bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of the COVID-19 Pandemic on Treatment Efficiency for Traumatic Brain Injury in the Emergency Department: A Multicenter Study in Taiwan
Authors: Lam Carlos , Yen Ju-Chuan , Wu Chia-Chieh , Lin Heng-Yu , Hsu Min-Huei
Published: November 2021

The coronavirus disease 2019 (COVID-19) pandemic has impacted emergency department (ED) practice, including the treatment of traumatic brain injury (TBI), which is commonly encountered in the ED. Our study aimed to evaluate TBI treatment efficiency in the ED during the COVID-19 pandemic. A retrospective observational study was conducted using the electronic medical records from three hospitals in metropolitan Taipei, Taiwan. The time from ED arrival to brain computed tomography (CT) and the time from ED arrival to surgical management were used as measures of treatment efficiency. TBI treatment efficiencies in the ED coinciding with a small-scale local COVID-19 outbreak in 2020 (P1) and large-scale community spread in 2021 (P2) were compared against the pre-pandemic efficiency recorded in 2019. The interval between ED arrival and brain CT was significantly shortened during P1 and P2 compared with the pre-pandemic interval, and no significant delay between ED arrival and surgical management was found, indicating increased treatment efficiency for TBI in the ED during the COVID-19 pandemic. Minimizing viral spread in the community and the hospital is vital to maintaining ED treatment efficiency and capacity. The ED should retain sufficient capacity to treat older patients with serious TBI during the COVID-19 pandemic.
Anterior Cervical Corpectomy with Fusion versus Anterior Hybrid Fusion Surgery for Patients with Severe Ossification of the Posterior Longitudinal Ligament Involving Three or More Levels: A Retrospective Comparative Study
Authors: Hirai Takashi , Yoshii Toshitaka , Sakai Kenichiro , Inose Hiroyuki , Yuasa Masato , Yamada Tsuyoshi , Matsukura Yu , Ushio Shuta , Morishita Shingo , Egawa Satoru , Onuma Hiroaki , Kobayashi Yutaka , Utagawa Kurando , Hashimoto Jun , Kawabata Atsuyuki , Tanaka Tomoyuki , Motoyoshi Takayuki , Takahashi Takuya , Hashimoto Motonori , Sakaeda Kentaro , Kato Tsuyoshi , Arai Yoshiyasu , Kawabata Shigenori , Okawa Atsushi
Published: November 2021

Various studies have found a high incidence of early graft dislodgement after multilevel corpectomy. Although a hybrid fusion technique was developed to resolve implant failure, the hybrid and conventional techniques have not been clearly compared in terms of perioperative complications in patients with severe ossification of the posterior longitudinal ligament (OPLL) involving three or more levels. The purpose of this study was to compare clinical and radiologic outcomes between anterior cervical corpectomy with fusion (ACCF) and anterior hybrid fusion for the treatment of multilevel cervical OPLL. We therefore retrospectively reviewed the clinical and radiologic data of 53 consecutive patients who underwent anterior fusion to treat cervical OPLL: 30 underwent ACCF and 23 underwent anterior hybrid fusion. All patients completed 2 years of follow-ups. Implant migration was defined as subsidence > 3 mm. There were no significant differences in demographics or clinical characteristics between the ACCF and hybrid groups. Early implant failure occurred significantly more frequently in the ACCF group (5 cases, 16.7%) compared with the hybrid group (0 cases, 0%). The fusion rate was 80% in the ACCF group and 100% in the hybrid group. Although both procedures can achieve satisfactory neurologic outcomes for multilevel OPLL patients, hybrid fusion likely provides better biomechanical stability than the conventional ACCF technique.
Predictive Factors Involved in Postpartum Regressions of Cytological/Histological Cervical High-Grade Dysplasia Diagnosed during Pregnancy
Authors: Gomez Yvan , Balaya Vincent , Lepigeon Karine , Mathevet Patrice , Jacot-Guillarmod Martine
Published: November 2021

Objective: The aim of this study was to describe the evolution of high-grade cervical dysplasia during pregnancy and the postpartum period and to determine factors associated with dysplasia regression. Methods: Pregnant patients diagnosed with high-grade lesions were identified in our tertiary hospital center. High-grade lesions were defined either cytologically, by high squamous intraepithelial lesion/atypical squamous cells being unable to exclude HSIL (HSIL/ASC-H), or histologically, with cervical intraepithelial neoplasia (CIN) 2+ (all CIN 2 and CIN 3) during pregnancy. Postpartum regression was defined cytologically or histologically by at least a one-degree reduction in severity from the antepartum diagnosis. A logistic regression model was applied to determine independent predictive factors for high-grade cervical dysplasia regression after delivery. Results: Between January 2000 and October 2017, 79 patients fulfilled the inclusion criteria and were analyzed. High-grade cervical lesions were diagnosed by cytology in 87% of cases (69/79) and confirmed by histology in 45% of those (31/69). The overall regression rate in our cohort was 43% (34/79). Univariate analysis revealed that parity (p = 0.04), diabetes (p = 0.04) and third trimester cytology (p = 0.009) were associated with dysplasia regression. Nulliparity (OR = 4.35; 95%CI = (1.03–18.42); p= 0.046) was identified by multivariate analysis as an independent predictive factor of high-grade dysplasia regression. The presence of HSIL on third-trimester cervical cytology (OR = 0.17; 95%CI = (0.04–0.72); p = 0.016) was identified as an independent predictive factor of high-grade dysplasia persistence at postpartum. Conclusion: Our regression rate was high, at 43%, for high-grade cervical lesions postpartum. Parity status may have an impact on dysplasia regression during pregnancy. A cervical cytology should be performed at the third trimester to identify patients at risk of CIN persistence after delivery. However, larger cohorts are required to confirm these results.
Increased Serum Levels of S100A4 and S100A15 in Individuals Suffering from Hidradenitis Suppurativa
Authors: Batycka-Baran Aleksandra , Matusiak Łukasz , Nowicka-Suszko Danuta , Szepietowski Jacek C. , Baran Wojciech
Published: November 2021

Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease. Recently, some S100 proteins have been suggested to play an important role in the pathogenesis of chronic immune-mediated inflammatory diseases and they may constitute valuable biomarkers for these diseases’ diagnosis and monitoring. The objective of the current study was to investigate, for the first time, serum levels of S100A4 and S100A15 in individuals suffering from HS. Furthermore, we assessed the associations between S100A4 and S100A15 serum levels and the severity of disease, CRP serum concentration and some demographic and clinical data. Serum levels of S100A4 and S100A15 were evaluated with the commercially available ELISA kit according to the manufacturer’s instructions. The serum level of S100A4 in individuals with HS was significantly elevated as compared to controls, with the highest level found in the individuals in Hurley stage II. The S100A15 serum level was positively correlated with the CRP concentration and was associated with the severity of the disease. The serum level of S100A15 in the individuals in Hurley stage III was significantly elevated compared to that of the controls and the individuals with HS in Hurley stages I and II. S100A4 and S100A15 may be considered as new serum biomarkers for the monitoring of HS progression, and they may play a role in the pathogenesis of HS by promoting inflammatory process and fibrosis.
Women and Men’s Perspectives on the Factors Related to Women’s Dyadic Sexual Desire, and on the Treatment of Hypoactive Sexual Desire Disorder
Authors: Friedmann Enav , Cwikel Julie
Published: November 2021

Sexuality is a basic human need, which is expressed in the context of intimate personal relations. However, in studies of women’s sexuality, men’s attitudes are often overlooked. Health care providers can benefit from the examination of how both women and men perceive women’s sexual desire and what are the most acceptable avenues for treatment for women’s hypoactive sexual desire disorder (HSDD). This research aimed to explore differences between women and men on the factors affecting women’s sexual desire and the appropriate avenues for treatment. Data were collected using an online questionnaire from 233 heterosexual adults who had a dyadic, steady intimate relationship over most of the previous year. A theory-based questionnaire of 28 items was developed to explore the factors associated with women’s sexual desire. One quarter (7/28) of the items affecting women’s sexual desire were ranked significantly differently between women and men. Among women, interpersonal issues and physical attraction, and among men, physical attraction and daily hassles were the significant predictors of women’s sexual desire. Women more than men endorsed psychological help such as a sex therapist or psychologist as a more appropriate treatment for HSDD, while both men and women viewed the internet as a reasonable way to gain treatment information. Both women and men viewed gynecologists as a more acceptable source of treatment than a family doctor. Religious authorities were the least likely source of treatment advice for both women and men. The results support a multi-dimensional model of women’s sexual desire and suggest that psychological interventions to treat HSDD may be preferred by women more than men.
Efficacy of Regional Chemotherapy Approach in Peritoneal Metastatic Gastric Cancer
Authors: Aigner Kornelia , Vashist Yogesh Kumar , Selak Emir , Gailhofer Sabine , Aigner Karl Reinhard
Published: November 2021

Peritoneal spread is frequent in gastric cancer (GC) and a palliative condition. After failure to systemic chemotherapy (sCTx) remaining therapeutic options are very limited. We evaluated the feasibility and efficacy of locoregional chemotherapy (RegCTx) in peritoneal metastatic GC. In total, 38 (23 male and 15 female) patients with peritoneal metastatic GC after failure of previous sCTx and unresectable disease were enrolled in this study. Using the hypoxic abdominal stop-flow perfusion, upper abdominal perfusion and intraarterial infusion technique in total 114 cycles with Cisplatin, Adriamycin and Mitomycin C were applied. No significant procedure related toxicity was noticed- especially no Grade 3 or 4 toxicity occurred. With the RegCTx approach a median overall survival of 17.4 months was achieved. Patients who had undergone previously resection of the GC the median overall survival was even better with 23.5 months. RegCTx is a promising, safe and efficient approach in diffuse metastatic GC. The evaluation of RegCTx in the setting of multimodal treatment approach at less advanced stages is also warranted.
Efficacy and Safety of the Cudrania tricuspidata Extract on Functional Dyspepsia: A Randomized Double-Blind Placebo-Controlled Multicenter Study
Authors: Shin Jinyoung , Oh Tae-Hoon , Kim Joo-Yun , Shim Jae-Jung , Lee Jung-Lyoul
Published: November 2021

Cudrania tricuspidata is a folk remedy used to treat inflammation in patients with tumors or liver damage. This study investigated the efficacy of Cudrania tricuspidata extract (CTE) for relieving the symptoms of functional dyspepsia. In an 8-week, randomized, double-blind, placebo-controlled study, 100 adults with any condition featured in the Rome IV criteria and a Gastrointestinal Symptoms Scale (GIS) score ≥4 were randomly allocated to take either a placebo (maltodextrin) or a 50 mg CTE tablet, which equally included celluloses, magnesium stearate, and silicon dioxide, twice daily, 20 January 2020, and 3 August 2020. Among the 83 participants finally analyzed, the CTE group was associated with a significant reduction in the gastrointestinal symptom rating scale (day 0: 8.0 ± 5.2, day 28: 4.7 ± 3.9, and day 56: 2.3 ± 2.4, p < 0.001, respectively) in comparison with the control group (day 0: 8.1 ± 4.7, day 28: 7.8 ± 5.7, and day 56: 7.5 ± 6.6, p > 0.05) after adjusting for smoking, drinking, eating habits, stress levels, and caffeine intake. The CTE group resulted in significant improvements of GIS, Nepean Dyspepsia Index (Korean version), and functional dyspepsia-related quality of life over time. There were no different adverse events (p = 0.523). These findings suggest that CTE is safe and efficacious for alleviating gastrointestinal symptoms in patients with functional dyspepsia.
Utility of Neutrophil-to-Lymphocyte Ratio, Platelet-to-Lymphocyte Ratio, and Systemic Immune Inflammation Index as Prognostic, Predictive Biomarkers in Patients with Metastatic Renal Cell Carcinoma Treated with Nivolumab and Ipilimumab
Authors: Iinuma Koji , Enomoto Torai , Kawada Kei , Fujimoto Shota , Ishida Takashi , Takagi Kimiaki , Nagai Shingo , Ito Hiroki , Kawase Makoto , Nakai Chie , Kawase Kota , Kato Daiki , Takai Manabu , Nakane Keita , Kameyama Koji , Koie Takuya
Published: November 2021

The aim of this study was to assess the utility of neutrophil-to-lymphocyte ratio (NLR), plate-let-to-lymphocyte ratio (PLR), and systemic immune inflammation index (SII) as predictive biomarkers with oncological outcomes for metastatic renal cell carcinoma (mRCC) patients treated with nivolumab and ipilimumab (NIVO + IPI). We conducted a retrospective multicenter cohort study assessing patients with mRCC treated with NIVO + IPI at eight institutions in Japan. In this study, the follow-up period was median 14 months. The 1-year overall- and progression-free survival (PFS) rates were 89.1% and 63.1, respectively. The objective response rate (ORR) and disease control rate (DCR) were 41.9% and 81.4%, respectively. The 1-year PFS rates were 85.7% and 49.1% for NLR ≤ 2.8 and >2.8, respectively (p = 0.005), and 75.5% and 49.7% for PLR ≤ 215.6 and >215.6, respectively (p = 0.034). Regarding SII, the 1-year PFS rates were 90.0% and 54.8% when SII was ≤561.7 and >561.7, respectively (p = 0.023). Therefore, NLR, PLR, and SII levels in mRCC patients treated with NIVO + IPI may be useful in predicting oncological outcomes.
Deep Learning on Oral Squamous Cell Carcinoma Ex Vivo Fluorescent Confocal Microscopy Data: A Feasibility Study
Authors: Shavlokhova Veronika , Sandhu Sameena , Flechtenmacher Christa , Koveshazi Istvan , Neumeier Florian , Padrón-Laso Víctor , Jonke Žan , Saravi Babak , Vollmer Michael , Vollmer Andreas , Hoffmann Jürgen , Engel Michael , Ristow Oliver , Freudlsperger Christian
Published: November 2021

Background: Ex vivo fluorescent confocal microscopy (FCM) is a novel and effective method for a fast-automatized histological tissue examination. In contrast, conventional diagnostic methods are primarily based on the skills of the histopathologist. In this study, we investigated the potential of convolutional neural networks (CNNs) for automatized classification of oral squamous cell carcinoma via ex vivo FCM imaging for the first time. Material and Methods: Tissue samples from 20 patients were collected, scanned with an ex vivo confocal microscope immediately after resection, and investigated histopathologically. A CNN architecture (MobileNet) was trained and tested for accuracy. Results: The model achieved a sensitivity of 0.47 and specificity of 0.96 in the automated classification of cancerous tissue in our study. Conclusion: In this preliminary work, we trained a CNN model on a limited number of ex vivo FCM images and obtained promising results in the automated classification of cancerous tissue. Further studies using large sample sizes are warranted to introduce this technology into clinics.
Sarcopenia’s Prognostic Impact on Patients Treated with Immune Checkpoint Inhibitors: A Systematic Review and Meta-Analysis
Authors: Lee Donggun , Kim Na Won , Kim Jong Yeob , Lee Joo Hyung , Noh Ji Hyun , Lee Haejun , Jeong Jin Woon , Lee Seungeun , Kang Jeonghyun
Published: November 2021

Background: Although sarcopenia has been reported to predict survival in cancer patients, its impact on patients who received immune checkpoint inhibitors (ICIs) has not been thoroughly investigated. This systematic review aimed to assess the long-term oncologic impact of sarcopenia on patients who received ICIs. Methods: A systematic review of studies indexed in the PubMed, Embase, and Cochrane databases, up to April 1, 2021, was conducted. Studies that reported hazard ratios (HRs) for overall survival (OS) and progression-free survival (PFS) based on sarcopenia in patients treated with ICIs were included. The inverse variance method was used with a random-effects model for data analysis. Results: A total of 1284 patients from 14 studies were included. Among the patients who received ICIs, patients with sarcopenia had a significant increase in overall mortality compared to patients without sarcopenia in univariate analyses (HR = 1.66, 95% CI = 1.20–2.29, p = 0.002) and in adjusted HRs (HR = 1.55, 95% CI = 1.15–2.10, p = 0.004). The same results were obtained for PFS by both univariate analysis (HR = 1.75, 95% CI = 1.37–2.23, p < 0.001) and adjusted HRs (HR = 1.63, 95% CI 1.28–2.09, p < 0.001). Conclusions: Sarcopenia appears to be an effective biomarker for predicting long-term oncologic outcomes in patients receiving ICI therapy and hence plays an important role when making treatment decisions. However, the fundamental role of this association with survival should be further investigated in large cohorts and clinical trials.
Artificial Intelligence Supports Decision Making during Open-Chest Surgery of Rare Congenital Heart Defects
Authors: Lo Muzio Francesco Paolo , Rozzi Giacomo , Rossi Stefano , Luciani Giovanni Battista , Foresti Ruben , Cabassi Aderville , Fassina Lorenzo , Miragoli Michele
Published: November 2021

The human right ventricle is barely monitored during open-chest surgery due to the absence of intraoperative imaging techniques capable of elaborating its complex function. Accordingly, artificial intelligence could not be adopted for this specific task. We recently proposed a video-based approach for the real-time evaluation of the epicardial kinematics to support medical decisions. Here, we employed two supervised machine learning algorithms based on our technique to predict the patients’ outcomes before chest closure. Videos of the beating hearts were acquired before and after pulmonary valve replacement in twelve Tetralogy of Fallot patients and recordings were properly labeled as the “unhealthy” and “healthy” classes. We extracted frequency-domain-related features to train different supervised machine learning models and selected their best characteristics via 10-fold cross-validation and optimization processes. Decision surfaces were built to classify two additional patients having good and unfavorable clinical outcomes. The k-nearest neighbors and support vector machine showed the highest prediction accuracy; the patients’ class was identified with a true positive rate ≥95% and the decision surfaces correctly classified the additional patients in the “healthy” (good outcome) or “unhealthy” (unfavorable outcome) classes. We demonstrated that classifiers employed with our video-based technique may aid cardiac surgeons in decision making before chest closure.
Transition to Online Education during the COVID-19 Pandemic: Impact of Changes in Alcohol Consumption and Experiencing Hangovers on Academic Functioning
Authors: Merlo Agnese , Hendriksen Pauline A. , Garssen Johan , Bijlsma Elisabeth Y. , Engels Ferdi , Bruce Gillian , Verster Joris C.
Published: November 2021

In the Netherlands, the 2019 coronavirus (COVID-19) pandemic had a significant impact on daily life, with two extensive lockdowns enforced to combat the spread of the SARS-CoV-2 virus. These measures included the closure of bars and restaurants, and the transition from face-to-face to online education. A survey was conducted among Dutch pharmacy students and PhD-candidates to investigate the impact of COVID-19 lockdown on alcohol consumption, hangovers, and academic functioning. The analysis revealed a significant reduction in both quantity and frequency of alcohol consumption during the COVID-19 lockdown periods. This was accompanied with a significant reduction in hangover frequency and lower hangover severity during COVID-19 lockdown periods. The distribution of scores on academic performance showed great variability between respondents: while some participants reported impairment, others reported improved performance during the COVID-19 pandemic, or no change. Women reported that significantly more time investment was associated with maintaining these performance levels. Consistent among participants was the notion of reduced interactions with teachers and other students. Participants who reported more hangovers and most severe hangovers before COVID-19 benefited from the lockdown periods in terms of improved academic performance. Positive correlations were found between study grades/output and both the frequency and severity of hangovers experienced before COVID-19, suggesting that heavier drinkers, in particular, improved academic performance during the lockdown periods. In conclusion, COVID-19 lockdowns were associated with a significant reduction in both alcohol consumption and experiencing hangovers, which was, among heavier drinkers particularly, associated with significantly improved academic functioning.
To Balloon or Not to Balloon? The Effects of an Intra-Aortic Balloon-Pump on Coronary Artery Flow during Extracorporeal Circulation Simulating Normal and Low Cardiac Output Syndromes
Authors: Reymond Philippe , Bendjelid Karim , Giraud Raphaël , Richard Gérald , Murith Nicolas , Cikirikcioglu Mustafa , Huber Christoph
Published: November 2021

ECMO is the most frequently used mechanical support for patients suffering from low cardiac output syndrome. Combining IABP with ECMO is believed to increase coronary artery blood flow, decrease high afterload, and restore systemic pulsatile flow conditions. This study evaluates that combined effect on coronary artery flow during various load conditions using an in vitro circuit. In doing so, different clinical scenarios were simulated, such as normal cardiac output and moderate-to-severe heart failure. In the heart failure scenarios, we used peripheral ECMO support to compensate for the lowered cardiac output value and reach a default normal value. The increase in coronary blood flow using the combined IABP-ECMO setup was more noticeable in low heart rate conditions. At baseline, intermediate and severe LV failure levels, adding IABP increased coronary mean flow by 16%, 7.5%, and 3.4% (HR 60 bpm) and by 6%, 4.5%, and 2.5% (HR 100 bpm) respectively. Based on our in vitro study results, combining ECMO and IABP in a heart failure setup further improves coronary blood flow. This effect was more pronounced at a lower heart rate and decreased with heart failure, which might positively impact recovery from cardiac failure.
Clinical Events with Edoxaban in South Korean and Taiwanese Atrial Fibrillation Patients in Routine Clinical Practice
Authors: Choi Eue-Keun , Lin Wei-Shiang , Hwang Gyo-Seung , Kirchhof Paulus , De Caterina Raffaele , Chen Cathy , Unverdorben Martin , Wang Chun-Chieh , Kim Young-Hoon
Published: November 2021

Edoxaban is approved for stroke prevention in nonvalvular atrial fibrillation (AF) patients in numerous countries. Outcome data are sparse on edoxaban treatment in AF patients from routine clinical practice, especially in Asian patients. Global ETNA (Edoxaban in rouTine cliNical prActice) is a noninterventional study that integrates data from patients from multiple regional registries into one database. Here, we report the 1-year clinical events from AF patients receiving edoxaban in South Korea and Taiwan. Clinical events assessed included bleeding, strokes, systemic embolic events, transient ischemic attacks (TIAs), and all-cause and cardiovascular death. Overall, 2677 patients (mean (range) age 72 (66–78) years, male 59.7%, mean CHA2DS2-VASc score ± standard deviation 3.1 ± 1.4) were treated with 60 or 30 mg edoxaban and had 1-year follow-up data. The annualized event rates for major bleeding and clinically relevant non-major (CRNM) bleeding were 0.78% and 0.47%, respectively. Annualized event rates for ischemic stroke and hemorrhagic stroke were 0.90% and 0.19%, respectively. Event rates for major and CRNM bleeding and rates of ischemic stroke and TIA were higher in Taiwanese patients than in Korean patients. Event rates were low and similar to those found in other studies of edoxaban in Korean and Taiwanese AF patients, thus supporting the safety and effectiveness of edoxaban in this population.
Self-Reported Adverse Events of COVID-19 Vaccines in Polish Healthcare Workers and Medical Students. Cross-Sectional Study and Pooled Analysis of CoVaST Project Results in Central Europe
Authors: Dziedzic Arkadiusz , Riad Abanoub , Attia Sameh , Klugar Miloslav , Tanasiewicz Marta
Published: November 2021

Background: Optimization of COVID-19 vaccination rate among healthcare personnel is of utmost priority to secure provision of uninterrupted care and to protect the most vulnerable patients. This study, as part of the global CoVaST project, aimed to assess the occurrence of short-term adverse events (SRAEs) of two most administered COVID-19 vaccines, mRNA-based (Pfizer-BioNTech and Moderna) and viral vector-based (AstraZeneca) in healthcare sector workers (HWs). Methods: A cross-sectional survey-based study was carried out for the first time among 317 Polish healthcare sector personnel and medical students using a validated and pre-tested questionnaire. The online questionnaire included 25 pre-tested, validated questions concerning demographic data, medical parameters, COVID-19-related anamneses, and local or systemic reactions (reactogenicity) associated with COVID-19 vaccination. Descriptive statistics, inferential tests and binary logistic regression were performed. Results: Out of the 247 participating HWs, 79.8% were females, and 77.5% received mRNA-based vaccines, while 24.5% received a viral vector-based vaccine. Cumulatively, 78.9% and 60.7% of the participants reported at least one local and one systemic SRAE respectively, following their COVID-19 first or second dose of vaccine. A wide array of SRAEs was observed, while pain at injection site (76.9%) was the most common local SRAE, and fatigue (46.2%), headache (37.7%), muscle pain (31.6%) were the most common systemic SRAEs. The vast proportion of local (35.2%) and systemic (44.8%) SRAEs subsided up to 1 day after inoculation with both types of vaccines. The mRNA-based vaccine versions seem to cause higher prevalence of local SRAEs, mainly pain within injection site (81.3% vs. 71.7%; p = 0.435), while the viral vector-based vaccine was linked with increased incidents of mild systemic side effects (76.7% vs. 55.3%; p = 0.004) after both doses. Pooled analysis revealed uniform results while comparing the prevalence of SRAEs in HWs as recipients in four central European countries (OR = 2.38; 95% CI = 2.03–2.79). Conclusions: The study confirmed the safety of commonly administered vaccines against COVID-19, which were associated with mild, self-resolving adverse events. No major vaccine-related incidents were reported which would affect every day functioning, significantly. The younger age group (below 29 y.o.) were associated with an increased risk of adverse events generally. The results enhanced current data regarding COVID-19 vaccination active surveillance in selected occupational groups.
Risk Stratification and Treatment Algorithm of Metastatic Renal Cell Carcinoma
Authors: Grimm Marc-Oliver , Leucht Katharina , Foller Susan
Published: November 2021

Systemic therapy for metastatic renal cell carcinoma has continuously evolved over the last two decades. Significant improvements in overall survival and quality of life of patients with advanced disease have been observed. With the approval of combination therapies with PD(L)-1 immune checkpoint inhibitors (ICI) as first-line therapy in 2019, the previous standard VEGFR-TKI monotherapy has been replaced as the primary treatment option. In addition to immunotherapy with nivolumab and ipilimumab, three VEGFR-TKI/ICI combinations are now approved. Therapy selection should be preceded by risk stratification using defined criteria from the International Metastatic Renal Cell Carcinoma Database Consortium (IMDC). Clinical parameters, as well as detailed patient counseling on differences in the efficacy profile (response rate, long-term progression-free survival), potential side effects, and impact on quality of life, are of key importance in the individual treatment decision.
COVID-19 and Diabetes
Authors: Bellido Virginia , Pérez Antonio
Published: November 2021

Diabetes mellitus (DM) is one of the most common comorbid conditions in persons with COVID-19 and a risk factor for poor prognosis. The reasons why COVID-19 is more severe in persons with DM are currently unknown although the scarce data available on patients with DM hospitalized because of COVID-19 show that glycemic control is inadequate. The fact that patients with COVID-19 are usually cared for by health professionals with limited experience in the management of diabetes and the need to prevent exposure to the virus may also be obstacles to glycemic control in patients with COVID-19. Effective clinical care should consider various aspects, including screening for the disease in at-risk persons, education, and monitoring of control and complications. We examine the effect of COVID-19 on DM in terms of glycemic control and the restrictions arising from the pandemic and assess management of diabetes and drug therapy in various scenarios, taking into account factors such as physical exercise, diet, blood glucose monitoring, and pharmacological treatment. Specific attention is given to patients who have been admitted to hospital and critically ill patients. Finally, we consider the role of telemedicine in the management of DM patients with COVID-19 during the pandemic and in the future.
Analysis, Design and Realization of a Furnace for In Situ Wettability Experiments at High Temperatures under X-ray Microtomography
Authors: Fedele Roberto , Hameed Fareeha , Cefis Nicola , Vergani Gabriele
Published: November 2021

In this study, we analyzed the problem of a compact furnace, to be used for in situ experiments in a cone-beam X-ray microtomography commercial system. The design process was accomplished and outlined through its main steps, until the realization of a prototype. The furnace was conceived to carry out wettability experiments at temperatures up to 700 °C and under inert atmosphere on sessile droplets of a molten metal alloy, with a few millimeters diameter, posed on a thin ceramic substrate. X-ray imaging of the molten droplet is expected to permit an accurate three-dimensional reconstruction of the droplet profile and a robust estimation of the related quantities (such as the contact angle and the surface tension) utilized for the assessment of metal-ceramic joints by brazing. The challenges faced during this project, mostly related to the constraints of the setup, and the novel solutions implemented were discussed also with the support of analytical and numerical tools, in terms of interaction of X-rays with matter, geometry and working principle, heat transfer and insulation, material selection.
A Coastal Flood Early-Warning System Based on Offshore Sea State Forecasts and Artificial Neural Networks
Authors: Chondros Michalis , Metallinos Anastasios , Papadimitriou Andreas , Memos Constantine , Tsoukala Vasiliki
Published: November 2021

An integrated methodological approach to the development of a coastal flood early-warning system is presented in this paper to improve societal preparedness for coastal flood events. The approach consists of two frameworks, namely the Hindcast Framework and the Forecast Framework. The aim of the former is to implement a suite of high-credibility numerical models and validate them according to past flooding events, while the latter takes advantage of these validated models and runs a plethora of scenarios representing distinct sea-state events to train an Artificial Neural Network (ANN) that is capable of predicting the impending coastal flood risks. The proposed approach was applied in the flood-prone coastal area of Rethymno in the Island of Crete in Greece. The performance of the developed ANN is good, given the complexity of the problem, accurately predicting the targeted coastal flood risks. It is capable of predicting such risks without requiring time-consuming numerical simulations; the ANN only requires the offshore wave characteristics (height, period and direction) and sea-water-level elevation, which can be obtained from open databases. The generic nature of the proposed methodological approach allows its application in numerous coastal regions.
The Effect of Various Salinities and Light Intensities on the Growth Performance of Five Locally Isolated Microalgae [Amphidinium carterae, Nephroselmis sp., Tetraselmis sp. (var. red pappas), Asteromonas gracilis and Dunaliella sp.] in Laboratory Batch Cultures
Authors: Hotos George N. , Avramidou Despoina
Published: November 2021

After a 1.5-year screening survey in the lagoons of Western Greece in order to isolate and culture sturdy species of microalgae for aquaculture or other value-added uses, as dictated primarily by satisfactory potential for their mass culture, five species emerged, and their growth was monitored in laboratory conditions. Amphidinium carterae, Nephroselmis sp., Tetraselmis sp. (var. red pappas), Asteromonas gracilis, and Dunaliella sp. were batch cultured using low (20 ppt), sea (40 ppt), and high salinity (50 or 60 or 100 ppt) and in combination with low (2000 lux) and high (8000 lux) intensity illumination. The results exhibited that all these species can be grown adequately in all salinities and with the best growth in terms of maximum cell density, specific growth rate (SGR), and biomass yield (g dry weight/L) at high illumination (8000 lux). The five species examined exhibited different responses in the salinities used, whereby Amphidinium clearly performs best in 20 ppt, far better than 40 ppt, and even more so than 50 ppt. Nephroselmis and Tetraselmis grow almost the same in 20 and 40 ppt and less well in 60 ppt. Asteromonas performs best in 100 ppt, although it can grow quite well in both 40 and 60 ppt. Dunaliella grows equally well in all salinities (20, 40, 60 ppt). Concerning the productivity, assessed as the maximum biomass yield at the end of the culture period, the first rank is occupied by Nephroselmis with ~3.0 g d.w./L, followed by Tetraselmis (2.0 g/L), Dunaliella (1.58 g/L), Amphidinium (1.19 g/L), and Asteromonas (0.7 g/L) with all values recorded at high light (8000 lux).
Effects of Phytophthora Inoculations on Photosynthetic Behaviour and Induced Defence Responses of Plant Volatiles in Field-Grown Hybrid Poplar Tolerant to Bark Canker Disease
Authors: Ďurkovič Jaroslav , Bubeníková Tatiana , Gužmerová Adriána , Fleischer Peter , Kurjak Daniel , Čaňová Ingrid , Lukáčik Ivan , Dvořák Miloň , Milenković Ivan
Published: November 2021

Bark cankers accompanied by symptoms of decline and dieback are the result of a destructive disease caused by Phytophthora infections in woody plants. Pathogenicity, gas exchange, chlorophyll a fluorescence, and volatile responses to P. cactorum and P. plurivora inoculations were studied in field-grown 10-year-old hybrid poplar plants. The most stressful effects of P. cactorum on photosynthetic behaviour were found at days 30 and 38 post-inoculation (p.-i.), whereas major disturbances induced by P. plurivora were identified at day 30 p.-i. and also belatedly at day 52 p.-i. The spectrum of volatile organic compounds emitted at day 98 p.-i. was richer than that at day 9 p.-i, and the emissions of both sesquiterpenes α-cubebene and germacrene D were induced solely by the Phytophthora inoculations. Significant positive relationships were found between both the axial and the tangential development of bark cankers and the emissions of α-cubebene and β-caryophyllene, respectively. These results show that both α-cubebene and germacrene D are signal molecules for the suppression of Phytophthora hyphae spread from necrotic sites of the bark to healthy living tissues. Four years following inoculations, for the majority of the inoculated plants, the callus tissue had already closed over the bark cankers.
Privacy, Porn, and Gay Sex Parties: The Carceral Governance of Homosexuality in Indonesia
Authors: Wijaya Hendri Yulius
Published: November 2021

This article examines how the recent Indonesian Pornography Law renders homosexuality and/or homosexual acts intelligible to the Indonesia state and society by institutionalising them as criminal offences. By drawing on insights from queer studies and exploring the cases of gay arrests in the country, I demonstrate that certain same-sex sexual acts are more susceptible to criminalisation, especially when those acts blur the distinction between public and private. The deployment of the Pornography Law against gay people, together with the anti-LGBT media environment in the country, has carried consequences for LGBT individuals, particularly gay people, by making them visible, legible, and thus subject to state surveillance and control.
Distinctive Role of the Systemic Inflammatory Profile in Non-Small-Cell Lung Cancer Younger and Elderly Patients Treated with a PD-1 Immune Checkpoint Blockade: A Real-World Retrospective Multi-Institutional Analysis
Authors: Nardone Valerio , Giannicola Rocco , Giannarelli Diana , Saladino Rita Emilena , Azzarello Domenico , Romeo Caterina , Bianco Giovanna , Rizzo Maria Rosaria , Di Meo Irene , Nesci Antonio , Pastina Pierpaolo , Falzea Antonia Consuelo , Caracciolo Daniele , Reginelli Alfonso , Caraglia Michele , Luce Amalia , Mutti Luciano , Giordano Antonio , Cappabianca Salvatore , Pirtoli Luigi , Barbieri Vito , Tassone Pierfrancesco , Tagliaferri Pierosandro , Correale Pierpaolo
Published: November 2021

An immune checkpoint blockade with mAbs to PD-1 and PD-L1 is an expanding therapeutic option for mNSCLC patients. This treatment strategy is based on the use of mAbs able to restore the anti-tumor activity of intratumoral T cells inhibited by PD-1 binding to PD-L1/2 on tumor and inflammatory cells. It has been speculated that a chronic status of systemic inflammation as well as the immunosenescence physiologically occurring in elderly patients may affect the efficacy of the treatment and the occurrence of irAEs. We performed a multi-institutional retrospective study aimed at evaluating the effects of these mAbs (nivolumab or atezolizumab) in 117 mNSCLC patients younger (90 cases) and older (27 cases) than 75 years in correlation with multiple inflammatory parameters (NLR, CRP, ESR, LDH and PCT). No differences were observed when the cohorts were compared in terms of the frequency of PFS, OS, inflammatory markers and immune-related adverse events (irAEs). Similarly, the occurrence of irAEs was strictly correlated with a prolonged OS survival in both groups. On the contrary, a negative correlation between the high baseline levels of inflammatory markers and OS could be demonstrated in the younger cohort only. Overall, PD-1/PD-L1-blocking mAbs were equally effective in young and elderly mNSCLC patients; however, the detrimental influence of a systemic inflammation at the baseline was only observed in young patients, suggesting different aging-related inflammation immunoregulative effects.
Diffusion Model of Parallel Plate Crack Grouting Based on Foaming Expansion Characteristics of Polymer Slurry
Authors: Liang Jiasen , Ma Shaokun , Du Xueming
Published: November 2021

Polymers as a new chemical grouting material have been widely used in fractured rock mass; however, the understanding of polymer diffusion characteristics still needs to be further improved. In order to study the diffusion mechanism of foamed polymer slurry in rock fissures, the radial diffusion model of polymer single crack grouting is derived in consideration of the factors such as grouting volume, crack width and expansion rate. The influence of different factors on slurry diffusion radius, diffusion pressure and flow rate is analyzed, The diffusion model is verified by finite element numerical simulation. The findings show that (1) The results of slurry diffusion radius, pressure and velocity distribution at different times under different working conditions in the present model are in good agreement with the analytical solution; (2) The diffusion pressure is directly proportional to the grouting volume and expansion multiple, and inversely proportional to the crack width. In addition, diffusion pressure decreases with the increase of diffusion distance, and the pressure at the corresponding distance increases slowly with time, and finally tends to be stable; (3) For the same section, the radial velocity decreases slowly with the increase of time; for different sections, the flow velocity increases sharply with the increase of the distance between the section and the central axis of the grouting hole.
Truck Driver Fatigue Detection Based on Video Sequences in Open-Pit Mines
Authors: Wang Yi , He Zhengxiang , Wang Liguan
Published: November 2021

Due to complex background interference and weak space–time connection, traditional driver fatigue detection methods perform poorly for open-pit truck drivers. For these issues, this paper presents a driver fatigue detection method based on Libfacedetection and an LRCN. The method consists of three stages: (1) using a face detection module with a tracking method to quickly extract the ROI of the face; (2) extracting and coding the features; (3) combining the coding model to build a spatiotemporal classification network. The innovation of the method is to utilize the spatiotemporal features of the image sequence to build a spatiotemporal classification model suitable for this task. Meanwhile, a tracking method is added to the face detection stage to reduce time expenditure. As a result, the average speed with the tracking method for face detection on video is increased by 74% in comparison with the one without the tracking method. Our best model adopts a DHLSTM and feature-level frame aggregation, which achieves high accuracy of 99.30% on the self-built dataset.
Period of Arrhythmia Anchored around an Infarction Scar in an Anatomical Model of the Human Ventricles
Authors: Mangileva Daria , Konovalov Pavel , Dokuchaev Arsenii , Solovyova Olga , Panfilov Alexander V.
Published: November 2021

Rotating nonlinear waves of excitation in the heart cause dangerous cardiac arrhythmias. Frequently, ventricular arrhythmias occur as a result of myocardial infarction and are associated with rotation of the waves around a post-infarction scar. In this paper, we perform a detailed in silico analysis of scroll waves in an anatomical model of the human ventricles with a generic model of the infarction scar surrounded by the gray zone with modified properties of the myocardial tissue. Our model includes a realistic description of the heart shape, anisotropy of cardiac tissue and a detailed description of the electrical activity in human ventricular cells by a TP06 ionic model. We vary the size of the scar and gray zone and analyze the dependence of the rotation period on the injury dimensions. Two main regimes of wave scrolling are observed: the scar rotation, when the wave rotates around the scar, and the gray zone rotation, when the wave rotates around the boundary of the gray zone and normal tissue. The transition from the gray zone to the scar rotation occurs for the width of gray zone above 10–20 mm, depending on the perimeter of the scar. We compare our results with simulations in 2D and show that 3D anisotropy reduces the period of rotation. We finally use a model with a realistic shape of the scar and show that our approach predicts correctly the period of the arrhythmia.
Numerical Study on Vibration Response and Fatigue Damage of Axial Compressor Blade Considering Aerodynamic Excitation
Authors: Fu Xi , Ma Chao , Lin Jiewei , Zhang Junhong
Published: November 2021

Axial compressor blades with a deformed initial torsion angle caused by aerodynamic excitation resonated at the working speed and changed the rule of fatigue damage accumulation. The fatigue life of a blade has a prediction error, even causing serious flight accidents if the effect of torque causing damage deterioration of the blade fatigue life is neglected. Therefore, in this paper, a uniaxial non-linear fatigue damage model was modified using the equivalent stress with torsional shear stress, and the proposed fatigue model including the torsional moment was used to study the compressor blade fatigue life. Then, the blade numerical simulation model was established to calculate the vibration characteristics under complex loads of airflow excitation and a rotating centrifugal force. Finally, the blade fatigue life under actual working conditions was predicted using the modified fatigue model. The results show that the interaction between centrifugal and aerodynamic loads affects the natural frequency, as the frequencies in modes dominated by bending deformation decreased whereas those dominated by torsional deformation increased. Furthermore, the blade root of the suction surface showed stress concentration, but there is an obvious difference of stress distribution and amplitude between the normal stress and the equivalent stress including torsional shear stress. The additional consideration of the torsional shear stress decreased the predicted fatigue life by 4.5%. The damage accumulation rate changes with the loading cycle, and it accelerates fast for the last 25% of the cycle, when the blade fracture may occur at any time. Thus, the aerodynamic excitation increased the safety factor of blade fatigue life prediction.
Review of Recent Advances in Lipid Analysis of Biological Samples via Ambient Ionization Mass Spectrometry
Authors: Lu Haiyan , Zhang Hua , Xu Shuling , Li Lingjun
Published: November 2021

The rapid and direct structural characterization of lipids proves to be critical for studying the functional roles of lipids in many biological processes. Among numerous analytical techniques, ambient ionization mass spectrometry (AIMS) allows for a direct molecular characterization of lipids from various complex biological samples with no/minimal sample pretreatment. Over the recent years, researchers have expanded the applications of the AIMS techniques to lipid structural elucidation via a combination with a series of derivatization strategies (e.g., the Paternò–Büchi (PB) reaction, ozone-induced dissociation (OzID), and epoxidation reaction), including carbon–carbon double bond (C=C) locations and sn-positions isomers. Herein, this review summarizes the reaction mechanisms of various derivatization strategies for C=C bond analysis, typical instrumental setup, and applications of AIMS in the structural elucidation of lipids from various biological samples (e.g., tissues, cells, and biofluids). In addition, future directions of AIMS for lipid structural elucidation are discussed.
Main Problems Using DEM Modeling to Evaluate the Loose Soil Collection by Conceptual Machine as a Background for Future Extraterrestrial Regolith Harvesting DEM Models
Authors: Młynarczyk Przemysław , Brewczyński Damian
Published: November 2021

Nowadays, rapid product development is a key factor influencing a company’s success. In the Space 4.0. era, an integrated approach with the use of 3D printing and DEM modeling can be particularly effective in the development of technologies related to space mining. Unfortunately, both 3D printing and DEM modeling are not without flaws. This article shows the possibilities and problems resulting from the use of DEM simulation and 3D printing simultaneously in the rapid development of a hypothetical mining machine. For the subsequent development of the regolith harvesting model, loose soil harvesting simulations were performed and the underlying problems were defined and discussed. The results show that it is possible to use both technologies simultaneously to be able to effectively and accurately model the behavior of this type of machine in various gravitational conditions in the future.