bluuebunny/crossref_metadata_2025 huggingface dataset:
A New Look at Immunogenetics of Pregnancy: Maternal Major Histocompatibility Complex Class I Educates Uterine Natural Killer Cells
Authors: Bos Manon , Colucci Francesco
Published: August 2024

Our incomplete knowledge of maternal–fetal interface (MFI) physiology impedes a better understanding of the pathological mechanisms leading to pregnancy complications, such as pre-eclampsia and fetal growth restriction. At the MFI, uterine natural killer (uNK) cells do not attack fetal cells but engage in crosstalk with both fetal and maternal cells to support feto-placental development. However, mother and fetus are genetically half-mismatched and certain combinations of variable immune genes—human leukocyte antigens (HLAs) and killer-cell immunoglobulin-like receptor (KIR), indeed, the most variable gene sets in the genome—associate with pregnancy outcomes, suggesting that these interactions regulate uNK cell function. How do these interactions influence the physiology and pathology at the MFI? Uterine NK cell function is regulated by both maternal and fetal Major Histocompatibility Complex (MHC); however, evidence for fetal cells educating uNK cells is lacking, and new evidence shows that maternal rather than fetal MHC class I molecules educate uNK cells. Furthermore, uNK cell education works through self-recognition by the ancient and conserved NKG2A receptor. Pregnant mice lacking this receptor produce normal litter sizes, but a significant portion of the offspring have low birthweight and abnormal brain development. Evidence from a genome-wide association study of over 150,000 human pregnancies validates the finding because women whose NKG2A receptor is genetically determined to engage their own MHC class I molecules are exposed to lower risk of developing pre-eclampsia, suggesting that maternal uNK cell education is a pre-requisite for a healthy pregnancy and, likely, for healthy offspring too.
AAV-NDI1 Therapy Provides Significant Benefit to Murine and Cellular Models of Glaucoma
Authors: Millington-Ward Sophia , Palfi Arpad , Shortall Ciara , Finnegan Laura K. , Bargroff Ethan , Post Iris J. M. , Maguire John , Irnaten Mustapha , O′Brien Colm , Kenna Paul F. , Chadderton Naomi , Farrar G. Jane
Published: August 2024

Glaucoma, a leading cause of blindness, is a multifactorial condition that leads to progressive loss of retinal ganglion cells (RGCs) and vision. Therapeutic interventions based on reducing ocular hypertension are not always successful. Emerging features of glaucoma include mitochondrial dysfunction and oxidative stress. In the current study, NDI1-based gene therapy, which improves mitochondrial function and reduces reactive oxygen species, was delivered intraocularly via an adeno-associated viral vector (AAV). This AAV-NDI1 therapy protected RGCs from cell death in treated (1552.4 ± 994.0 RGCs/mm2) versus control eyes (1184.4 ± 978.4 RGCs/mm2, p < 0.05) in aged DBA/2J mice, a murine model of glaucoma. The photonegative responses (PhNRs) of RGCs were also improved in treated (6.4 ± 3.3 µV) versus control eyes (5.0 ± 3.1 µV, p < 0.05) in these mice. AAV-NDI1 also provided benefits in glaucomatous human lamina cribrosa (LC) cells by significantly increasing basal and maximal oxygen consumption rates and ATP production in these cells. Similarly, NDI1 therapy significantly protected H2O2-insulted primary porcine LC cells from oxidative stress. This study highlights the potential utility of NDI1 therapies and the benefits of improving mitochondrial function in the treatment of glaucoma.
The Ubiquitin Ligase Adaptor NDFIP1 Interacts with TRESK and Negatively Regulates the Background K+ Current
Authors: Pergel Enikő , Tóth Dániel J. , Baukál Dóra , Veres Irén , Czirják Gábor
Published: August 2024

The TRESK (K2P18.1, KCNK18) background potassium channel is expressed in primary sensory neurons and has been reported to contribute to the regulation of pain sensations. In the present study, we examined the interaction of TRESK with NDFIP1 (Nedd4 family-interacting protein 1) in the Xenopus oocyte expression system by two-electrode voltage clamp and biochemical methods. We showed that the coexpression of NDFIP1 abolished the TRESK current under the condition where the other K+ channels were not affected. Mutations in the three PPxY motifs of NDFIP1, which are responsible for the interaction with the Nedd4 ubiquitin ligase, prevented a reduction in the TRESK current. Furthermore, the overexpression of a dominant-negative Nedd4 construct in the oocytes coexpressing TRESK with NDFIP1 partially reversed the down-modulating effect of the adaptor protein on the K+ current. The biochemical data were also consistent with the functional results. An interaction between epitope-tagged versions of TRESK and NDFIP1 was verified by co-immunoprecipitation experiments. The coexpression of NDFIP1 with TRESK induced the ubiquitination of the channel protein. Altogether, the results suggest that TRESK is directly controlled by and highly sensitive to the activation of the NDFIP1-Nedd4 system. The NDFIP1-mediated reduction in the TRESK component may induce depolarization, increase excitability, and attenuate the calcium dependence of the membrane potential by reducing the calcineurin-activated fraction in the ensemble background K+ current.
Balanced Duality: H2O2-Based Therapy in Cancer and Its Protective Effects on Non-Malignant Tissues
Authors: Zaher Amira , Petronek Michael S. , Allen Bryan G. , Mapuskar Kranti A.
Published: August 2024

Conventional cancer therapy strategies, although centered around killing tumor cells, often lead to severe side effects on surrounding normal tissues, thus compromising the chronic quality of life in cancer survivors. Hydrogen peroxide (H2O2) is a secondary signaling molecule that has an array of functions in both tumor and normal cells, including the promotion of cell survival pathways and immune cell modulation in the tumor microenvironment. H2O2 is a reactive oxygen species (ROS) crucial in cellular homeostasis and signaling (at concentrations maintained under nM levels), with increased steady-state levels in tumors relative to their normal tissue counterparts. Increased steady-state levels of H2O2 in tumor cells, make them vulnerable to oxidative stress and ultimately, cell death. Recently, H2O2-producing therapies—namely, pharmacological ascorbate and superoxide dismutase mimetics—have emerged as compelling complementary treatment strategies in cancer. Both pharmacological ascorbate and superoxide dismutase mimetics can generate excess H2O2 to overwhelm the impaired H2O2 removal capacity of cancer cells. This review presents an overview of H2O2 metabolism in the physiological and malignant states, in addition to discussing the anti-tumor and normal tissue-sparing mechanism(s) of, and clinical evidence for, two H2O2-based therapies, pharmacological ascorbate and superoxide dismutase mimetics.
Antibody to Endogenous Cardiotonic Steroid Reverses Vascular Fibrosis and Restores Vasorelaxation in Chronic Kidney Disease
Authors: Agalakova Natalia I. , Mikhailova Elena V. , Ershov Ivan A. , Nadei Olga V. , Pyankov Arseny A. , Galagoudza Michael M. , Adair C. David , Romanova Irina V. , Bagrov Alexei Y.
Published: August 2024

Marinobufagenin (MBG) is implicated in chronic kidney disease, where it removes Fli1-induced inhibition of the collagen-1. We hypothesized that (i) in nephrectomized rats, aortic fibrosis develops due to elevated plasma MBG and inhibited Fli1, and (ii) that the antibody to MBG reduces collagen-1 and improves vasodilatation. A partial nephrectomy was performed in male Sprague-Dawley rats. Sham-operated animals comprised the control group. At 5 weeks following nephrectomy, rats were administered the vehicle (n = 8), or the anti-MBG antibody (n = 8). Isolated aortic rings were tested for their responsiveness to sodium nitroprusside following endothelin-1-induced constriction. In nephrectomized rats, there was an increase in the intensity of collagen staining in the aortic wall vs. the controls. In antibody-treated rats, the structure of bundles of collagen fibers had ordered organization. Western blots of the aorta had lower levels of Fli1 (arbitrary units, 1 ± 0.05 vs. 0.2 ± 0.01; p < 0.001) and greater collagen-1 (arbitrary units, 1 ± 0.01 vs. 9 ± 0.4; p < 0.001) vs. the control group. Administration of the MBG antibody to rats reversed the effect of the nephrectomy on Fli1 and collagen-1 proteins. Aortic rings pretreated with endothelin-1 exhibited 50% relaxation following the addition of sodium nitroprusside (EC50 = 0.28 μmol/L). The responsiveness of the aortic rings obtained from nephrectomized rats was markedly reduced (EC50 = 3.5 mol/L) compared to the control rings. Treatment of rats with the antibody restored vasorelaxation. Thus, the anti-MBG antibody counteracts the Fli1-collagen-1 system and reduces aortic fibrosis.
Transcriptome-Wide Identification of Dark- and Salt-Induced Senescence-Related NAC Gene Family Members in Alfalfa
Authors: Duan Xiangxue , Tian Daicai , Gao Peiran , Sun Yue , Peng Xiaojing , Wen Jiangqi , Xie Hongli , Wang Zeng-Yu , Chai Maofeng
Published: August 2024

Leaves are a key forage part for livestock, and the aging of leaves affects forage biomass and quality. Preventing or delaying premature leaf senescence leads to an increase in pasture biomass accumulation and an improvement in alfalfa quality. NAC transcription factors have been reported to affect plant growth and abiotic stress responses. In this study, 48 NAC genes potentially associated with leaf senescence were identified in alfalfa under dark or salt stress conditions. A phylogenetic analysis divided MsNACs into six subgroups based on similar gene structure and conserved motif. These MsNACs were unevenly distributed in 26 alfalfa chromosomes. The results of the collinearity analysis show that all of the MsNACs were involved in gene duplication. Some cis-acting elements related to hormones and stress were screened in the 2-kb promoter regions of MsNACs. Nine of the MsNAC genes were subjected to qRT-PCR to quantify their expression and Agrobacterium-mediated transient expression to verify their functions. The results indicate that Ms.gene031485, Ms.gene032313, Ms.gene08494, and Ms.gene77666 might be key NAC genes involved in alfalfa leaf senescence. Our findings extend the understanding of the regulatory function of MsNACs in leaf senescence.
Recent Advances in Plant Somatic Embryogenesis: Where We Stand and Where to Go?
Authors: Martínez MªTeresa , Corredoira Elena
Published: August 2024

Somatic embryogenesis (SE) is a fascinating example of the plant cellular totipotency concept [...]
Enhanced CO2 Capture Potential of Chitosan-Based Composite Beads by Adding Activated Carbon from Coffee Grounds and Crosslinking with Epichlorohydrin
Authors: Loryuenyong Vorrada , Nakhlo Worranuch , Srikaenkaew Praifha , Yaidee Panpassa , Buasri Achanai , Eiad-Ua Apiluck
Published: August 2024

Carbon dioxide (CO2) capture has been identified as a potential technology for reducing the anthropic emissions of greenhouse gases, particularly in post-combustion processes. The development of adsorbents for carbon capture and storage is expanding at a rapid rate. This article presents a novel sustainable synthesis method for the production of chitosan/activated carbon CO2 adsorbents. Chitosan is a biopolymer that is naturally abundant and contains amino groups (–NH2), which are required for the selective adsorption of CO2. Spent coffee grounds have been considered as a potential feedstock for the synthesis of activated coffee grounds through carbonization and chemical activation. The chitosan/activated coffee ground composite microspheres were created using the emulsion cross-linking method with epichlorohydrin. The effects of the amount of chitosan (15, 20, and 25 g), activated coffee ground (10, 20, 30, and 40%w/w), and epichlorohydrin (2, 3, 4, 5, 6, 7 and 8 g) were examined. The CO2 capture potential of the composite beads is superior to that of the neat biopolymer beads. The CO2 adsorbed of synthesized materials at a standard temperature and pressure is improved by increasing the quantity of activated coffee ground and epichlorohydrin. These findings suggest that the novel composite bead has the potential to be applied in CO2 separation applications.
Role of Lipids in the Pathogenesis of Parkinson’s Disease
Authors: Kamano Shumpei , Ozawa Daisaku , Ikenaka Kensuke , Nagai Yoshitaka
Published: August 2024

Aggregation of α-synuclein (αSyn) and its accumulation as Lewy bodies play a central role in the pathogenesis of Parkinson’s disease (PD). However, the mechanism by which αSyn aggregates in the brain remains unclear. Biochemical studies have demonstrated that αSyn interacts with lipids, and these interactions affect the aggregation process of αSyn. Furthermore, genetic studies have identified mutations in lipid metabolism-associated genes such as glucocerebrosidase 1 (GBA1) and synaptojanin 1 (SYNJ1) in sporadic and familial forms of PD, respectively. In this review, we focus on the role of lipids in triggering αSyn aggregation in the pathogenesis of PD and propose the possibility of modulating the interaction of lipids with αSyn as a potential therapy for PD.
Genome-Wide Association Study Reveals Marker–Trait Associations with Resistance to Pythium irregulare from Soybean Germplasm
Authors: Detranaltes Christopher , Ma Jianxin , Cai Guohong
Published: August 2024

Soybean (Glycine max (L.) Merr.) ranks as the second-largest crop by total production in the United States, despite its production experiencing significant constraints from plant pathogens, including those causing seedling diseases. Pythium irregulare Buisman stands out as a predominant driver of yield loss associated with the seedling disease complex. There is currently a lack of public or commercial varieties available to growers with adequate genetic resistance to manage this pathogen. To address the pressing need for germplasm resources and molecular markers associated with P. irregulare resistance, we conducted a screening of 208 genetically diverse soybean accessions from the United States Department of Agriculture Soybean Germplasm Collection (USDA-SGC) against two geographically and temporally distinct isolates under controlled greenhouse conditions. Disease severity was assessed through comparisons of the root weight and stand count ratios of inoculated plants to mock-inoculated controls. Employing linear mixed modeling, we identified ten accessions (PI 548520, PI 548360, PI 548362, PI 490766, PI 547459, PI 591511, PI 547460, PI 84946-2, PI 578503, FC 29333) with resistance significantly above the population average to one or both of two isolates originating from Ohio or Indiana. Previously curated genotyping data, publicly accessible via the SoyBase database, was subsequently utilized for conducting a genome-wide association study. This analysis led to the discovery of two significant marker–trait associations (MTAs) located on chromosomes 10 and 15 and accounting for 9.3% and 17.2% of the phenotypic variance, respectively. The resistant germplasm and MTAs uncovered through this study provide additional resources and tools for the genetic improvement of soybean resistance to seedling disease caused by P. irregulare.
Phytosterols Augment Endurance against Interactive Effects of Heat and Drought Stress on Biochemical Activities of Citrullus lanatus var. citroides (L.H. Bailey) Mansf. Ex Greb
Authors: Mandizvo Takudzwa , Mabhaudhi Tafadzwanashe , Mashilo Jacob , Odindo Alfred Oduor
Published: August 2024

Water deficit and heat are the primary abiotic stresses affecting plants. We conducted in vitro experiments to investigate how citron watermelon seedlings respond to water deficit and heat, focusing on growth, water status, reserve mobilization, hydrolase activity, and metabolite partitioning, including non-structural carbohydrate availability, during the vulnerable stage of seedling establishment crucial for crop production. To reveal the involvement of phytosterols (stigmasterol, sitosterol, and campesterol) in combined stress tolerance, four citron watermelon genotypes were investigated under varying osmotic potential [−0.05 MPa, −0.09 MPa and −0.19 MPa] and temperature (26 °C and 38 °C). Phytosterols were analyzed by gas chromatography–mass spectrometry (GC–MS). Seedlings subjected to osmotic stress from polyethylene glycol (PEG) exhibited reduced growth, linked to relative water content (RWC) changes, delayed starch mobilization in cotyle-dons, and decreased non-structural carbohydrate availability in roots. High temperature retarded the photosynthetic apparatus’s establishment and compromised photosynthetic pigment activity and dry matter production. The results suggest that inherent stress tolerance in citron watermelon is characterized by the increased accumulation of lipids, mainly sterols, especially in heat/drought-stressed plants. This study provides valuable information about the metabolic response of citron watermelon to combined stress and metabolites identified, which will encourage further study in transcriptome and proteomics to improve drought tolerance.
Characterization and Degradation of Perovskite Mini-Modules
Authors: Ebner R. , Mittal A. , Ujvari G. , Hadjipanayi M. , Paraskeva V. , Georghiou G. E. , Hadipour A. , Aguirre A. , Aernouts T.
Published: August 2024

Organic–inorganic hybrid metal halide perovskites are poised to revolutionize the next generation of photovoltaics with their exceptional optoelectronic properties and compatibility with low-cost and large-scale fabrication methods. Since perovskite tends to degrade over short time intervals due to various parameters (oxygen, humidity, light, and temperature), advanced characterization methods are needed to understand their degradation mechanisms. In this context, investigation of the electrical and optoelectronic properties of several perovskite mini-modules was performed by means of photo- and electroluminescence imaging as well as Dark Lock-In Thermography methods. Current–voltage curves at periodic time intervals and External Quantum Efficiency measurements were implemented alongside other measurements to reveal correlations between the electrical and radiative properties of the solar cells. The different imaging techniques used in this study reveal the changes in radiative emission processes and how those are correlated with performance. Alongside the indoor optoelectronic characterization of perovskite reference samples, the outdoor monitoring of two perovskite modules of the same structure for 23 weeks is reported. Significant performance degradation is presented outdoors from the first week of testing for both samples under test. The evolution of the major electrical characteristics of the mini-modules and the diurnal changes were studied in detail. Finally, dark storage recovery studies after outdoor exposure were implemented to investigate changes in the major electrical parameters.
C–H Activation via Group 8–10 Pincer Complexes: A Mechanistic Approach
Authors: Serrano-García Juan S. , Amaya-Flórez Andrés , R.-Galindo Jordi , González-Sebastián Lucero , Delgado-Rangel Luis Humberto , Morales-Morales David
Published: August 2024

C–H bond activation is a crucial synthetic strategy widely utilized in both academic and industrial settings. Due to the strong and kinetically inert nature of the C–H bond, its functionalization typically requires metal-based catalysts. This review highlights the most significant advancements in homogeneously catalyzed reactions using pincer complexes with metals from groups 8–10, capable of promoting challenging C–H activation, published since 2010. In particular, it focuses on C–H bond activation for borylation, isomerization, and dehydrogenation, among other processes, discussing their scope and mechanistic insights.
Efficient and Accurate 3D Thickness Measurement in Vessel Wall Imaging: Overcoming Limitations of 2D Approaches Using the Laplacian Method
Authors: HashemizadehKolowri SeyyedKazem , Akcicek Ebru Yaman , Akcicek Halit , Ma Xiaodong , Ferguson Marina S. , Balu Niranjan , Hatsukami Thomas S. , Yuan Chun
Published: August 2024

The clinical significance of measuring vessel wall thickness is widely acknowledged. Recent advancements have enabled high-resolution 3D scans of arteries and precise segmentation of their lumens and outer walls; however, most existing methods for assessing vessel wall thickness are 2D. Despite being valuable, reproducibility and accuracy of 2D techniques depend on the extracted 2D slices. Additionally, these methods fail to fully account for variations in wall thickness in all dimensions. Furthermore, most existing approaches are difficult to be extended into 3D and their measurements lack spatial localization and are primarily confined to lumen boundaries. We advocate for a shift in perspective towards recognizing vessel wall thickness measurement as inherently a 3D challenge and propose adapting the Laplacian method as an outstanding alternative. The Laplacian method is implemented using convolutions, ensuring its efficient and rapid execution on deep learning platforms. Experiments using digital phantoms and vessel wall imaging data are conducted to showcase the accuracy, reproducibility, and localization capabilities of the proposed approach. The proposed method produce consistent outcomes that remain independent of centerlines and 2D slices. Notably, this approach is applicable in both 2D and 3D scenarios. It allows for voxel-wise quantification of wall thickness, enabling precise identification of wall volumes exhibiting abnormal wall thickness. Our research highlights the urgency of transitioning to 3D methodologies for vessel wall thickness measurement. Such a transition not only acknowledges the intricate spatial variations of vessel walls, but also opens doors to more accurate, localized, and insightful diagnostic insights.
Common Mistakes in Managing Patients with Inflammatory Bowel Disease
Authors: Gisbert Javier P. , Chaparro María
Published: August 2024

Introduction: Errors are very common in medical practice and in particular, in the healthcare of patients with inflammatory bowel disease (IBD); however, most of these can be prevented. Aim: To address common errors in the management of IBD. Methods: Our approach to this problem consists in identifying mistakes frequently observed in clinical practice (according to our experience) in the management of patients with IBD, then reviewing the scientific evidence available on the subject, and finally proposing the most appropriate recommendation for each case. Results: The most common mistakes in the management of IBD include those related to diagnosis and differential diagnosis, prevention, nutrition and diet, treatment with different drugs (mainly 5-aminosalicylates, corticosteroids, thiopurines, and anti-TNF agents), extraintestinal manifestations, anemia, elderly patients, pregnancy, and surgery. Conclusions: Despite the availability of guidelines for both disease management and preventive aspects of IBD care, a considerable variation in clinical practice still remains. In this review, we have identified common mistakes in the management of patients with IBD in clinical practice. There is a clear need for a greater dissemination of clinical practice guidelines among gastroenterologists and for the implementation of ongoing training activities supported by scientific societies. Finally, it is desirable to follow IBD patients in specialized units, which would undoubtedly be associated with higher-quality healthcare and a lower likelihood of errors in managing these patients.
Major Depressive Disorder with Catatonia: A Phenotype Related to Autistic Traits and High Suicidality
Authors: Carpita Barbara , Amatori Giulia , Cremone Ivan Mirko , Bonelli Chiara , Nardi Benedetta , Massimetti Gabriele , Pini Stefano , Dell’Osso Liliana
Published: August 2024

Background: Major Depressive Disorder (MDD) represents a significant global health concern, often complicated by comorbidities such as catatonia and autism spectrum disorder (ASD). Recognizing the interplay among these conditions and their impact on suicidal tendencies is crucial for effective clinical management. Methods: A total sample of 147 subjects with MDD was divided into Significant Catatonia (SC) and Non-Significant Catatonia (NSC) groups based on Catatonia Spectrum (CS) scores. Participants were evaluated through the Structured Clinical Interview for DSM-5, Research Version (SCID-5-RV), the Adult Autism Subtreshold Spectrum (AdAS Spectrum), and the Mood Spectrum—Self Report questionnaires. Statistical analyses included Mann–Whitney U test, Chi-square test, logistic regression analyses, and a decision tree model. Results: The SC group exhibited higher CS, AdAS Spectrum, and MOODS-SR total and domain scores compared to the NSC group. Individuals with significant autistic traits were over-represented in the SC group, as well as participants with higher suicidality, suicidal ideation, and a history of suicide attempts. The total AdAS Spectrum and MOOD-SR score, the AdAS domain “Hyper-hypo reactivity to sensory input”, and the “Cognitive depressive” MOOD-SR domain were predictive of belonging to the SC group. Suicidality levels appeared to be higher in clinically significant ASD, intermediate in subjects with autistic traits (AT), and low in the absence of AT. Conclusions: the study suggests the existence of a specific phenotype of MDD associated with catatonia, characterized by elevated autistic traits and suicide risk.
Exploring the Influence of Contextual Factors and the Caregiving Process on Caregiver Burden and Quality of Life Outcomes of Heart Failure (HF) Dyads after a Hospital Discharge: A Mixed-Methods Study
Authors: Oliver Tamara L. , Hetland Breanna , Schmaderer Myra , Zolty Ronald , Wichman Christopher , Pozehl Bunny
Published: August 2024

Background: This study explores heart failure (HF) dyadic contextual factors and caregiver burden during acute exacerbation hospitalization and discharge. Methods: It employed a mixed-methods approach, with HF dyads completing questionnaires and semi-structured interviews at a one-week post-discharge outpatient visit. Quantitative tools included the SF-12 Quality of Life, Zarit Burden Interview (ZBI), Bakas Caregiving Outcomes Scale (BCOS), and Self-Care of Heart Failure Index v. 6 (SCHFI). Thematic analysis was conducted on interview data to assess caregiver burden, disease trajectory, comorbidities, caregiving time, and employment status. Results: Twelve HF dyads participated, with caregivers (six female, six male) averaging 65.76 years. The ZBI indicated a low caregiver burden (median score of 15), but qualitative data revealed a higher perceived burden related to social isolation, future fears, and caregiver dependence. Male caregivers reported a lower burden than females. Positive goal congruence was noted in caregiving hours and HF management compliance. HF patients had a 10-year survival prediction of 22.75% per the Charlson Comorbidity Index, with 69% in NYHA class III and an average ejection fraction of 37.7%. Caregivers working full-time and caring for higher NYHA-class patients showed higher ZBI and BCOS scores. Conclusions: The study highlights the need for mixed methods and longitudinal research to understand HF disease trajectory and caregiver burden, emphasizing the importance of including caregivers in HF education and screening for perceived burden to improve outcomes and reduce re-hospitalizations.
Mortality Outcomes and Contributing Risk Factors in Patients with Hospital-Associated Disability
Authors: Jo Soo-Jeong , Lee So-Hee , Min Hyo-Jin , Kim Hee-Ji , Kong Hyun-Ho
Published: August 2024

Background/Objectives: Hospital-associated disability (HAD), a functional decline following acute hospitalization, is a common complication associated with mortality and unfavorable prognoses in patients admitted to acute care hospitals. However, few studies have investigated mortality and associated factors in patients with HAD and have been limited by inconsistent HAD assessment tools and criteria. This study investigated mortality and risk factors in patients with HAD using specific criteria. Methods: This retrospective study evaluated patients referred to the Department of Rehabilitation Medicine with suspected HAD between June 2022 and March 2023. The collected data included medical histories, diagnostic tests for HAD (including muscle strength, balance, and modified Barthel Index), and bioelectrical impedance analysis (BIA). Multivariate logistic regression analysis was conducted to identify factors associated with mortality. Kaplan–Meier survival curves were constructed for mortality at 3 and 7 months. Results: A total of 455 patients were identified, among which 206 patients diagnosed with HAD (73.1 ± 12.5 years) were included in the analysis. The 3-month mortality rate was 27.2%. In the multivariate analysis, male sex (odds ratio (OR), 3.23; p < 0.01), a history of cancer (OR, 2.18; p < 0.05), and a low phase angle (OR, 0.69; p < 0.05) were significantly associated with mortality. A phase angle < 2.9° on BIA was associated with a significant increase in 3-month (hazard ratio (HR), 1.85; 95% confidence interval (CI), 1.06–3.23) and 7-month (HR, 2.80; 95% CI, 1.75–4.98) mortality. Conclusions: Patients with HAD had a high mortality rate, with several factors, particularly low BIA phase angles, associated with increased mortality.
Frequency of BRAF Mutations in Dysplastic Nevi, Lentigo Maligna, and Melanoma In Situ
Authors: Prkačin Ivana , Šamija Ivan , Filipović Nika , Vucić Matej , Vučić Majda , Ferara Nikola , Šitum Mirna
Published: August 2024

Background: In melanomas, mutations in the BRAF gene are common and their occurrence represents an early oncogenic event. Our goal was to determine and compare the frequency of BRAF gene mutations in dysplastic nevi (ND) and melanomas in situ (MIS), as well as whether there is a correlation between the presence of BRAF gene mutations and various anamnestic, clinical, and histopathologic variables. Methods: A total of 175 patients—106 with ND, 41 with MIS, and 28 with lentigo maligna (LM) were included in the study. DNA was extracted from tissue samples and analyzed using the competitive allele-specific TaqMan chain reaction by polymerase in real time to detect the presence of BRAF V600E and V600K mutations. The data were compared with anamnestic, clinical, and histopathological data. Results: There is a statistically significant correlation between the presence of BRAF mutation and the diagnosis of melanoma in situ (χ2 test, χ2 = 29.17, p < 0.0001). Patients with LM had a significantly lower incidence of BRAF mutations compared to patients with ND and MIS. There was a significant correlation between the presence of a BRAF mutation and tumor localization, as well as the age of the patient, but no statistically significant correlation between the presence of a BRAF mutation and sex, tumor size, or previous melanoma diagnosis. Conclusions: BRAF mutations in ND are essentially required; however, they are an insufficient oncogenic trigger for the development of melanoma. This research contributes to a better understanding of the etiopathogenesis of melanoma and the role of ND as possible precursor lesions.
A Novel Model Based on CNN–ViT Fusion and Ensemble Learning for the Automatic Detection of Pes Planus
Authors: Doğan Kamil , Selçuk Turab , Yılmaz Abdurrahman
Published: August 2024

Background: Pes planus, commonly known as flatfoot, is a condition in which the medial arch of the foot is abnormally low or absent, leading to the inner part of the foot having less curvature than normal. Symptom recognition and errors in diagnosis are problems encountered in daily practice. Therefore, it is important to improve how a diagnosis is made. With the availability of large datasets, deep neural networks have shown promising capabilities in recognizing foot structures and accurately identifying pes planus. Methods: In this study, we developed a novel fusion model by combining the Vgg16 convolutional neural network (CNN) model with the vision transformer ViT-B/16 to enhance the detection of pes planus. This fusion model leverages the strengths of both the CNN and ViT architectures, resulting in improved performance compared to that in reports in the literature. Additionally, ensemble learning techniques were employed to ensure the robustness of the model. Results: Through a 10-fold cross-validation, the model demonstrated high sensitivity, specificity, and F1 score values of 97.4%, 96.4%, and 96.8%, respectively. These results highlight the effectiveness of the proposed model in quickly and accurately diagnosing pes planus, making it suitable for deployment in clinics or healthcare centers. Conclusions: By facilitating early diagnosis, the model can contribute to the better management of treatment processes, ultimately leading to an improved quality of life for patients.
Body Weight and Allergic Asthma: A Narrative Review
Authors: Imayama Ikuyo , Eccles Jacob D. , Ascoli Christian , Kudlaty Elizabeth , Park Gye Young
Published: August 2024

Obesity is a known risk factor for asthma development, progression, and exacerbation. Nevertheless, the underlying pathophysiological mechanisms explaining how obesity contributes to the development and progression of asthma have yet to be established. Here, we review human studies examining the associations between asthma and obesity, focusing on the literature from the past 10 years. Overall, current evidence suggests that while both asthma and obesity are complex diseases with significant heterogeneity, they both share various features of chronic inflammation. Furthermore, the interactions between asthma and obesity likely involve allergen-specific T helper type 2 (type 2) immune responses, as well as diverse non-type 2 inflammatory pathways. However, despite considerable progress, studies to date have not definitively elucidated the mechanisms that account for the observed association. A large-scale population-based study combined with translational immunological research, including targeted asthma therapies and pharmacological weight loss therapies, may be required to properly dissect the details of obesity-related asthma pathophysiology.
Joint Preservation Surgery Using Supramalleolar Osteotomy Combined with Posterior Tibial Tendon Release and Lateral Ligament Augmentation in Advanced Varus Ankle Arthritis
Authors: Park Chul Hyun , Park Jeong-Jin , Woo In-Ha
Published: August 2024

Background: Recent studies utilizing weight-bearing computed tomography have identified abnormal internal rotation of the talus in advanced varus ankle arthritis (VAA) with a large talar tilt (TT), influenced by the posterior tibial tendon (PTT). This study aimed to evaluate the clinical and radiographic results of supramalleolar osteotomy (SMO) combined with PTT release and lateral ligament augmentation for VAA with a large TT. Methods: From January 2015 to September 2018, 15 patients with VAA and a large TT (greater than 5°) underwent SMO combined with PTT release. Clinical results, including visual analog scale (VAS) for pain, American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, and ankle osteoarthritis scale (AOS), were assessed. Radiographic results were assessed with various parameters, including medial distal tibial angle (MDTA), anterior distal tibial angle (ADTA), talar tilt (TT), talus center migration (TCM), Meary angle, hindfoot alignment angle (HAA), and hindfoot moment arm (HMA) on foot and ankle weight-bearing radiographs. Clinical and radiographic results were evaluated preoperatively and at the last follow-up. Results: VAS, AOFAS ankle-hindfoot score, and AOS improved significantly from 7.5, 54.4, and 72.6 preoperatively to 3.1, 82.5, and 34.5 postoperatively, respectively. All radiographic parameters exhibited significant changes postoperatively, with the exception of the Meary angle, which demonstrated no significant change. Four patients exhibited improvement in radiographic stage postoperatively; however, average radiographic stage did not significantly improve postoperatively in all patients. One patient progressed to end-stage arthritis postoperatively, necessitating additional ankle arthrodesis. Conclusions: In conclusion, lengthening and lateral ligament augmentation combined with bony realignment procedures may be a reasonable option for treating VAA with a large TT greater that 5°.
Is There Any Purpose in Routine Syndesmotic Screw Removal? Systematic Literature Review
Authors: Wójtowicz Błażej G. , Chawrylak Katarzyna , Lesman Jędrzej , Domżalski Marcin
Published: August 2024

Introduction: The aim of this systematic review is to examine the recent evidence comparing the removal and non-removal of syndesmotic screws in tibiofibular syndesmosis injuries in terms of functional, clinical, and radiographic outcomes. Methods: A comprehensive literature review was conducted to identify clinical studies on syndesmotic screw removal and its outcomes, searching the Cochrane Library and PubMed Medline for publications from 1 January 2004 to 12 February 2024. Studies were included if they involved tibiofibular syndesmotic screw fixation, assessed screw removal or retention, described clinical outcomes, and were original research with at least fifteen patients per group. Results: Most reviewed articles (18 out of 27; 67%) found no significant differences between the routine removal and retention of syndesmotic screws post-fixation. Four retrospective studies (15%) suggested that retaining screws might result in worse outcomes compared to removal. Two studies (7%) indicated that removing screws could introduce additional risks. One study (4%) observed that post-removal, there is some fibula–tibia separation without affecting the medial clear space. Another study (4%) noted that intraosseous screw breakage might increase the need for implant removal due to pain. Additionally, no significant differences in ankle function were found among groups with varying intervals of screw removal. Conclusions: The current literature does not definitively support routine removal of syndesmotic screws. Given the potential complications and financial costs, routine removal should not be performed unless specifically indicated.
Computer-Assisted Algorithm for Quantification of Fibrosis by Native Cardiac CT: A Pilot Study
Authors: Gonciar Diana , Berciu Alexandru-George , Dulf Eva-Henrietta , Orzan Rares Ilie , Mocan Teodora , Danku Alex Ede , Lorenzovici Noemi , Agoston-Coldea Lucia
Published: August 2024

Background/Objectives: Recent advances in artificial intelligence, particularly in cardiac imaging, can potentially enhance patients’ diagnosis and prognosis and identify novel imaging markers. We propose an automated, computer-aided algorithm utilizing native cardiac computed tomography (CT) imaging to identify myocardial fibrosis. This study aims to evaluate its performance compared to CMR markers of fibrosis in a cohort of patients diagnosed with breast cancer. Methods: The study included patients diagnosed with early HER2+ breast cancer, who presented LV dysfunction (LVEF < 50%) and myocardial fibrosis detected on CMR at the time of diagnosis. The patients were also evaluated by cardiac CT, and the extracted images were processed for the implementation of the automatic, computer-assisted algorithm, which marked as fibrosis every pixel that fell within the range of 60–90 HU. The percentage of pixels with fibrosis was subsequently compared with CMR parameters. Results: A total of eight patients (n = 8) were included in the study. High positive correlations between the algorithm’s result and the ECV fraction (r = 0.59, p = 0.126) and native T1 (r = 0.6, p = 0.112) were observed, and a very high positive correlation with LGE of the LV(g) and the LV-LGE/LV mass percentage (r = 0.77, p = 0.025; r = 0.81, p = 0.015). A very high negative correlation was found with GLS (r = −0.77, p = 0.026). The algorithm presented an intraclass correlation coefficient of 1 (95% CI 0.99–1), p < 0.001. Conclusions: The present pilot study proposes a novel promising imaging marker for myocardial fibrosis, generated by an automatic algorithm based on native cardiac CT images.
HLA-A29 Negative Birdshot-like Chorioretinopathy Associated with Vitiligo—Case Report
Authors: Krzemińska Julia , Kurek Anna , Żebrowska Agnieszka , Waszczykowska Arleta
Published: August 2024

A 54-year-old, one-eyed Caucasian male was admitted to the Ophthalmology Clinic due to a gradual deterioration of vision in the right eye for approximately two weeks. The patient denied any trauma or viral infection during this time. On the day of admission, the patient’s best corrected visual acuity (BCVA) in the right eye was 0.5 on the Snellen scale. The patient’s left eye had been atrophied for several years, with no light perception and no visibility of the fundus due to previous trauma and multiple surgeries. Ophthalmologic examination of the anterior segment and vitreous body of both eyes showed no signs of inflammation. Fundus examination of the right eye revealed scattered inflammatory foci, creamy-yellow and round, visible in all sectors. Laboratory tests, imaging studies, optical coherence tomography (OCT) angiographies, OCTs of the macula and optic nerve head, fluorescein angiographies (FAs), electroretinograms (ERGs), and visual field tests were performed. These examinations led to a diagnosis of a disease resembling birdshot-like chorioretinopathy. Immunogenetic testing of the patient did not reveal the presence of human leukocyte antigen (HLA)-A29. Dermatological and immunological consultations were conducted, and a differential diagnosis was made. Due to the reduced visual acuity (VA) observed and the inability to assess the left eye, a high-dose corticosteroid therapy was initiated, which was gradually tapered, along with the application of an immunosuppressive drug. The course of the disease was typical for birdshot chorioretinopathy, with chronic periods of remissions and exacerbations. The patient’s clinical improvement was only achieved after co-administration of general corticosteroids at a dose of 0.5–1 mg/kg/day, mycofenolate mofetil, and periocular (sub-Tenon’s) triamcinolone.
Predicting Successful Weaning through Sonographic Measurement of the Rapid Shallow Breathing Index
Authors: Chung Eunki , Leem Ah Young , Lee Su Hwan , Kang Young Ae , Kim Young Sam , Chung Kyung Soo
Published: August 2024

Background: Diaphragmatic dysfunction correlates with weaning failure, highlighting the need to independently assess the diaphragm’s effects on weaning. We modified the rapid shallow breathing index (RSBI), a predictor of successful weaning, by incorporating temporal variables into existing ultrasound-derived diaphragm index to create a simpler index closer to tidal volume. Methods: We conducted a prospective observational study of patients who underwent a spontaneous breathing trial in the medical intensive care unit (ICU) at Severance Hospital between October 2022 and June 2023. Diaphragmatic displacement (DD) and diaphragm inspiratory time (Ti) were measured using lung ultrasonography. The modified RSBI was defined as follows: respiratory rate (RR) divided by DD was defined as D-RSBI, and RR divided by the sum of the products of DD and Ti on both sides was defined as DTi-RSBI. Results: Among the sonographic indices, DTi-RSBI had the highest area under the receiver operating characteristic (ROC) curve of 0.774 in ROC analysis, and a correlation was found between increased DTi-RSBI and unsuccessful extubation in a multivariable logistic regression analysis (adjusted odds ratio 0.02, 95% confidence interval 0.00–0.97). Conclusions: The DTi-RSBI is beneficial in predicting successful weaning in medical ICU patients.
An Analysis of Ocular Biometrics: A Comprehensive Retrospective Study in a Large Cohort of Pediatric Cataract Patients
Authors: Schwarzenbacher Luca , Wassermann Lorenz , Rezar-Dreindl Sandra , Reiter Gregor S. , Schmidt-Erfurth Ursula , Stifter Eva
Published: August 2024

Objectives: This study aims to provide a comprehensive analysis of ocular biometric parameters in pediatric patients with cataracts to optimize surgical outcomes. By evaluating various biometric data, we seek to enhance the decision-making process for intraocular lens (IOL) placement, particularly with advanced technologies like femtosecond lasers. Methods: This retrospective comparative study included pediatric patients with cataracts who underwent ocular biometric measurements and cataract extraction with anterior vitrectomy at the Medical University of Vienna between January 2019 and December 2021. Parameters measured included corneal diameter (CD), axial length (AL), corneal thickness (CT) and flat and steep keratometry (Kf and Ks). The study explored the correlations between these parameters and IOL placement. Results: A total of 136 eyes from 68 pediatric patients were included in the study. Significant positive correlations were found between corneal diameter, age and AL. The mean CD was 11.4 mm, mean AL was 19.5 mm, CT was 581.2 ± 51.8 µm, Kf was 7.76 ± 0.55 mm and Ks 7.41 ± 0.59 mm, respectively. Older pediatric patients with larger corneal diameters and longer ALs were more likely to receive in-the-bag IOL implantation. Conversely, younger patients often required alternative IOL placements or remained aphakic. Our data indicated that over 95% of the study population and all patients aged one year and older had a corneal diameter of 10 mm or larger. Conclusions: Detailed ocular biometric analysis is crucial for optimizing both surgical outcomes and postoperative care in pediatric cataract patients. The positive correlations between CD, age and AL underline the importance of individualized surgical planning tailored to each patient’s unique anatomical features. Additionally, our findings suggest that the use of a femtosecond laser is both feasible and safe for pediatric patients aged one year and older, potentially offering enhanced surgical precision and improved outcomes.
Sex Differences in the Energy System Contribution during Sprint Exercise in Speed-Power and Endurance Athletes
Authors: Archacki Damian , Zieliński Jacek , Ciekot-Sołtysiak Monika , Zarębska Ewa Anna , Kusy Krzysztof
Published: August 2024

Background/Objectives: A high level of specific metabolic capacity is essential for maximal sprinting in both male and female athletes. Various factors dictate sex differences in maximal power production and energy utilization. This study aims to compare the contribution of energy systems between male and female athletes with similar sport-specific physiological adaptations during a 15-s sprint exercise. Methods: The endurance group consisted of 17 males (23 ± 7 y) and 17 females (20 ± 2 y). The speed-power group included 14 males (21.1 ± 2.6 y) and 14 females (20 ± 3 y). The contribution of phosphagen, glycolytic, and aerobic systems was determined using the three-component PCr-LA-O2 method. Results: Significant differences were observed in the energy expenditure for all systems and total energy expenditure between males and females in both groups (p = 0.001–0.013). The energy expenditure in kJ for individual systems (phosphagen–glycolytic–aerobic) was 35:25:7 vs. 20:16:5 in endurance males vs. female athletes, respectively. In the speed-power group, male athletes expended 33:37:6 kJ and female athletes expended 21:25:4 kJ, respectively. The percentage proportions did not differ between males and females in any system. The contribution of the phosphagen–glycolytic–aerobic systems was 52:37:11 vs. 48:39:13 in endurance male and female athletes, respectively. For speed-power males vs. female athletes, the proportions were 42:50:8 vs. 41:50:9, respectively. Conclusions: Despite the differences in body composition, mechanical output, and absolute energy expenditure, the energy system contribution appears to have a similar metabolic effect between male and female athletes engaged in sprint exercises with similar sport-related adaptations. The magnitude and profile of sex differences are related to sports discipline.