bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of Motherwort Injection Versus Intramuscular Oxytocin for Preventing Postpartum Hemorrhage Among Women Who Underwent Cesarean Section
Authors: Li Ming-xi , Liu Chun-rong , Chen Meng , Shang Hong-cai , Wang Wen , Luo Xiao-chao , Li Ling , Qi Ya-na , Xiong Yi-quan , Huang Shi-yao , Wang Jing , Zou Kang , Liu Xing-hui , Tan Jing , Sun Xin
Published: March 2022

Objectives: Subject to ethical constraints, real-world data are an important resource for evaluating treatment effects of medication use during pregnancy and the postpartum period. This study investigated whether motherwort injection, a traditional Chinese medicine preparation, was more effective than intramuscular (IM) oxytocin for preventing postpartum hemorrhage (PPH) in a real-world setting when intravenous (IV) oxytocin is administered.

Methods: We conducted an active-controlled, propensity-score matched cohort study using an established pregnancy registry database. Women who underwent cesarean section and received IV oxytocin at the third stage of labor were included. We used an active-comparator design to minimize indication bias, in which we compared IM motherwort injection in the uterus versus IM oxytocin, both on top of IV oxytocin use. We applied 1:1 propensity-score matching (PSM) to balance patient baseline characteristics and used a logistic regression model to estimate treatment effect (i.e., risk difference (RD) and odds ratio (OR)) by using the counterfactual framework. The outcomes of interest were blood loss over 500 ml within 2 h after delivery (PPH, primary) and blood loss over 1,000 ml (severe PPH, secondary). We conducted four sensitivity analyses to examine the robustness of the results.

Results: A total of 22,519 pregnant women underwent cesarean sections, among which 4,081 (18.12%) PPH and 480 (2.13%) severe PPH occurred. Among included women, 586 (2.60%) were administrated with IM motherwort injection, and 21,933 (97.40%) used IM oxytocin. After PSM, patient baseline characteristics were well balanced. Compared with IM oxytocin, the use of IM motherwort injection was associated with significantly lower risk of PPH (RD −25.26%, 95% CI −30.04% to −20.47%, p < 0.001; OR 0.25, 95% CI 0.18 to 0.32, p < 0.001) and severe PPH (RD −3.58%, 95% CI −5.87% to −1.30%, p < 0.001; OR 0.39, 95% CI 0.20 to 0.71, p < 0.002). Sensitivity analyses showed that the results were similar.

Conclusion: With the use of data from a real-world setting, the findings consistently showed that among women undergoing cesarean section who had received IV oxytocin, the additional use of IM motherwort injection could achieve a lower risk of PPH as compared to the additional use of IM oxytocin. Our study suggested a paradigm for investigating the treatment effect of Chinese herbal medicine in the real-world practice setting.
Integrated Application of Thiourea and Biochar Improves Maize Growth, Antioxidant Activity and Reduces Cadmium Bioavailability in Cadmium-Contaminated Soil
Authors: Haider Fasih Ullah , Virk Ahmad Latif , Rehmani Muhammad Ishaq Asif , Skalicky Milan , Ata-ul-Karim Syed Tahir , Ahmad Naeem , Soufan Walid , Brestic Marian , Sabagh Ayman E. L. , Liqun Cai
Published: March 2022

Graphical Abstract
Decision Thresholds for Medical Tests Under Ambiguity Aversion
Authors: Sevim Dilek , Felder Stefan
Published: March 2022

We consider medical decision-making under diagnostic and therapeutic uncertainty and analyze how ambiguity aversion affects the decisions to test and treat, thereby contributing to the understanding of the observed heterogeneity of such decisions. We show that under diagnostic ambiguity (i.e., the probability of disease is ambiguous), prior testing becomes more attractive if the default option is no treatment and less so if the default option is treatment. Conversely, with therapeutic ambiguity (i.e., the probability of a successful treatment is ambiguous), ambiguity aversion reduces the tolerance toward treatment failure so that the test option is chosen at a lower probability of failure. We differentiate between conditional and unconditional ambiguity aversion and show that this differentiation has implications for the propensity to test. We conclude by discussing the normative scope of ambiguity aversion for the recommendations and decisions of regulatory bodies.
Health Care Expenditures Among Individuals With Chronic Psychotic Disorders in Ontario: An Analysis Over Time
Authors: de Oliveira Claire , Iwajomo Tomisin , Kurdyak Paul
Published: March 2022

Chronic psychotic disorders are severe and disabling mental disorders associated with poor psychiatric and medical outcomes, and among the most costly mental disorders to treat. Understanding trends in aggregate health care expenditures over time, and respective drivers, can provide relevant insights for decision makers, namely around appropriate allocation of scarce resources within the health care sector. Using administrative health care times series data from Ontario, this analysis examined trends in aggregate public health care expenditures and activity from 2012 to 2019 among all individuals with a diagnosis of a chronic psychotic disorder. Total aggregate health care expenditures for individuals with a chronic psychotic disorder in Ontario increased at a moderate rate over this time period, in line with the growth of the number of people diagnosed, and thus not likely driven by unit costs or resource use. Psychiatric hospitalizations made up the largest share of health care expenditures (~30%). Nonetheless, among all health services, expenditures of acute medical hospitalizations, outpatient prescription drugs and home care saw the largest growth over time. Mean/per capita health care expenditures were greater for females, and increased with age as well as with the presence of comorbidities/chronic conditions. In particular, mean/per capita health care expenditures increased steadily with the number of comorbidities and were highest for individuals with 5 or more comorbidities and those with congestive heart failure, highlighting the ever-increasing importance of addressing physical health conditions among this patient population. These findings will have important implications for decision makers, namely around the appropriate allocation of health care resources for patients with chronic psychotic disorders. Future research should continue to monitor health care expenditures for individuals with chronic psychotic disorders as well as extend this analysis beyond 2019 to understand how the COVID-19 pandemic, and resulting lockdowns, has impacted aggregate health care expenditures and outcomes for patients living with chronic psychotic disorders.
Case Report: Using Telehealth to Treat Triceps Tendinopathy in a Rock Climber
Authors: Vagy Jared
Published: March 2022

This case study presents a 38-year-old, female rock climber with posterior elbow pain who was evaluated and treated using Telehealth. The use of telehealth for a clinical exam requires a larger emphasis be placed on posture observation and movement analysis since hands on assessment techniques cannot be used. During the patient exam, movement analyses identified scapulohumeral positional faults and dyskinesis, while self-palpation and self-midline resistance testing helped identify that the triceps tendon was the pathological tissue. A comprehensive rehabilitation program was developed based on concepts of regional interdependence to treat contributing factors in the scapular region and source tissues in the brachial region. After 10 weeks, the climber's pain decreased from 4/10 to 0/10. She made a full recovery back to her previous grade of V8 bouldering and was able to complete a V10 longstanding boulder project pain-free. This is the first case study of its kind to identify unilateral scapular dyskinesia in a patient with suspected triceps tendinopathy and to demonstrate a positive treatment effect by combining scapular strength exercises with eccentric exercises addressing the affected tissue.
A Novel Staining Method for Detection of Brain Perivascular Injuries Induced by Nanoparticle: Periodic Acid-Schiff and Immunohistochemical Double-Staining
Authors: Onoda Atsuto , Hagiwara Shin , Kubota Natsuko , Yanagita Shinya , Takeda Ken , Umezawa Masakazu
Published: March 2022

Background: To protect developing brain from any unfavorable effects, it is necessary to construct experimental techniques that can sensitively detect and evaluate developmental toxicity. We have previously shown that brain perivascular tissues, especially perivascular macrophages (PVMs), respond sensitively even to weak stimuli by foreign toxicants such as low-dose exposure to nanoparticle. This paper shows the protocol of a novel staining method that enables easy detection and rapid evaluation of brain perivascular abnormalities.

Methods: As weak stimulus, low-dose of carbon black nanoparticle (95 μg/kg) or titanium dioxide nanoparticle (100 μg/kg) was intranasally administered to pregnant mice at gestational days 5 and 9. The offspring brains were used to confirm the properties of PVMs and to find suitable protocols for the detection and evaluation of the mild denaturation of PVMs. Furthermore, various procedures of novel combinational double staining including periodic acid-Schiff (PAS) staining and immunohistochemistry were examined. In addition, we checked the alterations in neurotransmitter levels and the behaviors of the offspring.

Results and discussion: Maternal exposure to low-dose of nanoparticle at levels where no significant effects on the brain were observed, such as abnormal behavior, alteration of neurotransmitter levels, or microglial activation, resulted in mild denaturation of the PVMs, which was captured by PAS staining. However, it was difficult to detect and determine slight histopathological alterations. Therefore, we established PAS-immunohistochemical double-staining method for the brain. This double staining method enabled easy detection and rapid evaluation of brain perivascular abnormalities and the relationship between PVMs and the surrounding cells. In addition, this double staining allows evaluation of the histopathological denaturation of the PVMs and the associated abnormalities in the surrounding tissues in the same section.

Conclusion: The slight responses of brain perivascular tissues, such as mild denaturation of PVMs, were sensitively and easily determined by the PAS-immunohistochemical double-staining method. This double staining method is a powerful tool to assess brain perivascular injuries including PVM denaturation and the relationship between the expression of various molecules and the morphology of PVMs. We propose that the observation of the tissue around brain blood vessels using the double staining provides potential endpoints to evaluate developmental neurotoxicity.
Why Vaccinate Against COVID-19? A Population-Based Survey in Switzerland
Authors: Fadda Marta , Camerini Anne Linda , Fiordelli Maddalena , Corna Laurie , Levati Sara , Amati Rebecca , Piumatti Giovanni , Crivelli Luca , Suggs L. Suzanne , Albanese Emiliano
Published: March 2022

Objectives: This study examined factors associated with COVID-19 vaccination intention at the very beginning of the vaccination campaign in a representative sample of the population in southern Switzerland.

Methods: In March 2021, we measured vaccination intention, beliefs, attitudes, and trust in a sample of the Corona Immunitas Ticino study.

Results: Of the 2681 participants, 1933 completed the questionnaire (response rate = 72%; 55% female; meanage = 41, SD = 24, rangeage = 5–91). Overall, 68% reported an intention to get vaccinated. Vaccination intention was higher in social/healthcare workers, and increased with age, trust in public health institutions, and confidence in the vaccine efficacy. Prior infection of a family member, predilection for waiting for more evidence on the safety and efficacy of the vaccine, and for alternative protective means were negatively associated with intention.

Conclusion: In view of needs of COVID-19 vaccine boosters and of suboptimal vaccination coverage, our results have relevant public health implications and suggest that communication about vaccine safety and efficacy, and aims of vaccination programs, should be bi-directional, proportionate, and tailored to the concerns, expectations, and beliefs of different population subgroups.
UAV Noise Emission—A Combined Experimental and Numerical Assessment
Authors: Cussen Kai , Garruccio Simone , Kennedy John
Published: March 2022

Noise emission will be a significant obstacle to the widespread uptake of unmanned aerial vehicles or UAVs. The assessment and mitigation of UAV noise will require validated modelling approaches. The European Union has recently mandated an UAV sound power measurement procedure based on a procedure for measuring machinery or equipment. It is not clear if this legally mandated noise assessment will provide useful data for environmental noise modelling of UAVs. This research aimed to determine the sound power level of a UAV according to the legally mandated ISO 3744 and to investigate the suitability of commercial implementations of ISO 9613 for modelling noise emission from UAVs. A class C1 UAV was used for the investigation which also included controlled flyover tests. Several different operating conditions were measured and modelled and the results compared. The small scale UAV used had a sound power of 86.8 dB (A) and modelled flyover tests agreed with experimental values within ±2.1 decibels at distances up to 30 m and within angles of 45–90° of the receiver. The validated model was then used for a case study of UAV noise emission in an urban setting. The model demonstrated the potential for UAV noise emission to significantly exceed urban background noise levels by up to 10 dB. It was found that flight altitude relative to building height had a significant impact on the number of allowable UAV operations within WHO LDEN guidelines.
Dynamic Measurement of Portos Tomato Seedling Growth Using the Kinect 2.0 Sensor
Authors: González-Barbosa José-Joel , Ramírez-Pedraza Alfonso , Ornelas-Rodríguez Francisco-Javier , Cordova-Esparza Diana-Margarita , González-Barbosa Erick-Alejandro
Published: March 2022

Traditionally farmers monitor their crops employing their senses and experience. However, the human sensory system is inconsistent due to stress, health, and age. In this paper, we propose an agronomic application for monitoring the growth of Portos tomato seedlings using Kinect 2.0 to build a more accurate, cost-effective, and portable system. The proposed methodology classifies the tomato seedlings into four categories: The first corresponds to the seedling with normal growth at the time of germination; the second corresponds to germination that occurred days after; the third category entails exceedingly late germination where its growth will be outside of the estimated harvest time; the fourth category corresponds to seedlings that did not germinate. Typically, an expert performs this classification by analyzing ten percent of the randomly selected seedlings. In this work, we studied different methods of segmentation and classification where the Gaussian Mixture Model (GMM) and Decision Tree Classifier (DTC) showed the best performance in segmenting and classifying Portos tomato seedlings.
Individual and Interactive Effects of Multiple Abiotic Stress Treatments on Early-Season Growth and Development of Two Brassica Species
Authors: Sehgal Akanksha , Reddy Kambham Raja , Walne Charles Hunt , Barickman T. Casey , Brazel Skyler , Chastain Daryl , Gao Wei
Published: March 2022

Potential global climate change-related impacts on crop production have emerged as a major research priority and societal concern during the past decade. Future changes, natural and human-induced, projected in the climate have implications for regional and global crop production. The simultaneous occurrence of several abiotic stresses instead of stress conditions is most detrimental to crops, and this has been long known by farmers and breeders. The green leafy vegetables of the Brassicaceae family have especially gained attention due to their many health benefits. However, little information is available about abiotic stress’s effects on Brassica vegetables’ growth and development. An experiment was conducted on two Brassica species: B. oleracea L. var. acephala WINTERBOR F1 (hybrid kale) and B. juncea var. GREEN WAVE OG (mustard greens). Seven treatments were imposed on the two brassica species in soil–plant–atmosphere–research (SPAR) units under optimum moisture and nutrient conditions, including a control treatment (optimal temperature and UV-B conditions at ambient CO2 levels), and six treatments where stresses were elevated: CO2, UV-B, temperature (T), CO2+UV-B, CO2+T, and CO2+UV-B+T. Above- and below-ground growth parameters were assessed at 26 d after sowing. Several shoot and root morphological and developmental traits were evaluated under all the treatments. The measured growth and development traits declined significantly under individual stresses and under the interaction of these stresses in both the species, except under elevated CO2 treatment. All the traits showed maximum reductions under high IV-B levels in both species. Leaf area showed 78% and 72% reductions, and stem dry weight decreased by 73% and 81% in kale and mustard, respectively, under high UV-B levels. The increased CO2 concentrations alleviated some deleterious impacts of high temperature and UV-B stresses. The results of our current study will improve our understanding of the adverse effects of environmental stresses on the early-season growth and development of two Brassica species.
Short Communication: Prognostic Values of a Multiparametric Risk Score in Maize Silage Undergoing Different Ensiling Conditions
Authors: Serva Lorenzo , Magrin Luisa , Marchesini Giorgio , Andrighetto Igino
Published: March 2022

We studied the effects of the use of Lactobacillus buchneri (Lb) and the maize pre-ensiling composition on the aerobic silage stability in a panel of 88 maize ensiled 60 days in 21 L buckets. Lb was dispensed at three dosages and compared to a control (pure water). The prognostic multiparametric risk score was used to find the risk factors related to the chemical composition of the fresh plant, associated with the onset of aerobic instability in maize silage. A multivariable Akaike’s Information Criterion in the backward Cox proportional hazard regression was estimated for pre-ensiled maize chemical traits. A Multiple Factorial Analysis (MFA) was calculated. The hazard ratios were 1.02, 1.34, 0.66, 0.65, 1.57, and 1.06 for dry matter (DM), crude protein (CP), ether extract (EE), aNDF, lignin (sulfuric acid, sa), and water-soluble carbohydrates (WSC), respectively (p < 0.05, DM, p = 0.15). At the MFA, ash, CP, aNDF, ADF, and lignin (sa) were grouped with a positive Dim-1, while DM, EE, and starch were grouped with a negative coordinate; WSC stood alone with Dim-1 close to zero. CP, EE, aNDF, lignin (sa), and WSC resulted in the most relevant traits and were used to build the nomogram. The use of strains of Lb improved the aerobic stability for maize harvested at <300 g/kg of DM.
Genetic Bases of Flow- and Sink-Related Traits in Rice Revealed by Genome-Wide Association Study
Authors: Zhai Laiyuan , Wang Yun , Yan An , Chen Liqiang , Shao Kuitian , Zhang Wenzhong , Xu Jianlong
Published: March 2022

Rice yield is determined by source, sink, and flow and the coordination of these factors. However, the genetic base of the sink-flow is still unknown. We conducted on genome-wide association to detect quantitative trait loci (QTL) related to sink size (the number of rachis branches and spikelet number in rachis branches) and flow vascular bundle (large and small vascular bundles number in panicle neck and second internode) using 440 germplasm resources. The accessions exhibited marked variation in all traits and demonstrated complex phenotypic correlations. A total of 138 QTL affecting the 8 traits were detected using 3,188,500 high-quality single nucleotide polymorphism markers. Sixteen QTL clusters simultaneously affected flow and sink traits, which might explain the genetic base of significant correlations between flow and sink traits. The nine candidate genes in two consistent chromosomal regions simultaneously affecting multiple vascular bundle and sink size traits by performing gene-based association analysis and haplotype analysis. Among them, D2 (LOC_Os01g10040) and Gn1a (LOC_Os01g10110) for qPLVN1.1, qSLVN1.1, and qPRN1.2 and OsPIN5b (LOC_Os08g41720) for qPLVN8, qSLVN8, qSSVN8, and qSTSN8.2 were considered the most likely candidate genes based on functional annotations. The results provide useful information for improving rice yield potential via balancing sink–flow relationships by marker-assisted selection.
Freezability of Dog Semen after Collection in Field Conditions and Cooled Transport
Authors: Colombo Martina , Morselli Maria Giorgia , Franchi Giulia , Schäfer-Somi Sabine , Luvoni Gaia Cecilia
Published: March 2022

Dog semen freezing is gaining popularity, but it has to be performed in equipped facilities, which can be far from the place where the stud dog lives. The aim of this study was to evaluate whether freezing dog semen after 24 or 48 h of cooled transport to an equipped laboratory was possible when semen collection was performed in the field such as in local breeding kennels. Single ejaculates from different dogs (mixed breeds and ages) were collected. In Experiment I, 10 ejaculates were conventionally frozen using the Uppsala method or frozen after 24 or 48 h of storage in a Styrofoam transport box cooled by icepacks. In Experiment II, 10 ejaculates were used to assess the influence of two extenders (Uppsala chilling extender or freezing extender 1) used for semen dilution during the 24 or 48 h storage. Motility, morphology, membrane, and acrosome integrity were analyzed as well as spermatozoa zona-binding ability. No significant differences were observed among the frozen groups, regardless of freezing time (Experiment I) or extender (Experiment II). Motility at thawing, however, decreased in absolute value at 48 h. Freezing of freshly collected semen is the gold standard, but the results obtained in this study prompt the application of freezing after cooled transport for the long-term preservation of dog semen, especially if the transport can be organized in 24 h.
Looking for Dog Blood Donors in an Endemic Area for Vector-Borne Infections of Central Italy
Authors: Antognoni Maria Teresa , Vascellari Marta , Da Rold Graziana , Toniolo Federica , Sgubin Sofia , Zanardello Claudia , Carminato Antonio , Miglio Arianna
Published: March 2022

Dogs are proved to be competent reservoir hosts for several vector-borne pathogens. Their prevalence varies according to the geographical area. Many vector-borne pathogens may be transmitted by blood transfusion. The purpose of this study was to determine the serological and molecular prevalence of some vector-borne pathogens in dog blood donors, living in central Italy. Blood samples of 126 donors (19 breeds) included were tested for a broad serological and DNA-base tests panel. The differences in pathogen prevalence according to age, sex, and breeds were tested (chi-square test, Fisher’s exact test). Overall, 50 animals (39.7%) tested positive at PCR (polymerase chain reaction) and/or serology (IFAT, indirect fluorescent antibody test) for at least one pathogen. Three dogs were positive at both serology and PCR. A tendency of hemoplasmas to be more prevalent in older dogs (41.2%) compared to the younger ones (25.7%) was noted. We highlight the difficulties of selecting healthy blood donor dogs in an endemic area for vector-borne infections. It is important to choose the serological and biomolecular investigations panel that is most suited to the donor’s environment. Close collaboration between clinician and parasitologists is important in the interpretation of IFAT and PCR results. Finally, we underline the important role of blood donors as an epidemiological tool for active surveillance against canine vector-borne diseases.
Immunoexpression of Relaxin and Its Receptors in Stifle Joints of Dogs with Cranial Cruciate Ligament Disease
Authors: Restucci Brunella , Sgadari Mariafrancesca , Fatone Gerardo , Valle Giovanni Della , Aragosa Federica , Caterino Chiara , Ferrara Gianmarco , Niebauer Gert W.
Published: March 2022

The etiology of spontaneous cranial cruciate ligament rupture in dogs is unknown despite being one of the most impacting orthopedic diseases in dogs. Numerous studies have contributed to the understanding of a multifactorial pathogenesis, this, however, without identifying a pivotal link to explain progressive collagen degeneration and osteoarthritic changes. In human medicine, recent reports have identified relaxin as a triggering factor in ligament ruptures in knee and metacarpal joints. We thus hypothesized that relaxin might also play a role in canine cruciate ligament rupture. Relaxin’s primarily known property is connective tissue remodeling through collagenolysis. We therefore investigated relaxin and its cognate receptors LGR7/LGR8 in 18 dogs with cranial cruciate ligament disease (CCLD) and compared them to a group of dogs with normal stifle joints. Applying immunohistochemistry (IHC), double immunofluorescence (dIF), and western blot analysis (WB), we found strong and significantly increased expression of both relaxin and its receptors in ruptured cruciate ligaments, and in synovial membranes. Pattern of immuno-staining on dIF strongly suggests relaxin binding to primed receptors and activation of signaling properties, which in turn may have affected collagen matrix metabolism. Thus, in canine cranial cruciate ligament disease, relaxin/receptor signaling may be a primary trigger for collagen fiber degradation and collagen lysis, eventually followed by ligament rupture.
Morphing Natural Product Platensimycin via Heck, Sonogashira, and One-Pot Sonogashira/Cycloaddition Reactions to Produce Antibiotics with In Vivo Activity
Authors: Deng Youchao , Li Yuling , Wen Zhongqing , Ruiz Claudia H. , Weng Xiang , Cameron Michael D. , Duan Yanwen , Huang Yong
Published: March 2022

Type II fatty acid synthases are promising drug targets against major bacterial pathogens. Platensimycin (PTM) is a potent inhibitor against β-ketoacyl-[acyl carrier protein] synthase II (FabF) and β-ketoacyl-[acyl carrier protein] synthase I (FabB), while the poor pharmacokinetics has prevented its further development. In this work, thirty-two PTM derivatives were rapidly prepared via Heck, Sonogashira, and one-pot Sonogashira/cycloaddition cascade reactions based on the Gram-scale synthesis of 6-iodo PTM (4). About half of the synthesized compounds were approximately equipotent to PTM against the tested Staphylococcus aureus strains. Among them, the representative compounds 4, A4, and B8 exhibited different plasma protein binding affinity or stability in the human hepatic microsome assay and showed improved in vivo efficacy over PTM in a mouse peritonitis model. In addition, A4 was also effective in an S. aureus-infected skin mouse model. Our study not only significantly expands the known PTM derivatives with improved antibacterial activities in vivo, but showcased that C–C cross-coupling reactions are useful tools to functionalize natural product drug leads.
Editorial for the Special Issue: “Current and Novel Antimicrobial Strategies for Bacterial and Fungal Infections by Resistant Organisms”
Authors: Maraolo Alberto Enrico
Published: March 2022

The pandemic driven by the SARS-CoV-2 infection has compelled health services globally to direct all available human and economic resources toward fighting the novel coronavirus [...]
The Safety of Consuming Water Dropwort Used to Purify Livestock Wastewater Considering Accumulated Antibiotics and Antibiotic Resistance Genes
Authors: Yao Dongrui , Chang Yajun , Wang Wei , Sun Linhe , Liu Jixiang , Zhao Huijun , Zhang Weiguo
Published: March 2022

Research is lacking on the health risks of antibiotics and antibiotic resistance genes (ARGs) in water dropwort grown in livestock wastewater. Our results showed that antibiotics from livestock wastewater were absorbed and bioaccumulated by water dropwort. The concentration of antibiotics was higher in the roots than in the stems and leaves. The health-risk coefficients of antibiotics in water dropwort were below the threshold (<0.1), indicating that in this case study, the consumption of water dropwort used to purify livestock wastewater was safe for humans considering accumulated antibiotics. ARGs were closely correlated between livestock wastewater and water dropwort, with the results showing that all 13 ARGs detected in the livestock wastewater were also found in the water dropwort. Tetracycline resistance genes were more abundant than the other ARGs in both the livestock wastewater and water dropwort. The estimated daily intake of ARGs in water dropwort for humans ranged from 2.06 × 106 to 7.75 × 1012 copies g−1, suggesting the potential risk of intaking ARGs in water dropwort cannot be ignored. Although the safety of consuming water dropwort used to purify livestock wastewater, considering accumulated antibiotics and ARGs, was assessed in this study, more studies should be conducted to ensure we fully understand the health risks.
The Structural and Functional Study of Efflux Pumps Belonging to the RND Transporters Family from Gram-Negative Bacteria
Authors: Vargiu Attilio Vittorio , Phan Gilles , Venter Henrietta , Broutin Isabelle
Published: March 2022

Antimicrobial-resistant bacterial infections are a major and costly public health concern [...]
Prevalence and Molecular Typing of Carbapenemase-Producing Enterobacterales among Newborn Patients in Italy
Authors: Agosta Marilena , Bencardino Daniela , Argentieri Marta , Pansani Laura , Sisto Annamaria , Ciofi Degli Atti Marta Luisa , D’Amore Carmen , Putignani Lorenza , Bagolan Pietro , Iacobelli Barbara Daniela , Dotta Andrea , Martini Ludovica , Di Chiara Luca , Magnani Mauro , Perno Carlo Federico , Andreoni Francesca , Bernaschi Paola
Published: March 2022

The spread of carbapenemase-producing Enterobacterales (CPE), especially Klebsiella pneumoniae (K. pneumoniae) and Escherichia coli (E. coli), is a serious public health threat in pediatric hospitals. The associated risk in newborns is due to their underdeveloped immune system and limited treatment options. The aim was to estimate the prevalence and circulation of CPE among the neonatal intensive units of a major pediatric hospital in Italy and to investigate their molecular features. A total of 124 CPE were isolated from rectal swabs of 99 newborn patients at Bambino Gesù Children’s Hospital between July 2016 and December 2019. All strains were characterized by antimicrobial susceptibility testing, detection of resistance genes, and PCR-based replicon typing (PBRT). One strain for each PBRT profile of K. pneumoniae or E. coli was characterized by multilocus-sequence typing (MLST). Interestingly, the majority of strains were multidrug-resistant and carried the blaNDM gene. A large part was characterized by a multireplicon status, and FII, A/C, FIA (15%) was the predominant. Despite the limited size of collection, MLST analysis revealed a high number of Sequence Types (STs): 14 STs among 28 K. pneumoniae and 8 STs among 11 E. coli, with the prevalence of the well-known clones ST307 and ST131, respectively. This issue indicated that some strains shared the same circulating clone. We identified a novel, so far never described, ST named ST10555, found in one E. coli strain. Our investigation showed a high heterogeneity of CPE circulating among neonatal units, confirming the need to monitor their dissemination in the hospital also through molecular methods.
Fabrication and Evaluation of W/O Emulsion Loaded with Linum usitatissimum Seeds Extract for Anti-Leishmaniasis Efficacy
Authors: Khan Barkat Ali , Faiz Sumera , Khan Muhammad Khalid , Menaa Farid , Olah Neli-Kinga , Almoshari Yosif , Alamoudi Jawaher Abdullah , Almawash Saud
Published: March 2022

Leishmaniasis, remains a serious health problem in many developing countries with thousands of new cases recorded annually. Novel therapies are required as existing treatment regimens are limited by their high cost, high toxicity, increased parasite resistance, patient’s intolerance, and invasive means of long-duration administration. With several studies reporting the anti-leishmaniasis promise of medicinal plants, interest in plants and herbal drugs is attracting much attention worldwide. In this pilot study, we analysed extracts of Linum usitatissimum seeds (LU) to identify essential phytochemicals and test their activity against cutaneous leishmaniasis both in-vitro and in-vivo. We performed phytochemical screening of LU seeds extract as well as its in-vitro leishmanicidal and anti-amastigote assays. Water-in-oil cream containing 10% LU crude extract (10 mg/mL) was then prepared. The stability of the cream was evaluated for 28 days at 8 °C, 25 °C and 40 °C. In-vivo efficacy and safety of the cream was performed in 26 patients with cutaneous leishmaniasis who agreed to participate voluntarily in the study. The active treatment period lasted for 3 weeks, while the follow-up period was extended to 4 months. During the active study period, images of skin lesions were taken before and after treatment. Analyses of LU seeds extract confirmed the presence of terpenoids, flavonoids, tannins, alkaloids, and polyphenols. In-vitro studies showed significant activity against promastigote and intracellular amastigote forms of Leishmaniamajor. The cream was pharmaceutically stable, although some minor changes were noticed in relation to its physical characteristics. In-vivo assessment of the cream showed a 69.23% cure rate with no side effects, allergy, or irritation. We conclude that our newly developed water in oil cream containing 10% LU seeds extract could be an effective and safe topical anti-leishmanial medication for patients with CL.
The Double-Edged Sword of Oxidative Stress in Skin Damage and Melanoma: From Physiopathology to Therapeutical Approaches
Authors: Emanuelli Monica , Sartini Davide , Molinelli Elisa , Campagna Roberto , Pozzi Valentina , Salvolini Eleonora , Simonetti Oriana , Campanati Anna , Offidani Annamaria
Published: March 2022

The skin is constantly exposed to exogenous and endogenous sources of reactive oxygen species (ROS). An adequate balance between ROS levels and antioxidant defenses is necessary for the optimal cell and tissue functions, especially for the skin, since it must face additional ROS sources that do not affect other tissues, including UV radiation. Melanocytes are more exposed to oxidative stress than other cells, also due to the melanin production process, which itself contributes to generating ROS. There is an increasing amount of evidence that oxidative stress may play a role in many skin diseases, including melanoma, being the primary cause or being a cofactor that aggravates the primary condition. Indeed, oxidative stress is emerging as another major force involved in all the phases of melanoma development, not only in the arising of the malignancy but also in the progression toward the metastatic phenotype. Furthermore, oxidative stress seems to play a role also in chemoresistance and thus has become a target for therapy. In this review, we discuss the existing knowledge on oxidative stress in the skin, examining sources and defenses, giving particular consideration to melanocytes. Therefore, we focus on the significance of oxidative stress in melanoma, thus analyzing the possibility to exploit the induction of oxidative stress as a therapeutic strategy to improve the effectiveness of therapeutic management of melanoma.
Obtaining Fat-Soluble Pigments—Carotenoids from the Biomass of Chlorella Microalgae
Authors: Bazarnova Julia , Smyatskaya Yulia , Shlykova Antonina , Balabaev Aleksei , Đurović Saša
Published: March 2022

The aim of this study was to use a directed mode of cultivation of the microalgae Chlorella for biomass production, followed by the subsequent extraction of carotenoids. The effect of a stress inducer of carotenogenesis (hydrogen peroxide) and a growth stimulator (pyridoxine, vitamin B6) on the accumulation of photosynthetic pigments by the biomass of the microalga C. vulgarisBIN in the process of directed cultivation was studied. It was revealed that the combination of these additives in the culture medium increases the content of chlorophylls and carotenoids in the biomass twofold compared to the control sample. The preliminary activation of the biomass by high-speed ultra-homogenization (a rotor rotation range from 6000 to 12,000 rpm) was also investigated. Using ultrasound extraction, the pigment complex was isolated from the activated biomass. The saponification and subsequent neutralization of carotenoids were carried out in an inert medium. The resulting sample contained carotenoids in the amount of 52 ± 3 mg/mL. The chemical profile of the carotenoids in the biomass of the microalga Chlorella vulgaris BIN was also established. The major carotenoid was lutein (45%), followed by fucoxanthin (12%) and β-carotene (4.3%). The oil extract of the carotenoids may be used for the further production of a microencapsulated product with the aim of targeted delivery to the lower parts of the gastrointestinal tract.
Focal Dice Loss-Based V-Net for Liver Segments Classification
Authors: Prencipe Berardino , Altini Nicola , Cascarano Giacomo Donato , Brunetti Antonio , Guerriero Andrea , Bevilacqua Vitoantonio
Published: March 2022

Liver segmentation is a crucial step in surgical planning from computed tomography scans. The possibility to obtain a precise delineation of the liver boundaries with the exploitation of automatic techniques can help the radiologists, reducing the annotation time and providing more objective and repeatable results. Subsequent phases typically involve liver vessels’ segmentation and liver segments’ classification. It is especially important to recognize different segments, since each has its own vascularization, and so, hepatic segmentectomies can be performed during surgery, avoiding the unnecessary removal of healthy liver parenchyma. In this work, we focused on the liver segments’ classification task. We exploited a 2.5D Convolutional Neural Network (CNN), namely V-Net, trained with the multi-class focal Dice loss. The idea of focal loss was originally thought as the cross-entropy loss function, aiming at focusing on “hard” samples, avoiding the gradient being overwhelmed by a large number of falsenegatives. In this paper, we introduce two novel focal Dice formulations, one based on the concept of individual voxel’s probability and another related to the Dice formulation for sets. By applying multi-class focal Dice loss to the aforementioned task, we were able to obtain respectable results, with an average Dice coefficient among classes of 82.91%. Moreover, the knowledge of anatomic segments’ configurations allowed the application of a set of rules during the post-processing phase, slightly improving the final segmentation results, obtaining an average Dice coefficient of 83.38%. The average accuracy was close to 99%. The best model turned out to be the one with the focal Dice formulation based on sets. We conducted the Wilcoxon signed-rank test to check if these results were statistically significant, confirming their relevance.
Oral Microbiota in Patients with Peri-Implant Disease: A Narrative Review
Authors: Butera Andrea , Pascadopoli Maurizio , Pellegrini Matteo , Gallo Simone , Zampetti Paolo , Scribante Andrea
Published: March 2022

Peri-implant infections are the most common complications related to the placement of dental implants. There are many microbial similarities between peri-implantitis and periodontitis but due to current laboratory techniques there are just as many differences. This review was performed to assess changes in the oral microbiota at sites with peri-implant disease, according to the state of the art. The peri-implant microbiota presents a lower microbial quality than the periodontal microbiota, becoming increasingly complex as it progresses from peri-implant mucositis to peri-implantitis. The microbial difference detected between the peri-implant and periodontal microbiota is primarily related to whole bacterial populations, rather than specific bacterial taxa. The use of probiotics could support the reduction of peri-implant pockets, in association with mechanical debridement, due to their mechanism of action of competitive inhibition for adhesion sites. The peri-implant microbiota represents a qualitatively inferior but quantitatively superior bacterial ecosystem for some bacterial genera compared to the periodontal microbiota, showing that a progression from healthy state to peri-implantitis causes changes in microbiota composition in the absence of specific disease-causing bacteria. Transcriptomics could provide useful information for the prevention, diagnosis, and therapy of peri-implant pathology through knowledge of bacterial virulence factors.
Elastodontic Therapy of Hyperdivergent Class II Patients Using AMCOP® Devices: A Retrospective Study
Authors: Inchingolo Alessio Danilo , Ceci Sabino , Patano Assunta , Inchingolo Angelo Michele , Montenegro Valentina , Di Pede Chiara , Malcangi Giuseppina , Marinelli Grazia , Coloccia Giovanni , Garibaldi Mariagrazia , Kruti Zamira , Palmieri Giulia , De Leonardis Nicole , Rapone Biagio , Mancini Antonio , Semjonova Alexandra , Nucci Ludovica , Bordea Ioana Roxana , Scarano Antonio , Lorusso Felice , Ferrara Elisabetta , Farronato Marco , Tartaglia Gianluca Martino , Di Venere Daniela , Cardarelli Filippo , Inchingolo Francesco , Dipalma Gianna
Published: March 2022

Background: The management of a hyperdivergent growth pattern is one of the most challenging in orthodontics and different treatments are advocated. The present study analyses the effectiveness of elastodontic therapy with AMCOP® devices in treating children with hyperdivergent class II malocclusion and the effect on the upper airway patency. Methods: The study group included 21 patients (10 males and 11 females, mean age 8.22 ± 1.17 years) with a hyperdivergent growth and a class II malocclusion treated with AMCOP® devices. Cephalometric analysis was performed before treatment (T0) and after treatment (T1). Results: After treatment, the cephalometric analysis revealed a correction of the class II malocclusion and a modification of the growth pattern with a divergence reduction. The improvement of the upper airway space was also observed. Conclusion: The elastodontic therapy effectively corrected hyperdivergent class II malocclusion in growing patients over a short period.
Mixed-Integer Linear Programming for Decentralized Multi-Carrier Optimal Energy Management of a Micro-Grid
Authors: Faghiri Mohammad , Samizadeh Shadi , Nikoofard Amirhossein , Khosravy Mahdi , Senjyu Tomonobu
Published: March 2022

Increasing the load demand and penetration of renewable energy sources (RESs) poses real challenges for optimal energy management of distribution networks. Moreover, considering multi-carrier energy systems has increased the efficiency of systems, and provides an opportunity for using the advantages of RESs. In this regard, we adopted a new framework based on the new challenges in the multi-carrier energy micro-grid (MEMG). In the proposed method, a comprehensive MEMG was modeled that benefits from a large assortment of distributed energy resources (DERs), such as micro-turbines, fuel cells, wind turbines, and energy storage. Considering many DERs is necessary, because these resources could cover one another’s disadvantages, which have a great impact on the total cost of the MEMG and decrease the emission impacts of fossil-fuel-based units. Furthermore, waste power plants, inverters, rectifiers, and emission constraints are considered in the proposed method for modeling a practical MEMG. Additionally, for modeling the uncertainty of stochastic parameters, a model based on a multilayer neural network was used in this paper. The results of this study indicate that using a decentralized model, along with stochastic methods for predicting uncertainty, can reduce operational costs in micro-grids and computational complexity compared with optimal centralized programming methods. Finally, the equations and results obtained from the proposed method were evaluated by experiments.
On the Reliability of CNNs in Clinical Practice: A Computer-Aided Diagnosis System Case Study
Authors: Loddo Andrea , Putzu Lorenzo
Published: March 2022

Leukocytes classification is essential to assess their number and status since they are the body’s first defence against infection and disease. Automation of the process can reduce the laborious manual process of review and diagnosis by operators and has been the subject of study for at least two decades. Most computer-aided systems exploit convolutional neural networks for classification purposes without any intermediate step to produce an accurate classification. This work explores the current limitations of deep learning-based methods applied to medical blood smear data. In particular, we consider leukocyte analysis oriented towards leukaemia prediction as a case study. In particular, we aim to demonstrate that a single classification step can undoubtedly lead to incorrect predictions or, worse, to correct predictions obtained with wrong indicators provided by the images. By generating new synthetic leukocyte data, it is possible to demonstrate that the inclusion of a fine-grained method, such as detection or segmentation, before classification is essential to allow the network to understand the adequate information on individual white blood cells correctly. The effectiveness of this study is thoroughly analysed and quantified through a series of experiments on a public data set of blood smears taken under a microscope. Experimental results show that residual networks perform statistically better in this scenario, even though they make correct predictions with incorrect information.
Multidimensional Study on Users’ Evaluation of the KRAKEN Personal Data Sharing Platform
Authors: Gabrielli Silvia , Rizzi Silvia , Mayora Oscar , More Stefan , Pérez Baun Juan Carlos , Vandevelde Wim
Published: March 2022

Background: Recent advances in the design of blockchain-based personal data sharing platforms bring the benefit of empowering users with more control and privacy-preserving measures in sharing data products. However, so far very little is known about users’ intentions to adopt such platforms for providing or consuming data products. Objective: This study aims to investigate users’ main expectations, preferences, and concerns regarding the adoption of blockchain-based personal data sharing platforms in the health and education domains. Methods: Fifteen participants were involved in a multidimensional evaluation of a prototyped release of the KRAKEN blockchain-based data sharing platform and asked to assess it in the health or education pilot domains. Data collected during online group interviews with participants were analyzed by applying the micro interlocutor technique to provide a descriptive overview of participant responses. Results: Participants showed a marginal acceptance of the prototype usability, asking for some improvements of the user experience and for a more transparent presentation of the platform security and privacy preserving capabilities. Participants expressed interest in using the platform as data providers and consumers as well as setting privacy policies for sharing data products with third parties, including the possibility of revoking access to data. Conclusions: Blockchain-based data sharing platforms are more likely to engage target users when technical design is informed by a deeper knowledge of their needs, expectations, and relevant concerns.