bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of Periodontal Treatment in Patients with Periodontitis and Diabetes: Review of Systematic Reviews with Meta-Analyses in the Last Five Years
Authors: López-Valverde Nansi , Rueda José Antonio Blanco
Published: September 2024

Background: Periodontitis is a chronic infectious–inflammatory pathology, with a high prevalence, which destroys the dental support and, if left untreated, leads to tooth loss. It is associated with other pathologies, particularly diabetes mellitus. Objectives: Our objective was to conduct a review of systematic reviews with meta-analyses to determine the evidence for periodontal treatment on periodontitis and diabetes. Second, we assessed the risk of bias and methodological quality using the AMSTAR-2 and ROBIS tools. Methods: We performed bibliographic searches in PubMed/Medline, Embase, Cochrane Central, Dentistry & Oral Sciences Source databases and in the Web of Science (WOS) scientific information service to identify systematic reviews with meta-analyses from the last five years. Results: Eighteen studies that met the inclusion criteria and evaluated 16,247 subjects were included. The most studied parameters were probing pocket depth, clinical attachment level, bleeding on probing and the glycated hemoglobin. Most of the included meta-analyses evaluated adult patients with periodontitis and type 2 diabetes mellitus (T2DM). Most of the meta-analyses considered and assessed by AMSTAR-2 showed significant methodological errors. The risk of bias was the domain with the worst assessment with the ROBIS tool. Conclusions: Despite the weaknesses of the included meta-analyses in terms of methodological quality and the risk of bias, periodontal treatment and DM treatment appear to contribute to improved clinical outcomes in a bidirectional manner between periodontitis and DM.
The Prevalence and Correlates of Anxiety, Stress, Mood Disorders, and Sleep Disturbances in Poland after the Outbreak of the Russian–Ukrainian War 2022
Authors: Hoffmann Karolina , Michalak Michał , Kopciuch Dorota , Bryl Wiesław , Kus Krzysztof , Nowakowska Elżbieta , Paczkowska Anna
Published: September 2024

Background: The conflict of the Russian–Ukrainian War that began on 24 February 2022 has profoundly changed Europe. The primary objective of this study was to assess the prevalence of anxiety, stress, depression, and insomnia among a group of surveyed Poles in the first months after the outbreak of war in 2022. The secondary goal was to analyze potential risk factors for these mental disorders. Methods: A cross-sectional survey-based study was conducted. An anonymous questionnaire was created using Google Forms and distributed through social media from March 2022 to June 2022. The questionnaire included the Depression, Anxiety and Stress Scale (DASS-21) and an evaluation of the Insomnia Severity Index (ISI). Results: Overall, 11.26% of 311 participants had depression, 10.29% had anxiety, and 24.12% experienced stress. Further, 62.05% of them declared sleep disturbances, and about 60% of them reported experiencing fears associated with the war. The outcomes of the assessment of psychiatric symptoms (depression, anxiety, stress and sleep disturbance) were associated with following factors: self-reported health status, fear of Russian invasion of Ukraine, and fear of the war extending to Poland. When the results for psychiatric symptoms were categorized into two groups, severe and non-severe, logistic regression analysis was only feasible for the insomnia variable. For this variable, multivariate logistic regression identified key potential factors: age, stress, and fear of Russian invasion of Ukraine. Conclusions: The respondents were found to be highly concerned about the war. In total, almost half of them manifested symptoms of anxiety, depression, and/or stress. Slightly less than two-thirds had sleep disorders. This study confirms that in a crisis situation, mental health screening is necessary.
Short-Term and Long-Term Risk of Diabetes Mellitus among Patients with Spinal Cord Injury: A Nationwide Retrospective Cohort Study
Authors: Kim Seonghye , Han Kyung-Do , Kim Bongseong , Min Ju-Hong , Chang Won Hyuk , Cho In Young , Shin Dong Wook
Published: September 2024

Objectives: Estimating the risk of diabetes mellitus (DM) is important for the proper management of patients with spinal cord injury (SCI). We investigated the short-term and long-term risks of DM among patients with SCI, according to the presence or severity of post-SCI disability and the level of injury. Methods: We conducted a retrospective cohort study using the Korean National Health Insurance Service (2010–2018) database. After matching by age and sex, 6129 SCI patients and 22,979 controls were included. The primary outcome was incident DM, and risk was evaluated for both the short term (within 1 year after SCI) and the long term (after 1 year of SCI diagnosis). Results: The risk of DM was higher among patients with cervical- and thoracic-level SCI accompanied by disability compared to the controls during follow-up (4.6 ± 2.6 years). The short-term risk of DM was higher among patients with SCI (odds ratio [OR] 2.51, 95% confidence interval [CI] 1.91–3.27) than among the controls and it was even higher among patients with severe disability (OR 5.38, 95% CI 2.91–9.27). According to the level of injury, patients with cervical SCI had the highest short-term risk of DM (with disability, OR 4.93, 95% CI 3.07–7.63). There was no significant increase of DM risk in the long term, after 1 year of SCI diagnosis. Conclusions: Patients with SCI accompanied by severe disability and cervical-level injury had higher risks of pronounced DM in the short term. The findings of this study emphasize the need for active surveillance of DM among patients with high-level SCI and disability, especially in the short term, in addition to continuous monitoring and proper management of DM in the long term.
Applying Classic Literature to Facilitate Cultural Heritage Tourism for Youth through Multimedia E-Book
Authors: Kasemsarn Kittichai
Published: September 2024

The majority of cultural heritage tourism globally lacks the diversity of young tourists since there is a universal trend among youth worldwide considering that cultural and heritage stories are unrelated to their lifestyles and not designed for them. This research therefore makes use of classic Thai literature that the target group (grade 12) has studied, “Khun Chang Khun Phaen (KCKP)”, which includes actual heritage places in the province of Suphan Buri. It aims to create and evaluate design guidelines applying classic literature to facilitate cultural heritage tourism and interest in learning classic literature and history, specifically for youth, in three phases. In Phase 1, design guidelines are developed based on the answers of on-site questionnaires distributed to 600 young people. In Phase 2, a multimedia KCKP e-book is created, and in Phase 3, this multimedia KCKP e-book is evaluated using the results from 100 on-site questionnaires—serving as the research’s success criterion. The findings indicate that this e-book may spark a strong interest in youth for KCKP literature (mean = 4.53/5), cultural heritage tourism (mean = 4.56/5), and history (mean = 4.72/5). These findings affirm that the design guidelines effectively engage young tourists and promote an appreciation for cultural heritage, history, and classic literature.
A Machine Learning Approach to Map the Vulnerability of Groundwater Resources to Agricultural Contamination
Authors: Gómez-Escalonilla Victor , Martínez-Santos Pedro
Published: September 2024

Groundwater contamination poses a major challenge to water supplies around the world. Assessing groundwater vulnerability is crucial to protecting human livelihoods and the environment. This research explores a machine learning-based variation of the classic DRASTIC method to map groundwater vulnerability. Our approach is based on the application of a large number of tree-based machine learning algorithms to optimize DRASTIC’s parameter weights. This contributes to overcoming two major issues that are frequently encountered in the literature. First, we provide an evidence-based alternative to DRASTIC’s aprioristic approach, which relies on static ratings and coefficients. Second, the use of machine learning approaches to compute DRASTIC vulnerability maps takes into account the spatial distribution of groundwater contaminants, which is expected to improve the spatial outcomes. Despite offering moderate results in terms of machine learning metrics, the machine learning approach was more accurate in this case than a traditional DRASTIC application if appraised as per the actual distribution of nitrate data. The method based on supervised classification algorithms was able to produce a mapping in which about 45% of the points with high nitrate concentrations were located in areas predicted as high vulnerability, compared to 6% shown by the original DRASTIC method. The main difference between using one method or the other thus lies in the availability of sufficient nitrate data to train the models. It is concluded that artificial intelligence can lead to more robust results if enough data are available.
LPG Semantic Ontologies: A Tool for Interoperable Schema Creation and Management
Authors: Bernasconi Eleonora , Ceriani Miguel , Ferilli Stefano
Published: September 2024

Ontologies are essential for the management and integration of heterogeneous datasets. This paper presents OntoBuilder, an advanced tool that leverages the structural capabilities of semantic labeled property graphs (SLPGs) in strict alignment with semantic web standards to create a sophisticated framework for data management. We detail OntoBuilder’s architecture, core functionalities, and application scenarios, demonstrating its proficiency and adaptability in addressing complex ontological challenges. Our empirical assessment highlights OntoBuilder’s strengths in enabling seamless visualization, automated ontology generation, and robust semantic integration, thereby significantly enhancing user workflows and data management capabilities. The performance of the linked data tools across multiple metrics further underscores the effectiveness of OntoBuilder.
Innovative Research and Applications in Hydrodynamics and Flow Control
Authors: Du Peng , Hu Haibao , Chen Xiaopeng
Published: September 2024

This work aims to collect cutting-edge developments in the area of hydrodynamics and flow control, including both fundamental and engineering research [...]
Lifestyle Habits and Risk of Cardiovascular Mortality in Menopausal Women with Cardiovascular Risk Factors: A Retrospective Cohort Study
Authors: Lopez-Pineda Adriana , Soriano-Maldonado Cristina , Arrarte Vicente , Sanchez-Ferrer Francisco , Bertomeu-Gonzalez Vicente , Ruiz-Nodar Juan Miguel , Quesada Jose A. , Cordero Alberto
Published: September 2024

Current cardiovascular prevention guidelines emphasise considering sex, gender, and gender identity in risk assessment. This study evaluated the impact of lifestyle habits and chronic diseases on cardiovascular mortality risk in women over 50 with high vascular risk and developed a predictive model for menopausal women with cardiovascular risk factors. A retrospective cohort study used data from the 2011 Spanish National Health Survey and the national death register, focusing on menopausal and postmenopausal women without prior cardiovascular events but with at least one major risk factor. Participants were followed for up to 10 years, assessing mortality from circulatory system diseases and other causes. Exposure variables included socio-demographics, lifestyle habits, health status, self-perceived health, health service use, and pharmacological treatments. Of the 21,007 respondents, 3057 women met the inclusion criteria. The 10-year cumulative incidence of mortality from circulatory causes was 5.9%, and from other causes, 12.7%. Independent predictors of cardiovascular mortality were never consuming legumes, poor self-perceived health, diabetes treatment, lack of physical activity, and older age. Lipid-lowering treatment was protective. The model demonstrated good fit and predictive capacity (C-index = 0.773). This study highlights the significant influence of physical activity, legume consumption, self-perceived health, and specific treatments on cardiovascular mortality risk in menopausal women.
Comparative Study of Endoscopic Treatment for Intrahepatic and Common Bile Duct Stones Using Peroral Cholangioscopy
Authors: Sakamoto Yuri , Takeda Yohei , Yamashita Taro , Seki Yuta , Kawahara Shiho , Hirai Takayuki , Suto Noriyuki , Shimosaka Takuya , Hamamoto Wataru , Koda Hiroki , Onoyama Takumi , Matsumoto Kazuya , Yashima Kazuo , Isomoto Hajime , Yamaguchi Naoyuki
Published: September 2024

Objectives: Although peroral cholangioscopy has improved the endoscopic treatment of difficult stones, the treatment of intrahepatic stones remains challenging. The incidence of cholangitis is high when peroral cholangioscopy is used to treat intrahepatic stones. This study aimed to investigate the efficacy and safety of endoscopic treatment with peroral cholangioscopy for intrahepatic and common bile duct stones. Methods: Patients aged ≥20 years, who underwent endoscopic treatment with peroral cholangioscopy for intrahepatic or common bile duct stones at Tottori University Hospital from January 2016 to December 2022, were retrospectively evaluated to determine the efficacy and safety of the treatment. Results: Overall, 70 patients were included in this study: 22 in the intrahepatic stone group and 48 in the common bile duct stone group. Stones were smaller (8 vs. 17.5 mm, p < 0.001) and more numerous (p = 0.016) in the intrahepatic stone group than in the common bile duct stone group. Although the common bile duct stone group exhibited a higher rate of complete stone clearance in the first session, no significant differences were observed in the final results. The intrahepatic stone group had a higher incidence of cholangitis (36% vs. 8%, p = 0.007); however, all cases were mild. Conclusions: Endoscopic treatment with peroral cholangioscopy for intrahepatic stones may be associated with a higher incidence of cholangitis than that for common bile duct stones. Since saline irrigation may contribute to the development of cholangitis, it is important to be aware of intraductal bile duct pressure when performing peroral cholangioscopy.
Clinical Predictors of Mood Disorders and Prevalence of Neuropsychiatric Symptoms in Patients with Systemic Lupus Erythematosus
Authors: Recio-Barbero María , Cabezas-Garduño Janire , Varona Jimena , Ruiz-Irastorza Guillermo , Horrillo Igor , Meana J. Javier , Santos-Zorrozúa Borja , Segarra Rafael
Published: September 2024

Background/Objectives: We aimed to determine the prevalence and clinical correlations of mood disorders in a sample of systemic lupus erythematosus (SLE) patients. Hence, we hypothesized that the prevalence of mood disorders would be lower than reported in the literature and that patients would remain clinically stable and show less damage accrual despite low-dose corticosteroid prescription. Methods: In total, 92 SLE outpatients gave informed consent to participate in this cross-sectional study. Psychiatric and autoimmune clinical data were obtained, and a structured psychiatric interview was performed. The main clinical scales for the assessment of clinical symptomatology were included. To examine the potential relationships of presenting a mood disorder in SLE, clinical correlations and multivariate analyses were performed. Results: Mood disorders were the most prevalent disorder reported by SLE patients (16%), followed by adjustment disorders (5%). A significant proportion of patients presented psychosocial disturbances that did not meet the ICD-10 criteria for psychiatric diagnosis. According to the cut-off criterion for the Montgomery–Åsberg Depression Rating Scale (MADRS), up to 27% of the sample met the clinical criteria for depression. The multivariate analysis revealed a relationship between the presence of a mood disorder with total scores of the MADRS and the Young Mania Rating Scale (YMRS). Conclusions: The prevalence of mood disorders in patients with SLE was lower than previously reported. Although self-report clinical scales are useful for assessing clinical symptomatology, they should not be used in place of a comprehensive standardized interview conducted by a trained mental health specialist. Multidisciplinary teamwork is required for the early identification and therapeutic management of autoimmune patients with neuropsychiatric disorders.
A Retrospective Analysis of 1311 Oral Surgery Procedures Performed in a Pediatric Hospital in Barcelona: A Study of Their Characteristics and Age-Related Diagnoses
Authors: Ferrés-Amat Elvira , Guinot-Jimeno Francisco , Veloso-Durán Ana , Ñaupari-Pocomucha Josselyn , Ferrés-Amat Eduard , Prats-Armengol Jordi , Mareque-Bueno Javier , Ferrés-Padró Eduard
Published: September 2024

Background: Oral surgery involves the diagnosis and surgical treatment of diseases affecting the soft and hard tissues of the oral cavity and encompasses a wide range of surgical interventions. The aim of this investigation was to study the characteristics and age-related diagnoses of these oral surgeries, as well as to describe the surgical procedures performed in a pediatric oral and maxillofacial surgery service. Methods: A descriptive, retrospective, observational, and relational study was conducted on children and adolescents aged from 0 to 22 years who were treated in a pediatric oral and maxillofacial surgery service at a children’s hospital. Results: We analyzed 1311 surgical interventions (51.4% were on boys and 48.6% on girls), consisting of 24.8% soft tissue surgeries, 65.9% bone and dental tissue surgeries, and 9.3% mixed tissue surgeries. The most common pathologies were tooth eruption disorders (65.9%), followed by ankyloglossia (20.5%). The most frequent treatment was wisdom teeth extraction (31.3%). A statistically significant association (p < 0.05) was found between surgical treatments and variables such as age, sex, tissue type, and biopsy. Conclusions: This study enhances our understanding of pediatric oral surgery, emphasizing that the most common pathology is altered tooth eruption, while the most frequent surgical intervention is the extraction of wisdom teeth at different stages of development.
Multimodal Analgesia and Outcomes in Hysterectomy Surgery—A Population-Based Analysis
Authors: Cozowicz Crispiana , Gerner Hannah D. , Zhong Haoyan , Illescas Alex , Reisinger Lisa , Poeran Jashvant , Liu Jiabin , Memtsoudis Stavros G.
Published: September 2024

Objective: We aimed to investigate the impact of multimodal analgesia on postoperative complications and opioid prescription on a national level. Methods: This retrospective cross-sectional study included n = 1,307,923 hysterectomies (01/2006–12/2022, Premier Healthcare claims data). Multimodal analgesia was defined as opioid use with the addition of non-opioid analgesic modes, grouped into four categories: opioid-only and 1, 2, or 3 or more additional non-opioid analgesics. Multivariable regression models measured associations between multimodal categories and outcomes (composite/respiratory/cardiac/gastrointestinal/genitourinary, and CNS complications, oral morphine milligram equivalents [MME], and length of hospital stay [LOS]). Odds ratios (OR) and 95% confidence intervals (CI) are reported. Results: Overall, 84.3% (1,102,812/1,307,923) received multimodal analgesia, of which 58.9%, 28.0%, and 13.1% received 1, 2, or 3 or more additional non-opioid analgesics, respectively. The odds of any composite complication (any ≥1 complication) decreased with the addition of 1, 2, 3, or more analgesic modalities (versus opioid-only): OR 0.66 (CI 0.64; 0.68), OR 0.63 (CI 0.61; 0.66), OR 0.65 (CI 0.62; 0.67), respectively. Similar patterns existed for respiratory, cardiac, and genitourinary complications. Opioid prescription decreased incrementally with 1,2, 3, or more non-opioid analgesic modalities by 9.51 mg (CI 11.16; 7.86) and 15.29 mg (CI 17.21; 13.37) and 29.35 mg (CI 31.79; 26.91) cumulative MME. LOS was reduced by 0.52 days (CI 0.54; 0.51), 0.49 days (CI 0.51; 0.47), and 0.40 days (CI 0.43; 0.38), respectively. Costs were reduced by $765 (CI 817; 714) or $479 (CI 539; 419) with 1 or 2 multimodal modes. Conclusions: These findings suggest substantial benefits of multimodal analgesia, including significant decreases in serious complications (especially respiratory, cardiac, and genitourinary), opioid consumption, and hospitalizations. Multimodal analgesia may facilitate safe and efficient pain management with optimized opioid consumption.
Reducing Length of Hospital Stay Following Transcatheter Aortic Valve Implantation
Authors: Gonnah Ahmed R. , Khokhar Arif A. , Chow Ji-Jian , Hartley Adam , Sethi Rahul , Khawaja Saud , Hadjiloizou Nearchos , Ruparelia Neil , Mikhail Ghada , Malik Iqbal
Published: September 2024

Transcatheter aortic valve implantation (TAVI) has emerged as a safe and effective treatment for severe aortic stenosis across the spectrum of surgical risk cohorts. Subsequently, the dramatic increase in procedural volume worldwide has placed significant financial and logistical pressures on healthcare institutions, particularly regarding hospital length of stay (LOS), which can adversely affect patient flow. In this review article, we discuss different peri-procedural strategies developed to reduce LOS and facilitate early discharge after TAVI.
To Operate or Not? Evaluating the Best Approach for First-Time Patellar Dislocations: A Review
Authors: Tedeschi Roberto , Platano Daniela , Giorgi Federica , Donati Danilo
Published: September 2024

Background: The optimal management of first-time patellar dislocations remains a subject of debate. While surgical intervention is often recommended to reduce the risk of redislocation, the benefits over conservative treatment regarding knee function and complication rates are not clearly established. This systematic review aims to compare the effectiveness of surgical versus conservative treatment in preventing redislocation and improving knee function, while also considering complication rates. Methods: A comprehensive search of databases, including PubMed, Scopus, and Web of Science, was conducted up to July 2024. Seven randomized controlled trials involving 411 participants were included. The primary outcome was the redislocation rate, with secondary outcomes including knee function, complication rates, and the need for re-interventions. The quality of the studies was assessed using the PEDro scale. Results: Surgical treatment generally resulted in lower redislocation rates compared to conservative management. However, the improvement in knee function was inconsistent, with some studies showing no significant differences or even favoring conservative treatment. Surgical intervention was associated with a higher risk of complications and re-interventions, particularly in older studies with less advanced techniques. Conclusions: Surgical intervention appears effective in reducing redislocation rates but comes with a risk of complications. Conservative treatment remains a viable option, particularly for patients with lower activity levels or higher surgical risks. The decision between surgical and conservative management should be individualized, taking into account patient-specific factors and potential risks. Further high-quality research is needed to provide more definitive guidance.
Consensus Statements among European Sleep Surgery Experts on Snoring and Obstructive Sleep Apnea: Part 3 Palatal Surgery, Outcomes and Follow-Up, Complications, and Post-Operative Management
Authors: Olszewska Ewa , De Vito Andrea De , Heiser Clemens , Vanderveken Olivier , O'Connor-Reina Carlos , Baptista Peter , Kotecha Bhik , Vicini Claudio
Published: September 2024

Background/Objectives: Exploring and establishing a consensus on palatal surgery, the outcomes and follow-up after the palatal surgery, the complications of palatal surgery, and the post-operative management after palatal surgery for snoring and obstructive sleep apnea (OSA) among sleep surgeons is critical in the surgical management of patients with such conditions. Methods: Using the Delphi method, a set of statements was developed based on the literature and circulated among a panel of eight European experts. Responses included agreeing and disagreeing with each statement, and the comments were used to assess the level of consensus and to develop a revised version. The new version with the level of consensus and anonymized comments was sent to each panel member as the second round. This was repeated over a total of five rounds. Results: The final set included a total of 111 statements, 27 of which were stand-alone questions and 21 of which contained 84 sub-statements. Of the 34 statements regarding palatal surgery, consensus was achieved among all eight, seven, and six panelists for 50%, 35.3%, and 5.9% of the questions, respectively. Of the 43 statements regarding the outcomes and follow-up after the palatal surgery, consensus was achieved among all eight, seven, and six panelists for 53.5%, 23.3%, and 4.7% of the questions, respectively. Of the 24 statements regarding complications after the palatal surgery, consensus was achieved among all eight, seven, and six panelists for 91.7%, 0%, and 4.2% of the questions, respectively. Of the 10 statements regarding post-operative management after palatal surgery, consensus was achieved among all eight, seven, and six panelists for 10%, 30%, and 30% of the papers, respectively. Conclusions: This consensus provides an overview of the work of European sleep surgeons to develop a set of statements on palatal surgery for the treatment of snoring and OSA, the outcomes and follow-up, the complications, and the post-operative management of palatal surgery. We believe that this will be helpful in everyday practice. It also indicates key areas for further studies in sleep surgery.
Clinical Phenotype of HLA B*44 Patients in a Rheumatology Outpatient Clinic Favors Peripheral Arthropathies
Authors: Aljinović Jure , Šošo Daniela , Petrić Marin , Perković Dijana , Marasović Krstulović Daniela , Kero Darko , Marinović Ivanka
Published: September 2024

Objective: The genetic background of HLA-B*27 in spondyloarthritis is known, and the search for another gene with similar role is ongoing. We wanted to investigate clinical presentations of HLA-B*44 patients in rheumatology practice. Methods: A cross-sectional retrospective study of 303 HLA-B*44 adult patients from the outpatient rheumatology clinic from 5/2018-5/2024. Clinical phenotype, confirmed or excluded rheumatic diagnosis, therapy used, and data on HLA A, B, and DR alleles inherited with B*44 were analyzed. Results: A female predominance of 2.79:1 was noted. A total of 150 [49.5%] patients were referred due to peripheral joint pain, 77 [25.4%] due to combined spine and peripheral joint pain or spine alone (57 [18.8%]). A total of 19 [6.3%] patients had no symptoms of the musculoskeletal system. Statistically significant peripheral joint affection was proved in females but not in males (p = 0.04). A total of 121 [40%] patients from B*44 group had established rheumatic disease, with the rest being excluded or under observation. The most common working diagnoses were polyarthritis (32 [10.5%]) and mono-oligoarthritis (14 [4.6%]). A second allele in addition to HLA B*44 showed a similar frequency to the general population. Patients with HLA B*44/44 and B*27/44 genotypes were at the most risk for having definitive rheumatic disease (>60%). Conventional synthetic disease-modifying anti-rheumatic drugs (DMARDs) were used in 38.6% of patients, non-steroidal anti-inflammatory drugs were used in 31.6% of patients, biologic DMARDs were used in 8.9% of patients, and corticosteroids were used in 7.3% of patients. Conclusions: The most common presentation in HLA-B*44 patients is peripheral joint affection. Most patients with HLA-B*27/44 and B*44/44 genotypes had definitive rheumatic disease. B*44 homozygosity or B*27/44 might be risk factors for arthritis development.
The Interplay between Severe Cirrhosis and Heart: A Focus on Diastolic Dysfunction
Authors: Lupu Dragoș , Nedelcu Laurențiu , Țînț Diana
Published: September 2024

Background/Objectives: Cardiovascular involvement in severe cirrhosis presents diagnostic challenges and carries significant prognostic implications. This study aims to evaluate the relationship between liver disease severity and portal hypertension with the burden of diastolic dysfunction. Methods: We prospectively enrolled patients with hepatic cirrhosis, classified according to the Child–Pugh criteria. Of the 102 patients included, 65 were classified as Group A (non-severe cirrhosis: Child–Pugh Classes A and B) and 37 as Group B (severe cirrhosis: Child–Pugh Class C). Portal vein and spleen diameters were assessed using abdominal ultrasound. All patients underwent echocardiographic evaluation. LV systolic function was assessed by measuring ejection fraction, while diastolic function was evaluated using three parameters: E/Em ratio, E/Vp ratio, and indexed left atrial volume. Results: We observed a significantly greater burden of diastolic dysfunction in Group B compared to Group A. Specifically, the E/Vp ratio was 2.2 ± 0.4 in Group B versus 1.9 ± 0.3 in Group A (p < 0.001); the indexed LA volume was 34.5 ± 3.2 mL/m2 in Group B versus 30.1 ± 2.9 mL/m2 in Group A (p < 0.001); and the E/Em ratio was 17.0 ± 3.0 in Group B versus 11.5 ± 2.8 in Group A (p < 0.001). Additionally, the mean diameters of the portal vein and spleen were larger in Group B, with measurements of 14.3 ± 2.1 mm versus 11.5 ± 1.6 mm for the portal vein and 15.0 ± 1.2 mm versus 11.7 ± 1.5 mm for the spleen (p < 0.001), which correlated with the extent of diastolic dysfunction. Conclusions: Diastolic dysfunction was prevalent in 55% of patients with liver cirrhosis. The burden of diastolic dysfunction was higher in patients with severe hepatic cirrhosis compared to those with milder forms, and it correlated with the severity of portal hypertension, as assessed by measuring portal vein diameter and spleen diameter.
Comparison of Spectral CT and MRI in Pelvic Ring Fragility Fractures: A Prospective Diagnostic Accuracy Study
Authors: Unthan Mark , Ullrich Bernhard W. , Heinen Camilla , Kohler Felix C. , Schenk Philipp , Franiel Tobias , Bürckenmeyer Florian
Published: September 2024

Background/Objectives: Fragility fractures of the pelvis (FFP) are characterized by inadequate trauma to a structurally compromised bone, primarily in osteoporosis. Conventional CT studies can be inadequate in identifying FFPs. An MRI of the pelvis is considered the gold standard in diagnosing FFPs. Spectral CT or Dual-Energy CT may have comparable diagnostic accuracy. It provides additional insights into associated bone marrow edema. The aim of this prospective monocentric study is to evaluate the diagnostic accuracy of Spectral CT compared to the gold standard MRI in diagnosing FFP. Methods: Over a 2-year period, patients presenting in the emergency department with clinical suspicion of an FFP were consecutively included. They underwent Spectral CT (GE Revolution 16 cm GSI) upon admission, followed by an MRI. The gold standard for diagnosing FFP is pelvic MRI, showing sensitivity and specificity ranging from 97% to 100%. The acquired images were evaluated and classified using the osteoporotic fractures of the pelvis (OFP) classification. Results: Compared to the reference test, which was the MRI pelvis, the sensitivity of the CT pelvis was determined to be 86.8 (95% confidence interval (CI) 71.9–95.6%) with a specificity of 84.6% (95% CI: 54.6–98.1%, p = 0.453). Spectral CT could identify an additional FFP correctly, exhibiting a sensitivity of 89.5% (95% CI: 75.2–97.1%, p = 0.688), while maintaining the same specificity as the conventional CT. The inter-rater reliability assessment for Spectral CT, conducted by four independent raters, resulted in a Fleiss’ Kappa value of 0.516 (95% CI: 0.450–0.582, p < 0.001). Conclusion: The sensitivity of Spectral CT in the detection of pelvic ring fragility fractures shows a slightly lower sensitivity compared to MRI. There were no statistically significant differences observed when compared to conventional CT or MRI. In conclusion, Spectral CT may be beneficial in distinguishing FFP, particularly in cases where a definitive diagnosis is uncertain. Level of Evidence: II.
Behavioral Alterations of Spatial Cognition and Role of the Apolipoprotein E-ε4 in Patients with MCI Due to Alzheimer’s Disease: Results from the BDSC-MCI Project
Authors: Cammisuli Davide Maria , Bellocchio Virginia , Milesi Alessandra , Aiello Edoardo Nicolò , Poletti Barbara , Verde Federico , Silani Vincenzo , Ticozzi Nicola , Marchesi Gloria , Granese Valentina , Vignati Benedetta , Isella Valeria , Zago Stefano , Difonzo Teresa , Pomati Simone , Porta Giovanni , Cattaldo Stefania , Mauro Alessandro , Castelnuovo Gianluca
Published: September 2024

Background: Beyond memory deterioration, spatial disorientation may occur along the continuum of normal aging—dementia of Alzheimer’s type. The present study aims at detecting behavioral disorders of spatial cognition in prodromal Alzheimer’s disease (AD) and verifying the association between Apolipoprotein E-ε4 (ApoE-ε4) genotype and gait patterns during a real-world naturalistic task. Methods: A sample of 58 elderly participants, of which 20 patients with mild cognitive impairment with CFS biomarker evidence of AD, 23 individuals with subjective cognitive decline (SCD), and 15 healthy controls (HCs), was tested by a modified version of the Detour Navigation Test (DNT-mv). Generalized linear models were run to explore the association between group belonging and wrong turns (WTs)/moments of hesitation (MsH) as behavioral disorientation scores of the DNT-mv as well as the effect of ApoE-ε4 genotype on time and walking speed registered by a smartphone app providing GPS tracking of body movement around urban environments. Results: Patients with MCI due to AD reported more WTs than individuals with SCD and HCs. Further, the ApoE-ε4 genotype determined a lower capacity in spatial information processing, influencing gait during naturalistic spatial navigation tasks. Conclusions: Behavior alterations of spatial cognition can be detected ecologically in prodromal AD. The use of technological solutions supporting gait analysis may help in corroborating the experimental observation.
Albumin in Normovolemic Fluid Management for Severe Traumatic Brain Injury: Controversies and Research Gaps
Authors: Wiedermann Christian J.
Published: September 2024

Traumatic brain injury (TBI) is a significant public health issue characterized by high mortality rates and long-term complications. This commentary examines the controversial role of the use of albumin in the fluid management of patients with severe TBI. Despite its physiological benefits, the clinical use of albumin remains controversial due to the fact that various studies have yielded mixed results. Serum albumin is important for maintaining normovolemia, primarily through its contribution to colloid osmotic pressure, which helps to retain fluid in the circulatory system. This review highlights the existing evidence, examines inconsistencies in guideline recommendations, and suggests future research directions to clarify the efficacy and safety of the use of albumin in maintaining normovolemia in patients with TBI. The review also discusses the potential benefits of small-volume resuscitation strategies for the management of acute kidney injury in TBI patients, drawing parallels with the management of septic acute kidney injury. The need for further well-designed randomized controlled trials and ethical considerations in studies regarding the use of hyperoncotic albumin in TBI management is emphasized.
In Vitro Wound-Healing Potential of Phenolic and Polysaccharide Extracts of Aloe vera Gel
Authors: Iosageanu Andreea , Mihai Elena , Seciu-Grama Ana-Maria , Utoiu Elena , Gaspar-Pintiliescu Alexandra , Gatea Florentina , Cimpean Anisoara , Craciunescu Oana
Published: September 2024

The present study aimed to conduct a comparative investigation of the biological properties of phenolic and polysaccharide extracts obtained using an ultrasound-assisted technique from Aloe vera gel and their effects on each stage of the wound healing process in in vitro experimental models. HPLC analysis showed that the phenolic extract contained aloin, ferulic, and caffeic acid, as well as quercetin dihydrate, as major compounds. Capillary zone electrophoresis indicated the prevalence of mannose and glucose in the polysaccharide extract. Cell culture testing revealed the anti-inflammatory properties of the phenolic extract at a concentration of 0.25 mg/mL through significant inhibition of pro-inflammatory cytokines—up to 28% TNF-α and 11% IL-8 secretion—in inflamed THP-1-derived macrophages, while a pro-inflammatory effect was observed at 0.5 mg/mL. The phenolic extract induced 18% stimulation of L929 fibroblast proliferation at a concentration of 0.5 mg/mL, enhanced the cell migration rate by 20%, and increased collagen type I synthesis by 18%. Moreover, the phenolic extract exhibited superior antioxidant properties by scavenging free DPPH (IC50 of 2.50 mg/mL) and ABTS (16.47 mM TE/g) radicals, and 46% inhibition of intracellular reactive oxygen species (ROS) production was achieved. The polysaccharide extract demonstrated a greater increase in collagen synthesis up to 25%, as well as antibacterial activity against Staphylococcus aureus with a bacteriostatic effect at 25 mg/mL and a bactericidal one at 50 mg/mL. All these findings indicate that the phenolic extract might be more beneficial in formulations intended for the initial phases of wound healing, such as inflammation and proliferation, while the polysaccharide extract could be more suitable for use during the remodeling stage. Moreover, they might be combined with other biomaterials, acting as efficient dressings with anti-inflammatory, antioxidant, and antibacterial properties for rapid recovery of chronic wounds.
Full-Body Harness versus Waist Belt: An Examination of Force Production and Pain during an Isoinertial Device Maximal Voluntary Isometric Contraction
Authors: Dufner Trevor J. , Rodriguez Jonathan M. , Kitterman McKenna J. , Dawlabani Jennifer C. , Moon Jessica M. , Wells Adam J.
Published: September 2024

Background/Objectives: This study examined the differences in participant force production and pain between a squat maximal voluntary isometric contraction (IMVIC) performed with either a waist belt (WB) or full-body harness (FBH) on the Desmotec D.EVO isoinertial device (D.EVO). Agreement between FBH IMVIC and a traditional force plate squat MVIC (TMVIC) was also assessed. Methods: Twenty adults completed FBH, WB, and TMVIC assessments on two separate occasions. Two-way treatment x time ANOVAs were conducted to compare force outputs and pain between treatments (FBH vs. WB) across time. Test-retest reliability was assessed using intraclass correlation coefficients. Associations between outcomes were determined using Pearson’s r. Standard error of estimate, constant error, total error, and Bland-Altman plots were used to assess agreement between IMVIC and TMVIC. Results: FBH and WB IMVIC exhibited good to excellent reliability (ICC2,1 = 0.889–0.994) and strong associations (r = 0.813 and 0.821, respectively) when compared to TMVIC. However, agreement between FBH and TMVIC was poor. No significant interaction or main effects were observed for pain. FBH maximum isometric force (MIF) was significantly higher than WB MIF. WB IMVIC was the only significant predictor of TMVIC (R2 = 0.674). Conclusions: Our findings indicate that the D.EVO should not be utilized as a replacement for a traditional MVIC setup.
A Hybrid Approach for Image Acquisition Methods Based on Feature-Based Image Registration
Authors: Kumawat Anchal , Panda Sucheta , Gerogiannis Vassilis C. , Kanavos Andreas , Acharya Biswaranjan , Manika Stella
Published: September 2024

This paper presents a novel hybrid approach to feature detection designed specifically for enhancing Feature-Based Image Registration (FBIR). Through an extensive evaluation involving state-of-the-art feature detectors such as BRISK, FAST, ORB, Harris, MinEigen, and MSER, the proposed hybrid detector demonstrates superior performance in terms of keypoint detection accuracy and computational efficiency. Three image acquisition methods (i.e., rotation, scene-to-model, and scaling transformations) are considered in the comparison. Applied across a diverse set of remote-sensing images, the proposed hybrid approach has shown marked improvements in match points and match rates, proving its effectiveness in handling varied and complex imaging conditions typical in satellite and aerial imagery. The experimental results have consistently indicated that the hybrid detector outperforms conventional methods, establishing it as a valuable tool for advanced image registration tasks.
Unleashing the Power of Contrastive Learning for Zero-Shot Video Summarization
Authors: Pang Zongshang , Nakashima Yuta , Otani Mayu , Nagahara Hajime
Published: September 2024

Video summarization aims to select the most informative subset of frames in a video to facilitate efficient video browsing. Past efforts have invariantly involved training summarization models with annotated summaries or heuristic objectives. In this work, we reveal that features pre-trained on image-level tasks contain rich semantic information that can be readily leveraged to quantify frame-level importance for zero-shot video summarization. Leveraging pre-trained features and contrastive learning, we propose three metrics featuring a desirable keyframe: local dissimilarity, global consistency, and uniqueness. We show that the metrics can well-capture the diversity and representativeness of frames commonly used for the unsupervised generation of video summaries, demonstrating competitive or better performance compared to past methods when no training is needed. We further propose a contrastive learning-based pre-training strategy on unlabeled videos to enhance the quality of the proposed metrics and, thus, improve the evaluated performance on the public benchmarks TVSum and SumMe.
The Role of Cardiovascular Imaging in the Diagnosis of Athlete’s Heart: Navigating the Shades of Grey
Authors: Baba Ali Nima , Attaripour Esfahani Sogol , Scalia Isabel G. , Farina Juan M. , Pereyra Milagros , Barry Timothy , Lester Steven J. , Alsidawi Said , Steidley David E. , Ayoub Chadi , Palermi Stefano , Arsanjani Reza
Published: September 2024

Athlete’s heart (AH) represents the heart’s remarkable ability to adapt structurally and functionally to prolonged and intensive athletic training. Characterized by increased left ventricular (LV) wall thickness, enlarged cardiac chambers, and augmented cardiac mass, AH typically maintains or enhances systolic and diastolic functions. Despite the positive health implications, these adaptations can obscure the difference between benign physiological changes and early manifestations of cardiac pathologies such as dilated cardiomyopathy (DCM), hypertrophic cardiomyopathy (HCM), and arrhythmogenic cardiomyopathy (ACM). This article reviews the imaging characteristics of AH across various modalities, emphasizing echocardiography, cardiac magnetic resonance (CMR), and cardiac computed tomography as primary tools for evaluating cardiac function and distinguishing physiological adaptations from pathological conditions. The findings highlight the need for precise diagnostic criteria and advanced imaging techniques to ensure accurate differentiation, preventing misdiagnosis and its associated risks, such as sudden cardiac death (SCD). Understanding these adaptations and employing the appropriate imaging methods are crucial for athletes’ effective management and health optimization.
Temporal Scales of Mass Wasting Sedimentation across the Mississippi River Delta Front Delineated by 210Pb/137Cs Geochronology
Authors: Duxbury Jeffrey , Bentley Samuel J. , Xu Kehui , Jafari Navid H.
Published: September 2024

The Mississippi River Delta Front (MRDF) is a subaqueous apron of rapidly deposited and weakly consolidated sediment extending from the subaerial portions of the Birdsfoot Delta of the Mississippi River, long characterized by mass-wasting sediment transport. Four (4) depositional environments dominate regionally (an undisturbed topset apron, mudflow gully, mudflow lobe, and prodelta), centering around mudflow distribution initiated by a variety of factors (hurricanes, storms, and fluid pressure). To better understand the spatiotemporal scales of the events as well as the controlling processes, eight cores (5.8–8.0 m long) taken offshore from the South Pass (SP) and the Southwest Pass (SWP) were analyzed for gamma density, grain size, sediment fabric (X-radiography), and geochronology (210Pb/137Cs radionuclides). Previous work has focused on the deposition of individual passes and has been restricted to <3 m core penetration, limiting its geochronologic completeness. Building on other recent studies, within the mudflow gully and lobe cores, the homogeneous stepped profiles of 210Pb activities and the corresponding decreased gamma density indicate the presence of gravity-driven mass failures. 210Pb/137Cs indicates that gully sedimentary sediment accumulation since 1953 is greater than 580 cm (sediment accumulation rate [SAR] of 12.8 cm/y) in the southwest pass site, and a lower SAR of the South Pass gully sites (2.6 cm/y). This study shows that (1) recent dated mudflow deposits are identifiable in both the SWP and SP; (2) SWP mudflows have return periods of 10.7 y, six times more frequent than at the SP (66.7 y); (3) 210Pb inventories display higher levels in the SWP area, with the highest focusing factors in proximal/gully sedimentation, and (4) submarine landslides in both study areas remain important for sediment transport despite the differences in sediment delivery and discharge source proximity.