bluuebunny/crossref_metadata_2025 huggingface dataset:
The Radioactive Elements in the Atmosphere of HD25354—Are They the Result of the Symmetric Decay of the Chemical Elements of the Island of Stability?
Authors: Yushchenko Volodymyr , Gopka Vira , Yushchenko Alexander , Demessinova Aizat , Jeong Yeuncheol , Pavlenko Yakiv , Shavrina Angelina , Musaev Faig , Alimgazinova Nazgul
Published: September 2024

In this research, we investigated the observed spectra of the hot peculiar star HD25354 with an effective temperature Teff = 12,800 K, identified the lines of radioactive chemical elements, including the elements with short decay time, and estimated the abundances of these elements. We tried to confirm or reject the existence of promethium lines and lines of other radioactive elements which were detected in previous investigations of this star and explain the physical mechanisms which are responsible for the synthesis of these elements in the stellar atmosphere. We used two high-dispersion spectra of HD25354 observed with the 2 m telescope of Terskol observatory with resolving power near R = 60,000, and a signal to noise ratio near 200. The spectrum of the star from the archive of the 1.93 m telescope of Haute-Provence observatory was also used. The observations were compared with synthetic spectra and the abundance of promethium was found using the best four lines of this element in the observed spectra: logN(Pm) = 5.84 ± 0.16 in the scale logN(H) = 12. It is comparable to the abundances of stable lanthanides in the atmosphere of this star. The abundance of thorium derived from two lines of double-ionized thorium is logN(Th) = 3.59 ± 0.15. The upper limits for technetium, radium, actinium, uranium, and americium abundances are found to be equal to 4.0, 3.0, 1.25, 3.5, and 4.0, respectively. Maybe the existence of promethium lines and lines of other unstable chemical elements in the spectra of HD25354, as well as the other stars of our Galaxy, Magellanic Clouds, and Fornax dwarf galaxy, can be explained by contamination of its atmosphere by the products of kilonova outburst and by symmetric decay of chemical elements with long decay times located at the island of stability (atomic numbers Z = 110–128) of transfermium elements. Maybe the decay of superheavy elements of the island of stability can be one of the reasons for the enhanced abundances of rare earth lanthanides in different types of stars.
The Relationships between Greenstone Belts and the Kryvyi Rih–Kremenchuk Basin in the Middle Dnieper Domain of the Ukrainian Shield Revealed by Detrital Zircon
Authors: Artemenko Hennadii , Shumlyanskyy Leonid , Chew David , Drakou Foteini , Dhuime Bruno , Moreira Hugo , Butyrin Valeryi
Published: September 2024

Detrital zircons from two samples of metasandstones from the Lykhmanivka Syncline, Middle Dnieper Domain of the Ukrainian Shield (Skelevate Formation of the Kryvyi Rih Group), have been dated by the LA-ICP-MS U-Pb method. Metasandstones from the northern part of the syncline yield zircons belonging to four age groups: 3201 ± 12 Ma, 3089 ± 11 Ma, 2939 ± 8 Ma, and 2059 ± 4 Ma. All three Archean groups originated from similar rock types that crystallized at different times from the same mafic source (lower crust) with a 176Lu/177Hf ratio of about 0.020. In contrast, zircon from metasediments from the southern end of the Lykhmanivka Syncline fall within two age groups: 3174 ± 13 Ma, and 2038 ± 9 Ma. In terms of Hf isotope compositions, the detrital zircons from the two oldest age groups in both samples are very similar. The source area was dominated by rocks of the Auly Group (3.27–3.18 Ga) and the Sura Complex (3.17–2.94 Ga). The proportion of zircons dated at 2.07–2.03 Ga, which reflects the timing of metamorphism, is 5%. The metamorphic nature of the Paleoproterozoic zircon allows us to define the maximum depositional age of the metasandstones of the Lykhmanivka Syncline at ca. 2.9 Ga, which is in good agreement with the earlier results from the metaterrigenous rocks of the Kryvyi Rih–Kremenchuk Basin. Our data also indicate the local nature of sedimentation and the absence of significant transport and mixing of detrital material within the basin.
Deterministic Physically Based Distributed Models for Rainfall-Induced Shallow Landslides
Authors: Sannino Giada , Bordoni Massimiliano , Bittelli Marco , Meisina Claudia , Tomei Fausto , Valentino Roberto
Published: September 2024

Facing global warming’s consequences is a major issue in the present times. Regarding the climate, projections say that heavy rainfalls are going to increase with high probability together with temperature rise; thus, the hazard related to rainfall-induced shallow landslides will likely increase in density over susceptible territories. Different modeling approaches exist, and many of them are forced to make simplifications in order to reproduce landslide occurrences over space and time. Process-based models can help in quantifying the consequences of heavy rainfall in terms of slope instability at a territory scale. In this study, a narrative review of physically based deterministic distributed models (PBDDMs) is presented. Models were selected based on the adoption of the infinite slope scheme (ISS), the use of a deterministic approach (i.e., input and output are treated as absolute values), and the inclusion of new approaches in modeling slope stability through the ISS. The models are presented in chronological order with the aim of drawing a timeline of the evolution of PBDDMs and providing researchers and practitioners with basic knowledge of what scholars have proposed so far. The results indicate that including vegetation’s effects on slope stability has raised in importance over time but that there is still a need to find an efficient way to include them. In recent years, the literature production seems to be more focused on probabilistic approaches.
Recent Developments in the Non-Pharmacological Management of Children’s Behavior Based on Distraction Techniques: A Concise Review
Authors: Chen Jieyi , Deng Ke , Yu Dikuan , Fan Cancan , Liu Limin , Gu Haijing , Huang Fang , Huo Yongbiao
Published: September 2024

Oral diseases and conditions affect children’s oral health and negatively influence their overall health. Early detection and intervention are important in mitigating these negative consequences. However, dental fear and anxiety (DFA) regarding dental procedures often hinder children from seeking necessary dental care. Non-pharmacological behavior management strategies, such as distraction techniques, are commonly adopted to manage children’s behaviors. Distraction techniques have been developed rapidly in recent years and are widely accepted by both health professionals and parents due to their noninvasive and low-cost nature. This concise review aims to summarize current distraction techniques applied during dental treatments, especially for children. The most commonly reported techniques for children are audio distraction, audio-visual distraction, tactile distraction, olfactory distraction, and gustatory distraction. Audio distraction techniques involving music and storytelling help children relax. Audio-visual distraction techniques help to divert children’s attention from the dental treatment. Tactile stimuli can reduce the transmission of pain signals. Olfactory stimuli can help children feel comfortable and relaxed. Gustatory distraction involving sweet substances can create a positive environment. These distraction techniques effectively reduce DFA in children and improve their satisfaction with dental procedures. As technology continues to develop, further research is needed to provide more robust, evidence-based guidance for dentists using distraction techniques.
Corporate Governance and Employee Productivity: Evidence from Jordan
Authors: Ajlouni Abdullah , Bastida Francisco , Nurunnabi Mohammad
Published: September 2024

This research paper aims to investigate the impact of ownership concentration, insider ownership, and board size on employee productivity for 136 Jordanian public shareholding firms listed on the Amman Stock Exchange (ASE) from 2012 to 2021. Ownership concentration has been measured by Herfindahl–Hirschman Index (HHI), whereas insider ownership and board size have been represented as the proportion of shares held by insiders and by the number of board members, respectively. Lastly, employee productivity has been measured using a data envelopment analysis (DEA) tool. We employed ordinary least squares regression (OLS) including firm-year-fixed effects. Our empirical results indicate a non-linear relation between ownership concentration and employee productivity, whereby the productivity of employees increases in firms with a proportion of ownership concentration less than 60%. In addition, we found a non-linear relation between insider ownership and employee productivity, whereby the productivity of employees increases in firms with proportion of insider ownership less than 50%. Moreover, we found a non-linear relation between board size and employee productivity, whereby the productivity of employees increases in firms that have less than 11 board members. Our outcome contributed to the knowledge found in the previous literature, as it is the first to highlight the productivity of employees in emerging economies, such as the economy in Jordan. Furthermore, our findings could be useful for the Jordan Securities Commission (JSC) and the ASE on their continuous process to improve and develop corporate governance instructions.
Profiling Reduced Expression of Contractile and Mitochondrial mRNAs in the Human Sinoatrial Node vs. Right Atrium and Predicting Their Suppressed Expression by Transcription Factors and/or microRNAs
Authors: Chen Weixuan , Aminu Abimbola J. , Yin Zeyuan , Karaesmen Irem , Atkinson Andrew J. , Kuniewicz Marcin , Holda Mateusz , Walocha Jerzy , Perde Filip , Molenaar Peter , Dobrzynski Halina
Published: September 2024

(1) Background: The sinus node (SN) is the main pacemaker of the heart. It is characterized by pacemaker cells that lack mitochondria and contractile elements. We investigated the possibility that transcription factors (TFs) and microRNAs (miRs) present in the SN can regulate gene expression that affects SN morphology and function. (2) Methods: From human next-generation sequencing data, a list of mRNAs that are expressed at lower levels in the SN compared with the right atrium (RA) was compiled. The mRNAs were then classified into contractile, mitochondrial or glycogen mRNAs using bioinformatic software, RStudio and Ingenuity Pathway Analysis. The mRNAs were combined with TFs and miRs to predict their interactions. (3) Results: From a compilation of the 1357 mRNAs, 280 contractile mRNAs and 198 mitochondrial mRNAs were identified to be expressed at lower levels in the SN compared with RA. TFs and miRs were shown to interact with contractile and mitochondrial function-related mRNAs. (4) Conclusions: In human SN, TFs (MYCN, SOX2, NUPR1 and PRDM16) mainly regulate mitochondrial mRNAs (COX5A, SLC25A11 and NDUFA8), while miRs (miR-153-3p, miR-654-5p, miR-10a-5p and miR-215-5p) mainly regulate contractile mRNAs (RYR2, CAMK2A and PRKAR1A). TF and miR-mRNA interactions provide a further understanding of the complex molecular makeup of the SN and potential therapeutic targets for cardiovascular treatments.
Nobiletin, as a Novel PDE4B Inhibitor, Alleviates Asthma Symptoms by Activating the cAMP-PKA-CREB Signaling Pathway
Authors: Zhang Yan , Yang Yaping , Liang Huicong , Liang Yuerun , Xiong Guixin , Lu Fang , Yang Kan , Zou Qi , Zhang Xiaomin , Du Guanhua , Xu Ximing , Hao Jiejie
Published: September 2024

Asthma is a chronic airway inflammation that is considered a serious public health concern worldwide. Nobiletin (5,6,7,8,3′,4′-hexamethyl flavonoid), an important compound isolated from several traditional Chinese medicines, especially Citri Reticulatae Pericarpium, is widely used for a number of indications, including cancer, allergic diseases, and chronic inflammation. However, the mechanism by which nobiletin exerts its anti-asthmatic effect remains unclear. In this research, we comprehensively demonstrated the anti-asthmatic effects of nobiletin in an animal model of asthma. It was found that nobiletin significantly reduced the levels of inflammatory cells and cytokines in mice and alleviated airway hyperresponsiveness. To explore the target of nobiletin, we identified PDE4B as the target of nobiletin through pharmacophore modeling, molecular docking, molecular dynamics simulation, SPR, and enzyme activity assays. Subsequently, it was found that nobiletin could activate the cAMP-PKA-CREB signaling pathway downstream of PDE4B in mouse lung tissues. Additionally, we studied the anti-inflammatory and anti-airway remodeling effects of nobiletin in LPS-induced RAW264.7 cells and TGF-β1-induced ASM cells, confirming the activation of the cAMP-PKA-CREB signaling pathway by nobiletin. Further validation in PDE4B-deficient RAW264.7 cells confirmed that the increase in cAMP levels induced by nobiletin depended on the inhibition of PDE4B. In conclusion, nobiletin exerts anti-asthmatic activity by targeting PDE4B and activating the cAMP-PKA-CREB signaling pathway.
RNA-Binding Proteins as Novel Effectors in Osteoblasts and Osteoclasts: A Systems Biology Approach to Dissect the Transcriptional Landscape
Authors: Meshcheryakova Anastasia , Bohdan Serhii , Zimmermann Philip , Jaritz Markus , Pietschmann Peter , Mechtcheriakova Diana
Published: September 2024

Bone health is ensured by the coordinated action of two types of cells—the osteoblasts that build up bone structure and the osteoclasts that resorb the bone. The loss of balance in their action results in pathological conditions such as osteoporosis. Central to this study is a class of RNA-binding proteins (RBPs) that regulates the biogenesis of miRNAs. In turn, miRNAs represent a critical level of regulation of gene expression and thus control multiple cellular and biological processes. The impact of miRNAs on the pathobiology of various multifactorial diseases, including osteoporosis, has been demonstrated. However, the role of RBPs in bone remodeling is yet to be elucidated. The aim of this study is to dissect the transcriptional landscape of genes encoding the compendium of 180 RBPs in bone cells. We developed and applied a multi-modular integrative analysis algorithm. The core methodology is gene expression analysis using the GENEVESTIGATOR platform, which is a database and analysis tool for manually curated and publicly available transcriptomic data sets, and gene network reconstruction using the Ingenuity Pathway Analysis platform. In this work, comparative insights into gene expression patterns of RBPs in osteoblasts and osteoclasts were obtained, resulting in the identification of 24 differentially expressed genes. Furthermore, the regulation patterns upon different treatment conditions revealed 20 genes as being significantly up- or down-regulated. Next, novel gene–gene associations were dissected and gene networks were reconstructed. Additively, a set of osteoblast- and osteoclast-specific gene signatures were identified. The consolidation of data and information gained from each individual analytical module allowed nominating novel promising candidate genes encoding RBPs in osteoblasts and osteoclasts and will significantly enhance the understanding of potential regulatory mechanisms directing intracellular processes in the course of (patho)physiological bone turnover.
Systemic Immune Factors and Risk of Allergic Contact Dermatitis: A Bidirectional Mendelian Randomization Study
Authors: Long Yingxin , Dai Wenzhang , Cai Kexin , Xiao Yuan , Luo Anqi , Lai Ziwei , Wang Junlin , Xu Lipeng , Nie Hong
Published: September 2024

Skin inflammation and immune regulation have been suggested to be associated with allergic contact dermatitis (ACD) progression, but whether the system’s immune regulation is a cause or a potential mechanism is still unknown. This study aims to assess the upstream and downstream of systemic immune factors on ACD within a bidirectional Mendelian-randomization design. A bidirectional two-sample MR analysis was employed to implement the results from genome-wide association studies for 52 system immune factors and ACD. Genetic associations with systemic immune factors and ACD were obtained from the IEU Open GWAS project database. The inverse-variance weighted (IVW) method was adopted as the primary MR analysis, MR-Egger, weighted median, MR-pleiotropy residual sum, and outlier (MR-PRESSO) was also used as the sensitivity analyses. Only Tumor necrosis factor ligand superfamily member 11 (TNFS11) from among 52 systemic immune factors was associated with a protective effect of ACD. However, ACD was associated with a decrease in Interleukin-9 (IL9) and an increase in C-X-C motif chemokine 1 (GROα), Tumor necrosis factor ligand superfamily member 10 (TRAIL), C4, and complement factor B of the assessed systemic immune factors. This study identified TNFS11 as the upstream regulator and IL9, GROα, TRAIL, C4, and complement factor B as the downstream regulator of ACD, providing opportunities for new therapeutic exploitation of ACD. Nonetheless, these associations of systemic immune factors need to be verified in vivo.
Comparison and Determination of the Content of Mosapride Citrate by Different qNMR Methods
Authors: Lian Xiaofang , Li Yiran , Zuo Limin , Zhao Xuejia , Liu Huiyi , Gu Yongsheng , Jia Qingying , Yao Jing , Shan Guangzhi
Published: September 2024

As a salt-type compound, mosapride citrate’s metabolism and side effects are correlated with its salt-forming ratio. Several techniques were developed in this work to compare various quantitative nuclear magnetic resonance (qNMR) methodologies and to quantitatively examine the content of raw materials. Among the qNMR techniques, methods for 1H NMR and 19F NMR were developed. Appropriate solvents were chosen, and temperature, number of scans, acquisition time, and relaxation delay parameter settings were optimized. Maleic acid was chosen as the internal standard in 1H NMR, and the respective characteristic signals of mosapride and citrate were selected as quantitative peaks. The internal standard in 19F NMR analysis was 4,4′-difluoro diphenylmethanone, and the distinctive signal peak at −116.15 ppm was utilized to quantify mosapride citrate. The precision, repeatability, linearity, stability, accuracy, and robustness of the qNMR methods were all validated according to the ICH guidelines. By contrasting the outcomes with those from high-performance liquid chromatography (HPLC), the accuracy of qNMR was assessed. As a result, we created a quicker and easier qNMR approach to measure the amount of mosapride citrate and evaluated several qNMR techniques to establish a foundation for choosing quantitative peaks for the qNMR method. Concurrently, it is anticipated that various selections of distinct quantitative objects will yield the mosapride citrate salt-forming ratio.
Tumor Cell Communications as Promising Supramolecular Targets for Cancer Chemotherapy: A Possible Strategy
Authors: Alekseenko Irina , Zhukova Lyudmila , Kondratyeva Liya , Buzdin Anton , Chernov Igor , Sverdlov Eugene
Published: September 2024

Fifty-two years have passed since President Nixon launched the “War on Cancer”. Despite unparalleled efforts and funds allocated worldwide, the outlined goals were not achieved because cancer treatment approaches such as chemotherapy, radiation therapy, hormonal and targeted therapies have not fully met the expectations. Based on the recent literature, a new direction in cancer therapy can be proposed which targets connections between cancer cells and their microenvironment by chemical means. Cancer–stromal synapses such as immunological synapses between cancer and immune cells provide an attractive target for this approach. Such synapses form ligand–receptor clusters on the interface of the interacting cells. They share a common property of involving intercellular clusters of spatially proximate and cooperatively acting proteins. Synapses provide the space for the focused intercellular signaling molecules exchange. Thus, the disassembly of cancer–stromal synapses may potentially cause the collapse of various tumors. Additionally, the clustered arrangement of synapse components offers opportunities to enhance treatment safety and precision by using targeted crosslinking chemical agents which may inactivate cancer synapses even in reduced concentrations. Furthermore, attaching a cleavable cell-permeable toxic agent(s) to a crosslinker may further enhance the anti-cancer effect of such therapeutics. The highlighted approach promises to be universal, relatively simple and cost-efficient. We also hope that, unlike chemotherapeutic and immune drugs that interact with a single target, by using supramolecular large clusters that include many different components as a target, the emergence of a resistance characteristic of chemo- and immunotherapy is extremely unlikely.
An Assessment Model for Agricultural Databases: The Arthropod Pesticide Resistance Database as a Case Study
Authors: Payumo Jane , Bello-Bravo Julia , Chennuru Vineeth , Mercene Solo Arman , Yim Chaeyeon , Duynslager Lee , Kanamarlapudi Bhanu , Posos-Parra Omar , Payumo Sky , Mota-Sanchez David
Published: September 2024

This paper presents a multi-method approach for evaluating the utility and impact of agricultural databases in the context of the rapidly expanding digital economy. Focusing on the Arthropod Pesticide Resistance Database, one of the most comprehensive global resources on arthropod pesticide resistance, we offer a framework for assessing the effectiveness of agricultural databases. Our approach provides practical guidance for developers, users, evaluators, and funders on how to measure the impact of these digital tools, using relevant metrics and data to validate their contributions. Additionally, we introduce an index-based method that evaluates impact across multiple dimensions, including data usage, accessibility, inclusivity, knowledge generation, innovation, research and policy development, and collaboration. The detailed methodology serves as both a reference and a model for evaluating the impact of other agricultural databases, ensuring they effectively support decision-making and foster innovation in the agricultural sector.
Routine ICU Surveillance after Brain Tumor Surgery: Patient Selection Using Machine Learning
Authors: Neumann Jan-Oliver , Schmidt Stephanie , Nohman Amin , Naser Paul , Jakobs Martin , Unterberg Andreas
Published: September 2024

Background/Objectives: Routine postoperative ICU admission following brain tumor surgery may not benefit selected patients. The objective of this study was to develop a risk prediction instrument for early (within 24 h) postoperative adverse events using machine learning techniques. Methods: Retrospective cohort of 1000 consecutive adult patients undergoing elective brain tumor resection. Nine events/interventions (CPR, reintubation, return to OR, mechanical ventilation, vasopressors, impaired consciousness, intracranial hypertension, swallowing disorders, and death) were chosen as target variables. Potential prognostic features (n = 27) from five categories were chosen and a gradient boosting algorithm (XGBoost) was trained and cross-validated in a 5 × 5 fashion. Prognostic performance, potential clinical impact, and relative feature importance were analyzed. Results: Adverse events requiring ICU intervention occurred in 9.2% of cases. Other events not requiring ICU treatment were more frequent (35% of cases). The boosted decision trees yielded a cross-validated ROC-AUC of 0.81 ± 0.02 (mean ± CI95) when using pre- and post-op data. Using only pre-op data (scheduling decisions), ROC-AUC was 0.76 ± 0.02. PR-AUC was 0.38 ± 0.04 and 0.27 ± 0.03 for pre- and post-op data, respectively, compared to a baseline value (random classifier) of 0.092. Targeting a NPV of at least 95% would require ICU admission in just 15% (pre- and post-op data) or 30% (only pre-op data) of cases when using the prediction algorithm. Conclusions: Adoption of a risk prediction instrument based on boosted trees can support decision-makers to optimize ICU resource utilization while maintaining adequate patient safety. This may lead to a relevant reduction in ICU admissions for surveillance purposes.
Effectiveness of Treating Obstructive Sleep Apnea by Surgeries and Continuous Positive Airway Pressure: Evaluation Using Objective Sleep Parameters and Patient-Reported Outcomes
Authors: Hsu Yu-Ching , Wang Jung-Der , Chang Sheng-Mao , Chiu Ching-Ju , Chien Yu-Wen , Lin Cheng-Yu
Published: September 2024

Background/Objectives: Uvulopalatopharyngoplasty (UPPP), palatal plus nasal surgery (PNS), and continuous positive airway pressure (CPAP) are widely implemented treatments for obstructive sleep apnea (OSA). This study aims to explore the long-term effects on objective sleep parameters and patient-reported outcomes (PROs) following different therapeutic interventions for OSA. Methods: Data from patients with moderate-to-severe OSA were retrospectively collected from a medical center and a regional hospital, spanning from December 2011 to August 2018. Objective evaluations included the Apnea–Hypopnea Index (AHI), minimum O2 saturation, and sleep efficiency. The PROs consisted of the Snore Outcomes Survey and Epworth Sleepiness Scale. Using mixed-effects models, we evaluated longitudinal changes in sleep parameters and PROs, accounting for repeated measures and variations within individuals over time. Results: Among 448 patients with moderate-to-severe OSA, follow-up data were collected for 42 patients undergoing UPPP surgery, 171 undergoing PNS, 127 using CPAP, and 108 in the non-treated group. The mean follow-up was 16.7 months (SD = 11.9, range: 1.6–77.3). Significant improvements were observed in AHI, minimum O2 saturation, and hypersomnia immediately following interventions with UPPP, PNS, and CPAP therapy (p < 0.05). Moreover, the analysis revealed no significant rate of change in these parameters over time, suggesting that the benefits of these treatments were sustained in the long term. Furthermore, all interventions exhibited a significant short-term effect on self-reported snoring when compared to the control group, with a p-value of less than 0.001. However, the magnitude of this improvement gradually decreased over time. The snore scores seemed to return to pre-treatment levels among the UPPP, PNS, and CPAP groups after averages of 46.4, 63.5, and 74.4 months, respectively (all p < 0.05). Conclusions: Surgical interventions and CPAP therapy showed potential long-term effectiveness in managing OSA. Snoring symptoms reappeared about 3.9–5.3 years after surgical treatments, which seemed earlier than the average of 6.2 years in patients receiving CPAP and should be considered in patient-participatory decision-making processes.
Comparison of Efficacy of Micropulse Laser Settings for Glaucoma Management
Authors: Kim Emily Y. , Walker Brooks D. , Hopkins Nikolas S. , Fowler Samuel , Jerkins Brian M. , Kanner Elliott M. , Wright Claire L.
Published: September 2024

Objectives: This study aims to compare micropulse transscleral cyclophotocoagulation (MP-TSCPC) laser parameters and determine the optimal laser setting. Methods: A retrospective study was performed on 351 eyes from patients who underwent MP-TSCPC at four power settings (1500 mW, 2000 mW, 2250 mW, and 2500 mW) from June 2018 to December 2021. The primary measurements of the efficacy of MP-TSCPC were the degree of intraocular pressure (IOP) reduction and the number of glaucoma medication reductions. The rate of hypotony was obtained to assess the safety of MP-TSCPC. Results: At 1500, 2000, and 2500 mW, the mean IOP reduction at each visit was statistically significant compared to the baseline, and at 2250 mW, the mean IOP was only significantly different at 18 months (p < 0.05). The change in the number of medications with 2000 mW has shown significance at 1 and 3 months from the baseline; with 2500 mW, statistical significance was shown at 3, 6, 12, and 18 months (p < 0.05) compared to the baseline. Mean IOP reductions (%) were greater in 2000 mW than in 1500 mW at 1 week, 1 month, and 3 months and were greater in 2500 than in 1500 mW at 1 week (p < 0.05). There was no significance for mean IOP reductions at 6, 12, and 18 months across all powers. Only two occurrences of hypotony were reported. Conclusions: MP-TSCPC at 1500 mW, 2000 mW, and 2500 mW is a safe and effective treatment for IOP reduction. MP-TSCPC at 2250 mW is safe but may show delayed effectiveness in IOP reduction. In the long term, no one specific power setting was found to be superior for IOP reduction.
Visceral Leishmaniasis Following A+AVD Treatment in a Patient with Classical Hodgkin’s Lymphoma: A Case Report and Review of the Literature
Authors: Banegas Daniela Estefania , Moioli Alessia , Santoni Eleonora , Tagliavini Erica , Quaglia Francesca Maria , Bernardelli Andrea , Visco Carlo
Published: September 2024

We present the case of a 43-year-old Caucasian man who developed visceral leishmaniasis (VL) following treatment with a combination of brentuximab vedotin and doxorubicin, vinblastine, and dacarbazine (A+AVD) for advanced-stage classical Hodgkin’s lymphoma (cHL). The patient initially showed a favorable response to the treatment, but shortly after completing six cycles, he experienced recurrent fever, splenomegaly, and severe anemia. Extensive infectious disease evaluations led to a diagnosis of VL, confirmed by PCR testing. The patient was treated with amphotericin B, resulting in full clinical recovery. In addition to presenting this rare case, we conducted a full review of the literature on VL in the context of hematological disorders, including non-Hodgkin’s lymphoma, splenic marginal zone lymphoma, and other lymphoproliferative diseases. This review highlights the increasing prevalence of VL in immunocompromised individuals, particularly those undergoing treatments like chemotherapy or immunotherapy, and underscores the importance of considering VL in differential diagnoses when such patients present with persistent fever and splenomegaly.
Development of a Risk Predictive Model for Erectile Dysfunction at 12 Months after COVID-19 Recovery: A Prospective Observational Study
Authors: Natal Alvarez Fernando , Conde Redondo Maria Consuelo , Sierrasesumaga Martin Nicolas , Garcia Viña Alejandro , Marfil Peña Carmen , Bahillo Martinez Alfonso , Jojoa Mario , Tamayo Gomez Eduardo
Published: September 2024

Objectives: To develop a risk prediction model for the identification of features involved in the prediction of erectile dysfunction (ED) at 12 months following COVID-19 recovery. Methods: We performed an observational prospective multicentre study. Participants were classified according to their history of COVID-19: (I) patients with a past history of COVID-19 and (II) patients without a previous microbiological diagnosis of COVID-19. A total of 361 patients (past history of COVID-19, n = 166; no past history of COVID-19, n = 195) were assessed from January 2022 to March 2023. Patients with a past history of COVID-19 were assessed at 12 months following COVID-19 recovery. The primary outcome measure was ED, assessed through the 5-item International Index of Erectile Function (IIEF-5). Data concerning epidemiologic variables, comorbidities and active treatment were also collected. We performed a binary logistic regression to develop a risk predictive model. Among the models developed, we selected the one with the higher Area Under the Curve (AUC). Results: The median age was 55 years in both groups. The ED prevalence was 55.9% in patients with past history of COVID-19 and 44.1% in those with no past history of COVID-19. The best predictive model developed for ED comprised 40 variables and had an AUC of 0.8. Conclusions: We developed a regression model for the prediction of ED 12 months after COVID-19 recovery. The application of our predictive tool in a community setting could eventually prevent the adverse effects of ED on cardiovascular health and the associated unfavourable economic impact.
The Impact of Physical Activity on Adolescent Low Back Pain: A Systematic Review
Authors: Costici Edoardo , De Salvatore Sergio , Oggiano Leonardo , Sessa Sergio , Curri Cloe , Ruzzini Laura , Costici Pier Francesco
Published: September 2024

Background: The relationship between physical activity and low back pain (LBP) in adolescents is complex, with conflicting evidence on whether activity is protective or a risk factor. The COVID-19 pandemic has introduced new challenges, increasing sedentary behaviors among adolescents. This systematic review updates the evidence on the association between physical activity and LBP in this population, focusing on the impact of the pandemic. Methods: A systematic search of PubMed, Cochrane Library, Web of Science, Medline, and SCOPUS identified observational studies published between January 2011 and December 2023. This review focused on adolescents aged 10 to 19 years, examining the effects of various physical activity levels and types on LBP incidence. Quality assessment was conducted using the ROBINS-I tool. Results: Twelve studies were included, with a total of 78,850 adolescents. The findings suggest a U-shaped relationship between physical activity and LBP, where low and high activity levels increase LBP risk, while moderate activity appears protective. The pandemic exacerbated LBP prevalence, likely due to increased sedentary behavior. Gender differences were noted, with females more likely to report LBP, particularly related to sports participation. Conclusions: Moderate physical activity may protect against LBP in adolescents, whereas both inactivity and excessive activity heighten risk. The pandemic’s impact highlights the need for balanced physical activity to prevent LBP. Further research should explore the long-term effects of these changes.
Diagnostic Challenges of Axenfeld-Rieger Syndrome and a Novel FOXC1 Gene Mutation in a Polish Family
Authors: Wowra Bogumił , Wysocka-Kosmulska Marzena , Stanienda-Sokół Karolina , Łach-Wojnarowicz Olga , Dobrowolski Dariusz , Wylęgała Edward
Published: September 2024

(1) Axenfeld-Rieger syndrome (ARS) is a rare autosomal dominant disorder, the symptoms of which include both ocular and systemic abnormalities. In the studied subjects, the cornea was significantly opacified with peripheral scarring neovascularization, which is not specific to this syndrome. A suspicion of incorrect diagnosis was raised despite an initial diagnosis of a bilateral Chandler syndrome. (2) In order to provide the proper diagnosis, a DNA sequencing genetic test was conducted with three sisters carrying the presence of a genome imbalance in the FOXC1 gene. The aim of this study is to report a case of a Polish family with a novel gene mutation and its relation with ARS. (3) Our findings implicate the novel deletion of the FOXC1 gene in the pathogenesis of ARS in the affected family. The phenotypic variability observed, including differences in corneal and systemic anomalies, underscores the importance of genetic testing and suggests the influence of non-genetic factors on ARS manifestation.
Adoption of the Robotic Platform across Thoracic Surgeries
Authors: Tung Kaity H. , Yendamuri Sai , Seastedt Kenneth P.
Published: September 2024

With the paradigm shift in minimally invasive surgery from the video-assisted thoracoscopic platform to the robotic platform, thoracic surgeons are applying the new technology through various commonly practiced thoracic surgeries, striving to improve patient outcomes and reduce morbidity and mortality. This review will discuss the updates in lung resections, lung transplantation, mediastinal surgeries with a focus on thymic resection, rib resection, tracheal resection, tracheobronchoplasty, diaphragm plication, esophagectomy, and paraesophageal hernia repair. The transition from open surgery to video-assisted thoracoscopic surgery (VATS) to now robotic video-assisted thoracic surgery (RVATS) allows complex surgeries to be completed through smaller and smaller incisions with better visualization through high-definition images and finer mobilization, accomplishing what might be unresectable before, permitting shorter hospital stay, minimizing healing time, and encompassing broader surgical candidacy. Moreover, better patient outcomes are not only achieved through what the lead surgeon could carry out during surgeries but also through the training of the next generation via accessible live video feedback and recordings. Though larger volume randomized controlled studies are pending to compare the outcomes of VATS to RVATS surgeries, published studies show non-inferiority data from RVATS performances. With progressive enhancement, such as overcoming the lack of haptic feedback, and future incorporation of artificial intelligence (AI), the robotic platform will likely be a cost-effective route once surgeons overcome the initial learning curve.
Interdisciplinary Management of Traumatic Injuries to the Kidneys and Urinary Tract Caused by Blunt Abdominopelvic Trauma
Authors: Wendler Johann J. , Albert Christian , Cash Hannes , Meyer Frank , Pech Maciej , Schostak Martin , Mertens Peter R. , Porsch Markus
Published: September 2024

Purpose: Blunt abdominopelvic trauma frequently results in injuries to the urinary organs, especially in polytrauma. The urotrauma is rarely an acute life-threatening event; however, it may lead to severe complications. Methods: This review addresses the under-representation of urological trauma management in interdisciplinary medical training and its impact on patient outcomes. It compiles evidence-based recommendations and guidelines from multiple specialties, focusing on common challenges in managing these injuries. The resource is tailored for primary care physicians in radiology, trauma surgery, internal medicine, urology, and nephrology. Results: Urinary tract injuries can occur even if the patient’s condition initially appears normal. An exclusion diagnosis is obligatory by contrast medium tomography of the entire urinary tract and, if suspected, an additional uroendoscopic examination. Interventional therapy by catheterisation of the urinary tract is often required. Urosurgical treatment is not commonly needed, but when there is a demand, it must be administered via an interdisciplinary approach with visceral and trauma surgery. Over 90% of life-threatening kidney injuries (usually up to grade 4–5 AAST) are presently treated by interventional radiologists. Acute kidney injury (AKI) as a complication in trauma patients may complicate clinical management and often worsens the outcome. The incidence of trauma-associated AKI in patients admitted to an intensive care unit is high. Conclusions: Patients suffering from blunt abdominopelvic trauma should ideally be referred to certified trauma centres with subspecialised or fully specialised care provided by visceral/vascular surgery, trauma surgery, interventional radiology, urology, and nephrology. This recommendation is based on the complex nature of most damage patterns.
Biomechanical Comparison of Three Modified Kessler Techniques for Flexor Tendon Repair: Implications in Surgical Practice and Early Active Mobilization
Authors: Schellnegger Marlies , Lin Alvin C. , Holzer-Geissler Judith C. J. , Haenel Annika , Pirrung Felix , Hecker Andrzej , Kamolz Lars P. , Hammer Niels , Girsch Werner
Published: September 2024

Objective: Managing flexor tendon injuries surgically remains challenging due to the ongoing debate over the most effective suture technique and materials. An optimal repair must be technically feasible while providing enough strength to allow for early active mobilization during the post-operative phase. This study aimed to assess the biomechanical properties of three modified Kessler repair techniques using two different suture materials: a conventional two-strand and a modified four-strand Kirchmayr–Kessler repair using 3-0 Prolene® (2s-KK-P and 4s-KK-P respectively), and a four-strand Kessler–Tsuge repair using 4-0 FiberLoop® (4s-KT-FL). Methods: Human flexor digitorum profundus (FDP) tendons were retrieved from Thiel-embalmed prosections. For each tendon, a full-thickness cross-sectional incision was created, and the ends were reattached using either a 2s-KK-P (n = 30), a 4s-KK-P (n = 30), or a 4s-KT-FL repair (n = 30). The repaired tendons were tested using either a quasi-static (n = 45) or cyclic testing protocol (n = 45). Maximum force (Fmax), 2 mm gap force (F2mm), and primary failure modes were recorded. Results: In both quasi-static and cyclic testing groups, tendons repaired using the 4s-KT-FL approach exhibited higher Fmax and F2mm values compared to the 2s-KK-P or 4s-KK-P repairs. Fmax was significantly higher with a 4s-KK-P versus 2s-KK-P repair, but there was no significant difference in F2mm. Suture pull-out was the main failure mode for the 4s-KT-FL repair, while suture breakage was the primary failure mode in 2s- and 4s-KK-P repairs. Conclusions: FDP tendons repaired using the 4s-KT-FL approach demonstrated superior biomechanical performance compared to 2s- and 4s-KK-P repairs, suggesting that the 4s-KT-FL tendon repair could potentially reduce the risk of gapping or re-rupture during early active mobilization.
Improving Therapy for Children with Scoliosis through Reducing Ionizing Radiation by Using Alternative Imaging Methods—A Study Protocol
Authors: Keil Fee , Schneider Robert , Polomac Nenad , Zabar Omar , Finger Tobias , Holzgreve Fabian , Czabanka Marcus , Erbe Christina , Groneberg David A. , Hattingen Elke , Ohlendorf Daniela , Diaremes Panagiotis
Published: September 2024

Background: Patients with scoliosis often require multiple imaging modalities. The aim of this study was to find out whether primary diagnosis, including surgical planning, could be carried out entirely without computed tomography (CT) scans and whether follow-up could be replaced with alternative methods without the use of X-rays. In order to reduce the radiation exposure in the diagnosis and treatment of severe scoliosis, we expect to replace X-rays with radiation-free or less-intensive radiation examinations. This study protocol is interdisciplinary. Methods: A total of 50 male and female patients (children and adolescents, aged 7–18 years) treated for scoliosis will be analyzed. In addition to routine projection radiographs, preoperative CT, and/or X-ray stereoradiography (EOS) examinations, thin-slice 3D magnetic resonance imaging (MRI) sequences will be retrospectively reformatted during the preoperative MRI examination. A three-dimensional back scan (video-raster stereography) and an intraoral scan will also be obtained. The following questions should be answered at the end of the project: (1) Can MRI examination with additional thin-slice 3D reconstruction answer all relevant questions for preoperative planning instead of CT? (2) Are EOS or whole-spine X-ray examinations in combination with MRI data sufficient for the evaluation of the pedicles and spinal deformity? (3) Does the Cobb angle in the radiograph correlate with the calculations from the back scanner image and can follow-up checks be replaced? (4) Are there any correlations between dental anomalies and scoliosis? Conclusions: Until now, pediatric patients with scoliosis have been diagnosed, monitored, and treated with numerous independent specialist disciplines, such as pediatricians, orthopedic surgeons, neurosurgeons, and general practitioners with different radiological issues. The aim of this project is to reduce radiation and lower perioperative risks by creating a preoperative and follow-up-related standard protocol in close interdisciplinary and targeted cooperation between all the specialist disciplines involved. In line with the holistic examination approach, the associated accompanying diseases and developmental disorders such as dental and neuronal malformations will also be examined. On the one hand, CT-based questions could be replaced with the reconstruction of thin-slice MRI sequences. In addition, it may be possible to use the three-dimensional back scan as an intermediate diagnostic procedure instead of X-rays in the monitoring of severe scoliosis. Insofar as correlations or causalities between scoliosis and occlusal anomalies, early orthodontic intervention could positively benefit the duration of therapy at a later stage.
Impact of Lung Ultrasound along with C-Reactive Protein Point-of-Care Testing on Clinical Decision-Making and Perceived Usefulness in Routine Healthcare for Patients with Lower Respiratory Tract Infections: Protocol for Analytical Observational Study
Authors: Llinas Anna , Paredes Eugeni , Sol Joaquim , Palacin Jose Maria , Solanes Monica , Martinez Javier , Florensa Carme , Llort Laia , Castañ Maria Teresa , Gracia Maria Isabel , Paül Josep Miquel , Ortega Bravo Marta , Llor Carl
Published: September 2024

Background: Lower respiratory tract infections (LRTIs) are a significant cause of primary care consultations. Differentiating between viral and bacterial infections is critical for effective treatment and to minimize unnecessary antibiotic use. This study investigates the impact of combining lung ultrasound (LUS) with capillary blood C-reactive protein (CRP) rapid testing on clinical decision-making for patients with LRTIs. Objectives: The primary objective is to assess how the integration of CRP testing and LUS influences antibiotic prescription decisions. The study aims to quantify the percentage change in antibiotic prescriptions before and after performing LUS, following history taking, clinical examination, and CRP testing. Methods: This analytical observational study will be conducted in six primary care centers within the Health Region of Lleida, Catalonia, serving a mixed urban and rural population of approximately 105,000 residents. The study will recruit 196 patients aged 18 and over, presenting with LRTI symptoms and not treated with antibiotics in the preceding 14 days. Participants will undergo CRP testing followed by LUS during their consultation. Statistical analyses, including linear regression, bivariate analysis, Pearson or Spearman correlation, and logistic regression, will be used to evaluate the impact of LUS on clinical decisions and its predictive value in diagnosing bacterial infections. Results and Conclusions: This study will provide insights into the role of LUS combined with CRP testing in improving diagnostic accuracy and guiding antibiotic prescription decisions in primary care. The findings aim to enhance treatment protocols for LRTIs, reducing unnecessary antibiotic use and improving patient outcomes.
Biofilm Formation, Antibiotic Resistance, and Infection (BARI): The Triangle of Death
Authors: Giordano Vincenzo , Giannoudis Peter V.
Published: September 2024

Fracture-related infection (FRI) is a devastating event, directly affecting fracture healing, impairing patient function, prolonging treatment, and increasing healthcare costs. Time plays a decisive role in prognosis, as biofilm maturation leads to the development of antibiotic resistance, potentially contributing to infection chronicity and increasing morbidity and mortality. Research exploring the association between biofilm maturation and antibiotic resistance in orthopaedics primarily addresses aspects related to quality of life and physical function; however, little exists on life-threatening conditions and mortality. Understanding the intrinsic relationship between biofilm maturation, bacterial resistance, and mortality is critical in all fields of medicine. In the herein narrative review, we summarize recent evidence regarding biofilm formation, antibiotic resistance, and infection chronicity (BARI), the three basic components of the “triangle of death” of FRI, and its implications. Preoperative, perioperative, and postoperative prevention strategies to avoid the “triangle of death” of FRI are presented and discussed. Additionally, the importance of the orthopaedic trauma surgeon in understanding new tools to combat infections related to orthopaedic devices is highlighted.