bluuebunny/crossref_metadata_2025 huggingface dataset:
Mineralocorticoid receptor antagonist treatment improved arterial stiffness in patients with primary aldosteronism: a cohort study compared with adrenalectomy
Authors: Liao Che-Wei , Lin Yen-Tin , Tsai Cheng-Hsuan , Chang Yi-Yao , Chen Zheng-Wei , Lu Ching-Chu , Pan Chien-Ting , Chang Chin-Chen , Lee Bo-Ching , Chiu Yu-Wei , Huang Wei-Chieh , Huang Kuo-How , Lai Tai-Shuan , Hung Chi-Shen , Wu Vin-Cent , Wu Xue-Ming , Lin Yen-Hung ,   the TAIPAI Study Group
Published: January 2023

Background:

Elevated arterial stiffness in patients with primary aldosteronism (PA) can be reversed after adrenalectomy; however, the effect of medical treatment with mineralocorticoid receptor antagonist (MRAs) is unknown.

Objectives:

The aim of this study was to evaluate the effect of MRAs and compare both treatment strategies on arterial stiffness in PA patients.

Design:

Prospective cohort study.

Methods:

We prospectively enrolled PA patients from 2006 to 2019 who received either adrenalectomy or MRA treatment (spironolactone). We compared their baseline and 1-year post-treatment biochemistry characteristics and arterial pulse wave velocity (PWV) to verify the effects of treatment and related determinant factors.

Results:

A total 459 PA patients were enrolled. After 1:1 propensity score matching for age, sex and blood pressure (BP), each group had 176 patients. The major determinant factors of baseline PWV were age and baseline BP. The adrenalectomy group had greater improvements in BP, serum potassium level, plasma aldosterone concentration, and aldosterone-to-renin ratio. The MRA group had a significant improvement in PWV after 1 year of treatment (1706.2 ± 340.05 to 1613.6 ± 349.51 cm/s, p < 0.001). There were no significant differences in post-treatment PWV ( p = 0.173) and improvement in PWV ( p = 0.579) between the adrenalectomy and MRA groups. The determinant factors for an improvement in PWV after treatment were hypertension duration, baseline PWV, and the decrease in BP.

Conclusion:

The PA patients who received medical treatment with MRAs had a significant improvement in arterial stiffness. There was no significant difference in the improvement in arterial stiffness between the two treatment strategies.
Sociodemographic and clinical variables as determinants of mortality and survival in patients with acute ST-elevation myocardial infarction in the Eastern Amazon
Authors: Amoras Tárcio Sadraque Gomes , Mendonça Thalia Saraiva , Melo Giovana Salomão , Pereira Kleber Renato Ponzi , Zaninotto Christielaine Venzel , de Oliveira Sheila Santos , da Silva Rosana Moreira , Gomes Fabiana Campos , de Melo Neto João Simão
Published: January 2023

Background:

The aim of this study was to analyze the influence of sociodemographic and clinical variables as determinants of mortality and survival in patients with ST-segment elevation acute myocardial infarction in the Eastern Amazon.

Design and methods:

This observational, longitudinal, and retrospective study was conducted at the Gaspar Vianna Clinical Hospital Foundation in patients hospitalized from January 2017 to June 2020. Patients were divided into two groups: those who survived (G1) ( n = 646) and those who died (G2) ( n = 37). Sociodemographic and clinical variables associated with mortality and survival in these two groups were analyzed.

Results:

Patients with STEMI who had the highest risk of death were often the oldest (G1: 61.58 ± 10.74 years; G2: 69.57 ± 9.02 years; t = −4.492; p = 0.001), with Killip III-IV classifications (OR = 0.13; 95% CI = 0.02–0.71; p = 0.03), and with diseases such as heart failure (OR = 0.07; 95% CI = 0.004–1.50; p = 0.168) or renal failure (OR = 0.03; 95% CI = 0.006–0.16; p = 0.0001). In addition, female sex (hazard ratio = 2.073; 95% CI = 1.413–5.170), Killip III-IV classifications (hazard ratio = 4.041; 95% CI = 1.703–18.883) and the presence of heart failure (hazard ratio = 34.102; 95% CI = 4.410–263.684) or renal failure (hazard ratio = 14.278; 95% CI = 3.275–62.248) shortened in-hospital survival.

Conclusions:

Specific sociodemographic and clinical aspects influenced mortality and survival in patients with acute ST -elevation myocardial infarction.
Preparation and characterization of cetuximab-loaded egg serum albumin nanoparticles and their uses as a drug delivery system against Caco-2 colon cancer cells
Authors: Salim Elsayed I. , Mosbah Abeer M. , Elhussiny F. A. , Hanafy Nemany A. N. , Abdou Y.
Published: January 2023

To avoid the harmful side effects of cetuximab and improve its therapeutic efficacy, egg serum albumin (ESA) was used as a targeting drug carrier moiety for cancer therapy against Caco-2 colon cancer cells. The simple improved desolvation method was used to synthesize ESA nanoparticles (ESA-NPs) and cetuximab-loaded albumin nanoparticles (CET-ANPs) with glutaraldehyde as a crosslinking agent. The ESA-NPs and CET-ANPs were spherically shaped, and their sizes and surface potentials were 100 and − 24 nm and 170 and − 20 nm, respectively, as determined using transmission electron microscopy (TEM) and a Zeta potential analyzer. The specific functional groups of the prepared nanoparticles were revealed by FTIR analysis. In the MTT (3-(4, 5-dimethylthiazolyl-2)-2, 5-diphenyltetrazolium bromide) assay, CET-ANPs exerted the highest antitumor activity after 24 h followed by CET, ESA-NPs, and pure ESA. Combination of CET + ESA-NPs at different IC50 concentrations at ratios of 1:1, 1:2, 2:1, 1:4, 4:1, 1:9, or 9:1 showed significant synergistic effects with a combination index (CI) > 1. Furthermore, the CET either loaded with ESA-NPs or administered in combination (CET + ESA NPs) caused significant apoptotic damage, as well as an S-phase or G2/M cell cycle arrest to the cancer cells, respectively. These were directly linked with a significant upregulation of mRNA expression of Caspase3 and Bax genes and an extreme downregulation of the mRNA expression of Bcl2, particularly in the combination treatment group, as compared to the untreated cells. Finally, ESA-NPs improved the effectiveness of cetuximab, strongly caused apoptotic and antiproliferative action with lower systemic toxicity, and could be suggested for the targeted administration of anticancer medications in various nanosystems.
Whole-genome resequencing reveals genetic differences and the genetic basis of parapodium number in Russian and Chinese Apostichopus japonicus
Authors: Guo Chao , Zhang Xianglei , Li Yuanxin , Xie Jiahui , Gao Pingping , Hao Pengfei , Han Lingshu , Zhang Jinyuan , Wang Wenpei , Liu Peng , Ding Jun , Chang Yaqing
Published: January 2023

Background

Apostichopus japonicus is an economically important species in the global aquaculture industry. Russian A. japonicus, mainly harvested in the Vladivostok region, exhibits significant phenotypic differentiation, including in many economically important traits, compared with Chinese A. japonicus owing to differences in their habitat. However, both the genetic basis for the phenotypic divergence and the population genetic structure of Russian and Chinese A. japonicus are unknown.

Result

In this study, 210 individuals from seven Russian and Chinese A. japonicus populations were sampled for whole-genome resequencing. The genetic structure analysis differentiated the Russian and Chinese A. japonicus into two groups. Population genetic analyses indicated that the Russian population showed a high degree of allelic linkage and had undergone stronger positive selection compared with the Chinese populations. Gene ontology terms enriched among candidate genes with group selection analysis were mainly involved in immunity, such as inflammatory response, antimicrobial peptides, humoral immunity, and apoptosis. Genome-wide association analysis yielded eight single-nucleotide polymorphism loci significantly associated with parapodium number, and these loci are located in regions with a high degree of genomic differentiation between the Chinese and Russia populations. These SNPs were associated with five genes. Gene expression validation revealed that three of these genes were significantly differentially expressed in individuals differing in parapodium number. AJAP08772 and AJAP08773 may directly affect parapodium production by promoting endothelial cell proliferation and metabolism, whereas AJAP07248 indirectly affects parapodium production by participating in immune responses.

Conclusions

This study, we performed population genetic structure and GWAS analysis on Chinese and Russian A. japonicus, and found three candidate genes related to the number of parapodium. The results provide an in-depth understanding of the differences in the genetic structure of A. japonicus populations in China and Russia, and provide important information for subsequent genetic analysis and breeding of this species.
Longitudinal neuropsychological trajectories in idiopathic normal pressure hydrocephalus: a population–based study
Authors: Lilja-Lund Otto , Maripuu Martin , Kockum Karin , Andersson Johanna , Lindam Anna , Nyberg Lars , Laurell Katarina
Published: January 2023

Background

Idiopathic normal pressure hydrocephalus (iNPH) is a progressive syndrome affecting gait, incontinence, and cognition in a significant number of older adults. Still, prospective studies on early development of symptoms are scarce.

Aim

To investigate how neuropsychological functions develop before and in already diagnosed iNPH over a two-year period in a population-based material.

Method

A sample of 104 participants (median [IQR] 75 [72–80] years old) from the general population underwent CT-imaging and clinical assessment at baseline and follow-up. We used the iNPH symptom scale covering four domains (Neuropsychology, Gait, Balance, Incontinence) and additional tests of executive functions. Morphological signs were rated with the iNPH Radscale. Non-parametric statistics with Bonferroni corrections and a significance-level of p < 0.05 were used.

Results

Median (IQR) time to follow-up was 25 (23–26) months. Effect size (ES) for individuals who developed iNPH (n = 8) showed a large (ES r = -0.55) decline in the Gait domain and on the Radscale (ES r = -0.60), with a medium deterioration in declarative memory (ES r = -0.37). Those having iNPH at baseline (n = 12) performed worse on one executive sub-function i.e., shifting (p = 0.045).

Conclusion

Besides deterioration in gait and radiology, our results suggest that a neuropsychological trajectory for those developing iNPH includes a reduction in declarative memory. Executive dysfunction was limited to those already having iNPH at baseline. These findings could suggest that memory impairments are included in the early development of iNPH.
Experiences of giving birth during the COVID-19 pandemic: a qualitative analysis of social media comments through the lens of birth integrity
Authors: Miani Céline , Leiße Antonia , Wandschneider Lisa , Batram-Zantvoort Stephanie
Published: January 2023

Background

Social media offer women a space to discuss birth-related fears and experiences. This is particularly the case during the COVID-19 pandemic when measures to contain the spread of the virus and high rates of infection have had an impact on the delivery of care, potentially restricting women’s rights and increasing the risk of experiencing different forms of mistreatment or violence. Through the lens of birth integrity, we focused on the experiences of women giving birth in Germany as shared on social media, and on what may have sheltered or violated their integrity during birth.

Methods

Using thematic analysis, we identified key themes in 127 comments and associated reactions (i.e. “likes”, emojis) posted on a Facebook public page in response to the dissemination of a research survey on maternity care in the first year of the COVID-19 pandemic.

Results

Women contributing to the dataset gave birth during March and December 2020. They were most negatively affected by own mask-wearing –especially during the active phase of labour, not being allowed a birth companion of choice, lack of supportive care, and exclusion of their partner from the hospital. Those topics generated the most reactions, revealing compassion from other women and mixed feelings about health measures, from acceptation to anger. Many women explicitly formulated how inhumane or disrespectful the care was. While some women felt restricted by the tight visiting rules, those were seen as positive by others, who benefited from the relative quiet of maternity wards and opportunities for postpartum healing and bonding.

Conclusion

Exceptional pandemic circumstances have introduced new parameters in maternity care, some of which appear acceptable, necessary, or beneficial to women, and some of which can be considered violations of birth integrity. Our research calls for the investigation of the long-term impact of those violations and the reassessment of the optimal conditions of the delivery of respectful maternity during the pandemic and beyond.
Spherical pneumonia caused by Ralstonia mannitolilytica: a case report and literature review
Authors: Ma Jianli , Zhang Chuantao , Dang Kaijie , Liao Yichao , Feng Xue , Zhou Pengcheng
Published: January 2023

Background

Spherical pneumonia is an extremely rare condition that is difficult to diagnose. It is a specific type of lung infection that often manifests as a round or round-like mass on chest imaging. Spherical pneumonia is easily misdiagnosed as a pulmonary tumor; therefore, awareness of this disease must be strengthened.

Case presentation

The patient was a 29-year-old female who had persistent cough and sputum for approximately 1 month and fever for 5 days. Chest computed tomography (CT) at our hospital revealed a mass in the lower lobe of the right lung near the hilar region, with obstructive pulmonary atelectasis and obstructive pneumonia. Although lung cancer was suspected, Ralstonia mannitolilytica was detected by metagenomic next-generation sequencing (mNGS) of bronchoalveolar lavage fluid, and no cancer cells or Mycobacterium tuberculosis were detected. Finally, the patient was diagnosed with spherical pneumonia caused by R. mannitolilytica. Anti-infective treatment, symptomatic treatment, and administration of a traditional Chinese medicine decoction were performed based on the syndrome differentiation. After 10 days of treatment, chest CT revealed few lesions in the lower lobe of the right lung, which were significantly reduced compared with those in the past.

Conclusions

Spherical pneumonia caused by R. mannitolilytica has not yet been reported and differential diagnosis is key in clinical diagnosis. When spherical pneumonia is difficult to diagnose, mNGS may be a better alternative.
Osteoarthritis or arthritis? Toward understanding of primary Sjögren’s syndrome patients with arthralgia
Authors: Gao Ronglin , Pu Jincheng , Wu Zhenzhen , Tang Jianping , Wang Xuan
Published: January 2023

Objective

To identify primary Sjögren’s syndrome (pSS) patients with arthralgia at risk for osteoarthritis (OA) or arthritis.

Methods

This study included 368 pSS patients admitted to a mono-centric from March 2010 to December 2020. Patients were divided into groups according to whether complicated with OA or arthritis. Data were analyzed to determine the differences in demographical characteristics, symptoms, and laboratory examination.

Results

The involvement of the OA joints was predominately knee and spine sites (including cervical and lumbar spine degeneration). When diagnosing arthritis, it was mainly peripheral symmetric polyarthritis, the most affected sites were the interphalangeal and metacarpophalangeal joints. There were significant differences in age, disease duration, uric acid (UA), and total cholesterol (TC) between pSS-OA and pSS-nOA patients (P < 0.050). Logistic regression analysis showed that age (OR = 1.965; P = 0.009) and joint pain (OR = 3.382; P < 0.001) were dangerous factors associated with OA. Interestingly, although the level of UA, TC, and triglycerides (TG) was shown to be positive with OA, there was no statistical significance after the OR was computed in the four-cell table. In pSS-arthritis, EULAR Sjögren's syndrome disease activity index (ESSDAI) (P = 0.011), the frequency of joint pain (P < 0.001), and muscular involvement (P = 0.037) were higher than non-arthritis group. In pSS patients only presenting with joint pain, arthritis patients had higher ESSDAI and system involvements, but lower UA and TG levels compared with OA group (P < 0.050).

Conclusion

In pSS patients with arthralgia, OA accounted for the majority. pSS patients with advanced age and more pronounced metabolic characteristics, such as elevated blood lipids and uric acid, was a key factor in groups at risk for OA. However, arthritis patients had higher rates of dry mouth and eye, higher disease activity, antibodies positive, and more organs damage. In the future, it may be necessary to be more cautious in the diagnosis of joint manifestations in pSS patients in order to make the appropriate treatments.
Epidemiological characteristics and comparative outcome of blast versus gunshot injuries of the extremities in Somalia
Authors: Mohamed Abdullahi Yusuf , Ibrahim Hassan Salad , Taşkoparan Hüseyin , Ibrahim Yasin Barkhad
Published: January 2023

Background

War conflicts and terror-related injuries constitute a significant public health problem in Somalia. We aim to characterize and compare the injury characteristics of gunshot and blast injuries of the extremities.

Methods

The data of 333 patients with gunshot and blast injuries of the extremities over three years were retrospectively reviewed. The demographics, injury characteristics, and outcomes were analyzed.

Results

Most of the patients had injuries due to gunshot casualties compared with blast victims (n = 222, 66.7% vs. n = 111, 33.3%). Patients with gunshot wounds (GSW) had a more significant proportion of males than those with blast wounds (BW) (95.5% vs. 85.6%, P < 0.001). There were more open extremity fractures in GSW casualties (96.4% vs. 81.1%). The BW victims had significantly higher associated injuries (52.3% vs. 18.5%, P < 0.001). The BW group had a higher injury severity score (ISS ≥ 16 in 55%, P < 0.001). The need for an intensive care unit (ICU) admission was significantly higher in the BW patients (18% vs. 6.3%, P < 0.001); as well as the length of hospital stay (LOS) was higher in the BW group compared with the GW patients (> 2-week hospital stay in 31% vs. 19%, P < 0.04). About a 2.7% mortality rate was observed in BW (P < 0.014).

Conclusion

Gunshot and explosion injuries comprise the majority of war and terror-related trauma of the extremities. These injury mechanisms differ in the body regions involved, the severity of the injury, duration of hospital stay, need for ICU admission, and mortality. Assessment and management of such devastating casualties require a complex and multidisciplinary approach.
A feasibility study of reduced full-of-view synthetic high-b-value diffusion-weighted imaging in uterine tumors
Authors: Tang Qian , Zhou Qiqi , Chen Wen , Sang Ling , Xing Yu , Liu Chao , Wang Kejun , Liu Weiyin Vivian , Xu Lin
Published: January 2023

Objectives

This study aimed to evaluate the feasibility of reduced full-of-view synthetic high-b value diffusion-weighted images (rFOV-syDWIs) in the clinical application of cervical cancer based on image quality and diagnostic efficacy.

Methods

We retrospectively evaluated the data of 35 patients with cervical cancer and 35 healthy volunteers from May to November 2021. All patients and volunteers underwent rFOV-DWI scans, including a 13b-protocol: b = 0, 25, 50, 75, 100, 150, 200, 400, 600, 800, 1000, 1200, and 1500 s/mm2 and a 5b-protocol: b = 0, 100, 400, 800,1500 s/mm2. rFOV-syDWIs with b values of 1200 (rFOV-syDWIb=1200) and 1500 (rFOV-syDWIb=1500) were generated from two different multiple-b-value image datasets using a mono-exponential fitting algorithm. According to homoscedasticity and normality assessed by the Levene’s test and Shapiro–Wilk test, the inter-modality differences of quantitative measurements were, respectively, examined by Wilcoxon signed-rank test or paired t test and the inter-group differences of ADC values were examined by independent t test or Mann–Whitney U test.

Results

A higher inter-reader agreement between SNRs and CNRs was found in 13b-protocol and 5b-protocol rFOV-syDWIb=1200/1500 compared to 13b-protocol rFOV-sDWIb=1200/1500 (p < 0.05). AUC of 5b-protocol syADCmean,b=1200/1500 and syADCminimum,b=1200/1500 was equal or higher than that of 13b-protocol sADCmean,b=1200/1500 and sADCminimum,b=1200/1500.

Conclusions

rFOV-syDWIs provide better lesion clarity and higher image quality than rFOV-sDWIs. 5b-protocol rFOV-syDWIs shorten scan time, and synthetic ADCs offer reliable diagnosis value as scanned 13b-protocol DWIs.
Multi-modal artificial intelligence for the combination of automated 3D breast ultrasound and mammograms in a population of women with predominantly dense breasts
Authors: Tan Tao , Rodriguez-Ruiz Alejandro , Zhang Tianyu , Xu Lin , Beets-Tan Regina G. H. , Shen Yingzhao , Karssemeijer Nico , Xu Jun , Mann Ritse M. , Bao Lingyun
Published: January 2023

Objectives

To assess the stand-alone and combined performance of artificial intelligence (AI) detection systems for digital mammography (DM) and automated 3D breast ultrasound (ABUS) in detecting breast cancer in women with dense breasts.

Methods

430 paired cases of DM and ABUS examinations from a Asian population with dense breasts were retrospectively collected. All cases were analyzed by two AI systems, one for DM exams and one for ABUS exams. A selected subset (n = 152) was read by four radiologists. The performance of AI systems was based on analysis of the area under the receiver operating characteristic curve (AUC). The maximum Youden’s index and its associated sensitivity and specificity were also reported for each AI systems. Detection performance of human readers in the subcohort of the reader study was measured in terms of sensitivity and specificity.

Results

The performance of the AI systems in a multi-modal setting was significantly better when the weights of AI-DM and AI-ABUS were 0.25 and 0.75, respectively, than each system individually in a single-modal setting (AUC-AI-Multimodal = 0.865; AUC-AI-DM = 0.832, p = 0.026; AUC-AI-ABUS = 0.841, p = 0.041). The maximum Youden’s index for AI-Multimodal was 0.707 (sensitivity = 79.4%, specificity = 91.2%). In the subcohort that underwent human reading, the panel of four readers achieved a sensitivity of 93.2% and specificity of 32.7%. AI-multimodal achieves superior or equal sensitivity as single human readers at the same specificity operating points on the ROC curve.

Conclusion

Multimodal (ABUS + DM) AI systems for detecting breast cancer in women with dense breasts are a potential solution for breast screening in radiologist-scarce regions.
Complications of cochlear implants with MRI scans in different body regions: type, frequency and impact
Authors: Alberalar Nilüfer Deniz , Reis Jonas , Piechotta Paula Louise , Beetz Nick Lasse , Fehrenbach Uli , Geisel Dominik , Thomas Andreas , Busse Harald , Denecke Timm
Published: January 2023

Objectives

The aim was to assess the type, frequency and impact of MRI-related complications in patients with cochlear implants (CI) and MRI indications in different body regions.

Methods

For that purpose, the institutional radiology database of a single tertiary hospital was searched for patients with a CI who underwent MRI between 2001 and 2018. The number of MRI examinations and complications were retrieved from the patient record. Examinations were categorized into five distinct body regions or combinations thereof. Records of CI artifacts in the head also included basic information on diagnostic image quality.

Results

Out of 1017 MRI database entries (examinations) of patients with a CI, 91 records were after implantation (71 patients) and 66 were attempted (no contraindications, 49 patients). In four cases (4/66, 6.1%), the magnet was dislocated and had to be replaced surgically. Three out of four severe complications occurred for examination regions outside the head. Thirteen MRI examinations were aborted due to pain (19.7%) and one because of artifacts—resulting in 48 scans (72.7%) completed successfully (36 patients). All cranial scans featured device artifacts in all sequences, but the majority of them did not affect proper imaging diagnostics in the respective region.

Conclusion

This retrospective, single-center analysis of patients with MRI-conditional cochlear implants shows that MRI-related complications were common, at least in models with a fixed magnet, despite appropriate precautions and compliance with the manufacturers’ guidelines. MRI examinations of CI patients should therefore be indicated strictly until the exact causes have been clarified.
Synthesis and preclinical evaluation of novel 99mTc-labeled PSMA ligands for radioguided surgery of prostate cancer
Authors: Kunert Jan-Philip , Müller Max , Günther Thomas , Stopper León , Urtz-Urban Nicole , Beck Roswitha , Wester Hans-Jürgen
Published: January 2023

Background

Radioguided surgery (RGS) has recently emerged as a valuable new tool in the management of recurrent prostate cancer (PCa). After preoperative injection of a 99mTc-labeled prostate-specific membrane antigen (PSMA) inhibitor, radioguided intraoperative identification and resection of lesions is facilitated by means of suitable γ-probes. First clinical experiences show the feasibility of RGS and suggest superiority over conventional lymph node dissection in recurrent PCa. However, commonly used [99mTc]Tc-PSMA-I&S exhibits slow whole-body clearance, thus hampering optimal tumor-to-background ratios (TBR) during surgery. We therefore aimed to develop novel 99mTc-labeled, PSMA-targeted radioligands with optimized pharmacokinetic profile to increase TBR at the time of surgery.

Methods

Three 99mTc-labeled N4-PSMA ligands were preclinically evaluated and compared to [99mTc]Tc-PSMA-I&S. PSMA affinity (IC50) and internalization were determined on LNCaP cells. Lipophilicity was assessed by means of the distribution coefficient logD7.4 and an ultrafiltration method was used to determine binding to human plasma proteins. Biodistribution studies and static µSPECT/CT-imaging were performed at 6 h p.i. on LNCaP tumor-bearing CB17-SCID mice.

Results

The novel N4-PSMA tracers were readily labeled with [99mTc]TcO4− with RCP > 95%. Comparable and high PSMA affinity was observed for all [99mTc]Tc-N4-PSMA-ligands. The ligands showed variable binding to human plasma and medium to low lipophilicity (logD7.4 − 2.6 to − 3.4), both consistently decreased compared to [99mTc]Tc-PSMA-I&S. Biodistribution studies revealed comparable tumor uptake among all [99mTc]Tc-N4-PSMA-ligands and [99mTc]Tc-PSMA-I&S, while clearance from most organs was superior for the novel tracers. Accordingly, increased TBR were achieved. [99mTc]Tc-N4-PSMA-12 showed higher TBR than [99mTc]Tc-PSMA-I&S for blood and all evaluated tissue. In addition, a procedure suitable for routine clinical production of [99mTc]Tc-N4-PSMA-12 was established. Labeling with 553 ± 187 MBq was achieved with RCP of 98.5 ± 0.6% (n = 10).

Conclusion

High tumor accumulation and favorable clearance from blood and non-target tissue make [99mTc]Tc-N4-PSMA-12 an attractive tracer for RGS, possibly superior to currently established [99mTc]Tc-PSMA-I&S. Its GMP-production according to a method presented here and first clinical investigations with this novel radioligand is highly recommended.
Low-complexity selective mapping technique for PAPR reduction in downlink power domain OFDM-NOMA
Authors: Mounir Mohamed , Youssef Mohamed Ibrahim , Aboshosha Ashraf Mohamed
Published: January 2023

To support ultra-massive connectivity, non-orthogonal multiple access (NOMA) techniques are expected to be used in 6G instead of conventional orthogonal multiple access (OMA) techniques. Furthermore, given that orthogonal frequency division multiplexing (OFDM) was used by 4G and 5G, NOMA is expected to be combined with OFDM to mitigate frequency selectivity in multipath channels. However, after passing through nonlinear high power amplifiers (HPAs), OFDM-NOMA has reportedly suffered from nonlinear distortion due to the high peak-to-average power ratio (PAPR) problem, thus reducing users’ achievable data rates, sum rate capacity, and users’ bit error rate after going through nonlinear HPAs. Many PAPR reduction techniques have been introduced in the literature; however, high PAPR reduction gain comes at the expense of computational complexity. In this paper, a novel selective mapping (SLM) scheme for PAPR reduction in OFDM-NOMA systems is proposed. By utilizing the structure of the OFDM-NOMA transmitter, the proposed SLM scheme achieves the same performance as that of the conventional SLM scheme while requiring less computational complexity.
Treatment strategy for spontaneous coronary artery dissection based on anatomical characteristics
Authors: Ma Yuanji , Zhong Xin , Yin Jiasheng , Lu Hao , Pan Congcong , Huang Dong , Ge Junbo
Published: January 2023

Objectives

To compare the clinical and angiographic characteristics of high-risk and low-risk spontaneous coronary artery dissection (SCAD) patients to determine the optimal treatment strategy.

Background

SCAD is a rare and emerging cause of acute coronary syndrome and sudden cardiac death, especially in young female patients. However, the indication of percutaneous coronary intervention (PCI) in patients with SCAD remains elusive.

Methods

We evaluated the clinical and angiographic characteristics of all SCAD patients admitted to our center from 2012 to 2020. The outcomes of the high-risk and low-risk SCAD patients according to the location of the lesion segment with dissection or intramural hematoma were compared. Further analyses were performed to evaluate the vessel healing or residual dissection in the patients receiving the follow-up angiography.

Results

A total of 81 SCAD patients were enrolled in the present study, in which 38 patients were categorized as high-risk group, defined as involvement of the left main artery or proximal segment of any main coronary artery. PCI was the more common treatment approach in the high-risk group (68.4%), while conservative treatment was more common in the low-risk group (62.8%). The incidence of major adverse cardiac events, defined as cardiac death, myocardial infarction, unstable angina pectoris, severe arrhythmias, or heat failure, within 1 year follow-up was similar between the two groups. 57 patients (70.4%) received the follow-up angiography after 1 year. The high- and low-risk groups had a similar rate of vessel healing among the PCI treatment patients. However, more patients achieved spontaneous healing in the low-risk group than the high-risk group among the conservative treatment patients (86.4% vs. 33.3%, p < 0.05).

Conclusions

Conservative management remains the recommended treatment strategy for the low-risk SCAD patients. PCI could be considered in high-risk SCAD patients with favorable clinical outcomes and vessel healing. Characterization of lesion anatomy may be an important indicator for treatment decision.
Historical-architectural analysis of Cartagena de Indias heritage
Authors: Saba Manuel , Carrascal Jorge Luis Álvarez , Cruz Alfonso Rafael Cabrera
Published: January 2023

In the last four decades, the historical heritage of Cartagena de Indias has been at the center of national and international attention due to its classification as a World Heritage Site according to the United Nations Educational, Scientific and Cultural Organization (UNESCO). Many historians and architects in the past have narrated the heroic deeds of the city of Cartagena, its role in the independence of Colombia, as well as the history of its construction. Its history, extension and majesty currently attract hundreds of thousands of tourists each year. Tourism representing the second source of income in the region after industry. However, today the heritage continues to suffer from several challenges that deserve to be faced by the community in general, the scientific community and institutions. Its particular state of conservation and some state of deterioration has generated a call for attention by UNESCO to categorize it as heritage at risk due to the effects of climate change (UNESCO 2016), which represented a crucial moment for the authors offering several points of reflection that have given life to this work. Part of the problems of deterioration and decay of the fortifications is due to a deep lack of knowledge on the part of civil society and the authorities about the construction history and the stratification of interventions on the heritage. For this reason, the objective of this paper is to analyze the history of the interventions and modifications of the fortifications, including the submarine defense system of Cartagena de Indias, as well as to evaluate the state of the city at the end of the Spanish viceroyalty. In this work, history, architecture and engineering come together, proposing a journey into the past, a broad vision of heritage and its current problems. In the conclusions, the authors matured a series of recommendations as a result of the present investigation and their personal experience in heritage management. It is considered essential to apply these measures in the short-medium term for the heritage protection and its conservation for future generations.
Predictability of orthodontic tooth movement with aligners: effect of treatment design
Authors: Castroflorio Tommaso , Sedran Ambra , Parrini Simone , Garino Francesco , Reverdito Matteo , Capuozzo Riccardo , Mutinelli Sabrina , Grybauskas Simonas , Vaitiekūnas Mantas , Deregibus Andrea
Published: January 2023

Backgrounds

The present study was designed to define: (1) which are the less predictable OTM with Invisalign aligners when the treatment plan is designed by expert operators, (2) if the presence and shape of attachments influence the predictability of OTM and (3) if patients’ demographics influence OTM predictability. The sample comprises 79 prospectively recruited patients (mean age 30.8 years; SD 12.0; 23 M, 56 F), treated by expert operators with an average of 27 aligners (SD 15) in the maxillary arch and 25 aligners (SD 11) in the mandibular arch. Post-treatment digital models and final virtual treatment plan models were exported from ClinCheck® software as STL files and subsequently imported into Geomagic Qualify ®software, to compare final teeth positions. The differences were calculated and tested for statistical significance for each tooth in the mesial–distal, vestibular–lingual and occlusal–gingival directions, as well as for angulation, inclination and rotation. In addition, the statistical significance of categorical variables was tested.

Results

The lack of correction was significant for all movements and in all group of teeth (P < 0.01) except for the rotation of maxillary first molar. The prescribed OTM, the group of teeth and movement, the frequency of aligner change and the use of attachment influence the outcome. The greatest discrepancies in predicted and achieved tooth position were found for angular movements and rotation of teeth characterized by round-shaped crowns, for a ratio of approximately 0.4° per 1° prescribed. Optimized attachments for upper canines and lower premolar rotation seem not working properly. Second molar movements are mostly unexpressed. Furthermore, changing the aligner every 14 days will reduce the lack of correction of the 12% with respect to 7 days aligner change.

Conclusions

Predictability of orthodontic movement with aligners still has limitations related to the biomechanics of the system: the shape of some attachments and the characteristics of aligner material need to be redefined. However, the results of this study allow to properly design the virtual treatment plan, revealing how much overcorrection is needed and which attachments are most effective.
High intake of dietary phytochemical index may be related to reducing risk of diabetic nephropathy: a case–control study
Authors: Bahrampour Niki , Mirzababaei Atieh , Hosseininasab Dorsa , Abaj Faezeh , Clark Cain C. T. , Mirzaei Khadijeh
Published: January 2023

Objective

Diabetic nephropathy (DN) is involved in 40% of patients with type 2 diabetes, Phytochemical index (PI) foods are known as antioxidant and anti-inflammatory agents. Higher intake of phytochemicals can improve glucose tolerance, hypertension and complications of DN. This study sought to discern the relationship between dietary PI and DN.

Methods

This was a case–control study which was conducted between 210 diabetic women. General characteristics, blood pressure, biochemical serum levels, and anthropometric measurements were evaluated. Physical activity and dietary intakes were assessed via short form of physical activity questionnaire and 147 items-validated food frequency questionnaires, respectively. Then, PI was calculated through method of McCarty and divided to 2 groups of lower and higher of median. Independent samples T tests were used to identify differences in quantitative variables. To investigate the relationship between dietary PI and risk of DN, logistic regression was used. The odds ratio (OR) of DN, and its 95% confidence interval (CI), in each groups of PI were shown.

Results

The percentage of daily intake of energy from fruits and vegetables were higher than the other sources of phytochemical rich foods. Higher consumption of vitamin A was seen in higher group of PI among the control group, after adjusting for energy intake. In the higher adherence of median of dietary PI group, intake of fruits, vegetables, legumes, grains, and olives of controls were higher than cases. In addition, soy consumption was statistically different between lower and higher adherence of median of dietary PI among cases. There was an inverse relationship between dietary PI and risk of DN (OR = 0.44; 95% CI: 0.25–0.77; P = 0.04). After adjusting for potential confounders, the association remained significant, albeit with lower odds of having DN (OR = 0.15; 95% CI: 0.06–0.36; P < 0.001).

Conclusion

Finally, the present study found evidence indicating an inverse relationship between consumption of foods rich in phytochemicals and risk of DN in this sample.
Give women what they want: contraceptive discontinuation and method preference in urban Ghana
Authors: Compton Sarah D. , Manu Adom , Maya Ernest , Morhe Emmanuel S. K. , Dalton Vanessa K.
Published: January 2023

Background

Unmet need for contraception remains high in Ghana. Reducing the number of women who discontinue their contraceptive use is one way to decrease the number of women with an unmet need. In this study, we investigated factors associated with discontinuation among a cohort of Ghanaian women.

Methods

Women who were beginning a new method of contraception at one of six urban clinics in Accra and Kumasi, Ghana were invited to participate in our study. Participants were interviewed before and after their counseling session, and at 3-, 6-, 9-, and 12-months post-enrollment to determine continuation. During follow-up, participants who were no longer using their method were asked why, if they were using any method of contraception, and if so, which method. Logistic regression analysis was performed to identify factors associated with discontinuation for reason other than pregnancy or desired pregnancy.

Results

Of the 472 women who reported leaving their counseling session with a method, 440 (93.2%) had at least one follow-up contact. Of the 440 women, 110 (25%) discontinued their method at some point over the 12-month period, and 94 (85.5%) did so for reasons other than pregnancy or desired pregnancy. In the multivariate regression analysis, women who reported they were given their method of choice were 12.0% less likely to discontinue due to a non-pregnancy reason (p=0.005); those who used a long-acting reversible contraceptive (LARC) method were 11.1% less likely (p=.001); and those who reported they would choose to use that method again, one measure of satisfaction, were 23.4% less likely (p<.001).

Conclusions

To our knowledge, the current study is the first to explore method preference and its relation to continuation. Women in our study who reported they were given the contraceptive method of their choice were less likely to discontinue using that method for non-pregnancy-related reasons. Further, those who adopted a LARC method and those who reported they would make the same method choice again were less likely to discontinue. Women should be supported in selecting a contraceptive method of their choice. Providers should work with their clients to find a method which meets their preferences.
Two cases of aseptic internal jugular vein thrombophlebitis associated with hemodialysis catheter, presenting as sore throat: case report and literature review
Authors: Yoshida Shun , Usui Koichi , Naganuma Tsukasa , Nukui Ikuo , Wakasugi Masakiyo
Published: January 2023

Background

Non-cuffed hemodialysis (HD) catheters are often used for emergency or temporary vascular access. Its complications include thrombosis and catheter-related bloodstream infection (CRBSI); however, thrombophlebitis can also occur. Thrombophlebitis of the internal jugular vein (IJV) may present with symptoms, such as fever, lateral neck pain, and swelling, regardless of the presence or absence of infection; however, symptoms may be minor and easily overlooked. Sore throat is a well-known symptom of Lemierre's syndrome, but has not been reported in cases of thrombophlebitis without infection. We report two cases of HD catheter-associated IJV thrombophlebitis in patients that were diagnosed with sore throat.

Case presentation

Case 1 included a 58-year-old woman with diabetic nephropathy on HD. She was admitted to our hospital due to the occlusion of an arteriovenous fistula (AVF) for dialysis. A temporary HD catheter was placed in the right IJV until an arteriovenous graft (AVG) was fabricated. After admission, CRBSI was suspected because she developed fever; however, bacteremia was ruled out and a sore throat gradually developed. Contrast-enhanced computed tomography (CT) revealed thrombophlebitis of the right IJV. Anticoagulation therapy was initiated and she was discharged due to an improvement of symptoms. Case 2 included an 83-year-old man with end-stage renal disease due to hypertensive nephrosclerosis. He was admitted to our hospital because of AVF occlusion. A temporary HD catheter was inserted into the right IJV and an AVG was created. He had elevated C-reactive protein levels after catheter placement but was asymptomatic. When removing the catheter, he complained of throat discomfort. Ultrasonography of the neck revealed thrombotic obstruction of the right IJV, and contrast-enhanced CT revealed thrombophlebitis of the right IJV. Blood culture results were negative. He was discharged after anticoagulation therapy was started and symptoms improved.

Conclusions

The presence of sore throat leads to the diagnosis of IJV thrombophlebitis. Pharyngeal symptoms that develop after central venous catheter (CVC) placement should be differentiated from thrombophlebitis using a minimally invasive vascular ultrasound.
Artificial intelligence (AI) in biomedical research: discussion on authors’ declaration of AI in their articles title
Authors: Sardanelli Francesco , Castiglioni Isabella , Colarieti Anna , Schiaffino Simone , Di Leo Giovanni
Published: January 2023

Artificial intelligence (AI) and its different approaches, from machine learning to deep learning, are not new. We discuss here about the declaration of AI in the title of those articles dealing with AI. From 1990 to 2021, while AI articles in the PubMed increased from 300 to 59,596, the percentage declaring AI in the title describes a U-like-shaped curve: about 30% in early 1990s, less than 13% in 2005–2014, again 30% in 2020–2021. A similar trend was observed for AI in medical imaging. While the initial decline could be due to the establishment of AI methods, the recent increase could be related to the capacity of AI to outperform humans, especially in image recognition, fuelled by the adoption of graphic processing units for general purpose computing. The recent increase may also be due to the relevance of open issues about AI, including the standardisation of methods, explainability of results, and concerns about AI-induced epoch-making transformations: to say “We are using AI” in the title may also reflect these concerns.
Bacterial topography of the upper and lower respiratory tract in pigs
Authors: Pirolo Mattia , Espinosa-Gongora Carmen , Alberdi Antton , Eisenhofer Raphael , Soverini Matteo , Eriksen Esben Østergaard , Pedersen Ken Steen , Guardabassi Luca
Published: January 2023

Background

Understanding the complex structures and interactions of the bacterial communities inhabiting the upper (URT) and lower (LRT) respiratory tract of pigs is at an early stage. The objective of this study was to characterize the bacterial topography of three URT (nostrils, choana, and tonsils) and LRT (proximal trachea, left caudal lobe and secondary bronchi) sites in pigs. Thirty-six post-mortem samples from six pigs were analysed by 16S rRNA gene quantification and sequencing, and the microbiota in nostrils and trachea was additionally profiled by shotgun sequencing.

Results

The bacterial composition obtained by the two methods was congruent, although metagenomics recovered only a fraction of the diversity (32 metagenome-assembled genomes) due to the high proportion (85–98%) of host DNA. The highest abundance of 16S rRNA copies was observed in nostrils, followed by tonsils, trachea, bronchi, choana and lung. Bacterial richness and diversity were lower in the LRT compared to the URT. Overall, Firmicutes and Proteobacteria were identified as predominant taxa in all sample types. Glasserella (15.7%), Streptococcus (14.6%) and Clostridium (10.1%) were the most abundant genera but differences in microbiota composition were observed between the two tracts as well as between sampling sites within the same tract. Clear-cut differences were observed between nasal and tonsillar microbiomes (R-values 0.85–0.93), whereas bacterial communities inhabiting trachea and lung were similar (R-values 0.10–0.17). Moraxella and Streptococcus were more common in bronchial mucosal scraping than in lavage, probably because of mucosal adherence. The bacterial microbiota of the choana was less diverse than that of the nostrils and similar to the tracheal microbiota (R-value 0.24), suggesting that the posterior nasal cavity serves as the primary source of bacteria for the LRT.

Conclusion

We provide new knowledge on microbiota composition and species abundance in distinct ecological niches of the pig respiratory tract. Our results shed light on the distribution of opportunistic bacterial pathogens across the respiratory tract and support the hypothesis that bacteria present in the lungs originate from the posterior nasal cavity. Due to the high abundance of host DNA, high-resolution profiling of the pig respiratory microbiota by shotgun sequencing requires methods for host DNA depletion.