bluuebunny/crossref_metadata_2025 huggingface dataset:
C-Type Natriuretic Peptide (CNP) Could Improve Sperm Motility and Reproductive Function of Asthenozoospermia
Authors: Li Na , Dong Xinyi , Fu Sen , Wang Xiaoyan , Li Huaibiao , Song Ge , Huang Donghui
Published: September 2022

This study is to analyze the effect of C-type natriuretic peptide (CNP) on sperm motility of asthenozoospermia and explore the influence mechanism of CNP on the reproductive system and sperm motility. Our results showed that the concentration of CNP in asthenospermia patients’ semen was lower than in normal people’s. The motility of sperm could be improved markedly by CNP and 8-Br-cGMP, while the effect of CNP was inhibited by NPR-B antagonist and KT5823. In the asthenozoospermia mouse model induced by CTX, CNP injection could improve sperm motility in the epididymis, alleviate tissue damage in the testes and epididymis, and increase testosterone levels. The asthenospermia mouse model showed high activity of MDA and proinflammatory factors (TNF-α, IL-6), as well as low expression of antioxidants (SOD, GSH-Px, CAT) in the testis and epididymis, but this situation could be significantly ameliorated after being treated with CNP. Those studies indicated that the concentration of CNP in the semen of asthenospermia patients is lower than in normal people and could significantly promote sperm motility through the NPR-B/cGMP pathway. In the asthenospermia mouse model induced by CTX, CNP can alleviate the damage of cyclophosphamide to the reproductive system and sperm motility. The mechanism may involve increasing testosterone and reducing ROS and proinflammatory factors to damage the tissue and sperm.
A Metagenomic and Gene Expression Analysis in Wheat (T. durum) and Maize (Z. mays) Biofertilized with PGPM and Biochar
Authors: Graziano Sara , Caldara Marina , Gullì Mariolina , Bevivino Annamaria , Maestri Elena , Marmiroli Nelson
Published: September 2022

Commodity crops, such as wheat and maize, are extremely dependent on chemical fertilizers, a practice contributing greatly to the increase in the contaminants in soil and water. Promising solutions are biofertilizers, i.e., microbial biostimulants that when supplemented with soil stimulate plant growth and production. Moreover, the biofertilizers can be fortified when (i) provided as multifunctional consortia and (ii) combined with biochar with a high cargo capacity. The aim of this work was to determine the molecular effects on the soil microbiome of different biofertilizers and delivery systems, highlight their physiological effects and merge the data with statistical analyses. The measurements of the physiological parameters (i.e., shoot and root biomass), transcriptomic response of genes involved in essential pathways, and characterization of the rhizosphere population were analyzed. The results demonstrated that wheat and maize supplemented with different combinations of selected microbial consortia and biochar have a positive effect on plant growth in terms of shoot and root biomass; the treatments also had a beneficial influence on the biodiversity of the indigenous rhizo-microbial community, reinforcing the connection between microbes and plants without further spreading contaminants. There was also evidence at the transcriptional level of crosstalk between microbiota and plants.
Potential Therapeutic Agents against Paclitaxel—And Sorafenib-Resistant Papillary Thyroid Carcinoma
Authors: Kim Seok-Mo , Park Keunwan , Lim Jin Hong , Yun Hyeok Jun , Kim Sang Yong , Choi Kyung Hwa , Kim Chan Wung , Lee Jae Ha , Weicker Raymond , Pan Cheol-Ho , Park Ki Cheong
Published: September 2022

Thyroid carcinoma, a disease in which malignant cells form in the thyroid tissue, is the most common endocrine carcinoma, with papillary thyroid carcinoma (PTC) accounting for nearly 80% of total thyroid carcinoma cases. However, the management of metastatic or recurrent therapy-refractory PTC is challenging and requires complex carcinoma therapy. In this study, we proposed a new clinical approach for the treatment of therapy-refractory PTC. We identified sarco/endoplasmic reticulum calcium ATPase (SERCA) as an essential factor for the survival of PTC cells refractory to the treatment with paclitaxel or sorafenib. We validated its use as a potential target for developing drugs against resistant PTC, by using patient-derived paclitaxel- or sorafenib-resistant PTC cells. We further discovered novel SERCA inhibitors, candidates 7 and 13, using the evolutionary chemical binding similarity method. These novel SERCA inhibitors determined a substantial reduction of tumors in a patient-derived xenograft tumor model developed using paclitaxel- or sorafenib-resistant PTC cells. These results could provide a basis for clinically meaningful progress in the treatment of refractory PTC by identifying a novel therapeutic strategy: using a combination therapy between sorafenib or paclitaxel and specific SERCA inhibitors for effectively and selectively targeting extremely malignant cells such as antineoplastic-resistant and carcinoma stem-like cells.
The TaWRKY22–TaCOPT3D Pathway Governs Cadmium Uptake in Wheat
Authors: Liu Xiaojuan , Wang Hongcheng , He Fang , Du Xuye , Ren Mingjian , Bao Yinguang
Published: September 2022

Cadmium (Cd) is a heavy metal nonessential for plants; this toxic metal accumulation in crops has significant adverse effects on human health. The crosstalk between copper (Cu) and Cd has been reported; however, the molecular mechanisms remain unknown. The present study investigated the function of wheat Cu transporter 3D (TaCOPT3D) in Cd tolerance. The TaCOPT3D transcripts significantly accumulated in wheat roots under Cd stress. Furthermore, TaCOPT3D-overexpressing lines were compared to wildtype (WT) plants to test the role of TaCOPT3D in Cd stress response. Under 20 mM Cd treatment, TaCOPT3D-overexpressing lines exhibited more biomass and lower root, shoot, and grain Cd accumulation than the WT plants. In addition, overexpression of TaCOPT3D decreased the reactive oxygen species (ROS) levels and increased the active antioxidant enzymes under Cd conditions. Moreover, the transcription factor (TF) TaWRKY22, which targeted the TaCOPT3D promoter, was identified in the regulatory pathway of TaCOPT3D under Cd stress. Taken together, these results show that TaCOPT3D plays an important role in regulating plant adaptation to cadmium stress through bound by TaWRKY22. These findings suggest that TaCOPT3D is a potential candidate for decreasing Cd accumulation in wheat through genetic engineering.
Identification of miRNAs and Target Genes at Key Stages of Sexual Differentiation in Androdioecious Osmanthus fragrans
Authors: Zhang Cheng , Zhang Kailu , Chai Zihan , Song Yanfeng , Wang Xianrong , Duan Yifan , Zhang Min
Published: September 2022

Androdioecy is the crucial transition state in the evolutionary direction of hermaphroditism to dioecy, however, the molecular mechanisms underlying the formation of this sex system remain unclear. While popular in China for its ornamental and cultural value, Osmanthus fragrans has an extremely rare androdioecy breeding system, meaning that there are both male and hermaphroditic plants in a population. To unravel the mechanisms underlying the formation of androdioecy, we performed small RNA sequencing studies on male and hermaphroditic O. fragrans. A total of 334 miRNAs were identified, of which 59 were differentially expressed. Functional categorization revealed that the target genes of differentially expressed miRNAs were mainly involved in the biological processes of reproductive development and the hormone signal transduction pathway. We speculated that the miRNA160, miRNA167, miRNA393 and miRNA396 families may influence the sex differentiation in O. fragrans. Overall, our study is the first exploration of miRNAs in the growth and development process of O. fragrans, and is also the first study of androdioecious plants from the miRNA sequencing perspective. The analysis of miRNAs and target genes that may be involved in the sex differentiation process lay a foundation for the ultimate discovery of the androdioecious molecular mechanism in O. fragrans.
Whole Body Vibration Improves Brain and Musculoskeletal Health by Modulating the Expression of Tissue-Specific Markers: FNDC5 as a Key Regulator of Vibration Adaptations
Authors: Cariati Ida , Bonanni Roberto , Pallone Gabriele , Romagnoli Cristian , Rinaldi Anna Maria , Annino Giuseppe , D’Arcangelo Giovanna , Tancredi Virginia
Published: September 2022

Whole body vibration (WBV) is well known to exert beneficial effects on multiple tissues, improving synaptic transmission, muscle mass, bone quality, and reducing anxiety and depressive behavior. However, the underlying molecular mechanisms are not yet fully understood, and organs and tissues may respond differently to the vibratory stimulus depending on multiple factors. Therefore, we investigated the WBV effects on the brain and musculoskeletal tissue of 4-month-old young mice, evaluating synaptic plasticity by electrophysiological recordings and tissue organization by histology and histomorphometric analysis. Specifically, WBV protocols were characterized by the same vibration frequency (45 Hz), but different in vibration exposure time (five series of 3 min for the B protocol and three series of 2 min and 30 s for the C protocol) and recovery time between two vibration sessions (1 min for the B protocol and 2 min and 30 s for the C protocol). In addition, immunohistochemistry was conducted to evaluate the expression of fibronectin type III domain-containing protein 5 (FNDC5), as well as that of tissue-specific markers, such as brain-derived neurotrophic factor (BDNF) in brain, myostatin in muscle and collagen I (COL-1) in bone. Our results suggest that the WBV effects depend closely on the type of protocol used and support the hypothesis that different organs or tissues have different susceptibility to vibration. Further studies will be needed to deepen our knowledge of physiological adaptations to vibration and develop customized WBV protocols to improve and preserve cognitive and motor functions.
A Study on the Prediction of Cancer Using Whole-Genome Data and Deep Learning
Authors: Lee Young-Ji , Park Jun-Hyung , Lee Seung-Ho
Published: September 2022

The number of patients diagnosed with cancer continues to increasingly rise, and has nearly doubled in 20 years. Therefore, predicting cancer occurrence has a significant impact on reducing medical costs, and preventing cancer early can increase survival rates. In the data preprocessing step, since individual genome data are used as input data, they are classified as individual genome data. Subsequently, data embedding is performed in character units, so that it can be used in deep learning. In the deep learning network schema, using preprocessed data, a character-based deep learning network learns the correlation between individual feature data and predicts cancer occurrence. To evaluate the objective reliability of the method proposed in this study, various networks published in other studies were compared and evaluated using the TCGA dataset. As a result of comparing various networks published in other studies using the same data, excellent results were obtained in terms of accuracy, sensitivity, and specificity. Thus, the superiority of the effectiveness of deep learning networks in predicting cancer occurrence using individual whole-genome data was demonstrated. From the results of the confusion matrix, the validity of the model for predicting the cancer using an individual’s whole-genome data and the deep learning proposed in this study was proven. In addition, the AUC, which is the area under the ROC curve, which judges the efficiency of diagnosis as a performance evaluation index of the model, was found to be 90% or more, good classification results were derived. The objectives of this study were to use individual genome data for 12 cancers as input data to analyze the whole genome pattern, and to not separately use reference genome sequence data of normal individuals. In addition, several mutation types, including SNV, DEL, and INS, were applied.
Could Alcohol Abuse and Dependence on Junk Foods Inducing Obesity and/or Illicit Drug Use Represent Danger to Liver in Young People with Altered Psychological/Relational Spheres or Emotional Problems?
Authors: Tarantino Giovanni , Cataldi Mauro , Citro Vincenzo
Published: September 2022

Recent data show that young people, mainly due to the pressure of some risk factors or due to disrupted interpersonal relationships, utilise greater reward value and display greater sensitivity to the reinforcing properties of “pleasurable stimuli”, specifically in those situations in which an enhanced dopamine release is present. Alcoholic beverages, foods rich in sugar and fat, and illicit drug use are pleasurable feelings associated with rewards. Research shows that there is a link between substance abuse and obesity in brain functioning. Still, alcohol excess is central in leading to obesity and obesity-related morbidities, such as hepatic steatosis, mainly when associated with illicit drug dependence and negative eating behaviours in young people. It is ascertained that long-term drinking causes mental damage, similarly to drug abuse, but also affects liver function. Indeed, beyond the pharmacokinetic interactions of alcohol with drugs, occurring in the liver due to the same metabolic enzymes, there are also pharmacodynamic interactions of both substances in the CNS. To complicate matters, an important noxious effect of junk foods consists of inducing obesity and obesity-related NAFLD. In this review, we focus on some key mechanisms underlying the impact of these addictions on the liver, as well as those on the CNS.
Applications of Metabolomics in Calcium Metabolism Disorders in Humans
Authors: Podgórska Beata , Wielogórska-Partyka Marta , Godzień Joanna , Siemińska Julia , Ciborowski Michał , Szelachowska Małgorzata , Krętowski Adam , Siewko Katarzyna
Published: September 2022

The pathogenesis of the disorders of calcium metabolism is not fully understood. This review discusses the studies in which metabolomics was applied in this area. Indeed, metabolomics could play an essential role in discovering biomarkers and elucidating pathological mechanisms. Despite the limited bibliography, the present review highlights the potential of metabolomics in identifying the biomarkers of some of the most common endocrine disorders, such as primary hyperparathyroidism (PHPT), secondary hyperparathyroidism (SHPT), calcium deficiency, osteoporosis and vitamin D supplementation. Metabolites related to above-mentioned diseorders were grouped into specific classes and mapped into metabolic pathways. Furthermore, disturbed metabolic pathways can open up new directions for the in-depth exploration of the basic mechanisms of these diseases at the molecular level.
A Flexible Data Evaluation System for Improving the Quality and Efficiency of Laboratory Analysis and Testing
Authors: Tu Yonghui , Tang Haoye , Gong Hua , Hu Wenyou
Published: September 2022

In a chemical analysis laboratory, sample detection via most analytical devices obtains raw data and processes it to validate data reports, including raw data filtering, editing, effectiveness evaluation, error correction, etc. This process is usually carried out manually by analysts. When the sample detection volume is large, the data processing involved becomes time-consuming and laborious, and manual errors may be introduced. In addition, analytical laboratories typically use a variety of analytical devices with different measurement principles, leading to the use of various heterogeneous control software systems from different vendors with different export data formats. Different formats introduce difficulties to laboratory automation. This paper proposes a modular data evaluation system that uses a global unified management and maintenance mode that can automatically filter data, evaluate quality, generate valid reports, and distribute reports. This modular software design concept allows the proposed system to be applied to different analytical devices; its integration into existing laboratory information management systems (LIMS) could maximise automation and improve the analysis and testing quality and efficiency in a chemical analysis laboratory, while meeting the analysis and testing requirements.
The Role of E-Government Ambidexterity as the Impact of Current Technology and Public Value: An Empirical Study
Authors: Hariguna Taqwa , Rahardja Untung , Sarmini
Published: September 2022

This study aims to assess the impact of public value on e-government ambidexterity. Furthermore, current technology variables, public value variables, and e-government ambidexterity are incorporated into a framework for measuring e-government service performance. The partial least square structural equation modeling (SEM-PLS) approach was used in this study as the quantitative method. Four hundred twenty-five final data points were used as a sample, and all seven proposed hypotheses are accepted, have positive values, and have a significant impact. This study can be used as a guide for e-government organizers at the national and regional levels, as well as a resource for other studies examining e-government ambidexterity.
High-Temperature, Bond, and Environmental Impact Assessment of Alkali-Activated Concrete (AAC)
Authors: Ramagiri Kruthi Kiran , Kara De Maeijer Patricia , Kar Arkamitra
Published: September 2022

Alkali-activated binders (AABs) offer the opportunity to upcycle a variety of residues into products that can have added value. Although AABs are reported to have a superior high-temperature performance, their thermal behavior is heavily governed by their microstructure. The present study, therefore, evaluates the effect of varying fly ash:slag ratios, activator modulus (Ms), and high temperatures on the microstructure of AAB using X-ray diffraction, Fourier transform infrared spectroscopy, and scanning electron microscopy coupled with energy-dispersive spectroscopy. Furthermore, the mechanical properties of alkali-activated concrete (AAC) are investigated through compressive, bond, flexural, and split tensile strengths. A life cycle assessment of AAC is performed using the ReCiPe 2016 methodology. The results from microstructural experiments show the formation of new crystalline phases and decomposition of reaction products on high temperature exposure, and they correlate well with the observed mechanical performance. The 28-days compressive strength with slag content is enhanced by 151.8–339.7%. AAC with a fly ash:slag ratio of 70:30 and Ms of 1.4 is proposed as optimal from the obtained results. The results reveal that the biggest impact on climate change comes from transport (45.5–48.2%) and sodium silicate (26.7–35.6%).
Earlier Morning Arrival to Pollen-Rewarding Flowers May Enable Feral Bumble Bees to Successfully Compete with Local Bee Species and Expand Their Distribution Range in a Mediterranean Habitat
Authors: Bar-Shai Noam , Motro Uzi , Shmida Avishai , Bloch Guy
Published: September 2022

During recent decades, bumble bees (Bombus terrestris) have continuously expanded their range in the Mediterranean climate regions of Israel. To assess their potential effects on local bee communities, we monitored their diurnal and seasonal activity patterns, as well as those of native bee species in the Judean Hills. We found that all bee species tend to visit pollen-providing flowers at earlier times compared to nectar-providing flowers. Bumble bees and honey bees start foraging at earlier times and colder temperatures compared to other species of bees. This means that the two species of commercially managed social bees are potentially depleting much of the pollen, which is typically non-replenished, before most local species arrive to gather it. Taking into consideration the long activity season of bumble bees in the Judean hills, their ability to forage at the low temperatures of the early morning, and their capacity to collect pollen at early hours in the dry Mediterranean climate, feral and range-expanding bumble bees potentially pose a significant competitive pressure on native bee fauna. Their effects on local bees can further modify pollination networks, and lead to changes in the local flora.
Enemy-Risk Effects in Parasitoid-Exposed Diamondback Moth Larvae: Potential Mediation of the Interaction by Host Plants
Authors: Kihata Naoki , Shikano Ikkei
Published: September 2022

Enemy-risk effects (i.e., non-consumptive effects) describe the non-lethal fitness costs incurred by animals when they perceive a risk of predation. These effects can result from fear-associated changes in behavior and physiology. Diamondback moth larvae (Plutella xylostella) are known to violently wriggle backwards and drop from their host plants, usually suspending themselves with a silk thread, when threatened by predators and parasitoids. Here, we investigated the developmental costs associated with this behavior when larvae were exposed to its specialist parasitoid wasp (Diadegma insulare). Additionally, the structural and chemical properties of plants are well-known to influence predation and parasitism rates of herbivorous insects. Yet, few studies have examined the influence of plants on enemy-risk effects. Therefore, we examined the developmental costs associated with parasitism risk on two host plants. Diamondback moth larvae were placed on either cabbage or Virginia pepperweed plants and exposed to gravid parasitoids with truncated ovipositors, which prevented piercing of the host cuticle without affecting host searching and attacking behaviors. On Virginia pepperweed, risk of parasitism resulted in reduced larval weight gain, longer development time, and smaller adult size compared to larvae that were not exposed to parasitoids. However, on cabbage, parasitoid exposure prolonged development time but had no significant effects on larval weight gain and adult size. On both plants, parasitoid-exposed larvae were found feeding on older foliage than younger foliage. Our findings demonstrate that the enemy-escape behavior of diamondback moths has developmental costs and that plants may mediate the intensity of these enemy-risk effects.
A Prospective, Case-Control Study of Serum Metabolomics in Neonates with Late-Onset Sepsis and Necrotizing Enterocolitis
Authors: Thomaidou Agathi , Deda Olga , Begou Olga , Lioupi Artemis , Kontou Angeliki , Gika Helen , Agakidou Eleni , Theodoridis Georgios , Sarafidis Kosmas
Published: September 2022

Late-onset sepsis (LOS) and necrotizing enterocolitis (NEC) are major causes of neonatal morbidity and mortality. In this prospective, case-control study, we evaluated the metabolic profile of neonates with LOS and NEC. Blood samples were collected from 15 septic neonates and 17 neonates with NEC at the clinical suspicion of the specific diseases. Sixteen gestational and postnatal age-matched neonates without sepsis/NEC served as controls. Serum metabolic profiles were assessed using liquid chromatography–quadrupole time-of-flight mass spectrometry. Metabolomic analysis revealed significant differences in the metabolic profile of neonates with LOS or NEC compared to controls. More specifically, a number of molecules possibly identified as phosphatidylcholines or lysophosphatidylcholines were found to be significantly reduced both in neonates with LOS and those with NEC compared to controls. Additionally, L-carnitine could efficiently discriminate NEC cases from controls. The results of the current study suggest that certain phospholipids and their derivatives could possibly be used as biomarkers for the early detection of LOS and NEC.
Assessing a Video-Based Intervention to Promote Parent Communication Strategies with a Deaf Infant: A Feasibility and Acceptability Study
Authors: Kelly Ciara , Crawford Ellen , Morgan Gary , Matthews Danielle
Published: September 2022

Infant–parent interaction forms the foundation for language learning. For the majority of deaf infants, hearing loss can impact access to, and the quality of communicative interactions, placing language development at risk. Support for families to meet the challenges faced during interaction is highly variable in the United Kingdom. In a step towards more standardized but tailorable family support, we co-produced an instructional, video-based intervention, testing for feasibility in terms of behavior change in seven communicative strategies and acceptability with 9 parents, forming study 1. Parents increased their use of the majority of behaviors and found content and delivery acceptable. However, further development was required to: (a) support use of semantically contingent talk and attention getting strategies to elicit infant attention, and (b) ensure the information was provided in a bite-size format that could be tailored to individual families. In study 2, the intervention was refined based on findings from study 1 and assessed for acceptability with 9 parents and 17 professionals, who reported similar high acceptability scores. Final refinements and modifications could be addressed in future interventions. The current studies provide a positive early step towards a standardized intervention to support communication that could be used in routine practice.
COVID-19 in Older Adults at the Time of the Omicron Variant
Authors: Gabrielli Maurizio
Published: September 2022

Since its outbreak, COVID-19 has had a significant impact on older adults worldwide [...]
Correlation between Hypoperfusion Intensity Ratio and Functional Outcome in Large-Vessel Occlusion Acute Ischemic Stroke: Comparison with Multi-Phase CT Angiography
Authors: Wan Zhifang , Meng Zhihua , Xie Shuangcong , Fang Jin , Li Li , Chen Zhensong , Liu Jinwu , Jiang Guihua
Published: September 2022

Background and purpose: Previous studies have shown that Hypoperfusion Intensity Ratio (HIR) derived from Perfusion Imaging (PWI) associated with collateral status in large-vessel occlusion (LVO) acute ischemic stroke (AIS) and could predict the rate of collateral flow, speed of infarct growth, and clinical outcome after endovascular treatment (EVT). We hypothesized that HIR derived from CT Perfusion (CTP) imaging could relatively accurately predict the functional outcome in LVO AIS patients receiving different types of treatment. Methods: Imaging and clinical data of consecutive patients with LVO AIS were retrospectively reviewed. Multi-phase CT angiography (mCTA) scoring was performed by 2 blinded neuroradiologists. CTP images were processed using an automatic post-processing analysis software. Correlation between the HIR and the functional outcome was calculated using the Spearman correlation. The efficacy of the HIR and the CTA collateral scores for predicting prognosis were compared. The optimal threshold of the HIR for predicting favorable functional outcome was determined using receiver operating characteristic (ROC) curve analysis. Results: 235 patients with LVO AIS were included. Patients with favorable functional outcome had lower HIR (0.1 [interquartile range (IQR), 0.1–0.2]) vs. 0.4 (IQR, 0.4–0.5)) and higher mCTA collateral scores (3 [IQR, 3–4] vs. 3 [IQR, 2–3]; p < 0.001) along with smaller infarct core volume (2.1 [IQR, 1.0–4.5]) vs. (15.2 [IQR, 5.5–39.3]; p < 0.001), larger mismatch ratio (22.9 [IQR, 11.6–45.6]) vs. (5.8 [IQR, 2.6–14]); p < 0.001), smaller ischemic volume (59.0 [IQR, 29.7–89.2]) vs. (97.5 [IQR, 68.7–142.2]; p < 0.001), and smaller final infarct volume (12.6 [IQR, 7.5–18.4]) vs. (78.9 [IQR, 44.5–165.0]; p < 0.001) than those with unfavorable functional outcome. The HIR was significantly positively correlated with the functional outcome [r = 0.852; 95% confidence interval (CI): 0.813–0.884; p < 0.0001]. The receiver operating characteristic (ROC) analysis showed that the optimal threshold for predicting a favorable functional outcome was HIR ≤ 0.3 [area under the curve (AUC) 0.968; sensitivity 88.89%; specificity 99.21%], which was higher than the mCTA collateral score [AUC 0.741; sensitivity 82.4%; specificity 48.8%]. Conclusions: HIR was associated with the functional outcome of LVO AIS patients, and the correlation coefficient was higher than mCTA collateral score. HIR outperformed mCTA collateral score in predicting functional outcome.
Optimal Timing for Cardiac Surgery in Infective Endocarditis with Neurological Complications: A Narrative Review
Authors: Siquier-Padilla Joan , Cuervo Guillermo , Urra Xabier , Quintana Eduard , Hernández-Meneses Marta , Sandoval Elena , Lapeña Pau , Falces Carles , Mestres Carlos A. , Paez-Carpio Alfredo , Moreno Asunción , Miro José María
Published: September 2022

In patients with infective endocarditis and neurological complications, the optimal timing for cardiac surgery is unclear due to the varied risk of clinical deterioration when early surgery is performed. The aim of this review is to summarize the best evidence on the optimal timing for cardiac surgery in the presence of each type of neurological complication. An English literature search was carried out from June 2018 through July 2022. The resulting selection, comprising observational studies, clinical trials, systematic reviews and society guidelines, was organized into four sections according to the four groups of neurological complications: ischemic, hemorrhagic, infectious, and asymptomatic complications. Cardiac surgery could be performed without delay in cases of ischemic vascular neurological complication (provided the absence of severe damage, which can be avoided with the performance of mechanical thrombectomy in cases of major stroke), as well as infectious or asymptomatic complications. In the presence of intracranial hemorrhage, a delay of four weeks is recommended for most cases, although recent studies have suggested that performing cardiac surgery within four weeks could be a suitable option for selected cases. The findings of this review are mostly in line with the recommendations of the current European and American infective endocarditis guidelines.
Acute Idiopathic Blind Spot Enlargement Syndrome—New Perspectives in the OCT Era
Authors: Zimmermann Julian A. , Eter Nicole , Biermann Julia
Published: September 2022

Acute idiopathic blind spot enlargement syndrome (AIBSES) is characterized by unilateral visual field loss in the blind spot area, acute onset photopsia, and funduscopically few or no optic disc changes. AIBSES predominantly affects young adults and is often misdiagnosed as optic neuritis because of low awareness. Optical coherence tomography (OCT) has become the gold standard in diagnosing AIBSES as a disease of the outer retina. In our case series, we present three consecutive patients with AIBSES followed prospectively with and without steroid therapy. The patients, aged 25 to 27 years, presented in our neuroophthalmology department between 2020 and 2021. We report their disease course and management and discuss therapeutic options, as no well-established procedures exist. Common pitfalls and diagnostic errors are analysed. Two women and one man showed unilateral acute-onset photopsia and blind spot enlargement on perimetry without visual acuity reduction. Spectral domain OCT (Heidelberg Engineering, Heidelberg, Germany) revealed marked peripapillary changes in the ellipsoid zone and autofluorescence in all patients, corresponding to faint blurring of the optic disc margin. Characteristically, there was no P100 latency delay in the visual evoked potential in any of the patients. Two patients received weight-adapted oral prednisolone, which was gradually tapered over six to eight weeks. Two patients showed full recovery of their symptoms at six and seven months after onset, while mild defect healing was seen in one treated patient after 12 months. Follow-up OCT showed restoration of the outer retinal layers 6–12 months after disease onset. Careful history taking and an unprejudiced ophthalmological workup helps in diagnosing AIBSES in young adults with unilateral acute visual field defects. While its etiology is still unclear, accurate diagnosis of AIBSES can be made with peripapillary OCT. In our cases, the disease course of AIBSES was much better than its reputation. Early corticosteroid treatment may support outer retinal reorganisation, which can be followed with OCT in accordance with visual field restoration. This should be addressed in a prospective study.
CO2 Is Beneficial to Gut Microbiota Homeostasis during Colonoscopy: Randomized Controlled Trial
Authors: Yang Xue , Xiu Wen-Bo , Wang Jin-Xia , Li Liang-Ping , He Chong , Gao Cai-Ping
Published: September 2022

Background: Many studies have reported minor complications and disturbance of the gut microbiota after colonoscopy. Compared with air, carbon dioxide (CO2) insufflation could decrease minor complications, but its impact on gut microbiota remains unknown. Methods: Thirty-eight healthy subjects were assessed and twenty were randomized to receive either CO2 or air insufflation during colonoscopy. Neither the participants nor the staff involved in the follow-up knew which gas was used. Minor complications were assessed using symptom scores. Fecal samples were collected at eight time-points for microbiome analysis by full-length 16S rRNA gene amplicon analysis. Results: Baseline characteristics were similar in both groups. The recovery of minor complications after colonoscopy was faster in the CO2 group (the day of the colonoscopy) than in the air group (the day after the colonoscopy). There was no significant reduction in alpha diversity (species richness) of the first stool after colonoscopy in the CO2 group (115.0 ± 32.81 vs. 97.4 ± 42.31, p = 0.28) compared with the air group (123.8 ± 37.25 vs. 84.8 ± 31.67, p = 0.04). However, there were no differences in beta diversity between the groups. Linear discriminant analysis effect size (LEfSe) analysis indicated that anaerobic probiotics such as Bacteroides caccae, Bacteroides finegoldii and Bacteroides thetaiotaomicron were more abundant in the CO2 group than in the air group within 14 days after colonoscopy. On the contrary, the content of Escherichiacoli, Ruminococcus torques and Ruminococcus guavus was higher in the air group. Conclusions: CO2 is beneficial to gut microbiota homeostasis during colonoscopy in healthy subjects. The effects in patients with different diseases need to be further studied.
A Study on the Reference Values and Cutoff Criteria of Masking Level Difference for Children Aged 7–12 Years
Authors: Leite Filho Carlos Alberto , de Oliveira Viana Mônica , Branco-Barreiro Fátima Cristina Alves , Frota Silvana Maria Monte Coelho
Published: September 2022

The Masking Level Difference (MLD) test is one of the main instruments for investigating binaural interaction. Studies with children aged 7–12 years still disagree about the influence of age on test performance and present discordant reference values. This study aimed to verify the effect of age on the performance of children aged 7–12 years in the MLD test and to establish reference values and cutoff criteria for this age group. Fifty-nine children with normal hearing were organized in three groups according to their age: 7–8 (n = 20), 9–10 (n = 20), and 11–12 (n = 19) years. The participants completed the MLD test by Auditec®. The Kruskal–Wallis statistical test was used to compare groups. Reference values were obtained by calculating mean, standard deviation, median, mode, and percentiles, while the cutoff criterion was obtained by subtracting two standard deviations from the mean. No statistically significant differences were observed between the groups regarding the MLD test measures. The mean MLD was 10.51 ± 1.84 dB and the cutoff point was set at 7 dB. Thus, reference values for the MLD test were established for children aged 7–12 years, who presented no effect of age on test performance.
Efficacy, Safety and Pharmacoeconomic Analysis of Intravenous Ferric Carboxymaltose in Anemic Hemodialysis Patients Unresponsive to Ferric Gluconate Treatment: A Multicenter Retrospective Study
Authors: Rosati Alberto , Conti Paolo , Berto Patrizia , Molinaro Sabrina , Baldini Federica , Egan Colin Gerard , Panichi Vincenzo
Published: September 2022

Patients undergoing hemodialysis with iron deficiency anemia (IDA) receiving treatment with erythropoiesis-stimulating agents (ESAs) who were intolerant or non-responsive to intravenous (i.v.) ferric gluconate (FG) (hemoglobin; Hb values < 10.5 g/dL or increase in <1 g/dL) or % transferrin saturation; TSAT of <20%) in the previous 6 months were switched to i.v. ferric carboxymaltose (FCM). Changes in iron status parameters, economic and safety measures were also assessed. Seventy-seven hemodialysis patients aged 68 ± 15 years were included. Erythropoietin resistance index decreased from 24.2 ± 14.6 at pre-switch to 20.4 ± 14.6 after 6 months of FCM treatment and Hb levels ≥10.5 g/dL improved from 61% to 75.3% patients (p = 0.042). A 1 g/dL increase in Hb levels was also seen in 26% of patients as well as a 37.7% increase in patients achieving >20% increase in TSAT after FCM. Levels of Hb, TSAT and ferritin parameters increased during FCM treatment with a concomitant decrease in ESA. A mixed-model analysis, which also considered gender, confirmed these trends. Safety variables remained stable, no hypersensitivity reaction was recorded and only one patient reported an adverse event after FCM. FCM treatment was associated with a cost saving of 11.11 EUR/patient/month. These results confirm the efficacy, safety and cost-effectiveness of FCM in correcting IDA in hemodialysis patients.
Predicting Mortality Using Machine Learning Algorithms in Patients Who Require Renal Replacement Therapy in the Critical Care Unit
Authors: Chang Hsin-Hsiung , Chiang Jung-Hsien , Wang Chi-Shiang , Chiu Ping-Fang , Abdel-Kader Khaled , Chen Huiwen , Siew Edward D. , Yabes Jonathan , Murugan Raghavan , Clermont Gilles , Palevsky Paul M. , Jhamb Manisha
Published: September 2022

Background: General severity of illness scores are not well calibrated to predict mortality among patients receiving renal replacement therapy (RRT) for acute kidney injury (AKI). We developed machine learning models to make mortality prediction and compared their performance to that of the Sequential Organ Failure Assessment (SOFA) and HEpatic failure, LactatE, NorepInephrine, medical Condition, and Creatinine (HELENICC) scores. Methods: We extracted routinely collected clinical data for AKI patients requiring RRT in the MIMIC and eICU databases. The development models were trained in 80% of the pooled dataset and tested in the rest of the pooled dataset. We compared the area under the receiver operating characteristic curves (AUCs) of four machine learning models (multilayer perceptron [MLP], logistic regression, XGBoost, and random forest [RF]) to that of the SOFA, nonrenal SOFA, and HELENICC scores and assessed calibration, sensitivity, specificity, positive (PPV) and negative (NPV) predicted values, and accuracy. Results: The mortality AUC of machine learning models was highest for XGBoost (0.823; 95% confidence interval [CI], 0.791–0.854) in the testing dataset, and it had the highest accuracy (0.758). The XGBoost model showed no evidence of lack of fit with the Hosmer–Lemeshow test (p > 0.05). Conclusion: XGBoost provided the highest performance of mortality prediction for patients with AKI requiring RRT compared with previous scoring systems.
Perioperative Factors Impact on Mortality and Survival Rate of Geriatric Patients Undergoing Surgery in the COVID-19 Pandemic: A Prospective Cohort Study in Indonesia
Authors: Rehatta Nancy Margarita , Chandra Susilo , Sari Djayanti , Lestari Mayang Indah , Senapathi Tjokorda Gde Agung , Nurdin Haizah , Wirabuana Belindo , Pramodana Bintang , Pradhana Adinda Putra , Isngadi Isngadi , Anggraeni Novita , Sikumbang Kenanga Marwan , Halimi Radian Ahmad , Jasa Zafrullah Khany , Nasution Akhyar Hamonangan , Mochamat Mochamat , Purwoko Purwoko
Published: September 2022

Background: The COVID-19 pandemic continues to have an impact on geriatric patients worldwide since geriatrics itself is an age group with a high risk due to declined physiological function and many comorbidities, especially for those who undergo surgery. In this study, we determine the association between perioperative factors with 30-day mortality and a survival rate of geriatric patients undergoing surgery during COVID-19 pandemic. Methods: A prospective cohort study was conducted at 14 central hospitals in Indonesia. The recorded variables were perioperative factors, 30-day mortality, and survival rate. Analyses of associations between variables and 30-day mortality were performed using univariate/multivariable logistic regression, and survival rates were determined with Kaplan–Meier survival analysis. Results: We analyzed 1621 elderly patients. The total number of patients who survived within 30 days of observation was 4.3%. Several perioperative factors were associated with 30-day mortality (p < 0.05) is COVID-19 (OR, 4.34; 95% CI, 1.04–18.07; p = 0.04), CCI > 3 ( odds ratio [OR], 2.33; 95% confidence interval [CI], 1.03–5.26; p = 0.04), emergency surgery (OR, 3.70; 95% CI, 1.96–7.00; p ≤ 0.01), postoperative ICU care (OR, 2.70; 95% CI, 1.32–5.53; p = 0.01), and adverse events (AEs) in the ICU (OR, 3.43; 95% CI, 1.32–8.96; p = 0.01). Aligned with these findings, COVID-19, CCI > 3, and comorbidities have a log-rank p < 0.05. The six comorbidities that have log-rank p < 0.05 are moderate-to-severe renal disease (log-rank p ≤ 0.01), cerebrovascular disease (log-rank p ≤ 0.01), diabetes with chronic complications (log-rank p = 0.03), metastatic solid tumor (log-rank p = 0.02), dementia (log-rank p ≤ 0.01), and rheumatology disease (log-rank p = 0.03). Conclusions: Having at least one of these conditions, such as COVID-19, comorbidities, emergency surgery, postoperative ICU care, or an AE in the ICU were associated with increased mortality in geriatric patients undergoing surgery during the COVID-19 pandemic.
The Impact of Bariatric-Surgery-Induced Weight Loss on Patients Undergoing Liver Transplant: A Focus on Metabolism, Pathophysiological Changes, and Outcome in Obese Patients Suffering NAFLD-Related Cirrhosis
Authors: Sarno Gerardo , Schiavo Luigi , Calabrese Pietro , Álvarez Córdova Ludwig , Frias-Toral Evelyn , Cucalón Gabriela , Garcia-Velasquez Eloisa , Fuchs-Tarlovsky Vanessa , Pilone Vincenzo
Published: September 2022

Because of their condition, patients with morbid obesity develop several histopathological changes in the liver, such as non-alcoholic fatty liver disease (NAFLD), non-alcoholic steatohepatitis (NASH), cirrhosis, and end-stage liver disease (ESLD). Hence, a liver transplant (LT) becomes an opportune solution for them. Due to many challenges during the perioperative and postoperative periods, these patients are recommended to lose weight before the surgery. There are many proposals to achieve this goal, such as intragastric balloons and many different bariatric surgery (BS) procedures in combination with a preparation diet (very-low-calorie diet, ketogenic diet, etc.). All the interventions focus on losing weight and keeping the continuity and functionality of the digestive tract to avoid postoperative complications. Thus, this review analyzes recent publications regarding the metabolic and pathophysiological impacts of BS in LT patients suffering from NAFLD-related cirrhosis, the effect of weight loss on postoperative complications, and exposes the cost-effectiveness of performing BS before, after, and at liver transplantation. Finally, the authors recommend BS before the LT since there are many positive effects and better outcomes for patients who lose weight before the procedure. Nevertheless, further multicentric studies are needed to determine the generalizability of these recommendations due to their impact on public health.
Associations between Sleep Characteristics and Cardiovascular Risk Factors in Adolescents Living with Type 1 Diabetes
Authors: Wu Nana , Jamnik Veronica K. , Koehle Michael S. , Guan Yanfei , Li Yongfeng , Kaufman Kai , Warburton Darren E. R.
Published: September 2022

Adolescents living with type 1 diabetes (T1D) have an increased risk of developing cardiovascular disease. Sleep patterns have physiological and behavioral impacts on diabetes outcomes. This study aimed to investigate the associations between sleep patterns and CVD risk factors in adolescents living with T1D and their peers living without T1D. This cross-sectional study assessed CVD risk factors and sleep characteristics (and their associations) in adolescents, aged 12–18 years, living with T1D (n = 48) and their peers (n = 19) without T1D. Outcomes included blood pressure, lipid profiles, and sleep characteristics (accelerometry). Statistical differences between groups were determined with chi-square or independent samples t-tests. The associations between sleep characteristics and CVD risk factors were assessed with multivariate linear regression analyses. We found no significant differences between the two groups in terms of sleep duration, efficiency, sleep onset and offset, and frequency of awakenings, and there were associations between sleep efficiency and LDL-C (β = −0.045, p = 0.018, model R2 = 0.230) and triglycerides (β = −0.027, p = 0.012, model R2 = 0.222) after adjusting confounders (diabetes status, sex, age, pubertal stage) in all participants. In conclusion, adolescents with T1D and without T1D sleep less than the recommended eight hours per night. The associations between sleep efficiency and LDL-C and triglycerides are independent of sleep duration, regardless of sex, age, and pubertal stage.
Fighting Fatigue in Systemic Lupus Erythematosus: Experience of Dehydroepiandrosterone on Clinical Parameters and Patient-Reported Outcomes
Authors: Skoglund Oliver , Walhelm Tomas , Thyberg Ingrid , Eriksson Per , Sjöwall Christopher
Published: September 2022

Manifestations related to ongoing inflammation in systemic lupus erythematosus (SLE) are often adequately managed, but patient-reported outcome measures (PROMs) support that fatigue and low quality of life (QoL) in the absence of raised disease activity remain major burdens. The adrenal hormone dehydroepiandrosterone (DHEA) has shown potential as a pharmacological agent for managing fatigue in mild SLE. We retrospectively evaluated data on dosage, disease activity, corticosteroid doses, concomitant antirheumatic drugs, and PROMs regarding pain intensity, fatigue, and well-being (visual analogue scales), QoL (EQ-5D-3L) and functional disability. A total of 15 patients with SLE were exposed to DHEA and 15 sex- and age-matched non-exposed SLE patients served as comparators. At baseline, 83% of the DHEA-exposed patients had subnormal DHEA concentration. The 15 subjects prescribed DHEA were exposed during a median time of 12 months (IQR 16.5) [range 3–81] and used a median daily dose of 50 mg of DHEA (IQR 25.0) [range 25–200]. Neither disease activity, nor damage accrual, changed significantly over time among patients using DHEA, and no severe adverse events were observed. Numerical improvements of all evaluated PROMs were seen in the DHEA-treated group, but none reached statistical significance. For DHEA-exposed patients, a non-significant trend was found regarding fatigue comparing baseline and 36 months (p = 0.068). In relation to SLE controls, the DHEA-exposed group initially reported significantly worse fatigue, pain, and well-being, but the differences diminished over time. In conclusion, DHEA was safe, but evidence for efficacy of DHEA supplementation in relation to PROMs were not found. Still, certain individuals with mild SLE, plagued by fatigue and absence of increased disease activity, appear to benefit from DHEA in terms of improved fatigue and QoL. Testing of DHEA concentration in blood should be performed before initiation, and investigation of other conditions, or reasons responsible for fatigue, must always be considered first.