bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparative Feeding and Defecation Behaviors of Trypanosoma cruzi-Infected and Uninfected Triatomines (Hemiptera: Reduviidae) from the Americas
Authors: Killets Keswick C. , Wormington Jillian , Zecca Italo , Chaves Luis Fernando , Hamer Gabriel L. , Hamer Sarah A.
Published: February 2025

Triatomines are vectors of Trypanosoma cruzi (Kinetoplastida: Trypanosomatidae), the agent of Chagas disease. Stercorarian transmission occurs when infectious parasites are passed in insect feces to vertebrates through the biting wound or mucosa. Defecating on hosts during or shortly after blood feeding is, therefore, critical for transmission, and delayed triatomine defecation behavior has been posited to contribute to a low incidence of human Chagas disease in the U.S. We allowed nymphal T. cruzi-infected and uninfected Triatoma gerstaeckeri (Stål, 1859) and Triatoma sanguisuga (LeConte, 1855) to interact with restrained guinea pigs and measured insect feeding and defecation events; South American Rhodnius prolixus (Stål, 1859; Latin America) served as a comparison group. In 148 trials, 40.0% of insects fed, of which 71.2% defecated. Compared to R. prolixus, T. gerstaeckeri had >9 times higher odds of feeding, and T. sanguisuga fed longer. Observations of defecation while feeding occurred across all three species. The post-feeding defecation interval (PFDI) of R. prolixus was significantly shorter (4.54 ± 2.46 min) than that of T. gerstaeckeri (9.75 ± 2.52 min) and T. sanguisuga (20.69 ± 8.98 min). Furthermore, the PFDI was shorter for TcI-infected insects compared to uninfected insects. Triatoma gerstaeckeri and T. sanguisuga are capable of stercorarian transmission, although the calculated metrics suggest they are less efficient vectors than R. prolixus.
Pattern of Diversity and Prediction of Suitable Areas of Grasshoppers from the Qinghai–Tibet Plateau in China (Orthoptera: Acridoidea)
Authors: Bao Bowen , Wang Xicheng , Peng Zhenrui , Zhu Qingyao , Li Xinjiang , Zhang Daochuan
Published: February 2025

The Qinghai–Tibet Plateau is recognized as a biodiversity hotspot, with a wide variety of grasshopper species, including several endemic to the region, which play significant roles in both agricultural and forestry ecosystems. The purpose of this study was to analyze the species diversity and distribution pattern of grasshoppers on the Qinghai–Tibet Plateau. A comprehensive database comprising 390 grasshopper species was established through specimen collection, a literature review, and a geographical distribution data analysis. Diversity analysis showed that the diversity of species under the five vegetation types was relatively average. However, the alpine cold vegetation of Qinghai–Tibet and subtropical evergreen broad-leaved forest still showed a relatively high Shannon index and Simpson index. Grasshopper species are mainly concentrated in the eastern and southern parts of the Qinghai–Tibet Plateau. The richness pattern showed that grasshopper species diversity was particularly high in certain mountain areas, with Bayankala Mountain and Hengduan Mountain being endemic hotspots. The MaxEnt models were used to assess the potential habitats for four dominant genera of grasshoppers under projected climate change scenarios for 2050 and 2070. Altitude was the factor affecting the distribution of Locusta, Chorthippus, and Kingdonella, while precipitation and temperature were the factors affecting the distribution of Leuconemacris. These findings improve our understanding of the distribution patterns of different grasshopper species across various habitat types on the Qinghai–Tibet Plateau and provide valuable insights for developing targeted ecological protection strategies in response to environmental changes.
Routing Protocols Performance on 6LoWPAN IoT Networks
Authors: Chia Pei Siang , Kamis Noor Hisham , Abdul Razak Siti Fatimah , Yogarayan Sumendra , Yassin Warusia , Abdollah Mohd Faizal
Published: February 2025

IPv6 over Low-Power Wireless Personal Area Networks (6LoWPAN) are specifically designed for applications that require lower data rates and reduced power consumption in wireless internet connectivity. In the context of 6LoWPAN, Internet of Things (IoT) devices with limited resources can now seamlessly connect to the network using IPv6. This study focuses on examining the performance and power consumption of routing protocols in the context of 6LoWPAN, drawing insights from prior research and utilizing simulation techniques. The simulation involves the application of routing protocols, namely Routing Protocol for Low-power and Lossy (RPL) Networks, Ad hoc On-demand Distance Vector (AODV), Lightweight On-demand Ad hoc Distance-vector Next Generation (LOADng), implemented through the Cooja simulator. The simulation also runs in different network topologies to gain an insight into the performance of the protocols in the specific topology including random, linear, and eclipse topology. The raw data gathered from the tools including Powertrace and Collect-View were then analyzed with Python code to transfer into useful information and visualize the graph. The results demonstrate that the power consumption, specifically CPU power, Listen Power, and Total Consumption Power, will increase with the incremental of motes. The result also shows that RPL is the most power-efficient protocol among the scenarios compared to LOADng and AODV. The result is helpful because it brings insights into the performance, specifically power consumption in the 6LoWPAN network. This result is valuable to further implement these protocols in the testbed as well as provide an idea of the algorithmic enhancements.
Evaluation of Dose Reduction Factors and Impact on Progression-Free Survival in Patients Treated with CDK 4/6 Inhibitors
Authors: Güren Ali Kaan , Guliyev Murad , Alan Özkan , Çadırci Kıvanç , Belevi İpek Naz , Gültürk İlkay , Özge Emre , Kocaaslan Erkam , Ağyol Yeşim , Erel Pınar , Paçacı Burak , Tunç Mustafa Alperen , Majidova Nargiz , Sever Nadiye , Çelebi Abdussamet , Arıkan Erdoğan Rukiye , Işık Selver , Demirci Nebi Serkan , Sarı Murat , Köstek Osman , Bayoğlu İbrahim Vedat
Published: February 2025

Introduction: CDK 4/6 inhibitors are effectively utilized among patients with hormone-positive, HER-2-negative metastatic breast cancer. The dose reduction for these patients varies between 35% and 57% across multiple trials. We aim to clarify the characteristics of patients who had dosage reduction and the effect of this reduction on survival outcomes. Materials and Methods: The study was designed as a retrospective, multicenter study. Patients who received CDK 4/6 inhibitors in the first-line and subsequent treatment settings were grouped based on dose reductions. Progression-free survival was compared between these groups, and factors influencing dose reduction were analyzed. Results: Multivariate logistic regression study demonstrated that patients aged 65 and older, with a Charlson CI score of 2 or higher, having metastases in three or more sites, and classed as normal weight, had greater dosage reductions. Dose reduction had no impact on progression-free survival (PFS) (p = 0.114 for first-line treatment, p = 0.528 for second and subsequent-line treatment; p > 0.05). Conclusions: Regarding the absence of disparity in progression-free survival between patients with dose reduction and those without, dose reduction should not be avoided in certain patient groups to ensure therapy continuity and mitigate potential adverse effects.
The Prognostic Value of Systemic Inflammation Index in Breast Cancer: A Retrospective Study in Western Romania
Authors: Ciurescu Sebastian , Tomescu Larisa , Șerban Denis , Nicolae Nicoleta , Nan Georgiana , Buciu Victor , Ilaș Diana-Gabriela , Cîtu Cosmin , Vernic Corina , Sas Ioan
Published: February 2025

Background/Objectives: Breast cancer remains a leading cause of cancer-related morbidity worldwide, and refining prognostic tools is essential for individualized patient management. Recent evidence suggests that the systemic immune–inflammation index (SII), derived from routine blood tests, may offer valuable prognostic insights. This study aimed to evaluate whether SII can reliably predict clinical outcomes for patients undergoing curative resection. Methods: We retrospectively analyzed patients with histologically confirmed breast cancer who underwent surgical intervention at a single tertiary center. Preoperative complete blood counts were used to calculate SII. Using receiver operating characteristic (ROC) curve analysis, we identified an optimal SII cutoff. Using statistical tests, including t-tests and ANOVA, we examined differences in clinicopathological factors between low- and high-SII groups. Using univariate and multivariate analyses, we explored associations between SII and variables such as tumor stage and hormone receptor status. Results: Patients with elevated SII levels showed significant associations with more advanced tumor stage and systemic inflammatory profiles. The identified SII cutoff separated patients into distinct risk groups, and high SII values correlated with poorer prognostic features. Multivariate models indicated that SII provided additional predictive value beyond standard markers. Conclusions: Our findings suggest that SII may provide prognostic insights into breast cancer, particularly in stratifying patients based on inflammatory profiles. However, the current study does not support the use of SII as a clinical tool for tailoring treatment strategies. Further preclinical and randomized controlled trials are required to determine its predictive utility and to assess its potential integration into personalized management approaches.
CBCT-Based Morphological Study of the Accessory Foramina of the Canalis Sinuosus: Prevalence, Morphological Variants, and Significance for Implant Surgery
Authors: Schnutenhaus Sigmar , Heckemann Christian , Götz Werner , Olms Constanze
Published: February 2025

Objective: The canalis sinuosus in the premaxillary region often has accessory canals palatal to the central and lateral incisors. These small anatomical structures are of increasing interest due to numerous case reports of postoperative complications following surgery in the upper anterior region. Methods: This study examined the number, position, and extent of the accessory foramina of the canalis sinuosus in 210 patients. Furthermore, this study examined the distances to neighboring teeth and to the buccal cortical bone in edentulous patients. Three-dimensional tomographic (CBCT) images were created with a resolution of 0.2 voxels and were evaluated using the Osirix MD 11.0 program. Results: The results showed a prevalence of 97% for accessory foramina, confirming them as a clear anatomical structure. Males had significantly more terminal openings of the canalis sinuosus than females, with clustering in the fourth to sixth decades of life. The foramina had a mean extension of 0.9 mm and a mean distance of 4.6 mm to adjacent teeth. Conclusions: This narrow position is particularly relevant for surgical procedures. Greater attention should be focused on larger foramina in implant planning, as postoperative complications are increasingly being described. Foramina and accessory canals should be detected in three-dimensional, navigated implant planning in order to minimize the risk of injury during oral surgery.
Effectiveness of Brodalumab for the Treatment of Moderate-to-Severe Psoriasis: A Retrospective, Real-World Multicenter Study with a Focus on Obese and Multi-Failure Patients—IL PSO (Italian Landscape Psoriasis)
Authors: Orsini Diego , Graceffa Dario , Burlando Martina , Campanati Anna , Campione Elena , Guarneri Claudio , Narcisi Alessandra , Pella Paolo , Romita Paolo , Travaglini Massimo , Zichichi Leonardo , Arancio Luisa , Baggini Ginevra , Balestri Riccardo , Bianchelli Tommaso , Bianchi Luca , Brunasso Alexandra , Cagni Anna , Caldarola Giacomo , Calianno Gianluca , Carpentieri Anton , Carriero Martino , Carugno Andrea , Cona Franco , Costanzo Antonio , Cozzani Emanuele , Dal Bello Giacomo , Danzuso Giovanni , Dattola Annunziata , Donnarumma Marianna , De Col Elena , Esposito Maria , Fiorella Carmen , Galluzzo Marco , Graziola Francesca , Licata Gaetano , Licciardello Matteo , Legori Agostina , Malagoli Piergiorgio , Mola Federica , Moretta Gaia , Muracchioli Andrea , Musumeci Attilia , Musumeci Maria , Pagnanelli Gianluca , Panasiti Vincenzo , Peterle Lucia , Provenzano Eugenio , Rubatto Marco , Sarno Oriele , Strippoli Davide , Vaira Fabrizio , Fargnoli Maria
Published: February 2025

Background/Objectives: Brodalumab is a monoclonal antibody against the anti-IL-17 receptor A, approved for patients with moderate-to-severe psoriasis. This retrospective study investigated patients in clinical practice to assess the impact of body weight and previous treatments with biologics on the effectiveness of brodalumab. Methods: Patients were treated according to clinical practice, and assessed at baseline, 16, 36 and 52 weeks by means of the Psoriasis Area Severity Index (PASI) and DLQI score. Overall, 299 patients were included (147 naïve to biologics). Results: Mean PASI was significantly reduced compared with the baseline in the overall population by week 4 and continued to decrease at each study time point (15.9 ± 7.9 at baseline, 5.4 ± 5.3 at week 4, 1.9 ± 3.6 at week 6, 1.0 ± 2.1 at week 36, and 0.8 ± 2.1 at week 52; p < 0.001 at each control). PASI improved significantly both in bio-naïve and bio-experienced patients (p < 0.001). The proportions of patients achieving PASI 75, PASI 90, and PASI 100 were comparable between the bio-naïve and bio-experienced groups at all time points. The percentages of patients who achieved PASI 75 were similar in obese and non-obese subjects at all determinations except the visit performed after 36 weeks of treatment (94.3% non-obese vs. 83.1% obese, p = 0.005). PASI 90 was achieved more frequently among non-obese patients than obese patients after 36 weeks (80.7% vs. 64.4%, p = 0.008) and 52 weeks of treatment (84.1% vs. 71.7%, 0.027). The probability of achieving PASI 75 and PASI 100 was independent of nutritional status at any time during the study. Conclusions: In conclusion, our results confirm that brodalumab has both rapid and sustained effectiveness in patients with moderate-to-severe psoriasis; our results could be extended to patients with multiple risk factors impairing treatment response, such as multiple biological failure and obesity.
A Narrative Review of Surgery for Prolactinomas: Considerations and Controversies
Authors: Mann Jennifer A. , Starreveld Yves , Riva-Cambrin Jay , Lithgow Kirstie
Published: February 2025

For several decades, dopamine agonist therapy has been the mainstay of treatment for prolactinomas, with surgery generally considered a second line for cases failing medical therapy due to intolerance or resistance. There is increasing recognition of the burden of long-term DA therapy; many patients experience debilitating side effects, and emerging evidence demonstrates that the prevalence of impulse control disorders has been vastly underreported. Long-term DA therapy is associated with significant costs to patients and healthcare systems, which is projected to exceed that of surgery in many circumstances. Recent advancements in surgical approaches, including endoscopic transsphenoidal surgery, have led to improved surgical outcomes (82–100% remission rates; serious complication rates < 2%), prompting a reappraisal of the role of surgery for prolactinoma. Favourable surgical outcomes have been observed in both remission and complication rates for microprolactinomas and well-circumscribed macroprolactinomas, leading to consideration of surgery as an earlier, or first-line, option in the treatment paradigm. Potential advantages of surgical management should be weighed against institutional case volume and expertise, the risk of perioperative complications, and the need for adjuvant medical therapy post-operatively. Ultimately, patients and care-providers should engage in shared decision-making following informed discussion about the risks and benefits of both medical and surgical approaches.
Use of Hexapod External Fixation in Limb Lengthening in Patients with Disproportionate Short Stature: A Systematic Review of the Last 20 Years
Authors: Testa Gianluca , Marchetti Michela , Sapienza Marco , Ilardo Martina , Mangano Sebastiano , Condorelli Giuseppe , Pavone Vito
Published: February 2025

Background: Limb lengthening is a surgical procedure intended to correct discrepancies and deformities in limb length or to enhance limb length for functional or cosmetic reasons. Short stature, often seen as a physical condition, can significantly affect a patient’s quality of life. The advancement of limb lengthening methods, including the creation of hexapod external fixation systems, has heightened the precision and efficacy of these procedures. The Taylor spatial frame (TSF), a form of hexapod external fixator, grants three-dimensional control of bone movement and is increasingly used to rectify deformities and lengthen limbs. This systematic review aims to assess the effectiveness of the hexapod external fixator in limb lengthening and deformity correction compared to other external fixation systems, focusing on outcomes such as achieved lengthening, healing index, complications, and follow-up duration. Methods: A structured search was engineered in four crucial search engines (PubMed, Scopus, Web of Science, and Medline) spanning 2004 to 2024. Results: The studies included in this review indicate that the average lengthening accomplished with the hexapod fixator ranged from 3 to 5.9 cm, with a healing index between 37 and 68.6 days/cm. The most frequent complications were pin site infections, compartment syndrome, and delayed union. The follow-up duration ranged from 6.8 months to 6 years. These studies also compared the hexapod external fixator with other external fixators, showing that while the TSF allowed more accurate deformity corrections, it often displayed a higher healing index. Conclusions: The hexapod external fixator, specifically the TSF, is an effective instrument for limb lengthening and deformity correction in patients with short stature. Although it provides superior three-dimensional control for deformity correction, the healing index and treatment duration can be longer compared to traditional external fixators. Further studies with larger sample sizes and extended follow-up are needed to perfect treatment protocols and thoroughly evaluate the long-term outcomes and complications associated with this technique.
Biomechanical Evaluation of a Novel V-Shaped A2 Pulley Reconstruction Technique Using a Free Palmaris Longus Tendon Graft Tenodesis
Authors: Halát Gabriel , Halát Hannah E. , Negrin Lukas L. , Koch Thomas , Hirtler Lena , Fuchssteiner Christoph , Hajdu Stefan
Published: February 2025

Background: The aim of this biomechanical investigation was to evaluate a V-shaped three-point graft tenodesis technique using a free palmaris longus (PL) tendon for reconstructing traumatic A2 pulley lesions and to compare its biomechanical performance with two previously described reconstruction techniques. Methods: After A2 pulley lesion simulation in 27 fingers (index, middle and ring finger) from nine human anatomical hand specimens, reconstructions were performed using the innovative V-shaped graft tenodesis technique, a double-loop encircling technique and a suture anchor graft fixation technique. Load at failure and the failure mechanisms were evaluated. Results: The V-shaped graft tenodesis technique was superior biomechanically (p = 0.004) considering load at failure (mean: 299 N). The only observed failure mechanism in this group was the extrusion of the central tenodesis screw. In contrast, reconstructions in the other two groups failed due to suture cut-out. Conclusions: Patients may benefit from the new technique’s high load tolerance during early mobilization. Furthermore, a reduction in complications may be anticipated due to an absence of sutures and the sparing of extensor structures.
Donor Heart Preservation for Heart Transplantation: Single-Center Experience with Three Different Techniques
Authors: Lechiancole Andrea , Gliozzi Gregorio , Sponga Sandro , Visentin Pierluigi , Beltrami Antonio , Piani Daniela , Benedetti Giovanni , Daffarra Cristian , Dralov Andriy , Meneguzzi Matteo , Guzzi Giorgio , Di Lorenzo Alessandro , Stella Laura , Bortolotti Uberto , Livi Ugolino , Vendramin Igor
Published: February 2025

Objectives: In addition to traditional ice-cold storage (ICS), other techniques are emerging in the field of donor heart preservation for heart transplantation (HTx). However, in many centers, it could be difficult to justify their use, due to the higher costs and the greater technical complexity compared to ICS. This study aims to analyze the results obtained for HTx at our center employing ICS, controlled hypothermia with Paragonix SherpaPak (PSP), and ex vivo normothermic perfusion with Organ Care System (OCS) as donor graft preservation strategies. Methods: All HTx performed at the University Hospital of Udine, between January 2020 and August 2024, was analyzed and patient outcomes and complications after HTx were assessed. Endomyocardial biopsies were performed in donor hearts immediately after retrieval (T0), before implantation (T1), and at reperfusion (T2) to evaluate signs of myocardial damage. Results: Overall, 100 patients were transplanted with a donor heart preserved with ICS (n = 30), PSP (n = 36), or OCS (n = 34). Compared to ICS, PSP and OCS recipients showed a higher median IMPACT score (5 vs. 8 vs. 7, respectively, p = 0.05) and tended to have a higher rate of bridging to HTx with a long-term ventricular assist device (7% vs. 17% vs. 29%, p = 0.06). OCS was more commonly used in cases of expected ischemic time >4 h compared to ICS and PSP (p < 0.01). Histologically, severe degrees of cellular damage were higher in those hearts preserved with ICS. The 30-day mortality was 3% vs. 6% vs. 9% in ICS, PSP, and OCS groups, respectively (p = 0.65). Moderate-to-severe primary graft dysfunction was 37% vs. 11% vs. 17% (p = 0.03) in the three groups. Conclusions: PSP and OCS seem to be valid alternatives to traditional ICS, and their use could be strongly considered, particularly in the most complex and critical settings, until further data are available on more patient experiences.
A Comparison of the Treatment of Periodontal Infraosseous Defects with or Without Biomaterials by a Minimally Invasive Surgical Approach
Authors: Gómez-Menchero Alberto , Royón-Gálvez Marina , Andrés-García Rodrigo , Herrero-Climent Mariano , Ríos-Carrasco Blanca , Fernandez-Palacín Fernando , Jaramillo-Santos Reyes
Published: February 2025

Background: The aim of this study was to evaluate the clinical and radiological efficacy of minimally invasive surgical techniques for infraosseous defects by evaluating the effects of Emdogain (EMD) applied alone or with a xenograft, with a follow-up period of one year. Methods: Forty patients with a combined total of forty-eight intraosseous defects participated in the research. Of these, 20 participants were treated with EMD (group 1), and 28 were treated with EMD and a xenograft (group 2). The clinical measurements probing depth (PD), recession (REC), and clinical attachment level (CAL) were assessed at six sites on the tooth. Additionally, the following intraoperative clinical measurements were taken: (1) distance from the cementoenamel junction (CEJ) to the bottom of the defect (CEJ-BD) and (2) distance from the CEJ to the most coronal extension of the interproximal bone crest (CEJ-BC). The infraosseous component of the defect was defined as INTRA = (CEJ-BD) − (CEJ-BC). Results: In comparison with the baseline, both treatment options showed statistically significant improvements in reducing PD and increasing CAL. The reduction in PD was 3.25 ± 0.786 mm for group 1 and 3.29 ± 1.013 mm for group 2. In terms of CAL gain, group 1 recorded a value of 4.65 ± 1.387 mm, compared with 5.07 ± 1.631 mm in group 2. Both groups showed a noticeable increase in radiographic bone filler, with an average of 69.85 ± 17.773%. Conclusions: The two regeneration techniques were both effective for the treatment of deep intraosseous defects, encouraging more substantial filling compared with preoperative levels.
Coronary Microvascular Dysfunction and Vasospastic Angina—Pathophysiology, Diagnosis and Management Strategies
Authors: Abramik Joanna , Mariathas Mark , Felekos Ioannis
Published: February 2025

Coronary artery disease is one of the leading public health problems in the world in terms of mortality and economic burden from the disease. Traditionally, the focus of research and clinical pathways leading to the diagnosis and treatment of coronary artery disease was on the more common variant of the disease resulting from atherosclerosis in the epicardial coronary arteries. However, coronary microvasculature, representing the vast majority of the total heart circulation, has the greatest influence on overall coronary resistance and, therefore, blood flow. Coronary microvascular dysfunction (CMD), characterized by structural or functional abnormalities in the microvasculature, significantly impacts myocardial perfusion. Endothelial dysfunction results in inadequate coronary dilation during exercise or spontaneous spasm in the microvasculature or epicardial arteries. A significant proportion of people presenting for coronary angiography in the context of angina have unobstructed epicardial coronary arteries yet are falsely reassured about the benign nature of their condition. Meanwhile, increasing evidence indicates that patients diagnosed with CMD as well as vasospastic angina (VSA) face an increased risk of Major Adverse Cardiovascular Events (MACEs), including death. The aim of this review is to outline the current practice with regard to invasive and non-invasive methods of CMD and VSA diagnosis and assess the evidence supporting the existing treatment strategies. These include endotype-specific pharmacological therapies, a holistic approach to lifestyle modifications and risk factor management and novel non-pharmacological therapies. Furthermore, the review highlights critical gaps in research and suggests potential areas for future investigation, to improve understanding and management of these conditions.
Iris-Claw Intraocular Lens Implantation in Pediatric Population: Indications, Outcomes, and a Comparison with Adult Population
Authors: Al-Dwairi Rami , Jammal Hisham M. , Al Qudah Mohammad , Alazmi Hamad , Almutairi Saad , Aleshawi Abdelwahab
Published: February 2025

Objective: The utilization of iris-claw intraocular lens (IOL) in adult cases of capsular insufficiency has been investigated. However, the use of iris-claw IOL in the pediatric population is still under investigation. In this study, we evaluated the overall practice of iris-claw IOL implantation in pediatrics and compared the visual outcomes and postoperative complication rates between children and adults. Methods: Retrospectively, we examined the practice, indications, and outcomes of pediatric patients who underwent iris-claw “Artisan®” intraocular lens implantation (IOL). All patients who underwent iris-claw IOL implantation for any causative indications were enrolled in the study. The outcome was compared by visual acuity and postoperative complications. Furthermore, the outcomes in pediatrics were compared to another adult group. Results: In this study, 41 eyes of 34 pediatric patients were included with a mean age of 11.1 years and a mean follow-up period of 24.5 months. Trauma is the most common indication for iris-claw IOL in pediatrics, followed by ectopia lentis and by congenital cataract. Iris-claw IOL was implanted anteriorly in 70.7% of pediatrics. Patients with retropupillary position achieved better visual outcome. Anterior iris-claw IOL had higher intraocular pressure readings and more decentration and disenclavation. In comparison with the adult group consisting of 130 eyes, pediatric iris-claw implantation was associated with more decentration and disenclavation, while adult practice was associated with more macular edema. Conclusions: Iris-claw IOL offers a relatively safe method for optical rehabilitation in pediatric patients where the capsular support is inadequate. Retropupillary implantation may achieve better visual outcome with less frequency of glaucoma and corneal endothelial loss.
Quality-of-Life Assessment in Patients Undergoing Mastectomy and Breast Reconstruction for Moderate-Penetrance Gene-Related Breast Cancer
Authors: Cătană Andreea , Iordănescu Irina , Filip Gheorghe Gerald , Filip Simona , Militaru Mariela Sanda , Pătrășcanu Andrada-Adelaida , Pîrlog Lorin-Manuel
Published: February 2025

Background. Breast cancer remains a leading cause of cancer-related death among women, with genetic mutations playing a key role. While high-penetrance mutations are well-studied, moderate-to-low-penetrance mutations, which present challenges in clinical decision-making and patient outcomes, are less understood. This study explores the quality of life of breast cancer patients with moderate-penetrance mutations, focusing on the psychosocial and physical consequences of mastectomy and reconstruction to improve patient-centered care. Materials and Methods. A cohort of 620 breast cancer patients treated at Regina Maria Private Health Network, Bucharest, between January 2022 and July 2024 was identified. From this group, 61 patients were selected based on the following criteria: (1) meeting NCCN genetic testing guidelines, (2) carrying moderate-to-low-penetrance mutations, (3) undergoing bilateral mastectomy with double reconstruction, and (4) agreeing to complete a modified version of the BREAST-Q questionnaire. Genetic testing was performed using a 125-gene next-generation sequencing panel. Statistical analyses included non-parametric tests to examine group differences and correlations. Results. Significant correlations were found between several factors. Emotional distress was positively correlated with concerns for family, while couple relationships and financial burden showed a strong positive association. Negative correlations were found between couple relationships and self-concept. Distress levels varied, with “Interference with personal relationships” causing more distress than “Impact on employment”, and financial burden causing more distressing than impact on sexuality. Conclusions. Prophylactic mastectomy significantly reduces cancer risk for women with moderate-penetrance mutations. This study highlights the relationship between surgical choices and quality-of-life factors, advancing personalized prevention strategies and emphasizing patient-centered care.
In Vitro Assessment of Fluconazole and Cyclosporine A Antifungal Activities: A Promising Drug Combination Against Different Candida Species
Authors: Carton Juan Daniel , de-la-Fuente Iñigo , Sevillano Elena , Jauregizar Nerea , Quindós Guillermo , Eraso Elena , Guridi Andrea
Published: February 2025

Invasive candidiasis is a common fungal infection associated with multiple risk factors, such as cancer, neutropenia, corticosteroid therapy, catheterization, and the use of broad-spectrum antibiotic treatment. Candida albicans is the predominant causative agent, although other Candida species have been emerging in the last years, together with a rise in a number of strains resistant to the currently available antifungal drugs, which poses a challenge when treating these infections. Drug repurposing and drug combinations are promising strategies for the treatment of invasive mycoses. In this study, we evaluated the effect of the combination of fluconazole (FLZ) and cyclosporine A (CsA) against 39 clinical isolates and reference strains of Candida. Two methods, the Loewe additivity model and Bliss independence model, were used to assess the antifungal activity of the drug combination according to CLSI and EUCAST guidelines. The results demonstrated a synergistic effect between fluconazole (FLZ) and cyclosporine A (CsA) against 15–17 Candida isolates, depending on the evaluation model used, including FLZ-resistant strains of C. albicans, C. glabrata, C. parapsilosis, and C. tropicalis. Notably, the combination significantly reduced the minimum inhibitory concentration (MIC) of FLZ in a substantial number of isolates, including those with resistance to FLZ. Additionally, time–kill curve studies confirmed the synergistic interaction, further validating the potential of this combination as an alternative therapeutic strategy for candidiasis treatment. These findings emphasize the importance of investigating innovative drug combinations to address the challenges posed by antifungal resistance and improve treatment options for invasive fungal infections.
Geomorphological and Geological Characteristics Slope Unit: Advancing Township-Scale Landslide Susceptibility Assessment Strategies
Authors: Chen Gang , Zeng Taorui , Liu Dongsheng , Chen Hao , Wang Linfeng , Wang Liping , Zhang Kaiqiang , Glade Thomas
Published: February 2025

The current method for dividing slope units primarily relies on hydrological analysis methods, which consider only geomorphological factors and fail to reveal the geological boundaries during landslides. Consequently, this approach does not fully satisfy the requirements for detailed landslide susceptibility assessments at the township scale. To address this limitation, we propose a new landslide susceptibility evaluation model based on geomorphological and geological characteristics. The key challenges addressed include: (i) Optimization of the slope unit division method. This is accomplished by integrating geomorphological features, such as slope gradient and aspect, with geological features, including lithology, slope structure types, and disaster categories, to develop a process for extracting slope units based on both geomorphological and geological characteristics. The results indicate that the proposed slope units outperform the hydrological analysis methods in three key indicators: overlap, shape regularity, and spatial distribution uniformity. (ii) Development and validation of the evaluation model. A landslide susceptibility index system is developed using multi-source data, with susceptibility prediction conducted via the XGBoost model optimized by Bayesian methods. The model’s accuracy is validated using the Receiver Operating Characteristic (ROC) curve. The results show that the proposed slope units achieve an AUC value of 0.973, surpassing the hydrological method. (iii) Analysis of landslide susceptibility variations. The susceptibility of the two types of slope units is analyzed through landslide case studies. The consistency between the proposed slope units and field verification results is explained using engineering geological characteristics. The SHAP model is then used to examine the influence of key disaster-inducing and individual factors on landslide occurrence.
Evaluation Study on the Smart and Interactive Landscape Design of Haiyuntai Waterfront Park from the Perspective of a Sustainable City
Authors: Yuan Jingwen , Wang Zhixiang , Xing Siyan , Kim Chulsoo
Published: February 2025

With the rapid development of technological progress and smart city construction, the concept of sustainable cities is gradually being integrated into all aspects of urban construction. In this context, the public’s demand for high-quality and rich leisure experiences is increasing, and the design, management, and service standards of urban parks are also being upgraded. As an innovative product of the integration of ecological civilisation and information technology, smart interactive parks have become an important direction for promoting sustainable urban development, especially in the landscape design of waterside parks, which show unique significance. This study explores the application of the smart interactive concept in the landscape design of waterside parks from the perspective of sustainable cities, aiming to construct a set of evaluation frameworks to assess its effectiveness and value in urban development. Through in-depth analyses of the smart interaction concept and its application in landscape design, this study combines environmental psychology, landscape ecology, and GIS technology to propose innovative goals, strategies, and design methods for waterside smart interactive landscapes that can support the ecological and social needs of sustainable cities. Domestic and international case studies show that the successful application of smart interactive technologies in waterside parks not only improves environmental quality but also promotes economic development by enhancing the attractiveness of the parks, providing multiple values for sustainable cities. In the empirical research section, this paper takes Haeundae Waterside Park in South Korea as the object of investigation and constructs a design framework based on project selection and indicator quantification to further validate the effectiveness of the practical application of the smart interactive concept in waterside park landscape design. Based on the findings, this paper proposes a series of policy recommendations to promote the construction of smart interactive parks and sustainable urban development. These recommendations not only provide theoretical support for the future development of Haeundae Waterside Park but also provide a reference for the design and planning of public spaces in other cities around the world. By promoting the integration of smart interactive concepts with ecological sustainability, this study provides an innovative reference path for urban planners, landscape architects. and environmentalists to help realise the goal of a sustainable city with coordinated ecological, social, and economic development.
Impact of Excess Adiposity on Cardiorespiratory Fitness in Children and Adolescents with Kawasaki Disease
Authors: Chen Guan-Bo , Tuan Sheng-Hui , Tsai Yi-Ju , Huang I-Ching , Liou I-Hsiu , Lin Ko-Long
Published: February 2025

(1) Background: To assess the impact of excessive body fat on cardiorespiratory fitness (CRF) and coronary artery health in children and adolescents following acute Kawasaki disease (KD-CA). (2) Methods: A retrospective study of KD-CA patients (ages 8–16) who completed cardiopulmonary exercise testing (CPET) in the last five years. Participants were classified based on body mass index (BMI) and fat mass index (FMI) into normal and excessive adiposity groups. Coronary artery (CA) Z-scores were calculated using the Lambda-Mu-Sigma method, with peak VO2 Z-scores (peak VO2 Z-score) derived from a database of Hong Kong Chinese children and adolescents. Primary outcomes included peak VO2 Z-score, Max-Z (maximum CA Z-score), anaerobic threshold metabolic equivalent (AT MET), peak MET, and pulse oxygen. Statistical analyses were conducted to evaluate differences across groups. (3) Results: A total of 112 KD-CA patients were included (mean age: 11.71 ± 2.54 years). The mean peak VO2 Z-score was −0.63 ± 0.98. Participants with normal BMI and FMI had significantly higher pulse oxygen levels compared to those with excessive BMI and FMI (both p < 0.001). Additionally, those with normal FMI showed higher AT MET, peak MET, peak VO2 Z-score (p = 0.049), and lower Max-Z (p = 0.026) than excessive FMI participants. Boys, especially those with normal adiposity, had superior AT MET, peak MET, pulse oxygen, and Max-Z compared to girls. (4) Conclusions: Excessive adiposity in KD-CA patients is associated with reduced CRF and elevated Max CA Z-score. These findings highlight the need to monitor body composition to optimize cardiovascular health in this population.
Clinical and Prognostic Value of VHL in Korean Patients with Rectal Cancer
Authors: Moon Sang-Won , Lee Jun-Chae , Lee Jae-Ho , Kim Tae-Young , Park Jong Ho
Published: February 2025

Background and Objectives: Von Hippel–Lindau (VHL) disease is caused by mutations in the VHL gene and can develop various cancers. Hypoxia-inducible factors 1 and 2 alphas, regulated by the VHL gene, can increase the levels of vascular endothelial growth factor, thereby activating cancer progression. Here, we demonstrated clinical and prognostic values of VHL expression in rectal cancer (RC). Materials and Methods: Von Hippel–Lindau mRNA expression was examined in 60 patients with RC. Furthermore, we evaluated survival to determine the prognostic significance of VHL mRNA expression levels in RC using the Cancer Genome Atlas (TCGA) data. Results: Lower VHL expression was correlated with the recurrence (p = 0.058) and lymphatic invasion (p = 0.078), although it was not statistically significant. In TCGA data, VHL expression level was correlated with the M stage (p = 0.044); however, it had a possible association with lymphatic invasion (p = 0.068) and N stage (p = 0.104). Survival analysis showed that lower VHL gene expression predicted poorer survival in both patients with RC and TCGA data. Conclusions: This study identified a significant correlation between VHL gene expression and RC for the first time using patient tissues and TCGA data, suggesting that the VHL gene expression level could be a potential biomarker or candidate for the treatment of RC. Further studies are required to identify the molecular pathogenesis and clinical characteristics of VHL disease in RC.
Dual-Polarized Metasurface-Integrated Antenna for Integrated Imaging of LWIR Camera and SAR
Authors: Hu Jijian , Dong Zhenghong , Xia Lurui , Chen Xueqi
Published: February 2025

The integrated imaging of LWIR cameras and SAR is one of the important directions of multi-sensor integration. In order to reduce the structural complexity of LWIR cameras and SAR-integrated imaging antenna, a dual-polarized metasurface-integrated antenna (MIA) is designed in this paper. It is composed of a microwave metasurface antenna and an optical metalens, and the metalens is embedded in the center of the metasurface antenna. The MIA uses the powerful electromagnetic wave control ability to simplify the optical and microwave signal transmission paths and reduce the number of devices. At the same time, in order to expand the function of the MIA, based on the principle of metasurface, the dual-linearly polarized and dual-circularly polarized MIAs are designed and simulated, respectively. The results show that the designed dual-polarized MIA has good performance. This paper provides a new scheme for the integrated imaging system of LWIR cameras and SAR with simple structure, diverse functions and easy integration.
Hyperinfection by Strongyloides stercoralis: Series of Cases in a Regional Hospital in Southern Spain
Authors: Lucas-Dato Ana , Hernández-Rabadán María Dolores , Arroyo Pedro Luis Boils , Llenas-García Jara
Published: February 2025

Background: Strongyloidiasis is a neglected tropical disease caused by the nematode Strongyloides stercoralis. In immunosuppressed patients, it may progress to hyperinfection syndrome (HIS) and disseminated strongyloidiasis (DS), both of which are associated with high mortality rates. We reviewed cases of HIS and DS in a Spanish hospital located in an area with endemic strongyloidiasis. Methods: All of the patients who met the HIS or DIS criteria between 1999 and 2023 at the Vega Baja Hospital in Orihuela (Alicante, Spain) were included. Results: Five patients were identified, four of them autochthonous (median age 72 years, 80% male), with three cases of HIS and two cases of DS in the form of meningitis, due to E. faecalis and E. coli. The most common risk factor, observed in three patients, was corticosteroid use. Two patients died. Conclusions: This case series highlights the severity of infections in immunocompromised patients in an endemic area of Spain, emphasizing the need to establish screening protocols for patients at risk of immunosuppression, including both locals and migrants.
Metagenomic and Metabolomic Analyses Reveal the Role of a Bacteriocin-Producing Strain of Enterococcus faecalis DH9003 in Regulating Gut Microbiota in Mice
Authors: Fu Zhiyu , Zhang Haitao , Yang Zhenzhu , Liu Yujun , Wang Peng , Zhang Junjie , Chi Hai
Published: February 2025

To investigate the regulatory effect of a bacteriocin-producing strain of Enterococcus faecalis DH9003 on the gut microbiota of mice, 15 healthy C57 male mice were randomly administered an equal volume of sterile normal saline (HD, control group, n = 7) and E. faecalis DH9003 (YD, treatment group, n = 8) via gavage. Metagenomic and metabolomic analyses were performed to determine the composition and metabolic function of the intestinal microbiota in mice. The results showed that the relative abundance of Firmicutes continuously increased over time in YD compared to HD. The number of E. faecalis DH9003 increased slowly and remained steady from days 7 to 28, indicating that E. faecalis DH9003 could colonize a considerable number of mouse guts via intragastric administration. Supplementation with E. faecalis DH9003 demonstrated a regulatory effect on the intestinal microbiota composition of mice, causing a shift in the relative abundance of Bacteroidetes and Firmicutes at the phylum level. In addition, a total of 2426 different metabolites were found in mouse feces, including 1286 and 1140 metabolites in positive and negative modes, respectively. Vitamin B6 and succinate were the most regulated and downregulated metabolites in negative ion mode, and the most upregulated and downregulated metabolites in positive ion mode were N-methyl-glutamic acid and N-octanoyl sphingosine. In conclusion, E. faecalis DH9003 can colonize mice gut, affecting the gut microbiota and metabolic competence. This strain therefore offers considerable potential for application as a probiotic.
Screening, Identification, and Fermentation Optimization of the Antagonistic Actinomycete Strain TCS21-117 Against Botrytis cinerea
Authors: Chen Fei , Hu Xuan , Hong Ziyang , Duan Jing , Zhou Sha , Chen Jie , Wang Dan , Lin Haiping
Published: February 2025

Biological control is considered one of the most important methods for preventing and controlling the worldwide fungal disease gray mold, caused by Botrytis cinerea. Among the various agents used in biological control, actinomycetes represent a significant group of microorganisms that offer valuable resources for biocontrol strategies. In this study, a total of 132 actinomycetes, belonging to four genera (Streptomyces, Kitasatospora, Amycolatopsis, and Nocardia), were isolated from soil. Among the five media tested, ISP-2 and GS NO.1 media were found to be highly suitable for isolating actinomycetes. It is worth mentioning that the strain TCS21-117 displayed significant inhibitory effects against Botrytis cinerea and nine other pathogenic fungi. The strain TCS21-117 was identified as Streptomyces roietensis by its morphological characteristics and phylogenetic analysis of the 16S rRNA gene. The optimum culture conditions for the strain TCS21-117 were a potato dextrose broth medium at an initial pH of 8.0, a liquid volume of 125 mL in a 250 mL flask, 180 r·min−1 at 28 °C, and an inoculum size of 1% for 7 days. Under these conditions, the inhibition rate against Botrytis cinerea was 93.31%, a significant increase (31.98%) as compared to the control. Notably, the antifungal compounds produced by the strain TCS21-117 exhibited strong stability across a range of temperatures, pH levels, and durations of storage and UV irradiation. This study showed that the Streptomyces roietensis strain TCS21-117 had strong inhibitory activity against Botrytis cinerea under optimized fermentation conditions, enriching the microbial resources for gray mold control.