bluuebunny/crossref_metadata_2025 huggingface dataset:
Chronic Epinephrine-Induced Endoplasmic Reticulum and Oxidative Stress Impairs Pancreatic β-Cells Function and Fate
Authors: Zhang Ran , Yao Bingpeng , Li Rui , Limesand Sean W. , Zhao Yongju , Chen Xiaochuan
Published: June 2024

Epinephrine influences the function of pancreatic β-cells, primarily through the α2A-adrenergic receptor (α2A-AR) on their plasma membrane. Previous studies indicate that epinephrine transiently suppresses insulin secretion, whereas prolonged exposure induces its compensatory secretion. Nonetheless, the impact of epinephrine-induced α2A-AR signaling on the survival and function of pancreatic β-cells, particularly the impact of reprogramming after their removal from sustained epinephrine stimulation, remains elusive. In the present study, we applied MIN6, a murine insulinoma cell line, with 3 days of high concentration epinephrine incubation and 2 days of standard incubation, explored cell function and activity, and analyzed relevant regulatory pathways. The results showed that chronic epinephrine incubation led to the desensitization of α2A-AR and enhanced insulin secretion. An increased number of docked insulin granules and impaired Syntaxin-2 was found after chronic epinephrine exposure. Growth curve and cell cycle analyses showed the inhibition of cell proliferation. Transcriptome analysis showed the occurrence of endoplasmic reticulum stress (ER stress) and oxidative stress, such as the presence of BiP, CHOP, IRE1, ATF4, and XBP, affecting cellular endoplasmic reticulum function and survival, along with UCP2, OPA1, PINK, and PRKN, associated with mitochondrial dysfunction. Consequently, we conclude that chronic exposure to epinephrine induces α2A-AR desensitization and leads to ER and oxidative stress, impairing protein processing and mitochondrial function, leading to modified pancreatic β-cell secretory function and cell fate.
Circular RNA hsa_circ_0002268 (PHACTR1) Is Specific to Gestational Diabetes Mellitus in a Polish Pregnant Population
Authors: Dłuski Dominik Franciszek , Cieśla Marek , Darmochwał-Kolarz Dorota
Published: June 2024

Gestational diabetes mellitus (GDM) is an intolerance of carbohydrate of any degree, which appears for the first time or is diagnosed during pregnancy. The objective of this study is to assess the differences in circular RNA (circRNA) in a Polish pregnant population with and without GDM. A total of 62 pregnant women, 34 with GDM and 28 controls, were enrolled in the study. Total RNAs were extracted from plasma and reverse transcription to complementary DNA (cDNA) was performed. A panel covering 271 amplicons, targeting both linear and circular as well as negative control gene transcripts, was used. Next-generation sequencing was used to evaluate the circRNA quantity. Data analysis was performed using the Coverage Analysis plugin in the Torrent Suite Software (Torrent Suite 5.12.3). A two-step normalization was performed by dividing each transcript read count by the total number of reads generated for the sample, followed by dividing the quantity of each transcript by β-actin gene expression. Both circular and linear forms of RNAs were independently evaluated. A total of 57 transcripts were dysregulated between pregnant women with GDM and controls. Most of the targets (n = 25) were downregulated (cut-off ratio below 0.5), and one target showed a trend toward strong upregulation (ratio 1.45). A total of 39 targets were positively correlated with fasting plasma glucose (FPG), but none of the tested targets were correlated with insulin, CRP or HOMA-IR levels. Among the pregnant women with gestational diabetes, the relative quantity of hsa_circ_0002268 (PHACTR1) was approximately 120% higher than among healthy pregnant women: 0.046 [0.022–0.096] vs. 0.021 [0.007–0.047], respectively, (p = 0.0029). Elevated levels of hsa_circ_0002268 (PHACTR1) might be specific to the Polish population of pregnant women with GDM, making it useful as a potential molecular biomarker in the management of GDM in Poland.
α-Fe2O3/, Co3O4/, and CoFe2O4/MWCNTs/Ionic Liquid Nanocomposites as High-Performance Electrocatalysts for the Electrocatalytic Hydrogen Evolution Reaction in a Neutral Medium
Authors: Ibarra José , Aguirre María Jesus , del Río Rodrigo , Henriquez Rodrigo , Faccio Ricardo , Dalchiele Enrique A. , Arce Roxana , Ramírez Galo
Published: June 2024

Transition metal oxides are a great alternative to less expensive hydrogen evolution reaction (HER) catalysts. However, the lack of conductivity of these materials requires a conductor material to support them and improve the activity toward HER. On the other hand, carbon paste electrodes result in a versatile and cheap electrode with good activity and conductivity in electrocatalytic hydrogen production, especially when the carbonaceous material is agglomerated with ionic liquids. In the present work, an electrode composed of multi-walled carbon nanotubes (MWCNTs) and cobalt ferrite oxide (CoFe2O4) was prepared. These compounds were included on an electrode agglomerated with the ionic liquid N-octylpyridinium hexafluorophosphate (IL) to obtain the modified CoFe2O4/MWCNTs/IL nanocomposite electrode. To evaluate the behavior of each metal of the bimetallic oxide, this compound was compared to the behavior of MWCNTs/IL where a single monometallic iron or cobalt oxides were included (i.e., α-Fe2O3/MWCNTs/IL and Co3O4/MWCNTs/IL). The synthesis of the oxides has been characterized by X-ray diffraction (XRD), RAMAN spectroscopy, and field emission scanning electronic microscopy (FE-SEM), corroborating the nanometric character and the structure of the compounds. The CoFe2O4/MWCNTs/IL nanocomposite system presents excellent electrocatalytic activity toward HER with an onset potential of −270 mV vs. RHE, evidencing an increase in activity compared to monometallic oxides and exhibiting onset potentials of −530 mV and −540 mV for α-Fe2O3/MWCNTs/IL and Co3O4/MWCNTs/IL, respectively. Finally, the system studied presents excellent stability during the 5 h of electrolysis, producing 132 μmol cm−2 h−1 of hydrogen gas.
Inflammatory Bowel Disease: A Comprehensive Analysis of Molecular Bases, Predictive Biomarkers, Diagnostic Methods, and Therapeutic Options
Authors: Diez-Martin Eguzkiñe , Hernandez-Suarez Leidi , Muñoz-Villafranca Carmen , Martin-Souto Leire , Astigarraga Egoitz , Ramirez-Garcia Andoni , Barreda-Gómez Gabriel
Published: June 2024

In inflammatory bowel diseases (IBDs), such as Crohn’s disease (CD) and ulcerative colitis (UC), the immune system relentlessly attacks intestinal cells, causing recurrent tissue damage over the lifetime of patients. The etiology of IBD is complex and multifactorial, involving environmental, microbiota, genetic, and immunological factors that alter the molecular basis of the organism. Among these, the microbiota and immune cells play pivotal roles; the microbiota generates antigens recognized by immune cells and antibodies, while autoantibodies target and attack the intestinal membrane, exacerbating inflammation and tissue damage. Given the altered molecular framework, the analysis of multiple molecular biomarkers in patients proves exceedingly valuable for diagnosing and prognosing IBD, including markers like C reactive protein and fecal calprotectin. Upon detection and classification of patients, specific treatments are administered, ranging from conventional drugs to new biological therapies, such as antibodies to neutralize inflammatory molecules like tumor necrosis factor (TNF) and integrin. This review delves into the molecular basis and targets, biomarkers, treatment options, monitoring techniques, and, ultimately, current challenges in IBD management.
Bioactivity of Eugenol: A Potential Antibiotic Adjuvant with Minimal Ecotoxicological Impact
Authors: Ferrando Natalia , Pino-Otín María Rosa , Terrado Eva , Ballestero Diego , Langa Elisa
Published: June 2024

Combining commercial antibiotics with adjuvants to lower their minimum inhibitory concentration (MIC) is vital in combating antimicrobial resistance. Evaluating the ecotoxicity of such compounds is crucial due to environmental and health risks. Here, eugenol was assessed as an adjuvant for 7 commercial antibiotics against 14 pathogenic bacteria in vitro, also examining its acute ecotoxicity on various soil and water organisms (microbiota, Vibrio fischeri, Daphnia magna, Eisenia foetida, and Allium cepa). Using microdilution methods, checkerboard assays, and kinetic studies, the MICs for eugenol were determined together with the nature of its combinations with antibiotics against bacteria, some unexposed to eugenol previously. The lethal dose for the non-target organisms was also determined, as well as the Average Well Color Development and the Community-Level Physiological Profiling for soil and water microbiota. Our findings indicate that eugenol significantly reduces MICs by 75 to 98%, which means that it could be a potent adjuvant. Ecotoxicological assessments showed eugenol to be less harmful to water and soil microbiota compared to studied antibiotics. While Vibrio fischeri and Daphnia magna were susceptible, Allium cepa and Eisenia foetida were minimally affected. Given that only 0.1% of eugenol is excreted by humans without metabolism, its environmental risk when used with antibiotics appears minimal.
Prokaryotic Expression and Functional Verification of Antimicrobial Peptide LRGG
Authors: Liu Xiang , Ding Yining , Shen Yuhan , Liu Sizhuo , Liu Yuehua , Wang Yuting , Wang Shikun , Gualerzi Claudio Orlando , Fabbretti Attilio , Guan Lili , Kong Lingcong , Zhang Haipeng , Ma Hongxia , He Chengguang
Published: June 2024

The antimicrobial peptide LRGG (LLRLLRRGGRRLLRLL-NH2) was designed and chemically synthesized in a study conducted by Jia et al. Gram-negative bacteria were found to be sensitive to LRGG and exhibited a high therapeutic index. Genetic engineering methods were used to create the prokaryotic fusion expression vector pQE-GFP-LRGG, and the resulting corresponding fusion protein GFP-LRGG was subsequently expressed and purified. The precursor GFP was then removed by TEV proteolysis, and pure LRGG was obtained after another round of purification and endotoxin removal. The prokaryotic-expressed antimicrobial peptide LRGG displays a broad-spectrum antibacterial effect on Gram-negative bacteria, and its minimum inhibitory activity (MIC) against Escherichia coli can reach 2 μg/mL. Compared to the chemically synthesized LRGG, the prokaryotic-expressed LRGG exhibits similar temperature, pH, salt ion, serum stability, and cell selectivity. Furthermore, prokaryotic-expressed LRGG showed excellent therapeutic effects in both the infection model of cell selectivity and no embryotoxicity in a Galleria mellonella infection model. The mechanism by which LRGG causes bacterial death was found to be the disruption of the Gram-negative cell membrane.
Metabolic Effects of Ketogenic Diets: Exploring Whole-Body Metabolism in Connection with Adipose Tissue and Other Metabolic Organs
Authors: Ahmad Yusra , Seo Dong Soo , Jang Younghoon
Published: June 2024

The ketogenic diet (KD) is characterized by minimal carbohydrate, moderate protein, and high fat intake, leading to ketosis. It is recognized for its efficiency in weight loss, metabolic health improvement, and various therapeutic interventions. The KD enhances glucose and lipid metabolism, reducing triglycerides and total cholesterol while increasing high-density lipoprotein levels and alleviating dyslipidemia. It significantly influences adipose tissue hormones, key contributors to systemic metabolism. Brown adipose tissue, essential for thermogenesis and lipid combustion, encounters modified UCP1 levels due to dietary factors, including the KD. UCP1 generates heat by uncoupling electron transport during ATP synthesis. Browning of the white adipose tissue elevates UCP1 levels in both white and brown adipose tissues, a phenomenon encouraged by the KD. Ketone oxidation depletes intermediates in the Krebs cycle, requiring anaplerotic substances, including glucose, glycogen, or amino acids, for metabolic efficiency. Methylation is essential in adipogenesis and the body’s dietary responses, with DNA methylation of several genes linked to weight loss and ketosis. The KD stimulates FGF21, influencing metabolic stability via the UCP1 pathways. The KD induces a reduction in muscle mass, potentially involving anti-lipolytic effects and attenuating proteolysis in skeletal muscles. Additionally, the KD contributes to neuroprotection, possesses anti-inflammatory properties, and alters epigenetics. This review encapsulates the metabolic effects and signaling induced by the KD in adipose tissue and major metabolic organs.
Developing Pavement Maintenance Strategies and Implementing Management Systems
Authors: Huang Li-Ling , Lin Jyh-Dong , Huang Wei-Hsing , Kuo Chun-Hung , Chiou Yi-Shian , Huang Mao-Yuan
Published: June 2024

The traffic volume and maintenance demand on Taiwan’s provincial highways have been steadily increasing. One of the most challenging issues in maintenance is determining the optimal timing and allocation of funds to avoid duplicative investments and maximize resource utilization. Currently, provincial highway maintenance units rely heavily on manual processes and paper-based records, using experiential methods to formulate maintenance strategies and conduct maintenance operations. This indicates a lack of objective maintenance strategies and pavement management systems in these units. This study aims to address this gap by integrating domestic and international literature on pavement maintenance decision-making. Existing approaches typically fall into two categories: “Pavement Indicator Rating” and “Pavement Maintenance Prioritization”. However, there has not been research integrating these methods for decision-making. Therefore, this research integrates these two approaches to establish a comprehensive maintenance strategy for Taiwan’s provincial highways. The Analytic Hierarchy Process (AHP) is employed as the decision-making theory, involving expert interviews to calculate maintenance weights for different pavement maintenance indicators. The results show that the pothole count, International Roughness Index (IRI), and Pavement Condition Index (PCI) are the three most critical maintenance indicators. The first phase of the maintenance strategy uses the “Pavement Indicator Rating“ to directly assess the pothole count, IRI, and PCI to categorize pavement sections as “maintenance sections” or “observation sections”. The second phase employs “Pavement Maintenance Prioritization”, integrating maintenance weights for each indicator to calculate maintenance scores. This phase prioritizes maintenance activities based on the results of the first phase’s rating for “maintenance sections”. Additionally, a provincial highway pavement management system is proposed to implement these strategies, enhancing maintenance management efficiency and ensuring the overall quality and longevity of provincial highway maintenance efforts.
Design Principles for Laser-Printed Macrofluidics
Authors: Gome Gilad , Benny Ofra , Shoseyov Oded , Giron Jonathan
Published: June 2024

This paper presents a novel method for fabricating fluidic circuits using laser printing technology. The method allows for rapid prototyping of macrofluidic devices with control over fluid manipulation and environmental conditions. We employed a high-resolution laser cutter to etch fluidic channels into various substrates, optimizing parameters such as laser power, speed, and substrate material. Our results demonstrate excellent performance in controlling fluid flow and maintaining environmental conditions, handling a wide range of fluids and flow rates. The devices were tested in multiple settings such as with high school students and in research laboratories in universities. We tested the laser-printed macrofluidcs mechanically for durability. We present previous works in microbiology with plants, microbial, and mammalian cell lines showing reliable operation with minimal leakage and consistent fluid dynamics. The versatility and scalability of this approach make it a promising tool for advancing research and innovation in fluidics, providing a robust platform for growing, manipulating, and experimenting with diverse biological systems from cells to whole organisms. We conclude that laser-printed macrofluidics can significantly contribute to fields such as biomedical research, synthetic biology, tissue engineering, and STEM education.
Postoperative Atrial Fibrillation Prediction by Left Atrial Size in Coronary Artery Bypass Grafting and Five-Year Survival Outcome
Authors: Gerçek Mustafa , Börgermann Jochen , Gummert Jan , Gerçek Muhammed
Published: June 2024

Background: Postoperative Atrial Fibrillation (POAF) is a common complication in cardiac surgery. Despite its multifactorial origin, the left atrial (LA) size is closely linked to POAF, raising the question of a valid cut-off value and its impact on the long-term outcome. Methods: Patients without a history of AF who underwent coronary artery bypass grafting between 2014 and 2016 were selected for this retrospective study. LA size was preoperatively assessed using the left atrial anterior–posterior diameter (LAAPd). Correlation and logistic regression analyses were performed, following a receiver-operating characteristic (ROC) analysis. Propensity score matching (PSM) was applied to ensure group comparability, followed by a comparison analysis regarding the primary endpoint of POAF and the secondary endpoints of all-cause mortality and stroke during a five-year follow-up. Results: A total of 933 patients were enrolled in the study eventually revealing a significant correlation between LAAPd and POAF (cor = 0.09, p < 0.01). A cut-off point of 38.5 mm was identified, resulting in groups with 366 patients each after PSM. Overall, patients with a dilated LA presented a significantly higher rate of POAF (22.3% vs. 30.4%, p = 0.02). In a five-year follow-up, a slightly higher rate of all-cause mortality (9.8% vs. 13.7%, HR 1.4 [0.92–2.29], p = 0.10) was observed, but there was no difference in the occurrence of strokes (3.6% vs. 3.3%, p = 0.87). Conclusions: An LAAPd of >38.5 mm was found to be an independent predictor of POAF after coronary artery bypass grafting and resulted in a non-significant tendency towards a worse outcome regarding all-cause mortality in a five-year follow-up.
Agreement between CT-Angiography and Digital Subtraction Angiography in Predicting Angiographic Vasospasm in Patients with Subarachnoid Hemorrhage
Authors: Moser Miriam M. , Gramss Leon , Marik Wolfgang , Weber Michael , Hirschmann Dorian , Wang Wei-Te , Dodier Philippe , Kasprian Gregor , Bavinzski Gerhard , Rössler Karl , Hosmann Arthur
Published: June 2024

Background/Objectives: Digital subtraction angiography (DSA) is the gold standard in the diagnosis of cerebral vasospasm, frequently observed after subarachnoid hemorrhage (SAH). However, less-invasive methods, such as computed tomography angiography (CTA), may be equally accurate. To further clarify comparability, this study evaluated the reliability of CTA in detecting cerebral vasospasm. Methods: This retrospective study included 51 patients with SAH who underwent both CTA and DSA within 24 h. The smallest diameter of the proximal cerebral arterial segments was measured in both modalities at admission and during the vasospasm period. The mean difference in diameter, the intraclass correlation coefficient (ICC) of CTA and DSA, the difference in grade of vasospasm and sensitivity, the specificity and the positive predictive value (PPV) for CTA were calculated. Results: A total of 872 arterial segments were investigated. At time of admission, arterial diameters were significantly smaller on CTA compared to DSA in all segments (−0.26 ± 0.12 mm; p < 0.05). At time of suspected vasospasm (day 9 ± 5), these differences remained significant only for the M1 segment (−0.18 ± 0.37 mm, p = 0.02), the P1 segment (−0.13 ± 0.24 mm, p = 0.04) and the basilar artery (−0.20 ± 0.37 mm, p = 0.0.04). The ICC between CTA and DSA was good (0.5–0.8). The sensitivity of CTA for predicting angiographic vasospasm was 99%, the specificity was 50% and the PPV was 92%. Conclusions: Arterial diameters measured on CTA may underestimate the arterial caliber observed in DSA; however, these absolute differences were minor. Importantly, vessel diameter alone does not fully reflect malperfusion, requiring additional imaging techniques such as CT perfusion.
Robotic-Assisted Nephrectomy for Living Kidney Donation—Single Center Initial Experience (Case Series) and Review of the Literature
Authors: Kędzierska-Kapuza Karolina , Łopuszyńska Inga , Mizerska Agnieszka , Matejak-Górska Marta , Safranow Krzysztof , Durlik Marek
Published: June 2024

Background: Robotic-assisted nephrectomy for living kidney-donation (RANLD) has the potential of becoming the leading technique of harvesting kidney, if expertise is available. The aim of this work is to present our initial experience with robotic technique with additional hand-assistance. Materials and Methods: We initiated RANLD at our clinic using the DaVinci System in September 2022, since then harvesting six kidneys, four left and two right; in two cases, multiple arteries existed. The renal vessels were ligated using vascular staplers. All the operations included a hand-assist with the use of Gelport. The mean operation time was 119.2 min (SD 12 min). Results: There were no conversions or donors’ post-operative complications. Time of discharge from the hospital was 4.5 days post-operatively. Total hospital length of stay was 7.8 days. All the harvested kidneys were transplanted, five of them with adequate function, three with initially delayed function, and one needed to be removed due to thrombotic complications. Post-operative was pain assessed on the VAS scale and overall pain was assessed according to the NRS scale. At the discharge day, donors’ performance status was about 87.5% according to the Karnofsky scale. The donors resumed their normal life activity within 15.7 days and returned to work within 45.2 days. The serum mean creatinine level before the donation was 0.85 mg/dL (SD 0.1 mg/dL), and mean eGFR (MDRD) = 91.8 mL/min/1.73 m2 (SD 16.1 mL/min/1.73 m2). Conclusions: Further development of RANLD could lead to an increase in the number of living kidney donors, particularly in Poland where the number is currently lower than that of deceased donors. Prolonged operation time, longer warm ischemic time, and high equipment costs are significant drawbacks of RANLD.
A Cross-Sectional Study of Disparities in Healthcare Transition in Cerebral Palsy
Authors: Colquitt Gavin , Keko Mario , Rochani Haresh D. , Modlesky Christopher M. , Vova Joshua , Maitre Nathalie Linda
Published: June 2024

Background: Cerebral palsy (CP) is the most common physical disability among children, affecting their lifespan. While CP is typically nonprogressive, symptoms can worsen over time. With advancements in healthcare, more children with CP are reaching adulthood, creating a greater demand for adult care. However, a significant lack of adult healthcare providers exists, as CP is predominantly considered a pediatric condition. This study compares the transition experiences of children with CP compared to those with other developmental disabilities (DDs) and typically developing children (TDC). Methods: This study utilizes cross-sectional data from the National Survey of Children’s Health (NSCH) from 2016–2020, including 71,973 respondents aged 12–17. Children were categorized into three groups: CP (n = 263), DD (n = 9460), and TDC (n = 36,053). The analysis focused on the receipt of transition services and identified demographic and socioeconomic factors influencing these services. Results: Only 9.7% of children with CP received necessary transition services, compared to 19.7% of children with DDs and 19.0% of TDC. Older age, female sex, non-Hispanic white ethnicity, and higher household income were significant predictors of receiving transition services. Children with CP were less likely to have private time with healthcare providers and receive skills development assistance compared to other groups. Conclusions: The findings highlight disparities and critical needs for targeted interventions and structured transition programs to improve the transition from pediatric to adult healthcare for children with CP. Addressing disparities in service receipt and ensuring coordinated, continuous care are essential for improving outcomes for children with CP.
Natural History and Predictors for Hemorrhage in Supratentorial Brain Arteriovenous Malformations
Authors: Miron Ioana , Prună Viorel M. , Visarion Dan M. , Petrescu George E. D. , Gorgan Radu M.
Published: June 2024

Background/Objectives: Approximately half of the patients harboring supratentorial brain arterio-venous malformations (stAVMs) present with hemorrhage, and another considerable proportion suffer from epileptic seizures. An important milestone in the management of this vascular pathology is acknowledging their natural history, especially across long periods of time. The aim of this study was to assess the predictive factors for hemorrhage and for epileptic seizures as presenting symptoms in stAVMs. Methods: We retrospectively analyzed patients with stAVMs admitted to our institution between 2012 and 2022 and evaluated predictive factors for hemorrhage and the risk factors associated with epileptic seizures. Results: The cohort included 169 patients, 78 of them (46.2%) presenting with intracerebral hemorrhage (ICH). Seventy-seven (45.5%) patients suffered from epileptic seizures. The annual hemorrhagic rate was 1.28%/year. Unruptured lesions (p = 0.001, OR 3.1, 95% CI 1.6–6.2), superficial venous drainage (p = 0.007, OR 2.7, 95% CI 1.3–5.7) and large nidus size (p = 0.025, OR 4, 95% CI 1.2–13.5) were independently associated with seizures. Among unruptured lesions, superficial venous drainage (OR 2.6, p = 0.036, 95% CI 1.06–6.3) and frontal/temporal/parietal location (OR 2.7, p = 0.040, 95 CI% 1.04–6.9) significantly increased the risk of seizures as a presenting symptom in multivariate analysis. Patients younger than 18 (p = 0.003, OR 4.5, 95% CI 1.6–12.2), those with AVMs < 3 cm (p = 0.03, OR 2, 95% CI 1.07–3.9) or those with deep located AVMs (p = 0.035, OR 2.3, 95% CI 1.06–5.1) presented statistically more often with ICH in multivariate regression. Small size (HR 1.8, 95% CI 1.09–3, p = 0.022) and exclusively deep venous drainage (HR 2.2, 95% CI 1.2–4, p = 0.009) were independent predictors for ICH, in time-dependent birth-to-diagnosis analysis. After shifting the birth-to-diagnosis curve by 10 years, unique arterial feeder demonstrated a positive correlation with ICH presentation as well. Conclusions: Small AVMs, those with exclusively deep venous drainage, unique arterial feeder or deep location may pose higher hemorrhagic risks for the patient, and therapeutic strategies should be tailored accordingly. When managing unruptured brain AVMs, it is important to consider the risk of developing seizures, in addition to the lifelong risk of hemorrhage, in determining the optimal treatment approach for each patient.
Step-Up versus Open Approach in the Treatment of Acute Necrotizing Pancreatitis: A Case-Matched Analysis of Clinical Outcomes and Long-Term Pancreatic Sufficiency
Authors: Pavlek Goran , Romic Ivan , Kekez Domina , Zedelj Jurica , Bubalo Tomislav , Petrovic Igor , Deban Ognjan , Baotic Tomislav , Separovic Ivan , Strajher Iva Martina , Bicanic Kristina , Pavlek Ana Ettinger , Silic Vanja , Tolic Gaja , Silovski Hrvoje
Published: June 2024

Background/Objectives: Acute necrotizing pancreatitis (ANP) with secondary infection of necrotic tissue is associated with a high rate of complications and mortality. The optimal approach is still debatable, but the minimally invasive modality has gained great attention in the last decade as it follows the principle of applying minimal surgical trauma to achieve a satisfying therapeutic objective. We compared clinical outcomes between the step-up approach (SUA) and open necrosectomy (ON) in the treatment of acute necrotizing pancreatitis. Methods: A prospective cohort study over the period of 2011–2021 in a university teaching hospital was performed. Results of 99 consecutive patients with ANP who required surgical/radiological intervention were collected. A case match analysis (2:1) was performed, and the final groups comprised 40 patients in the OA group and 20 patients in the SUA group. Demographic, clinicopathologic, and treatment data were reviewed. Results: Baseline characteristics and disease severity were comparable between the two groups. The patients from the SUA group had a significantly lower morbidity rate and rate of pancreatic insufficiency. Death occurred in 4 of 20 patients (20%) in the SUA group and in 11 of 40 patients (27.5%) in the ON group (risk ratio with the step-up approach, 0.72; 95% confidence interval, 0.26 to 1.99; p = 0.53). Conclusions: A minimally invasive step-up approach provides comparable outcomes to open necrosectomy in the treatment of ANP with infected pancreatic necrosis. While mortality and hospital stay were comparable between the groups, morbidity and pancreatic insufficiency were significantly lower in the SUA group. Further studies on a larger number of patients are required to define the place of SUA in the modern treatment of ANP.
An Umbrella Review and Updated Meta-Analysis of Imaging Modalities in Occult Scaphoid and Hip and Femoral Fractures
Authors: Jorisal Patricia , Sulay Callistus Bruce Henfry , Octavius Gilbert Sterling
Published: June 2024

Background: Occult fractures may cause multiple morbidities. If occult fractures were detected earlier, complications may be preventable. This umbrella review and updated meta-analysis will aim to evaluate the use of imaging modalities in detecting occult scaphoid and hip fractures. Methods: The protocol for this study is available in the International Prospective Register of Systematic Reviews (PROSPERO) database (CRD42024525388). The literature search started and ended on 17 March 2024. We searched seven academic databases: MEDLINE, Cochrane Library, Pubmed, Science Direct, Google Scholar, WHO International Clinical Trials Registry Platform, and The Joanna Briggs Institute (JBI) database. The meta-analysis was conducted with the STATA program using the “midas” command. Results: There are four systematic reviews evaluating occult hip and femoral fractures with 6174 patients and two reviews evaluating occult scaphoid fractures with 1355 patients. The prevalence of occult scaphoid fracture and occult hip and femoral fractures is 23.87% (95% CI 18.25–29.49) and 44.8% (95% CI 39.38–51.4), respectively. Magnetic resonance imaging (MRI) had the best posterior probability of positive likelihood ratio (LR+) with 95% and 96% and negative likelihood ratio (LR-) with 0.15% and 1% for both occult scaphoid and hip fractures, respectively, assuming a 25% baseline. MRI could both confirm and exclude occult hip fractures while it can only confirm occult scaphoid fractures. Bone scans are inappropriate for either type of occult fractures The level of evidence for occult scaphoid fracture is weak while it is suggestive for occult hip fractures. Conclusion: The findings strengthen the use of MRI after an initially negative radiograph fracture for occult hip and femoral fractures, with a CT scan as a viable second option.
Survival and Treatment Modalities in Primary Vaginal Melanoma—Case Report and a Narrative Review
Authors: Guzik Paweł , Łukasiewicz Martyna , Harpula Magdalena , Zając Paweł , Żmuda Marcin , Śniadecki Marcin , Topolewski Paweł
Published: June 2024

Background/Objectives: Primary vaginal melanoma (PVM) is a rare cancer representing five percent of vaginal cancers and less than one percent of all female vaginal melanomas, with an incidence rate of 0.46 per million women per year. The aim of this study was to present a case of combined therapy and conservative surgical treatment in a young patient with PVM and to perform a systematic review of the same subject. Methods: We performed a narrative review of the literature and presented a case report. Results: The review yielded a total of 43 articles. We presented treatment modalities and survival outcomes. The presented case involved a combination of surgical treatment with adjuvant therapy comprising nivolumab and ipilimumab. Conclusions: PVM is a disease with a poor prognosis; however, new treatment options are promising and have a great chance of significantly improving survival. The combination of the wide local excision of the primary lesion followed by adjuvant therapies results in the best outcomes in the treatment of PVM. Future clinical studies are warranted to provide new evidence for the treatment outcomes of nonsurgical, metastatic PVM and the adjuvant treatment of PVM.
Reducing Left Ventricular Wall Stress through Aortic Valve Enlargement via Transcatheter Aortic Valve Implantation in Severe Aortic Stenosis
Authors: Chiang Chih-Yao , Lin Shen-Che , Hsu Jung-Cheng , Chen Jer-Shen , Huang Jih-Hsin , Chiu Kuan-Ming
Published: June 2024

Background: In aortic stenosis, the left ventricle exerts additional force to pump blood through the narrowed aortic valve into the downstream arterial vasculature. Adaptive hypertrophy helps to maintain wall stress homeostasis but at the expense of impaired compliance. Advanced ventricular deformation impacts the extent of functional recovery benefits achieved through transcatheter aortic valve implantation. Methods and Results: Subgroups were stratified based on output, with low-flow severe aortic stenosis defined as stroke volume index <35 mL· m−2. Before intervention, the low-flow subgroup exhibited worse effective orifice area index and arterial and global impedance, along with thinner wall thickness and larger chamber volume marginally. LV performance, including stroke volume index, ventricular elastance, and ventricular–arterial coupling, were notably inferior, consistent with worse adverse remodeling. Although the effective orifice area index was similarly augmented after TAVI, inferior recovery benefits were noted. Persistently higher wall stress and energy consumption were observed, along with poorer ventricular–arterial coupling. These changes in wall stress showed an inverse relationship with alterations in wall thickness and were proportional to changes in dimension and volume. Additionally, they were proportional to changes in left ventricular end-systolic pressure, pressure–volume area, and ventricular–arterial coupling but inversely related to ventricular end-systolic elastance. Conclusions: The study revealed that aortic valve enlargement through transcatheter aortic valve implantation reduces left ventricular wall stress in severe aortic stenosis. The reduced recovery benefits in the low-flow subgroup were evident. Wall stress could serve as a marker of mechanical benefit after the intervention.
Improving Social and Personal Rhythm Dysregulation in Young and Old Adults with Bipolar Disorder: Post-Hoc Analysis of a Feasibility Randomized Controlled Trial Using Virtual Reality-Based Intervention
Authors: Sancassiani Federica , Perra Alessandra , Kurotschka Peter K. , Kalcev Goce , Galetti Alessia , Zaccheddu Rosanna , Locci Aurora , Piludu Federica , Di Natale Lorenzo , De Lorenzo Valerio , Fornaro Michele , Nardi Antonio Egidio , Primavera Diego
Published: June 2024

Introduction: Rehabilitative interventions employing technology play a crucial role in bipolar disorder (BD) treatment. The study aims to appraise the virtual reality (VR)-based cognitive remediation (CR) and the interpersonal rhythm approaches to treatment outcomes of BD across different age groups. Methods: Post-hoc analysis of a 12-week randomizedcontrolled cross-over feasibility trial involving people with mood disorders (BD, DSM-IV) aged 18–75 years old: thirty-nine exposed to the experimental VR-based CR vs 25 waiting list controls. People with BD relapse, epilepsy or severe eye diseases (due to the potential VR risks exposure) were excluded. Biological Rhythms Interview of Assessment in Neuropsychiatry (BRIAN) was used to measure the outcome. Results: Cases and controls did not statistically significantly differ in age and sex distributions. Personal rhythm scores improved over the study follow-up in the experimental vs the control group (APC = 8.7%; F = 111.9; p < 0.0001), both in young (18–45 years) (APC = 5.5%; F = 70.46; p < 0.0001) and, to a lesser extent, older (>46 years) adults (APC = 10.5%; F = 12.110; p = 0.002). Conclusions: This study observed improved synchronization of personal and social rhythms in individuals with BD after a virtual reality cognitive remediation intervention, particularly in social activity, daily activities, and chronotype, with greater benefits in the younger population.
Expression of Hormones’ Receptors in Human Corneal Endothelium from Fuchs’ Dystrophy: A Possible Gender’ Association
Authors: De Piano Maria , Abicca Irene , Dinu Valentin , Roszkowska Anna Maria , Micera Alessandra , Schiano-Lomoriello Domenico
Published: June 2024

Background: Age and sex are the most significant risk of factors for advanced Fuchs dystrophy. Nevertheless, few data are available on the hormone’s receptor pattern expressed in adult and advanced fuchs endothelial corneal dystrophy (FECD). We investigated the impact of gender, growth factors and extracellular matrix (ECM) regulatory proteins expressed by the dystrophic endothelia. Methods: Ten dystrophic endothelial tissues and 10 normal endothelial sheets (corneoscleral specimens; Eye Bank) were used for this characterization study. Hormones’ receptors (ERα, AR, PR, SHBG), few growth factors (VEGFA, βNGF, TGFβ1), some ECM regulators (MMP1, MMP7) and few inflammatory cytokines (IFNγ, IL10) were analyzed by real-time RT-PCR. Results: ERα transcripts were significantly increased, AR and SHBG transcripts were decreased in Fuchs endothelia from female patients, and no changes were detected for PR transcripts. VEGFA, βNGF and TGFβ1 transcripts were upregulated in Fuchs’ endothelia, but not significantly linked to gender. High MMP1 and low MMP7 transcripts’ expression were detected in Fuchs’ specimens, mainly in males than females. An increased IFNγ (Th1) transcript expression was observed in females than males, and a trend to increase for IL10 (Th2) transcripts was detected in males than females. Conclusions: Our findings clearly indicate that hormone receptors, growth factors and matrix mediators as well as a Th1 pathway are predominant in Fuchs’ dystrophy, displaying a pattern of expression specific for the female phenotype. The differential expression of hormones’ receptors and the Th1/Th2 ratio might prompt to new theories to be tested in vitro and in vivo models, such as the use of hormonal substitute for counteracting this endothelial cell lost.
The Effects of High-Intensity Interval Training on Cognitive and Physical Skills in Basketball and Soccer Players
Authors: Shiraz Sehrish , Salimei Chiara , Aracri Maurizio , Di Lorenzo Carlo , Farsetti Pasquale , Parisi Attilio , Iellamo Ferdinando , Caminiti Giuseppe , Perrone Marco Alfonso
Published: June 2024

As athletes pursue excellence, training techniques continue to advance, making structured physical activity an essential tool for enhancing performance. To optimize athletic performance in modern competitive sports, the balance of physical performance and mental clarity is required. This study seeks to examine the effects of High-Intensity Interval Training (HIIT) on cognitive and physical skills in basketball and soccer players. A 3-week HIIT protocol was incorporated based on the Wingate technique. This study included 10 soccer players and 10 basketball players with an average age of 22.79 ± 1.90 years. Participants performed pre- and post-intervention assessments. Physical proficiency was assessed using 20 m sprint, change-of-direction (COD) and dribbling tests, while cognitive skills were assessed using motion object tracking (MOT), working memory, perceptual load (PL), and attention window (AW) tests. The HIIT intervention significantly improved cognitive performance in particular; noteworthy observations were a 15% improvement in motion object tracking test scores and a 16% increase in working memory test scores for basketball players. The attention window test scores showed a 32% increase, and perceptual load test scores were 31% decreased for soccer players post-intervention. There were significant improvements in physical skills; for example, sprint times were decreased by 6%, and change-of-direction and dribbling times were reduced by 8% and 7%, respectively, indicating improved agility, speed, and ball control abilities. In conclusion, both groups performed significantly better on cognitive and physical skill tests post-HIIT intervention.
Heat Input Control Strategies in DED
Authors: Egorov Sergei , Soffel Fabian , Schudeleit Timo , Bambach Markus , Wegener Konrad
Published: June 2024

In the context of directed energy deposition (DED), the production of complex components necessitates precise control of all processing parameters while mitigating undesirable factors like heat accumulation. This research seeks to explore and validate with various materials the impact of a geometry-based analytical model for minimizing heat input on the characteristics and structure of the resultant DED components. Furthermore, it aims to compare this approach with other established methods employed to avoid heat accumulation during production. The geometry of the fabricated specimens was assessed using a linear laser scanner, cross-sections were analyzed through optical microscopy, and the effect on mechanical properties was determined via microhardness measurements. The specimens manufactured using the developed analytical model exhibited superior geometric precision with lower energy consumption without compromising mechanical properties.
Ocular Manifestations and Complications of Patent Foramen Ovale: A Narrative Review
Authors: Lixi Filippo , Fazzini Luca , Cannas Claudia , Montisci Roberta , Giannaccare Giuseppe
Published: June 2024

Patent foramen ovale (PFO) is a prevalent congenital cardiac anomaly associated with a persistent opening between the atrial septum, allowing communication between the left and right atria. Despite often being asymptomatic, PFO can lead to various clinical presentations, including cryptogenic stroke and other embolic events. Transient visual disturbances, alterations in the visual field, migraine with aura, impaired eye movement and endogenous eye infections may prompt patients to seek ophthalmological consultation. Understanding these diverse clinical scenarios is crucial for early detection, appropriate management and mitigating the morbidity burden associated with PFO. This narrative review aims at examining the spectrum of clinical presentations of ocular pictures associated with PFO. The pathophysiology, diagnosis and treatment methods for PFO will be described, emphasizing the importance of a multidisciplinary approach involving ophthalmologists, cardiologists, neurologists and imaging specialists. In the future, prospective studies and clinical trials are warranted to provide further insights into the preventive role and optimal therapeutic strategies for managing PFO-related ocular complications, ultimately guiding clinical decision making and optimizing patient care.
External Auditor’s Reliance Decision on the Internal Audit Function: A Qualitative Analysis on the Coordination Process
Authors: Chui Lawrence , Pike Byron J. , Martin Kasey
Published: June 2024

Authoritative standards encourage external auditors to coordinate their efforts with the client’s internal audit function (IAF) as part of a financial statement audit. Academic research on this relationship finds that it has the potential to improve audit quality and efficiency. The objective of this research is to better understand how coordination can impact the external auditor’s decision to rely on the IAF. Prior research has shown that the reliance decision is complex and involves several factors that must be considered simultaneously. In this study, we surveyed external auditors to better understand the benefits of coordinating efforts, the antecedents to successful coordination, and the elements that potentially inhibit external auditors from relying on the work of internal auditors. We find that external auditors are coordinating with the IAF to achieve more efficient and effective audits. The degree of this reliance, however, does vary between audits and is largely dependent upon the perceived competence and objectivity of the IAF as well as effective communication. Our findings are informative to external audit practitioners and their decision to rely on IAFs and work towards a successful arrangement where the integrated audit is applied more efficiently and effectively. This additional insight also helps inform and direct future research into external auditors’ coordination decisions.
Does the Way Variables Are Calculated Change the Conclusions to Be Drawn? A Study Applied to the Ratio ROI (Return on Investment)
Authors: Patrocínio Tiago , Madaleno Mara , Nogueira Manuel Carlos
Published: June 2024

This research aims to analyse the financial performance of companies using one of the most used profitability indicators, the return on investment (ROI), which measures the company’s performance in terms of the profit generated over time. To this end, several different methods are used to calculate the ROI indicator, considering the different calculation methods used by different authors over the years. The use of different ROI calculation formulas has been identified in the literature, leading to different conclusions. Based on a sample of 2805 Portuguese companies, it examines how the different indicators react to the different variables analysed, using nine different econometric models. Through this study, it is possible to verify that the different variables that depend on the return on investment have different results, namely that the variables “age” and “size” have a negative effect on the return on investment. On the other hand, “financial leverage” and “ROA” have a positive impact on the contribution to the return on investment. We also found that the different variables behave similarly for virtually all types of ROI calculation, although not completely harmonious, especially in terms of impact. The results are empirically vital, as they alert researchers and companies to the need for standardised formulas for calculating variables such as ROI so that results are not distorted. Using one to the detriment of the other impacts the results obtained and the analyses to be carried out. How empirical research will continue to use the ROI metric will always depend on its users’ discretion and free will.
Climate Change and Corporate Financial Performance
Authors: Liu Lian , Beirne John , Azhgaliyeva Dina , Rahut Dil
Published: June 2024

Climate change impacts will continue to worsen with rising greenhouse gas (GHG) emissions, underscoring the growing necessity to foresee and comprehend the impact of climate change risks on economic activity. Using quarterly firm-level data of 209 firms from the People’s Republic of China (PRC) over the period Q1 2018–Q2 2022, this study estimates the impact of firms’ exposure to climate-related risks on their financial performance. The results indicate a notable adverse effect of climate change exposure on firms’ rate of return, with a lag of around two years. Firms located in more climate-vulnerable coastal areas and high-income provinces experience relatively greater negative impacts on their financial returns. Our findings have important policy implications for firms aiming to maximize their returns through enhanced climate change mitigation and adaptation efforts.