bluuebunny/crossref_metadata_2025 huggingface dataset:
Approach for Elucidating the Molecular Mechanism of Epithelial to Mesenchymal Transition in Fibrosis of Asthmatic Airway Remodeling Focusing on Cl− Channels
Authors: Yoshie Susumu , Murono Shigeyuki , Hazama Akihiro
Published: December 2023

Airway remodeling caused by asthma is characterized by structural changes of subepithelial fibrosis, goblet cell metaplasia, submucosal gland hyperplasia, smooth muscle cell hyperplasia, and angiogenesis, leading to symptoms such as dyspnea, which cause marked quality of life deterioration. In particular, fibrosis exacerbated by asthma progression is reportedly mediated by epithelial-mesenchymal transition (EMT). It is well known that the molecular mechanism of EMT in fibrosis of asthmatic airway remodeling is closely associated with several signaling pathways, including the TGF-β1/Smad, TGF-β1/non-Smad, and Wnt/β-catenin signaling pathways. However, the molecular mechanism of EMT in fibrosis of asthmatic airway remodeling has not yet been fully clarified. Given that Cl− transport through Cl− channels causes passive water flow and consequent changes in cell volume, these channels may be considered to play a key role in EMT, which is characterized by significant morphological changes. In the present article, we highlight how EMT, which causes fibrosis and carcinogenesis in various tissues, is strongly associated with activation or inactivation of Cl− channels and discuss whether Cl− channels can lead to elucidation of the molecular mechanism of EMT in fibrosis of asthmatic airway remodeling.
Role of Drosophila in Human Disease Research 3.0
Authors: Cotterill Sue , Yamaguchi Masamitsu
Published: December 2023

Drosophila melanogaster has become a commonly used animal model for biomedical research in a variety of areas [...]
VdPT1 Encoding a Neutral Trehalase of Verticillium dahliae Is Required for Growth and Virulence of the Pathogen
Authors: Chen Lihua , Ma Xiaohu , Sun Tiange , Zhu Qian-Hao , Feng Hongjie , Li Yongtai , Liu Feng , Zhang Xinyu , Sun Jie , Li Yanjun
Published: December 2023

Verticillum dahliae is a soil-borne phytopathogenic fungus causing destructive Verticillium wilt disease. We previously found a trehalase-encoding gene (VdPT1) in V. dahliae being significantly up-regulated after sensing root exudates from a susceptible cotton variety. In this study, we characterized the function of VdPT1 in the growth and virulence of V. dahliae using its deletion-mutant strains. The VdPT1 deletion mutants (ΔVdPT1) displayed slow colony expansion and mycelial growth, reduced conidial production and germination rate, and decreased mycelial penetration ability and virulence on cotton, but exhibited enhanced stress resistance, suggesting that VdPT1 is involved in the growth, pathogenesis, and stress resistance of V. dahliae. Host-induced silencing of VdPT1 in cotton reduced fungal biomass and enhanced cotton resistance against V. dahliae. Comparative transcriptome analysis between wild-type and mutant identified 1480 up-regulated and 1650 down-regulated genes in the ΔVdPT1 strain. Several down-regulated genes encode plant cell wall-degrading enzymes required for full virulence of V. dahliae to cotton, and down-regulated genes related to carbon metabolism, DNA replication, and amino acid biosynthesis seemed to be responsible for the decreased growth of the ΔVdPT1 strain. In contrast, up-regulation of several genes related to glycerophospholipid metabolism in the ΔVdPT1 strain enhanced the stress resistance of the mutated strain.
Military Decision-Making Process Enhanced by Image Detection
Authors: Žigulić Nikola , Glučina Matko , Lorencin Ivan , Matika Dario
Published: December 2023

This study delves into the vital missions of the armed forces, encompassing the defense of territorial integrity, sovereignty, and support for civil institutions. Commanders grapple with crucial decisions, where accountability underscores the imperative for reliable field intelligence. Harnessing artificial intelligence, specifically, the YOLO version five detection algorithm, ensures a paradigm of efficiency and precision. The presentation of trained models, accompanied by pertinent hyperparameters and dataset specifics derived from public military insignia videos and photos, reveals a nuanced evaluation. Results scrutinized through precision, recall, map@0.5, mAP@0.95, and F1 score metrics, illuminate the supremacy of the model employing Stochastic Gradient Descent at 640 × 640 resolution: 0.966, 0.957, 0.979, 0.830, and 0.961. Conversely, the suboptimal performance of the model using the Adam optimizer registers metrics of 0.818, 0.762, 0.785, 0.430, and 0.789. These outcomes underscore the model’s potential for military object detection across diverse terrains, with future prospects considering the implementation on unmanned arial vehicles to amplify and deploy the model effectively.
Dynamic Semiosis: Meaning, Informing, and Conforming in Constructing the Past
Authors: Thibodeau Kenneth
Published: December 2023

Constructed Past Theory (CPT) is an abstract representation of how information about the past is produced and interpreted. It is grounded in the assertion that whatever we can write or say about anything in the past is the product of cognition. Understanding how information about the past is produced requires the identification and analysis of both the sources on which that information is based and the way in which the constructor approaches the task to select, analyze, and organize information to achieve the purpose for which the information was sought. CPT models this dual process, providing a basis for evaluation. It is descriptive, not prescriptive. CPT has been articulated using UML class diagrams with the objective of facilitating implementation in automated systems. This article reformulates CPT using type theory and extends its reach by applying and adapting concepts from semiotics. The results are more detailed models that facilitate differentiating what things meant to people in the past from how the constructor understands them. This article concludes with suggestions for applying CPG concepts in constructing information about the past and identifying areas where further research is needed.
Fifth Element: The Current State of Boron Chemistry
Authors: Stogniy Marina Yu.
Published: December 2023

The fifth element of the Periodic Table is boron [...]
Oxidative Stress Mediates Epigenetic Modifications and the Expression of miRNAs and Genes Related to Apoptosis in Diabetic Retinopathy Patients
Authors: Karam-Palos Sarah , Andrés-Blasco Irene , Campos-Borges Cristina , Zanón-Moreno Vicente , Gallego-Martínez Alex , Alegre-Ituarte Victor , García-Medina Jose J. , Pastor-Idoate Salvador , Sellés-Navarro Inmaculada , Vila-Arteaga Jorge , Lleó-Perez Antonio V. , Pinazo-Durán Maria D.
Published: December 2023

Knowledge on the underlying mechanisms and molecular targets for managing the ocular complications of type 2 diabetes mellitus (T2DM) remains incomplete. Diabetic retinopathy (DR) is a major cause of irreversible visual disability worldwide. By using ophthalmological and molecular-genetic approaches, we gathered specific information to build a data network for deciphering the crosslink of oxidative stress (OS) and apoptosis (AP) processes, as well as to identify potential epigenetic modifications related to noncoding RNAs in the eyes of patients with T2DM. A total of 120 participants were recruited, being classified into two groups: individuals with T2MD (T2MDG, n = 67), divided into a group of individuals with (+DR, n = 49) and without (−DR, n = 18) DR, and a control group (CG, n = 53). Analyses of compiled data reflected significantly higher plasma levels of malondialdehyde (MDA), superoxide dismutase (SOD), and glutathione peroxidase (GPx) and significantly lower total antioxidant capacity (TAC) in the +DR patients compared with the −DR and the CG groups. Furthermore, the plasma caspase-3 (CAS3), highly involved in apoptosis (AP), showed significantly higher values in the +DR group than in the −DR patients. The microRNAs (miR) hsa-miR 10a-5p and hsa-miR 15b-5p, as well as the genes BCL2L2 and TP53 involved in these pathways, were identified in relation to DR clinical changes. Our data suggest an interaction between OS and the above players in DR pathogenesis. Furthermore, potential miRNA-regulated target genes were identified in relation to DR. In this concern, we may raise new diagnostic and therapeutic challenges that hold the potential to significantly improve managing the diabetic eye.
Myocardial Mechanics and Associated Valvular and Vascular Abnormalities in Left Ventricular Noncompaction Cardiomyopathy
Authors: Nemes Attila
Published: December 2023

Left ventricular (LV) non-compaction (LVNC) is a rare genetic cardiomyopathy due to abnormal intra-uterine arrest of compaction of the myocardial fibers during endomyocardial embryogenesis. Due to the partial or complete absence of LV compaction, the structure of the LV wall shows characteristic abnormalities, including a thin compacted epicardium and a thick non-compacted endocardium with prominent trabeculations and deep intertrabecular recesses. LVNC is frequently associated with chronic heart failure, life-threatening ventricular arrhythmias, and systemic embolic events. According to recent findings, in the presence of LVNC, dysfunctional LV proved to be associated with left atrial volumetric and functional abnormalities and consequential dilated and functionally impaired mitral annulus, partly explaining the higher prevalence of regurgitation. Although the non-compaction process morphologically affects only the LV, signs of remodeling of the right heart were also detected. Moreover, dilation and stiffening of the aorta were present. The aim of the present detailed review was to summarize findings regarding changes in cardiac mechanics, valvular abnormalities, and vascular remodeling detected in patients with LVNC.
Analysis of Pain Management after Anatomic VATS Resection in Austrian Thoracic Surgery Units
Authors: Ponholzer Florian , Schweiger Thomas , Ghanim Bahil , Maier Herbert , Hutter Jörg , Tomaselli Florian , Krause Axel , Müller Michael , Lindenmann Jörg , Spruk Gero , Augustin Florian
Published: December 2023

Background: Postoperative pain influences rehabilitation, postoperative complications and quality of life. Despite its impact, there are no uniform treatment guidelines. Different centers seem to use various strategies. This study aims to analyze pain management regimens used after anatomic VATS resections in Austrian thoracic surgery units, with a special interest in opioid usage and strategies to avoid opioids. Methods: A questionnaire was designed to assess the use of regional anesthesia, postoperative pain medication and characteristics of individual pain management regimens. The questionnaire was sent to all thoracic surgery units in Austria, with nine out of twelve departments returning them. Results: All departments use regional anesthesia during the procedure. Four out of nine centers use epidural analgesia or an intercostal catheter for postoperative regional anesthesia in at least 50% of patients. Two departments follow an opioid restrictive regimen, five depend on the visual analogue scale (VAS) and two administer opioids on a fixed schedule. Three out of nine departments use NSAIDs on a fixed schedule. The most used medication is metamizole (eight out of nine centers; six on a fixed schedule, two depending on VAS) followed by piritramide (six out of nine centers; none as a fixed prescription). Conclusions: This study reflects the heterogeneity in postoperative pain treatment after VATS anatomic lung resections. All departments use some form of regional anesthesia in the perioperative period; prolonged regional anesthesia is not utilized uniformly to reduce opioid consumption, as suggested in enhanced recovery after surgery programs. More evidence is needed to optimize and standardize postoperative pain treatment.
High-Flow Nasal Cannula Therapy as an Adjuvant Therapy for Respiratory Support during Endoscopic Techniques: A Narrative Review
Authors: Corral-Blanco Marta , Sayas-Catalán Javier , Hernández-Voth Ana , Rey-Terrón Laura , Villena-Garrido Victoria
Published: December 2023

High-flow nasal cannula (HFNC) is a respiratory support technique that delivers a controlled concentration of oxygen with high flow, heat, and humidity via the nasal pathway. As it has many physiological effects, its use has increased for a variety of clinical indications; however, there is limited guidance on using HFNC as a respiratory support tool during endoscopic procedures. We conducted a narrative review to evaluate the effect of HFNC as an adjuvant tool during fiberoptic bronchoscopy (FOB), upper gastrointestinal tract endoscopy, and surgical procedures in adults. A search of the PubMed and Cochrane databases were performed. Approximately 384 publications were retrieved, and 99 were selected (93 original works and 6 case reports with a literature review). In patients who underwent FOB, HFNC appears to be superior to conventional oxygen therapy (COT) in preventing hypoxaemia. In contrast, for gastrointestinal endoscopy, the current evidence is insufficient to recommend HFNC over COT in a cost-effective manner. Finally, in surgical procedures such as laryngeal microsurgery or thoracic surgery, HFNC has been shown to be a safe and effective alternative to orotracheal intubation. As the results are heterogeneous, we advocate for the need for more quality studies to understand the effectiveness of HFNC during endoscopic procedures.
Prognostic Value of the Area of Lung Involved in Severe and Non-Severe Bronchiolitis: An Observational, Ultrasound-Based Study
Authors: Camporesi Anna , Vetrugno Luigi , Morello Rosa , De Rose Cristina , Ferrario Stefania , Buonsenso Danilo
Published: December 2023

Background: Point of care lung ultrasound (LUS) has a definite role in viral bronchiolitis when combined with clinical data. Previous data showed a bigger involvement of the superior lung zones in more severe cases. The aim of the present study is to describe whether different lung areas are implicated to different degrees in patients admitted to a Pediatric Intensive Care Unit (PICU) and needing ventilation compared to those with less severe forms. Methods: observational, prospective study. LUS scores of single lung areas and clinical data were collected for all children aged 0–12 months presenting with bronchiolitis to the participating centers and used as covariates for logistic regression having “PICU admission” as outcome. A subsequent analysis was carried out to investigate factors concurring with different lung zones’ involvement. Results: 173 patients were enrolled. Difficulty in feeding, presence of wheezing, SpO2 were all risk factors for PICU admission. Superior lung areas’ LUS scores presented higher Odds Ratios for PICU admission and need for ventilation than inferior ones. Age and prematurity concurred in determining their higher LUS scores. Conclusions: Superior lobes’ greater involvement could be favored by the geometrical distribution of relative bronchi, exiting with an acute angle from mainstem bronchi in small children where airway caliber is small and only small volumes of secretions can be occlusive.
The Prevalence of the Frailty Syndrome in a Hospital Setting—Is Its Diagnosis a Challenge? A Comparison of Four Frailty Scales in a Cross-Sectional Study
Authors: Kasiukiewicz Agnieszka , Wojszel Zyta Beata
Published: December 2023

The study aimed to assess the prevalence of the frailty syndrome in older patients hospitalized in the geriatric ward depending on the diagnostic criteria used, the feasibility of particular diagnostic scales in hospitalized patients, and their compatibility; 416 patients (81.2 ± 6.91 years) admitted to the Department of Geriatrics of Hospital of the Ministry of the Interior and Administration in Bialystok within eight months were included in the study. Four diagnostic scales were used to identify the frailty syndrome: Fried criteria, 7-point Clinical Frailty Scale (CFS), 40-item Frailty Index (FI), and FRAIL Scale. Depending on the scale, the prevalence of frailty syndrome varied from 26.8% (FRAIL Scale), 52.3% (Clinical Frailty Scale), and 58.1% (Fried criteria) up to 62.9% (Frailty Index). We observed the highest feasibility for CFS (100%) and the lowest for the Fried scale (79.8%). The highest level of agreement was found between the CFS and Frailty Index, with 80.3% consistent ratings (Cohen Kappa 0.6). Patients in the geriatric ward are characterized by a high prevalence of frailty, although it differs depending on the criteria. The most difficult to use in daily practice was the Fried scale, while the Clinical Frailty Scale was determined feasible in all patients.
Hormone Replacement Therapy Is Associated with Disease Activity Improvement among Post-Menopausal Women with Inflammatory Bowel Disease
Authors: Freeman Morgan , Lally Lauren , Teigen Levi , Graziano Elliot , Shivashankar Raina , Shmidt Eugenia
Published: December 2023

(1) Background: There are limited data available to guide clinical decision-making regarding the effects of hormone replacement therapy (HRT) in post-menopausal women with inflammatory bowel disease (IBD). In this study, we sought to characterize a population of post-menopausal women with IBD and to determine the effects of HRT on their disease activity. (2) Methods: A multicenter, retrospective, case–control cohort study of post-menopausal women with IBD was conducted. The physician global assessment (PGA) score was used to quantify disease activity. To control for the effects of menopause, IBD patients who had not undergone HRT were used as controls. (3) Results: There was a significant reduction in the frequency of PGA scores ≥2 post HRT treatment (p < 0.01). HRT treatment was associated with a 5.6× increase in the odds of post-HRT PGA score improvement compared to controls (OR 5.6; 95% CL 1.6, 19.7) in our univariate logistic regression analysis. (4) Conclusion: Post-menopausal IBD women who underwent HRT therapy showed an improvement in their disease symptoms following HRT compared to post-menopausal women without HRT therapy, who showed no change.
Robotic Lateral Pelvic Lymph Node Dissection in Rectal Cancer: A Feasibility Study from a European Centre
Authors: Chang Tou Pin , Ali Oroog , Tsimogiannis Kostas , Sica Giuseppe S. , Khan Jim S.
Published: December 2023

Introduction: The role of robotic lateral pelvic lymph node dissection (LPLND) for lateral pelvic nodal disease (LPND) in rectal cancer has yet to be investigated in the Western hemisphere. This study aims to investigate the safety and feasibility of robotic LPLND by utilising a well-established totally robotic TME protocol. Methods: We conducted a retrospective study on 17 consecutive patients who underwent robotic LPLND for LPND ± TME for rectal cancer between 2015 and 2021. A single docking totally robotic approach from the left hip with full splenic mobilisation was performed using the X/Xi da Vinci platform. All patients underwent a tri-compartmental robotic en bloc excision of LPND with preservation of the obturator nerve and pelvic nerve plexus, leaving a well-skeletonised internal iliac vessel and its branches. Results: The median operative time was 280 min, which was 40 min longer than our standard robotic TME. The median BMI was 26, and there were no conversions. The median inpatient stay was 7 days with no Clavien-Dindo > 3 complications. One patient (6%) developed local recurrence and metastatic disease within 5 months. The proportion of histologically confirmed LPND was 41%, of which 94% were well to moderately differentiated adenocarcinoma. Median pre-operative lateral pelvic node size was significantly higher in positive nodes (14 mm vs. 8 mm (p = 0.01)). All patients had clear resection margins on histology. Discussion: Robotic LPLND is safe and feasible with good peri-operative and short-term outcomes, with the ergonomic advantages of a robotic TME docking protocol readily transferrable in LPLND.
Management of Teeth with Grade 3 Endo-Periodontal Lesions by Combined Endodontic and Regenerative Periodontal Therapy
Authors: Tietmann Christina , Tezer Ivet , Youssef Emad , Jepsen Søren , Jepsen Karin
Published: December 2023

(1) Background: Severely compromised teeth affected by endo-periodontal lesions are often assigned a “hopeless” prognosis, however, there is only limited evidence available. (2) Methods: In a retrospective study, we evaluated the long-term effectiveness of combined endodontic and regenerative periodontal therapy in teeth with advanced endo-periodontal lesions: 35 patients (age 47–83 years) with a total of 39 teeth diagnosed with grade 3 endo-periodontal lesions were treated by endodontists using an operating microscope followed by regenerative periodontal surgery. (3) Results: Changes in radiographic bone levels (rBl) and probing pocket depths (PPDs) were evaluated after 1 year (T1) and up to 7 years postoperatively (Tfinal). Mean rBL gain was significant with 4.87 ± 3.47 mm after 1 year (T1) and stable results with a mean rBL gain of 4.70 ± 3.37 mm at Tfinal. Mean PPD was significantly reduced from 9.74 ± 2.05 mm at baseline to 5.04 ± 1.61 mm at T1 and to 4.87 ± 2.32 mm at Tfinal. Tooth loss amounted to 10.3% (n = 4) and was due to root fracture. (4) Conclusion: The results suggest that the combined endodontic and regenerative periodontal therapy of endo-periodontal lesions of “hopeless” teeth can lead to favorable long-term results with tooth retention for up to 7 years.
Factors Associated with Post-Traumatic Growth during the COVID-19 Pandemic: A Systematic Review
Authors: Bovero Andrea , Balzani Sarah , Tormen Gabriela , Malandrone Francesca , Carletto Sara
Published: December 2023

The COVID-19 pandemic was an unprecedented event that further stimulated the debate on the concept of trauma. To increase knowledge about the traumatic potential of the pandemic, the main objective of this study was to identify, through a systematic literature review, the main factors associated with the adaptive outcome of post-traumatic growth caused by COVID-19. Studies were selected from the PsychInfo, Embase, and PubMed databases, and 29 articles were included at the end of the screening process. The identified factors are of different natures, including personal variables such as personality traits, coping, and cognitive strategies used to face adversity, and interpersonal variables, one of the most important of which is the level of social support. In addition, several results confirmed a relationship between post-traumatic growth and post-traumatic stress symptoms, as well as indices related to psychological well-being. Finally, the results are discussed by comparing them with those already present in the literature, as well as with some of the main explanatory models of post-traumatic growth. In this regard, some of the factors identified, such as maladaptive coping, avoidance symptoms, optimism, and low-stress tolerance, suggest the possibility that the process of post-traumatic growth may also be characterized by an illusory dimension.
Primary Care Clinicians’ Prescribing Patterns of Reduced-Dose Direct Oral Anticoagulants for Extended-Phase Venous Thromboembolism Treatment
Authors: Groat Danielle , Martin Karlyn , Rosovsky Rachel , Sanfilippo Kristen , Gaddh Manila , Baumann Kreuziger Lisa , Federici Elizabeth , Woller Scott
Published: December 2023

The direct anticoagulants (DOACs), apixaban and rivaroxaban, are used for extended-phase treatment of venous thromboembolism (VTE) and have labeling for dose reduction for this indication. The objective of this study was to better understand primary care clinician prescribing patterns of apixaban and rivaroxaban for extended-phase anticoagulation. We conducted a 21-question survey targeting members of the American College of Physicians and United States Veterans Administration anticoagulation management services. Survey questions covered prescribing behaviors for dose reduction of apixaban and rivaroxaban for extended VTE treatment, as well as questions related to the respondent’s practice setting. We used logistic regression to assess associations between demographics and prescribing behaviors. We used k-means clustering to identify distinct groups of prescribing patterns. Among 227 respondents, most were attending physicians (60%) and one-third (34%) practiced in internal medicine or primary care. Most (59%) indicated they dose-reduced DOACs. Hospitalists (no outpatient care) were least likely to dose-reduce (OR 0.09 [95% CI 0.03–0.22]), as well as early-career clinicians (0.53 [0.30–0.91]). Pharmacists and clinicians who treat over 500 VTE patients annually were most likely to dose reduce (6.4 [2.9–16.3]), (2.9 [1.5–6.0]), respectively. We identified five clusters of dosing behaviors and characterized clinician makeup. Clusters were primarily differentiated by frequency of dose reduction, DOAC preference, and temporary re-escalation of doses. We identified clinician characteristics that are associated with dose-reduction prescribing behaviors; these analyses provide insight into where targeted interventions, such as protocolization and education, would be most beneficial.
Antithrombotic Therapy Optimization in Patients with Atrial Fibrillation Undergoing Percutaneous Coronary Intervention
Authors: Gragnano Felice , Capolongo Antonio , Micari Antonio , Costa Francesco , Garcia-Ruiz Victoria , De Sio Vincenzo , Terracciano Fabrizia , Cesaro Arturo , Moscarella Elisabetta , Coletta Silvio , Raucci Pasquale , Fimiani Fabio , De Luca Leonardo , Gargiulo Giuseppe , Andò Giuseppe , Calabrò Paolo
Published: December 2023

The antithrombotic management of patients with atrial fibrillation (AF) undergoing percutaneous coronary intervention (PCI) poses numerous challenges. Triple antithrombotic therapy (TAT), which combines dual antiplatelet therapy (DAPT) with oral anticoagulation (OAC), provides anti-ischemic protection but increases the risk of bleeding. Therefore, TAT is generally limited to a short phase (1 week) after PCI, followed by aspirin withdrawal and continuation of 6–12 months of dual antithrombotic therapy (DAT), comprising OAC plus clopidogrel, followed by OAC alone. This pharmacological approach has been shown to mitigate bleeding risk while preserving adequate anti-ischemic efficacy. However, the decision-making process remains complex in elderly patients and those with co-morbidities, significantly influencing ischemic and bleeding risk. In this review, we discuss the available evidence in this area from randomized clinical trials and meta-analyses for post-procedural antithrombotic therapies in patients with non-valvular AF undergoing PCI.
Letermovir Rescue Therapy in Kidney Transplant Recipients with Refractory/Resistant CMV Disease
Authors: von Hoerschelmann Ellen , Münch Johannes , Gao Linde , Lücht Christian , Naik Marcel G. , Schmidt Danilo , Pitzinger Paul , Michel Detlef , Avaniadi Parthenopi , Schrezenmeier Eva , Choi Mira , Halleck Fabian , Budde Klemens
Published: December 2023

(1) Background: CMV infections remain a problem after kidney transplantation, particularly if patients are refractory or resistant (r/r) to treatment with valganciclovir (VGCV) or ganciclovir (GCV). (2) Methods: In a single-center retrospective study, kidney transplant recipients (KTR) receiving letermovir (LTV) as rescue therapy for VGCV-/GCV-r/r CMV disease were analyzed regarding CMV history, immunosuppression, and outcomes. (3) Results: Of 201 KTR treated for CMV between 2017 and 2022, 8 patients received LTV following treatment failure with VGCV/GCV. All patients received CMV prophylaxis with VGCV according to the center’s protocol, and 7/8 patients had a high-risk (D+/R−) CMV constellation. In seven of eight cases, rising CMV levels occurred during prophylaxis. In seven of eight patients, a mutation in UL97 associated with a decreased response to VGCV/GCV was detected. In four of eight patients, LTV resulted in CMV clearance after 24 ± 10 weeks (16–39 weeks), two of eight patients stabilized at viral loads <2000 cop/mL (6–20 weeks), and two of eight patients developed LTV resistance (range 8–10 weeks). (4) Conclusion: LTV, which is currently evaluated for CMV prophylaxis in kidney transplantation, also shows promising results for the treatment of patients with VGCV/GCV resistance despite the risk of developing LTV resistance. Additional studies are needed to further define its role in the treatment of patients with CMV resistance.
Understanding Barriers Impacting upon Patient Wellbeing: A Nationwide Italian Survey and Expert Opinion of Dermatologists Treating Patients with Moderate-to-Severe Psoriasis
Authors: Prignano Francesca , Argenziano Giuseppe , Bardazzi Federico , Borroni Riccardo G. , Brunasso Alexandra M. G. , Burlando Martina , Cagni Anna Elisabetta , Campione Elena , Cinotti Elisa , Colonna Fabrizio , Cuccia Aldo , Dastoli Stefano , De Pasquale Rocco , De Simone Clara , Di Lernia Vito , Dini Valentina , Fabbrocini Gabriella , Galluzzi Claudia , Giacchetti Alfredo , Giofrè Claudia , Lasagni Claudia , Lembo Serena , Loconsole Francesco , Montesu Maria Antonia , Pella Paolo , Piaserico Stefano , Pigatto Paolo , Richetta Antonio Giovanni , Scuotto Adriana , Stroppiana Elena , Venturini Marina , Vinci Anna Stefania , Zichichi Leonardo , Fargnoli Maria Concetta
Published: December 2023

A nationwide cross-sectional online survey was administered to dermatologists managing patients with moderate-to-severe plaque psoriasis across Italy to obtain real-world dermatologists’ perspectives on the impact of psoriasis and its treatment on patients’ daily lives and quality of life (QoL). A total of 91 dermatologists (aged 39.1 ± 11.2 years) completed a 31-question survey and workshop sessions were undertaken in order to identify the best management approach to achieve patient wellbeing. Social (4.2 ± 0.1), physical (4.26 ± 0.2) and mental components (4.1 ± 0.3) were rated by dermatologists as contributing to patient wellbeing to similar extents. While a high proportion (85.4%; rating of 4.3 out of 5) of dermatologists felt that they considered the QoL of patients, a lower proportion (69.6%; rating of 3.7 out of 5) felt that patients were satisfied in this regard. The psoriasis area and severity index and body surface area were the instruments most frequently used to assess the physical domain, while interviews/questions and the dermatology life quality index were used to assess social and mental domains, with only 60% of dermatologists following up on these aspects. The importance of investigating the presence of comorbidities was recognized but not always carried out by many dermatologists, (>70%), particularly for obesity and anxiety/depression. This survey identified key components contributing to barriers impacting on the QoL of patients with moderate-to-severe psoriasis from the perspective of the dermatologist.
Vagus Nerve Stimulation in the Carotid Triangle: An Effective Method for Monitoring the Recurrent Laryngeal Nerve in Thyroid and Parathyroid Surgery
Authors: Traba Alfredo , de Abreu Angela , Nevado Clara , Duran Hipólito , Gil Antonio , Pérez Seoane María , Lopez-Gonzalez Laura , Ortega Miguel A. , Álvarez-Mon Melchor , Martin Pedro , San Roman Juan , Díaz-Pedrero Raul
Published: December 2023

Objective: Our objective is the description of the technique of vagus nerve stimulation in carotid triangle in order to monitor the recurrent laryngeal nerve (RLN) during thyroid and parathyroid surgery. Methods: We stimulated the vagus nerve in the carotid triangle during 150 thyroid or parathyroid surgeries using a monopolar electromyography electrode inserted under the mastoid process towards the jugular foramen as a cathode, and using another subdermal electrode in the mastoid as an anode. Another complementary method of vagus stimulation was achieved with a pair of subdermal electrodes, placing the cathode at the mandibular angle and the anode at the mastoid. Results: In all patients, compound muscle action potential (CMAP) was recorded in the vocal cords with both stimulation techniques, allowing semi-continuous monitoring to be carried out. Intraoperative lesions were detected in 16 of the cases; 9 of them were transient with CMAP recovery achieved when modifying surgical maneuvers. Conclusions: Vagus nerve stimulation in the carotid triangle is a reliable technique for monitoring the RLN in thyroid surgery. Vagus nerve stimulation in the carotid triangle is effective and safe for RLN monitoring, and it is a clear alternative to direct continuous stimulation of the nerve that by contrast requires its dissection in the carotid sheath.
Anatomical and Functional Outcomes with Prompt versus Delayed Initiation of Anti-VEGF in Exudative Age-Related Macular Degeneration
Authors: Gershoni Assaf , Barayev Edward , Daood Rabeea H. , Yogev Maureen , Gal-Or Orly , Reitblat Olga , Tsessler Maria , Schaap Fogler Michal , Tuuminen Raimo , Ehrlich Rita
Published: December 2023

Purpose: To investigate the correlation between time from diagnosis of treatment-naïve exudative age-related macular degeneration (AMD) to the introduction of anti-VEGF treatment and anatomical and functional outcomes. Design: Retrospective cohort study. Methods: Included were treatment-naïve exudative AMD patients who presented to a single tertiary medical center between 2012 and 2018. All patients were treated within the first 30 days of their diagnosis with three monthly intravitreal injections of bevacizumab. Patients were divided into three groups: group 1 (prompt anti-VEGF) were injected with bevacizumab within ten days, group 2 (intermediate anti-VEGF) within 11–20 days, and group 3 (delayed anti-VEGF) within 21–30 days from diagnosis. Baseline characteristics and clinical outcomes were compared up to two years from treatment. Results: 146 eyes of 146 patients were included. Sixty-eight patients were in the prompt anti-VEGF group, 31 in the intermediate anti-VEGF group, and 47 in the delayed anti-VEGF group. Following the induction phase of three intravitreal bevacizumab injections, the mean central subfield macular thickness (328.0 ± 115.4 µm vs. 364.6 ± 127.2 µm vs. 337.7 ± 150.1 µm, p = 0.432) and the best-corrected visual acuity (0.47 ± 0.38 vs. 0.59 ± 0.48 vs. 0.47 ± 0.44 logMAR units, p = 0.458) were comparable between the prompt, intermediate and delayed anti-VEGF groups. Anatomical and functional outcomes, treatment burden, number of relapses and eyes with second-line anti-VEGF therapy were comparable between the groups at both 1-year and 2-year timepoints. Conclusions: Our real-world evidence data emphasize that even if anti-VEGF induction cannot be initiated promptly within ten days from diagnosis of naïve exudative AMD, the visual and anatomical prognosis of the patients may not worsen if the treatment is started within one month of diagnosis.
Exploring the Place of Fish Skin Grafts with Omega-3 in Pediatric Wound Management
Authors: Cherry Ibrahim , Tarhini Lana , Doan Marie , De Buys Roessingh Anthony
Published: December 2023

Wound healing in the pediatric population is known to be a challenge and poorly studied. Split-thickness skin grafts, full-thickness skin grafts, and flaps overlap their applications with the growing field of cellular and tissue-based therapies. However, their role in pediatric reconstruction has yet to be defined. The Kerecis® Omega-3 wound patch, derived from decellularized codfish skin, has garnered attention due to its preserved microscopic architecture resembling the human extracellular matrix. This acellular dermal matrix acts as a scaffold, fostering dermal cell and capillary adhesion while harnessing omega-3 polyunsaturated fatty acids for granulation acceleration and antimicrobial effects. This study presents a comprehensive review and surgical protocol for utilizing Kerecis® fish skin in pediatric wound care. The research embraces a case series involving five patients with diverse wound locations. The Kerecis® Omega-3 wound patch underwent meticulous application and careful monitoring. The results highlight an average time of 48.6 days for complete epithelialization, yielding favorable outcomes with no hypertrophic scarring and mild retraction. Kerecis® fish skin grafting stands as a tool that not only accelerates healing but also addresses the multifaceted challenges associated with wound management in the pediatric population: the avoidance of donor site morbidity and improved postoperative pain control.
Changes in Gloss Alteration, Surface Roughness, and Color of Direct Dental Restorative Materials after Professional Dental Prophylaxis
Authors: Miyashita-Kobayashi Aya , Haruyama Akiko , Nakamura Keigo , Wu Chia-Ying , Kuroiwa Akihiro , Yoshinari Nobuo , Kameyama Atsushi
Published: December 2023

In the context of optimizing dental care for patients who are elderly, the purpose of this in vitro study was to evaluate the surface gloss (with a micro-area gloss meter) of, surface roughness (with a compact surface roughness measuring instrument) of, and color change (with a dental colorimeter) in two commercially available injectable resin-based composites (Estelite Universal Flow (EUF) and Beautifil Flow Plus F00 (BFP)) as well as two glass–ionomer cements (GC Fuji II LC CAPSULE (FLC) and GC Fuji IX GP EXTRA CAPSULE (FGP)), before and after dental prophylaxis. After 24 h, the surfaces of each specimen were polished at 2500 rpm with a prophy brush (Mersage Brush, Shofu) and one-step prophylaxis paste (Prophy Paste Pro, Directa): under 100 or 300 gf load, and for 10 or 30 s, 4× cycles of cleaning. After mechanical cleaning, conditions were found for a significant reduction in the gloss level (EUF, BFP, or FLC; p < 0.05) and a significant increase in surface roughness (BFP; 300 gf load, 10 s × four cycles of cleaning). Overall, the longer time or higher prophylaxis load tended to decrease the surface gloss. However, the observed change in surface roughness varied between the restorative materials. There was no color change post-prophylaxis.
Distribution Patterns and Genesis of Geological Fractures/Microfaults in the Qiongdongnan Basin, North of the South China Sea
Authors: Yu Junfeng , Song Ruiyou , Chao Caixia
Published: December 2023

The Qiongdongnan Basin (QDNB), located in the north of the South China Sea, is a Cenozoic rift basin with abundant oil and gas resources. Large flake hydrates have been found in the core fractures of Quaternary formations in the deep-water depression of the QDNB. In order to understand the spatial distribution patterns of these fractures, their geneses in sedimentary basins, and their influences on gas migration and accumulation, such fractures have been observed using high-resolution 3D seismic images and visualization techniques. Four types of fractures and their combinations have been identified, namely bed-bounded fractures/microfaults, unbounded fractures, fracture bunches, and fracture clusters. Bed-bounded fractures/microfaults are mainly short and possess high density; they have developed in mass transport depositions (MTDs) or Meishan and Sanya Formations. The unbounded fractures/microfaults that occur in Miocene–Pliocene formations are mainly long and discrete, and are dominantly caused by strong tectonic movements, the concentration of stress, and sustained intense overpressure. The fracture bunches and fracture clusters that occur in Oligocene–Early Miocene formations have commonly developed with the accumulation of large numbers of fractures and may be related to the release of pressure, diapirs, and basement fault blocks (228.9 ± 1 Ma). In this study, six fluid charging or leakage models are proposed based on distinct fracture types, assuming the uniform conductivity of each fracture. In a 3D space view, a vertical decrease in the fracture scale (number or density) will more likely result in gas supply than dispersion, thus promoting the accumulation of gas in the reservoirs. Nevertheless, the fractures above the Bottom Simulating Reflect (BSR)/seismic anomaly are excessively developed, and bed-bounded fractures within a particular layer, such as MTDs, can easily cause seabed leakage. These results are useful for explaining the vertical migration of gas/fluids in areas and formations with less developed gas chimneys, faults, diapirs, and other structures, particularly in post-rifting basins.
Experimental and Numerical Analysis of Ultimate Carrying Capacity of a Funnel Structure with Opening under Wind Pressure
Authors: Ao Lei , Ding Ziqi , Liu Bin , Pei Zhiyong , Tang Qin , Wu Weiguo
Published: December 2023

This study presents experimental and finite element investigations on the ultimate strength of the funnel structure of a large passenger ship subjected to wind pressure. An experimental test is conducted using a similar model to analyze the failure characteristics of the funnel structure. The model is designed based on similar theories to simulate the progressive collapse behavior of an actual ship’s funnel under wind load. Additionally, a simplified wind loading device is also developed to apply large wind loads. Practical insights are provided in the research to assess the opening’s influence on reducing the ultimate strength of funnel structures when suffering wind pressure. Results represent the failure initiated at the edges of the large opening, with stress concentration primarily occurring at the stiffener end, showing good agreement with the simulated results performed using the finite element method. Furthermore, the effects of different parameters on the ultimate strength of the funnel structure are discussed by using the numerical method. This analysis provides an important guide for the design of funnel structures of passenger ships with openings.
Performance Analysis of a WPCN-Based Underwater Acoustic Communication System
Authors: Xing Ronglin , Zhang Yuhang , Feng Yizhi , Ji Fei
Published: December 2023

Underwater acoustic communication (UWAC) has a wide range of applications, including marine environment monitoring, disaster warning, seabed terrain exploration, and oil extraction. It plays an indispensable and increasingly important role in marine resource exploration and marine economic development. In current UWAC systems, the terminal nodes are usually powered by energy-limited batteries. Due to the harshness of the underwater environment, especially in the ocean environment, it is very costly and difficult, even impossible, to replace the batteries for the terminal nodes in UWACs, which results in the short lifetime and unreliability of the terminal nodes and the systems. In this paper, we present the application of a wireless powered communication network (WPCN) to the UWAC systems to provide an auxiliary and convenient energy supplement for solving the energy-limited problem of the terminal nodes, where the hybrid access point (H-AP) transfers energy to the terminal nodes in the downlink. In contrast, the terminal nodes use the harvested energy to transmit the information to the H-AP in the uplink. To evaluate the proposed WPCN-based UWAC systems, we investigate the performance of the average bit error rate (BER), outage probability, and achievable information rate for the systems in a frequency-selective sparse channel and non-white noise environment. We derive the closed-form expression for the probability density function (PDF) of the received signal-to-noise ratio (SNR). Based on this, we further derive novel closed-form expressions for the average BER and the outage probability of the systems. Numerical results confirm the validity of the proposed analytical results. It is shown that there exists an optimal signal frequency and time allocation factor for the systems to achieve optimal performance, and a larger optimal time allocation factor is preferred for a smaller hybrid access point (H-AP) transmit power or a larger transmission distance, while a smaller optimal signal frequency is required for a larger transmission distance.
Diversity of Arbuscular Mycorrhizal Fungi in Distinct Ecosystems of the North Caucasus, a Temperate Biodiversity Hotspot
Authors: Yurkov Andrey P. , Kryukov Alexey A. , Gorbunova Anastasiia O. , Kudriashova Tatyana R. , Kovalchuk Anastasia I. , Gorenkova Anastasia I. , Bogdanova Ekaterina M. , Laktionov Yuri V. , Zhurbenko Peter M. , Mikhaylova Yulia V. , Puzanskiy Roman K. , Bagrova Tatyana N. , Yakhin Oleg I. , Rodionov Alexander V. , Shishova Maria F.
Published: December 2023

Background: Investigations that are focused on arbuscular mycorrhizal fungus (AMF) biodiversity is still limited. The analysis of the AMF taxa in the North Caucasus, a temperate biodiversity hotspot, used to be limited to the genus level. This study aimed to define the AMF biodiversity at the species level in the North Caucasus biotopes. Methods: The molecular genetic identification of fungi was carried out with ITS1 and ITS2 regions as barcodes via sequencing using Illumina MiSeq, the analysis of phylogenetic trees for individual genera, and searches for operational taxonomic units (OTUs) with identification at the species level. Sequences from MaarjAM and NCBI GenBank were used as references. Results: We analyzed >10 million reads in soil samples for three biotopes to estimate fungal biodiversity. Briefly, 50 AMF species belonging to 20 genera were registered. The total number of the AM fungus OTUs for the “Subalpine Meadow” biotope was 171/131, that for “Forest” was 117/60, and that for “River Valley” was 296/221 based on ITS1/ITS2 data. The total number of the AM fungus species (except for virtual taxa) for the “Subalpine Meadow” biotope was 24/19, that for “Forest” was 22/13, and that for “River Valley” was 28/24 based on ITS1/ITS2 data. Greater AMF diversity, as well as number of OTUs and species, in comparison with that of forest biotopes, characterized valley biotopes (disturbed ecosystems; grasslands). The correlation coefficient between “Percentage of annual plants” and “Glomeromycota total reads” r = 0.76 and 0.81 for ITS1 and ITS2, respectively, and the correlation coefficient between “Percentage of annual plants” and “OTUs number (for total species)” was r = 0.67 and 0.77 for ITS1 and ITS2, respectively. Conclusion: High AMF biodiversity for the river valley can be associated with a higher percentage of annual plants in these biotopes and the active development of restorative successional processes.
Thromboelastography-Guided Anticoagulation in Critically Ill COVID-19 Patients: Mortality and Bleeding Outcomes
Authors: Duenas Sean , Derfel Juliana , Gorlin Margaret , Romano Serena , Huang Wei , Smith Alex , Ticona Javier , Sison Cristina , Lesser Martin , Shore-Lesserson Linda , Hajizadeh Negin , Wang Janice
Published: December 2023

Hypercoagulability in COVID-19 patients was associated with increased mortality risk during the pandemic. This retrospective, observational study investigated whether the use of a thromboelastography (TEG)-guided anticoagulation protocol could decrease death and bleeding in critically ill COVID-19 patients. A TEG-guided protocol was instituted in one of two intensive care units. Primary outcomes of composite scores were the following: (0) major bleed and death; (1) death without major bleed; (2) major bleed without death; and (3) no bleed or death. Out of 134 patients, 67 in the TEG group were propensity matched to 67 in the comparator group based on age, gender, body mass index, presence of chronic kidney disease, cardiovascular disease, diabetes, and duration of non-invasive ventilation. There were no significant differences in rates of composite outcomes of bleeding or death in patients managed with or without a TEG-guided protocol (p = 0.22, Bowker symmetry testing). Out of the 67 patients in the TEG group, the TEG protocol led to anticoagulation change in 26 patients. Death was lower in this TEG-changed group (54%) compared to the comparator group (81%), although not significant (p = 0.07). TEG-guided protocol use did not reduce composite outcomes of death and bleeding, Future studies may further elucidate potential benefits.