bluuebunny/crossref_metadata_2025 huggingface dataset:
New Species, New Records, and Updated Key to the Paravelia (Hemiptera: Heteroptera: Veliidae) from Brazil
Authors: Rodrigues Juliana Mourão dos Santos , Moreira Felipe Ferraz Figueiredo
Published: June 2022

The broad-shouldered water-strider genus Paravelia Breddin, 1898 (Hemiptera: Heteroptera: Veliidae: Veliinae) is currently represented in Brazil by 38 species. Although the diversity of the genus in the country is relatively well known, eight states remain with no records of any species: Acre, Alagoas, Ceará (CE), Paraíba, Paraná, Pernambuco (PE), Piauí (PI), and Tocantins. Aiming to fill these gaps, several expeditions were carried out at conservation areas of the Caatinga biome between 2018 and 2021: Aiuaba Ecological Station (CE), Catimbau National Park (PE), and Serra das Confusões National Park (PI). Paravelia luisi sp. nov., a new species from PE, is described and illustrated. In addition, new records of P. bilobata Rodrigues, Moreira, Nieser, Chen & Melo, 2014, P. digitata Rodrigues & Moreira, 2016, and P. nieseri Moreira & Barbosa, 2012, and an updated key to the Brazilian species of Paravelia are provided. This study increases the number of species of Paravelia known in Brazil to 39 and provides the first records of the genus from three states: PE, with two species, and CE and PI, with one species each.
A Cease in Shift Work Reverses Arterial Stiffness but Increases Weight and Glycosylated Hemoglobin A 5-Month Follow-Up in Industry
Authors: Skogstad Marit , Aass Hans Christian D. , Lunde Lars-Kristian , Skare Øivind , Sirnes Per Anton , Matre Dagfinn
Published: June 2022

Background: Literature suggests an association between shift work and cardiovascular disease (CVD). Limited evidence is available on how a cessation of shift work affects CVD risk factors. Aim: We investigated whether a five-month plant shutdown affected CVD risk factors in 30 industrial shift workers. Methods: We collected demographic data, self-reported data on physical activity (PA) and medical history by questionnaire. Pre- and post-plant shutdown, we measured blood pressure (BP), heart rate, lipids, glycosylated hemoglobin (HbA1c) and C-reactive protein (CRP). Additionally, we collected markers of inflammation, Matrix metalloproteinase-9 (MMP-9), Interleukin-6 (IL-6), Monocyte chemoattractant protein-1 (MCP-1), Tumor necrosis factor-alpha (TNF-α), P-selectin, Interleukin-1 beta (IL-1β), and Interleukin-23 (IL-23). We also examined arterial stiffness (central blood pressure, augmentation pressure, and pulse wave velocity) by means of SphygmoCor® (AtCor Medical Pty Ltd., Sydney, Australia). We monitored sleep by actigraphy prior to and after plant shutdown, with additional registration of sleep quality and assessment of insomnia symptoms. Results: After five months of plant shutdown, we found that HbA1c increased by 1.9 mmol/mol, weight by 1 kg and MCP-1 by 27.3 pg/mL, all unexpectedly. The other markers of inflammation did not change during shutdown, but CRP decreased close to significant levels. There were no changes in lipids during follow-up. Pulse-wave velocity (PWV) was reduced from 8.1 m/s (SD = 1.5) to 7.6 m/s (SD = 1.5), p = 0.03. The workers reported fewer signs of insomnia after shutdown. Conclusions: Our findings suggest that a five-month cessation in shift work increases weight and HbA1c, but also improves insomnia symptoms and reverses arterial stiffening.
Benefits of a Balance Exercise Assist Robot in the Cardiac Rehabilitation of Older Adults with Cardiovascular Disease: A Preliminary Study
Authors: Hashimoto Kakeru , Hirashiki Akihiro , Ozaki Kenichi , Kawamura Koki , Sugioka Junpei , Tanioku Shunya , Sato Kenji , Ueda Ikue , Itoh Naoki , Nomoto Kenichiro , Kokubo Manabu , Shimizu Atsuya , Kondo Izumi
Published: June 2022

We examined whether adding robot-supported balance exercises to cardiac rehabilitation improves the ability to balance in older adults with cardiovascular disease (CVD). We conducted a prospective study in 52 older adults who had been hospitalized for worsening CVD. Once weekly for four months, for a total of sixteen sessions as outpatients, the subjects used a Balance Exercise Assist Robot (BEAR) to perform balance exercises and an ergometer for aerobic exercises. Participants’ mean age was 76.9 ± 6.8 years (range, 65–95 years), and their mean brain natriuretic protein level was 164.0 ± 190.0 pg/mL. After the intervention, participants showed significant improvements in gait speed (before, 1.06 ± 0.33 m/s; after, 1.23 ± 0.30 m/s; p < 0.001), Short Physical Performance Battery score (before, 10.02 ± 2.25; after, 10.88 ± 1.79; p ˂ 0.001), timed up-and-go (before, 11.11 ± 5.07 s; after, 9.45 ± 3.45 s; p ˂ 0.001), and knee extension (before, 26.97 ± 11.78 kgf; after, 30.13 ± 13.04 kgf; p = 0.001). Cardiac rehabilitation including exercises using BEAR improved physical functioning and the ability to balance in older adults with CVD. Frail and prefrail patients improved, whereas robust ones did not change.
Recurrence Rates and Its Associated Factors after Early Spinal Instrumentation for Pyogenic Spondylodiscitis: A Nationwide Cohort Study of 2148 Patients
Authors: Lim Jeong Seop , Kim Tae-Hwan
Published: June 2022

Recent studies have consistently reported the safety and effectiveness of early spinal instrumentation for pyogenic spondylodiscitis. However, none of these studies investigated the recurrence rate or associated factors based on this specific group of patients. Recurrence prediction models that are not based on a homogenous cohort of patients undergoing early spinal instrumentation show theoretical limitations for clinical use. A nationwide, population-based, retrospective cohort study using a claims database was planned to investigate the recurrence rate and its associated factors in patients who underwent early instrumented spinal fusion surgery for pyogenic spondylodiscitis. We used data from the Korean National Health Insurance claims database collected between 2014 and 2018. A total of 2148 patients who underwent early (within 6 weeks after the diagnosis) instrumented spinal fusion surgery for pyogenic spondylodiscitis were included, including 1925 patients (90%) without recurrence and 223 patients (10%) with recurrence. Logistic regression models were used to identify factors associated with recurrence, and sensitivity analysis was performed according to two different definitions for recurrence: shorter (2 weeks or more) and longer (6 weeks or more) periods of antibiotic therapy for recurrence. The recurrence rates in our cohort were 14.1%, 10.4%, and 8.0% at 2, 4, and 6 weeks, respectively, in relation to the duration of antibiotic treatment for recurrence. We identified age 60–69 years (OR = 2.42), age > 70 years (OR = 2.29), posterior thoracic approach (OR = 1.85), multiple surgical approaches (OR = 4.17), use of a cage (OR = 1.66), transfusion (OR = 2.55), antibiotics for resistant organisms (OR = 2.55), and systemic steroid treatment over 2 weeks (OR = 2.27) as the factors associated with recurrence. The recurrence rates and associated factors from our first population-based and the largest clinical study can be practically used as a reasonable reference and provide clinicians with an acceptable tool for the comprehensive risk assessment for recurrence after early spinal instrumentation for pyogenic spondylodiscitis.
The Predictive Value of Anticholinergic Burden Measures in Relation to Cognitive Impairment in Older Chronic Complex Patients
Authors: Tristancho-Pérez Ángela , Villalba-Moreno Ángela , López-Malo de Molina María Dolores , Santos-Ramos Bernardo , Sánchez-Fidalgo Susana
Published: June 2022

Anticholinergic burden (AB) is related to cognitive impairment (CI) and older complex chronic patients (OCCP) are more susceptible. Our objective was to evaluate the predictive value of ten anticholinergic scales to predict a potential CI due to anticholinergic pharmacotherapy in OCCP. An eight-month longitudinal multicentre study was carried out in a cohort of OCCP, in treatment with at least one anticholinergic drug and whose cognition status had been evaluated by Pfeiffer test twice for a period of 6–15 months. CI was considered when the Pfeiffer test increased 2 or more points. AB was detected using ten scales included on the Anticholinergic Burden Calculator. An ROC curve analysis was performed to assess the discriminative capacity of the scales to predict a potential CI and the cut-off point of AB that obtains better validity indicators. 415 patients were included (60.2% female, median age of 85 years (IQR = 11)). 190 patients (45.8%) manifested CI. Only the DBI (Drug Burden Index) showed statistically significant differences in the median AB between patients without CI and with CI (0.5 (1.00) vs. 0.67 (0.65), p = 0.006). At the ROC curve analysis, statistically significant values were obtained only with the DBI (AUC: 0.578 (0.523–0.633), p = 0.006). The cut-off point with the greatest validity selected for the DBI was an AB of 0.41 (moderate risk) (sensitivity = 81%, specificity = 36%, PPV = 51%). The DBI is the scale with the greatest discriminatory power to detect OCCP at risk of CI and the best cut-off point is a load value of 0.41.
Patient-Reported Outcome Measures in Diseases of the Head and Neck
Authors: Printza Athanasia
Published: June 2022

Patient-reported outcome measures (PROMs) are measurement tools that capture a person’s perception of their own health [...]
Usefulness of Procalcitonin as a Predictor of Long-Term Prognosis in the Early Postoperative Period after Esophagectomy for Esophageal Cancer
Authors: Booka Eisuke , Kikuchi Hirotoshi , Haneda Ryoma , Soneda Wataru , Kawata Sanshiro , Murakami Tomohiro , Matsumoto Tomohiro , Hiramatsu Yoshihiro , Takeuchi Hiroya
Published: June 2022

The aim of this study was to investigate the relationship between serum procalcitonin (PCT) levels after esophagectomy and infectious complications and long-term prognosis. A total of 105 patients who underwent esophagectomy between 2012 and 2019 were stratified into two groups: PCT-High group of ≥1 ng/mL and PCT-Low group of <1 ng/mL. The clinical outcomes and prognostic factors were compared between the two groups 2 postoperative days (POD), 4 POD, and 7 POD after esophagectomy. As the postoperative days passed, the association between PCT and infectious complications became stronger, and the positive predictive value was 100% at 7 POD. At 2 POD, there was no significant association between PCT elevation and infectious complications. Patients in the PCT-Low group had significantly worse overall survival (OS) and recurrence-free survival (RFS) than those in the PCT-High group at 2 POD (p = 0.026 and p = 0.011, respectively). In multivariate analysis, advanced pathological stage (hazard ratio (HR), 5.348; 95% confidence interval (CI), 2.299–12.500; p < 0.001) and PCT-Low group at 2 POD (HR, 3.673; 95% CI, 1.116–12.092; p = 0.032) were also independent predictors of worse OS. PCT in the early postoperative period after esophagectomy could be a good predictor of prognosis.
The Association between General Anesthesia and New Postoperative Uses of Sedative–Hypnotics: A Nationwide Matched Cohort Study
Authors: Tai Chen-Yu , Liu Hsin-Yi , Cata Juan P. , Dai Ying-Xiu , Chen Mu-Hong , Chen Jui-Tai , Chen Tzeng-Ji , Wu Hsiang-Ling , Cherng Yih-Giun , Li Chun-Cheng , Wang Chien-Wun , Tai Ying-Hsuan
Published: June 2022

Sedative–hypnotic misuse is associated with psychiatric diseases and overdose deaths. It remains uncertain whether types of anesthesia affect the occurrence of new postoperative uses of sedative–hypnotics (NPUSH). We used reimbursement claims data of Taiwan’s National Health Insurance and conducted propensity score matching to compare the risk of NPUSH between general and neuraxial anesthesia among surgical patients who had no prescription of oral sedative–hypnotics or diagnosis of sleep disorders within the 12 months before surgery. The primary outcome was NPUSH within 180 days after surgery. Multivariable logistic regression models were used to calculate the adjusted odds ratio (aOR) and 95% confidence interval (CI). A total of 92,222 patients were evaluated after matching. Among them, 15,016 (16.3%) had NPUSH, and 2183 (4.7%) were made a concomitant diagnosis of sleep disorders. General anesthesia was significantly associated both with NPUSH (aOR: 1.17, 95% CI: 1.13–1.22, p < 0.0001) and NPUSH with sleep disorders (aOR: 1.11, 95% CI: 1.02–1.21, p = 0.0212) compared with neuraxial anesthesia. General anesthesia was also linked to NPUSH that occurred 90–180 days after surgery (aOR: 1.12, 95% CI: 1.06–1.19, p = 0.0002). Other risk factors for NPUSH were older age, female, lower insurance premium, orthopedic surgery, specific coexisting diseases (e.g., anxiety disorder), concurrent medications (e.g., systemic steroids), postoperative complications, perioperative blood transfusions, and admission to an intensive care unit. Patients undergoing general anesthesia had an increased risk of NPUSH compared with neuraxial anesthesia. This finding may provide an implication in risk stratification and prevention for sedative–hypnotic dependence after surgery.
Primary Orbital Reconstruction with Selective Laser Melting (SLM) of Patient-Specific Implants (PSIs): An Overview of 96 Surgically Treated Patients
Authors: Rana Majeed , Moellmann Henriette L. , Schorn Lara , Lommen Julian , Rana Madiha , Wilkat Max , Hufendiek Karsten
Published: June 2022

Contemporary advances in technology have allowed the transfer of knowledge from industrial laser melting systems to surgery; such an approach could increase the degree of accuracy in orbital restoration. The aim of this study was to examine the accuracy of selective laser melted PSIs (patient-specific implants) and navigation in primary orbital reconstruction. Ninety-six patients with orbital fractures were included in this study. Planned vs. achieved orbital volumes (a) and angles (b) were compared to the unaffected side (n = 96). The analysis included the overlay of post-treatment on planned images (iPlan 3.0.5, Brainlab®, Feldkirchen, Germany). The mean difference in orbital volume between the digitally planned orbit and the postoperative orbit was 29.16 cm3 (SD 3.54, presurgical) to 28.33 cm3 (SD 3.64, postsurgical, t = 5.00, df = 95.00; p < 0.001), resulting in a mean volume difference (planned vs. postop) of less than 1 cm3. A 3D analysis of the color mapping showed minor deviations compared to the mirrored unaffected side. The results suggested that primary reconstruction in complex orbital wall fractures can be routinely achieved with a high degree of accuracy by using selective laser melted orbital PSIs.
Long-Term Outcomes of Robotic-Assisted, Video-Assisted and Open Surgery in Non-Small Cell Lung Cancer: A Matched Analysis
Authors: Casiraghi Monica , Mariolo Alessio Vincenzo , Mohamed Shehab , Sedda Giulia , Maisonneuve Patrick , Mazzella Antonio , Lo Iacono Giorgio , Petrella Francesco , Spaggiari Lorenzo
Published: June 2022

Introduction: This study makes a comparison between stage I non-small cell lung cancer (NSCLC) patients subjected to either robotic-assisted thoracic surgery (RATS), video-assisted thoracic surgery (VATS) or open thoracotomy, with the aim to evaluate differences between these three approaches in terms of oncological outcomes. Method: We reviewed data from 1367 consecutive patients who, between 2011 and 2017, underwent lobectomy for NSCLC with either open surgery, VATS or RATS, and performed a matched case-control study based on patients’ age, gender, clinical stage (IA, IB) and ASA score. Results: 180 patients (n = 72 RATS, n = 36 VATS, n = 72 open) were analyzed. Complication rates were found to be comparable (72.2% open, 86.1% VATS, 81.9% RATS), with similar grades of severity. The median number of resected lymph nodes was higher in open surgery (n = 22) than in VATS (n = 15; p = 0.0001) and in RATS (n = 17; p = 0.004). Pathological N2 upstaging was higher in open surgery (9.7%) compared to VATS (5.6%) and RATS (5.6%). However, the recurrence rate in VATS was significantly higher than in RATS (log rank p = 0.03). No statistically significant differences were detected in 5-year OS and cancer-specific survival. Conclusions: no differences were found in OS and cancer-specific survival between VATS, RATS and open lobectomy for stage I NSCLC patients; even if in VATS, the incidence of recurrences, in particular local recurrences, was higher than in RATS and in open surgery.
Identifying Candidates for Immunotherapy among Patients with Non-Melanoma Skin Cancer: A Review of the Potential Predictors of Response
Authors: Zelin Enrico , Maronese Carlo Alberto , Dri Arianna , Toffoli Ludovica , Di Meo Nicola , Nazzaro Gianluca , Zalaudek Iris
Published: June 2022

Background: Non-melanoma skin cancer (NMSC) stands as an umbrella term for common cutaneous malignancies, including basal cell carcinoma (BCC) and cutaneous squamous cell carcinoma (cSCC), together with rarer cutaneous cancers, such as Merkel cell carcinoma (MCC) and other forms of adnexal cancers. The majority of NMSCs can be successfully treated with surgery or radiotherapy, but advanced and metastatic stages may require systemic approaches such as immunotherapy with immune checkpoint inhibitors (ICIs). Summary: Since immunotherapy is not effective in all patients and can potentially lead to severe adverse effects, an important clinical question is how to properly identify those who could be suitable candidates for this therapeutic choice. In this paper, we review the potential features and biomarkers used to predict the outcome of ICIs therapy for NMSCs. Moreover, we analyze the role of immunotherapy in special populations, such as the elderly, immunocompromised patients, organ transplant recipients, and subjects suffering from autoimmune conditions. Key messages: Many clinical, serum, histopathological, and genetic features have been investigated as potential predictors of response in NMSCs treated with ICIs. Although this field of research is very promising, definitive, cost-effective, and reproducible biomarkers are still lacking and further efforts are needed to validate the suggested predictors in larger cohorts.
Impact of Smoking Status in Combination Treatment with EGFR Tyrosine Kinase Inhibitors and Anti-Angiogenic Agents in Advanced Non-Small Cell Lung Cancer Harboring Susceptible EGFR Mutations: Systematic Review and Meta-Analysis
Authors: Lee Tai-Huang , Chen Hsiao-Ling , Chang Hsiu-Mei , Wu Chiou-Mei , Wu Kuan-Li , Kuo Chia-Yu , Wei Po-Ju , Chen Chin-Ling , Liu Hui-Lin , Hung Jen-Yu , Yang Chih-Jen , Chong Inn-Wen
Published: June 2022

Patients with advanced non-small cell lung cancer (NSCLC) who harbor susceptible epidermal growth factor receptor (EGFR) mutations and are treated with EGFR tyrosine kinase inhibitors (TKIs) show longer progression-free survival (PFS) than those treated with chemotherapy. However, developed EGFR-TKI resistance limits PFS improvements. Currently, combination treatment with EGFR-TKIs and anti-angiogenic agents is considered a beneficial regimen for advanced-stage NSCLC harboring susceptible EGFR mutations. However, several trials reported osimertinib plus bevacizumab failed to show superior efficacy over osimertinib alone. However, subgroup analysis showed significantly longer PFS among patients with a history of smoking over those who never smoked. We performed a comprehensive systematic review and meta-analysis to evaluate the smoking status impact. At the end of the process, a total of 2068 patients from 11 randomized controlled trials (RCTs) were included in our meta-analysis. Overall, combination EGFR-TKI plus anti-angiogenic agent treatment showed significantly better PFS among patients with a smoking history (Hazard Ratio (HR) = 0.59, 95% confidence interval (CI) = 0.48–0.73). Erlotinib-based combination therapy showed positive PFS benefits regardless of smoking status (HR = 0.54, 95%CI = 0.41–0.71 for ever smoker, HR = 0.69, 95%CI = 0.54–0.87 for never smoker). Combination therapy prolonged PFS significantly regardless of ethnicity (HR: 0.64, 95% CI: 0.44–0.93 for Asian RCTs, HR: 0.55, 95% CI: 0.41–0.74 for global and non-Asian RCTs). PROSPERO registration number is CRD42022304198).
Use of Dupilumab in Bullous Pemphigoid: Where Are We Now?
Authors: Russo Roberto , Capurro Niccolò , Cozzani Emanuele , Parodi Aurora
Published: June 2022

Bullous pemphigoid (BP) is the most frequent autoimmune subepidermal bullous disease. At present, the main treatment options are represented by corticosteroids and immunosuppressant drugs. Steroids often need to be administered in high doses, with subsequent adverse events and safety issues, as BP mainly affects elderly people. As dupilumab, a recombinant fully human IgG4 monoclonal antibody with binding specificity to human interleukin-4 receptor IL-4Rα has become paramount in the treatment of atopic dermatitis, its use in autoimmune bullous diseases has been theorized and it has been used to treat patients with BP. Dupilumab seems to be an effective and safe option to treat recalcitrant BP. Here, we report the results of a literature review on the use of dupilumab in BP, including a total of 30 treated patients in 9 papers.
Trained Immunity as a Trigger for Atherosclerotic Cardiovascular Disease—A Literature Review
Authors: Zieleniewska Natalia Anna , Kazberuk Małgorzata , Chlabicz Małgorzata , Eljaszewicz Andrzej , Kamiński Karol
Published: June 2022

Atherosclerosis remains the leading cause of cardiovascular diseases and represents a primary public health challenge. This chronic state may lead to a number of life-threatening conditions, such as myocardial infarction and stroke. Lipid metabolism alterations and inflammation remain at the forefront of the pathogenesis of atherosclerotic cardiovascular disease, but the overall mechanism is not yet fully understood. Recently, significant effects of trained immunity on atherosclerotic plaque formation and development have been reported. An increased reaction to restimulation with the same stimulator is a hallmark of the trained innate immune response. The impact of trained immunity is a prominent factor in both acute and chronic coronary syndrome, which we outline in this review.
Risk of Depression during Menopause in Women from Poland, Belarus, Belgium, and Greece
Authors: Krajewska-Ferishah Katarzyna , Kułak-Bejda Agnieszka , Szyszko-Perłowska Agnieszka , Shpakou Andrei , Van Damme-Ostapowicz Katarzyna , Chatzopulu Antigoni
Published: June 2022

Introduction: Menopause is a physiological period in a woman’s life, but it is often accompanied by symptoms that affect mental well-being and general health, including a tendency for depression. Aim of the study: To evaluate the predisposition to the symptoms of depression in women from Poland, Belarus, Belgium, and Greece. Material and methods: the method of diagnostic survey was used, and the research tools were: The Menopause Rating Scale, the Kupperman Index, Beck Depression Inventory, and a self-made survey questionnaire. Results: Hormone replacement therapy (HRT) was used by 15.8% of Polish, 19% of Belgian, 14.3% of Belarusian, and 15.2% of Greek women patients. The mean value of the Kupperman Index (range 0–63) in Poland was 14.8 ± 8.6, in Belgium—15.5 ± 6.6, Belarus—14.0 ± 9.4, and Greece—10.8 ± 6.5, while the total measure of Menopause Rating Scale (MRS) (range 0–44) was 12.2 ± 7.6 in Poland, 13.8 ± 6.5 in Belgium, 10.8 ± 8.0 in Belarus and 12.9 ± 7.4 in Greece. The severity of mental distress followed a similar pattern across all countries (slightly stronger than mild). The results for somatic complaints were similar, whereas the level of sexual issues varied, with the highest in Belgium and the lowest in Belarus. The mildest symptoms of menopause were experienced by Belarusian women and the most severe by Belgian women. The severity of depression, according to the Beck Depression Inventory (range 0–63), was as follows: Poland 10.5 ± 7.9; Belgium—11.1 ± 5.7; Belarus—13.7 ± 5.7; Greece—11.8 ± 6.6. Conclusions: The differences between the development of perimenopausal-related symptoms across countries were statistically significant. The incidence and severity of depression showed statistically significant differences between the countries studied—the highest was in Belarus and the lowest in Poland. Depression levels were not differentiated by subjects’ age or the use of hormone therapy but by subjects’ education. In Poland and Belarus, increased menopausal pain measured by the Kupperman Index altered levels of depression; in Belgium, there were no such correlations, and in Greece, the correlation was statistically significant, but its strength was negligible. A clearer correlation of the effects of development in menopausal symptoms on the level of depression was shown when measured with the MRS scale—in Greece and Belgium, the correlation was relatively weak, but in Poland and Belarus, it was relatively high.
How to Optimize Cardioversion of Atrial Fibrillation
Authors: Airaksinen K. E. Juhani
Published: June 2022

Cardioversion (CV) is an essential component of rhythm control strategy in the treatment of atrial fibrillation (AF). Timing of CV is an important manageable factor in optimizing the safety and efficacy of CV. Based on observational studies, the success rate of CV seems to be best (≈95%) at 12–48 h after the onset of arrhythmic symptoms compared with a lower success rate of ≈85% in later elective CV. Early AF recurrences are also less common after acute CV compared with later elective CV. CV causes a temporary increase in the risk of thromboembolic complications. Effective anticoagulation reduces this risk, especially during the first 2 weeks after successful CV. However, even during therapeutic anticoagulation, each elective CV increases the risk of stroke 4-fold (0.4% vs. 0.1%) during the first month after the procedure, compared with acute (<48 h) CV or avoiding CV. Spontaneous CVs are common during the early hours of AF. The short wait-and-see approach, up to 24–48 h, is a reasonable option for otherwise healthy but mildly symptomatic patients who are using therapeutic anticoagulation, since they are most likely to have spontaneous rhythm conversion and have no need for active CV. The probability of early treatment failure and antiarrhythmic treatment options should be evaluated before proceeding to CV to avoid the risks of futile CVs.
Forgetting the Unforgettable: Transient Global Amnesia Part I: Pathophysiology and Etiology
Authors: Sparaco Marco , Pascarella Rosario , Muccio Carmine Franco , Zedde Marialuisa
Published: June 2022

Transient global amnesia (TGA) is a clinical syndrome characterized by the sudden onset of a temporary memory disorder with a profound anterograde amnesia and a variable impairment of the past memory. Since the first description, dating back over 60 years, several cases have beenreported in the literature. Nevertheless, TGA remains one of the most mysterious diseases in clinical neurology. The debate regarding the etiology of this disease has focused mainly on three different mechanisms: vascular (due to venous flow changes or focal arterial ischemia), epileptic, and migraine related. However, to date there is no scientific proof of any of these mechanisms. Furthermore, the demonstration by diffusion-weighted MRI of lesions in the CA1 field of the hippocampus cornu ammonis led us to hypothesize that the selective vulnerability of CA1 neurons to metabolic stress could play a role in the pathophysiology of TGA. In this review, we summarize current knowledge on the anatomy, vascularization and function of the hippocampus. Furthermore, we discuss the emerging theories on the etiology and the pathophysiological cascade leading to an impairment of hippocampal function during the attacks.
A Practical Procedure for Predicting the Remaining Fatigue Life at an Arbitrary Stress Ratio
Authors: Kim Ho Sung
Published: June 2022

A practical procedure for predicting the remaining fatigue life at an arbitrary stress ratio is developed and verified. The procedure was based on the validated damage function, in conjunction with the Kim and Zhang S-N curve model. The damage function was used for finding various iso-damage points dependent on three independent variables (i.e., stress level, number of fatigue cycles, and stress ratio). The verification was conducted using Alclad 24S-T aluminium alloy, available in the literature for fatigue loading varied under three different loading schemes. The first scheme was for two different stress ratios, the second was for three different stress ratios, and the last was for a single stress ratio as a special case. The prediction accuracies were found to be in an error range of −0.1 to 5.6%, −0.5 to −0.6, and 1.5 to 1.7% for the 1st, 2nd, and 3rd schemes, respectively.
Beach-Dune System Morphodynamics
Authors: D’Alessandro Felice , Tomasicchio Giuseppe Roberto , Frega Ferdinando
Published: June 2022

Coastal dunes are known for their functions in ecological systems in addition to their aesthetic qualities, providing a highly valuable and unique habitat of due to their biodiversity of flora and fauna [...]
An Improved Ship Trajectory Prediction Based on AIS Data Using MHA-BiGRU
Authors: Bao Kexin , Bi Jinqiang , Gao Miao , Sun Yue , Zhang Xuefeng , Zhang Wenjia
Published: June 2022

According to the statistics of water transportation accidents, collision accidents are on the rise as the shipping industry has expanded by leaps and bounds, and the water transportation environment has become more complex, which can result in grave consequences, such as casualties, environmental destruction, and even massive financial losses. In view of this situation, high-precision and real-time ship trajectory prediction based on AIS data can serve as a crucial foundation for vessel traffic services and ship navigation to prevent collision accidents. Thus, this paper proposes a high-precision ship track prediction model based on a combination of a multi-head attention mechanism and bidirectional gate recurrent unit (MHA-BiGRU) to fully exploit the valuable information contained in massive AIS data and address the insufficiencies in existing trajectory prediction methods. The primary advantages of this model are that it allows for the retention of long-term ship track sequence information, filters and modifies ship track historical data for enhanced time series prediction, and models the potential association between historical and future ship trajectory status information with the current state via the bidirectional gate recurrent unit. Significantly, the introduction of a multi-head attention mechanism calculates the correlation between the characteristics of AIS data, actively learns cross-time synchronization between the hidden layers of ship track sequences, and assigns different weights to the result based on the input criterion, thereby enhancing the accuracy of forecasts. The comparative experimental results also verify that MHA-BiGRU outperforms the other ship track prediction models, demonstrating that it possesses the characteristics of ease of implementation, high precision, and high reliability.
Secure Automatic Identification System (SecAIS): Proof-of-Concept Implementation
Authors: Goudosis Athanasios , Katsikas Sokratis
Published: June 2022

The automatic identification system (AIS), despite its importance in worldwide navigation at sea, does not provide any defence mechanisms against deliberate misuse, e.g., by sea pirates, terrorists, business adversaries, or smugglers. Previous work has proposed an international maritime identity-based cryptographic infrastructure (mIBC) as the foundation upon which the offer of advanced security capabilities for the conventional AIS can be built. The proposed secure AIS (SecAIS) does not require any modifications to the existing AIS infrastructure, which can still be used for normal operations. Security-enhanced AIS messages enjoying source authentication, encryption, and legitimate pseudo-anonymization can be handled on an as-needed basis. This paper reports on a proof-of-concept implementation of the SecAIS. Specifically, we report on the implementation of the SecAIS over an mIBC founded on the RFC6507 (ECCSI) and the RFC6508 (SAKKE) standards, and we discuss the results of performance tests with this implementation. The tests indicate that the SecAIS is a feasible solution that does not affect the conventional AIS infrastructure and has an affordable operational cost.
Experimental Study on Unsteady Cavitating Flow and Its Instability in Liquid Rocket Engine Inducer
Authors: Wang Hao , Feng Jian , Liu Keyang , Shen Xi , Xu Bin , Zhang Desheng , Zhang Weibin
Published: June 2022

To study instability in the unsteady cavitating flow in a liquid rocket engine inducer, visualization experiments of non-cavitating and cavitating flows inside a model inducer were carried out at different flow conditions. Visual experiments were carried out to capture the evolution of non-cavitating and cavitating flows in a three-bladed inducer by using a high-speed camera. The external characteristic performance, cavitation performance, and pressure pulsation were analyzed based on the observation of non-cavitation and cavitation development and their instabilities. Under non-cavitation conditions, the change of flow rate has a significant impact on the pressure pulsation characteristics in the inducer. The occurrence of cavitation aggravated the instability of the flow and caused the intensity of pressure pulsation at each measuring point to increase. This cavitation structure has strong instability, and the tail region is often accompanied by shedding cavitation clouds perpendicular to the blade surface.
Dynamic Genome-Wide Transcription Profiling and Direct Target Genes of CmWC-1 Reveal Hierarchical Light Signal Transduction in Cordyceps militaris
Authors: Zhang Jiaojiao , Wang Fen , Liu Mengqian , Fu Mingjia , Dong Caihong
Published: June 2022

Light is necessary for primordium differentiation and fruiting body development for most edible fungi; however, light perception and signal transduction have only been well studied in model fungi. In this study, a hierarchical network of transcriptional response to light in Cordyceps militaris, one of the edible fungi, has been described on a genome-wide scale using dynamic transcriptome analysis. It was shown that light regulated the transcript of 1722 genes, making up 18% of the whole genome of C. militaris. Analysis of light-responsive genes in C. militaris identified 4 categories: immediate-early, early, late, and continuous light-responsive genes, and the gene number increased distinctly with prolonged light exposure. Light-responsive genes with distinct functional categories showed specific time-dependent regulation. The target genes of CmWC-1, the most important photoreceptor, were revealed by ChIP-seq. A total of 270 significant peaks corresponding to 427 genes were identified to be directly regulated by CmWC-1, among which 143 genes respond to light. Based on 270 ChIP-seq peaks, the binding site for CmWC-1 was identified as AAATCAGACCAC/GTGGTCTGATTT, differing from the binding site by the homolog in Neurospora crassa. Elucidating the mechanisms of light perception and signal transduction will be helpful for further research on the fruiting body development in edible fungi.
Antibiotic-Induced Treatments Reveal Stress-Responsive Gene Expression in the Endangered Lichen Lobaria pulmonaria
Authors: Chavarria-Pizarro Tania , Resl Philipp , Kuhl-Nagel Theresa , Janjic Aleksandar , Fernandez Mendoza Fernando , Werth Silke
Published: June 2022

Antibiotics are primarily found in the environment due to human activity, which has been reported to influence the structure of biotic communities and the ecological functions of soil and water ecosystems. Nonetheless, their effects in other terrestrial ecosystems have not been well studied. As a result of oxidative stress in organisms exposed to high levels of antibiotics, genotoxicity can lead to DNA damage and, potentially, cell death. In addition, in symbiotic organisms, removal of the associated microbiome by antibiotic treatment has been observed to have a big impact on the host, e.g., corals. The lung lichen Lobaria pulmonaria has more than 800 associated bacterial species, a microbiome which has been hypothesized to increase the lichen’s fitness. We artificially exposed samples of L. pulmonaria to antibiotics and a stepwise temperature increase to determine the relative effects of antibiotic treatments vs. temperature on the mycobiont and photobiont gene expression and the viability and on the community structure of the lichen-associated bacteria. We found that the mycobiont and photobiont highly reacted to different antibiotics, independently of temperature exposure. We did not find major differences in bacterial community composition or alpha diversity between antibiotic treatments and controls. For these reasons, the upregulation of stress-related genes in antibiotic-treated samples could be caused by genotoxicity in L. pulmonaria and its photobiont caused by exposure to antibiotics, and the observed stress responses are reactions of the symbiotic partners to reduce damage to their cells. Our study is of great interest for the community of researchers studying symbiotic organisms as it represents one of the first steps to understanding gene expression in an endangered lichen in response to exposure to toxic environments, along with dynamics in its associated bacterial communities.
Nation-Wide Analysis of Glaucoma Medication Prescription in Fiscal Year of 2019 in Japan
Authors: Tanito Masaki
Published: June 2022

To report the updated prescription trend of antiglaucoma medications, the dose-based prescription of a glaucoma medication in Japan in the fiscal year 2019 was aggregated by using the National Database of Health Insurance Claims and Specific Health Checkups of Japan (NDB) Open data. Of the 100 most frequently prescribed topical medications for outpatients from out-hospital pharmacies, 32 glaucoma medications were identified. This year, 150.8 million ml of glaucoma medications prescribed accounted for 12.3% of the total prescription dose (1.3 billion ml). The dose was the largest with prostaglandin FP2α agonist (PGF2α), followed by the fixed-dose combination (FDC) of β-blocker and carbonic anhydrase inhibitor (β + CAI) and α2-agonist. Prescription doses peaked at 75–79 years old for all medication classes, except for prostaglandin EP2 agonist of that peaked 10 years younger age class than other medications. The prescription dose was larger in women (55.3%) than men (44.7%), single medication formulation (71.2%) than FDC (28.8%), and brand-name (85.2%) than generic (14.8%). By multivariate analysis, prescription doses were affected by roles of the sex (p = 0.0066) and brand-name or generic (p = 0.032), but not by single medication formulation or FDC (p = 0.67); age was the most remarkable parameter for the difference in prescription dose (p < 0.0001). Dose-based anti-glaucoma medication prescription was analyzed using the government-provided most recent database on a national scale. The results provide the up-to-date real-world glaucoma medication prescriptions where the country has the highest aging rate in the world.
The Validity of Machine Learning Procedures in Orthodontics: What Is Still Missing?
Authors: Auconi Pietro , Gili Tommaso , Capuani Silvia , Saccucci Matteo , Caldarelli Guido , Polimeni Antonella , Di Carlo Gabriele
Published: June 2022

Artificial intelligence (AI) models and procedures hold remarkable predictive efficiency in the medical domain through their ability to discover hidden, non-obvious clinical patterns in data. However, due to the sparsity, noise, and time-dependency of medical data, AI procedures are raising unprecedented issues related to the mismatch between doctors’ mentalreasoning and the statistical answers provided by algorithms. Electronic systems can reproduce or even amplify noise hidden in the data, especially when the diagnosis of the subjects in the training data set is inaccurate or incomplete. In this paper we describe the conditions that need to be met for AI instruments to be truly useful in the orthodontic domain. We report some examples of computational procedures that are capable of extracting orthodontic knowledge through ever deeper patient representation. To have confidence in these procedures, orthodontic practitioners should recognize the benefits, shortcomings, and unintended consequences of AI models, as algorithms that learn from human decisions likewise learn mistakes and biases.
Immune Cell Networks Uncover Candidate Biomarkers of Melanoma Immunotherapy Response
Authors: Vo Duong H. T. , McGleave Gerard , Overton Ian M.
Published: June 2022

The therapeutic activation of antitumour immunity by immune checkpoint inhibitors (ICIs) is a significant advance in cancer medicine, not least due to the prospect of long-term remission. However, many patients are unresponsive to ICI therapy and may experience serious side effects; companion biomarkers are urgently needed to help inform ICI prescribing decisions. We present the IMMUNETS networks of gene coregulation in five key immune cell types and their application to interrogate control of nivolumab response in advanced melanoma cohorts. The results evidence a role for each of the IMMUNETS cell types in ICI response and in driving tumour clearance with independent cohorts from TCGA. As expected, ‘immune hot’ status, including T cell proliferation, correlates with response to first-line ICI therapy. Genes regulated in NK, dendritic, and B cells are the most prominent discriminators of nivolumab response in patients that had previously progressed on another ICI. Multivariate analysis controlling for tumour stage and age highlights CIITA and IKZF3 as candidate prognostic biomarkers. IMMUNETS provide a resource for network biology, enabling context-specific analysis of immune components in orthogonal datasets. Overall, our results illuminate the relationship between the tumour microenvironment and clinical trajectories, with potential implications for precision medicine.
PhenGenVar: A User-Friendly Genetic Variant Detection and Visualization Tool for Precision Medicine
Authors: Shin JaeMoon , Jeon Junbeom , Jung Dawoon , Kim Kiyong , Kim Yun Joong , Jeong Dong-Hoon , Yoon JeeHee
Published: June 2022

Precision medicine has been revolutionized by the advent of high-throughput next-generation sequencing (NGS) technology and development of various bioinformatic analysis tools for large-scale NGS big data. At the population level, biomedical studies have identified human diseases and phenotype-associated genetic variations using NGS technology, such as whole-genome sequencing, exome sequencing, and gene panel sequencing. Furthermore, patients’ genetic variations related to a specific phenotype can also be identified by analyzing their genomic information. These breakthroughs paved the way for the clinical diagnosis and precise treatment of patients’ diseases. Although many bioinformatics tools have been developed to analyze the genetic variations from the individual patient’s NGS data, it is still challenging to develop user-friendly programs for clinical physicians who do not have bioinformatics programing skills to diagnose a patient’s disease using the genomic data. In response to this demand, we developed a Phenotype to Genotype Variation program (PhenGenVar), which is a user-friendly interface for monitoring the variations in a gene of interest for molecular diagnosis. This allows for flexible filtering and browsing of variants of the disease and phenotype-associated genes. To test this program, we analyzed the whole-genome sequencing data of an anonymous person from the 1000 human genome project data. As a result, we were able to identify several genomic variations, including single-nucleotide polymorphism, insertions, and deletions in specific gene regions. Therefore, PhenGenVar can be used to diagnose a patient’s disease. PhenGenVar is freely accessible and is available at our website.
Anxiety Is a Mediator between Heart Rate Variability and Quality of Life in Chronic Obstructive Pulmonary Disease
Authors: Wu Da-Wei , Chang Li-Hsin , Yang Po-Chou , Kuo Tzu-Yu , Tsai Dong-Lin , Chen Huang-Chi , Yuan Hui-Lan , Chen Pei-Shih , Chen Szu-Chia , Lin I-Mei
Published: June 2022

Autonomic nervous system (ANS) dysregulation is an important pathophysiological mechanism in patients with chronic obstructive pulmonary disease (COPD). Heart rate variability (HRV) is a common index for ANS, and HRV has been used to explore the association between ANS and clinical illnesses. This study aimed to explore the group differences in HRV, depression, anxiety, and quality of life between participants with COPD and healthy controls (HC group), and whether emotion plays a mediating role between HRV and quality of life in participants with COPD. A total of ninety-six participants with COPD and 59 participants in the HC group completed the Beck Depression Inventory-II (BDI-II), Beck Anxiety Inventory (BAI), and Saint George’s Respiratory Questionnaire (SGRQ). Assessment of spirometry pulmonary function and five minute lead II electrocardiography (ECG) were also performed under the resting baseline. The COPD group had higher depression scores (F = 4.10, p = 0.008), and a lower quality of life (F = 14.44, p < 0.001) and HRV indices (such as standard deviation of RR intervals (F = 5.49, p < 0.05) and low frequency (F = 3.03, p < 0.05)) compared to the HC group. Sympathetic activation was positively correlated with depression (r = 0.312, p < 0.01), anxiety (r = 0.420, p < 0.001), and poor quality of life (r = 0.467, p < 0.001) in the COPD group. After controlling for age and sex, anxiety (β = 0.585, p < 0.001) and sympathetic activation (β = 0.231, p < 0.05) positively predicted poor quality of life, and lung function (β = −0.251, p < 0.01) negatively predicted poor quality of life. Therefore, anxiety is a mediator between sympathetic activation and quality of life. Emotional and HRV screening should be applied to COPD patients in clinical practice, and emotional management or HRV biofeedback training can be used to improve anxiety and HRV for future studies.