bluuebunny/crossref_metadata_2025 huggingface dataset:
Antidiabetic and Hypolipidemic Efficiency of Lactobacillus plantarum Fermented Oat (Avena sativa) Extract in Streptozotocin-Induced Diabetes in Rats
Authors: Algonaiman Raya , Alharbi Hend F. , Barakat Hassan
Published: June 2022

Antidiabetic properties of fermented foods have been previously demonstrated. This study aimed to examine the antidiabetic and hypolipidemic potential activities of L. plantarum fermented oat extract in Streptozotocin-induced diabetic rats. Firstly, inoculating 1% of L. plantarum starter culture in 10% whole oat flour in aqueous media resulted in 8.36 log CFU mL−1 and pH 4.60 after 72 h of fermentation at 37 °C. With time progression of oat fermentation, total phenolic content (TPC), antioxidant activity (AOA), and γ-aminobutyric acid (GABA) contents were significantly increased up to 72 h. On the contrary, a significant reduction in β-glucan content was observed only after 72 h of fermentation. Secondly, separated aqueous extracts, i.e., unfermented oat extract (UFOE) and L. plantarum fermented oat extract (LFOE) were examined in vivo in a rat model, which consisted of five groups. Group 1 (negative group, NR); GROUP 2 (positive group, STZ), intraperitoneally injected with a single dose of 45 mg kg−1 BW of Streptozotocin and administered 7 mL of distilled water orally per day; Group 3 (STZ+MET), diabetic rats orally administered 50 mg of metformin kg−1 BW daily; Group 4 (STZ+UFOE), diabetic rats orally administered 7 mL of UFOE daily; and Group 5 (STZ+UFOE), diabetic rats orally administered 7 mL of LFOE daily for 6 weeks. Monitoring random blood glucose (RBG) and fasting blood glucose (FBG) showed that both the UFOE and the LFOE alleviated hyperglycemia in the STZ-induced diabetic rats. The extracts were significantly efficient in improving serum lipid profiles as compared with the positive group. Moreover, liver and kidneys’ functions were improved, and both extracts promoted hepatoprotective and nephroprotective characteristics. Furthermore, the administration of the UFOE and the LFOE efficiently attenuated GSH, CAT, and SOD enzymes and decreased MDA levels as compared with the positive group. In conclusion, data indicate the potential of UFOE and LFOE in future strategies as functional supplements against diabetes and diabetes-related complications.
Supplementation of Labneh with Passion Fruit Peel Enhanced Survival of E. coli Nissle 1917 during Simulated Gastrointestinal Digestion and Adhesion to Caco-2 Cells
Authors: Darwish Mohamed Samir , Abou-Zeid Noha A. , Khojah Ebtihal , AL Jumayi Huda A. , Alshehry Garsa A. , Algarni Eman H. , Elawady Asmaa A.
Published: June 2022

Passion fruit peel powder (PFPP) was used to supplement the probiotic labneh to increase the activity of Escherichia coli Nissle 1917 (EcN) during production and storage. Labneh was manufactured with PFPP (0.5% and 1%) and analyzed at 0, 7, and 15 days of cold storage for postacidification and sensory properties and viability of EcN, survival of EcN to simulated gastrointestinal tract stress, and adhesion potential of EcN to Caco-2 cells. Acidification kinetics during fermentation showed that supplementation with PFPP reduced the time needed to decrease pH and reach the maximum acidification rate. PFPP addition contributed to postacidification of labneh during storage. PFPP had a beneficial effect (p < 0.05) on counts of EcN in labneh during different storage periods. Consumer preference expectations for labneh enriched with PFPP (0.5% and 1%) were higher than those for the control. PFPP provided a significant protective action for EcN during simulated gastrointestinal transit and had a positive effect on EcN adhesion to Caco-2 cells in vitro, although this decreased during storage with labneh. Labneh supplementation with PFPP can be recommended because of the positive effect on EcN viability and the high nutritional value, which may increase the appeal of the product to consumers.
H1299R Variant in Factor V and Recurrent Pregnancy Loss: A Systematic Review and Meta-Analysis Protocol
Authors: Ardizzone Alessio , Capra Anna Paola , Mondello Stefania , Briuglia Silvana , La Rosa Maria Angela , Campolo Michela , Esposito Emanuela
Published: June 2022

Recurrent pregnancy loss (RPL) is defined as the loss of two or more pregnancies, affecting approximately 1 to 3% of women worldwide. Scientific data highlight a possible correlation between thrombophilic genetic variants and RPL. H1299R variant in the factor V gene would lead to an increased thrombotic risk associated with frequent miscarriages. However, the data are often conflicting, making this an interesting question for further investigations by evaluating genotype-phenotype correlations to improve the clinical management and genetic counseling of couples. A systematic review and meta-analysis will follow the preferred reporting elements for systematic review and meta-analysis protocols (PRISMA-P). The Pubmed (MEDLINE) and Embase (OVID) databases will be explored to identify suitable articles based on inclusion and exclusion criteria. Inclusion criteria are: (a) H1299R genotyping with clear data reported, referred to as Heterozygous (Het) and/or Homozygous (Hom); (b) articles written in English; (c) analyses of only RPL female patients having at least two or more previous pregnancy losses and compared with a control group. This analysis will present selected scientific evidence, addressing the questions concerning the association between the H1299R variant and RPL, hoping to clarify this still unresolved issue. PROSPERO registration number: CRD42022330077.
MDSCMF: Matrix Decomposition and Similarity-Constrained Matrix Factorization for miRNA–Disease Association Prediction
Authors: Ni Jiancheng , Li Lei , Wang Yutian , Ji Cunmei , Zheng Chunhou
Published: June 2022

MicroRNAs (miRNAs) are small non-coding RNAs that are related to a number of complicated biological processes, and numerous studies have demonstrated that miRNAs are closely associated with many human diseases. In this study, we present a matrix decomposition and similarity-constrained matrix factorization (MDSCMF) to predict potential miRNA–disease associations. First of all, we utilized a matrix decomposition (MD) algorithm to get rid of outliers from the miRNA–disease association matrix. Then, miRNA similarity was determined by utilizing similarity kernel fusion (SKF) to integrate miRNA function similarity and Gaussian interaction profile (GIP) kernel similarity, and disease similarity was determined by utilizing SKF to integrate disease semantic similarity and GIP kernel similarity. Furthermore, we added L2 regularization terms and similarity constraint terms to non-negative matrix factorization to form a similarity-constrained matrix factorization (SCMF) algorithm, which was applied to make prediction. MDSCMF achieved AUC values of 0.9488, 0.9540, and 0.8672 based on fivefold cross-validation (5-CV), global leave-one-out cross-validation (global LOOCV), and local leave-one-out cross-validation (local LOOCV), respectively. Case studies on three common human diseases were also implemented to demonstrate the prediction ability of MDSCMF. All experimental results confirmed that MDSCMF was effective in predicting underlying associations between miRNAs and diseases.
Near-Hexaploid and Near-Tetraploid Aneuploid Progenies Derived from Backcrossing Tetraploid Parents Hibiscus syriacus × (H. syriacus × H. paramutabilis)
Authors: Chen Hsuan , Contreras Ryan N.
Published: June 2022

Hibiscus syriacus, azalea, is an important woody ornamental shrub planted throughout many temperate and subtropical regions of the world. However, flower size is smaller in this species than some of its relatives. To increase flower size, interspecific hybridization has been used, and such hybrid cultivars are usually characterized by larger flowers, increased vigor, diverse leaf shapes, and reduced fertility. Our earlier studies have shown that these hybrid cultivars could backcross with H. syriacus when used as male parents. To understand the breeding potential of these hybrid cultivars, two popular tetraploid hybrid cultivars, ‘Lohengrin’ and ‘Resi’, were used as pollen parents to backcross several tetraploid H. syriacus cultivars. As a result, 28.76% and 64.4% of ‘Lohengrin’ and ‘Resi’ progenies exhibited larger flowers than both of their parents. Interestingly, 14 of 18 progenies of ‘Resi’ were putative hexaploids, whereas 19 tested ‘Lohengrin’ progenies were tetraploid. Because putative hexaploid progenies were only observed among progenies of ‘Resi’, this hybrid cultivar appears to produce unreduced gametes. In addition, among the 14 putative hexaploids derived from ‘Resi’, 11 had larger flowers than both of their parents and their tetraploid siblings (p < 0.05). The 45S rDNA and 5S rDNA locus segregation among those BC1F1 progenies was tested by fluorescent in situ hybridization (FISH), and the wide range of 45S rDNA signal numbers among siblings indicated that these aneuploids resulted from unequal segregation or chromosome rearrangement. Chromosome counting confirmed aneuploidy among BC1F1 progenies. Ploidy diversity and aneuploidy have been known to contribute to various elements of morphological diversity, such as larger flower size and reduced fertility, which are important in ornamental plant breeding. The present study demonstrated the breeding potential of interspecific Hibiscus cultivars for increasing ploidy level and flower size.
Effect of Temperature and Photoperiod Preconditioning on Flowering and Yield Performance of Three Everbearing Strawberry Cultivars
Authors: Rivero Rodmar , Remberg Siv Fagertun , Heide Ola M. , Sønsteby Anita
Published: June 2022

Environmental control of flowering in everbearing strawberry is well known, while the optimal commercial raising conditions for high and continuous yield remains unsettled. We exposed freshly rooted plants of cultivars Altess, Favori and Murano to 9 °C, 15 °C, 21 °C and 27 °C, respectively, at two photoperiods for 4 weeks, and assessed flowering and yield performance. Long days at 15–21 °C enhanced flowering, while short days (SD), particularly at 27 °C, decreased flowering. Runner formation was enhanced by SD, being inversely related to flowering. Yields the next season were highest in plants exposed to 15–21 °C, whereas the seasonal harvest distribution varied. In concurrence with earlier reports, the size of the first fruit flush determined the magnitude of the second flush and the length of the off period when little fruit was produced. The large first fruiting flushes of plants exposed to 21 and 27 °C gave particularly long off periods and small second flushes. Moderate first flushes of plants from intermediate temperatures also resulted in a more evenly distributed harvest and the largest yields. Developing flowers and fruits are strong sinks for photosynthates; therefore, the size of the first fruit flush must be compromised to optimize fruit yield and seasonal crop distribution.
Survey of Viruses Infecting Tomato, Cucumber and Mung Bean in Tajikistan
Authors: Chan Yuan-Li , Saidov Nurali , Lee Li-Mei , Kuo Fu-Hsun , Shih Su-Ling , Kenyon Lawrence
Published: June 2022

Viral diseases are major constraints to tomato, cucumber and mung bean production in most areas where these crops are grown. To identify the viruses on the crops in Tajikistan, a field survey was conducted in 2019. Samples of cucumber, mung bean and tomato with virus-like symptoms were collected and the viruses present were diagnosed by RT-PCR and PCR. Across all the samples, a very high proportion of the samples were infected with viruses from the genera Cucumovirus and Potyvirus. Cucumber mosaic virus (CMV; Cucumovirus) was very common in the collected samples of the three crops. As for Potyvirus, Potato virus Y (PVY) was detected in the collected tomato samples, Zucchini yellow mosaic virus (ZYMV) was identified in the collected cucumber samples, and Bean common mosaic virus (BCMV) was detected in 53% of the mung bean samples. Over 68% of the collected samples were infected with two or more viruses, suggesting that mixed infections are common for the three crops. Due to the results that the most identified viruses for the three crops are transmitted by aphids, the management of aphids is extremely important for the production of tomato, cucumber and mung bean in Tajikistan.
Mesenteric Lymphadenitis Presenting as Acute Abdomen in a Child with Multisystem Inflammatory Syndrome
Authors: Blevrakis Evangelos , Vergadi Eleni , Stefanaki Maria , Alexiadi-Oikonomou Iris , Rouva Glykeria , Germanakis Ioannis , Galanakis Emmanouil
Published: June 2022

Multisystem inflammatory syndrome in children (MIS-C) may develop as a rare complication following COVID-19. MIS-C presentation varies substantially, but fever and gastrointestinal symptoms are the most prominent. Indeed, gastrointestinal involvement may be severe enough to present as acute abdomen, posing challenges to clinicians. We present herein the case of a healthy five-year-old male who presented with fever, vomiting, and abdominal pain, resembling acute abdomen. The patient had no history of SARS-CoV-2 infection or exposure, and MIS-C diagnosis was initially surpassed unnoticed. The patient underwent exploratory laparotomy that only revealed mesenteric lymphadenitis. Postoperatively, the patient met the clinical and laboratory diagnostic criteria of MIS-C. SARS-CoV-2 exposure was serologically confirmed and MIS-C treatment was commenced, resulting in defervescence and a satisfactory outcome. In young patients presenting with acute abdomen, surgeons should be aware of MIS-C, so that earlier diagnosis and appropriate treatment are made prior to surgical interventions.
GIS and Machine Learning for Analysing Influencing Factors of Bushfires Using 40-Year Spatio-Temporal Bushfire Data
Authors: He Wanqin , Shirowzhan Sara , Pettit Christopher James
Published: June 2022

The causes of bushfires are extremely complex, and their scale of burning and probability of occurrence are influenced by the interaction of a variety of factors such as meteorological factors, topography, human activity and vegetation type. An in-depth understanding of the combined mechanisms of factors affecting the occurrence and spread of bushfires is needed to support the development of effective fire prevention plans and fire suppression measures and aid planning for geographic, ecological maintenance and urban emergency management. This study aimed to explore how bushfires, meteorological variability and other natural factors have interacted over the past 40 years in NSW Australia and how these influencing factors synergistically drive bushfires. The CSIRO’s Spark toolkit has been used to simulate bushfire burning spread over 24 h. The study uses NSW wildfire data from 1981–2020, combined with meteorological factors (temperature, precipitation, wind speed), vegetation data (NDVI data, vegetation type) and topography (slope, soil moisture) data to analyse the relationship between bushfires and influencing factors quantitatively. Machine learning-random forest regression was then used to determine the differences in the influence of bushfire factors on the incidence and burn scale of bushfires. Finally, the data on each influence factor was imported into Spark, and the results of the random forest model were used to set different influence weights in Spark to visualise the spread of bushfires burning over 24 h in four hotspot regions of bushfire in NSW. Wind speed, air temperature and soil moisture were found to have the most significant influence on the spread of bushfires, with the combined contribution of these three factors exceeding 60%, determining the spread of bushfires and the scale of burning. Precipitation and vegetation showed a greater influence on the annual frequency of bushfires. In addition, burn simulations show that wind direction influences the main direction of fire spread, whereas the shape of the flame front is mainly due to the influence of land classification. Besides, the simulation results from Spark could predict the temporal and spatial spread of fire, which is a potential decision aid for fireproofing agencies. The results of this study can inform how fire agencies can better understand fire occurrence mechanisms and use bushfire prediction and simulation techniques to support both their operational (short-term) and strategic (long-term) fire management responses and policies.
Efficacy and Safety of a Combined Aerobic, Strength and Flexibility Exercise Training Program in Patients with Implantable Cardiac Devices
Authors: Squeo Maria Rosaria , Di Giacinto Barbara , Perrone Marco Alfonso , Santini Massimo , Sette Maria Luisa , Fabrizi Emanuele , Vaquer Antonia , Parisi Attilio , Spataro Antonio , Biffi Alessandro
Published: June 2022

Purpose: The “FIDE Project” (Fitness Implantable DEvice) was organized by the Institute of Sports Medicine and Science and the World Society of Arrhythmias with the aim of demonstrating the usefulness of exercise training in improving functional capacity in patients with implantable cardiac devices. Materials and Methods: Thirty sedentary patients were selected for the project (25 males and 5 females), with a mean age of 73 ± 5 years (range 44–94 years). Twenty-five were implanted with a Pacemaker (PM) and five with an Implantable Cardioverter Defibrillator (ICD). Atrial fibrillation/atrial flutter was present in ten (34%) patients, post-ischemic dilated cardiomyopathy in five (17.2%), sick sinus syndrome in six (20,7%), complete atrium-ventricular block in six (20.7%), hypertrophic cardiomyopathy in one (3.4%) and recurrent syncope in one (3.4%). The baseline assessment comprised cardiovascular examination, resting and stress ECG, cardiopulmonary exercise testing (V ̇O2peak), strength assessment of different muscle groups, and a flexibility test. The same measurements were repeated after 15–20 consecutive training sessions, over a 2-month period. The exercise prescription was set to 70–80% of HRR (Heart rate reserve) and to 50–70% of 1RM (1-repetition maximum, muscular force). The training protocol consisted of two training sessions per week performed in our institute, 90 min for each (warm-up, aerobic phase, strength phase and stretching) and one or more at home autonomously. Results: The cardiopulmonary testing after the training period documents a significant improvement in V ̇O2peak (15 ± 4 mL/kg/min vs. 17 ± 4; p = 0.001) and in work load (87 ± 30 watts vs. 108 ± 37; p = 0.001). Additionally, strength capacity significantly increased after the cardiac rehabilitation program, (quadriceps: 21 ± 18 kg vs. 29 ± 16 kg, p = 0.00003). Flexibility tests show a positive trend, but without statistical significance (sit-and-reach test: −19 ± 11 cm vs. −15 ± 11.7 cm; back-scratch test: −19 ± 11.6 cm vs. −15 ± 10 cm; lateral flexibility right −44 ± 1.4 cm vs. −43 ± 9.5 cm; left −43 ± 5 vs. −45 ± 8.7 cm). Conclusion: A brief period of combined aerobic, strength and flexibility exercise training (FIDE project) proved to be effective and safe in improving functional capacity in patients with cardiac implantable devices.
Hypertriglyceridemia and Other Risk Factors of Chronic Kidney Disease in Type 2 Diabetes: A Hospital-Based Clinic Population in Greece
Authors: Migdalis Ilias , Ioannidis Ioannis , Papanas Nikolaos , Raptis Athanasios , Sotiropoulos Alexios , Dimitriadis George ,   on behalf of the Hellenic Diabetic Nephropathy Study (HDNS)
Published: June 2022

Aims/Introduction: Several reports indicate an increasing prevalence of chronic kidney disease (CKD) in type 2 diabetes mellitus (T2DM). Hyperglycemia and hypertension are the main risk factors for CKD development and progression. However, despite the achievement of recommended targets for blood glucose and blood pressure (BP), the residual risk of diabetic chronic kidney disease (DCKD) remains relatively high. The aim of this study is to examine dyslipidemia and other major risk factors to provide support for the prevention and treatment of DCKD. Materials and Methods: Participants are from the Redit-2-Diag study that examines 1759 subjects within a period of 6 months. DCKD severity is staged according to KDIGO criteria. Results: An increase in hemoglobin A1c (1 unit) and systolic blood pressure (1 mm Hg) increases the probability of being classified into a higher CKD stage by 14% and 26%, respectively. Moreover, an increase of triglycerides by 88.5 mg/dL increases the risk of classification to a worse CKD stage by 24%. Conclusions: Elevated triglycerides, systolic blood pressure, and poor glycemic control increase the risk of CKD in T2DM and should be addressed in the treatment strategies.
Sneaky Diagnosis of Pleural Malignant Mesothelioma in Thoracic Surgery: All That Glitters Is Not Gold
Authors: Orlandi Riccardo , Bono Francesca , Cortinovis Diego , Cardillo Giuseppe , Cioffi Ugo , Guttadauro Angelo , Pirondini Emanuele , Canova Stefania , Cassina Enrico , Raveglia Federico
Published: June 2022

Malignant Pleural Mesothelioma (MPM) is a highly aggressive disease whose diagnosis could be challenging and confusing. It could occur with atypical presentations on every examined level. Here, we present three unconventional cases of the complex diagnostic process of MPM that we have experienced during routine practice: a patient with reactive mesothelial hyperplasia mimicking MPM, an unexpected presentation of MPM with persistent unilateral hydropneumothorax, a rare case of MPM in situ. Then, we review the relevant literature on each of these topics. Definitive biomarkers to confidently distinguish MPM from other pleural affections are still demanded. Patients presenting with persistent hydropneumothorax must always be investigated for MPM. MPM in situ is now a reality, and this raises questions about its management.
Time-Limited Therapy with Belatacept in Kidney Transplant Recipients
Authors: Letellier Thibault , Kervella Delphine , Sadek Abderrahmane , Masset Christophe , Garandeau Claire , Fourgeux Cynthia , Gourain Victor , Poschmann Jeremie , Blancho Gilles , Ville Simon ,   on behalf of the Divat Consortium
Published: June 2022

Introduction: In kidney transplant recipients, belatacept is usually pursued indefinitely after it has been started. In the setting of the belatacept shortage and after having evaluated the benefit–risk ratio, we established a strategy consisting of time-limited belatacept therapy/transient calcineurin inhibitor withdrawal, whose results are analyzed in that study. Methods: We considered all the kidney transplant recipients that had been switched from conventional immunosuppressive therapy to belatacept and then for whom belatacept has been withdrawn intentionally. Furthermore, in the first 8 patients, we assessed changes in peripheral blood mononuclear cells (PBMC) transcriptome using RNAseq before and 3 months after belatacept withdrawal. Results: Over the study period, 28 out of 94 patients had belatacept intentionally withdrawn including 25 (89%) switched to low-dose CNI. One rejection due to poor compliance occurred. The eGFR after 12 months remained stable from 48 ± 19 mL.1.73 m−2 to 46 ± 17 mL.1.73 m−2 (p = 0.68). However, patients that resumed belatacept/withdrew CNIs (n = 10) had a trend towards a better eGFR comparing with the others (n = 15): 54 ± 20 mL.1.73 m−2 vs. eGFR 43 ± 16 mL.1.73 m−2, respectively (p = 0.15). The only factor associated with belatacept resumption was when the withdrawal took place during the COVID-19 outbreak. Transcriptome analysis of PBMCs, did not support rebound in alloimmune response. Conclusions: These findings underpin the use of belatacept as part of a time-limited therapy, in selected kidney transplant recipients, possibly as an approach to allow efficient vaccination against SARS-CoV-2.
Predictors and Consequences of Sac Shrinkage after Endovascular Infrarenal Aortic Aneurysm Repair
Authors: Vedani Sébastien Michel , Petitprez Séverine , Weinz Eva , Corpataux Jean-Marc , Déglise Sébastien , Deslarzes-Dubuis Céline , Côté Elisabeth , Ricco Jean-Baptiste , Saucy François
Published: June 2022

Background: Aneurysm shrinkage has been proposed as a marker of successful endovascular aneurysm repair (EVAR). We evaluated the impact of sac shrinkage on secondary interventions, on survival and its association with endoleaks, and on compliance with instructions for use (IFU). Methods: This observational retrospective study was conducted on all consecutive patients receiving EVAR for an infrarenal abdominal aortic aneurysm (AAA) using exclusively Endurant II/IIs endograft from 2014 to 2018. Sixty patients were entered in the study. Aneurysm sac shrinkage was defined as decrease ≥5 mm of the maximum aortic diameter. Univariate methods and Kaplan–Meier plots assessed the potential impact of shrinkage. Results: Twenty-six patients (43.3%) experienced shrinkage at one year, and thirty-four (56.7%) had no shrinkage. Shrinkage was not significantly associated with any demographics or morbidity, except hypertension (p = 0.01). No aneurysm characteristics were associated with shrinkage. Non-compliance with instructions for use (IFU) in 13 patients (21.6%) was not associated with shrinkage. Three years after EVAR, freedom from secondary intervention was 85 ± 2% for the entire series, 92.3 ± 5.0% for the shrinkage group and 83.3 ± 9% for the no-shrinkage group (Logrank: p = 0.49). Survival at 3 years was not significantly different between the two groups (85.9 ± 7.0% vs. 79.0 ± 9.0%, Logrank; p = 0.59). Strict compliance with IFU was associated with less reinterventions at 3 years (92.1 ± 5.9% vs. 73.8 ± 15%, Logrank: p = 0.03). Similarly, survival at 3 years did not significantly differ between strict compliance with IFU and non-compliance (81.8 ± 7.0% vs. 78.6 ± 13.0%, Logrank; p = 0.32). Conclusion: This study suggests that shrinkage ≥5 mm at 1-year is not significantly associated with a better survival rate or a lower risk of secondary intervention than no-shrinkage. In this series, the risk of secondary intervention regardless of shrinkage seems to be linked more to non-compliance with IFU. Considering the small number of patients, these results must be confirmed by extensive prospective studies.
Relationship between the Use of Fentanyl-Based Intravenous Patient-Controlled Analgesia and Clinically Significant Events in Laparoscopic Gynecological Surgery: A Single-Center Retrospective Cohort Study
Authors: Hamada Miho , Takeda Chikashi , Dong Li , Hirotsu Akiko , Shizuya Izumi , Mizota Toshiyuki
Published: June 2022

Background: This study examined the relationship between the use of fentanyl-based intravenous patient-controlled analgesia (ivPCA) and the incidence of a clinically significant event (CSE), while considering both the analgesic effects and side effects in laparoscopic gynecological surgery. Methods: This study included 816 patients undergoing laparoscopic gynecological surgery under general anesthesia at Kyoto University Hospital between 2012 and 2018. The primary exposure was the use of fentanyl-based ivPCA. We defined an outcome measure—CSE—that integrates severe wound pain and vomiting assumed to negatively affect patient recovery. We performed multivariable logistic regression analysis to assess the independent relationship between ivPCA use and CSE. Results: Multivariable logistic regression analysis revealed that fentanyl-based ivPCA was independently associated with increased CSE (adjusted odds ratio (95% confidence interval): 1.80 (1.24–2.61), p = 0.002). Use of ivPCA was associated with a reduced incidence of postoperative severe wound pain (adjusted odds ratio (95% confidence interval): 0.50 (0.27–0.90), p = 0.022), but was also associated with an increased incidence of vomiting (adjusted odds ratio (95% confidence interval): 2.65 (1.79–3.92), p < 0.001). Conclusion: The use of fentanyl-based ivPCA in laparoscopic gynecological surgery is associated with increased CSE.
The European Institute of Oncology Thyroid Imaging Reporting and Data System for Classification of Thyroid Nodules: A Prospective Study
Authors: De Fiori Elvio , Lanza Carolina , Carriero Serena , Tettamanzi Francesca , Frassoni Samuele , Bagnardi Vincenzo , Mauri Giovanni
Published: June 2022

Background: To evaluate the performance, quality and effectiveness of “IEO-TIRADS” in assigning a TI-RADS score to thyroid nodules (TN) when compared with “EU-TIRADS” and the US risk score calculated with the S-Detect software (“S-Detect”). The primary objective is the evaluation of diagnostic accuracy (DA) by “IEO-TIRADS”, “S-Detect” and “EU-TIRADS”, and the secondary objective is to evaluate the diagnostic performances of the scores, using the histological report as the gold standard. Methods: A radiologist collected all three scores of the TNs detected and determined the risk of malignancy. The results of all the scores were compared with the histological specimens. The sensitivity (SE), specificity (SP), and diagnostic accuracy (DA), with their 95% confidence interval (95% CI), were calculated for each method. Results: 140 TNs were observed in 93 patients and classified according to all three scores. “IEO-TIRADS” has an SE of 73.6%, an SP of 59.2% and a DA of 68.6%. “EU-TIRADS” has an SE of 90.1%, an SP of 32.7% and a DA of 70.0%. “S-Detect” has an SE of 67.0%, an SP of 69.4% and a DA of 67.9%. Conclusion: “IEO-TIRADS” has a similar diagnostic performance to “S-Detect” and “EU-TIRADS”. Providing a comparable DA with other reporting systems, IEO-TIRADS holds the potential of being applied in clinical practice.
Colistin Monotherapy versus Colistin plus Meropenem Combination Therapy for the Treatment of Multidrug-Resistant Acinetobacter baumannii Infection: A Meta-Analysis
Authors: Huang Chienhsiu , Chen Ihung , Tang Tiju
Published: June 2022

(1) Introduction: Colistin combination therapy with other antibiotics is a way to enhance colistin activity. The purpose of this meta-analysis was to compare the efficacy and safety of treatment with colistin monotherapy versus colistin plus meropenem combination therapy in patients with drug-resistant Acinetobacter baumannii infection. (2) Methods: All studies were included if they reported one or more of the following outcomes: clinical improvement, complete microbiological response, 14-day mortality, hospital mortality, or nephrotoxicity. (3) Results: Three randomized controlled trials and seven retrospective studies were included in the meta-analysis. Colistin monotherapy has similar rates of clinical improvement, 14-day mortality, hospital mortality, and nephrotoxicity as colistin plus meropenem combination therapy. Regarding complete microbiological response, the colistin plus meropenem combination was better than colistin monotherapy. (4) Discussion: Previous meta-analyses demonstrated heterogeneity in study quality and a lack of evidence supporting the use of colistin-based combination therapy. Our meta-analysis clearly showed that colistin combined with meropenem was not superior to colistin monotherapy for the treatment of Acinetobacter baumannii infection. (5) Conclusions: The efficacy and safety of treatment with colistin monotherapy and that of colistin plus meropenem combination therapy in patients with drug-resistant Acinetobacter baumannii infection were comparable. The majority of the evidence was obtained from nonrandomized studies, and high-quality randomized controlled trials are needed to confirm the role of colistin plus meropenem combination therapy in the treatment of multidrug-resistant Acinetobacter baumannii infection.
Quality of Life in the First Year after Ischemic Stroke Treated with Acute Revascularization Therapy
Authors: Do Rego Aboudou Matinou , Duloquin Gauthier , Sauvant Marie , Amaral Simon , Thomas Quentin , Devilliers Hervé , Béjot Yannick
Published: June 2022

(1) Background: we aimed to describe the disease-specific quality of life (QoL) of ischemic stroke patients treated with acute revascularization therapy, its evolution from 6 months to 12 months, and associated factors. (2) Methods: QoL was assessed with the SS-QoL in consecutive patients treated with either intravenous thrombolysis (IVT) and/or mechanical thrombectomy (MT). Variables associated with QoL scores and its evolution were studied using multivariate mixed models, and interaction with time. Analyses were performed in four domains of SS-QoL: self-care, mobility, mood, and social roles. (3) Results: Among the 501 included patients (mean (sd) age 68.9 (14.5), 49% women), lower post-stroke QoL was independently related to lower level of school education, prestroke mRS > 2, and 24 h NIHSS score > 4. Independent predictors of unfavorable evolution of QoL over time were age <75 years (Mobility p = 0.0194 and Mood p = 0.0015), NIHSS score ≤ 4, (Self-care p = 0.0053 and Mood p = 0.0048), and modified Rankin Scale score ≤ 2 (Social roles, p = 0.0006). Revascularization therapy had no significant effect on the QoL scores, but patients treated with MT (alone or as bridging therapy) had significantly greater improvement in mobility score between 6 and 12 months than patients treated with IVT alone (p = 0.0072). (4) Conclusion: QoL evolution over one year had only slight variation and was associated with the modalities of acute treatment, age, and stroke severity.
In Search for the Missing Link in APECED-like Conditions: Analysis of the AIRE Gene in a Series of 48 Patients
Authors: Fierabracci Alessandra , Belcastro Eugenia , Carbone Elena , Pagliarosi Olivia , Palma Alessia , Pacillo Lucia , Giancotta Carmela , Zangari Paola , Finocchi Andrea , Cancrini Caterina , Delfino Domenico Vittorio , Cappa Marco , Betterle Corrado
Published: June 2022

Autoimmune diseases are a heterogeneous group of disorders of the immune system. They can cluster in the same individual, revealing various preferential associations for polyendocrine autoimmune syndromes. Clinical observation, together with advances in genetics and the understanding of pathophysiological processes, has further highlighted that autoimmunity can be associated with immunodeficiency; autoimmunity may even be the first primary immunodeficiency manifestation. Analysis of susceptibility genes for the development of these complex phenotypes is a fundamental issue. In this manuscript, we revised the clinical and immunologic features and the presence of AIRE gene variations in a cohort of 48 patients affected by high polyautoimmunity complexity, i.e., APECED-like conditions, also including patients affected by primary immunodeficiency. Our results evidenced a significant association of the S278R polymorphism of the AIRE gene with APECED-like conditions, including both patients affected by autoimmunity and immunodeficiency and patients with polyautoimmunity compared to healthy controls. A trend of association was also observed with the IVS9+6 G>A polymorphism. The results of this genetic analysis emphasize the need to look for additional genetic determinants playing in concert with AIRE polymorphisms. This will help to improve the diagnostic workup and ensure a precision medicine approach to targeted therapies in APECED-like patients.
Characterization of Choroidal Morphology and Vasculature in the Phenotype of Pachychoroid Diseases by Swept-Source OCT and OCTA
Authors: Qiu Bingjie , Zhang Xinyuan , Li Zhiqing , Chhablani Jay , Fan Hao , Wang Yanhong , Xie Rui
Published: June 2022

The objective of this study was to characterize the choroidal morphology and vasculature in pachychoroid diseases (PCD). A total of 49 eyes with polypoidal choroidal vasculopathy (PCV), 43 eyes with neovascular age-related macular degeneration (nAMD), and 50 eyes with central serous chorioretinopathy (CSC), along with 80 healthy eyes, were enrolled in this nested case-control study. The swept-source optical coherent tomography (OCT), OCT angiography, and En face images were quantitatively analyzed. Multivariate logistic regression models showed that older age and increased vessel density (VD) in the choriocapillaris (CC) layer were independent risk factors for both PCV (page < 0.001, pVD = 0.004), and nAMD (page < 0.001, pVD = 0.005). Decreased VD in the Sattler’s layer was an independent risk factor for PCV (p = 0.014). Increased VD in the Haller’s layer was an independent risk factor for CSC (p = 0.001). The proportion of the diffuse type of collateral circulation in the Sattler’ layer in CSC group was significantly higher than in the other three groups (p < 0.001). We concluded that the involvement of the blood flow in the CC, Haller’s, and Sattler’s layers are differently affected in CSC, nAMD, and PCV eyes, indicating the different pathological mechanism underlying the phenotype of PCD. The age-dependent establishment of collateral circulation in the Sattler’s layer may play a compensatory role regarding ischemic injury in the development of PCD.
Blood Biomarkers of Response to Immune Checkpoint Inhibitors in Non-Small Cell Lung Cancer
Authors: Alfranca Yolanda Lage , Garcia María Eugenia Olmedo , Rueda Ana Gómez , Ballesteros Pablo Álvarez , Rodríguez Diana Rosero , Velasco Marisa Torres
Published: June 2022

Immune checkpoint inhibitors (ICIs) have revolutionized the treatment landscape of non-small cell lung cancer (NSCLC), either used in monotherapy or in combination with chemotherapy. While some patients achieve durable responses, some will not get benefit from this treatment. Early identification of non- responder patients could avoid unnecessary treatment, potentially serious immune-related adverse events and reduce treatment costs. PD-L1 expression using immunohistochemistry is the only approved biomarker for the selection of patients that can benefit from immunotherapy. However, application of PD-L1 as a biomarker of treatment efficacy shows many deficiencies probably due to the complexity of the tumor microenvironment and the technical limitations of the samples. Thus, there is an urgent need to find other biomarkers, ideally blood biomarkers to help us to identify different subgroups of patients in a minimal invasive way. In this review, we summarize the emerging blood-based markers that could help to predict the response to ICIs in NSCLC.
Proprotein Convertase Subtilisin/Kexin Type 9 Inhibitors Use for Atherogenic Dyslipidemia in Solid Organ Transplant Patients
Authors: Cuomo Gianluigi , Cioffi Giuseppe , Di Lorenzo Anna , Iannone Francesca Paola , Cudemo Giuseppe , Iannicelli Anna Maria , Pacileo Mario , D’Andrea Antonello , Vigorito Carlo , Iannuzzo Gabriella , Giallauria Francesco
Published: June 2022

Dyslipidemia is a widespread risk factor in solid organ transplant patients, due to many reasons, such as the use of immunosuppressive drugs, with a consequent increase in cardiovascular diseases in this population. PCSK9 is an enzyme mainly known for its role in altering LDL levels, consequently increasing cardiovascular risk. Monoclonal antibody PCSK9 inhibitors demonstrated remarkable efficacy in the general population in reducing LDL cholesterol levels and preventing cardiovascular disease. In transplant patients, these drugs are still poorly used, despite having comparable efficacy to the general population and giving fewer drug interactions with immunosuppressants. Furthermore, there is enough evidence that PCSK9 also plays a role in other pathways, such as inflammation, which is particularly dangerous for graft survival. In this review, the current evidence on the function of PCSK9 and the use of its inhibitors will be discussed, particularly in transplant patients, in which they may provide additional benefits.
Alzheimer’s Disease CSF Biomarker Profiles in Idiopathic Normal Pressure Hydrocephalus
Authors: Mazzeo Salvatore , Emiliani Filippo , Bagnoli Silvia , Padiglioni Sonia , Del Re Lorenzo Maria , Giacomucci Giulia , Balestrini Juri , Ingannato Assunta , Moschini Valentina , Morinelli Carmen , Galdo Giulia , Polito Cristina , Ferrari Camilla , Pansini Gastone , Della Puppa Alessandro , Sorbi Sandro , Nacmias Benedetta , Bessi Valentina
Published: June 2022

Patients with idiopathic normal pressure hydrocephalus (iNPH) frequently show pathologic CSF Aβ42 levels, comparable with Alzheimer’s Disease (AD). Nevertheless, the clinical meaning of these findings has not been fully explained. We aimed to assess the role of AD CSF biomarkers (Aβ42, Aβ42/Aβ40, p-tau, t-tau) in iNPH. To this purpose, we enrolled 44 patients diagnosed with iNPH and 101 with AD. All the patients underwent CSF sampling. We compared CSF biomarker levels in iNPH and AD: Aβ42 levels were not different between iNPH and AD, while Aβ42/Aβ40, p-tau, and t-tau were significantly different and showed excellent accuracy in distinguishing iNPH and AD. A multiple logistic regression analysis showed that Aβ42/Aβ40 was the variable that most contributed to differentiating the two groups. Furthermore, iNPH patients with positive Aβ42/Aβ40 had higher p-tau and t-tau than iNPH patients with negative Aβ42/Aβ40. Those iNPH patients who showed cognitive impairment had lower Aβ42/Aβ40 and higher p-tau than patients without cognitive impairment. We concluded that positive CSF Aβ42 with negative Aβ42/Aβ40, p-tau, and t-tau is a typical CSF profile of iNPH. On the contrary, positive Aβ42/Aβ40 in iNPH patients, especially when associated with positive p-tau, may lead to suspicion of a coexistent AD pathology.
Development of Digital Biomarkers of Mental Illness via Mobile Apps for Personalized Treatment and Diagnosis
Authors: Chen I-Ming , Chen Yi-Ying , Liao Shih-Cheng , Lin Yu-Hsuan
Published: June 2022

The development of precision psychiatry is largely based on multi-module measurements from the molecular, cellular, and behavioral levels, which are integrated to assess neurocognitive performances and clinically observed psychopathology. Nevertheless, quantifying mental activities and functions accurately and continuously has been a major difficulty within this field. This article reviews the latest efforts that utilize mobile apps to collect human–smartphone interaction data and contribute towards digital biomarkers of mental illnesses. The fundamental principles underlying a behavioral analysis with mobile apps were introduced, such as ways to monitor smartphone use under different circumstances and construct long-term patterns and trend changes. Examples were also provided to illustrate the potential applications of mobile apps that gain further insights into traditional research topics in occupational health and sleep medicine. We suggest that, with an optimized study design and analytical approach that accounts for technical challenges and ethical considerations, mobile apps will enhance the systemic understanding of mental illnesses.
Supervision of Banking Networks Using the Multivariate Threshold-Minimum Dominating Set (mT-MDS)
Authors: Gogas Periklis , Papadimitriou Theophilos , Matthaiou Maria-Artemis
Published: June 2022

The global financial crisis of 2008, triggered by the collapse of Lehman Brothers, highlighted a banking system that was widely exposed to systemic risk. The minimization of the systemic risk via a close and detailed monitoring of the entire banking network became a priority. This is a complex and demanding task considering the size of the banking systems; in the US and the EU they include more than 10,000 institutions. In this paper, we introduce a methodology which identifies a subset of banks that can: (a) efficiently represent the behavior of the whole banking system, and (b), provide, in the case of a failure, a plausible range of the crisis dispersion. The proposed methodology can be used by the regulators as an auxiliary monitoring tool to identify groups of banks that are potentially in distress and try to swiftly remedy their problems and minimize the propagation of the crisis by restricting contagion. This methodology is based on graph theory, and more specifically, complex networks. We termed this setting a “multivariate Threshold–Minimum Dominating Set” (mT-MDS), and it is an extension of the Threshold–Minimum Dominating Set methodology. The method was tested on a dataset of 570 U.S. banks, including 429 solvent ones and 141 failed ones. The variables used to create the networks were as follows: the total interest expense; the total interest income; the tier 1 (core) risk-based capital; and the total assets. The empirical results reveal that the proposed methodology can be successfully employed as an auxiliary tool for the efficient supervision of a large banking network.
Botox Therapy for Hypertrophy of the Masseter Muscle Causes a Compensatory Increase of Stiffness of Other Muscles of Masticatory Apparatus
Authors: Mierzwa Dorota , Olchowy Cyprian , Olchowy Anna , Nawrot-Hadzik Izabela , Dąbrowski Paweł , Chobotow Sławomir , Grzech-Leśniak Kinga , Kubasiewicz-Ross Paweł , Dominiak Marzena
Published: June 2022

Little is known about the nature of masseter muscle hypertrophy. We investigated the masseter muscle stiffness change after a single intra-masseteric session of Botox injections in people with benign bilateral masseter hypertrophy and the effect of the treatment on the stiffness of the temporalis muscle. Stiffness of the muscles was measured with shear-wave elastography at baseline and 3 weeks after Botox injections in 22 otherwise healthy people. Before the treatment, the stiffness of the masseter was lower than of the temporalis muscle (10.18 ± 1.67 kPa vs. 11.59 ± 1.54 kPa; p = 0.002). After the treatment, this difference increased (6.38 ± 1.34 vs. 13.10 ± 1.92; p < 0.0001). The drop in the stiffness of the masseter muscle was symmetrical (left side by 3.78 kPa; right side by 3.83 kPa). No differences between the left and right sides of the face in terms of muscle stiffness were observed. The study shows that Botox injections reduce stiffness of the masticatory muscles which, in turn, increases the stiffness of the temporalis muscles. Due to the knock-on effect of the change in the masseter function on the other masticatory muscles, simultaneous evaluation and treatment of the temporalis muscle may be required to ensure the desired functional and cosmetic effect.
Multi Expression Programming Model for Strength Prediction of Fly-Ash-Treated Alkali-Contaminated Soils
Authors: Khan Kaffayatullah , Ashfaq Mohammed , Iqbal Mudassir , Khan Mohsin Ali , Amin Muhammad Nasir , Shalabi Faisal I. , Faraz Muhammad Iftikhar , Jalal Fazal E.
Published: June 2022

Rapid industrialization is leading to the pollution of underground natural soil by alkali concentration which may cause problems for the existing expansive soil in the form of producing expanding lattices. This research investigates the effect of stabilizing alkali-contaminated soil by using fly ash. The influence of alkali concentration (2 N and 4 N) and curing period (up to 28 days) on the unconfined compressive strength (UCS) of fly ash (FA)-treated (10%, 15%, and 20%) alkali-contaminated kaolin and black cotton (BC) soils was investigated. The effect of incorporating different dosages of FA (10%, 15%, and 20%) on the UCSkaolin and UCSBC soils was also studied. Sufficient laboratory test data comprising 384 data points were collected, and multi expression programming (MEP) was used to create tree-based models for yielding simple prediction equations to compute the UCSkaolin and UCSBC soils. The experimental results reflected that alkali contamination resulted in reduced UCS (36% and 46%, respectively) for the kaolin and BC soil, whereas the addition of FA resulted in a linear rise in the UCS. The optimal dosage was found to be 20%, and the increase in UCS may be attributed to the alkali-induced pozzolanic reaction and subsequent gain of the UCS due to the formation of calcium-based hydration compounds (with FA addition). Furthermore, the developed models showed reliable performance in the training and validation stages in terms of regression slopes, R, MAE, RMSE, and RSE indices. Models were also validated using parametric and sensitivity analysis which yielded comparable variation while the contribution of each input was consistent with the available literature.