bluuebunny/crossref_metadata_2025 huggingface dataset:
Changes over Time in Hemoglobin A1C (HbA1C) Levels Predict Long-Term Survival Following Acute Myocardial Infarction among Patients with Diabetes Mellitus
Authors: Plakht Ygal , Gilutz Harel , Shiyovich Arthur
Published: July 2021

Frequent fluctuations of hemoglobin A1c (HbA1C) values predict patient outcomes. However, data regarding prognoses depending on the long-term changes in HbA1C among patients after acute myocardial infarction (AMI) are scarce. We evaluated the prognostic significance of HbA1C levels and changes among diabetic patients (n = 4066) after non-fatal AMI. All the results of HbA1C tests up to the 10-year follow-up were obtained. The changes (∆) of HbA1C were calculated in each patient. The time intervals of ∆HbA1C values were classified as rapid (<one year) and slow (≥one year) changes. The outcome was all-cause mortality. The highest mortality rates of 53.8% and 35.5% were found in the HbA1C < 5.5–7% and ∆HbA1C = −2.5–(−2%) categories. A U-shaped association was observed between HbA1C and mortality: adjOR = 1.887 and adjOR = 1.302 for HbA1C < 5.5% and ≥8.0%, respectively, as compared with 5.5–6.5% (p < 0.001). Additionally, ∆HbA1C was associated with the outcome (U-shaped): adjOR = 2.376 and adjOR = 1.340 for the groups of <−2.5% and ≥2.5% ∆HbA1C, respectively, as compared to minimal ∆HbA1C (±0.5%) (p < 0.001). A rapid increase in HbA1C (but not decrease) was associated with a greater risk of mortality. HbA1C values and their changes are significant prognostic markers for long-term mortality among AMI-DM patients. ∆HbA1C and its timing, in addition to absolute HbA1C values, should be monitored.
Impact of Early Pancreatic Graft Loss on Outcome after Simultaneous Pancreas–Kidney Transplantation (SPKT)—A Landmark Analysis
Authors: Lehner Lukas Johannes , Öllinger Robert , Globke Brigitta , Naik Marcel G. , Budde Klemens , Pratschke Johann , Eckardt Kai-Uwe , Kahl Andreas , Zhang Kun , Halleck Fabian
Published: July 2021

(1) Background: Simultaneous pancreas–kidney transplantation (SPKT) is a standard therapeutic option for patients with diabetes mellitus type I and kidney failure. Early pancreas allograft failure is a complication potentially associated with worse outcomes. (2) Methods: We performed a landmark analysis to assess the impact of early pancreas graft loss within 3 months on mortality and kidney graft survival over 10 years. This retrospective single-center study included 114 adult patients who underwent an SPKT between 2005 and 2018. (3) Results: Pancreas graft survival rate was 85.1% at 3 months. The main causes of early pancreas graft loss were thrombosis (6.1%), necrosis (2.6%), and pancreatitis (2.6%). Early pancreas graft loss was not associated with reduced patient survival (p = 0.168) or major adverse cerebral or cardiovascular events over 10 years (p = 0.741) compared to patients with functioning pancreas, after 3 months. Moreover, kidney graft function (p = 0.494) and survival (p = 0.461) were not significantly influenced by early pancreas graft loss. (4) Conclusion: In this study, using the landmark analysis technique, early pancreas graft loss within 3 months did not significantly impact patient or kidney graft survival over 10 years.
Effects of Total Knee Arthroplasty on Coronal and Sagittal Whole-Body Alignments: Serial Assessments Using Whole-Body EOS
Authors: Kim Seong-Chan , Choi Han-Gyeol , Kim Joo-Sung , Kim Tae-Woo , Lee Yong-Seuk
Published: July 2021

Background: The aims of this study were to evaluate the effects of correcting lower limb alignment by total knee arthroplasty (TKA) on the spinopelvic alignment and to identify patients with difference in the knee joint between clinically measured passive motion and the actual standing posture. Methods: In this retrospective study, 101 patients who underwent TKA and whose serial whole-body EOS X-ray were available were included. The relationship of the knee and spinopelvic alignment was analyzed by evaluating the parameters of standing anterior-posterior and lateral whole-body EOS X-ray. The differences between postoperative passive motion and weight-bearing posture in the knee joint were assessed in both coronal and sagittal planes. Furthermore, the causes of such differences were analyzed. Results: Significant correlations between Δpelvic obliquity and coronal ΔHip-Knee-Ankle (HKA)Rt-Lt angle between the preoperative and 3-month and 1-year postoperative data (p < 0.001 and p < 0.005, respectively) and improved with coronal lower limb alignment close to neutral resulted in decreased pelvic obliquity (p < 0.001, ß = 0.085 and p = 0.005, ß = 0.065, respectively) were observed. The correlations between Δpelvic tilt (PT) and Δsacral slope (SS) and sagittal ΔHKARt-Lt angle were statistically significant (PT: p < 0.001 and p < 0.045; SS: p = 0.002 and p < 0.001, respectively). The improved sagittal alignment close to neutral resulted in decreased PT and increased SS. The difference between postoperative passive motion and the weight-bearing posture of the knee joint was correlated with lumbar lordosis and sagittal C7 plumb line-sacrum distance (p = 0.042 and p < 0.001, respectively). Conclusions: The correction of lower limb alignment with TKA affected pelvic parameters dominantly; however, there was little effect on the spinal alignment. Additionally, patients with anterior stooping or lumbar flat back demonstrated difference in extension between passive knee motion and standing. Therefore, rather than only focusing on changes in the knee alignment correction, knee surgeons should also evaluate the spinopelvic alignment before surgery to consider the prognosis of the standing and predict the possible changes in the whole-body alignment. This preoperative assessment may improve the prognosis of TKA.
Blood Pressure Profiles and Cognitive Function from Adulthood to Old Age: Chasing a Golden Middle Way?
Authors: Del Pinto Rita , Grassi Davide , Bocale Raffaella , Carubbi Francesco , Ferri Claudio , Desideri Giovambattista
Published: July 2021

With the demographic shift toward advanced ages, it is imperative to understand the biological mechanisms behind common, disabling age-related diseases such as cognitive impairment in its mild form to overt dementia. Hypertension, a major cardiovascular risk factor, is epidemiologically linked to vascular and Alzheimer-type dementia, with possible mechanisms being atherosclerotic macro- and microvascular damage leading to neuronal cell death, as well as proinflammatory events responsible for neurodegeneration. Nevertheless, there is currently a knowledge gap as to which population to target, what the diagnostics test, and how to manage early pathogenic events in order to prevent such a dramatic and disabling condition. While clinical trials data support the benefit of active BP control with antihypertensive medications on the risk of future cognitive impairment, hypotension appears to be related to accelerated cognitive decline in both the fit and the cognitively frail elderly. Dedicated, technologically advanced studies assessing the relation of BP with dementia are needed to clarify the pathophysiological mechanisms in the association before a tailored preventive, diagnostic, and therapeutic approach to one of the most widespread modern medical challenges becomes a reality.
Virtual Reality Interventions for Needle-Related Procedural Pain, Fear and Anxiety—A Systematic Review and Meta-Analysis
Authors: Czech Oliver , Wrzeciono Adam , Rutkowska Anna , Guzik Agnieszka , Kiper Paweł , Rutkowski Sebastian
Published: July 2021

Needle-related procedures are often a source of pain, anxiety and fear in young patients. This systematic review aimed to investigate the effectiveness of virtual reality (VR) on reducing pain, fear and anxiety in pediatric patients undergoing needle-related procedures. Pain, anxiety, fear, changes in blood pressure and heart rate as well as satisfaction were evaluated as outcomes during needle-related procedures in VR compared with standard care conditions. A meta-analysis was performed, taking into account online databases. Two authors independently conducted literature searches in December 2020. The last search was conducted in March 2021 from a total of 106 records, 7 met our inclusion criteria. One study was excluded from the meta-analysis due to insufficient data. VR was applied as a distractor during venous access. Statistically significant benefits of using VR were shown in children’s pain scores, where VR significantly decreased symptoms (n = 3204 patients, MD = −2.85; 95% CI −3.57, −2.14, for the Wong–Baker Faces Pain Rating Scale and n = 2240 patients, MD = −0.19; 95% CI −0.58, 0.20, for the Faces Pain Scale—Revised). The analysis of fear, anxiety and satisfaction scores revealed no significant differences between the conditions, as the studies were too heterogeneous to be pooled. Distraction using virtual reality may be an effective intervention for reducing pain in children undergoing needle-related medical procedures. However, further research in the implementation of VR as a distractor for children and adolescents is required, due to the limited research into this field.
Characterization of Drug-Resistant Lipid-Dependent Differentially Detectable Mycobacterium tuberculosis
Authors: Mesman Annelies , Baek Seung-Hun , Huang Chuan-Chin , Kim Young-Mi , Cho Sang-Nae , Ioerger Thomas , Barreda Nadia , Calderon Roger , Sassetti Christopher , Murray Megan
Published: July 2021

An estimated 15–20% of patients who are treated for pulmonary tuberculosis (TB) are culture-negative at the time of diagnosis. Recent work has focused on the existence of differentially detectable Mycobacterium tuberculosis (Mtb) bacilli that do not grow under routine solid culture conditions without the addition of supplementary stimuli. We identified a cohort of TB patients in Lima, Peru, in whom acid-fast bacilli could be detected by sputum smear microscopy, but from whom Mtb could not be grown in standard solid culture media. When we attempted to re-grow Mtb from the frozen sputum samples of these patients, we found that 10 out of 15 could be grown in a glycerol-poor/lipid-rich medium. These fell into the following two groups: a subset that could be regrown in glycerol after “lipid-resuscitation”, and a group that displayed a heritable glycerol-sensitive phenotype that were unable to grow in the presence of this carbon source. Notably, all of the glycerol-sensitive strains were found to be multidrug resistant. Although whole-genome sequencing of the lipid-resuscitated strains identified 20 unique mutations compared to closely related strains, no single genetic lesion could be associated with this phenotype. In summary, we found that lipid-based media effectively fostered the growth of Mtb from a series of sputum smear-positive samples that were not culturable in glycerol-based Lowenstein–Jensen or 7H9 media, which is consistent with Mtb’s known preference for non-glycolytic sources during infection. Analysis of the recovered strains demonstrated that both genetic and non-genetic mechanisms contribute to the observed differential capturability, and suggested that this phenotype may be associated with drug resistance.
Differences in Biometric Fetal Weight Estimation Accuracy and Doppler Examination Results in Uncomplicated Term Singleton Pregnancies between Vertex and Breech Presentation
Authors: Jennewein Lukas , Theissen Simon , Pfeifenberger Hemma Roswitha , Zander Nadja , Fischer Kyra , Eichbaum Christine , Louwen Frank
Published: July 2021

Doppler examination of the umbilical artery and the fetal middle cerebral artery is evaluated predominantly in pregnancies with fetuses in cephalic presentation and never has been elucidated in breech presentation. Evidence on the accuracy of fetal weight estimation in dependence of the fetal presentation is controversial. Nevertheless, clinical decisions including recommendations for a cesarean section or labor induction based on these examinations are applied to pregnancies with fetuses in breech presentation. The objective of this study was to investigate the influence of the fetal presentation on fetal weight estimation accuracy, umbilical artery and middle cerebral artery resistance indices (RI) in a prospective case control study. Ultrasound examinations in 305 uncomplicated term pregnancies (153 vertex presentations, 152 breech) were investigated. Non-parametric variables were compared using Pearson’s chi2 test and Wilcoxon chi2 test, depending on variable scaling. Fetal weight estimation accuracy was not significantly different between vertex presentation group (VP) (6.97%) and breech presentation group (BP) (7.96%, p = 0.099). Fetal head circumference measurements were significantly larger in BP (350 mm vs. 341 mm in VB, p > 0.0001) while abdominal circumferences were significantly smaller (VP: 338 mm, BP: 331 mm, p = 0.0039) and weight estimation was not significantly different. Umbilical artery RIs were not significantly different between VP (54.5) and BP (55.3, p = 0.354). Fetal middle cerebral artery RIs also showed no significant differences (VP: 71.2, BP: 70.7, p = 0.335). Our study shows that fetal Doppler (RI) and weight estimation ultrasound originally calibrated in cephalic pregnancies are applicable to pregnancies with fetuses in breech presentation.
Oral Antioxidant Treatment of Men Significantly Improves the Reproductive Outcome of IVF Cycles
Authors: Scaruffi Paola , Licata Emanuele , Maccarini Elena , Massarotti Claudia , Bovis Francesca , Sozzi Fausta , Stigliani Sara , Dal Lago Alessandro , Casciano Ida , Rago Rocco , Anserini Paola
Published: July 2021

Some 30% to 80% of male sub-fertility may be associated with oxidative stress that damages spermatozoa and can decrease success of in vitro fertilization (IVF) techniques. This multicenter, longitudinal, prospective study aimed to investigate whether oral antioxidant supplementation improved the reproductive competence of men who had had low fertilization rates in their previous intracytoplasmic sperm injection (ICSI) cycles without azoospermia or severe oligozoospermia or any identifiable andrological disease. Seventy-seven men from couples who had an ICSI attempt with unexplained <60% fertilization rate took an antioxidant mix of myo-inositol, alpha-lipoic acid, folic acid, coenzyme Q10, zinc, selenium, and vitamins B2, B6, and B12. Semen parameters were analyzed before (T0) and after 90 days (T90) of treatment, and outcomes of the paired T0 and T90 cycles were compared. After the treatment there was an increase in sperm concentration (p = 0.027), total motile sperm count (p = 0.003), progressive motility (p < 0.0001), and a decreasing trend of DNA-fragmented spermatozoa. Embryological outcomes (fertilization, embryo quality, blastocyst development) were significantly higher in T90 than T0 cycles. No T0 cycle resulted in an evolutive pregnancy. Conversely, in T90 cycles 29 singleton clinical pregnancies were obtained. No negative neonatal outcomes were recorded in newborns after antioxidant treatment. Diet supplementation of men who have had low fertilization rates in their previous ICSI cycles with a combination of myo-inositol, alpha-lipoic acid, folic acid, coenzyme Q10, zinc, selenium, betaine, and vitamins may improve semen reproductive potential and ICSI clinical outcome.
Non-Contact Automatic Vital Signs Monitoring of Infants in a Neonatal Intensive Care Unit Based on Neural Networks
Authors: Khanam Fatema-Tuz-Zohra , Perera Asanka G. , Al-Naji Ali , Gibson Kim , Chahl Javaan
Published: July 2021

Infants with fragile skin are patients who would benefit from non-contact vital sign monitoring due to the avoidance of potentially harmful adhesive electrodes and cables. Non-contact vital signs monitoring has been studied in clinical settings in recent decades. However, studies on infants in the Neonatal Intensive Care Unit (NICU) are still limited. Therefore, we conducted a single-center study to remotely monitor the heart rate (HR) and respiratory rate (RR) of seven infants in NICU using a digital camera. The region of interest (ROI) was automatically selected using a convolutional neural network and signal decomposition was used to minimize the noise artefacts. The experimental results have been validated with the reference data obtained from an ECG monitor. They showed a strong correlation using the Pearson correlation coefficients (PCC) of 0.9864 and 0.9453 for HR and RR, respectively, and a lower error rate with RMSE 2.23 beats/min and 2.69 breaths/min between measured data and reference data. A Bland–Altman analysis of the data also presented a close correlation between measured data and reference data for both HR and RR. Therefore, this technique may be applicable in clinical environments as an economical, non-contact, and easily deployable monitoring system, and it also represents a potential application in home health monitoring.
The Effect of Mesoscale Eddy on the Characteristic of Sound Propagation
Authors: Liu Jiaqi , Piao Shengchun , Gong Lijia , Zhang Minghui , Guo Yongchao , Zhang Shizhao
Published: July 2021

A mesoscale eddy is detected and tracked in the western North Pacific region. Within the life cycle of the cyclonic eddies, the intensities of eddies make a difference. Satellite images indicate the oceanic eddy keeps westward-moving until it disappears. Oceanographic and acoustic characteristics of the eddy are studied. The acoustic energy distribution results from the different intensity of both modelled eddy and measured eddy are calculated. With sound propagation through the cyclonic eddy and anticyclonic eddy, the position of convergence zone moves away from and towards the acoustic source compared with the sound propagation through background hydrography. The coupling coefficient of different orders of normal modes changes significantly. The closer to the centre of the eddy, the stronger the coupling coefficient.
Machine Learning Approaches to Predict In-Hospital Mortality among Neonates with Clinically Suspected Sepsis in the Neonatal Intensive Care Unit
Authors: Hsu Jen-Fu , Chang Ying-Feng , Cheng Hui-Jun , Yang Chi , Lin Chun-Yuan , Chu Shih-Ming , Huang Hsuan-Rong , Chiang Ming-Chou , Wang Hsiao-Chin , Tsai Ming-Horng
Published: July 2021

Background: preterm and critically ill neonates often experience clinically suspected sepsis during their prolonged hospitalization in the neonatal intensive care unit (NICU), which can be the initial sign of final adverse outcomes. Therefore, we aimed to utilize machine learning approaches to predict neonatal in-hospital mortality through data-driven learning. Methods: a total of 1095 neonates who experienced clinically suspected sepsis in a tertiary-level NICU in Taiwan between August 2017 and July 2020 were enrolled. Clinically suspected sepsis was defined based on clinical features and laboratory criteria and the administration of empiric antibiotics by clinicians. The variables used for analysis included patient demographics, clinical features, laboratory data, and medications. The machine learning methods used included deep neural network (DNN), k-nearest neighbors, support vector machine, random forest, and extreme gradient boost. The performance of these models was evaluated using the area under the receiver operating characteristic curve (AUC). Results: the final in-hospital mortality of this cohort was 8.2% (90 neonates died). A total of 765 (69.8%) and 330 (30.2%) patients were randomly assigned to the training and test sets, respectively. Regarding the efficacy of the single model that most accurately predicted the outcome, DNN exhibited the greatest AUC (0.923, 95% confidence interval [CI] 0.953–0.893) and the best accuracy (95.64%, 95% CI 96.76–94.52%), Cohen’s kappa coefficient value (0.74, 95% CI 0.79–0.69) and Matthews correlation coefficient value (0.75, 95% CI 0.80–0.70). The top three most influential variables in the DNN importance matrix plot were the requirement of ventilator support at the onset of suspected sepsis, the feeding conditions, and intravascular volume expansion. The model performance was indistinguishable between the training and test sets. Conclusions: the DNN model was successfully established to predict in-hospital mortality in neonates with clinically suspected sepsis, and the machine learning algorithm is applicable for clinicians to gain insights and have better communication with families in advance.
The Neutrophil-to-Lymphocyte and Platelet-to-Lymphocyte Ratios Predict Reperfusion and Prognosis after Endovascular Treatment of Acute Ischemic Stroke
Authors: Lee Sang-Hwa , Jang Min Uk , Kim Yerim , Park So Young , Kim Chulho , Kim Yeo Jin , Sohn Jong-Hee
Published: July 2021

Background: Studies assessing the prognostic effect of inflammatory markers of blood cells on the outcomes of patients with acute ischemic stroke treated with endovascular treatment (EVT) are sparse. We evaluated whether the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) affect reperfusion status in patients receiving EVT. Methods: Using a multicenter registry database, 282 patients treated with EVT were enrolled in this study. The primary outcome measure was unsuccessful reperfusion rate after EVT defined by thrombolysis in cerebral infarction grades 0–2a. Logistic regression analysis was performed to analyze the association between NLR/PLR and unsuccessful reperfusion rate after EVT. Results: Both NLR and PLR were higher in the unsuccessful reperfusion group than in the successful reperfusion group (p < 0.001). Multivariate analysis showed that both NLR and PLR were significantly associated with unsuccessful reperfusion (adjusted odds ratio (95% confidence interval): 1.11 (1.04–1.19), PLR: 1.004 (1.001–1.01)). The receiver operating characteristic curve showed that the predictive ability of both NLR and PLR was close to good (area under the curve (AUC) of NLR: 0.63, 95% CI (0.54–0.72), p < 0.001; AUC of PLR: 0.65, 95% CI (0.57–0.73), p < 0.001). The cutoff values of NLR and PLR were 6.2 and 103.6 for unsuccessful reperfusion, respectively. Conclusion: Higher NLR and PLR were associated with unsuccessful reperfusion after EVT. The combined application of both biomarkers could be useful for predicting outcomes after EVT.
Incidence and Time Point of Sepsis Detection as Related to Different Sepsis Definitions in Severely Burned Patients and Their Accompanying Time Course of Pro-Inflammatory Biomarkers
Authors: Niggemann Pia , Rittirsch Daniel , Buehler Philipp Karl , Schweizer Riccardo , Giovanoli Pietro , Reding Theresia , Graf Rolf , Plock Jan Alexander , Klein Holger Jan
Published: July 2021

Background: Diagnosis of sepsis in burn patients remains difficult for various reasons. One major problem is the definition of sepsis itself. Therefore, previous and current sepsis definitions are a matter of ongoing validation, but a well-defined consensus on which clinical and laboratory parameters to incorporate in such a definition is lacking. The aim of the present study was to compare the incidence and time-related occurrence of septic events according to different definitions as well as their accompanying time course of pro-inflammatory biomarkers. Methods: Across the first 14 days after admission, the incidence and time point of sepsis according to three different definitions (Sepsis-3, Sepsis American Burns Association [ABA] 2007, Sepsis Zurich Burn Center) were assessed on a daily basis in adult burn patients with total body surface area (TBSA) ≥15% admitted to the Zurich Burn Center between May 2015 and October 2018. In order to investigate how well daily drawn proinflammatory biomarkers (white blood cells (WBCs), C-reactive protein (CRP), procalcitonin (PCT), and novel pancreatic stone protein (PSP)) reflect the progression of sepsis depending on its type of definition, a longitudinal mixed model analysis was performed across the first 14 days for septic and non-septic patients. Additionally, the relative increase of biomarker levels 24, 48, and 72 h prior to a septic event was analyzed for each definition used. Results: In our cohort of 90 severely burned patients, Sepsis-3 identified 46 patients (51.1%) as septic, while ABA 2007 and the Zurich Burn Center definition counted 33 patients (36.7%) and 24 patients (26.6%), respectively. Sepsis-3 detected sepsis about 1 day earlier than Sepsis ABA 2007 (p < 0.001) and about 0.5 days earlier than Sepsis Zurich Burn Center (p = 0.04). The course of pro-inflammatory biomarkers was largely unaffected by the type of sepsis definition. Irrespective of the sepsis definition, PSP was the only marker to demonstrate a highly significant interaction between time and group (sepsis versus no sepsis) (p < 0.001) with a 3.3–5.5-fold increase within 72 h before the event of sepsis, whereas CRP, PCT, and WBC showed only mild undulations. Conclusions: Despite the ongoing dilemma of how to define sepsis in burn patients, a continually calculated SOFA score as used in Sepsis-3 is advantageous to early identify a patient’s detrimental progression to sepsis. Inclusion of biomarkers, such as PSP, may help support the burn specialist’s diagnosis of sepsis and could improve the diagnostic performance of current and future definitions in burn patients.
Ovarian Reserve after Chemotherapy in Breast Cancer: A Systematic Review and Meta-Analysis
Authors: Romito Alessia , Bove Sonia , Romito Ilaria , Zace Drieda , Raimondo Ivano , Fragomeni Simona Maria , Rinaldi Pierluigi Maria , Pagliara Domenico , Lai Antonella , Marazzi Fabio , Marchetti Claudia , Paris Ida , Franceschini Gianluca , Masetti Riccardo , Scambia Giovanni , Fabi Alessandra , Garganese Giorgia
Published: July 2021

Background: Worldwide, breast cancer (BC) is the most common malignancy in the female population. In recent years, its diagnosis in young women has increased, together with a growing desire to become pregnant later in life. Although there is evidence about the detrimental effect of chemotherapy (CT) on the menses cycle, a practical tool to measure ovarian reserve is still missing. Recently, anti-Mullerian hormone (AMH) has been considered a good surrogate for ovarian reserve. The main objective of this paper is to evaluate the effect of CT on AMH value. Methods: A systematic review and meta-analysis were conducted on the PubMed and Scopus electronic databases on articles retrieved from inception until February 2021. Trials evaluating ovarian reserves before and after CT in BC were included. We excluded case reports, case-series with fewer than ten patients, reviews (narrative or systematic), communications and perspectives. Studies in languages other than English or with polycystic ovarian syndrome (PCOS) patients were also excluded. AMH reduction was the main endpoint. Egger’s and Begg’s tests were used to assess the risk of publication bias. Results: Eighteen trials were included from the 833 examined. A statistically significant decline in serum AMH concentration was found after CT, persisting even after years, with an overall reduction of −1.97 (95% CI: −3.12, −0.82). No significant differences in ovarian reserve loss were found in the BRCA1/2 mutation carriers compared to wild-type patients. Conclusions: Although this study has some limitations, including publication bias, failure to stratify the results by some important factors and low to medium quality of the studies included, this metanalysis demonstrates that the level of AMH markedly falls after CT in BC patients, corresponding to a reduction in ovarian reserve. These findings should be routinely discussed during oncofertility counseling and used to guide fertility preservation choices in young women before starting treatment.
Update on Robotic Rectal Prolapse Treatment
Authors: Formisano Giampaolo , Ferraro Luca , Salaj Adelona , Giuratrabocchetta Simona , Pisani Ceretti Andrea , Opocher Enrico , Bianchi Paolo Pietro
Published: July 2021

Rectal prolapse is a condition that can cause significant social impairment and negatively affects quality of life. Surgery is the mainstay of treatment, with the aim of restoring the anatomy and correcting the associated functional disorders. During recent decades, laparoscopic abdominal procedures have emerged as effective tools for the treatment of rectal prolapse, with the advantages of faster recovery, lower morbidity, and shorter length of stay. Robotic surgery represents the latest evolution in the field of minimally invasive surgery, with the benefits of enhanced dexterity in deep narrow fields such as the pelvis, and may potentially overcome the technical limitations of conventional laparoscopy. Robotic surgery for the treatment of rectal prolapse is feasible and safe. It could reduce complication rates and length of hospital stay, as well as shorten the learning curve, when compared to conventional laparoscopy. Further prospectively maintained or randomized data are still required on long-term functional outcomes and recurrence rates.
Conservation, Restoration, and Sustainable Use of Biodiversity Based on Habitat Quality Monitoring: A Case Study on Jeju Island, South Korea (1989–2019)
Authors: Hong Hyun-Jung , Kim Choong-Ki , Lee Hyun-Woo , Lee Woo-Kyun
Published: July 2021

Biodiversity loss is progressing despite biodiversity being essential for human survival, prosperity, and well-being. Conservation, restoration, and sustainable use of the habitat, given that its change is the most prominent factor causing the deterioration of biodiversity, represents a highly effective way of securing biodiversity. Therefore, we assessed and monitored habitat quality as a proxy for biodiversity with habitat quantity in Jeju Island, South Korea. We used an InVEST model with data on the habitat type, suitability, sensitivity, accessibility, and threat factors. Natural habitats throughout Jeju had rapidly decreased in area by 24.9% from 1989 to 2019, and this change contributed to the degradation of habitat quality by 15.8%. We provided significant evidence on the critical degradation of habitat for a long period of over 30 years and highlighted the urgent need for policies and behaviors that enhance biodiversity. We proposed appropriate strategies to prompt people to conserve better, restore effectively, and use biodiversity sustainably. We expect that our findings will provide scientific and evidence-based guidance for policy-making on biodiversity enhancement and will further support achievement of the Sustainable Development Goals and Aichi Biodiversity Targets, in addition to compliance with the New Deal for Nature and People.
Increased Pace of Aging in COVID-Related Mortality
Authors: Galkin Fedor , Parish Austin , Bischof Evelyne , Zhang John , Mamoshina Polina , Zhavoronkov Alex
Published: July 2021

Identifying prognostic biomarkers and risk stratification for COVID-19 patients is a challenging necessity. One of the core survival factors is patient age. However, chronological age is often severely biased due to dormant conditions and existing comorbidities. In this retrospective cohort study, we analyzed the data from 5315 COVID-19 patients (1689 lethal cases) admitted to 11 public hospitals in New York City from 1 March 2020 to 1 December. We calculated patients’ pace of aging with BloodAge—a deep learning aging clock trained on clinical blood tests. We further constructed survival models to explore the prognostic value of biological age compared to that of chronological age. A COVID-19 score was developed to support a practical patient stratification in a clinical setting. Lethal COVID-19 cases had higher predicted age, compared to non-lethal cases (Δ = 0.8–1.6 years). Increased pace of aging was a significant risk factor of COVID-related mortality (hazard ratio = 1.026 per year, 95% CI = 1.001–1.052). According to our logistic regression model, the pace of aging had a greater impact (adjusted odds ratio = 1.09 ± 0.00, per year) than chronological age (1.04 ± 0.00, per year) on the lethal infection outcome. Our results show that a biological age measure, derived from routine clinical blood tests, adds predictive power to COVID-19 survival models.
N-(2,2-Diphenylethyl)-2-(6-methoxynaphthalen-2-yl)propanamide
Authors: Manolov Stanimir , Ivanov Iliyan , Bojilov Dimitar
Published: July 2021

N-(2,2-Diphenylethyl)-2-(6-methoxynaphthalen-2-yl)propanamide was prepared by a reaction between 2,2-diphenylethan-1-amine and naproxen in high yield. The newly obtained naproxen derivative was fully analyzed and characterized via 1H, 13C, UV, IR, and mass spectral data.
The Impact of Gelatin on the Pharmaceutical Characteristics of Fucoidan Microspheres with Posaconazole
Authors: Szekalska Marta , Citkowska Aleksandra , Wróblewska Magdalena , Winnicka Katarzyna
Published: July 2021

Fungal infections and invasive mycoses, despite the continuous medicine progress, are an important globally therapeutic problem. Multicompartment dosage formulations (e.g., microparticles) ensure a short drug diffusion way and high surface area of drug release, which as a consequence can provide improvement of therapeutic efficiency compared to the traditional drug dosage forms. As fucoidan is promising component with wide biological activity per se, the aim of this study was to prepare fucospheres (fucoidan microparticles) and fucoidan/gelatin microparticles with posaconazole using the one-step spray-drying technique. Pharmaceutical properties of designed fucospheres and the impact of the gelatin addition on their characteristics were evaluated. An important stage of this research was in vitro evaluation of antifungal activity of developed microparticles using different Candida species. It was observed that gelatin presence in microparticles significantly improved swelling capacity and mucoadhesiveness, and provided a sustained POS release. Furthermore, it was shown that gelatin addition enhanced antifungal activity of microparticles against tested Candida spp. strains. Microparticles formulation GF6, prepared by the spray drying of 20% fucoidan, 5% gelatin and 10% Posaconazole, were characterized by optimal mucoadhesive properties, high drug loading and the most sustained drug release (after 8 h 65.34 ± 4.10% and 33.81 ± 5.58% of posaconazole was dissolved in simulated vaginal fluid pH 4.2 or 0.1 M HCl pH 1.2, respectively).
Lipid Nanoparticles Loaded with Selected Iridoid Glycosides as Effective Components of Hydrogel Formulations
Authors: Dąbrowska Marta , Nowak Izabela
Published: July 2021

One possibility of improving active ingredient penetration into deeper skin layers to enhance the cosmetic product effectiveness, is the application of lipid nanoparticles. The aim of the study presented in this paper was to evaluate the potential of hydrogel formulations enriched with iridoid glycosides-loaded lipid nanoparticles. Lipid nanocarriers were produced using an emulsification-ultrasonication method based on multiple emulsions. The encapsulation efficiency was determined at the level of 89% and 77% for aucubin and catalpol, respectively. The next stage was the incorporation of the obtained dispersions of lipid nanoparticles into hydrogel formulations, followed by determination of their physicochemical properties, shelf-life stability, and application properties (in vivo tests). The introduction of lipid nanoparticles increased the stabilization of the consistency of the obtained hydrogel formulations, and was confirmed by viscosity measurements. No effect of lipid nanoparticle incorporation on shelf-life stability of the hydrogels was detected. In vivo studies showed improvements in moisture content of the epidermis, transepidermal water loss, skin topography, and macrorelief parameters. In particular, a synergistic effect of the active ingredients and lipid nanoparticles on the anti-wrinkle effect, moisturizing effect, and regeneration of the protective barrier of the stratum corneum was evidenced. The attractiveness of aucubin and catalpol as cosmetic raw materials in hydrogel formulations was evidenced, especially when the iridoid glycosides were applied in the form of lipid nanoparticles.
Experimental Study on Basalt Fiber Crack Resistance of Asphalt Concrete Based on Acoustic Emission
Authors: Yang Kang , He Zhaoyi , Li Dongxue , Xu Hao , Kong Lin
Published: July 2021

In this study, the semicircle three-point bending tests of ordinary asphalt concrete and basalt fiber asphalt concrete were carried out and acoustic emission parameters were collected during the test. The differences of the characteristics of acoustic emission parameters between basalt fiber asphalt concrete and ordinary asphalt concrete were analyzed, and the damage stages were divided based on the variation of acoustic emission parameters; Rise Angle and Average Frequency were introduced to study the cracking mode and crack resistance mechanism of asphalt concrete with basalt fiber. The results show that the acoustic emission parameters can well represent the toughening and crack resistance effect of basalt fiber in asphalt concrete, and the damage stages can be divided into three stages: microcrack initiation stage, fracture stage, and residual stage. The duration of the fracture stage and the load resistance time of the specimen were greatly prolonged. The proportion of shear events in the whole failure process increased greatly after the basalt fibers were added, especially in the fracture stage, which reduced the tensile failure tendency of the specimens, and thus improved the bending and tensile performance of the specimens and played a toughening and crack resistance role in the fracture stage.
Research Progress of Transparent Electrode Materials with Sandwich Structure
Authors: Qin Li-Hao , Yan Yong-Qi , Yu Gan , Zhang Zhao-Yi , Zhama Tuofu , Sun Hui
Published: July 2021

The nonrenewable nature of fossil energy has led to a gradual decrease in reserves. Meanwhile, as society becomes increasingly aware of the severe pollution caused by fossil energy, the demand for clean energy, such as solar energy, is rising. Moreover, in recent years, electronic devices with screens, such as mobile phones and computers, have had increasingly higher requirements for light transmittance. Whether in solar cells or in the display elements of electronic devices, transparent conductive films directly affect the performance of these devices as a cover layer. In this context, the development of transparent electrodes with low sheet resistance and high light transmittance has become one of the most urgent issues in related fields. At the same time, conventional electrodes can no longer meet the needs of some of the current flexible devices. Because of the high sheet resistance, poor light transmittance, and poor bending stability of the conventional tin-doped indium tin oxide conductive film and fluorine-doped tin oxide transparent conductive glass, there is a need to find alternatives with better performance. In this article, the progress of research on transparent electrode materials with sandwich structures and their advantages is reviewed according to the classification of conductive materials to provide reference for research in related fields.
Accuracy Evaluation of Additively and Subtractively Fabricated Palatal Plate Orthodontic Appliances for Newborns and Infants–An In Vitro Study
Authors: Aretxabaleta Maite , Unkovskiy Alexey , Koos Bernd , Spintzyk Sebastian , Xepapadeas Alexander B.
Published: July 2021

Different approaches for digital workflows have already been presented for their use in palatal plates for newborns and infants. However, there is no evidence on the accuracy of CAD/CAM manufactured orthodontic appliances for this kind of application. This study evaluates trueness and precision provided by different CAM technologies and materials for these appliances. Samples of a standard palatal stimulation plate were manufactured using stereolithography (SLA), direct light processing (DLP) and subtractive manufacturing (SM). The effect of material (for SM) and layer thickness (for DLP) were also investigated. Specimens were digitized with a laboratory scanner (D2000, 3Shape) and analyzed with a 3D inspection software (Geomagic Control X, 3D systems). For quantitative analysis, differences between 3D datasets were measured using root mean square (RMS) error values for trueness and precision. For qualitative analysis, color maps were generated to detect locations of deviations within each sample. SM showed higher trueness and precision than AM technologies. Reducing layer thickness in DLP did not significantly increase accuracy, but prolonged manufacturing time. All materials and technologies met the clinically acceptable range and are appropriate for their use. DLP with 100 µm layer thickness showed the highest efficiency, obtaining high trueness and precision within the lowest manufacturing time.
High-Harmonic Injection-Based Brushless Wound Field Synchronous Machine Topology
Authors: Bukhari Syed Sabir Hussain , Mangi Fareed Hussain , Sami Irfan , Ali Qasim , Ro Jong-Suk
Published: July 2021

This paper discusses the design and analysis of a high-harmonic injection-based field excitation scheme for the brushless operation of wound field synchronous machines (WFSMs) in order to achieve a higher efficiency. The proposed scheme involves two inverters. One of these inverters provides the three-phase fundamental-harmonic current to the armature winding, whereas the second inverter injects the single-phase high-harmonic i.e., 6th harmonic current in this case, to the neutral-point of the Y-connected armature winding. The injection of the high-harmonic current in the armature winding develops the high-harmonic magnetomotive force (MMF) in the air gap of the machine beside the fundamental. The high-harmonic MMF induces the harmonic current in the excitation winding of the rotor, whereas the fundamental MMF develops the main armature field. The harmonic current is rectified to inject the direct current (DC) into the main rotor field winding. The main armature and rotor fields, when interacting with each other, produce torque. Finite element analysis (FEA) is carried out in order to develop a 4-pole 24-slot machine and investigate it using a 6th harmonic current injection for the rotor field excitation to both attain a brushless operation and analyze its electromagnetic performance. Later on, the performance of the proposed topology is compared with the typical brushless WFSM topology employing the 3rd harmonic current injection-based field excitation scheme.
An Enhanced Evolutionary Software Defect Prediction Method Using Island Moth Flame Optimization
Authors: Khurma Ruba Abu , Alsawalqah Hamad , Aljarah Ibrahim , Elaziz Mohamed Abd , Damaševičius Robertas
Published: July 2021

Software defect prediction (SDP) is crucial in the early stages of defect-free software development before testing operations take place. Effective SDP can help test managers locate defects and defect-prone software modules. This facilitates the allocation of limited software quality assurance resources optimally and economically. Feature selection (FS) is a complicated problem with a polynomial time complexity. For a dataset with N features, the complete search space has 2N feature subsets, which means that the algorithm needs an exponential running time to traverse all these feature subsets. Swarm intelligence algorithms have shown impressive performance in mitigating the FS problem and reducing the running time. The moth flame optimization (MFO) algorithm is a well-known swarm intelligence algorithm that has been used widely and proven its capability in solving various optimization problems. An efficient binary variant of MFO (BMFO) is proposed in this paper by using the island BMFO (IsBMFO) model. IsBMFO divides the solutions in the population into a set of sub-populations named islands. Each island is treated independently using a variant of BMFO. To increase the diversification capability of the algorithm, a migration step is performed after a specific number of iterations to exchange the solutions between islands. Twenty-one public software datasets are used for evaluating the proposed method. The results of the experiments show that FS using IsBMFO improves the classification results. IsBMFO followed by support vector machine (SVM) classification is the best model for the SDP problem over other compared models, with an average G-mean of 78%.
Lithium-Ion Battery SOC Estimation Based on Adaptive Forgetting Factor Least Squares Online Identification and Unscented Kalman Filter
Authors: Wang Hao , Zheng Yanping , Yu Yang
Published: July 2021

In order to improve the estimation accuracy of the battery state of charge (SOC) based on the equivalent circuit model, a lithium-ion battery SOC estimation method based on adaptive forgetting factor least squares and unscented Kalman filtering is proposed. The Thevenin equivalent circuit model of the battery is established. Through the simulated annealing optimization algorithm, the forgetting factor is adaptively changed in real-time according to the model demand, and the SOC estimation is realized by combining the least-squares online identification of the adaptive forgetting factor and the unscented Kalman filter. The results show that the terminal voltage error identified by the adaptive forgetting factor least-squares online identification is extremely small; that is, the model parameter identification accuracy is high, and the joint algorithm with the unscented Kalman filter can also achieve a high-precision estimation of SOC.
Teaching and Learning to Program: Umbrella Review of Introductory Programming in Higher Education
Authors: Sobral Sónia Rolland
Published: July 2021

Introductory programming courses in science, technology, engineering, and mathematics (STEM) degrees are critical to student success throughout the students’ academic and professional route but have traditional failure and dropout rates. The number of publications and reviews on the subject is growing, so we realize the need to prepare an umbrella review, or review of reviews, to group previous studies and extract more comprehensive and ambitious results. Based on the databases ACM, Google Scholar, IEEE, SCOPUS and Web of Science libraries, a formal search was created that resulted in 21 reviews on programming fundamentals in higher education context. Results include bibliometric information on the CS1 reviews, in the context of higher education (namely annual evolution, number and information on authors, types and sources of information, countries of affiliation, languages, keywords and most cited articles), the purpose of the reviews and research questions, methods (namely search strategy, databases used, eligibility criteria) and results (number of records and tables or divisions were made to catalog the articles). We present a taxonomy with four different types of purpose: general, specific, student group and teacher directed. We found very interesting catalogs that can serve as a tool for future work, whether by researchers in the field or by authors who intend to carry out reviews related to introduction to programming, especially in the context of higher education.
TPACK of Prospective Mathematics Teachers at an Early Stage of Training
Authors: Morales-López Yuri , Chacón-Camacho Yerlin , Vargas-Delgado Wilbert
Published: July 2021

The objective of this work is to present the results of an investigation on the technological, pedagogical and content knowledge evidenced by mathematics teachers in the second year of initial training (preservice) at the Universidad Nacional, from the TPACK model perspective, on the subject of functions. The research has a qualitative approach with an interpretive hermeneutical stance. A sample of 27 teachers in training who were enrolled in courses related to the three base domains of the TPACK model (pedagogical, technological and content of quadratic function) during the first semester (I cycle) of 2020 was used. Three instruments with situations involving the quadratic function were created to determine students’ knowledge. They were also asked to design their own situation to teach an element linked to this topic, which was then shared and evaluated by their peers. The results show that participants possess instrumental dominance over the basic forms of knowledge underlying the model. It is concluded that, although participants have already experimented in courses related to these forms of knowledge, there is insufficient evidence to ascertain that their current knowledge would allow them to integrate technologies as a didactic resource within the teaching of the subject of quadratic function.