGIS 3.16.2 “Hannover” (minimum mappable unit 100 m2). The results showed that 70.16% of the historical landscape was preserved, while the surface of vineyards decreased because of their abandonment. We observed that vineyards are the land use that requires more attention in future planning strategies, and that the landscape’s integrity is affected by the limited introduction of non-traditional vine-breeding techniques (espaliers) and new crops (olives groves). The methodology was able to assess the terraced landscape’s integrity in a dynamic perspective. The good integrity makes the study area a potential GIAHS-FAO site. Future planning strategies will have to lead the changing processes and preserve the landscape’s integrity.
Seasonal and Altitudinal Variation in Chemical Composition of Celtis australis L. Tree Foliage
Authors: Singh Bhupendra , Kumar Munesh , Cabral-Pinto Marina M. S. , Bhatt Bhagwati Prasad
Published: December 2022

Celtis australis is an important agroforestry tree in the Himalayan region providing major fodder to the livestock and many other needs for sustaining life in local rural communities. Including their fodder value and wide altitudinal distribution ranges, it is extracted by the villagers in large scale during the lean period (May to June). Thus, the aim was to understand the nutritive values of the species influenced by the altitude and harvesting season. For this investigation, leaves of C. australis were collected from four different altitudes during the months of February to December. The nutritive value of collected foliage, i.e., dry matter, ash, potassium, calcium, phosphorus, crude protein, crude fiber, starch, sugar, and phenolic were estimated by using stranded methods. The results of present study reveal that significant seasonal variations have been observed for the chemical composition of C. australis tree foliage collected from different altitudes. On an average, between seasons, crude protein ranged from 9.17 to 16.97%, phosphorus 0.08 to 0.16%, potassium 0.28 to 0.76%, crude fiber 13.94 to 19.80%, sugars 1.11 to 1.83%, and starch 4.79 to 6.53%. Altitude also significantly influenced nutritive content. Between altitudes, phosphorus ranged from 0.10 to 0.11%, potassium 0.42 to 0.50%, crude protein 12.66 to 14.02%, crude fiber 1.61 to 1.71%, sugars 1.45 to 1.66%, starch 4.71 to 6.31%, and phenolic 0.43 to 0.78%. Potassium, calcium, crude protein, and starch were significantly positively correlated with altitude of foliage collection. However, dry matter content, phosphorus, and soluble sugars, significantly correlated inversely with altitude.
Left Atrial Remodeling in Response to Aortic Valve Replacement: Pathophysiology and Myocardial Strain Analysis
Authors: Lisi Matteo , Pastore Maria Concetta , Fiorio Alessio , Cameli Matteo , Mandoli Giulia Elena , Righini Francesca Maria , Cavigli Luna , D’Ascenzi Flavio , Focardi Marta , Rubboli Andrea , Campo Gianluca , Mondillo Sergio , Henein Michael Y.
Published: December 2022

Severe aortic stenosis (AS) is the most common valve disease in the elderly and is associated with poor prognosis if treated only medically. AS causes chronic pressure overload, concentric left ventricular (LV) hypertrophy, myocardial stiffness, and diastolic dysfunction. This adverse remodeling also affects the left atrium (LA), which dilates and develops myocardial fibrosis, with a reduction in intrinsic function and a consequent high risk of the development of atrial fibrillation. Speckle-tracking echocardiography is able to detect myocardial dysfunction before other conventional parameters, such as LV ejection fraction, and also predict clinical outcomes. This review aims at describing LV and LA remodeling in AS and before and after aortic valve replacement and the usefulness of myocardial strain analysis in this clinical setting.