bluuebunny/crossref_metadata_2025 huggingface dataset:
The Effect of Covering Corn Silage with Tomato or Apple Pomace on Fermentation Parameters and Feed Quality
Authors: Ünlü Hayrullah Bora , Canbolat Önder , Yerlikaya Oktay , Esen Selim , Palangi Valiollah , Lackner Maximilian
Published: July 2024

The current study assessed the effects of covering corn silage with tomato or apple pomace on fermentability and feed quality. The in vitro gas production test was performed using graded 100 mL syringes. Incubation times were 3, 6, 12, 24, 48, 72, and 96 h. In vitro gas generation characteristics were significantly altered by TP (tomato pomace) and AP (apple pomace), both alone and in conjunction with PE (polyethylene) films, regardless of their presence. As a result of the effects found on NH3-N concentration, aerobic stability, and yeast activity, TP and AP have the potential to become an eco-friendly alternative to PE films. The gas production from the immediately soluble fraction (a) of corn silage was only affected when the corn silage was covered with a combination of AP and PE compared to the CPE group (p < 0.001). The largest cluster includes correlations of the DOM-TDDM (r = 0.90), DOM-AA (r = 0.88), and Ash-TDDM (r = 0.86) correlations. The most substantial negative correlations were identified between DM-CO2 (r = −82), DM-Yeast (r = −0.79), and CF-DOM (r = −0.79). Nonetheless, the use of pomace as a silage cover presents an inexpensive alternative to plastic films for silage that does not have the environmental problems associated with persistent micro- and nanoplastics.
The Effects of a Saccharomyces cerevisiae Strain Overexpressing the Endopolygalacturonase PGU1 Gene on the Aminoacidic, Volatile, and Phenolic Compositions of Cabernet Sauvignon Wines
Authors: Fernández-González Mónica , Izquierdo-Cañas Pedro Miguel , García-Romero Esteban , Paniagua-Martínez Tania , Gómez-Alonso Sergio
Published: July 2024

The addition of pectinase enzymes during the maceration stage of grape skins in order to improve the extraction yields and color of red wines is a common practice in many wineries. The objective of this work was to study in depth the changes that occurred in the aminoacidic, volatile, and phenolic compositions of Cabernet Sauvignon wines fermented with a Saccharomyces cerevisiae strain genetically modified with the gene encoding for endopolygalacturonase (PGU1) in transcriptional fusion with the promoter of the phosphoglycerate kinase (PGK1) gene, both from S. cerevisiae origin. A higher yield extraction of wine was obtained in wines fermented with the modified strain (PW), increasing by around 6.1% compared to the control wine (CW). Moreover, there was a 40% decrease in the malic acid content in the PW, thus suggesting that this modified yeast could be investigated as a malic acid-reducing agent. There were slight differences in other aroma volatile compounds studied as well as in the phenolic content. However, there was a considerable increase in the amino acid content in the PW.
Microservice-Based Vehicular Network for Seamless and Ultra-Reliable Communications of Connected Vehicles
Authors: Zarie Mira M. , Ateya Abdelhamied A. , Sayed Mohammed S. , ElAffendi Mohammed , Abdellatif Mohammad Mahmoud
Published: July 2024

The fifth-generation (5G) cellular infrastructure is expected to bring about the widespread use of connected vehicles. This technological progress marks the beginning of a new era in vehicular networks, which includes a range of different types and services of self-driving cars and the smooth sharing of information between vehicles. Connected vehicles have also been announced as a main use case of the sixth-generation (6G) cellular, with ultimate requirements beyond the 5G (B5G) and 6G eras. These networks require full coverage, extremely high reliability and availability, very low latency, and significant system adaptability. The significant specifications set for vehicular networks pose considerable design and development challenges. The goals of establishing a latency of 1 millisecond, effectively handling large amounts of data traffic, and facilitating high-speed mobility are of utmost importance. To address these difficulties and meet the demands of upcoming networks, e.g., 6G, it is necessary to improve the performance of vehicle networks by incorporating innovative technology into existing network structures. This work presents significant enhancements to vehicular networks to fulfill the demanding specifications by utilizing state-of-the-art technologies, including distributed edge computing, e.g., mobile edge computing (MEC) and fog computing, software-defined networking (SDN), and microservice. The work provides a novel vehicular network structure based on micro-services architecture that meets the requirements of 6G networks. The required offloading scheme is introduced, and a handover algorithm is presented to provide seamless communication over the network. Moreover, a migration scheme for migrating data between edge servers was developed. The work was evaluated in terms of latency, availability, and reliability. The results outperformed existing traditional approaches, demonstrating the potential of our approach to meet the demanding requirements of next-generation vehicular networks.
Upcycling of Defatted Sesame Seed Meal via Protein Amyloid-Based Nanostructures: Preparation, Characterization, and Functional and Antioxidant Attributes
Authors: Eze Fredrick Nwude , Muangrat Rattana , Singh Sudarshan , Jirarattanarangsri Wachira , Siriwoharn Thanyaporn , Chalermchat Yongyut
Published: July 2024

Herein, the possibility of valorizing defatted sesame seed meal (DSSM) as a viable source for valuable plant proteins and amyloid-based nanostructure was investigated. Sesame seed protein isolate (SSPI) and the major storage protein globulin (SSG) were prepared by alkaline extraction–isoelectric point precipitation as well as fractionation in the case of SSG. The protein samples were characterized for their physicochemical attributes. SSPI and SSG were also evaluated for their ability to form amyloid structures under heating (90 °C) at low pH (2.0). Additionally, the functional attributes, antioxidant activity, and biocompatibility of the proteins and amyloid nanostructures were also examined. SSPI and SSG were both successfully prepared from DSSM. The data showed that the physicochemical attributes of both protein samples were quite similar, except for the fact that SSG was mostly composed of 11S globulin, as evinced by Tricine-SDS-PAGE analysis. TEM micrographs revealed that SSG was able to form curly-shaped fibrillar amyloid structures, whereas those derived from SSPI were mostly amorphous. Thioflavin-T assay and Tricine-SDS-PAGE analysis indicated that acidic heating promoted protein hydrolysis and self-aggregation of the hydrolyzed peptides into a β-sheet rich amyloid structure. Importantly, the amyloid preparations displayed commendable solubility, superior water and oil holding capacities, and antioxidant activity against DPPH and ABTS. The protein amyloid nanostructures were found to be non-toxic against RAW264.7 cells, HaCaT cells, and red blood cells. These findings indicate that DSSM could be upcycled into valuable protein amyloid structures with good potentialities as novel food ingredients.
Effect of Neutral and Acidic Protease Processing Intervals on Optimising Nutritional Value and Enhancing Physico-Chemical Properties of Oat Drink
Authors: Ibrahim Monica Nabil Gayed , Andreson Helena , Ben-Othman Sana , Jõudu Ivi
Published: July 2024

This study aimed to maximise the content of water-soluble protein (WSP) and β-glucan (BG) in oat drink (OD) products by optimising the duration of treatment with neutral (NP) and acidic (AP) proteases. Additionally, it investigated the correlation between changes in the OD’s nutritional profile and its rheological and sensory properties. After initial treatment with α-amylase, the OD samples were divided into two groups, i.e., one treated with NP and the other with AP for 30, 60, 120, and 180 min. The samples were then analysed for their WSP and BG contents. Samples with an optimised treatment duration were evaluated for their rheological and sensory properties. The OD sample treated with AP for 60 min exhibited the highest β-glucan (0.52 g/100 mL) and WSP (1.56 g/100 mL) contents, improved storage stability, and the lowest sedimentation rate (2.13%/h), compared to the control OD sample. However, sensorially, this sample was characterised by a sticky, gluey mouthfeel and was less acceptable as a drinkable product. This study demonstrated the potential effect of protease treatment on enhancing the nutritional value and stability of OD products, although further studies are necessary to improve the sensory properties of these drinks.
Usefulness of the 1H NMR Multisuppression Approach for the Global Characterization of Monovarietal Extra-Virgin Olive Oils
Authors: Goicoechea-Oses Encarnacion , Ruiz-Aracama Ainhoa
Published: July 2024

Extra-virgin olive oil (EVOO) is one of the most appreciated vegetable oils worldwide, but its high price makes it prone to suffer adulteration with lower quality oils. Therefore, it is important to have methodologies able to study EVOO composition as a whole in a simple and fast way, in order to guarantee its quality and safety. For this purpose, in this study, commercial samples of five Spanish olive cultivars (Arbequina, Arroniz, Cornicabra, Hojiblanca, Picual) were studied by Proton Nuclear Magnetic Resonance (1H NMR) spectroscopy, using standard and multisuppression pulses. The aim was to explore the possibility of 1H NMR use to characterize in a single run and in a global way the composition of these monocultivar oils, regarding not only their main components (fatty acids supported on triglycerides) but also minor ones (squalene, sterols, diterpenic wax esters of phytol and geranylgeraniol, phenolic and secoiridoid derivatives, like tyrosol, hydroxytyrosol, oleacein, oleocanthal, and lignans, among others, and aldehydes). The use of univariate and multivariate statistical analyses confirmed the presence of compositional features that were specific to some olive varieties. The Arbequina and Arroniz oils showed the most characteristic features that allowed for clearly differentiating them from the others. In contrast, the discrimination between the Cornicabra, Hojiblanca and Picual oils was not so easily achieved.
Multiple Solutions to the Fractional p-Laplacian Equations of Schrödinger–Hardy-Type Involving Concave–Convex Nonlinearities
Authors: Kim Yun-Ho
Published: July 2024

This paper is concerned with nonlocal fractional p-Laplacian Schrödinger–Hardy-type equations involving concave–convex nonlinearities. The first aim is to demonstrate the L∞-bound for any possible weak solution to our problem. As far as we know, the global a priori bound for weak solutions to nonlinear elliptic problems involving a singular nonlinear term such as Hardy potentials has not been studied extensively. To overcome this, we utilize a truncated energy technique and the De Giorgi iteration method. As its application, we demonstrate that the problem above has at least two distinct nontrivial solutions by exploiting a variant of Ekeland’s variational principle and the classical mountain pass theorem as the key tools. Furthermore, we prove the existence of a sequence of infinitely many weak solutions that converges to zero in the L∞-norm. To derive this result, we employ the modified functional method and the dual fountain theorem.
Novel Approach by Shifted Fibonacci Polynomials for Solving the Fractional Burgers Equation
Authors: Alharbi Mohammed H. , Abu Sunayh Abdullah F. , Atta Ahmed Gamal , Abd-Elhameed Waleed Mohamed
Published: July 2024

This paper analyzes a novel use of the shifted Fibonacci polynomials (SFPs) to treat the time-fractional Burgers equation (TFBE). We first develop the fundamental formulas of these polynomials, which include their power series representation and the inversion formula. We establish other new formulas for the SFPs, including integer and fractional derivatives, in order to design the collocation approach for treating the TFBE. These derivative formulas serve as tools that aid in constructing the operational metrics for the integer and fractional derivatives of the SFPs. We use these matrices to transform the problem and its underlying conditions into a system of nonlinear equations that can be treated numerically. An error analysis is analyzed in detail. We also present three illustrative numerical examples and comparisons to test our proposed algorithm. These results showed that the proposed algorithm is advantageous since highly accurate approximate solutions can be obtained by choosing a few terms of retained modes of SFPs.
Fractional-Order Tabu Learning Neuron Models and Their Dynamics
Authors: Yu Yajuan , Gu Zhenhua , Shi Min , Wang Feng
Published: July 2024

In this paper, by replacing the exponential memory kernel function of a tabu learning single-neuron model with the power-law memory kernel function, a novel Caputo’s fractional-order tabu learning single-neuron model and a network of two interacting fractional-order tabu learning neurons are constructed firstly. Different from the integer-order tabu learning model, the order of the fractional-order derivative is used to measure the neuron’s memory decay rate and then the stabilities of the models are evaluated by the eigenvalues of the Jacobian matrix at the equilibrium point of the fractional-order models. By choosing the memory decay rate (or the order of the fractional-order derivative) as the bifurcation parameter, it is proved that Hopf bifurcation occurs in the fractional-order tabu learning single-neuron model where the value of bifurcation point in the fractional-order model is smaller than the integer-order model’s. By numerical simulations, it is shown that the fractional-order network with a lower memory decay rate is capable of producing tangent bifurcation as the learning rate increases from 0 to 0.4. When the learning rate is fixed and the memory decay increases, the fractional-order network enters into frequency synchronization firstly and then enters into amplitude synchronization. During the synchronization process, the oscillation frequency of the fractional-order tabu learning two-neuron network increases with an increase in the memory decay rate. This implies that the higher the memory decay rate of neurons, the higher the learning frequency will be.
Towards a Healthy Diet in an Adolescent Population: The Mediating Role of Motivation and Perceived Barriers between Self-Efficacy and Weight Regulation
Authors: Marentes-Castillo María , Castillo Isabel , Tomás Inés , Álvarez Octavio
Published: July 2024

(1) Background: Adolescence is a critical period when dietary choices are a major concern. It is therefore important to understand the psychological factors that explain these choices. The objective of this study was to assess the predictive role of perceived self-efficacy for healthy eating and weight regulation on healthy and unhealthy eating behavior through the mediation of autonomous motivation, controlled motivation, amotivation, and perceived barriers to daily mechanisms affecting healthy consumption. (2) Methods: A total of 994 adolescents between 15 and 19 years old from Mexico and Spain participated in the study. The Spanish versions of the healthy eating and weight self-efficacy questionnaire, the behavioral regulation in exercise questionnaire, the barriers to healthy eating scale, and the weight-related behaviors scale questionnaire were used to measure the variables of interest. (3) Results: Mediated serial regression analysis showed that barriers to healthy eating (the daily mechanism of food consumption) reduced healthy eating choices. Healthy eating and weight self-efficacy also showed a positive significant relationship with autonomous motivation and a negative relationship with controlled motivation and amotivation. All the types of motivation showed a positive relationship with barriers to healthy eating. (4) Conclusions: The results point out the need to enhance self-efficacy, promote autonomous motivation, and reduce perceived barriers in young people with respect to healthy eating.
Exploring Family Ties and Interpersonal Dynamics—A Geospatial Simulation Analyzing Their Influence on Evacuation Efficiency within Urban Communities
Authors: Chu Hao , Wu Jianping , Perez Liliana , Huang Yonghua
Published: July 2024

Guaranteeing efficient evacuations in urban communities is critical for preserving lives, minimizing disaster impacts, and promoting community resilience. Challenges such as high population density, limited evacuation routes, and communication breakdowns complicate evacuation efforts. Vulnerable populations, urban infrastructure constraints, and the increasing frequency of disasters further contribute to the complexity. Despite these challenges, the importance of timely evacuations lies in safeguarding human safety, enabling rapid disaster response, preserving critical infrastructure, and reducing economic losses. Overcoming these hurdles necessitates comprehensive planning, investment in resilient infrastructure, effective communication strategies, and continuous community engagement to foster preparedness and enhance evacuation efficiency. This research looks into the complexities of evacuation dynamics within urban residential areas, placing a particular focus on the interaction between joint-rental arrangements and family ties and their influence on evacuation strategies during emergency situations. Using agent-based modeling, evacuation simulation scenarios are implemented using the Changhongfang community (Shanghai) while systematically exploring how diverse interpersonal relationships impact the efficiency of evacuation processes. The adopted methodology encompasses a series of group experiments designed to determine the optimal proportions of joint-rental occupants within the community. Furthermore, the research examines the impact of various exit selection strategies on evacuation efficiency. Simulation outcomes shed light on the fundamental role of interpersonal factors in shaping the outcomes of emergency evacuations. Additionally, this study emphasizes the critical importance of strategic exit selections, revealing their potential to significantly enhance overall evacuation efficiency in urban settings.
The Management of Railway Operations during the Planned Interruption of Railway Infrastructure
Authors: Bulková Zdenka , Gašparík Jozef , Zitrický Vladislav
Published: July 2024

A planned interruption of railway infrastructure is a situation where the operation of the track line or the operation of railway transport is limited. If there is also a restriction on the railway infrastructure, it means there will be complications not only for passengers but, above all, for railway undertakings operating freight transport. However, because of the planned railway infrastructure interruption, the quality of services provided not only to passengers but also to freight transport is decreasing. The aim of this paper is to propose effective planned maintenance works based on the analysis and evaluation of the processes performed during the planned railway infrastructure interruption or restriction. The research describes the process of affected railway infrastructure from technical, cost, and safety points of view. A methodological procedure is proposed under the condition of the Czech infrastructure manager. The main method is the calculation of the costs for the railway infrastructure manager and railway operator during the infrastructure interruption. The application part is undertaken using two interrupted lines according to the established alternative timetable in the area of České Budějovice.
Novel Strategy to Evaluate Platinum Photocatalysts for Hydrosilation-Curable Silicones
Authors: Michailidis Melina , Leman John , Bonitatibus Peter J.
Published: July 2024

UV-activated catalytic hydrosilation is a low-temperature crosslinking process that has attracted attention for its high efficiency and lower energy demand relative to thermal curing. In this study, formulations comprising industrially relevant model silanes and Pt photocatalysts trimethyl(methylcyclopentadienyl)platinum(IV) and trimethyl(pentamethylcyclopentadienyl)platinum(IV) (MeCpPtMe3 and Cp*PtMe3, respectively) were prepared with and without a photosensitizer (PS) and assessed for catalytic performance by a novel strategy. Photopolymerizations were initiated using different wavelengths from LEDs and monitored in real-time using an Attenuated Total Reflectance-Fourier Transform Infrared (ATR-FTIR) “well” strategy to track the degree of cure in ultra-thin films by consumption of hydride via the disappearance of the Si-H bending absorption band at 915 cm−1. Irradiation of formulations with 365 nm excitation showed higher conversions relative to 400 nm light and improvements to calculated initial reaction rates by incorporation of a PS suggested increased sensitization to 365 nm irradiation. To the best of our knowledge, this is the first study to report catalytic performance, electronic absorption spectroscopic data, and the crystal structure of Cp*PtMe3.
Taxonomic Revision of the Nearctic Genus Drepanaphis Del Guercio (Hemiptera, Aphididae: Drepanosiphinae)
Authors: Malik Kamila , Bugaj-Nawrocka Agnieszka , Wieczorek Karina
Published: July 2024

The Nearctic aphid genus Drepanaphis Del Guercio, 1909, the largest within the subfamily Drepanosiphinae (Hemiptera: Aphididae), is characterised by distinctive dorsal abdominal tubercles. This study presents a comprehensive taxonomic revision of the genus, expanding the recognised species to 18, including the newly described Drepanaphis robinsoni Malik sp. nov. Detailed descriptions and figures for 44 morphs, encompassing alate viviparous females, oviparous females and males, are provided, with new identification keys for all known species and morphs. The sexual morphs of 15 species, particularly oviparous females, are documented for the first time. Morphometric and principal component analyses (PCA) are employed to distinguish the studied taxa. This study identifies and corrects numerous misidentifications in museum collections, previously labelled as D. acerifoliae, D. choanotricha, D. kanzensis, D. knowltoni, D. parva, D. sabrinae or D. tissoti. Furthermore, it revalidates the distinct status of D. nigricans and D. tissoti, which had been synonymised in earlier works. Current range maps for all species and images of key morphological features obtained through light and scanning electron microscopy are also presented, providing a more complete understanding of this understudied genus.
The Effects of Natural Insecticides on the Green Peach Aphid Myzus persicae (Sulzer) and Its Natural Enemies Propylea quatuordecimpunctata (L.) and Aphidius colemani Viereck
Authors: Lami Francesco , Burgio Giovanni , Magagnoli Serena , Depalo Laura , Lanzoni Alberto , Frassineti Elettra , Marotti Ilaria , Alpi Mattia , Mercatante Dario , Rodriguez-Estrada Maria Teresa , Dinelli Giovanni , Masetti Antonio
Published: July 2024

Botanical insecticides and soaps are frequently proposed as environmentally safer alternatives to synthetic insecticides. However, the efficacy and selectivity of these products are often only partially supported by empirical evidence. Here, we tested the effectiveness of five botanical insecticides, belonging to different categories, on the green peach aphid Myzus persicae (Sulzer) and their selectivity towards two natural enemies, the ladybird beetle Propylea quatuordecimpunctata (L.) and the parasitoid Aphidius colemani (Dalman). White thyme essential oil (EO), sweet orange EO, crude garlic extract and Marseille soap were tested and compared with a pyrethrin-based commercial product. Both direct spray assays and residual contact assays on treated cabbage leaf disks were carried out. The tested products had low efficacy against aphids when compared to pyrethrins but were in general less detrimental to ladybird beetle larvae, meaning that if applied against other pests, they have a lower chance of harming this agent of aphid biocontrol. Some of the products (soap, orange EO) did, however, show direct exposure toxicity toward ladybird larvae, and thyme EO had extensive phytotoxic effects on cabbage leaves, possibly indirectly leading to higher mortality in ladybird adults. These results underline the necessity for case-by-case evaluations of botanical insecticides.
Arterial Vascularization of the Forehead in Aesthetic Dermatology Procedures: A Review
Authors: Kliniec Katarzyna , Domagała Zygmunt , Kempisty Bartosz , Szepietowski Jacek C.
Published: July 2024

Background: The growing popularity of aesthetic procedures on the face raises the question of their safety. The forehead region is crucial aesthetically, but due to its abundant vascularization, it is also one of the most dangerous areas for dermatologic procedures, especially in the glabella area. The purpose of this article is to review the literature on the arterial vascularization of the forehead to identify potential high-risk zones for aesthetic dermatology procedures. Methods: A database search (PubMed, Web of Science, Scopus, and Embase) was conducted, and the titles and abstracts of all identified studies were screened, followed by full-text evaluation. Results: We identified 714 articles during the database search, and 25 articles were included in the review. The included studies used cadaveric dissection and computed tomography applied to cadavers as well as Doppler ultrasonography on volunteers to evaluate the forehead arteries (supratrochlear (STrA), supraorbital (SOA), central (CA), paracentral artery (PCA), and frontal branch of superficial temporal artery(FBSTA)). A total of 1714 cases involving the forehead arteries were analyzed. The included arteries were observed over a relatively large area, and their locations varied. The CA and PCA in cadaver studies were observed in an area of 0.2 to 10.8 mm and 0.8 to 16.2 mm, respectively, on the entire path from the glabellar point to the frontal prominence point. The distances from the midline in cadaveric studies at various measurement points ranged from 0.6 to 28.0 mm for the superficial branch of the STrA and 13.6 to 40.7 mm for the deep branch of STrA. In case of SOA, the distance from the midline ranged from 23 to 32 mm. Measurements from the midline in Doppler studies ranged from 0 to 23 mm for STrA and from 10 to 50 mm for the SOA. In studies using computed tomography, STrA was observed at a distance of 11 to 21 mm and the SOA at a distance of 21 to 32 mm, both lateral to the midline. Conclusions: Medical professionals should be aware of zones where frontal arteries are more likely to be encountered. The glabella region appears to be one of the most dangerous areas for dermatologic procedures. It is believed that the supratrochlear, supraorbital, and the paracentral arteries may cause ophthalmic complications due to occlusion of the ophthalmic artery, while this risk for the frontal branch of the superficial temporal artery seems to be low but cannot be completely excluded.
Antimicrobial Resistance Trends in Hidradenitis Suppurativa Lesions
Authors: Koumaki Dimitra , Evangelou Georgios , Maraki Sofia , Rovithi Evangelia , Petrou Danae , Apokidou Erato Solia , Gregoriou Stamatios , Koumaki Vasiliki , Ioannou Petros , Zografaki Kyriaki , Doxastaki Aikaterini , Katoulis Alexander , Papadopoulou Kalliopi , Stafylaki Dimitra , Mavromanolaki Viktoria Eirini , Krasagakis Konstantinos
Published: July 2024

Background/Objectives: Antibiotic (AB) therapy is the first step in managing hidradenitis suppurativa (HS). Knowledge of the local patterns of antimicrobial resistance is paramount for the appropriate selection of antimicrobials. This study aimed to assess the occurrence of antibiotic resistance in patients with HS. Methods: A cross-sectional study was conducted on 103 patients with HS seen at the Dermatology Department at the University Hospital of Heraklion, Heraklion, Crete, Greece, from January 2019 to December 2023, who were not on any antibiotics in the last three months. Results: A total of 103 patients with HS participated in this study. Purulent material from 139 skin lesions of these patients was swabbed, and 79.86% (111/139) tested positive for bacteria. Gram-positive isolates accounted for 73%, whereas Gram-negative isolates comprised 27%. Among the isolates, 85.1% were aerobes, and 14.9% were anaerobic. The most common bacterial families isolated were Staphylococcaceae (48.27%), Enterobacteriaceae (14.94%), and Streptococcaceae (6.89%). The antibiogram profiles of bacterial cultures revealed a 57.1% resistance to levofloxacin and a 53.3% resistance to penicillin in Staphylococcus lugdunensis, whereas Staphylococcus aureus showed a 76.9% resistance to penicillin and a 58.3% resistance to fusidic acid. High resistance rates of 63.5% for tigecycline, 63.3% for ampicillin, and 40.5% for colistin were observed for Gram-negative isolates. Resistances of 62.5%, 61.5%, and 53.8% to erythromycin, clindamycin, and penicillin, respectively, were observed in the anaerobes. Conclusions: Patients with HS displayed considerable resistance to bacterial proliferation. The revised therapeutic guidelines for HS should incorporate the latest insights into bacterial antibiotic resistance.
Understanding Type II Endoleak: A Harmless Imaging Finding or a Silent Threat?
Authors: Koudounas Georgios , Giannopoulos Stefanos , Charisis Nektarios , Labropoulos Nicos
Published: July 2024

Type II endoleak (T2EL) represents a challenging clinical entity following endovascular abdominal aortic aneurysm repair (EVAR). Although several studies have suggested that T2ELs are related to an increased risk of aneurysm sac growth and subsequent rupture, the exact role that T2ELs play in long-term outcomes remains debatable. Understanding the pathophysiology, diagnostic modalities, and management options of T2ELs is important for patients’ safety and proper resource utilization. While conservative management may be suitable for asymptomatic patients with a stable aneurysm size, interventional approaches, including transarterial embolization, direct sac puncture embolization and open conversion have been described for patients with persistent T2EL associated with sac expansion. However, more research is needed to better determine the clinical benefit of such interventions. A thorough evaluation of all endoleak types before T2EL treatment would be reasonable for patients with T2ELs associated with sac expansion. Further studies are needed to refine treatment strategies aimed at minimizing T2EL-related complications. Collaborative efforts among vascular specialists, radiologists, and researchers are of paramount importance to address this ongoing clinical challenge.
Clinical and Economic Consequences of a First Major Bleeding Event in Patients Treated with Direct Factor Xa Inhibitors in Spain: A Long-Term Observational Study
Authors: Escobar Carlos , Palacios Beatriz , Villarreal Miriam , Gutiérrez Martín , Capel Margarita , Aranda Unai , Hernández Ignacio , García María , Lledó Laura , Arenillas Juan F.
Published: July 2024

Aims: Our aims were to describe the clinical characteristics, adverse clinical events, healthcare resource utilization (HCRU) and costs of patients with major bleeding during direct Factor Xa inhibitor (FXai) use. Methods: This is a retrospective cohort study that included secondary data from computerized health records of seven Spanish Autonomous Communities. Patients with a first major bleeding during treatment with a direct FXai were analyzed during a 3-year period. Results: Of 8972 patients taking a direct FXai, 470 (5.24%) had major bleeding (mean age (SD) 77.93 (9.71) years, 61.06% women). The most frequent indications for using FXais were atrial fibrillation (78.09%) and venous thromboembolism (17.66%). Among those with major bleeding, 88.94% presented with gastrointestinal bleeding, 6.81% intracranial bleeding, 2.13% trauma-related bleeding and 4.26% other major bleeding. Prothrombin complex concentrates were used in 63.19%, followed by transfusion of blood products (20.21%) and Factor VIIa (7.66%). In total, 4.26% of patients died in the hospital due to the first major bleeding. At the study end (after 3-year follow-up), 28.94% of the patients had died, 12.34% had a myocardial infarction and 9.15% an ischemic stroke. At year 3, overall bleeding cost was EUR 5,816,930.5, of which 79.74% accounted for in-hospital costs to treat the bleeding episode. Conclusions: Despite the use of replacement agents being high, major events were common, with a 29% mortality at the end of the follow up, and HCRU and costs were high, evidencing the need for new reversal treatment strategies.
Control of Haemorrhage in Orthopaedic Trauma
Authors: Kenyon Robert M. , Leighton Jennifer L.
Published: July 2024

This paper aims to outline current practices and examine promising new advancements in the modern management of haemorrhage in orthopaedic trauma. Many prehospital and perioperative haemorrhage control strategies and techniques have been available to clinicians for multiple decades, yet our understanding and utilisation of these practices continues to be refined and optimised. There is a particular focus in this article on issues related to resuscitation and coagulation in trauma. We examine the complex mechanisms that lead to coagulopathy in trauma patients as well as the transformative effect tranexamic acid has had in limiting blood loss. We also explore some emerging technologies such as endovascular interventions and clot-stabilising dressings and devices that are likely to have a significant impact going forward.
Opening-Wedge High Tibial Osteotomy with a Cancellous Strut Bone Allograft Is Inadequate for Achieving Satisfactory and Lasting Correction in Neglected Infantile Tibia Vara: Results from a Cohort of 29 Patients
Authors: Depaoli Alessandro , Ramella Marco , Menozzi Grazia Chiara , Di Gennaro Giovanni Luigi , Rocca Gino , Trisolino Giovanni
Published: July 2024

Background: Infantile tibia vara (ITV) is a rare proximal tibia deformity in infancy, leading to progressive knee varus. High tibial osteotomy is commonly practiced but has high recurrence rates. This study analyzed factors affecting treatment failure and recurrence in children undergoing opening-wedge high tibial osteotomy (OWHTO) for ITV. Methods: We retrospectively studied children with ITV who had OWHTO with a press-fit cancellous bone allograft between 2000 and 2020, with ≥2-year follow-up. Outcomes included recurrence (knee varus with tibiofemoral angle > 10°), complications, and reintervention. Results: We analyzed 39 knees in 29 patients (mean age: 4.8 ± 1.9 years; median follow-up: 7.4 years). Recurrence occurred in 22 cases (56%). Age at surgery significantly influenced recurrence, with rates of 16% before age 5 versus 95% later (hazard ratio: 12.0, p = 0.001). Langenskiöld stage also affected recurrence (β-coefficient: 2.7, 95% C.I. 1.0–4.5, p = 0.002; pseudo-R-squared: 0.50, p = 0.001), with recurrence in all stage IV or higher cases. Conclusions: Early diagnosis and treatment before age 5, ideally with Langenskiöld stage III or lower, are crucial for stable correction with OWHTO alone. Late, high-grade ITV may require combined, acute or gradual, and/or staged correction. Further evidence is needed for optimal management.
Subclinical Atherosclerosis in Alopecia Areata: Usefulness of Arterial Ultrasound for Disease Diagnosis and Analysis of Its Relationship with Cardiometabolic Parameters
Authors: Burgos-Blasco Patricia , Gonzalez-Cantero Alvaro , Hermosa-Gelbard Angela , Jiménez-Cahue Juan , Buendía-Castaño Diego , Berna-Rico Emilio , Abbad-Jaime de Aragón Carlota , Vañó-Galván Sergio , Saceda-Corralo David
Published: July 2024

Background/Objectives: Chronic systemic inflammation is a risk factor that increases the development of atherosclerosis and predisposes to cardiovascular diseases (CVDs). The systemic inflammatory profile of alopecia areata (AA) regarding IFNγ and Th1 cytokine dysregulation has previously been described, suggesting an increased incidence of CVDs in this population. No previous studies investigated the possible relationship between atherosclerosis and AA by cardiovascular imaging techniques. To determine the prevalence, distribution and burden of subclinical atherosclerosis in AA. Methods: We conducted a case–control study in 62 participants, including 31 patients with severe AA (SALT > 75) and 31 healthy controls, matched for age, sex and body mass index (BMI). The participants underwent a detailed history assessment and were subjected to the measurement of weight, height, abdominal circumference and blood pressure. A fasting blood sample was also collected. Subclinical atherosclerosis was evaluated by ultrasonography of the bilateral femoral and carotid arteries. Results: The AA patients had an increased prevalence of subclinical atherosclerosis (54.7%) compared to the healthy controls (22.6%, p = 0.010). The prevalence of atheroma plaques was significantly higher in the carotid arteries (41.90% vs. 12.9%, p = 0.009), while no significant differences were found in femoral plaque prevalence. The AA patients with atherosclerotic plaques were older (p < 0.001) and had a longer time since AA diagnosis (p = 0.11) and increased serum levels of glycated hemoglobin (p = 0.029) and triglycerides (p = 0.009). In a regression analysis, duration of disease and neutrophil/lymphocyte ratio were the main predictors of atherosclerosis. Conclusions: AA patients have an increased prevalence of carotid subclinical atherosclerosis. The duration of AA, systemic inflammation and insulin resistance appear to play a role in the development of subclinical atherosclerosis in this population.
Interstitial Foci Expression of Indoleamine 2,3-Dioxygenase 1: A Potential Biomarker for Kidney Transplant Rejection
Authors: Wiśnicki Krzysztof , Donizy Piotr , Kuriata-Kordek Magdalena , Uchmanowicz Izabella , Zachciał Justyna , Hałoń Agnieszka , Janczak Dariusz , Banasik Mirosław
Published: July 2024

(1) Background: Kidney transplantation is the best therapy for patients with end-stage renal disease, but the risk of rejection complicates it. Indoleamine 2,3-dioxygenase 1 (IDO1), an enzyme involved in immune response modulation, has been suggested to play a role in transplant immunological injury. The aim of the study was to explore the expression of IDO1 in the interstitial foci of transplanted kidneys and its potential association with rejection episodes. (2) Methods: This retrospective study analysed kidney transplant biopsies from 121 patients, focusing on IDO1 expression in interstitial foci. Immunohistochemistry was used to detect IDO1, and patients were categorised based on IDO1 presence (IDO1-IF positive or negative). The incidence of rejection was compared between these groups. (3) Results: Patients with IDO1 expression in interstitial foci (IDO1-IF(+)) exhibited higher incidences of rejection 46/80 (57.5%) vs. 10/41 (24.34%) patients compared to IDO1-IF(−) patients, which was statistically significant with p = 0.0005. The analysis of antibody-mediated rejection showed that IDO1-IF(+) patients developed AMR at 12/80 (15%), while only 1 IDO1-IF(−) negative patient did (2,44%), with p = 0.035. T-cell-mediated rejection was also more common in IDO1-IF(+) patients 43/80 (53.75%) than in IDO1-IF(−) patients 7/41 (17.07%), with p = 0.0001. (4) Conclusions: IDO1 expression in interstitial foci of renal transplant biopsies is associated with a higher incidence of rejection, suggesting that IDO1 could serve as a potential biomarker for transplant rejection. These findings highlight the importance of IDO1 in immune regulation and its potential utility in improving the management of kidney transplant recipients.
Age as an Effect Modifier of the Effects of Transcutaneous Auricular Vagus Nerve Stimulation (taVNS) on Heart Rate Variability in Healthy Subjects
Authors: Gianlorenço Anna Carolyna , Pacheco-Barrios Kevin , Daibes Marianna , Camargo Lucas , Choi Hyuk , Song Jae-Jun , Fregni Felipe
Published: July 2024

Background: Evidence suggests that vagus nerve stimulation can modulate heart rate variability (HRV). However, there is a lack of mechanistic studies in healthy subjects assessing the effects of bilateral transcutaneous auricular vagus nerve stimulation (taVNS) on HRV. Our study aims to investigate how taVNS can influence the HRV response, including the influence of demographic variables in this response. Methods: Therefore, we conducted a randomized controlled study with 44 subjects, 22 allocated to active and 22 to sham taVNS. Results: Our results showed a significant difference between groups in the high-frequency (HF) metric. Active taVNS increased the HF metric significantly as compared to sham taVNS. Also, we found that age was a significant effect modifier of the relationship between taVNS and HF-HRV, as a larger increase in HF-HRV was seen in the older subjects. Importantly, there was a decrease in HF-HRV in the sham group. Conclusions: These findings suggest that younger subjects can adapt and maintain a constant level of HF-HRV regardless of the type of stimulation, but in the older subjects, only the active taVNS recipients were able to maintain and increase their HF-HRV. These results are important because they indicate that taVNS can enhance physiological regulation processes in response to external events.
Hypothermic Ventricular Fibrillation in Redo Minimally Invasive Mitral Valve Surgery: A Promising Solution for a Surgical Challenge
Authors: Salman Jawad , Franz Maximilian , Aburahma Khalil , de Manna Nunzio Davide , Tavil Saleh , Ali-Hasan-Al-Saegh Sadeq , Ius Fabio , Boethig Dietmar , Zubarevich Alina , Schmack Bastian , Kaufeld Tim , Popov Aron-Frederik , Ruhparwar Arjang , Weymann Alexander
Published: July 2024

Background: Minimally invasive mitral valve surgery (MIMVS) is a treatment for severe mitral valve pathologies. In redo cases, especially after coronary artery bypass grafting (CABG) surgery with patent mammary bypass grafts, establishing aortic clamping followed by antegrade cardioplegia application might be challenging. Here, we present the outcome of hypothermic ventricular fibrillation as an alternative to conventional cardioprotection. Methods: Patients who underwent MIMVS either received hypothermic ventricular fibrillation (study group, n = 48) or antegrade cardioprotection (control group, n = 840) and were observed for 30 postoperative days. Data were retrospectively analyzed and collected from January 2011 until December 2022. Results: Patients in the study group had a higher preoperative prevalence of renal insufficiency (p = 0.001), extracardiac arteriopathy (p = 0.001), insulin-dependent diabetes mellitus (p = 0.001) and chronic lung disease (p = 0.036). Furthermore, they had a longer surgery time and a lower repair rate (p < 0.001). No difference, however, was seen in postoperative incidences of stroke (p = 0.26), myocardial infarction (p = 1) and mitral valve re-operation (p = 1) as well as 30-day mortality (p = 0.1) and postoperative mitral valve insufficiency or stenosis. Conclusions: The patients who underwent redo MIMVS with hypothermic ventricular fibrillation did not have worse outcomes or more serious adverse events compared to the patients who received routine conventional cardioprotection. Therefore, the use of hypothermic ventricular fibrillation appears to be a promising cardioprotective technique in this challenging patient population requiring redo MIMVS.
Long-Term Benefits of Photobiomodulation Therapy on Health-Related Quality of Life in Burning Mouth Syndrome Patients: A Prospective Study
Authors: de Abreu João Mendes , Nunes Tiago , Almiro Pedro A. , Figueiredo José , Corte-Real Ana
Published: July 2024

Background/Objectives: Burning Mouth Syndrome (BMS) patients experience a reduction in health-related quality of life and an increased intake of medication. Photobiomodulation with low-level laser therapy has been demonstrated to be an efficacious treatment for BMS. However, its long-term benefits remain relatively unknown. This study aimed to evaluate the impact of prolonged Photobiomodulation with low-level laser therapy on BMS patients by examining the efficacy of an outpatient protocol in a real-world setting. Methods: A prospective study was designed to address the research question. Photobiomodulation was performed, irradiating the affected areas once every two weeks for 12 months. Health-related quality of life was assessed using the EQ-5D-5L questionnaire at the initial consultation and after 6 months and 12 months of treatment. Additionally, the patients’ pharmacological profile was also monitored. Nonparametric statistical analysis was performed (p < 0.05 was considered statistically significant). Results: The study was completed by 15 individuals, comprising 14 females and 1 male. The results indicated a statistically significant improvement (p < 0.001) in four of the five dimensions of the health-related quality of life questionnaire, namely self-care, usual activities, pain/discomfort, and anxiety/depression, along with the patients’ perceived health level. A total of 13 participants reported suspending or reducing their intake of medications for Burning Mouth Syndrome. Conclusions: Therefore, Photobiomodulation with low-level laser therapy has a positive effect on improving patients’ quality of life and reducing BMS symptoms, contributing to a subsequent reduction or suspension of previous medications. These findings support the efficacy of the applied protocol. Given the innovative methodology and promising results, further research is warranted.
Beyond Stress Ischemia: Unveiling the Multifaceted Nature of Coronary Vulnerable Plaques Using Cardiac Computed Tomography
Authors: Napoli Gianluigi , Mushtaq Saima , Basile Paolo , Carella Maria Cristina , De Feo Daniele , Latorre Michele Davide , Baggiano Andrea , Ciccone Marco Matteo , Pontone Gianluca , Guaricci Andrea Igoren
Published: July 2024

Historically, cardiovascular prevention has been predominantly focused on stress-induced ischemia, but recent trials have challenged this paradigm, highlighting the emerging role of vulnerable, non-flow-limiting coronary plaques, leading to a shift towards integrating plaque morphology with functional data into risk prediction models. Coronary computed tomography angiography (CCTA) represents a high-resolution, low-risk, and largely available non-invasive modality for the precise delineation of plaque composition, morphology, and inflammatory activity, further enhancing our ability to stratify high-risk plaque and predict adverse cardiovascular outcomes. Coronary artery calcium (CAC) scoring, derived from CCTA, has emerged as a promising tool for predicting future cardiovascular events in asymptomatic individuals, demonstrating incremental prognostic value beyond traditional cardiovascular risk factors in terms of myocardial infarction, stroke, and all-cause mortality. Additionally, CCTA-derived information on adverse plaque characteristics, geometric characteristics, and hemodynamic forces provides valuable insights into plaque vulnerability and seems promising in guiding revascularization strategies. Additionally, non-invasive assessments of epicardial and pericoronary adipose tissue (PCAT) further refine risk stratification, adding prognostic significance to coronary artery disease (CAD), correlating with plaque development, vulnerability, and rupture. Moreover, CT imaging not only aids in risk stratification but is now emerging as a screening tool able to monitor CAD progression and treatment efficacy over time. Thus, the integration of CAC scoring and PCAT evaluation into risk stratification algorithms, as well as the identification of high-risk plaque morphology and adverse geometric and hemodynamic characteristics, holds promising results for guiding personalized preventive interventions, helping physicians in identifying high-risk individuals earlier, tailoring lifestyle and pharmacological interventions, and improving clinical outcomes in their patients.