bluuebunny/crossref_metadata_2025 huggingface dataset:
Bichromatic Splicing Detector Allows Quantification of THRA1 and THRA2 Splicing Isoforms in Single Cells by Fluorescent Live-Cell Imaging
Authors: Graceffo Eugenio , Pedersen Elisa , Rosário Marta , Krude Heiko , Schuelke Markus
Published: December 2024

Thyroid hormone receptor alpha (THRα) is a nuclear hormone receptor that binds triiodothyronine (T3) and acts as an important transcription factor in development, metabolism, and reproduction. The coding gene, THRA, has two major splicing isoforms in mammals, THRA1 and THRA2, which encode THRα1 and THRα1, respectively. The better characterized isoform, THRα1, is a transcriptional stimulator of genes involved in cell metabolism and growth. The less well-characterized isoform, THRα2, lacks the ligand-binding domain (LBD) and may act as an inhibitor of THRα1 activity. Thus, the ratio of THRα1 to THRα2 isoforms is critical for transcriptional regulation in various tissues and during development and may be abnormal in a number of thyroid hormone resistance syndromes. However, the complete characterization of the THRα isoform expression pattern in healthy human tissues, and especially the study of changes in the ratio of THRα1 to THRα2 in cultured patient cells, has been hampered by the lack of suitable tools to detect the isoform-specific expression patterns. Therefore, we developed a plasmid pCMV-THRA-RFP-EGFP splicing detector that allows the visualization and quantification of the differential expression of THRA1 and THRA2 splicing isoforms in living single cells during time-lapse and perturbation experiments. This tool enables experiments to further characterize the role of THRα2 and to perform high-throughput drug screening. Molecules that modify THRA splicing may be developed into drugs for the treatment of thyroid hormone resistance syndromes.
Different Correlation Patterns Between Circulating Amino Acids and Body Temperature in Fibromyalgia Syndrome: A Cross-Sectional Study
Authors: Casas-Barragán Antonio , Molina Francisco , Tapia-Haro Rosa María , Martínez-Martos José Manuel , Ramírez-Expósito María Jesús , Rus Alma , Correa-Rodríguez María , Aguilar-Ferrándiz María Encarnación
Published: December 2024

The aim of this study was to analyze the association between circulating amino acids and central and peripheral body temperature in subjects with and without fibromyalgia syndrome (FMS). A total of 47 patients with FMS and 59 healthy subjects were included in the study. The concentration of amino acids was determined in serum samples using a fluorimeter coupled with a high-performance liquid chromatography system. An infrared thermography camera was used to estimate peripheral hand temperatures. The core temperature of the body was estimated using an infrared thermometer, which was applied to the axillary and tympanic areas. Correlations between several thermographic variables of the hands and tryptophan, methionine, 3-methylhistidine, histidine, glutamic acid, and tyrosine were identified exclusively within the FMS group. In contrast, correlations between aminoadipic acid and serine and thermographic variables were observed only in the healthy control group. The concentrations of asparagine and lysine correlated with thermographic variables in both groups. The essential amino acid leucine was found to correlate with axillary temperature in FMS patients. However, it should be noted that the observed associations between aminoadipic acid and tryptophan blood concentrations and axillary temperature were limited to the control group. Several correlations were identified between circulating amino acids and different body temperatures in both healthy controls and patients with FMS. However, the correlation pattern differs significantly between FMS patients and healthy controls. These findings suggest the possibility of a change in the function of several amino acids in the thermoregulatory process in patients with FMS.
Latest Therapeutical Approaches for Triple-Negative Breast Cancer: From Preclinical to Clinical Research
Authors: Pont Mariona , Marqués Marta , Sorolla Anabel
Published: December 2024

Triple-negative breast cancer (TNBC) represents roughly one-sixth of all breast cancer patients, but accounts for 30–40% of breast cancer deaths. Due to the lack of typical biomarkers exploited clinically for breast cancer, it remains very difficult to treat. Moreover, its intrinsic high heterogeneity and proneness to become resistant to the drugs administered makes the treatment management very challenging for oncologists. Herein, we outline the different therapies used currently for TNBC and list the ongoing clinical trials to provide an overview of the most recent TNBC therapeutic landscape. In addition, we highlight the emerging therapies in the preclinical stage that hold the most promise, such as epigenetic modulators, CRISPR, miniproteins, radioconjugates, cancer vaccines, and PROTACs. Moreover, we navigate through the existing limitations and challenges which hamper the development of new and more effective treatments for TNBC. Lastly, we point to emerging new directions that may revolutionize future therapy for TNBC.
Plasma microRNAs Associate Positive, Negative, and Cognitive Symptoms with Inflammation in Schizophrenia
Authors: Miyano Takuya , Hirouchi Masakazu , Yoshimura Naoki , Hattori Kotaro , Mikkaichi Tsuyoshi , Kiyosawa Naoki
Published: December 2024

Schizophrenia is a complex and heterogenous psychiatric disorder characterized by positive, negative, and cognitive symptoms. Our previous study identified three subgroups of schizophrenia patients based on plasma microRNA (miRNA) profiles. The present study aims to (1) verify the reproducibility of the miRNA-based patient stratification and (2) explore the pathophysiological pathways linked to the symptoms using plasma miRNAs. We measured levels of 376 miRNAs in plasma samples of schizophrenia patients and obtained their Positive and Negative Syndrome Scale (PANSS) scores and the Brief Assessment of Cognition in Schizophrenia (BACS) scores. The plasma miRNA profiles identified similar subgroups of patients as in the previous study, suggesting miRNA-based patient stratification is potentially reproducible. Our multivariate analysis identified optimal combinations of miRNAs to estimate the PANSS positive and negative subscales and BACS composite scores. Those miRNAs consistently enriched ‘inflammation’ and ‘NFκB1′ according to miRNA set enrichment analysis. Our literature-based text mining and survey confirmed that those miRNAs were associated with IL-1β, IL-6, and TNFα, suggesting that exacerbated positive, negative, and cognitive symptoms are associated with high inflammation. In conclusion, miRNAs are a potential biomarker to identify patient subgroups reflecting pathophysiological conditions and to investigate symptom-related molecular mechanisms in schizophrenia.
The Multifaced Role of Collagen in Cancer Development and Progression
Authors: Lo Buglio Gabriele , Lo Cicero Alessandra , Campora Simona , Ghersi Giulio
Published: December 2024

Collagen is a crucial protein in the extracellular matrix (ECM) essential for preserving tissue architecture and supporting crucial cellular functions like proliferation and differentiation. There are twenty-eight identified types of collagen, which are further divided into different subgroups. This protein plays a critical role in regulating tissue homeostasis. However, in solid tumors, the balance can be disrupted, due to an abundance of collagen in the tumor microenvironment, which significantly affects tumor growth, cell invasion, and metastasis. It is important to investigate the specific types of collagens in cancer ECM and their distinct roles in tumor progression to comprehend their unique contribution to tumor behavior. The diverse pathophysiological functions of different collagen types in cancers illustrate collagen’s dual roles, offering potential therapeutic options and serving as prognostic markers.
Itchy E3 Ubiquitin Ligase-Mediated Ubiquitination of Ferritin Light Chain Contributes to Endothelial Ferroptosis in Atherosclerosis
Authors: Zeng Yi , Fu Shuai , Xia Yuwei , Meng Guoliang , Xu Xiaole
Published: December 2024

This research seeks to investigate the function and fundamental mechanisms of Itchy E3 ubiquitin ligase (ITCH), a HECT (homologous to E6AP carboxyl terminus)-type E3 ubiquitin ligase, in endothelial ferroptosis, particularly in the context of atherosclerosis, which has been underexplored. The levels of ITCH protein in the aortas of mice with atherosclerosis were analyzed. Constructs for ITCH RNA interference were generated and introduced into human aortic endothelial cells (HAECs). The findings indicated that ITCH protein expression was elevated in atherosclerotic mice and HAECs exposed to oxidized low-density lipoprotein (ox-LDL). ITCH downregulation significantly mitigated ox-LDL-induced endothelial injury and dysfunction. Reducing ITCH expression inhibited ox-LDL-induced endothelial ferroptosis. This study also revealed that ITCH mediates ox-LDL-induced ubiquitin-dependent degradation of ferritin light chain (FTL) in HAECs. The protective impact of ITCH knockdown against ox-LDL-induced ferroptosis and endothelial injury was reversed by FTL siRNA. Additionally, in vivo experiments showed that inhibiting ITCH reduced atherosclerosis progression and reversed ferroptosis in the aorta, with an associated increase in FTL protein expression in the aortas of mice. This study demonstrates that ITCH interacts with and regulates the stability of the FTL protein via the ubiquitin–proteasome system, contributing to ox-LDL-induced ferroptosis and endothelial cell dysfunction. Targeting components of the ITCH-FTL pathway holds potential as a therapeutic strategy against atherosclerosis.
Comparative Analysis of Conventional CNN v’s ImageNet Pretrained ResNet in Medical Image Classification
Authors: Raptis Christos , Karavasilis Efstratios , Anastasopoulos George , Adamopoulos Adam
Published: December 2024

Convolutional Neural Networks (CNNs) are the prevalent technology in computer vision and have become increasingly popular for medical imaging data classification and analysis. In this field, due to the scarcity of medical data, pretrained ResNets on ImageNet can be considered a suitable first approach. This paper examines the medical imaging classification accuracy of conventional basic custom CNNs compared to ImageNet pretrained ResNets on various medical datasets in an effort to give more information about the importance of medical data and its preprocessing techniques for disease studies. Microscope-extracted cytological images were examined along with chest X-rays, MRI brain scans, and melanoma photographs. The medical images were examined in various sets, class combinations, and resolutions. Augmented image datasets and asymmetrical training and validation splits among the classes were also examined. Models were developed after they were tested and fine-tuned with respect to their network size, parameter values and network methods, image resolution, size of dataset, multitude, and genre of class. Overfitting was also examined, and comparative studies regarding the computational cost of different models were performed. The models achieved high accuracy in image classification that varies depending on the dataset and can be easily incorporated in future over-the-internet medical decision-supporting (telemedicine) environments. In addition, it appeared that conventional basic custom CNN overperformed ImageNet pretrained ResNets. The obtained results indicate the importance of utilizing medical image data as a testbed for improvements in CNN classification performance and the possibility of using CNNs and data preprocessing techniques for disease studies.
Ni(II) and Cu(II) Ion Coordination by the Novel (2E,2′E)-N,N′-(2-Hydroxypropane-1,3-diyl)bis[(2-hydroxyimino)propanamide] Ligand in the Solid State and in Aqueous Medium
Authors: Nikolayenko Igor Vasyl , Bazzicalupi Carla , Theron Thomas-John , Grimmer Craig
Published: December 2024

In the process of a systematic study of the bis-chelate oxime-amide ligands with different polymethylene spacers and their transition metal complexes, two new Ni(II) and Cu(II) complexes of the mhiea2poh ligand have been isolated, and their molecular and crystal structures determined by single crystal X-ray diffraction. Potentiometric titrations were performed on a range of aqueous solutions in both systems, which allowed the identification of various complex species and afforded their stability constants. ESR spectra of samples with optimised concentrations of complexes in Cu(II)–L–H system were recorded. A distinguishing feature of both systems is the dimerization of anionic pseudo-macrocyclic complexes. The latter is caused either by centrosymmetric hydrogen bonding of the hydroxy group on the propane spacer to the oximato oxygen of the opposing unit or by back-to-back π-stacking of planar complex units. ESR measurements indicated likely coupling of Cu-Cu paramagnetic centres in the dimers.
Influence of Floral Strip Width on Spider and Carabid Beetle Communities in Maize Fields
Authors: Li Jia-Lu , Huang Lan-Mei , Xiang Zi-Yi , Zhao Jian-Ning , Yang Dian-Lin , Wang Hui , Zhang Yan-Jun
Published: December 2024

The study explored the impact of floral strip width on the spider and carabid beetle communities in maize fields over two years. Three widths of floral strips (2 m, 4 m, and 6 m) were compared with maize-only control strips to evaluate species diversity and distribution. The results showed significant differences in both spider and carabid populations between floral and control strips, with 4 m and 6 m widths consistently harboring higher biodiversity. The results also showed distinct community clustering within floral strips in 2021, which became more cohesive by 2022. Further analysis validated significant community dissimilarities between different strip widths and controls, highlighting the ecological advantages of wider floral strips for enhancing natural enemy biodiversity. Spider activity density was notably higher in floral strips than in adjacent farmland, peaking at the edges of 4 m-wide strips and decreasing in 6 m-wide strips, with the lowest density in 2 m-wide strips. Carabid beetle activity density varied considerably with strip width and proximity to the edge, typically peaking at the edges of wider strips. Spiders were more responsive to strip width than carabid beetles. Based on these findings, we suggest using 4 m- or 6 m-wide floral strips to enhance biodiversity and natural pest control in agricultural landscapes; the floral strips narrower than 4 m (such as 2 m) could not support optimal biodiversity, as spiders and carabid beetles do not disperse far into the maize field, with spiders having dispersal distances of less than 3 m and carabid beetles less than 10 m. Vegetation characteristics significantly influenced spider and carabid communities, impacting species richness, diversity indices, and community structures across two study years. These insights highlight the necessity of thoughtfully designing floral strips to enhance biodiversity and natural pest control in agricultural landscapes.
Bacteria Derived from Diamondback Moth, Plutella xylostella (L.) (Lepidoptera: Plutellidae), Gut Regurgitant Negatively Regulate Glucose Oxidase-Mediated Anti-Defense Against Host Plant
Authors: Qiao Qingxuan , Feng Huiting , Jiao Lu , Zaheer Uroosa , Zheng Chanqin , Zhou Li , Lin Guifang , Xiang Xiujuan , Liao Huang , Li Shanyu , Lu Haiyan , Yin Anyuan , Salum Yussuf Mohamed , Wei Hui , Chen Wei , He Weiyi , Yang Feiying
Published: December 2024

The ongoing interplay among plants, insects, and bacteria underscores the intricate balance of defense mechanisms in ecosystems. Regurgitant bacteria directly/indirectly impact plant immune responses, but the underlying mechanism is unclear. Here, we focus on the interaction between regurgitant bacteria, diamondback moth (DBM), and plant. Six culturable bacteria were isolated from DBM gut regurgitant, including three Enterobacter strains (RB1-3), Micrococcus sp. (RB4), Staphylococcus haemolyticus (RB5), and Bacillus cereus (RB6). These RB strains suppressed genes related to jasmonic acid and glucosinolate signaling pathways but had little effect on salicylic acid signaling pathway genes in Arabidopsis thaliana wounds. RB1 and RB5 inhibited DBM development on A. thaliana but not on an artificial diet. RB1 and RB5 significantly suppressed GOX genes and proteins in DBMs. However, the Pxgox2 insect mutant strain inoculated with RB1 or RB5 did not significantly affect DBM feeding on A. thaliana compared to the wild type. Six RB have been functionally identified, with RB1 and RB5 negatively regulating GOX-mediated host adaptability. The deliberate addition of RB1 and RB5 can negatively affect DBM herbivory and fitness. Our study provides a molecular basis for the further application of RB for insect pest management by modulating insect–plant interactions.
Portable Arbitrary Pulse Generator for Driving Microcoils for Micromagnetic Neurostimulation
Authors: Bloom Robert P. , Saha Renata , Sanger Zachary , Low Walter C. , Netoff Theoden I. , Wang Jian-Ping
Published: December 2024

Micromagnetic stimulation (μMS) is a promising branch of neurostimulation but without some of the drawbacks of electrical stimulation. Microcoil (μcoil)-based magnetic stimulation uses small micrometer-sized coils that generate a time-varying magnetic field, which, as per Faraday’s Laws of Electromagnetic Induction, induces an electric field on a conductive surface. This method of stimulation has the advantage of not requiring electrical contact with the tissue; however, these μcoils are not easy to operate. Large currents are required to generate the required magnetic field. These large currents are too large for standard test equipment to provide, and additional power amplifiers are needed. To aid in the testing and development of micromagnetic stimulation devices, we have created a compact single-unit test setup for driving these devices called the µCoil Driver. This unit is designed to drive small inductive loads up to ±8 V at 5 A and 10 kHz.
Enhancing Intergenerational Connections: Exploring the Benefits for Older Adults and College Students in a Telephonic Reassurance Program
Authors: Zorotovich Jennifer , Reeder Hunter , Sweeney Thomas Patrick , Naqvi Aylia Z. , Edwards-Bianchi Adrienne
Published: December 2024

Loneliness is well documented as a major, yet preventable, risk factor for well-being among older adults that was exacerbated by the COVID-19 pandemic. Nearly half of some countries’ older population experience loneliness, which significantly increases risks for dementia, heart disease, stroke, depression, anxiety, hospitalization, and even hastened death. Utilizing socioemotional selectivity theory, the current study addresses. the inverse relationship between aging and social outlet availability by providing empirical data on the benefits of intergenerational programming. Data from adult–college student dyads who participated in a telephone reassurance program focused on reminiscence guiding were analyzed to determine outcomes of participation. Qualitative analyses revealed the emergence of themes surrounding familial/friendship bonds and self-discovery among adult participants and a rejuvenated appreciation for the little things in life as well as a sense of purpose from meaningful contributions among college student participants. Results are discussed in terms of continued growth and development during late adulthood and professional and personal growth among students. The psychologically and emotionally meaningful nature of quality intergenerational programs provides a platform for the formation of unique relationships to offset fractured social outlets during later life, providing protections against loneliness and work to establish unique relationships between disparate groups who otherwise may never have crossed paths.
Pulmonary Embolism Response Teams—Evidence of Benefits? A Systematic Review and Meta-Analysis
Authors: Bryan Amelia , Tran Quincy K. , Ahari Jalil , Mclaughlin Erin , Boone Kirsten , Pourmand Ali
Published: December 2024

Background: Venous thromboembolisms constitute a major cause of morbidity and mortality with 60,000 to 100,000 deaths attributed to pulmonary embolism in the US annually. Both clinical presentations and treatment strategies can vary greatly, and the selection of an appropriate therapeutic strategy is often provider specific. A pulmonary embolism response team (PERT) offers a multidisciplinary approach to clinical decision making and the management of high-risk pulmonary emboli. There is insufficient data on the effect of PERT programs on clinical outcomes. Methods: We searched PubMed, Scopus, Web of Science, and Cochrane to identify PERT studies through March 2024. The primary outcome was all-cause mortality, and the secondary outcomes included the rates of surgical thrombectomy, catheter directed thrombolysis, hospital length of stay (HLOS), and ICU length of stay (ICULOS). We used the Newcastle−Ottawa Scale tool to assess studies’ quality. We used random-effects models to compare outcomes between the pooled populations and moderator analysis to identify sources of heterogeneity and perform subgroup analysis. Results: We included 13 observational studies, which comprised a total of 12,586 patients, 7512 (60%) patients were from the pre-PERT period and 5065 (40%) patients were from the PERT period. Twelve studies reported the rate of all-cause mortality for their patient population. Patients in the PERT period were associated with similar odds of all-cause mortality as patients in the pre-PERT period (OR: 1.52; 95% CI: 0.80–2.89; p = 0.20). In the random-effects meta-analysis, there was no significant difference in ICULOS between PERT and pre-PERT patients (difference in means: 0.08; 95% CI: −0.32 to 0.49; p = 0.68). There was no statistically significant difference in HLOS between the two groups (difference in means: −0.82; 95% CI: −2.86 to 1.23; p = 0.43). Conclusions: This meta-analysis demonstrates no significant difference in all studied measures in the pre- and post-PERT time periods, which notably included patient mortality and length of stay. Further study into the details of the PERT system at institutions reporting mortality benefits may reveal practice differences that explain the outcome discrepancy and could help optimize PERT implementation at other institutions.
Coronary Artery Disease and Severe Aortic Stenosis: Contemporary Treatment Options for Patients Undergoing Transcatheter Aortic Valve Implantation
Authors: Ktenopoulos Nikolaos , Karanasos Antonios , Katsaros Odysseas , Apostolos Anastasios , Latsios George , Moulias Athanasios , Papafaklis Michael I. , Tsigkas Grigorios , Tsioufis Constantinos , Toutouzas Konstantinos , Davlouros Periklis
Published: December 2024

Approximately 50% of individuals eligible for transcatheter aortic valve implantation (TAVI) have coronary artery disease (CAD). The influence of CAD, both its prevalence and severity, on post-TAVI clinical results has yielded conflicting findings. Recent research has shown positive results for the use of computed tomography angiography and functional percutaneous evaluation of coronary lesions in the pre-TAVI assessment, besides the classic coronary angiography. As we anticipate the outcomes of current randomized studies, it has become common practice to perform invasive revascularization on TAVI patients with obstructive CAD. Furthermore, there is a lack of comprehensive data about the occurrence, features, and treatment of coronary incidents after TAVI. There is also growing concern about the possible difficulties in accessing the coronary arteries in patients who need coronary angiography with or without intervention after TAVI. This review presents a comprehensive analysis of the contemporary treatment options of CAD in patients undergoing TAVI. In this context, it examines the incidence of CAD in TAVI candidates; its clinical significance; the assessment and management of CAD before, concomitant, and after the procedure, including patients’ unresolved concerns; and possible future aspects.
Heparin Resistance in Patients Receiving Extracorporeal Membrane Oxygenation: A Review
Authors: Li Tatyana , Zhailauova Azhar , Kuanyshbek Aidyn , Wachruschew Iwan , Tulegenov Shaimurat , Sazonov Vitaliy , Kapyshev Timur
Published: December 2024

Heparin resistance (HR) in patients on extracorporeal membrane oxygenation (ECMO) exacerbates bleeding and thrombogenesis. Thus far, there is no universal definition of what this condition entails and no unified strategy for assessing heparin’s efficacy in ECMO patients. The most frequent discrepancy when it comes to defining HR is the difference in the reported doses: units per day (U/d) or per kilogram per hour (U/kg/h). Another disagreement arises with regard to the various methods of measuring unfractionated heparin (UFH) efficacy. Due to numerous processes that begin with ECMO initiation, including protein layer formation on the surface of circuits, the recruitment of immune cells, the activation of complement and contact activation systems, and platelets, assessing pure antithrombin consumption is complicated. Moreover, there is an alternative anticoagulation procedure performed by a serine protease inhibitor named heparin cofactor II, which could also contribute to heparin consumption. Considering simultaneously launched processes of inflammation and thrombogenesis in response to contact with artificial surfaces on ECMO, we listed the possible mechanisms contributing to additional antithrombin consumption. The effect of the flow on the platelets’ activation and von Willebrand factor (vWF) assembly was also described. We reviewed the scientific literature from PubMed and Embase to identify possible definitions of heparin resistance during ECMO treatment among pediatric and adult cohorts. We identified 13 records describing different approaches to assessing HR and described our vision of delineating HR on ECMO.
Management of Type III Occipital Condyle Fractures
Authors: Kwon Jae Hyun , Chinthala Anoop Sai , Arnold Jonathan C. , Witten Andrew J. , Bohnstedt Bradley N.
Published: December 2024

Background/Objectives: Occipital condyle fractures (OCFs) can be seen in around 4–19% of patients who suffer from cervical spine trauma. Anderson and Montesano system type III OCFs, which are avulsion fractures, are potentially unstable and operative. This study evaluates the management of type III OCFs at our institution over a 22-year period. Methods: This retrospective study reviewed all cases of type III OCFs at our institution from July 2001 to March 2023, identified via imaging reports. Using the in-house radiology imaging informatics system “Doris” (Dig Our Radiology Information System), reports containing the terms subluxation, avulsion, unstable, or type 3/III with occipital condyle, occipital condylar, occipital fx, or occipital fracture were collected. We also searched for Montesano type III/3 fracture. Electronic medical records were used to collect clinical and demographic data. Patients evaluated by the neurosurgical team with at least 1 month of follow-up were included in the analysis. Results: A total of 563 patients were identified with type III OCFs. A total of 56 patients met the inclusion criteria. The majority (91%, 51/56) were treated conservatively with cervical orthosis. A small subset (8.9%, 5/56) underwent occipito-cervical fusion. Three had concomitant unstable C1 fractures, while the other two had significant coronal deformity associated with their type III OCF. Conclusions: At our institution, type III OCFs are predominantly managed with cervical orthosis. Only those with an associated malalignment of the occipito-cervical joint underwent fusion. These findings suggest that most type III OCFs can be treated conservatively with orthosis once stability is confirmed with an upright radiograph.
Transdermal Fentanyl Patch Effectiveness in Postoperative Pain
Management in Orthopedic Patients: Literature Review
Authors: Niculae Andrei , Checherita Ionel Alexandru , Peride Ileana , Tiglis Mirela , Ene Razvan , Neagu Tiberiu Paul , Ene Dragos
Published: December 2024

Controlling pain after major orthopedic surgery may be challenging, and it is related to delayed recovery, the development of chronic pain, and analgesic dependence. It is well known that effective postoperative pain control can reduce hospital stays by ensuring a more rapid rehabilitation,thereby decreasing the overall costs. Despite the development of analgesics, the use of opioids and their derivates remains the cornerstone of treatment for patients with acute moderate-to-severe pain in association with general or regional anesthesia. To reduce the risk of side effects and opioid addiction, considering the alarming epidemiological reports in relation to opioid abuse, combined analgesic methods are used, in addition to lower dosages or different forms of administration, such as transdermal administration. Fentanyl transdermal patches appear to be effective in controlling postoperative pain as part of multimodal analgesic regimens in knee and hip surgery, shoulder arthroplasty, traumatic fractures, and one-day surgery; this treatment has fewer associated side effects and can be safely used even in patients with renal impairment. It is also recommended for postoperative pain management in combination with a femoral–sciatic nerve block during foot and ankle surgery.
An Overview of Recent Clinical Trials for Diabetic Foot Ulcer Therapies
Authors: Ganesan Ovya , Orgill Dennis P.
Published: December 2024

Diabetic foot ulcers (DFUs) are a major complication of diabetes, leading to high mortality, reduced quality of life, neuropathy, ischemia, infection, and amputation risks. The prevalence of these ulcers is only on the rise as more people suffer from type 2 diabetes and obesity. The current wound management involves wound dressings, offloading, debridement, and infection control, but more must be done to keep up with the rising prevalence of DFUs and the strain they put on patients and the healthcare system. To find recent therapeutic advances in DFU treatment, we searched PubMed for novel therapeutics from the past 5 years. We found a diversity of promising interventions, including advanced wound dressings and topicals, physical energy-based therapies, regenerative scaffolds, and growth factor- and cell-based therapies. Recent therapies hold significant promise in healing more DFUs faster and more effectively. Providers should consider employing safe, novel therapeutics when standard dressings are not effective.
Effect of the COVID-19 Pandemic on the Management of Breast Cancer Patients
Authors: Dalda Yasin , Akbulut Sami , Kucukakcali Zeynep , Ogut Zeki , Dalda Ozlem , Alan Saadet , Isik Burak
Published: December 2024

Background: The COVID-19 pandemic has significantly affected breast cancer patients by causing delays in diagnosis and treatment processes. This study aims to investigate the effects of the pandemic on the treatment process and short-term outcomes of breast cancer patients. Methods: This retrospective, cross-sectional, single-center study included 414 patients who underwent surgery for breast cancer at the Inonu University General Surgery Clinic between March 2018 and June 2021. The patients were divided into two groups: pre-pandemic (Pre-COVID-19; n = 240) and pandemic (COVID-19 Era; n = 174) periods. The groups were compared in terms of demographic, clinical, and histopathological variables. Results: During the pandemic period, the use of neoadjuvant therapy (from 21.3% to 34.5%) and preoperative PET-CT imaging (from 80.4% to 90.8%) rates increased, while breast-conserving surgery (from 27.9% to 19.0%) and the presence of comorbid diseases (from 45.0% to 29.9%) decreased significantly. While there was no significant difference between the groups in terms of the time from diagnosis to surgery (25 vs. 28.5 days, p = 0.121), the time to report the pathology result after surgery decreased during the pandemic period (28 vs. 23 days, p < 0.001). There was no significant difference between the groups in terms of immunohistochemical (ER, PR, Ki-67, E-cadherin, and c-erbB2), histopathological (lymphovascular invasion, perineural invasion, comedo necrosis, modified Bloom–Richardson grade, and TNM classification), and clinical (recurrence, metastasis, and axillary lymph node metastasis) features of the tumor. The mortality rate in the Pre-COVID-19 group (7.1%) was significantly higher than in the COVID-19 Era group (2.3%) (p = 0.049). Finally, in terms of the survival analysis, a statistically significant difference was found between the Pre-COVID-19 and COVID-19 Era groups in terms of the mean follow-up duration of the patients (p = 0.044). Conclusions: The study results show that the use of neoadjuvant therapy and radical surgery preference increased in breast cancer treatment during the pandemic period, but there was no significant change in tumor biology and histopathological features. Breast-conserving surgery rates, comorbidity rates, and pathology reporting times were significantly shortened. Long-term follow-up periods of 3 and 5 years are needed to see the impact of the pandemic on breast cancer patients.
Two-Dimensional and Three-Dimensional Changes in Deformational Head Shapes During Repositioning Therapy and Cranial Remolding Treatment
Authors: Graham Tiffany , Wang Jijia , Calderon Fabian A. , Moses Victoria , Hallac Rami R.
Published: December 2024

Backgrounds/Objectives: The surge in deformational head shapes (DHSs) over the past 30 years has led to increased interest in comparing the treatment options of Repositioning Therapy (RT) and a Cranial Remolding Orthosis (CRO). This study investigates the amount and rate of 2D and 3D correction in infants with DHSs during these treatments. Methods: A total of 34 infants with DHSs were enrolled (RT group, n = 18; CRO group, n = 16). Infants were discharged after achieving correction or reaching 12 months of age. Two-dimensional scan/caliper measurements and three-dimensional scan measurements were collected at treatment initiation and conclusion (or 12 months of age). Results: Asymmetric infants in the RT group averaged a 2dCVAI reduction of 3.59 ± 1.57 and 3dCVAI correction of 12.17 ± 13.02 versus 4.44 ± 2.99 and 21.72 ± 15.36 correction in the CRO group (2d p = 0.6656; 3d p = 0.1417). Disproportionate infants in the RT group averaged a 2dCI reduction of 3.13% ± 2.57% and 3dCI reduction of 24.53 ± 24.01 while the CRO group averaged 5.21% ± 2.78% and 55.98 ± 25.77 (2d p = 0.0383*; 3d p = 0.0254*). Asymmetrical RT mean 2dCVAI weekly change was 0.21 ± 0.15 while CRO was 0.23 ± 0.17 (p = 0.7796). The 3dCVAI weekly change was 1.05 ± 1.55 in the RT group versus 1.17 ± 0.95 in the CRO group (p = 0.4328). Disproportionate RT mean 2dCI weekly change was 0.12 ± 0.11 while CRO was 0.23 ± 0.11 (p = 0.0440*). The 3dCI weekly change was 0.87 ± 0.91 in the RT group versus 3.02 ± 2.16 in the CRO group (p = 0.0143*). Conclusions: Results indicate that CRO treatment achieves greater total correction and rate of correction. Statistical significance was found in the treatment of disproportional DHSs, but further investigation is needed with a larger sample size.
A Randomized Controlled Trial on the Efficacy of 20% Human Albumin in Reducing Pleural Effusion After Cardiopulmonary Bypass
Authors: Setlers Kaspars , Aispure Klaudija , Zolovs Maksims , Zvaigzne Ligita , Sabelnikovs Olegs , Stradins Peteris , Strike Eva
Published: December 2024

Background/Objectives: Cardiopulmonary bypass can lead to hemodilution, causing a fluid shift to the interstitial space. Albumin helps counteract the intravascular fluid movement to the extravascular space and reduces the risk of complications associated with fluid imbalance. Our main objective was to evaluate the effectiveness of albumin addition in the cardiopulmonary bypass priming solution compared to standard priming, focusing on its role in reducing pleural effusion development. Methods: This was a single-center randomized controlled trial conducted at a tertiary care hospital specializing in cardiology and cardiac surgery. It involved 70 individuals scheduled for elective open-heart surgery. All cases were randomly assigned into two groups of 35 patients. The study group replaced 100 mL of standard CPB priming solution with 100 mL of 20% human albumin. We measured serum albumin levels before and after the surgery, 6 and 12 h after, and calculated colloid oncotic pressure. Thorax CT scans were performed on the first postoperative day to measure and calculate pleural effusion volume. Results: Albumin addition to cardiopulmonary bypass priming solution led to a significant reduction in pleural effusion development after CPB. An albumin level <35 g/L after the surgery showed a significant increase in pleural effusion development, and 100 mL of 20% albumin was sufficient to maintain serum albumin levels > 35 g/L. Conclusions: Our study suggests a link between postoperative hypoalbuminemia and the early development of pleural effusion after CPB, as well as the possible benefits of adding 100 mL of 20% albumin compared to standard crystalloid CPB priming to minimize postoperative pleural effusion development.
The Impact of Ketamine on Outcomes in Acute Pain Management: An Umbrella Review
Authors: Viderman Dmitriy , Mukazhan Diyara , Kapessova Kamilla , Tungushpayev Meiram , Badenes Rafael
Published: December 2024

Background/Objectives: Ketamine offers effective pain relief with fewer side effects than traditional analgesics, making it a promising alternative for acute pain treatment. However, further research is needed to fully assess its role in perioperative care. This umbrella review aimed to compile the highest-quality evidence available regarding the application of ketamine in managing acute pain. Methods: A thorough search of the literature was carried out in PubMed, Scopus, and the Cochrane Library, including systematic reviews that focused on the application of ketamine in managing acute pain. The data extraction included the research type, analgesics used, number of studies and patients per review, pain types, scoring methods, ketamine doses, administration routes, and reporting guidelines. Results: Of the 807 records identified, 20 studies met the inclusion criteria. In accordance with the AMSTAR-2 evaluation, most of the systematic reviews were rated as critically low quality. Intravenous ketamine administered during the perioperative period was found to reduce the pain intensity of acute pain within 15–30 and 60 min following treatment, and decrease postoperative opioid consumption by 14–50% at both 24 and 48 h after surgery. Conclusions: Evidence shows that intravenous ketamine reduces the pain intensity, postoperative opioid use, and the risk of vomiting and nausea while improving analgesia, making it a valuable adjunct in perioperative pain management.
The Radiologic Evaluation and Clinical Significance of Glenohumeral Bone Loss in Anterior Shoulder Instability
Authors: Zinner Matthew A. , Neufeld Eric V. , Goodwillie Andrew D.
Published: December 2024

Glenoid and humeral bone loss is associated with a high incidence of recurrent shoulder instability and failure of arthroscopic stabilization procedures. However, the radiographic evaluation of bony Bankart and Hill–Sachs injuries continues to pose a diagnostic challenge, and a universally accepted optimal method of measurement is lacking. The purpose of this review is to summarize the advantages and disadvantages of various techniques and imaging modalities available for measuring glenoid bone loss in shoulder instability, including conventional roentgenography, 2-dimensional and 3-dimensional computed tomography (CT), and magnetic resonance imaging (MRI). We also review the concepts of engaging “on-track” and “off-track” Hill–Sachs lesions. Finally, we highlight the clinical importance of obtaining accurate determinations of bone loss by the various methods available, as it can affect surgical decision making and the appropriate procedure required to ensure shoulder stability is adequately restored.
An Upcycling Strategy for Polyethylene Terephthalate Fibers: All-Polymer Composites with Enhanced Mechanical Properties
Authors: Gnoffo Chiara , Arrigo Rossella , Frache Alberto
Published: December 2024

In this work, an effective route for achieving high-performance all-polymer materials through the proper manipulation of the material microstructure and starting from a waste material is proposed. In particular, recycled polyethylene terephthalate (rPET) fibers from discarded safety belts were used as reinforcing phase in melt-compounded high-density polyethylene (HDPE)-based systems. The formulated composites were subjected to hot- and cold-stretching for obtaining filaments at different draw ratios. The performed characterizations pointed out that the material morphology can be profitably modified through the application of the elongational flow, which was proven able to promote significant microstructural evolutions of the rPET dispersed domains, eventually leading to the obtainment of micro-fibrillated all-polymer composites. Furthermore, tensile tests demonstrated that hot-stretched and, especially, cold-stretched materials show significantly enhanced tensile modulus and strength as compared to the unfilled HDPE filaments, likely due to the formation of a highly oriented and anisotropic microstructure.
Determination of Crack Depth in Brickworks by Ultrasonic Methods: Numerical Simulation and Regression Analysis
Authors: Beskopylny Alexey N. , Stel’makh Sergey A. , Shcherban’ Evgenii M. , Dolgov Vasilii , Razveeva Irina , Beskopylny Nikita , Elshaeva Diana , Chernil’nik Andrei
Published: December 2024

Ultrasonic crack detection is one of the effective non-destructive methods of structural health monitoring (SHM) of buildings and structures. Despite its widespread use, crack detection in porous and heterogeneous composite building materials is an insufficiently studied issue and in practice leads to significant errors of more than 40%. The purpose of this article is to study the processes occurring in ceramic bricks weakened by cracks under ultrasonic exposure and to develop a method for determining the crack depth based on the characteristics of the obtained ultrasonic response. At the first stage, the interaction of the ultrasonic signal with the crack and the features of the pulse propagation process in ceramic bricks were considered using numerical modeling with the ANSYS environment. The FEM model allowed us to identify the characteristic aspects of wave propagation in bricks and compare the solution with the experimental one for the reference sample. Further experimental studies were carried out on ceramic bricks, as the most common elements of buildings and structures. A total of 110 bricks with different properties were selected. The cracks were natural or artificially created and were of varying depth and width. The experimental data showed that the greatest influence on the formation of the signal was exerted by the time parameters of the response: the time when the signal reaches a value of 12 units, the time of reaching the first maximum, the time of reaching the first minimum, and the properties of the material. Based on the regression analysis, a model was obtained that relates the crack depth to the signal parameters and the properties of the material. The error in the predicted values according to this model was approximately 8%, which was significantly more accurate than the existing approach.
Current Role of CT Pulmonary Angiography in Pulmonary Embolism: A State-of-the-Art Review
Authors: Diaz-Lorenzo Ignacio , Alonso-Burgos Alberto , Friera Reyes Alfonsa , Pacios Blanco Ruben Eduardo , de Benavides Bernaldo de Quiros Maria del Carmen , Gallardo Madueño Guillermo
Published: December 2024

The purpose of this study is to conduct a literature review on the current role of computed tomography pulmonary angiography (CTPA) in the diagnosis and prognosis of pulmonary embolism (PE). It addresses key topics such as the quantification of the thrombotic burden, its role as a predictor of mortality, new diagnostic techniques that are available, the possibility of analyzing the thrombus composition to differentiate its evolutionary stage, and the applicability of artificial intelligence (AI) in PE through CTPA. The only finding from CTPA that has been validated as a prognostic factor so far is the right ventricle/left ventricle (RV/LV) diameter ratio being >1, which is associated with a 2.5-fold higher risk of all-cause mortality or adverse events, and a 5-fold higher risk of PE-related mortality. The increasing use of techniques such as dual-energy computed tomography allows for the more accurate diagnosis of perfusion defects, which may go undetected in conventional computed tomography, identifying up to 92% of these defects compared to 78% being detected by CTPA. Additionally, it is essential to explore the latest advances in the application of AI to CTPA, which are currently expanding and have demonstrated a 23% improvement in the detection of subsegmental emboli compared to manual interpretation. With deep image analysis, up to a 95% accuracy has been achieved in predicting PE severity based on the thrombus volume and perfusion deficits. These advancements over the past 10 years significantly contribute to early intervention strategies and, therefore, to the improvement of morbidity and mortality outcomes for these patients.
Influence of Coir Fibre Preparation on Mechanical Properties of Coir Fibre/Epoxy Resin Composites
Authors: Rujnić Havstad Maja , Tucman Ines , Krajačić Bruno , Pilipović Ana
Published: December 2024

Polymer composites have been utilized across various industries, especially in transportation, for many years. With a growing emphasis on sustainable production resources, the industry increasingly favours composite materials reinforced with natural fibres or particles. Unlike conventional fibres such as glass, carbon, or aramid, natural fibres typically have low compatibility with polymer matrices, often necessitating pretreatment to enhance bonding. In this study, coir fibres were physically and chemically treated with sodium bicarbonate solutions at varying concentrations (5–15%) and immersion durations (0–5 days). The treated fibres were then mixed into epoxy resin and poured into moulds to produce test specimens for evaluating mechanical properties. The fibre content in the composites ranged from 10 to 20%. Statistical analysis revealed that immersion time significantly affects all mechanical properties tested (tensile modulus, tensile strength, strain, and impact strength). Solution concentration significantly influences tensile modulus and strain, while fibre content significantly affects tensile modulus and strength. The conducted optimization shows that the best mechanical properties are achieved with the minimum tested coir fibre content of 10%. Maximum stiffness and strength can be expected with the longest immersion time of 5 days in the highest solution concentration of 15%. The best strain and impact strength properties, however, are observed at the lowest solution concentration of 5%.