bluuebunny/crossref_metadata_2025 huggingface dataset:
The Pathophysiologic Role of Gelsolin in Chronic Kidney Disease: Focus on Podocytes
Authors: Yu Chia-Jung , Damaiyanti Dian W. , Yan Shian-Jang , Wu Chih-Hsing , Tang Ming-Jer , Shieh Dar-Bin , Liu Peter P. , Liu Ping-Yen
Published: December 2021

Chronic kidney disease (CKD) is normally related to proteinuria, a common finding in a compromised glomerular filtration barrier (GFB). GFB is a structure composed of glomerular endothelial cells, the basement membrane, and the podocytes. CKD with podocyte damage may be associated with actin cytoskeleton reorganization, resulting in podocyte effacement. Gelsolin plays a critical role in several diseases, including cardiovascular diseases and cancer. Our current study aimed to determine the connection between gelsolin and podocyte, and thus the mechanism underlying podocyte injury in CKD. Experiments were carried out on Drosophila to demonstrate whether gelsolin had a physiological role in maintaining podocyte. Furthermore, the survival rate of gelsolin-knocked down Drosophila larvae was extensively reduced after AgNO3 exposure. Secondly, the in vitro podocytes treated with puromycin aminonucleoside (PAN) enhanced the gelsolin protein expression, as well as small GTPase RhoA and Rac1, which also regulated actin dynamic expression incrementally with the PAN concentrations. Thirdly, we further demonstrated in vivo that GSN was highly expressed inside the glomeruli with mitochondrial dysfunction in a CKD mouse model. Our findings suggest that an excess of gelsolin may contribute to podocytes damage in glomeruli.
Extracellular Vesicles Allow Epigenetic Mechanotransduction between Chondrocytes and Osteoblasts
Authors: Shang Xiaobin , Böker Kai Oliver , Taheri Shahed , Lehmann Wolfgang , Schilling Arndt F.
Published: December 2021

MicroRNAs (miRNAs) can be transported in extracellular vesicles (EVs) and are qualified as possible messengers for cell–cell communication. In the context of osteoarthritis (OA), miR-221-3p has been shown to have a mechanosensitive and a paracrine function inside cartilage. However, the question remains if EVs with miR-221-3p can act as molecular mechanotransducers between cells of different tissues. Here, we studied the effect of EV-mediated transport in the communication between chondrocytes and osteoblasts in vitro in a rat model. In silico analysis (Targetscan, miRWalk, miRDB) revealed putative targets of miRNA-221-3p (CDKN1B/p27, TIMP-3, Tcf7l2/TCF4, ARNT). Indeed, transfection of miRNA-221-3p in chondrocytes and osteoblasts resulted in regulation of these targets. Coculture experiments of transfected chondrocytes with untransfected osteoblasts not only showed regulation of these target genes in osteoblasts but also inhibition of their bone formation capacity. Direct treatment with chondrocyte-derived EVs validated that chondrocyte-produced extracellular miR-221-3p was responsible for this effect. Altogether, our study provides a novel perspective on a possible communication pathway of a mechanically induced epigenetic signal through EVs. This may be important for processes at the interface of bone and cartilage, such as OA development, physiologic joint homeostasis, growth or fracture healing, as well as for other tissue interfaces with differing biomechanical properties.
CsAGA1 and CsAGA2 Mediate RFO Hydrolysis in Partially Distinct Manner in Cucumber Fruits
Authors: Hua Bing , Zhang Mengying , Zhang Jinji , Dai Haibo , Zhang Zhiping , Miao Minmin
Published: December 2021

A Raffinose family oligosaccharides (RFOs) is one of the major translocated sugars in the vascular bundle of cucumber, but little RFOs can be detected in fruits. Alpha-galactosidases (α-Gals) catalyze the first catabolism step of RFOs. Six α-Gal genes exist in a cucumber genome, but their spatial functions in fruits remain unclear. Here, we found that RFOs were highly accumulated in vascular tissues. In phloem sap, the stachyose and raffinose content was gradually decreased, whereas the content of sucrose, glucose and fructose was increased from pedicel to fruit top. Three alkaline forms instead of acid forms of α-Gals were preferentially expressed in fruit vascular tissues and alkaline forms have stronger RFO-hydrolysing activity than acid forms. By inducible gene silencing of three alkaline forms of α-Gals, stachyose was highly accumulated in RNAi-CsAGA2 plants, while raffinose and stachyose were highly accumulated in RNAi-CsAGA1 plants. The content of sucrose, glucose and fructose was decreased in both RNAi-CsAGA1 and RNAi-CsAGA2 plants after β-estradiol treatment. In addition, the fresh- and dry-weight of fruits were significantly decreased in RNAi-CsAGA1 and RNAi-CsAGA2 plants. In cucurbitaceous plants, the non-sweet motif within the promoter of ClAGA2 is widely distributed in the promoter of its homologous genes. Taken together, we found RFOs hydrolysis occurred in the vascular tissues of fruits. CsAGA1 and CsAGA2 played key but partly distinct roles in the hydrolysis of RFOs.
Take a Break to Repair: A Dip in the World of Double-Strand Break Repair Mechanisms Pointing the Gaze on Archaea
Authors: De Falco Mariarosaria , De Felice Mariarita
Published: December 2021

All organisms have evolved many DNA repair pathways to counteract the different types of DNA damages. The detection of DNA damage leads to distinct cellular responses that bring about cell cycle arrest and the induction of DNA repair mechanisms. In particular, DNA double-strand breaks (DSBs) are extremely toxic for cell survival, that is why cells use specific mechanisms of DNA repair in order to maintain genome stability. The choice among the repair pathways is mainly linked to the cell cycle phases. Indeed, if it occurs in an inappropriate cellular context, it may cause genome rearrangements, giving rise to many types of human diseases, from developmental disorders to cancer. Here, we analyze the most recent remarks about the main pathways of DSB repair with the focus on homologous recombination. A thorough knowledge in DNA repair mechanisms is pivotal for identifying the most accurate treatments in human diseases.
Extracellular Prion Protein Aggregates in Nine Gerstmann–Sträussler–Scheinker Syndrome Subjects with Mutation P102L: A Micromorphological Study and Comparison with Literature Data
Authors: Jankovska Nikol , Matej Radoslav , Olejar Tomas
Published: December 2021

Gerstmann–Sträussler–Scheinker syndrome (GSS) is a hereditary neurodegenerative disease characterized by extracellular aggregations of pathological prion protein (PrP) forming characteristic plaques. Our study aimed to evaluate the micromorphology and protein composition of these plaques in relation to age, disease duration, and co-expression of other pathogenic proteins related to other neurodegenerations. Hippocampal regions of nine clinically, neuropathologically, and genetically confirmed GSS subjects were investigated using immunohistochemistry and multichannel confocal fluorescent microscopy. Most pathognomic prion protein plaques were small (2–10 µm), condensed, globous, and did not contain any of the other investigated proteinaceous components, particularly dystrophic neurites. Equally rare (in two cases out of nine) were plaques over 50 µm having predominantly fibrillar structure and exhibit the presence of dystrophic neuritic structures; in one case, the plaques also included bulbous dystrophic neurites. Co-expression with hyperphosphorylated protein tau protein or amyloid beta-peptide (Aβ) in GSS PrP plaques is generally a rare observation, even in cases with comorbid neuropathology. The dominant picture of the GSS brain is small, condensed plaques, often multicentric, while presence of dystrophic neuritic changes accumulating hyperphosphorylated protein tau or Aβ in the PrP plaques are rare and, thus, their presence probably constitutes a trivial observation without any relationship to GSS development and progression.
Robustness Analysis of an Electrohydraulic Steering Control System Based on the Estimated Uncertainty Model
Authors: Mitov Alexander , Slavov Tsonyo , Kralev Jordan
Published: December 2021

The impossibility of replacing hydraulic drives with other type drives in heavy duty machinery is the main reason for the development of a system for controlling hydraulic power steering. Moreover, the need for remote automatic control of the steering in specific types of mobile machinery leads to significant scientific interest in the design of embedded systems for controlling electro-hydraulic steering units. This article introduces an approach, which has been developed by authors, for robust stability and robust performance analysis of two embedded systems for controlling electro-hydraulic power steering in mobile machinery. It is based on the suggested new more realistic “black box” SIMO model with output multiplicative uncertainty. The uncertainty is obtained by parameters confidence interval and Gauss approximation formula. The embedded control systems used a linear-quadratic Gaussian (LQG) controller and H∞ controller. The synthesis of the controllers was performed on the basis of a nominal part of an uncertainty model. Robust stability and robust performance analyses were performed in the framework of a so-called structured singular value, μ. The obtained theoretical results were experimentally approved by real experiments with both of the developed control systems, which were physically realized as a laboratory test rig.
Application of Machine Learning Techniques to Predict the Price of Pre-Owned Cars in Bangladesh
Authors: Amik Fahad Rahman , Lanard Akash , Ismat Ahnaf , Momen Sifat
Published: December 2021

Pre-owned cars (i.e., cars with one or more previous retail owners) are extremely popular in Bangladesh. Customers who plan to purchase a pre-owned car often struggle to find a car within a budget as well as to predict the price of a particular pre-owned car. Currently, Bangladesh lacks online services that can provide assistance to customers purchasing pre-owned cars. A good prediction of prices of pre-owned cars can help customers greatly in making an informed decision about buying a pre-owned car. In this article, we look into this problem and develop a forecasting system (using machine learning techniques) that helps a potential buyer to estimate the price of a pre-owned car he is interested in. A dataset is collected and pre-processed. Exploratory data analysis has been performed. Following that, various machine learning regression algorithms, including linear regression, LASSO (Least Absolute Shrinkage and Selection Operator) regression, decision tree, random forest, and extreme gradient boosting have been applied. After evaluating the performance of each method, the best-performing model (XGBoost) was chosen. This model is capable of properly predicting prices more than 91% of the time. Finally, the model has been deployed as a web application in a local machine so that this can be later made available to end users.
Performance of a Native Butterfly and Introduced Moth on Native and Introduced Lineages of Phragmites australis
Authors: Lambert Adam M. , Tewksbury Lisa A. , Casagrande Richard A.
Published: December 2021

This study examined the performance of Poanes viator (Edwards) (Hesperiidae), a native North American skipper, and Rhizedra lutosa (Hübner) (Noctuidae), an introduced moth, reared on native and non-native, invasive lineages of Phragmites australis. Poanes viator is a generalist on monocots and larvae were also fed leaves of Zizania aquatica, a native macrophyte that the skipper commonly uses as a host plant. Larval survival and duration, pupal weight, and pupation time were compared for P. viator feeding on leaf tissue and R. lutosa feeding on rhizomes of either native or introduced plants. We also tested an artificial diet supplemented with P. australis rhizome powder as a potential food for rearing other stalk and rhizome boring Lepidoptera. In experiments using excised plant tissues, some individuals of both species fed and developed to the pupal stage on native and introduced plants, but overall, larval survival rates were low. Plant species/haplotype identity did not cause strong differences in larval survival for either species. However, P. viator larvae only pupated when feeding on native plants (Zizania aquatica and native P. australis haplotypes), whereas R. lutosa successfully pupated on both native and introduced P. australis. Although larval survival was low, 100% of P. viator and 95% of R. lutosa that reached the pupal stage emerged as adults. Rhizedra lutosa larvae fed an artificial diet supplemented with P. australis rhizome powder had significantly greater survival and pupal weights, and shorter pupation times than larvae fed rhizomes only. Several specialist Lepidopteran species are being considered for approval as biological control agents for the non-native P. australis haplotype, and the convenience and increased larval performance make this artificial diet a good alternative for rearing organisms.
Source Regions of the First Immigration of Fall Armyworm, Spodoptera frugiperda (Lepidoptera: Noctuidae) Invading Australia
Authors: Qi Guo-Jun , Ma Jian , Wan Jing , Ren Yong-Lin , McKirdy Simon , Hu Gao , Zhang Zhen-Fei
Published: December 2021

Fall armyworm is recognized as one of most highly destructive global agricultural pests. In January 2020, it had first invaded Australia, posing a significant risk to its biosecurity, food security, and agricultural productivity. In this study, the migration paths and wind systems for the case of fall armyworm invading Australia were analyzed using a three-dimensional trajectory simulation approach, combined with its flight behavior and NCEP meteorological reanalysis data. The analysis showed that fall armyworm in Torres Strait most likely came from surrounding islands of central Indonesia on two occasions via wind migration. Specifically, fall armyworm moths detected on Saibai and Erub Islands might have arrived from southern Sulawesi Island, Indonesia, between January 15 and 16. The fall armyworm in Bamaga most likely arrived from the islands around Arafura Sea and Sulawesi Island of Indonesia, between January 26 and 27. The high risk period for the invasion of fall armyworm is only likely to have occurred in January–February due to monsoon winds, which were conducive to flight across the Timor Sea towards Australia. This case study is the first to confirm the immigration paths and timing of fall armyworm from Indonesia to Australia via its surrounding islands.
Facilitating Semantic Interoperability of Trustworthy IoT Entities in Cultural Spaces: The Smart Museum Ontology
Authors: Zachila Konstantina , Kotis Konstantinos , Paparidis Evangelos , Ladikou Stamatia , Spiliotopoulos Dimitris
Published: December 2021

Nowadays, cultural spaces (e.g., museums and archaeological sites) are interested in adding intelligence in their ecosystem by deploying different types of smart applications such as automated environmental monitoring, energy saving, and user experience optimization. Such an ecosystem is better realized through semantics in order to efficiently represent the required knowledge for facilitating interoperability among different application domains, integration of data, and inference of new knowledge as insights into what may have not been observed at first sight. This paper reports on our recent efforts for the engineering of a smart museum (SM) ontology that meets the following objectives: (a) represent knowledge related to trustworthy IoT entities that “live” and are deployed in a SM, i.e., things, sensors, actuators, people, data, and applications; (b) deal with the semantic interoperability and integration of heterogeneous SM applications and data; (c) represent knowledge related to museum visits and visitors toward enhancing their visiting experience; (d) represent knowledge related to smart energy saving; (e) represent knowledge related to the monitoring of environmental conditions in museums; and (f) represent knowledge related to the space and location of exhibits and collections. The paper not only contributes a novel SM ontology, but also presents the updated HCOME methodology for the agile, human-centered, collaborative and iterative engineering of living, reused, and modular ontologies.
Season of Birth and Cardiovascular Mortality in Atrial Fibrillation: A Population-Based Cohort Study
Authors: Gue Ying X. , Bisson Arnaud , Bodin Alexandre , Herbert Julien , Lip Gregory Y. H. , Fauchier Laurent
Published: December 2021

Background: The fetal origins hypothesis have associated early life exposures with the development of adverse health outcomes in adulthood. Season of birth has been shown to be associated with overall and cardiovascular mortality. Methods: We performed a retrospective database study to explore the association between season of birth and mortality in patients with atrial fibrillation. Results: A total of 8962 patients with AF were identified in the database with 1253 deaths recorded. AF patients born in spring and summer had a higher mortality rate when compared to those born in autumn and winter (hazard ratio (HR) 1.13, 95% confidence interval (CI) 1.01–1.26, p = 0.03). This effect was consistent in the male subgroup (HR 1.25, 95% CI 1.03–1.51, p = 0.02 for males born in spring; HR 1.24, 95% CI 1.03–1.51, p = 0.03 for males born in summer when compared to winter as the reference) but not in females (HR 1.02, 95% CI 0.79–1.31, p = 0.88 for females born in spring; HR 1.11, 95% CI 0.87–1.42, p = 0.39 for females born in summer when compared to winter as the reference). Results persisted after adjustment for baseline characteristics and clinical risk profile. A similar pattern was observed with cardiovascular mortality. Conclusion: Birth in spring or summer is associated with a higher risk of cardiovascular mortality in male AF patients, but not in females. This could be related to the underlying differences in rates of major adverse clinical events between genders. Further studies should aim at clarifying the mechanisms behind this association, which may help us understand the higher level of risk in female patients with AF.
Cervical Spinal Alignment Change Accompanying Spondylosis Exposes Harmonization Failure with Total Spinal Balance: A Japanese Cohort Survey Randomly Sampled from a Basic Resident Registry
Authors: Ikegami Shota , Uehara Masashi , Tokida Ryosuke , Nishimura Hikaru , Sakai Noriko , Horiuchi Hiroshi , Kato Hiroyuki , Takahashi Jun
Published: December 2021

The relationship between spinal posture and quality of life has garnered considerable attention with the increase in older community-dwelling residents. However, details of this association remain insufficient. A recent Japanese population cohort epidemiological locomotion survey (the Obuse study) revealed that the C2–C7 cervical sagittal vertical axis (CSVA) began to increase in males from their 60s, but not in females. This study aimed to clarify the pathology of these cervical spondylotic changes. A total of 411 participants (202 male and 209 female) aged between 50 and 89 years were selected by random sampling from a cooperating town’s resident registry. All participants underwent lateral X-ray photography in a standing position for the measurement of several sagittal spinal alignment parameters, including CSVA, C2–C7 cervical lordosis (CL), T1 slope (T1S), and sagittal vertical axis (SVA). The presence of cervical spondylotic changes was also recorded. Associations of cervical sagittal spinal alignment with cervical spondylosis and between cervical and total sagittal spinal alignment were examined. The prevalence of cervical spondylosis was significantly higher in males (81%) than in females (70%) (p = 0.01). CL was significantly smaller in cervical spondylosis subjects when adjusted by age (3.4 degrees less; p = 0.01). T1S minus CL displayed a moderate positive correlation with CSVA in both males and females (r = 0.49 and 0.48, respectively, both p < 0.01). In males only, CSVA and CL showed weak positive correlations with SVA (r = 0.31 and 0.22, respectively, both p < 0.01) independently of age. Cervical spinal misalignment was more clearly associated with diminished SF-8TM scores in females than in males. In community-dwelling elderly residents, cervical sagittal spinal alignment change accompanying cervical spondylosis manifested as hypofunction to compensate for whole-spine imbalance.
The Impact of Interval between Recurrence and Reinjection in Anti-VEGF Therapy for Diabetic Macular Edema in Pro Re Nata Regimen
Authors: Takamura Yoshihiro , Kida Teruyo , Noma Hidetaka , Inoue Makoto , Yoshida Shigeo , Nagaoka Taiji , Noda Kousuke , Yamada Yutaka , Morioka Masakazu , Gozawa Makoto , Matsumura Takehiro , Inatani Masaru
Published: December 2021

Background: Pro re nata (PRN) regimen using anti-vascular endothelial growth factor (VEGF) agent is popular for the treatment of diabetic macular edema (DME). We investigated the influence of waiting time (WT) and interval between the date of recurrence of edema and re-injection on treatment efficacy. Methods: This retrospective study conducted at 7 sites in Japan enrolled patients who received intravitreal injection of ranibizumab (IVR) and aflibercept (IVA) in 1+PRN regimen. Enrolled patients were divided into 2 groups: prompt group (less than 1 week) and deferred group (3 weeks or more). Central retinal thickness (CRT) and best corrected visual acuity (BCVA) were measured every month for 1 year. Results: CRT in the deferred group was significantly higher than that in the prompt group at 2, 5, 6, 7, and 12 months (p < 0.05). BCVA in the prompt group was significantly better than that in the deferred group at 7, 10, and 12 months (p < 0.05). Conclusion: The prompt group was superior in anatomical and functional improvement of DME in anti-VEGF therapy than the deferred group. Our data suggests that shorter WT is recommended for better visual prognosis in the treatment for DME.
Does Humeral Component Version Affect Range of Motion and Clinical Outcomes in Reverse Total Shoulder Arthroplasty? A Systematic Review
Authors: Jassim Shivan S. , Ernstbrunner Lukas , Ek Eugene T.
Published: December 2021

Background: Prosthesis selection, design, and placement in reverse total shoulder arthroplasty (RTSA) affect post-operative results. The aim of this systematic review was to evaluate the influence of the humeral stem version and prosthesis design (inlay vs. onlay) on shoulder function following RTSA. Methods: A systematic review of the literature on post-operative range of motion (ROM) and functional scores following RTSA with specifically known humeral stem implantations was performed using MEDLINE, Pubmed, and Embase databases, and the Cochrane Library. Functional scores included were Constant scores (CSs) and/or American Shoulder and Elbow Surgeons (ASES) scores. The patients were organised into three separate groups based on the implanted version of their humeral stem: (1) less than 20° of retroversion, (2) 20° of retroversion, and (3) greater than 20° of retroversion. Results: Data from 14 studies and a total of 1221 shoulders were eligible for analysis. Patients with a humeral stem implanted at 20° of retroversion had similar post-operative mean ASES (75.8 points) and absolute CS (68.1 points) compared to the group with humeral stems implanted at less than 20° of retroversion (76 points and 62.5 points; p = 0.956 and p = 0.153) and those implanted at more than 20° of retroversion (73.3 points; p = 0.682). Subjects with humeral stem retroversion at greater than 20° tended towards greater active forward elevation and external rotation compared with the group at 20° of retroversion (p = 0.462) and those with less than 20° of retroversion (p = 0.192). Patients with an onlay-type RTSA showed statistically significantly higher mean post-operative internal rotation compared to patients with inlay-type RTSA designs (p = 0.048). Other functional scores and forward elevation results favoured the onlay-types, but greater external rotation was seen in inlay-type RTSA designs (p = 0.382). Conclusions: Humeral stem implantation in RTSA at 20° of retroversion and greater appears to be associated with higher post-operative outcome scores and a greater range of motion when compared with a retroversion of less than 20°. Within these studies, onlay-type RTSA designs were associated with greater forward elevation but less external rotation when compared to inlay-type designs. However, none of the differences in outcome scores and range of motion between the humeral version groups were statistically significant.
Trends in Hospital Admissions and Death Causes in Patients with Systemic Lupus Erythematosus: Spanish National Registry
Authors: Moreno-Torres Víctor , Tarín Carlos , Ruiz-Irastorza Guillermo , Castejón Raquel , Gutiérrez-Rojas Ángela , Royuela Ana , Durán-del Campo Pedro , Mellor-Pita Susana , Tutor Pablo , Rosado Silvia , Sánchez Enrique , Martínez-Urbistondo María , de Mendoza Carmen , Yebra Miguel , Vargas Juan-Antonio
Published: December 2021

Background: the admission and death causes of SLE patients might have changed over the last years. Methods: Analysis of the Spanish National Hospital Discharge database. All individuals admitted with SLE, according to ICD-9, were selected. The following five admission categories were considered: SLE, cardiovascular disease (CVD), neoplasm, infection, and venous-thromboembolic disease (VTED), along four periods of time (1997–2000, 2001–2005, 2006–2010, and 2011–2015). Results: The admissions (99,859) from 43.432 patients with SLE were included. The absolute number of admissions increased from 15,807 in 1997–2000 to 31,977 in 2011–2015. SLE decreased as a cause of admission (from 47.1% to 20.8%, p < 0.001), while other categories increased over the time, as follows: 5% to 8.6% for CVD, 8.2% to 13% for infection, and 1.4% to 5.5% for neoplasm (p < 0.001 for all). The admission mortality rate rose from 2.22% to 3.06% (p < 0.001) and the causes of death evolved in parallel with the admission categories. A significant trend to older age was observed over time in the overall population and deceased patients (p < 0.001). Conclusions: Better control of SLE over the past two decades has led to a decrease in early admissions, and disease chronification. As a counterpart, CVD, infections, and neoplasm have become the main causes of admissions and mortality.
Adjuvant Therapy with Budesonide Post-Kasai Reduces the Need for Liver Transplantation in Biliary Atresia
Authors: Kuebler Joachim F. , Madadi-Sanjani Omid , Pfister Eva D. , Baumann Ulrich , Fortmann David , Leonhardt Johannes , Ure Benno M. , Manns Michael P. , Taubert Richard , Petersen Claus
Published: December 2021

Based on the hypothesis that autoimmunological factors coregulate the pathomechanism in biliary atresia (BA), adjuvant therapy with steroids has become routine, although its efficacy has never been proven. In 2010, a study on the advantages of budesonide compared to prednisolone in autoimmune hepatitis gave rise to experimental therapy using budesonide as an adjuvant BA treatment. Ninety-five BA patients prospectively received a budesonide 2 mg/dose rectal foam daily for three months (SG). A case-matched control group (CG: 81) was retrospectively recruited. The outcome measures were survival with native liver (SNL), determined at six months and two years after the Kasai procedure. The follow-up rate was 100%. At six months, SNL was statistically not different but became so after two years (SG: 54%; CG: 32%; p < 0.001). No steroid-related side effects were observed, except for eight patients with finally caught-up growth retardation. This study demonstrates for the first time a significantly longer survival with native liver in patients with BA after adjuvant therapy. However, indication, dosage, and duration of any budesonide application is not given in neonates with BA. Hence, we suggest extending the postoperative use of budesonide in a multicenter observational study with a clearly defined follow-up protocol, particularly in terms of potentially underestimated side effects.
Evaluation of the Effectiveness of Modified Pectoral Nerve Blocks Type II (PECS II) for Vascular Access Port Implantation Using Cephalic Vein Venesection
Authors: Janc Jarosław , Szamborski Marek , Milnerowicz Artur , Łysenko Lidia , Leśnik Patrycja
Published: December 2021

The vascular access port implantation procedure can be performed using the venesection method by inserting a catheter into the cephalic vein in the region of the deltopectoral groove. This method eliminates the need for catheter tunneling. An alternative method to infiltration anaesthesia for port implantation may be a modified pectoral nerve block type II (PECS II). This study aimed to evaluate the effectiveness of modified PECS II for vascular access port implantation using cephalic vein venesection. This retrospective observational study was conducted at the 4th Military Clinical Hospital in Wroclaw, Poland. A group of 114 patients underwent the modified PECS II block and additional cutaneous infiltration anesthesia at the incision line. Pain intensity was assessed on the NRS scale measured intraoperatively at four points. The QoR-15 questionnaire was used to assess patient satisfaction during the first 24 h after surgery. The operator’s condition assessment score was used to assess surgical conditions and operator comfort. The analysis showed that the median pain intensity during vascular port implantation was 0. A statistically significant difference in pain intensity was demonstrated between the specialist’s group and the resident’s group at the second and third measurement points (p < 0.008; p < 0.012). The mean value on the QoR-15 scale was 132. There was a significant difference between the pain scores of the groups. The mean score in the pain position in the specialist’s group was 18 points and in the resident’s group, it was 19 points (p < 0.029). In conclusion, the present study revealed that the modified PECS II block is an effective and safe method of anesthesia for Port-A-Cath implantation.
First Experience in the Control of the Venous Side of the Brain AVM
Authors: Waldeck Stephan , Chapot Rene , von Falck Christian , Froelich Matthias F. , Brockmann Marc , Overhoff Daniel
Published: December 2021

Background and purpose: Brain arteriovenous malformations (AVM) are increasingly curable with endovascular embolization. This study examines the preliminary experience with a novel double-sided hybrid approach in the treatment of cerebral arteriovenous malformations (AVM) versus a purely single-sided intra-arterial approach. Materials and methods: The single-center study cohort included 18 patients with brain AVMs (Spetzler–Martin Grade 2 or 3) having stand-alone endovascular treatment with either the arterial-side-only pressure cooker technique (aPCT) (group 1; n = 9) or a double-sided hybrid intra-arterial and transvenous approach (HIPRENE) (group 2; n = 9). Results: Patients belonging to group 2 had lower rates of intra-procedural hemorrhaging (66.7% vs. 33.3%, p = 0.169) and needed fewer treatment sessions to achieve nidus occlusion (1.7 vs. 1.2, p = 0.136). The HIPRENE treatment regime led to higher nidus occlusion rates after the initial treatment compared to aPCT (77.7% vs. 44.4%, p = 0.167). Group 2 patients had a lower rate of neuromonitoring events (22.2% vs. 44.4%, p = 0.310) and fewer accounts of blood flow obstruction in post-operative MRIs (33.3% vs. 55.6%, p = 0.319). Conclusion: A double-sided hybrid intra-arterial and transvenous approach might have benefits for curative endovascular brain AVM treatment in patients with Spetzler–Martin Grade 2 or 3. In our small study cohort, the HIPRENE treatment regime had higher nidus occlusion rates after the first treatment, which reduces the number of treatment sessions and lowers intra- and post-operative complication rates. Further randomized controlled studies are awaited to corroborate our preliminary outcomes.
Glenoid Component Position Does Not Affect Short-Term Clinical and Radiologic Outcomes in Total Shoulder Arthroplasty
Authors: Simon Maciej , Crofts Helen , Sasyniuk Treny , Johnston Kayla , Plausinis Derek , Zarzour Zane , Leung Fay , Chin Patrick , Regan William
Published: December 2021

Background: Malpositioning of the glenoid component in total shoulder arthroplasty (TSA) remains the primary source of loosening. The purpose of this study is firstly, to quantify postoperative glenoid component position in patients having a TSA and secondly, to explore whether glenoid component radiolucency is associated with glenoid position, clinical outcomes and patient-reported measures in the short-term (two year) follow-up period. Methods: This study was a sub-study of a larger clinical trial that included patients who underwent a TSA and who were randomized into two different glenoid types with a minimum two-year follow-up period. Post-operative radiographic assessments (six weeks and two years) were used to measure glenoid component position (version, inclination, offset) and humeral head centering anterior–posterior (AP) and superior–inferior (SI), and to assess glenoid component radiolucent scoring (modified Lazarus). Pre-operative X-rays were used to measure glenoid version, inclination and Walch classification. Patient-reported measures (PROMs) included the EQ-5D health slider and the Western Ontario Osteoarthritis (WOOS) and American Shoulder and Elbow Surgeons (ASES) score and were captured at baseline and two years postoperative. Clinical outcomes including range of motion and complications were also documented. Statistical analysis included t-tests and regression modeling. Results: Ninety-one patients with an average age of 69.9 ± 6.2 years were included in this study. Glenoid component position improved significantly in version (−19.4 ± 8.6° to −17.7 ± 8.5°; p < 0.045) and inclination (11.5 ± 7.1° to 5.9 ± 6.3°; p < 0.00001) from preoperative to six weeks postoperative. Glenoid component offset in SI and humeral head centering in AP remained unchanged throughout the follow-up. Radiolucency (Lazarus classification) was recorded in 21 cases (17.3%) with a Lazarus score of 1 (15 cases) and 2 (6 cases). The EQ-5D health slider, WOOS and ASES, and ROM confirmed continuous improvements from the preoperative scores to the two-year follow-up (p < 0.05). Regression models showed no correlation between glenoid component radiolucency at two years and the postoperative week six glenoid component position; however, female gender was a significant variable. Conclusion: Glenoid component changes from its original native glenoid were observed following TSA. Glenoid inclination was improved more than version from baseline, and the humeral head remained well-centered in AP and SI at two years. Radiolucency of the glenoid at two years is not negatively associated with PROMs or component position; however, female gender was identified as a significant predictor and warrants further investigation. Complications are not associated with glenoid position or radiolucency, but longer-term follow-up is required.
A Randomized Trial Assessing the Muscle Strength and Range of Motion in Elderly Patients following Distal Radius Fractures Treated with 4- and 6-Week Cast Immobilization
Authors: Olech Jarosław , Konieczny Grzegorz , Tomczyk Łukasz , Morasiewicz Piotr
Published: December 2021

Background: There is no consensus among orthopedic surgeons as to the required period of cast immobilization in distal radius fractures in elderly patients. The purpose of this study was to assess muscle strength and range of motion symmetry in elderly patients after distal radius fractures with different periods of cast immobilization. Methods: This study evaluated 50 patients (33 women and 17 men), aged over 65 years, after cast immobilization treatment for distal radius fracture. The mean age at the beginning of treatment was 71 years. The mean duration of follow-up was 1 year and 3 months. The first subgroup (n = 24) comprised the patients whose fractures had been immobilized in a cast for 6 weeks, another subgroup (n = 26) comprised the patients with 4-week cast immobilization. We assessed: (1) muscle strength, (2) range of motion. Results: The mean grip strength in the treated limb was 71% and 81% of that in the healthy limb in the groups with 4-week and 6-week cast immobilization, respectively (p = 0.0432). The study groups showed no differences in the mean grip strength in the treated limbs or the mean grip strength in the healthy limbs. The mean treated limb flexion was 62° and 75° in the 4-week and 6-week immobilization groups, respectively (p = 0.025). The evaluated groups showed no differences in terms of any other range of motion parameters. The grip strength and range of motion values were significantly lower in the treated limb than in the healthy limb in both evaluated groups. Only the values of wrist radial deviation in the 6-week cast immobilization group showed no differences between the treated and healthy limbs. Conclusion: Higher values of injured limb muscle strength and greater mean range of wrist flexion were achieved in the 6-week subgroup. Neither of the evaluated groups achieved a symmetry of muscle strength or range of motion after treatment. Full limb function did not return in any of the elderly distal radius fracture patients irrespective of cast immobilization duration.
The Aortic Annulus Stabilization Technique Prevents Paravalvular Leaks after Rapid Deployment Aortic Valve Implantation
Authors: Caporali Elena , Lorusso Roberto , Torre Tiziano , Toto Francesca , Pozzoli Alberto , Pedrazzini Giovanni , Demertzis Stefanos , Ferrari Enrico
Published: December 2021

Background: Surgical aortic valve replacement with rapid deployment bioprosthesis guarantees good hemodynamic results but carries the risk of paravalvular leaks. To address this issue, an annulus stabilization technique has been recently developed. Methods: Clinical and hemodynamic parameters from patients treated for aortic valve replacement with the rapid deployment bioprosthesis and a concomitant annulus stabilization technique were prospectively collected and retrospectively analyzed. Echocardiographic data at discharge and at 1-year follow-up were collected and analysed. Results: A total of 57 patients (mean age 74.3 ± 6.1 years) with symptomatic aortic valve stenosis underwent aortic valve replacement with the rapid deployment bioprosthesis and concomitant annulus stabilization technique (mean valve size: 23.8 ± 1.9 mm). Combined procedures accounted for 56.1%. Hospital mortality was 1.8% and a new pacemaker for conduction abnormalities was implanted in 10 patients. The pre-discharge echocardiographic control showed absence of paravalvular leaks of any degree in all patients with mean valve gradient of 9.6 ± 4.0 mmHg. The 1-year echocardiographic control confirmed the good valve hemodynamic (mean gradient of 8.0 ± 2.8 mmHg) and absence of leaks. Conclusion: In this preliminary clinical experience, the annulus stabilization technique prevents postoperative paravalvular leaks after rapid deployment aortic valve implantation, up to 1-year postoperatively. Studies on larger series are of paramount importance to confirm the long-term efficacy of this new surgical technique.
Ejaculations and Benign Prostatic Hyperplasia: An Impossible Compromise? A Comprehensive Review
Authors: Couteau Nicolas , Duquesne Igor , Frédéric Panthier , Thiounn Nicolas , Timsit Marc-Olivier , Mejean Arnaud , Pinar Ugo , Audenet François
Published: December 2021

Background: Benign prostatic hyperplasia (BPH) is commonly responsible for lower urinary tract symptoms (LUTS) in men aged 50 or over. Sexual dysfunctions, such as ejaculatory disorders (EjD), go along with LUTS but are frequently overlooked in the initial evaluation. This review aimed to detail BPH-related EjD, as well as their modifications by medical, surgical, and interventional treatments. Methods: We conducted a narrative review looking for publications between 1990 and 2020, regarding physiopathology, epidemiology, evaluation, and therapeutic management (medical, surgical, and interventional) of BPH-related EjD. Results: Sixty-five articles were included in our final analysis. Forty-six percent of men presenting with LUTS reported EjD. If the prevalence increases with age and LUTS severity, the functional impairment is not correlated with age. Several self-questionnaires evaluated the sexual function, but only four approaches are specific to EjD. Medical therapies were exposed to anejaculation, rather than retrograde ejaculation (RE) (4–30% (alpha-blockers), 4–18% (5-alpha-reductase inhibitors)). Regarding surgical therapies, trans-urethral resection of the prostate (TURP) and incision of the prostate (TUIP) are associated with 50–70% and 21–35% of RE. The RE rate is important after open simple prostatectomy but can be reduced with robotic approaches and urethral sparing techniques (19%). Anatomic endoscopic enucleation of the prostate (AEEP) with or without a laser source is associated with an 11–36% RE rate, according to supramontanal preservation. Recent surgical techniques (Rezum©, Aquablation©, or Urolift©) were developed to preserve antegrade ejaculation with promising short-term results. Regardless of the surgical approach, anatomic studies suggest that the preservation of peri-montanal tissue (7.5 mm laterally; 10 mm proximally) is primordial to avoid post-operative RE. Finally, prostate artery embolization (PAE) limits the RE rate but exposes it to a 12 months 10% re-intervention rate. Conclusion: EjD concerns almost half of the patients presenting BPH-related LUTS. Initial evaluation of EjD impairment is primordial before medical or surgical therapy. Peri-montanal tissue preservation represents a key point for antegrade ejaculation preservation, regardless of the surgical option.
Anterior-Segment Swept-Source Ocular Coherence Tomography and Scheimpflug Imaging Agreement for Keratometry and Pupil Measurements in Healthy Eyes
Authors: Pérez-Bartolomé Francisco , Rocha-De-Lossada Carlos , Sánchez-González José-María , Feu-Basilio Silvia , Torras-Sanvicens Josep , Peraza-Nieves Jorge
Published: December 2021

This study examines agreement between the devices Anterion® and Pentacam HR® used for corneal and pupil measurements in healthy eyes. The parameters compared between the two devices were: anterior Km (D), anterior K2 (D), anterior K1 (D), anterior K1 axis (°), anterior astigmatism (D), anterior K max (D), posterior Km (D), posterior K2 (D), posterior K1 (D), posterior K1 axis (°), posterior astigmatism (D), CCT (µm), thinnest point thickness (µm), thinnest point X-coordinate (mm), thinnest point Y-coordinate (mm), pupil diameter (mm), pupil center-corneal vertex distance (mm) (angle kappa), pupil centroid angle (°), pupil centroid X-coordinate (mm), and pupil centroid Y-coordinate (mm). The Student’s t test for independent samples identified significant differences (p < 0.005) between devices for the measurements anterior and posterior flat K axis, posterior flat K, steep K, and mean K. For these last three measurements, although significant, none of the differences were clinically relevant. Corneal power and thickness measurements except Kf axis showed excellent agreement between Anterion and Pentacam. In a clinical setting we would not recommend the interchangeable use of Pentacam and Anterion for measurement of pupil parameters.
Polymerization Shrinkage, Hygroscopic Expansion, Elastic Modulus and Degree of Conversion of Different Composites for Dental Application
Authors: Borges Alexandre Luiz Souto , Dal Piva Amanda Maria de Oliveira , Moecke Sabrina Elise , de Morais Raquel Coutinho , Tribst João Paulo Mendes
Published: December 2021

Objectives: To characterize the mechanical properties of different resin-composites for dental application. Methods: Thirteen universal dentin shade composites (n = 10) from different manufacturers were evaluated (4 Seasons, Grandio, Venus, Amelogen Plus, P90, Z350, Esthet-X, Amaris, Vita-l-escence, Natural-Look, Charisma, Z250 and Opallis). The polymerization shrinkage percentage was calculated using a video-image recording device (ACUVOL—Bisco Dental) and the hygroscopic expansion was measured after thermocycling aging in the same equipment. Equal volumes of material were used and, after 5 min of relaxation, baseline measurements were calculated with 18 J of energy delivered from the light-curing unit. Specimens were stored in a dry-dark environment for 24 h then thermocycled in distilled water (5–55 °C for 20,000 cycles) with volume measurement at each 5000 cycles. In addition, the pulse-excitatory method was applied to calculate the elastic modulus and Poisson ratio for each resin material and the degree of conversion was evaluated using Fourier transform infrared spectroscopy. Results: The ANOVA showed that all composite volumes were influenced by the number of cycles (α = 0.05). Volumes at 5 min post-polymerization (12.47 ± 0.08 cm3) were significantly lower than those at baseline (12.80 ± 0.09 cm3). With regard to the impact of aging, all resin materials showed a statistically significant increase in volume after 5000 cycles (13.04 ± 0.22 cm3). There was no statistical difference between volumes measured at the other cycle steps. The elastic modulus ranged from 22.15 to 10.06 GPa and the Poisson ratio from 0.54 to 0.22 with a significant difference between the evaluated materials (α = 0.05). The degree of conversion was higher than 60% for all evaluated resin composites.
Age and Not the Preferred Limb Influences the Kinematic Structure of Pointing Movements
Authors: Kornatz Kurt W. , Poston Brach , Stelmach George E.
Published: December 2021

In goal-directed movements, effective open-loop control reduces the need for feedback-based corrective submovements. The purpose of this study was to determine the influence of hand preference and aging on submovements during single- and two-joint pointing movements. A total of 12 young and 12 older right-handed participants performed pointing movements that involved either elbow extension or a combination of elbow extension and horizontal shoulder flexion with their right and left arms to a target. Kinematics were used to separate the movements into their primary and secondary submovements. The older adults exhibited slower movements, used secondary submovements more often, and produced relatively shorter primary submovements. However, there were no interlimb differences for either age group or for the single- and two-joint movements. These findings indicate that open-loop control is similar between arms but compromised in older compared to younger adults.
The Transition to Noncommunicable Disease: How to Reduce Its Unsustainable Global Burden by Increasing Cognitive Access to Health Self-Management
Authors: Gottfredson Linda S.
Published: December 2021

The global epidemic of noncommunicable diseases (NCDs), such as cardiovascular disease and diabetes, is creating unsustainable burdens on health systems worldwide. NCDs are treatable but not curable. They are less amenable to top-down prevention and control than are the infectious diseases now in retreat. NCDs are mostly preventable, but only individuals themselves have the power to prevent and manage the diseases to which the enticements of modernity and rising prosperity have made them so susceptible (e.g., tobacco, fat-salt-carbohydrate laden food products). Rates of nonadherence to healthcare regimens for controlling NCDs are high, despite the predictable long-term ravages of not self-managing an NCD effectively. I use international data on adult functional literacy to show why the cognitive demands of today’s NCD self-management (NCD-SM) regimens invite nonadherence, especially among individuals of below-average or declining cognitive capacity. I then describe ways to improve the cognitive accessibility of NCD-SM regimens, where required, so that more patients are better able and motivated to self-manage and less likely to err in life-threatening ways. For the healthcare professions, I list tools they can develop and deploy to increase patients’ cognitive access to NCD-SM. Epidemiologists could identify more WHO “best buy” interventions to slow or reverse the world’s “slow-motion disaster” of NCDs were they to add two neglected variables when modeling the rising burdens of disease. The neglected two are both cognitive: the distribution of cognitive capacity levels of people in a population and the cognitive complexity of their health environments.