bluuebunny/crossref_metadata_2025 huggingface dataset:
Pharmacological Modulation by Low Molecular Weight Heparin of Purinergic Signaling in Cardiac Cells Prevents Arrhythmia and Lethality Induced by Myocardial Infarction
Authors: Filho Carlos Eduardo Braga , Barbosa Adriano Henrique Pereira , Nicolau Lucas Antonio Duarte , Medeiros Jand Venes Rolim , Pires-Oliveira Marcelo , dos Santos Póvoa Rui Manuel , Govato Tânia Carmen Penãranda , Júnior Hézio Jadir Fernandes , de Carvalho Rafael Guzella , Luna-Filho Bráulio , Sabia Tallo Fernando , de Araújo Erisvaldo Amarante , Padrão Tavares José Gustavo , Arida Ricardo Mario , Caricati-Neto Afonso , Menezes-Rodrigues Francisco Sandro
Published: February 2023

Background: Although several studies suggest that heparins prevent arrhythmias caused by acute myocardial infarction (AMI), the molecular mechanisms involved remain unclear. To investigate the involvement of pharmacological modulation of adenosine (ADO) signaling in cardiac cells by a low-molecular weight heparin (enoxaparin; ENOX) used in AMI therapy, the effects of ENOX on the incidences of ventricular arrhythmias (VA), atrioventricular block (AVB), and lethality (LET) induced by cardiac ischemia and reperfusion (CIR) were evaluated, with or without ADO signaling blockers. Methods: To induce CIR, adult male Wistar rats were anesthetized and subjected to CIR. Electrocardiogram (ECG) analysis was used to evaluate CIR-induced VA, AVB, and LET incidence, after treatment with ENOX. ENOX effects were evaluated in the absence or presence of an ADO A1-receptor antagonist (DPCPX) and/or an inhibitor of ABC transporter-mediated cAMP efflux (probenecid, PROB). Results: VA incidence was similar between ENOX-treated (66%) and control rats (83%), but AVB (from 83% to 33%) and LET (from 75% to 25%) incidences were significantly lower in rats treated with ENOX. These cardioprotective effects were blocked by either PROB or DPCPX. Conclusion: These results indicate that ENOX was effective in preventing severe and lethal arrhythmias induced by CIR due to pharmacological modulation of ADO signaling in cardiac cells, suggesting that this cardioprotective strategy could be promising in AMI therapy.
Benralizumab Efficacy in Late Non-Responders to Mepolizumab and Variables Associated with Occurrence of Switching: A Real-Word Perspective
Authors: Caminati Marco , Marcon Alessandro , Guarnieri Gabriella , Miotti Jessica , Bagnasco Diego , Carpagnano Giovanna Elisiana , Pelaia Girolamo , Vaia Rachele , Maule Matteo , Vianello Andrea , Senna Gianenrico
Published: February 2023

Overlapping eligibility to different biologics for severe asthma is still challenging, especially when addressing the same target. We aimed to characterize severe eosinophilic asthma patients according to their maintained or reduced response to mepolizumab over time and to explore baseline variables significantly associated with the occurrence of switching to benralizumab. We performed a multicentre retrospective observational study evaluating OCS reduction, exacerbation rate, lung function, exhaled nitric oxide levels (FeNO), Asthma control test (ACT), and blood eosinophil concentrations at baseline and before and after switching occurrence among 43 female and 25 male patients with severe asthma aged 23 to 84 years. Younger age, higher OCS daily dose and lower blood eosinophils at baseline were associated with a significantly higher risk (odds) for switching occurrence. All the patients showed an optimal response to mepolizumab, up to six months. The need for switching, according to the above-mentioned criterion, occurred for 30 out of 68 patients after a median time of 21 months (Q1–Q3: 12–24) from mepolizumab initiation. At the follow-up time-point after the switch (median time: 31 months, Q–Q3: 22–35), all the outcomes substantially improved and no cases of poor clinical response to benralizumab were detected. Although the small sample size and the retrospective design represent major limitations, to our knowledge, our study provides the first real-word focus on clinical variables potentially predicting a better response to anti IL-5r in patients fully eligible for both mepolizumab and benralizumab and suggests that in late non responder patients to mepolizumab, more robustly targeting the IL-5 axis may be effective.
Radiologic Predictors for Clinical Improvement in PAO—A Perspective Study
Authors: Kołodziejczyk Kamil , Czwojdziński Adam , Czubak-Wrzosek Maria , Czubak Jarosław
Published: February 2023

The aim of this study was to evaluate the results of surgical treatment of developmental dysplasia of the hip (DDH) with periacetabular osteotomy (PAO) and determine the values of radiological parameters that would allow us to obtain an optimal clinical result. Radiological evaluation included determining the center-edge angle (CEA), medialization, distalization, femoral head coverage (FHC), and ilioischial angle as measured on a standardized AP radiograph of the hip joints. Clinical evaluation was based on the HHS, WOMAC, Merle d’Aubigne–Postel scales and Hip Lag Sign. The results of PAO presented decreased medialization (mean 3.4 mm), distalization (mean 3.5 mm), and ilioischial angle (mean 2.7°); improvement in femoral head bone cover; an increased CEA (mean 16.3°) and FHC (mean 15.2%); clinically increased HHS (mean 22 points) and M. Postel–d’Aubigne (mean 3.5 points) scores; and a decrease in WOMAC (mean 24%). HLS improved in 67% of patients after surgery. Qualification of patients with DDH for PAO should be based on the following values of three parameters: CEA < 26°, FHC < 75%, and ilioischial angle >85.9°. To achieve better clinical results, it is necessary to increase the average CEA value by 11° and the average FHC by 11% and reduce the average ilioischial angle by 3°.
A Retrospective Analysis of the American Thrombosis and Hemostasis Network Dataset Describing Outcomes of Dental Extractions in Persons with Hemophilia
Authors: Messenger Heather , Kulkarni Roshni , Recht Michael , He Chunla
Published: February 2023

Introduction: dental extractions (DEs) in persons with hemophilia A or B (PWH-A or PWH-B) are often associated with bleeding and needing hemostatic therapies (HTs). Aim: to analyze the American Thrombosis and Hemostasis Network (ATHN) dataset (ATHNdataset) to assess trends, uses and impacts of HT on bleeding outcomes following DEs. Methods: PWH seen at ATHN affiliates who underwent DEs and opted to share their data with the ATHNdataset between 2013–2019 were identified. The type of DEs, use of HT and bleeding outcomes were assessed. Results: Among 19,048 PWH ≥2 years of age, 1157 underwent 1301 episodes of DE. Those on prophylaxis experienced a nonsignificant reduction in dental bleeding episodes. Standard half-life factor concentrates were used more often than extended half-life products. PWHA were more likely to undergo DE in the first 30 years of life. Those with severe hemophilia were less likely to undergo DE than those with a mild disease (OR: 0.83; 95% CI: 0.72–0.95). PWH with inhibitors had statistically significantly increased odds of dental bleeding (OR: 2.09, 95% CI; 1.21–3.63). Conclusion: our study showed that persons with mild hemophilia and younger age were more likely to undergo DE; the presence of inhibitors increased the likelihood of bleeding, while those with prophylaxis and receiving HT experienced a non-statistically significant reduction in bleeding.
Pancreatic Neuroendocrine Neoplasms Larger than 4 cm: A Retrospective Observational Study of Surgery, Histology, and Outcome
Authors: Milanetto Anna Caterina , Gais Zürcher Anna-Lea , David Alina , Fassan Matteo , Pasquali Claudio
Published: February 2023

Background: Pancreatic neuroendocrine neoplasms (pNENs) are often detected as large primary lesions, even with distant metastases, and their prognosis may be difficult to predict. Methods: In this retrospective study, we retrieved data of patients treated for a large pNEN in our Surgical Unit (1979–2017) to evaluate the possible prognostic role of clinic-pathological features and surgery. Cox-proportional hazard regression models were used to find possible associations among some variables (clinical features, surgery, and histology) and survival at univariate and multivariate analyses. Results: Among 333 pNENs, we identified 64 patients (19%) with a lesion > 4 cm. Patients’ median age was 61 years, median tumor size was 6.0 cm, and 35 (55%) patients had distant metastases at diagnosis. There were 50 (78%) nonfunctioning pNENs, and 31 tumors localized in the body/tail region of the pancreas. Overall, 36 patients underwent a standard pancreatic resection (with 13 associated liver resection/ablation). Regarding histology, 67% of pNENs were N1, and 34% were grade 2. After a median follow-up of 48 months (up to 33 years), 42 patients died of disease. Median survival after surgery was 79 months, and six patients experienced recurrence (median DFS 94 months). At multivariate analysis, distant metastases were associated with a worse outcome, while having undergone radical tumor resection was a protective factor. Conclusions: In our experience, about 20% of pNENs have a size > 4 cm, 78% are nonfunctioning, and 55% show distant metastases at diagnosis. Nevertheless, a long-term survival of more than five years may be achieved after surgery.
Expectant, Medical, and Surgical Management of Ovarian Endometriomas
Authors: Muzii Ludovico , Galati Giulia , Mattei Giulia , Chinè Alessandra , Perniola Giorgia , Di Donato Violante , Di Tucci Chiara , Palaia Innocenza
Published: February 2023

Management options for ovarian endometriomas include expectant management, medical treatment, surgical treatment, in vitro fertilization (IVF), or a combination of the above. The choice of management depends on many clinical parameters that should be taken into consideration, the first of which is the main presenting symptom. Most patients are today referred to medical therapy as a first option in the case of associated pain, and to IVF in the case of associated infertility. When both symptoms are present, usually surgery is the preferred approach. Recently, however, surgical excision of an ovarian endometrioma has been associated with a postoperative reduction in the ovarian reserve, and recent guidelines suggest that the clinician should caution the patient as to the possible damage to the ovarian reserve in the case of surgery. However, evidence has been published as to a possible detrimental effect of the ovarian endometrioma on the ovarian reserve even if expectant management is followed. In this review, the current evidence on the conservative management of ovarian endometriomas, with particular focus on the issue of the ovarian reserve, is evaluated, and the different surgical techniques for the treatment of ovarian endometriomas are discussed.
Long-Term Stability of Hydrothermally Aged and/or Dynamically Loaded One-Piece Diameter Reduced Zirconia Oral Implants
Authors: Kohal Ralf-Joachim , Trinkner Anja , Burkhardt Felix , Patzelt Sebastian Berthold Maximilian , Vach Kirstin , Kušter Monika , Abram Anže , Kocjan Andraž , Nold Julian
Published: February 2023

The aim of this in vitro study was to evaluate the long-term stability of one-piece diameter reduced zirconia oral implants under the influence of loading and artificial aging in a chewing simulator as well as the fracture load in a static loading test. Thirty-two one-piece zirconia implants with a diameter of 3.6 mm were embedded according to the ISO 14801:2016 standard. The implants were divided into four groups of eight implants. The implants of group DLHT were dynamically loaded (DL) in a chewing simulator for 107 cycles with a load of 98 N and simultaneously hydrothermally aged (HT) using a hot water bath at 85 °C. Group DL was only subjected to dynamic loading and group HT was exclusively subjected to hydrothermal aging. Group 0 acted as a control group: no dynamical loading, no hydrothermal ageing. After exposure to the chewing simulator, the implants were statically loaded to fracture in a universal testing machine. To evaluate group differences in the fracture load and bending moments, a one-way ANOVA with Bonferroni correction for multiple testing was performed. The level of significance was set to p < 0.05. In the static loading test, group DLHT showed a mean fracture load of 511 N, group DL of 569 N, group HT of 588 N and control group 0 of 516 N. The average bending moments had the following values: DLHT: 283.5 Ncm; DL: 313.7 Ncm; HT: 324.4 Ncm; 0: 284.5 Ncm. No significant differences could be found between the groups. Hydrothermal aging and/or dynamic loading had no significant effect on the stability of the one-piece diameter reduced zirconia implants (p > 0.05). Within the limits of this investigation, it can be concluded that dynamic loading, hydrothermal aging and the combination of loading and aging did not negatively influence the fracture load of the implant system. The artificial chewing results and the fracture load values indicate that the investigated implant system seems to be able to resist physiological chewing forces also over a long service period.
Progress for Journal of Functional Morphology and Kinesiology in 2022
Authors: Musumeci Giuseppe
Published: February 2023

The Journal of Functional Morphology and Kinesiology (JFMK, ISSN: 2411-5142), which was first released in March 2016, saw significant developments in 2022 [...]
Modelling Manoeuvrability in the Context of Ship Collision Analysis Using Non-Linear FEM
Authors: Sviličić Šimun , Rudan Smiljko
Published: February 2023

Ship collisions are rare events that may have a significant impact on the safety of people, ships, and other marine structures, as well as on the environment. Because of this, they are extensively studied but events that just precede collision are often overlooked. To rationally assess collision risks and consequences, a ship’s trajectory, and consequently the velocity and collision angle, should be known. One way to achieve this is through accurate modelling of ship manoeuvrability in collision analysis using non-linear FEM (NFEM). The Abkowitz manoeuvring model is implemented in the LS-Dyna software code and is therefore coupled with FEM calculations. Hydrodynamic forces are calculated in each time step of the LS-Dyna calculation and added to the FE model continuously through calculation. The accuracy of the calculations depends on the choice of and values of hydrodynamic derivatives from the Abkowitz model. Abkowitz’s model derives hydrodynamic forces in the Taylor expansion series to provide hydrodynamic derivatives. The application of the procedure is sensitive on higher-order Taylor series members. This article reviews different sets of hydrodynamic derivatives available for the KVLCC2 ship. Each of them is incorporated into the LS-Dyna NFEM solver by a user-made Fortran subroutine, with standard Zigzag and turning manoeuvres simulated and results compared with the experimental tests. As a result, the optimal selection of hydrodynamic derivatives is determined, laying a foundation for assessing the risk of ship collision due to different ship manoeuvres prior to the collision itself.
A Turbulence Survey in the Gulf of Naples, Mediterranean Sea, during the Seasonal Destratification
Authors: Kokoszka Florian , Conversano Fabio , Iudicone Daniele , Ferron Bruno , Bouruet-Aubertot Pascale
Published: February 2023

The seasonality of the vertical mixing at coastal sites is not well characterized yet. Here, a time series of the dissipation rate of turbulent kinetic energy (ε) was obtained from weekly morning microstructure observations covering the destratification period (July 2015, February 2016) at a coastal site in the western Mediterranean Sea, influenced by freshwater runoffs. Estimated with bulk parameters from the public re-analyzed dataset ERA5, the Ekman layer, and the convective penetration depth scale with the mixed layer depth (MLD) with a good agreement. Below the MLD, peaks of ε are observed in the baroclinic layers that progressively overlap with the bottom layer, where repeated near-bottom turbidity peaks provide evidence of sediment resuspension, suggesting energetic processes within the bottom boundary layer. In the subsurface, moderate values (10−9 to 10−8 W kg−1) are observed, following a Burr type XII distribution. Significant correlation with ε at MLD is obtained with a model combining the effects of wind, wind–wave, and convection, highlighting a calm sea bias in our data, plus a sunrise bias when morning buoyancy fluxes are stabilizing. Another correlation, obtained from a pure-wind estimation 18 h before, suggests the role of wind in generating internal waves in the stratified layers, thus, impacting mixing intensity.
Depositional Environment and Organic Matter Enrichment in the Lower Paleozoic Shale from the Northeastern Margin of the Yangtze Platform, South China
Authors: Liu Peng , Liu Changjie , Guo Ruiliang
Published: February 2023

In this study, twenty-six core shale samples were collected from the marine Lower Paleozoic shale in a well in the northeastern margin of the Yangtze Platform. Analyses of TOC content, mineral composition, major elements, along with trace and rare earth elements were conducted on the samples. The results were used to investigate the depositional conditions and their effects on organic matter accumulation and preservation. Generally, the sedimentation period of Niutitang Formation shale was in a cold and arid climate with anoxic marine environments, while the shale from Wufeng-Longmaxi Formation was formed in a warm and humid climate with oxic marine environments. In addition, the Wufeng-Longmaxi and Niutitang formations are characterized by low paleo-productivity. The organic matter enrichment for shale in this study could be simultaneously controlled by paleo-redox state and paleo-productivity. Organic matter enrichment of the Niutitang shale is mainly driven by preservation rather than productivity, while the dominant driving factor is the opposite for the Wufeng-Longmaxi shale. Additionally, palaeoclimate and terrestrial influx intensity were found to significantly impact the organic matter enrichment in the Wufeng-Longmaxi shale. The findings have implications for the understanding of the sedimentary processes, organic matter enrichment and preservation and shale gas potential of the study area.
A Bayesian Optimization Algorithm for the Optimization of Mooring System Design Using Time-Domain Analysis
Authors: Lim Jisu , Choi Minjoo , Lee Seungjae
Published: February 2023

Dynamic analysis can consider the complex behavior of mooring systems. However, the relatively long analysis time of the dynamic analysis makes it difficult to use in the design of mooring systems. To tackle this, we present a Bayesian optimization algorithm (BOA) which is well known as fast convergence using a small number of data points. The BOA evaluates design candidates using a probability-based objective function which is updated during the optimization process as more data points are achieved. In a case study, we applied the BOA to improve an initial mooring system that had been designed by human experts. The BOA was also compared with a genetic algorithm (GA) that used a pre-trained surrogate model for fast evaluation. The optimal designs that were determined by both the BOA and GA have a 50% lower maximum tension than the initial design. However, the computation time of the GA needed 20 times more than that of the BOA because of the training time of the surrogate model.
Case Series of End-Stage Liver Disease Patients with Severe Coccidioidomycosis
Authors: Ho Daniel , Kelley Kristen D. , Dandekar Satya , Cohen Stuart H. , Thompson George R.
Published: February 2023

Liver disease causes relative compromise of the host immune system through multiple overlapping mechanisms and is an established risk factor for invasive fungal diseases including candidiasis and cryptococcosis. This immunologic derangement also leads to rapid progression of disease with resultant increases in morbidity and mortality. We describe severe coccidioidomycosis cases in the setting of liver dysfunction. Collaborative multi-center epidemiologic studies should be performed to determine the incidence of severe coccidioidomycosis in patients with concurrent liver disease.
Metoprolol and CYP2D6: A Retrospective Cohort Study Evaluating Genotype-Based Outcomes
Authors: Collett Savannah , Massmann Amanda , Petry Natasha J. , Van Heukelom Joel , Schultz April , Hellwig Tadd , Baye Jordan F.
Published: February 2023

Metoprolol is a medication commonly utilized in select patients to achieve a reduction in heart rate, systolic blood pressure, or other indications. A majority of metoprolol metabolism occurs via CYP2D6. Decreased expression of the CYP2D6 enzyme increases the concentration of metoprolol. Current pharmacogenomics guidelines by the Dutch Pharmacogenomics Working Group recommend slower titrations and dose decreases to minimize adverse effects from poor metabolizers or normal metabolizers taking concomitant medications that are strong inhibitors of CYP2D6 (phenoconverters). This study aimed to evaluate adverse effects such as bradycardia, hypotension, and syncope in patients who are expected to have absent CYP2D6 enzyme activity due to drug–drug or drug–gene interactions. The secondary aims of this study were to evaluate heart rate measurements for the included participants. Retrospective data were collected for individuals with CYP2D6 genotyping results obtained for clinical purposes. Three categories (CYP2D6 normal metabolizers, poor metabolizers, and phenoconverters) were assigned. A total of 325 participants were included. There was no statistically significant difference found in the primary composite outcome between the three metabolizer groups (p = 0.054). However, a statistically significant difference was identified in the incidences of bradycardia between the poor metabolizers and the normal metabolizers or phenoconverters (p < 0.0001). The average heart rates were 2.8 beats per minute (bpm) and 2.6 bpm lower for the poor metabolizer and phenoconverter groups, respectively, compared to the normal metabolizers (p < 0.0001 for both comparisons). This study further supports the role of genetic testing in precision medicine to help individualize patient care as CYP2D6 poor metabolizers taking metoprolol were found to have an increase in bradycardia. Additional research is needed to clarify the dose relationship in this drug–gene interaction.
Improving Outcomes in the Advanced Gastrointestinal Stromal Tumors: The Role of the Multidisciplinary Team Discussion Intervention
Authors: Ran Pan , Zhou Hui , Li Jinjin , Tan Tao , Yang Hao , Li Juan , Zhang Jun
Published: February 2023

Objectives: There is disagreement over the prognostic value of multidisciplinary team (MDT) discussion for advanced gastrointestinal stromal tumors (GISTs). This study examined how an MDT affected patients with advanced GISTs in terms of their overall survival (OS) and whether it may enhance their performance status (PS). Methods: A retrospective data analysis was conducted on patients with advanced GISTs between 2000 and 2022. Depending on whether they had received the MDT discussion intervention, the patients were split into two groups. The OS between the two groups was compared using the Kaplan–Meier method. A multivariate Cox regression analysis was used to analyze the prognostic variables for advanced GIST. Fisher’s test was used to investigate the relationship between an MDT and PS. Results: There were 122 patients with an MDT and 117 patients without an MDT in this study. In comparison to the non-MDT group, the MDT group showed a higher survival rate (5-year OS, 42.62% vs. 28.21%, p < 0.05). MDT was an independent prognostic factor for OS in univariate and multivariate Cox regression analyses (p < 0.05). Fisher’s test revealed that there were variations in PS between the two groups (p < 0.05). Conclusions: The effectiveness of an MDT in the treatment of advanced GIST was examined for the first time in this study. MDT discussion intervention is an effective measure for improving the outcomes of patients with advanced GISTs.
Orphan Drugs in Neurology—A Narrative Review
Authors: Sirbu Carmen Adella , Ivan Raluca , Authier Francois Jerome , Ionita-Radu Florentina , Jianu Dragos Catalin , Vasiliu Octavian , Constantin Ciprian , Tuță Sorin
Published: February 2023

Background and aims: Orphan diseases, or rare diseases, are defined in Europe as diseases that affect less than 5 out of every 10,000 citizens. Given the small number of cases and the lack of profit potential, pharmaceutical companies have not invested much in the development of possible treatments. However, over the last few years, new therapies for rare diseases have emerged, giving physicians a chance to offer personalized treatment. With this paper, we aim to present some of the orphan neurological diseases for which new drugs have been developed lately. Methods: We have conducted a literature review of the papers concerning rare diseases and their treatment, and we have analyzed the existing studies for each orphan drug. For this purpose, we have used the Google Scholar search engine and the Orphanet. We have selected the studies published in the last 15 years. Results. Since the formation of the National Organization for Rare Diseases, the Orphan Drug Act, and the National Institutes of Health Office of Rare Diseases, pharmacological companies have made a lot of progress concerning the development of new drugs. Therefore, diseases that until recently were without therapeutic solutions benefit today from personalized treatment. We have detailed in our study over 15 neurological and systemic diseases with neurological implications, for which the last 10–15 years have brought important innovations regarding their treatment. Conclusions: Many steps have been taken towards the treatment of these patients, and the humanity and professionalism of the pharmaceutical companies, along with the constant support of the patient’s associations for rare diseases, have led to the discovery of new treatments and useful future findings.
Type 1 Diabetes Mellitus and Autoimmune Diseases: A Critical Review of the Association and the Application of Personalized Medicine
Authors: Popoviciu Mihaela Simona , Kaka Nirja , Sethi Yashendra , Patel Neil , Chopra Hitesh , Cavalu Simona
Published: February 2023

Type 1 Diabetes Mellitus (T1DM) is a common hyperglycemic disease characterized by the autoimmune destruction of insulin-producing beta cells of the pancreas. Various attempts have been made to understand the complex interplay of genetic and environmental factors which lead to the development of the autoimmune response in an individual. T1DM is frequently associated with other autoimmune illnesses, the most common being autoimmune thyroid disorders affecting more than 90% of people with T1D and autoimmune disorders. Antithyroid antibodies are present in around 20% of children with T1D at the start of the illness and are more frequent in girls. Patients with T1DM often have various other co-existing multi-system autoimmune disorders including but not limited to thyroid diseases, parathyroid diseases, celiac disease, vitiligo, gastritis, skin diseases, and rheumatic diseases. It is a consistent observation in clinics that T1DM patients have other autoimmune disorders which in turn affect their prognosis. Concomitant autoimmune illness might affect diabetes care and manifest itself clinically in a variety of ways. A thorough understanding of the complex pathogenesis of this modern-day epidemic and its association with other autoimmune disorders has been attempted in this review in order to delineate the measures to prevent the development of these conditions and limit the morbidity of the afflicted individuals as well. The measures including antibody screening in susceptible individuals, early identification and management of other autoimmune disorders, and adoption of personalized medicine can significantly enhance the quality of life of these patients. Personalized medicine has recently gained favor in the scientific, medical, and public domains, and is frequently heralded as the future paradigm of healthcare delivery. With the evolution of the ‘omics’, the individualization of therapy is not only closer to reality but also the need of the hour.
Exploring the Barriers to and Potential for Sustainable Transitions in Urban–Rural Systems through Participatory Causal Loop Diagramming of the Food–Energy–Water Nexus
Authors: Zellner Moira , Massey Dean , Rozhkov Anton , Murphy John T.
Published: February 2023

Understanding Food–Energy–Water (FEW) systems is crucial in order to plan for a resilient and sustainable future of interdependent urban–rural regions. While research tends to focus on urban transitions, the topic remains understudied relative to urban-rural regions. The often conflicting pressures in these regions (e.g., urbanization and growing crop production) may pose distinctive challenges where large urbanizations are adjacent to sparsely populated rural areas. These systems may further shift in response to local and global economic and demographic trends, as well as climate change. Identifying these complex system trajectories is critical for sustainability and resilience planning and policy, which requires the pooling of both urban and rural expertise across multiple disciplines and domains. We convened panels of subject matter experts within a participatory causal loop diagramming (CLD) approach. Our workshops were facilitated by our research team to collaboratively construct the web of connections among the elements in the urban–rural FEW system. The CLDs and the discussions around them allowed the group to identify potentially significant lever points in the system (e.g., support for minority farmers to enhance food security while reducing waste), barriers to sustainability (e.g., laws restricting the sale of water treatment biosolids), and potential synergies across sectors (e.g., food and green energy advocacy jointly pressing for policy changes). Despite the greater understanding of urban–rural interdependence afforded by participatory CLD, urban factors were consistently prioritized in the representation of the integrated system, highlighting the need for new paradigms to support sustainable urban–rural transitions.
Exploring the Application of a Debris Flow Likelihood Regression Model in Mediterranean Post-Fire Environments, Using Field Observations-Based Validation
Authors: Diakakis Michalis , Mavroulis Spyridon , Vassilakis Emmanuel , Chalvatzi Vassiliki
Published: February 2023

Post-fire geomorphic processes and associated risks are an important threat in Mediterranean environments. Currently, post-fire mass movement prediction has limited applications across the Mediterranean despite the abundance of both forest fires and landslide/debris flow disasters. This work applies a debris flow generation likelihood model to evaluate the probability of mass movement phenomena in different catchments of a burnt area, after a catastrophic fire near Schinos (Attica, Greece) in 2021. Then, it uses field observations from the area, recording mass movement phenomena after high-intensity rainfall events, to validate the results. The findings show that the model is successful in determining the probability of debris flow generation in the 21 basins of the study area, ranging from 0.05 to 0.893. The probability values show a statistically significant correlation (sig. = 0.001) with the actual debris flow occurrences in the area, and satisfactory results in terms of the model’s predictive ability, functioning well within the particular geo-environmental characteristics of the Mediterranean environment. The results establish the reliability of the approach as a tool to assess mass movement risks in a region with an abundance of post-fire related hazards and disastrous events.
How Does the Farmland Management Scale Affect Grain Losses at Harvest? Analysis of Mediating Effect of Agricultural Input Based on Harvesting
Authors: Hou Bohan , Yu Wenwen , Chen Zhengtong , Yu Jin
Published: February 2023

Previous studies have demonstrated that grain loss in the harvest process accounts for a large loss in all aspects of the grain supply chain. This research extensively discusses the impact of farmland management scale on grain loss in the harvest process based on survey data on farmers’ productivity in the Shandong and Hebei provinces of China. The findings revealed that the scale of farmland operation directly influenced the grain loss during harvest and that this effect is greatly reduced as the farmland operation scale increases. This study also constructed an intermediary model, investigated the influence mechanisms, and added agricultural capital as a variable in the harvest link. It was discovered that the scale of agricultural land management has an indirect effect on grain loss in the harvest link via the input of agricultural capital in the harvest link. The increase in agricultural capital investment in the harvest link considerably reduced this effect. In order to decrease grain losses during the harvest process, this paper suggests expanding the size of agricultural enterprises, developing new agricultural corporate organizations, and further playing the role of the rural land market.
Characteristics of NDVI Changes in the Altay Region from 1981 to 2018 and Their Relationship to Climatic Factors
Authors: Yan Yang , Cheng Junhui , Li Yongkang , Fan Jie , Wu Hongqi
Published: February 2023

Vegetation growth and its response to climatic factors have become one of the most pressing issues in ecological research. However, no consensus has yet been reached on how to resolve this problem in arid areas with a high-elevation gradient and complex underlying surface. Here, NOAA CDR AVHRR NDVI V5 for 1981–2018 and China’s regional surface meteorological faction-driven datasets were used. General linear regression, the Mann-Kendall test and sliding t-test, Pearson correlations, and the Akaike information criterion (AIC), on a grid-scale, were applied to analyze the annual normalized difference vegetation index (NDVI) and its relationship with temperature and precipitation in the Altay region. Results revealed that the temporal trend of NDVI for most grid cells was non-significant. However, mountains, coniferous forests, grasslands, and meadows in the high-elevation zone displayed a slow increasing trend in NDVI. Further, NDVI was positively correlated with the mean annual temperature and total annual precipitation, the latter playing a more significant role. Yet, for desert and shrub vegetation and coniferous forest, their NDVI had insignificant negative correlations with the mean annual temperature. Hence, both the trends and drivers of NDVI of high elevation are highly complex. This study’s findings provide a reference for research on vegetation responses to climate change in arid areas having a high-elevation gradients and complex underlying surfaces.
Characteristics and Roles of School Gardens in Urban Areas of Japan: Perspective of School Managers
Authors: Wang Rushi , Yanai Shigeto
Published: February 2023

Children spend most of their time at school; thus, agricultural experiences (AEs) in school gardens through school organizations are important for children to remain connected to agriculture and nature. Although various studies confirm the tremendous benefits of school gardens, the lack of studies on the characteristics of school gardens and the factors that influence the effectiveness of their AEs is telling. In this study, a questionnaire was developed and sent to the school garden managers of the public elementary schools in an urban area in Japan to analyze the characteristics of school garden and their influencing factors through descriptive analysis and inferential statistics. The results identified the location effects on the type of school gardens: school gardens inside the school are better able to ensure the safety of children but have less connection with the community; school farms outside the school are better able to ensure a place for children to have AEs; schools with both a school garden and farm have a stronger connection to the community than those with only school gardens, however, safety is decreased. In addition, the lack of budget, teachers, supportive policies, and motivation among school garden managers in operating school gardens was noted. Therefore, ensuring government support, coordinating the time of school garden managers, and strengthening the connection and cooperation between elementary schools and local communities are primary issues for consideration in the future.
Valuation of Visitor Perception of Urban Forest Ecosystem Services in Kuala Lumpur
Authors: Jamean Emylia Shakira , Abas Azlan
Published: February 2023

Urban forests play a vital role in maintaining the city ecological balance and providing ecosystem services to citizens. Ecosystem services lead to better quality of life, better environmental quality, and more sustainable urban growth. However, many emerging nations have often progressed at the price of lowering and sacrificing forest coverage, which has a negative impact on the benefits that the public receives from natural green spaces. As a result, the goals of this research were to ascertain visitor impressions of urban forests in Kuala Lumpur, to assess the value assigned by visitors to urban forests in Kuala Lumpur, and to investigate the elements that impact the willingness to pay. A questionnaire-based field study was conducted on a total of 254 respondents among Taman Tugu Urban Forest visitors, Kuala Lumpur. The results show that visitor perceptions of regulating services, cultural services, and supporting services were positive, with high-level score values of 4.74, ±0.40, 4.69, ±0.37, and 4.70, ±0.50. Furthermore, provisioning services were perceived to be of moderately high level (3.49, ±1.12), and visitor perceptions of urban forest amenities were positive, with high-level scores (4.39, ±0.53). Overall, this indicates that visitors had a very good perception of Taman Tugu Urban Forest ecosystem services. However, when we looked at the factors that contributed to the willingness to pay for the conservation of urban forests and entry, only the perception of the amenities provided at Taman Tugu had a significant relationship with the willingness to pay. A total of 79.1% of visitors expressed their willingness to pay, for forest conservation, an average payment value of MYR 51.32 per year, while 65% of visitors were willing to pay, as entry fees at urban forests, an average payment value of MYR 3.07 per person. It can be concluded that visitors had a positive perception of urban forests in Kuala Lumpur and were willing to contribute for conservation and entry fee purposes. We hope that the findings of this research contribute to a better understanding of urban forest ecosystem services in Kuala Lumpur and visitor perception. In addition, this study could also be useful to policy makers to formulate a specific policy focus on urban forests by comprehensively and holistically including the monetary value of the ecosystem services provided, considering public opinion and needs, and performing financial allocation for conserving and managing urban forests. This is to ensure that the urban sustainable development goals and smart city aims can be achieved.
Learning Curve of Transperineal MRI/US Fusion Prostate Biopsy: 4-Year Experience
Authors: Hsieh Po-Fan , Li Po-I , Lin Wei-Ching , Chang Han , Chang Chao-Hsiang , Wu Hsi-Chin , Chang Yi-Huei , Wang Yu-De , Huang Wen-Chin , Huang Chi-Ping
Published: February 2023

This study aimed to evaluate the learning curve of transperineal magnetic resonance imaging (MRI)/ultrasound (US) fusion biopsy in a team composed of a single surgeon, a single radiologist, and a single pathologist. We prospectively enrolled 206 patients undergoing MRI/US fusion prostate biopsy and divided them into four cohorts by the year of biopsy. We analyzed temporal changes in clinically significant prostate cancer (csPC) detection rate, percentage of positive cores on biopsy, and Gleason upgrading rate after radical prostatectomy. The csPC detection rate by MRI/US fusion targeted biopsy (TB) increased significantly (from 35.3% to 60.0%, p = 0.01). With increased experience, the csPC detection rates for small (≤1 cm) and anterior target lesions gradually increased (from 41.2% to 51.6%, p = 0.5; from 54.5% to 88.2%, p = 0.8, respectively). The percentage of positive cores on TB increased significantly (from 18.4% to 44.2%, p = 0.001). The Gleason upgrading rate gradually decreased (from 22.2% to 11.1%, p = 0.4). In conclusion, with accumulated experience and teamwork, the csPC detection rate by TB significantly increased. Multidisciplinary team meetings and a free-hand biopsy technique were the key factors for overcoming the learning curve.
Treatment of HIV-Associated Lupus-like Membranous Nephropathy with Tacrolimus: A Case Report and Review of the Literature
Authors: Kofotolios Ioannis , Tsiakas Stathis , Skalioti Chrysanthi , Kapsia Eleni , Liapis George , Marinaki Smaragdi
Published: February 2023

Renal complications of HIV infection are common and histologically diverse. Besides HIV-associated nephropathy, which is the most well-defined glomerular disorder, immune-complex-mediated glomerulonephritis (HIVICK) is also encountered in the setting of HIV infection and may occasionally present with “lupus-like” features by light microscopy and immunofluorescence. Management of HIVICK remains controversial and mainly focuses on HIV viremia suppression with combined antiretroviral therapy. Immunosuppressive therapy may be used in order to mitigate the renal inflammation induced by the immune complex deposition. Data regarding the use of immunosuppressants in HIVICK are very limited, mostly including corticosteroids and mycophenolate acid analogues. Herein, we present the case of a 40-year-old HIV-infected Caucasian man with nephrotic syndrome, renal impairment, and a “lupus-like” membranous pattern in the kidney biopsy, who achieved a partial response of his proteinuria with a tacrolimus-based regimen in combination with antiretroviral therapy.
Role of the Interventional Radiologist in the Treatment of Desmoid Tumors
Authors: Goldberg Daniel , Woodhead Gregory , Hannallah Jack , Young Shamar
Published: February 2023

Desmoid tumors are locally aggressive soft tissue tumors with variable clinical presentation. As is the case with most relatively rare tumors, a multidisciplinary team approach is required to best manage these patients. Surgical resection, systemic therapy, and radiation therapy have classically been mainstays of treatment for desmoid tumors; however, a more conservative “wait-and-see” approach has been adopted given their high recurrence rates and significant morbidity associated with the aforementioned therapies. Given the challenges of classical treatment methods, interventional radiologists have begun to play a significant role in minimally invasive interventions for desmoid tumors. Herein, the authors review imaging characteristics of desmoid tumors, current management recommendations, and minimally invasive therapeutic intervention options.
Neurotrophins and Other Growth Factors in the Pathogenesis of Alzheimer’s Disease
Authors: Numakawa Tadahiro , Kajihara Ryutaro
Published: February 2023

The involvement of the changed expression/function of neurotrophic factors in the pathogenesis of neurodegenerative diseases, including Alzheimer’s disease (AD), has been suggested. AD is one of the age-related dementias, and is characterized by cognitive impairment with decreased memory function. Developing evidence demonstrates that decreased cell survival, synaptic dysfunction, and reduced neurogenesis are involved in the pathogenesis of AD. On the other hand, it is well known that neurotrophic factors, especially brain-derived neurotrophic factor (BDNF) and its high-affinity receptor TrkB, have multiple roles in the central nervous system (CNS), including neuronal maintenance, synaptic plasticity, and neurogenesis, which are closely linked to learning and memory function. Thus, many investigations regarding therapeutic approaches to AD, and/or the screening of novel drug candidates for its treatment, focus on upregulation of the BDNF/TrkB system. Furthermore, current studies also demonstrate that GDNF, IGF1, and bFGF, which play roles in neuroprotection, are associated with AD. In this review, we introduce data demonstrating close relationships between the pathogenesis of AD, neurotrophic factors, and drug candidates, including natural compounds that upregulate the BDNF-mediated neurotrophic system.
The Current Strategy in Hormonal and Non-Hormonal Therapies in Menopause—A Comprehensive Review
Authors: Pop Anca , Nasui Bogdana , Bors Roxana , Penes Ovidiu , Prada Ana , Clotea Eliza , Crisan Simona , Cobelschi Calin , Mehedintu Claudia , Carstoiu Monica , Varlas Valentin
Published: February 2023

Menopause is a natural stage of hormonal aging in women, accompanied by a series of symptoms that reduce the quality of life of a fully active person. As no therapy is entirely satisfactory, the race for a better option is in full swing. Our study objective is to investigate the most recent menopause studies on pharmacological resources, emerging therapies, and the particularities of hormonal replacement therapy (HRT). For this purpose, a comprehensive search was conducted in two main databases (PubMed and Web of Science) guided by the specific keywords “menopause” and “therapy” or “estrogen” or “progesterone” or “hormone replacement” during the last ten years period. Studies were eligible if they met certain criteria: randomized controlled trials (RCT) in adult women with menopause and hormonal or non-hormonal therapies. We selected 62 RCTs, which are focused on four main topics: (a) epidemiology of menopause-related symptoms, (b) hormonal replacement therapy (HRT) selective estrogen receptor modulators, (c) emerging therapies, and (d) menopause. HRT has proven a real health benefit for menopausal women; besides, complementary interventions must be considered. Further studies are needed on menopause and menopause-related therapies. The continuous updating of clinical experience will strengthen the therapeutic benefit and the decision to treat patients safely. This goal will fully access all therapeutic resources to address an unresolved health issue of active adult women.
The Use of Multimodality Imaging for the Diagnosis of Myocardial Outpouchings and Invaginations: A Systematic Review
Authors: Pavasini Rita , Bianchi Nicola , Frascaro Federica , Marchini Federico , Meossi Sofia , Zanarelli Luca , Sanguettoli Federico , Cossu Alberto , Tonet Elisabetta , Passarini Giulia , Campo Gianluca
Published: February 2023

Cardiac ventricular outpouchings and invaginations are rare structural abnormalities and usually incidental findings during cardiac imaging. A definitive diagnosis is possible through the use of multimodality imaging. A systematic review of the literature was carried out in November 2022 to identify studies regarding ventricular outpouchings and invaginations. The main aim of the review is to summarize knowledge regarding epidemiology, etiology, diagnosis and prognosis of patients with ventricular outpouchings (aneurisms or diverticula) and invaginations (crypts and recesses). Overall, 26 studies published between 2000 and 2020 were included in the review. Diverticula and congenital aneurysms incidence ranges between 0.6 and 4.1%. Myocardial recesses and crypts range between 9% in the general population and up to 25% in patients with hypertrophic cardiomyopathy. The combined use of echocardiography, cardiac computed tomography (CCT) and cardiac magnetic resonance (CMR) is useful to establish tissue contractility, fibrosis, extension and relationship with adjacent structures for differential diagnosis of both invaginations and outpouchings. In conclusion, both outpouchings and invaginations are rare entities: a definitive diagnosis may be aided by the use of combining multiple imaging techniques, and the treatment depends both on the lesion-specific risk of complications and on the potential association of some lesions with cardiomyopathy.