bluuebunny/crossref_metadata_2025 huggingface dataset:
Evolution of CRISPR/Cas Systems for Precise Genome Editing
Authors: Hryhorowicz Magdalena , Lipiński Daniel , Zeyland Joanna
Published: September 2023

The bacteria-derived CRISPR/Cas (an acronym for regularly interspaced short palindromic repeats/CRISPR-associated protein) system is currently the most widely used, versatile, and convenient tool for genome engineering. CRISPR/Cas-based technologies have been applied to disease modeling, gene therapies, transcriptional modulation, and diagnostics. Nevertheless, some challenges remain, such as the risk of immunological reactions or off-target effects. To overcome these problems, many new methods and CRISPR/Cas-based tools have been developed. In this review, we describe the current classification of CRISPR systems and new precise genome-editing technologies, summarize the latest applications of this technique in several fields of research, and, finally, discuss CRISPR/Cas system limitations, ethical issues, and challenges.
Response of G-NUMEN LaBr3(Ce) Detectors to High Counting Rates
Authors: Gandolfo Elisa Maria , Oliveira José Roberto Brandao , Campajola Luigi , Pierroutsakou Dimitra , Boiano Alfonso , Agodi Clementina , Cappuzzello Francesco , Carbone Diana , Cavallaro Manuela , Ciraldo Irene , Calvo Daniela , Delaunay Franck , Eke Canel , Longhitano Fabio , Medina Nilberto , Moralles Mauricio , Sartirana Diego , Sharma Vijay Raj , Spatafora Alessandro , Toufen Dennis , Finocchiaro Paolo
Published: September 2023

The G-NUMEN array is the future gamma spectrometer of the NUMEN experiment (nuclear matrix element for neutrinoless double beta decay), to be installed around the object point of the MAGNEX magnetic spectrometer at the INFN-LNS laboratory. This project aims to explore double-charge exchange (DCE) reactions in order to obtain crucial information about neutrinoless double beta decay (0νββ). The primary objective of the G-NUMEN array is to detect the gamma rays emitted from the de-excitation of the excited states that are populated via DCE reactions with a good energy resolution and detection efficiency, amidst a background composed of the transitions from competing reaction channels with far higher cross sections. To achieve this, G-NUMEN signals will be processed in coincidence with those generated by the detection of reaction ejectiles by the MAGNEX focal plane detector (FPD). Under the expected experimental conditions, G-NUMEN detectors will operate at high counting rates, of the order of hundreds of kHz per detector, while maintaining excellent energy and timing resolutions. The complete array will consist of over 100 LaBr3(Ce) scintillators. Initial tests were conducted on the first detectors of the array, allowing for the determination of their performance at high rates.
A Comprehensive Review of Management Strategies for Bicuspid Aortic Valve (BAV): Exploring Epidemiology, Aetiology, Aortopathy, and Interventions in Light of Recent Guidelines
Authors: Bulut Halil Ibrahim , Arjomandi Rad Arian , Syrengela Angeliki-Aikaterini , Ttofi Iakovos , Djordjevic Jasmina , Kaur Ramanjit , Keiralla Amar , Krasopoulos George
Published: September 2023

Objective: bicuspid aortic valve (BAV) stands as the most prevalent congenital heart condition intricately linked to aortic pathologies encompassing aortic regurgitation (AR), aortic stenosis, aortic root dilation, and aortic dissection. The aetiology of BAV is notably intricate, involving a spectrum of genes and polymorphisms. Moreover, BAV lays the groundwork for an array of structural heart and aortic disorders, presenting varying degrees of severity. Establishing a tailored clinical approach amid this diverse range of BAV-related conditions is of utmost significance. In this comprehensive review, we delve into the epidemiology, aetiology, associated ailments, and clinical management of BAV, encompassing imaging to aortic surgery. Our exploration is guided by the perspectives of the aortic team, spanning six distinct guidelines. Methods: We conducted an exhaustive search across databases like PubMed, Ovid, Scopus, and Embase to extract relevant studies. Our review incorporates 84 references and integrates insights from six different guidelines to create a comprehensive clinical management section. Results: BAV presents complexities in its aetiology, with specific polymorphisms and gene disorders observed in groups with elevated BAV prevalence, contributing to increased susceptibility to other cardiovascular conditions. The altered hemodynamics inherent to BAV instigate adverse remodelling of the aorta and heart, thus fostering the development of epigenetically linked aortic and heart diseases. Employing TTE screening for first-degree relatives of BAV patients might be beneficial for disease tracking and enhancing clinical outcomes. While SAVR is the primary recommendation for indicated AVR in BAV, TAVR might be an option for certain patients endorsed by adept aortic teams. In addition, proficient teams can perform aortic valve repair for AR cases. Aortic surgery necessitates personalized evaluation, accounting for genetic makeup and risk factors. While the standard aortic replacement threshold stands at 55 mm, it may be tailored to 50 mm or even 45 mm based on patient-specific considerations. Conclusion: This review reiterates the significance of considering the multifactorial nature of BAV as well as the need for further research to be carried out in the field.
Management of Residual Risk in Chronic Coronary Syndromes. Clinical Pathways for a Quality-Based Secondary Prevention
Authors: Giubilato Simona , Lucà Fabiana , Abrignani Maurizio Giuseppe , Gatto Laura , Rao Carmelo Massimiliano , Ingianni Nadia , Amico Francesco , Rossini Roberta , Caretta Giorgio , Cornara Stefano , Di Matteo Irene , Di Nora Concetta , Favilli Silvia , Pilleri Anna , Pozzi Andrea , Temporelli Pier Luigi , Zuin Marco , Amico Antonio Francesco , Riccio Carmine , Grimaldi Massimo , Colivicchi Furio , Oliva Fabrizio , Gulizia Michele Massimo
Published: September 2023

Chronic coronary syndrome (CCS), which encompasses a broad spectrum of clinical presentations of coronary artery disease (CAD), is the leading cause of morbidity and mortality worldwide. Recent guidelines for the management of CCS emphasize the dynamic nature of the CAD process, replacing the term “stable” with “chronic”, as this disease is never truly “stable”. Despite significant advances in the treatment of CAD, patients with CCS remain at an elevated risk of major cardiovascular events (MACE) due to the so-called residual cardiovascular risk. Several pathogenetic pathways (thrombotic, inflammatory, metabolic, and procedural) may distinctly contribute to the residual risk in individual patients and represent a potential target for newer preventive treatments. Identifying the level and type of residual cardiovascular risk is essential for selecting the most appropriate diagnostic tests and follow-up procedures. In addition, new management strategies and healthcare models could further support available treatments and lead to important prognostic benefits. This review aims to provide an overview of the diagnostic and therapeutic challenges in the management of patients with CCS and to promote more effective multidisciplinary care.
Multi-Stage Treatment for Spetzler–Martin Grades III, IV, and V Arteriovenous Malformations: Preoperative Embolization and Microsurgical Resection in a Consecutive Series of 250 Patients
Authors: Alfter Marcel , Albiña-Palmarola Pablo , Cimpoca Alexandru , Díaz-Peregrino Roberto , Jans Paul , Ganslandt Oliver , Kühne Dietmar , Henkes Hans
Published: September 2023

Purpose. The treatment of high-grade brain AVMs is challenging and has no guidelines available to date. This study was aimed at reporting the experience of two centers in treating these AVMs through a multi-stage approach consisting of preoperative embolization and microsurgical resection. Methods. A retrospective review was performed for 250 consecutive patients with a diagnosis of high-grade brain AVM (Spetzler–Martin grades III, IV, and V) treated in two centers in Germany between January 1989 and February 2023. The analyzed data included demographic, clinical, morphological, and neurological data. Results. A total of 150 cases (60%) were classified as Spetzler–Martin grade III, 82 cases (32.8%) were classified as grade IV, and 18 cases (7.2%) were classified as grade V. Eighty-seven cases (34.8%) presented with hemorrhage. The devascularization percentages achieved were <50% in 24 (9.6%), 50–80% in 55 (22%), and >80% in 171 (68.4%) cases. The average number of sessions was 5.65 ± 5.50 and 1.11 ± 0.32 endovascular and surgical procedures, respectively, and did not significantly differ by rupture status. Death or dependency (mRS score ≥ 3) after the last follow-up was observed in 18.8% of patients and was significantly associated with age > 80 years and poor baseline neurological condition. The complete resection rate was 82.3% and was significantly associated with age > 80 years, large nidus, and deep venous drainage. Permanent disabling neurological deficit after at least 3 months of follow-up was diagnosed in 13.2% of patients and was significantly associated with age > 80 years and infratentorial locations. Conclusion. A multi-stage treatment for high-grade AVMs is feasible for selected cases but comes at a functional cost. The devascularization percentage was not associated with the investigated outcomes. Age > 80 years was associated with poor safety and effectiveness outcomes; consequently, this treatment should be offered only in exceptional circumstances.
Correction: Ding et al. Full-Right Full-Left Split Liver Transplantation for Two Adult Recipients: A Single-Center Experience in China. J. Clin. Med. 2023, 12, 3782
Authors: Ding Limin , Yu Xizhi , Zhang Rui , Qian Junjie , Zhang Wu , Wu Qinchuan , Zhou Lin , Yang Zhe , Zheng Shusen
Published: September 2023

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Systematic Evaluation of the Effects of Voluntary Activation on Lower Extremity Motor Thresholds
Authors: Cash Jasmine J. , Bowden Mark G. , Boan Andrea D. , McTeague Lisa M. , Kindred John H.
Published: September 2023

The purpose of this investigation was to elucidate the relationship between the resting motor threshold (rMT) and active motor threshold (aMT). A cross-sectional comparison of MTs measured at four states of lower extremity muscle activation was conducted: resting, 5% maximal voluntary contraction (MVC), 10%MVC, and standing. MTs were measured at the tibialis anterior in the ipsilesional and contralesional limbs in participants in the chronic phase (>6 months) of stroke (n = 11) and in the dominant limb of healthy controls (n = 11). To compare across activation levels, the responses were standardized using averaged peak-to-peak background electromyography (EMG) activity measured at 10%MVC + 2SD for each participant, in addition to the traditional 0.05 mV criterion for rMT (rMT50). In all participants, as muscle activation increased, the least square mean estimates of MTs decreased (contralesional: p = 0.008; ipsilesional: p = 0.0015, healthy dominant: p < 0.0001). In healthy controls, rMT50 was significantly different from all other MTs (p < 0.0344), while in stroke, there were no differences in either limb (p > 0.10). This investigation highlights the relationship between rMT and aMTs, which is important as many stroke survivors do not present with an rMT, necessitating the use of an aMT. Future works may consider the use of the standardized criterion that accounted for background EMG activity across activation levels.
A Prospective Study of the Assessment of the Efficacy of a Biodegradable Poly(l-lactic acid/ε-caprolactone) Membrane for Guided Bone Regeneration
Authors: Shido Rena , Ohba Seigo , Tominaga Risa , Sumita Yoshinori , Asahina Izumi
Published: September 2023

Biodegradable guided bone regeneration (GBR) membranes consist primarily of collagen and aliphatic polyesters. This study assessed the comparative efficacy of a poly(l-lactic-caprolactone) [P(LA/CL)] membrane versus that of a collagen membrane in GBR. Patients requiring GBR simultaneously or before dental implant placement in edentulous regions were randomly assigned to one of two membranes. Within each membrane, they were subdivided into 3 groups: dental implants were placed simultaneously with GBR in groups A and B, and 180 days post-GBR in group C. The augmented bone width was measured at 1, 3, and 6 mm from the implant’s neck (groups A and B) or the reference line (group C), utilizing cone-beam computed tomography images, immediately and 150 days post-surgery. A histological study was performed to evaluate bone formation in group C. No adverse events were observed. In the collagen group, the absorbed ratios of the augmented bone were 40.9 ± 36.7%, 29.4 ± 30.1%, and 11.1 ± 22.0% at 1, 3, and 6 mm, respectively; the ratio at 6 mm was significantly lower than that at 1 mm (p = 0.0442). In the P(LA/CL) group, those were 26.2 ± 27.3%, 17.1 ± 19.7%, and 13.3 ± 16.4% at 1, 3, and 6 mm, respectively, with no significant difference at each point. No significant inter-membrane differences were observed. The bone augmentation potential of the P(LA/CL) membrane matched that of the collagen membrane. P(LA/CL) could be used as a safe and effective membrane in GBR.
Eosinophilic Granulomatosis with Polyangiitis: Latest Findings and Updated Treatment Recommendations
Authors: Watanabe Ryu , Hashimoto Motomu
Published: September 2023

Eosinophilic granulomatosis with polyangiitis (EGPA) causes necrotizing vasculitis and eosinophil-rich granulomatous inflammation in small- to medium-sized vessels, resulting in multiple organ damage. EGPA is classified as an antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis, with myeloperoxidase-ANCA detected in approximately one-third of the patients. Conventional treatment of EGPA relies on systemic glucocorticoids (GCs) in combination with cyclophosphamide when poor prognostic factors are present; however, the dilemma between disease control and drug-related adverse effects has long been a challenge. Recent studies have revealed that the genetic background, pathophysiology, and clinical manifestations differ between ANCA-positive and ANCA-negative patients; however, mepolizumab, an interleukin (IL)-5 inhibitor, is effective in both groups, suggesting that the IL-5-eosinophil axis is deeply involved in the pathogenesis of both ANCA-positive and ANCA-negative EGPA. This review summarizes the latest knowledge on the pathophysiology of EGPA and focuses on the roles of eosinophils and ANCA. We then introduce the current treatment recommendations and accumulated evidence for mepolizumab on EGPA. Based on current unmet clinical needs, we discuss potential future therapeutic strategies for EGPA.
Occurrence and Risk Factors for Perioperative Treatment Discontinuation during Magnetic Resonance-Guided High-Intensity Focused Ultrasound (MR-HIFU) Therapy in Symptomatic Uterine Fibroids—A Retrospective Case–Control Study
Authors: Kociuba Jakub , Łoziński Tomasz , Latra Kamil , Korczyńska Lidia , Skowyra Artur , Zarychta Elżbieta , Ciebiera Michał
Published: September 2023

Background: The main aim of our study involves the analysis of reasons and risk factors for perioperative treatment discontinuation in patients with symptomatic uterine fibroids (UFs) who were qualified for magnetic resonance-guided high-intensity focused ultrasound (MR-HIFU) and in whom the procedure was discontinued. Methods: The presented research included 372 women who were primarily eligible for MR-HIFU, but the procedure was interrupted. The reasons and risk factors for treatment discontinuation were analyzed. A statistical comparison of two cohorts (patients in whom the treatment was discontinued and completed) was conducted based on epidemiological factors, UF characteristics and the implementation of uterotonics. Results: The mean discontinuation rate was 18.28% (n = 68). The main reason was the malposition of the intestines (52.94% of all cases). The thermoablation of subserosal UFs was a statistically significant risk factor of perioperative treatment discontinuation (OR 4.62, CI 95% 2.04–10.56), while the therapy of intramural UFs considerably decreased the risk (OR 0.21, CI 95% 0.08–0.51). The volume of the targeted UF was negatively correlated with the risk of discontinuation (OR 0.991, CI 95% 0.986–0.996). Augmentation with oxytocin, but not misoprostol, during the procedure significantly decreased the risk of potential discontinuation (OR 0.15, CI 95% 0.045–0.387, p < 0.001). Conclusion: Although the discontinuation rate seems to be relatively low, further prospective randomized trials are needed to confirm our results. The establishment of particular eligibility criteria for the treatment is a crucial issue in this area. Resigning from the procedure in cases at a high risk of discontinuation might increase patient safety and shorten the time to introduce the most appropriate therapy.
Pulp Revascularization in an Autotransplanted Mature Tooth: Visualization with Magnetic Resonance Imaging and Histopathologic Correlation
Authors: Rugani Petra , Brcic Iva , Magyar Marton , Schwarze Uwe Yacine , Jakse Norbert , Ebeleseder Kurt
Published: September 2023

Autotransplantation of a mature tooth usually leads to pulpal necrosis. Root canal treatment is recommended to prevent related inflammatory complications a few weeks after surgery. Extraoral root-end resection may facilitate reperfusion and obviate root canal treatment, but cannot be pictured with conventional dental radiography at this point in time. In the case of a lower mature transplanted molar, contrast-enhanced magnetic resonance imaging proved to be a feasible method for visualizing pulp revascularization just 4 weeks after autotransplantation. Consequently, root canal treatment was obviated. Nevertheless, the tooth had to be extracted 18 months postoperatively due to external cervical root resorption, probably caused by the extraction trauma. This allowed the histological processing and examination of the newly generated intracanal tissue. Uninflamed fibrovascular connective tissue was found, while odontoblasts or cementoblast-like cells were absent. These findings indicated that it was most likely stem cells from the bone marrow and the periodontal ligament that drove the regeneration.
Demographics and Outcomes of Extracorporeal Membrane Oxygenation in COVID-19 Patients: National Database Analysis
Authors: Ahmad Rami , Abrahamian Andrew , Salih Ayman , Patel Rayna , Holtzapple Zachary , Assaly Ragheb , Safi Fadi
Published: September 2023

Introduction: The effectiveness of extracorporeal membrane oxygenation (ECMO) in treating COVID-19 patients has been variable. To gain a better insight, we examined the outcomes of ECMO in COVID-19 patients using data from the 2020 National Inpatient Sample database. Methods: We analyzed data from adult hospital admissions where COVID-19 was the primary diagnosis. The primary outcome was all-cause inpatient mortality. Secondary outcomes were length of stay (LOS), cost, and discharge disposition. Results: We identified 1,048,025 COVID-19 admissions, of which 98,528 were on mechanical ventilation (MV), and only 1.8% received ECMO. In-hospital mortality of mechanically ventilated patients who received ECMO was 49%, compared to 59% with no ECMO (p < 0.001). ECMO treatment was associated with a reduced risk of mortality (HR = 0.67, p < 0.0001, CI 0.57–0.79) even after adjustment for confounders and other comorbidities. Patients on ECMO had significantly extended hospital stays and were more likely to be discharged to an acute care facility. Younger and male patients were more likely to receive ECMO treatment. Females had a lower mortality risk, while race and obesity were not associated with an increased risk of death. Conclusion: ECMO treatment may offer survival benefits in severe COVID-19. Based on our findings, we suggest early ECMO treatment for patients with a high mortality risk.
Serum Albumin Levels: A Biomarker to Be Repurposed in Different Disease Settings in Clinical Practice
Authors: Gremese Elisa , Bruno Dario , Varriano Valentina , Perniola Simone , Petricca Luca , Ferraccioli Gianfranco
Published: September 2023

Serum albumin (ALB), one of the most important proteins in human physiology, has the main functions of maintaining plasma oncotic pressure and plasma volume, transporting hormones, vitamins, oligominerals and drugs, and exerting a powerful antioxidant-anti-inflammatory role. Its prognostic value in liver and malabsorption syndromes is well known. In this narrative review, an analysis of the most important studies evaluating the prognostic significance of low serum ALB levels in hospitalized patients was performed. Specifically, the risk in emergency medicine, cardiovascular diseases, Coronavirus Disease 19 (COVID-19) infection, nephrology, oncology, and autoimmune rheumatic diseases has been examined to fully explore its clinical value. ALB is a negative acute-phase reactant and the reduction in its serum levels represents a threatening parameter for long-term survival in several clinical settings, and a strong biomarker for a poor prognosis in most diseases. Therefore, clinicians should consider serum ALB as a valuable tool to assess the efficacy of specific therapies, both in hospitalized patients and in chronic follow-up.
Fetal Third-Trimester Functional Cardiovascular Abnormalities and Neonatal Elevated Bilirubin Level
Authors: Respondek-Liberska Maria , Sylwestrzak Oskar , Murlewska Julia , Biały Łucja , Krekora Michał , Tadros-Zins Monika , Gulczyńska Ewa , Strzelecka Iwona
Published: September 2023

Background: The aim of the study was to analyze the neonatal outcomes of fetuses with diagnosed functional cardiovascular abnormalities, also considering the connection with neonatal hyperbilirubinemia. Materials and Methods: It was an observational study of 100 neonates who had fetal echocardiography examinations in the third trimester (mean gestational age during the last echocardiography was 34 ± 3 weeks and mean birth weight was 3550 g). There were two groups: A: normal heart anatomy + no functional anomalies; group B: normal heart anatomy + functional abnormalities. Hyperbilirubinemia was defined as a bilirubin level of >10 mg%. Results: In group A, there were 72 cases and only 5 cases despite having normal heart anatomy and normal heart study that presented additional problems. In group B (28 cases), the prenatal functional findings included tricuspid regurgitation (TR) (15 cases, 53%), pericardial effusion (4 cases, 14%), myocardial hypertrophy (4 cases, 14%), cardiomegaly (2 cases, 7%), abnormal bidirectional blood flow across the foramen ovale (3 cases, 11%), aneurysm of atrial septum (2 case, 7%), abnormal E/A ratio for mitral and tricuspid valve (1 case, 3%), bright spot (3 case, 11%), abnormal Doppler flow in ductus arteriosus compared to aortic arch (difference >60 cm/s) (1 case, 3%), supraventricular tachycardia (SVT) (1 case), and mitral regurgitation (1 case, 3%). In group A (n = 72 cases), bilirubin levels of >10 mg/dL were observed in 8% of newborns. In group B (n = 28), bilirubin levels of > 10 m/dL were observed in 46% of cases and TR was present in group B in 53% of cases (15/28 cases). The difference between group A and B in terms of elevated bilirubin levels was statistically significant (p < 0.001). Conclusions: In the case of fetal normal heart anatomy and normal heart study, a good neonatal outcome may be expected. When fetal cardiovascular functional abnormalities in normal heart anatomy are detected, with special attention paid to tricuspid valve regurgitation, a neonatal elevated bilirubin level (mean 11 mg/dL, range 10–15 mg/dL) may be expected.
From Innate Immunity to Metabolic Disorder: A Review of the NLRP3 Inflammasome in Diabetes Mellitus
Authors: Nițulescu Iris Maria , Ciulei George , Cozma Angela , Procopciuc Lucia Maria , Orășan Olga Hilda
Published: September 2023

The role of the NLRP3 inflammasome is pivotal in the pathophysiology and progression of diabetes mellitus (DM), encompassing both type 1 (T1D), or type 2 (T2D). As part of the innate immune system, NLRP3 is also responsible for the chronic inflammation triggered by hyperglycemia. In both conditions, NLRP3 facilitates the release of interleukin-1β and interleukin-18. For T1D, NLRP3 perpetuates the autoimmune cascade, leading to the destruction of pancreatic islet cells. In T2D, its activation is associated with the presence of insulin resistance. NLRP3 activation is also instrumental for the presence of numerous complications associated with DM, microvascular and macrovascular. A considerable number of anti-diabetic drugs have demonstrated the ability to inhibit the NLRP3 inflammasome.
Effect of a Real-Time Audio Ventilation Feedback Device on the Survival Rate and Outcomes of Patients with Out-of-Hospital Cardiac Arrest: A Prospective Randomized Controlled Study
Authors: Lee Eun Dong , Jang Yun Deok , Kang Ji Hun , Seo Yong Song , Yoon Yoo Sang , Kim Yang Weon , Jeong Woong Bin , Ji Jae Gu
Published: September 2023

The purpose of this study was to evaluate the effect of real-time audio ventilation feedback on the survival of patients with an out-of-hospital cardiac arrest (OHCA) during advanced cardiac life support (ACLS) performed by paramedics. This research was a prospective randomized controlled study performed in Busan, South Korea, from July 2022 to December 2022. This study included 121 patients, ages 19 and up, who were transferred to the study site, excluding 91 patients who did not receive CPR under a doctor’s direction as well as those who had a ’(DNR)’ order among 212 adult CA patients. OHCA patients’ clinical prognosis was compared by being randomly assigned to either a general manual defibrillator (NVF) group (N = 58) or a manual defibrillator with an audio ventilation feedback (AVF) group (N = 63). To verify the primary outcome, the cerebral performance category (CPC), return of spontaneous consciousness (ROSC), 30h survival, and survival discharge were compared. Multivariate logistic regression was conducted to analyze the association between the audio-feedback manual defibrillator (AVF) and the ROSC of OHCA patients. This study analyzed 121 patients among 212 OHCA patients. The ROSC (AVF group: 32 {26.4%} vs. NVF group: 21 {17.3%}), 24 h survival (AVF group: 24 {19.8%} vs. NVF group: 11 {9.0%}), and survival discharge (AVF group: 12 {9.9%} vs. NVF group: 6 {4.9%}) were higher in the AVF group than the NVF group. However, upon analyzing CPC scores in the surviving patients between the two groups, there was no significant difference (AVF group: 4.1 ± 1.23 vs. NVF group:4.7 ± 1.23, p = 1.232). Multivariate logistic regression analysis showed that the use of AVF was associated with a higher ROSC (odds ratio {OR}, 0.46; 95% confidence interval {CI}, 0.23–0.73; p < 0.01) and higher survival at 30 h (OR, 0.63; 95% CI, 0.41–0.98; p = 0.01).
Mid-Term Feasibility of Percutaneous Left Atrial Appendage Occlusion in Elderly Patients with Non-Valvular Atrial Fibrillation
Authors: Fukuda Nobuyuki , Imamura Teruhiko , Tanaka Shuhei , Kataoka Naoya , Ushijima Ryuichi , Ueno Hiroshi , Kinugawa Koichiro
Published: September 2023

Background: Percutaneous left atrial appendage occlusion (LAAO) therapy using the WATCHMAN system has been introduced to prevent thrombosis and minimize the use of anticoagulants in patients with non-valvular atrial fibrillation. Given the high risk of bleeding and stroke in elderly patients, these patients would be good candidates for this therapy. However, the efficacy and feasibility of LAAO therapy in elderly patients remains uncertain. Methods: Consecutive patients who underwent LAAO therapy using the WATCHMAN system in a large academic center between June 2020 and March 2023 were included. The safety and efficacy of LAAO therapy during the 1-year observation period in patients aged ≥85 years old were compared with those in the younger cohort. Results: A total of 188 patients (78.4 ± 6.9 years old, 133 male patients) were included. 34 patients were ≥85 years old, 96 were between 75 and 84 years old, and 58 were <75 years old. The elderly group had a higher CHA2DS2-VASc score and were at greater risk of falling-related bleeding compared with the younger cohort. The device implantations were successful in all patients except for one. During the 1-year observation period, one patient had a peri-device leak >5 mm and there were 6 device-related cases of thrombosis, whose incidence was not significantly different between the groups (p = 0.98). The cumulative incidences of bleeding and thrombotic events in the elderly group were as low as in the younger cohort (p > 0.05 for both). Most anticoagulants were terminated regardless of age. Conclusion: The mid-term feasibility and efficacy of percutaneous LAAO therapy using the WATCHMAN system in elderly patients aged ≥85 years were as acceptable as in the younger cohort.
Impact of Baseline Anemia in Patients Undergoing Transcatheter Aortic Valve Replacement: A Prognostic Systematic Review and Meta-Analysis
Authors: Jiménez-Xarrié Elena , Asmarats Lluis , Roqué-Figuls Marta , Millán Xavier , Li Chi Hion Pedro , Fernández-Peregrina Estefanía , Sánchez-Ceña Juan , Massó van Roessel Albert , Maestre Hittinger M. Luz , Paniagua Pilar , Arzamendi Dabit
Published: September 2023

Transcatheter aortic valve replacement (TAVR) is currently the treatment of choice for patients aged ≥75 years with severe aortic stenosis. Preoperative anemia is present in a large proportion of patients and may increase the risk of post-procedural complications. The purpose of this prognostic systematic review was to analyze the impact of baseline anemia on short- and mid-term outcomes following TAVR. A computerized search was performed on PubMed and Web of Science databases for studies published between January 2013 and December 2022. Primary outcomes were 30-day need for transfusion, acute renal failure, 30-day and mid-term mortality, and readmission during the first year post-TAVR. Data were analyzed via random effects model using inverse variance method with 95% confidence intervals. Eleven observational studies met our eligibility criteria and included a total of 12,588 patients. The prevalence of baseline anemia ranged between 39% and 72%, with no relevant sex differences. Patients with preprocedural anemia received more blood transfusions [OR: 2.95 (2.13–4.09)]), and exhibited increased rates of acute kidney injury [OR:1.74 (1.45–2.10)], short-term mortality [OR: 1.47 (1.07–2.01], and mid-term [OR: 1.89 (1.58–2.25)] mortality following TAVR compared with those without anemia. Baseline anemia determined an increased risk for blood transfusion, acute kidney injury, and short/mid-term mortality among TAVR recipients.
Neuropathic Pain in the Emergency Setting: Diagnosis and Management
Authors: Doneddu Pietro Emiliano , Pensato Umberto , Iorfida Alessandra , Alberti Claudia , Nobile-Orazio Eduardo , Fabbri Andrea , Voza Antonio
Published: September 2023

Neuropathic pain, traditionally considered a chronic condition, is increasingly encountered in the emergency department (ED), accounting for approximately 20% of patients presenting with pain. Understanding the physiology and key clinical presentations of neuropathic pain is crucial for ED physicians to provide optimal treatment. While diagnosing neuropathic pain can be challenging, emphasis should be placed on obtaining a comprehensive medical history and conducting a thorough clinical examination. Patients often describe neuropathic pain as a burning or shock-like sensation, leading them to seek care in the ED after ineffective relief from common analgesics such as paracetamol and NSAIDs. Collaboration between emergency medicine specialists, neurologists, and pain management experts can contribute to the development of evidence-based guidelines specifically tailored for the emergency department setting. This article provides a concise overview of the common clinical manifestations of neuropathic pain that may prompt patients to seek emergency care.
Dental Occlusion Characteristics for Treatment Decision-Making Regarding Surgery-First Approach in Orthodontics
Authors: Chen Ying-Chen , Chen Carol Yi-Hsuan , Chen Min-Chi , Ko Ellen Wen-Ching , Lin Cheng-Hui
Published: September 2023

The surgery-first approach (SFA) is conducted to decrease the difficulty and duration of orthodontic treatment by correcting the skeletal discrepancy at the initial stage of treatment. However, the indication of the SFA has not been well defined yet. This study explored the dental occlusion characteristics for treatment decision-making regarding the SFA. A total of 200 skeletal Class III patients were consecutively collected and divided into two groups: the orthodontic-first approach (OFA) group and the SFA group. The pretreatment digital dental models and lateral cephalograms were measured. Logistic regression was completed and receiver operating characteristic (ROC) curves were obtained to predict the probability of the SFA. Results showed that the ROC model with L1-MP, upper and lower arch length discrepancy, overbite, and asymmetric tooth number as influencing factors revealed that the sensitivity and specificity for determining SFA were 83.0% and 65.0%, respectively; the accuracy of prediction was 75.0%. In conclusion, our findings indicate that the six measurements from digital dental models and lateral cephalograms can be effectively applied in treatment decision-making for the SFA with satisfactory accuracy.
Efficacy of Non-Invasive Brain Stimulation for Treating Depression in Patients with Traumatic Brain Injury: A Meta-Analysis and Meta-Regression of Randomized Controlled Trials
Authors: Chang Chun-Hung , Chou Po-Han , Chuang Hao-Yu , Yao Chi-Yu , Chen Wei-Jen , Tsai Hsin-Chi
Published: September 2023

Objective: This meta-analysis aimed to ascertain the efficacy of non-invasive brain stimulation (NIBS)—comprising repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS)—for depression in traumatic brain injury (TBI) patients. Methods: Comprehensive searches were conducted in PubMed, Cochrane Database of Systematic Reviews, and the Cochrane Central Register of Controlled Trials up to 28 January 2023. Random-effects models assessed the treatment effects, and heterogeneity was evaluated through I2 statistics and funnel plot inspection. Results: From 10 trials (234 participants; 8 rTMS, 2 tDCS), NIBS was found significantly more effective than sham in alleviating depressive symptoms (SMD: 0.588, 95% CI: 0.264–0.912; p < 0.001). rTMS, specifically, showed higher efficacy (SMD: 0.707, 95% CI: 0.306–1.108; p = 0.001) compared to sham, whereas tDCS outcomes were inconclusive (SMD: 0.271, 95% CI: −0.230 to 0.771; p = 0.289). Meta-regression found no correlation with the number of sessions, treatment intensity, or total dose. Notably, while post-treatment effects were significant, they diminished 1–2 months post intervention. Adverse events associated with NIBS were minimal, with no severe outcomes like seizures and suicide reported. Conclusions: rTMS emerged as a potent short-term intervention for depression in TBI patients, while tDCS findings remained equivocal. The long-term efficacy of NIBS is yet to be established, warranting further studies. The low adverse event rate reaffirms NIBS’s potential safety.
Pedunculated Focal Nodular Hyperplasia: When in Doubt, Should We Cut It Out?
Authors: Tsalikidis Christos , Mitsala Athanasia , Pappas-Gogos George , Romanidis Konstantinos , Tsaroucha Alexandra K. , Pitiakoudis Michail
Published: September 2023

Focal nodular hyperplasia (FNH) is the second most common benign hepatic tumor and can rarely present as an exophytic solitary mass attached to the liver by a stalk. Most FNH cases are usually detected as incidental findings during surgery, imaging or physical examination and have a high female predominance. However, the pedunculated forms of FNH are particularly rare and commonly associated with severe complications and diagnostic challenges. Hence, our study aims to provide a comprehensive summary of the available data on the pedunculated FNH cases among adults and children. Furthermore, we will highlight the role of different therapeutic options in treating this clinical entity. The use of imaging techniques is considered a significant addition to the diagnostic toolbox. Regarding the optimal treatment strategy, the main indications for surgery were the presence of symptoms, diagnostic uncertainty and increased risk of complications, based on the current literature. Herein, we also propose a management algorithm for patients with suspected FNH lesions. Therefore, a high index of suspicion and awareness of this pathology and its life-threatening complications, as an uncommon etiology of acute abdomen, is of utmost importance in order to achieve better clinical outcomes.
Optimization of Isotactic Polypropylene Nanocomposite Content of Tungsten Carbide for Material Extrusion 3D Printing
Authors: Moutsopoulou Amalia , Petousis Markos , Michailidis Nikolaos , Mountakis Nikolaos , Argyros Apostolos , Papadakis Vassilis , Spiridaki Mariza , Charou Chrysa , Ntintakis Ioannis , Vidakis Nectarios
Published: September 2023

In this study, innovative nanocomposite materials for material extrusion (MEX) 3D printing were developed using a polypropylene (PP) polymer with tungsten carbide (WC) nanopowder. The raw materials were converted into filaments using thermomechanical extrusion. The samples were then fabricated for testing according to the international standards. Extensive mechanical testing was performed on the 3D-printed specimens, including tensile, impact, flexural, and microhardness assessments. In addition, the impact of ceramic additive loading was examined. The thermal and stoichiometric characteristics of the nanocomposites were examined using thermogravimetric analysis, energy-dispersive X-ray spectroscopy, differential scanning calorimetry, and Raman spectroscopy. The 3D-printed shape, quality, and fracture process of the specimens were examined using scanning electron microscopy. The results showed that the filler significantly enhanced the mechanical characteristics of the matrix polymer without reducing its thermal stability or processability. Notably, the highest level of nanocomposite mechanical responsiveness was achieved through the inclusion of 6.0 and 8.0 wt. % fillers. The 10.0 wt. % loading nanocomposite showed significantly increased microhardness, indicating a possible high resistance to wear.
Production of Feline Universal Erythrocytes with Methoxy Polyethylene Glycol
Authors: Kim Hyung Kyu , Ahn Dan Bi , Jang Han Byeol , Ma Jing , Xing Juping , Yoon Joo Won , Lee Kyung Hee , Lee Dong Min , Kim Chang Hyun , Kim Hee Young
Published: September 2023

Blood group mismatch in veterinary medicine is a significant problem in blood transfusion, sometimes leading to severe transfusion reactions and even patient death. Blood groups vary from species to species and there are three known blood groups in cats: A, B and AB. While A-type cats are most common, there is a shortage of feline B-type blood groups in cats. By using methoxy polyethylene glycol (mPEG) to protect antigenic epitopes on red blood cells (RBCs), we aimed to find the optimal conditions for the production of feline universal RBCs. The surfaces of feline A-type RBCs were treated with mPEG at various molecular weights and concentrations. Agglutination tests showed that the coating of feline A-type RBCs with mPEG of 20 kDa and 2 mM blocked hemagglutination to feline anti-A alloantibodies over 8 h. While no differences in RBC size and shape between intact and mPEG-treated RBCs were seen, coating RBCs with mPEG inhibited the binding of feline anti-A alloantibodies. Furthermore, the mPEG-treated RBCs did not cause spontaneous hemolysis or osmotic fragility, compared to control RBCs. According to a monocyte monolayer assay, mPEG treatment significantly reduced feline anti-A antibody-mediated phagocystosis of RBCs. These results confirm the potential of using activated mPEG on feline A-type RBC to create universal erythrocytes for transfusion to B-type cats.
CCGAN as a Tool for Satellite-Derived Chlorophyll a Concentration Gap Reconstruction
Authors: Ćatipović Leon , Matić Frano , Kalinić Hrvoje , Sathyendranath Shubha , Županović Tomislav , Dingle James , Jackson Thomas
Published: September 2023

This work represents a modification of the Context Conditional Generative Adversarial Network as a novel implementation of a non-linear gap reconstruction approach of missing satellite-derived chlorophyll a concentration data. By adjusting the loss functions of the network to focus on the structural credibility of the reconstruction, high numerical and structural reconstruction accuracies have been achieved in comparison to the original network architecture. The network also draws information from proxy data, sea surface temperature, and bathymetry, in this case, to improve the reconstruction quality. The implementation of this novel concept has been tested on the Adriatic Sea. The most accurate model reports an average error of 0.06mgm−3 and a relative error of 3.87%. A non-deterministic method for the gap-free training dataset creation is also devised, further expanding the possibility of combining other various oceanographic data to possibly improve the reconstruction efforts. This method, the first of its kind, has satisfied the accuracy requirements set by scientific communities and standards, thus proving its validity in the initial stages of conceptual utilisation.
The Registration Situation and Use of Mycopesticides in the World
Authors: Jiang Yali , Wang Jingjing
Published: September 2023

Mycopesticides are living preparations that use fungal cells, such as spores and hyphae, as active ingredients. They mainly include mycoinsecticides, mycofungicides, mycoherbicides and nematophagous fungi. The utilization of fungi for controlling agricultural pests can be traced back to approximately 1880, when entomopathogenic fungi were initially employed for this purpose. However, it was not until 1965 that the world’s first mycopesticide, Beauveria bassiana, was registered as Boverin® in the former Soviet Union. In past decades, numerous novel mycopesticides have been developed for their lower R&D costs, as well as the environmentally friendly and safe nature. In this review, we investigated the mycopesticides situation of registration in USA, EU, China, Canada and Australia. Superisingly, it was found that the registered mycopesticides are extremely raised in recent years. Currently, the insecticides, fungicides (nematocides) and herbicides were respectively registered 27, 53 and 8 fungal strains. This paper also analyzes the main problems currently faced by mycopesticides and offers suggestions for their future development.
The Dynamic Dependency between a Cryptocurrency ETF and ETFs Representing Conventional Asset Classes
Authors: Velazquez Marcos , Gormus Alper , Vafai Nima
Published: September 2023

Using daily closing price observations between November 2017 and February 2023, this paper documents how the shocks of a cryptocurrency ETF resonate with ETFs representing traditional asset classes in terms of price and volatility. We find price transmission from the cryptocurrency ETF into the ETFs of several currencies, small-cap equities, and inflation. Risk propagation from the cryptocurrency ETF flows toward ETFs constituted of equities of various sizes, oil prices, high-yield corporate bonds, and inflation. There is scant evidence of transmission from ETFs with underlying conventional assets into the cryptocurrency ETF. The findings bear implications for low-cost risk management strategies.
Measuring Supply Chain Performance as SCOR v13.0-Based in Disruptive Technology Era: Scale Development and Validation
Authors: Özkanlısoy Özden , Bulutlar Füsun
Published: September 2023

Background: Supply chain performance measurement is an integral part of supply chain management today, as it makes many critical contributions to supply chains, especially for companies and supply chains to identify potential problems and improvement fields, evaluate the efficiency of processes, and enhance the health and success of supply chains. The purpose of this study is to contribute to future research and practical applications by presenting a more standard, comprehensive, and up-to-date measurement scale developed based on the SCOR model version 13.0 performance measures in the disruptive technology era. Methods: The study was performed in seven stages and the sample size consists of 227 companies for pilot data and 452 companies for the main data. The stages comprise item generation and purification, exploratory factor analysis for the pilot study and main study, confirmatory factor analysis for the main study, convergent, discriminant, and nomological validity appraisal, and investigation of bias effect. Results: The scale was developed and validated as a five-factor and thirty-one item structure. Conclusions: Some key trends and indicators must be followed today to perceive the landscape of future supply chains. This measurement scale closely follows the future supply chains. Additionally, the findings have been confirmed by the contributions of disruptive technologies and the conceptual structure of supply chain management.
Enhancing Quality Control of Chip Seal Construction through Machine Learning-Based Analysis of Surface Macrotexture Metrics
Authors: Bao Jieyi , Adcock Joseph , Li Shuo , Jiang Yi
Published: September 2023

Efforts to enhance quality control (QC) practices in chip seal construction have predominantly relied on single surface friction metrics such as mean profile depth (MPD) or friction number. These metrics assess chip seal quality by targeting issues such as aggregate loss or excessive bleeding, which may yield low friction numbers or texture depths. However, aggregate loss, particularly due to snowplow operations, does not always result in slippery conditions and may lead to uneven surfaces. The correlation between higher MPD or friction number and superior chip seal quality is not straightforward. This research introduces an innovative machine learning-based approach to enhance chip seal QC. Using a hybrid DBSCAN-Isolation Forest model, anomaly detection was conducted on a dataset comprising 183,794 20 m MPD measurements from actual chip seal projects across six districts in Indiana. This resulted in typical 20 m segment MPD ranges of [0.9 mm, 1.9 mm], [0.6 mm, 2.1 mm], [0.3 mm, 1.3 mm], [1.0 mm, 1.7 mm], [0.6 mm, 1.9 mm], and [1.0 mm, 2.3 mm] for the respective six districts in Indiana. A two-step QC procedure tailored for chip seal evaluation was proposed. The first step calculated outlier percentages across 1-mile segments, with an established limit of 25% outlier segments per wheel track. The second step assessed unqualified rates across projects, setting a threshold of 50% for unqualified 1-mile wheel track segments. Through validation analysis of four chip seal projects, both field inspection and friction measurements closely aligned with the proposed methodology’s results. The methodology presented establishes a foundational QC standard for chip seal projects, enhancing both acceptance efficiency and safety by using a quantitative method and minimizing the extended presence of practitioners on roadways.
(E)-3-Heptyl-2-(4-thiomorpholinostyryl)benzo[d]thiazol-3-ium Iodide as Solvatochromic and Fluorogenic Dye for Spectroscopy Applications
Authors: Vasilev Aleksey A. , Kandinska Meglena I. , Kostadinov Anton , Dietz Laura , Baluschev Stanislav
Published: September 2023

The development of new selective fluorogenic probes for monitoring microbiological objects and cellular compartments may help to determine the mechanism of pathogenesis of new pathogens in living cells. The easy and reliable synthetic strategy for the direct preparation of chemically pure styryl dye (E)-3-heptyl-2-(4-thiomorpholinostyryl)benzo[d]thiazol-3-ium iodide is described. The photophysical properties in different solvents and in water medium neat and in the presence of the dsDNA and RNA of the dye is demonstrated and compared with that of the known structure analogue. The cellular uptake and the ability to bind cell organelles is determined. The introduction of a heptyl substituent attached to the quaternary nitrogen atom of the benzothiazole ring leads to an improvement in the photophysical properties of the dye.