bluuebunny/crossref_metadata_2025 huggingface dataset:
Identification and Functional Analysis of Key microRNAs in the Early Extrauterine Environmental Adaptation of Piglets
Authors: Wen Mingxing , Li Jing , Qiu Wanling , Zhang Jinwei , Long Keren , Lu Lu , Jin Long , Sun Jing , Ge Liangpeng , Li Xuewei , Li Mingzhou , Ma Jideng
Published: February 2025

Neonatal mammals must rapidly adapt to significant physiological changes during the transition from the intrauterine to extrauterine environments. This adaptation, particularly in the metabolic and respiratory systems, is essential for survival. MicroRNAs (miRNAs) are small noncoding RNAs that regulate various physiological and pathological processes by binding to the 3′ untranslated regions of mRNAs. This study aimed to identify miRNAs involved in the early extrauterine adaptation of neonatal piglets and explore their functions. We performed small RNA sequencing on six tissues (heart, liver, spleen, lung, multifidus muscle, and duodenum) from piglets 24 h before birth (day 113 of gestation) and 6 h after birth. A total of 971 miRNA precursors and 1511 mature miRNAs were identified. Tissue-specific expression analysis revealed 881 tissue-specific miRNAs and 164 differentially expressed miRNAs (DE miRNAs) across the tissues. Functional enrichment analysis showed that these DE miRNAs are significantly enriched in pathways related to early extrauterine adaptation, such as the NFκB, PI3K/AKT, and Hippo pathways. Specifically, miR-22-3p was significantly upregulated in the liver post-birth and may regulate the PI3K/AKT pathway by targeting AKT3, promoting gluconeogenesis, and maintaining glucose homeostasis. Dual-luciferase reporter assays and HepG2 cell experiments confirmed AKT3 as a target of miR-22-3p, which activates the AKT/FoxO1 pathway, enhancing gluconeogenesis and glucose production. Furthermore, changes in blood glucose and liver glycogen levels in newborn piglets further support the role of miR-22-3p in glucose homeostasis. This study highlights the importance of miRNAs, particularly miR-22-3p, in the early extrauterine adaptation of neonatal piglets, offering new insights into the physiological adaptation of neonatal mammals.
Improved Recombinant Adeno-Associated Viral Vector Production via Molecular Evolution of the Viral Rep Protein
Authors: Steininger Thomas , Öttl Veronika , Franken Linda E. , Frank Cornelius , Ohland Philip , Lopez Ferreiro Miriam , Klostermann Stefan , Fritsch Johannes , Hirschauer Evelyn , Sandmeir Anna , Hilgenfeld Luisa D. , Semmelmann Florian , Dürr Marie-Sofie , Konkel Fabian , Pechmann Gregor , Linder Sabine , Haindl Markus , Yazicioglu Mustafa N. , Ringler Philippe , Lauer Matthias E. , Phichith Denis , Seeber Stefan , Fakhiri Julia
Published: February 2025

In the dynamic field of gene therapy, recombinant adeno-associated viruses (rAAVs) have become leading viral vectors due to their safety, long-term expression, and wide-ranging cell and tissue tropism. With numerous FDA approvals and commercial products underscoring their potential, there is a critical need for efficient production processes to achieve high vector titers and quality. A major challenge in rAAV production is the efficient packaging of the genome into the viral capsid, with empty or partially filled capsids often representing over 90% of the produced material. To tackle this issue, we engineered the replication and packaging proteins of an AAV (Rep) to boost their functionality and improve vector titers. We subjected a complex Rep library derived from the AAV serotypes 1–13 to directed evolution in an AAV producer cell line. After each round of selection, single clones were analyzed, showing enrichment of specific hybrid Rep domains. Comparative analysis of these selected clones revealed considerable differences in their ability to package AAV2-based viral genomes, with hybrid Rep proteins achieving up to a 2.5-fold increase in packaging efficiency compared to their parental counterparts. These results suggest that optimizing rep gene variants through directed evolution is an effective strategy to enhance rAAV production efficiency.
Sex Chromosome Dosage Compensation in Insects
Authors: Xie Xingcheng , Zhang Yakun , Peng Heyuan , Deng Zhongyuan
Published: February 2025

Dosage compensation (DC) is of crucial importance in balancing the sex-linked gene expression between males and females. It serves to guarantee that the proteins or other enzymatic products encoded by the sex chromosome exhibit quantitative parity between the two genders. During the evolutionary process of achieving dose compensation, insects have developed a wide variety of mechanisms. There exist two primary modes of dosage compensation mechanisms, including the up-regulation of heterogametic sex chromosomes in the heterogamety and down-regulation of homogametic sex chromosomes in the homogamety. Although extensive investigations have been conducted on dosage compensation in model insects, many questions still remain unresolved. Meanwhile, research on non-model insects is attracting increasing attention. This paper systematically summarizes the current advances in the field of insect dosage compensation with respect to its types and mechanisms. The principal insects involved in this study include the Drosophila melanogaster, Tribolium castaneum, Bombyx mori, and other lepidopteran insects. This paper analyzes the controversial issues about insect dosage compensation and also provides prospects for future research.
Thalassemias and Sickle Cell Diseases in Pregnancy: SITE Good Practice
Authors: Pinto Valeria Maria , Cima Rosanna , Di Maggio Rosario , Alga Maria Livia , Gigante Antonia , Longo Filomena , Pasanisi Anna Maria , Venturelli Donatella , Cassinerio Elena , Casale Maddalena , Origa Raffaella , Zanconato Giovanni , Forni Gian Luca , De Franceschi Lucia
Published: February 2025

Background: Hereditary hemoglobin disorders are the most common globally distributed monogenic red cell diseases. The rights of women with thalassemia or sickle cell disease (SCD) to motherhood need to be protected by creating a roadmap to guide her, and her family network, along all the phases of the event. In fact, pregnancy in these vulnerable patients requires special attention and guidelines from the counseling stage (giving information about the special requirement and risks posed by their pregnancy with respect to the general population) the pre-conception stage, the early and mid-late pregnancy stage, to labor and lactation. The biocomplexity of these diseases requires a multidisciplinary team synergizing with gynecologists and obstetricians. In addition, the presence of a multicultural scenario requires healthcare workers to overcome stereotypes and adopt appropriate anthropological tools that might help them integrate the different cultural models of disease and motherhood. Methods: The Management Committee of the Society for Thalassemia and Hemoglobinopathies (SITE) selected and brought together a multidisciplinary and multiprofessional group made up of experts in hemoglobinopathies and experts in anthropology, flanked along with by experts with methodological and organizational expertise in order to create recommendations based on the integration of available scientific evidence together with expert opinion. Results: The panelists critically analyzed the literature, combining in a single document practices developed over several years of managing young women with hemoglobinopathies in a sensitive phase of their lives. Conclusions: This good practice document is the result of a collegial effort by Italian experts on hemoglobinopathies who are members of SITE. (SITE).
Differential Fatigue Profile in Patients with Post-COVID Condition, Fibromyalgia, and Multiple Sclerosis
Authors: Oliver-Mas Silvia , Matias-Guiu Jordi A. , Delgado-Alonso Cristina , Cuevas Constanza , Alcalá Ramírez del Puerto José Manuel , López-Carbonero Juan Ignacio , Matias-Guiu Jorge , Diez-Cirarda Maria
Published: February 2025

Background/Objectives: Fatigue is a prevalent and debilitating symptom in Post-COVID Condition (PCC), fibromyalgia, and multiple sclerosis (MS). Although these conditions share clinical similarities, the underlying mechanisms of fatigue across these conditions may differ and remain poorly understood. This study aimed to compare the intensity and characteristics of fatigue in these three conditions to identify shared and distinct features. Methods: We conducted a cross-sectional study involving 429 participants: 219 with PCC, 112 with fibromyalgia, and 98 with MS. Participants completed a questionnaire specifically developed for the study via the Google Forms platform. This questionnaire was developed by a group of professionals in the hospital specializing in fatigue related to these three conditions, in collaboration with expert patients. The questionnaire was reported following the Checklist for Reporting Results of Internet E-Surveys (CHERRIES) recommendations. Results: Fatigue intensity was significantly higher in PCC and fibromyalgia compared to MS. Some differences in fatigue characteristics were observed: MS patients reported more fatigue in response to heat and a greater impact of mood on fatigue. Furthermore, delayed fatigue and reduced benefits from rest were more pronounced in both PCC and fibromyalgia. No significant differences were found regarding cognitive fatigue or difficulties in predicting the ability to perform activities. Conclusions: These results underscore some clinical characteristics in the intensity and quality of fatigue across PCC, fibromyalgia, and MS. These findings could suggest different mechanisms in the pathophysiology of the fatigue. Our study underscores the need for tailored diagnostic tools and interventions in managing fatigue in these three conditions.
Long-Term Clinical Relevance of Hyponatremia Identified During Acute Phase of Myocardial Infarction
Authors: Eliasz Karolina , Stępień Konrad , Wojtylak Maja , Andrasz Oliwia , Majka Katarzyna , Mazurek Gabriela , Horosin Grzegorz , Plizga Jakub , Nowak Karol , Krawczyk Krzysztof , Podolec Mateusz , Nessler Jadwiga , Zalewski Jarosław
Published: February 2025

Background/Objectives: Hyponatremia is associated with increased mortality in the general hospital population. We sought to investigate whether hyponatremia affects the long-term survival of patients following a myocardial infarction (MI) in both ST-segment elevation (STEMI) and non-ST elevation (NSTEMI) presentations. Methods: In this study, 862 MI patients who were hospitalized between 2012 and 2017 were retrospectively followed-up within the median time period of 41.9 [28.2–73.5] months. All participants were assigned to a hyponatremic or normonatremic group with hyponatremia defined as a sodium level of less than 135 mEq/L on admission. Results: In the acute phase of an MI, hyponatremia was diagnosed in 31 (3.6%) patients. The patients with hyponatremia were less often male (38.7 vs. 70.4%, p < 0.001), and less frequently had Killip class I (63.3 vs. 80%) but more often had Killip class IV on admission (16.7 vs. 4.2%, p = 0.024) and more often had a history of impaired renal function (32.3 vs. 15.5%, p = 0.013) than those with normonatremia. Hyponatremic patients had higher troponin T levels on admission by 75.1% (p = 0.003), a higher isoenzyme MB of creatine kinase level by 34.4% (p = 0.006), and lower hemoglobin (by 8.5%, p = 0.001) levels as compared to the normonatremia group. Long-term mortality was significantly higher in the patients with hyponatremia versus normonatremia (18 [58.1%] vs. 243 [29.2%], log-rank p < 0.001). This was driven by differences in the NSTEMI population (65 vs. 30.5%, p < 0.001). By a Cox proportional hazard regression analysis, hyponatremia was associated with a higher long-term mortality (hazard ratio [HR] of 2.222, a 95% confidence interval [CI] of 1.309–3.773, and p = 0.003). Conclusions: Hyponatremia rarely identified in acute phase of MI was associated with higher long-term mortality, particularly in the NSTEMI population.
Pre-Hospital Critical Care for Out-of-Hospital Cardiac Arrests with Return of Spontaneous Circulation: A Retrospective Observational Study
Authors: Watson Adam J. R. , Henderson Delphi , Beecham Ryan , Ward James , Owen Peter , Hannah Julian , Plumb James , Dushianthan Ahilanandan
Published: February 2025

Background/Objectives: Out-of-hospital cardiac arrests (OHCAs) are common, with return of spontaneous circulation (ROSC) achieved in approximately 25% of patients. However, it remains unknown whether post-ROSC care delivered by a pre-hospital critical care team (CCT) improves patient outcomes. We therefore aimed to investigate this in OHCA patients admitted to our intensive care unit (ICU). Methods: In this retrospective observational study, consecutive adults with ROSC after non-traumatic OHCA admitted to our ICU between 1 September 2019 and 31 August 2022 were included. We compared patients who received post-ROSC care from a CCT to those who received standard care. The primary outcome was a good neurological outcome on hospital discharge (defined as Cerebral Performance Category 1–2). Descriptive statistics, Area Under the Receiver Operating Characteristic Curve (AUC) values, and adjusted Odds Ratios (ORs) are reported. We constructed multivariable logistic regression models that adjusted for the component variables of the MIRACLE2 score. Results: We included 126 OHCAs (median age 63 years, 69% male), which were largely witnessed (82%), involved bystander cardiopulmonary resuscitation (87%), and had an initial shockable rhythm (61%). The prevalence of good neurological outcomes was higher in patients who received post-ROSC care from a pre-hospital CCT (37% vs. 17%, p = 0.012). The MIRACLE2 score was a strong predictor of good neurological outcomes (AUC 0.932), and in our multivariable analysis, good neurological outcome was associated with both CCT presence post-ROSC (aOR 3.77, 95% CI 1.02–13.89) and the delivery of PHEA (aOR 4.10, 95% CI 1.10–15.27, p = 0.035). Furthermore, in patients meeting the Utstein criteria (n = 69), good neurological outcomes were also more prevalent with CCT presence post-ROSC (62% vs. 29%, p < 0.001). Conclusions: We found that post-ROSC care delivered by a pre-hospital CCT was associated with good neurological outcomes on hospital discharge.
Comprehensive Management of Bowel Endometriosis: Surgical Techniques, Outcomes, and Best Practices
Authors: Tsuei Angie , Nezhat Farr , Amirlatifi Nikki , Najmi Zahra , Nezhat Azadeh , Nezhat Camran
Published: February 2025

Bowel endometriosis is a complex condition predominantly impacting women in their reproductive years, which may lead to chronic pain, gastrointestinal symptoms, and infertility. This review highlights current approaches to the diagnosis and management of bowel endometriosis, emphasizing a multidisciplinary strategy. Diagnostic methods include detailed patient history, physical examination, and imaging techniques like transvaginal ultrasound (TVUS) and magnetic resonance imaging (MRI), which aid in preoperative planning. Management options range from hormonal therapies for symptom relief to minimally invasive surgical techniques. Surgical interventions, categorized as shaving excision, disc excision, or segmental resection, depend on factors such as lesion size, location, and depth. Shaving excision is preferred for its minimal invasiveness and lower complication rates, while segmental resection is reserved for severe cases. This review also explores nerve-sparing strategies to reduce surgical morbidity, particularly for deep infiltrative cases close to the rectal bulb, anal verge, and rectosigmoid colon. A structured, evidence-based approach is recommended, prioritizing conservative surgery to avoid complications and preserve fertility as much as possible. Comprehensive management of bowel endometriosis requires expertise from both gynecologic and gastrointestinal specialists, aiming to improve patient outcomes while minimizing long-term morbidity.
The Evaluation of New-Generation Biomarker sCD14ST Provides New Insight into COVID-19’s Effect on Bone Remodeling
Authors: Galliera Emanuela , Massaccesi Luca , Mangiavini Laura , De Vecchi Elena , Villa Francesca , Corsi Romanelli Massimiliano Marco , Peretti Giuseppe Maria
Published: February 2025

Background/Objectives: The COVID-19 pandemic has increased interest in osteoimmunology because of the impact of SARS-CoV-2 on both the immune system and the bone microenvironment. Soluble CD14ST could influence the production of the osteoimmunological regulators of osteoclast differentiation. The aim of this study is to evaluate the role of sCD14ST in COVID-19’s effects on bone remodeling—evaluating, in particular, the correlation with new-generation osteoimmunological biomarkers—and to acquire comprehensive knowledge of the effects of the disease on the immune and skeletal system. Methods: The serum level of sCD14ST was measured in COVID-19-positive and COVID-19-negative patients undergoing orthopedic surgery and correlated with the inflammatory and osteoimmunological biomarkers RANKL/OPG, FGF23, IL-6, C-reactive protein (CRP), procalcitonin (PCT), sRAGE, and SuPAR. Results: In our patients, sCD14ST showed a strong increase in COVID-19-positive patients, and a significant decrease in tandem with the infection resolution, confirming its diagnostic and prognostic value. sCD14ST was more clinically relevant than the two canonically inflammatory makers used in the clinical protocols, CRP and PCT, and displayed a good positive correlation with FGF23, RANKL/OPG, IL-6, and SuPAR and a negative correlation with sRAGE. Conclusions: Monitoring sCD14ST along with SuPAR may offer valuable insights into immune system dysregulation and bone-related complications in conditions characterized by inflammation. These soluble receptors represent important links between immune activation and bone metabolism, especially in the context of diseases like COVID-19, where the inflammatory response may impact bone fragility.
Atrioventricular Block Treatment: Pacing Site, AV Synchrony, or Both?
Authors: Biffi Mauro , Bagatin Annalisa , Spadotto Alberto , Lazzeri Mirco , Carecci Alessandro , Bartoli Lorenzo , Martignani Cristian , Angeletti Andrea , Diemberger Igor , Massaro Giulia , Bertelli Michele , Ziacchi Matteo
Published: February 2025

Background/Objectives: Right ventricular pacing (RVP), leadless pacing (LL), and conduction system pacing (CSP) are treatment options for atrioventricular block (AVB), each with distinct characteristics. However, the long-term outcomes of these pacing strategies remain insufficiently compared. This study evaluates clinical and echocardiographic outcomes of patients with AVB treated with dual chamber RVP, His bundle pacing (HBP), or LL. Methods: This single-center observational registry study included 22 consecutive patients receiving LL with atrioventricular resynchronization functionality (October 2020 to October 2022), matched with 66 control patients receiving either RVP (33 patients) or HBP (33 patients) using propensity score matching (2:3:3 ratio). Primary and secondary endpoints included all-cause mortality, cardiovascular mortality, heart failure, and echocardiographic outcomes. Atrioventricular synchrony in the LL group was assessed. Results: At two years, all-cause mortality was significantly higher in the LL group compared to RVP (36.4% vs. 6.1%, p = 0.002) and HBP (36.4% vs. 12.1%, p = 0.03), but LL had a more severe clinical profile. Cardiovascular mortality and heart failure incidence showed no significant differences. Patients receiving RVP showed a significant decrease in left ventricular ejection fraction and an increase in ventricular volumes. In contrast, HBP patients exhibited favorable cardiac remodeling. Stratification based on atrial sensing showed that LL patients with >66% AV synchrony had a lower mortality (p = 0.02). Conclusions: CSP offers superior results compared to other pacing methods in terms of ventricular function owing to a physiological ventricular activation and maintenance of AV synchrony. However, LL may be a viable alternative for frail and high-risk patients, as the suboptimal AV synchrony is traded off with lesser ventricular dyssynchrony.
Pericapsular Nerve Group Block Plus Lateral Femoral Cutaneous Nerve Block vs. Fascia Iliaca Compartment Block in Hip Replacement Surgery
Authors: Vetrone Francesco , Saglietti Francesco , Galimberti Andrea , Pezzi Angelo , Umbrello Michele , Cuttone Giuseppe , La Via Luigi , Vetrugno Luigi , Deana Cristian , Girombelli Alessandro
Published: February 2025

Background: Optimal pain control with limited muscle weakness after total hip arthroplasty (THA) is paramount for a swift initiation of physical therapy and ambulation, thus expediting hospital discharge. FICB (Fascia Iliaca Compartment Block) has been recommended because it offers pain control with a low risk of motor block. PENG (Pericapsular Nerve Group) block with LFCN (Lateral Femoral Cutaneous Nerve) has been proposed as an alternative that offers comparable pain control with a lower risk of motor block; however, evidence is limited. We aimed to investigate the degree of muscle weakness and pain control with PENG + LFCN. Methods: Patients undergoing elective THA from November 2022 to October 2023 have been retrospectively analyzed. The degree of quadriceps femoris muscle paresis was assessed with the MRC scale at 6 h postoperatively. Secondary outcomes: NRS score at 6, 12, and 24 h, total opioid consumption, and time to first rescue opioid. Results: In total, 80 patients were included in the study, 57 received PENG + LFCN, and the remaining 23 received FICB. PENG + LCFN resulted in a higher MRC at 6 h (4 [4; 5] vs. 3 [2; 4] p = 0.0001) and better pain control (mean difference [95% CI] at 6 h, 0.93 [0.14; 1.72], at 12 h, 0.47 [−0.49; 1.43], and at 24 h, 0.39 [0.25; 1.2], p = 0.0006). Less PRN opioids were requested in the PENG + LFCN vs. FICB groups (7.5 [0; 15] MME vs. 60 [40; 80], p = 0.001). Conclusions: PENG + LFCN was associated with less muscle weakness, better pain control, and less rescue opioids in patients undergoing elective THA. A larger prospective study is needed to confirm this finding.
Bitot-like Spots and Congenital Aniridia: A Case Report
Authors: Mocanu Valeria , Horhat Raluca , Horhat Florin-Raul , Poenaru-Sava Mihai
Published: February 2025

Background: Bitot’s spots, defined as white foamy triangular or round-shaped spots with the base located at the temporal limbus and the apex towards the lateral canthus, were initially associated with vitamin A deficiency (VAD). More recently, Bitot’s spots were also described in patients with normal vitamin A levels, associated with aniridia, dry-eye syndrome and post-thermal or chemical injury, as well as the usage of benzalkonium chloride (BAK) eyedrops. The aim of this article is to present the management of Bitot-like spots in a patient with congenital aniridia. Methods: An 8-year-old female patient with type 1 congenital aniridia, glaucoma, cataract, strabismus, congenital nistagmus and aniridia-associated keratopathy presented with changes in conjunctival appearance. The ophthalmological examination revealed Bitot-like spots with a foamy appearance, triangular shape, temporal location and proximity to the limbus. Further investigations were required in order to identify the cause of Bitot-like spots. Vitamin D deficiency, dry-eye syndrome, birch and Phleum genus pollen allergy were diagnosed. The patient underwent oral medication with vitamin D and topical treatment with steroids eye solution, preservative-free artificial tears and vitamin A ointment. Results: After three months of treatment, we observed the disappearance of the Bitot-like spots. Conclusions: Congenital aniridia, but also its complications such as glaucoma, dry-eye syndrome and the use of benzalkonium chloride topical medication, increases the risk of Bitot-like spots.
Outcomes of Resectable Locally Advanced Non-Small Cell Lung Cancer After Neoadjuvant Chemoimmunotherapy: A Single Institution Experience
Authors: Noy Jose , Chang Alexander , Chow Nelly P. , De Jesus Fernandez Javier , Dureja Rohan , Cotamo Luis Miguel , Alnajar Ahmed , Nguyen Dao M. , Villamizar Nestor
Published: February 2025

Introduction: Immunotherapy has revolutionized the treatment for locally advanced resectable non-small-cell lung cancer (NSCLC). In clinical trials, the combination of neoadjuvant immunotherapy and chemotherapy has resulted in a higher rate of pathologic complete response in comparison with neoadjuvant chemotherapy alone. Our study aims to describe surgical and oncological outcomes after neoadjuvant chemoimmunotherapy and lung resection at our academic center outside clinical trials. Methods: We retrospectively analyzed 54 patients who received neoadjuvant chemoimmunotherapy and underwent surgical resection from 2018 to 2024. Demographics, pre-operative systemic treatment, surgical approach and postoperative outcomes were evaluated. Results: The median age was 65 years, 46% were female, and 67% of patients had a non-squamous histology, chiefly adenocarcinoma. The most common clinical stage was IIIA (54%). Major findings include a 41% pathologic complete response (pCR) and 52% major pathologic response (MPR) rate. Neoadjuvant chemoimmunotherapy resulted in downstaging in 78% (n = 42) of patients. Most patients (83%) had their operation completed robotically. R0 resection was achieved in 96%. Median length of stay was significantly shorter after robotic operations, with no significant difference in complications compared to the open group. At a median follow up of 16 months, 24 months of recurrence-free survival was estimated at 76% (95% CI: 61–94) and overall survival, 93% (CI: 84–100). Conclusion: At our medical center, induction chemoimmunotherapy followed by anatomic lung resection has resulted in a high rate of complete pathologic response, overall survival and recurrence-free survival. The robotic approach after induction chemoimmunotherapy is safe and associated with shorter length of stay and faster recovery time.
A Systematic Review of Open, Laparoscopic, and Robotic Inguinal Hernia Repair: Management of Inguinal Hernias in the 21st Century
Authors: Huerta Sergio , Garza Amanda M.
Published: February 2025

Background: In the 21st century, the management of groin hernias (GHs) has evolved from watchful waiting (WW) to robotic hernia repair (RHR). The present study interrogates the status of robotics in the context of current repairs and provides one author’s perspectives. Methods: A systematic review was undertaken using Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines for studies comparing open (OHR) to robotic hernia repair (RHR); RHR to laparoscopic hernia repair (LHR); or OHR vs. LHR vs. RHR. The historical context was extracted from previous reviews. Results: Fifty-four studies were included in the analysis. Three techniques have withstood the test of time: OHR (tissue and mesh repairs), laparo-endoscopic (TEP and TAPP), and RHR. The literature indicates that RHR is safe and effective for the management of groin hernias. Operative times and costs remain a concern when using this technique. While the number of overall complications with RHR is similar to OHR, in a minority of cases, complications are more consequential with the robotic platform. Conclusions: RHR has emerged as an unequivocally powerful technique for the management of GHs. OHR remains the technique of choice for local/regional anesthesia, posterior recurrences, and in centers that lack other platforms. In low- and middle-income countries, OHR is the most utilized technique. Centers of excellence should offer all techniques of repair including WW.
Enteral Nutrition Versus a Combination of Enteral and Parenteral Nutrition in Critically Ill Adult Patients in the Intensive Care Unit: An Overview of Systematic Reviews and Meta-Analysis
Authors: Papanikolaou Paraskevi , Theodoridis Xenophon , Papaemmanouil Androniki , Papageorgiou Niki N. , Tsankof Alexandra , Haidich Anna-Bettina , Savopoulos Christos , Tziomalos Konstantinos
Published: February 2025

Background/Objectives: Uncertainty persists about the best methods and timing for providing medical nutrition therapy (MNT) in the acute phase of critical illness. We conducted an overview of systematic reviews to examine and appraise the findings of the current systematic reviews and performed an updated meta-analysis incorporating newly published randomized controlled trials (RCTs) to investigate whether enteral nutrition (EN) is superior to the combination of EN and parenteral nutrition (PN) in patients admitted to the intensive care unit (ICU). Methods: We systematically searched three databases to retrieve systematic reviews and RCTs. Two independent reviewers performed the screening, data extraction, and quality assessment processes. The random effects model was utilized to synthesize the data regarding primary and secondary outcomes. Results: There was no difference between the two interventions regarding the efficacy and safety endpoints, apart from the bloodstream infections, which were found to be increased in the group that received the combination of EN+PN (RR = 1.27, 95%CI = 1.03 to 1.56, PI = 0.91 to 1.77, I2 = 0%). Conclusions: According to the present overview of systematic reviews and meta-analyses, there was no observed benefit on mortality, length of ICU stay or hospitalization, and duration of mechanical ventilation in critically ill patients receiving a combination of EN and PN in comparison to those receiving sole enteral nutrition in the ICU. Furthermore, no difference was observed in the rates of respiratory infections as well as the appearance of adverse events, such as vomiting and diarrhea. On the other hand, there was an increase in bloodstream infection rates in patients who received EN+PN compared to EN alone. Due to the limited implications of the results in clinical practice, further research is needed.
Reverse Shoulder Arthroplasty in Patients with Rheumatoid Arthritis: A Nationwide Analysis
Authors: Beauperthuy Andrew G. , Linton Nadia F. , Falgiano Peter A. , Mekkawy Kevin L. , Rodriguez Hugo C. , Gupta Ashim
Published: February 2025

Introduction: Reverse shoulder arthroplasty (RSA) was originally developed for treating rotator cuff arthropathy but is now commonly used for rheumatoid arthritis (RA)-related shoulder degeneration. While previous studies have identified RA to be a risk factor for complications following total shoulder arthroplasty, its specific impact on RSA outcomes remains unclear. This study aims to evaluate the post-operative medical and implant-related complications, and healthcare utilization, among RA patients undergoing RSA. Methods: A retrospective analysis of patients undergoing RSA was conducted using a national administrative claims database from 2010 to 2023. Patients who underwent RSA with and without RA were identified using corresponding diagnoses and procedural codes. Patients with RA who underwent RSA had propensity score matched to a control on a 1:5 basis. The control group consisted of patients who did not have RA and underwent RSA for any other indication. Results: A total of 7232 of RSA patients with RA were matched to 36,054 control patients. The RA cohort had significantly higher rates of 90-day medical complications when compared to the control (p < 0.001), with the highest rates in urinary tract infections (OR: 9.69), pulmonary embolisms (OR: 9.69), and the need for blood transfusions (OR:9.41). Patients with RA had significantly greater odds of developing all implant-related complications within 2 years compared to the control group (p < 0.001). This cohort also had significantly higher fall rates (p < 0.001) and mean lengths of stay (3.42 vs. 2.0 days, p < 0.0001). Conclusions: RSA patients with prior diagnoses of RA face a higher risk of implant-related and medical complications, falls, and prolonged hospital stays compared to the control. These findings suggest that RA is an independent risk factor for reverse total shoulder arthroplasty. Therefore, these patients should be closely monitored post-operatively to reduce complications, cost of care, and length of stay. Level of Evidence: III, retrospective case–control study
Contemporary Management of Cerebrospinal Fluid Rhinorrhoea: A Review of the Literature
Authors: Mughal Zahir , Martinez-Devesa Pablo , Boukas Alexandros , Jeyaretna Sanjeeva , Qureishi Ali
Published: February 2025

Background/Objectives: Cerebrospinal fluid (CSF) rhinorrhoea carries a significant risk of life-threatening intracranial complications. This review provides a contemporary overview of current management strategies for CSF rhinorrhoea. Methods: We conducted a literature review, examining studies from Medline, Embase, and Google Scholar published within the last 20 years. This narrative synthesis summarises the current and future trends in the management of CSF rhinorrhoea. Results: The management of CSF leaks requires a multidisciplinary approach, encompassing a thorough clinical assessment, targeted diagnostic testing, and a spectrum of surgical and non-surgical interventions. Endoscopic techniques, particularly the use of vascularised flaps such as the nasoseptal flap, has become central to anterior skull base reconstruction. Numerous graft and flap choices provide tailored solutions based on defect size and CSF flow characteristics, with reported success rates exceeding 90%. Conclusions: Endoscopic repair of CSF rhinorrhoea continues to evolve, with modern techniques significantly enhancing success rates and reducing morbidity. Further understanding of underlying aetiologies, advances in technology, and refinement in surgical technique are areas for future innovation in CSF rhinorrhoea management.
Clinical Outcome and Costs Based on the Degree of Vitamin K Antagonist Control for Non-Valvular Atrial Fibrillation
Authors: Dalmau Llorca M. Rosa , Hernández Rojas Zojaina , Castro Blanco Elisabet , Carrasco-Querol Noèlia , Gonçalves Alessandra Queiroga , Espuny Cid Anna , Fernández Sáez José , García-Goñi Manuel , Pérez-Villacastín Julián , Aguilar Martín Carina
Published: February 2025

Introduction and objectives: Adequate anticoagulation control with vitamin K antagonists (VKAs) in non-valvular atrial fibrillation (NVAF) improves health outcomes. Knowing how the economic burden depends on the degree of anticoagulation control may be relevant for decision makers. This study analyses health outcomes and costs in relation to the degree of control of anticoagulation with VKAs in NVAF in primary care using real-world data. Methods: The present study analyzes health outcomes and costs based on Rosendaal’s time in therapeutic range (TTR), considering values of TTR > 70% to indicate adequate control. It was carried out using data from 2018, from the perspective of the health system, with a time horizon of 1 year, in 325 Primary Care Centers in Catalonia, Spain. Results: A total of 42,374 real cases were analyzed, with 46.71% categorized as receiving adequate anticoagulation control. All costs were higher for poor anticoagulation control, resulting in EUR 1811.28 per patient for poor anticoagulation control compared with EUR 1609.25 per patient for adequate anticoagulation control. Adequate TTR control provided a protective effect in admissions due to cranial hemorrhage events (ORadj = 0.75; 95% CI, 0.60–0.94), gastrointestinal bleeding (ORadj = 0.66; 95% CI, 0.54–0.80), and mortality (ORadj = 0.65; 95% CI, 0.60–0.70). Conclusions: Adequate anticoagulation control is associated with a reduction in cranial hemorrhage event admissions, gastrointestinal bleeding admissions, and mortality. The cost arising from patients with adequate control was lower than that for patients with inadequate control. Strategies to improve anticoagulation control could improve health outcomes and costs.
Observations and Numerical Modelling of the Sumatra Tsunami of 28 March 2005
Authors: Medvedeva Alisa , Rabinovich Alexander
Published: February 2025

On 28 March 2005, a major Mw 8.6 earthquake occurred near Nias and Simeulueislands, in the vicinity of northwestern Sumatra (Indonesia). The earthquake generated a significant tsunami. Although it was not as destructive as the 2004 Sumatra tsunami, the 2005 event was of sufficient strength to be recorded by tide gauges throughout the entire Indian Ocean. We selected 12 records for analysis, most from open-ocean islands but also some from continental stations. The maximum wave heights were measured at Salalah (Oman) (87 cm), Colombo (Sri Lanka), Pointe La Rue (Seychelles) and Rodrigues Island (53–54 cm). The dominant wave periods, estimated from frequency–time (f-t) diagrams, were 60–66 min, 40–48 min, and 20 min, which we assume are associated with the 2005 tsunami source. From the same stations, we calculated the mean ratio of the 2004 to 2005 tsunami heights as 5.11 ± 0.60, with the maximum and minimum heights to the west and south of the source region as 9.0 and 2.49, respectively. We also used these data to estimate the mean energy index, E0 = 65 cm2, for the 2005 tsunami, which was 16 times smaller than for the 2004 event. The USGS seismic solution was used to construct a numerical model of the 2005 tsunami and to simulate the tsunami waveforms for all 12 tide gauge stations. The results of the numerical computations were in general agreement with the observations and enabled us to map the spatial wave field of the event. To estimate the influence of location and orientation of the source area on the propagating tsunami waves, we undertook a set of additional numerical experiments and found that this influence is substantial and that these factors explain some of the differences between the physical properties of the 2004 and 2005 events.
Species Identification and Frequency Characteristic of Japanese Anchovy (Engraulis japonicus) Using Hydro-Acoustics
Authors: Park Geunchang , Mukai Tohru , Lee Kyounghoon
Published: February 2025

In this study, the KRM (Kirchhoff-ray mode) model was used to identify the acoustic scattering characteristics of anchovies according to frequency, and the school detection method and dB-difference method were used to identify the acoustic signals of Japanese anchovy on the echogram. The TS (target strength) values of anchovies were checked in the echograms of areas where more than 95% of anchovies were collected to establish frequency range. In addition, the parameter values were set by estimating the size of the anchovy school from the echogram, and the echo signal of the anchovy was identified by school detection using the set parameter values. The results showed that the average TS fluctuations of anchovies were larger for small-sized anchovies (5.5 cm) than for large-sized anchovies (16.9 cm), but TS fluctuations after frequency 130 kHz showed similar trends. Species identification analysis identified only the echo signal of anchovies in the echograms, with depths of 20–70 m for anchovies and 90–110 m for other fish species.
Mechanisms of Strength Degradation of Dental Zirconia Due to Glazing: Dependence on Glaze Thickness
Authors: Nonaka Kazumichi , Teramae Mitsuji , Pezzotti Giuseppe
Published: February 2025

Glazing is a common method for smoothing the surface of zirconia and imitating the appearance of natural teeth. Several authors have previously reported that glazing reduces the strength of zirconia. However, the dependence of strength on glaze thickness and the mechanism of strength reduction remains unclear. Clarifying these factors is particularly important for improving the reliability of zirconia prostheses. In this study, three types of zirconia were glazed with various thicknesses, and their strength was evaluated. The results showed that the strength of the materials decreased with increasing glaze thickness. The decrease in the fracture load of the glazed test specimen stopped at a load where the stress necessary to fracture the glaze material was applied to the surface of the glaze layer. Furthermore, the strength reduction mechanism was investigated using FEM analysis, fractography, and Raman spectroscopy. The results suggested that the strength reduction due to glazing was a consequence of the crack-tip stress concentration developed upon the preliminary fracture of the glaze layer.
Effect of Undercut Bolt Anchor Depth on Failure Cone Geometry: A Numerical FEM Analysis and Experimental Verification
Authors: Jonak Józef , Wójcik Andrzej , Karpiński Robert , Jonak Kamil
Published: February 2025

This study examined the influence of the effective embedment depth hef of undercut anchors and the diameter of their heads on the formation of the so-called cone failure angle α. Cone failure formation during simulated anchor pull-out tests was analyzed numerically using the Finite Element Method (FEM) with the ABAQUS software and the XFEM algorithm. The analysis was conducted for three sizes of undercut anchor heads and four embedment depths. The numerical analysis results were compared with field test results obtained during pull-out tests of anchors installed in a rock medium (sandstone). Good agreement was observed between the numerical and field test results. The results of the numerical study are highly consistent with those obtained during the field survey. Moreover, they align closely with findings from previous numerical studies conducted by members of the research team, as presented in earlier publications. For the assumed simulation and field test conditions (sedimentary rocks, gray sandstone), no clear correlation was found between the embedment depth or the anchor head diameter and the value of the cone failure angle in the initial phase of the failure zone development. This result contrasts with certain findings reported in the literature. Many existing studies on anchor bolts focus on material properties or load-bearing capacity, but lack an in-depth analysis of how anchor depth influences the geometry of the failure cone. This research addresses that gap, providing valuable insights with practical implications for design codes and safety evaluations.
Impact of Yttrium Oxide on the Synthesis and Sintering Properties of Cordierite–Mullite Composite Ceramics
Authors: Zhang Hui , Feng Lu , Mao Weibo , Liu Quanming , Zhao Liang , Zhang Hong
Published: February 2025

To enhance the mechanical properties and high-temperature performance of cordierite–mullite composite ceramics, yttrium oxide (Y2O3), a rare earth metal oxide, was employed as a sintering aid to fabricate these composites via in situ synthesis and non-pressure sintering. This study systematically investigated the formation mechanisms of the cordierite and mullite phases and examined the effects of yttrium oxide on the densification behavior, mechanical properties, volumetric stability, and thermal shock resistance. The results indicate that incorporating yttrium oxide (1.5–6.0 wt%) not only promoted the formation of the cordierite phase but also refined the microstructure and enhanced the thermal shock stability at a sintering temperature of 1350 °C. An optimal addition of 3 wt% yttrium oxide ensures that the primary phases are cordierite and mullite, with a microstructure characterized by uniformly distributed micropores, hexagonal short-columnar cordierite, and interlocking rod-like mullite, thereby significantly improving both the mechanical properties and thermal shock stability. Specifically, the room-temperature compressive strength increased by 121%, the flexural strength increased by 177%, and, after three thermal shock cycles at 1100 °C, the retention rates for compressive and flexural strengths were 87.66% and 71.01%, respectively. This research provides a critical foundation for enhancing the mechanical properties and high-temperature service performance of cordierite–mullite saggers used in lithium battery cathode materials.
Generalizing the Cross Product to N Dimensions: A Novel Approach for Multidimensional Analysis and Applications
Authors: Brahim Belhaouari Samir , Kahalan Yunis Carreon , Aksikas Ilyasse , Hamdi Abdelouahed , Belhaouari Ismael , Haoudi Elias Nabel , Bensmail Halima
Published: February 2025

This paper presents a generalization of the cross product to N dimensions, extending the classical operation beyond its traditional confines in three-dimensional space. By redefining the cross product to accommodate N−1 arguments in N dimensions, a framework has been established that retains the core properties of orthogonality, magnitude, and anticommutativity. The proposed method leverages the determinant approach and introduces the polar sine function to calculate the magnitude of the cross product, linking it directly to the volume of an N-dimensional parallelotope. This generalization not only enriches the theoretical foundation of vector calculus but also opens up new applications in high-dimensional data analysis, machine learning, and multivariate time series. The results suggest that this extension of the cross product could serve as a powerful tool for modeling complex interactions in multi-dimensional spaces, with potential implications across various scientific and engineering disciplines.
Ordered Kernels of OBCI-Algebras in the Homomorphism Environment
Authors: Yang Eunsuk , Roh Eun-Hwan , Jun Young-Bae
Published: February 2025

Yang, Roh and Jun recently introduced kernels of homomorphisms in OBCI-algebras and left an ordered generalization of those kernels as a future work. As its answer, we introduce the concept of ordered kernels of OBCI-algebras in the homomorphism environment. To be more concrete, first of all, the notion of ordered kernels of OBCI-algebras is intruduced. Next, properties of those ordered kernels related to (ordered) subalgebras, (ordered) filters and functional compositions are discussed in homomorphisms of OBCI-algebras.
Insights on Hydrogen Bond Network of Water in Phospholipid Membranes: An Infrared Study at Varying Hydration
Authors: Conti Nibali Valeria , Branca Caterina , Wanderlingh Ulderico , Verduci Rosaria , Bonaccorso Elisa , Ciccolo Andrea , D’Angelo Giovanna
Published: February 2025

Water in membrane interphases is vital for cellular biological functions, but despite its importance, the structure and function of biological water remain elusive. Here, by studying the OH stretching mode in partially hydrated lipid multilayers by FTIR measurements, relevant information on the water structure near the surface with lipid membranes has been gathered. The water hydrogen bond network is highly perturbed in the first layers that are in contact with the lipid membrane, exhibiting strong deviations from tetrahedral symmetry and a significant number of defects, such as isolated water molecules and a large number of hydrogen-bonded water dimers in the interphase region. These findings support the hypothesis that water chains form in phospholipid membranes, and are involved in the proton transfer across lipid bilayers by phosphate groups of opposing lipids. Furthermore, we have determined that even at very low hydration levels, a small amount of water is embedded within the confined spaces of the hydrocarbon region of phospholipid bilayers, which could potentially contribute to the structural stability of the lipid membrane.