bluuebunny/crossref_metadata_2025 huggingface dataset:
Haemophilic Pelvic Pseudotumour: A New Surgical Option
Authors: Pasta Gianluigi , Ruggieri Roberta , Annunziata Salvatore , Gallese Alessandro , Gagliardi Vincenzo Pio , Cuzzocrea Fabrizio , Ghiara Matteo , Russo Mariaconcetta , Preti Paola Stefania , Santi Roberto Mario , Mosconi Mario , Benazzo Francesco
Published: September 2021

Background: Haemophilia is an inherited coagulopathy caused by the absence or dysfunction of clotting factor VIII or IX. Clinical manifestations are generally secondary to recurrent bleeding episodes mainly in the musculoskeletal system. Bleeding symptoms appear early in life and, when the disease is severe (when plasma factor VIII or IX activity is <1% of normal), joint and muscle bleeding may occur spontaneously. A pseudotumour is a recurrent, chronic, encapsulated, slowly expanding, muscle hematoma. Haemophilic pseudotumour is a rare complication of haemophilia which occurs, as a condition either from repeated spontaneous bleeding or coming from a traumatic origin, in 1–2% of haemophilic patients. Case report: A 32-year-old man with severe haemophilia A referred to our Clinic with a massive right iliac wing pseudotumour complicated by Staphylococcus aureus superinfection and skin fistulisation. In this report we describe the medical management and surgical treatment by the adoption of a novel surgical technique which involves the use of a pedicle-screw and rod system (PSRS), a polyglycolic acid MESH and bone cement in order to build up an artificial ilium-like bony mass. This case report highlights the importance of interdisciplinary approach and the efficacy of eradicating surgery as treatment, especially in the case of large and long-lasting lesions.
A Theory-Based Analysis of COVID-19 Vaccine Hesitancy among African Americans in the United States: A Recent Evidence
Authors: Sharma Manoj , Batra Kavita , Batra Ravi
Published: September 2021

African Americans have been disproportionately vaccinated at lower rates, which warrants the development of theory-based interventions to reduce vaccine hesitancy in this group. The fourth-generation theories, e.g., multi-theory model (MTM) of health behavior change, are vital in developing behavioral interventions. Therefore, the current study aims to determine recent trends in COVID-19 vaccination rates and to test the MTM model in predicting the initiation of COVID-19 vaccines among vaccine-hesitant Blacks. A sample of 428 unvaccinated African Americans were recruited through a web-based survey using a 28-item psychometric valid questionnaire. Chi-square, independent-samples-t-test or Welch’s t test, and Pearson’s correlation tests were utilized for the analyses. Hierarchical regression modelling was performed to determine the increment in variation accounted for through addition of predictors over a set of models. Nearly 48% of unvaccinated Blacks reported being vaccine-hesitant. The vaccine-hesitant group was relatively younger (40.5 years ± 15.8 vs. 46.2 years ± 17.4, p < 0.001), were Republicans (22.1% vs. 10.0%, p < 0.001), lived in the North-East region (26.0% vs. 11.4%, p < 0.001) and had religious affiliations other than Christianity (21.2% vs. 13.6%, p = 0.04). The mean scores of perceived advantages ((9.01 ± 3.10 vs. 7.07 ± 3.60, p < 0.001) and behavioral confidence (8.84 ± 3.76 vs. 5.67 ± 4.09, p < 0.001) were higher among vaccine non-hesitant group as opposed to the hesitant ones. In a final regression model, all MTM constructs) predicted nearly 65% of variance in initiating COVID-19 vaccination behavior among the vaccine-hesitant group (adjusted R2 = 0.649, F = 32.944, p < 0.001). With each unit increment in MTM constructs (e.g., participatory dialogue and behavior confidence), the initiation of COVID-19 vaccination among vaccine-hesitant Blacks increased by 0.106 and 0.166 units, respectively. Based on the findings of this study a m-health educational intervention to promote COVID-19 vaccine uptake behavior among Blacks is proposed.
Analysis of Health Care Billing via Quantile Variable Selection Models
Authors: Ekin Tahir , Damien Paul
Published: September 2021

Fraudulent billing of health care insurance programs such as Medicare is in the billions of dollars. The extent of such overpayments remains an issue despite the emerging use of analytical methods for fraud detection. This motivates policy makers to also be interested in the provider billing characteristics and understand the common factors that drive conservative and/or aggressive behavior. Statistical approaches to tackling this problem are confronted by the asymmetric and/or leptokurtic distributions of billing data. This paper is a first attempt at using a quantile regression framework and a variable selection approach for medical billing analysis. The proposed method addresses the varying impacts of (potentially different) variables at the different quantiles of the billing aggressiveness distribution. We use the mammography procedure to showcase our analysis and offer recommendations on fraud detection.
Isolation in Natural Host Cell Lines of Wolbachia Strains wPip from the Mosquito Culex pipiens and wPap from the Sand Fly Phlebotomus papatasi
Authors: Bell-Sakyi Lesley , Beliavskaia Alexandra , Hartley Catherine S. , Jones Laura , Luu Lisa , Haines Lee R. , Hamilton James G. C. , Darby Alistair C. , Makepeace Benjamin L.
Published: September 2021

Endosymbiotic intracellular bacteria of the genus Wolbachia are harboured by many species of invertebrates. They display a wide range of developmental, metabolic and nutritional interactions with their hosts and may impact the transmission of arboviruses and protozoan parasites. Wolbachia have occasionally been isolated during insect cell line generation. Here, we report the isolation of two strains of Wolbachia, wPip and wPap, during cell line generation from their respective hosts, the mosquito Culex pipiens and the sand fly Phlebotomus papatasi. wPip was pathogenic for both new C. pipiens cell lines, CPE/LULS50 and CLP/LULS56, requiring tetracycline treatment to rescue the lines. In contrast, wPap was tolerated by the P. papatasi cell line PPL/LULS49, although tetracycline treatment was applied to generate a Wolbachia-free subline. Both Wolbachia strains were infective for a panel of heterologous insect and tick cell lines, including two novel lines generated from the sand fly Lutzomyia longipalpis, LLE/LULS45 and LLL/LULS52. In all cases, wPip was more pathogenic for the host cells than wPap. These newly isolated Wolbachia strains, and the novel mosquito and sand fly cell lines reported here, will add to the resources available for research on host–endosymbiont relationships, as well as on C. pipiens, P. papatasi, L. longipalpis and the pathogens that they transmit.
Temperature and Photoperiodic Response of Diapause Induction in Anastatus japonicus, an Egg Parasitoid of Stink Bugs
Authors: Zhao Can , Guo Yi , Liu Zixin , Xia Yue , Li Yuyan , Song Ziwei , Zhang Baoxin , Li Dunsong
Published: September 2021

Anastatus japonicus Ashmead is a widely used biological control agent against stink bugs that can be successfully reared using the large eggs of the Chinese silkworm. In this study, environmental factors responsible for the induction of diapause in A. japonicus were investigated on host eggs of the Chinese silkworm. A. japonicus exhibited a facultative, mature larval diapause within its host eggs. Second–third instar larva are the most sensitive stages to diapause stimuli. The accumulation of diapause stimuli during all the larval stages maximized the diapause response. A short photoperiod of 10L:14D and temperature of 17 °C led to the occurrence of the highest diapause response, while a long photoperiod (14L:10D) and low temperatures (11 and 14 °C) prevented the diapause. A specific exposure period was required to reach high diapause incidence. Diapausing mature larvae had a significantly higher survival rate after 180 days storage at 10 °C than that of nondiapausing mature larvae. Taken together, results suggest methods that could be exploited in the developmental regulation, field-release pretreatment technology, and long-term storage of A. japonicus.
Results of Simultaneous Unicompartmental Knee Arthroplasty and Anterior Cruciate Ligament Reconstruction: A Systematic Review
Authors: Albo Erika , Campi Stefano , Zampogna Biagio , Torre Guglielmo , Papalia Giuseppe Francesco , Diaz Balzani Lorenzo Alirio , Alifano Anna Maria , Papalia Rocco , Denaro Vincenzo
Published: September 2021

This systematic review aimed to investigate the clinical and functional outcomes and complication rate of simultaneous anterior cruciate ligament reconstruction (ACLR) and unicompartmental knee arthroplasty (UKA). A systematic search in PubMed–Medline, Cochrane Library, and Google Scholar was carried out to identify eligible randomized clinical trials, observational studies, or case series that reported on clinical and functional results of combined ACLR and UKA in adults with a unicompartmental knee osteoarthritis and ACL deficiency. Four retrospective studies and three prospective studies were included in this review. A total of 169 patients were included with a mean follow-up of 6.3 years. The Mean Oxford Knee Score improved from 29.4 to 43.9 at the final follow-up. All the other reported scores significantly improved after surgery. The overall revision rate was 3.5%. The MINORS score ranged from 8 to 14. Association analysis of MINORS score and year of publication, through Pearson’s coefficient, showed no significant association (p = −0.089). Simultaneous ACLR and UKA is a safe procedure with a significant postoperative improvement of functional and clinical outcomes for patients with ACL injury that complain of knee instability and isolated medial compartment pain.
Usefulness of the Modified Videofluoroscopic Dysphagia Scale in Evaluating Swallowing Function among Patients with Amyotrophic Lateral Sclerosis and Dysphagia
Authors: Lee Byung Joo , Eo Hyoshin , Park Donghwi
Published: September 2021

Introduction: The videofluoroscopic dysphagia scale (VDS) is used to predict the long-term prognosis of dysphagia among patients with the condition. Previously, a modified version of the VDS (mVDS) was established to overcome the relatively low inter-rater reliability of VDS, and was verified in patients with dysphagia, such as stroke patients. However, the validity of mVDS in patients with amyotrophic lateral sclerosis (ALS) has never been proved. Therefore, in this study, we attempted to seek the validity of the mVDS score in patients with ALS suffering from dysphagia. Method: Data from the videofluoroscopic swallowing study (VFSS) of 34 patients with ALS and dysphagia were retrospectively collected. We investigated the presence of aspiration pneumonia and the selected feeding method based on the VFSS. We also evaluated the correlations between the mVDS and the selected feeding method, and between the mVDS and the presence of aspiration pneumonia. Multivariate logistic regression and receiver operating characteristic (ROC) analyses were performed during the data analysis. Results: In patients with ALS and dysphagia, the mVDS scores were statistically correlated with the selected feeding method (p < 0.05) and the presence of aspiration pneumonia (p < 0.05). In the ROC curve analysis, the area under the ROC curve values for the selected feeding method and the presence of aspiration pneumonia were 0.886 (95% confidence interval (CI), 0.730–0.969; p < 0.0001) and 0.886 (95% CI, 0.730–0.969; p < 0.0001), respectively. Conclusion: The mVDS can be a useful tool for quantifying the severity of dysphagia and interpreting the VFSS findings in patients with ALS and dysphagia. However, further studies involving a more general population of patients with ALS are needed to elucidate a more accurate cut-off value for the allowance of oral feeding and the presence of aspiration pneumonia.
Acute Hypoxemic Respiratory Failure in Children at the Start of COVID-19 Outbreak: A Nationwide Experience
Authors: López-Fernández Yolanda M. , Martínez-de-Azagra Amelia , González-Gómez José M. , Pérez-Caballero Macarrón César , García-González María , Parrilla-Parrilla Julio , Miñambres-Rodríguez María , Madurga-Revilla Paula , Gómez-Zamora Ana , Rodríguez-Campoy Patricia , Mayordomo-Colunga Juan , Butragueño-Laiseca Laura , Núñez-Borrero Rocío , González-Martín Jesús M. , Slutsky Arthur S. , Villar Jesús ,   on behalf the Prevalence and Outcome of Acute Hypoxemic Respiratory Failure in Children (PANDORA-CHILD) Network
Published: September 2021

Study design: This is a prospective, multicenter, and observational study with the aim of describing physiological characteristics, respiratory management, and outcomes of children with acute hypoxemic respiratory failure (AHRF) from different etiologies receiving invasive mechanical ventilation (IMV) compared with those affected by SARS-CoV-2. Methods and Main Results: Twenty-eight patients met the inclusion criteria: 9 patients with coronavirus disease 2019 (COVID-19) and 19 patients without COVID-19. Non-COVID-19 patients had more pre-existing comorbidities (78.9% vs. 44.4%) than COVID-19 patients. At AHRF onset, non-COVID-19 patients had worse oxygenation (PaO2/FiO2 = 95 mmHg (65.5–133) vs. 150 mmHg (105–220), p = 0.04), oxygenation index = 15.9 (11–28.4) vs. 9.3 (6.7–10.6), p = 0.01), and higher PaCO2 (48 mmHg (46.5–63) vs. 41 mmHg (40–45), p = 0.07, that remained higher at 48 h: 54 mmHg (43–58.7) vs. 41 (38.5–45.5), p = 0.03). In 12 patients (5 COVID-19 and 7 non-COVID-19), AHRF evolved to pediatric acute respiratory distress syndrome (PARDS). All non-COVID-19 patients had severe PARDS, while 3 out of 5 patients in the COVID-19 group had mild or moderate PARDS. Overall Pediatric Intensive Care Medicine (PICU) mortality was 14.3%. Conclusions: Children with AHRF due to SARS-CoV2 infection had fewer comorbidities and better oxygenation than patients with non-COVID-19 AHRF. In this study, progression to severe PARDS was rarely observed in children with COVID-19.
Current Management Options in Irvine–Gass Syndrome: A Systemized Review
Authors: Orski Michał , Gawęcki Maciej
Published: September 2021

Irvine–Gass syndrome (IGS) remains one of the most common complications following uneventful cataract surgery. In most cases, macular edema (ME) in IGS is benign, self-limiting, and resolves spontaneously without visual impairment; however, persistent edema and refractory cases may occur and potentially deteriorate visual function. Despite the relatively high prevalence of IGS, no solid management guidelines exist. We searched the PUBMED database for randomized clinical trials (RCT) or case series of at least 10 cases published since 2000 evaluating different treatment strategies in patients with cystoid macular edema (CME). The search revealed 28 papers that fulfilled the inclusion criteria with only seven RCTs. The scarceness of material makes it impossible to formulate strong recommendations for the treatment of IGS. Clinical practice and theoretical background support topical non-steroidal anti-inflammatory drugs (NSAIDs) as the first-line therapy. Invasive procedures, such as periocular steroids, intravitreal corticosteroids, and anti-vascular endothelial growth factor (anti-VEGF), are usually applied in prolonged or refractory cases. Results of novel applications of subthreshold micropulse laser (SML) are also promising and should be studied carefully in terms of the safety profile and cost effectiveness. Early initiation of invasive treatment for providing better functional results must be examined in further research.
Incremental Diagnostic Value of CT Fractional Flow Reserve Using Subtraction Method in Patients with Severe Calcification: A Pilot Study
Authors: Kamo Yuki , Fujimoto Shinichiro , Nozaki Yui O. , Aoshima Chihiro , Kawaguchi Yuko O. , Dohi Tomotaka , Kudo Ayako , Takahashi Daigo , Takamura Kazuhisa , Hiki Makoto , Okai Iwao , Okazaki Shinya , Tomizawa Nobuo , Kumamaru Kanako K. , Aoki Shigeki , Minamino Tohru
Published: September 2021

Although on-site workstation-based CT fractional flow reserve (CT-FFR) is an emerging method for assessing vessel-specific ischemia in coronary artery disease, severe calcification is a significant factor affecting CT-FFR’s diagnostic performance. The subtraction method significantly improves the diagnostic value with respect to anatomic stenosis for patients with severe calcification in coronary CT angiography (CCTA). We evaluated the diagnostic capability of CT-FFR using the subtraction method (subtraction CT-FFR) in patients with severe calcification. This study included 32 patients with 45 lesions with severe calcification (Agatston score >400) who underwent both CCTA and subtraction CCTA using 320-row area detector CT and also received invasive FFR within 90 days. The diagnostic capabilities of CT-FFR and subtraction CT-FFR were compared. The sensitivities, specificities, positive predictive values (PPVs), and negative predictive values (NPVs) of CT-FFR vs. subtraction CT-FFR for detecting hemodynamically significant stenosis, defined as FFR ≤ 0.8, were 84.6% vs. 92.3%, 59.4% vs. 75.0%, 45.8% vs. 60.0%, and 90.5% vs. 96.0%, respectively. The area under the curve for subtraction CT-FFR was significantly higher than for CT-FFR (0.84 vs. 0.70) (p = 0.04). The inter-observer and intra-observer variabilities of subtraction CT-FFR were 0.76 and 0.75, respectively. In patients with severe calcification, subtraction CT-FFR had an incremental diagnostic value over CT-FFR, increasing the specificity and PPV while maintaining the sensitivity and NPV with high reproducibility.
Does a Very Short Length of Abstinence Improve Assisted Reproductive Technique Outcomes in Infertile Patients with Severe Oligo-Asthenozoospermia?
Authors: Barbagallo Federica , Calogero Aldo E. , Condorelli Rosita A. , Farrag Ashraf , Jannini Emmanuele A. , La Vignera Sandro , Manna Claudio
Published: September 2021

In recent years, a growing number of studies seem to support the beneficial effects of a very short abstinence period on sperm parameters, especially in patients with oligo-asthenozoospermia (OA). On this basis, the aim of this study was to evaluate the effects of a short period of abstinence (1 h) on intracytoplasmic sperm injection (ICSI) outcomes in infertile patients with severe OA. We performed a retrospective study on 313 ICSI cycles in which couples were divided into two different groups based on sperm parameters of the male partners. Group 1 included normozoospermic men or male partners with a mild OA (n = 223). Group 2 included male partners with severe OA (n = 90). They were asked to provide a second consecutive ejaculation after 1 h from the first one. The best ejaculate was used to perform ICSI. We found a significant increase of total (p < 0.001) and progressive motility (p < 0.001) in the second ejaculate of patients of Group 2 compared with those of the first one. Spermatozoa of the second ejaculate were chosen for ICSI for all patients in Group 2. We found statistically significant improvement of clinical pregnancy rate (p = 0.001) and embryo quality (p = 0.003) in couples in Group 2 compared to those of Group 1. No statistically significant difference was found in fertilization, implantation, live birth delivery, and miscarriage rates between the two groups. Therefore, a second semen sample collected after a very short time-interval in patients with severe OA allowed us to obtain significantly higher clinical pregnancy rate with improved embryo quality compared to normozoospermic men or patients with mild OA. Fertilization, implantation, live birth delivery, and miscarriage rates were similar between the two groups. The present study shows that a second consecutive ejaculate could represent a simple strategy to obtain better sperm parameters and assisted reproductive technology (ART) outcomes in infertile patients with mild-severe OA.
Distinct Effects of Interleukin-1β Inhibition upon Cytokine Profile in Patients with Adult-Onset Still’s Disease and Active Articular Manifestation Responding to Canakinumab
Authors: Ghannam Khetam , Zernicke Jan , Kedor Claudia , Listing Joachim , Burmester Gerd-R. , Foell Dirk , Feist Eugen
Published: September 2021

Adult-onset Still’s disease (AOSD) is a systemic auto-inflammatory disease characterized by the presence of immunologically mediated inflammation and deficient resolution of inflammation. Canakinumab is an approved IL-1β inhibitor in the treatment of AOSD with a balanced efficacy and safety profile. Since inflammatory cytokines play a major role in the pathogenesis of AOSD, we investigated the effects of canakinumab on the cytokine profile of AOSD patients from a randomized controlled trial. Multiplex analysis and ELISA were used to test the concentrations of several cytokines at three time points—week 0 (baseline), week 1 and week 4—in two patient groups—placebo and canakinumab. Two-way repeated-measures analysis of variance revealed a significant temporal effect on the concentrations of MRP 8/14, S100A12, IL-6 and IL-18 with a significant decrease at week 4 in the canakinumab group exclusively. Comparing responders with non-responders to canakinumab showed a significant decrease in MRP 8/14, IL-1RA, IL-18 and IL-6 in responders at week 4, while S100A12 levels decreased significantly in responders and non-responders. In summary, canakinumab showed a striking effect on the cytokine profile in patients with AOSD, exhibiting a clear association with clinical response.
Sexuality, Quality of Life, Anxiety, Depression, and Anger in Patients with Anal Fissure. A Case–Control Study
Authors: Navarro-Sánchez Antonio , Luri-Prieto Paloma , Compañ-Rosique Antonio , Navarro-Ortiz Ramón , Berenguer-Soler María , Gil-Guillén Vicente F. , Cortés-Castell Ernesto , Navarro-Cremades Felipe , Gómez-Pérez Luis , Pérez-Tomás Carla , Palazón-Bru Antonio , Montejo Angel L. , Pérez-Jover Virtudes
Published: September 2021

Anal fissures (AFs) are lesions located in the lower anal canal. They can be primary (chronic or acute) or secondary to a basic disease. There is high comorbidity of depression and anxiety in patients with chronic AF, with poorer quality of life (QoL) and sexual function. This is a case–control study carried out in the San Juan Hospital (Alicante, Spain). Sixty-seven participants were included in the study, including 35 cases and 32 controls: 36 males and 31 females. This study aims to investigate the association of presenting AFs with sexuality, quality of life, anxiety, depression, and anger. The instruments used were the Spanish validated versions of the validated original selected questionnaires. These instruments were used to assess health-related quality of life, anxiety, anger, depression, and sexual function. Results show higher values in cases than in controls with statistical significance in anxiety state and trait; anxiety and depression; bodily pain, general health, and vitality; and 10 of the 12 anger factors. Higher values in controls than in cases with statistical significance in sexuality and many of the QoL factors were found. Addressing these issues in AF surgical patients would be beneficial for their clinical assessment and intervention.
Impact of Biological Agents on Postsurgical Complications in Inflammatory Bowel Disease: A Multicentre Study of Geteccu
Authors: García María José , Rivero Montserrat , Miranda-Bautista José , Bastón-Rey Iria , Mesonero Francisco , Leo-Carnerero Eduardo , Casas-Deza Diego , Cagigas Fernández Carmen , Martin-Cardona Albert , El Hajra Ismael , Hernández-Aretxabaleta Nerea , Pérez-Martínez Isabel , Fuentes-Valenzuela Esteban , Jiménez Nuria , Rubín de Célix Cristina , Gutiérrez Ana , Suárez Ferrer Cristina , Huguet José María , Fernández-Clotet Agnes , González-Vivó María , Del Val Blanca , Castro-Poceiro Jesús , Melcarne Luigi , Dueñas Carmen , Izquierdo Marta , Monfort David , Bouhmidi Abdel , Ramírez De la Piscina Patricia , Romero Eva , Molina Gema , Zorrilla Jaime , Calvino-Suárez Cristina , Sánchez Eugenia , Nuñez Andrea , Sierra Olivia , Castro Beatriz , Zabana Yamile , González-Partida Irene , De la Maza Saioa , Castaño Andrés , Nájera-Muñoz Rodrigo , Sánchez-Guillén Luis , Riat Castro Micaela , Rueda José Luis , Benítez José Manuel , Delgado-Guillena Pedro , Tardillo Carlos , Peña Elena , Frago-Larramona Santiago , Rodríguez-Grau María Carmen , Plaza Rocío , Pérez-Galindo Pablo , Martínez-Cadilla Jesús , Menchén Luis , Barreiro-De Acosta Manuel , Sánchez-Aldehuelo Rubén , De la Cruz María Dolores , Lamuela Luis Javier , Marín Ignacio , Nieto-García Laura , López-San Román Antonio , Herrera José Manuel , Chaparro María , Gisbert Javier P. ,   on behalf of the Young Group of GETECCU
Published: September 2021

Background: The impact of biologics on the risk of postoperative complications (PC) in inflammatory bowel disease (IBD) is still an ongoing debate. This lack of evidence is more relevant for ustekinumab and vedolizumab. Aims: To evaluate the impact of biologics on the risk of PC. Methods: A retrospective study was performed in 37 centres. Patients treated with biologics within 12 weeks before surgery were considered “exposed”. The impact of the exposure on the risk of 30-day PC and the risk of infections was assessed by logistic regression and propensity score-matched analysis. Results: A total of 1535 surgeries were performed on 1370 patients. Of them, 711 surgeries were conducted in the exposed cohort (584 anti-TNF, 58 vedolizumab and 69 ustekinumab). In the multivariate analysis, male gender (OR: 1.5; 95% CI: 1.2–2.0), urgent surgery (OR: 1.6; 95% CI: 1.2–2.2), laparotomy approach (OR: 1.5; 95% CI: 1.1–1.9) and severe anaemia (OR: 1.8; 95% CI: 1.3–2.6) had higher risk of PC, while academic hospitals had significantly lower risk. Exposure to biologics (either anti-TNF, vedolizumab or ustekinumab) did not increase the risk of PC (OR: 1.2; 95% CI: 0.97–1.58), although it could be a risk factor for postoperative infections (OR 1.5; 95% CI: 1.03–2.27). Conclusions: Preoperative administration of biologics does not seem to be a risk factor for overall PC, although it may be so for postoperative infections.
XEN Glaucoma Implant for the Management of Glaucoma in Naïve Patients versus Patients with Previous Glaucoma Surgery
Authors: Lewczuk Katarzyna , Konopińska Joanna , Jabłońska Joanna , Rudowicz Jacek , Laszewicz Patrycja , Dmuchowska Diana Anna , Mariak Zofia , Rękas Marek
Published: September 2021

This retrospective study analyzed the surgical and refractive outcomes of a XEN Gel Implant (Allergan, Abbvie Company, Irvine, CA, USA) in naïve patients versus those with previous glaucoma surgery. We evaluated the efficacy of XEN implantation in 86 glaucoma patients during a long-term follow-up period. Patients were divided into two groups: naïve patients (Group 1) and patients with previous glaucoma surgery (Group 2). Eyes that received a XEN Gel Stent placement from December 2014 to October 2019 were included. Intraocular pressure (IOP) change, corrected distance visual acuity (CDVA), change in glaucoma medications, frequency of slit lamp revision procedures, and frequency of secondary glaucoma surgeries were the primary outcomes. In Group 1, the mean IOP before surgery was decreased significantly from 25.00 ± 7.52 mmHg to 16.83 ± 5.12 mmHg by the end of the study. In Group 2, the mean IOP decreased significantly from 25.35 ± 7.81 mmHg to 17.54 ± 5.34 mmHg. The mean IOP decrease from baseline was 29% in Group 1 and 27% in Group 2 (p = 0.567). There were no significant differences between the groups in the IOP baseline level, the final level, or the change between preoperative and final levels. The qualified success rate for Group 2 was 68.7% versus 76.5% for Group 1 for the initial procedure and 15.4% vs. 20.2%, respectively, for complete success rate (p > 0.05). However, at the end of the follow-up, more patients achieved an IOP < 18 mmHg in Group 1 than in Group 2. Despite the need for more anti-glaucoma medications, repeat XEN Gel implantation appears to show promising results in patients with previously failed anti-glaucoma procedures, owing to its minimal invasiveness.
Using Deep Neural Networks for Predicting Age and Sex in Healthy Adult Chest Radiographs
Authors: Yang Chung-Yi , Pan Yi-Ju , Chou Yen , Yang Chia-Jung , Kao Ching-Chung , Huang Kuan-Chieh , Chang Jing-Shan , Chen Hung-Chieh , Kuo Kuei-Hong
Published: September 2021

Background: The performance of chest radiography-based age and sex prediction has not been well validated. We used a deep learning model to predict the age and sex of healthy adults based on chest radiographs (CXRs). Methods: In this retrospective study, 66,643 CXRs of 47,060 healthy adults were used for model training and testing. In total, 47,060 individuals (mean age ± standard deviation, 38.7 ± 11.9 years; 22,144 males) were included. By using chronological ages as references, mean absolute error (MAE), root mean square error (RMSE), and Pearson’s correlation coefficient were used to assess the model performance. Summarized class activation maps were used to highlight the activated anatomical regions. The area under the curve (AUC) was used to examine the validity for sex prediction. Results: When model predictions were compared with the chronological ages, the MAE was 2.1 years, RMSE was 2.8 years, and Pearson’s correlation coefficient was 0.97 (p < 0.001). Cervical, thoracic spines, first ribs, aortic arch, heart, rib cage, and soft tissue of thorax and flank seemed to be the most crucial activated regions in the age prediction model. The sex prediction model demonstrated an AUC of >0.99. Conclusion: Deep learning can accurately estimate age and sex based on CXRs.
Hypoalgesic and Motor Effects of Neural Mobilisation versus Soft-Tissue Interventions in Experimental Craniofacial Hyperalgesia: A Single-Blinded Randomised Controlled Trial
Authors: Díaz-Sáez Marta , Sáenz-Jiménez Cristina , Villafañe Jorge Hugo , Paris-Alemany Alba , La Touche Roy
Published: September 2021

Objective: The present trial aimed to compare the effects of the mobilisation of the nervous system (NS) to those of a soft-tissue intervention in subjects exposed to an experimentally induced hyperalgesia of the masticatory muscles. Methods: The study was a single-blinded randomised controlled trial. A total of 49 participants (mean ± SD age: 41 ± 11 years; 61% female) with latent myofascial trigger points (LMTrPs) in the craniofacial region were randomly assigned to one of three groups: neural mobilisation (NM), soft-tissues techniques and stretching (STT-S), and control group (CG). An initial assessment (baseline) was performed before the provocation chewing masticatory test. The pre-treatment measurements were registered 24 h later. Next, the randomised intervention was applied, and afterwards, post-treatment data were obtained. Outcome measures included pain-free maximum mouth opening (MMO), pressure pain thresholds (PPTs) in the trigeminal and cervical region, and trigeminal and cervical two-point discrimination (TPD). Results: ANOVA revealed significant differences for the time × group interaction for pain-free MMO and PPTs. The results showed an improvement in the MMO and the PPTs for NM and STT-S groups but not for the CG. There were no differences between the NM and STT-S groups. However, the effect sizes were large for the NM and medium for the STT-S. No differences were found for TDP between groups nor over time. Conclusions: The results show that with NM and STT-S techniques, we could influence motor and sensory variables in asymptomatic subjects with LMTrPs after a masticatory provocation test. Both techniques increased MMO and PPTs in the short term. These beneficial effects lead us to consider the importance of including these methods in clinical practice.
The Accuracy of a Screening System for Carpal Tunnel Syndrome Using Hand Drawing
Authors: Watanabe Takuro , Koyama Takafumi , Yamada Eriku , Nimura Akimoto , Fujita Koji , Sugiura Yuta
Published: September 2021

When carpal tunnel syndrome (CTS), an entrapment neuropathy, becomes severe, thumb motion is reduced, which affects manual dexterity, such as causing difficulties in writing; therefore, early detection of CTS by screening is desirable. To develop a screening method for CTS, we developed a tablet app to measure the stylus trajectory and pressure of the stylus tip when drawing a spiral on a tablet screen using a stylus and, subsequently, used these data as training data to predict the classification of participants as non-CTS or CTS patients using a support vector machine. We recruited 33 patients with CTS and 31 healthy volunteers for this study. From our results, non-CTS and CTS were classified by our screening method with 82% sensitivity and 71% specificity. Our CTS screening method can facilitate the screening for potential patients with CTS and provide a quantitative assessment of CTS.
Neuropathic Pain in Hand Osteoarthritis: A Cross-Sectional Study
Authors: Magni Nico , Collier Jill , McNair Peter , Rice David A.
Published: September 2021

Symptomatic hand osteoarthritis (OA) is a severely debilitating condition. Neuropathic pain (NP) has been shown to be a factor affecting pain severity, hand function, psychological wellbeing, body schema, and the number of pain medications in people with OA of other joints. The aim of this study was to assess the prevalence of NP in symptomatic hand OA and assess its association with pain, hand function, measures of psychological wellbeing, sleep, body schema disturbances, and number of pain medications. Participants with symptomatic hand OA diagnosed through the American College of Rheumatology criteria, were recruited and completed a series of online questionnaires. These included the Douleur Neuropathique 4 interview (DN4-interview), Short Form Brief Pain Inventory (SF-BPI), Neglect-like Symptoms questionnaire, Functional Index of Hand Osteoarthritis (FIHOA), Centre for Epidemiologic Studies Depression Scale (CES-D), Pain Catastrophising Scale (PCS), and the Pittsburgh Sleep Quality Index (PSQI). Logistic regression with age, body mass index, and sex as covariates were utilised to assess differences between participants with and without NP as identified through the DN4-interview. Correlation analysis assessed the relationship between pain intensity, body schema alterations, and number of pain medications. A total of 121 participants were included in the present study. Forty-two percent of participants presented with NP. Participants with NP reported higher levels of worst pain (OR: 10.2 95% CI: 2.2 to 48.5; p = 0.007). Worst pain intensity correlated with the number of pain medications (rho = 0.2; p = 0.04), and neglect-like symptoms (rho = 0.4; p < 0.0001). No difference between phenotypes was shown for catastrophising, function, depression, neglect-like symptoms, pain interference, or sleep. A large proportion of people with symptomatic hand OA present with NP. This phenotype is characterised by greater levels of pain intensity. Pain intensity is associated with number of pain relief medications and body schema alteration. Psychological factors, hand function, and sleep do not appear to be affected by the presence of NP.
Minimal Dentinal Tubule Penetration of Endodontic Sealers in Warm Vertical Compaction by Direct Detection via SEM Analysis
Authors: Schmidt Sina , Schäfer Edgar , Bürklein Sebastian , Rohrbach Arno , Donnermeyer David
Published: September 2021

Sealer staining using rhodamine B dye to investigate the penetration depth of endodontic sealers was proven unsuitable for this purpose. This study aimed to investigate the sealer penetration depth into dentinal tubules by scanning electron microscopy (SEM). Root canals of 52 human upper central incisors were instrumented using the ProTaper Gold NiTi system (Dentsply Sirona, York, PA, USA) up to size F3. After irrigation with sodium hypochlorite and citric acid combined with ultrasonic activation, the root canals were either filled using the epoxy resin sealer AH Plus (Dentsply Sirona) or the calcium silicate-based sealer Total Fill BC Sealer HiFlow (TFHF, FKG Dentaire, La Chaux-de-Fonds, Switzerland) by warm vertical compaction. Root slices of 1 mm thickness were obtained at 2 to 3, 5 to 6 and 8 to 9 mm from the apex. The root slices were investigated for sealer penetration into the dentinal tubules using SEM according to four root quadrants (buccal, mesial, oral, distal). Statistical analysis was performed by the Kruskal-Wallis test (p = 0.05) as data were not normally distributed according to the Shapiro-Wilk test. AH Plus penetrated significantly deeper into the dentinal tubules compared to TFHF at each root level (p < 0.05). Dentinal sealer penetration was deeper in the bucco-oral direction compared to the mesio-distal direction. AH Plus penetrated deeper into dentinal tubules than TFHF. Warm vertical compaction exerting high pressure on the root canal filling material is not able to press sealers deep into dentinal tubules as penetration depth values did not exceed a mean of 110 µm in SEM.
Radial Basis Function Neural Network Sliding Mode Control for Ship Path Following Based on Position Prediction
Authors: Zhang Hugan , Zhang Xianku , Bu Renxiang
Published: September 2021

In the process of ship navigation, due to the characteristics of large inertia and large time delay, overshoot can easily occur in the process of path following. Once the ship deviates from the waypoint, it is prone to grounding and collision. Considering this problem, a sliding mode control algorithm based on position prediction using the radial basis function (RBF) neural network is proposed. The desired heading angle is designed according to a backstepping algorithm. The hyperbolic tangent function is used to design the sliding surface, and the course is controlled by sliding mode control. The second-order Taylor expansion is used to predict the future position, the current error and future error functions are constructed, and the total errors are fed back to the desired heading angle. In the sliding mode control system, the RBF neural network is used to approximate the total unknown term, and a velocity observer is introduced to obtain the surge velocity and sway velocity. To verify the effectiveness of the algorithm, the mathematical model group (MMG) model is used for simulation. The simulation results show the effectiveness and superiority of the designed controller. Therefore, the RBF neural network sliding mode controller based on predicted position has robustness for ship path following.
The Biology of Mesopelagic Fishes and Their Catches (1950–2018) by Commercial and Experimental Fisheries
Authors: Pauly Daniel , Piroddi Chiara , Hood Lincoln , Bailly Nicolas , Chu Elaine , Lam Vicky , Pakhomov Evgeny A. , Pshenichnov Leonid K. , Radchenko Vladimir I. , Palomares Maria Lourdes D.
Published: September 2021

Following a brief review of their biology, this contribution is an attempt to provide a global overview of the catches of mesopelagic fishes (of which 2.68 million tonnes were officially reported to the FAO) throughout the world ocean from 1950 to 2018, to serve as a baseline to a future development of these fisheries. The overview is based on a thorough scanning of the literature dealing with commercial or experimental fisheries for mesopelagics and their catches, and/or the mesopelagic bycatch of other fisheries. All commercial (industrial and artisanal) fisheries for mesopelagic fishes were included, as well as experimental fisheries of which we were aware, while catches performed only to obtain scientific samples were omitted. The processes of generating bycatch and causing discards are discussed, with emphasis on Russian fisheries. From peer-reviewed and gray literature, we lifted information on mesopelagic fisheries and assembled it into one document, which we then summarized into two text tables with catch data, one by country/region, the other by species or species groups.
Assessment of the Spatial Distribution and Risk Associated with Fruit Rot Disease in Areca catechu L.
Authors: Balanagouda Patil , Sridhara Shankarappa , Shil Sandip , Hegde Vinayaka , Naik Manjunatha K. , Narayanaswamy Hanumappa , Balasundram Siva K.
Published: September 2021

Phytophthora meadii (McRae) is a hemibiotrophic oomycete fungus that infects tender nuts, growing buds, and crown regions, resulting in fruit, bud, and crown rot diseases in arecanut (Areca catechu L.), respectively. Among them, fruit rot disease (FRD) causes serious economic losses that are borne by the growers, making it the greatest yield-limiting factor in arecanut crops. FRD has been known to occur in traditional growing areas since 1910, particularly in Malnad and coastal tracts of Karnataka. Systemic surveys were conducted on the disease several decades ago. The design of appropriate management approaches to curtail the impacts of the disease requires information on the spatial distribution of the risks posed by the disease. In this study, we used exploratory survey data to determine areas that are most at risk. Point pattern (spatial autocorrelation and Ripley’s K function) analyses confirmed the existence of moderate clustering across sampling points and optimized hotspots of FRD were determined. Geospatial techniques such as inverse distance weighting (IDW), ordinary kriging (OK), and indicator kriging (IK) were performed to predict the percent severity rates at unsampled sites. IDW and OK generated identical maps, whereby the FRD severity rates were higher in areas adjacent to the Western Ghats and the seashore. Additionally, IK was used to identify both disease-prone and disease-free areas in Karnataka. After fitting the semivariograms with different models, the exponential model showed the best fit with the semivariogram. Using this model information, OK and IK maps were generated. The identified FRD risk areas in our study, which showed higher disease probability rates (>20%) exceeding the threshold level, need to be monitored with the utmost care to contain and reduce the further spread of the disease in Karnataka.
Augmenting the Activity of Chlorhexidine for Decolonization of Candida auris from Porcine skin
Authors: Johnson Chad J. , Eix Emily F. , Lam Brandon C. , Wartman Kayla M. , Meudt Jennifer J. , Shanmuganayagam Dhanansayan , Nett Jeniel E.
Published: September 2021

Candida auris readily colonizes skin and efficiently spreads among patients in healthcare settings worldwide. Given the capacity of this drug-resistant fungal pathogen to cause invasive disease with high mortality, hospitals frequently employ chlorhexidine bathing to reduce skin colonization. Using an ex vivo skin model, we show only a mild reduction in C. auris following chlorhexidine application. This finding helps explain why chlorhexidine bathing may have failures clinically, despite potent in vitro activity. We further show that isopropanol augments the activity of chlorhexidine against C. auris on skin. Additionally, we find both tea tree (Melaleuca alternifolia) oil and lemongrass (Cymbopogon flexuosus) oil to further enhance the activity of chlorhexidine/isopropanol for decolonization. We link this antifungal activity to individual oil components and show how some of these components act synergistically with chlorhexidine/isopropanol. Together, the studies provide strategies to improve C. auris skin decolonization through the incorporation of commonly used topical compounds.
Advances in Personalized Medicines along with Functional Genomics and Pharmacogenomics
Authors: Lee Su-Jun
Published: September 2021

State-of-the-art research on the human genome has produced remarkable research achievements in pharmacogenomics and functional genomics, and these research results are making an invaluable contribution to the advancement of personalized medicine [...]
Management of COVID-19 Patients in the Emergency Department
Authors: Pantazopoulos Ioannis , Tsikrika Stamatoula , Kolokytha Stavroula , Manos Emmanouil , Porpodis Konstantinos
Published: September 2021

COVID-19 is an emerging disease of global public health concern. As the pandemic overwhelmed emergency departments (EDs), a restructuring of emergency care delivery became necessary in many hospitals. Furthermore, with more than 2000 papers being published each week, keeping up with ever-changing information has proven to be difficult for emergency physicians. The aim of the present review is to provide emergency physician with a summary of the current literature regarding the management of COVID-19 patients in the emergency department.
Novel Digital Measurement Technique to Analyze the Palatine Suture Expansion after Palatine Rapid Maxillary Expansion Technique
Authors: Requena Pérez Mariano , Zubizarreta-Macho Álvaro , Colino Gallardo Pedro , Albaladejo Martínez Alberto , Garcovich Daniele , Alvarado-Lorenzo Alfonso
Published: September 2021

The aim of the study was to validate a novel digital measurement method to quantify the volume of the midpalatal suture after rapid maxillary expansion (RME). Material and methods: Eight patients with maxillary skeletal transverse deficiency were submitted to palatine suture expansion using the McNamara orthodontic appliance during a period of nine months. After 30 days of treatment, all patients were exposed postoperatively to a cone-beam computed tomography (CBCT) scan. Afterwards, the scans were uploaded into the three-dimensional orthodontic-planning software to allow the volumetric assessment of the palatine suture expansion through palatine rapid maxillary expansion using a McNamara appliance. The repeatability was analyzed by repeating twice the measures by a single operator and reproducibility was analyzed by repeating three times the measures by two operators, and Gage R&R statistical analysis was performed. Results: The expansion of the midpalatal suture by means of the rapid maxillary expansion technique, in terms of digital volume measurement, showed a repeatability value of 0.09% and between the two operators a reproducibility value of 0.00% was shown. Conclusions: The novel measurement technique demonstrated a high repeatability and reproducibility rate for volume assessment of the palatine suture expansion through palatine rapid maxillary expansion technique.
Influence of the Computer-Aided Static Navigation Technique and Mixed Reality Technology on the Accuracy of the Orthodontic Micro-Screws Placement. An In Vitro Study
Authors: Riad Deglow Elena , Toledano Gil Sergio , Zubizarreta-Macho Álvaro , Bufalá Pérez María , Rodríguez Torres Paulina , Tzironi Georgia , Albaladejo Martínez Alberto , López Román Antonio , Hernández Montero Sofía
Published: September 2021

To analyze the effect of a computer-aided static navigation technique and mixed reality technology on the accuracy of orthodontic micro-screw placement. Material and methods: Two hundred and seven orthodontic micro-screws were placed using either a computer-aided static navigation technique (NAV), a mixed reality device (MR), or a conventional freehand technique (FHT). Accuracy across different dental sectors was also analyzed. CBCT and intraoral scans were taken both prior to and following orthodontic micro-screw placement. The deviation angle and horizontal deviation were then analyzed; these measurements were taken at the coronal entry point and apical endpoint between the planned and performed orthodontic micro-screws. In addition, any complications resulting from micro-screw placement, such as spot perforations, were also analyzed across all dental sectors. Results: The statistical analysis showed significant differences between study groups with regard to the coronal entry-point (p < 0.001). The NAV study group showed statistically significant differences from the FHT (p < 0.001) and MR study groups (p < 0.001) at the apical end-point (p < 0.001), and the FHT group found significant differences from the angular deviations of the NAV (p < 0.001) and MR study groups deviations (p = 0.0011). Different dental sectors also differed significantly. (p < 0.001) Additionally, twelve root perforations were observed in the FHT group, while there were no root perforations in the NAV group. Conclusions: Computer-aided static navigation technique enable more accurate orthodontic micro-screw placement and fewer intraoperative complications when compared with the mixed reality technology and conventional freehand techniques.