bluuebunny/crossref_metadata_2025 huggingface dataset:
A Pseudomonas Lysogenic Bacteriophage Crossing the Antarctic and Arctic, Representing a New Genus of Autographiviridae
Authors: Liu Zhenyu , Jiang Wenhui , Kim Cholsong , Peng Xiaoya , Fan Cong , Wu Yingliang , Xie Zhixiong , Peng Fang
Published: April 2023

Polar regions tend to support simple food webs, which are vulnerable to phage-induced gene transfer or microbial death. To further investigate phage-host interactions in polar regions and the potential linkage of phage communities between the two poles, we induced the release of a lysogenic phage, vB_PaeM-G11, from Pseudomonas sp. D3 isolated from the Antarctic, which formed clear phage plaques on the lawn of Pseudomonas sp. G11 isolated from the Arctic. From permafrost metagenomic data of the Arctic tundra, we found the genome with high-similarity to that of vB_PaeM-G11, demonstrating that vB_PaeM-G11 may have a distribution in both the Antarctic and Arctic. Phylogenetic analysis indicated that vB_PaeM-G11 is homologous to five uncultured viruses, and that they may represent a new genus in the Autographiviridae family, named Fildesvirus here. vB_PaeM-G11 was stable in a temperature range (4–40 °C) and pH (4–11), with latent and rise periods of about 40 and 10 min, respectively. This study is the first isolation and characterization study of a Pseudomonas phage distributed in both the Antarctic and Arctic, identifying its lysogenic host and lysis host, and thus provides essential information for further understanding the interaction between polar phages and their hosts and the ecological functions of phages in polar regions.
Plasma Surface Modification of 3Y-TZP at Low and Atmospheric Pressures with Different Treatment Times
Authors: Kang Sung Un , Kim Chul-Ho , You Sanghyun , Lee Da-Young , Kim Yu-Kwon , Kim Seung-Joo , Kim Chang-Koo , Kim Hee-Kyung
Published: April 2023

The efficiency of plasma surface modifications depends on the operating conditions. This study investigated the effect of chamber pressure and plasma exposure time on the surface properties of 3Y-TZP with N2/Ar gas. Plate-shaped zirconia specimens were randomly divided into two categories: vacuum plasma and atmospheric plasma. Each group was subdivided into five subgroups according to the treatment time: 1, 5, 10, 15, and 20 min. Following the plasma treatments, we characterized the surface properties, including wettability, chemical composition, crystal structure, surface morphology, and zeta potential. These were analyzed through various techniques, such as contact angle measurement, XPS, XRD, SEM, FIB, CLSM, and electrokinetic measurements. The atmospheric plasma treatments increased zirconia’s electron donation (γ−) capacity, while the vacuum plasma treatments decreased γ− parameter with increasing times. The highest concentration of the basic hydroxyl OH(b) groups was identified after a 5 min exposure to atmospheric plasmas. With longer exposure times, the vacuum plasmas induce electrical damage. Both plasma systems increased the zeta potential of 3Y-TZP, showing positive values in a vacuum. In the atmosphere, the zeta potential rapidly increased after 1 min. Atmospheric plasma treatments would be beneficial for the adsorption of oxygen and nitrogen from ambient air and the generation of various active species on the zirconia surface.
For Special Issue “Molecular Mechanisms of Responses to Low-Intensity Exposures 2.0” of International Journal of Molecular Sciences
Authors: Kudryasheva Nadezhda S.
Published: April 2023

The intention of this Special Issue is to highlight the peculiarities of low-intensity/low-concentration exposures for organisms and to examine the molecular mechanisms of the organismal responses [...]
Hybrid Silver-Containing Materials Based on Various Forms of Bacterial Cellulose: Synthesis, Structure, and Biological Activity
Authors: Vasil’kov Alexander , Butenko Ivan , Naumkin Alexander , Voronova Anastasiia , Golub Alexandre , Buzin Mikhail , Shtykova Eleonora , Volkov Vladimir , Sadykova Vera
Published: April 2023

Sustained interest in the use of renewable resources for the production of medical materials has stimulated research on bacterial cellulose (BC) and nanocomposites based on it. New Ag-containing nanocomposites were obtained by modifying various forms of BC with Ag nanoparticles prepared by metal–vapor synthesis (MVS). Bacterial cellulose was obtained in the form of films (BCF) and spherical BC beads (SBCB) by the Gluconacetobacter hansenii GH-1/2008 strain under static and dynamic conditions. The Ag nanoparticles synthesized in 2-propanol were incorporated into the polymer matrix using metal-containing organosol. MVS is based on the interaction of extremely reactive atomic metals formed by evaporation in vacuum at a pressure of 10−2 Pa with organic substances during their co-condensation on the cooled walls of a reaction vessel. The composition, structure, and electronic state of the metal in the materials were characterized by transmission and scanning electron microscopy (TEM, SEM), powder X-ray diffraction (XRD), small-angle X-ray scattering (SAXS) and X-ray photoelectron spectroscopy (XPS). Since antimicrobial activity is largely determined by the surface composition, much attention was paid to studying its properties by XPS, a surface-sensitive method, at a sampling depth about 10 nm. C 1s and O 1s spectra were analyzed self-consistently. XPS C 1s spectra of the original and Ag-containing celluloses showed an increase in the intensity of the C-C/C-H groups in the latter, which are associated with carbon shell surrounding metal in Ag nanoparticles (Ag NPs). The size effect observed in Ag 3d spectra evidenced on a large proportion of silver nanoparticles with a size of less than 3 nm in the near-surface region. Ag NPs in the BC films and spherical beads were mainly in the zerovalent state. BC-based nanocomposites with Ag nanoparticles exhibited antimicrobial activity against Bacillus subtilis, Staphylococcus aureus, Escherichia coli bacteria and Candida albicans and Aspergillus niger fungi. It was found that AgNPs/SBCB nanocomposites are more active than Ag NPs/BCF samples, especially against Candida albicans and Aspergillus niger fungi. These results increase the possibility of their medical application.
Recognizing the Wadi Fluvial Structure and Stream Network in the Qena Bend of the Nile River, Egypt, on Landsat 8-9 OLI Images
Authors: Lemenkova Polina , Debeir Olivier
Published: April 2023

With methods for processing remote sensing data becoming widely available, the ability to quantify changes in spatial data and to evaluate the distribution of diverse landforms across target areas in datasets becomes increasingly important. One way to approach this problem is through satellite image processing. In this paper, we primarily focus on the methods of the unsupervised classification of the Landsat OLI/TIRS images covering the region of the Qena governorate in Upper Egypt. The Qena Bend of the Nile River presents a remarkable morphological feature in Upper Egypt, including a dense drainage network of wadi aquifer systems and plateaus largely dissected by numerous valleys of dry rivers. To identify the fluvial structure and stream network of the Wadi Qena region, this study addresses the problem of interpreting the relevant space-borne data using R, with an aim to visualize the land surface structures corresponding to various land cover types. To this effect, high-resolution 2D and 3D topographic and geologic maps were used for the analysis of the geomorphological setting of the Qena region. The information was extracted from the space-borne data for the comparative analysis of the distribution of wadi streams in the Qena Bend area over several years: 2013, 2015, 2016, 2019, 2022, and 2023. Six images were processed using computer vision methods made available by R libraries. The results of the k-means clustering of each scene retrieved from the multi-temporal images covering the Qena Bend of the Nile River were thus compared to visualize changes in landforms caused by the cumulative effects of geomorphological disasters and climate–environmental processes. The proposed method, tied together through the use of R scripts, runs effectively and performs favorably in computer vision tasks aimed at geospatial image processing and the analysis of remote sensing data.
On the Question of the Complex Processing of Pyrite Cinders
Authors: Kenzhaliyev Bagdaulet , Surkova Tatiana , Yessimova Dinara , Abikak Yerkezhan , Mukhanova Ainur , Fischer Dametken
Published: April 2023

A complex processing variant for pyrite cinders, i.e., the technogenic waste generated in the production of sulfuric acid, was proposed. This method provided preliminary chemical activation of the initial raw materials that comprised thermal treatment with a sodium bicarbonate solution and resulted in structural and phase changes of separate minerals. Due to chemical activation, it was possible to separate the nonferrous metals into separate products (in addition to the partial extraction of iron) and then concentrate the noble metals in the residue. The noble metals were then able to be extracted through a leaching process with a complex reagent based on sulfur compounds and subsequent cementation with zinc dust. The developed method, unlike pyrometallurgical methods, is less energy-consuming and more easily implemented than the known hydrometallurgical variants, enabling the separation of nonferrous metals and the partial separation of iron into separate middlings at the first stage. Noble metals are concentrated in the residue and extracted from it.
Exploring the Interaction of Pyridine-Based Chalcones with Trinuclear Silver(I) Pyrazolate Complex
Authors: Olbrykh Arina , Titov Aleksei , Smol’yakov Alexander , Filippov Oleg , Shubina Elena S.
Published: April 2023

The investigation of the interaction of cyclic trinuclear silver(I) pyrazolate [AgPz]3 (Pz = 3,5-bis(trifluoromethyl)pyrazolate) with pyridine-based chalcones (anthracen-9-yl and phenyl-substituted ones) has been performed by IR-, UV-vis, and NMR spectroscopies in the solution. The carbonyl group participates in coordination with metal ions in all complexes. However, the network of π-π/M-π non-covalent intermolecular interactions mainly influences complex formation. The spectral data suggest retaining the structures for all studied complexes in the solution and solid state. E-Z isomerization in the case of anthracene-containing compounds significantly influences the complexation. E-isomer of chalcones seeks the planar structure in the complexes with [AgPz]3. In contrast, the Z-isomer of chalcone demonstrates the chelating coordination of O- and N atoms to silver ions. The complexation of anthracene-containing chalcones allows the switching of the emission nature from charge transfer to ligand-centered at 77 K. In contrast, phenyl-substituted chalcone in complex with macrocycle demonstrates that the emission significantly shifted (Δ = ca. 155 nm) to the low-energy region compared to the free base.
Secure Adaptive Context-Aware ABE for Smart Environments
Authors: Inshi Saad , Chowdhury Rasel , Ould-Slimane Hakima , Talhi Chamseddine
Published: April 2023

Predicting context-aware activities using machine-learning techniques is evolving to become more readily available as a major driver of the growth of IoT applications to match the needs of the future smart autonomous environments. However, with today’s increasing security risks in the emerging cloud technologies, which share massive data capabilities and impose regulation requirements on privacy, as well as the emergence of new multiuser, multiprofile, and multidevice technologies, there is a growing need for new approaches to address the new challenges of autonomous context awareness and its fine-grained security-enforcement models. The solutions proposed in this work aim to extend our previous LCA-ABE work to provide an intelligent, dynamic creation of context-aware policies, which has been achieved through deploying smart-learning techniques. It also provides data consent, automated access control, and secure end-to-end communications by leveraging attribute-based encryption (ABE). Moreover, our policy-driven orchestration model is able to achieve an efficient, real-time enforcement of authentication and authorization (AA) as well as federation services between users, service providers, and connected devices by aggregating, modelling, and reasoning context information and then updating consent accordingly in autonomous ways. Furthermore, our framework ensures that the accuracy of our algorithms is above 90% and their precision is around 85%, which is considerably high compared to the other reviewed approaches. Finally, the solution fulfills the newly imposed privacy regulations and leverages the full power of IoT smart environments.
Preparticipation Screening of Athletes: The Prevalence of Positive Family History
Authors: Jiravska Godula Bogna , Jiravsky Otakar , Pesova Petra , Jelinek Libor , Sovova Marketa , Moravcova Katarina , Ozana Jaromir , Hudec Miroslav , Miklik Roman , Hecko Jan , Sknouril Libor , Sovova Eliska
Published: April 2023

Sudden cardiac death (SCD) is a leading cause of death among athletes, and those with a positive family history (FH) of SCD and/or cardiovascular disease (CVD) may be at increased risk. The primary objective of this study was to assess the prevalence and predictors of positive FH of SCD and CVD in athletes using four widely used preparticipation screening (PPS) systems. The secondary objective was to compare the functionality of the screening systems. In a cohort of 13,876 athletes, 1.28% had a positive FH in at least one PPS system. Multivariate logistic regression analysis identified the maximum heart rate as significantly associated with positive FH (OR = 1.042, 95% CI = 1.027–1.056, p < 0.001). The highest prevalence of positive FH was found using the PPE-4 system (1.20%), followed by FIFA, AHA, and IOC systems (1.11%, 0.89%, and 0.71%, respectively). In conclusion, the prevalence of positive FH for SCD and CVD in Czech athletes was found to be 1.28%. Furthermore, positive FH was associated with a higher maximum heart rate at the peak of the exercise test. The findings of this study revealed significant differences in detection rates between PPS protocols, so further research is needed to determine the optimal method of FH collection.
Development and Validation of a Small for Gestational Age Screening Model at 21–24 Weeks Based on the Real-World Clinical Data
Authors: Gao Jing , Xiao Zhongzhou , Chen Chao , Shi Hu-Wei , Yang Sen , Chen Lei , Xu Jie , Cheng Weiwei
Published: April 2023

Background: Small for gestational age (SGA) is a condition in which fetal birthweight is below the 10th percentile for the gestational age, which increases the risk of perinatal morbidity and mortality. Therefore, early screening for each pregnant woman is of great interest. We aimed to develop an accurate and widely applicable screening model for SGA at 21–24 gestational weeks of singleton pregnancies. Methods: This retrospective observational study included medical records of 23,783 pregnant women who gave birth to singleton infants at a tertiary hospital in Shanghai between 1 January 2018 and 31 December 2019. The obtained data were nonrandomly classified into training (1 January 2018 to 31 December 2018) and validation (1 January 2019 to 31 December 2019) datasets based on the year of data collection. The study variables, including maternal characteristics, laboratory test results, and sonographic parameters at 21–24 weeks of gestation were compared between the two groups. Further, univariate and multivariate logistic regression analyses were performed to identify independent risk factors for SGA. The reduced model was presented as a nomogram. The performance of the nomogram was assessed in terms of its discrimination, calibration, and clinical usefulness. Moreover, its performance was assessed in the preterm subgroup of SGA. Results: Overall, 11,746 and 12,037 cases were included in the training and validation datasets, respectively. The developed SGA nomogram, comprising 12 selected variables, including age, gravidity, parity, body mass index, gestational age, single umbilical artery, abdominal circumference, humerus length, abdominal anteroposterior trunk diameter, umbilical artery systolic/diastolic ratio, transverse trunk diameter, and fasting plasma glucose, was significantly associated with SGA. The area under the curve value of our SGA nomogram model was 0.7, indicating a good identification ability and favorable calibration. Regarding preterm SGA fetuses, the nomogram achieved a satisfactory performance, with an average prediction rate of 86.3%. Conclusions: Our model is a reliable screening tool for SGA at 21–24 gestational weeks, especially for high-risk preterm fetuses. We believe that it will help clinical healthcare staff to arrange more comprehensive prenatal care examinations and, consequently, provide a timely diagnosis, intervention, and delivery.
Perinatal and Maternal Outcomes According to the Accurate Term Antepartum Ultrasound Estimation of Extreme Fetal Weights
Authors: Mozas-Moreno Juan , Sánchez-Fernández Mariola , González-Mesa Ernesto , Olmedo-Requena Rocío , Amezcua-Prieto Carmen , Jiménez-Moleón José J.
Published: April 2023

(1) Background: The accuracy of ultrasound estimation of fetal weight (EFW) at term may be useful in addressing obstetric complications since birth weight (BW) is a parameter that represents an important prognostic factor for perinatal and maternal morbidity. (2) Methods: In a retrospective cohort study of 2156 women with a singleton pregnancy, it is verified whether or not perinatal and maternal morbidity differs between extreme BWs estimated at term by ultrasound within the seven days prior to birth with Accurate EFW (difference < 10% between EFW and BW) and those with Non-Accurate EFW (difference ≥ 10% between EFW and BW). (3) Results: Significantly worse perinatal outcomes (according to different variables such as higher rate of arterial pH at birth < 7.20, higher rate of 1-min Apgar < 7, higher rate of 5-min Apgar < 7, higher grade of neonatal resuscitation and need for admission to the neonatal care unit) were found for extreme BW estimated by antepartum ultrasounds with Non-Accurate EFW compared with those with Accurate EFW. This was the case when extreme BWs were compared according to percentile distribution by sex and gestational age following the national reference growth charts (small for gestational age and large for gestational age), and when they were compared according to weight range (low birth weight and high birth weight). (4) Conclusions: Clinicians should make a greater effort when performing EFW by ultrasound at term in cases of suspected extreme fetal weights, and need to take an increasingly prudent approach to its management.
Heart Valve Involvement in Patients with Antiphospholipid Syndrome: A Long-Term Follow-Up Study of a Single Centre
Authors: Pons Isaac , Louro Joana , Sitges Marta , Vidal Bàrbara , Cervera Ricard , Espinosa Gerard
Published: April 2023

Background: Valve involvement is the most common cardiac manifestation in antiphospholipid syndrome (APS). The objective of the study was to describe the prevalence, clinical and laboratory features, and evolution of APS patients with heart valve involvement. Methods: A retrospective longitudinal and observational study of all APS patients followed by a single centre with at least one transthoracic echocardiographic study. Results: 144 APS patients, 72 (50%) of them with valvular involvement. Forty-eight (67%) had primary APS, and 22 (30%) were associated with systemic lupus erythematosus (SLE). Mitral valve thickening was the most frequent valve involvement present in 52 (72%) patients, followed by mitral regurgitation in 49 (68%), and tricuspid regurgitation in 29 (40%) patients. Female sex (83% vs. 64%; p = 0.013), arterial hypertension (47% vs. 29%; p = 0.025), arterial thrombosis at APS diagnosis (53% vs. 33%; p = 0.028), stroke (38% vs. 21%; p = 0.043), livedo reticularis (15% vs. 3%; p = 0.017), and lupus anticoagulant (83% vs. 65%; p = 0.021) were more prevalent in those with valvular involvement. Venous thrombosis was less frequent (32% vs. 50%; p = 0.042). The valve involvement group suffered from higher mortality (12% vs. 1%; p = 0.017). Most of these differences were maintained when we compared patients with moderate-to-severe valve involvement (n = 36) and those with no or mild involvement (n = 108). Conclusions: Heart valve disease is a frequent manifestation in our cohort of APS patients and is associated with demographic, clinical and laboratory features, and increased mortality. More studies are needed, but our results suggest that there may be a subgroup of APS patients with moderate-to-severe valve involvement with its own characteristics that differs from the rest of the patients with mild valve involvement or without valve involvement.
Sleep Bruxism and Orofacial Pain in Patients with Sleep Disorders: A Controlled Cohort Study
Authors: Bartolucci Maria Lavinia , Incerti Parenti Serena , Bortolotti Francesco , Della Godenza Veronica , Vandi Stefano , Pizza Fabio , Plazzi Giuseppe , Alessandri-Bonetti Giulio
Published: April 2023

Background: The gold standard for the diagnosis of sleep bruxism (SB) is laboratory polysomnography (L-PSG) recording. However, many clinicians still define SB using patients’ self-assessment and/or clinical tooth wear (TW). The purpose of this cross-sectional controlled study was to compare the prevalence of TW, head-neck muscles sensitivity and Temporomandibular Disorders (TMD) between SB and non-SB patients diagnosed with L-PSG in a cohort of patient with sleep disorders (SD). Methods: 102 adult subjects with suspected SD underwent L-PSG recording to assess the presence of sleep disorder and SB. TW was clinically analyzed using TWES 2.0. The pressure pain threshold (PPT) of masticatory muscles were assessed using a Fisher algometer. Diagnostic criteria for TMD (DC/TMD) were used to evaluate the presence of TMD. SB self-assessment questionnaires were administered. TWES score, PPT, TMD prevalence and questionnaire results were compared between SB and non-SB patients. Results: 22 SB patients and 66 non-SB patients with SD were included. No significant differences emerged between groups in regards to TW, the PPT values, or SB’s self-assessment questionnaires as well the prevalence of TMD. Conclusion: in a SD population, TW is not pathognomonic of active SB and SB self-assessment is not reliable. There seems to be no correlation between SB, TMD and head/neck muscle sensitivity.
Pulmonary Recruitment Prior to Intraoperative Multiple Pulmonary Ground-Glass Nodule Localization Increases the Localization Accuracy—A Retrospective Study
Authors: Wang Yu Hsiang , Su Pei Chin , Huang Hsu Chih , Au Kenneth , Lin Frank Cheau Feng , Chen Chih Yi , Chou Ming Chih , Hsia Jiun Yi
Published: April 2023

The standard treatment for early-stage lung cancer is complete tumor excision by limited resection of the lung. Preoperative localization is used before video-assisted thoracoscopic surgery (VATS) to improve the accuracy of pulmonary nodule excision. However, lung atelectasis and hypoxia resulting from controlling apnea during the localization procedure may affect the localization accuracy. Pre-procedural pulmonary recruitment may improve the respiratory mechanics and oxygenation during localization. In this study, we investigated the potential benefits of pre-localization pulmonary recruitment prior to pulmonary ground-glass nodule localization in a hybrid operating room. We hypothesized that pre-localization pulmonary recruitment would increase the localization accuracy, improve oxygenation, and prevent the need for re-inflation during the localization procedure. We retrospectively enrolled patients with multiple pulmonary nodule localizations before surgical intervention in our hybrid operating room. We compared the localization accuracy between patients who had undergone pre-procedure pulmonary recruitment and patients who had not. Saturation, re-inflation rate, apnea time, procedure-related pneumothorax, and procedure time were also recorded as secondary outcomes. The patients who had undergone pre-procedure recruitment had better saturation, shorter procedure time, and higher localization accuracy. The pre-procedure pulmonary recruitment maneuver was effective in increasing regional lung ventilation, leading to improved oxygenation and localization accuracy.
Anxiety and Depressive Symptoms Correlated to Patient-Reported Outcome Measures after Rotator Cuff Repair: A Prospective Study in the Perioperative Period
Authors: Longo Umile Giuseppe , De Salvatore Sergio , Piergentili Ilaria , Panattoni Nicolò , Marchetti Anna , De Marinis Maria Grazia , Denaro Vincenzo
Published: April 2023

Anxiety and depressive symptoms adversely affect surgical outcomes in patients with rotator cuff tear (RCT) undergoing surgical repair. Patients without a diagnosis of mood disorders, such as anxiety and depression, before rotator cuff repair (RCR) can be considered an optimal candidate for surgery. The objective of this prospective observational study was to evaluate the relationship between anxiety and depressive symptoms, using the Hospital Anxiety and Depression Scale (HADS) as an assessment tool, and patient-reported outcome measures in RCT after repair surgery. This study included patients with RCT undergoing arthroscopic rotator cuff repair (RCR). Forty-three patients were included who had completed the HADS, Constant Murley Score (CMS), and Short Form Health Survey 36 (SF-36) questionnaires before surgery and in the postoperative follow-up, at 1 month, 3 months, and 6 months. The Friedman test showed that there were statistically significant changes in the different times point for HADS (p < 0.001), anxiety subscale of HADS, i.e., HADS-A (p < 0.001), depression subscale of HADS, i.e., HADS-D (p < 0.001), CMS (p < 0.001), and SF-36 (p < 0.001). The average scores of HADS, HADS-A, and HADS-D improved at each follow-up, showing improvement in discomfort. From the third month after surgery, there was an improvement in anxiety and depression disorders related to improved quality of life, functionality, and pain perception. The trend remained stable until the sixth month of follow up. This study shows that anxiety and depressive symptoms in RCT patients are significantly reduced after RCR with subsequent important improvements in terms of functionality, ability to carry out activities of daily living, perceived pain, and quality of life.
Connection between Cardiac Fibrosis Biomarkers and Echocardiography Parameters in Advanced Chronic Kidney Disease Patients
Authors: Ureche Carina , Dodi Gianina , Covic Alexandra , Nedelcu Alina , Volovăț Simona R. , Sascău Radu A. , Stătescu Cristian , Covic Adrian
Published: April 2023

Background: Myocardial fibrosis represents a mainstay pathway in the pathophysiology of uremic cardiomyopathy. This process leads to structural and functional changes in the heart, which can be detected by echocardiography. The purpose of our study was to determine the association between four echocardiographic parameters (ejection fraction (EF), global longitudinal strain (GLS), mean E/e’ ratio, and left atrial volume indexed) and biomarkers associated with cardiac fibrosis, such as procollagen type I carboxy-terminal propeptide (PICP), procollagen type III N-terminal peptide (P3NP), and galectin-3 (Gal-3) in patients with end-stage renal disease (ESRD). Methods: 140 patients with ESRD were enrolled and investigated by echocardiography and the serum levels of the aforementioned biomarkers were determined at baseline. Results: The mean EF was 53.63 ± 8%, the mean GLS was −10.2 ± 5.3%, the mean E/e’ ratio was 9.8 ± 4.3, and the mean left atrial volume indexed (LAVI) was 45.8 ± 14.2 mL/m2. The average levels for PICP, P3NP, and Gal-3 were 457.2 ± 240 µg/L, 242 ± 199.9 µg/L, and 10.7 ± 3.7 ng/mL, respectively. In regression analysis, PICP was strongly associated with all four echocardiographic parameters (EF: p = 0.0002, R2 = 0.69; GLS: p = 0.00001, R2 = 0.81; mean E/e’: p = 0.00002; R2 = 0.89; LAVI: p = 0.003; R2 = 0.73). P3NP and Gal-3 were only associated with the EF (p = 0.01, R2 = 0.31 and p = 0.02; R2 = 0.35, respectively). Conclusion: Our study evidenced that PICP, a collagen-derived biomarker, is associated with important echocardiography parameters, suggesting that it can serve as an indicator of the presence of subclinical systolic and diastolic dysfunction in patients with advanced CKD.
The Clinical Value of Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio for Predicting Hematoma Expansion and Poor Outcomes in Patients with Acute Intracerebral Hemorrhage
Authors: Kim Yejin , Sohn Jong-Hee , Kim Chulho , Park So Young , Lee Sang-Hwa
Published: April 2023

There is little knowledge of the effect of inflammatory markers on the prognoses of hematoma expansion (HE) in patients with intracranial hemorrhage (ICH). We evaluated the impact of neutrophil–lymphocyte ratio (NLR) and platelet–lymphocyte ratio (PLR) on HE and worse outcomes after acute ICH. This study included 520 consecutive patients with ICH from the registry database enrolled over 80 months. Patients’ whole blood samples were collected upon arrival in the emergency department. Brain computed tomography scans were performed during hospitalization and repeated at 24 h and 72 h. The primary outcome measure was HE, defined as relative growth >33% or absolute growth <6 mL. A total of 520 patients were enrolled in this study. Multivariate analysis showed that NLR and PLR were associated with HE (NLR: odds ratio [OR], [95% CI] = 1.19 [1.12–1.27], p < 0.001; PLR: OR, [95% CI] = 1.01 [1.00–1.02], p = 0.04). Receiver operating characteristic curve analysis revealed that NLR and PLR could predict HE (AUC of NLR: 0.84, 95% CI [0.80–0.88], p < 0.001; AUC of PLR: 0.75 95% CI [0.70–0.80], p < 0.001). The cut-off value of NLR for predicting HE was 5.63, and that of PLR was 23.4. Higher NLR and PLR values increase HE risk in patients with ICH. NLR and PLR were reliable for predicting HE after ICH.
Prospective Evaluation of Magnetic Resonance Imaging Features of Magnesium-Based Alloy Screw Resorption in Pediatric Fractures
Authors: Waelti Stephan L. , Wildermuth Simon , Willems Erik P. , Fischer Tim , Dietrich Tobias J. , Leschka Sebastian , Matissek Christoph , Krebs Thomas , Markart Stefan
Published: April 2023

Background: The resorption of magnesium-based alloy bioabsorbable screws results in the release of hydrogen gas, which can mimic infection and enter the growth plate. The screw itself and the released gas may also affect image quality. Objective: The evaluation of magnetic resonance imaging (MRI) findings during the most active phase of screw resorption is the objective, with particular focus on the growth plate and to assess for the presence of metal-induced artifacts. Material and Methods: In total, 30 prospectively acquired MRIs from 17 pediatric patients with fractures treated with magnesium screws were assessed for the presence and distribution of intraosseous, extraosseous, and intra-articular gas; gas within the growth plate; osteolysis along the screw; joint effusion; bone marrow edema; periosteal reaction; soft tissue edema; and metal-induced artifacts. Results: Gas locules were found in the bone and soft tissues in 100% of the examinations, intra-articular in 40%, and in 37% of unfused growth plates. Osteolysis and the periosteal reaction were present in 87%, bone marrow edema in 100%, soft tissue edema in 100%, and joint effusion in 50% of examinations. Pile-up artifacts were present in 100%, and geometric distortion in 0% of examinations. Fat suppression was not significantly impaired in any examination. Conclusions: Gas and edema in the bone and soft tissues are normal findings during the resorption of magnesium screws and should not be misinterpreted as infection. Gas can also be detected within growth plates. MRI examinations can be performed without metal artifact reduction sequences. Standard fat suppression techniques are not significantly affected.
Use of Recombinant Activated Factor VII in Bleeding Lung Transplant Patients Undergoing Perioperative ECMO Therapy
Authors: Laxar Daniel , Schaden Eva , Wiegele Marion , Hötzenecker Konrad , Schwarz Stefan , Gratz Johannes
Published: April 2023

Background: Hemostasis in critically ill patients represents a fragile balance between hypocoagulation and hypercoagulation, and is influenced by various factors. Perioperative use of extracorporeal membrane oxygenation (ECMO)—increasingly used in lung transplantation—further destabilizes this balance, not least due to systemic anticoagulation. In the case of massive hemorrhage, guidelines recommend considering recombinant activated Factor VII (rFVIIa) as an ultima ratio treatment only after several preconditions of hemostasis have been established. These conditions are calcium levels ≥ 0.9 mmol/L, fibrinogen levels ≥ 1.5 g/L, hematocrit ≥ 24%, platelet count ≥ 50 G/L, core body temperature ≥ 35 °C, and pH ≥ 7.2. Objectives: This is the first study to examine the effect of rFVIIa on bleeding lung transplant patients undergoing ECMO therapy. The fulfillment of guideline-recommended preconditions prior to the administration of rFVIIa and its efficacy alongside the incidence of thromboembolic events were investigated. Methods: In a high-volume lung transplant center, all lung transplant recipients receiving rFVIIa during ECMO therapy between 2013 and 2020 were screened for the effect of rFVIIa on hemorrhage, fulfillment of recommended preconditions, and incidence of thromboembolic events. Results and Discussion: Of the 17 patients who received 50 doses of rFVIIa, bleeding ceased in four patients without surgical intervention. Only 14% of rFVIIa administrations resulted in hemorrhage control, whereas 71% of patients required revision surgery for bleeding control. Overall, 84% of all recommended preconditions were fulfilled; however, fulfillment was not associated with rFVIIa efficacy. The incidence of thromboembolic events within five days of rFVIIa administration was comparable to cohorts not receiving rFVIIa.
Transalbugineal Artificial Urinary Sphincter: A Refined Implantation Technique to Improve Surgical Outcomes
Authors: Sacco Emilio , Marino Filippo , Gandi Carlo , Bientinesi Riccardo , Totaro Angelo , Moretto Stefano , Gavi Filippo , Campetella Marco , Racioppi Marco
Published: April 2023

The artificial urinary sphincter (AUS) implantation is an effective treatment of post-prostatectomy urinary incontinence (PPI). Still, it may result in troublesome complications such as intraoperative urethral lesion and postoperative erosion. Based on the multilayered structure of the tunica albuginea of the corpora cavernosa, we evaluated an alternative transalbugineal surgical technique of AUS cuff placement with the aim to decrease perioperative morbidity while preserving the integrity of the corpora cavernosa. A retrospective study was conducted in a tertiary referral center from September 2012 to October 2021, including 47 consecutive patients undergoing AUS (AMS800®) transalbugineal implantation. At a median (IQR) follow-up of 60 (24–84) months, no intraoperative urethral injury and only one noniatrogenic erosion occurred. The actuarial 12 mo and 5 yr overall erosion-free rates were 95.74% (95% CI: 84.04–98.92) and 91.76% (95% CI: 75.23–97.43), respectively. In preoperatively potent patients, the IIEF-5 score remained unchanged. The social continence (0–1 pads per day) rate was 82.98% (CI 95%: 68.83–91.10) at 12 mos and 76.81% (CI 95%: 60.56–87.04) at 5 yrs follow-up. Our technically refined approach to AUS implantation may help to avoid intraoperative urethral lesions and lower the risk of subsequent erosion without compromising sexual function in potent patients. Prospective and adequately powered studies are necessary to achieve more compelling evidence.
Antegrade Intramedullary Femoral Lengthening and Distal Temporary Hemiepiphysiodesis for Combined Correction of Leg Length Discrepancy and Coronal Angular Deformity in Skeletally Immature Patients
Authors: Laufer Andrea , Frommer Adrien , Gosheger Georg , Toporowski Gregor , Rölfing Jan Duedal , Antfang Carina , Roedl Robert , Vogt Bjoern
Published: April 2023

Leg length discrepancies (LLD) are frequently associated with coronal malalignment. Temporary hemiepiphysiodesis (HED) is a well-established procedure for the correction of limb malalignment in skeletally immature patients. For treatment of LLD > 2 cm, lengthening with intramedullary devices gains increasing popularity. However, no studies have investigated the combined application of HED and intramedullary lengthening in skeletally immature patients. This retrospective single-center study evaluated the clinical and radiological outcomes of femoral lengthening with an antegrade intramedullary lengthening nail combined with temporary HED performed in 25 patients (14 females) between 2014 and 2019. Temporary HED through the implantation of flexible staples of the distal femur and/or proximal tibia was either performed prior (n = 11), simultaneously (n = 10) or subsequently (n = 4) to femoral lengthening. The mean follow-up period was 3.7 years (±1.4). The median initial LLD was 39.0 mm (35.0–45.0). Twenty-one patients (84%) presented valgus and four (16%) showed varus malalignment. Leg length equalization was achieved in 13 of the skeletally mature patients (62%). The median LLD of the eight patients with residual LLD > 10 mm at skeletal maturity was 15.5 mm (12.8–21.8). Limb realignment was observed in nine of seventeen skeletally mature patients (53%) in the valgus group, and in one of four patients (25%) in the varus group. Combining antegrade femoral lengthening and temporary HED is a viable option to correct LLD and coronal limb malalignment in skeletally immature patients; however, achieving limb length equalization and realignment may be difficult in cases of severe LLD and angular deformity, in particular.
The Inflammatory Bowel Disease—Disk Tool for Assessing Disability in Inflammatory Bowel Disease Patients: Validation of the Greek Version
Authors: Katsoula Anastasia , Axiaris Georgios , Mpitouli Afroditi , Palatianou Maria , Christidou Angeliki , Dimitriadis Nikolaos , Nakos Andreas , Pastras Ploutarchos , Kourkoulis Panagiotis , Karatzas Pantelis , Moutzoukis Miltiadis , Zlatinoudis Charalampos , Philippidis Athanasios , Kourikou Anastasia , Kokkotis Georgios , Gklavas Antonios , Machaira Angeliki , Mantaka Aikaterini , Talimtzi Persefoni , Anagnostopoulou Evaggelia , Koutroubakis Ioannis E. , Papaconstantinou Ioannis , Bamias Georgios , Manolakopoulos Spilios , Mathou Nicoletta , Paraskeva Konstantina , Protopappas Andreas , Tsironi Eftychia , Katsanos Konstantinos H. , Christodoulou Dimitrios K. , Papatheodoridis Georgios , Michalopoulos Georgios , Theocharis Georgios , Triantos Christos , Pachiadakis Ioannis , Soufleris Konstantinos , Viazis Nikolaos , Mantzaris Gerassimos J. , Tribonias Georgios , Tzouvala Maria , Theodoropoulou Angeliki , Karmiris Konstantinos , Zampeli Evanthia , Michopoulos Spyridon , Haidich Anna-Bettina , Giouleme Olga
Published: April 2023

Background: The Inflammatory Bowel Disease-Disk (IBD-Disk) is a physician-administered tool that evaluates the functional status of patients with Inflammatory Bowel Disease (IBD). The aim of our study was to validate the content of the IBD-Disk in a Greek cohort of IBD patients. Methods: Two questionnaires [the IBD Disk and the IBD-Disability Index (IBD-DI)] were translated into Greek and administered to IBD patients at baseline visit, after 4 weeks and 6 months. Validation of the IBD Disk included measuring of concurrent validity, reproducibility, and internal consistency. Results: A total of 300 patients were included at baseline and 269 at follow-up. There was a good correlation between the total scores of the IBD-Disk and IBD-DI at baseline (Pearson correlation 0.87, p < 0.001). Reproducibility of the total IBD-Disk score was very good [intra-class correlation coefficient (ICC), 95% confidence interval (CI) 0.89 (0.86–0.91)]. Cronbach’s coefficient alpha for all items achieved 0.90 (95%CI 0.88–0.92), demonstrating a very good homogeneity of the IBD-Disk items. Female gender and extraintestinal manifestations were significantly associated with a higher IBD-Disk total score. Conclusions: The Greek version of the IBD-Disk proved to be a reliable and valid tool in detecting and assessing IBD-related disability in a Greek cohort of IBD patients.
Review of Osteoradionecrosis of the Jaw: Radiotherapy Modality, Technique, and Dose as Risk Factors
Authors: Topkan Erkan , Kucuk Ahmet , Somay Efsun , Yilmaz Busra , Pehlivan Berrin , Selek Ugur
Published: April 2023

Radiotherapy (RT) or concurrent chemoradiotherapy (CCRT) is the cornerstone of organ-sparing or adjuvant therapy for nearly all head and neck cancers. Unfortunately, aggressive RT or CCRT can result in severe late toxicities, such as osteoradionecrosis of the jaws (ORNJ). The incidence of ORNJ is currently less than 5–6% due to advances in dental preventive care programs, RT planning systems, and RT techniques. Although numerous patient-, tumor-, and treatment-related factors may influence the incidence rates of ORNJ, RT modality (equipment), technique, and dose-volume-related factors are three of the most influential factors. This is mainly because different RT equipment and techniques have different levels of success at delivering the prescribed dose to the focal volume of the treatment while keeping the “organ at risk” safe. ORNJ risk is ultimately determined by mandibular dose, despite the RT technique and method being known predictors. Regardless of the photon delivery method, the radiobiological effects will be identical if the total dose, dose per fraction, and dose distribution within the tissue remain constant. Therefore, contemporary RT procedures mitigate this risk by reducing mandibular dosages rather than altering the ionizing radiation behavior in irradiated tissues. In light of the paucity of studies that have examined the impact of RT modality, technique, and dose-volume-related parameters, as well as their radiobiological bases, the present review aims to provide a comprehensive overview of the published literature on these specific issues to establish a common language among related disciplines and provide a more reliable comparison of research results.
Time Trends of Environmental and Socioeconomic Risk Factors in Patients with Inflammatory Bowel Disease over 40 Years: A Population-Based Inception Cohort 1977–2020
Authors: Wetwittayakhlang Panu , Gonczi Lorant , Golovics Petra A. , Kurti Zsuzsanna , Pandur Tunde , David Gyula , Erdelyi Zsuzsanna , Szita Istvan , Lakatos Laszlo , Lakatos Peter L.
Published: April 2023

Background: Data from population-based studies investigating trends in environmental factors associated with inflammatory bowel disease (IBD) is lacking. We aimed to assess long-term time trends of environmental and socioeconomic factors in IBD patients from a well-defined population-based cohort from Veszprem, Hungary. Methods: Patients were included between 1 January 1977, and 31 December 2020. Trends of environmental and socioeconomic factors were evaluated in three periods based on the decade of diagnosis, representing different therapeutic eras: cohort-A,1977–1995; cohort-B,1996–2008 (immunomodulator era); and cohort-C, 2009–2020 (biological era). Results: A total of 2240 incident patients with IBD were included (ulcerative colitis (UC) 61.2%, male 51.2%, median age at diagnosis: 35 years (IQR 29–49)). Rates of active smoking significantly decreased over time in Crohn’s disease (CD): 60.2%, 49.9%, and 38.6% in cohorts A/B/C (p < 0.001). In UC, the rates were low and stable: 15.4%, 15.4%, and 14.5% in cohorts A/B/C (p = 0.981). Oral contraceptive use was more common in CD compared to UC (25.0% vs. 11.6%, p < 0.001). In UC, prevalence of appendectomy before diagnosis decreased over time: 6.4%, 5.5%, and 2.3% in cohorts A/B/C (p = 0.013). No significant changes were found in the socio-geographic characteristics of the IBD population (urban living: UC, 59.8%/64.8%/ 62.5% (p = 0.309) and CD, 62.5%/ 62.0%/ 59.0% (p = 0.636), in cohorts A/B/C). A greater percentage of patients had completed secondary school as the highest education level in later cohorts in both UC (42.9%/50.2%/51.6%, p < 0.001) and CD (49.2%/51.7%/59.5%, p = 0.002). A higher percentage of skilled workers (34.4%/36.2%/38.9%, p = 0.027) was found in UC, but not in CD (p = 0.454). Conclusion: The association between trends of known environmental factors and IBD is complex. Smoking has become less prevalent in CD, but no other major changes occurred in socioeconomic factors over the last four decades that could explain the sharp increase in IBD incidence.
Advances in Canaloplasty—Modified Techniques Yield Strong Pressure Reduction with Low Risk Profile
Authors: Szurman Peter
Published: April 2023

For decades, trabeculectomy (TE) was considered the gold standard for surgical treatment of open-angle glaucoma owing to its powerful intraocular pressure (IOP)-lowering potency. However, owing to the invasive nature and high-risk profile of TE, this standard is changing, and minimally invasive procedures are becoming more preferable. In particular, canaloplasty (CP) has been established as a much gentler alternative in everyday life and is under development as a full-fledged replacement. This technique involves probing Schlemm’s canal with a microcatheter and inserting a pouch suture that places the trabecular meshwork under permanent tension. It aims to restore the natural outflow pathways of the aqueous humor and is independent of external wound healing. This physiological approach results in a significantly lower complication rate and allows considerably simplified perioperative management. There is now extensive evidence that canaloplasty achieves sufficient pressure reduction as well as a significant reduction in postoperative glaucoma medications. Unlike MIGS procedures, the indication is not only mild to moderate glaucoma; today, even advanced glaucoma benefits from the very low hypotony rate, which largely avoids a wipeout phenomenon. However, approximately half of patients are not completely medication-free after canaloplasty. As a consequence, a number of canaloplasty modifications have been developed with the goal of further enhancing the IOP-lowering effect while avoiding the risk of serious complications. By combining canaloplasty with the newly developed suprachoroidal drainage procedure, the individual improvements in trabecular facility and uveoscleral outflow facility appear to have an additive effect. Thus, for the first time, an IOP-lowering effect comparable to a successful trabeculectomy can be achieved. Other implant modifications also enhance the potential of canaloplasty or offer additional benefits such as the possibility of telemetric IOP self-measurement by the patient. This article reviews the modifications of canaloplasty, which has the potential to become a new gold standard in glaucoma surgery via stepwise refinement.