bluuebunny/crossref_metadata_2025 huggingface dataset:
The Slavcleft: A Three-Center Study of the Outcome of Treatment of Cleft Lip and Palate Considering Palatal Shape
Authors: Petrova Tereza , Brudnicki Andrzej , Kotova Magdalena , Urbanova Wanda , Dubovska Ivana , Polackova Petra , Voborna Iva , Fudalej Piotr S.
Published: September 2023

The degree of deviation of palatal shape from the norm may reflect facial growth disturbance in cleft lip and palate (CLP). The objective of this study was to compare the palatal morphology in children treated with different surgical protocols. Palatal shape was assessed with geometric morphometrics (GM) including Procrustes superimposition, principal component analysis (PCA), and permutation tests with 10,000 permutations, in 24 children treated with two-stage repair with a late palatoplasty (Prague group; mean age at assessment 8.9 years), 16 children after two-stage repair with early palatoplasty (Bratislava group; mean age 8.2 years), and 53 children treated with a one-stage repair (Warsaw group, mean age 10.3 years). The non-cleft control group comprised 60 children at 8.6 years. The first five principal components (PCs) accounted for a minimum of 5% of the total shape variability (65.9% in total). The Procrustes distance was largest for the Prague vs. Control pair and smallest for the Prague vs. Bratislava pair. Nonetheless, all intergroup differences were statistically significant (p < 0.01). One can conclude that variations in palatal shape roughly correspond to cephalometric and dental arch relationship findings from prior research. Among the children who underwent a one-stage repair of the complete cleft, their palatal morphology most closely resembled that of the non-cleft controls. Conversely, children who received late palatoplasty exhibited the greatest degree of deviation.
Serum Cytokine and miRNA Levels Are Differently Expressed in Right- and Left-Sided Colon Cancer
Authors: De Nunzio Valentina , Donghia Rossella , Pesole Pasqua L. , Coletta Sergio , Calò Nicola , Notarnicola Maria
Published: September 2023

The tumor location in colorectal cancer (right- or left-sided colon cancer) is a key factor in determining disease progression. Right- and left-sided colon tumors are different in their clinical and molecular characteristics. Dysregulation of serum levels of proinflammatory cytokines, such as Transforming Growth Factor β (TGF-β) and Tumor Necrosis Factor-α (TNF-α), and Peroxisome Proliferator Activated Receptor-γ (PPAR-γ), known to be a growth-limiting and differentiation-promoting factor, as well as changes in miRNAs expression, are the major signaling pathways involved in the pathogenesis of this neoplasia. In the serum from 60 colorectal cancer (CRC) patients, we compared the differences in the expression of the levels of TGF-β, TNF-α, and PPAR-γ and in the expression of the main human miRNAs between right and left CRC. A significant over-expression in the TGF-β and TNF-α levels was observed in the serum from right-sided colon cancer patients. For the PPAR-γ, the patients with CRC located on the right-side showed lower levels than those detected in the serum from left-sided CRC subjects. Furthermore, significant differences also existed in the expression of specific circulating miRNAs between right- and left-sided CRC. In particular, the right upregulated miRNAs were all involved in the cell growth and proliferation related pathways. These findings confirm that the analysis of circulating levels of TGF-β, TNF-α, and PPAR-γ, as well as the study of the specific miRNAs in the serum, are able to identify specific characteristics of CRC patients, useful for choosing a personalized treatment protocol.
Impact of Selected Eicosanoids in Normal and Pathological Pregnancies
Authors: Szczuko Małgorzata , Golańska Justyna , Palma Joanna , Ziętek Maciej
Published: September 2023

Background: Pregnancy is a physiological state in which the female body undergoes a series of changes and adaptations to provide the best possible conditions for the growth and development of the forming baby. The internal adaptations that take place lead to the production of inflammation, which is necessary for the initial and final stages of pregnancy (embryo implantation and induction of labor). Gestational diabetes mellitus is considered to be the most common pathology during this period. However, many more serious health complications can arise, which include pre-eclampsia, fetal stunting, and preterm labor. The purpose of this study was to analyze the impact of the levels of individual eicosanoids on the course of normal pregnancy and the possibility of pathologies including gestational diabetes and pre-eclampsia. Methods: Sixty-nine pregnant women who were overweight or obese before and during pregnancy were studied. Eicosanoids were extracted as appropriate and then determined using liquid chromatography. The levels of eicosanoids studied in pregnant women differed not only according to the week of pregnancy but also in relation to individual anthropometric and biochemical parameters. Results: There was a significant correlation between being overweight and having a high BMI before pregnancy—as well as biochemical parameters of lipid and carbohydrate profiles—and the occurrence of pathological conditions in pregnancy. Conclusions: Eicosanoids are involved in the pathology of pregnancy associated with the occurrence of gestational diabetes and pre-eclampsia. Salicylic acid may find use in the treatment of pregnant women exposed to both phenomena, as well as in overweight and obese women found before pregnancy. Diets rich in natural salicylates, methods of administration, and pharmacotherapy and dosage need further study. Some of the mediators (lipoxin, prostaglandin and leucotrien) may be new diagnostic markers in pregnancy pathology and intervention pathways in the future.
Key Considerations When Addressing Physical Inactivity and Sedentary Behaviour in People with Asthma
Authors: Urroz Guerrero Paola D. , Oliveira Joice M. , Lewthwaite Hayley , Gibson Peter G. , McDonald Vanessa M.
Published: September 2023

People with asthma tend to be less physically active and more sedentary than people without asthma. This narrative review aimed to present key considerations when addressing physical inactivity and sedentary behaviour in people with asthma by identifying barriers and facilitators, determinants and correlates, and intervention approaches. Using a search strategy, electronic databases were searched for relevant studies. Data extracted from studies were qualitatively synthesised. A total of 26 studies were included in the review. Six studies reported asthma symptoms as a barrier to physical activity, while four studies reported having a supportive network as a physical activity facilitator. Across studies, physical activity correlates/determinants were pulmonary function, exercise capacity, body mass index, dyspnoea, psychological health, and asthma control. Interventions that effectively improved physical activity in the short term were a step-based prescription programme, a weight loss programme incorporating aerobic and resistance training, and a weight loss lifestyle intervention, while a high-intensity interval training pulmonary rehabilitation program was effective in the long term. The collective findings suggest that a personalised physical activity programme incorporating different strategies is needed. There was minimal evidence to provide recommendations to optimise sedentary behaviour in asthma, and more research is needed on the topic.
The Use of Intact Fish Skin Grafts in the Treatment of Necrotizing Fasciitis of the Leg: Early Clinical Experience and Literature Review on Indications for Intact Fish Skin Grafts
Authors: Dueppers Philip , Bozalka Roland , Kopp Reinhard , Menges Anna-Leonie , Reutersberg Benedikt , Schrimpf Claudia , Moreno Rivero Francisco Jose , Zimmermann Alexander
Published: September 2023

Background: Necrotizing fasciitis (NF) is a serious infectious disease that can initially place the patient’s life in danger and, after successful surgical and antibiotic treatment, leaves extensive wounds with sometimes even exposed bones and tendons. Autologous skin grafts are not always possible or require adequate wound bed preparation. Novel intact fish skin grafts (iFSGs; Kerecis® Omega3 Wound, Kerecis hf, Isafjördur, Iceland) have already shown their potential to promote granulation in many other wound situations. Faster wound healing rates and better functional and cosmetic outcomes were observed due to their additionally postulated anti-inflammatory and analgesic properties. Therefore, iFSGs may also be essential in treating NF. We present our initial experience with iFSGs in treating leg wounds after NF and review the literature for the current spectrum of clinical use of iFSGs. Case Presentations: We present two male patients (aged 60 and 69 years) with chronic or acute postsurgical extensive leg ulcers six weeks and six days after necrotizing fasciitis, respectively. Both suffered from diabetes mellitus without vascular pathologies of the lower limbs. A single application of one pre-meshed (Kerecis® Graftguide) and one self-meshed 300 cm2 iFSG (Kerecis® Surgiclose) was performed in our operation room after extensive surgical debridement and single circles of negative wound pressure therapy. Application and handling were easy. An excellent wound granulation was observed, even in uncovered tibia bone and tendons, accompanied by pain relief in both patients. Neither complications nor allergic reactions occurred. The patients received autologous skin grafting with excellent functional and cosmetic outcomes. Conclusions: iFSGs have the potential to play a significant role in the future treatment of NF due to the fast promotion of wound granulation and pain relief. Our experience may encourage surgeons to use iFSGs in NF patients, although high-quality, large-sized studies are still required to confirm these results. The observed effects of iFSGs on wounds associated with NF may be transferred to other wound etiologies as well.
Ulnar-Sided Sclerosis of the Lunate Does Not Affect Outcomes in Patients Undergoing Volar Locking Plate Fixation for Distal Radius Fracture
Authors: Baek Jong-Hun , Lee Jae-Hoon , Ku Ki-Hyeok
Published: September 2023

Background and aim: Radial shortening after distal radius fracture causes ulnar impaction, and a mild reduction loss of radial height occurs even after volar locking plate fixation. This study aimed to determine whether preoperative ulnar-sided sclerosis affects clinical outcomes after volar locking plate fixation for distal radius fracture (DRF). Method: Among 369 patients who underwent volar locking plate fixation for DRF, 18 with preoperative ulnar-sided sclerosis of the lunate were included in Group A and compared to a 1:4 age-, sex- and fracture-pattern-matched cohort without sclerosis (72 patients, Group B). The visual analog scale (VAS), Disabilities of the Arm, Shoulder, and Hand (DASH) score, and grip strength were assessed as clinical outcomes. Ulnar variance (UV), radial inclination, radial length, and volar tilt at two weeks after surgery and the final follow-up were measured as radiographic outcomes. Results: The mean VAS and DASH scores and grip strength did not differ between the two groups. The mean UV at two weeks after surgery and the last follow-up was significantly higher in Group A. The mean changes in UV were +0.62 mm in Group A and +0.48 mm in Group B. There were no significant intergroup differences. Neither UV nor its changes showed any association with DASH and VAS scores. Conclusions: Preoperative ulnar-sided sclerosis of the lunate did not affect clinical outcomes after volar locking plate fixation, even if UV increased postoperatively.
Advanced Anterior Eye Segment Imaging for Ichthyosis
Authors: Micińska Anna , Nowińska Anna , Teper Sławomir , Kokot-Lesik Joanna , Wylęgała Edward
Published: September 2023

The purpose of this study was to describe ocular surface and anterior eye segment findings in various types of ichthyoses. Methods: This was a single-center prospective observational study. The study group consisted of five patients (P1–P5) aged 13–66 years. Multimodal imaging was performed, including slit-lamp examinations, swept-source optical coherence tomography (SS-OCT), and in vivo confocal microscopy (IVCM). Results: All patients were diagnosed with moderate-to-severe dry eye disease (DED). The corneas showed a significant pattern of irregularity, with a significant difference between the corneal thickness at the apex (CAT) and the corneal thinnest thickness (CTT), exceeding 375 µm. Three patients were diagnosed with ectasia patterns based on SS-OCT. All patients showed abnormalities in at least one Fourier index parameter for at least one eye at 3 or 6 mm in the keratometric, anterior, or posterior analyses. IVCM examinations revealed changes in all corneal layers. Conclusions: By combining the results of multimodal imaging, we were able to detect preclinical abnormalities, distinguish characteristic changes common to ichthyosis, and reveal the depth and characteristics of corneal abnormalities. Therefore, patients with ichthyosis should be examined for DED and ectatic disorders early in clinical practice.
The Correlation between Objective Ligament Laxity and the Clinical Outcome of Mechanically Aligned TKA
Authors: Campi Stefano , Papalia Rocco , Esposito Carlo , Candela Vincenzo , Gambineri Andrea , Longo Umile Giuseppe
Published: September 2023

Instability is one of the causes of failure in total knee arthroplasty (TKA). The aim of this study was to analyze the correlation between objective ligament laxity and the clinical outcome of mechanically aligned TKA. Fifty-one knees in 47 patients were evaluated at a minimum follow-up of 6 months. The correlation between the angular displacement and functional scores (Knee Society Score and Knee Injury and Osteoarthritis Score) was analyzed. A negative correlation (p-value < 0.05) was observed between medial laxity ≥5° at 0, 30, 60, and 90° of flexion and the outcome measures. Lateral laxity did not correlate with the clinical outcome. At 30° of knee flexion, a total varus and valgus laxity ≥10° was related to poorer outcomes. The same amount of angular displacement did not influence the outcome in the other flexion angles. There was no difference in single-radius vs multi-radius implants in terms of medial and lateral laxity and clinical outcome. A valgus displacement ≥5° measured at 0, 30, 60, and 90 degrees of flexion correlated with an inferior clinical outcome. In contrast, the same amount of displacement measured on the lateral compartment did not influence the clinical outcome after TKA.
Portrait of Dysferlinopathy: Diagnosis and Development of Therapy
Authors: Bouchard Camille , Tremblay Jacques P.
Published: September 2023

Dysferlinopathy is a disease caused by a dysferlin deficiency due to mutations in the DYSF gene. Dysferlin is a membrane protein in the sarcolemma and is involved in different functions, such as membrane repair and vesicle fusion, T-tubule development and maintenance, Ca2+ signalling, and the regulation of various molecules. Miyoshi Myopathy type 1 (MMD1) and Limb–Girdle Muscular Dystrophy 2B/R2 (LGMD2B/LGMDR2) are two possible clinical presentations, yet the same mutations can cause both presentations in the same family. They are therefore grouped under the name dysferlinopathy. Onset is typically during the teenage years or young adulthood and is characterized by a loss of Achilles tendon reflexes and difficulty in standing on tiptoes or climbing stairs, followed by a slow progressive loss of strength in limb muscles. The MRI pattern of patient muscles and their biopsies show various fibre sizes, necrotic and regenerative fibres, and fat and connective tissue accumulation. Recent tools were developed for diagnosis and research, especially to evaluate the evolution of the patient condition and to prevent misdiagnosis caused by similarities with polymyositis and Charcot–Marie–Tooth disease. The specific characteristic of dysferlinopathy is dysferlin deficiency. Recently, mouse models with patient mutations were developed to study genetic approaches to treat dysferlinopathy. The research fields for dysferlinopathy therapy include symptomatic treatments, as well as antisense-mediated exon skipping, myoblast transplantation, and gene editing.
The Treatment Landscape of Elderly Patients with Hormone Receptor-Positive Her2 Negative Advanced Breast Cancer: Current Perspectives and Future Directions
Authors: Laface Carmelo , Giuliani Francesco , Melaccio Assunta , Pappagallo Maria Nicla , Santoro Anna Natalizia , Perrone Martina , De Santis Pierluigi , Guarini Chiara , Carrozzo Daniela , Fedele Palma
Published: September 2023

Breast cancer (BC) in elderly women is an increasing health issue due to demographic changes. BC tends to present later and may receive less than standard treatment options. More often, BC in elderly patients is endocrine-positive (HR+). The treatment of elderly patients with metastatic BC (mBC) represents a therapeutic challenge. In recent years, the treatment landscape of patients that are HR+/Her2-negative has changed due to the introduction in clinical practice of new targeted drugs, which have improved patient outcomes. Elderly patients are a small percentage of all patients enrolled in clinical trials and, to date, there are no standardized guidelines that define the best treatment option for this patient population. This can lead to undertreatment or overtreatment, impacting patient morbidity and mortality. Geriatric Assessment tools to tailor the treatment in elderly patients are underused because they are long and difficult to apply in a busy routine clinical practice. For all these reasons, there is an urgent need to produce data about the best treatment for elderly patients with HR+ mBC. Herein, we report data from randomized clinical trials and real-world evidence on the therapeutic options for HR+ Her2-negative mBC elderly patients and explore future treatment directions.
Points to Consider in Health Assessment of Adult Patients with Primary Antibody Deficiencies
Authors: Napiórkowska-Baran Katarzyna , Ziętkiewicz Marcin , Więsik-Szewczyk Ewa , Matyja-Bednarczyk Aleksandra , Tykwińska Marta , Alska Ewa , Rosada Tomasz , Szynkiewicz Ewa , Lubański Jakub , Schmidt Oskar , Szymczak Bartłomiej , Koperska Kinga , Bartuzi Zbigniew
Published: September 2023

An improved recognition of inborn errors of immunity (IEI) is associated with an increase in life expectancy and a higher incidence of complications and related conditions. The aim of the study was to analyze factors enabling the primary prevention: BMI, smoking and selected laboratory tests (morphology with smear, creatinine, eGFR, total protein, albumin, ferritin, folic acid, vitamin B12, vitamin D3) included in the protocols of standard of care for adult patients with primary antibody deficiencies (PADs). The study included 94 participants ≥ 18 years old, diagnosed with PADs. Overweight was found in 17%, obesity in 14% and underweight in 15% of patients; 11.5% of patients smoked. Leukopenia was diagnosed in 16%, neutropenia in 8.5%, lymphopenia in 22.5% and thrombocytopenia in 14% of patients. A decreased concentration of hemoglobin was found in 32%, total protein in 19%, albumin in 17%, vitamin D3 in 52%, vitamin B12 in 6.5%, folic acid in 34% and ferritin in 26% of patients. Creatinine concentrations were elevated in 16% of patients, while in 20%, eGFR was reduced. Only a holistic assessment of comorbidities and complications of deficiency, as well as regular follow-up and lifestyle changes, can yield the best results in the long-term care of patients.
The Effectiveness of Adductor Canal Block Compared to Femoral Nerve Block on Readiness for Discharge in Patients Undergoing Outpatient Anterior Cruciate Ligament Reconstruction: A Multi-Center Randomized Clinical Trial
Authors: ten Hoope Werner , Admiraal Manouk , Hermanides Jeroen , Hermanns Henning , Hollmann Markus W. , Lirk Philipp , Kerkhoffs Gino M. M. W. , Steens Jeroen , van Beek Rienk
Published: September 2023

This study evaluated the effect of adductor canal block (ACB) versus femoral nerve block (FNB) on readiness for discharge in patients undergoing outpatient anterior cruciate ligament (ACL) reconstruction. We hypothesized that ACB would provide sufficient pain relief while maintaining motor strength and safety, thus allowing for earlier discharge. This was a randomized, multi-center, superiority trial. From March 2014 to July 2017, patients undergoing ACL reconstruction were enrolled. The primary outcome was the difference in readiness for discharge, defined as Post-Anesthetic Discharge Scoring System score ≥ 9. Twenty-six patients were allocated to FNB and twenty-seven to ACB. No difference in readiness for discharge was found (FNB median 1.8 (95% CI 1.0 to 3.5) vs. ACB 2.9 (1.5 to 4.7) hours, p = 0.3). Motor blocks and (near) falls were more frequently reported in patients with FNB vs. ACB (20 (76.9%) vs. 1 (3.7%), p < 0.001, and 7 (29.2%) vs. 1 (4.0%), p = 0.023. However, less opioids were consumed in the post-anesthesia care unit for FNB (median 3 [0, 21] vs. 15 [12, 42.5] oral morphine milligram equivalents, p = 0.004) for ACB. Between patients with FNB or ACB, no difference concerning readiness for discharge was found. Despite a slight reduction in opioid consumption immediately after surgery, FNB demonstrates a less favorable safety profile compared to ACB, with more motor blocks and (near) falls.
Validation of a Brief Form of the Self-Administered Multidimensional Prognostic Index: The SELFY-BRIEF-MPI Project
Authors: Morganti Wanda , Veronese Nicola , Barbagelata Marina , Castagna Alberto , Custodero Carlo , Solimando Luisa , Burgio Marianna Ilarj , Montana Lampo Sofia Elena , Seminerio Emanuele , Puleo Gianluca , Senesi Barbara , Cammalleri Lisa , Ruotolo Giovanni , Sabbà Carlo , Barbagallo Mario , Pilotto Alberto
Published: September 2023

In clinical practice, self-administered and brief tools to promptly identify older people at risk of frailty are required. The Multidimensional Prognostic Index (MPI), derived from the Comprehensive Geriatric Assessment (CGA) seems reliable enough to serve this purpose, but despite the several versions developed over the past 15 years, it lacks a self-administered and brief version. In this study, we aimed to evaluate the agreement between an abbreviated form of the SELFY-MPI (i.e., SELFY-BRIEF-MPI) and the standard version of the MPI. Four Italian hospitals consecutively enrolled outpatients and inpatients >65 years. The sample included 105 participants (mean age = 78.8 years, 53.3% females). Overall, the two versions showed non-statistically significant differences (Standard-MPI 0.42 ± 0.19 vs.. SELFY-BRIEF-MPI 0.41 ± 0.18; p = 0.104) and a very strong correlation (R = 0.86, p < 0.001). The Bland–Altman Plot revealed that only 5/105 measurements (4.76%) were outside the limits of agreement. The accuracy of the SELFY-BRIEF-MPI in identifying frail people (defined as a Standard-MPI > 0.66) was optimal (area under the curve, AUC = 0.90, p < 0.001). To predict multidimensional frailty, a SELFY-BRIEF-MPI score of 0.60 exhibited the greatest sensitivity/specificity ratio. In conclusion, the SELFY-BRIEF-MPI reported a good agreement with the standard version of the MPI, indicating its application in the screening of multidimensional frailty among older people.
The Immunomodulatory Effect of Various Anaesthetic Practices in Patients Undergoing Gastric or Colon Cancer Surgery: A Systematic Review and Meta-Analysis of Randomized Clinical Trials
Authors: Konstantis Georgios , Tsaousi Georgia , Kitsikidou Elisavet , Zacharoulis Dimitrios , Pourzitaki Chryssa
Published: September 2023

Background: Gastric and colorectal carcinomas are associated with increased mortality and an increasing incidence worldwide, while surgical resection remains the primary approach for managing these conditions. Emerging evidence suggests that the immunosuppression induced by the chosen anaesthesia approach, during the perioperative period, can have a significant impact on the immune system and consequently the prognosis of these patients. Aim: This systematic review aims to comprehensively summarize the existing literature on the effects of different anaesthesia techniques on immune system responses, focusing on cellular immunity in patients undergoing the surgical removal of gastric or colorectal carcinomas. There is no meta-analysis investigating anaesthesia’s impact on immune responses in gastric and colorectal cancer surgery. Anaesthesia is a key perioperative factor, yet its significance in this area has not been thoroughly investigated. The clinical question of how the anaesthetic technique choice affects the immune system and prognosis remains unresolved. Methods: Major electronic databases were searched up to February 2023 to May 2023 for relevant randomized controlled trials (RCTs). The study protocol has been registered with Prospero (CRD42023441383). Results: Six RCTs met the selection criteria. Among these, three RCTs investigated the effects of volatile-based anaesthesia versus total intravenous anaesthesia (TIVA), while the other three RCTs compared general anaesthesia alone to the combination of general anaesthesia with epidural anaesthesia. According to our analysis, there were no significant differences between TIVA and volatile-based anaesthesia, in terms of primary and secondary endpoints. The combination of general anaesthesia with epidural analgesia had a positive impact on NK cell counts (SMD 0.61, 95% CI 0.28 to 0.94, I2 0.0% at 24 and 72 h after the operation), as well as on CD4+ cells (SMD 0.59, CI 95% 0.26 to 0.93, I2 0.0%). However, the CD3+ cell count, CD4+/CD8+ ratio, neutrophil-to-lymphocyte ratio (NLR), IL-6 and TNF-α levels remained unaffected. Conclusions: The combination of epidural analgesia and general anaesthesia can potentially improve, postoperatively, the NK cell count and CD4+ cell levels in gastric or colon surgery patients. However, the specific impact of TIVA or volatile-based anaesthesia remains uncertain. To gain a better understanding of the immunomodulatory effects of anaesthesia, in this particular group of cancer patients, further well-designed trials are required.
Beneficial Effects of Combined Use of Extracorporeal Membrane Oxygenation and Hypothermic Machine Perfusion in Porcine Donors after Cardiac Death for Liver Transplantation
Authors: Iwata Hiroyoshi , Obara Hiromichi , Nakajo Tetsuya , Kaneko Hiroki , Okazawa Yuga , Mohd Zin Nur Khatijah , Bochimoto Hiroki , Ohashi Makito , Kawada Yoko , Ohara Mizuho , Yokoo Hideki , Matsuno Naoto
Published: September 2023

Grafts from donors after cardiac death (DCD) have greatly contributed to expanding the donor organ pool. This study aimed to determine the benefits of subnormothermic extracorporeal membrane oxygenation (ECMO) and hypothermic machine perfusion (HMP) in a porcine model of DCD liver. Female domestic crossbred Large Yorkshire and Landrace pigs weighing approximately 20 kg were used. The abdominal aorta and inferior vena cava were cannulated and connected to an ECMO circuit for in situ perfusion of the abdominal organs at 22 °C for 60 min, 45 min after cardiac death. The pigs were divided into the cold storage (CS) group (n = 3), where liver grafts were preserved at 4 °C, and the HMP group (n = 3), where liver grafts were preserved by HMP at 8–10 °C. After 4 h of preservation, liver function was evaluated using an isolated liver reperfusion model for 2 h. Although the difference was insignificant, the liver effluent enzyme levels in the HMP group were lower than those in the CS group. Furthermore, morphological findings showed fewer injured hepatocytes in the HMP group than in the CS group. The combined use of in situ subnormothermic ECMO and HMP was beneficial for the functional improvement of DCD liver grafts.
Facile Fabrication of Absorption-Dominated Biodegradable Poly(lactic acid)/Polycaprolactone/Multi-Walled Carbon Nanotube Foams towards Electromagnetic Interference Shielding
Authors: Liu Tong , Feng Huiyao , Zeng Weiqiang , Jin Chenhong , Kuang Tairong
Published: September 2023

The use of electromagnetic interference shielding materials in the mitigation of electromagnetic pollution requires a broader perspective, encompassing not only the enhancement of the overall shielding efficiency (SET), but also the distinct emphasis on the contribution of the absorption shielding efficiency within the total shielding efficiency (SEA/SET). The development of lightweight, biodegradable electromagnetic interference shielding materials with dominant absorption mechanisms is of paramount importance in reducing electromagnetic pollution and the environmental impact. This study presents a successful fabrication strategy for a poly(lactic acid)/polycaprolactone/multi-walled carbon nanotube (PCL/PLA/MWCNT) composite foam, featuring a uniform porous structure. In this approach, melt mixing is combined with particle leaching techniques to create a co-continuous phase morphology when PCL and PLA are present in equal mass ratios. The MWCNT is selectively dispersed within the PCL matrix, which facilitates the formation of a robust conductive network within this morphology. In addition, the addition of the MWCNT content reduces the size of the phase domain in the PCL/PLA/MWCNT composite, showing an adept ability to construct a compact and stable conductive network. Based on its porous architecture and continuous conductive network, the composite foam with an 80% porosity and 7 wt% MWCNT content manifests an exceptional EMI shielding performance. The SET, specific SET, and SEA/SET values achieved are 22.88 dB, 88.68 dB·cm3/g, and 85.80%, respectively. Additionally, the resulting composite foams exhibit a certain resistance to compression-induced deformations. In summary, this study introduces a practical solution that facilitates the production of absorption-dominated, lightweight, and biodegradable EMI shielding materials at scale.
Radiolabeled Human Serum Albumin Nanoparticles Co-Loaded with Methotrexate and Decorated with Trastuzumab for Breast Cancer Diagnosis
Authors: Ekinci Meliha , Alencar Luciana Magalhães Rebelo , Lopes André Moreni , Santos-Oliveira Ralph , İlem-Özdemir Derya
Published: September 2023

Breast cancer is a leading cause of cancer-related mortality among women worldwide, with millions of new cases diagnosed yearly. Addressing the burden of breast cancer mortality requires a comprehensive approach involving early detection, accurate diagnosis, effective treatment, and equitable access to healthcare services. In this direction, nano-radiopharmaceuticals have shown potential for enhancing breast cancer diagnosis by combining the benefits of nanoparticles and radiopharmaceutical agents. These nanoscale formulations can provide improved imaging capabilities, increased targeting specificity, and enhanced sensitivity for detecting breast cancer lesions. In this study, we developed and evaluated a novel nano-radio radiopharmaceutical, technetium-99m ([99mTc]Tc)-labeled trastuzumab (TRZ)-decorated methotrexate (MTX)-loaded human serum albumin (HSA) nanoparticles ([99mTc]-TRZ-MTX-HSA), for the diagnosis of breast cancer. In this context, HSA and MTX-HSA nanoparticles were prepared. Conjugation of MTX-HSA nanoparticles with TRZ was performed using adsorption and covalent bonding methods. The prepared formulations were evaluated for particle size, PDI value, zeta (ζ) potential, scanning electron microscopy analysis, encapsulation efficiency, and loading capacity and cytotoxicity on MCF-7, 4T1, and MCF-10A cells. Finally, the nanoparticles were radiolabeled with [99mTc]Tc using the direct radiolabeling method, and cellular uptake was performed with the nano-radiopharmaceutical. The results showed the formation of spherical nanoparticles, with a particle size of 224.1 ± 2.46 nm, a PDI value of 0.09 ± 0.07, and a ζ potential value of −16.4 ± 0.53 mV. The encapsulation efficiency of MTX was found to be 32.46 ± 1.12%, and the amount of TRZ was 80.26 ± 1.96%. The labeling with [99mTc]Tc showed a high labeling efficiency (>99%). The cytotoxicity studies showed no effect, and the cellular uptake studies showed 97.54 ± 2.16% uptake in MCF-7 cells at the 120th min and were found to have a 3-fold higher uptake in cancer cells than in healthy cells. In conclusion, [99mTc]Tc-TRZ-MTX-HSA nanoparticles are promising for diagnosing breast cancer and evaluating the response to treatment in breast cancer patients.
The Effects of Massage Guns on Performance and Recovery: A Systematic Review
Authors: Ferreira Ricardo Maia , Silva Rafael , Vigário Pedro , Martins Pedro Nunes , Casanova Filipe , Fernandes Ricardo Jorge , Sampaio António Rodrigues
Published: September 2023

The use of massage guns has become increasingly popular in recent years. Although their use is more and more common, both in a clinical and sports context, there is still little information to guide the practitioners. This systematic review aimed to determine the effects of massage guns in healthy and unhealthy populations as pre- and post-activity or part of a treatment. Data sources used were PubMed, PEDro, Scopus, SPORTDiscus, Web of Science and Google Scholar, and the study eligibility criteria were based on “healthy and unhealthy individuals”, “massage guns”, “pre-activity, post-activity or part of a treatment” and “randomized and non-randomized studies” (P.I.C.O.S.). Initially, 281 records were screened, but only 11 could be included. Ten had a moderate risk of bias and one a high risk of bias. Massage guns could be effective in improving iliopsoas, hamstrings, triceps suralis and the posterior chain muscles’ flexibility. In strength, balance, acceleration, agility and explosive activities, it either did not have improvements or it even showed a decrease in performance. In the recovery-related outcomes, massage guns were shown to be cost-effective instruments for stiffness reduction, range of motion and strength improvements after a fatigue protocol. No differences were found in contraction time, rating of perceived exertion or lactate concentration. Massage guns can help to improve short-term range of motion, flexibility and recovery-related outcomes, but their use in strength, balance, acceleration, agility and explosive activities is not recommended.
Assessment of Landsat-8 and Sentinel-2 Water Indices: A Case Study in the Southwest of the Buenos Aires Province (Argentina)
Authors: Santecchia Guillermina Soledad , Revollo Sarmiento Gisela Noelia , Genchi Sibila Andrea , Vitale Alejandro José , Delrieux Claudio Augusto
Published: September 2023

The accuracy assessment of three different Normalized Difference Water indices (NDWIs) was performed in La Salada, a typical lake in the Pampean region. Data were gathered during April 2019, a period in which floods occurred in a large area in the Southwest of the Buenos Aires Province (Argentina). The accuracy of the estimations using spaceborne medium-resolution multi-spectral imaging and the reliability of three NDWIs to highlight shallow water features in satellite images were evaluated using a high-resolution airbone imagery as ground truth. We show that these indices computed using Landsat-8 and Sentinel-2 imagery are only loosely correlated to the actual flooded area in shallow waters. Indeed, NDWI values vary significantly depending on the satellite mission used and the type of index computed.
A Deep Learning-Based Model for Classifying Osteoporotic Lumbar Vertebral Fractures on Radiographs: A Retrospective Model Development and Validation Study
Authors: Ono Yohei , Suzuki Nobuaki , Sakano Ryosuke , Kikuchi Yasuka , Kimura Tasuku , Sutherland Kenneth , Kamishima Tamotsu
Published: September 2023

Early diagnosis and initiation of treatment for fresh osteoporotic lumbar vertebral fractures (OLVF) are crucial. Magnetic resonance imaging (MRI) is generally performed to differentiate between fresh and old OLVF. However, MRIs can be intolerable for patients with severe back pain. Furthermore, it is difficult to perform in an emergency. MRI should therefore only be performed in appropriately selected patients with a high suspicion of fresh fractures. As radiography is the first-choice imaging examination for the diagnosis of OLVF, improving screening accuracy with radiographs will optimize the decision of whether an MRI is necessary. This study aimed to develop a method to automatically classify lumbar vertebrae (LV) conditions such as normal, old, or fresh OLVF using deep learning methods with radiography. A total of 3481 LV images for training, validation, and testing and 662 LV images for external validation were collected. Visual evaluation by two radiologists determined the ground truth of LV diagnoses. Three convolutional neural networks were ensembled. The accuracy, sensitivity, and specificity were 0.89, 0.83, and 0.92 in the test and 0.84, 0.76, and 0.89 in the external validation, respectively. The results suggest that the proposed method can contribute to the accurate automatic classification of LV conditions on radiography.
Cardiac Autonomic Function and Functional Capacity in Post-COVID-19 Individuals with Systemic Arterial Hypertension
Authors: Cunha Edelvita Fernanda Duarte , Silveira Matheus Sobral , Milan-Mattos Juliana Cristina , Cavalini Heitor Fernandes Silveira , Ferreira Ádrya Aryelle , Batista Joice de Souza , Uzumaki Lara Cazé , Guimarães João Paulo Coelho , Roriz Pedro Igor Lustosa , Dantas Fabianne Maisa de Novaes Assis , Hautala Arto J. , de Abreu Raphael Martins , Catai Aparecida Maria , Schwingel Paulo Adriano , Neves Victor Ribeiro
Published: September 2023

Individuals diagnosed with systemic arterial hypertension (SAH) are considered risk groups for COVID-19 severity. This study assessed differences in cardiac autonomic function (CAF) and functional capacity (FC) in SAH individuals without COVID-19 infection compared to SAH individuals post-COVID-19. Participants comprised 40 SAH individuals aged 31 to 80 years old, grouped as SAH with COVID-19 (G1; n = 21) and SAH without COVID-19 (G2; n = 19). CAF was assessed via heart rate variability (HRV), measuring R–R intervals during a 10-min supine period. Four HRV indices were analyzed through symbolic analysis: 0V%, 1V%, 2LV%, and 2UV%. FC assessment was performed by a 6-min walk test (6MWT). G1 and G2 showed no significant differences in terms of age, anthropometric parameters, clinical presentation, and medication use. G2 exhibited superior 6MWT performance, covering more distance (522 ± 78 vs. 465 ± 59 m, p < 0.05). Specifically, G2 demonstrated a moderate positive correlation between 6MWT and the 2LV% index (r = 0.58; p < 0.05). Shorter walking distances were observed during 6MWT in SAH individuals post-COVID-19. However, the study did not find impaired cardiac autonomic function in SAH individuals post-COVID-19 compared to those without. This suggests that while COVID-19 impacted FC, CAF remained relatively stable in this population.
Comparing Machine Learning Classifiers for Predicting Hospital Readmission of Heart Failure Patients in Rwanda
Authors: Rizinde Theogene , Ngaruye Innocent , Cahill Nathan D.
Published: September 2023

High rates of hospital readmission and the cost of treating heart failure (HF) are significant public health issues globally and in Rwanda. Using machine learning (ML) to predict which patients are at high risk for HF hospital readmission 20 days after their discharge has the potential to improve HF management by enabling early interventions and individualized treatment approaches. In this paper, we compared six different ML models for this task, including multi-layer perceptron (MLP), K-nearest neighbors (KNN), logistic regression (LR), decision trees (DT), random forests (RF), and support vector machines (SVM) with both linear and radial basis kernels. The outputs of the classifiers are compared using performance metrics including the area under the receiver operating characteristic curve (AUC), sensitivity, and specificity. We found that RF outperforms all the remaining models with an AUC of 94% while SVM, MLP, and KNN all yield 88% AUC. In contrast, DT performs poorly, with an AUC value of 57%. Hence, hospitals in Rwanda can benefit from using the RF classifier to determine which HF patients are at high risk of hospital readmission.
Recursive Feature Elimination with Cross-Validation with Decision Tree: Feature Selection Method for Machine Learning-Based Intrusion Detection Systems
Authors: Awad Mohammed , Fraihat Salam
Published: September 2023

The frequency of cyber-attacks on the Internet of Things (IoT) networks has significantly increased in recent years. Anomaly-based network intrusion detection systems (NIDSs) offer an additional layer of network protection by detecting and reporting the infamous zero-day attacks. However, the efficiency of real-time detection systems relies on several factors, including the number of features utilized to make a prediction. Thus, minimizing them is crucial as it implies faster prediction and lower storage space. This paper utilizes recursive feature elimination with cross-validation using a decision tree model as an estimator (DT-RFECV) to select an optimal subset of 15 of UNSW-NB15’s 42 features and evaluates them using several ML classifiers, including tree-based ones, such as random forest. The proposed NIDS exhibits an accurate prediction model for network flow with a binary classification accuracy of 95.30% compared to 95.56% when using the entire feature set. The reported scores are comparable to those attained by the state-of-the-art systems despite decreasing the number of utilized features by about 65%.
Impacts of Partial Substitution of Chemical Fertilizer with Organic Fertilizer on Soil Organic Carbon Composition, Enzyme Activity, and Grain Yield in Wheat–Maize Rotation
Authors: Li Xiaoliang , Fang Junchao , Shagahaleh Hiba , Wang Jianfei , Hamad Amar Ali Adam , Alhaj Hamoud Yousef
Published: September 2023

This study explored the effect of the long-term partial replacement of chemical fertilizer with organic fertilizer on soil organic carbon composition, enzyme activity, and crop yields in the wheat–maize rotation area of northern Anhui, China. This study also specified the proper amount of organic fertilizer replacement that should be used for chemical fertilizer. Different fertilization modes were used (no fertilization, CK; chemical fertilizer, CF; chemical fertilizer and straw returning, CF + S; chemical fertilizer, straw returning, and straw decomposition agent, CF + S + DA; 70% chemical fertilizer and 50% organic fertilizer, 70% CF + 50% OF; 70% chemical fertilizer, 50% organic fertilizer and straw returning, 70% CF + 50% OF + S; 50% chemical fertilizer and 100% organic fertilizer, 50% CF + 100% OF; and 50% chemical fertilizer, 100% organic fertilizer, and straw returning, 50% CF + 100% OF + S). Variations in the organic carbon composition, enzyme activity, soil pH, and crop yields in the wheat–maize rotation under different fertilization treatments were analyzed. The results showed that the replacement of chemical fertilizer with organic fertilizer results in improved crop yields in wheat–maize rotation. The long-term partial replacement of chemical fertilizer with organic fertilizer can increase the quality of soil humus, alleviate soil acidification, and improve soil enzyme activity. Straw returning and organic fertilizer application can considerably raise the activities of urease, acid phosphatase, and nitrate reductase in soil. The soil pH of the CF treatment was reduced compared to the CK treatment, while organic fertilizer application alleviated soil acidification when compared to CF treatment. Organic fertilization increases the total organic carbon content of the soil, which was 19.6~85.5% higher than in the CK treatment. Applying straw and organic fertilizer significantly increased the ratio of the humic/fulvic acid in the soil. The soil active carbon forms of the soil with the application of organic fertilizer and straw returning were significantly higher than those of the CK and CF treatments. This study suggests that the optimal fertilizer management option in northern Anhui’s wheat–maize rotation area is to replace 50% of the chemical fertilizer with organic fertilizer, and to fully return straw to the field. This would include 150 kg N h·m−2, 60 kg P2O5 h·m−2, 50 kg K2O h·m−2, 6000 kg organic fertilizer h·m−2, and full straw return to the field.
Effect of Graphene on Nickel Surface Relaxation: Molecular Dynamics Simulation
Authors: Konorev Sergiy , Yanchuk Vitalii , Kruhlov Ivan , Orlov Andrii , Sidorenko Sergii , Vladymyrskyi Igor , Prikhodko Sergey , Voloshko Svitlana
Published: September 2023

The effect of graphene (GR) on Ni surface relaxation and reconstruction in three different substrate orientations, {111}, {001}, and {011}, at two different temperatures, 300 K and 400 K, was studied using molecular dynamics simulation. The change in the interplanar distances of the substrate and redistribution of Ni and C atoms in a direction perpendicular to the surface was compared with the equilibrium state of GR and bulk Ni, in the absence of the counterpart. The surface reconstruction for the GR/Ni system was analyzed based on the calculated radial pair distribution functions of Ni and C atoms. The surface roughness was visualized using 2D atomic distribution maps. The introduction of GR on the Ni surface in any crystallographic orientation decreases the maximum modification of interplanar spacing compared to the bulk by less than 1%. For the studied substrate orientations and temperatures, it was found that the most densely packed {111} orientation of the Ni base provides minimal changes in the structural parameters of both counterparts at 400 K. Additionally, the system formed by GR deposition on Ni {111} at 400 K is characterized by the least roughness.
Investigation of Friction Coefficient Changes in Recycled Composite Materials under Constant Load
Authors: Güneş Aydın , Düzcükoğlu Hayrettin , Salur Emin , Aslan Abdullah , Şahin Ömer Sinan
Published: September 2023

The surface quality of machine elements may deteriorate over time while operating under different conditions. This deterioration adversely affects the wear behavior in the contact areas, and these materials become unusable over time. In machine elements especially, the heat transfer, wear amount and surface roughness parameters in the contact area are very important in order for the system to work efficiently. In order to understand this change, composite materials were produced by adding spheroidal graphite cast iron (GGG40) with high lubricating properties at different rates to bronze (CuSn10), which is widely used as a self-lubricating bearing material. In this study, four different mixing ratios (B60D40, B70D30, B80D20 and B90D10) and B100, which is completely produced from bronze chips, were used for comparison purposes. In addition, these produced composite materials were compared with pure CuSn10 and pure GGG40 via double-acting isostatic hot pressing, and then the results were examined. The composite materials were made at two different temperatures (400 °C and 450 °C) and three different pressures (480 MPa, 640 MPa and 820 MPa) using recycled waste chips. Composites produced by recycling waste chips both reduce costs and make a positive contribution to the natural environment. Thus, more advantageous self-lubricating bearing materials will be produced, and the efficiency will be increased in these materials. The time-dependent variation in the friction coefficient observed after the wear tests performed under constant load is explained, and the resulting surface structures are presented with SEM images and EDS analyses. After the wear tests, it was observed that the process parameters used in production effectively influenced the wear behavior. In particular, when the production pressure was low (480 MPa), the wear behavior was adversely affected because sufficient bonding between the chips could not be achieved. In addition, as the amount of GGG40 used as a reinforcement material increased, the spheroidal graphite contained in it positively affected the wear behavior. The lubricating effect provided by this spheroidal graphite reduced wear in the contact area and the friction coefficient.