bluuebunny/crossref_metadata_2025 huggingface dataset:
Eco-Friendly Microwave Synthesis of Sodium Alginate-Chitosan Hydrogels for Effective Curcumin Delivery and Controlled Release
Authors: Ristić Ivan , Nikolić Ljubiša , Cakić Suzana , Nikolić Vesna , Tanasić Jelena , Zvezdanović Jelena , Krstić Marija
Published: October 2024

In this study, we developed sodium alginate-chitosan hydrogels using a microwave-assisted synthesis method, aligning with green chemistry principles for enhanced sustainability. This eco-friendly approach minimizes chemical use and waste while boosting efficiency. A curcumin:2-hydroxypropyl-β-cyclodextrin complex was incorporated into the hydrogels, significantly increasing the solubility and bioavailability of curcumin. Fourier Transform Infrared Spectroscopy (FTIR) analysis confirmed the structure and successful incorporation of curcumin, in both its pure and complexed forms, into the polymer matrix. Differential scanning calorimetry revealed distinct thermal transitions influenced by the hydrogel composition and physical cross-linking. Hydrogels with higher alginate content had higher swelling ratios (338%), while those with more chitosan showed the lowest swelling ratios (254%). Scanning Electron Microscopy (SEM) micrographs showed a porous structure as well as successful incorporation of curcumin or its complex. Curcumin release studies indicated varying releasing rates between its pure and complexed forms. The chitosan-dominant hydrogel exhibited the slowest release rate of pure curcumin, while the alginate-dominant hydrogel exhibited the fastest. Conversely, for curcumin from the inclusion complex, a higher chitosan proportion led to the fastest release rate, while a higher alginate proportion resulted in the slowest. This study demonstrates that the form of curcumin incorporation and gel matrix composition critically influence the release profile. Our findings offer valuable insights for designing effective curcumin delivery systems, representing a significant advancement in biodegradable and sustainable drug delivery technologies.
Leveraging Quality Improvement and Shared Learning to Improve Infant Well-Child Visit Rates in Texas
Authors: Rocha Emily Stauffer , Peñate Susana Beatriz , Van Ramshorst Ryan D.
Published: October 2024

Texas Medicaid improved infant well-child visit rates by participating in a national learning collaborative. The two-year program encouraged creativity and innovation in care for Medicaid recipients through partnerships with managed care organizations (MCOs). The MCO projects discovered valuable practices in member outreach and were disseminated in shared learning experiences. At the completion of the learning collaborative, Texas Medicaid surveyed the MCO participants to assess the impact of their projects on Medicaid beneficiaries in Texas as well as the quality improvement project format. Collectively, the MCOs raised the infant well-child visit rate year-over-year. All of the partner MCOs stated they plan to continue focused work on improving infant well-child visit rates after the learning collaborative.
Social Media Influences on Dietary Awareness in Children
Authors: Prybutok Victor , Prybutok Gayle , Yogarajah Jesudhas
Published: October 2024

Background: Social media platforms have become increasingly influential channels for discussing various aspects of children’s health, including dietary habits and food choices. This research explores the impact of social media on childhood dietary habits regarding the foods children consume by analyzing published findings about online videos and other social media platforms. Methods: From a pool of 9646 articles available on Google Scholar, Science Direct, Web of Science, and ProQuest, 25 were selected for inclusion in this systematic literature review after meeting the qualifying criteria. The screened papers contained clinical studies, cross-sectional studies, and editorials published in English. Results: A review of these articles revealed that individuals’ communication with friends via social media significantly enhanced their comprehension of conversations related to weight management. The results of this research inform efforts to combat poor diets and promote overall well-being among children at an earlier stage when personal interactions are likely limited. To promote the healthy growth of children, it is essential that the videos they engage with offer them appropriate guidance on maintaining a nutritious diet. Ultimately, this research provides insights into how social media creates environments conducive to the well-being of children. Conclusions: As a result, social media can serve as a valuable resource to help mitigate the prevalence of obesity in this vulnerable population.
Unravelling the Role of Gut and Oral Microbiota in the Pediatric Population with Type 1 Diabetes Mellitus
Authors: Luppi Stefania , Aldegheri Luana , Azzalini Eros , Pacetti Emanuele , Barucca Sebastiani Giulia , Fabiani Carolina , Robino Antonietta , Comar Manola
Published: October 2024

Type 1 Diabetes Mellitus (T1DM) is a chronic autoimmune disease that results in the destruction of pancreatic β cells, leading to hyperglycaemia and the need for lifelong insulin therapy. Although genetic predisposition and environmental factors are considered key contributors to T1DM, the exact causes of the disease remain partially unclear. Recent evidence has focused on the relationship between the gut, the oral cavity, immune regulation, and systemic inflammation. In individuals with T1DM, changes in the gut and oral microbial composition are commonly observed, indicating that dysbiosis may contribute to immune dysregulation. Gut dysbiosis can influence the immune system through increased intestinal permeability, altered production of short chain fatty acids (SCFAs), and interactions with the mucosal immune system, potentially triggering the autoimmune response. Similarly, oral dysbiosis may contribute to the development of systemic inflammation and thus influence the progression of T1DM. A comprehensive understanding of these relationships is essential for the identification of biomarkers for early diagnosis and monitoring, as well as for the development of therapies aimed at restoring microbial balance. This review presents a synthesis of current research on the connection between T1DM and microbiome dysbiosis, with a focus on the gut and oral microbiomes in pediatric populations. It explores potential mechanisms by which microbial dysbiosis contributes to the pathogenesis of T1DM and examines the potential of microbiome-based therapies, including probiotics, prebiotics, synbiotics, and faecal microbiota transplantation (FMT). This complex relationship highlights the need for longitudinal studies to monitor microbiome changes over time, investigate causal relationships between specific microbial species and T1DM, and develop personalised medicine approaches.
The Role of the Extracellular Matrix in the Pathogenesis and Treatment of Pulmonary Emphysema
Authors: Cantor Jerome
Published: October 2024

Pulmonary emphysema involves progressive destruction of alveolar walls, leading to enlarged air spaces and impaired gas exchange. While the precise mechanisms responsible for these changes remain unclear, there is growing evidence that the extracellular matrix plays a critical role in the process. An essential feature of pulmonary emphysema is damage to the elastic fiber network surrounding the airspaces, which stores the energy needed to expel air from the lungs. The degradation of these fibers disrupts the mechanical forces involved in respiration, resulting in distension and rupture of alveolar walls. While the initial repair process mainly consists of elastin degradation and resynthesis, continued alveolar wall injury may be associated with increased collagen deposition, resulting in a mixed pattern of emphysema and interstitial fibrosis. Due to the critical role of elastic fiber injury in pulmonary emphysema, preventing damage to this matrix component has emerged as a potential therapeutic strategy. One treatment approach involves the intratracheal administration of hyaluronan, a polysaccharide that prevents elastin breakdown by binding to lung elastic fibers. In clinical trials, inhalation of aerosolized HA decreased elastic fiber injury, as measured by the release of the elastin-specific cross-linking amino acids, desmosine, and isodesmosine. By protecting elastic fibers from enzymatic and oxidative damage, aerosolized HA could alter the natural history of pulmonary emphysema, thereby reducing the risk of respiratory failure.
Unveiling the Role of Two Rhodopsin-like GPCR Genes in Insecticide-Resistant House Flies, Musca domestica
Authors: Xin Juanjuan , Brown Dylan , Wang Yifan , Wang Xin , Li Ming , Li Ting , Liu Nannan
Published: October 2024

Insecticide resistance in insects, driven by the overexpression of P450 enzymes, presents a significant challenge due to the enhanced metabolic detoxification of insecticides. Although the transcriptional regulation of P450 genes is not yet fully understood, G-protein-coupled receptor (GPCR) genes have emerged as key regulators in this process. This study is the first to associate GPCR genes with insecticide resistance in Musca domestica. We identified two key rhodopsin-like GPCR genes, ALHF_02706.g1581 and ALHF_04422.g2918, which were significantly overexpressed in the resistant ALHF strain compared to sensitive strains. Notably, both ALHF_02706.g1581 and ALHF_04422.g2918 were mapped to autosome 2, where critical but unidentified regulatory factors controlling resistance and P450 gene regulation are located. This supports our hypothesis that GPCRs function as trans-regulatory factors for P450-mediated resistance. Functional analysis using transgenic Drosophila demonstrated that overexpression of these rhodopsin-like GPCR genes increased permethrin resistance by approximately two-fold. Specifically, ALHF_02706.g1581 overexpression significantly upregulated the Drosophila resistance-related P450 genes CYP12D1, CYP6A2, and CYP6A8, while ALHF_04422.g2918 increased CYP6G1 and CYP6A2 expression, thereby enhancing insecticide detoxification in rhodopsin-like GPCR transgenic Drosophila lines. These findings suggest that these rhodopsin-like GPCR genes on autosome 2 may act as trans-regulatory factors for P450-mediated resistance, underscoring their critical role in insecticide detoxification and resistance development in M. domestica.
The Evolution and Biological Activity of Metazoan Mixed Lineage Kinase Domain-Like Protein (MLKL)
Authors: Wang Qingyue , Yuan Zihao , Xu Hang , Chen Yuan , Sun Li
Published: October 2024

In mammals, mixed lineage kinase domain-like protein (MLKL) is the executor of necroptosis. MLKL comprises an N-terminal domain (NTD), which alone suffices to trigger necroptosis by forming pores in the plasma membrane, and a C-terminal domain that inhibits the NTD activity. Evolutionarily, MLKL is poorly conserved in animals and not found in Protostomia. Although MLKL orthologs exist in invertebrate Deuterostomia, the biological activity of invertebrate MLKL is unknown. Herein, we examined 34 metazoan phyla and detected MLKL not only in Deuterostomia but also in Protostomia (Rotifera). The Rotifera MLKL exhibited low identities with non-Rotifera MLKL but shared relatively high identities with non-metazoan MLKL. In invertebrates, MLKL formed two phylogenetic clades, one of which was represented by Rotifera. In vertebrates, MLKL expression was tissue-specific and generally rich in immune organs. When expressed in human cells, the MLKL-NTD of Rotifera, Echinodermata, Urochordata, and Cephalochordata induced strong necroptosis. The necroptotic activity of Rotifera MLKL depended on a number of conserved residues. Together these findings provided new insights into the evolution of MLKL in Metazoa and revealed the biological activity of invertebrate MLKL.
Comparative Analysis of Serum and Serum-Free Medium Cultured Mesenchymal Stromal Cells for Cartilage Repair
Authors: Kang Meiqi , Yang Yanmeng , Zhang Haifeng , Zhang Yuan , Wu Yingnan , Denslin Vinitha , Othman Rashidah Binte , Yang Zheng , Han Jongyoon
Published: October 2024

Mesenchymal stromal cells (MSCs) are promising candidates for cartilage repair therapy due to their self-renewal, chondrogenic, and immunomodulatory capacities. It is widely recognized that a shift from fetal bovine serum (FBS)-containing medium toward a fully chemically defined serum-free (SF) medium would be necessary for clinical applications of MSCs to eliminate issues such as xeno-contamination and batch-to-batch variation. However, there is a notable gap in the literature regarding the evaluation of the chondrogenic ability of SF-expanded MSCs (SF-MSCs). In this study, we compared the in vivo regeneration effect of FBS-MSCs and SF-MSCs in a rat osteochondral defect model and found poor cartilage repair outcomes for SF-MSCs. Consequently, a comparative analysis of FBS-MSCs and SF-MSCs expanded using two SF media, MesenCult™-ACF (ACF), and Custom StemPro™ MSC SFM XenoFree (XF) was conducted in vitro. Our results show that SF-expanded MSCs constitute variations in morphology, surface markers, senescence status, differentiation capacity, and senescence/apoptosis status. Highly proliferative MSCs supported by SF medium do not always correlate to their chondrogenic and cartilage repair ability. Prior determination of the SF medium’s ability to support the chondrogenic ability of expanded MSCs is therefore crucial when choosing an SF medium to manufacture MSCs for clinical application in cartilage repair.
Impact of Gut Microbiota and SCFAs in the Pathogenesis of PCOS and the Effect of Metformin Therapy
Authors: Kukaev Evgenii , Kirillova Ekaterina , Tokareva Alisa , Rimskaya Elena , Starodubtseva Natalia , Chernukha Galina , Priputnevich Tatiana , Frankevich Vladimir , Sukhikh Gennady
Published: October 2024

Polycystic ovary syndrome (PCOS) is a complex disorder that impacts both the endocrine and metabolic systems, often resulting in infertility, obesity, insulin resistance, and cardiovascular complications. The aim of this study is to investigate the role of intestinal flora and its metabolites, particularly short-chain fatty acids (SCFAs), in the development of PCOS, and to assess the effects of metformin therapy on these components. SCFA levels in fecal and blood samples from women with PCOS (n=69) and healthy controls (n=18) were analyzed using Gas Chromatography–Mass Spectrometry (GC/MS) for precise measurement. Fecal microbiota were quantitatively detected by real-time polymerase chain reaction (PCR). To assess the efficacy of six months of metformin treatment, changes in the microbiota and SCFAs in the PCOS group (n=69) were also evaluated. The results revealed that women with PCOS exhibited a significant reduction in beneficial bacteria (namely, the C. leptum group and Prevotella spp.) alongside a notable overgrowth of opportunistic microorganisms (C. perfringens, C. difficile, Staphylococcus spp., and Streptococcus spp.). An overproduction of acetic acid (AA, FC=0.47, p<0.05) and valeric acid (VA, FC=0.54, p<0.05) suggests a link between elevated SCFAs and the development of obesity and PCOS. Interestingly, AA in the bloodstream might offer a protective effect against PCOS by ameliorating key symptoms such as high body mass index (r=−0.33, p=0.02), insulin resistance (r=−0.39, p=0.02), and chronic inflammation. Although serum SCFA levels showed non-significant changes following metformin treatment (p>0.05), the normalization of AA in the gut underscores that metformin exerts a more pronounced effect locally within the gastrointestinal tract. Furthermore, the study identified the most effective model for predicting the success of metformin therapy, based on serum concentrations of butyric acid (BA) and VA, achieving a 91% accuracy rate, 100% sensitivity, and 80% specificity. These promising findings highlight the potential for developing targeted interventions and personalized treatments, ultimately improving clinical outcomes for women with PCOS.
Comparative Photosynthetic Capacity, Respiration Rates, and Nutrient Content of Micropropagated and Wild-Sourced Sphagnum
Authors: Keightley Anna T. , Field Chris D. , Rowson James G. , Caporn Simon J. M.
Published: October 2024

The rapid, effective restoration of degraded peatlands is urgently needed to reduce their current high levels of carbon loss. The re-introduction of Sphagnum moss, along with re-wetting, is key to returning carbon sequestration and retention capabilities to northern degraded bogs. Micropropagated Sphagnum has already been applied in large quantities, and more is planned, for restoration projects in Britain and parts of Europe. A comparison with wild-sourced Sphagnum material is therefore pertinent to demonstrate its safety and suitability for wide-scale application. Six Sphagnum species of both micropropagated and wild-sourced origin were assessed for photosynthetic capacity, nutrient content, form parity, chlorocyst size, and chloroplast numbers. Micropropagated Sphagnum had significantly higher light-saturated photosynthesis (Pmax) rates, little color expression, an open growth habit, greater chloroplast numbers, and more numerous, smaller shoot apices than wild-sourced Sphagnum. Higher Pmax rates were associated with a lower bulk density and higher tissue nutrient concentrations. Potentially, greater chloroplast numbers in micropropagated Sphagnum facilitate higher photosynthesis rates, driving rapid growth in early-stage plants, particularly in optimum moisture conditions. Micropropagated Sphagnum can be used confidently, propagated in large quantities, and will likely establish well on application to sites where re-wetting has already occurred, therefore making it highly beneficial for the restoration of degraded bogs.
Novel Predictive Biomarkers in the Head and Neck Squamous Cell Carcinoma (HNSCC)
Authors: Miniuk Magdalena , Reszeć-Giełażyn Joanna , Bortnik Piotr , Borsukiewicz Agata , Mroczek Aleksandra
Published: October 2024

Head and neck squamous cell carcinoma (HNSCC) is the sixth most common cancer worldwide, characterized by high aggressiveness and frequent metastasis to regional lymph nodes. Despite advances in therapy, including checkpoint inhibitor immunotherapy, surgery, radiotherapy, and chemotherapy, survival rates for patients with advanced HNSCC remain unsatisfactory. This article presents the latest research on predictive biomarkers such as PD-L1, PD-1, CTLA-4, p53, and HPV, which may enhance treatment efficacy and improve clinical outcomes for patients. The clinical value of these biomarkers, their limitations, and their potential application in HNSCC therapy are emphasized. Special attention is given to immunotherapy, which shows promising results in treating this type of cancer through the modulation of the immune response. The review’s findings highlight the need for further research on new biomarkers to develop more personalized and effective therapeutic strategies for HNSCC patients.
Modified Peritoneal Fenestration as a Preventive Method for Lymphocele after Kidney Transplantation: A Preliminary Report
Authors: Sabagh Mohammadsadegh , Weber Sanaz , Sabetkish Nastaran , Ramouz Ali , Fakour Sanam , Morath Christian , Mieth Markus , Zeier Martin , Khajeh Elias , Mehrabi Arianeb , Golriz Mohammad
Published: October 2024

Background: We aimed to assess the safety of a modified peritoneal fenestration technique with clipping of the window edges during kidney transplantation (KTx) and to determine its impact on reducing lymphocele following KTx. We compared the outcomes of this modified method with those of peritoneal fenestration without clipping. Methods: Among 430 consecutive KTxs performed between 2015 and 2019, preventive peritoneal fenestration and clipping of the margins were performed in 25 patients. These patients were compared with 75 matched patients in whom the margins were not clipped. Postoperative lymphocele formation and other patient data were compared between these two groups. Results: The rate of clinically relevant lymphocele decreased by 2.7% after peritoneal fenestration with clipping, although this decrease was not statistically significant (p = 0.829). There was no significant increase in the rate of other complications in the modified fenestration group (p = 0.067). The incidence of clinically significant lymphocele formation was notably higher in patients with a body mass index greater than 25 kg/m2 (p = 0.028). Univariate analysis indicated that older recipients, individuals with a history of previous abdominal surgery, those receiving the kidney from deceased and older donors were at increased risk of developing a clinically relevant lymphocele. Conclusions: Our preliminary results suggest that peritoneal fenestration with clipping may be as effective as the conventional fenestration technique in preventing lymphocele formation. Further clinical trials with larger sample sizes are required to determine the exact role of preventive peritoneal fenestration with clipping in preventing clinically relevant lymphocele after KTx.
Post-Intensive Care Syndrome as a Burden for Patients and Their Caregivers: A Narrative Review
Authors: Schembari Giovanni , Santonocito Cristina , Messina Simone , Caruso Alessandro , Cardia Luigi , Rubulotta Francesca , Noto Alberto , Bignami Elena G. , Sanfilippo Filippo
Published: October 2024

Millions of critically ill patients are discharged from intensive care units (ICUs) every year. These ICU survivors may suffer from a condition known as post-intensive care syndrome (PICS) which includes a wide range of cognitive, psychological, and physical impairments. This article will provide an extensive review of PICS. ICU survivors may experience cognitive deficits in memory and attention, with a slow-down of mental processing and problem-solving. From psychological perspectives, depression, anxiety, and post-traumatic stress disorder are the most common issues suffered after ICU discharge. These psycho-cognitive impairments might be coupled with ICU-acquired weakness (polyneuropathy and/or myopathy), further reducing the quality of life, the ability to return to work, and other daily activities. The burden of ICU survivors extends to families too, leading to the so-called PICS-family (or PICS-F), which entails the psychological impairments suffered by the family and, in particular, by the caregiver of the ICU survivor. The development of PICS (and PICS-F) is likely multifactorial, and both patient- and ICU-related factors may influence it. Whilst the prevention of PICS is complex, it is important to identify the patients at higher risk of PICS, and clinicians should be aware of the tools available for diagnosis. Stakeholders should implement strategies to achieve PICS prevention and to support its effective treatment during the recovery phase with dedicated pathways and supporting care.
The SpO2/FiO2 Ratio Combined with Prognostic Scores for Pneumonia and COVID-19 Increases Their Accuracy in Predicting Mortality of COVID-19 Patients
Authors: Zinna Giuseppe , Pipitò Luca , Colomba Claudia , Scichilone Nicola , Licata Anna , Barbagallo Mario , Russo Antonio , Coppola Nicola , Cascio Antonio
Published: October 2024

Background: Identifying high-risk COVID-19 patients is critical for emergency department decision-making. Our study’s primary objective was to identify new independent predictors of mortality and their predictive utility in combination with traditional pneumonia risk assessment scores and new risk scores for COVID-19 developed during the pandemic. Methods: A retrospective study was performed in two Italian University Hospitals. A multivariable logistic model was used to locate independent parameters associated with mortality. Results: Age, PaO2/FiO2, and SpO2/FiO2 ratios were found to be independent parameters associated with mortality. This study found that the Pneumonia Severity Index (PSI) was superior to many of the risk scores developed during the pandemic, for example, the International Severe Acute Respiratory Infection Consortium Coronavirus Clinical Characterisation Consortium (ISARIC 4C) (AUC 0.845 vs. 0.687, p < 0.001), and to many of the risk scores already in use, for example, the National Early Warning Score 2 (NEWS2) (AUC 0.845 vs. 0.589, p < 0.001). Furthermore, our study found that the Pneumonia Severity Index had a similar performance to other risk scores, such as CRB-65 (AUC 0.845 vs. 0.823, p = 0.294). Combining the PaO2/FiO2 or SpO2/FiO2 ratios with the risk scores analyzed improved the prognostic accuracy. Conclusions: Adding the SpO2/FiO2 ratio to the traditional, validated, and already internationally known pre-pandemic prognostic scores seems to be a valid and rapid alternative to the need for developing new prognostic scores. Future research should focus on integrating these markers into existing pneumonia scores to improve their prognostic accuracy.
Impact of Comorbid Polycystic Ovary Syndrome on Clinical and Laboratory Parameters in Female Adolescents with Metabolic Dysfunction-Associated Steatotic Liver Disease: A Cross-Sectional Study
Authors: Keskin Murat , Arsoy Hanife Aysegul , Kara Ozlem , Sarandol Emre , Koca Nizameddin , Yilmaz Yusuf
Published: October 2024

Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) and polycystic ovary syndrome (PCOS) share several pathophysiological mechanisms. While the prevalence of MASLD has been extensively studied in PCOS populations, the occurrence of PCOS among female adolescents with transient elastography (TE)-confirmed MASLD in pediatric hepatology settings remains poorly characterized. This cross-sectional study aims to address this knowledge gap and elucidate potential clinical and biochemical differences between female adolescents with MASLD and comorbid PCOS compared to those without PCOS. Methods: The study cohort included 45 female adolescents with TE-diagnosed MASLD. Comparative analyses of clinical and laboratory parameters were performed between those with (n = 19) and those without (n = 26) comorbid PCOS, diagnosed according to the Rotterdam criteria. Results: Adolescents with MASLD and comorbid PCOS exhibited significantly higher weight, lower height, and increased waist circumference compared to those without PCOS. Additionally, the prevalence of acanthosis nigricans was significantly higher in the PCOS group (68.4% versus 34.6%, p = 0.025). Regarding laboratory parameters, serum phosphorus levels and liver enzymes—including aspartate aminotransferase, alanine aminotransferase, and gamma-glutamyl transferase—were significantly lower in adolescents with comorbid PCOS. However, no significant differences were observed in lipid profiles, glucose metabolism, or novel non-invasive biomarkers of MASLD. Conclusions: This study reveals distinct clinical and biochemical profiles in female adolescents with MASLD and comorbid PCOS compared to those without PCOS. These findings have the potential to inform and refine future screening protocols and diagnostic algorithms for these interrelated conditions, specifically tailored to pediatric hepatology settings.
To Be in Pain: Pain Multidimensional Questionnaire as Reliable Tool to Evaluate Multifaceted Aspects of Pain
Authors: Forte Giuseppe , Favieri Francesca , De Pascalis Vilfredo , Casagrande Maria
Published: October 2024

Background/Objectives: Pain is a multidimensional experience influenced by sensory, emotional, and cognitive factors. Traditional pain assessments often fail to capture this complexity. This study aimed to develop and validate the Pain Multidimensional Questionnaire (Pa-M-QU), a new self-report tool designed to assess pain catastrophizing, sensitivity, and coping strategies. Methods: Two independent samples of Italian-speaking participants, aged 18 and above, were recruited online. The first sample (n = 392; mean age = 29.36) was used for exploratory factor analysis (EFA), and the second sample (n = 123; mean age = 28.0) for confirmatory factor analysis (CFA). Pearson’s correlations and convergent validity analyses were conducted. Results: From an initial pool of 59 items identified through focus group discussions, 35 items were removed based on reliability analysis. The final 24-item Pa-M-QU features a three-factor structure: catastrophizing, pain sensitivity, and coping with pain. Conclusions: The Pa-M-QU offers a rapid, non-invasive assessment that captures the multidimensional nature of pain. It is a starting point to develop tools for both clinical and research settings, aiding in evaluating pain in healthy individuals and predicting acute and chronic pain disorders. Future research should focus on refining the Pa-M-QU for broader clinical applications and exploring its potential to complement or replace traditional pain assessments, thereby advancing pain management and research.
Endo-Aortic Clamping with the IntraClude® Device in Minimally Invasive Total Coronary Revascularization via Left Anterior Thoracotomy (TCRAT)
Authors: Sellin Christian , Dörge Hilmar , Massoudy Parwis , Liebold Andreas , Balan Robert
Published: October 2024

Minimally invasive, sternum-sparing total coronary revascularization in multivessel disease via left anterior mini-thoracotomy (TCRAT) was introduced recently. Intra-aortic balloon occlusion is a conceivable option to avoid manipulation of the ascending aorta, to reduce the risk of stroke and to be able to treat patients with severe calcifications and unfavorable aortic anatomies. Background/Objectives: The aim of our study was to show that the use of the IntraClude® device, as part of minimally invasive coronary artery bypass grafting (CABG) via left anterior mini-thoracotomy, is feasible. Methods: From May to December 2023, CABG via left anterior mini-thoracotomy on cardiopulmonary bypass and cardioplegic arrest was successfully performed in 20 patients (17 male, 67.6 ± 8.2 (51–82) years). All patients had significant coronary artery disease (three-vessel: n = 6; two-vessel: n = 11; one-vessel: n = 3) with indication for surgical revascularization. The mean EuroScore2 was 2.6. Results: All patients successfully underwent minimally invasive CABG using endo-aortic balloon occlusion. A total of 43 distal anastomoses (2.2 ± 0.6 (1–3) per patient) were performed by using left internal artery mammary (n = 20) and radial artery (n = 14) for grafting the left anterior descending (n = 19), circumflex (n = 15) and right (n = 6) coronary artery. There was no hospital mortality, no stroke, no myocardial infarction or repeat revascularization. A total of 15 out of 20 patients left hospital within 8 days after surgery. Conclusions: TCRAT by using the IntraClude® device is feasible without compromising surgical principles while avoiding the external manipulation of the ascending aorta. The use of intra-aortic balloon occlusion instead of transthoracic clamps further reduces the invasiveness of the procedure.
Innovative COVID-19 Point-of-Care Diagnostics Suitable for Tuberculosis Diagnosis: A Scoping Review
Authors: Holtgrewe Lydia M. L. , Jain Sonal , Dekova Ralitza , Broger Tobias , Isaacs Chris , Theron Grant , Nahid Payam , Cattamanchi Adithya , Denkinger Claudia M. , Yerlikaya Seda
Published: October 2024

Rapid and accurate point-of-care (POC) tuberculosis (TB) diagnostics are crucial to bridge the TB diagnostic gap. Leveraging recent advancements in COVID-19 diagnostics, we explored adapting commercially available POC SARS-CoV-2 tests for TB diagnosis in line with the World Health Organization (WHO) target product profiles (TPPs). A scoping review was conducted following PRISMA-ScR guidelines to systematically map POC antigen and molecular SARS-CoV-2 diagnostic tests potentially meeting the TPPs for TB diagnostic tests for peripheral settings. Data were gathered from PubMed/MEDLINE, bioRxiv, medRxiv, publicly accessible in vitro diagnostic test databases, and developer websites up to 23 November 2022. Data on developer attributes, operational characteristics, pricing, clinical performance, and regulatory status were charted using standardized data extraction forms and evaluated with a standardized scorecard. A narrative synthesis of the data is presented. Our search yielded 2003 reports, with 408 meeting eligibility criteria. Among these, we identified 66 commercialized devices: 22 near-POC antigen tests, 1 POC molecular test, 31 near-POC molecular tests, and 12 low-complexity molecular tests potentially adaptable for TB. The highest-scoring SARS-CoV-2 diagnostic tests were the near-POC antigen platform LumiraDx (Roche, Basel, Switzerland), the POC molecular test Lucira Check-It (Pfizer, New York, NY, USA), the near-POC molecular test Visby (Visby, San Jose, CA, USA), and the low-complexity molecular platform Idylla (Biocartis, Lausanne, Switzerland). We highlight a diverse landscape of commercially available diagnostic tests suitable for potential adaptation to peripheral TB testing. This work aims to bolster global TB initiatives by fostering stakeholder collaboration, leveraging SARS-CoV-2 diagnostic technologies for TB, and uncovering new commercial avenues to tackle longstanding challenges in TB diagnosis.
Non-Pharmacological Management of Gestational Diabetes Mellitus with a High Fasting Glycemic Parameter: A Hospital-Based Study in Vietnam
Authors: Nguyen Hang Giang , Nguyen Khanh Trang Huynh , Nguyen Phuc Nhon
Published: October 2024

Background/Objectives: The prevalence of gestational diabetes mellitus (GDM) is increasing at an alarming rate worldwide. Delayed management can lead to adverse composite outcomes for both mother and her offspring. To our knowledge, the clinical association between glycemic parameters and the results of the non-pharmacological GDM approach remains limited; thus, this study aimed to address this important clinical issue in the literature. Methods: This was a retrospective cross-sectional study of 174 Vietnamese pregnant women with the positive oral glucose tolerance test (OGTT) for a high fasting glycemic parameter at Hung Vuong Hospital from 04/2022 to 07/2022. This study aimed to evaluate the success rate of GDM with an elevated index of fasting glycemic concentration which was managed after 2 weeks of a dietary regimen combined with adequate physical activities and to reveal its related factors. Results: Out of 174 singleton pregnancies that met the inclusion criteria, 103 GDM pregnant women were successfully managed after 2 weeks of monitoring (59.2%; 95% confidence intervals (CI): 51.9–66.5). The study revealed a fair correlation between the corresponding test of blood glucose at OGTT and after 2 weeks of GDM management (r = 0.270–0.290, p < 0.0001). The GDM pregnant women with an elevated fasting glycemic parameter and with any of elevated 1 h or 2 h blood glucose levels and in cases of three elevated glycemic parameters (fasting, 1 h, and 2 h blood glucose at the initial results of OGTT) reduced the success rate of glycemic control to 56.5%, 49.2%, respectively, compared to the group with solely a high fasting index of blood glucose (69.6%). The pregnant women who participated in high-intensity sports activities related to a two-fold increase in success rate compared with the group engaging in light and moderate-intensity physical activity. Conclusions: The success rate of glycemic control in GDM women was highest in the group with solitary fasting hyperglycemia and lower in the contributory groups with two and three high parameters. The application of diet therapy plus physical activities among GDM pregnant women is potentially necessary to improve the effectiveness of treatment, minimize adverse pregnancy outcomes, and reduce substantially the hospitalization rate.
The DANish Disseminated Intravascular Coagulation (DANDIC) Cohort Study: Time Trends in Incidence and Short-Term Mortality
Authors: Flæng Simon , Granfeldt Asger , Sørensen Henrik Toft , Adelborg Kasper
Published: October 2024

Background: Disseminated intravascular coagulation (DIC) is a severe condition affecting the coagulation system. However, current knowledge regarding its incidence and mortality remains limited. In this study, we examined the incidence and mortality of DIC, including time trends, in Denmark. Methods: In this population-based cohort study, potential DIC cases were identified through the hospital laboratory database in the Central Denmark Region which has a population of approximately 1.3 million residents. Eligibility criteria were age above 18 years, a positive DIC score, and a disease associated with DIC. All eligible patients underwent a review of their medical records. Follow-up started on the date of a patient’s first positive DIC score. Age- and sex-standardized incidence rates were calculated using year-specific DIC events as the numerator and the adult population of the Central Denmark Region as the denominator. All-cause 30-day mortality in the DIC cohort was computed based on Kaplan–Meier estimates and the mortality rates between subgroups were examined using logistic regression. Results: Among the 40,534 patients for whom all DIC biomarkers were measured on the same date, 6748 had a positive DIC score. Of these, 2565 were included in the cohort. The median age was 64 years, and 56.1% were men. The overall incidence rate per 100,000 person years declined during the study period, from 33.1 in 2013 to 24.0 in 2020. Thirty-day all-cause mortality was 35% in 2013 and 41.3% in 2020. Conclusions: The overall incidence rate of DIC declined between 2013 and 2020, mainly reflecting a declining incidence among patients with infection-associated DIC. Mortality did not improve.
In Patients Presenting with an ST-Elevation Myocardial Infarction, Overweight and Obese Patients Have the Lowest Inpatient Mortality whereas Cachexia Patients Have the Highest Inpatient Mortality Followed by Patients with Morbid Obesity
Authors: Movahed Mohammad Reza , Abhari Amir Parsa , Hashemzadeh Mehrtash
Published: October 2024

Introduction: The obesity paradox has been observed in patients with cardiovascular disease. The goal of this study was to evaluate whether obesity has a protective effect in patients presenting with an ST elevation myocardial infarction (STEMI). Method: Using the large Nationwide Inpatient (NIS) sample database, we evaluated the mortality in patients with a STEMI based on weight categories. Results: A total of 2,161,640 STEMI patients were found in the database over age 18. We found that overweight and obesity had the lowest mortality using univariate (overweight mortality of 5% vs. obesity mortality of 6.5% vs. 10.9% for normal weights) and multivariate analyses (overweight OR: 0.52, CI: 0.43–063; p < 0.001 and obesity OR: 0.7, CI: 0.67–0.74; p < 0.001), whereas cachexia was associated with the highest mortality in the univariate (cachexia 24.5%) and multivariate (OR: 2.28, CI: 2.13–2.44; p < 0.001) analyses, followed by morbid obesity in the multivariate analysis (OR: 1.07, CI: 1.02–1.12; p = 0.004). Conclusions: We observed a partial obesity paradox in patients with a STEMI showing that overweight have the best survival rates followed by obesity. Cachexia followed by morbid obesity had the lowest survival rates.
Could the Suboccipital Release Technique Result in a Generalized Relaxation and Self-Perceived Improvement? A Repeated Measure Study Design
Authors: Sillevis Rob , Hansen Anne Weller
Published: October 2024

Background: Musculoskeletal disorders such as cervicogenic headaches present with suboccipital muscle hypertonicity and trigger points. One manual therapy intervention commonly used to target the suboccipital muscles is the suboccipital release technique, previously related to positive systemic effects. Therefore, this study aimed to determine the immediate and short-term effects of the Suboccipital Release Technique (SRT) on brainwave activity in a subgroup of healthy individuals. Methods: Data were collected from 37 subjects (20 females and 17 males, with a mean age of 24.5). While supine, the subjects underwent a head hold followed by suboccipital release. A total of four 15 s electroencephalogram (EEG) measurements were taken and a Global Rating of Change Scale was used to assess self-perception. Results: There was a statistically significant difference (p < 0.005) in various band waves under the following electrodes: AF3, F7, F3, FC5, T7, P7, O1, O2, P8, T8, and FC6. An 8-point range in the Global Rating of Change Scores with a mean score of 1.649 (SD = 1.719 and SE = 0.283) supported the hypothesis of a self-perceived benefit from the intervention. Conclusions: The results of this study indicate that the suboccipital release technique significantly affects brain wave activity throughout different brain regions. This change is likely not the result of any placebo effect and correlates highly with the subject’s self-perception of a change following the intervention. These findings support the clinical use of the suboccipital release technique when a centralized effect is desired.
Resistance Exercise Participation in Community-Dwelling Older Adults in Korea: Associated Factors and Sex Differences
Authors: Mun Seo Young , Choi Byung-Chan , Lee Jung Soo , Kim Yeo Hyung
Published: October 2024

Background/Objectives: Despite the importance of resistance exercise in older adults, factors associated with participation remain unclear, especially regarding sex differences. This study investigated sociodemographic, behavioral, and comorbidity factors associated with insufficient resistance exercise participation among community-dwelling older adults in Korea, with analyses stratified by sex. Methods: Nationally representative cross-sectional data from 8671 participants aged ≥65 years (3758 men and 4913 women; mean age 72.8) were analyzed using the 6th-8th Korea National Health and Nutrition Examination Surveys (2014–2019). Complex-sample multivariable logistic regression identified factors associated with insufficient resistance exercise overall and by sex. Results: Women had a higher prevalence of insufficient resistance exercise than men (91.27% vs. 71.04%, p < 0.001). Older age groups, particularly those aged ≥80 years (OR: 2.39; 95% CI: 1.86–3.07), and those with lower education (OR: 1.56; 95% CI: 1.33–1.82), rural residence (OR: 1.89; 95% CI: 1.49–2.38), low household income, (OR: 1.45; 95% CI: 1.13–1.88), insufficient aerobic exercise (OR: 1.68; 95% CI: 1.46–1.94), current smoking (OR: 1.70; 95% CI: 1.26–2.29), and diabetes (OR: 1.28; 95% CI: 1.09–1.51) were independently associated with a higher likelihood of insufficient resistance exercise. The association of household income, current smoking, hypertension, and diabetes with resistance exercise adherence showed differences in sex-stratified analyses. Conclusions: Multiple sociodemographic, behavioral, and comorbid factors are linked to resistance exercise adherence among older Koreans. Tailored, sex-specific interventions are needed to promote resistance exercise in this population, informing public health strategies and further research on effective approaches for diverse older adults.
Novel Biomarkers of Grade I Left Ventricular Diastolic Dysfunction in Type 2 Diabetes Patients with Metabolic-Dysfunction-Associated Steatotic Liver Disease
Authors: Braha Adina , Timar Bogdan , Ivan Viviana , Balica Monica Micloș , Dăniluc Larisa , Timar Romulus
Published: October 2024

Background/Objectives: Prior research has identified a significant association between heart disease and metabolic-dysfunction-associated steatotic liver disease (MASLD); however, the underlying mechanisms are unclear. This study aimed to identify predictive biomarkers associated with grade I left ventricular diastolic dysfunction (LVDD) in patients with type 2 diabetes mellitus (T2DM). Methods: This single-center, cross-sectional study evaluated 73 T2DM patients for grade 1 LVDD and MASLD using 2D echocardiography, tissue analysis, spectral color Doppler, and Fibromax. Results: This study analyzed 50 patients (mean age 58.0 ± 11.3 years) with a median diabetes duration of 7 years, abdominal obesity (mean body mass index (BMI) 34.4 ± 5.9 kg/m2), and a mean HbA1c of 7.9 ± 1.5%. The prevalence of grade I LVDD, fibrosis, mild steatosis, moderate-to-severe liver steatosis, mild MASLD, and moderate MASLD was 54%, 44%, 14%, 80%, 43%, and 34%, respectively. Regression analysis revealed that grade 1 LVDD was positively associated with age, Fibrotest, α2-macroglobulin, epicardiac adipose tissue (EAT), and negatively associated with lateral s′, E wave, E/e′, E/A, medium E′, and septal e′ (p < 0.05 for all). α2-macroglobulin > 1.92 g/L (area under the receiver operating characteristic curve (AUROC) = 0.782, sensitivity 70.4%, specificity 81.2%) and fibrotest score > 0.11 (AUROC 0.766, sensitivity 92.6%, specificity 56.2%) were significant predictors of grade I LVDD. Conclusions: Although the underlying mechanisms remain unclear, innovative non-invasive biomarkers, such as α2-macroglobulin or fibrotest, could concurrently indicate liver stiffness and the likelihood of grade I LVDD, an early, asymptomatic HF stage in T2DM patients.
Coupled Modeling of Sea Surface Launch Flow and Multi-Body Motion
Authors: Liu Haotian , Li Shangming , Hou Shilong , Fu Debin
Published: October 2024

To simulate the launching process of missile complex flow, movement, and constraint states, a multifield coupling model is put forward based on a computational fluid dynamics (CFD) method. In this coupled model, a CFD method is used to solve the three-dimensional compressible transient flow, and the six-degree motion of the launching platform is considered, and the virtual contact method is used to deal with the constraint states of the guideway and the slider. The active force and moment are applied to the launching platform to simulate its rolling, pitching, and heaving motions under the 5-level waves. Collision detection is carried out through the minimum clearance distance between the slider and the guideway, and the contact force is handled by a modified Herz collision model. In the problem of launching a missile from the water surface, the change characteristics of the flow field, the load response characteristics, and the relative motion laws of the missile and the launching platform during the catapulting process are investigated. The results show that the motion laws of the projectile and the launch tube in the constrained direction are the same, and the established coupling model is able to simulate the launch separation process of the missile in the constrained state. In addition, the effect of wind load on the missile ejection process is analyzed using the coupled model.