bluuebunny/crossref_metadata_2025 huggingface dataset:
Anti-Inflammatory Effects of Immunostimulation in Patients with COVID-19 Pneumonia
Authors: Santus Pierachille , Radovanovic Dejan , Garziano Micaela , Pini Stefano , Croce Giuseppe , Fuccia Giuseppe , Spitaleri Debora , Biasin Mara , Clerici Mario , Trabattoni Daria
Published: December 2021

Background: The effects of immunomodulators in patients with Coronavirus Disease 2019 (COVID-19) pneumonia are still unknown. We investigated the cellular inflammatory and molecular changes in response to standard-of-care + pidotimod (PDT) and explored the possible association with blood biomarkers of disease severity. Methods: Clinical characteristics and outcomes, neutrophil-to-lymphocyte ratio (NLR), plasma and cell supernatant chemokines, and gene expression patterns after SARS-CoV-2 and influenza (FLU) virus in vitro stimulation were assessed in 16 patients with mild-moderate COVID-19 pneumonia, treated with standard of care and PDT 800 mg twice daily (PDT group), and measured at admission, 7 (T1), and 12 (T2) days after therapy initiation. Clinical outcomes and NLR were compared with age-matched historical controls not exposed to PDT. Results: Hospital stay, in-hospital mortality, and intubation rate did not differ between groups. At T1, NLR was 2.9 (1.7–4.6) in the PDT group and 5.5 (3.4–7.1) in controls (p = 0.037). In the PDT group, eotaxin and IL-4 plasma concentrations progressively increased (p < 0.05). Upon SARS-CoV-2 and FLU-specific stimulation, IFN-γ was upregulated (p < 0.05), while at genetic transcription level, Pathogen Recognition Receptors (TRLs) were upregulated, especially in FLU-stimulated conditions. Conclusions: Immunomodulation exerted by PDT and systemic corticosteroids may foster a restoration in the innate response to the viral infection. These results should be confirmed in larger RCTs.
Safety of Bedside Placement of Tunneled Hemodialysis Catheters in the Intensive Care Unit: Translating from the COVID-19 Experience
Authors: Sohail Mohammad Ahsan , Hanane Tarik , Lane James , Vachharajani Tushar J.
Published: December 2021

Background: Critically ill patients with coronavirus disease 2019 (COVID-19) and kidney dysfunction often require tunneled hemodialysis catheter (TDC) placement for kidney replacement therapy, typically under fluoroscopic guidance to minimize catheter-related complications. This entails transportation of patients outside the intensive care unit to a fluoroscopy suite, which may potentially expose many healthcare providers to COVID-19. One potential strategy to mitigate the risk of viral transmission is to insert TDCs at the bedside, using ultrasound and anatomic landmarks only, without fluoroscopic guidance. Methods: We reviewed all COVID-19 patients in the intensive care unit who underwent right internal jugular TDC insertion at the bedside between April and December 2020. Outcomes included catheter placement-related complications such as post-procedural bleeding, air embolism, dysrhythmias, pneumothorax/hemothorax, and catheter tip malposition. TDC insertion was considered successful if the catheter was able to achieve blood flow sufficient to perform either a single intermittent or 24 h of continuous hemodialysis treatment. Results: We report a retrospective, single-center case series of 25 patients with COVID-19 who had right internal jugular TDCs placed at the bedside, 10 of whom underwent simultaneous insertion of small-bore right internal jugular tunneled central venous catheters for infusion. Continuous veno-venous hemodialysis was utilized for kidney replacement therapy in all patients, and a median catheter blood flow rate of 200 mL/min (IQR: 200–200) was achieved without any deviation from the dialysis prescription. No catheter insertion-related complications were observed, and none of the catheter tips were malpositioned. Conclusions: Bedside right internal jugular TDC placement in COVID-19 patients, using ultrasound and anatomic landmarks without fluoroscopic guidance, may potentially reduce the risk of COVID-19 transmission among healthcare workers without compromising patient safety or catheter function. Concomitant insertion of tunneled central venous catheters in the right internal jugular vein for infusion may also be safely accomplished and further help limit personnel exposure to COVID-19.
Redefining Remission Induction Chemotherapy Ineligibility by Early Mortality in De Novo Acute Myeloid Leukemia
Authors: Li You-Cheng , Shih Yu-Hsuan , Chen Tsung-Chih , Gau Jyh-Pyng , Su Yu-Chen , Chen Mei-Hui , Hsu Chiann-Yi , Liao Cai-Sian , Teng Chieh-Lin Jerry
Published: December 2021

The therapeutic strategies for acute myeloid leukemia (AML) patients ineligible for remission induction chemotherapy have been improving in the past decade. Therefore, it is important to define ineligibility for remission induction chemotherapy. We retrospectively assessed 153 consecutive adult de novo AML patients undergoing remission induction chemotherapy and defined early mortality as death within the first 60 days of treatment. The 153 patients were stratified into the early mortality group (n = 29) and the non-early mortality group (n = 124). We identified potential factors to which early mortality could be attributed, investigated the cumulative incidence of early mortality for each aspect, and quantified the elements. The early mortality rate in our study cohort was 19.0%. Age ≥ 65 years (odds ratio (OR): 3.15; 95% confidence interval (CI): 1.05–9.44; p = 0.041), Eastern Cooperative Oncology Group performance status ≥ 2 (OR: 4.87; 95% CI: 1.77–13.41; p = 0.002), and lactate dehydrogenase ≥ 1000 IU/L (OR: 4.20; 95% CI: 1.57–11.23; p = 0.004) were the risk factors that substantially increased early mortality in AML patients. Patients with two risk factors had a significantly higher early mortality rate than those with one risk factor (68.8% vs. 20.0%; p < 0.001) or no risk factors (68.8% vs. 9.2%; p < 0.001). In conclusion, older age, poor clinical performance, and a high tumor burden were risks for early mortality in AML patients receiving remission induction chemotherapy. Patients harboring at least two of these three factors should be more carefully assessed for remission induction chemotherapy.
Is Computer-Assisted Tissue Image Analysis the Future in Minimally Invasive Surgery? A Review on the Current Status of Its Applications
Authors: Tanos Vasilios , Neofytou Marios , Soliman Ahmed Samy Abdulhady , Tanos Panayiotis , Pattichis Constantinos S.
Published: December 2021

Purpose: Computer-assisted tissue image analysis (CATIA) enables an optical biopsy of human tissue during minimally invasive surgery and endoscopy. Thus far, it has been implemented in gastrointestinal, endometrial, and dermatologic examinations that use computational analysis and image texture feature systems. We review and evaluate the impact of in vivo optical biopsies performed by tissue image analysis on the surgeon’s diagnostic ability and sampling precision and investigate how operation complications could be minimized. Methods: We performed a literature search in PubMed, IEEE, Xplore, Elsevier, and Google Scholar, which yielded 28 relevant articles. Our literature review summarizes the available data on CATIA of human tissues and explores the possibilities of computer-assisted early disease diagnoses, including cancer. Results: Hysteroscopic image texture analysis of the endometrium successfully distinguished benign from malignant conditions up to 91% of the time. In dermatologic studies, the accuracy of distinguishing nevi melanoma from benign disease fluctuated from 73% to 81%. Skin biopsies of basal cell carcinoma and melanoma exhibited an accuracy of 92.4%, sensitivity of 99.1%, and specificity of 93.3% and distinguished nonmelanoma and normal lesions from benign precancerous lesions with 91.9% and 82.8% accuracy, respectively. Gastrointestinal and endometrial examinations are still at the experimental phase. Conclusions: CATIA is a promising application for distinguishing normal from abnormal tissues during endoscopic procedures and minimally invasive surgeries. However, the efficacy of computer-assisted diagnostics in distinguishing benign from malignant states is still not well documented. Prospective and randomized studies are needed before CATIA is implemented in clinical practice.
Improving Adherence to Myofunctional Therapy in the Treatment of Sleep-Disordered Breathing
Authors: O’Connor-Reina Carlos , Ignacio Garcia Jose María , Rodriguez Alcala Laura , Rodríguez Ruiz Elisa , Garcia Iriarte María Teresa , Casado Morente Juan Carlos , Baptista Peter , Plaza Guillermo
Published: December 2021

Myofunctional therapy (MT) is used to treat sleep-disordered breathing. However, MT has low adherence—only ~10% in most studies. We describe our experiences with MT delivered through a mobile health app named Airway Gym®, which is used by patients who have rejected continuous positive airway pressure and other therapies. We compared ear, nose, and throat examination findings, Friedman stage, tongue-tie presence, tongue strength measured using the Iowa oral performance instrument (IOPI), and full polysomnography before and after the 3 months of therapy. Participants were taught how to perform the exercises using the app at the start. Telemedicine allowed physicians to record adherence to and accuracy of the exercise performance. Fifty-four patients were enrolled; 35 (64.8%) were adherent and performed exercises for 15 min/day on five days/week. We found significant changes (p < 0.05) in the apnoea–hypopnoea index (AHI; 32.97 ± 1.8 to 21.9 ± 14.5 events/h); IOPI score (44.4 ± 11.08 to 49.66 ± 10.2); and minimum O2 saturation (80.91% ± 6.1% to 85.09% ± 5.3%). IOPI scores correlated significantly with AHI after the therapy (Pearson r = 0.4; p = 0.01). The 19 patients who did not adhere to the protocol showed no changes. MT based on telemedicine had good adherence, and its effect on AHI correlated with IOPI and improvement in tongue-tie.
Implications of Elevated Fibrosis-4 Index in Patients Receiving Trans-Catheter Aortic Valve Replacement
Authors: Imamura Teruhiko , Narang Nikhil , Onoda Hiroshi , Tanaka Shuhei , Ushijima Ryuichi , Sobajima Mitsuo , Fukuda Nobuyuki , Ueno Hiroshi , Kinugawa Koichiro
Published: December 2021

Background: The prognostic implication of the fibrosis-4 index, which represents the degree of hepatic injury, on patients receiving trans-catheter aortic valve replacement (TAVR) remains unknown. Methods: Patients who underwent TAVR to treat severe aortic stenosis at our institute between 2015 and 2020 were included in this retrospective study and followed for 2 years from the index discharge. The impact of the fibrosis-4 index, which was calculated using age, hepatic enzymes, and platelet count, on 2-year heart failure readmissions was investigated. Results: A total of 272 patients (median age 85 (82, 88) years old, 76 (28%) men) were included. The median baseline fibrosis-4 index was 2.8 (2.2, 3.7). A high fibrosis-4 index (>3.79) was associated with higher cumulative incidence of the primary endpoint (18% versus 4%, p < 0.001) and higher event rates (0.1041 versus 0.0222 events/year, p < 0.001), with an adjusted hazard ratio of 1.27 (95% confidence interval 1.04–1.54, p = 0.019). Conclusion: an elevated fibrosis-4 index at baseline, indicating the existence of persistent hepatic congestion, was associated with incidences of heart failure following TAVR. Calculating the fibrosis-4 index before TAVR is highly encouraged for risk stratification and shared decision making.
Causes of Exocrine Pancreatic Insufficiency Other Than Chronic Pancreatitis
Authors: Kunovský Lumír , Dítě Petr , Jabandžiev Petr , Eid Michal , Poredská Karolina , Vaculová Jitka , Sochorová Dana , Janeček Pavel , Tesaříková Pavla , Blaho Martin , Trna Jan , Hlavsa Jan , Kala Zdeněk
Published: December 2021

Exocrine pancreatic insufficiency (EPI), an important cause of maldigestion and malnutrition, results from primary pancreatic disease or is secondary to impaired exocrine pancreatic function. Although chronic pancreatitis is the most common cause of EPI, several additional causes exist. These include pancreatic tumors, pancreatic resection procedures, and cystic fibrosis. Other diseases and conditions, such as diabetes mellitus, celiac disease, inflammatory bowel disease, and advanced patient age, have also been shown to be associated with EPI, but the exact etiology of EPI has not been clearly elucidated in these cases. The causes of EPI can be divided into loss of pancreatic parenchyma, inhibition or inactivation of pancreatic secretion, and postcibal pancreatic asynchrony. Pancreatic enzyme replacement therapy (PERT) is indicated for the conditions described above presenting with clinically clear steatorrhea, weight loss, or symptoms related to maldigestion and malabsorption. This review summarizes the current literature concerning those etiologies of EPI less common than chronic pancreatitis, the pathophysiology of the mechanisms of EPI associated with each diagnosis, and treatment recommendations.
Semi-Rigid Fixation Using a Sliding Plate for Treating Fractures of the Mandibular Condylar Process
Authors: So Byung-Kyu , Ko Kyeong-Soo , Kim Dong-Hyuck , Jang Hyon-Seok , Lee Eui-Seok , Lim Ho-Kyung
Published: December 2021

Occlusal displacement often occurs after surgery for condylar process fractures because it is difficult to reduce these fractures precisely. However, performing semi-rigid fixation using a sliding plate may overcome this limitation. A retrospective clinical comparison between semi-rigid and rigid fixations was performed. Among 34 patients who had unilateral condylar process fractures, 17 were treated with rigid fixation and the remaining with semi-rigid fixation using a sliding plate. For all patients, panoramic radiographs were collected 1 day and 6 months after surgery. In these radiographs, ramus height and condylar process inclination were measured, and the differences between the fractured and normal sides were assessed. Additionally, the radiographic density of the fracture area was measured. Differences in surgical outcomes and operative times between the two groups and changes in postoperative deviations within each group were analyzed. There was no statistically significant difference in ramus height and condylar process inclination between the two groups at postoperative day 1 and 6 months. Radio-density was observed to be higher in the rigid fixation group, and it increased with time in both groups. The semi-rigid fixation group had a significantly shorter operative time than the other group did. Semi-rigid and rigid fixations showed no differences in terms of effectiveness and outcomes of surgery. In terms of operative time, semi-rigid fixation was superior to rigid fixation.
Usefulness of Inflammation-Based Prognostic Scores in Patients with Surgically Treated Pancreatic Ductal Adenocarcinoma
Authors: Hong Sarang , Hwang Dae Wook , Lee Jae Hoon , Song Ki Byung , Lee Woohyung , Kwak Bong Jun , Park Yejong , Kim Song-Cheol
Published: December 2021

In this study, we evaluated the prognostic value of inflammation-based prognostic scores in patients undergoing curative surgery for pancreatic ductal adenocarcinoma (PDAC). A retrospective analysis was conducted for 914 patients undergoing curative surgical resection for PDAC between January 2011 and April 2016. Inflammation-based scores of modified Glasgow Prognostic Score (mGPS), neutrophil-lymphocyte ratio, and platelet-lymphocyte ratio were assessed. mGPS was classified as high (1 or 2) or low (0). Median age was 63 (range, 33–88) years; 538 patients (58.9%) were male. A high mGPS was independently associated with poor overall survival (OS) and disease-free survival (DFS) (median OS: 25.4 months vs. 20.4 months, p = 0.001; median DFS: 11.6 months vs. 9.3 months, p = 0.002), poor OS in patients with TNM stage I PDAC (44 months vs. 24.8 months, p = 0.001), and poor OS and DFS in patients with tumors located at the pancreatic head or uncinate process (OS: 25.4 months vs. 20.4 months; p = 0.007, DFS: 11.4 months vs. 8.87 months; p = 0.005). Preoperative mGPS was a significant prognostic factor for PDAC after curative resection; thus, mGPS can be a useful prognostic predictive factor in patients with TNM stage I PDAC, especially for tumors located at the head and uncinate.
PSYChosomatic Medicine in ONcologIc and Cardiac Disease (PSYCHONIC) Study—A Retrospective and Prospective Observational Research Protocol
Authors: Roncella Adriana , Pristipino Christian , Di Carlo Oretta , Ansuini Matteo , Corbosiero Angela , Di Fusco Stefania Angela , Palumbo Gabriella , Gigantesco Antonella , Mirabella Fiorino , De Angelis Rosanna , Pasceri Vincenzo , Cancellara Laura , Colivicchi Furio , Allan Robert , Mirri Maria Alessandra , Speciale Giulio
Published: December 2021

Psychosocial factors play an important role in non-communicable diseases (NCDs). This observational study is primarily aimed at assessing the relationship of psychological characteristics of patients with the outcomes of different NCDs, and to assess short-term psychotherapy (STP) efficacy in the real world. Methods: One hundred and forty patients with recent acute myocardial infarction, Takotsubo syndrome, or non-metastatic breast cancer and a control group of 140 age and sex-matched healthy subjects, will be enrolled. All subjects will be administered psychometric tests, quality of life tests, a specific body perception questionnaire, a dream questionnaire, and a projective test, the Six Drawing test at baseline and follow-up. All subjects with medical conditions will be asked to freely choose between an ontopsychological STP along with standard medical therapy and, whenever indicated, rehabilitation therapy or medical therapy plus rehabilitation alone. The study endpoints will be to evaluate: the relationship of the psychological characteristics of enrolled subjects with the outcomes of different NCDs, predictors of the choice of psychotherapy, and the efficacy of ontopsychological intervention on psychological and medical outcomes. Conclusion: This study will generate data on distinctive psychological characteristics of patients suffering from different CDs and their relationship with medical outcomes, as well as explore the efficacy of ontopsychological STP in these patients in the real world. (Number of registration: NCT03437642).
Macular Hemorrhage Due to Age-Related Macular Degeneration or Retinal Arterial Macroaneurysm: Predictive Factors of Surgical Outcome
Authors: Pierre Mitta , Mainguy Adam , Chatziralli Irini , Pakzad-Vaezi Kaivon , Ruiz-Medrano Jorge , Bodaghi Bahram , Loewenstein Anat , Ambati Jayakrishna , de Smet Marc D. , Tadayoni Ramin , Touhami Sara
Published: December 2021

Objective: The study aimed to determine the outcomes and prognostic factors of vitrectomy, subretinal injection of tissue-plasminogen activator and gas tamponade in macular hemorrhage (MaH) due to age-related macular degeneration (AMD) or retinal arterial macroaneurysm (RAM). Methods: The study design utilized a multicentric retrospective case series design of consecutive patients undergoing surgery between 2014 and 2019. Results: A total of 65 eyes from 65 patients were included in the study. Surgery was performed after a mean period of 7.1 days. Displacement of MaH was achieved in 82% of the eyes. Mean best-corrected visual acuity (BCVA) improved from 20/500 to 20/125 at month(M)1 and M6 (p < 0.05). At M6, BCVA worsening was associated with an older age at diagnosis (p = 0.0002) and higher subretinal OCT elevation of MaH (p = 0.03). The use of treat and extend (TE) (OR = 16.7, p = 0.001) and small MaH fundus size (OR = 0.64 and 0.74 for horizontal and vertical fundus size, p < 0.05) were predictive of a higher likelihood of obtaining a countable BCVA at M1. Baseline BCVA was predictive of postoperative BCVA (p < 0.05). Retinal detachment and MaH recurrence occurred in 3% and 9.3% of cases at M6. Conclusion: MaH surgery stabilizes or improves BCVA in 85% of cases. Younger age at diagnosis, better baseline BCVA figures, smaller subretinal MaH height and use of TE regime were predictive of the best postoperative outcomes.
Brain Tumor Segmentation Based on Deep Learning’s Feature Representation
Authors: Aboussaleh Ilyasse , Riffi Jamal , Mahraz Adnane Mohamed , Tairi Hamid
Published: December 2021

Brain tumor is considered as one of the most serious causes of death in the world. Thus, it is very important to detect it as early as possible. In order to predict and segment the tumor, many approaches have been proposed. However, they suffer from different problems such as the necessity of the intervention of a specialist, the long required run-time and the choice of the appropriate feature extractor. To address these issues, we proposed an approach based on convolution neural network architecture aiming at predicting and segmenting simultaneously a cerebral tumor. The proposal was divided into two phases. Firstly, aiming at avoiding the use of the labeled image that implies a subject intervention of the specialist, we used a simple binary annotation that reflects the existence of the tumor or not. Secondly, the prepared image data were fed into our deep learning model in which the final classification was obtained; if the classification indicated the existence of the tumor, the brain tumor was segmented based on the feature representations generated by the convolutional neural network architectures. The proposed method was trained on the BraTS 2017 dataset with different types of gliomas. The achieved results show the performance of the proposed approach in terms of accuracy, precision, recall and Dice similarity coefficient. Our model showed an accuracy of 91% in tumor classification and a Dice similarity coefficient of 82.35% in tumor segmentation.
Serotonin Transporter Genetic Variation and Antidepressant Response and Tolerability: A Systematic Review and Meta-Analysis
Authors: Stein Kiera , Maruf Abdullah Al , Müller Daniel J. , Bishop Jeffrey R. , Bousman Chad A.
Published: December 2021

Antidepressants are used to treat several psychiatric disorders; however, a large proportion of patients do not respond to their first antidepressant therapy and often experience adverse drug reactions (ADR). A common insertion–deletion polymorphism in the promoter region (5-HTTLPR) of the serotonin transporter (SLC6A4) gene has been frequently investigated for its association with antidepressant outcomes. Here, we performed a systematic review and meta-analysis to assess 5-HTTLPR associations with antidepressants: (1) response in psychiatric disorders other than major depressive disorder (MDD) and (2) tolerability across all psychiatric disorders. Literature searches were performed up to January 2021, yielding 82 studies that met inclusion criteria, and 16 of these studies were included in the meta-analyses. Carriers of the 5-HTTLPR LL or LS genotypes were more likely to respond to antidepressant therapy, compared to the SS carriers in the total and European ancestry-only study populations. Long (L) allele carriers taking selective serotonin reuptake inhibitors (SSRIs) reported fewer ADRs relative to short/short (SS) carriers. European L carriers taking SSRIs had lower ADR rates than S carriers. These results suggest the 5-HTTLPR polymorphism may serve as a marker for antidepressant outcomes in psychiatric disorders and may be particularly relevant to SSRI treatment among individuals of European descent.
Correlation of Volume of Macular Edema with Retinal Tomography Features in Diabetic Retinopathy Eyes
Authors: Gadde Santosh Gopi Krishna , Kshirsagar Arpita , Anegondi Neha , Mochi Thirumalesh B. , Heymans Stephane , Ghosh Arkasubhra , Roy Abhijit Sinha
Published: December 2021

Optical coherence tomography (OCT) enables the detection of macular edema, a significant pathological outcome of diabetic retinopathy (DR). The aim of the study was to correlate edema volume with the severity of diabetic retinopathy and response to treatment with intravitreal injections (compared to baseline). Diabetic retinopathy (DR; n = 181) eyes were imaged with OCT (Heidelberg Engineering, Germany). They were grouped as responders (a decrease in thickness after intravitreal injection of Bevacizumab), non-responders (persistent edema or reduced decrease in thickness), recurrent (recurrence of edema after injection), and treatment naïve (no change in edema at follow-up without any injection). The post-treatment imaging of eyes was included for all groups, except for the treatment naïve group. All eyes underwent a 9 × 6 mm raster scan to measure the edema volume (EV). Central foveal thickness (CFT), central foveal volume (CFV), and total retinal volume (TRV) were obtained from the early treatment diabetic retinopathy study (ETDRS) map. The median EV increased with DR severity, with PDR having the greatest EV (4.01 mm3). This correlated positively with TRV (p < 0.001). Median CFV and CFT were the greatest in severe NPDR. Median EV was the greatest in the recurrent eyes (4.675 mm3) and lowest (1.6 mm3) in the treatment naïve group. Responders and non-responders groups had median values of 3.65 and 3.93 mm3, respectively. This trend was not observed with CFV, CFT, and TRV. A linear regression yielded threshold values of CFV (~0.3 mm3), CFT (~386 µm), and TRV (~9.06 mm3), above which EV may be detected by the current scanner. In this study, EV provided a better distinction between the response groups when compared to retinal tomography parameters. The EV increased with disease severity. Thus, EV can be a more precise parameter to identify subclinical edema and aid in better treatment planning.
Psoas Muscle Volume as an Opportunistic Diagnostic Tool to Assess Sarcopenia in Patients with Hip Fractures: A Retrospective Cohort Study
Authors: So Sang-Pil , Lee Bum-Sik , Kim Ji-Wan
Published: December 2021

Purpose: This study aims to determine whether the psoas volume measured from a pelvic computed tomography (CT) could be a potential opportunistic diagnostic tool to measure muscle mass and sarcopenia in patients with hip fractures. Methods: This was a retrospective cohort study. In total; 57 consecutive patients diagnosed with hip fractures who underwent surgery were enrolled. A cross-sectional area of the psoas muscle was measured at the lumbar (L) 3 and L4 vertebrae from a pelvic CT for the diagnosis of hip fractures. The psoas muscle volume was calculated with a three-dimensional modeling software program. The appendicular skeletal muscle mass (ASM) and preoperative handgrip strength (HS) were measured. The correlations between the psoas muscle volume/area and ASM/HS were assessed. Data on patient demographics; postoperative complication; length of hospital stay; and Koval scores were also recorded and analyzed with respect to the psoas muscle area/volume. Results: The psoas muscle volume and adjusted values were significantly correlated with ASM; which showed a stronger correlation than the psoas muscle area did at the L3 or L4 level. HS was correlated with the psoas volume or adjusted values; but not with the cross-sectional area of the psoas muscle. Among the adjusted values; the psoas muscle volume adjusted for the patient’s height (m2) showed a strongest correlation with ASM and HS. The psoas muscle volume was not significantly correlated with postoperative complications or short-term functional outcomes. Conclusions: The psoas muscle volume measured from a pelvic CT for the diagnosis of hip fractures showed a stronger correlation with ASM and HS than the cross-sectional area did. Therefore; the psoas muscle volume could be a potential diagnostic tool to assess the quantity of the skeletal muscle in patients with hip fractures without an additional examination.
Predictors of In-Hospital Mortality for Road Traffic Accident-Related Severe Traumatic Brain Injury
Authors: Chen Chien-Hung , Hsieh Yu-Wei , Huang Jen-Fu , Hsu Chih-Po , Chung Chia-Ying , Chen Chih-Chi
Published: December 2021

(1) Background: Road traffic accidents (RTAs) are the leading cause of pediatric traumatic brain injury (TBI) and are associated with high mortality. Few studies have focused on RTA-related pediatric TBI. We conducted this study to analyze the clinical characteristics of RTA-related TBI in children and to identify early predictors of in-hospital mortality in children with severe TBI. (2) Methods: In this 15-year observational cohort study, a total of 618 children with RTA-related TBI were enrolled. We collected the patients’ clinical characteristics at the initial presentations in the emergency department (ED), including gender, age, types of road user, the motor components of the Glasgow Coma Scale (mGCS) score, body temperature, blood pressure, blood glucose level, initial prothrombin time, and the intracranial computed tomography (CT) Rotterdam score, as potential mortality predictors. (3) Results: Compared with children exhibiting mild/moderate RTA-related TBI, those with severe RTA-related TBI were older and had a higher mortality rate (p < 0.001). The in-hospital mortality rate for severe RTA-related TBI children was 15.6%. Compared to children who survived, those who died in hospital had a higher incidence of presenting with hypothermia (p = 0.011), a lower mGCS score (p < 0.001), a longer initial prothrombin time (p < 0.013), hyperglycemia (p = 0.017), and a higher Rotterdam CT score (p < 0.001). Multivariate analyses showed that the mGCS score (adjusted odds ratio (OR): 2.00, 95% CI: 1.28–3.14, p = 0.002) and the Rotterdam CT score (adjusted OR: 2.58, 95% CI: 1.31–5.06, p = 0.006) were independent predictors of in-hospital mortality. (4) Conclusions: Children with RTA-related severe TBI had a high mortality rate. Patients who initially presented with hypothermia, a lower mGCS score, a prolonged prothrombin time, hyperglycemia, and a higher Rotterdam CT score in brain CT analyses were associated with in-hospital mortality. The mGCS and the Rotterdam CT scores were predictive of in-hospital mortality independently.
Expression Dynamics of Heme Oxygenase-1 in Tumor Cells and the Host Contributes to the Progression of Tumors
Authors: Fang Jun , Islam Rayhanul , Gao Shanghui , Zhang Cheng , Kunisaki Ryotaro , Sakaguchi Shogo , Honda Naoya , Zhou Jian-Rong , Yokomizo Kazumi
Published: December 2021

Heme oxygenase (HO-1) plays an important role in cellular protection against various stresses. The induction of HO-1 is an effective strategy for reactive oxygen species-related diseases, inflammatory diseases, as well as suppressing carcinogenesis. On the other hand, the high expression of HO-1 is now well known in many tumors. In this study, we investigated the dynamics of HO-1 expression in the host and the tumor. In the mouse sarcoma S180 solid tumor model and the rat hepatoma AH136B ascitic tumor model, HO-1 expression in the tumor, as indicated by the end product of HO-1 activation, i.e., carbon monoxide, gradually increased along with tumor growth. Over-expression of HO-1 expression in mouse colon cancer C26 tumor cells significantly promoted tumor growth as well as lung metastasis, whereas opposite results were found when the HO-1 expression was reduced in the cells. On the other hand, upregulating HO-1 levels in the host by using an HO-1 inducer protected the progression of the xenograft tumor in mice, whereas lowering HO-1 expression in the host with an HO-1 inhibitor showed accelerated tumor growth and lung metastasis after subcutaneous tumor xenograft inoculation. These findings strongly suggest that the balance of HO-1 levels in the host and the tumor cells is essential for the occurrence, progression, and prognosis of cancer. Maintenance of appropriately high HO-1 levels in the host is favorable for cancer prevention, whereas suppression of HO-1 in the tumor cells may thus become a therapeutic strategy for cancer.
Preoperative Assessment of Language Dominance through Combined Resting-State and Task-Based Functional Magnetic Resonance Imaging
Authors: Ott Christian , Rosengarth Katharina , Doenitz Christian , Hoehne Julius , Wendl Christina , Dodoo-Schittko Frank , Lang Elmar , Schmidt Nils Ole , Goldhacker Markus
Published: December 2021

Brain lesions in language-related cortical areas remain a challenge in the clinical routine. In recent years, the resting-state fMRI (RS-fMRI) was shown to be a feasible method for preoperative language assessment. The aim of this study was to examine whether language-related resting-state components, which have been obtained using a data-driven independent-component-based identification algorithm, can be supportive in determining language dominance in the left or right hemisphere. Twenty patients suffering from brain lesions close to supposed language-relevant cortical areas were included. RS-fMRI and task-based (TB-fMRI) were performed for the purpose of preoperative language assessment. TB-fMRI included a verb generation task with an appropriate control condition (a syllable switching task) to decompose language-critical and language-supportive processes. Subsequently, the best fitting ICA component for the resting-state language network (RSLN) referential to general linear models (GLMs) of the TB-fMRI (including models with and without linguistic control conditions) was identified using an algorithm based on the Dice index. Thereby, the RSLNs associated with GLMs using a linguistic control condition led to significantly higher laterality indices than GLM baseline contrasts. LIs derived from GLM contrasts with and without control conditions alone did not differ significantly. In general, the results suggest that determining language dominance in the human brain is feasible both with TB-fMRI and RS-fMRI, and in particular, the combination of both approaches yields a higher specificity in preoperative language assessment. Moreover, we can conclude that the choice of the language mapping paradigm is crucial for the mentioned benefits.
Precision Medicine: Technological Impact into Breast Cancer Diagnosis, Treatment and Decision Making
Authors: Tilli Tatiana Martins
Published: December 2021

Breast cancer is the most common cancer in women, impacting 2.1 million women each year. The number of publications on BC is much higher than for any other type of tumor, as well as the number of clinical trials. One of the consequences of all this information is reflected in the number of approved drugs. This review aims to discuss the impact of technological advances in the diagnosis, treatment and decision making of breast cancer and the prospects for the next 10 years. Currently, the literature has described personalized medicine, but what will the treatment be called for in the coming years?
The Problem of Densification of Large-Panel Housing Estates upon the Example of Cracow
Authors: Szczerek Eliza
Published: December 2021

The paper focuses on the phenomenon of intense, uncontrolled densification of large-panel housing estates in Poland. Despite the fact that such housing estates as a legacy of the Modernist concept of segregation of functions are often burdened with problems, they still have considerable potential, which results predominantly from their urban advantages, such as functional and spatial logic, large amounts of open public space, and abundance of greenery. Unfortunately, this potential is being destroyed by introducing new buildings, ignoring the existing urban layout of the housing estate along with its original compositional assumptions. This type of densification results from—without limitations—the pressure exerted by developers in the free-market economy, and it often leads to problems such as the devastation of urban layouts of these housing estates, breaking the continuity of public spaces, appropriation of green areas, strengthening of monofunctionality, etc. This problem is becoming noticeable in the scientific debate, although it is still difficult to obtain reliable data illustrating the densifications of such housing estates. The goal of this paper is to present the scales and character of such densifications of the large-panel housing estates, which pose a threat of devastation of their urban layouts often considered as urban heritage. The paper proposes a method of a quantitative analysis of the housing estates with reference to the increase in the built-up area and a qualitative analysis of the character of development with reference to its distribution. This method comprises a sequence of subsequent steps with relevant criteria. In the results, it demonstrates the scale of the problem, which in many cases is already big and still growing. The resultant threat of devastation of the urban layout and its consequences are presented upon selected examples of housing estates in Cracow, Poland. This paper is a voice in a discussion devoted to the current status, but most of all to the future of large-panel housing estates, particularly in terms of their protection as valuable achievements of urban planning of the second half of the 20th century, and to stopping unfavorable tendencies of urban destruction.
Ecological Embeddedness in the Maya Built Environment: Inspiration for Contemporary Cities
Authors: Akbar Naji , Abubakar Ismaila Rimi , Shah Ayesha Agha , Al-Madani Wafa
Published: December 2021

Cities nowadays are the most significant source of environmental degradation threatening local and global ecosystems. Interestingly, many ancient settlements present excellent lessons and inspiration for addressing our current urban predicaments, given their environmental stewardship. This research explores how the ecologically embedded settlement patterns, building configurations, urban agriculture and home gardening, and water conservation of the Maya-built environment can offer insights about mitigating contemporary urban sustainability challenges. Mayans’ respect for nature not only guaranteed sustainable habitats but also engendered one of the most remarkable civilizations in a region that did not offer generous support for human accommodation. The Mayan world view promoted the idea of one spirit dwelling in all humans and other-than-human entities in an environment, making everything sacred and kin to everything else. The regional climate was kept under control by protecting the vegetation that also provided other ecological benefits. Land use was mixed, and residences were constructed with native and recyclable materials utilizing natural light and ventilation. The Mayan civilization inspires us to manage and protect plants, not cut them down; conserve water, not waste it; listen to the environmental feedback, not reject it; and, most importantly, it begs us to embrace nature as our own mother, not disown it as something dispensable. These principles have significant implications on urban land-use planning and policies today.
Human Activities Introduced Degenerations of Wetlands (1975–2013) across the Sanjiang Plain North of the Wandashan Mountain, China
Authors: Xie Jing , Sun Yeran , Liu Xiao , Ding Zhi , Lu Ming
Published: December 2021

Human-induced dramatic loss and fragmentation of wetlands need further understanding through historical backtracking analysis at a geographical landscape scale. In this study, we investigated time-series wetlands maps from 1975, 1983, 1989, 2000, 2006, and 2013 derived from Landsat images based on the object-oriented classification of wetlands across the Sanjiang Plain north of the Wandashan Mountains. The spatial and temporal changes in the wetlands that occurred at different time periods and the Euclidean distances between artificial land-use types and natural land-cover areas were evaluated for their impact. Our results showed that wetland was the dominant landscape in 1975; however, arable land became the main land coverage in 2013 owing to severe changes in agricultural development over the past decades. The closer to arable land, the greater the wetland loss during the entire investigated period; agriculture activities were the dominant driving force for the degradation of wetlands based on landscape changes; secondary was the rapid expansion in building land use (i.e., human settlement, transportation, and establishment of irrigation canals). More specifically, the rapid loss of wetland areas over 1975–2000 was mainly owing to extensive agricultural reclamation. The mitigated loss of wetland areas over 2000–2013 was because of the protection and restored implementation of wetlands under governmental policies. The wetlands of the study area suffered severe human disturbance, and our analysis may help explain the loss process of wetlands, but more effective management and administration is still needed to address the issues around the balance between agricultural production and wetland protection for further sustainable development.
Soil Water Retention as Affected by Management Induced Changes of Soil Organic Carbon: Analysis of Long-Term Experiments in Europe
Authors: Panagea Ioanna S. , Berti Antonio , Čermak Pavel , Diels Jan , Elsen Annemie , Kusá Helena , Piccoli Ilaria , Poesen Jean , Stoate Chris , Tits Mia , Toth Zoltan , Wyseure Guido
Published: December 2021

Soil water retention (SWR) is an important soil property related to soil structure, texture, and organic matter (SOM), among other properties. Agricultural management practices affect some of these properties in an interdependent way. In this study, the impact of management-induced changes of soil organic carbon (SOC) on SWR is evaluated in five long-term experiments in Europe (running from 8 up to 54 years when samples were taken). Topsoil samples (0–15 cm) were collected and analysed to evaluate the effects of three different management categories, i.e., soil tillage, the addition of exogenous organic materials, the incorporation of crop residues affecting SOC and water content under a range of matric potentials. Changes in the total SOC up to 10 g C kg−1 soil (1%) observed for the different management practices, do not cause statistically significant differences in the SWR characteristics as expected. The direct impact of the SOC on SWR is consistent but negligible, whereas the indirect impact of SOC in the higher matric potentials, which are mainly affected by soil structure and aggregate composition, prevails. The different water content responses under the various matric potentials to SOC changes for each management group implies that one conservation measure alone has a limited effect on SWR and only a combination of several practices that lead to better soil structure, such as reduced soil disturbances combined with increased SOM inputs can lead to better water holding capacity of the soil.
Chondral and Soft Tissue Injuries Associated to Acute Patellar Dislocation: A Systematic Review
Authors: Migliorini Filippo , Marsilio Emanuela , Cuozzo Francesco , Oliva Francesco , Eschweiler Jörg , Hildebrand Frank , Maffulli Nicola
Published: December 2021

Introduction: Chondral and soft tissue injuries can be associated with first time patellar dislocation, but it is unclear how common they are, and which tissues are affected. A systematic review of the literature was performed to investigate the frequency, location, and extent of chondral and medial patellofemoral ligament (MPFL) injuries in patients following first time patellar dislocation. Methods: This systematic review was conducted according to the PRISMA guidelines. PubMed, Google Scholar, Embase, and Web of Science databases were accessed in November 2021. All the published clinical studies reporting the frequency, location, and extent of soft tissue lesions following first time patellar dislocation were accessed. Studies reporting data on habitual, congenital, or recurrent patellofemoral instability were excluded. Results: Data from 42 articles (2254 patients, mean age 21.6 ± 7.3 years) were retrieved. Ninety-eight percent of patients who experienced first time patellar dislocation demonstrated MPFL rupture at MRI. Forty-eight percent of MPFL ruptures were located at the patellar side, 34% at the femoral insertion site, and 18% in the midportion. Eighty-five percent of patients showed signs of patellar chondral damage at MRI, and trochlear chondral injuries were evidenced in 47% of patients. Intra-articular loose bodies were observed in 11.5% of patients. At arthroscopy, the medial facet and the crest of the patella more commonly exhibited chondral lesions than the lateral facet and femoral trochlea. Conclusions: Most patients suffer chondral damage and MPFL tears following after a first time patellar dislocation.
Failures of the Fontan System in Univentricular Hearts and Mortality Risk in Heart Transplantation: A Systematic Review and Meta-Analysis
Authors: Márquez-González Horacio , Hernández-Vásquez Jose Gustavo , Del Valle-Lom Montserrat , Yáñez-Gutiérrez Lucelli , Klünder-Klünder Miguel , Almeida-Gutiérrez Eduardo , Koretzky Solange Gabriela
Published: December 2021

The Fontan procedure (FP) is the standard surgical treatment for Univentricular heart diseases. Over time, the Fontan system fails, leading to pathologies such as protein-losing enteropathy (PLE), plastic bronchitis (PB), and heart failure (HF). FP should be considered as a transitional step to the final treatment: heart transplantation (HT). This systematic review and meta-analysis aims to establish the risk of death following HT according to the presence of FP complications. There was a total of 691 transplanted patients in the 18 articles, immediate survival 88% (n = 448), survival from 1 to 5 years of 78% (n = 427) and survival from 5.1 to 10 years of 69% (n = 208), >10 years 61% (n = 109). The relative risk (RR) was 1.12 for PLE (95% confidence interval [CI] = 0.89–1.40, p = 0.34), 1.03 for HF (0.7–1.51, p = 0.88), 0.70 for Arrhythmias (0.39–1.24, p = 0.22), 0.46 for PB (0.08–2.72, p = 0.39), and 5.81 for CKD (1.70–19.88, p = 0.005). In patients with two or more failures, the RR was 1.94 (0.99–3.81, p = 0.05). After FP, the risk of death after HT is associated with CKD and with the presence of two or more failures.
Colocalization Analysis of Lipo-Deoxyribozyme Consisting of DNA and Protic Catalysts in a Vesicle-Based Protocellular Membrane Investigated by Confocal Microscopy
Authors: Hirata Yuiko , Matsuo Muneyuki , Kurihara Kensuke , Suzuki Kentaro , Nonaka Shigenori , Sugawara Tadashi
Published: December 2021

The linkage between the self-reproduction of compartments and the replication of DNA in a compartment is a crucial requirement for cellular life. In our giant vesicle (GV)-based model protocell, this linkage is achieved through the action of a supramolecular catalyst composed of membrane-intruded DNA and amphiphilic acid catalysts (C@DNA) in a GV membrane. In this study, we examined colocalization analysis for the formation of the supramolecular catalyst using a confocal laser scanning fluorescence microscope with high sensitivity and resolution. Red fluorescence spots emitted from DNA tagged with Texas Red (Texas Red-DNA) were observed in a GV membrane stained with phospholipid tagged with BODIPY (BODIPY-HPC). To our knowledge, this is the first direct observation of DNA embedded in a GV-based model protocellular membrane containing cationic lipids. Colocalization analysis based on a histogram of frequencies of “normalized mean deviation product” revealed that the frequencies of positively correlated [lipophilic catalyst tagged with BODIPY (BODIPY-C) and Texas Red-DNA] were significantly higher than those of [BODIPY-HPC and Texas Red-DNA]. This result demonstrates the spontaneous formation of C@DNA in the GV membrane, which serves as a lipo-deoxyribozyme for producing membrane lipids from its precursor.