bluuebunny/crossref_metadata_2025 huggingface dataset:
Nod-like Receptors: Critical Intracellular Sensors for Host Protection and Cell Death in Microbial and Parasitic Infections
Authors: Babamale Abdulkareem Olarewaju , Chen Szu-Ting
Published: October 2021

Cell death is an essential immunological apparatus of host defense, but dysregulation of mutually inclusive cell deaths poses severe threats during microbial and parasitic infections leading to deleterious consequences in the pathological progression of infectious diseases. Nucleotide-binding oligomerization domain (NOD)-Leucine-rich repeats (LRR)-containing receptors (NLRs), also called nucleotide-binding oligomerization (NOD)-like receptors (NLRs), are major cytosolic pattern recognition receptors (PRRs), their involvement in the orchestration of innate immunity and host defense against bacteria, viruses, fungi and parasites, often results in the cleavage of gasdermin and the release of IL-1β and IL-18, should be tightly regulated. NLRs are functionally diverse and tissue-specific PRRs expressed by both immune and non-immune cells. Beyond the inflammasome activation, NLRs are also involved in NF-κB and MAPK activation signaling, the regulation of type I IFN (IFN-I) production and the inflammatory cell death during microbial infections. Recent advancements of NLRs biology revealed its possible interplay with pyroptotic cell death and inflammatory mediators, such as caspase 1, caspase 11, IFN-I and GSDMD. This review provides the most updated information that caspase 8 skews the NLRP3 inflammasome activation in PANoptosis during pathogen infection. We also update multidimensional roles of NLRP12 in regulating innate immunity in a content-dependent manner: novel interference of NLRP12 on TLRs and NOD derived-signaling cascade, and the recently unveiled regulatory property of NLRP12 in production of type I IFN. Future prospects of exploring NLRs in controlling cell death during parasitic and microbial infection were highlighted.
An Integrative Study on Asphondylia spp. (Diptera: Cecidomyiidae), Causing Flower Galls on Lamiaceae, with Description, Phenology, and Associated Fungi of Two New Species
Authors: Bernardo Umberto , Nugnes Francesco , Gargiulo Simona , Nicoletti Rosario , Becchimanzi Andrea , Stinca Adriano , Viggiani Gennaro
Published: October 2021

An integrative study on some species of Asphondylia was carried out. Two species of gall midges from Italy, Asphondylia rivelloi sp. nov. and Asphondylia micromeriae sp. nov. (Diptera: Cecidomyiidae), causing flower galls respectively on Clinopodium vulgare and Micromeria graeca (Lamiaceae), are described and illustrated. The characteristics of each developmental stage and induced galls are described, which allowed the discrimination of these new species in the complex of Asphondylia developing on Lamiaceae plants. Molecular data based on sequencing both nuclear (ITS2 and 28S-D2) and mitochondrial (COI) genes are also provided in support of this discrimination. Phylogeny based on nuclear markers is consistent with the new species, whereas COI phylogeny suggests introgression occurring between the two species. However, these species can also be easily identified using a morphological approach. Phenology of host plants and gall midges are described, and some peculiar characteristics allow the complete and confident discrimination and revision of the treated species. Gall-associated fungi were identified as Botryosphaeria dothidea,Alternaria spp., and Cladosporium spp.
The Chorion Proteome of Diaphorina citri, the Vector of Huanglongbing Disease in Citrus
Authors: Santos-Ortega Yulica , Killiny Nabil
Published: October 2021

Nowadays, the Asian citrus psyllid, Diaphorina citri (Kuwayama) (Hemiptera: Liviidae) is considered the most devastating pest of citrus because it transmits “Candidatus Liberibacter asiaticus”, the putative causal agent of huanglongbing (HLB) or citrus greening. Controlling the vector is the main strategy used to mitigate HLB. Targeting D. citri at the very early stages of its development may offer an effective control strategy. Identifying chorion proteins will contribute to a better understanding of embryo development and egg hatching and thus could lead to valuable targets to better control psyllid populations. Herein, we analyze the chorion proteins of D. citri. Mass spectrometry-based bottom-up/shotgun proteomics and databases were queried to achieve protein identification. Fifty-one proteins were identified in D. citri chorion. The D. citri chorion proteins were divided into eight categories according to their biological or molecular function: i—enzymes (25%); ii—binding proteins (10%); iii—structural proteins (8%); iv—homeostasis-related proteins, mostly vitellogenins (8%); v—proteins related to gene expression (6%); vi—immune system proteins (6%); vii—other proteins (16%); and viii—uncharacterized proteins (21%). The composition of the chorion proteome suggested that the hatching rate could be reduced by silencing chorion-related genes. The proteomic analysis of D. citri chorion tissue allowed us to identify its proteins, providing promising new targets for D. citri control through RNA interference technology.
Recent Advances in Insect Rearing Methodology to Promote Scientific Research and Mass Production
Authors: Huynh Man P. , Shelby Kent S. , Coudron Thomas A.
Published: October 2021

The benefits obtained from our ability to produce insects have encompassed a wide array of applications, from the early stages of examining different species, to the present day of mass production for multiple purposes [...]
Occurrence of the South American Tomato Leaf Miner, Tuta absoluta (Meyrick) in Southern Shan, Myanmar
Authors: Yule Sopana , Htain Ni Ni , Oo Aung Kyaw , Sotelo-Cardona Paola , Srinivasan Ramasamy
Published: October 2021

The South American tomato leaf miner, Tuta absoluta (Meyrick) (Lepidoptera: Gelechiidae), one of the most important invasive insect pests affecting tomato production worldwide, was for the first time detected in Myanmar. Preliminary surveys on pest occurrence on tomato crops in Myanmar suggested the presence of T. absoluta in Southern Shan State, but there was no official survey conducted until the end of 2019. Therefore, this study aimed to confirm the presence of T. absoluta in Myanmar. The presence of T. absoluta was specifically observed in the Southern Shan State, which is the largest tomato production area in Myanmar, where tomato is grown under two cultivation methods, floating and land cultivation. The highest T. absoluta infestation was recordedat Kalaw with (82%), followed by Inle Lake (i.e., floating cultivation) (20%) and Pin Ta Ya (10%). The amount of T. absoluta larvae was significantly higher in the lower third of the plants, followed by the middle section and upper section, respectively, in three fields surveyed. Potential and severe economic damage may be expected if management practices are not in place to reduce the presence of this invasive pest. It is of immediate importance that plant protection and quarantine offices of ASEAN member states coordinate their response to T. absoluta and build their capacity to monitor the pest and develop a strategy for when it arrives. In addition, a suitable management strategy is needed to reduce the occurrence of this invasive pest.
Cervical Cancer and Fertility-Sparing Treatment
Authors: Zaccarini François , Sanson Claire , Maulard Amandine , Schérier Stéphanie , Leary Alexandra , Pautier Patricia , Chargari Cyrus , Genestie Catherine , Gouy Sébastien , Morice Philippe
Published: October 2021

Radical hysterectomy with pelvic node dissection is the standard treatment for early-stage cervical cancer. However, the latter can be diagnosed at a young age when patients have not yet achieved their pregnancy plans. Dargent first described the vaginal radical trachelectomy for patients with tumors <2 cm. It has since been described a population of low risk of recurrence: patients with tumors <2 cm, without deep stromal infiltration, without lymphovascular invasion (LVSI), and with negative lymph nodes. These patients can benefit from a less radical surgery such as conization or simple trachelectomy with the evaluation of the pelvic node status. Tumors larger than 2 cm have a higher risk of recurrence and their treatment is a challenge. There are currently two options for these patients: abdominal radical trachelectomy or neoadjuvant chemotherapy (NACT), followed by fertility-sparing surgery. All patients who wish to preserve their fertility must be referred to expert centers.
Comparison of Longitudinal and Cross-Sectional Approaches in Studies on Knowledge, Attitude and Practices Related to Non-Medical Tranquilizer Use
Authors: Mallah Narmeen , Battaglia Julia , Figueiras Adolfo , Takkouche Bahi
Published: October 2021

Research about the association of knowledge and attitudes with practices (KAP) of non-medical tranquilizer use is scarce. We compared findings from cross-sectional and longitudinal approaches in a KAP-based study on non-medical tranquilizer use in Spain using data collected from the same population. Eight-hundred forty-seven participants completed a validated KAP questionnaire at baseline and were then followed-up bimonthly for one year for episodes of non-medical tranquilizer use. Non-medical use was defined as unprescribed use, non-adherence to treatment, storage/sharing of tranquilizers, or a combination of those practices. Adjusted odds ratios (ORs) and their 95% confidence intervals (CIs) were estimated using logistic regression from cross-sectional data and generalized linear mixed models for repeated measures in the longitudinal approach. Only the longitudinal approach showed that limited knowledge about the effect of tranquilizers on behaviour [OR: 3.24 (95% CI: 1.12–9.38)] and about the negative effect of their excessive consumption [OR: 4.12 (95% CI: 1.5–11.33)] is associated with storing/sharing tranquilizers. Both cross-sectional and longitudinal analyses indicated that personal attitudes towards tranquilizers and attitudes towards healthcare providers are associated with non-medical tranquilizer use, yet with different magnitude of associations. Differences between the two approaches were also observed for individual types of non-medical use. Certain discrepancies exist between findings from longitudinal and cross-sectional approaches on KAP of non-medical tranquilizer use. KAP studies are the backbone for designing and evaluating prevention programs on non-medical tranquilizer use, and hence choosing a proper study design, scrutinizing the associated biases, and carefully interpreting findings from those studies are required.
A Systematic Review and Meta-Analysis of Enzyme Replacement Therapy in Late-Onset Pompe Disease
Authors: Dornelles Alícia Dorneles , Junges Ana Paula Pedroso , Pereira Tiago Veiga , Krug Bárbara Corrêa , Gonçalves Candice Beatriz Treter , Llerena Juan Clinton , Kishnani Priya Sunil , de Oliveira Haliton Alves , Schwartz Ida Vanessa Doederlein
Published: October 2021

Pompe disease (PD) is a glycogen storage disorder caused by deficient activity of acid alpha-glucosidase (GAA). We sought to review the latest available evidence on the safety and efficacy of recombinant human GAA enzyme replacement therapy (ERT) for late-onset PD (LOPD). Methods: We systematically searched the MEDLINE (via PubMed), Embase, and Cochrane databases for prospective clinical studies evaluating ERT for LOPD on pre-specified outcomes. A meta-analysis was also performed. Results: Of 1601 articles identified, 22 were included. Studies were heterogeneous and with very low certainty of evidence for most outcomes. The following outcomes showed improvements associated with GAA ERT, over a mean follow-up of 32.5 months: distance walked in the 6-min walking test (6MWT) (mean change 35.7 m (95% confidence interval [CI] 7.78, 63.75)), physical domain of the SF-36 quality of life (QOL) questionnaire (mean change 1.96 (95% CI 0.33, 3.59)), and time on ventilation (TOV) (mean change −2.64 h (95% CI −5.28, 0.00)). There were no differences between the pre- and post-ERT period for functional vital capacity (FVC), Walton and Gardner-Medwin Scale score, upper-limb strength, or total SF-36 QOL score. Adverse events (AEs) after ERT were mild in most cases. Conclusion: Considering the limitations imposed by the rarity of PD, our data suggest that GAA ERT improves 6MWT, physical QOL, and TOV in LOPD patients. ERT was safe in the studied population. PROSPERO register: 135102.
Results of a 2021 French National Survey on Management of Patients with Advanced Stage Epithelial Ovarian Cancer
Authors: Drouin Leonor , Guani Benedetta , Balaya Vincent , Azaïs Henri , Betrian Sarah , Bolze Pierre-Adrien , Dabi Yohann , Kerbage Yohan , Sanson Claire , Zaccarini François , Mathevet Patrice , Lécuru Fabrice , Guyon Fréderic , Akladios Cherif , Bendifallah Sofiane , Deluche Elise ,   on behalf of the SFOG Campus (Young of French Society of Gynecological Oncology)
Published: October 2021

Background: The aim of this study was to assess current French practices in the management of patients with advanced epithelial ovarian cancer. Method: a 58-question electronic survey was distributed anonymously to the members of the SFOG (French Society of Gynaecological Oncology), GINECO-ARCAGY (National Investigators Group for Ovarian and Breast Cancer Studies in France) and FRANCOGYN (French research group in oncological and gynaecological surgery). Initial diagnostic workup and staging, pathological data, surgical data, treatments and follow-up strategies were assessed. Results: a total of 107 participants responded to emailed surveys. Most of the respondents were obstetrician-gynaecologists (37.4%), surgical oncologists (34.6%) and medical oncologists (17.8%). According to most (76.8%) participants, less than 50% of patients were eligible for primary debulking surgery (PDS). The LION study criteria were applied in 69.5% of cases during PDS and 39% after chemotherapy. The timing of BRCA testing was very heterogeneous and ranged from 1 to 6 months. The use of bevacizumab as an adjuvant schedule was lower in cases of no residual disease (for 54.5% of respondents) compared to cases of residual disease (for 63.6% of respondents). In cases of BRCA1-2 mutations, olaparib was given by 75.8–84.8% of respondents, whereas niraparib was given in cases of BRCA wild-type diseases. Conclusion: this survey provides an extensive and a unique review of current French practices in the management of patients with advanced epithelial ovarian cancer in 2021.
Preclinical Advances of Therapies for Laminopathies
Authors: Benarroch Louise , Cohen Enzo , Atalaia Antonio , Ben Yaou Rabah , Bonne Gisèle , Bertrand Anne T
Published: October 2021

Laminopathies are a group of rare disorders due to mutation in LMNA gene. Depending on the mutation, they may affect striated muscles, adipose tissues, nerves or are multisystemic with various accelerated ageing syndromes. Although the diverse pathomechanisms responsible for laminopathies are not fully understood, several therapeutic approaches have been evaluated in patient cells or animal models, ranging from gene therapies to cell and drug therapies. This review is focused on these therapies with a strong focus on striated muscle laminopathies and premature ageing syndromes.
Pneumothorax and/or Pneumomediastinum Worsens the Prognosis of COVID-19 Patients with Severe Acute Respiratory Failure: A Multicenter Retrospective Case-Control Study in the North-East of Italy
Authors: Bonato Matteo , Fraccaro Alessia , Landini Nicholas , Zanardi Giuseppe , Catino Cosimo , Savoia Francesca , Malacchini Nicola , Zeraj Fabiola , Peditto Piera , Catalanotti Vito , Marcon Elisabetta , Rossi Emanuela , Pauletti Alessia , Galvan Silvia , Adami Riccardo , Tiepolo Marta , Salasnich Mauro , Cuzzola Maria , Zampieri Francesca , Rattazzi Marcello , Peta Mario , Baraldo Simonetta , Saetta Marina , Morana Giovanni , Romagnoli Micaela
Published: October 2021

Pneumothorax (PNX) and pneumomediastinum (PNM) are potential complications of COVID-19, but their influence on patients’ outcomes remains unclear. The aim of the study was to assess incidence, risk factors, and outcomes of severe COVID-19 complicated with PNX/PNM. Methods: A retrospective multicenter case-control analysis was conducted in COVID-19 patients admitted for respiratory failure in intermediate care units of the Treviso area, Italy, from March 2020 to April 2021. Clinical characteristics and outcomes of patients with and without PNX/PNM were compared. Results: Among 1213 patients, PNX and/or PNM incidence was 4.5%. Among these, 42% had PNX and PNM, 33.5% only PNX, and 24.5% only PNM. COVID-19 patients with PNX/PNM showed higher in-hospital (p = 0.02) and 90-days mortality (p = 0.048), and longer hospitalization length (p = 0.002) than COVID-19 patients without PNX/PNM. At PNX/PNM occurrence, one-third of subjects was not mechanically ventilated, and the respiratory support was similar to the control group. PNX/PNM occurrence was associated with longer symptom length before hospital admission (p = 0.005) and lower levels of blood lymphocytes (p = 0.017). Conclusion: PNX/PNM are complications of COVID-19 associated with a worse prognosis in terms of mortality and length of hospitalization. Although they are more frequent in ventilated patients, they can occur in non-ventilated, suggesting that mechanisms other than barotrauma might contribute to their presentation.
KIFC1 Is Associated with Basal Type, Cisplatin Resistance, PD-L1 Expression and Poor Prognosis in Bladder Cancer
Authors: Sekino Yohei , Pham Quoc Thang , Kobatake Kohei , Kitano Hiroyuki , Ikeda Kenichiro , Goto Keisuke , Hayashi Tetsutaro , Nakahara Hikaru , Sentani Kazuhiro , Oue Naohide , Yasui Wataru , Teishima Jun , Hinata Nobuyuki
Published: October 2021

Kinesin family member C1 (KIFC1), a minus end-directed motor protein, is reported to play an essential role in cancer. This study aimed to analyze KIFC1 expression and examine KIFC1 involvement in cisplatin resistance in bladder cancer (BC). Immunohistochemistry showed that 37 of 78 (47.4%) BC cases were positive for KIFC1. KIFC1-positive cases were associated with high T stage and lymph node metastasis. Kaplan-Meier analysis showed that KIFC1-positive cases were associated with poor prognosis, consistent with the results from public databases. Molecular classification in several public databases indicated that KIFC1 expression was increased in basal type BC. Immunohistochemistry showed that KIFC1-positive cases were associated with basal markers 34βE12, CK5 and CD44. KIFC1 expression was increased in altered TP53 compared to that in wild-type TP53. Immunohistochemistry showed that KIFC1-positive cases were associated with p53-positive cases. P53 knockout by CRISPR-Cas9 induced KIFC1 expression in BC cell lines. Knockdown of KIFC1 by siRNA increased the sensitivity to cisplatin in BC cells. Kaplan-Meier analysis indicated that prognosis was poor among KIFC1-positive BC patients treated with cisplatin-based chemotherapy. Immunohistochemistry showed that KIFC1-positive cases were associated with PD-L1-positive cases. High KIFC1 expression was associated with a favorable prognosis in patients treated with atezolizumab from the IMvigor 210 study. These results suggest that KIFC1 might be a promising biomarker and therapeutic target in BC.
The Reevaluation of Thrombin Time Using a Clot Waveform Analysis
Authors: Wada Hideo , Ichikawa Yuhuko , Ezaki Minoru , Matsumoto Takeshi , Yamashita Yoshiki , Shiraki Katsuya , Shimaoka Motomu , Shimpo Hideto
Published: October 2021

Object: Although thrombin burst has attracted attention as a physiological coagulation mechanism, clinical evidence from a routine assay for it is scarce. This mechanism was therefore evaluated by a clot waveform analysis (CWA) to assess the thrombin time (TT). Material and Methods: The TT with a low concentration of thrombin was evaluated using a CWA. We evaluated the CWA-TT of plasma deficient in various clotting factors, calibration plasma, platelet-poor plasma (PPP), and platelet-rich plasma (PRP) obtained from healthy volunteers, patients with thrombocytopenia, and patients with malignant disease. Results: Although the TT-CWA of calibration plasma was able to be evaluated with 0.01 IU/mL of thrombin, that of FVIII-deficient plasma could not be evaluated. The peak time of CWA-TT was significantly longer, and the peak height significantly lower, in various deficient plasma, especially in FVIII-deficient plasma compared to calibration plasma. The second peak of the first derivative (1st DP-2) was detected in PPP from healthy volunteers, and was shorter and higher in PRP than in PPP. The 1st DP-2 was not detected in PPP from patients with thrombocytopenia, and the 1st DP-2 in PRP was significantly lower in patients with thrombocytopenia and significantly higher in patients with malignant disease than in healthy volunteers. Conclusion: The CWA-TT became abnormal in plasma deficient in various clotting factors, and was significantly affected by platelets, suggesting that the CWA-TT may be a useful test for hemostatic abnormalities.
Non-Adhesive Liquid Embolic Agents in Extra-Cranial District: State of the Art and Review of the Literature
Authors: Piacentino Filippo , Fontana Federico , Curti Marco , Macchi Edoardo , Coppola Andrea , Ossola Christian , Giorgianni Andrea , Marra Paolo , Mosconi Cristina , Ierardi Anna Maria , Basile Antonio , Golfieri Rita , Carrafiello Gianpaolo , Carcano Giulio , Venturini Massimo
Published: October 2021

This review focuses on the use of “new” generation of non-adhesive liquid embolic agents (NALEA). In literature, non-adhesive liquid embolic agents have mainly been used in the cerebral district; however, multiple papers describing the use of NALEA in the extracranial district have been published recently and the aim of this review is to explore and analyze this field of application. There are a few NALEA liquids such as Onyx, Squid, and Phil currently available in the market, and they are used in the following applications: mainly arteriovenous malformations, endoleaks, visceral aneurysm or pseudoaneurysm, presurgical and hypervascular lesions embolization, and a niche of percutaneous approaches. These types of embolizing fluids can be used alone or in combination with other embolizing agents (such as coils or particles) so as to enhance its embolizing effect or improve its possible defects. The primary purpose of this paper is to evaluate the use of NALEAs, predominantly used alone, in elective embolization procedures. We did not attempt a meta-analysis due to the data heterogeneity, high number of case reports, and the lack of a consistent follow-up time period.
Chord Mu (µ) and Chord Alpha (α) Length Changes in Fuchs Endothelial Corneal Dystrophy before and after Descemet Membrane Endothelial Keratoplasty (DMEK) Surgery
Authors: Rocha-de-Lossada Carlos , Sánchez-González José-María , Borroni Davide , Llorens-Bellés Víctor , Rachwani-Anil Rahul , Torras-Sanvicens Josep , Romano Vito , Peraza-Nieves Jorge
Published: October 2021

This paper will evaluate chord mu and alpha length in patients with Fuchs endothelial corneal dystrophy (FECD) and its changes following Descemet membrane endothelial keratoplasty (DMEK). Patients with FECD that underwent DMEK surgery were included in this retrospective study. Scheimpflug Tomography was carried out in order to calculate chord mu and chord alpha lengths prior to surgery and at 3 and 12 months postoperative. This study included 27 eyes from 27 patients. Significant changes in chord mu were observed within the first three months (from 0.47 ± 0.32 to 0.29 ± 0.21 mm, p < 0.01) and remained stable 12 months postoperative (0.30 ± 0.21 mm, p > 0.05). However, chord alpha remained stable throughout the 12 months post surgery (from 0.53 ± 0.19 to 0.49 ± 0.14 mm, p > 0.05). In addition to the pupillary center distance from the corneal center (from 0.35 ± 0.25 to 0.34 ± 0.20 mm, p > 0.05) also remain stable. In FECD patients undergoing DMEK surgery, chord mu length decreased, and chord alpha length remained stable after 12 months of follow-up.
Questionnaire Survey on Driving among Patients with Age-Related Macular Degeneration in Japan
Authors: Hara Chikako , Sawa Miki , Gomi Fumi , Nishida Kohji
Published: October 2021

Purpose: This study aimed to assess driving capabilities in patients with exudative age-related macular degeneration (AMD) causing unilateral blindness or paracentral scotoma without vision deterioration. Methods: Of the 275 patients with AMD who responded to a questionnaire regarding car driving at Osaka University Hospital, we excluded 78 patients who answered that they had never driven. Finally, 197 patients were included (50 with bilateral and 142 with unilateral AMD). We investigated the relationship between the questionnaire findings and best-corrected visual acuity (BCVA). Results: The mean age was 74.8 ± 6.9 years, and the mean BCVA in the right and left eyes were 0.48 and 0.47, respectively. A negative correlation was observed between the proportion of patients who stopped driving due to AMD and the vision in the worse eye (p < 0.0001); however, 66% of participants were still driving. Regardless of the BCVA, 84% of them wished to continue driving. Concerning perceived dangerous situations, all patients reported an oversight of people or signals and night driving; further, patients with unilateral and bilateral vision deterioration reported vision narrowness and difficulty with discerning signal colours, respectively. Conclusion: Despite the associated danger, patients with AMD continued driving. Close attention should be paid to the driving activities among patients with AMD, even if they have passed the relevant driving tests.
Effect of Different Corticosteroid Regimens on the Outcome of Severe COVID-19-Related Acute Respiratory Failure. A Retrospective Analysis
Authors: Umbrello Michele , Formenti Paolo , Nespoli Stefano , Pisano Eleonora , Bonino Cecilia , Muttini Stefano
Published: October 2021

Background: Systemic corticosteroids are associated with reduced mortality in COVID-19-related acute respiratory failure; however, the type and dose has not yet been established. Objectives: To compare the outcomes of dexamethasone vs. methylprednisolone, along with the effects of rescue, short-term, high-dose boluses of corticosteroids. Methods: Before/after and case/control retrospective analysis of consecutive critically ill COVID-19 subjects. Subjects were initially given dexamethasone; however, after review of the local protocol, methylprednisolone was suggested. A three-day course of 1000 mg/day of methylprednisolone was administered in the case of refractory hypoxemia within the first 10 days of treatment. Propensity score-adjusted comparisons were performed. Results: A total of 81 consecutive subjects were included (85% males, 60 ± 10 years, SAPS II 27 ± 7, SOFA 4 [IQR 3, 6] points) and 51 of these subjects (62.9%) received dexamethasone and 29 (35.8%) had methylprednisolone. The groups were well matched for age, comorbidities, and severity at admission. No differences were found in the duration of ICU stay, hospital mortality, or infectious complications between the groups. A total of 22 subjects (27.2%) received a rescue bolus; these subjects had a significantly lower oxygenation, a higher driving pressure, and an increased ventilatory ratio during the first ten days. Short-term/high-dose boluses were associated with higher hospital mortality, longer mechanical ventilation and ICU and hospital stay, and more infectious complications. A subgroup of subjects who received the boluses had significantly improved oxygenation and lower hospital mortality. Conclusions: We were unable to find any difference between dexamethasone or methylprednisolone on the explored outcomes; high-dose boluses of corticosteroids were associated with a worse outcome. However, a subgroup of subjects was identified in whom the high-dose boluses seemed beneficial.
Adventures of Clinical Psychology
Authors: Roccella Michele , Vetri Luigi
Published: October 2021

Clinical psychology strives to fully grasp the person in his totality and in his individuality, helping him adequately address his own deep internal suffering and discomfort, social uneasiness, and harmonize his own needs, desires and, attachments [...]
Serum Calprotectin a Potential Biomarker in Juvenile Idiopathic Arthritis: A Meta-Analysis
Authors: Altobelli Emma , Angeletti Paolo Matteo , Petrocelli Reimondo , Lapergola Giuseppe , Farello Giovanni , Cannataro Giovanni , Breda Luciana
Published: October 2021

Juvenile idiopathic arthritis (JIA) is the most common inflammatory chronic disease affecting children and adolescents. Today, there are no specific biomarkers of inflammation. Therefore, it is important to identify new markers as predictors of disease activity. Recently, some researchers have directed their interest toward a protein, calprotectin (CLP), as a potential biomarker. The primary objective of our systematic review and meta-analysis was to analyze the possible role of CLP in JIA. Method: A literature search was conducted using PubMed, EMBASE, Scopus, Science Direct on 10 August 2021. The selection of studies was made using the PRISMA 2020 guidelines. Cohen’s d with 95% CI and p-value were used as a measure of effect size. The random effects model was used to account for different sources of variation among studies. Heterogeneity was assessed using Q statistics and I2. The publication bias was analyzed and represented by a funnel plot, and funnel plot symmetry was assessed with Egger’s test. Results: Our results at follow-up showed a statistically significant difference between patients with active disease compared to patients with inactive disease: 0.39 (0.16; 0.62), p = 0.001; without statistical heterogeneity. Another important aspect that emerged were the differences between the systemic disease form and any form of inactive disease showing a different concentration of calprotectin: 0.74 (0.40; 1.08), p < 0.001; without statistical heterogeneity. On the other hand, meta-regression analyses performed on gender, age, duration of disease, percentage of patients with ANA+ or RF+, medium value of ESR or CRP were not statistically significant. A statistically significant difference in serum calprotectin concentration between patients with JIA and healthy controls were observed. In fact, it presented lower values in the control group. Conclusions: The use of serum CLP could represent, in the future, a useful tool in JIA in order to stratify disease activity more accurately and may aid a more tailored approach to drug of choice in children with JIA. Further studies are needed to evaluate CLP as a predictor of flare in combination with other potential biomarkers of subclinical disease activity.
The Effect of Diabetes Mellitus on the Recurrence of Atrial Fibrillation after Ablation
Authors: Guckel Denise , Isgandarova Khuraman , Bergau Leonard , Piran Misagh , El Hamriti Mustapha , Imnadze Guram , Braun Martin , Khalaph Moneeb , Fink Thomas , Sciacca Vanessa , Nölker Georg , Lee-Barkey Young-Hee , Tschöpe Diethelm , Sommer Philipp , Sohns Christian
Published: October 2021

Diabetes mellitus (DM) plays a crucial role in the regulation of atrial fibrillation (AF). This study aimed to evaluate the outcome of pulmonary vein isolation (PVI) using a single-shot device in patients with AF and DM. A total of 531 consecutive patients undergoing initial cryoballoon (CB)-guided PVI were evaluated. Two hundred eighty-one patients (53%) suffered from paroxysmal AF (PAF; mean age 51 ± 23.2 years, 26% female), 250 patients (48%) from persistent AF (PERS; 64 ± 10.0 years old, 30% female) and 80 patients (15%) were diagnosed with coincidental DM (68 ± 19.6 years old, 30% female). Follow-up visits were performed at 3, 6 and 12 months including 7-day Holter ECGs. Primary endpoint was the first documented recurrence of atrial tachyarrhythmia. AF recurrence occurred in 26% (140 patients). PAF patients with DM presented with a significantly higher risk for arrhythmia recurrence (Kaplan Meier analysis; Log rank p < 0.001 *). Multivariate analyses found DM to be an independent predictor (IP) for AF recurrence (p = 0.009 *, hazard ratio (HR) 4.363, confidence interval (CI) 1.456–13.074). In PERS, DM was associated with a 43% increase in AF recurrence (p = 0.320, HR 1.427, CI 0.707–2.879). DM has relevant effects on AF recurrence after PVI-only ablation approaches for AF. Major differences were observed in PAF as DM seems to favor the development of individual arrhythmia substrate, which is usually not yet present in PAF. In PERS, DM effects are less pronounced as individual fibrosis has already developed. Thus, personalized paths addressing individual arrhythmia substrates are needed in this specific cohort of patients.
Manual Correction of Voxel Misclassifications in Mesiotemporal Structures Does Not Alter Brain–Behavioral Results in an Episodic Memory Task
Authors: Hartmann Francina , Reinhardt Julia , Stippich Christoph , Krumm Sabine
Published: October 2021

Voxel-based morphometry (VBM) is an established method for assessing grey matter volumes across the brain. The quality of magnetic resonance imaging (MRI) and the chosen data preprocessing steps can affect the outcome of VBM analyses. We recognized a lack of publicly available and commonly used protocols, which indicates that standardized and optimized preprocessing protocols are needed. This paper focuses on the time- and resource-consuming manual correction of misclassifications of grey matter voxels in cortical structures important in Alzheimer’s dementia. A total of 126 individuals, including 63 patients with very early Alzheimer’s disease and 63 cognitively normal participants, received thorough neuropsychological testing and 3-Tesla MRI. Automated preprocessing of T1 MPRAGE images was performed, and misclassifications of grey matter voxels were manually identified and corrected. In a second run, the manual correction step was skipped. Multiple regression analyses using DARTEL in SPM8 were then conducted with the manually corrected and uncorrected sample, respectively. Manual correction of voxel misclassifications did not have a major impact on the correlation between episodic memory performance and structural brain imaging results. We conclude that, although performing all preprocessing steps remains the gold standard, skipping manual correction of voxel misclassifications is permitted when investigating populations on the Alzheimer’s disease spectrum.
Experimental Study on the Shear Band of Methane Hydrate-Bearing Sediment
Authors: Lu Xiaobing , Zhang Xuhui , Sun Fangfang , Wang Shuyun , Liu Lele , Liu Changling
Published: October 2021

The occurrence of a shear band is often thought as the precursor of failure. To study the initiation of shear banding in gas hydrate-bearing sediments, two groups of triaxial compression tests combined with a CT (computer tomography) scan were conducted by triaxial CT-integrated equipment under two confining pressures and seven hydrate saturations. The macro stress–strain curves and the corresponding CT scanning images of the micro-structure and the distribution of the components were obtained. The geometric parameters of the shear bands were measured based on the CT images at four typical axial strains, respectively. The distribution characteristics of soil particles, water, hydrate and gas were also analyzed. It is shown that the existence of methane hydrate changes the mechanical property of hydrate-bearing sediment from plastic failure to brittle failure when the hydrate saturation is over 13%, which occurs in the range of the tests in this paper. The peak of the deviatoric stress increases with the hydrate saturation. The shear band is in either a single oblique line or inter-cross lines depending on the hydrate saturation, the effective confining pressure and the initial distribution of the gas hydrate. Most of the shear band surfaces are not straight, and the widths of the shear bands are almost non-uniformly distributed.
COVID-19-Associated Pulmonary Aspergillosis in Patients with Acute Leukemia: A Single-Center Study
Authors: Rajic Jovan , Gmizic Ivana , Gunjak Tara , Milosevic Violeta , Pantic Nikola , Sabljic Nikica , Mitrovic Mirjana , Djuric Stefanovic Aleksandra , Lazic Ljubica , Jovanovic Snezana , Milošević Ivana , Barac Aleksandra , Vidovic Ana
Published: October 2021

Patients with coronavirus disease 19 (COVID-19) have increased susceptibility to secondary respiratory infections including invasive pulmonary aspergillosis (IPA). COVID-19-associated pulmonary aspergillosis (CAPA) is difficult to diagnose and can be associated with increased mortality especially in severe immunodeficiency such as hematological malignancies. Our study evaluates IPA in COVID-19 patients defined as COVID-19-CAPA among patients with acute leukemia (AL). A retrospective single-center study analyzed 46 patients with COVID-19 infection and acute leukemia, admitted to the Clinic for Haematology, Clinical Center of Serbia, Belgrade between the 2 April 2020 and 15 May 2021. During hospitalization, all participants were diagnosed with probable IPA according to the previous consensus definitions. Positive serology and galactomannan (GM) detection values in bronchoalveolar lavage (BAL) and serum were used as microbiological criteria. COVID-19 associated probable IPA was found in 22% (9/41) tested patients, where serum GM and IgM anti-Aspergillus antibodies were positive in 12% (5/41) and 10% (4/41) had positive serology for aspergillosis. One patient died while eight recovered during follow-up. Our study showed that COVID-19 might be a risk factor for IPA development in patients with AL. Early diagnosis and prompt treatment are required as reported mortality rates are high.
Machine Learning Model to Identify Sepsis Patients in the Emergency Department: Algorithm Development and Validation
Authors: Lin Pei-Chen , Chen Kuo-Tai , Chen Huan-Chieh , Islam Md. Mohaimenul , Lin Ming-Chin
Published: October 2021

Accurate stratification of sepsis can effectively guide the triage of patient care and shared decision making in the emergency department (ED). However, previous research on sepsis identification models focused mainly on ICU patients, and discrepancies in model performance between the development and external validation datasets are rarely evaluated. The aim of our study was to develop and externally validate a machine learning model to stratify sepsis patients in the ED. We retrospectively collected clinical data from two geographically separate institutes that provided a different level of care at different time periods. The Sepsis-3 criteria were used as the reference standard in both datasets for identifying true sepsis cases. An eXtreme Gradient Boosting (XGBoost) algorithm was developed to stratify sepsis patients and the performance of the model was compared with traditional clinical sepsis tools; quick Sequential Organ Failure Assessment (qSOFA) and Systemic Inflammatory Response Syndrome (SIRS). There were 8296 patients (1752 (21%) being septic) in the development and 1744 patients (506 (29%) being septic) in the external validation datasets. The mortality of septic patients in the development and validation datasets was 13.5% and 17%, respectively. In the internal validation, XGBoost achieved an area under the receiver operating characteristic curve (AUROC) of 0.86, exceeding SIRS (0.68) and qSOFA (0.56). The performance of XGBoost deteriorated in the external validation (the AUROC of XGBoost, SIRS and qSOFA was 0.75, 0.57 and 0.66, respectively). Heterogeneity in patient characteristics, such as sepsis prevalence, severity, age, comorbidity and infection focus, could reduce model performance. Our model showed good discriminative capabilities for the identification of sepsis patients and outperformed the existing sepsis identification tools. Implementation of the ML model in the ED can facilitate timely sepsis identification and treatment. However, dataset discrepancies should be carefully evaluated before implementing the ML approach in clinical practice. This finding reinforces the necessity for future studies to perform external validation to ensure the generalisability of any developed ML approaches.
Development of an Advanced Sham Coil for Transcranial Magnetic Stimulation and Examination of Its Specifications
Authors: Takano Mayuko , Havlicek Jiri , Phillips Dan , Nakajima Shinichiro , Mimura Masaru , Noda Yoshihiro
Published: October 2021

Transcranial magnetic stimulation (TMS) neurophysiology has been widely applied worldwide, but it is often contaminated by confounders other than cortical stimulus-evoked activities. Although advanced sham coils that elaborately mimic active stimulation have recently been developed, their performance is not examined in detail. Developing such sham coils is crucial to improve the accuracy of TMS neurophysiology. Herein, we examined the specifications of the sham coil by comparison with the active coil. The magnetic flux and click sound pressure changes were measured when the stimulus intensity was varied from 10% to 100% maximum stimulator output (MSO), and the changes in coil surface temperature over time with continuous stimulation at 50% MSO for each coil. The magnetic flux change at the center of the coil showed a peak of 12.51 (kT/s) for the active coil, whereas it was 0.41 (kT/s) for the sham coil. Although both coils showed a linear change in magnetic flux as the stimulus intensity increased, due to the difference in coil winding structure, the sham coil took less than half the time to overheat and had 5 dB louder coil click sounds than the active coil. The sham coil showed a sufficiently small flux change at the center of the coil, but the flux change from the periphery of the coil was comparable to that of the active coil. Future use of high-quality sham coil will extend our understanding of the TMS neurophysiology of the cortex at the stimulation site.
Risk of Enteric Infection in Patients with Gastric Acid Supressive Drugs: A Population-Based Case-Control Study
Authors: Kuo Chia-Jung , Lin Cheng-Yu , Chen Chun-Wei , Hsu Chiu-Yi , Hsieh Sen-Yung , Chiu Cheng-Tang , Lin Wey-Ran
Published: October 2021

Long-term use of gastric-acid-suppressive drugs is known to be associated with several adverse effects. However, the association between enteric infection and acid suppression therapy is still uncertain. This study aimed to evaluate the association between gastric acid suppression and the risk of enteric infection. Materials and Methods: We conducted a population-based case-control study using the data from Chang Gung Research Database (CGRD) in Taiwan. Between January 2008 and December 2017, a total of 154,590 adult inpatients (age > 18) were identified. A pool of potential eligible controls according to four propensity scores matching by sex, age, and index year were extracted (n = 89,925). Subjects with missing data or who received less than 7 days of proton pump inhibitors (PPIs) and/or H2-receptor antagonists (H2RAs) were excluded. Finally, 17,186 cases and 69,708 corresponding controls were selected for analysis. The use of PPIs and H2RAs, the result of microbiological samples, and co-morbidity conditions have been analyzed. Confounders were controlled by conditional logistic regression. Results: 32.84% of patients in the case group used PPIs, compared with 7.48% in the control group. Of patients in the case group, 9.9% used H2RAs, compared with 6.9% in the control group. Of patients in the case group, 8.3% used a combination of PPIs and H2RAs, compared with 2.7% in the control group. The most common etiological pathogens were Enterococcus (44.8%), Clostridioides difficile (34.5%), and Salmonella spp. (10.2%). The adjusted odds ratio (OR) for PPI use with enteric infection was 5.526 (95% confidence interval [CI], 5.274–5.791). For H2RAs, the adjusted odds ratio was 1.339 (95% confidence interval [CI], 1.261–1.424). Compared to the control group, persons with enteric infection had more frequent acid-suppressive agent usage. Conclusions: This study demonstrates that gastric-acid-suppressive drug use is associated with an increased risk of enteric infection after adjusting for potential biases and confounders.
Review of Experience in Recent Studies on the Dynamics of Land Urbanisation
Authors: Biłozor Andrzej , Cieślak Iwona
Published: October 2021

Urbanisation rapidly accelerated in the 20th century. Along with the increasing dynamics of this phenomenon, the desire to know its origins and its course as well as to anticipate its effects is also growing. Investigations into the mechanisms governing urbanisation have become the subject of numerous studies and research projects. In addition, there has been a rapid increase in the number of tools and methods used to track and measure this phenomenon. However, new methods are still being sought to identify changes in space caused by urbanisation. Some of the indicators of urbanisation processes taking place include quantitative, qualitative and structural changes in land use, occurring at a certain time and place. These processes, related to human activity at a given time and in a given area, are determined by spatial diffusion, usually spreading from the city center towards the peripheral zones. Changes in land use involve the transition from less intensive to more intensive forms of land use. The constant effort to acquire new land for development, the search for alternative solutions for the location of investments and the need to determine the correct direction of development generates the need to constantly apply newer methods in the study of the dynamics of urbanisation processes. This paper presents an overview of recent studies and the most interesting—in the authors’ opinion—methods used in research into the dynamics of urbanisation processes. The main objective of the authors was to produce a compendium to guide the reader through the wide range of topics and to provide inspiration for their own research.
Expansion of Industrial Parks in the Beijing–Tianjin–Hebei Urban Agglomeration: A Spatial Analysis
Authors: Kang Lei , Ma Li
Published: October 2021

Today, China is witnessing large-scale expansion of industrial parks. Rapid urbanization has resulted in the planning, development, and functional transformation of large industrial parks. Some of the expansions have occurred in core areas, while others involved the establishment of new park spaces in peripheral areas. This study examines industrial parks’ spatial expansion in the Beijing–Tianjin–Hebei urban agglomeration and supplements the currently limited spatial expansion analyses of groups of development zones within specific regions. From the perspective of land use change, the study characterizes the spatial expansion of industrial parks in the three periods 1990–2000, 2000–2010, and 2010–2015. Results reveal the following: (1) During the three periods, the footprint of major industrial parks in Beijing–Tianjin–Hebei increased continuously, whereas the average annual growth rates diminished by 11.51%, 8.17%, and 3.38% for 1990–2000, 2000–2010, and 2010–2015, respectively. (2) In terms of spatial layout, the density of industrial parks has always been high in Beijing and Tianjin, and it increased over the three periods in Hebei, with more industrial parks established in the southeastern and fewer in the northern regions. (3) Regarding expansion modes, the period 1990–2000 witnessed several edge-expansions in core areas, such as Beijing and Tianjin, and limited expansions in peripheral cities; in 2000–2010, mainly edge- and infilling expansions occurred in core cities and characteristically outlying expansions in peripheral ones. In 2010–2015, infilling expansions took place in core cities and edge-expansions of established industrial parks occurred in small and medium-sized cities. Identifying the expansion modes is instrumental in differentiating industrial park development paths and optimizing an entire region’s spatial planning for industrial parks.