bluuebunny/crossref_metadata_2025 huggingface dataset:
Federated Learning of Explainable AI Models in 6G Systems: Towards Secure and Automated Vehicle Networking
Authors: Renda Alessandro , Ducange Pietro , Marcelloni Francesco , Sabella Dario , Filippou Miltiadis C. , Nardini Giovanni , Stea Giovanni , Virdis Antonio , Micheli Davide , Rapone Damiano , Baltar Leonardo Gomes
Published: August 2022

This article presents the concept of federated learning (FL) of eXplainable Artificial Intelligence (XAI) models as an enabling technology in advanced 5G towards 6G systems and discusses its applicability to the automated vehicle networking use case. Although the FL of neural networks has been widely investigated exploiting variants of stochastic gradient descent as the optimization method, it has not yet been adequately studied in the context of inherently explainable models. On the one side, XAI permits improving user experience of the offered communication services by helping end users trust (by design) that in-network AI functionality issues appropriate action recommendations. On the other side, FL ensures security and privacy of both vehicular and user data across the whole system. These desiderata are often ignored in existing AI-based solutions for wireless network planning, design and operation. In this perspective, the article provides a detailed description of relevant 6G use cases, with a focus on vehicle-to-everything (V2X) environments: we describe a framework to evaluate the proposed approach involving online training based on real data from live networks. FL of XAI models is expected to bring benefits as a methodology for achieving seamless availability of decentralized, lightweight and communication efficient intelligence. Impacts of the proposed approach (including standardization perspectives) consist in a better trustworthiness of operations, e.g., via explainability of quality of experience (QoE) predictions, along with security and privacy-preserving management of data from sensors, terminals, users and applications.
A Review of Knowledge Graph Completion
Authors: Zamini Mohamad , Reza Hassan , Rabiei Minou
Published: August 2022

Information extraction methods proved to be effective at triple extraction from structured or unstructured data. The organization of such triples in the form of (head entity, relation, tail entity) is called the construction of Knowledge Graphs (KGs). Most of the current knowledge graphs are incomplete. In order to use KGs in downstream tasks, it is desirable to predict missing links in KGs. Different approaches have been recently proposed for representation learning of KGs by embedding both entities and relations into a low-dimensional vector space aiming to predict unknown triples based on previously visited triples. According to how the triples will be treated independently or dependently, we divided the task of knowledge graph completion into conventional and graph neural network representation learning and we discuss them in more detail. In conventional approaches, each triple will be processed independently and in GNN-based approaches, triples also consider their local neighborhood.
Morphology Tuned Pressure Induced Amorphization in VO2(B) Nanobelts
Authors: Cheng Benyuan , Zhang Huafang , Li Quanjun , Liu Jing , Liu Bingbing
Published: August 2022

Pressure-induced amorphization (PIA) has drawn great attention since it was first observed in ice. This process depends closely on the crystal structure, the size, the morphology and the correlated pressurization environments, among which the morphology-tuned PIA remains an open question on the widely concerned mesoscale. In this work, we report the synthesis and high-pressure research of VO2(B) nanobelts. XRD and TEM were performed to investigate the amorphization process. The amorphization pressure in VO2(B) nanobelts(~30 GPa) is much higher than that in previous reported 2D VO2(B) nanosheets(~21 GPa), the mechanism is the disruption of connectivity at particular relatively weaker bonds in the (010) plane. These results suggest a morphology-tuned pressure-induced amorphization, which could promote the fundamental understanding of PIA.
New Records and Updated Checklist of the Pentatomoidea (Hemiptera: Heteroptera) of Greece
Authors: Tsagkarakis Antonios , Thanou Zoi , Chaldeou Aikaterini , Moschou Ioanna , Kalaitzaki Argyro , Drosopoulos Sakis
Published: August 2022

Eight species of the superfamily Pentatomoidea are recorded from Greece for the first time: Aelia germari Küster 1852, Eurygaster hottentotta (Fabricius 1775), Eysarcoris aeneus (Scopoli 1763), Neottiglossa lineolata (Herrich-Schaeffer 1830), Neottiglossa pusilla (Gallen 1789), Picromerus bidens (Linnaeus 1758), Podops (Podops) inunctus (Fabricius 1775) and Tarisa pallescens (Jakovlev 1871). A complete updated species checklist with distributional data notes for all the new species for Greece are provided.
Seasonal Dynamics of Fruit Flies (Diptera: Drosophilidae) in Forests of the European Russia
Authors: Gornostaev Nikolai G. , Ruchin Alexander B. , Esin Mikhail N. , Kulikov Aleksei M.
Published: August 2022

(1) Background: Seasonal dynamics of the abundance and species diversity of various insect groups is of great importance for understanding their life cycles; (2) Methods: In our study, Drosophilidae species and their seasonal changes in Mordovia State Nature Reserve were explored. We collected the flies by crown fermental traps in five types of forests (birch, aspen, linden, pine and oak) since May to October in 2019. (3) Results: A total of 4725 individuals belonging to 9 genera and 30 species of drosophilid flies were identified, among them 15 species in 3 genera are new to the Republic of Mordovia. Drosophila obscura and D. histrio were the most abundant species in traps, the other mass species are D. kuntzei, D. testacea, D. phalerata, S. rufifrons, D. bifasciata, A. semivirgo, and L. quinquemaculata. (4) Conclusions: We found three groups of mass species with significant correlation of seasonal dynamics, e.g., D.obscura and D. bifasciata; D. histrio, D. kuntzei, D. phalerata, and D. testacea, and, finally, A. semivirgo and S. rufifrons. Apparently, the similarity observed in the seasonal dynamics of these drosophilid species is influenced at a high degree by their food preferences and rearing sites.
Circulating Monocyte Chemoattractant Protein-1 in Patients with Cardiogenic Shock Complicating Acute Myocardial Infarction Treated with Mild Hypothermia: A Biomarker Substudy of SHOCK-COOL Trial
Authors: Cheng Wenke , Fuernau Georg , Desch Steffen , Freund Anne , Feistritzer Hans-Josef , Pöss Janine , Buettner Petra , Thiele Holger
Published: August 2022

Background: There is evidence that monocyte chemoattractant protein-1 (MCP-1) levels reflect the intensity of the inflammatory response in patients with cardiogenic shock (CS) complicating acute myocardial infarction (AMI) and have a predictive value for clinical outcomes. However, little is known about the effect of mild therapeutic hypothermia (MTH) on the inflammatory response in patients with CS complicating AMI. Therefore, we conducted a biomarker study to investigate the effect of MTH on MCP-1 levels in patients with CS complicating AMI. Methods: In the randomized mild hypothermia in cardiogenic shock (SHOCK-COOL) trial, 40 patients with CS complicating AMI were enrolled and assigned to MTH (33 °C) for 24 h or normothermia at a 1:1 ratio. Blood samples were collected at predefined time points at the day of admission/day 1, day 2 and day 3. Differences in MCP-1 levels between and within the MTH and normothermia groups were assessed. Additionally, the association of MCP-1 levels with the risk of all-cause mortality at 30 days was analyzed. Missing data were accounted for by multiple imputation as sensitivity analyses. Results: There were differences in MCP-1 levels over time between patients in MTH and normothermia groups (P for interaction = 0.013). MCP-1 levels on day 3 were higher than on day 1 in the MTH group (day 1 vs day 3: 21.2 [interquartile range, 0.25–79.9] vs. 125.7 [interquartile range, 87.3–165.4] pg/mL; p = 0.006) and higher than in the normothermia group at day 3 (MTH 125.7 [interquartile range, 87.3–165.4] vs. normothermia 12.3 [interquartile range, 0–63.9] pg/mL; p = 0.011). Irrespective of therapy, patients with higher levels of MCP-1 at hospitalization tended to have a decreased risk of all-cause mortality at 30 days (HR, 2.61; 95% CI 0.997–6.83; p = 0.051). Conclusions: The cooling phase of MTH had no significant effect on MCP-1 levels in patients with CS complicating AMI compared to normothermic control, whereas MCP-1 levels significantly increased after rewarming. Trial registration: NCT01890317.
TNF-α Predicts Endothelial Function and Number of CD34+ Cells after Stimulation with G-CSF in Patients with Advanced Heart Failure
Authors: Ugovšek Sabina , Rehberger Likozar Andreja , Finderle Sanjo , Poglajen Gregor , Okrajšek Renata , Vrtovec Bojan , Šebeštjen Miran
Published: August 2022

Patients with advanced heart failure (HF) have reduced cardiac output and impaired peripheral blood flow, which diminishes endothelial shear stress and consequently flow-mediated dilatation (FMD). The aim of our study was to find out whether endothelial dysfunction is associated with the number of CD34+ cells and TNF-α levels in patients with ischemic and non-ischemic HF after stimulation with granulocyte colony-stimulating factor (G-CSF). We included 56 patients with advanced HF (LVEF < 35%). Eighteen patients (32.14%) had ischemic and 38 (67.86%) patients had non-ischemic HF. FMD of the brachial artery was performed before the patients underwent 5-day bone marrow stimulation with daily subcutaneous injections of G-CSF (5 μg/kg bid). On the fifth day peripheral blood CD34+ cell count was measured. No statistically significant differences were found between the patient groups in NT-proBNP levels ((1575 (425–2439) vs. 1273 (225–2239)) pg/mL; p = 0.40), peripheral blood CD34+ cell count ((67.54 ± 102.32 vs. 89.76 ± 71.21) × 106; p = 0.32), TNF-α ((8.72 ± 10.30 vs. 4.96 ± 6.16) ng/mL; p = 0.13) and FMD (6.7 ± 5.4 vs. 7.2 ± 5.9%; p = 0.76). In a linear regression model, only FMD (p = 0.001) and TNF-α (p = 0.003) emerged as statistically significant predictors of CD34+ cells counts. Our study suggests that TNF-α is a good predictor of impaired endothelial function and of CD34+ cells mobilization after G-CSF stimulation in patients with advanced HF of ischemic and non-ischemic origin.
Tei Index Is a Useful Adjunctive Tool in the Diagnostic Workup of Patients with Acute Myocarditis
Authors: Mirna Moritz , Schmutzler Lukas , Vogl Fabian , Topf Albert , Hoppe Uta C. , Lichtenauer Michael
Published: August 2022

Background: Tei index (TI) is a combined myocardial performance index, which was found to be more sensitive for overall cardiac dysfunction than systolic or diastolic parameters alone. Currently, there is only limited evidence for this measure in the context of myocarditis. Thus, TI could add additional benefits to conventional diagnostic workup. Methods: TI of patients with myocarditis (n = 40), acute coronary syndrome (n = 29) and controls (n = 50) was retrospectively analyzed concerning its discriminatory ability for myocarditis. Results: TI was most pathological in patients with myocarditis (median 0.41 vs. 0.35 vs. 0.31, p < 0.0001). Its discriminatory ability was better than that of EF or E/e’ (AUCs: TI: 0.71, p < 0.0001; EF: 0.57, p = 0.112; E/e’: 0.64, p = 0.983), which was also verified in logistic regression analysis (B(SE) = 0.81(0.23), p = 0.0004). The association of TI with myocarditis remained significant even after correction for confounders in propensity score weighted analysis. Conclusions: The TI showed a better discriminatory ability for myocarditis than conventional echocardiographic parameters. Since TI is easily conducted, it might be a helpful adjunctive tool to supplement conventional diagnostic modalities in patients with suspected myocarditis.
Evaluation of the Severity of Malocclusion in Children with Osteogenesis Imperfecta
Authors: De Nova-García Manuel Joaquín , Bernal-Barroso Fabiola , Mourelle-Martínez Maria Rosa , Gallardo-López Nuria Esther , Diéguez-Pérez Montserrat , Feijoo-García Gonzalo , Burgueño-Torres Laura
Published: August 2022

Occlusion is the way in which the dental arches are related to each other and depends on craniofacial growth and development. It is affected in patients with Osteogenesis Imperfecta (OI) who present altered craniofacial development. The malocclusion present in 49 patients diagnosed with different types of OI aged between 4 and 18 was studied. The control group of healthy people was matched for age, sex, and molar class. To study the mixed and permanent dentition, the American Board of Orthodontics (ABO) discrepancy Index was applied. The primary dentition was evaluated with a Temporary Dentition Occlusion Analysis proposed for this study. The OI group obtained higher scores in the Discrepancy Index than the control group, indicating a high difficulty of treatment. The most significant differences were found in types III and IV of the disease. Regarding the variables studied, the greatest differences were found in the presence of lateral open bite in patients with OI, and in the variable “others” (agenesis and ectopic eruption). The analysis of primary dentition did not show significant differences between the OI and control groups. Patients with OI have more severe malocclusions than their healthy peers. Malocclusion is related to the severity of the disease and may progress with age.
Genetic Variants in Epidermal Differentiation Complex Genes as Predictive Biomarkers for Atopic Eczema, Allergic Sensitization, and Eczema-Associated Asthma in a 6-Year Follow-Up Case–Control Study in Children
Authors: Dębińska Anna , Danielewicz Hanna , Sozańska Barbara
Published: August 2022

Atopic eczema is the most common chronic inflammatory skin disease of early childhood and is often the first manifestation of atopic march. Therefore, one challenge is to identify the risk factors associated with atopic eczema that may also be predictors of atopic disease progression. The aim of this study was to investigate the association of SNPs in hornerin (HRNR) and filaggrin-2 (FLG2) genes with childhood atopic eczema, as well as other atopic phenotypes. Genotyping for HRNR and FLG2 was performed in 188 children younger than 2 years of age, previously screened for the FLG null mutations, and followed at yearly intervals until the age of 6. We demonstrated that risk variants of HRNR rs877776[C] and FLG2 rs12568784[T] were associated with atopic eczema, allergic sensitization, and susceptibility to the complex phenotype—asthma plus eczema. These effects seem to be supplementary to the well-known associations for FLG mutations and may be modulated by gene–gene interactions. Additionally, in children with eczema, these genetic variants may also be considered, along with FLG mutations, as predictive biomarkers for eczema-associated asthma. In conclusion, our results indicate that genetic variants in the epidermal differentiation complex gene could contribute to the pathogenesis of atopic eczema and progression to subsequent allergic disease.
Advances and Remaining Challenges in the Treatment for Borderline Resectable and Locally Advanced Pancreatic Ductal Adenocarcinoma
Authors: Sulciner Megan L. , Ashley Stanley W. , Molina George
Published: August 2022

Pancreatic ductal adenocarcinoma (PDAC) remains one of the deadliest malignancies in the United States. Improvements in imaging have permitted the categorization of patients according to radiologic involvement of surrounding vasculature, i.e., upfront resectable, borderline resectable, and locally advanced disease, and this, in turn, has influenced the sequence of chemotherapy, surgery, and radiation therapy. Though surgical resection remains the only curative treatment option, recent studies have shown improved overall survival with neoadjuvant chemotherapy, especially among patients with borderline resectable/locally advanced disease. The role of radiologic imaging after neoadjuvant therapy and the potential benefit of adjuvant therapy for borderline resectable and locally advanced disease remain areas of ongoing investigation. The advances made in the treatment of patients with borderline resectable/locally advanced disease are promising, yet disparities in access to cancer care persist. This review highlights the significant advances that have been made in the treatment of borderline resectable and locally advanced PDAC, while also calling attention to the remaining challenges.
Comparison of Operative Times in Primary Bilateral Total Knee Arthroplasty Performed by a Single Surgeon
Authors: Ishii Yoshinori , Noguchi Hideo , Sato Junko , Takahashi Ikuko , Ishii Hana , Ishii Ryo , Ishii Kei , Toyabe Shin-ichi
Published: August 2022

Purpose: Prolonged operative time (OT) is associated with adverse complications after total knee arthroplasty (TKA). The purpose of this study was to determine whether preoperative factors, such as sex, age, body mass index, body weight (BW), body height, American Society of Anesthesiologists grade, tibiofemoral angle, hospital for special surgery scores, surgical side, surgical order, and calendar year of surgery, affect OT. Methods: One hundred and nineteen patients (238 knees) with osteoarthritis who underwent staged bilateral primary TKA performed by a single surgeon were evaluated. The medical records of 15 males and 104 females were retrospectively reviewed. All variables were expressed as median (interquartile range). Results: The OT for all TKAs was 57 min (51, 65). The OT on the left side (59 min (52–67)) was longer than that on the right side (55 min (50–62)) (p = 0.015). Multiple regression analysis revealed that longer OT was related to BW (β = 0.488, p < 0.001), calendar year of surgery (β = −0.218, p< 0.001), and operative side (β = −0.151, p = 0.007). The Jonckheere–Terpstra test showed a trend toward decreasing OT with calendar year on the left side (p = 0.037) (surgeon’s non-dominant side), but not on the right (p = 0.795). Body height, BW, and body mass index showed weak correlations (r = 0.212, p = 0.001; r = 0.352, p < 0.001; r = 0.290, p < 0.001, respectively) with OT. Conclusion: Patients with a large physique, and especially obesity, with an affected knee on the surgeon’s non-dominant side may require a longer OT; OT decreased over time.
Role of Lipid-Lowering Therapy in Peripheral Artery Disease
Authors: Belur Agastya D. , Shah Aangi J. , Virani Salim S. , Vorla Mounica , Kalra Dinesh K.
Published: August 2022

Atherosclerosis is a multifactorial, lipoprotein-driven condition that leads to plaque formation within the arterial tree, leading to subsequent arterial stenosis and thrombosis that accounts for a large burden of cardiovascular morbidity and mortality globally. Atherosclerosis of the lower extremities is called peripheral artery disease and is a major cause of loss in mobility, amputation, and critical limb ischemia. Peripheral artery disease is a common condition with a gamut of clinical manifestations that affects an estimated 10 million people in the United States of America and 200 million people worldwide. The role of apolipoprotein B-containing lipoproteins, such as LDL and remnant lipoproteins in the development and progression of atherosclerosis, is well-established. The focus of this paper is to review existing data on lipid-lowering therapies in lower extremity atherosclerotic peripheral artery disease.
Quality-of-Life Assessment after Head and Neck Oncological Surgery for Advanced-Stage Tumours
Authors: Bejenaru Paula Luiza , Popescu Bogdan , Oancea Alina Lavinia Antoaneta , Simion-Antonie Catrinel Beatrice , Berteșteanu Gloria Simona , Condeescu-Cojocarița Mihnea , Cîrstea Anca Ionela , Oașă Irina Doinița , Schipor-Diaconu Teodora Elena , Popescu Dan , Grigore Raluca
Published: August 2022

Squamous cell carcinoma of the head and neck (HNSCC) is a common malignancy often diagnosed in the advanced stage with a complex negative influence on the patient’s quality of life (QoL). Given its multi-modal treatment, the first step is to adequately balance the needs of the patient, and the second step includes the consultations, interventions, and care provided by the medical team, with the purpose of improving the overall management of the HNSCC. Current attempts to develop and validate quality-of-life instruments specific to cancers of the head and neck have been reported, and certain questionnaires are now available. We performed a retrospective study in a tertiary centre, involving 89 patients who survived 3 years after HNSCC surgery. A patient-related outcome measurement was made using the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 and QLQ-H&N35 instruments to assess QoL at admission and 3 years after treatment. The 3-year survivors reported an overall improvement in QoL compared with those in the pre-treatment period. The unique details of head and neck cancer treatments outline the importance of considering the characteristics of the patient population in quality-of-life research and also identify how quality-of-life data can contribute to the care provided by the multi-disciplinary team involved in a patient’s follow-up.
Pharmacological Management of Neuropathic Pain after Radiotherapy in Head and Neck Cancer Patients: A Systematic Review
Authors: Kouri Maria , Rekatsina Martina , Vadalouca Athina , Siafaka Ioanna , Vardas Emmanouil , Papadopoulou Erofili , Paladini Antonella , Varrassi Giustino
Published: August 2022

Background: Neuropathic pain (NP) in head and neck cancer (HNC) patients represents a treatment challenge. Most studies investigating drugs against NP are conducted in patients suffering with diabetic neuropathy or postherpetic neuralgia, while data are limited in cancer pain management. Additionally, regarding cancer therapy-related NP, most of the studies do not focus on HNC patients. The aim of this review is to identify the studies on systematically administered medication for NP management that included HNC patients under radiotherapy. Methods: A systematic literature search was performed, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, in PubMed, Cochrane Library, Web of Science and ClinicalTrials.gov on 30 October 2021. The medical subject heading (MeSH) terms were (“head and neck cancer” OR “tumor”) AND “neuropathic pain” AND “medication” AND “radiotherapy.” The Cochrane Collaboration tool was used for quality assessment. Results: The search identified 432 articles. Three more articles were identified after searching the reference lists of the retrieved articles. A total of 10 articles met the eligibility inclusion criteria and were included in this review; 6 on gabapentin, 1 on pregabalin, 1 on nortriptyline, 1 on methadone, and 1 on ketamine. Statistically significant results in pain reduction compared to placebo or standard pain medication were found in the studies on pregabalin (p = 0.003), methadone (p = 0.03), ketamine (p = 0.012), and in two out of six gabapentin studies (p < 0.004). Two of the studies (both concerning gabapentin) had no comparison arm. Conclusions: Treatments including pregabalin, methadone, ketamine, and gabapentin were found to provide pain relief against HNC NP. While there is a plethora of pharmacological treatments available for the management of NP, only a few studies have been conducted regarding the pharmacological management of therapy-related NP in HNC patients. More studies should be conducted regarding the pharmacological approaches in HNC therapy-related NP so that specific treatment algorithms can be developed.
Evaluation of the Correlation between Regional Retinal Ganglion Cell Damage and Visual Field Sensitivity in Patients with Advanced Glaucoma
Authors: Rezkallah Amina , Douma Ikrame , Bonjour Maxime , Mathis Thibaud , Kodjikian Laurent , Denis Philippe
Published: August 2022

(1) Background: to investigate the correlation between structural (retinal ganglion cells and retinal nerve fibers) and functional alterations analyzed point-by-point in the central 10 degrees of the visual field of patients with advanced glaucoma using Humphrey 10-2 visual field tests. (2) Methods: Single-center prospective cohort study carried on from October 2018 to February 2019 at the Croix-Rousse hospital, Lyon, France. The primary outcome measure was the point-by-point correlation between retinal sensitivity (Humphrey 10-2) and retinal ganglion cell complex (GCC) thickness. (3) Results: 29 eyes of 27 patients were examined. Of these, 15 eyes had a mean deviation (MD) less than −20 dB. There were statistically significant linear relationships between GCC thickness and 10-2 visual field sensitivity for several points in the lower part of the visual field, with lower retinal sensitivity being associated with thicker GCC layers. There were no strong linear relationships or statistically significant correlations in the other regions of the visual field. For the patients with MD < −20 dB, there were statistically significant linear relationships between GCC thickness and 10-2 visual field sensitivity for several points in the superior nasal region. Retinal sensitivity was not correlated with retinal nerve fibre layer thickness. (4) Conclusions: In this study of patients with advanced glaucoma, GCC thickness was linearly associated with 10-2 visual field sensitivity in certain regions, negatively for patients with less-severe glaucoma. The initial thickening raises questions about the apoptosis mechanism, while the thinning observed in the most severe cases is consistent with the ganglion cell death identified on visual field tests.
Resistance Training with Blood Flow Restriction and Ocular Health: A Brief Review
Authors: Krzysztofik Michał , Zygadło Dorota , Trybek Paulina , Jarosz Jakub , Zając Adam , Rolnick Nicholas , Wilk Michał
Published: August 2022

Despite the many health benefits of resistance training, it has been suggested that high-intensity resistance exercise is associated with acute increases in intraocular pressure which is a significant risk factor for the development of glaucomatous optic nerve damage. Therefore, resistance training using a variety of forms (e.g., resistance bands, free weights, weight machines, and bodyweight) may be harmful to patients with or at risk of glaucoma. An appropriate solution for such people may involve the combination of resistance training and blood flow restriction (BFR). During the last decade, the BFR (a.k.a. occlusion or KAATSU training) method has drawn great interest among health and sports professionals because of the possibility for individuals to improve various areas of fitness and performance at lower exercise intensities. In comparison to studies evaluating the efficiency of BFR in terms of physical performance and body composition changes, there is still a paucity of empirical studies concerning safety, especially regarding ocular health. Although the use of BFR during resistance training seems feasible for glaucoma patients or those at risk of glaucoma, some issues must be investigated and resolved. Therefore, this review provides an overview of the available scientific data describing the influence of resistance training combined with BFR on ocular physiology and points to further directions of research.
The Impact of Probiotics and Prebiotics on Dry Eye Disease Signs and Symptoms
Authors: Tavakoli Azadeh , Markoulli Maria , Papas Eric , Flanagan Judith
Published: August 2022

Dry eye is considered an inflammatory disease. Gut microbiota are important in the regulation of low-grade chronic inflammation, including in the eye. Probiotics and prebiotics are increasingly used to regulate chronic-disease-associated gut dysbiosis. Therefore, this double-masked, randomized controlled clinical trial aimed to explore the potential of oral probiotics and prebiotics in the management of dry eye disease. In total, 41 participants with dry eye received probiotic and prebiotic supplements (treatment group, n = 23) or respective placebos (control group, n = 18) for 4 months. Dry eye symptoms and signs were evaluated using the Ocular Surface Disease Index (OSDI), Dry Eye Questionnaire 5, osmolarity, non-invasive keratograph break-up time (NIKBUT), ocular surface staining, tear meniscus height (TMH), lipid layer thickness, and conjunctival redness. After 4 months, the average OSDI score of the treatment group was significantly better compared to that of the controls (16.8 ± 5.9 vs. 23.4 ± 7.4; p < 0.001). The NIKBUT and TMH did not change significantly with treatment (p = 0.31 and p = 0.84) but reduced significantly for controls on average by −5.5 ± 1.0 secs (p = 0.03) and 0.2 ± 0.1 mm (p = 0.02). These data suggest that probiotics and prebiotics might be effective in the management of dry eye disease.
Limbic Responses to Aversive Visual Stimuli during the Acute and Recovery Phase of Takotsubo Syndrome
Authors: Steiger Ruth , Tuovinen Noora , Adukauskaite Agne , Senoner Thomas , Spitaler Philipp , Bilgeri Valentin , Dabkowska-Mika Agnieszka , Siedentopf Christian , Bauer Axel , Gizewski Elke Ruth , Hofer Alex , Barbieri Fabian , Dichtl Wolfgang
Published: August 2022

The role of the limbic system in the acute phase and during the recovery of takotsubo syndrome needs further clarification. In this longitudinal study, anatomical and task-based functional magnetic resonance imaging of the brain was performed during an emotional picture paradigm in 19 postmenopausal female takotsubo syndrome patients in the acute and recovery phases in comparison to sex- and aged-matched 15 healthy controls and 15 patients presenting with myocardial infarction. Statistical analyses were performed based on the general linear model where aversive and positive picture conditions were included in order to reveal group differences during encoding of aversive versus positive pictures and longitudinal changes. In the acute phase, takotsubo syndrome patients showed a lower response in regions involved in affective and cognitive emotional processes (e.g., insula, thalamus, frontal cortex, inferior frontal gyrus) while viewing aversive versus positive pictures compared to healthy controls and patients presenting with myocardial infarction. In the recovery phase, the response in these brain regions normalized in takotsubo syndrome patients to the level of healthy controls, whereas patients 8–12 weeks after myocardial infarction showed lower responses in the limbic regions (mainly in the insula, frontal regions, thalamus, and inferior frontal gyrus) compared to healthy controls and takotsubo syndrome patients. In conclusion, compared to healthy controls and patients suffering from acute myocardial infarction, limbic responses to aversive visual stimuli are attenuated during the acute phase of takotsubo syndrome, recovering within three months. Reduced functional brain responses in the recovery phase after a myocardial infarction need further investigation.
Home Oral Care Domiciliary Protocol for the Management of Dental Erosion in Rugby Players: A Randomized Clinical Trial
Authors: Butera Andrea , Gallo Simone , Pascadopoli Maurizio , Scardina Giuseppe Alessandro , Pezzullo Sofia , Scribante Andrea
Published: August 2022

People performing regular physical activity are at high risk of dental erosion especially in cases of high sport drinks intake. Biomimetic hydroxyapatite-based oral hygiene products, like toothpastes and mouthwashes, have been investigated in recent years for their remineralizing activity on the teeth. The aim of the present study was to evaluate the efficacy of two different oral hygiene protocols, respectively consisting of the combination of a hydroxyapatite-based toothpaste plus mouthwash (Trial group) or toothpaste alone (Control Group). At baseline (T0), as well as at 15 days (T1), 30 days (T2) and 90 days (T3), the following clinical indexes were assessed: Basic Erosive Wear Examination (BEWE), Schiff Air Index (SAI), Visual Analogue Scale (VAS), Plaque Index (PI) and Bleeding Index (BI). In general, for all the indexes assessed, a progressive intragroup reduction was noticed from the baseline to the subsequent timepoints, with no intergroup differences. Accordingly, the use of the hydroxyapatite-based toothpaste, alone or in combination with the mouthwash containing hydroxyapatite as well, is an effective method for the domiciliary management of dental erosion in physically active individuals like rugby players.
Comparison of the Postoperative Outcomes of the Mini-Flap Bilateral Axillo-Breast Approach (BABA) and Conventional BABA Robot-Assisted Thyroidectomy
Authors: Shin Ik Beom , Bae Dong Sik
Published: August 2022

The bilateral axillo-breast approach (BABA) for robot-assisted thyroidectomy has some advantages over other minimally invasive thyroidectomies. However, some people do not consider this as a minimally invasive thyroidectomy because of the wider surgical skin flap. Thus, we devised mini-flap BABA robot-assisted thyroidectomy and analyzed the postoperative outcomes. The clinical records of 44 patients undergoing BABA robot-assisted thyroidectomy using a conventional flap or mini-flap were evaluated retrospectively. There were no significant group differences in clinicopathological characteristics. The operating and flap making times were shorter in the mini-flap group (206.18 ± 31.09 vs. 178.90 ± 34.43 min, p = 0.009; 38.85 ± 2.73 vs. 32.21 ± 8.62 min, p = 0.003, respectively). The total drainage amount was smaller in the mini-flap group (196.57 ± 81.40 vs. 150.74 ± 40.80 mL, p = 0.027). The numeric rating scale score and number of analgesics were lower at 2 h postoperatively in the mini-flap group (5.52 ± 0.87 vs. 4.57 ± 1.31, p = 0.006; 0.95 ± 0.22 vs. 0.65 ± 0.49, p = 0.012, respectively). There was no significant group difference in immediate oncological outcomes (p = 1.000). Mini-flap BABA robot-assisted thyroidectomy minimized the surgical flap and improved surgical outcomes. Therefore, it is a form of minimally invasive thyroidectomy. However, long-term follow-up of oncological outcomes is needed.
Prediction of Neonatal Respiratory Morbidity Assessed by Quantitative Ultrasound Lung Texture Analysis in Twin Pregnancies
Authors: Moreno-Espinosa Ana L. , Hawkins-Villarreal Ameth , Coronado-Gutierrez David , Burgos-Artizzu Xavier P. , Martínez-Portilla Raigam J. , Peña-Ramirez Tatiana , Gallo Dahiana M. , Hansson Stefan R. , Gratacòs Eduard , Palacio Montse
Published: August 2022

The objective of this study was to evaluate the performance of quantitative ultrasound of fetal lung texture analysis in predicting neonatal respiratory morbidity (NRM) in twin pregnancies. This was an ambispective study involving consecutive cases. Eligible cases included twin pregnancies between 27.0 and 38.6 weeks of gestation, for which an ultrasound image of the fetal thorax was obtained within 48 h of delivery. Images were analyzed using quantusFLM® version 3.0. The primary outcome of this study was neonatal respiratory morbidity, defined as the occurrence of either transient tachypnea of the newborn or respiratory distress syndrome. The performance of quantusFLM® in predicting NRM was analyzed by matching quantitative ultrasound analysis and clinical outcomes. This study included 166 images. Neonatal respiratory morbidity occurred in 12.7% of cases, and it was predicted by quantusFLM® analysis with an overall sensitivity of 42.9%, specificity of 95.9%, positive predictive value of 60%, and negative predictive value of 92.1%. The accuracy was 89.2%, with a positive likelihood ratio of 10.4, and a negative likelihood ratio of 0.6. The results of this study demonstrate the good prediction capability of NRM in twin pregnancies using a non-invasive lung texture analysis software. The test showed an overall good performance with high specificity, negative predictive value, and accuracy.
Gentle Touch Therapy, Pain Relief and Neuroplasticity at Baseline in Fibromyalgia Syndrome: A Randomized, Multicenter Trial with Six-Month Follow-Up
Authors: Salgado Afonso Shiguemi Inoue , Takemoto Miriam Hatsue , de Souza Carla Fernanda Tallarico Carvalho , Salm Daiana Cristina , da Rosa Danielli , Cardoso Gabriela Correa , Ludtke Daniela Dero , Soares Silvia Fiorillo Cabrera , Ferreira Júlia Koerich , Dutra Aline Raulino , Szeremeta Yuri Cordeiro , Mazzardo Gustavo , Mayra Joice , Sheffer Débora da Luz , Caumo Wolnei , Bittencourt Edsel B. , Schleip Robert , Latini Alexandra , Bobinski Franciane , Martins Daniel Fernandes
Published: August 2022

Background: Fibromyalgia (FM) is considered a stress-related disorder characterized mainly by chronic widespread pain. Its pathogenesis is unknown, but cumulative evidence points at dysfunctional transmitter systems and inflammatory biomarkers that may underlie the major symptoms of the condition. This study aimed to evaluate pain scores (primary outcome), quality of life, inflammatory biomarkers and neurotransmitter systems in women with FM (secondary outcomes) subjected to gentle touch therapy (GTT) or placebo. Methods: A total of 64 female patients with FM were randomly assigned to two groups, namely GTT (n = 32) or Placebo (n = 32). Clinical assessments were conducted at baseline and post-intervention with six-month follow-up. We measured serum catecholamines (dopamine), indolamines and intermediary metabolites (serotonin or 5-hydroxyindolacetic acid (5-HIAA)), as well as tetrahydrobiopterin (BH4), which is a cofactor for the synthesis of neurotransmitters and inflammatory biomarkers in women with FM. A group of healthy individuals with no intervention (control group) was used to compare biochemical measurements. Intervention effects were analyzed using repeated measures (RM) two-way ANOVA followed by Bonferroni post hoc test and mixed ANCOVA model with intention to treat. Results: Compared to placebo, the GTT group presented lower pain scores and brain-derived neurotrophic factor (BDNF) levels without altering the quality of life of women with FM. Changes in BDNF had a mediating role in pain. Higher baseline serum BDNF and 5-HIAA or those with a history of anxiety disorder showed a higher reduction in pain scores across time. However, women with higher serum dopamine levels at baseline showed a lower effect of the intervention across the observation period revealed by an ANCOVA mixed model. Conclusions: In conclusion, lower pain scores were observed in the GTT group compared to the placebo group without altering the quality of life in women with FM. Reductions in BDNF levels could be a mechanism of FM pain status improvement. In this sense, the present study encourages the use of these GTT techniques as an integrative and complementary treatment of FM.
A Device Strategy-Matched Comparison Analysis among Different Intermacs Profiles: A Single Center Experience
Authors: Caraffa Raphael , Bejko Jonida , Carrozzini Massimiliano , Bifulco Olimpia , Tarzia Vincenzo , Lorenzoni Giulia , Bottigliengo Daniele , Gregori Dario , Castellani Chiara , Bottio Tomaso , Angelini Annalisa , Gerosa Gino
Published: August 2022

Background: The present study evaluates outcomes of LVAD patients, taking into account the device strategy and the INTERMACS profile. Methods: We included 192 LVAD-patients implanted between January 2012 and May 2021. The primary and secondary end-points were survival and major adverse events between Profiles 1–3 vs. Profile 4, depending on implantation strategies (Bridge-to-transplant-BTT; Bridge-to-candidacy-BTC; Destination-Therapy-DT). Results: The overall survival was 67% (61–75) at 12 months and 61% (54–70) at 24 months. Profile 4 patients showed significantly higher survival (p = 0.018). Incidences of acute right-ventricular-failure (RVF) (p = 0.046), right-ventricular-assist-device (RVAD) implantation (p = 0.015), and continuous-venovenous-hemofiltration (CVVH) (p = 0.006) were higher in Profile 1–3 patients, as well as a longer intensive care unit stays (p = 0.050) and in-hospital-mortality (p = 0.012). Twelve-month and 24-month survival rates were higher in the BTT rather than in BTC (log-rank = 0.410; log-rank = 0.120) and in DT groups (log-rank = 0.046). In the BTT group, Profile 1–3 patients had a higher need for RVAD support (p = 0.042). Conclusions: LVAD implantation in elective patients was associated with better survival and lower complications incidence. LVAD implantation in BTC patients has to be considered before their conditions deteriorate. DT should be addressed to elective patients in order to guarantee acceptable results.
Myeloid-Derived Suppressor Cells: New Insights into the Pathogenesis and Therapy of MDS
Authors: Velegraki Maria , Stiff Andrew , Papadaki Helen A. , Li Zihai
Published: August 2022

Myelodysplastic syndromes (MDS) are hematopoietic malignancies characterized by the clonal expansion of hematopoietic stem cells, bone marrow failure manifested by cytopenias, and increased risk for evolving to acute myeloid leukemia. Despite the fact that the acquisition of somatic mutations is considered key for the initiation of the disease, the bone marrow microenvironment also plays significant roles in MDS by providing the right niche and even shaping the malignant clone. Aberrant immune responses are frequent in MDS and are implicated in many aspects of MDS pathogenesis. Recently, myeloid-derived suppressor cells (MDSCs) have gained attention for their possible implication in the immune dysregulation associated with MDS. Here, we summarize the key findings regarding the expansion of MDSCs in MDS, their role in MDS pathogenesis and immune dysregulation, as well their potential as a new therapeutic target for MDS.
Mechanical Unloading of the Left Ventricle before Coronary Reperfusion in Preclinical Models of Myocardial Infarction without Cardiogenic Shock: A Meta-Analysis
Authors: Benenati Stefano , Crimi Gabriele , Macchione Andrea , Giachero Corinna , Pescetelli Fabio , Balbi Manrico , Porto Italo , Vercellino Matteo
Published: August 2022

Aim: to compare a conventional primary reperfusion strategy with a primary unloading approach before reperfusion in preclinical studies. Methods: we performed a meta-analysis of preclinical studies. The primary endpoint was infarct size (IS). Secondary endpoints were left ventricle end-diastolic pressure (LVEDP), mean arterial pressure (MAP), heart rate (HR), cardiac output (CO). We calculated mean differences (MDs) and associated 95% confidence intervals (CIs). Sensitivity and subgroup analyses on the primary and secondary endpoints, as well as a meta-regression on the primary endpoint using the year of publication as a covariate, were also conducted. Results: 11 studies (n = 142) were selected and entered in the meta-analysis. Primary unloading reduced IS (MD −28.82, 95% CI −35.78 to −21.86, I2 96%, p < 0.01) and LVEDP (MD −3.88, 95% CI −5.33 to −2.44, I2 56%, p = 0.02) and increased MAP (MD 7.26, 95% CI 1.40 to 13.12, I2 43%, p < 0.01) and HR (MD 5.26, 95% CI 1.97 to 8.55, I2 1%, p < 0.01), while being neutral on CO (MD −0.11, 95% CI −0.95 to 0.72, I2 88%, p = 0.79). Sensitivity and subgroup analyses showed, overall, consistent results. The meta-regression on the primary endpoint demonstrated a significant influence of the year of publication on effect estimate. Conclusions: in animal models of myocardial infarction, a primary unloading significantly reduces IS and exerts beneficial hemodynamic effects compared to a primary reperfusion.
Cystoid Macular Edema after Rhegmatogenous Retinal Detachment Repair with Pars Plana Vitrectomy: Rate, Risk Factors, and Outcomes
Authors: Merad Malik , Vérité Fabien , Baudin Florian , Ghezala Inès Ben , Meillon Cyril , Bron Alain Marie , Arnould Louis , Eid Pétra , Creuzot-Garcher Catherine , Gabrielle Pierre-Henry
Published: August 2022

(1) Background: The aim was to describe the rate and outcomes of cystoid macular edema (CME) after pars plana vitrectomy (PPV) for primary rhegmatogenous retinal detachment (RRD) and to identify risk factors and imaging characteristics. (2) Methods: A retrospective consecutive case study was conducted over a 5-year period among adult patients who underwent PPV for primary RRD repair. The main outcome measure was the rate of CME at 12 months following PPV. (3) Results: Overall, 493 eyes were included. The CME rate was 28% (93 patients) at 12 months. In multivariate analysis, eyes with worse presenting visual acuity (VA) (odds ratio [OR], 1.55; 95% CI, 1.07–2.25; p = 0.02) and grade C proliferative vitreoretinopathy (PVR) (OR, 2.88; 95% CI, 1.04–8.16; p = 0.04) were more at risk of developing CME 1 year after PPV. Endolaser retinopexy was associated with a greater risk of CME than cryotherapy retinopexy (OR, 3.06; 95% CI, 1.33–7.84; p = 0.01). Eyes undergoing cataract surgery within 6 months of the initial RRD repair were more likely to develop CME at 12 months (OR, 1.96; 95% CI, 1.06–3.63; p = 0.03). (4) Conclusions: CME is a common complication after PPV for primary RRD repair. Eyes with worse presenting VA, severe PVR at initial presentation, endolaser retinopexy, and cataract surgery within 6 months of initial RRD repair were risk factors for postoperative CME at 12 months.
Looped Elastic Resistance during Squats: How Do Band Position and Stiffness Affect Hip Myoelectric Activity?
Authors: Martins Eduardo C. , Steffen Lucas B. , Gomes Diogo , Herzog Walter , Haupenthal Alessandro , de Brito Fontana Heiliane
Published: August 2022

Looped elastic bands around the thigh are commonly used during squats and result in increased hip activation. Due to the closed kinetic chain nature of the squat exercise, one may expect that placing the elastic band on distal segments, close to the floor contact, may not result in the same increase in hip muscle activation as that achieved with a looped band around the thigh. We analyzed the effects of band position (thigh, lower leg, and forefoot) and band stiffness on the myoelectric activity of the tensor fascia latae, gluteus medius, gluteus maximus, biceps femoris, vastus medialis, and vastus lateralis during squats in 35 healthy subjects (18 men and 17 women). The greatest myoelectric activity of hip muscles was observed when the stiffest band was positioned around the forefeet with an increase in 24% for the tensor fascia latae, 83% for the gluteus medius, and 68% for the gluteus maximus compared to free (without resistance band) squatting. Contrary to previous thinking, the use of elastic bands around the forefeet during squats can elicit increased myoelectric activity of hip muscles, with a magnitude often greater than when the band is placed around the thigh segments.
Image Quality Comparison between Digital Breast Tomosynthesis Images and 2D Mammographic Images Using the CDMAM Test Object
Authors: Tsalafoutas Ioannis A. , Epistatou Angeliki C. , Delibasis Konstantinos K.
Published: August 2022

To evaluate the image quality (IQ) of synthesized two-dimensional (s2D) and tomographic layer (TL) mammographic images in comparison to the 2D digital mammographic images produced with a new digital breast tomosynthesis (DBT) system. Methods: The CDMAM test object was used for IQ evaluation of actual 2D images, s2D and TL images, acquired using all available acquisition modes. Evaluation was performed automatically using the commercial software that accompanied CDMAM. Results: The IQ scores of the TLs with the in-focus CDMAM were comparable, although usually inferior to those of 2D images acquired with the same acquisition mode, and better than the respective s2D images. The IQ results of TLs satisfied the EUREF limits applicable to 2D images, whereas for s2D images this was not the case. The use of high-dose mode (H-mode), instead of normal-dose mode (N-mode), increased the image quality of both TL and s2D images, especially when the standard mode (ST) was used. Although the high-resolution (HR) mode produced TL images of similar or better image quality compared to ST mode, HR s2D images were clearly inferior to ST s2D images. Conclusions: s2D images present inferior image quality compared to 2D and TL images. The HR mode produces TL images and s2D images with half the pixel size and requires a 25% increase in average glandular dose (AGD). Despite that, IQ evaluation results with CDMAM are in favor of HR resolution mode only for TL images and mainly for smaller-sized details.