bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of Systemic Comorbidities on Ocular Hypertension and Open-Angle Glaucoma, in a Population from Spain and Portugal
Authors: Garcia-Villanueva Carolina , Milla Elena , Bolarin José M. , García-Medina José J. , Cruz-Espinosa Javier , Benítez-del-Castillo Javier , Salgado-Borges José , Hernández-Martínez Francisco J. , Bendala-Tufanisco Elena , Andrés-Blasco Irene , Gallego-Martinez Alex , Zanón-Moreno Vicente C. , Pinazo-Durán María Dolores
Published: September 2022

Open-angle glaucoma (OAG), the most prevalent clinical type of glaucoma, is still the main cause of irreversible blindness worldwide. OAG is a neurodegenerative illness for which the most important risk factor is elevated intraocular pressure (IOP). Many questions remain unanswered about OAG, such as whether nutritional or toxic habits, other personal characteristics, and/or systemic diseases influence the course of glaucoma. As such, in this study, we performed a multicenter analytical, observational, case–control study of 412 participants of both sexes, aged 40–80 years, that were classified as having ocular hypertension (OHT) or OAG. Our primary endpoint was to investigate the relationship between specific lifestyle habits; anthropometric and endocrine–metabolic, cardiovascular, and respiratory events; and commonly used psychochemicals, with the presence of OHT or OAG in an ophthalmologic population from Spain and Portugal. Demographic, epidemiological, and ocular/systemic clinical data were recorded from all participants. Data were analyzed using the R Statistics v4.1.2 and RStudio v2021.09.1 programs. The mean age was 62 ± 15 years, with 67–80 years old comprising the largest subgroup sample of participants in both study groups. The central corneal thickness (ultrasound pachymetry)-adjusted IOP (Goldman tonometry) in each eye was 20.46 ± 2.35 and 20.1 ± 2.73 mmHg for the OHT individuals, and 15.8 ± 3.83 and 16.94 ± 3.86 mmHg for the OAG patients, with significant differences between groups (both p = 0.001). The highest prevalence of the surveyed characteristics in both groups was for overweight/obesity and daily coffee consumption, followed by psychochemical drug intake, migraine, and peripheral vasospasm. Our data show that overweight/obesity, migraine, asthma, and smoking are major risk factors for conversion from OHT to OAG in this Spanish and Portuguese population.
Pulmonary Embolism in the Cancer Associated Thrombosis Landscape
Authors: Poenou Géraldine , Dumitru Dumitru Teona , Lafaie Ludovic , Mismetti Valentine , Ayoub Elie , Duvillard Cécile , Accassat Sandrine , Mismetti Patrick , Heestermans Marco , Bertoletti Laurent
Published: September 2022

In cancer patients, pulmonary embolism (PE) is the second leading cause of death after the cancer itself, most likely because of difficulties in diagnosing the disease due to its nonclassical presentation. The risk of PE recurrence and possibly the case-fatality rate depends on whether the patient presents a symptomatic PE, an unsuspected PE, a subsegmental PE, or a catheter-related PE. Choosing the best therapeutic option is challenging and should consider the risk of both the recurrence of thrombosis and the occurrence of bleeding. The purpose of this review is to provide an overview of the clinical characteristics and the treatment of cancer-associated PE, which could benefit clinicians to better manage the deadliest form of thrombosis associated with cancer. After a brief presentation of the epidemiological data, we will present the current attitude towards the diagnosis and the management of cancer patients with PE. Finally, we will discuss the perspectives of how the medical community can improve the management of this severe medical condition.
A Comparative Analysis of Robot-Assisted Laparoscopic Pyeloplasty in Pediatric and Adult Patients: Does Age Matter?
Authors: Kang Bosik , Suh Jungyo , Lim Bumjin , Kim Kun Suk , Song Sang Hoon
Published: September 2022

We investigated factors that affect the surgical outcomes of robotic pyeloplasty by comparing the surgical results of pediatric and adult patients with ureteropelvic junction stricture (UPJO). We retrospectively reviewed patients who underwent robotic pyeloplasty for UPJO between January 2013 and February 2022. The patients were categorized into two groups: the pediatric (≤18 years) and adult (>18 years) groups. The perioperative and postoperative outcomes and surgical complications were comparatively analyzed. Prognostic factors for predicting surgical failure were analyzed with multivariable logistic regression analysis. The pediatric group showed longer total operation and console times. The mean pain score was lower in the pediatric group than in the adult group on days 1 and 2 after surgery. The average amount of morphine used in the pediatric group was lower during postoperative days 0–2. No differences in the length of hospital stay, incidence of surgical failure, and incidence of urolithiasis requiring treatment after robotic pyeloplasty were observed between the groups. The only factor that predicted surgical failure was a history of urolithiasis before surgery. The results showed that age did not affect the surgical outcome.
Noninvasive Liver Fibrosis Staging: Comparison of MR Elastography with Extracellular Volume Fraction Analysis Using Contrast-Enhanced CT
Authors: Yano Keigo , Onishi Hiromitsu , Tsuboyama Takahiro , Nakamoto Atsushi , Ota Takashi , Fukui Hideyuki , Tatsumi Mitsuaki , Tanigaki Takumi , Gotoh Kunihito , Kobayashi Shogo , Honma Keiichiro , Eguchi Hidetoshi , Tomiyama Noriyuki
Published: September 2022

Purpose: To compare the accuracy of liver fibrosis staging with MR elastography and of staging with extracellular volume fraction (fECV) analysis using contrast-enhanced CT. Methods: This retrospective study included 60 patients who underwent both MR elastography and contrast-enhanced CT before liver surgery between October 2013 and July 2020. Two radiologists independently measured liver stiffness of MR elastography and fECV of CT images. Accuracy for liver fibrosis staging was assessed using receiver operating characteristic (ROC) analysis. Correlations between liver stiffness or fECV and liver fibrosis were also evaluated by means of the Spearman rank correlation coefficient. Results: The areas under the ROC curves for MR elastography for each stage differentiation of ≥F1 (0.85, 0.82 for the two radiologists), ≥F2 (0.88, 0.89), ≥F3 (0.87, 0.86), and F4 (0.84, 0.83) were greater than those for fECV analysis with CT (0.64, p = 0.06, 0.69, p = 0.2; 0.62, p < 0.005, 0.63, p < 0.005; 0.62, p < 0.005, 0.62, p < 0.01; and 0.70, p = 0.08, 0.71, p = 0.2, respectively). The correlation coefficients between liver stiffness and liver fibrosis in A0 (0.67, 0.69 for the two radiologists), A1 (0.64, 0.66) and A2 group (0.58, 0.51) were significantly higher than those between fECV and liver fibrosis (0.28, 0.30; 0.27, 0.31; and 0.23, 0.07; p < 0.05 for all comparisons). Conclusion: MR elastography allows for more accurate liver fibrosis staging compared with fECV analysis with CT. In addition, MR elastography may be less affected than fECV analysis by the inflammatory condition.
ABCB1 Is Frequently Methylated in Higher-Grade Gliomas and May Serve as a Diagnostic Biomarker of More Aggressive Tumors
Authors: Majchrzak-Celińska Aleksandra , Sidhu Arvinder , Miechowicz Izabela , Nowak Witold , Barciszewska Anna-Maria
Published: September 2022

ABCB1 belongs to a superfamily of membrane transporters that use ATP hydrolysis to efflux various endogenous compounds and drugs outside the cell. Cancer cells upregulate ABCB1 expression as an adaptive response to evade chemotherapy-mediated cell death. On the other hand, several reports highlight the role of the epigenetic regulation of ABCB1 expression. In fact, the promoter methylation of ABCB1 was found to be methylated in several tumor types, including gliomas, but its role as a biomarker is not fully established yet. Thus, the aim of this study was to analyze the methylation of the ABCB1 promoter in tumor tissues from 50 glioma patients to verify its incidence and to semi-quantitively detect ABCB1 methylation levels in order to establish its utility as a potential biomarker. The results of this study show a high interindividual variability in the ABCB1 methylation level of the samples derived from gliomas of different grades. Additionally, a positive correlation between ABCB1 methylation, the WHO tumor grade, and an IDH1 wild-type status has been observed. Thus, ABCB1 methylation can be regarded as a potential diagnostic or prognostic biomarker for glioma patients, indicating more aggressive tumors.
Clinical Outcomes of Individuals with COVID-19 and Tuberculosis during the Pre-Vaccination Period of the Pandemic: A Systematic Review
Authors: Jhaveri Tulip A. , Fung Celia , LaHood Allison N. , Lindeborg Andrew , Zeng Chengbo , Rahman Rifat , Bain Paul A. , Velásquez Gustavo E. , Mitnick Carole D.
Published: September 2022

Background: Tuberculosis, like COVID-19, is most often a pulmonary disease. The COVID-19 pandemic has severely disrupted tuberculosis services in myriad ways: health facility closures, lockdowns, travel bans, overwhelmed healthcare systems, restricted export of antituberculous drugs, etc. The effects of the shared risk on outcomes of the two diseases is not known, particularly for the first year of the pandemic, during the period before COVID-19 vaccines became widely available. Objective: We embarked on a systematic review to elucidate the consequences of tuberculosis on COVID-19 outcomes and of COVID-19 on tuberculosis outcomes during the pre-vaccination period of the pandemic. Methods: The systematic review protocol is registered in PROSPERO. We conducted an initial search of PubMed, Embase, Web of Science, WHO coronavirus database, medRxiv, bioRxiv, preprints.org, and Google Scholar using terms relating to COVID-19 and tuberculosis. We selected cohort and case–control studies for extraction and assessed quality with the Newcastle-Ottawa scale. Results and Conclusion: We identified 2108 unique abstracts published between December 2019 and January 2021. We extracted data from 18 studies from 8 countries. A total of 650,317 persons had a diagnosis of COVID-19, and 4179 had a diagnosis of current or prior tuberculosis. We explored links between tuberculosis and COVID-19 incidence, mortality, and other adverse outcomes. Nine studies reported on mortality and 13 on other adverse outcomes; results on the association between tuberculosis and COVID-19 mortality/adverse outcomes were heterogenous. Tuberculosis outcomes were not fully available in any studies, due to short follow-up (maximum of 3 months after COVID-19 diagnosis), so the effects of COVID-19 on tuberculosis outcomes could not be assessed. Much of the rapid influx of literature on tuberculosis and COVID-19 during this period was published on preprint servers, and therefore not peer-reviewed. It offered limited examination of the effect of tuberculosis on COVID-19 outcomes and even less on the effect of COVID-19 on tuberculosis treatment outcomes.
Complications of Long Head of the Biceps Tenotomy in Association with Arthroscopic Rotator Cuff Repair: Risk Factors and Influence on Outcomes
Authors: Ranieri Riccardo , Nabergoj Marko , Xu Li , Coz Pierre Le , Mohd Don Ahmad Farihan , Lädermann Alexandre , Collin Philippe
Published: September 2022

Background: This study aims to report the rate of biceps-related complications after LHB tenotomy, investigating related risk factors and their influence on the outcome. The hypothesis is that these complications have a limited clinical influence. Methods: A single-center prospective observational study was performed between 2015 and 2017 on consecutive patients who underwent RCR associated with LHB tenotomy. Patients were clinically and radiologically evaluated preoperatively, at six months and one year, and screened for postoperative popeye deformity, cramps, and bicipital discomfort. Each complication was analyzed for the following risk factors: age, sex, body mass index (BMI), dominant arm, manual work, tear patterns, and tendon healing. Finally, the clinical outcome was compared between patients with and without complications. Results: 207 patients were analyzed. Cramps, popeye deformity, and discomfort, were respectively, present in 16 (7.7%), 38 (18.4%) and 52 (25.1%) cases at six months and 17 (8.2%), 18 (8.7%) and 24 (11.6%) cases at one year. Cramps were associated with lower age (p = 0.0005), higher BMI (p = 0.0251), single tendon tear (p = 0.0168), manual work (p = 0.0086) at six months and manual work (p = 0.0345) at one year. Popeye deformity was associated with male sex at six months (p < 0.0001). Discomfort was associated with lower age (p = 0.0065), manual work (p = 0.0099), popeye deformity (p = 0.0240) at six months and manual work (p = 0.0200), single tendon tear (p = 0.0370), popeye deformity (p = 0.0033) at one year. Patients without complications showed a significant higher Constant score, pain and subjective shoulder value (SSV) (75.3 vs. 70.4, p = 0.00252; 0.9 vs. 1.9, p < 0.00001; 80.2 vs. 76.4; p = 0.00124) at six months and pain and SSV (0.6 vs. 2.0; p = 0.00044; 91.1 vs. 77.8; p ≤ 0.00001) at one year. Conclusions: Younger age, male sex, higher BMI, manual work, and single tendon tears are risk factors associated with the development of biceps-related symptoms during the first year after tenotomy in association with rotator cuff repair. Nevertheless, the clinical influence of these symptoms on shoulder outcomes is limited.
Numerical Experiments on Hydrodynamic Performance and the Wake of a Self-Starting Vertical Axis Tidal Turbine Array
Authors: Zhu Lining , Hou Erhu , Zhou Qingwei , Wu He
Published: September 2022

In this paper, based on the CFD software ANSYS-Fluent, two-dimensional numerical models are established to investigate the hydrodynamic performance of a self-starting H-Darrius vertical axis tidal turbine (VATT) array of three turbines in a triangular layout with 3D in axial and radial distance. Three main aspects are explored in this study: (1) the self-starting performance, power coefficient, flow fields, and blade force of the double-row VATT array, which are compared with a stand-alone turbine, (2) the wake development of the front and rear displacement turbines, and (3) the feasibility of the double-row self-starting VATT array in practical applications. It is found that the power coefficients of the three turbines in the array all improved compared with that of the stand-alone turbine, and as the load increased, the difference between the averaged power coefficient of the array and a stand-alone turbine was more obvious, with a maximum difference of 3%. The main effects of the front turbines on the rear turbine are energy utilization and turbine vibration. Due to the beam effect between the front turbines, the incident flow rate of the rear turbine increased to approximately 1.2 times the free flow rate. However, the greater rotational fluctuations of the rear turbine mean that although it had a higher power factor, it was more susceptible to fatigue damage. The wake of the rear turbine in the array had a much larger area of influence on both the length and width, but the velocity deficit recovered more quickly to over 95% at a distance of 10D behind it. The rate of wake velocity recovery is load-dependent for a stand-alone self-starting turbine, but this was not evident in the arrays. The positive torque of the turbine is mainly generated when the blade rotates through an azimuth angle from 45° to 160° and mainly benefits from the inner side of the blade. For the double-row three-turbine array, the axial and radial spacing of 3D is reasonable in practical applications.
An Improved Approach to Wave Energy Resource Characterization for Sea States with Multiple Wave Systems
Authors: Jiang Xingjie , Gao Dalu , Hua Feng , Yang Yongzeng , Wang Zeyu
Published: September 2022

Generally, wave energy resource assessment and characterization are performed based on an entire wave spectrum, ignoring the detailed energy features that belong to wave systems, i.e., wind waves and swells. In reality, the energy is separately possessed by multiple wave systems, propagating at different directions and velocities. Therefore, it is the wave system that is the most fundamental unit of the wave energy resource. Although detailed analyses of wind waves and swells can be conducted via wave system partitioning, operational assessment methods that can reveal the detailed wave energy characteristics of wave systems still deserve further development. Following a two-step partitioning procedure, this paper presents an improved approach to the characterization of wave energy resources based on grouped wave systems. Wave systems classified as the same group are consistent in terms of propagation direction, velocity, and other characteristics of wave energy, but these characteristics between the groups are obviously different. Therefore, in comparison with the traditional method, the new approach can reveal more comprehensive and more detailed characteristics of the wave energy resource in terms of (i) wind-sea and swell components, (ii) directionality, and (iii) wave conditions; details that represent valuable information for the improvement of the performance of wave energy converter devices and the optimization of the layout of device arrays in wave farms.
Effect of Winding Steel Wire on the Collapse Pressure of Submarine Hose
Authors: Wei Daifeng , An Chen , Zhang Jixiang , Huang Yixuan , Gu Chenwang
Published: September 2022

The submarine hose plays a vital role in the single-point mooring system and is a necessary channel for medium transportation. Once crushed under the load of the seawater external pressure, it will cause oil and gas leakage and major safety accidents. It is a composite hose composed of a rubber layer, cord layer and steel helix wire, of which the steel helix wire plays an important part in bearing mechanical properties. In this work, python language was used to model the submarine hose parametrically, the finite element (FE) analysis software ABAQUS was utilized to analyze the ultimate bearing capacity of the hose under uniformly distributed external pressure loads and the influence of the initial ovality of the submarine hose, the diameter and pitch of the helix wire, the yield strength of the helix wire material on the ultimate bearing capacity of the submarine hose were studied. Through a large number of FE results, the ultimate bearing capacity of the hose was obtained by fitting the prediction formula.
Boussinesq Simulation of Coastal Wave Interaction with Bottom-Mounted Porous Structures
Authors: Fang Kezhao , Huang Minghan , Chen Guanglin , Wu Jinkong , Wu Hao , Jiang Tiantian
Published: September 2022

A Boussinesq-type wave model is developed in this paper to simulate the interaction of coastal waves with bottom-mounted porous structures. The governing equations are rewritten in the conservative form to facilitate the use of hybrid finite volume (FV) and finite difference (FD) method. Higher-order slope terms are also inserted into the equations to account for rapidly varying bathymetry. The convective flux is approximated using the FV method, while the remaining terms are discretized using the FD method in a uniform rectangle grid system. The time integration is implemented using the third order Runge–Kutta method with an adaptive time step. A single GPU parallel computation is also implemented to save computation costs. The numerical model is validated against a series of experimental datasets, including data acquired in a new laboratory experiment. The predictions are in overall agreement with the measurements, proving that the model is capable of handling wave interaction with porous structures in the coastal region for a wide range of scenarios.
Coniochaeta massiliensis sp. nov. Isolated from a Clinical Sampl28
Authors: Kabtani Jihane , Militello Muriel , Ranque Stéphane
Published: September 2022

The genus Coniochaeta belongs to the class Ascomycota and the family Coniochaetaceae. Some of the Coniochaeta species are plant and animal pathogens, while others are known to be primarily involved in human diseases. In the last few decades, case reports of human infections with Coniochaeta have increased, mainly in immunocompromised hosts. We have described and characterised a new species in the genus Coniochaeta, here named Coniochaeta massiliensis (PMML0158), which was isolated from a clinical sample. Species identification and thorough description were based on apposite and reliable phylogenetic and phenotypic approaches. The phylogenetic methods included multilocus phylogenetic analyses of four genomic regions: ITS (rRNA Internal Transcribed Spacers 1 and 2), TEF-1α (Translation Elongation Factor-1alpha), B-tub2 (β-tubulin2), and D1/D2 domains (28S large subunit rRNA). The phenotypic characterisation consisted, first, of a physiological analysis using both EDX (energy-dispersive X-ray spectroscopy) and BiologTM advanced phenotypic technology for fixing the chemical mapping and carbon-source oxidation/assimilation profiles. Afterwards, morphological characteristics were highlighted by optical microscopy and scanning electron microscopy. The in vitro antifungal susceptibility profile was characterised using the E-testTM exponential gradient method. The molecular analysis revealed the genetic distance between the novel species Coniochaeta massiliensis (PMML0158) and other known taxa, and the phenotypic analysis confirmed its unique chemical and physiological profile when compared with all other species of this genus.
Onychomycosis in Two Populations with Different Socioeconomic Resources in an Urban Nucleus: A Cross-Sectional Study
Authors: Alfageme-García Pilar , Jiménez-Cano Víctor Manuel , Ramírez-Durán María del Valle , Gómez-Luque Adela , Hidalgo-Ruiz Sonia , Basilio-Fernández Belinda
Published: September 2022

Onychomycosis is one of the most common foot conditions. Mixed onychomycosis and onychomycosis caused by non-dermatophyte moulds are increasing in incidence, especially in vulnerable populations, hence the importance of this study, which presents the prevalence of onychomycosis in a population of homeless people, comparing the findings with a sample of a well-resourced population. The total sample consisted of 70 participants, divided into two separate groups, a homeless population and a second group in which we included people attending a private clinic. The average age of the sample is [49.19 ± 28.81] with an age range of 18 to 78 years. In the homeless group, the most prevalent infectious agents were non-dermatophyte fungi, with a total of 48%, compared to 28% in the group housed. The most common site of infection in both groups was the nail of the first finger. We, therefore, conclude that there is a difference in the infecting agent in the homeless population and the population with homes.
Neurosurgical Defeats: Critically Ill Patients and the Role of Palliative Care Service
Authors: D’Alessandris Quintino Giorgio , Ricciotti Maria Adelaide , Palombi Davide , Agostini Ludovico , Mattogno Pier Paolo , Della Pepa Giuseppe Maria , Albanese Alessio , Chiesa Silvia , Dispenza Sabrina , Meloni Eleonora , Tummolo Anita Maria , Pallini Roberto , Barillaro Christian , Olivi Alessandro , Lauretti Liverana
Published: September 2022

The onco-functional balance in neuro-oncology requires maximizing tumor removal while rigorously preserving patients’ neurological status. When postoperative worsening prevents the implementation of oncologic treatments, palliative care service offers an individualized path for symptom and psychosocial distress relief. Here, we report on a series of 25 patients operated on for malignant brain tumor who did not undergo adjuvant treatments after neurosurgery; they represented 3.9% of the whole institutional surgical series. These patients were significantly older and had a lower preoperative Karnofsky performance status than the whole cohort. Importantly, in 22 out of 25 (88%) cases, a surgical complication occurred, leading to clinical worsening in 21 patients. For the end of life, the majority of patients chose a hospice care facility (72%). While a careful selection of brain tumor patients candidate to neurosurgery is required, palliative care service provided invaluable help in coping with patients’ and caregivers’ needs.
Association between A Family History of Colorectal Cancer and the Risk of Colorectal Cancer: A Nationwide Population-Based Study
Authors: Jung Yoon Suk , Song Huiyeon , Tran Mai Thi Xuan , Park Boyoung , Moon Chang Mo
Published: September 2022

Large-scale Asian studies on this topic are lacking. We evaluated the CRC risk associated with family history in the Korean population. We analyzed the data of participants aged ≥40 years who underwent national cancer screening between 2013 and 2014. During a mean follow-up of 4.7 ± 0.8 years, 0.43% of the 292,467 participants with family history and 0.28% of the 1,169,868 participants without family history developed CRC. Participants with a family history in any FDR, parents only, and siblings only had a higher risk of CRC than those without family history; adjusted hazard ratios (HRs) were 1.53, 1.46, and 1.61, respectively. Participants with a family history comprising both parents and siblings had an even higher risk of CRC than those without a family history (HR, 2.34). The HRs for CRC in the 40–49, 50–59, 60–69, 70–79, and ≥80 age groups with family history were 1.72, 1.74, 1.50, 1.30, and 0.78, respectively (p < 0.001). A family history of CRC in any FDR and both parents and siblings was associated with an approximately 1.5- and 2.3-fold increased risk of CRC. The effect of family history was relatively greater in the younger than the older age group.
Inferior Pedicle Reduction Mammoplasty as Corrective Surgery after Breast Conserving Surgery and Radiation Therapy
Authors: Atzori Giulia , Franchelli Simonetta , Gipponi Marco , Cornacchia Chiara , Diaz Raquel , Depaoli Francesca , Murelli Federica , Sparavigna Marco , Fregatti Piero , Friedman Daniele
Published: September 2022

Background/Aim—Twenty patients had corrective reconstruction surgery by means of a reduction mammaplasty or mastopexy after a previous BCS (Breast Conserving Surgery) and RT (Radiation Therapy); the risk factors and post-operative complications were reported in order to define a safe and effective technique for reduction mammaplasty in previously irradiated breast cancer patients. Materials and Methods—From June 2011 to December 2019, 20 pts. were operated on at the Breast Surgery Clinic of San Martino Policlinic Hospital, Genoa, Italy. Pre- and post-operative parameters included clinic-pathological features of the primary tumor; a lapse of time from primary radio-surgery; the extent of follow-up; the rate of post-operative wound infections; the persistence of breast asymmetry, and a post-operative patient satisfaction index by means of a BREAST-Q questionnaire. Results—Three patients (15%) developed minor complications in the irradiated breast, but no complication was observed into the non-irradiated breast. No statistically significant correlation was found between the post-operative complications and the risk factors. The statistical analysis of BREAST-Q questionnaire responses gave an average patient’s satisfaction index that was equal to 90.8/100 (range: 44 to 100). Conclusions—Inferior pedicle reduction mammoplasty is an effective reduction mammoplasty technique in regard to the extent of breast tissues that are to be removed both in irradiated and contralateral breast; moreover, the incidence of post-operative complications is clearly limited when a careful technique is adopted, and it can be reasonably applied also in patients with co-morbidity factors.
Risk Factors for Retained Hemothorax after Trauma: A 10-Years Monocentric Experience from First Level Trauma Center in Italy
Authors: Rossmann Marta , Altomare Michele , Pezzoli Isabella , Abruzzese Arianna , Spota Andrea , Vettorello Marco , Cioffi Stefano , Virdis Francesco , Bini Roberto , Chiara Osvaldo , Cimbanassi Stefania
Published: September 2022

Thoracic trauma occurs in 20–25% of all trauma patients worldwide and represents the third cause of trauma-related mortality. Retained hemothorax (RH) is defined as a residual hematic pleural effusion larger than 500 mL after 72 h of treatment with a thoracic tube. The aim of this study is to investigate risk factors for the development of RH in thoracic trauma and predictors of surgery. A retrospective, observational, monocentric study was conducted in a Trauma Hub Hospital in Milan, recording thoracic trauma from January 2011 to December 2020. Pre-hospital peripheric oxygen saturation (SpO2) was significantly lower in the RH group (94% vs. 97%, p = 0.018). Multivariable logistic regression analysis identified, as independent predictors of RH, sternum fracture (OR 7.96, 95% CI 1.16–54.79; p = 0.035), pre-admission desaturation (OR 0.96; 95% CI 0.77–0.96; p = 0.009) and the number of thoracic tube maintenance days (OR 1.22; 95% CI 1.09–1.37; p = 0.0005). The number of tubes placed and the 1° rib fracture were both significantly associated with the necessity of surgical treatment of RH (2 vs. 1, p = 0.004; 40% vs. 0%; p = 0.001). The risk of developing an RH in thoracic trauma should not be underestimated. Variables related to RH must be taken into account in order to schedule a proper follow-up after trauma.
Sonographic Assessment of Uterine Biometry for the Diagnosis of Diffuse Adenomyosis in a Tertiary Outpatient Clinic
Authors: Raimondo Diego , Lazzeri Lucia , Raffone Antonio , Giorgi Matteo , Orsini Benedetta , Verrelli Ludovica , Lenzi Jacopo , Travaglino Antonio , De Meis Lucia , Mollo Antonio , Zupi Errico , Seracchioli Renato , Casadio Paolo
Published: September 2022

Background: to compare several uterine biometric parameters at transvaginal ultrasound (TVUS) between adenomyosis and non-adenomyosis uteri and evaluate their role for the diagnosis of diffuse adenomyosis. Methods: prospective observational study conducted between the 1 February 2022 and the 30 April 2022. In this case, 56 patients with TVUS diagnosis of adenomyosis were included. A 1:1 ratio age and parity-matched group of non-adenomyosis patients was selected. We compared sonographic uterine biometric parameters (longitudinal (LD), anteroposterior (APD) and transverse (TD) diameters, volume, simple and complex diameter ratios) and investigated their diagnostic performance. Results: all sonographic parameters were significantly different between the study groups, except for TD/(LD+APD). Optimal cut-off values of APD and LD/APD showed the best sensitivity and specificity. APD diameter equal or superior to 39.5 mm (95% CI, 36.2–42.8) had sensitivity of 0.70 (95% CI, 0.57–0.80), specificity of 0.71 (95% CI, 0.59–0.82) and accuracy of 0.75 (95% CI, 0.66–0.84). LD/APD equal or inferior to 2.05 (95% CI, 1.96–2.13) showed sensitivity and specificity of 0.70 (95% CI, 0.57–0.80) each and accuracy of 0.72 (95% CI, 0.62–0.81). Conclusions: several biometric uterine parameters at TVUS in fertile-aged women were statistically different between adenomyosis and non-adenomyosis uteri, though their optimal cut-off values showed low accuracy in diagnosing adenomyosis.
Early Prognostic Stratification of Clostridioides difficile Infection in the Emergency Department: The Role of Age and Comorbidities
Authors: Covino Marcello , Gallo Antonella , Pero Erika , Simeoni Benedetta , Macerola Noemi , Murace Celeste Ambra , Ibba Francesca , Landi Francesco , Franceschi Francesco , Montalto Massimo
Published: September 2022

Clostridioides difficile infection (CDI) represents a significant cause of morbidity and mortality, mainly in older and frail subjects. Early identification of outcome predictors, starting from emergency department (ED) admission, could help to improve their management. In a retrospective single-center study on patients accessing the ED for diarrhea and hospitalized with a diagnosis of CDI infection, the patients’ clinical history, presenting symptoms, vital signs, and laboratory exams at ED admission were recorded. Quick sequential organ failure assessments (qSOFA) were conducted and Charlson’s comorbidity indices (CCI) were calculated. The primary outcomes were represented by all-cause in-hospital death and the occurrence of major cumulative complications. Univariate and multivariate Cox regression analyses were performed to establish predictive risk factors for poor outcomes. Out of 450 patients, aged > 81 years, dyspnea at ED admission, creatinine > 2.5 mg/dL, white blood cell count > 13.31 × 109/L, and albumin < 30 µmol/L were independently associated with in-hospital death and major complications (except for low albumin). Both in-hospital death and major complications were not associated with multimorbidity. In patients with CDI, the risk of in-hospital death and major complications could be effectively predicted upon ED admission. Patients in their 8th decade have an increased risk independent of comorbidities.
Predictors and Prognostic Impact of Left Ventricular Ejection Fraction Recovery after Impella-Supported Percutaneous Coronary Interventions in Acute Myocardial Infarction
Authors: Marin Federico , Pighi Michele , Zucchelli Federico , Ruzzarin Alessandro , Russo Giulio , Aurigemma Cristina , Romagnoli Enrico , Ferrero Valeria , Piccoli Anna , Scarsini Roberto , Pesarini Gabriele , Trani Carlo , Burzotta Francesco , Ribichini Flavio Luciano
Published: September 2022

Aim: The aim of our study is to assess the predictors and the prognostic role of left ventricle ejection fraction (LVEF) recovery after Impella-supported percutaneous coronary intervention (PCI) in patients presenting with acute myocardial infarction (AMI). Methods: This retrospective, observational study included patients admitted for AMI who underwent Impella-supported PCI in two Italian high-volume cardiac catheterization laboratories. Only patients who underwent an echocardiographic assessment of left ventricle ejection fraction (LVEF) before the procedure (acute LVEF) and during follow-up (follow-up LVEF) were included in the present analysis. Patients with a baseline LVEF ≥40% were excluded from the present analysis. LVEF recovery was calculated as the difference between follow-up LVEF and acute LVEF. A delta ≥5% was considered significant and was used to define the responder group. Results: From April 2007 to December 2020, 64 consecutive patients were included in our study. A total of 55 patients (86%) received hemodynamic support with Impella 2.5, and 9 patients (14%) with Impella CP. Median LVEF at follow-up was significantly higher compared to baseline (36% (30–42) vs. 30% (24–33), p < 0.001). Based on LVEF recovery, 37 patients (57.8%) were deemed responders. According to multivariate analysis, complete functional revascularization was an independent predictor of a significant EF recovery (OR: 0.159; 95% CI: 0.038–0.668; p = 0.012). At three-year follow-up, lack of LVEF recovery was the only predictor of mortality (HR: 5.315; 95% CI: 1.100–25.676; p = 0.038). Conclusions: Functional complete revascularization is an independent predictor of the recovery of LVEF in patients presenting with AMI who underwent Impella-supported PCI. The recovery of LV function is associated with improved prognosis and could be used to stratify the risk of future events at long-term follow-up.
Opposite Response to Vitamin K Antagonists: A Report of Two Cases and Systematic Review of Literature
Authors: Conti Valeria , Manzo Valentina , De Bellis Emanuela , Stefanelli Berenice , Sellitto Carmine , Bertini Nicola , Corbi Graziamaria , Ferrara Nicola , Filippelli Amelia
Published: September 2022

Vitamin K antagonists (VKAs) are used in the prophylaxis and treatment of thromboembolic disorders. Despite a high efficacy, their narrow therapeutic window and high response variability hamper their management. Several patients experience fluctuations in dose–response and are at increased risk of over- or under-anticoagulation. Therefore, it is essential to monitor the prothrombin time/international normalized ratio to determine the so-called stable dose and to adjust the dosage accordingly. Three polymorphisms, CYP2C9∗2, CYP2C9∗3 and VKORC1-1639G>A, are associated with increased sensitivity to VKAs. Other polymorphisms are associated with a request for a higher dose and VKA resistance. We described the clinical cases of two patients who were referred to the Clinical Pharmacology and Pharmacogenetics Unit of the University Hospital of Salerno for pharmacological counseling. One of them showed hypersensitivity and the other one was resistant to VKAs. A systematic review was performed to identify randomized clinical trials investigating the impact of pharmacogenetic testing on increased sensitivity and resistance to VKAs. Although international guidelines are available and information on the genotype-guided dosing approach has been included in VKA drug labels, VKA pharmacogenetic testing is not commonly required. The clinical cases and the results of the systematically reviewed RCTs demonstrate that the pharmacogenetic-based VKA dosing model represents a valuable resource for reducing VKA-associated adverse events.
Dopaminergic Gene Dosage Reveals Distinct Biological Partitions between Autism and Developmental Delay as Revealed by Complex Network Analysis and Machine Learning Approaches
Authors: Santos André , Caramelo Francisco , Melo Joana Barbosa , Castelo-Branco Miguel
Published: September 2022

The neurobiological mechanisms underlying Autism Spectrum Disorders (ASD) remains controversial. One factor contributing to this debate is the phenotypic heterogeneity observed in ASD, which suggests that multiple system disruptions may contribute to diverse patterns of impairment which have been reported between and within study samples. Here, we used SFARI data to address genetic imbalances affecting the dopaminergic system. Using complex network analysis, we investigated the relations between phenotypic profiles, gene dosage and gene ontology (GO) terms related to dopaminergic neurotransmission from a polygenic point-of-view. We observed that the degree of distribution of the networks matched a power-law distribution characterized by the presence of hubs, gene or GO nodes with a large number of interactions. Furthermore, we identified interesting patterns related to subnetworks of genes and GO terms, which suggested applicability to separation of clinical clusters (Developmental Delay (DD) versus ASD). This has the potential to improve our understanding of genetic variability issues and has implications for diagnostic categorization. In ASD, we identified the separability of four key dopaminergic mechanisms disrupted with regard to receptor binding, synaptic physiology and neural differentiation, each belonging to particular subgroups of ASD participants, whereas in DD a more unitary biological pattern was found. Finally, network analysis was fed into a machine learning binary classification framework to differentiate between the diagnosis of ASD and DD. Subsets of 1846 participants were used to train a Random Forest algorithm. Our best classifier achieved, on average, a diagnosis-predicting accuracy of 85.18% (sd 1.11%) on the test samples of 790 participants using 117 genes. The achieved accuracy surpassed results using genetic data and closely matched imaging approaches addressing binary diagnostic classification. Importantly, we observed a similar prediction accuracy when the classifier uses only 62 GO features. This result further corroborates the complex network analysis approach, suggesting that different genetic causes might converge to the dysregulation of the same set of biological mechanisms, leading to a similar disease phenotype. This new biology-driven ontological framework yields a less variable and more compact domain-related set of features with potential mechanistic generalization. The proposed network analysis, allowing for the determination of a clearcut biological distinction between ASD and DD (the latter presenting much lower modularity and heterogeneity), is amenable to machine learning approaches and provides an interesting avenue of research for the future.
Communicating Personal Melanoma Polygenic Risk Information: Participants’ Experiences of Genetic Counseling in a Community-Based Study
Authors: Smit Amelia K. , Espinoza David , Fenton Georgina L. , Kirk Judy , Innes Jessica S. , McGovern Michael , Limb Sharne ,   on behalf of the Managing Your Risk Study Group, Turbitt Erin , Cust Anne E.
Published: September 2022

Personalized polygenic risk information may be used to guide risk-based melanoma prevention and early detection at a population scale, but research on communicating this information is limited. This mixed-methods study aimed to assess the acceptability of a genetic counselor (GC) phone call in communicating polygenic risk information in the Melanoma Genomics Managing Your Risk randomized controlled trial. Participants (n = 509) received personalized melanoma polygenic risk information, an educational booklet on melanoma prevention, and a GC phone call, which was audio-recorded. Participants completed the Genetic Counseling Satisfaction Survey 1-month after receiving their risk information (n = 346). A subgroup took part in a qualitative interview post-study completion (n = 20). Survey data were analyzed descriptively using SPSS, and thematic analysis of the qualitative data was conducted using NVivo 12.0 software. The survey showed a high level of acceptability for the GC phone call (mean satisfaction score overall: 4.3 out of 5, standard deviation (SD): 0.6) with differences according to gender (mean score for women: 4.4, SD: 0.6 vs. men: 4.2, SD: 0.7; p = 0.005), health literacy (lower literacy: 4.1, SD: 0.8; average: 4.3, SD: 0.6; higher: 4.4, SD: 0.6: p = 0.02) and polygenic risk group (low risk: 4.5, SD: 0.5, SD: average: 4.3, SD: 0.7, high: 4.3, SD: 0.7; p = 0.03). During the GC phone calls, the discussion predominately related to the impact of past sun exposure on personal melanoma risk. Together our findings point to the importance of further exploring educational and support needs and preferences for communicating personalized melanoma risk among population subgroups, including diverse literacy levels.
Grocery Apps and Consumer Purchase Behavior: Application of Gaussian Mixture Model and Multi-Layer Perceptron Algorithm
Authors: Salamzadeh Aidin , Ebrahimi Pejman , Soleimani Maryam , Fekete-Farkas Maria
Published: September 2022

The purpose of this study is to investigate and compare the popularity of common grocery apps in Hungary as well as Iran. The data were gathered from Iranian and Hungarian users who had at least one online purchase experience using a grocery app. A Gaussian mixture model (GMM) and multi-layer perceptron (MLP) are used as supervised and unsupervised machine learning algorithms with Python programming to cluster customers and predict consumer behavior. The results revealed that Wolt in Hungary and Snappfood in Iran are the most popular grocery apps. Users in Iran are divided into three groups of users of app services and the type of full covariance has higher accuracy compared to the other three types (96%). Meanwhile, we found that the five apps used in Hungary have provided 95% accuracy from the users’ point of view based on the diagonal covariance. The MSE value (overfitting and cross-validation) is less than 0.1 in the MLP algorithm, which shows an acceptable amount of error. The results of overfitting indicate the proper fit of the MLP model. The findings of this study could be important for managers of online businesses. In the clustering section, the accuracy and value of consumer demographic information have been emphasized. Additionally, in the classification and prediction section, a kind of “customization” has been performed with an emphasis on market segmentation. This research used GMM and MLP machine learning algorithms as a creative way to cluster and classify consumers.
Design, Analysis, and Simulation of 60 GHz Millimeter Wave MIMO Microstrip Antennas
Authors: Martínez Quintero Juan Carlos , Estupiñán Cuesta Edith Paola , Escobar Quiroga Gabriel Leonardo
Published: September 2022

This article comparatively shows the evolution of parameters of three types of arrays for MIMO microstrip antennas, to which the number of ports is gradually incremented until reaching 32. The three arrays have a 1 × 2 configuration in each port and present different geometry or type of coupling in the next way: square patch with quarter-wave coupling (Antenna I), square patch with inset feed (Antenna II) and circular patch with quarter-wave coupling (Antenna III). The arrays were designed and simulated to operate on the millimetric wave band, specifically in the 60 GHz frequency to be used in wireless technologies such as IEEE 802.11 ad. A method of rapid prototyping was formulated to increase the number of elements in the array obtaining dimensions and coordinates of location in the layout in short periods of time. The simulation was conducted through ADS software, and the results of gain, directivity, return loss, bandwidth, beamwidth, and efficiency were evaluated. In terms of array results of 32 ports, Antenna III obtained the lowest return loss with −42.988 dB, being more than 19 dB lower than the others. The highest gain is also obtained by Antenna III with 24.541 dBi and an efficiency of 66%. Antenna II obtained better efficiency, reaching 71.03%, but with a gain of more than 2dB below the Antenna III. Antenna I obtained the best bandwidth.
Exploring the Ecological Climate Effects of Different Land Use Changes in the Yangtze River Basin from 2000 to 2020
Authors: Zhao Xiao , Zhu Mengyao , Liu Dandan , Xu Siqi , Ye Siyu , Wang Shuang , Cui Yaoping , Zhou Shenghui
Published: September 2022

Land use/cover change (LUCC) can change the energy balance of the earth’s surface by altering its biophysical properties (surface albedo), and it also has an important impact on the ecological climate. In this paper, using surface energy balance algorithms, the differences in energy balance and the resulting ecoclimatic effects under different land use changes in the Yangtze River basin from 2000 to 2020 were analyzed. The results showed that: (1) from 2000 to 2020, the energy uptake of surface net radiation (Rs) in the Yangtze River basin showed a downward trend with increasing intensity of impact from human activities. This indicated that human activities could weaken the positive trend of Rs uptake and increase the warming effect; (2) Rs and latent heat flux (LHF) showed an upward trend, which was more obvious in natural and semi-natural regions and mixed pixel regions; (3) LHF−Rs energy uptake showed a decreasing trend, indicating that the effect of Rs on surface absorbed energy was greater than that of LHF, which was more significant in old urban areas and urban expansion areas. This research highlights the variation in the surface energy budgets of the five land use types with different levels of human activities. This will provide a theoretical reference for future land planning and management. It will also provide a theoretical basis for judging climate change trends and urban heat island effects in the Yangtze River basin from the perspective of bio-geophysics.