bluuebunny/crossref_metadata_2025 huggingface dataset:
Food By-Products to Extend Shelf Life: The Case of Cod Sticks Breaded with Dried Olive Paste
Authors: Panza Olimpia , Lacivita Valentina , Palermo Carmen , Conte Amalia , Del Nobile Matteo Alessandro
Published: December 2020

Recently, the interest in recovery bioactive compounds from food industrial by-products is growing abundantly. Olive oil by-products are a source of valuable bioactive compounds with antioxidant and antimicrobial properties. One of the most interesting by-products of olive oil obtained by a two-phase decanter is the olive paste, a wet homogeneous pulp free from residuals of the kernel. To valorize the olive paste, ready-to-cook cod sticks breaded with dried olive oil by-products were developed. Shelf-life tests were carried out on breaded cod sticks and during 15 days of storage at 4 °C pH evolution, microbiological aspects, and sensory properties were also monitored. In addition, the chemical quality of both control and active samples was assessed in terms of total phenols, flavonoids, and antioxidant activity. The enrichment with olive paste increased the total phenols, the flavonoids, and the antioxidant activity of the breaded fish samples compared to the control. Furthermore, the bioactive compounds acted as antimicrobial agents, without compromising the sensory parameters. Therefore, the new products recorded a longer shelf life (12 days) than the control fish sample that remained acceptable for nine days.
Evaluation of Pulsed Light to Inactivate Brettanomyces bruxellensis in White Wine and Assessment of Its Effects on Color and Aromatic Profile
Authors: Pérez-López Antonio J. , Rodríguez-López María I. , Burló Francisco , Carbonell-Barrachina Ángel A. , Gabaldón José A. , Gómez-López Vicente M.
Published: December 2020

Brettanomyces bruxellensis is a wine spoilage yeast that could be inactivated by pulsed light (PL); however, this technology may induce changes in the quality of this alcoholic drink. The present research aimed to determine the potential of PL to inactivate B. bruxellensis inoculated in white wine and to assess the effect of this technology on the color and aromatic profile of the wine. For this, a cocktail of B. bruxellensis strains was inoculated into the wine and its inactivation by PL was determined and fitted to a microbial inactivation model. Along with this, the effect of PL on instrument-measured color, and the volatile compounds of the wine were evaluated by GC/MS and descriptive sensory analysis, respectively. B. bruxellensis was inactivated according to the Geeraerd model including the tail effect, with a maximum inactivation of 2.10 log reduction at 10.7 J/cm2; this fluence was selected for further studies. PL affected wine color but the total color difference was below the just noticeable difference at 10.7 J/cm2. The concentration of 13 out of 15 volatile compounds decreased due to the PL, which was noticeable by the panel. It is not clear if these compounds were photolyzed or volatilized in the open reactor during treatment. In conclusion, PL is able to inactivate B. bruxellensis in white wine but the treatment impairs the volatile profile. The use of a closed reactor under turbulent flow is recommended for disaggregating yeast clumps that may cause the tailing of the inactivation curve, and to avoid the possible escape of volatile compounds during treatment.
Content of Toxic Elements in 12 Groups of Rice Products Available on Polish Market: Human Health Risk Assessment
Authors: Bielecka Joanna , Markiewicz-Żukowska Renata , Nowakowski Patryk , Grabia Monika , Puścion-Jakubik Anna , Mielcarek Konrad , Gromkowska-Kępka Krystyna Joanna , Soroczyńska Jolanta , Socha Katarzyna
Published: December 2020

Background: Rice is one of the most commonly consumed grains. It could be a good source of nutrients in a diet, but its consumption could also contribute to exposure to toxic elements. All rice products available on the Polish market are imported, which may pose a particular concern as to the safety of their consumption. The aim of our study was to estimate the content of As, Cd, Pb, and Hg in rice products and to assess the health risk indicators related to exposure to toxic elements consumed with rice products among the adult population in Poland. Methods: A total of 99 samples from 12 groups of rice products (basmati, black, brown, parboiled, red, wild, white rice and expanded rice, rice flakes, flour, pasta, and waffles) available in the Polish market were obtained. The content of Hg was determined using the atomic absorption spectrometry method (AAS). To measure As, Cd, and Pb, inductively coupled plasma-mass spectrometry (ICP-MS) was used. The health risk was assessed by calculating several indicators. Results: The average As, Cd, Pb, and Hg contents in all studied products were 123.5 ± 77.1 μg/kg, 25.7 ± 26.5 μg/kg, 37.5 ± 29.3 μg/kg, and 2.8 ± 2.6 μg/kg, respectively. Exceedance of the limit established by the Polish National Food Safety Standard was observed in one sample as regards the As content and exceedance of the European Commission standard in two samples for Hg. The samples of foods imported from European markets (n = 27) had statistically higher As content (p < 0.05) than those imported from Asian countries (n = 53). The values of health risk indicators did not show an increased risk for the Polish adult population. However, the daily intake of 55 g of rice corresponds to the benchmark dose lower confidence limit (BMDL) for Pb. Conclusion: The studied rice products could be regarded as safe for consumption by the Polish population as far as the content of As, Cd, Pb, and Hg is concerned.
Grain Quality, Provitamin A Carotenoid Profiles, and Sensory Quality of Provitamin A-Biofortified Maize Stiff Porridges
Authors: Beswa Daniso , Siwela Muthulisi , Amonsou Eric O. , Kolanisi Unathi
Published: December 2020

Provitamin A-biofortified maize could contribute to the alleviation of vitamin A deficiency (VAD), which is prevalent in sub-Saharan Africa due to a high consumption of starchy, maize-based diets. Four varieties of provitamin A biofortified maize were studied for grain colour, grain texture, thousand kernel weight, and hectolitre mass. Provitamin A biofortified maize stiff porridges were prepared and their retained provitamin A was determined using lutein, zeaxanthin, β-cryptoxanthin, and β-carotene (all-trans and cis isomers) as standards. Provitamin A concentration in the biofortified porridges ranged from 2.24 to 3.18 µg/g and retention from 91–105%. Descriptive sensory analysis and the 5-point facial hedonic test were used to evaluate the sensory quality of the porridges. The biofortified maize porridges were described as sticky, fine, with high intensity residual grain, and having a slightly bitter aftertaste with a cooked maize flavour and aroma, whereas the intensities of these attributes were insignificant in white maize porridge. About 33% of the consumer sample (N = 60) liked the porridges and 28% disliked the porridges, whilst approximately 38% of the consumers were neutral. The findings suggest that biofortified maize stiff porridge can deliver a significant amount of provitamin A to targeted consumers, but the acceptance of biofortified maize still needs to be improved on.
The Effect of Moringa oleifera Leaf Powder on the Physical Quality, Nutritional Composition and Consumer Acceptability of White and Brown Breads
Authors: Govender Laurencia , Siwela Muthulisi
Published: December 2020

Fortifying popular, relatively affordable, but nutrient-limited staple foods, such as bread, with Moringa oleifera leaf powder (MOLP), could contribute significantly to addressing under nutrition, especially protein and mineral deficiencies, which are particularly prevalent among a large proportion of populations in sub-Saharan African countries. The current study aimed to determine the effect of MOLP on the physical quality, nutritional composition and consumer acceptability of white and brown breads. The texture, colour and nutritional composition of white and brown bread samples substituted with 5% and 10% (w/w) MOLPs were analysed using standard methods and compared with the control (0% MOLP). A consumer panel evaluated the acceptability of the bread samples using a nine-point hedonic scale. Bread samples became darker as the concentration of MOLP was increased, whilst nutrient levels increased. The overall consumer acceptability of the bread samples decreased with increasing concentrations of MOLP. However, brown bread samples were significantly more acceptable compared with corresponding white bread samples (p < 0.05). Under the experiment conditions of the current study, it seems that the bread containing 5% MOLP can be used to contribute significantly to addressing malnutrition, with respect to protein deficiency.
Physicochemical and Functional Characteristics of RD43 Rice Flour and Its Food Application
Authors: Suklaew Phim on , Chusak Charoonsri , Adisakwattana Sirichai
Published: December 2020

The increased use of a new rice cultivar is the result of increasing consumer demands for healthier choices. In this study, physicochemical, thermal, pasting, and functional properties of flour from RD43 rice, a new rice variety, and its food application were investigated. RD43 rice flour demonstrated an irregular and polyhedral shape with a volume mean diameter of 103 ± 0.15 µm. In addition, the amylose content of RD43 rice and Hom Mali rice flour was 19.04% and 16.38%, respectively. The X-ray diffraction (XRD) and Fourier Transforms Infrared (FTIR) confirmed the presence of a V-type crystalline structure and less crystallinity in RD43 rice flour, which resulted in a significant reduction of the water absorption index (WAI), swelling power (SP), water solubility index (WSI), gelatinization temperature, and pasting properties. Comparing with Hom Mali rice flour, RD43 rice flour had greater ability to disrupt cholesterol micellization and bind bile acid. Furthermore, it had lower starch digestibility, with a lower percentage of rapidly digestible starch (RDS) and higher percentage of undigestible starch than Hom Mali rice flour. Moreover, steamed muffins based on RD43 rice flour had lower starch digestibility than Hom Mali steamed muffins. The sensory analysis showed no significant differences between Hom Mali and RD43 steamed muffins. The findings suggest that RD43 rice flour could be an alternative ingredient for lowering the glycemic index of food products.
Cardiovascular Imaging Applications in Clinical Management of Patients Treated with Cardiac Resynchronization Therapy
Authors: Valzania Cinzia , Gadler Fredrik , Maret Eva , Eriksson Maria J.
Published: December 2020

Cardiovascular imaging techniques, including echocardiography, nuclear cardiology, multi-slice computed tomography, and cardiac magnetic resonance, have wide applications in cardiac resynchronization therapy (CRT). Our aim was to provide an update of cardiovascular imaging applications before, during, and after implantation of a CRT device. Before CRT implantation, cardiovascular imaging techniques may integrate current clinical and electrocardiographic selection criteria in the identification of patients who may most likely benefit from CRT. Assessment of myocardial viability by ultrasound, nuclear cardiology, or cardiac magnetic resonance may guide optimal left ventricular (LV) lead positioning and help to predict LV function improvement by CRT. During implantation, echocardiographic techniques may guide in the identification of the best site of LV pacing. After CRT implantation, cardiovascular imaging plays an important role in the assessment of CRT response, which can be defined according to LV reverse remodeling, function and dyssynchrony indices. Furthermore, imaging techniques may be used for CRT programming optimization during follow-up, especially in patients who turn out to be non-responders. However, in the clinical settings, the use of proposed functional indices for different imaging techniques is still debated, due to their suboptimal feasibility and reproducibility. Moreover, identifying CRT responders before implantation and turning non-responders into responders at follow-up remain challenging issues.
Grip Strength-Endurance in Ambitious and Recreational Climbers: Does the Strength Decrement Index Serve as a Feasible Measure?
Authors: Labott Berit Kristin , Held Steffen , Donath Lars
Published: December 2020

The present study investigated the time course of repetitive maximal isometric grip strength, depending on the arm position, laterality (dominant vs. non-dominant side), and climbing level. The intervention aimed to provide a feasible indicator of maximal strength-endurance in climbing. Seventeen recreational (climbing level (CL): 6.8 (SD 0.5) on the Union Internationale des Associations d’Alpinisme (UIAA) metric scale) and eleven ambitious (CL: 8.7 (SD 0.6) UIAA metric scale) climbers (age: 27 (8) years; BMI: 21.6 (1.9) kg/m2; ape index (arm span divided by body height): 1.05 (0.18); training volume: 2.2 (1.0) h/week). Participants completed maximal isometric handgrip strength (Fmax) tests in four positions (left and right hand beside the trunk as well as left and right hand above the shoulder) plus twelve repetitive work-relief cycles, lasting 4 and 1 s where isometric strength, heart rate, and perceived exertion were recorded. Fmax differed between groups in nearly all positions. A large side × position × time × group interaction was observed for repetitive isometric grip strength (p = 0.009, ηp2 = 0.71). However, subsequent post-hoc tests did not reveal a significant difference between groups during each testing position. Additional correlation analysis between asymmetry and CL showed an inverse relationship for ambitious climbers (r = −0.71). In conclusion, the degree of grip strength decline did not relevantly differentiate between ambitious and recreational climbers. Thus, the time course of handgrip strength seems to mainly rely on maximal grip strength during the first contraction.
The Trends of Medical Care Expenditure with Adjustment of Lifestyle Habits and Medication; 10-Year Retrospective Follow-Up Study
Authors: Ono Haruko , Akahoshi Kotomi , Kai Michiaki
Published: December 2020

In Japan, the prevention of lifestyle-related diseases is the most important issue for the optimization of medical expenditure. This study aimed to analyze the impact of lifestyle and medication status on medical expenditure. Health checkup data and medical expenditure records of a retrospective cohort of 1463 people aged between 40 and 65 years old who underwent specific health checks at least three times between 2008 and 2017 were analyzed. Regression analysis was performed with medical expenditure as the dependent variable and age, gender, waist ratio, medication status, and lifestyle habits as independent variables using a Tobit model. Focusing on the factors that increase medical expenditure, the regression coefficients of age, medication status, weight gain of 10 kg or more since the age of 20, and walking more than 1 h per day were 0.048 (95% CI 0.04 to 0.06), 1.020 (95% CI 0.88 to 1.16), 0.210 (95% CI 0.06 to 0.36), and −0.208 (95% CI −0.35 to −0.07), respectively. The estimate of 5-year cumulative medical expenditure showed that those with walking habits without medication had the lowest medical expenditure. The result of this study suggests that walking more than 1 h a day may lower health expenditure in the general population.
Chemical Characteristics of Atmospheric PM10 and PM2.5 at a Rural Site of Lijiang City, China
Authors: Liu Yu , Li Xurui , Wang Wan , Yin Baohui , Gao Yuanguan , Yang Xiaoyang
Published: December 2020

Emissions from biomass burning are very serious in Southeast Asia and South Asia in April. In order to explore the effect of long-range transport of biomass emissions from the Indochina Peninsula in Southwest China during the period of the southeast monsoon season and to find out the main pollution sources in local atmospheric PM2.5, a field campaign was conducted from 6–26 April 2011 in Lijiang, China. Twenty-four-hour PM10 and PM2.5 filter samples were collected, and inorganic ions, elements, and carbonaceous components (including organic carbon (OC) and elemental carbon (EC), polycyclic aromatic hydrocarbons (PAHs) and nitrated PAHs (NPAHs)) were measured. The monthly mean mass concentrations of particulate matter (PM) were 40.4 and 14.4 μg/m3 for PM10 and PM2.5, respectively. The monthly mean concentrations of OC and EC in PM10 were 6.2 and 1.6 μg/m3, respectively. The weekly mean concentrations of ∑PAHs and ∑NPAHs were 11.9 ng/m3 and 289 pg/m3, respectively, in atmospheric PM10 of Lijiang. The diagnostic ratios of PAH and NPAH isomers were used to analyze the sources of PAHs and NPAHs in PM10. The ratios of Benz(a)anthracene/(Chrysene+Benz(a)anthracen), Fluoranthene/(Fluoranthene+Pyrene) and Indeno(1,2,3-cd)pyrene/(Benzo(g,h,i)perylene+Indeno(1,2,3-cd)pyrene) were 0.45 ± 0.04, 0.61 ± 0.01, and 0.53 ± 0.03, respectively, indicating the contribution from coal combustion and biomass burning. The 1-nitropyrene/Pyrene (1-NP/Pyr) ratio was 0.004 ± 0.001, suggesting that the contribution to NPAHs mainly came from coal combustion. Sulfate was the most prominent inorganic ionic species, with monthly mean levels of 2.28 and 1.39 μg/m3 in PM10 and PM2.5, respectively. The monthly mean mass ratios of NO3−/SO42− were 0.40 and 0.23 in PM10 and PM2.5, respectively, indicating that the contribution of atmospheric anions from coal combustion sources was much more important than that from other sources. Based on the relatively high SO42− concentrations and low NO3−/SO42− ratios, combined with the data analysis of isomer ratios of PAHs and NPAHs, we can conclude that coal combustion, traffic, and dust were the major contributors to local atmospheric PM in Lijiang city, while biomass burning may also have contributed to local atmospheric PM in Lijiang city to some degree.
Gestational Diabetes: Overview with Emphasis on Medical Management
Authors: Lende Michelle , Rijhsinghani Asha
Published: December 2020

With the rising trend in obesity, the incidence of gestational diabetes mellitus (GDM) and perinatal complications associated with the condition are also on the rise. Since the early 1900s, much knowledge has been gained about the diagnosis, implications, and management of gestational diabetes with improved outcomes for the mother and fetus. Worldwide, there is variation in the definition of GDM, methods to screen for the condition, and management options. The International Association of Diabetes in Pregnancy Study Groups has published recommendations for a one-step approach to screen pregnant women for GDM, in order to develop outcome-based criteria that can be used internationally. However, management of GDM continues to be varied, and currently several options are available for treatment of hyperglycemia during pregnancy. A review of various aspects of GDM is discussed with a focus on the medical management during pregnancy, as practiced in the United States.
Structural Elements Detection and Reconstruction (SEDR): A Hybrid Approach for Modeling Complex Indoor Structures
Authors: Wu Ke , Shi Wenzhong , Ahmed Wael
Published: December 2020

We present a hybrid approach for modeling complex interior structural elements from the unstructured point cloud without additional information. The proposed approach focuses on an integrated modeling strategy that can reconstruct structural elements and keep the balance of model completeness and quality. First, a data-driven approach detects the complete structure points of indoor scenarios including the curved wall structures and detailed structures. After applying the down-sampling process to point cloud dataset, ceiling and floor points are detected by RANSAC. The ceiling boundary points are selected as seed points of the growing algorithm to acquire points related to the wall segments. Detailed structures points are detected using the Grid-Slices analysis approach. Second, a model-driven refinement is conducted to the structure points that aims to decrease the impact of point cloud accuracy on the quality of the model. RANSAC algorithm is implemented to detect more accurate layout, and the hole in structure points is repaired in this refinement step. Lastly, the Screened Poisson surface reconstruction approach is conducted to generate the model based on the structure points after refinement. Our approach was validated on the backpack laser dataset, handheld laser dataset, and synthetic dataset, and experimental results demonstrate that our approach can preserve the curved wall structures and detailed structures in the model with high accuracy.
Adjusting the Regular Network of Squares Resolution to the Digital Terrain Model Surface Shape
Authors: Gościewski Dariusz , Gerus-Gościewska Małgorzata
Published: December 2020

A regular network of squares is formed by points uniformly distributed (mostly in the square corners) over the surface that is represented by the network. Each point (node) of the network has specified coordinates (X and Y) with a fixed constant distance between them. The third coordinate in a node (H) is determined by the application of interpolation based on the points distributed (usually dispersed as a point cloud e.g., from LiDAR) over the surface of the area surrounding the node. The regular network of squares formed in this manner allows the representation of a digital terrain model (DTM) to be performed in spatial information systems (SIP, GIS). The main problem that arises during the construction of such a network is the proper determination of its resolution (the base distance between the coordinates X and Y) depending on the topography. This article presents a method of the regular network of squares resolution determination depending on the morphological shape of the terrain surface. Following the application of the procedures being described, a differently shaped terrain is assigned various network densities. This enables the minimisation of inaccuracies of the surface model being formed. Consequently, a regular network of squares is formed with different base square sizes, which is adjusted with its resolution to the morphology of the surface it describes. Such operations allow the terrain model accuracy to be maintained over the entire area while reducing the number of points stored in the DTM database to the minimum.
The Correlation between the Jobs–Housing Relationship and the Innovative Development of Sci-Tech Parks in New Urban Districts: A Case Study of the Hangzhou West Hi-Tech Corridor in China
Authors: Wu Yue , Yang Yue , Chen Qiuxiao , Xu Weishun
Published: December 2020

Sci-tech parks (STPs), as a key space carrier of urbanization, have transformed into comprehensive parks with mixed urban functions and advanced hi-tech industries. The jobs–housing relationship, which is closely related to the two major urban functions of work and residence, affects the efficiency of urban operation. This study focused on the correlation between the jobs–housing relationship and the innovative development of STPs, adopting the Hangzhou West Hi-Tech Corridor as a case study. Four indicators reflecting the jobs–housing balance index and commuting distance and ten indicators reflecting agglomeration degree, development scale, innovative ability, financial status, and comprehensive development level of enterprises were selected to perform partial least squares regression. The results show that the jobs–housing relationship was correlated with the innovative development of STPs. Relatively short commuting distance may promote the development and agglomeration of sci-tech enterprises. However, short average commuting distance was not necessarily good. The working space and living space needed to be mixed at an appropriate scale and distance—to be close but not too close. This study provides references for the future development of STPs and the application of mixed-use zoning in the urban spatial planning; additionally, it supports for the research and practice of industry–city integration and urbanization.
Local Segregation of Realised Niches in Lizards
Authors: Sillero Neftalí , Argaña Elena , Matos Cátia , Franch Marc , Kaliontzopoulou Antigoni , Carretero Miguel A.
Published: December 2020

Species can occupy different realised niches when sharing the space with other congeneric species or when living in allopatry. Ecological niche models are powerful tools to analyse species niches and their changes over time and space. Analysing how species’ realised niches shift is paramount in ecology. Here, we examine the ecological realised niche of three species of wall lizards in six study areas: three areas where each species occurs alone; and three areas where they occur together in pairs. We compared the species’ realised niches and how they vary depending on species’ coexistence, by quantifying niche overlap between pairs of species or populations with the R package ecospat. For this, we considered three environmental variables (temperature, humidity, and wind speed) recorded at each lizard re-sighting location. Realised niches were very similar when comparing syntopic species occurring in the same study area. However, realised niches differed when comparing conspecific populations across areas. In each of the three areas of syntopy, the less abundant species shift its realised niche. Our study demonstrates that sympatry may shift species’ realised niche.
Non-Invasive Human Embryo Metabolic Assessment as a Developmental Criterion
Authors: Motiei Marjan , Vaculikova Katerina , Cela Andrea , Tvrdonova Katerina , Khalili Reza , Rumpik David , Rumpikova Tatana , Glatz Zdenek , Saha Tomas
Published: December 2020

The selection of a highly-viable single embryo in assisted reproductive technology requires an acceptable predictive method in order to reduce the multiple pregnancy rate and increase the success rate. In this study, the metabolomic profiling of growing and impaired embryos was assessed on the fifth day of fertilization using capillary electrophoresis in order to find a relationship between the profiling and embryo development, and then to provide a mechanistic insight into the appearance/depletion of the metabolites. This unique qualitative technique exhibited the appearance of most non-essential amino acids and lactate, and depleting the serine, alanyl-glutamine and pyruvate in such a manner that the embryos impaired in their development secreted a considerably higher level of lactate and consumed a significantly higher amount of alanyl-glutamine. The different significant ratios of metabolomic depletion/appearance between the embryos confirm their potential for the improvement of the prospective selection of the developed single embryos, and also suggest the fact that pyruvate and alanyl-glutamine are the most critical ATP suppliers on the fifth day of blastocyst development.
Radiation-Induced Salivary Gland Dysfunction: Mechanisms, Therapeutics and Future Directions
Authors: Jasmer Kimberly J. , Gilman Kristy E. , Muñoz Forti Kevin , Weisman Gary A. , Limesand Kirsten H.
Published: December 2020

Salivary glands sustain collateral damage following radiotherapy (RT) to treat cancers of the head and neck, leading to complications, including mucositis, xerostomia and hyposalivation. Despite salivary gland-sparing techniques and modified dosing strategies, long-term hypofunction remains a significant problem. Current therapeutic interventions provide temporary symptom relief, but do not address irreversible glandular damage. In this review, we summarize the current understanding of mechanisms involved in RT-induced hyposalivation and provide a framework for future mechanistic studies. One glaring gap in published studies investigating RT-induced mechanisms of salivary gland dysfunction concerns the effect of irradiation on adjacent non-irradiated tissue via paracrine, autocrine and direct cell–cell interactions, coined the bystander effect in other models of RT-induced damage. We hypothesize that purinergic receptor signaling involving P2 nucleotide receptors may play a key role in mediating the bystander effect. We also discuss promising new therapeutic approaches to prevent salivary gland damage due to RT.
Endothelial Progenitor Cells as a Potential Biomarker in Interstitial Lung Disease Associated with Rheumatoid Arthritis
Authors: Pulito-Cueto Verónica , Remuzgo-Martínez Sara , Genre Fernanda , Mora-Cuesta Víctor M. , Iturbe-Fernández David , Fernández-Rozas Sonia , Atienza-Mateo Belén , Lera-Gómez Leticia , Alonso-Lecue Pilar , Rodríguez-Carrio Javier , Prieto-Peña Diana , Portilla Virginia , Blanco Ricardo , Corrales Alfonso , Gualillo Oreste , Cifrián José M. , López-Mejías Raquel , González-Gay Miguel A.
Published: December 2020

Interstitial lung disease (ILD) increases morbidity and mortality in patients with rheumatoid arthritis (RA). Although the pathogenesis of ILD associated with RA (RA-ILD+) remains poorly defined, vascular tissue is crucial in lung physiology. In this context, endothelial progenitor cells (EPC) are involved in endothelial tissue repair. However, little is known about their implication in RA-ILD+. Accordingly, we aimed to investigate the potential role of EPC related to endothelial damage in RA-ILD+. EPC quantification in peripheral blood from 80 individuals (20 RA-ILD+ patients, 25 RA-ILD− patients, 21 idiopathic pulmonary fibrosis (IPF) patients, and 14 healthy controls) was performed by flow cytometry. EPC were considered as CD34+, CD45low, CD309+ and CD133+. A significant increase in EPC frequency in RA-ILD+ patients, as well as in RA-ILD− and IPF patients, was found when compared with controls (p < 0.001, p = 0.02 and p < 0.001, respectively). RA-ILD+ patients exhibited a higher EPC frequency than the RA-ILD− ones (p = 0.003), but lower than IPF patients (p < 0.001). Our results suggest that EPC increase may represent a reparative compensatory mechanism in patients with RA-ILD+. The degree of EPC frequency may help to identify the presence of ILD in RA patients and to discriminate RA-ILD+ from IPF.
Characterization of Clostridioides difficile Strains, the Disease Severity, and the Microbial Changes They Induce
Authors: Rohana Hanan , Azrad Maya , Nitzan Orna , Adler Amos , Binyamin Dana , Koren Omry , Peretz Avi
Published: December 2020

Background: Clostridioides difficile infection (CDI) is a major nosocomial disease. The characteristics of different strains, the disease severity they cause, their susceptibility to antibiotics, and the changes they inflict on gut microbiome, have not been comprehensively studied in Israel. Methods: A severity score was calculated for 70 patients. Stool samples were tested for toxins presence using a special kit. Bacteria were isolated, identified by matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) and antibiotic susceptibility tests were performed for several antibiotics. Strains were classified by Multi-locus sequence typing (MLST), and changes in gut microbiome were tested. Results: ST04 (22.5%) and ST37 (12.7%) were the most frequent strains. Clade (phylogenetic lineage) 1 was the most (81.4%) prevalent. We found significant associations between ST and age (p = 0.024) and between ST and moxifloxacin susceptibility (p = 0.001). At the clade level, we found significant associations with binary toxin gene occurrence (p = 0.002), and with susceptibility to both metronidazole and vancomycin (p = 0.024, 0.035, respectively). Differences in intestine microbiome were affected by age, clades’ distribution and STs. Conclusions: By defining the characteristics of the different strains and clades, clinicians can choose medical interventions based on the predicted response or disease severity associated with each strain, enabling new advances in the field of personalized medicine.
Sex Differences in Left Ventricular Remodeling and Outcomes in Chronic Aortic Regurgitation
Authors: Kammerlander Andreas A. , Donà Carolina , Nitsche Christian , Koschutnik Matthias , Zafar Amna , Eslami Parastou , Duca Franz , Aschauer Stefan , Schönbauer Robert , Beitzke Dietrich , Loewe Christian , Hoffmann Udo , Gebhard Cathérine , Hengstenberg Christian , Mascherbauer Julia
Published: December 2020

Background: Left ventricular (LV) dilatation is a key compensatory feature in patients with chronic aortic regurgitation (AR). However, sex-differences in LV remodeling and outcomes in chronic AR have been poorly investigated so far. Methods: We performed cardiovascular magnetic resonance imaging (CMR) including phase-contrast velocity-encoded imaging for the measurement of regurgitant fraction (RegF) at the sinotubular junction, in consecutive patients with at least mild AR on echocardiography. We assessed LV size (end-diastolic volume indexed to body surface area, LVEDV/BSA) and investigated sex differences between LV remodeling and increasing degrees of AR severity. Cox-regression models were used to test differences in outcomes between men and women using a composite of heart failure hospitalization, unscheduled AR intervention, and cardiovascular death. Results: 270 consecutive patients (59.6% male, 59.8 ± 20.8 y/o, 59.6% with at least moderate AR on echocardiography) were included. On CMR, mean RegF was 18.1 ± 17.9% and a total of 65 (24.1%) had a RegF ≥ 30%. LVEDV/BSA was markedly closer related with AR severity (RegF) in men compared to women. Each 1-SD increase in LVEDV/BSA (mL/m2) was associated with a 9.7% increase in RegF in men and 5.9% in women, respectively (p-value for sex-interaction < 0.001). Based on previously published reference values, women—in contrast to men—frequently had a normal LV size despite severe AR (e.g., for LVEDV/BSA on CMR: 35.3% versus 8.7%, p < 0.001). In a Cox-regression model adjusted for age, LVEDV/BSA and RegF, women were at significantly higher risk for the composite endpoint when compared to men (adj. HR 1.81 (95%CI 1.09–3.03), p = 0.022). Conclusion: In patients with chronic AR, LV remodeling is a hallmark feature in men but not in women. Severity of AR may be underdiagnosed in female patients in the absence of LV dilatation. Future studies need to address the dismal prognosis in female patients with chronic AR.
Prevalence, Bother and Treatment Behavior Related to Lower Urinary Tract Symptoms and Overactive Bladder among Cardiology Patients
Authors: Przydacz Mikolaj , Dudek Przemyslaw , Chlosta Piotr
Published: December 2020

Purpose: The aim of this study was to measure, at the population level, the prevalence, bother, and treatment-related behavior for lower urinary tract symptoms (LUTS) and overactive bladder syndrome (OAB) in a large cohort of cardiology patients. Methods: This report is a further analysis of data from LUTS POLAND, a computer-assisted telephone survey that reflected the entire Polish population, stratified by age, sex, and place of residence. LUTS and OAB were assessed by a standardized protocol, the International Continence Society definitions, and validated questionnaires. In addition, all participants provided information regarding their behavior as it related to LUTS treatment. Results: Overall, 6005 participants completed interviews, and 1835 (30.6%) had received treatment by cardiologists. The prevalence of LUTS was 73.3% for cardiology participants compared with 57.0% for respondents who were not treated by cardiologists (p < 0.001). There were no differences between men and women in LUTS prevalence for cardiology patients. Nocturia was the most prevalent LUTS. LUTS were often bothersome, and storage symptoms were more bothersome than voiding or postmicturition symptoms. The prevalence of OAB syndrome was 50.7% in cardiology patients, higher than in noncardiology participants (36.6%, p < 0.001), and more women were affected than men. Only one-third of cardiology patients who reported LUTS were seeking treatment for LUTS, and most of them received treatment. There were no differences between persons living in urban and rural areas. Conclusions: LUTS and OAB were highly prevalent among cardiology patients. Although LUTS were often bothersome in this unique population, we found that the seeking of treatment for LUTS was minimal. These results highlight the need for cooperation between cardiologists and urologists.
Challenges Posed by Embryonic and Anatomical Factors in Systematic Lymphadenectomy for Endometrial Cancer
Authors: Freytag Damaris , Pape Julian , Dhanawat Juhi , Günther Veronika , Maass Nicolai , Gitas Georgios , Laganà Antonio Simone , Allahqoli Leila , Meinhold-Heerlein Ivo , Moawad Gaby N. , Biebl Matthias , Mettler Liselotte , Alkatout Ibrahim
Published: December 2020

Lymph node involvement has been shown to be one of the most relevant prognostic factors in a variety of malignancies; this is also true of endometrial cancer. The determination of the lymph node status is crucial in order to establish the tumor stage, and to consider adjuvant treatment. A wide range of surgical staging practices are currently used for the treatment of endometrial cancer. The necessity and extent of lymph node dissection is an ongoing controversial issue in gynecological oncology. Lymph node surgery in endometrial cancer is technically challenging, and can be time consuming because of the topographic complexity of lymphatic drainage as such, and the fact that the lymph nodes are directly adjacent to both blood vessels and nerves. Therefore, profound and exact knowledge of the anatomy is essential. Sentinel lymph node mapping was recently introduced in surgical staging with the aim of reducing morbidity, whilst also obtaining useful prognostic information from a patient’s lymph node status. The present review summarizes the current evidence on the role of lymph node surgery in endometrial cancer, focusing on the embryological, anatomical, and technical aspects.
Relationship between Soluble (Pro)Renin Receptor and Renin Activity in Patients with Severe Heart Failure
Authors: Ikeda Yoshifumi , Tsutsui Kenta , Yamada Yoshihiro , Kato Ritsushi , Muramatsu Toshihiro , Senbonmatsu Takaaki
Published: December 2020

The (pro)renin receptor ((P)RR), which evokes renin activity with prorenin, is secreted extracellularly as soluble (P)RR (s(P)RR) and may participate in tissue renin-angiotensin system (RAS) activity in severe heart failure (HF) patients. The aim of this study was to determine whether s(P)RR is an adequate marker in severe HF patients treated with RAS inhibitors, beta-blockers, and tolvaptan. We enrolled 11 patients with severe HF between May 2013 and June 2014. First of all, furosemide of all patients was changed to tolvaptan with hydrochlorothiazide and then the treatment had been changed according to the patient’s condition. After 1, 3, 6, and 12 months, the variance of s(P)RR, plasma renin activity (PRA), plasma renin concentration (PRC), brain natriuretic peptide (BNP) and their association was investigated. Furosemide was restarted in five patients and two patients suffered cardiac death. PRA/PRC and s(P)RR were unchanged (PRA: 10.7 ± 13.9 to 12.8 ± 8.5 ng/mL/h; PRC: 347.1 ± 577.5 to 148.3 ± 123.8 pg/mL; s(P)RR: 28.2 ± 19.3 to 33.4 ± 22.4 ng/mL) and had no significant correlations (PRA and s(P)RR: p = 0.36; PRC and s(P)RR: p = 0.35). There was a significant positive correlation with a high correlation coefficient (CC) between PRA and PRC (p < 0.0001, CC = 0.76), and a negative correlation with weak CC between BNP and s(P)RR (p = 0.01, CC = −0.45). In conclusion, s(P)RR was always high and had no correlations with disease state and PRA/PRC in severe HF patients.
Growth Differentiation Factor 15: A Biomarker with High Clinical Potential in the Evaluation of Kidney Transplant Candidates
Authors: de Cos Gomez Marina , Benito Hernandez Adalberto , Garcia Unzueta Maria Teresa , Mazon Ruiz Jaime , Lopez del Moral Cuesta Covadonga , Perez Canga Jose Luis , San Segundo Arribas David , Valero San Cecilio Rosalia , Ruiz San Millan Juan Carlos , Rodrigo Calabia Emilio
Published: December 2020

Kidney transplantation implies a significant improvement in patient survival. Nevertheless, early mortality after transplant remains high. Growth differentiation factor 15 (GDF-15) is a novel biomarker under study as a mortality predictor in multiple scenarios. The aim of this study is to assess the utility of GDF-15 to predict survival in kidney transplant candidates. For this purpose, 395 kidney transplant recipients with pretransplant stored serum samples were included. The median GDF-15 was 5331.3 (50.49–16242.3) pg/mL. After a mean of 90.6 ± 41.5 months of follow-up, 82 (20.8%) patients died. Patients with higher GDF-15 levels (high risk tertile) had a doubled risk of mortality after adjustment by clinical characteristics (p = 0.009). After adjustment by EPTS (Estimated Post Transplant Survival score) the association remained significant for medium hazards ratios (HR) 3.24 95%CI (1.2–8.8), p = 0.021 and high risk tertiles HR 4.3 95%CI (1.65–11.54), p = 0.003. GDF-15 improved the prognostic accuracy of EPTS at 1-year (ΔAUC = 0.09, p = 0.039) and 3-year mortality (ΔAUC = 0.11, p = 0.036). Our study suggests an independent association between higher GDF-15 levels and mortality after kidney transplant, adding accuracy to the EPTS score, an established risk prediction model currently used in kidney transplant candidates.
Effectiveness of a Program Combining Strengthening, Stretching, and Aerobic Training Exercises in a Standing versus a Sitting Position in Overweight Subjects with Knee Osteoarthritis: A Randomized Controlled Trial
Authors: Perez-Huerta Betsy Denisse , Díaz-Pulido Belén , Pecos-Martin Daniel , Beckwee David , Lluch-Girbes Enrique , Fernandez-Matias Ruben , Rubio María José Bolaños , Gallego-Izquierdo Tomas
Published: December 2020

There is an increasing incidence, prevalence, and burden of knee osteoarthritis due to a global increase in obesity and an aging population. The aim of the present study was to compare the effectiveness of the addition of aerobic exercises performed in an unloaded or loaded position to a conventional exercise program in overweight subjects with knee osteoarthritis. Twenty-four subjects were randomly allocated to receive 36 sessions of 30-min duration of either sitting aerobic exercises (experimental group) or standing aerobic exercises (control group). Pain intensity, knee disability, and quality-of-life data were collected at baseline and at 12, 24, and 36 sessions. Generalized linear mixed models (GLMMs) were constructed for the analysis of the differences. Significant differences were found in the experimental group for self-reported pain and knee pain and disability at 24 and 36 sessions (p < 0.05). Significant between-group differences were observed in change in self-reported knee pain and disability and quality of life from baseline to 24th- and 36th-session measurements in favor of the experimental group. Adherence to treatment was higher in the experimental group. Adding aerobic exercises in an unloaded position to a conventional exercise program produced superior effects over time for self-reported knee pain, knee pain and disability and quality of life compared to loaded aerobic exercises in overweight subjects with knee osteoarthritis.
Changes in Hepcidin Serum Levels Correlate with Clinical Improvement in Idiopathic Restless Legs Syndrome Patients
Authors: Im Hee-Jin , Kim Jee Hyun , Yun Chang-Ho , Kim Dong Wook , Oh Jeeyoung
Published: December 2020

Background: Restless legs syndrome (RLS) is a common sensory motor neurological disorder that is related to iron–dopamine dysregulation and immune system alteration. We aimed to assess the effects of serum hepcidin, an iron-regulating hormone, in drug-naive RLS patients compared to healthy controls and to evaluate its role in helping to predict clinical improvement after treatment with dopamine agonist. Methods: Nonanemic and drug-naive RLS patients (n = 18) and healthy controls (n = 15) were enrolled. The serum hepcidin and iron-related values in the serum were measured upon the first visit in both groups and 12 weeks later after dopaminergic treatment in 12 patients. Information about sociodemographic characteristics, sleep-related profiles, mood and anxiety was obtained upon the first visit in all participants as well as after treatment in RLS patients. Results: Serum hepcidin levels exhibited no significant differences between patients with drug-naïve RLS and healthy controls at diagnosis (7.1 ± 2.4 vs. 7.0 ± 3.2 ng/mL, p = 0.357). Decreased hepcidin levels were significantly associated with decreased RLS severity (β = 0.002, 95% CI = 0.00−0.00, p = 0.005) and improved quality of life (β = 0.002, 95% CI = 0.00−7.01, p = 0.044) in a dose-dependent manner after 12 weeks of treatment with a dopamine agonist. This association was independent of age, sex, inflammatory markers, sleep quality, insomnia, daytime sleepiness, depression and anxiety. Conclusions: This study demonstrates the role of hepcidin in evaluating the positive therapeutic response in RLS.
Molecular Detection of Mycobacterium tuberculosis in Oral Mucosa from Patients with Presumptive Tuberculosis
Authors: Molina-Moya Barbara , Ciobanu Nelly , Hernandez Marta , Prat-Aymerich Cristina , Crudu Valeriu , Adams Emily R. , Codreanu Alexandru , Sloan Derek J. , Cuevas Luis E. , Dominguez Jose
Published: December 2020

Tuberculosis (TB) diagnosis is increasingly based on the detection of Mycobacterium tuberculosis complex (MTBC) DNA in sputum using molecular diagnostic tests as the first test for diagnosis. However, sputum can be difficult to obtain in children, patients without productive cough, and the elderly and approaches testing non-sputum samples are needed. We evaluated whether TB can be detected from the oral mucosa of patients with TB. Adults with presumptive TB were examined using culture, Xpert MTB/RIF, smear microscopy and X-Rays. Oral mucosa swabs collected on PrimeStore-MTM, stored at room temperature if tested within 30 days or at −20 °C if examined at a later time. RT-PCR was performed to detect M. tuberculosis DNA. Eighty patients had bacteriologically-confirmed TB, 34 had bacteriologically-negative TB (negative tests but abnormal X-rays) and 152 were considered not to have TB (not TB). Oral swabs RT-PCR were positive in 29/80 (36.3%) bacteriologically-confirmed, 9/34 (26.5%) bacteriologically-negative and 29/152 (19.1%) not TB. The yield varied among samples stored for less and more than 30 days (p = 0.013) from 61% (11/18) and 29% (18/62) among bacteriologically confirmed, and 30.8% (4/13) and 23.8% (5/21) among bacteriologically-negative participants. Among not TB patients, the specificity was 80.9% (123/152), being 78.3% (18/23) among samples stored less than 30 days and 81.4% (105/129) among samples stored for more than 30 days (p = 0.46). The detection of M. tuberculosis in oral mucosa samples is feasible, but storage conditions may affect the yield.