bluuebunny/crossref_metadata_2025 huggingface dataset:
Tauroursodeoxycholic Acid (TUDCA) Relieves Streptozotocin (STZ)-Induced Diabetic Rat Model via Modulation of Lipotoxicity, Oxidative Stress, Inflammation, and Apoptosis
Authors: Mohamed Nema A. , Ithmil Mohammed T. , Elkady Ayman I. , Abdel Salam Sherine
Published: June 2024

Tauroursodeoxycholic acid (TUDCA) is approved for the treatment of liver diseases. However, the antihyperglycemic effects/mechanisms of TUDCA are still less clear. The present study aimed to evaluate the antidiabetic action of TUDCA in streptozotocin (STZ)-induced type 2 diabetes mellitus (T2DM) in rats. Fifteen adult Wistar albino male rats were randomly divided into three groups (n = five in each): control, diabetic (STZ), and STZ+TUDCA. The results showed that TUDCA treatment significantly reduced blood glucose, HbA1c%, and HOMA-IR as well as elevated the insulin levels in diabetic rats. TUDCA therapy increased the incretin GLP-1 concentrations, decreased serum ceramide synthase (CS), improved the serum lipid profile, and restored the glycogen content in the liver and skeletal muscles. Furthermore, serum inflammatory parameters (such as TNF-α, IL-6, IL-1ß, and PGE-2) were substantially reduced with TUDCA treatment. In the pancreas, STZ+TUDCA-treated rats underwent an obvious enhancement of enzymatic (CAT and SOD) and non-enzymatic (GSH) antioxidant defense systems and a marked decrease in markers of the lipid peroxidation rate (MDA) and nitrosative stress (NO) compared to STZ-alone. At the molecular level, TUDCA decreased the pancreatic mRNA levels of iNOS and apoptotic-related factors (p53 and caspase-3). In conclusion, TUDCA may be useful for diabetes management and could be able to counteract diabetic disorders via anti-hyperlipidemic, antioxidant, anti-inflammatory, and anti-apoptotic actions.
Mining Spatial-Temporal Frequent Patterns of Natural Disasters in China Based on Textual Records
Authors: Han Aiai , Yuan Wen , Yuan Wu , Zhou Jianwen , Jian Xueyan , Wang Rong , Gao Xinqi
Published: June 2024

Natural disasters pose serious threats to human survival. With global warming, disaster chains related to extreme weather are becoming more common, making it increasingly urgent to understand the relationships between different types of natural disasters. However, there remains a lack of research on the frequent spatial-temporal intervals between different disaster events. In this study, we utilize textual records of natural disaster events to mine frequent spatial-temporal patterns of disasters in China. We first transform the discrete spatial-temporal disaster events into a graph structure. Due to the limit of computing power, we reduce the number of edges in the graph based on domain expertise. We then apply the GraMi frequent subgraph mining algorithm to the spatial-temporal disaster event graph, and the results reveal frequent spatial-temporal intervals between disasters and reflect the spatial-temporal changing pattern of disaster interactions. For example, the pattern of sandstorms happening after gales is mainly concentrated within 50 km and rarely happens at farther spatial distances, and the most common temporal interval is 1 day. The statistical results of this study provide data support for further understanding disaster association patterns and offer decision-making references for disaster prevention efforts.
Influence of Soil Type and Moisture on Pupal Development of Chrysomya rufifacies (Macquart) at Two Different Temperatures
Authors: Bambaradeniya Tharindu B. , Magni Paola A. , Dadour Ian R.
Published: June 2024

The present study investigates the developmental process of Chrysomya rufifacies (Macquart) pupae and their dependency on soil composition, moisture levels, and temperature changes. This research holds implications for forensic and veterinary applications, providing crucial insights for estimating minimum postmortem intervals and managing myiasis-causing flies in diverse environments. Specifically, the study explores the impact of five moisture content levels in loam and sandy soils (0%, 20%, 40%, 60%, and 80%) on the pupal development of Ch. rufifacies under two distinct constant temperature regimes (24 ± 1 °C and 30 ± 1 °C). A significant correlation was observed between soil type and temperature regarding the time required to complete the pupal stages; however, moisture had no significant impact. Larvae exhibited varying survival rates across the two temperatures and five moisture levels in the two types of soils, particularly under extremely lower moisture conditions (0%) at 30 ± 1 °C, failing to progress to the pupariation stage. Additionally, growth parameters such as pupal length and width of the fully formed puparia were significantly impacted by temperature, soil type, and moisture level. Adult head width was systematically measured across different moisture levels and soil types, revealing distinct temperature-dependent responses. Furthermore, a sex-specific analysis highlighted that female Ch. rufifacies consistently displayed larger head widths and higher emergence rates compared to their male counterparts. This research enhances our understanding of the intricate interrelationship among three environmental variables: soil type, moisture level, and temperature, elucidating their collective impact on the pupation processes of dipterans.
Angle Dependence of Electrode Lead-Related Artifacts in Single- and Dual-Energy Cardiac ECG-Gated CT Scanning—A Phantom Study
Authors: Tarkowski Piotr , Siek Elżbieta , Staśkiewicz Grzegorz , Bielecki Dennis K. , Czekajska-Chehab Elżbieta
Published: June 2024

Background: The electrodes of implantable cardiac devices (ICDs) may cause significant problems in cardiac computed tomography (CT) because they are a source of artifacts that obscure surrounding structures and possible pathology. There are a few million patients currently with ICDs, and some of these patients will require cardiac imaging due to coronary artery disease or problems with ICDs. Modern CT scanners can reduce some of the metal artifacts because of MAR software, but in some vendors, it does not work with ECG gating. Introduced in 2008, dual-energy CT scanners can generate virtual monoenergetic images (VMIs), which are much less susceptible to metal artifacts than standard CT images. Objective: This study aimed to evaluate if dual-energy CT can reduce metal artifacts caused by ICD leads by using VMIs. The second objective was to determine how the angle between the electrode and the plane of imaging affects the severity of the artifacts in three planes of imaging. Methods: A 3D-printed model was constructed to obtain a 0–90-degree field at 5-degree intervals between the electrode and each of the planes: axial, coronal, and sagittal. This electrode was scanned in dual-energy and single-energy protocols. VMIs with an energy of 40–140 keV with 10 keV intervals were reconstructed. The length of the two most extended artifacts originating from the tip of the electrode and 2 cm above it—at the point where the thick metallic defibrillating portion of the electrode begins—was measured. Results: For the sagittal plane, these observations were similar for both points of the ICDs that were used as the reference location. VMIs with an energy over 80 keV produce images with fewer artifacts than similar images obtained in the single-energy scanning mode. Conclusions: Virtual monoenergetic imaging techniques may reduce streak artifacts arising from ICD electrodes and improve the quality of the image. Increasing the angle of the electrode as well as the imaging plane can reduce artifacts. The angle between the electrode and the beam of X-rays can be increased by tilting the gantry of the scanner or lifting the upper body of the patient.
Artificial Intelligence Applications for Thoracic Surgeons: “The Phenomenal Cosmic Powers of the Magic Lamp”
Authors: Cusumano Giacomo , D’Arrigo Stefano , Terminella Alberto , Lococo Filippo
Published: June 2024

In the digital age, artificial intelligence (AI) is emerging as a transformative force in various sectors, including medicine. This article explores the potential of AI, which is akin to the magical genie of Aladdin’s lamp, particularly within thoracic surgery and lung cancer management. It examines AI applications like machine learning and deep learning in achieving more precise diagnoses, preoperative risk assessment, and improved surgical outcomes. The challenges and advancements in AI integration, especially in computer vision and multi-modal models, are discussed alongside their impact on robotic surgery and operating room management. Despite its transformative potential, implementing AI in medicine faces challenges regarding data scarcity, interpretability issues, and ethical concerns. Collaboration between AI and medical communities is essential to address these challenges and unlock the full potential of AI in revolutionizing clinical practice. This article underscores the importance of further research and interdisciplinary collaboration to ensure the safe and effective deployment of AI in real-world clinical settings.
The Fate of Mitral Valve Surgery in the Pediatric Age: A 25-Year Single-Center Experience
Authors: Keizman Eitan , Tejman-Yarden Shai , Hubara Evyatar , Illouz Shay , Katz Uriel , Mishaly David , Serraf Alain E. , Pollak Uri
Published: June 2024

Background: The aim of this study was to evaluate the natural history of patients after mitral valve intervention in the pediatric age. Methods: This is a retrospective study including all patients who underwent mitral valve surgery from 1998 to 2022. The patients’ surgical reports, postoperative records, and ambulatory visits were reviewed. The endpoints of the study were survival and freedom from mitral valve reoperation. Results: Of the 70 patients included in the cohort, 61 patients (86.7%) had congenital mitral valve disease, of whom 46 patients (75.4%) had a predominantly mitral regurgitation lesion, and 15 patients (24.6%) had a predominantly mitral stenosis. In the mitral regurgitation group, all of the patients underwent valve repair with an operative mortality of one patient (2.1%), and with median follow-up of 4 years (range, 0.5–13 years), there was 4.3% mortality (n = 2) and 71.2% freedom from reoperation. In the mitral stenosis group, 11 patients underwent mitral valve repair, and 4 patients underwent valve replacement. There was an operative mortality of two patients (13.3%). With a 2-year median follow-up (range: 0.1–23 years), there were no additional mortality cases in the mitral stenosis group. All three patients who survived primary mitral valve replacement (100%) and four patients who survived a primary repair (40.0%) underwent reoperation. Conclusions: This study demonstrates encouraging outcomes for mitral valve repair. The mortality of patients with congenital mitral valve disease may also be related to a difficult postoperative course, rather than the MV lesion itself.
Prospective Study to Evaluate Rectus Femoris Muscle Ultrasound for Body Composition Analysis in Patients Undergoing Bariatric Surgery
Authors: Simó-Servat Andreu , Ibarra Montse , Libran Mireia , Escobar Lilian , Perea Verónica , Quirós Carmen , Puig-Jové Carlos , Barahona Maria-José
Published: June 2024

Background: Bariatric surgery (BS) has a significant impact on body composition (BC) and consequently may affect established sarcopenic obesity (SO) in candidate patients. The aim of this study was to assess the utility of muscle ultrasound (MUS) of rectus femoris thickness (RFT) for the evaluation of BC and skeletal muscle function in patients undergoing BS compared to bioimpedance analysis (BIA), dual-energy X-ray absorptiometry (DEXA) and dynamometry. On the other hand, we aimed to demonstrate how MUS of RFT correlates with quality of life (QoL) in this population, likely due to its ability to detect regional quadriceps muscle sarcopenia compared to the other mentioned methods. Methods: This was a prospective pilot study that included 77 participants (64.9% female, mean age: 53.2 ± 8.67 years) who underwent BS. Handgrip strength was measured using a dynamometer, fat-free mass index (iFFM) was assessed by BIA, appendicular muscle index (AMI) was calculated using DEXA, and RFT was measured by MUS. Moreover, homeostasis model assessment of insulin resistance (HOMA-IR) was calculated. All these measurements were conducted 1 month prior to BS and at the 12-month follow-up. QoL was assessed using the Moorehead–Ardelt questionnaire. Results: The mean BMI decreased by 12.95 ± 3.56 kg/m2 (p = 0.001). Firstly, we observed a positive correlation pre-surgery between HOMA and RFT (r = 0.27, p = 0.02), iFFM (r = 0.36, p = 0.001), AMI (r = 0.31, p = 0.01) and dynamometer readings (r = 0.26, p = 0.02). In addition, we found a correlation between RFT and iFFM (pre-surgery: r = 0.31, p = 0.01; post-surgery: r = 0.25, p = 0.05) and between RFT and lower-extremity AMI post-surgery (r = 0.27, p = 0.04). Secondly, we observed significant reductions in iFFM, AMI and RFT (p = 0.001), but not in dynamometer readings (p = 0.94). Finally, a tendency to a positive correlation between QoL questionnaire and RFT post-surgery results (r = 0.23, p = 0.079) was observed. Conclusions: Our results suggest that RFT measured by MUS is useful for evaluating SO and for the follow-up of these patients after BS. Moreover, RFT can provide relevant information about regional sarcopenia and probably has an accurate correlation with QoL in comparison with the other methods.
Centhaquine Increases Stroke Volume and Cardiac Output in Patients with Hypovolemic Shock
Authors: Khanna Aman , Vaidya Krish , Shah Dharmesh , Ranjan Amaresh K. , Gulati Anil
Published: June 2024

Introduction: Centhaquine is a resuscitative agent that acts on α2B adrenergic receptors. Its effect on cardiac output in hypovolemic shock patients has not been reported. Methods: This pilot study was conducted in 12 hypovolemic shock patients treated with centhaquine who participated in an open-label phase IV study (NCT05956418). Echocardiography was utilized to measure stroke volume (SV), cardiac output (CO), left ventricular outflow tract velocity time integral (LVOT-VTI) and diameter (LVOTd), heart rate (HR), left ventricular ejection fraction (LVEF) and fractional shortening (LVFS), and inferior vena cava (IVC) diameter before (0 min) and 60, 120, and 300 min after centhaquine (0.01 mg/kg) iv infusion for 60 min. Results: SV was significantly increased after 60, 120, and 300 min. CO increased significantly after 120 and 300 min despite a decrease in HR. IVC diameter and LVOT-VTI at these time points significantly increased, indicating the increased venous return. LVEF and LVFS did not change, while the mean arterial pressure (MAP, mmHg) increased after 120 and 300 min. Positive correlations between IVC diameter and SV (R2 = 0.9556) and between IVC diameter and MAP (R2 = 0.8928) were observed, which indicated the effects of an increase in venous return on SV, CO, and MAP. Conclusions: Centhaquine-mediated increase in venous return is critical in enhancing SV, CO, and MAP in patients with hypovolemic shock; these changes could be pivotal for reducing shock-mediated circulatory failure, promoting tissue perfusion, and improving patient outcomes. Trial Registration: CTRI/2021/01/030263 and NCT05956418.
Mechanical Valves: Past, Present, and Future—A Review
Authors: Leviner Dror B. , Abraham Dana , Ronai Tom , Sharoni Erez
Published: June 2024

The mechanical valve was first invented in the 1950s, and since then, a wide variety of prostheses have been developed. Although mechanical valves have outstanding durability, their use necessitates life-long treatment with anticoagulants, which increases the risk of bleeding and thromboembolic events. The current guidelines recommend a mechanical prosthetic valve in patients under 50–60 years; however, for patients aged 50–70 years, the data are conflicting and there is not a clear-cut recommendation. In recent decades, progress has been made in several areas. First, the On-X mechanical valve was introduced; this valve has a lower anticoagulant requirement in the aortic position. Second, a potential alternative to vitamin K-antagonist treatment, rivaroxaban, has shown encouraging results in small-scale trials and is currently being tested in a large randomized clinical trial. Lastly, an innovative mechanical valve that eliminates the need for anticoagulant therapy is under development. We attempted to review the current literature on the subject with special emphasis on the role of mechanical valves in the current era and discuss alternatives and future innovations.
Open Reduction and Internal Fixation with Plate and Screw versus Triplanar External Fixation in the Surgical Treatment of Calcaneal Fractures: A Retrospective Cohort Study
Authors: Pavone Vito , Sapienza Marco , Carnazza Michela , Vaccalluzzo Marco Simone , Leotta Giulia , Sergi Francesco , Mobilia Giuseppe , Di Via Danilo , Testa Gianluca
Published: June 2024

Background: The treatment of displaced intra-articular calcaneal fractures (DIACF) is debated. This study compares open reduction and internal fixation (ORIF) with minimally invasive osteosynthesis (MIOS). Methods: We conducted a retrospective study on 70 patients with DIACF treated between January 2018 and September 2022, divided into ORIF (n = 50) and MIOS (n = 20) groups. Functional outcomes were assessed using the Maryland Foot Score (MFS) and the Creighton-Nebraska Health Foundation Assessment Scale (CNHFAS). Radiographic outcomes, complication rates, and reintervention rates were evaluated. A chi-square analysis examined the correlation between Sanders classification and treatment choice. Results: The chi-square analysis indicated no significant correlation between the complexity of the fracture and the type of treatment chosen (χ2 = 0.175, p = 0.916). Additionally, the Cochran–Armitage test for trend showed no significant trend in the choice of treatment based on fracture complexity (statistic = 0.048, p = 0.826). A Kaplan–Meier analysis showed a longer time to reintervention for MIOS (p = 0.029). Complication rates were similar, with specific complications varying between groups. Quality-of-life outcomes were comparable. Conclusions: ORIF is preferable for high-demand patients due to better anatomical outcomes, while MIOS suits high-risk patients by reducing reinterventions and complications. Further randomized trials are needed to confirm these findings.
Leisure-Time Physical Activity in Subjects with Metabolic-Dysfunction-Associated Steatotic Liver Disease: An All-Cause Mortality Study
Authors: Curci Ritanna , Bonfiglio Caterina , Franco Isabella , Bagnato Claudia Beatrice , Verrelli Nicola , Bianco Antonella
Published: June 2024

Background: Metabolic-dysfunction-associated steatotic liver disease (MASLD) affects 30% of adults worldwide and is associated with obesity and cardiovascular risk factors. If left untreated, it can progress to severe liver disease. Lifestyle changes such as physical activity and weight loss help to reduce the severity and risk of mortality. This study estimated the impact of MASLD and leisure-time physical activity (LTPA) on mortality and examined how gender mediates this effect in a Southern Italian population. Methods: This work is a population-based prospective cohort study of inhabitants of Castellana Grotte (>30 years old) in Southern Italy, which began in 1985. Participants provided general health information, underwent anthropometric measurements and ultrasonography, and completed a validated questionnaire on their food intake and LTPA. The vital status was tracked through local municipalities Results: In total, 1826 participants (39% with MASLD) were enrolled in this study, drawn from 2970 eligible subjects; the mean age was 51.91 (±14.76) years and 56.2% were men. Subjects with MASLD who practiced low LTPA had a significantly higher risk of death than those who did not have MASLD and practiced high LTPA. In addition, subjects with MASLD who practiced low LTPA were about 19% less likely to survive to the age of 82 years. As regards gender, both men and women with MASLD and low LTPA showed a significant risk of death, but this was higher in women. Conclusions: The presence of MASLD, especially in women, increases the risk of death from all causes. LTPA plays a key role in the disease and reduces mortality in these individuals.
The Roles of GDF-9, BMP-15, BMP-4 and EMMPRIN in Folliculogenesis and In Vitro Fertilization
Authors: Fountas Serafeim , Petinaki Efthymia , Bolaris Stamatis , Kargakou Magdalini , Dafopoulos Stefanos , Zikopoulos Athanasios , Moustakli Efthalia , Sotiriou Sotirios , Dafopoulos Konstantinos
Published: June 2024

Growth differentiation factor 9 (GDF-9) contributes to early ovarian development and oocyte survival. Higher concentrations of GDF-9 in follicular fluid (FF) are associated with oocyte nuclear maturation and optimal embryo development. In in vitro fertilization (IVF), GDF-9 affects the ability of the oocyte to fertilize and subsequent embryonic development. Bone morphogenetic protein 15 (BMP-15) is involved in the regulation of ovarian function and affects oocyte development. During IVF, BMP-15 contributes to the formation of competent blastocysts. BMP-15 may play a role in embryo implantation by affecting endometrial receptivity. Bone morphogenetic protein 4 (BMP-4) is involved in the regulation of follicle growth and development and affects granulosa cell (GC) differentiation. In relation to IVF, BMP-4 is important for embryonic development, influences cell fate and differentiation, and plays a role in facilitating embryo–endometrial interactions during the implantation process. Extracellular matrix metalloproteinase inducer (EMMPRIN) is associated with ovulation and follicle rupture, promotes the release of mature eggs, and affects the modification of the extracellular matrix of the follicular environment. In IVF, EMMPRIN is involved in embryo implantation by modulating the adhesive properties of endometrial cells and promotes trophoblastic invasion, which is essential for pregnancy to occur. The purpose of the current article is to review the studies and recent findings of GDF-9, BMP-15, BMP-4 and EMMPRIN as fundamental factors in normal follicular development and in vitro fertilization.
Impact of Periodontitis on Endothelial Risk Dysfunction and Oxidative Stress Improvement in Patients with Cardiovascular Disease
Authors: Angjelova Angela , Jovanova Elena , Polizzi Alessandro , Laganà Ludovica , Santonocito Simona , Ragusa Rosalia , Isola Gaetano
Published: June 2024

Periodontitis is a multifactorial chronic inflammatory disease that affects the periodontium and overall oral health and is primarily caused by a dysbiotic gingival biofilm, which includes, among others, Gram-negative bacteria such as Porphyromonas gingivalis, Actinobacillus actinomycetemcomitans, and Tannerella forsythensis that colonize gingival tissues and that can lead, if not properly treated, to periodontal tissue destruction and tooth loss. In the last few decades, several large-scale epidemiological studies have evidenced that mild and severe forms of periodontitis are strictly bilaterally associated with several cardiovascular diseases (CVDs), stroke, and endothelial dysfunction. Specifically, it is hypothesized that patients with severe periodontitis would have compromised endothelial function, a crucial step in the pathophysiology of atherosclerosis and several CVD forms. In this regard, it was postulated that periodontal treatment would ameliorate endothelial dysfunction, hence bolstering the notion that therapeutic approaches targeted at diminishing cardiovascular risk factors and different forms of periodontal treatment could improve several CVD biomarker outcomes in the short- and long-term in CVD patients. The aim of this review is to update and analyze the link between periodontitis and CVD, focusing on the inflammatory nature of periodontitis and its correlation with CVD, the effects of periodontal therapy on endothelial dysfunction and oxidative stress, and the impact of such therapy on CVD biomarkers and outcomes. The article also discusses future research directions in this field.
A Guideline for Guidelines: A Novel Method to Assess the Helpfulness of Medical Guidelines
Authors: Koller Akos , Takács Johanna
Published: June 2024

Background/Objectives: The recommendations included in medical guidelines (GLs) provide important help to medical professionals for making clinical decisions regarding the diagnosis and treatment of various diseases. However, there are no systematic methods to measure the helpfulness of GLs. Thus, we developed an objective assessment of GLs which indicates their helpfulness and quality. We hypothesized that a simple mathematical analysis of ‘Recommendations’ and ‘Evidence’ would suffice. Methods: As a proof of concept, a mathematical analysis was conducted on the ‘2020 European Society of Cardiology Guidelines on Sports Cardiology and Exercise in Patients with Cardiovascular Disease Guideline’ (SCE-guideline). First, the frequencies of Classes of Recommendations (CLASS) and the Levels of Evidence (LEVEL) (n = 159) were analysed. Then, LEVEL areas under CLASS were calculated to form a certainty index (CI: −1 to +1). Results: The frequency of CLASS I (‘to do’) and CLASS III (‘not to do’) was relatively high in the SCE-guideline (52.2%). Yet, the most frequent LEVEL was C (41.2–83.8%), indicating only a relatively low quality of scientific evidence in the SCE-guideline. The SCE-guideline showed a relatively high CI (+0.57): 78.4% certainty and 21.6% uncertainty. Conclusions: The SCE-guideline provides substantial help in decision making through the recommendations (CLASS), while the supporting evidence (LEVEL) in most cases is of lower quality. This is what the newly introduced certainty index showed: a tool for ‘quality control’ which can identify specific areas within GLs, and can promote the future improvement of GLs. The newly developed mathematical analysis can be used as a Guideline for the Guidelines, facilitating the assessment and comparison of the helpfulness and quality of GLs.
Efficacy and Safety of Direct Oral Anticoagulants versus Warfarin in Obese Patients (BMI ≥ 30 kg/m2) with Atrial Fibrillation or Venous Thromboembolism: An Updated Systematic Review and Meta-Analysis
Authors: Karakasis Paschalis , Ktenopoulos Nikolaos , Pamporis Konstantinos , Sagris Marios , Soulaidopoulos Stergios , Gerogianni Maria , Leontsinis Ioannis , Giannakoulas George , Tousoulis Dimitris , Fragakis Nikolaos , Tsioufis Konstantinos
Published: June 2024

Background: Real-world data show limited utilization of direct oral anticoagulants (DOACs) in obese patients (body mass index [BMI] ≥ 30 kg/m2) due to concerns regarding their efficacy and safety in this demographic. Aim: This review aimed to consolidate current evidence on the efficacy and safety of DOACs versus warfarin in obese patients with non-valvular atrial fibrillation (AF) or venous thromboembolism (VTE). The primary efficacy outcome assessed a composite of all-cause mortality, stroke, systemic embolism (SE), and myocardial infarction (MI). Methods: A systematic search was conducted in MEDLINE, SCOPUS, and Cochrane databases from inception to December 28, 2023. Data were synthesized using random-effects meta-analysis. Results: A total of 35 studies involving 434,320 participants were analyzed. DOAC use was associated with a significant reduction in the risk of the composite outcome (RR = 0.80, 95% CI [0.65, 0.98], I2 = 95%), hemorrhagic stroke (RR = 0.58, 95% CI [0.38, 0.88], I2 = 92%), major bleeding (RR = 0.76, 95% CI [0.63, 0.92], I2 = 94%), gastrointestinal bleeding (RR = 0.59, 95% CI [0.49, 0.72], I2 = 88%), and intracranial bleeding (RR = 0.45, 95% CI [0.34, 0.60], I2 = 44%) compared to warfarin. A non-significant benefit of DOACs was observed for all-cause mortality, MI, the composite of stroke or SE, ischemic stroke, SE, VTE, and minor bleeding compared to warfarin. Subgroup analysis indicated no significant effect modification based on the indication for anticoagulation or study design. Conclusions: DOACs demonstrated a favorable efficacy and safety profile in obese individuals compared to warfarin.
Effects of δ Phase and Annealing Twins on Mechanical Properties and Impact Toughness of L-PBF Inconel 718
Authors: Tucho Wakshum Mekonnen , Ohm Bjorn Andre , Canizalez Sebastian Andres Pedraza , Egeland Andreas , Mildt Martin Bernard , Nedreberg Mette Lokna , Hansen Vidar Folke
Published: June 2024

In this study, the effects of the δ phase and annealing twins on the hardness, tensile properties, and Charpy impact toughness of Inconel 718 fabricated using L-PBF were investigated. The as-printed components underwent two stages of heat treatment to modify their microstructure and phases. The δ phase was induced through solid-solution heat treatment at 980 °C for 1 h, while annealing twins were formed at 1100 °C for 3 h. Following precipitation hardening, specimens containing δ precipitates exhibited a higher ultimate tensile strength (13%), yield strength (27%), and hardness (12%) compared to those rich in annealing twins. The enhanced mechanical strength was attributed to the presence of δ precipitates and differences in the extent of recrystallization, leading to variations in the density of retained lattice defects, including subgrain boundaries and primary phases. Conversely, specimens with annealing twins demonstrated a significantly higher impact toughness (four times) and ductility (twice) than those with δ precipitates. Annealing twins were found to enhance plasticity by impeding dislocation movement, while δ precipitates reduced plasticity by acting as sites for void formation and crack propagation. Microstructural, compositional, phase, crystallographic, and fractographic analyses were conducted using OM, SEM, TEM, and XRD techniques to identify the factors influencing the observed differences. The results indicate that the heat treatment approach involving annealing twins can effectively enhance the ductility of Inconel 718 while maintaining the necessary mechanical strength.
Scenario Analysis of Shorelines, Coastal Erosion, and Land Use/Land Cover Changes and Their Implication for Climate Migration in East and West Africa
Authors: Ideki Oye , Ajoku Osinachi
Published: June 2024

Climate change-induced sea level rise, shoreline changes, and coastal erosion are projected to drive massive population displacement and mobility in Africa. This study was conducted to examine the pattern of shoreline changes, coastal erosion, land use/land cover dynamics, projections, and their implications on internal migration in Senegal, Kenya, and Tanzania, representing West and East Africa. The digitized shoreline was mapped into erosion, accretion, and trend analysis, which further explains the vulnerability and physical processes that could trigger human displacement within the context of environmental/climate migration. Analysis of land use and land cover dynamics was obtained from Landsat 5 TM of 1986, Landsat 7 ET of 2006, Landsat 8 OLI/TIRS of 2016, and Landsat 9 OLI/TIRS of 2022 and computed using ArcGIS 10.7 for land-use change and percentage change in square kilometers was conducted to examine land use/land cover dynamics and their contributions to the risk of coastal erosion in the study regions. The outcome of the shoreline analysis reveals that 972.03 sqkm of land has been lost to coastal erosion in Senegal from 1986 to 2022 with 2016–2022 described as the period with the highest in terms of land loss. In Kenya, −463.30 sqkm of land has also been lost to coastal erosion and agents of wave processes, with 1986–2006 recording the highest share of −87.74% loss of valuable land, while in Tanzania, −1033.35 sqkm of valuable land has been lost from 1986 to 2022 to coastal erosion, with 2006–2016 alone recording −10.4634% of land loss. The result of the land use/land cover percentage change analysis indicates a massive loss of vegetation cover with a significant increase in settlement representing urbanization. The scenario analysis of the shoreline at 10, 20, and 30 m indicates that 567 persons per sqkm at 10 m, 25,904.6 persons per sqkm at 20 m, and 25,904.5 persons per sqkm will be displaced in Senegal at 30 m. In Kenya, 57,746 persons per sqkm are projected to be displaced at 10 m while 1210.5 persons per sqkm will be displaced at 20 m and 7737.32 persons per sqkm will be displaced at 30 m. In Tanzania, the maximum population density projected to be displaced at 10, 20, and 30 m is 10,260.97 per sqkm. Structured questionnaires were administered to elicit responses from coastal dwellers on their perception of coastal erosion and climate migration as part of ground truthing and the result of the survey affirms that coastal erosion and its exposure are the major drivers of climate migration in the study area.
Enhancing Maritime Navigation with Mixed Reality: Assessing Remote Pilotage Concepts and Technologies by In Situ Testing
Authors: Ujkani Arbresh , Hohnrath Pascal , Grundmann Robert , Burmeister Hans-Christoph
Published: June 2024

In response to the evolving landscape of maritime operations, new technologies are on the horizon as mixed reality (MR), which shall enhance navigation safety and efficiency during remote assistance as, e.g., in the remote pilotage use case. However, up to now, it is uncertain if this technology can provide benefits in terms of usability and situational awareness (SA) compared with screen-based visualizations, which are established in maritime navigation. Thus, this paper initially tests and assesses novel approaches to pilotage in the congested maritime environment, which integrates augmented reality (AR) for ship captains and virtual reality (VR) and desktop applications for pilots. The tested prototype employs AR glasses, notably the Hololens 2, to superimpose the Automatic Identification System (AIS) data directly into the captain’s field of view, while pilots on land receive identical information alongside live 360-degree video feeds from cameras installed on the ship. Additional minimum functionalities include waypoint setting, bearing indicators, and voice communication. The efficiency and usability of these technologies are evaluated through in situ tests conducted with experienced pilots on a real ship using the System Usability Scale, the Situational Awareness Rating Technique, as well as Simulator Sickness Questionnaires during the assessment. This includes a first indicative comparison of VR and desktop applications for the given use case.
Evaluation of Influencing Factors in Cleaning Performance for Bio-Fouling Removal Based on High-Pressure Water Jets
Authors: Ahn Jaehyeon , Yan Kaicheng , Bazher Salim Abdullah , Oh Jungkeun , Seo Daewon , Cho Su-gil , Kim Hyungwoo
Published: June 2024

Regular inspections and hull cleanings are essential to prevent bio-fouling on ships. However, traditional cleaning methods such as brush cleaning and high-pressure water-jet cleaning at docks are ineffective in cleaning niche areas like bow thrusters and sea chests. Consequently, cleaning robots based on brushes and water jets have been developed to effectively remove bio-fouling. However, there are concerns that brushes may damage hull coatings, allowing bio-fouling to penetrate the damaged areas. In this study, removal experiments were conducted to identify the most dominant factor in fouling removal using water jet-based cleaning, in preparation for the development of non-contact cavitation high-pressure water jet-cleaning robots. The Taguchi method was used to identify influential factors and generate experimental conditions, and equipment systems for the removal experiments were established. Image analysis was performed to assess the bio-fouling occurrences on each specimen before and after cleaning, and numerical simulations of the nozzle were conducted to estimate stagnation pressure and wall shear stress to confirm the effect on micro-fouling removal. The results indicated that pump pressure is the most influential factor in removing large bio-fouling organisms grown in marine environments and on ship surfaces.
Empirical Orthogonal Function Analysis on Long-Term Profile Evolution of Tidal Flats along a Curved Coast in the Qiantang River Estuary, China
Authors: Li Ying , Pan Dongzi
Published: June 2024

Abstract: Tidal flats are dynamic coastal ecosystems continually reshaped by natural processes and human activities. This study investigates the application of Empirical Orthogonal Function (EOF) analysis to the long-term profile evolution of tidal flats along the Jiansan Bend of the Qiantang River Estuary, China. By applying EOF analysis to profiles observed from 1984 to 2023, this study identifies dominant modes of variability and their spatial and temporal characteristics, offering insights into the complex sediment transport and morphological evolution processes. EOF analysis helps unravel the complex interactions between natural and anthropogenic factors shaping tidal flats, with the first three eigenfunctions accounting for over 90% of the observed variance. The first spatial eigenfunction captures the primary trend, while the subsequent two eigenfunctions reveal secondary and tertiary modes of variability. A conceptual model developed in this study elucidates the interplay between hydrodynamic forces and morphological changes, highlighting the rotation and oscillation of tidal flat profiles in response to seasonal variations in hydrological conditions. The findings emphasize the effectiveness of EOF analysis in capturing significant geomorphological processes and underscore its potential in enhancing the understanding of tidal flat dynamics, thereby informing more effective management and conservation strategies for these critical coastal environments.
Daily Fungal Cell-Free DNA Testing to Assess Clinical Status during Candida krusei Fungemia
Authors: Young Jo-Anne H. , Liu Xiaoying , Porter Emma , Sweet Hannah , Wang Wei , Evans Anton F. , Zhang Chi , Obeid Karam M.
Published: June 2024

We present a case of a man immunocompromised due to myelodysplastic syndrome with Candida krusei fungemia who had a rising cell-free DNA (cfDNA) giant magnetoresistance (GMR) signal when tested daily using plasma blood samples. With the rise in GMR signal paralleling the development of skin lesions in this patient, we conclude that cfDNA can be used to indicate uncontrolled infection and thus help monitor response to therapy. This index patient provides evidence that an invasive fungal infection requires both direct antifungal therapy and an intact immune system to control the infection. This biosensing platform has been simplified to potentially serve as a point-of-care test, setting it apart by overcoming the three common barriers of cfDNA testing: complexity, cost, and time.
Phytopathogenic Fungicidal Activity and Mechanism Approach of Three Kinds of Triphenylphosphonium Salts
Authors: Liu Xuelian , Liu Huihui , Yin Fahong , Li Yiyi , Jiang Jiazhen , Xiao Yumei , Wu Yanhua , Qin Zhaohai
Published: June 2024

The triphenylphosphonium (TPP) cation has been widely used as a carrier for mitochondria-targeting molecules. We synthesized two commonly employed targeting systems, namely, ω-triphenylphosphonium fatty acids (group 2) and ω-triphenylphosphonium fatty alcohols (group 3), to assess the impact of the TPP module on the biological efficacy of mitochondria-targeting molecules. We evaluated their fungicidal activities against nine plant pathogenic fungi in comparison to alkyl-1-triphenylphosphonium compounds (group 1). All three compound groups exhibited fungicidal activity and displayed a distinct “cut-off effect”, which depended on the length of the carbon chain. Specifically, group 1 compounds showed a cut-off point at C10 (compound 1–7), while group 2 and 3 compounds exhibited cut-off points at C15 (compound 2–12) and C14 (compound 3–11), respectively. Notably, group 1 compounds displayed significantly higher fungicidal activity compared to groups 2 and 3. However, group 2 and 3 compounds showed similar activity to each other, although susceptibility may depend on the pathogen tested. Initial investigations into the mechanism of action of the most active compounds suggested that their fungicidal performance may be primarily attributed to their ability to damage the membrane, as well as uncoupling activity and inhibition of fungal respiration. Our findings suggest that the TPP module used in delivery systems as aliphatic acyl or alkoxyl derivatives with carbon chains length < 10 will contribute negligible fungicidal activity to the TPP-conjugate compared to the effect of high level of accumulation in mitochondria due to its mitochondria-targeting ability. These results provide a foundation for utilizing TPP as a promising carrier in the design and development of more effective mitochondria-targeting drugs or pesticides.
Three New Species of Tuber Discovered in Alpine Fir Forests in Yunnan, China
Authors: Li Lin , Wan Shanping , Wang Yun , Thongklang Naritsada , Yang Mei , Liu Chengyi , Luo Zonglong , Li Shuhong
Published: June 2024

Three new species of Tuber, T. albicavum, T. laojunshanense, and T. umbilicicavatum belonging to the Puberulum phylogroup, are described based on specimens collected in alpine Abies forests at 3600–4000 m, Northwest Yunnan, China. T. albicavum is distinguished by its ascomata with a single chamber of 0.5–1.8 cm diameter, with an apical opening of 0.2–0.6 cm in diameter, and light golden-brown alveolate reticulate ascospores up to 30 μm in length; T. laojunshanense is characterized by having ascomata with a slightly tomentose surface, sometimes with a white navel, a relatively thick peridium, up to 280 µm, and yellow-brown spores with alveolate reticulate ornamentation, up to 34 µm in length; T. umbilicicavatum is characterized by smooth ascomata with a distinct white navel, a relatively thin peridium, up to 110 µm, and golden or golden-brown alveolate reticulate ascospores, up to 40 μm in length. The molecular analysis of the internal transcribed spacer region also supports that these three new species differ from previously described Tuber species.
Temporal Variations in Convergence Insufficiency Symptomatic Status among University Students before and after COVID-19: A Longitudinal Analysis from 2018 to 2023
Authors: Pena-Verdeal Hugo , Noya-Padin Veronica , Garcia-Queiruga Jacobo , Nores-Palmas Noelia , Giraldez Maria J. , Yebra-Pimentel Eva
Published: June 2024

The present study aimed to assess the symptomatic status of Convergence Insufficiency (CI) in university students from 2018 to 2023 considering the educational environment pre- and post-COVID-19 pandemic confinements. A Convergence Insufficiency Symptom Survey (CISS) was conducted annually from 2018 to 2023, excluding 2020, in an initial group of 217 third-year Optics and Optometry degree university student participants. In the final group (178 participants), the statistical differences in CISS scores between years were analysed, both overall and by questionnaire subgroup, along with associations between CISS diagnostic categories before and after 2020. Significant differences were found between years in the subscale and total score analyses (Kruskal–Wallis, both p ≤ 0.049). Pairwise comparisons showed significant differences for the performance subgroup in 2021 vs. 2019 and 2018 (Mann–Whitney, both p ≤ 0.004), while in terms of the total score, there was a statistical difference in 2021 vs. 2018 (Mann–Whitney, p < 0.001). The distribution analysis indicated a significant difference between groups (Chi, p = 0.004), with participants from 2021 or later more likely to exhibit higher CISS scores (OR = 3.47, 95%CI 1.04–8.58). The present study shows significant temporal increments in symptomatic status related to CI among university students from 2018 to 2023, indicating a potential impact of the COVID-19 pandemic educational landscape on these outcomes.
Contribution of Matrix Metalloproteinase-2 and Matrix Metalloproteinase-9 to Upper Tract Urothelial Cancer Risk in Taiwan
Authors: Wang Bo-Ren , Ma Hung-Huan , Chang Chao-Hsiang , Liao Cheng-Hsi , Chang Wen-Shin , Mong Mei-Chin , Yang Ya-Chen , Gu Jian , Bau Da-Tian , Tsai Chia-Wen
Published: June 2024

Matrix metalloproteinase (MMP)-2 and -9, which degrade type IV collagen, are linked to cancer invasion and metastasis. Gene polymorphisms in MMP-2 and MMP-9 can influence their function, impacting cancer development and progression. This study analyzed the association between polymorphisms MMP-2 rs243865 (C-1306T), rs2285053 (C-735T), and MMP-9 rs3918242 (C-1562T) with serum concentrations of these enzymes in upper tract urothelial cancer (UTUC) patients. We conducted a case–control study with 218 UTUC patients and 580 healthy individuals in Taiwan. Genotyping was performed using PCR/RFLP on DNA from blood samples, and MMP-2 and MMP-9 serum levels and mRNA expressions in 30 UTUC patients were measured using ELISA and real-time PCR. Statistical analysis showed that MMP-2 rs2285053 and MMP-9 rs3918242 genotypes were differently distributed between UTUC patients and controls (p = 0.0199 and 0.0020). The MMP-2 rs2285053 TT genotype was associated with higher UTUC risk compared to the CC genotype (OR = 2.20, p = 0.0190). Similarly, MMP-9 rs3918242 CT and TT genotypes were linked to increased UTUC risk (OR = 1.51 and 2.92, p = 0.0272 and 0.0054). In UTUC patients, TT carriers of MMP-2 rs2285053 and MMP-9 rs3918242 showed higher mRNA and protein levels (p < 0.01). These findings suggest that MMP-2 rs2285053 and MMP-9 rs3918242 genotypes are significant markers for UTUC risk and metastasis in Taiwan.
Behind the Genetics: The Role of Epigenetics in Infertility-Related Testicular Dysfunction
Authors: Crafa Andrea , Cannarella Rossella , Calogero Aldo E. , Gunes Sezgin , Agarwal Ashok
Published: June 2024

In recent decades, we have witnessed a progressive decline in male fertility. This is partly related to the increased prevalence of chronic diseases (e.g., obesity and diabetes mellitus) and risky lifestyle behaviors. These conditions alter male fertility through various non-genetic mechanisms. However, there is increasing evidence that they are also capable of causing sperm epigenetic alterations, which, in turn, can cause infertility. Furthermore, these modifications could be transmitted to offspring, altering their general and reproductive health. Therefore, these epigenetic modifications could represent one of the causes of the progressive decline in sperm count recorded in recent decades. This review focuses on highlighting epigenetic modifications at the sperm level induced by non-genetic causes of infertility. In detail, the effects on DNA methylation, histone modifications, and the expression profiles of non-coding RNAs are evaluated. Finally, a focus on the risk of transgenerational inheritance is presented. Our narrative review aims to demonstrate how certain conditions can alter gene expression, potentially leading to the transmission of anomalies to future generations. It emphasizes the importance of the early detection and treatment of reversible conditions (such as obesity and varicocele) and the modification of risky lifestyle behaviors. Addressing these issues is crucial for individual health, in preserving fertility, and in ensuring the well-being of future generations.