bluuebunny/crossref_metadata_2025 huggingface dataset:
Dermoscopy, Reflectance Confocal Microscopy and Optical Coherence Tomography Features of Acne: A Systematic Review
Authors: Alma Antonio , Sticchi Alberto , Chello Camilla , Guida Stefania , Farnetani Francesca , Chester Johanna , Bettoli Vincenzo , Pellacani Giovanni , Manfredini Marco
Published: March 2022

Noninvasive imaging techniques have recently outlined precise microscopic features of acne elementary lesions and accurate quantifications for disease severity staging and therapeutical efficacy follow-up. The aim of this review is to systematically describe current applications of dermoscopy, reflectance confocal microscopy (RCM), and optical coherence tomography (OCT) in acne vulgaris assessment and management. The study followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. We included studies conducted on human subjects with elementary lesions of acne vulgaris, reporting assessment of the lesions with dermoscopy, RCM, and/or OCT. At present there are few large studies regarding acne and noninvasive imaging techniques, representing the main limitation of this review. Clinical examination represents the first line in acne diagnosis and treatment. However, dermoscopy, RCM, and OCT are further tools that can improve acne classification, monitoring of treatment, and pathophysiologic characterization. In the near future, dermoscopy, RCM, and OCT could become routinely used for the evaluation of acne vulgaris to provide a deeper knowledge of the disease and to guide the clinician in the prescription of tailored treatment protocols based on each patient’s characteristics.
The ENIGI (European Network for the Investigation of Gender Incongruence) Study: Overview of Acquired Endocrine Knowledge and Future Perspectives
Authors: Cocchetti Carlotta , Romani Alessia , Collet Sarah , Greenman Yona , Schreiner Thomas , Wiepjes Chantal , den Heijer Martin , T’Sjoen Guy , Fisher Alessandra Daphne
Published: March 2022

Literature on the efficacy and safety of gender-affirming hormonal treatment (GAHT) in transgender people is limited. For this reason, in 2010 the European Network for the Investigation of Gender Incongruence (ENIGI) study was born. The aim of this review is to summarize evidence emerging from this prospective multicentric study and to identify future perspectives. GAHT was effective in inducing desired body changes in both trans AMAB and AFAB people (assigned male and female at birth, respectively). Evidence from the ENIGI study confirmed the overall safety of GAHT in the short/mid-term. In trans AMAB people, an increase in prolactin levels was demonstrated, whereas the most common side effects in trans AFAB people were acne development, erythrocytosis, and unfavorable changes in lipid profile. The main future perspectives should include the evaluation of the efficacy and safety of non-standardized hormonal treatment in non-binary trans people. Furthermore, long-term safety data on mortality rates, oncological risk, and cardiovascular, cerebrovascular and thromboembolic events are lacking. With this aim, we decided to extend the observation of the ENIGI study to 10 years in order to study all these aspects in depth and to answer these questions.
Characteristics and Outcomes of Patients with Acute Coronary Syndrome and COVID-19
Authors: Milovančev Aleksandra , Petrović Milovan , Popadić Višeslav , Miljković Tatjana , Klašnja Slobodan , Djuran Predrag , Ilić Aleksandra , Kovačević Mila , Stojšić Milosavljević Anastazija , Brajković Milica , Crnokrak Bogdan , Memon Lidija , Milojević Ana , Todorović Zoran , Čanković Milenko , Lukić Šarkanović Mirka , Bjelić Snežana , Tadić Snežana , Redžek Aleksandar , Zdravković Marija
Published: March 2022

Acute coronary syndrome (ACS) in patients with COVID-19 is triggered by various mechanisms and can significantly affect the patient’s further treatment and prognosis. The study aimed to investigate the characteristics, major complications, and predictors of mortality in COVID-19 patients with ACS. All consecutive patients hospitalized from 5 July 2020 to 5 May 2021 for ACS with confirmed SARS-Co-2 were prospectively enrolled and tracked for mortality until 5 June 2021. Data from the electronic records for age and diagnosis, matched non-COVID-19 and COVID-19 ACS group, were extracted and compared. Overall, 83 COVID-19 ACS patients, when compared to 166 non-COVID ACS patients, had significantly more prevalent comorbidities, unfavorable clinical characteristics on admission (acute heart failure 21.7% vs. 6.6%, p < 0.01) and higher rates of major complications, 33.7% vs. 16.8%, p < 0.01, and intrahospital 30-day mortality, 6.7% vs. 26.5%, p < 0.01. The strongest predictors of mortality were aortic regurgitation, HR 9.98, 95% CI 1.88; 52.98, p < 0.01, serum creatinine levels, HR 1.03, 95% CI 1.01; 1.04, p < 0.01, and respiratory failure therapy, HR 13.05, 95% CI 3.62; 47.01, p < 0.01. Concomitant ACS and COVID-19 is linked to underlying comorbidities, adverse presenting features, and poor outcomes. Urgent strategies are needed to improve the outcomes of these patients.
Therapeutic Drug Monitoring in Perianal Fistulizing Crohn’s Disease
Authors: Zulqarnain Mir , Deepak Parakkal , Yarur Andres J.
Published: March 2022

Perianal fistulas are a common complication of Crohn’s disease (CD) that has, historically, been challenging to manage. Despite the strong available evidence that anti-tumor necrosis factor (anti-TNF) agents are useful in the treatment of perianal fistulizing Crohn’s disease (PFCD), a significant number of these patients do not respond to therapy. The use of therapeutic drug monitoring (TDM) in patients with CD receiving biologic agents has evolved and is currently positioned as an important tool to optimize and guide biologic treatment. Considering the treatment of PFCD can represent a challenge; identifying novel tools to improve the efficacy of current treatments is an important unmet need. Given its emerging role in other phenotypes of Crohn’s disease, the use of TDM could also offer an opportunity to enhance the effectiveness of available therapies and improve outcomes in the subset of patients with PFCD receiving biologics. Overall, there is mounting evidence that higher anti-TNF drug levels are associated with better rates of “fistula healing”. However, studies have been limited by their use of subjective outcomes and observational designs. Ultimately, further interventional, randomized controlled trials looking into the relationship between drug exposure and fistula outcomes are needed.
A Novel Quantitative Parameter for Static Myocardial Computed Tomography: Myocardial Perfusion Ratio to the Aorta
Authors: Kouchi Takanori , Tanabe Yuki , Takemoto Takumasa , Yoshida Kazuki , Yamamoto Yuta , Miyazaki Shigehiro , Fukuyama Naoki , Nishiyama Hikaru , Inaba Shinji , Kawaguchi Naoto , Kido Tomoyuki , Yamaguchi Osamu , Kido Teruhito
Published: March 2022

We evaluated the feasibility of myocardial perfusion ratio to the aorta (MPR) in static computed tomography perfusion (CTP) for detecting myocardial perfusion abnormalities assessed by single-photon emission computed tomography (SPECT). Twenty-five patients with suspected coronary artery disease who underwent dynamic CTP and SPECT were retrospectively evaluated. CTP images scanned at a sub-optimal phase for detecting myocardial perfusion abnormalities were selected from dynamic CTP images and used as static CTP images in the present study. The diagnostic accuracy of MPR derived from static CTP was compared to those of visual assessment and conventional quantitative parameters such as myocardial CT attenuation (HU) and transmural perfusion ratio (TPR). The area under the curve of MPR (0.84; 95% confidence interval [CI], 0.76–0.90) was significantly higher than those of myocardial CT attenuation (0.73; 95% CI, 0.65–0.79) and TPR (0.76; 95% CI, 0.67–0.83) (p < 0.05). Sensitivity and specificity were 67% (95% CI, 54–77%) and 90% (95% CI, 86–92%) for visual assessment, 51% (95% CI, 39–63%) and 86% (95% CI, 82–89%) for myocardial CT attenuation, 63% (95% CI, 51–74%) and 84% (95% CI, 80–88%) for TPR, and 78% (95% CI, 66–86%) and 84% (95% CI, 80–88%) for MPR, respectively. MPR showed higher diagnostic accuracy for detecting myocardial perfusion abnormality compared with myocardial CT attenuation and TPR.
Outcomes of Primary vs. Delayed Strategy of Implanting a Cardiac Monitor for Unexplained Syncope
Authors: Yasa Ekrem , Intzilakis Theodoros , Ricci Fabrizio , Melander Olle , Hamrefors Viktor , Sutton Richard , Fedorowski Artur
Published: March 2022

Objective: Implantable cardiac monitors (ILR) have an important role in diagnosing unexplained syncope. However, outcomes of primary vs. delayed ILR implantation after initial syncope evaluation have not been explored. Methods: A total of 1705 patients with unexplained syncope were prospectively enrolled in the SYSTEMA (Syncope Study of Unselected Population in Malmö) cohort. Patients who underwent cardiovascular autonomic testing (CAT) and ILR were grouped into those referred to CAT after ILR implantation (primary ILR) and those in whom ILR was indicated after CAT (post-CAT ILR). Results: One-hundred-and-fifteen patients (6.7%) received ILRs. ILR recipients were older (58 vs. 52 years; p = 0.002), had more syncope recurrences (6 vs. 4; p < 0.001), more traumatic falls (72% vs. 53%; p < 0.001), and less prodrome (40% vs. 55%; p = 0.005) than patients without ILRs. During follow-up ≥16 months after ILR, 67 (58%) had normal sinus rhythm, 10 (8.7%) had sinus arrest, 10 (8.7%) AV-block, 13 (11.3%) atrial fibrillation, 9 (7.8%) supraventricular tachycardia, 4 (3.5%) sinus tachycardia and 2 (1.7%) ventricular tachycardia with clinical symptom reproduction. There were 52 patients (45%) in the primary-ILR group and 63 (55%) in the post-CAT ILR group. Proportions of negative ILR monitoring (17/52 vs. 25/63; p = 0.56) and pacemaker implantations (7/52 vs. 15/63; p = 0.23) did not differ between groups. Baseline ECG conduction disorders predicted pacemaker implantation (n = 11/17; odds ratio:10.6; 95%CI: 3.15–35.3; p < 0.001). CAT was more often positive (73% vs. 40%; p < 0.001) in primary-ILR group. Conclusions: Primary ILR implantation was associated with more positive CAT compared with delayed ILR implantation, but negative monitoring and pacemaker implantations were not different between groups. ECG conduction disorders predicted subsequent pacemaker implantation.
Assessment of Gastrointestinal Symptoms and Dyspnea in Patients Hospitalized due to COVID-19: Contribution to Clinical Course and Mortality
Authors: Kaliszewski Krzysztof , Diakowska Dorota , Nowak Łukasz , Tokarczyk Urszula , Sroczyński Maciej , Sępek Monika , Dudek Agata , Sutkowska-Stępień Karolina , Kiliś-Pstrusińska Katarzyna , Matera-Witkiewicz Agnieszka , Pomorski Michał , Protasiewicz Marcin , Sokołowski Janusz , Adamik Barbara , Kujawa Krzysztof , Doroszko Adrian , Madziarska Katarzyna , Jankowska Ewa Anita
Published: March 2022

Gastrointestinal manifestations may accompany the respiratory symptoms of COVID-19. Abdominal pain (AP) without nausea and vomiting is one of the most common. To date, its role and prognostic value in patients with COVID-19 is still debated. Therefore, we performed a retrospective analysis of 2184 individuals admitted to hospital due to COVID-19. We divided the patients into four groups according to presented symptoms: dyspnea, n = 871 (39.9%); AP, n = 97 (4.4%); AP with dyspnea together, n = 50 (2.3%); and patients without dyspnea and AP, n = 1166 (53.4%). The patients with AP showed tendency to be younger than these with dyspnea, but without AP (63.0 [38.0–70.0] vs. 65.0 [52.0–74.0] years, p = 0.061), and they were more often females as compared to patients with dyspnea (57.7% vs. 44.6%, p = 0.013, for females). Patients with AP as a separate sign of COVID-19 significantly less often developed pneumonia as compared to individuals with dyspnea or with dyspnea and AP together (p < 0.0001). Patients with AP or AP with dyspnea were significantly less frequently intubated or transferred to the intensive care unit (p = 0.003 and p = 0.031, respectively). Individuals with AP alone or with dyspnea had significantly lower rate of mortality as compared to patients with dyspnea (p = 0.003). AP as a separate symptom and also as a coexisting sign with dyspnea does not predispose the patients with COVID-19 to the worse clinical course and higher mortality.
Good Clinical Practice of the Italian Society of Thalassemia and Haemoglobinopathies (SITE) for the Management of Endocrine Complications in Patients with Haemoglobinopathies
Authors: Casale Maddalena , Baldini Marina Itala , Del Monte Patrizia , Gigante Antonia , Grandone Anna , Origa Raffaella , Poggi Maurizio , Gadda Franco , Lai Rosalba , Marchetti Monia , Forni Gian Luca
Published: March 2022

Background: The treatment of endocrinopathies in haemoglobinopathies is a continually expanding research area; therefore, recommendations supporting the appropriateness of treatments are a pressing need for the medical community. Methods: The Management Committee of SITE selected and gathered a multidisciplinary and multi-professional team, including experts in haemoglobinopathies and experts in endocrinopathies, who have been flanked by experts with methodological and organizational expertise, in order to formulate recommendations based on the available scientific evidence integrated by personal clinical experience. The project followed the systematic approach for the production of clinical practice guidelines according to the methodology suggested by the National Center for Clinical Excellence, Quality and Safety of Care (CNEC). Results: Out of 14 topics, 100 clinical questions were addressed, and 206 recommendations were elaborated on. The strength of recommendations, panel agreement, a short general description of the topic, and the interpretation of evidence were reported. Conclusions: Good Practice Recommendations are the final outcome of translational research and allow one to transfer to the daily clinical practice of endocrine complications in haemoglobinopathies.
Comparative Effectiveness of Intravitreal Anti-Vascular Endothelial Growth Factor Therapies for Managing Neovascular Age-Related Macular Degeneration: A Meta-Analysis
Authors: Matonti Frédéric , Korobelnik Jean-François , Dot Corinne , Gualino Vincent , Soler Vincent , Mrejen Sarah , Delyfer Marie-Noëlle , Baillif Stéphanie , Streho Maté , Gascon Pierre , Creuzot-Garcher Catherine , Kodjikian Laurent
Published: March 2022

Intravitreal injections (IVI) of anti-vascular endothelial growth factor (anti-VEGF) have become the standard of care for age-related macular degeneration (AMD). Although most pivotal trials have used monthly injections, alternative strategies that enable the injections to be administered on a more flexible schedule, including pro re nata (PRN) and treat-and-extend (T&E) regimens, are being applied more frequently. This review sought to provide further scientific evidence about the visual outcomes and treatment burden among the currently available anti-VEGF agents and regimens, including aflibercept, ranibizumab, abicipar and brolucizumab. To this end, a systematic review of published randomized studies was conducted from the MEDLINE and EMBASE databases and the Cochrane library, and a meta-analysis was applied to the obtained data using single-means modeling to compare the efficacy and maintenance among the different available treatments and regimens at Years 1 and 2. Quality analysis identified the best-informed data for modeling purposes. Overall, 47 relevant publications were retrieved for the analysis. Superior efficacy, meaning that there were observed improvements in visual acuity (VA) and central retinal thickness (CRT), occurred with monthly versus PRN regimens, yet a higher IVI number was also observed. Conversely, the T&E regimens displayed similar efficacy to the monthly regimens, but with a reduced IVI number. Aflibercept T&E exhibited similar efficacy to ranibizumab T&E, but with significantly lower IVI numbers at both Year 1 (p < 0.0001) and Year 2 (p = 0.0011). Though all of the regimens resulted in maintained efficacy between Years 1 and 2, the required IVI number varied. The retrieved data did not enable other regimens or newer anti-VEGF agents such as brolucizumab to be compared. In conclusion, the T&E regimens were shown to be the most efficient, optimizing durable effectiveness whilst minimizing the IVI number in newly diagnosed exudative AMD, with aflibercept requiring the lowest IVI number.
Clinical and Genetic Characteristics of Finnish Patients with Autosomal Recessive and Dominant Non-Syndromic Hearing Loss Due to Pathogenic TMC1 Variants
Authors: Kraatari-Tiri Minna , Haanpää Maria K. , Willberg Tytti , Pohjola Pia , Keski-Filppula Riikka , Kuismin Outi , Moilanen Jukka S. , Häkli Sanna , Rahikkala Elisa
Published: March 2022

Sensorineural hearing loss (SNHL) is one of the most common sensory deficits worldwide, and genetic factors contribute to at least 50–60% of the congenital hearing loss cases. The transmembrane channel-like protein 1 (TMC1) gene has been linked to autosomal recessive (DFNB7/11) and autosomal dominant (DFNA36) non-syndromic hearing loss, and it is a relatively common genetic cause of SNHL. Here, we report eight Finnish families with 11 affected family members with either recessively inherited homozygous or compound heterozygous TMC1 variants associated with congenital moderate-to-profound hearing loss, or a dominantly inherited heterozygous TMC1 variant associated with postlingual progressive hearing loss. We show that the TMC1 c.1534C>T, p.(Arg512*) variant is likely a founder variant that is enriched in the Finnish population. We describe a novel recessive disease-causing TMC1 c.968A>G, p.(Tyr323Cys) variant. We also show that individuals in this cohort who were diagnosed early and received timely hearing rehabilitation with hearing aids and cochlear implants (CI) have reached good speech perception in noise. Comparison of the genetic data with the outcome of CI rehabilitation increases our understanding of the extent to which underlying pathogenic gene variants explain the differences in CI rehabilitation outcomes.
Left Atrial Diameter in the Prediction of Thromboembolic Event and Death in Atrial Fibrillation
Authors: Krittayaphong Rungroj , Winijkul Arjbordin , Sairat Poom
Published: March 2022

Background: This study aimed to determine the predictive value of left atrial diameter (LAD), and the incremental prognostic value of LAD in combination with CHA2DS2-VASc score for predicting thromboembolic event and all-cause death in patients with non-valvular atrial fibrillation (AF). Methods: This is a prospective study from 27 hospitals during 2014–2017. LADi is LAD data indexed by body surface area, and LADi in the 4th quartile (LADi Q4) was considered high. Results: A total of 2251 patients (mean age 67.4 years, 58.6% male) were enrolled. Mean follow-up duration was 32.3 months. Rates of thromboembolic events and all-cause death were significantly higher in LADi Q4 patients than in LADi Q1–3 patients (2.89 vs. 1.11 per 100 person-years, p < 0.001, and 7.52 vs. 3.13 per 100 person-years, p < 0.001, respectively). LADi Q4 is an independent predictor of thromboembolic events and all-cause death with an adjusted hazard ratio and 95% confidence interval of 1.94 (1.24–3.05) and 1.81 (1.38–2.37), respectively. LADi has incremental prognostic value on top of the CHA2DS2-VASc score with the increase in global chi-square for thromboembolism (p = 0.005) and all-cause death (p < 0.001). Conclusions: LADi is an independent predictor of thromboembolic event and has incremental prognostic value in combination with CHA2DS2-VASc score in AF patients.
Current Strategies to Optimize Nutrition and Growth in Newborns and Infants with Congenital Heart Disease: A Narrative Review
Authors: Salvatori Guglielmo , De Rose Domenico Umberto , Massolo Anna Claudia , Patel Neil , Capolupo Irma , Giliberti Paola , Evangelisti Melania , Parisi Pasquale , Toscano Alessandra , Dotta Andrea , Di Nardo Giovanni
Published: March 2022

(1) Objective: This review aims to identify the clinical and practical barriers to optimizing nutrition in newborn infants with congenital heart disease (CHD) and to describe updated evidence-based recommendations for clinical and nutritional management of these patients in a narrative review. (2) Research Methods and Procedures: We conducted a search of the relevant literature published from 2000 to December 2021. (3) Results: CHD patients undergo several nutritional challenges related to the underlying cardiac disease anomaly, the potential increased risk of NEC, and delayed enteral feeding, resulting in inadequate energy intake and sub-optimal growth, increased morbidity and mortality. (4) Conclusions: To optimize nutrition and growth in newborn infants with CHD, standardized protocols should be implemented. Regular nutritional and growth assessment with a multi-disciplinary team is essential. We propose a decisional algorithm that may represent a potentially useful tool to guide clinicians to optimize growth and nutrition.
Validation and Psychometric Properties of the Spanish Version of the Fear of Childbirth Questionnaire (CFQ-e)
Authors: González-de la Torre Héctor , Domínguez-Gil Adela , Padrón-Brito Cintia , Rosillo-Otero Carla , Berenguer-Pérez Miriam , Verdú-Soriano José
Published: March 2022

The fear of childbirth is a topical concern, yet the issue has barely been studied in Spain, and only one fear of childbirth measurement instrument has been validated in the country. The aim of this study was to translate, adapt and validate the Fear of Childbirth Questionnaire (CFQ) for use in Spain, as well as to describe and evaluate the psychometric properties of the Spanish version of this instrument. In a first phase, a methodological study was carried out (translation–backtranslation and cross-cultural adaptation), and pilot study was carried out in the target population. In addition, content validation of the instrument was obtained (CFQ-e) from 10 experts. In the second phase, a cross-sectional study was carried out at several centres in Gran Canaria Island to obtain a validation sample. The evaluation of the psychometric properties of the CFQ-e, including construct validity through exploratory factor analysis and confirmatory factor analysis, the calculation of reliability via factor consistency using the ORION coefficients as well as alpha and omega coefficients were carried out. The CFQ-e showed evidence of content validity, adequate construct validity and reliability. The CFQ-e is composed of 37 items distributed in four subscales or dimensions: “fear of medical interventions”; “fear of harm and dying”; “fear of pain” and “fears relating to sexual aspects and embarrassment”. The CFQ-e constitutes a valid and reliable tool to measure the fear of childbirth in the Spanish pregnant population.
Protocol for Characterization of Addiction and Dual Disorders: Effectiveness of Coadjuvant Chronotherapy in Patients with Partial Response
Authors: Adan Ana , Navarro José Francisco ,   on behalf of ADDISCHRONO Group
Published: March 2022

This protocol aims to characterize patients with dual disorders (DD; comorbid major depression and schizophrenia) compared with patients with only a diagnosis of substance use disorder (SUD) and those with only a diagnosis of severe mental illness (SMI; major depression and schizophrenia), evaluating clinical and personality characteristics, circadian rhythmic functioning, genetic polymorphism and neuropsychological performance in order to obtain a clinical endophenotype of differential vulnerability for these diagnostic entities. Patients will be divided into three groups: DD (45 men with comorbid schizophrenia, 45 men and 30 women with major depression), SUD (n = 90, with a minimum of 30 women) and SMI males (45 with schizophrenia, 45 with major depression). All patients will be under treatment, with at least three months of SUD abstinence and/or with SMI in remission or with stabilized symptoms. Outpatients of both sexes with insufficient restoration of circadian rhythmicity with SUD (n = 30) and dual depression (n = 30) will be asked to participate in a second two-month study, being alternately assigned to the condition of the chronobiological adjuvant approach to the treatment of regular hour habits and exposure to light or to the usual treatment (control). The effect of the intervention and patient compliance will be monitored with a Kronowise KW6® ambulatory device during the first two weeks of treatment and again at weeks 4 and 8 weeks. After completing the evaluation, follow-up of the clinical evolution will be carried out at 3, 6 and 12 months. This project will allow us to analyze the functional impact of DD comorbidity and to develop the first study of chronobiological therapy in the treatment of SUD and dual depression, with results transferable to the clinical setting with cost-effective recommendations for a personalized approach.
Corneal Densitometry and In Vivo Confocal Microscopy in Patients with Monoclonal Gammopathy—Analysis of 130 Eyes of 65 Subjects
Authors: Kormányos Kitti , Kovács Klaudia , Németh Orsolya , Tóth Gábor , Sándor Gábor László , Csorba Anita , Czakó Cecília Nóra , Módis László , Langenbucher Achim , Nagy Zoltán Zsolt , Varga Gergely , Gopcsa László , Mikala Gábor , Szentmáry Nóra
Published: March 2022

Background: Corneal imaging may support an early diagnosis of monoclonal gammopathy. The goal of our study was to analyze corneal stromal properties using Pentacam and in vivo confocal cornea microscopy (IVCM) in subjects with monoclonal gammopathy. Patients and methods: In our cross-sectional study, patients with monoclonal gammopathy (130 eyes of 65 patients (40.0% males; age 67.65 ± 9.74 years)) and randomly selected individuals of the same age group, without hematological disease (100 eyes of 50 control subjects (40.0% males; age 60.67 ± 15.06 years)) were included. Using Pentacam (Pentacam HR; Oculus GmbH, Wetzlar, Germany), corneal stromal light scattering values were obtained (1) centrally 0–2 mm zone; (2) 2–6 mm zone; (3) 6–10 mm zone; (4) 10–12 mm zone. Using IVCM with Heidelberg Retina Tomograph with Rostock Cornea Module (Heidelberg Engineering, Heidelberg, Germany), the density of hyperreflective keratocytes and the number of hyperreflective spikes per image were manually analyzed, in the stroma. Results: In the first, second and third annular zone, light scattering was significantly higher in subjects with monoclonal gammopathy, than in controls (p ≤ 0.04). The number of hyperreflective keratocytes and hyperreflective spikes per image was significantly higher in stroma of subjects with monoclonal gammopathy (p ≤ 0.012). Conclusions: Our study confirms that increased corneal light scattering in the central 10 mm annular zone and increased keratocyte hyperreflectivity may give rise to suspicion of monoclonal gammopathy. As corneal light scattering is not increased at the limbal 10–12 mm annular zone in monoclonal gammopathy subjects, our spatial analysis provides evidence against the limbal origin of corneal paraprotein deposition. Using IVCM, stromal hyperreflective spikes may represent specific signs of monoclonal gammopathy.
Hospital at Home for Elderly COVID-19 Patients: A Preliminary Report with 100 Patients
Authors: Miyamoto Yuki , Matsuyama Tasuku , Kunimitsu Katsutomo , Nagano Hiroyuki , Yamada Yoshie , Murakami Shigemi , Yamahata Yoshihiro , Ohta Bon , Morikami Yoshiki , Nakagawa Masanori
Published: March 2022

Hospital-at-home (HaH) care is useful for patients with COVID-19 and an alternative strategy when hospital capacity is under pressure due to patient surges. However, the efficacy and safety of HaH in elderly patients with COVID-19 remain unknown. In Kyoto city, we conducted a retrospective medical record review of HaH care focused on elderly COVID-19 patients from 4 February to 25 June 2021. Eligible patients were (1) COVID-19 patients aged ≥70 years and those who lived with them or (2) COVID-19 patients aged <70 years with special circumstances and those who lived with them. During the study period, 100 patients received HaH care. Their median age was 76 years (interquartile range 56–83), and 65% were over 70 years. Among 100 patients, 36 (36%) had hypoxia (oxygen saturation ≤ 92%), 21 (21%) received steroid medication, and 34 (34%) received intravenous fluids. Although 22 patients were admitted to the hospital and 3 patients died there, no patients died during HaH care. HaH care may be safe and effective in elderly patients with COVID-19. Our study shows that HaH provides an alternative strategy for treating COVID-19 patients and can reduce the healthcare burden at hospitals.
Addressing Chemotherapy-Induced Peripheral Neuropathy Using Multi-Frequency Vibrometry and Patient-Reported Outcomes
Authors: Nielsen Sebastian W. , Lindberg Sanne , Ruhlmann Christina Halgaard Bruvik , Eckhoff Lise , Herrstedt Jørn
Published: March 2022

(1) The study evaluated correlations between multi-frequency vibrometry (MF-V) and the measure of chemotherapy-induced peripheral neuropathy developed by the European Organization for the Research and Treatment of Cancer (CIPN18). (2) Patients with cancer scheduled to undergo treatment with capecitabine and oxaliplatin (CAPOX) or carboplatin and paclitaxel (Carbo-Tax) were recruited in a prospective, observational study with MF-V and the CIPN18 from baseline to one year after end of treatment. (3) The study recruited 31 evaluable patients. All MF-V measurements correlated significantly with the CIPN18 scores (r = 0.25–0.48, p > 0.003), with a low frequency (32 Hz) from metatarsals showing the best correlation coefficients (0.059 Z-score per CIPN18 point change, r = 0.48, CI-95 = [0.32; 0.60], p > 0.0001). The largest change in MF-V scores from baseline was seen in low-frequency VPTs taken from metatarsals at 8 Hz three months after end of treatment (from −0.26, CI-95 [−0.85, 0.38] to 1.15, CI-95 [0.53, 1.84]) for patients treated with oxaliplatin and at 32 Hz one year after end of treatment (from 0.09, CI-95 [−0.56, 0.77] to 0.88, CI-95 [0.34, 1.47]) for patients treated with paclitaxel. (4) Low-frequency vibration perception thresholds (8 and 32 Hz) correlated better with CIPN18 scores than high-frequency ones (128 and 250 Hz). If validated, this finding will advance CIPN pathophysiological understanding and inform the development of assessment methods.
Using Kiln Boats to Reuse Marine Plastics
Authors: Liu Shuo-Fang , Lee Tzu-Chieh , McMillin Maggie , Li Yuan-Tai , Li Yun , Hsu Yuan-Chin
Published: March 2022

Microplastics are the biggest pollutants in marine ecosystems. Each year, over 8 million tons of plastic enter the oceans. Via microbes, microplastics may transport toxic chemicals into food webs. It is therefore important to create a way to remove microplastics and reduce the impact of microplastics on the ocean’s food web. This paper discusses the plan of using kiln firing, laser firing, pollution control, and green energy production to reuse marine plastics. We used a wood-fired kiln to design a kiln boat. The “Patch” is a large ocean area with trash. The calorific value of plastics is comparable to that of fuels, around 40 MJ/kg. This makes plastic a good fuel for ceramic firing. Based on our Taiwanese invention patent for a laser ceramic firing technique (Taiwan, R.O.C Patent Number: I687394 and I750055), we integrated a variety of ceramic technologies to address the problem of marine plastic pollution. A kiln boat is a good plan. Creating a moveable kiln not only reduces transportation costs but also reuses the calorific value of plastics. This is important in guiding future marine litter research and ocean cleanup management strategies.
Load Resistance Factor for Vertical Caisson Breakwater in Korea
Authors: Lee Il-Geun , Kim Dong-Hyawn
Published: March 2022

The load resistance factor according to the target reliability level was proposed using 16 vertical breakwaters constructed along the coast of Korea. Limit state functions for sliding and overturning limit states were defined. Reliability analysis was performed to obtain the sensitivity of the limit state function to the design variables. The partial safety factors of the design variable were obtained using the sensitivity, and the load resistance factor was calculated in turn. The representative value of load resistance factors was obtained by optimizing the load resistance factors for 16 vertical breakwaters, and it was verified that the breakwater designed using the representative value had a reliability index greater than the target value.
Internal Model Control-Based Observer for the Sideslip Angle of an Unmanned Surface Vehicle
Authors: Huang Yanwei , Shi Xiaocheng , Huang Wenchao , Chen Shaobin
Published: March 2022

Since the sideslip angle is often ignored or simplified in the process of path following of unmanned surface vehicle by using the line-of-sight (LOS) guidance law because of its fast change and the difficulty of measurement, an observer was proposed by internal model control (IMC) to quickly estimate the sideslip angle in the LOS guidance law. First, a prediction model was established for the tracking error, and a state space model for prediction errors was constructed as an internal model. With the introduction of the auxiliary variables, a new augmented system was set up for a state space model of the prediction errors. Then, the sideslip angle observer was designed by the theory of state feedback with the feature of the control law of a proportional-integral type. Theoretically, the stability of the system was proved based on the Lyapunov criteria. A simulation and experiment verified the effectiveness of the proposed sideslip angle observer in improving the path-following accuracy. The results show that the IMC-based observer introduces a proportional term of tracking error that is not considered by other observers, which is easier to implement and adjust, and has a faster response speed and a smaller steady-state error for the sideslip angle. In addition, the assumption of a small sideslip angle is not introduced in the design process, so the proposed observer provides an accurate estimation method for a large sideslip angle.
Transformation of Green Areas in Central Squares after Revitalization: Evidence from Cittaslow Towns in Northeast Poland
Authors: Jaszczak Agnieszka , Pochodyła Ewelina , Płoszaj-Witkowska Beata
Published: March 2022

In recent years, unfavorable changes in the development of city squares can be observed in Poland due to poorly conducted revitalization. These changes include, among others, the elimination of greenery or its significant reduction and the introduction of impervious surfaces to the places formerly designated by forms of greenery. This article highlights the need to redesign the central squares in small towns as part of their revitalization, including three levels of approach: functional, ecological, and aesthetic. The research aimed to analyze the degree of changes in the development of green areas in central squares due to the implementation of revitalization projects. Central squares in four selected towns of Cittaslow from the Warmia and Mazury region (northeastern Poland) were selected as the research area. The methods of comparative analysis were used, considering the comparison of functions, space, and composition, as well as the “research by design” method, which was adopted. A comparative analysis of changes in the arrangement of squares and analysis of changes in greenery structure was performed. The results showed that, in two examples, the changes related to removing greenery from the squares were not on a large scale due to the compensation with new forms. However, the vegetation was removed in two squares without introducing new forms or compensating for the greenery to a minimum extent. This allowed us to answer whether the structure and various forms submitted in the greenery projects in the squares, so-called landscape architecture objects, correspond to the current ecological design requirements. From the perspective of landscape architecture and ecological design, it was positive to introduce a diversified vegetation structure and supplement it with medium and tall forms, as evidenced by the development of the square in Biskupiec. However, the results also showed a negative aspect of the revitalization conducted by removing the greenery and replacing it with an impermeable surface, for example, in the square in Bartoszyce. The final stage was to propose general guidelines for revitalizing squares and design proposals considering introducing plant forms in the squares in the four analyzed towns.
Landscape and Unique Fascination: A Dual-Case Study on the Antecedents of Tourist Pro-Environmental Behavioral Intentions
Authors: Zheng Wei , Qiu Hongliang , Morrison Alastair M. , Wei Wei , Zhang Xihua
Published: March 2022

Although cultivating tourist pro-environmental behavioral intentions (TPEBI) has been emphasized, the effect of destination unique fascination on TPEBI is unknown. Applying the theory of planned behavior (TPB) and the cognition-affect-behavior (CAB) model, this research develops an integrated theoretical framework to predict TPEBI. The results suggested that: (1) attitudes toward the behavior, subjective norms, perceived behavioral control, destination unique fascination and tourist delight directly influence TPEBI; (2) tourist delight positively meditates the links between destination unique fascination and TPEBI; (3) the integrated model had better explanation power than either TPB or CAB models; and (4) a cross-validation method of rural and wetland cases demonstrated support for the results. This study enriches the extant studies of pro-environmental behavioral intentions by introducing an integrated conceptual model coupled with the cross-validation approach. Aside from the impact of TPB constructs, the research offers a reference for practitioners to promote TPEBI through the enhancement of destination unique fascination and tourist delight.
Urban-Rural Dependencies and Opportunities to Design Nature-Based Solutions for Resilience in Europe and China
Authors: Banzhaf Ellen , Anderson Sally , Grandin Gwendoline , Hardiman Richard , Jensen Anne , Jones Laurence , Knopp Julius , Levin Gregor , Russel Duncan , Wu Wanben , Yang Jun , Zandersen Marianne
Published: March 2022

Interrelationships between urban and rural areas are fundamental for the development and safeguarding of viable future living conditions and quality of life. These areas are not well-delineated or self-sufficient, and existing interrelations may privilege one over the other. Major urban challenges facing China and Europe are related to changes in climate, environment, and to decision-making that makes urban and rural landscapes more susceptible to environmental pressures. Focusing on the six European and Chinese cities and surrounding rural areas, under study in the joint EC and MOST-funded REGREEN project, we examine how nature-based solutions (NBS) may assist in counteracting these pressures. We explore urban-rural dependencies and partnerships regarding NBS that can enhance resilience in Europe and China. We analyse differences between European and Chinese systems of governance, reflecting on the significance of the scale of research needed to understand how NBS provide benefits. We highlight interactions between differently delineated sheds (watershed, airshed, natureshed, and peopleshed), which influence the interrelationships between urban and rural areas. There may be one-way or two-way interdependence, and the impact may be uni or multi-directional. The European and Chinese solutions, exemplified in this article, tackle the nexus of environmental and peoplesheds. We discuss complex human interactions (and how to model them) that may, or may not, lead to viable and equitable partnerships for implementing NBS in cities within Europe and in China.
Chamomile (Matricaria chamomilla L.): A Review of Ethnomedicinal Use, Phytochemistry and Pharmacological Uses
Authors: El Mihyaoui Amina , Esteves da Silva Joaquim C. G. , Charfi Saoulajan , Candela Castillo María Emilia , Lamarti Ahmed , Arnao Marino B.
Published: March 2022

Matricaria chamomilla L. is a famous medicinal plant distributed worldwide. It is widely used in traditional medicine to treat all kinds of diseases, including infections, neuropsychiatric, respiratory, gastrointestinal, and liver disorders. It is also used as a sedative, antispasmodic, antiseptic, and antiemetic. In this review, reports on M. chamomilla taxonomy, botanical and ecology description, ethnomedicinal uses, phytochemistry, biological and pharmacological properties, possible application in different industries, and encapsulation were critically gathered and summarized. Scientific search engines such as Web of Science, PubMed, Wiley Online, SpringerLink, ScienceDirect, Scopus, and Google Scholar were used to gather data on M. chamomilla. The phytochemistry composition of essential oils and extracts of M. chamomilla has been widely analyzed, showing that the plant contains over 120 constituents. Essential oils are generally composed of terpenoids, such as α-bisabolol and its oxides A and B, bisabolone oxide A, chamazulene, and β-farnesene, among other compounds. On the other hand, M. chamomilla extracts were dominated by phenolic compounds, including phenolic acids, flavonoids, and coumarins. In addition, M. chamomilla demonstrated several biological properties such as antioxidant, antibacterial, antifungal, anti-parasitic, insecticidal, anti-diabetic, anti-cancer, and anti-inflammatory effects. These activities allow the application of M. chamomilla in the medicinal and veterinary field, food preservation, phytosanitary control, and as a surfactant and anti-corrosive agent. Finally, the encapsulation of M. chamomilla essential oils or extracts allows the enhancement of its biological activities and improvement of its applications. According to the findings, the pharmacological activities of M. chamomilla confirm its traditional uses. Indeed, M. chamomilla essential oils and extracts showed interesting antioxidant, antibacterial, antifungal, anticancer, antidiabetic, antiparasitic, anti-inflammatory, anti-depressant, anti-pyretic, anti-allergic, and analgesic activities. Moreover, the most important application of M. chamomilla was in the medicinal field on animals and humans.
Cancer-Derived Extracellular Vesicles: Their Role in Sarcoma
Authors: Adib Anita , Sahu Ruhi , Mohta Shivangi , Pollock Raphael Etomar , Casadei Lucia
Published: March 2022

Soft tissue sarcomas (STS) are rare malignancies with limited responses to anticancer therapy. Extracellular vesicles (EVs) are a heterogeneous group of bi-lipid layer sacs secreted by cells into extracellular space. Investigations of tumor-derived EVs have revealed their functional capabilities, including cell-to-cell communication and their impact on tumorigenesis, progression, and metastasis; however information on the roles of EVs in sarcoma is currently limited. In this review we investigate the role of various EV cargos in sarcoma and the mechanisms by which those cargos can affect the recipient cell phenotype and the aggressivity of the tumor itself. The study of EVs in sarcoma may help establish novel therapeutic approaches that target specific sarcoma subtypes or biologies, thereby improving sarcoma therapeutics in the future.
Application of a Design for Excellence Methodology for a Wireless Charger Housing in Underwater Environments
Authors: Pereira Pedro Nuno de Almeida Arrojado da Silva , Campilho Raul Duarte Salgueiral Gomes , Pinto Andry Maykol Gomes
Published: March 2022

A major effort is put into the production of green energy as a countermeasure to climatic changes and sustainability. Thus, the energy industry is currently betting on offshore wind energy, using wind turbines with fixed and floating platforms. This technology can benefit greatly from interventive autonomous underwater vehicles (AUVs) to assist in the maintenance and control of underwater structures. A wireless charger system can extend the time the AUV remains underwater, by allowing it to charge its batteries through a docking station. The present work details the development process of a housing component for a wireless charging system to be implemented in an AUV, addressed as wireless charger housing (WCH), from the concept stage to the final physical verification and operation stage. The wireless charger system prepared in this research aims to improve the longevity of the vehicle mission, without having to return to the surface, by enabling battery charging at a docking station. This product was designed following a design for excellence (DfX) and modular design philosophy, implementing visual scorecards to measure the success of certain design aspects. For an adequate choice of materials, the Ashby method was implemented. The structural performance of the prototypes was validated via a linear static finite element analysis (FEA). These prototypes were further physically verified in a hyperbaric chamber. Results showed that the application of FEA, together with well-defined design goals, enable the WCH optimisation while ensuring up to 75% power efficiency. This methodology produced a system capable of transmitting energy for underwater robotic applications.
Multibody Model for the Design of a Rover for Agricultural Applications: A Preliminary Study
Authors: Califano Filippo , Cosenza Chiara , Niola Vincenzo , Savino Sergio
Published: March 2022

The employment of vehicles such as rovers equipped with automictic and robotic systems in agriculture is an emerging field. The development of suitable simulation models can aid in the design and testing of agricultural rovers before prototyping. Here, we propose a simulation test rig based on a multibody model to investigate the main issues connected with agricultural rover designs. The results of the simulations show significant differences between the two structures, especially regarding the energy savings, which is a key aspect for the applicability of a rover in field operations. The modular structure of the proposed simulation model can be easily adapted to other vehicle structures.
Orientation-Dependent Indentation Behaviour of Additively Manufactured FeCo Sample: A Quasi In-Situ Study
Authors: Pramanik Sudipta , Tasche Frederik , Hoyer Kay-Peter , Schaper Mirko
Published: March 2022

The quasi in-situ indentation behaviour of <110>||BD and <111>||BD-oriented grains in a FeCo alloy is studied in this investigation. The effect of build height on melt pool shape and melt pool size is also studied by finite element method simulations. As the building height increases, the aspect ratio of the elliptical melt pool increases. Correspondingly, the effect of the laser scan speed on the melt pool shape and size is studied by the finite element method, because, as the laser scan speed increases, the aspect ratio of the elliptical melt pool increases, too. The microstructural characterisation of the indentation area before and after indentation is performed by electron backscatter diffraction (EBSD). Based on the EBSD data grain reference orientation deviation (GROD), calculations are performed to describe the effect of indentations on the neighbouring grain orientations. High GROD angles are detected in the neighbouring grain region adjoining the indented grain. An in-depth slip trace analysis shows the activation of all three slip systems ({110}<111>, {112}<111> and {123}<111>) which is also confirmed by slip lines on the sample surface that are detected by laser scanning confocal microscopy. A high concentration of geometrically necessary dislocations (GNDs) are observed on the adjoining area to the indentation. Local surface topography measurements by laser scanning confocal microscopy confirmed the formation of pile-ups near the indentation.