bluuebunny/crossref_metadata_2025 huggingface dataset:
Donor-Derived Cell-Free DNA as a Non-Invasive Biomarker for Graft Rejection in Kidney Transplant Recipients: A Prospective Study among the Indian Population
Authors: Kumar Naveen , Tandon Archita , Rana Rashmi , Rana Devinder Singh , Bhalla Anil Kumar , Gupta Anurag , Sachdeva Mohinder Pal , Huirem Rohit Singh , Chauhan Kirti , Yashavarddhan M. H. , Basnal Atul , Gupta Ritu , Mallick Prashant Kumar , Ganguly Nirmal Kumar
Published: November 2023

Monitoring graft health and detecting graft rejection is crucial for the success of post-transplantation outcomes. In Western countries, the use of donor-derived cell-free DNA (dd-cfDNA) has gained widespread recognition as a diagnostic tool for kidney transplant recipients. However, the role of dd-cfDNA among the Indian population remains unexplored. The recipients were categorized into two groups: the post-transplant recipient (PTR) group (n = 16) and the random recipient (RR) group (n = 87). Blood samples were collected daily from the PTR group over a 7-day period, whereas the RR group’s samples were obtained at varying intervals. In this study, we used a targeted approach to identify dd-cfDNA, which eliminated the need for genotyping, and is based on the minor allele frequency of SNP assays. In the PTR group, elevated dd-cfDNA% levels were observed immediately after transplantation, but returned to normal levels within five days. Within the RR group, heightened serum creatinine levels were directly proportional to increased dd-cfDNA%. Sixteen recipients were advised to undergo biopsy due to elevated serum creatinine and other pathological markers. Among these sixteen recipients, six experienced antibody-mediated rejection (ABMR), two exhibited graft dysfunctions, two had active graft injury, and six (37.5%) recipients showed no rejection (NR). In cases of biopsy-proven ABMR and NR, recipients displayed a mean ± SD dd-cfDNA% of 2.80 ± 1.77 and 0.30 ± 0.35, respectively. This study found that the selected SNP assays exhibit a high proficiency in identifying donor DNA. This study also supports the use of dd-cfDNA as a routine diagnostic test for kidney transplant recipients, along with biopsies and serum creatinine, to attain better graft monitoring.
Relation of STAT3 rs1053005 Variation and miR-452-3p with Osteoarthritis Susceptibility and Severity and the Clinical Response to High-Molecular-Weight Hyaluronic Acid Injection in Osteoarthritis Patients
Authors: Wahba Alaa S. , Mohamed Dina A. , Mehanna Mohamed T. , Mesbah Noha M. , Abo-elmatty Dina M. , Mehanna Eman T.
Published: November 2023

Polymorphisms in the 3′ untranslated region of STAT3 mRNA can derange STAT3 gene expression via modifying the microRNA-binding site. This study aimed to examine the impact of STAT3 rs1053005 variation and miR-452-3p expression on osteoarthritis (OA) susceptibility and severity and the efficacy of intra-articular high-molecular-weight hyaluronic acid (HMW-HA) injection as a therapy option for knee OA. Two hundred and fifty-eight OA patients and 200 healthy controls were enrolled in the study. STAT3 genotyping and STAT3 and miR-452-3p expression were carried out using allelic-discrimination PCR and quantitative real-time PCR. Functional assessment and pain evaluation were performed for all patients. Eighty-three patients received HMW-HA injections, and multiple follow-up visits were performed. STAT3 mRNA was upregulated, and expression was positively associated with plasmin, TNF-α, MMP-3, and STAT3 serum levels, whereas miR-452-3p was downregulated and negatively associated with the previously mentioned parameters in OA patients. Osteoarthritis patients had a lower prevalence of the minor allele of the rs1053005 variant (p < 0.001). Plasmin, TNF, MMP-3, and STAT3 mRNA and protein levels were significantly decreased, and miR-452-3p expression was significantly increased in the GG genotype compared to AG and AA genotypes. HMW-HA injection improved OA patients’ clinical scores with concomitant decreased STAT3 levels and enhanced expression of miR-452-3p. More efficient improvement was observed in rs1053005 AG + GG genotype carriers vs. AA genotype carriers. The G allele of STAT3 rs1053005 (A/G) polymorphism was associated with decreased OA susceptibility and severity and enhanced clinical response to HMW-HA injection, possibly via enhancing miR-452-3p binding and a subsequent decrease in STAT3 expression.
Landscape Education Two Decades after the European Landscape Convention—A Study with Trainee Teachers
Authors: Crespo Castellanos José Manuel , Martínez-Hernández Carlos , Mateo Girona María Rosa , Rodríguez de Castro Ayar
Published: November 2023

The European Landscape Convention promotes the protection, management and planning of landscapes and organises international co-operation on landscape issues. Member states committed to implement measures such as promoting social education about landscapes. The convention stated that, although it was part of the education curricula in some countries, landscape education was to be expanded from a multidisciplinary perspective. The Education Act in force in Spain in 2008 (LOE, 2007), when the convention was ratified, included landscape in the syllabus, but not from as broad a perspective as that reflected in the ELC. Later education reforms have gradually increased the presence of the landscape in school curricula. This study examines landscape-related knowledge and awareness among current trainee primary school teachers, whose whole education has occurred under the umbrella of the ELC. This aims to assess whether the ELC’s targets have been met in terms of social awareness of landscape issues. A mixed questionnaire was designed, validated, and implemented in a sample of 322 students studying subjects related to the teaching of geography. The answers were analysed with descriptive and inferential statistics. The results reflect poor landscape-related knowledge and awareness, suggesting that the educational measures implemented since the ratification of the ELC have not been successful.
Moving Target Detection Algorithm for Millimeter Wave Radar Based on Keystone-2DFFT
Authors: Shen Wenjie , Wang Sijie , Wang Yanping , Li Yang , Lin Yun , Zhou Ye , Xu Xueyong
Published: November 2023

Millimeter wave radar has the advantage of all-day and all-weather capability for detection, speed measurement. It plays an important role in urban traffic flow monitoring and traffic safety monitoring. The conventional 2-dimensional Fast Fourier Transform (2DFFT) algorithm is performed target detection in the range-Doppler domain. However, the target motion will induce the range walk phenomenon, which leads to a decrease in the target energy and the performance of the target detection and speed measurement. To solve the above problems, this paper proposes a moving vehicle detection algorithm based on Keystone-2DFFT for a traffic scene. Firstly, this paper constructs and analyzes the Frequency Modulated ContinuousWave (FMCW) moving target signal model under traffic monitoring scenario’s radar observation geometry. The traditional 2DFFT moving target detection algorithm is briefly introduced. Then, based on mentioned signal model, an improved moving vehicle detection algorithm based on Keystone-2DFFT transform is proposed. The method first input the echo, then the range walk is removed by keystone transformation. the keystone transformation is achieved via Sinc interpolation. Next is transform data into range-Doppler domain to perform detection and speed estimation. The algorithm is verified by simulation data and real data.
Joint AP Selection and Task Offloading Based on Deep Reinforcement Learning for Urban-Micro Cell-Free UAV Network
Authors: Pan Chunyu , Wang Jincheng , Yue Xinwei , Guo Linyan , Yang Zhaohui
Published: November 2023

The flexible mobility feature of unmanned aerial vehicles (UAVs) leads to frequent handovers and serious inter-cell interference problems in UAV-assisted cellular networks. Establishing a cell-free UAV (CF-UAV) network without cell boundaries effectively alleviates frequent handovers and interference problems and has been an important topic of 6G research. However, in existing CF-UAV networks, a large amount of backhaul data increases the computational pressure on the central processing unit (CPU), which also increases system delay. Meanwhile, the mobility of UAVs also leads to time-varying channel conditions. Therefore, designing dynamic resource allocation schemes with the help of edge computing can effectively alleviate this problem. Thus, aiming at partial network breakdown in an urban-micro (UMi) environment, an urban-micro CF-UAV (UMCF-UAV) network architecture is proposed in this paper. A delay minimization problem and a dynamic task offloading (DTO) strategy that jointly optimizes access point (AP) selection and task offloading is proposed to reduce system delay in this paper. Considering the coupling of various resources and the non-convex feature of the proposed problem, a dynamic resource cooperative allocation (DRCA) algorithm based on deep reinforcement learning (DRL) to flexibly deploy AP selection and task offloading of UAVs between the edge and locally is proposed to solve the problem. Simulation results show fast convergence behavior of the proposed algorithm compared with classical reinforcement learning. Decreased system delay is obtained by the proposed algorithm compared with other baseline resource allocation schemes, with the maximize improvement being 53%.
Fault-Tolerant Consensus Control of Positive Networked Systems
Authors: He Zhansheng , Shen Jun
Published: November 2023

In this paper, we explore the consensus of positive networked systems with actuator faults. Firstly, the undirected and strongly connected topology is established with graph theory. The positive system theory is used to analyze the positive consensus of the closed-loop networked systems. State feedback gains are derived utilizing Algebraic Riccati Inequalities. Bounded multiplicative faults are regarded as uncertainties in the system matrix, while treating additive faults as external disturbances. Further, this transformation refocuses the analysis on the consensus problem with an L2-gain. Subsequently, the Genetic Algorithm is employed to optimize the L2 performance criteria. Finally, the effectiveness of the proposed theory is validated through simulations involving both single-input electric circuit systems and multi-input networked systems.
Augmenting Vehicular Ad Hoc Network Security and Efficiency with Blockchain: A Probabilistic Identification and Malicious Node Mitigation Strategy
Authors: Juárez Rubén , Bordel Borja
Published: November 2023

This manuscript delineates the development of an avant garde dual-layer blockchain architecture, which has been meticulously engineered to augment the security and operational efficacy of vehicular ad hoc networks (VANETs). VANETs, which are integral to the infrastructure of intelligent transport systems, facilitate the critical exchange of information between vehicular nodes. Despite their significance, these networks confront an array of formidable security vulnerabilities. Our innovative approach, employing a dual blockchain framework—the event chain and the reputation chain—meticulously tracks network activities, thereby significantly enhancing the trustworthiness and integrity of the system. This research presents a transformative dual-layer blockchain architecture, which was conceived to address the intricate security challenges pervasive in VANETs. The architecture pivots on a sophisticated reputation assessment framework, thus leveraging the principles of Bayesian inference and the analytical rigor of historical data to markedly diminish observational errors, as well as elevate the accuracy of reputation evaluations for vehicular nodes. A salient feature of our methodology is the implementation of an attenuation factor, which has been deftly calibrated to modulate the impact of historical behaviors on current reputation scores, thereby ensuring their relevance and alignment with recent vehicular interactions. Additionally, the numerical threshold serves as an indispensable mechanism, thus establishing a definitive criterion for the early identification of potentially malicious activities and enabling the activation of proactive security measures to safeguard the network’s integrity. Empirical validation of our dual-layer blockchain model has yielded a remarkable 86% efficacy in counteracting malevolent behaviors, thus significantly outperforming extant paradigms. These empirical outcomes underscore the model’s potential as a vanguard in the domain of secure and efficient reputation management within VANETs, thereby heralding a substantial advancement in the sphere of intelligent transportation systems.
Enabling Privacy-Preserving Data Sharing with Bilateral Access Control for Cloud
Authors: Wu Tong , Ma Xiaochen , Yan Hailun
Published: November 2023

Cloud computing plays an essential role in various fields. However, the existing cloud services face a severe challenge, which is how to share the data among a large scale of devices securely. In this paper, we introduce a cloud-based privacy-preserving data sharing scheme, derived from identity-based matchmaking encryption. In our scheme, the access policies are designed by both the sender and receiver simultaneously, to support bilateral access control. To improve efficiency, we delegate the match algorithm to the cloud server, reducing the computation cost and communication overhead on end devices without revealing the users’ privacy. Through formal security analysis, we show that our scheme holds security, authenticity, and privacy. Finally, we evaluate our scheme by conducting extensive experiments, indicating that our scheme is more efficient than the other data-sharing schemes in ME-based services in a real-world dataset.
Research on the Improvement of Lithium-Ion Battery Performance at Low Temperatures Based on Electromagnetic Induction Heating Technology
Authors: Wang Borui , Yan Mingyin
Published: November 2023

As the major power source for electric vehicles (EVs), lithium-ion batteries (LiBs) suffer from the degradation of technical performance and safety at low temperatures, which restricts the popularization of EVs in frigid regions. Thus, this study developed an extremely fast electromagnetic induction heating system in order to improve the poor performance of LiBs in cold weather. An electrochemical–thermal coupling model (ETCM), validated against the experimental results of charge and discharge, which successfully predicted LiB voltage, temperature, and other physical characteristics at various ambient temperatures, was established in COMSOL Multiphysics 6.0 as a development tool for evaluating the heating effect of the system. When the copper coil is subjected to a SAC (sinusoidal alternating current) of 8 A and 50 Hz, the LiB can be heated from 243.15 to 293.15 K within 6 min with an instantaneous temperature increase rate of 0.263 K/s and a homogeneous temperature distribution. The results of the capacity calibration, cyclable lithium detection, and HPPC simulation show that the heating method can visibly increase the Li+ concentration inside the active particle, and there was only a tiny concentration gradient on the surface of the particle. In addition, the internal resistance was approximately a quarter of that without heating; therefore, both the discharge energy and specific power boost were two times higher than the original level. Compared to the normal charge–discharge cycles at 293.15 K, the capacity retention of the LiB only decreased by 0.23% after 60 consecutive heating cycles, so the heating method can balance the temperature rise, work capacity, and LiB health. Furthermore, the improvements in the thermal insulation condition and material thermal conductivity are two feasible ways to optimize the temperature-increase effect.
Balanced Definition of Thresholds for Mode Tracking in a Long-Term Seismic Monitoring System
Authors: Coccimiglio Stefania , Miraglia Gaetano , Coletta Giorgia , Epicoco Rodolfo , Ceravolo Rosario
Published: November 2023

The catastrophic events of recent years have strengthened the awareness of the fragility of the built heritage and the importance of careful and targeted maintenance. This, in combination with the development of modern techniques for the analysis of large datasets, has favoured the diffusion of long-term seismic monitoring systems for the protection of structures. In the field of structural health monitoring, data-driven techniques allow crucial information to be extracted from measurements without the need to model the physical phenomena involved, circumventing potential limitations that may arise. On the other hand, however, the results of data-driven approaches are based entirely on the measured structural response; this is why a high reliability of the procedure for extracting diagnostic parameters is essential. In this perspective, a Mode Tracking procedure is proposed to obtain coherent time histories of the modal frequencies of a structure as environmental conditions vary. The procedure is applied to the Sanctuary of Vicoforte, an important monumental structure located in Piedmont, known for its imposing oval dome and characterized by a permanent structural monitoring system. This study aims to disentangle the frequency time series and obtain a rigorous database on which to set up damage identification processes.
Survival and Clinical Outcomes after Unconstrained Total Knee Arthroplasty for Tibial Plateau Fractures–A Retrospective Study with Minimum 4-Year Follow-Up
Authors: Nolte Philip-C. , Schlentrich Kim , Raisch Philipp , Jung Matthias K. , Grützner Paul A. , Bischel Oliver
Published: November 2023

This study investigated survival, complications, revisions, and patient-reported outcomes (PROs) for unconstrained total knee arthroplasty (TKA) in posttraumatic osteoarthritis (PTO) caused by intraarticular tibial plateau fractures with minimum four years follow-up. Forty-nine patients (71.4% male; 58.7 years) were included. Kaplan–Meier analysis was performed with failure defined as TKA removal. Patients without failure underwent pre- and postoperative evaluation (range of motion (ROM), Oxford Knee Score (OKS), Knee Society Score (KSS), anatomical femorotibial angle (aFTA), proximal tibial slope (PTS)) and Short Form-12 (SF-12) Physical (PCS) and Mental Component Summary (MCS) assessment at final follow-up. Fifteen (30.6%) patients had a complication, and eight (16.3%) patients underwent prosthesis removal at median 2.5 years. Cumulative survival rate of TKA was 79.6% at 20 years. A total of 32 patients with a mean follow-up of 11.8 years underwent further analyses. ROM (p = 0.028), aFTA (p = 0.044), pPS (p = 0.009), OKS (p < 0.001) and KSS (p < 0.001) improved significantly. SF-12 PCS was 42.3 and MCS was 54.4 at final follow-up. In general, one third of patients suffer a complication, and one in six patients has their prosthesis removed after TKA for PTO due to tibial plateau fractures. In patients who do not fail, TKA significantly improves clinical and radiographic outcomes at long-term follow-up.
Serous Cystadenoma: A Review on Diagnosis and Management
Authors: Ning Kylie , Salamone Ashley , Manos Lindsey , Lafaro Kelly J. , Afghani Elham
Published: November 2023

Incidental pancreatic cysts are highly prevalent, with management dependent on the risk of malignant progression. Serous cystadenomas (SCAs) are the most common benign pancreatic cysts seen on imaging. They have typical morphological patterns but may also show atypical features that mimic precancerous and cancerous cysts. If a confident diagnosis of SCA is made, no further follow-up is warranted. Therefore, a preoperative distinction between SCA and precancerous or cancerous lesions is critically essential. Distinguishing an SCA from other types of pancreatic cysts on imaging remains a challenge, thus leading to misdiagnosis and ramifications. This review summarizes the current evidence on diagnosing and managing SCA.
Obesity and Acute Kidney Injury in Patients with ST-Elevation Myocardial Infarction
Authors: Kanic Vojko , Suran David , Kompara Gregor
Published: November 2023

Background: Data on the association between obesity and acute kidney injury (AKI) in patients with ST-elevation myocardial infarction (STEMI) are sparse and inconclusive. We aimed to evaluate the association between obesity and AKI and the outcome in these patients. Methods: A retrospective observational study of 3979 STEMI patients undergoing percutaneous coronary intervention (PCI) was performed at a single center. Patients with and without AKI were compared. Patients were also divided into three categories according to BMI, and these were compared. All-cause mortality was determined at 30 days and over a median period of 7.0 years. Results: The incidence of AKI was similar in all BMI categories. There was no association between BMI categories and AKI (p = 0.089). The Spearman correlation coefficient between BMI categories and AKI showed no correlation (r = −0.005; p = 0.75). More AKI patients died within 30 days and in the long term [137 (18.5%) and 283 (38.1%) patients in the AKI group died compared to 118 (3.6%) and 767 (23.1%) in the non-AKI group; p < 0.0001]. AKI was harmful in all BMI categories (p < 0.0001) and was associated with more than a 2.5-fold and a 1.5-fold multivariable-adjusted 30-day and long-term mortality risk, respectively (aOR 2.59; 95% CI 1.84–3.64; p < 0.0001, aHR 1.54; 95% CI 1.32–1.80; p < 0.0001). BMI categories were not associated with 30-day mortality (p = 0.26) but were associated with long-term mortality (p < 0.0001). Overweight and obese patients had an approximately 25% lower long-term multivariable-adjusted risk of death than normal-weight patients. In patients with AKI, BMI was only associated with long-term risk (p = 0.022). Obesity had an additional beneficial effect in these patients, and only patients with obesity, but not overweight patients, had a lower multivariable adjusted long-term mortality risk than normal-weight patients (aHR 062; 95% CI 0.446–0.88 p = 0.007). Conclusions: In patients who experienced AKI, obesity had an additional positive modifying effect. Our data suggest that the incidence of AKI in STEMI patients is not BMI-dependent.
Small Bowel Capsule Endoscopy and Enteroscopy: A Shoulder-to-Shoulder Race
Authors: Singeap Ana-Maria , Sfarti Catalin , Minea Horia , Chiriac Stefan , Cuciureanu Tudor , Nastasa Robert , Stanciu Carol , Trifan Anca
Published: November 2023

Traditional methods have their limitations when it comes to unraveling the mysteries of the small bowel, an area historically seen as the “black box” of the gastrointestinal tract. This is where capsule endoscopy and enteroscopy have stepped in, offering a remarkable synergy that transcends the sum of their individual capabilities. From their introduction, small bowel capsule endoscopy and device-assisted enteroscopy have consistently evolved and improved, both on their own and interdependently. Each technique’s history may be told as a success story, and their interaction has revolutionized the approach to the small bowel. Both have advantages that could be ideally combined into a perfect technique: safe, non-invasive, and capable of examining the entire small bowel, taking biopsies, and applying therapeutical interventions. Until the realization of this perfect tool becomes a reality, the key for an optimal approach lies in the right selection of exploration method. In this article, we embark on a journey through the intertwined development of capsule endoscopy and enteroscopy, exploring the origins, technological advancements, clinical applications, and evolving inquiries that have continually reshaped the landscape of small bowel imaging.
Biophysical Behavior of Very High-Power Short-Duration Radiofrequency Ablation in Pulmonary Vein Isolation: Fast but Gently—Implications for a Successful Procedure
Authors: Celentano Eduardo , Cristiano Ernesto , Ignatiuk Barbara , Bia Elena , Girotto Lorenzo , Tarantino Nicola , De Groot Natasja M. S.
Published: November 2023

The very high-power short-duration (vHP-SD) ablation strategy is an alternative for pulmonary vein isolation (PVI) in patients with paroxysmal atrial fibrillation (PAF). However, the acute procedural biophysical behavior of successful lesion creation by means of this technique is still unexplored. We performed a retrospective case–control study aimed at evaluating the behavior of vHP-SD ablation parameters with the QDOT MICRO™ ablation catheter (Biosense Webster) compared with standard radiofrequency (RF) ablation with the THERMOCOOL SMARTTOUCH® ablation catheter. Twenty consecutive cases of symptomatic PAF treated with the QDOT MICRO™ ablation catheter from December 2022 to March 2023 were compared with cases treated with the standard technique. The acute procedural success of PVI was obtained in all cases with 2192 RF applications, and no adverse events occurred. Compared with the controls, vHP-SD cases featured a significant reduction in procedural time (47 ± 10 vs. 56 ± 12 min, p = 0.023), total RF time (3.8 [CI 3.4–4.6] vs. 21.2 [CI 18.4–24.9] min, p < 0.001), ablation phase time (25 ± 5 vs. 39 ± 9 min, p < 0.001), and irrigation volume (165 [CI 139–185] vs. 404 [CI 336–472] ml, p < 0.001). In vHP-SD RF ablation, a contact force of 5 g minimum throughout the 4 s of RF application appeared to be statistically significant in terms of an impedance drop of at least 10 Ohm (OR 2.63 [CI 1.37; 5.07], p = 0.003). In contrast, in the control group, the impedance drop depended linearly on the contact force. This suggests a different biophysical behavior of vHP-SD ablation. A maximum temperature and minimum contact force of >5 g independently predicted an effective impedance drop in vHP-SD. Increasing the contact force over 5 g during 4 s of vHP RF application might not be necessary to achieve a successful lesion.
Risk Factors Associated with Postoperative Outcomes in Diverticular Disease Undergoing Elective Colectomy—A Retrospective Cohort Study from the ACS-NSQIP Database
Authors: Hu Wan-Hsiang , Eisenstein Samuel , Parry Lisa , Ramamoorthy Sonia
Published: November 2023

Recommendations for elective colectomies after recovery from uncomplicated acute diverticulitis should be individualized. The kinds of associated risk factors that should be considered for this approach remain undetermined. The aim of this study was to identify the risk factors associated with postoperative outcomes in patients with diverticular disease after receiving an elective colectomy. This is a retrospective study using the multi-institutional, nationally validated database of the American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP). The patients who were diagnosed with diverticular disease and received an elective colectomy were included in our risk factor analyses. Postoperative mortality, morbidity, and overall complications were measured. Univariate and multivariate analyses were used to demonstrate the risk factors. We analyzed 30,468 patients with diverticular disease, 67% of whom received an elective colectomy. The rate of 30-day mortality was 0.2%, and superficial surgical site infection was the most common postoperative morbidity (7.2%) in the elective colectomies. The independent risk factors associated with overall complications were age ≥ 75, BMI ≥ 30, smoking status, dyspnea, hypertension, current kidney dialysis, chronic steroid use, ASA III, and open colectomy. In laparoscopic colectomy, 67.5% of the elective colectomies, the associated risk factors associated with overall complications still included age ≥ 75, smoking, hypertension, chronic steroid use, and ASA III. Identification of patient-specific risk factors may inform the decision-making process for elective colectomy and reduce the postoperative complications after mitigation of those risk factors.
Articular Cartilage Reconstruction with Hyaluronate-Based Scaffold Significantly Decreases Pain and Improves Patient’s Functioning
Authors: Gryglewicz Jarosław , Chaszczewska-Markowska Monika , Dorochowicz Mateusz , Drożdż Jerzy , Dragan Szymon Łukasz
Published: November 2023

Articular cartilage lesions negatively affect patients’ well-being, causing severe pain and significantly limiting functioning. The purpose of this study was to evaluate the effectiveness of a one-stage reconstruction, performed arthroscopically using a hyaluronate-based scaffold. Pain reduction and functional improvement were assessed. The study also evaluated if postoperative vitamin D supplementation and rehabilitation protocol impact obtained outcomes. A group of 29 patients was included in a retrospective study. All the participants underwent arthroscopic reconstruction of osteochondral lesions using hyaluronate-based scaffolds. The study group used standard questionnaires to self-assess their condition before surgery and at the time of completion. Despite the aforementioned, all the participants fulfilled two original questionnaires on postoperative rehabilitation and vitamin D supplementation. Significant pain reduction (mean NRS 1.83 vs. 7.21, p < 0.0001) and functional improvement (mean Lysholm score 82.38 vs. 40.38, p < 0.0001; mean OKS 40.2 vs. 23.1, p < 0.0001) were found. No differences in pain reduction and functional improvement were seen between genders. The impact of post-operative rehabilitation and vitamin D supplementation on clinical outcomes was found to be statistically nonsignificant. The results obtained in this study clearly confirm the effectiveness of osteochondral reconstruction using hyaluronate-based scaffolds. The outcomes were equally favorable, regardless of postoperative rehabilitation and vitamin D supplementation.
“It’s Like Listening to the Radio with a Little Interference”: A Qualitative Study Describing Pain Management among Patients with Psoriatic Arthritis
Authors: Brodin Nina , Sundström Björn , Björk Mathilda , Swärdh Emma
Published: November 2023

Pain is one of the most important areas to focus on in the assessment and treatment of psoriatic arthritis (PsA), and treatment should be individualized and based on the needs of the patient. Therefore, our aim was to explore and describe the management of pain among patients with PsA. We conducted semi-structured interviews with 11 participants with PsA (3 men and 8 women) and used qualitative content analysis to analyze the text. The results showed a main overarching theme of meaning and three subthemes. They were ‘Taking charge of life despite the constant murmur of pain’ through ‘Sorting out vulnerability’, ‘Reaching acceptance and engagement’, and ‘Directing focus to change’. Nine categories further described the components of pain management: ‘face uncertainty for the future, ‘consider restrictions’, ‘illuminate the invisible’, ‘increase awareness’, ‘find a permissive environment and social support’, ‘enhance inner endurance’, ‘reformulate emotions and thoughts’, ‘use distracting activities’, and ‘adjust activities’. The action components of pain management interpreted from a theoretical perspective highlight the importance for the patients of attaining the satisfaction of three basic psychological needs, i.e., competence, autonomy, and relatedness. Health professionals therefore need to increase the skills required for needs-supportive behaviors as well as facilitating spouse and peer support in the management of pain in PsA.
Probiotics in Postoperative Pain Management
Authors: Fyntanidou Barbara , Amaniti Aikaterini , Soulioti Eleftheria , Zagalioti Sofia-Chrysovalantou , Gkarmiri Sofia , Chorti Angeliki , Loukipoudi Lamprini , Ioannidis Aris , Dalakakis Ioannis , Menni Alexandra-Eleftheria , Shrewsbury Anne , Kotzampassi Katerina
Published: November 2023

Postoperative pain is the unpleasant sensory and emotional experience after surgery, its origin being both the inflammatory reaction induced by the surgical trauma on the abdominal wall and the splanchnic pain induced by the activation of nociceptors of the viscera, which are highly sensitive to distension, ischemia, and inflammation. Nowadays, it is well recognized that there is a close relationship between the gut microbiome and pain perception, and that microbiome is highly affected by both anesthesia and surgical manipulation. Thus, efforts to restore the disturbed microbiome via supplementation with beneficial bacteria, namely probiotics, seem to be effective. In this article, the knowledge gained mainly from experimental research on this topic is analyzed, the concluding message being that each probiotic strain works in its own way towards pain relief.
Clinical and Biochemical Implications of Hyaluronic Acid in Musculoskeletal Rehabilitation: A Comprehensive Review
Authors: Iaconisi Giorgia Natalia , Gallo Nunzia , Caforio Laura , Ricci Vincenzo , Fiermonte Giuseppe , Della Tommasa Simone , Bernetti Andrea , Dolce Vincenza , Farì Giacomo , Capobianco Loredana
Published: November 2023

Hyaluronic acid (HA) naturally occurs as a biopolymer in the human body, primarily in connective tissues like joints and skin. Functioning as a vital element of synovial fluid, it lubricates joints, facilitating fluid movement and diminishing bone friction to protect articular well-being. Its distinctive attributes encompass notable viscosity and water retention capacities, ensuring flexibility and absorbing shock during motion. Furthermore, HA has gained significant attention for its potential benefits in various medical applications, including rehabilitation. Ongoing research explores its properties and functions, especially its biomedical applications in several clinical trials, with a focus on its role in improving rehabilitation outcomes. But the clinical and biochemical implications of HA in musculoskeletal rehabilitation have yet to be fully explored. This review thoroughly investigates the properties and functions of HA while highlighting its biomedical applications in different clinical trials, with a special emphasis on its role in rehabilitation. The presented findings provide evidence that HA, as a natural substance, enhances the outcomes of musculoskeletal rehabilitation through its exceptional mechanical and biochemical effects.
Unraveling Extremely Damaging IRAK4 Variants and Their Potential Implications for IRAK4 Inhibitor Efficacy
Authors: Behairy Mohammed Y. , Eid Refaat A. , Otifi Hassan M. , Mohammed Heitham M. , Alshehri Mohammed A. , Asiri Ashwag , Aldehri Majed , Zaki Mohamed Samir A. , Darwish Khaled M. , Elhady Sameh S. , El-Shaer Nahla H. , Eldeen Muhammad Alaa
Published: November 2023

Interleukin-1-receptor-associated kinase 4 (IRAK4) possesses a crucial function in the toll-like receptor (TLR) signaling pathway, and the dysfunction of this molecule could lead to various infectious and immune-related diseases in addition to cancers. IRAK4 genetic variants have been linked to various types of diseases. Therefore, we conducted a comprehensive analysis to recognize the missense variants with the most damaging impacts on IRAK4 with the employment of diverse bioinformatics tools to study single-nucleotide polymorphisms’ effects on function, stability, secondary structures, and 3D structure. The residues’ location on the protein domain and their conservation status were investigated as well. Moreover, docking tools along with structural biology were engaged in analyzing the SNPs’ effects on one of the developed IRAK4 inhibitors. By analyzing IRAK4 gene SNPs, the analysis distinguished ten variants as the most detrimental missense variants. All variants were situated in highly conserved positions on an important protein domain. L318S and L318F mutations were linked to changes in IRAK4 secondary structures. Eight SNPs were revealed to have a decreasing effect on the stability of IRAK4 via both I-Mutant 2.0 and Mu-Pro tools, while Mu-Pro tool identified a decreasing effect for the G198E SNP. In addition, detrimental effects on the 3D structure of IRAK4 were also discovered for the selected variants. Molecular modeling studies highlighted the detrimental impact of these identified SNP mutant residues on the druggability of the IRAK4 ATP-binding site towards the known target inhibitor, HG-12-6, as compared to the native protein. The loss of important ligand residue-wise contacts, altered protein global flexibility, increased steric clashes, and even electronic penalties at the ligand–binding site interfaces were all suggested to be associated with SNP models for hampering the HG-12-6 affinity towards IRAK4 target protein. This given model lays the foundation for the better prediction of various disorders relevant to IRAK4 malfunction and sheds light on the impact of deleterious IRAK4 variants on IRAK4 inhibitor efficacy.
Tacrolimus Maintains the Balance of Neutrophil Extracellular Traps by Inducing DNA Methylation of Neutrophils to Reduce Immune Rejection
Authors: Xu Liang , Cai Ming
Published: November 2023

Immune rejection is a significant concern in organ transplantation, as it can lead to damage to and failure of the transplanted organ. To prevent or treat immune rejection, transplant recipients are commonly administered immunosuppressive drugs. Tacrolimus (FK506) is a widely used immunosuppressive drug in organ transplantation. The excessive formation of neutrophil extracellular traps (NETs) can contribute to inflammation and tissue damage. Although NETs play an antimicrobial role, their overproduction can be harmful. To investigate the mechanism by which FK506 suppresses immune rejection, we utilized HL-60 cells, which were differentiated into neutrophils using DMSO and induced to form NETs with phorbol myristate acetate (PMA), a very efficient and frequently used drug for inducing NET formation. By comparing pre- and post-treatment with FK506, we examined whether FK506 affects the formation of NETs. Various experimental techniques were employed, including confocal imaging for visualizing cell NETs, qPCR and Western blotting for gene and protein expression analyses, ELISAs for protein content detection, and LC-MS/MS for methylation detection. In our study, we discovered that FK506 can enhance DNA methylation, which likely contributes to the reduction in NETs. Genes and proteins related to methylation, namely, DNMT3B and TET3, exhibited significant correlations with methylation. Consistent changes in both genes and proteins suggest that DNMT3B and TET3 are key factors that are influenced by FK506, resulting in enhanced DNA methylation and the potential inhibition of PMA-induced NET production. In summary, we have identified a novel mechanism by which FK506 inhibits NET production through the enhancement of DNA methylation. This finding highlights a new aspect of FK506′s immunosuppressive effect. Our results provide valuable insights for clinical research, immunosuppression, and organ preservation strategies.
Ephedra alata Seeds Confer Kidney Protection against Early Life Exposure to Acephate by Regulating Oxidative Insult and Activating Autophagy
Authors: Mufti Afoua , Feriani Anouar , Contreras María del Mar , Nehdi Saber , Hfaeidh Najla , Tlili Nizar , Harrath Abdel Halim
Published: November 2023

The aim of the current work was to examine for the first time the nephropreventive capacity of Ephedra alata seed extract (E) against maternal exposure to acephate in rat offspring. The in vivo results revealed that E. alata supplementation for 28 days (40 mg/kg b.w.) significantly attenuated the nephrotoxicity in adult offspring induced by acephate. In fact, it decreased the levels of creatinine and uric acid and increased the albumin content compared to the intoxicated group. The in utero studies showed that E. alata inhibited the renal oxidative stress generated by acephate exposure by reducing lipid peroxidation and enhancing antioxidant biomarker activities (GSH, CAT, and SOD). The inhibition of DNA fragmentation and the improvement of the ultrastructural changes highlighted the prophylactic effect of E. alata in renal tissue. Additionally, the immunofluorescence study showed the upregulation of LC3 gene expression, suggesting the capacity of E. alata extract to stimulate autophagic processes as a protective mechanism. Molecular docking analysis indicated that hexadecasphinganine, the major compound in E. alata, has a higher affinity toward the Na+/K+-ATPase, epithelial sodium channel (ENaC), and sodium hydrogen exchanger 3 (NHE3) genes than acephate. Hexadecasphinganine could be considered a potential inhibitor of the activity of these genes and therefore exerted its preventive capacity. The obtained findings confirmed that E. alata seed extract exerted nephropreventive capacities, which could be related to its bioactive compounds, which possess antioxidant activities.
Neural Mobilization for Reducing Pain and Disability in Patients with Lumbar Radiculopathy: A Systematic Review and Meta-Analysis
Authors: Lin Long-Huei , Lin Ting-Yu , Chang Ke-Vin , Wu Wei-Ting , Özçakar Levent
Published: November 2023

Lumbar radiculopathy causes lower back and lower extremity pain that may be managed with neural mobilization (NM) techniques. This meta-analysis aims to evaluate the effectiveness of NM in alleviating pain and reducing disability in patients with lumbar radiculopathy. We hypothesized that NM would reduce pain and improve disability in the lumbar radiculopathy population, leveraging the statistical power of multiple studies. Electronic databases from their inception up to October 2023 were searched for randomized controlled trials (RCTs) that explored the impact of NM on lumbar radiculopathy. Our primary outcome measure was the alteration in pain intensity, while the secondary one was the improvement of disability, standardized using Hedges’ g. To combine the data, we employed a random-effects model. A total of 20 RCTs comprising 877 participants were included. NM yielded a significant reduction in pain intensity (Hedges’ g = −1.097, 95% CI = −1.482 to −0.712, p < 0.001, I2 = 85.338%). Subgroup analyses indicated that NM effectively reduced pain, whether employed alone or in conjunction with other treatments. Furthermore, NM significantly alleviated disability, with a notable effect size (Hedges’ g = −0.964, 95% CI = −1.475 to −0.453, p < 0.001, I2 = 88.550%), particularly in chronic cases. The findings provide valuable insights for clinicians seeking evidence-based interventions for this patient population. This study has limitations, including heterogeneity, potential publication bias, varied causal factors in lumbar radiculopathy, overall study quality, and the inability to explore the impact of neural pathology on NM treatment effectiveness, suggesting opportunities for future research improvements.
Home-Based Virtual Reality Exergame Program after Stroke Rehabilitation for Patients with Stroke: A Study Protocol for a Multicenter, Randomized Controlled Trial
Authors: Kang Dongheon , Park Jiyoung , Eun Seon-Deok
Published: November 2023

It is essential for stroke patients to maintain their therapy even after discharging inpatient rehabilitation. This is because recovery is an ongoing process that requires consistent effort. Virtual reality exergame training (VRET) is becoming widely used in stroke rehabilitation to improve physical, social, and psychological outcomes. Home-based VRET may be a more convenient and accessible option for stroke rehabilitation. This study will aim to determine the effectiveness of home-based VRET for patients with stroke who have been discharged from the hospital. This trial will randomly assign 120 participants to 8 weeks of either a VRET (intervention group) or daily life (control group). The study will measure cardiopulmonary endurance, muscular strength, functional capacity, gait, activities of daily living, and quality of life. Our main objective is to determine whether it is safe for patients to undergo VRET at home after they have been discharged from the hospital with a doctor’s note. Additionally, we aim to examine whether stroke patients are capable of exercising at home after being discharged from the hospital. This study’s outcome could pave the way for developing more comprehensive exercise protocols for stroke patients. Our findings will provide valuable insights into the efficacy of VRET as a therapeutic tool for stroke patients.
Novel Principles and Methods in Bacterial Cell Cycle Physiology: Celebrating the Charles E. Helmstetter Prize in 2022
Authors: Norris Vic , Zaritsky Arieh
Published: November 2023

This Special Issue celebrates the creation of the Charles E [...]
A Study of Adult Olfactory Proteins of Primitive Ghost Moth, Endoclita signifer (Lepidoptera, Hepialidae)
Authors: Xiao Guipeng , Lu Jintao , Yang Zhende , Fu Hengfei , Hu Ping
Published: November 2023

Endoclita signifer is a prominent wood-boring insect species in eucalyptus plantations in Guangxi, China, causing significant ecological and economic damage. A novel approach to controlling the challenging wood-boring pest involves disrupting the olfactory communication between insects and the volatile compounds emitted by plants. To identify the olfactory proteins contributing to host selection based on 11 GC-EAD-active volatiles from eucalyptus leaves and to discover the highly expressed olfactory proteins, we conducted a study on the antennal transcriptomes of adult E. signifer and screened key olfactory proteins in the antennae. We identified a total of 69 olfactory proteins. When compared to the larval transcriptomes, the antennal transcriptome of adult E. signifer revealed the presence of 17 new odorant-binding proteins (OBPs), including 2 pheromone-binding proteins (PBPs), 7 previously unreported chemosensory proteins (CSPs), 17 new odorant receptors (ORs), 4 new gustatory receptors (GRs), 11 novel ionotropic receptors (IRs), and 2 sensory neuron membrane proteins (SNMPs). Through the phylogenetic tree of OBPs and ORs, we identified EsigPBP2 and EsigPBP3 as two of the three PBPs, designated EsigOR13 as EsigOrco, and recognized EsigOR10 and EsigOR22 as the newly discovered EsigPRs in E. signifer. In the adult antennae, the expression levels of EsigGOBP14, EsigGOBP13, EsigOBP14, EsigOBP17, EsigCSP14, and EsigOR16 were notably high, indicating that these proteins could be pivotal in binding to plant volatiles.
Corrosion Performance of Fe-Based Amorphous Coatings via Laser Cladding Assisted with Ultrasonic in a Simulated Marine Environment
Authors: Han Huawei , Xiao Mingying , Wang Qichen
Published: November 2023

Fe-based amorphous alloys are considered potential coating materials for applications in marine corrosive environments owing to their high resistance to chloride ion corrosion. Fe-based amorphous alloy (Fe41Co7Cr15Mo14C15B6Y2) was deposited on AISI 1020 steel using ultrasonic-assisted laser cladding. The research findings revealed a gradient structure generated at the junction of the coating and substrate. Ultrasonic promoted crystallization and increased the gradient structure’s average thickness, reducing coating surface cracks. However, ultrasonic had little effect on the amorphous content of the prepared coating surface, which still had a high amorphous content. The Fe-based amorphous coating prepared via laser cladding with ultrasonic demonstrated good corrosion resistance. The corrosion resistance of the coating without ultrasonic was reduced significantly due to cracks. EIS results confirmed that corrosion resistance was related to crystallization and crack issues. Cr element segregation due to crystallization hindered passivation film forming, reducing its corrosion resistance. Crack corrosion enlarged the crack gap and hollowed out the coating and the substrate’s binding zone, accelerating coating failure.