bluuebunny/crossref_metadata_2025 huggingface dataset:
Clipping Effect on the Grain Nitrogen and Protein Fractions of Ancient and Old Wheats Grown in a Mediterranean Environment
Authors: Mefleh Marina , Motzo Rosella , Boukid Fatma , Giunta Francesco
Published: July 2023

This study is the first to assess the effects of clipping, cultivar, season, and their interactions on the protein composition of six old and ancient wheat cultivars (n = 6). For this, nitrogen content, the proportion of wheat protein fractions, and the molecular weight distribution of the extractable and unextractable glutenin polymers were investigated as a function of cultivar and clipping in two consecutive seasons. The relationships between genotypic variation in grain nitrogen and protein fraction content under clipping and non-clipping conditions were also assessed. Clipping delayed and shortened the grain filling period of all of the cultivars. The protein composition of some cultivars behaved differently to clipping due to differences in the environmental conditions of S1 (exceptional dry season) and S2 (rainy season). In S1, clipping decreased the ratio of gliadins over glutenins (GLI/GLU) (<1) of Cappelli and Giovanni Paolo, while in S2, clipping improved the GLI/GLU of Giovanni Paolo, Monlis, and Norberto. The unextractable polymeric proteins were not affected by clipping. Khorasan was shown to be indifferent to clipping in S1 and S2. These results suggest that it is possible to have ancient/old wheats suitable for a dual-purpose system, in different climatic conditions, while maintaining good grain quality traits. The increased market demand for ancient and old wheats presents an economic opportunity for farmers who adopt the dual-purpose technique to cultivate these resilient crops again and increase their profit margins and revenues.
Profile of Bioactive Components of Cocoa (Theobroma cacao L.) By-Products from Ecuador and Evaluation of Their Antioxidant Activity
Authors: Llerena Wilma , Samaniego Iván , Vallejo Christian , Arreaga Adner , Zhunio Billy , Coronel Zomayra , Quiroz James , Angós Ignacio , Carrillo Wilman
Published: July 2023

The aim of the study was to determine the profile of bioactive compounds in cocoa residues (mucilage and bean shells), and to evaluate their antioxidant activity in two cocoa varieties, Nacional X Trinitario type (Fine Aroma) and the variety CCN-51. The extraction of phytonutrients from the residues was carried out selectively. The characterization and quantification of the total polyphenol content (TPC), and the total flavonoid content (TFC) were determined by UV–VIS spectrophotometry. High-performance liquid chromatography (HPLC) was used to determine the phenolic profile and methylxanthines. The antioxidant activity was evaluated by the methods of 2-azinobis (3-ethyl-benzothiazoline-6-sulfonic acid) cation bleaching (ABTS), ferric-reducing antioxidant power (FRAP) and oxygen radical absorbance capacity (ORAC). The exudate mucilage samples from Nacional X Trinitario-type cocoa presented the highest content of TPC 105.08 mg gallic acid equivalents (GAE)/100 mL, TFC 36.80 mg catechin equivalents (CE)/100 mL, catechin (CAT) 35.44 mg/g, procyanidins (PCB2: 35.10; PCB1: 25.68; PCC1: 16.83 mg/L), epicatechin (EPI) 13.71 mg/L, caffeine (CAF) 0.90% and theobromine (TBR) 2.65%. In the cocoa bean shell, the variety CCN-51 presented a higher content of TPC (42.17 mg GAE/100 g) and TFC (20.57 mg CE/100 g). However, CAT (16.16 mg/g), CAF (0.35%) and TBR (1.28%) were higher in the Nacional X Trinitario cocoa type. The EPI presented no significant differences between the two samples studied (0.83 and 0.84 mg/g). The antioxidant activity values (ABTS, FRAP and ORAC methods) were higher in the samples of CCN-51 than in the Nacional X Trinitario type. The bean shell samples presented antioxidant values of 171.32, 192.22 and 56.87 mg Trolox equivalents (TE)/g, respectively, and the bean shell samples presented antioxidant values of 167.06, 160.06 and 52.53 mg TE/g, respectively. The antioxidant activity (ABTS, FRAP and ORAC) of the residues was correlated with the bioactive compounds of the mucilage and bean shells, showing a strong positive correlation (<0.99) with the procyanidins (B1, B2 and C1), EPI and CAT and a positive/moderate correlation (0.94) with methylxanthines.
Overview of the Incorporation of Legumes into New Food Options: An Approach on Versatility, Nutritional, Technological, and Sensory Quality
Authors: Schmidt Helena de Oliveira , Oliveira Viviani Ruffo de
Published: July 2023

Consumers are more aware and demanding of healthy food options, besides being concerned with environment-friendly consumption. This paper aims to evaluate nutritional, technological, and sensory characteristics of legumes and their products’ quality and versatility, considering potential applications in new food options. Legumes are foods that have a recognized nutritional group since they have high protein and fiber content. However, their consumption is still somehow limited for some reasons: in some countries it is not easy to find all the species or cultivars, they need an organization and planning before preparation since they need soaking, and there is the presence of antinutritional factors. Due to the different functionalities of legume proteins, they can be applied to a variety of foods and for different purposes, as grains themselves, aquafaba, extracts, flours, brans, and textured proteins and sprouts. These products have been inserted as ingredients in infant food formulations, gluten-free foods, vegetarian diets, and in hybrid products to reduce food costs as well. Foods such as bread, cakes, cookies, meat analogues, and other baked or cooked products have been elaborated with nutritional, technological and sensory quality. Further development of formulations focused on improving the quality of legume-based products is necessary because of their potential and protein quality.
Investigating Possible Correlations between Gamma-Ray and Optical Lightcurves for TeV-Detected Northern Blazars over 8 Years of Observations
Authors: Acharyya Atreya , Sadun Alberto C.
Published: July 2023

Blazars are a subclass of active galactic nuclei (AGN) having relativistic jets aligned within a few degrees of our line-of-sight and form the majority of the AGN detected in the TeV regime. The Fermi-Large Area Telescope (LAT) is a pair-conversion telescope, sensitive to photons having energies between 20 MeV and 2 TeV, and is capable of scanning the entire gamma-ray sky every three hours. Despite the remarkable success of the Fermi mission, many questions still remain unanswered, such as the site of gamma-ray production and the emission mechanisms involved. The Asteroid Terrestrial-impact Last Alert System (ATLAS) is a high cadence all sky survey system optimized to be efficient for finding potentially dangerous asteroids, as well as in tracking and searching for highly variable and transient sources, such as AGN. In this study, we investigate possible correlations between the Fermi-LAT observations in the 100 MeV–300 GeV energy band and the ATLAS optical data in the R-band, centered at 679 nm, for a sample of 18 TeV-detected northern blazars over 8 years of observations between 2015 and 2022. Under the assumption that the optical and gamma-ray flares are produced by the same outburst propagating down the jet, the strong correlations found for some sources suggest a single-zone leptonic model of emission.
Attitudes about Mechanical Restraint Use in Mental Health Hospitalization Services: A Spanish Survey
Authors: Aguilera-Serrano Carlos , Goodman-Casanova Jessica Marian , Bordallo-Aragón Antonio , García-Sánchez Juan Antonio , Mayoral-Cleries Fermín , Guzmán-Parra José
Published: July 2023

The aim of this study was to analyze the attitudes of professionals in Mental Health Services throughout Spain who are directly or indirectly involved in the use of mechanical restraint and the barriers perceived to reduce its use. The study involved an online anonymous survey using Google Forms completed by Spanish mental health professionals working with service users; the survey assessed their involvement in and general attitudes and beliefs towards mechanical restraint. The survey was completed by 225 participants. Only 13.30% of the participants considered that mechanical restraint use was never necessary to guarantee the safety of users/staff in dangerous situations. Poor staff training (38.0%) and a lack of resources/staff (34.7%) were the most frequent barriers identified for the reduction of mechanical restraint. In the multivariate analysis, participation in learning programs to prevent the use of mechanical restraint was associated with lower acceptance of the use of mechanical restraint, but the result was barely significant (p = 0.050). A high percentage of mental health staff still consider mechanical restraint use necessary for safety reasons. According to the results, the participants perceived that more staff and resources and better training could reduce the use of mechanical restraint in Mental Health Hospitalization Services.
Reciprocal Effects between Sleep Quality and Life Satisfaction in Older Adults: The Mediating Role of Health Status
Authors: Zhu Change , Zhou Lulin , Zhang Xinjie , Walsh Christine A.
Published: July 2023

Objectives: to examine the causal relationship between sleep quality and life satisfaction and explore the mediating role of health status on the relationship between sleep quality and life satisfaction. Methods: A total of 1856 older Chinese people participating in 2011, 2014, and 2018 waves of the Chinese Longitudinal Healthy Longevity Survey (CLHLS) were included. A cross-lagged panel analysis (CLPA) combined with mediator analysis was utilized. Results: The average sleep quality levels for the years 2011, 2014, and 2018 were 3.70, 3.63, and 3.47 out of 5, respectively. The corresponding average levels of health status were 3.47, 3.44, and 3.39 out of 5, and the average levels of life satisfaction were 3.75, 3.86, and 3.87 out of 5, respectively. In addition, sleep quality at prior assessment points was significantly associated with life quality at subsequent assessments, and vice versa. Also, health status partially mediated this prospective reciprocal relationship. Conclusions: There is a nonlinear decreased trend in sleep quality and health status, while there exists a nonlinear increased trend in life satisfaction for older adults from 2011 to 2018. Reciprocal positive effects between sleep quality and life satisfaction in older adults exist and are mediated by health status.
Genotypic and Sanitary Characterization of Minority Grapevine Varieties Prospected in Andalusia, Spain
Authors: Rodríguez-Torres Inmaculada , Martín Carrillo Ana , Ramírez María del Pilar , Gómez Gálvez Francisco Jesus , Velasco Arjona Leonardo , Padilla Carlos , Cretazzo Enrico
Published: July 2023

Andalusia is a Spanish region that is home to numerous minority varieties due to its diversity and territorial extension, offering the local viticulture the possibility of diversifying its wine production. The genotypic characterization of 98 specimens from six areas with a winemaking tradition in Andalusia was carried out between the years 2020 and 2022, by means of thirteen microsatellite markers, including the nine recommended by the OIV. A total of 33 different genotypes were obtained, 20 of which corresponded to profiles of already described varieties (11 of them are of 6 minority cultivars in Andalusia: ‘Rojal Tinto’, ‘Beba’, ‘Zurieles’, ‘Rome’, ‘Hebén’, ‘Mollar Cano’, ‘Listán Prieto’, ‘Listán del Condado’, ‘Jarrosuelto’, ‘Negra Dorada’, and ‘Mantúo de Pilas’), while the other 12 profiles did not match with previously identified varieties. These profiles were registered in the database of the IFAPA “Rancho de la Merced” Germplasm Bank. The eco-geographical groups of the new identified genotypes were determined through an analysis of genetic diversity. The presence of grapevine fanleaf virus, grapevine fleck virus, and grapevine leafroll-associated viruses was also determined due to the requirement of healthy clones of the new varieties for their potential interest to be authorized for cultivation in Spain.
A Novel Approach for Mining Spatiotemporal Explicit and Implicit Information in Multiscale Spatiotemporal Data
Authors: Wang Jianfei , Cao Wen
Published: July 2023

In the era of big data, a significant volume of spatiotemporal data exists in a multiscale format, describing diverse phenomena in the objective world across different spatial and temporal scales. While existing methods focus on analyzing the features and connections of spatiotemporal data at various scales, they often overlook the consideration of uncertainty in spatiotemporal information within the context of multiscale meaning. To effectively harness the potential of spatiotemporal data, it becomes crucial to capture the fuzzy spatiotemporal information inherent in multiscale datasets. This paper proposes a novel multiscale spatiotemporal correlation method that accounts for and quantifies the uncertainty of spatiotemporal information. Spatiotemporal information is categorized into two types, explicit information and implicit information, based on respective levels of uncertainty. The method employs spatiotemporal cubes to interpret the spatiotemporal items within the data, followed by the introduction of a benchmark scale to determine the certainty of each spatiotemporal item based on its range and topological relationships. Subsequently, spatiotemporal confidence and correlation index are proposed to gauge the significance of geographical elements and their interrelationships. To validate the proposed method, a multiscale spatiotemporal transaction dataset is generated and utilized in the experiment. The experimental results demonstrate that the proposed method effectively captures spatiotemporal implicit information and enables better utilization of multiscale spatiotemporal data. Notably, the importance of each object of study varies when analyzed using different benchmark scales, providing valuable insights for professionals to identify novel objects and associations worthy of consideration. The obtained results can be used to construct spatiotemporal knowledge graphs.
Mapping Agricultural Intensification in the Brazilian Savanna: A Machine Learning Approach Using Harmonized Data from Landsat Sentinel-2
Authors: Bolfe Édson Luis , Parreiras Taya Cristo , Silva Lucas Augusto Pereira da , Sano Edson Eyji , Bettiol Giovana Maranhão , Victoria Daniel de Castro , Sanches Ieda Del’Arco , Vicente Luiz Eduardo
Published: July 2023

Agricultural intensification practices have been adopted in the Brazilian savanna (Cerrado), mainly in the transition between Cerrado and the Amazon Forest, to increase productivity while reducing pressure for new land clearing. Due to the growing demand for more sustainable practices, more accurate information on geospatial monitoring is required. Remote sensing products and artificial intelligence models for pixel-by-pixel classification have great potential. Therefore, we developed a methodological framework with spectral indices (Normalized Difference Vegetation Index (NDVI), Normalized Difference Water Index (NDWI), and Soil-Adjusted Vegetation Index (SAVI)) derived from the Harmonized Landsat Sentinel-2 (HLS) and machine learning algorithms (Random Forest (RF), Artificial Neural Networks (ANNs), and Extreme Gradient Boosting (XGBoost)) to map agricultural intensification considering three hierarchical levels, i.e., temporary crops (level 1), the number of crop cycles (level 2), and the crop types from the second season in double-crop systems (level 3) in the 2021–2022 crop growing season in the municipality of Sorriso, Mato Grosso State, Brazil. All models were statistically similar, with an overall accuracy between 85 and 99%. The NDVI was the most suitable index for discriminating cultures at all hierarchical levels. The RF-NDVI combination mapped best at level 1, while at levels 2 and 3, the best model was XGBoost-NDVI. Our results indicate the great potential of combining HLS data and machine learning to provide accurate geospatial information for decision-makers in monitoring agricultural intensification, with an aim toward the sustainable development of agriculture.
A Survey and Evaluation of Android-Based Malware Evasion Techniques and Detection Frameworks
Authors: Faruki Parvez , Bhan Rati , Jain Vinesh , Bhatia Sajal , El Madhoun Nour , Pamula Rajendra
Published: July 2023

Android platform security is an active area of research where malware detection techniques continuously evolve to identify novel malware and improve the timely and accurate detection of existing malware. Adversaries are constantly in charge of employing innovative techniques to avoid or prolong malware detection effectively. Past studies have shown that malware detection systems are susceptible to evasion attacks where adversaries can successfully bypass the existing security defenses and deliver the malware to the target system without being detected. The evolution of escape-resistant systems is an open research problem. This paper presents a detailed taxonomy and evaluation of Android-based malware evasion techniques deployed to circumvent malware detection. The study characterizes such evasion techniques into two broad categories, polymorphism and metamorphism, and analyses techniques used for stealth malware detection based on the malware’s unique characteristics. Furthermore, the article also presents a qualitative and systematic comparison of evasion detection frameworks and their detection methodologies for Android-based malware. Finally, the survey discusses open-ended questions and potential future directions for continued research in mobile malware detection.
A Comparison of Machine Learning Techniques for the Detection of Type-2 Diabetes Mellitus: Experiences from Bangladesh
Authors: Uddin Md. Jamal , Ahamad Md. Martuza , Hoque Md. Nesarul , Walid Md. Abul Ala , Aktar Sakifa , Alotaibi Naif , Alyami Salem A. , Kabir Muhammad Ashad , Moni Mohammad Ali
Published: July 2023

Diabetes is a chronic disease caused by a persistently high blood sugar level, causing other chronic diseases, including cardiovascular, kidney, eye, and nerve damage. Prompt detection plays a vital role in reducing the risk and severity associated with diabetes, and identifying key risk factors can help individuals become more mindful of their lifestyles. In this study, we conducted a questionnaire-based survey utilizing standard diabetes risk variables to examine the prevalence of diabetes in Bangladesh. To enable prompt detection of diabetes, we compared different machine learning techniques and proposed an ensemble-based machine learning framework that incorporated algorithms such as decision tree, random forest, and extreme gradient boost algorithms. In order to address class imbalance within the dataset, we initially applied the synthetic minority oversampling technique (SMOTE) and random oversampling (ROS) techniques. We evaluated the performance of various classifiers, including decision tree (DT), logistic regression (LR), support vector machine (SVM), gradient boost (GB), extreme gradient boost (XGBoost), random forest (RF), and ensemble technique (ET), on our diabetes datasets. Our experimental results showed that the ET outperformed other classifiers; to further enhance its effectiveness, we fine-tuned and evaluated the hyperparameters of the ET. Using statistical and machine learning techniques, we also ranked features and identified that age, extreme thirst, and diabetes in the family are significant features that prove instrumental in the detection of diabetes patients. This method has great potential for clinicians to effectively identify individuals at risk of diabetes, facilitating timely intervention and care.
Unveiling the Thermoelectric Performances of Zn1−xFexSe Nanoparticles Prepared by the Hydrothermal Method
Authors: Isram Muhammad , Demontis Valeria , Magrin Maffei Riccardo , Abbas Khan Najaf , di Bona Alessandro , Benedetti Stefania , Amin Nasir , Mahmood Khalid , Rossella Francesco
Published: July 2023

Fe2+-doped ZnSe nanoparticles, with varying concentrations of Fe2+ dopants, were prepared by the hydrothermal method and investigated using a multi-technique approach exploiting scanning electron microscopy (SEM), X-ray diffraction (XRD), and Raman spectroscopy, as well as measurement of the electrical transport properties and Seebeck coefficient (S). The doped nanoparticles appeared as variable-sized agglomerates on nanocrystallites upon SEM investigation for any doping level. Combined XRD and Raman analyses revealed the occurrence of a cubic structure in the investigated samples. Electric and thermoelectric (TE) transport investigations showed an increase in TE performance with an increase in Fe atom concentrations, which resulted in an enhancement of the power factors from 13 µWm−1K−2 to 120 µWm−1K−2 at room temperature. The results were also dependent on the operating temperature. The maximum power factor of 9 × 10−3 Wm−1K−2 was achieved at 150 °C for the highest explored doping value. The possible applications of these findings were discussed.
Elemental Selenium in the Synthesis of Selenaheterocycles
Authors: Martynov Alexander V.
Published: July 2023

An overview of the known methods of introducing selenium under the action of elemental selenium into the structures of various saturated, unsaturated, and heteroaromatic selenacycles containing C–Se, N–Se, B–Se, Ge–Se and P–Se bonds is presented. These methods include metal, iodine, bromine or chlorine exchange for selenium and the direct cyclization of 1-(2-bromoaryl)benzimidazoles, polyunsaturated hydrocarbons, acetylenes, propargylic amines, 3-halogenaryl amides, aryl amides, diazo-compounds, 2-aminoacetophenone, and the annulation of ethynyl arenes. Three- and four-component reactions utilizing elemental selenium as one of the components and leading to selenium-containing heterocycles are presented as well.
Patient-Centred Outcomes after Totally Endoscopic Cardiac Surgery: One-Year Follow-Up
Authors: Claessens Jade , Goris Pieter , Yilmaz Alaaddin , Van Genechten Silke , Claes Marithé , Packlé Loren , Pierson Maud , Vandenbrande Jeroen , Kaya Abdullah , Stessel Björn
Published: July 2023

Patient-centred outcomes have grown in popularity over recent years in surgical care research. These patient-centred outcomes can be measured through the health-related quality of life (HRQL) without professional interpretations. In May 2022, a study regarding patient-centred outcomes up to 90 days postoperatively was published. Fourteen days after surgery, the HRQL decreased and returned to baseline levels after 30 days. Next, the HRQL significantly improved 90 days postoperatively. However, this study only focuses on a short-term follow-up of the patients. Hence, this follow-up study aims to assess the HRQL one year after totally endoscopic cardiac surgery. At baseline, 14, 30, and 90 days, and one year after surgery, the HRQL was evaluated using a 36-item short form and 5-dimensional European QoL questionnaires (EQ-5D). Using the 36-item short form questionnaire, a physical and mental component score is calculated. Over the period of one year, this physical and mental component score and the EQ-5D index value significantly improve. According to the visual analogue scale of the EQ-5D, patients score their health significantly higher one year postoperatively. In conclusion, after endoscopic cardiac surgery, the HRQL is significantly improved 90 days postoperatively and remains high one year afterward.
Untreated Injuries to the Anterolateral Capsular Structures Do Not Affect Outcomes and Kinematics after Anatomic Anterior Cruciate Ligament Reconstruction
Authors: Herbst Elmar , Costello Joanna , Popchak Adam J. , Tashman Scott , Irrgang James J. , Fu Freddie H. , Musahl Volker
Published: July 2023

Background: Injuries to the anterolateral complex (ALC) may contribute to increased rotatory knee laxity. However, it has not been evaluated whether such injuries affect in vivo kinematics when treated in situ. The purpose of this study was to determine the grade of ALC injury and its effect on kinematic and clinical outcomes of ACL-injured patients 24 months after anatomic ACL reconstruction. It was hypothesized that injury to the ALC would be significantly related to patient-reported outcomes (PROs) and in vivo knee kinematics during downhill running. Methods: Thirty-five subjects (mean age: 22.8 ± 8.5 years) participating in a randomized clinical trial to compare single- and double-bundle ACL reconstruction were included in the study. Subjects were divided into two groups based on the presence or absence of injury to the ALC, as determined on MRI scans performed within 6 weeks of injury. None of the patients underwent treatment for these ALC injuries. At 24 months, PROs, including the International Knee Documentation Committee Subjective Knee Form (IKDC-SKF), Knee injury and Osteoarthritis Outcome Score (KOOS) and in vivo knee kinematics during downhill running, were obtained. Pivot-shift test results, PROs and in vivo knee kinematics were compared between groups with and without ALC injury using the Pearson’s Chi Squared test and Mann–Whitney U test with significance set at p < 0.05. Results: The average interval between injury and performing the MRI scans was 9.5 ± 10 days. ALC injury was observed in 17 (49%) study participants. No significant differences were detected in PROs and in vivo kinematics between subjects with and without ALC injury (n.s.). Conclusion: The findings of this study demonstrate that MRI evidence of an ALC injury does not significantly affect in vivo knee kinematics and PROs even in individuals with a high-grade ALC injury. Injuries to the ALC as observed on MRI might not be a useful indication for an anterolateral procedure.
MRI-Conditional Breast Tissue Expander: First In-Human Multi-Case Assessment of MRI-Related Complications and Image Quality
Authors: Schiaffino Simone , Cozzi Andrea , Pompei Barbara , Scarano Angela Lia , Catanese Carola , Catic Armin , Rossi Lorenzo , Del Grande Filippo , Harder Yves
Published: July 2023

This study aims to assess potential complications and effects on the magnetic resonance imaging (MRI) image quality of a new MRI-conditional breast tissue expander (Motiva Flora®) in its first in-human multi-case application. Twenty-four patients with 36 expanders underwent non-contrast breast MRI with T1-weighted, T2-weighted, and diffusion-weighted imaging (DWI) sequences on a 3 T unit before breast tissue expander exchange surgery, being monitored during and after MRI for potential complications. Three board-certified breast radiologists blindly and independently reviewed image quality using a four-level scale (“poor”, “sufficient”, “good”, and “excellent”), with inter-reader reliability being assessed with Kendall’s τb. The maximum diameters of RFID-related artifacts on T1-weighted and DWI sequences were compared with the Wilcoxon signed-rank test. All 24 examinations were completed without patient-related or device-related complications. The T1-weighted and T2-weighted sequences of all the examinations had “excellent” image quality and a median 11 mm (IQR 9–12 mm) RFID artifact maximum diameter, significantly lower (p < 0.001) than on the DWI images (median 32.5 mm, IQR 28.5–34.5 mm). DWI quality was rated at least “good” in 63% of the examinations, with strong inter-reader reliability (Kendall’s τb 0.837, 95% CI 0.687–0.952). This first in-human study confirms the MRI-conditional profile of this new expander, which does not affect the image quality of T1-weighted and T2-weighted sequences and moderately affects DWI quality.
Scale-Up of Academic Mesenchymal Stromal Cell Production
Authors: Laroye Caroline , Gauthier Mélanie , Morello Jessica , Charif Naceur , Cannard Véronique Latger , Bonnet Céline , Lozniewski Alain , Tchirkov Andrei , De Isla Natalia , Decot Véronique , Reppel Loïc , Bensoussan Danièle
Published: July 2023

Background: Many clinical trials have reported the use of mesenchymal stromal cells (MSCs) following the indication of severe SARS-CoV-2 infection. However, in the COVID19 pandemic context, academic laboratories had to adapt a production process to obtain MSCs in a very short time. Production processes, especially freezing/thawing cycles, or culture medium have impacts on MSC properties. We evaluated the impact of an intermediate cryopreservation state during MSC culture to increase production yields. Methods: Seven Wharton’s jelly (WJ)-MSC batches generated from seven different umbilical cords with only one cryopreservation step and 13 WJ-MSC batches produced with intermediate freezing were formed according to good manufacturing practices. The identity (phenotype and clonogenic capacities), safety (karyotype, telomerase activity, sterility, and donor qualification), and functionality (viability, mixed lymphocyte reaction) were analyzed. Results: No significant differences between MSC production processes were observed, except for the clonogenic capacity, which was decreased, although it always remained above our specifications. Conclusions: Intermediate cryopreservation allows an increase in the production yield and has little impact on the basic characteristics of MSCs.
Multi-Site Spinal Cord Transcutaneous Stimulation Facilitates Upper Limb Sensory and Motor Recovery in Severe Cervical Spinal Cord Injury: A Case Study
Authors: Sharma Pawan , Panta Tudor , Ugiliweneza Beatrice , Bert Robert J. , Gerasimenko Yury , Forrest Gail , Harkema Susan
Published: July 2023

Individuals with cervical spinal cord injury (SCI) rank regaining arm and hand function as their top rehabilitation priority post-injury. Cervical spinal cord transcutaneous stimulation (scTS) combined with activity-based recovery training (ABRT) is known to effectively facilitate upper extremity sensorimotor recovery in individuals with residual arm and hand function post SCI. However, scTS effectiveness in facilitating upper extremity recovery in individuals with severe SCI with minimal to no sensory and motor preservation below injury level remains largely unknown. We herein introduced a multimodal neuro-rehabilitative approach involving scTS targeting systematically identified various spinal segments combined with ABRT. We hypothesized that multi-site scTS combined with ABRT will effectively neuromodulate the spinal networks, resulting in improved integration of ascending and descending neural information required for sensory and motor recovery in individuals with severe cervical SCI. To test the hypothesis, a 53-year-old male (C2, AIS A, 8 years post-injury) received 60 ABRT sessions combined with continuous multi-site scTS. Post-training assessments revealed improved activation of previously paralyzed upper extremity muscles and sensory improvements over the dorsal and volar aspects of the hand. Most likely, altered spinal cord excitability and improved muscle activation and sensations resulted in observed sensorimotor recovery. However, despite promising neurophysiological evidence pertaining to motor re-activation, we did not observe visually appreciable functional recovery on obtained upper extremity motor assessments.
The Importance of Being Aware of Intrinsic Methods’ Limitation in Low-Density Lipoprotein Cholesterol Determination to Correctly Identify Cardiovascular Risk: Is Direct Determination Obtained with the Roche System Systematically Overestimating LDL in Very High-Risk Patients with Triglycerides Concentration of Less than (<2.25 mmol/L)?
Authors: Cemin Roberto , Casablanca Simona , Ermacora Davide , Daves Massimo
Published: July 2023

Background: low-density lipoprotein cholesterol (LDL-C) is a strong cardiovascular risk factor, but the methods used to correctly determine it are is still questioned. The aim of this study was to compare the direct determination of LDL-C levels, obtained with the Roche cobas c system, with LDL-C values calculated through Sampson’s and Friedewald’s equations in very high-risk patients with triglycerides concentrations of less than 2.25 mmol/L (<200 mg/dL). Methods: in 127 consecutive patients with a recent diagnosis of acute coronary syndrome and triglycerides of less than 2.25 mmol/L, plasma LDL-C was measured directly and calculated with Sampson’s and Friedewald’s equations before hospital discharge, and the data were compared. Results: median LDL values obtained with the Friedenwald and Sampson equations and with direct determination were 2.31 (IQR 1.59–3.21), 2.36 (IQR 1.66–3.26) and 2.64 (IQR 1.97–3.65) mmol/L, respectively. Direct measurements were higher by 0.35 and 0.40 mmol/L when compared to the levels calculated with Sampson’s or Friedewald’s equations, respectively (p < 0.01). The correlation between the two equations was almost perfect (rho 0.997) but decreased when the directly determined data were compared to those calculated with Sampson’s equation (rho 0.954) or Friedewald’s method (rho 0.939). Conclusion: direct determination generated higher values of LDL-C concentration through a probable systematic overestimation.
Anatomical and Functional Connectivity of Critical Deep Brain Structures and Their Potential Clinical Application in Brain Stimulation
Authors: Kong Qiao , Sacca Valeria , Zhu Meixuan , Ursitti Amy Katherine , Kong Jian
Published: July 2023

Subcortical structures, such as the hippocampus, amygdala, and nucleus accumbens (NAcc), play crucial roles in human cognitive, memory, and emotional processing, chronic pain pathophysiology, and are implicated in various psychiatric and neurological diseases. Interventions modulating the activities of these deep brain structures hold promise for improving clinical outcomes. Recently, non-invasive brain stimulation (NIBS) has been applied to modulate brain activity and has demonstrated its potential for treating psychiatric and neurological disorders. However, modulating the above deep brain structures using NIBS may be challenging due to the nature of these stimulations. This study attempts to identify brain surface regions as source targets for NIBS to reach these deep brain structures by integrating functional magnetic resonance imaging (fMRI) and diffusion tensor imaging (DTI). We used resting-state functional connectivity (rsFC) and probabilistic tractography (PTG) analysis to identify brain surface stimulation targets that are functionally and structurally connected to the hippocampus, amygdala, and NAcc in 119 healthy participants. Our results showed that the medial prefrontal cortex (mPFC) is functionally and anatomically connected to all three subcortical regions, while the precuneus is connected to the hippocampus and amygdala. The mPFC and precuneus, two key hubs of the default mode network (DMN), as well as other cortical areas distributed at the prefrontal cortex and the parietal, temporal, and occipital lobes, were identified as potential locations for NIBS to modulate the function of these deep structures. The findings may provide new insights into the NIBS target selections for treating psychiatric and neurological disorders and chronic pain.
Intramyocardial Stem Cell Transplantation during Coronary Artery Bypass Surgery Safely Improves Cardiac Function: Meta-Analysis of 20 Randomized Clinical Trials
Authors: Soetisna Tri Wisesa , Thamrin Ahmad Muslim Hidayat , Permadijana Diajeng , Ramadhani Andi Nurul Erisya , Sugisman Sugisman , Santoso Anwar , Mansyur Muchtaruddin
Published: July 2023

IMSC transplantation during CABG is considered one of the most promising methods to effectively deliver stem cells and has been widely studied in many trials. But the results of outcomes and safety of this modality still vary widely. We conducted this meta-analysis of randomized controlled trials (RCTs) to evaluate not only the outcome but also the safety of this promising method. A meta-analysis was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. A comprehensive literature search was undertaken using the PubMed, Scopus, and Cochrane databases. Articles were thoroughly evaluated and analyzed. Twenty publications about IMSC during CABG were included. Primary outcomes were measured using LVEF, LVESV, LVESVI, LVESD, LVEDV, LVEDVI, LVEDD, WMSI, and 6-MWT. Safety measures were depicted by total deaths, MACE, CRD, CVA, myocardial infarction, ventricular arrhythmia, and cardiac-related readmission. IMSC transplantation during CABG significantly improved LVEF (MD = 3.89%; 95% CI = 1.31% to 6.46%; p = 0.003) and WMSI (MD = 0.28; 95% CI = 0.01–0.56; p = 0.04). Most of the other outcomes showed favorable results for the IMSC group but were not statistically significant. The safety analysis also showed no significant risk difference for IMSC transplantation compared to CABG alone. IMSC during CABG can safely improve cardiac function and tend to improve cardiac volumes and dimensions. The analysis and application of influencing factors that increase patients’ responses to IMSC transplantation are important to achieve long-term improvement.
Diagnosis and Non-Invasive Treatment of Obesity in Adults with Type 2 Diabetes Mellitus: A Review of Guidelines
Authors: Łuniewski Michał , Matyjaszek-Matuszek Beata , Lenart-Lipińska Monika
Published: July 2023

Obesity, a chronic disease with multifactorial etiopathogenesis, is characterized by excessive accumulation of adipose tissue. Obesity prevalence is growing globally at an alarming rate. The overwhelming majority of obesity cases are caused by inappropriate lifestyles, such as overconsumption of food and inadequate physical activity. Metabolic and biochemical changes due to increased adiposity resulted in numerous comorbidities, increased all-cause mortality, and reduced quality of life. T2DM (type 2 diabetes mellitus) and obesity have many common pathogenetic points and drive each other in a vicious cycle. The aim of this article is to review obesity management guidelines and highlight the most important points. Management of both obesity-related and T2DM complications incur enormous expenses on healthcare systems. It is, therefore, paramount to provide streamlined yet custom-tailored weight management in order to avoid the negative ramifications of both diseases. Efficient obesity treatment leads to better diabetes control since some antidiabetic medications support weight reduction. Obesity treatment should be overseen by a multi-disciplinary team providing indispensable information and individually tailored regimens to patients. Weight management should be multimodal and consist chiefly of MNT (medical nutrition therapy), physical activity, and lifestyle changes. A comprehensive approach to obesity treatment may give tangible results to quality of life and comorbidities.
Long-Term Effect of Guided Implant Surgery on Clinical Outcomes and Peri-Implantitis of Maxillary Implants—An Observational Cohort Study
Authors: Naeini Emitis Natali , De Bruyn Hugo , Bronkhorst Ewald M. , D’haese Jan
Published: July 2023

(1) Although the accuracy of static computer-aided implant surgery (sCAIP) is well reported, information on its long-term effect on peri-implant health and complications is scarce. (2) Twenty-six patients initially treated were recalled. Implant survival, radiographic bone level, peri-implant health, and complications were registered. A multilevel regression model was applied to study the relationship between the research variables. (3) Sixteen patients participated in this study (average age 58.5 years; range 27.8–73.8). The mean follow-up time was 9.1 years (range 7.3–11.3). Two implants failed, resulting in a survival rate of 97.1%. The mean bone level change corresponded to a loss of 0.63 mm (SD 1.90) for the whole group, 0.17 mm (SD 1.46), and 0.91 mm (SD 2.09) for tooth- and mucosa-supported guides, respectively. The mean PPD for the total group was 4.24 mm (SD 1.25), and 3.79 mm (SD 0.97) and 4.51 mm (SD 1.33) for the tooth- and mucosa-supported guides, respectively. Four implants (6.3%) were diagnosed with peri-implantitis. Coronal deviation was slightly associated with having a negative impact on bone level at follow-up, but this was not statistically significant. Seven patients (43.8%) experienced technical complications. Biological complications were seen in 3/16 patients (18.75%). (4) SCAIP may contribute to more predictable implant placement; the long-term clinical outcome is similar to conventional nonguided surgery.
Prognostic Role of Metabolic Exercise Testing in Heart Failure
Authors: Agdamag Arianne Clare , Van Iterson Erik H. , Tang W. H. Wilson , Finet J. Emanuel
Published: July 2023

Heart failure is a clinical syndrome with significant heterogeneity in presentation and severity. Serial risk-stratification and prognostication can guide management decisions, particularly in advanced heart failure, when progression toward advanced therapies or end-of-life care is warranted. Each currently utilized prognostic marker carries its own set of challenges in acquisition, reproducibility, accuracy, and significance. Left ventricular ejection fraction is foundational for heart failure syndrome classification after clinical diagnosis and remains the primary parameter for inclusion in most clinical trials; however, it does not consistently correlate with symptoms and functional capacity, which are also independently prognostic in this patient population. Utilizing the left ventricular ejection fraction as the sole basis of prognostication provides an incomplete characterization of this condition and is prone to misguide medical decision-making when used in isolation. In this review article, we survey and exposit the important role of metabolic exercise testing across the heart failure spectrum, as a complementary diagnostic and prognostic modality. Metabolic exercise testing, also known as cardiopulmonary exercise testing, provides a comprehensive evaluation of the multisystem (i.e., neurological, respiratory, circulatory, and musculoskeletal) response to exercise performance. These differential responses can help identify the predominant contributors to exercise intolerance and exercise symptoms. Additionally, the aerobic exercise capacity (i.e., oxygen consumption during exercise) is directly correlated with overall life expectancy and prognosis in many disease states. Specifically in heart failure patients, metabolic exercise testing provides an accurate, objective, and reproducible assessment of the overall circulatory sufficiency and circulatory reserve during physical stress, being able to isolate the concurrent chronotropic and stroke volume responses for a reliable depiction of the circulatory flow rate in real time.
Increased Thrombotic Risk in COVID-19: Evidence and Controversy
Authors: De Vita Antonio , Franceschi Francesco , Covino Marcello
Published: July 2023

The pandemic of respiratory disease caused by the novel coronavirus named SARS-CoV-2, which emerged at the end of 2019, is still ongoing [...]
What Types of Strategies Are Effective in Lumbar Spine Surgery? Considering the Etiology, Imaging Findings, and Risk of Complications
Authors: Seki Shoji , Akeda Koji , Kaito Takashi , Ohba Tetsuro
Published: July 2023

Lumbar spine surgery is commonly performed worldwide for the treatment of lumbar spinal disorder, and the surgery saves many patients with lower back and lower extremity pain [...]
Analysis of the Spinopelvic Parameters in Patients with Fragility Fractures of the Pelvis
Authors: Lodde Moritz F. , Fischer Thies M. , Riesenbeck Oliver , Roßlenbroich Steffen , Katthagen J. Christoph , Rometsch Daria , Günes Dennis , Schneider Marc , Raschke Michael J. , Liljenqvist Ulf
Published: July 2023

Background: We investigated the spinopelvic parameters of lumbar lordosis (LL), pelvic incidence (PI), pelvic tilt (PT) and sacral slope (SS) in patients with fragility fractures of the pelvis (FFPs). We hypothesized that these parameters differ from asymptomatic patients. Methods: All patients treated for FFPs in a center of maximal care of the German Spine Society (DWG) between 2017 and 2021 were included. The inclusion criteria were age ≥ 60 years and the availability of a standing lateral radiograph of the spine and pelvis in which the spine from T12 to S1 and both femoral heads were visible. The baseline characteristics and study parameters were calculated and compared with databases of asymptomatic patients. The two-sample t-Test was performed with p < 0.05. Results: The study population (n = 57) consisted of 49 female patients. The mean age was 81.0 years. The mean LL was 47.9°, the mean PT was 29.4°, the mean SS was 34.2° and the mean PI was 64.4°. The mean value of LLI was 0.7. LL, LLI and SS were significantly reduced, and PI and PT were significantly increased compared to asymptomatic patients. Conclusions: The spinopelvic parameters in patients with FFPs differ significantly from asymptomatic patients. In patients with FFPs, LL, LLI and SS are significantly reduced, and PI and PT are significantly increased. The sagittal spinopelvic balance is abnormal in patients with FFPs.
Circular RNA as Therapeutic Targets in Atherosclerosis: Are We Running in Circles?
Authors: Triska Jeffrey , Mathew Christo , Zhao Yang , Chen Yuqing E. , Birnbaum Yochai
Published: July 2023

Much attention has been paid lately to harnessing the diagnostic and therapeutic potential of non-coding circular ribonucleic acids (circRNAs) and micro-RNAs (miRNAs) for the prevention and treatment of cardiovascular diseases. The genetic environment that contributes to atherosclerosis pathophysiology is immensely complex. Any potential therapeutic application of circRNAs must be assessed for risks, benefits, and off-target effects in both the short and long term. A search of the online PubMed database for publications related to circRNA and atherosclerosis from 2016 to 2022 was conducted. These studies were reviewed for their design, including methods for developing atherosclerosis and the effects of the corresponding atherosclerotic environment on circRNA expression. Investigated mechanisms were recorded, including associated miRNA, genes, and ultimate effects on cell mechanics, and inflammatory markers. The most investigated circRNAs were then further analyzed for redundant, disparate, and/or contradictory findings. Many disparate, opposing, and contradictory effects were observed across experiments. These include levels of the expression of a particular circRNA in atherosclerotic environments, attempted ascertainment of the in toto effects of circRNA or miRNA silencing on atherosclerosis progression, and off-target, cell-specific, and disease-specific effects. The high potential for detrimental and unpredictable off-target effects downstream of circRNA manipulation will likely render the practice of therapeutic targeting of circRNA or miRNA molecules not only complicated but perilous.
Prevalence of Culturable Bacteria and Yeasts in the Nasopharynx Microbiota during the Physiological Course of Pregnancy
Authors: Kosikowska Urszula , Dłuski Dominik Franciszek , Pietras-Ożga Dorota , Leszczyńska-Gorzelak Bożena , Andrzejczuk Sylwia
Published: July 2023

The aim of the study was to compare the prevalence of the nasopharyngeal carriage of culturable microorganisms in the microbiota of asymptomatic women with a physiological pregnancy (PW) and nonpregnant women (NPW). Nasopharyngeal swabs were collected from 53 PW and 30 NPW to detect bacterial and fungal colonization. Isolates were identified using the culture method and the MALDI-TOF MS technique. The nasopharyngeal microbiota (NPM) partially differed between PW and NPW. These differences in the frequency of nasopharyngeal colonization between the PW and NPW groups were not statistically significant (p > 0.05); all cases were colonized by bacteria and only two cases in the PW group were colonized by yeasts, namely, Rhodotorula spp. High levels of staphylococcal colonization, including predominantly coagulase-negative staphylococci and S. aureus in the nasopharyngeal sample, were present in both groups. The reduced number of Gram-negative rods colonized in the cases studied was seen in samples from the NPW group, particularly with Enterobacterales, and anaerobic Cutibacterium spp. were isolated only in the PW group (p < 0.05). Moreover, a higher carriage rate of Enterobacter aerogenes colonization was statistically significant (p < 0.05) and correlated with the NPW group. Pregnancy may disturb the composition of the NPM represented by commensals and opportunistic bacteria and promote yeast colonization as compared to nonpregnant women.