bluuebunny/crossref_metadata_2025 huggingface dataset:
Daily Light Integral and Far-Red Radiation Influence Morphology and Quality of Liners and Subsequent Flowering and Development of Petunia in Controlled Greenhouses
Authors: Xia Jiaqi , Mattson Neil
Published: October 2024

Petunia stands as the top-selling bedding plant in the U.S., and improved lighting control in greenhouses holds the potential to reduce crop production time and optimize crop quality. This study investigated the impact of four distinct daily light integral (DLI) conditions with and without supplemental far-red (FR) radiation on the growth of petunia liners and subsequent development of finish plants. Two experiments were conducted in spring (9 April to 18 June 2021) and winter (28 October 2021 to 6 January 2022). Petunia cuttings were rooted in a common environment and then transferred to four greenhouse sections with different DLI treatments: 6, 9, 12, and 15 mol·m−2·d−1 for four weeks. Within each DLI condition, half of the plants were exposed to 28 μmol·m−2·s−1 supplemental FR radiation for 16 h daily (equivalent to 1.61 mol·m−2·d−1 light integral). The number of flower buds and open flowers were tracked daily. Representative liners were destructively harvested and evaluated after four weeks of lighting treatments. The remaining plants were transplanted and moved to a common DLI condition of 15 mol·m−2·d−1 for an additional three weeks before being destructively harvested and evaluated as finish plants. The primary finding reveals the promoting effect of DLI on flowering, branching, morphology, and biomass accumulation of petunia liners, with many effects persisting into the finish stage. A threshold DLI of 9 mol·m−2·d−1 was identified, as lower DLI (6 mol·m−2·d−1) resulted in extensive stem elongation, rendering the plants unmarketable. Higher DLI levels were found to be optimal in terms of flowering and morphology. Supplemental FR accelerated flowering by up to three days in the summer experiment and up to 12 days in the winter experiment. However, FR had limited impact on the number of flower buds and open flowers, branching, and shoot and root weight of the finish plants. Interactions between DLI and FR were observed on some parameters, whereby FR effects were more pronounced under lower DLI. Overall, both higher DLI and supplemental FR exhibited beneficial effects, but DLI had a more pronounced effect. Thus, DLI during petunia liner production appears more important than adding FR. This study well simulated the commercial propagation and production of petunia plants, providing practical insights for decision-making regarding lighting strategies.
The Effect of Stretching Exercises Applied to Caregivers of Children with Development Disabilities on Musculoskeletal Muscle Mobility and Respiratory Function
Authors: Atac Amine , Atak Ebrar
Published: October 2024

We aimed to investigate the effect of stretching exercises applied to the hamstring, one of the posterior muscle chains, on musculoskeletal flexibility, chest mobility, and respiratory function. Proprioceptive neuromuscular facilitation and static stretching exercises were applied to 30 healthcare personnel caring for children with developmental delays using a crossover randomized study design. Posterior muscle chain mobility was assessed using the popliteal angle test (PAT) for the hamstring muscle, the mobility of the lumbar muscles was assessed using the Schober test (ST), and the mobility of the posterior chain muscles as a whole was assessed using the finger-to-floor distance test. Chest mobility was measured using chest circumference measurements and lung volumes were measured using the pulmonary function test (PFT). The results showed that stretching exercises applied to the hamstrings led to significant improvements in PAT, ST, and chest mobility in the direction of maximal expiration (p < 0.05), without being superior to each other. Ten males (33.3%) and twenty females (66.7%) who met the inclusion criteria were analyzed. The mean age of the participants was 26.6 ± 5.9 years, the mean height was 169.53 ± 8.67 cm, the mean weight was 65.26 ± 12.03 kg, and the mean body mass index was 22.58 ± 3 kg/m2. Chest inspiratory mechanics also showed a low positive correlation with posterior muscle mobility (r = 0.381; p = 0.038). There was no significant change in PAT. Within the framework of the myofascial theory, stretching exercises that can contribute positively to the musculoskeletal and respiratory system structures of healthcare professionals can be recommended and encouraged to healthcare professionals.
Depression and Functioning during the COVID-19 Pandemic among Adults across Tunisia
Authors: Lambert Jessica E. , Charfi Fatma , Ouali Uta , Aissa Amina , de Jong Joop
Published: October 2024

We aimed to understand how risk (trauma history, health problems, financial problems, family problems) and protective (friend support, family support) factors influenced daily functioning (e.g., self-care, mobility, social participation) among Tunisian adults during the COVID-19 pandemic, directly and through their impact on depression, with a focus on gender differences. We recruited a representative sample of 2014 participants (1024 males, 990 females) using random digit dialing of mobile phone numbers across all 24 governorates in Tunisia. Females reported higher depression, greater impaired functioning, and a higher likelihood of having had COVID-19. Path analysis showed a good fit to the model when paths for males and females were allowed to vary, providing evidence for gender differences. Associations between trauma exposure and depression and depression and age with functioning were stronger among females. Social support from friends was a protective factor for males only. For males, all study variables were associated with functioning indirectly through their association with depression, except for support from friends. For females, family responsibilities and health problems had both direct and indirect effects, whereas other study variables were only linked with functioning through depression. Findings provide insights into factors that can be targeted in interventions aimed at reducing depression and improving daily functioning for males and females.
Promoting Resilience in Healthcare Workers: A Preventative Mental Health Education Program
Authors: Ho Scarlett S. , Sosina Wuraola , DePierro Jonathan M. , Perez Stefanie , Khan Aysha , Starkweather Sydney , Marin Deborah B. , Sharma Vansh , Ripp Jonathan A. , Peccoralo Lauren A. , Charney Dennis S.
Published: October 2024

Healthcare workers face greater risks for mental health conditions and chronic stress due to the demanding nature of their roles. The COVID-19 pandemic exacerbated these challenges and increased vulnerabilities to long-term mental health conditions. The present study adapts an existing resilience-based educational workshop program to address the time constraints and unique needs of the healthcare workforce in a post-COVID-19 world. Expanded from its initial focus on resilience, the workshop curriculum incorporates psychoeducation on common mental health issues. Between July 2022 and June 2024, a 15 min “huddle” format offered on-site training to equip HCWs in a large urban health system with coping strategies to prevent, manage, and recover from stress. Attendance and anonymous feedback were collected at each session via brief electronic surveys. Participant responses (n = 1403) obtained immediately post-huddle suggested positive impact on stress management, perceived leadership support, and resilience. Findings show the potential of brief huddles to improve mental health and resilience in healthcare workers and similar workforces. Our findings support the efficacy of brief, evidence-based educational huddles in enhancing resilience, mental health awareness, and coping skills among HCWs. This model holds significant potential for widespread implementation across healthcare and other high-stress workplaces.
Bridging the Language Gap in Healthcare: Implementing a Qualified Medical Interpreter Program for Lesser-Spoken Languages
Authors: Mavreles Ogrodnick Michelle , O’Connor Mary Helen , Lukas Coco , Feinberg Iris
Published: October 2024

Linguistic inequity drives systemic disparities in healthcare for non-native English speakers. This study evaluates a project to train and provide qualified medical interpreters (QMI) to assist volunteer and safety-net clinics and community-based organizations in supporting healthcare for immigrants and refugees. We provided scholarships to bilingual community members to take a medical interpreter training course and developed a workforce for those who passed the training course. We focused on lesser-spoken foreign languages such as Arabic, Amharic, Pashto, Dari, and Burmese. Those who passed the course participated in a semi-structured interview to learn about their experiences in the training program, as well as barriers and facilitators to becoming a QMI. To date, 23 people have passed the training and are part of the QMI workforce program that has provided 94 h of interpreter services over four months, serving 66 individual patients. The evaluation showed that community members have interest in becoming QMIs and many have the required language proficiency to enroll and pass training. Finding full-time employment for less spoken languages has proven to be challenging.
The Impact of Ecological Footprint, Urbanization, Education, Health Expenditure, and Industrialization on Child Mortality: Insights for Environment and Public Health in Eastern Europe
Authors: Popescu Gheorghe H. , Nica Elvira , Kliestik Tomas , Alpopi Cristina , Bîgu Ana-Madalina Potcovaru , Niță Sorin-Cristian
Published: October 2024

The purpose of this study is to examine the connection between child mortality in Eastern Europe and ecological footprint, urbanization, education, health expenditure, and industrialization. The study acknowledges the significance of understanding how these factors influence the infant mortality rates in this region from 1993 to 2022. The Grossman Health Outcome (H-O) model investigates the theoretical framework. For the existence of the cross-sectional dependency, mixed-order unit root, and cointegration problem, the famous Cross-Sectional Autoregressive Distributed Lag (CS-ARDL) approach is applied. The research also used the Augmented Mean Group (AMG) and Common Correlated Effects Mean Group (CCEMG) to check robustness. The findings illustrated that health expenditure and education lessen the infant mortality rate in Eastern European countries. But ecological footprint, industrialization and unemployment raise the infant mortality rate. According to the CS-ARDL findings, expenditure on healthcare significantly reduces child mortality. Still, the ecological footprint significantly impacts increasing child mortality. However, the AMG and CCEMG models demonstrate that investing in education is the most effective strategy for reducing child mortality. Therefore, the government of Eastern European countries should provide more priorities in the sustainable urbanization, health expenditure, and education sectors. The robustness of the AMG and CCEMG also demonstrated the strength of the CS-ARDL findings. This research paper contributes to SDG 3 by examining the environmental and health factors that influence child mortality in Eastern Europe. Policymakers, public health professionals, and other stakeholders can use the findings to inform the development and implementation of programs that specifically target the identified causes of child mortality.
Assessment of Fine-Scale Urban Heat Health Risk and Its Potential Driving Factors Based on Local Climate Zones in Shenzhen, China
Authors: Su Riguga , Yang Chaobin , Xu Zhibo , Luo Tingwen , Yang Lilong
Published: October 2024

Cities are facing increased heat-related health risks (HHRs) due to the combined effects of global warming and rapid urbanization. However, few studies have focused on HHR assessment based on fine-scale information. Moreover, most studies only analyze spatial HHR patterns and do not explore the potential driving factors. In this study, we estimated the potential HHRs based on the “hazard–exposure–vulnerability” framework by using multisource data, including the modified thermal–humidity index (MTHI), population density, and land cover. Then, the variations in the HHRs among different local climate zones (LCZs) at the fine spatial scale were analyzed in detail. Finally, we compared the different contributions of the LCZs and types of land cover to the HHRs and their three components by using multiple linear regression models. The results indicate that the spatial pattern of the HHRs was different from those of the individual components, and high-hazard regions do not mean high HHRs. There were huge variations in the HHRs among the different LCZs. The built-up LCZs typically had much higher HHRs than the natural ones, with compact LCZs facing the most severe risk. LCZ 6 (open low-rise buildings) had a relatively low HHR and should be paid more attention in future urban planning. Compared to the LCZs, the land covers better explained the variations in the HHR. In contrast, the LCZs better predicted the land surface temperatures. However, both the LCZs and land covers made only slight contributions to the heat exposure and vulnerability. Furthermore, the manmade buildings and impervious surface areas contributed much more to the HHR than the natural land covers. Therefore, the arrangement of the warming LCZs and land cover types is worthy of further investigation from the perspective of HHR mitigation.
Development of Malate Biosensor-Containing Hydrogels and Living Cell-Based Sensors
Authors: Ricks Nathan J. , Brachi Monica , McFadden Kevin , Jadhav Rohit G. , Minteer Shelley D. , Hammond Ming C.
Published: October 2024

Malate is a key intermediate in the citric acid cycle, an enzymatic cascade that is central to cellular energy metabolism and that has been applied to make biofuel cells. To enable real-time sensing of malate levels, we have engineered a genetically encoded, protein-based fluorescent biosensor called Malon specifically responsive to malate by performing structure-based mutagenesis of the Cache-binding domain of the Citron GFP-based biosensor. Malon demonstrates high specificity and fluorescence activation in response to malate, and has been applied to monitor enzymatic reactions in vitro. Furthermore, we successfully incorporated Malon into redox polymer hydrogels and bacterial cells, enabling analysis of malate levels in these materials and living systems. These results show the potential for fluorescent biosensors in enzymatic cascade monitoring within biomaterials and present Malon as a novel tool for bioelectronic devices.
Whole Genome Sequencing Analysis of Model Organisms Elucidates the Association Between Environmental Factors and Human Cancer Development
Authors: Hasegawa Shinya , Shoji Yutaka , Kato Mamoru , Elzawahry Asmaa , Nagai Momoko , Gi Min , Suzuki Shugo , Wanibuchi Hideki , Mimaki Sachiyo , Tsuchihara Katsuya , Totsuka Yukari
Published: October 2024

Determining a novel etiology and mechanism of human cancer requires extraction of characteristic mutational signatures derived from chemical substances. This study explored the mutational signatures of N-nitroso bile acid conjugates using Salmonella strains. Exposing S. typhimurium TA1535 to N-nitroso-glycine/taurine bile acid conjugates induced a predominance of C:G to T:A transitions. Two mutational signatures, B1 and B2, were extracted. Signature B1 is associated with N-nitroso-glycine bile acid conjugates, while Signature B2 is linked to N-nitroso-taurine bile acid conjugates. Signature B1 revealed a strong transcribed strand bias with GCC and GCT contexts, and the mutation pattern of N-nitroso-glycine bile acid conjugates in YG7108, which lacks O6-methylguanine DNA methyltransferases, matched that of the wild-type strain TA1535, suggesting that O6-methyl-deoxyguanosine contributes to mutations in the relevant regions. COSMIC database-based similarity analysis revealed that Signature B1 closely resembled SBS42, which is associated with occupational cholangiocarcinoma caused by overexposure to 1,2-dichlolopropane (1,2-DCP) and/or dichloromethane (DCM). Moreover, the inflammatory response pathway was induced by 1,2-DCP exposure in a human cholangiocyte cell line, and iNOS expression was positive in occupational cholangiocarcinomas. These results suggest that 1,2-DCP triggers an inflammatory response in biliary epithelial cells by upregulating iNOS and N-nitroso-glycine bile acid conjugate production, resulting in cholangiocarcinoma via DNA adduct formation.
Proteolysis Targeting Chimera Agents (PROTACs): New Hope for Overcoming the Resistance Mechanisms in Oncogene-Addicted Non-Small Cell Lung Cancer
Authors: Cordani Nicoletta , Nova Daniele , Sala Luca , Abbate Maria Ida , Colonese Francesca , Cortinovis Diego Luigi , Canova Stefania
Published: October 2024

Non-small cell lung cancer (NSCLC) remains a disease with a poor prognosis despite the advances in therapies. NSCLC with actionable oncogenic alterations represent a subgroup of diseases for which tyrosine kinase inhibitors (TKIs) have shown relevant and robust impact on prognosis, both in early and advanced stages. While the introduction of powerful TKIs increases the ratio of potentially curable patients, the disease does develop resistance over time through either secondary mutations or bypass activating tracks. Therefore, new treatment strategies are being developed to either overcome this inevitable resistance or to prevent it, and proteolysis targeting chimera agents (PROTACs) are among them. They consist of two linked molecules that bind to a target protein and an E3 ubiquitin ligase that causes ubiquitination and degradation of proteins of interest. In this paper, we review the rationale for PROTAC therapy and the current development of PROTACs for oncogene-addicted lung cancer. Moreover, we critically analyze the strengths and limitations of this promising technique that may help pave the way for future perspectives.
Molecular Dynamic Simulations of the Physical Properties of Four Ionic Liquids
Authors: Fan Jing , Pan Yuting , Gao Zhiqiang , Qu Hongwei
Published: October 2024

In this study, the molecular structure models of four ionic liquids were created, the reverse nonequilibrium molecular dynamics simulation (RNEMD) approach was used to predict their densities and viscosities, and their thermal conductivity was simulated using the non-equilibrium molecular dynamic simulation method (NEMD). The calculated results of ionic liquid densities were compared with the data in the literature; most of the variances are around 2.5%, and the maximum relative deviation was less than 6.27%; viscosity values were compared with the experimental data, with a maximum relative deviation of −8.96% and a minimum relative deviation of −2.72%. The simulated thermal conductivity has a good linear relationship with respect to temperature and pressure, which is in good agreement. This study provides a reference for molecular dynamics simulation to measure the physical properties of ionic liquids, which is important for the development of ionic liquids.
Genome-Wide Identification and Expression Analysis of the CLAVATA3/ESR-Related Gene Family in Tiger Nut
Authors: Gancheva Maria , Kon’kova Nina , Solovyeva Alla , Danilov Lavrentii , Gusev Konstantin , Lutova Ludmila
Published: October 2024

CLAVATA3 (CLV3)/EMBRYO SURROUNDING REGION (ESR)-related (CLE) genes encode a group of peptide hormones, which coordinate cell proliferation and differentiation in plants. Tiger nut (Cyperus esculentus L.) is a perennial monocot plant that produces oil-rich tubers. However, the mechanisms regulating tuber development in tiger nut are poorly understood, and nothing is known about CLE genes in tiger nut. In this study, we identified 34 CLE genes in the genomes, proteomes, and transcriptomes of C. esculentus (CeCLE). We analyzed their gene structures and expression profiles in different parts of the plant, at three stages of tuber development and in roots in response to dehydration stress. We found a relatively high expression level of CeCLE13 in growing tuber and suggested that the corresponding CLE peptide could be involved in the regulation of tuberization. We also analyzed CeCLE gene sequences in the genome of the most productive K-17 variety in the N. I. Vavilov All-Russian Institute of Plant Genetic Resources collection and found many single nucleotide polymorphisms, insertions, and deletions. Our data provides fundamental information for future research on tiger nut growth and tuberization.
Antibiotics Resistance and PGPR Traits of Endophytic Bacteria Isolated in Arid Region of Morocco
Authors: Taoufiq Khadijattou , Aberchane Laila , Amri Oukacha , Oufdou Khalid , El Biari Khouzaima , Talbi Abdeslem , Fghire Rachid , Ouachtak Hassan , Faghire Mustapha
Published: October 2024

This study aimed to characterize endophytic bacteria isolated from legume nodules and roots in the rhizosphere soils of Acacia trees in Morocco’s arid regions. The focus was on identifying bacterial strains with plant growth-promoting rhizobacteria (PGPR) traits and antibiotic resistance, which could enhance legume productivity under various abiotic stresses. Autochthonous legumes were used to harbor the endophytic bacteria, including chickpea (Cicer arietinum), faba bean (Vicia faba), lentil (Lens culinaris), and common bean (Phaseolus vulgaris). In a previous study, seventy-two isolates were obtained, and molecular characterization grouped them into twenty-two bacterial isolates. These twenty-two bacterial isolates were then further analyzed for their antibiotic resistance and key PGPR traits, such as phosphate solubilization, indole-3-acetic acid (IAA) production, and siderophore production. The results revealed that 86.36% of the isolates were resistant to erythromycin, 45.45% to ciprofloxacin, 22.73% to ampicillin-sulbactam, and 9.09% to tetracycline, with ciprofloxacin and tetracycline being the most effective. All isolates produced IAA, with HN51 and PN105 exhibiting the highest production at 6 µg of IAA per mg of protein. The other isolates showed varying levels of IAA production, ranging from moderate to low. Siderophore production, assessed using CAS medium, indicated that the strains PN121, LR142, LNR146, and HR26 exhibited high production, while the rest demonstrated moderate to low capacities. Additionally, 18.2% of the isolates demonstrated phosphate solubilization on YED-P medium, with PR135 and LNR135 being the most efficient, achieving solubilization indices of 2.14 and 2.13 cm, respectively. LR142 and LNR146 showed a moderate solubilization efficiency. Overall, these findings indicate that these isolated endophytic bacteria possess significant potential as biofertilizers, owing to their antibiotic resistance, IAA production, siderophore production, and phosphate solubilization abilities. These characteristics position them as promising candidates for enhancing legume growth under abiotic stress and contributing to sustainable agriculture in arid regions.
Species Diversity and Seasonal Abundance of Stomoxyinae (Diptera: Muscidae) and Tabanid Flies (Diptera: Tabanidae) on a Beef Cattle and a Buffalo Farm in Nakhon Si Thammarat Province, Southern Thailand
Authors: Phetcharat Yotsapat , Wongtawan Tuempong , Fungwithaya Punpichaya , Amendt Jens , Sontigun Narin
Published: October 2024

This study investigated species diversity and seasonal abundance of Stomoxyinae and tabanid flies, which are significant pests and vectors of animal pathogens, on a beef cattle and a buffalo farm in Nakhon Si Thammarat province, southern Thailand. During a one-year period from December 2020 to November 2021, flies were collected using Nzi traps from 6 a.m. to 6 p.m. over three consecutive days each month, resulting in the capture of 1912 biting flies, representing seven Stomoxyinae and nine tabanid species. The five most prevalent species were Tabanus megalops, Haematobia irritans exigua, Stomoxys calcitrans, Stomoxys indicus, and Stomoxys uruma. Fly density was notably higher on the beef cattle farm compared to the buffalo farm, with most species peaking during the rainy season, except for H. i. exigua, which was more abundant during the dry season. This study also examined the influence of temperature, relative humidity, and rainfall on fly density, revealing species-specific patterns. These findings offer updated insights into species diversity and seasonal trends, providing critical baseline data essential for the development of effective control strategies aimed at mitigating the impact of these flies on livestock health.
Extracorporeal Photopheresis with 5-Aminolevulinic Acid in Crohn’s Disease—A First-in-Human Phase I/II Study
Authors: Espeland Kristian , Christensen Eidi , Aandahl Astrid , Ulvær Andreas , Warloe Trond , Kleinauskas Andrius , Darvekar Sagar , Juzenas Petras , Vasovic Vlada , Peng Qian , Jahnsen Jørgen
Published: October 2024

Background/Objectives: With the increasing prevalence of Crohn’s disease (CD), treatment options for patients who fail conventional and advanced therapy are highly needed. Therefore, we explored the safety and efficacy of extracorporeal photopheresis (ECP) using 5-aminolevulinic acid (ALA) and blue light (405 nm). Methods: Patients with active CD who failed or were intolerant to biological therapy were eligible. Mononuclear cells (90 mL) were collected from each patient using a Spectra Optia® apheresis system and diluted with 100 mL of 0.9% sodium chloride in a collection bag. The cells were incubated with ALA at a concentration of 3 millimolar (mM) for 60 min ex vivo and illumination with an LED blue light (405 nm) source (BLUE-PIT®) before reinfusion to the patient. Recording of vital signs and adverse events were regularly performed. At week 13, we assessed the patients with colonoscopy, the Harvey Bradshaw Index (HBI), the Inflammatory Bowel disease Health Related Quality of Life Questionnaire, and the measurement of serum C-reactive protein and fecal calprotectin (FC) levels. Biopsies of the intestines were taken for immunohistochemistry. Results: Seven patients were included. Four patients completed the treatments, with a total of 24 treatments. Three of the four patients achieved a favorable response, including a lower HBI, lower FC levels, and/or endoscopic improvement. No significant adverse events were observed. The remaining three patients received only one, three, or five treatments due to technical difficulties, medical reasons, or the withdrawal of informed consent. Conclusions: ALA-based ECP appears safe and seems to give some clinical improvement for the patients with active CD who failed to respond to conventional and advanced therapies.
Triple Therapy De-Escalation and Withdrawal of Inhaled Corticosteroids to Dual Bronchodilator Therapy in Patients with Chronic Obstructive Pulmonary Disease (COPD): A Systematic Review and Meta-Analysis
Authors: Pirera Edoardo , Di Raimondo Domenico , Tuttolomondo Antonino
Published: October 2024

Background/Objectives: The interpretation of evidence on the de-escalation of triple therapy with the withdrawal of inhaled corticosteroids (ICSs) to dual bronchodilator therapy with a long-acting muscarinic antagonist (LAMA) and a long-acting beta-agonist (LABA) in patients with chronic obstructive pulmonary disease (COPD) is conflicting. We evaluated the efficacy and safety of ICS discontinuation from LABA-LAMA-ICS triple therapy compared to its continuation. Methods: We searched PubMed, Embase, Scopus, Web Of Science, clinicaltrial.gov, and CENTRAL for RCTs and observational studies from inception to 22 March 2024, investigating the effect of triple therapy de-escalation with the withdrawal of ICSs to dual therapy on the risk of COPD exacerbation, pneumonia, and lung function. This study was registered with PROSPERO, CRD42024527942. Results: A total of 3335 studies was screened; 3 RCTs and 3 real-world non-interventional studies were identified as eligible. The analysis of the time to the first moderate or severe exacerbation showed a pooled HR of 0.96 (95% CI, 0.80–1.15; I2 = 77%) for ICS withdrawal compared to triple therapy continuation. The analysis according eosinophil levels showed that COPD subjects with ≥300 eosinophils/µL had a significant increase in the incidence of moderate or severe exacerbations when de-escalated to LABA/LAMA (pooled HR: 1.35, 95% CI: 1.00–1.82; I2: 56%). ICS withdrawal did not significantly affect the risk of mortality and pneumonia. Conclusions: The de-escalation of triple therapy with ICS withdrawal does not affect the main outcomes evaluated (moderate or severe exacerbations, change in trough FEV1). COPD patients with high blood eosinophils (≥2% or ≥300 cells/µL) are most likely to benefit from continuing triple therapy.
Using a Patient-Reported Outcome Measure to Assess Physical, Psychosocial, and Existential Issues in COPD
Authors: Darum Sørensen Henriette , Egholm Cecilie Lindström , Løkke Anders , Barna Edina Nikolett , Hougaard Mie Sand , Raunkiær Mette , Farver-Vestergaard Ingeborg
Published: October 2024

Background: Chronic obstructive pulmonary disease (COPD) is marked by severe physical symptoms, impaired quality of life, and high psychological distress. Despite its impact, the identification of not only physical but also psychosocial and existential issues in the clinic lags behind that of other patient groups. Methods: This study aimed to assess physical, psychosocial, and existential issues among patients with COPD using a patient-reported outcome measure for general palliative care (the ‘PRO-Pall’) in a Danish outpatient clinic. We included 115 adults with COPD who completed the PRO-Pall either electronically or in the clinic. Sociodemographic and illness-related data were retrieved from their electronic health records. Results: We found that shortness of breath, tiredness, and difficulty walking were predominant physical issues. Worry about change in social roles was the most frequently reported psychosocial issue, while existential issues were reported by approximately one in ten patients. Most patients (44.5%) felt able to share their feelings with family or friends, and a majority (62.2%) felt their illness-related issues were addressed satisfactorily. Females expressed a greater need for rest and males more frequently reported intimacy issues. Higher COPD-impact on life measured by the COPD Assessment Test was associated with lower ratings on the quality-of-life item of the PRO-Pall independent of age, gender, lung function, and smoking status. Conclusions: Patients reported issues in physical, psychosocial, and existential dimensions of the PRO-Pall. The PRO-Pall shows potential as a broader alternative to measures that focus mainly on physical issues.
Comparison of Revision Techniques for Rod Fracture after Adult Spinal Deformity Surgery: Rod Replacement Alone or Coupled with Lateral Lumbar Interbody Fusions or Accessory Rods
Authors: Lee Ki Young , Lee Jung-Hee , Han Gil , Jung Cheol-Hyun , Park Hong Sik
Published: October 2024

Background: Rod fracture (RF) is the most common cause of revision in adult spinal deformity (ASD) surgery, and various treatment strategies for preventing RF are reported in the literature. This retrospective study, involving 139 ASD patients (aged ≥65 years and a minimum 2-year follow-up) who underwent long-segment fixation from T10 to sacrum with pedicle subtraction osteotomy (PSO), analyzed long-term results, including radiographical parameters and the incidence of recurrent RF (re-RF), to determine the most effective revision method for preventing RF. Methods: Patients were classified into three groups according to the revision method performed for RF: simple rod replacement (RR group, n = 17), lateral lumbar interbody fusion around the PSO site (RR + LLIF group, n = 8), and accessory rod insertion (RR + AR group, n = 22). Baseline characteristics and radiographical and clinical parameters were analyzed. Results: RF occurred in 47 patients (34%) at an average of 28 months following primary deformity correction. Re-RF occurred in six patients (13%) at an average of 37 months. Re-RF occurred most commonly in the RR group (p = 0.048). Every re-RF in the RR group occurred at the PSO site; none occurred in the RR + LLIF group, and one in the RR + AR group occurred near the L4–5. After both primary deformity correction and revision surgery, spinopelvic parameters had shown favorable results, and clinical outcomes had improved in all three groups without significant intergroup differences. Conclusions: Accessory rod insertion or an additional LLIF around the PSO site seems to provide greater strength and stability to the previously fused segments than a simple rod replacement, which demonstrates the need for additional support in revision surgery for RF after a PSO.
Hospital Mortality in Acute Decompensation of Alcoholic Liver Cirrhosis: Can Novel Survival Markers Outperform Traditional Ones?
Authors: Dejanović Božidar , Barak Otto , Čolović Petar , Janjić Nebojša , Savić Željka , Gvozdanović Nikola , Ružić Maja
Published: October 2024

Background: There is a strong correlation between systemic inflammation intensity and clinical presentation, disease progression, and survival during liver cirrhosis decompensation. This study aimed to evaluate the prognostic performance of blood-based biomarkers as meta-inflammation markers, including NLR, PLR, LMR, INPR, MPR, ALBI, FIB4, and APRI, in predicting hospital mortality in patients with acute decompensation of alcohol-related liver cirrhosis. Methods: Data from 411 patients with their first onset of acute decompensation were analyzed, forming two groups: deceased and survived during hospitalization. Generalized partial least squares regression analysis was applied to explore the effects of surrogate indicators on mortality rates, using mortality rate as the dependent variable. Root Mean Square Error, Akaike’s, and Bayesian information criteria determined that four components accounted for most of the variance. Results: Variables with significant negative contributions to the outcome prediction (ranked by standardized regression coefficients) were encephalopathy grade, total bilirubin, Child–Turcotte–Pugh score, MELD, NLR, MPV, FIB4, INR, PLR, and ALT. Coefficient sizes ranged from −0.63 to −0.09, with p-values from 0 to 0.018. Conclusions: NLR, PLR, and FIB4 significantly contribute to hospital mortality prediction in patients with acute decompensation of alcohol-related liver cirrhosis. Conversely, some variables used to predict liver disease severity, including INPR, APRI, LMR, and ALBI score, did not significantly contribute to hospital mortality prediction in this patient population.
18F-FDG-PET/CT Scan for Detection of Large Vessel Involvement in Giant Cell Arteritis: Arteser Spanish Registry
Authors: Estrada Paula , Domínguez-Álvaro Marta , Melero-González Rafael B. , de Miguel Eugenio , Silva-Díaz Maite , Valero Jesús A. , González Ismael , Sánchez-Martín Julio , Narváez Javier , Galíndez Eva , Mendizábal Javier , Iñiguez-Ubiaga Carlota L. , Rodríguez-Rodríguez Luis , Loricera Javier , Muñoz Alejandro , Moya-Alvarado Patricia , Moran-Álvarez Patricia , Navarro-Ángeles Vanessa A. , Galisteo Carlos , Castañeda Santos , Blanco Ricardo ,   on behalf of ARTESER Project Collaborative Group
Published: October 2024

Background/Objectives: Imaging studies have transformed the diagnosis of large vessel vasculitis (LVV) involvement in giant cell arteritis (GCA). A positron emission tomography/computed tomography (PET/CT) scan with 18-fluorodeoxyglucose (18F-FDG) has emerged as a valuable tool for assessing LVV. We aimed to determine the utility of an 18F-FDG-PET/CT scan in detecting LVV in GCA in the ARTESER registry. Methods: The ARTESER study is a large multicenter, retrospective, longitudinal, and observational study, promoted by the Spanish Society of Rheumatology. It included patients newly diagnosed with GCA across 26 tertiary hospitals from 1 June 2013 to 29 March 2019. Patients with a diagnosis of incidental GCA were included if they fulfilled specific criteria, including the ACR 1990 criteria, positive imaging examinations, or the expert clinical opinion of investigators. Differences between patients with positive and negative 18F-FDG-PET/CT scan results were analyzed using a bivariate model. A regression model assessed associations in patients with a positive scan, and the predictive capacity of the cumulative dose of glucocorticoids (GC) on PET scan outcomes was evaluated using ROC curve analysis. Results: Out of 1675 GCA patients included in the registry, 377 met the inclusion criteria of having an 18F-FDG-PET/CT scan. The majority were diagnosed with a cranial GCA phenotype, and 65% had LVV. The thoracic aorta was the most frequently affected. Cardiovascular disease, diabetes, and older age had a negative association with a positive scan outcome. The OR for having a positive 18F-FDG-PET/CTC scan was lower as the number of days increased. Depending on the cumulative dosage of the GC, the 18F-FDG-PET/CT scan showed an AUC of 0.74, with a Youden index > 60 mg/day. Conclusions: Younger patients showed a higher probability of presenting LVV as detected by the 18F-FDG-PET/CT scan. The timing of the examination and the cumulative dosage of the GC influenced the likelihood of a positive result, with earlier tests being more likely to detect inflammation.
Pain Severity During Hysteroscopy by GUBBINI System in Local Anesthesia: Covariance Analysis of Treatment and Effects, Including Patient Emotional State
Authors: Chmaj-Wierzchowska Karolina , Jasielska Aleksandra , Wszołek Katarzyna , Tomczyk Katarzyna , Lach Agnieszka , Mruczyński Adrian , Niegłos Martyna , Wilczyńska Aleksandra , Bednarek Kinga , Wilczak Maciej
Published: October 2024

Pain accompanying medical procedures can be considered in the “mind-body” problem of accounting for and describing the relationship between mental and physical processes (psyche and soma). Background/Objectives: The purpose of this study is to evaluate the severity of pain among patients undergoing a minihysteroscopy procedure under local anesthesia using the “GUBBINI SYSTEM” (GUBBINI Mini Hystero-Resectoscope; Tontarra Medizintechnik, Tuttlingen, Germany) and to assess the association of various covariates with pain during the procedure, including patient emotional state. Methods: This study included 171 patients admitted to the Center for Hysteroscopy under Local Anesthesia at the Heliodor Święcicki Gynecological and Obstetrical Clinical Hospital of the Karol Marcinkowski Medical University in Poznań, Poland, for hysteroscopic treatment under local anesthesia (paracervical, using lignocaine). The Center for Hysteroscopy is the first certified “CENTER OF EXCELLENCE” of The International Society for Gynecologic Endoscopy (ISGE) in Poland. Results: A positive relationship was observed between alexithymia and its trait of difficulty identifying emotions and pain, as well as between perceived pain and one of the deficits of emotional processing—signs of unprocessed emotion. Conclusions: In conclusion, before the hysteroscopy, adequate information and counseling related to the procedure can effectively reduce the pain and anxiety levels of the women, and nurses can navigate this stressful process. Providing education and counseling to all women undergoing hysteroscopy, and explaining the procedure in detail, should be the preferred approach.
Relationship of the Iliac Crest Height with Subsidence After Oblique Lateral Interbody Fusion at L4–5: A Quantitative and Categorical Analysis
Authors: Yang Jae-Hyuk , Lee Kun-Joon , Lee Seung-Yup , Lee Hyung-Rae
Published: October 2024

Background: This study aimed to evaluate the impact of iliac crest height on clinical and radiological outcomes following oblique lateral interbody fusion (OLIF) at the L4–5 level. Methods: Data of patients who underwent single-level OLIF at the L4–5 level for degenerative spinal stenosis were retrospectively analyzed. The patients were categorized into three groups based on their iliac crest height measured relative to the L4 and L5 pedicles. Categorical and quantitative analyses, including univariate and multivariate logistic regressions, were performed to identify subsidence predictors. Clinical outcomes, including visual analog scale scores for back and leg pain, were assessed over a minimum 2-year follow-up. Results: No significant differences in cage obliquity were observed across the iliac crest height groups (axial angles, p = 0.39; coronal angles, p = 0.79). However, subsidence was significantly more common in patients with higher iliac crest heights, particularly at crest level III, where the subsidence rate reached 43% (p = 0.01). Subsidence was predominantly associated with damage to the L5 endplate, which occurred in 83% of subsidence cases at crest level III. A cutoff value of 12 mm for iliac crest height, above which the risk of subsidence significantly increased, was identified (AUC = 0.688, p = 0.042). Conclusions: Iliac crest height is a critical factor for predicting subsidence following OLIF at the L4–5 level. Surgeons should consider alternative strategies and meticulous preoperative planning in patients with an iliac crest height ≥ 12 mm to reduce the risk of adverse outcomes. Further studies are needed to validate these findings and to explore their long-term implications.
Can Eye Tracking Help Assess the State of Consciousness in Non-Verbal Brain Injury Patients?
Authors: Zurek Grzegorz , Binder Marek , Kunka Bartosz , Kosikowski Robert , Rodzeń Małgorzata , Karaś Danuta , Mucha Gabriela , Olejniczak Roman , Gorączko Agata , Kujawa Katarzyna , Stachowicz Anna , Kryś-Noszczyk Karolina , Dryjska Joanna , Dryjski Marcin , Szczygieł Jarosław
Published: October 2024

Background/Objectives: Developments in eye-tracking technology are opening up new possibilities for diagnosing patients in a state of minimal consciousness because they can provide information on visual behavior, and the movements of the eyeballs are correlated with the patients’ level of consciousness. The purpose of this study was to provide validation of a tool, based on eye tracking by comparing the results obtained with the assessment obtained using the Coma Recovery Scale-Revised (CRS-R). Methods: The mul-ti-center clinical trial was conducted in Poland in 2022–2023. The results of 46 patients who were not able to communicate verbally due to severe brain injury were analyzed in this study. The state of consciousness of patients was assessed using the Minimally Conscious State Detection test (MCSD), installed on an eye tracker and compared to CRS-R. The examinations consisted of performing the MCSD test on patients five times (T1–T5) within 14 days. Collected data were processed based on the FDA and GCP’s regulatory requirements. Depending on the nature of the data, the mean and standard deviation, median and lower and upper quartiles, and maximum and minimum values were calculated. Passing–Bablok regression analysis was used to assess the measurement equiva-lence of the methods used. Results: There was no difference between the MCSD and CRS-R in the raw change between T5 and T1 time points, as well as in the total % of points from all time points. The MCSD results from each time point show that at least the first two measurements serve to famil-iarize and adapt the patient to the measurement process, and the third and next measurement should be considered reliable. Conclusions: The results indicated a significant relationship be-tween the scores obtained with MCSD and CRS-R. The results suggest that it seems reasonable to introduce an assessment of the patient’s state of consciousness based on eye-tracking technology. The use of modern technology to assess a patient’s state of consciousness opens up the opportunity for greater objectivity, as well as a reduction in the workload of qualified personnel.
L-Carnitine: A New Therapeutic Option for the Prevention of Atrial Fibrillation in Non-Cardiac Surgery—A Single-Group Interventional Pilot Study
Authors: Shingu Yasushige , Yokota Isao , Kato Tatsuya , Hida Yasuhiro , Kaga Kichizo , Gao Jingwen , Wakasa Satoru
Published: October 2024

Background: L-carnitine is essential in lipid metabolism and reportedly has preventive effects for arrhythmia. Our objective was to examine the incidence of postoperative atrial fibrillation (POAF) and changes in serum biomarker levels following perioperative L-carnitine administration in patients with lung cancer. Methods: Thirteen patients undergoing a lobectomy with preoperative serum brain natriuretic peptide levels >24 pg/mL were perioperatively administered L-carnitine for 5 days (3 g/3×). Accurate 95% confidence intervals (CI) for POAF incidence were calculated. Serum biomarkers for POAF in lung cancer and target proteins for L-carnitine were evaluated by using open-source data from proteomic analysis. Results: The incidence of POAF was 38.5% (95% CI 13.9%–68.4%). Fatty acid-binding protein 4 (FABP4) was selected as a candidate biomarker from 1472, 63, and 26 proteins related to lung cancer, L-carnitine, and AF, respectively. A positive correlation was observed between the predicted POAF incidence rate and preoperative FABP4 levels (Pearson’s r = 0.5183). The mean change in serum FABP4 after L-carnitine administration for 5 days was −2.9 ng/mL (95% CI −4.9 to −0.89 ng/mL). Conclusions: The incidence of POAF after a lobectomy was 38.5% after the perioperative administration of L-carnitine for patients at a high risk of POAF. The serum FABP4 level demonstrates potential as a candidate biomarker for POAF prediction.
Removal of Ibuprofen from Aqueous Solutions by Using Graphene Oxide@MgO
Authors: Malouchi Natalia , Tolkou Athanasia K. , Maroulas Konstantinos N. , Katsoyiannis Ioannis A. , Kyzas George Z.
Published: October 2024

In this study, a new composite adsorbent, namely magnesium oxide modified graphene oxide (hereafter abbreviated GO@MgO), was prepared for the removal of Ibuprofen (IBU), a non-steroidal anti-inflammatory drug (NSAID) compound. Graphene oxide was modified with MgO to improve its properties. Several factors important for the evolution of the adsorption process were investigated, such as the dose of the adsorbent, the pH, and the initial IBU content, as well as the duration of the procedure and temperature. According to the results obtained, it was found that at pH 3.0 ± 0.1, by applying 0.5 g/L GO@MgO to 100 mg/L IBU, more than 80% was removed, reaching 96.3% with the addition of 1.5 g/L adsorbent in 24 h. After 30 min, the equilibrium was reached (77% removal) by adding 0.5 g/L of GO@MgO. This study proves that GO@MgO is capable of economical and efficient adsorption. The IBU kinetic data followed the pseudo-second-order kinetic model. Langmuir and Freundlich isotherm models were used to interpret the adsorption, but the Freundlich model described the adsorption method more accurately. The positive values of ΔH0 (14.465 kJ/mol) confirm the endothermic nature of the adsorption. Due to the increase of ΔG0 values with temperature, the adsorption of IBU on GO@MgO is considered to be spontaneous.