bluuebunny/crossref_metadata_2025 huggingface dataset:
Healthcare Resource Utilization, Economic Burden, and Multi-Level Medical Security System for Individuals with Spinal Muscular Atrophy in Shaanxi Province, China
Authors: Zhao Mingyue , Ding Shengjie , Zhao Yuhan , Lin Chenglong , Han Yubei
Published: February 2025

Objectives: The objective of this study is to quantify healthcare resource utilization, economic burden, and the multi-level medical security system for Spinal Muscular Atrophy (SMA) patients in Shaanxi Province, China, from a societal perspective using a survey. Methods: This observational study employed an online survey with a retrospective cross-sectional design in Shaanxi Province, China. The survey examined various aspects of SMA, including resource utilization, direct and indirect economic burdens, and co-payment mechanisms within a multi-level medical security system. Results: Following the inclusion of nusinersen in the National Reimbursement Drug List (NRDL) in 2022, the treatment rate for SMA patients increased significantly. After risdiplam was added to the NRDL in 2023, its use also saw a marked increase. Treatment costs varied by SMA type: Type 1 incurred the highest costs (RMB 300,000 or USD 41,000), followed by Type 2 (RMB 270,000 or USD 37,000), Type 3 (RMB 200,000 or USD 27,000), and Type 4 (RMB 80,000 or USD 11,000). The primary sources of costs were productivity losses due to primary caregivers (32.94%), nusinersen usage (29.29%), and risdiplam usage (17.33%). Out-of-pocket costs for SMA patients accounted for 29.29% of the total costs. In 2023, basic medical insurance covered 49% of direct costs and 32% of total costs. Patients still had to pay 25.73% of the total cost for the direct costs. Conclusions: Basic medical insurance is a critical foundation for patient security and plays a pivotal role in reimbursement. In contrast, commercial insurance has a relatively limited impact on covering the costs for SMA patients. These findings highlight the substantial healthcare burden faced by SMA patients under the current healthcare system in China.
Efficient Micropropagation by Ex Vitro Rooting of Myrtus communis L.
Authors: Pardi Raimondo , Basile Giuseppe Natale , De Mastro Giuseppe , Gargano Maria Letizia , Tagarelli Anna , Ruta Claudia
Published: February 2025

This survey aims to develop a successful protocol through in vitro multiplication and ex vitro rooting of a native shrub, i.e., Myrtus communis L., in order to obtain the rapid production of large number of healthy plants. The in vitro proliferation showed how the two different genotypes (MR and MB) produced higher values in terms of shoot lengths, mean multiplication index (MMI) and number of nodes when treated with 6-benzylaminopurine (BAP) compared to the thidiazuron (TDZ) + 1-naphthalene acetic acid (NAA) combination. Concerning in vitro rooting, the experiment resulted in a high rooting rate (75%) and an average number of roots (5.13) by quickly dipping the basal portions in an indole-3-butyric acid (IBA) concentration of 3300 mg L−1, followed by transfer to a hormone-free growth medium (BM). In comparison, the other two concentrations tested (0.3 and 0.6 mg L−1) resulted in higher root length values. During the acclimatization phase, the study showed how the different treatments affected the development of the test shoots differently. In particular, shoots of both genotypes pre-treated by quickly dipping them in Clonex® to induce ex vitro rooting showed abundant root production only 10 days after the treatment compared to the in vitro rooting, in which roots were formed after 30 days. This suggests that ex vitro pre-treatment with Clonex® not only accelerates the rooting process compared to in vitro treatment, resulting in lower costs and easier processing, but also significantly increases root density, contributing to improved transplant success and plantlets quality. These results support the thesis that ex vitro rooting optimises plant propagation protocols, offering economic and practical advantages for nurseries and other propagation systems.
Social Return on Investment (SROI) Evaluation of Citizens Advice on Prescription: A Whole-Systems Approach to Mitigating Poverty and Improving Wellbeing
Authors: Granger Rachel , Hartfiel Ned , Ezeofor Victory , Abba Katharine , Corcoran Rhiannon , Anderson de Cuevas Rachel , Barr Benjamin , Gebremedhin Gebremariam Aregawi , Piroddi Roberta , Mahoney Clare , Gabbay Mark , Edwards Rhiannon Tudor
Published: February 2025

Citizens Advice on Prescription (CAP), a Liverpool (UK)-based service, provides welfare advice and link worker social prescription support to people experiencing and at risk of experiencing financial or social hardship. CAP, which receives referrals from healthcare and third-sector services, aims to improve service users’ financial security, health, and wellbeing. A mixed-methods social return on-investment (SROI) analysis was used to evaluate this service. Between May 2022 and November 2023, a subset of service users (n = 538) completed the Short Warwick–Edinburgh Mental Wellbeing Survey (SWEMWBS) at baseline and a 2-month follow-up. Supporting quantitative and qualitative economic data were also collected (February 2023–February 2024) through semi-structured interviews (n = 16). Changes in social value were determined by comparing pre- and post-SWEMWBS scores. These scores were then mapped to monetary values using the Mental Health Social Value Bank (MHSVB). SROI ratios were then calculated by dividing the change in social value by the associated service provision costs. The mean social value change per person ranged from GBP 505.70 to GBP 697.52, and the mean service provision cost was GBP 148.66 per person. The overall study reported a positive SROI return range of GBP 1: GBP 3.40–GBP 4.69. The results indicate that non-clinical support services, like CAP, may be an effective intervention for addressing the wider determinants of health and wellbeing.
Exploring the Roles of the Plant AT-Rich Sequence and Zinc-Binding (PLATZ) Gene Family in Tomato (Solanum lycopersicum L.) Under Abiotic Stresses
Authors: Fan Bei , Ren Min , Chen Guoliang , Zhou Xue , Cheng Guoting , Yang Jinyu , Sun Huiru
Published: February 2025

PLATZ transcription factors represent a novel class of zinc finger proteins unique to plants and play critical roles in plant growth and stress responses. This study performs a bioinformatic analysis on the PLATZ transcription factor family in tomato. In the tomato genome, 20 PLATZ transcription factors were identified, distributed across nine chromosomes, including two tandem duplication clusters and two segmental duplication events. Phylogenetic analysis classified tomato PLATZ family members into five subgroups, with consistent gene structures and motif distributions within the same subfamily. The stress-responsive and hormone signaling elements were widely distributed in the promoters of SlPLATZs. The qRT-PCR results showed that most tested SlPLATZs were highly expressed in flowers and significantly expressed under different abiotic stresses (PEG, low temperature, and salt treatments) and hormone treatments (ABA and SA). In addition, we determined that SlPLATZ13/17/18/19 showed transcriptional inhibitory activities via yeast and dual-luciferase reporter assays. The interactions between SlPLATZ17, SlDREB2, and SlDREB31 were preliminarily confirmed via yeast two-hybrid assays. Overall, this study provides a valuable theoretical foundation for functional function research on PLATZ transcription factors, particularly in response to abiotic stresses.
Differential Expression of Small Non-Coding RNAs in Uterine Leiomyomas
Authors: Chuang Tsai-Der , Ton Nhu , Rysling Shawn , Baghdasarian Daniel , Khorram Omid
Published: February 2025

We performed next-generation sequencing (NGS) on RNA from 19 paired leiomyoma (Lyo) and myometrium (Myo) specimens, stratified by race/ethnicity (White: n = 7; Black: n = 12) and mediator complex subunit 12 (MED12) mutation status (mutated: n = 10; non-mutated: n = 9). Analysis identified 2,189 small non-coding RNAs (sncRNAs) with altered expression in Lyo compared to paired Myo (≥1.5-fold change), including small nuclear RNAs (snRNAs), small nucleolar RNAs (snoRNAs), microRNAs (miRNAs), and PIWI-interacting RNAs (piRNAs). Among these, 17 sncRNAs showed differential expression in the MED12-mutated group versus Myo, while minimal changes were observed in the non-mutated group. Additionally, 31 sncRNAs displayed differential expression in Black women compared to White women. For validation, five novel miRNAs (miR-19a-3p, miR-99a-5p, miR-3196, miR-499a-5p, and miR-30d-3p) and five piRNAs (piR-009295, piR-020326, piR-020365, piR-006426, and piR-020485) were analyzed in 51 paired Lyo samples using qRT-PCR. Reduced expression of the selected sncRNAs was confirmed in Lyo versus Myo, with miR-19a-3p, miR-3196, miR-30d-3p, piR-006426, and piR-020485 linked to MED12 status, while miR-499a-5p and miR-30d-3p were associated with race/ethnicity. These findings suggest that sncRNA dysregulation contributes to altered gene expression in Lyo, influenced by MED12 mutation and racial background.
Association of Plasma Lipid Patterns and LDL Cholesterol Levels with Breslow Thickness and Ulceration in Melanoma Patients
Authors: Szász István , Koroknai Viktória , Várvölgyi Tünde , Pál László , Szűcs Sándor , Pikó Péter , Emri Gabriella , Janka Eszter , Szabó Imre Lőrinc , Ádány Róza , Balázs Margit
Published: February 2025

Recent evidence has highlighted the critical role of lipids in tumor biology. In this study, we analyzed the plasma lipid profiles of 151 melanoma patients (University of Debrecen, Department of Dermatology, Hungary) to examine the associations between specific lipid species and commonly used LDL-C lipid parameters, as well as the Breslow thickness and ulceration of primary tumors. Our analysis included patients who underwent primary tumor resection, comprising 83 individuals without metastases and 68 with metastases at the time of blood sampling. Lipid profiling was performed using the Lipidyzer™ platform, which targets over 1100 lipid species. Following quality control filtering, 802 lipids were included in the subsequent analyses. Ten lipids were found to have decreased plasma levels, while one lipid exhibited elevated plasma levels, both associated with an increased risk of higher Breslow thickness. Additionally, patients with thicker tumors (≥2 mm) demonstrated significantly higher LDL-C levels after adjusting for age, sex, therapy, and tumor presence (p = 0.032). Using forward stepwise regression, we identified a combination of four lipids—(CE(20:5), LCER(24:1), PE(P18:1/18:1), and LPE(18:2))—that demonstrated the strongest correlation with Breslow depth (AUC = 0.779, as determined by ROC analysis). Additionally, we identified 11 lipids significantly associated with tumor ulceration. Stepwise regression analysis further revealed two lipids (FFA(16:0) and PC(15:0/18:1)) capable of predicting tumor ulceration with an AUC score of 0.740. These findings suggest that individual lipid metabolism may influence tumor thickness and ulceration during the development and progression of primary melanoma.
Bicyclic N,S-Acetals Containing Fused Cysteine-Amide System as New Heterocyclic Class Targeting Human Farnesyltransferase (FTase-h)
Authors: Danton Fanny , Othman Mohamed , Lawson Ata Martin , Farce Amaury , Lipka Emmanuelle , Ghinet Alina , Moncol Ján , Semlali Abdelhabib , Daïch Adam
Published: February 2025

We report in this contribution the synthesis and in vitro biological evaluation of a novel class of chiral thiazoloisoindolinone scaffolds as potent inhibitors against human farnesyltransferase (FTase-h). The targeted products, sulfides (4), sulfoxides (5,6), and sulfones (7), containing up to three points of diversification, were obtained in a short-step sequence starting from the available and cost-effective L-cysteine hydrochloride (1), which is the source of N and S atoms and the chiral pool, and α-carbonyl benzoic acids (2), which are isoindolinone precursors. Concisely, the key ester intermediates (1) provide (a) sulfide-amides (4) by solvent-free amidation, (b) sulfoxides (5,6) by selective S-oxidation using NaIO4, and (c) sulfones (7) by oxidation using MMPP. Finally, the obtained N,S-acetal systems have shown promising inhibitory activities on FTase-h in the nanomolar range with excellent half maximal inhibitory concentration (IC50) values up to 4.0 nanomolar (for example, 25.1 nM for sulfide 4bI, 67.3 nM for sulfone 7bG, and more interesting of 4.03 nM for sulfoxide 5bG).
Framework for Addressing Imbalanced Data in Aviation with Federated Learning
Authors: Kabashkin Igor
Published: February 2025

The aviation industry generates vast amounts of data across multiple stakeholders, but critical faults and anomalies occur rarely, creating inherently imbalanced datasets that complicate machine learning applications. Traditional centralized approaches are further constrained by privacy concerns and regulatory requirements that limit data sharing among stakeholders. This paper presents a novel framework for addressing imbalanced data challenges in aviation through federated learning, focusing on fault detection, predictive maintenance, and safety management. The proposed framework combines specialized techniques for handling imbalanced data with privacy-preserving federated learning to enable effective collaboration while maintaining data security. The framework incorporates local resampling methods, cost-sensitive learning, and weighted aggregation mechanisms to improve minority class detection performance. The framework is validated through extensive experiments involving multiple aviation stakeholders, demonstrating a 23% improvement in fault detection accuracy and a 17% reduction in remaining useful life prediction error compared to conventional models. Results show the enhanced detection of rare but critical faults, improved maintenance scheduling accuracy, and effective risk assessment across distributed aviation datasets. The proposed framework provides a scalable and practical solution for using distributed aviation data while addressing both class imbalance and privacy concerns, contributing to improved safety and operational efficiency in the aviation industry.
An Adaptive Fatigue Detection Model for Virtual Reality-Based Physical Therapy
Authors: Martinez-Cid Sergio , Essalhi Mohamed , Herrera Vanesa , Albusac Javier , Schez-Sobrino Santiago , Vallejo David
Published: February 2025

This paper introduces a fatigue detection model specifically designed for immersive virtual reality (VR) environments, aimed at facilitating upper limb rehabilitation for individuals with spinal cord injuries (SCIs). The model’s primary application centers on the Box-and-Block Test, providing healthcare professionals with a reliable tool to monitor patient progress and adapt rehabilitation routines. At its core, the model employs data fusion techniques via ordered weighted averaging (OWA) operators to aggregate multiple metrics captured by the VR rehabilitation system. Additionally, fuzzy logic is employed to personalize fatigue assessments. Therapists are provided with a detailed classification of fatigue levels alongside a video-based visual representation that highlights critical moments of fatigue during the exercises. The experimental methodology involved testing the fatigue detection model with both healthy participants and patients, using immersive VR-based rehabilitation scenarios and validating its accuracy through self-reported fatigue levels and therapist observations. Furthermore, the model’s scalable design promotes its integration into remote rehabilitation systems, highlighting its adaptability to diverse clinical scenarios and its potential to enhance accessibility to rehabilitation services.
Detection of Victimization Patterns and Risk of Gender Violence Through Machine Learning Algorithms
Authors: Bernal-Monroy Edna Rocio , Castañeda-Monroy Erika Dajanna , Rentería-Ramos Rafael Ricardo , Campaña-Bastidas Sixto Enrique , Barrera Jessica , Palacios-Yampuezan Tania Maribel , González Gustin Olga Lucía , Tobar-Torres Carlos Fernando , Ceballos-Villada Zeneida Rocio
Published: February 2025

This paper explores the application of machine learning techniques and statistical analysis to identify the patterns of victimization and the risk of gender-based violence in San Andrés de Tumaco, Nariño, Colombia. Models were developed to classify women according to their vulnerability and risk of suffering various forms of violence, which were integrated into a decision-making tool for local authorities. The algorithms employed include K-means for clustering, artificial neural networks, random forests, decision trees, and multiclass classification algorithms combined with fuzzy classification techniques to handle the incomplete data. Implemented in Python and R, the models were statistically validated to ensure their reliability. Analysis based on health data revealed the key victimization patterns and risks associated with gender-based violence in the region. This study presents a data science model that uses a social determinant approach to assess the characteristics and patterns of violence against women in the Pacific region of Nariño. This research was conducted within the framework of the Orquídeas Program of the Colombian Ministry of Science, Technology, and Innovation.
The Role of Methyl Substitution in Spin Crossover of Fe(III) Complexes with Pentadentate Schiff Base Ligands
Authors: Nemec Ivan , Herchel Radovan
Published: February 2025

A series of mononuclear complexes, [Fe(L5)(bylim)](BPh4), where L5 represents a pentadentate Schiff base ligand, bylim is 1-benzyl-1-imidazole, and BPh4− is the tetraphenylborate anion, was synthesized. The determined crystal structures indicate the absence of significant cooperative interactions, which influence the properties of the eventual spin transition. Changes in magnetic behavior induced by substitution of the pentadentate ligand were investigated through magnetic susceptibility measurements. It was found that only complexes containing a non-substituted secondary amino group exhibit some form of spin crossover, whereas the majority of those with a methyl substituent remain in the high-spin state across the entire measured temperature range (2–300 K). The changes induced by the substitution of the secondary amine group were further explored through theoretical calculations at DFT and CASSCF/NEVPT2 levels of theory. The topology and energetics of electron density and atomic charges were investigated through QT-AIM calculations.
Untargeted Volatile Profiling Identifies Key Compounds Driving the Attraction of Western Flower Thrips to Alstroemeria Cultivars
Authors: Cubillos-Quijano Luis Gerardo , Díaz Marco , Coy-Barrera Ericsson , Rodríguez Daniel
Published: February 2025

Western flower thrips (WFTs) are significant pests affecting various crops globally. Developing sustainable strategies for managing WFTs is essential for improving thrips management. Ethological control methods, particularly those employing volatile organic compounds (VOCs) emitted by plants to influence insect behavior, have emerged as a promising avenue for pest management. Natural hosts such as Alstroemeria provide an intriguing yet underexplored opportunity for developing attractants tailored to WFT management. This study examined the behavioral preferences of WFTs towards flowers of four commercial Alstroemeria cultivars, focusing on variations in VOC profiles. Using headspace solid-phase microextraction (HS-SPME), VOCs were captured in vivo from cultivars with contrasting levels of WFT infestation. Gas chromatography coupled with mass spectrometry (GC-MS) was employed to analyze the VOCs, with linear retention indices aiding compound identification. An untargeted volatile profiling-based comparative analysis revealed key VOCs that differed among cultivars, shedding light on their potential correlation with WFT behavior. Behavioral assays identified three specific VOCs—butyl butyrate, 1-methylnaphthalene, and citronellyl acetate—as influential in attracting WFTs. Attraction responses were concentration-dependent, with two tested concentrations eliciting significant behavioral effects. These findings highlight the potential of these active VOCs as components of novel attractants for WFT management. The results direct future research and the development of tools to integrate ethological strategies into sustainable pest management practices for crops.
The Cross-Talk Between the Heart and the Liver: The Involvement of the Mitral Valve as a Novel Actor upon the Ancient Scene of Liver Cirrhosis
Authors: Cozzolino Domenico , Nevola Riccardo , Ruggiero Alberto , Romano Ciro , Umano Giuseppina Rosaria , Aitella Ernesto , Sardu Celestino , Marrone Aldo , Gentile Sandro
Published: February 2025

Background: To date, little is known about correlations between liver dysfunction and circulatory and cardiac abnormalities (e.g.,: mitral valve, MV) in patients with chronic liver disease (CLD). This study aimed to assess a potential parallelism between liver dysfunction and cardiovascular involvement and identify the factors associated with structural and functional MV disorders. Methods. Among 995 patients with CLD, 346 were enrolled and compared with 168 controls without liver disease. According to the degree of liver disease, patients were classified as patients with chronic hepatitis (142) or with liver cirrhosis (Child-A: 70; Child-B: 65; Child-C: 69). Results: Among the chronic hepatitis group, resting heart rate (HR) and left ventricular (LV) mass were higher than in the control group (p = 0.0008), whereas systemic vascular resistance (SVR) was lower (p = 0.01). Among cirrhotic patients, resting HR, left atrium dimensions/volumes, LV walls thickness, LV mass, cardiac output (CO), isovolumetric relaxation time (IVRT), deceleration time (DT) and prevalence of aortic stenosis were higher than in non-cirrhotic patients (p = 0.02), whereas the e/a ratio and SVR were lower (p = 0.0001). Among Child-B/C, CO, IVRT, DT, prevalence of MV regurgitation and MV calcification score were higher than in the remaining patients (p = 0.02), whereas SVR was lower (p < 0.0001). Among cirrhotic patients with MV regurgitation, Child–Pugh score, liver disease duration, resting HR, left chambers dimensions/mass, CO, IVRT, DT and MV calcification score were higher compared to patients without regurgitation (p < 0.000), whereas mean blood pressure, e/a ratio and SVR were lower (p = 0.008). At multivariate analysis, Child–Pugh score, liver disease duration, left chambers volume/mass and MV calcification score were independently associated with MV regurgitation in cirrhotic patients. Child–Pugh score and MV calcification score strongly correlated in cirrhotic patients (r = 0.68, 95% CI 0.60–0.75, p < 0.0001). Conclusions: The magnitude of cardiac morpho/functional abnormalities is associated with the severity of liver dysfunction. Structural and functional MV abnormalities could represent a novel sign of cardiac involvement in liver cirrhosis. The severity and duration of liver disease, the enlargement of cardiac chambers and leaflet calcium accumulation could play a key role.
Genetic Background in Patients with Cancer Therapy-Induced Cardiomyopathy
Authors: Fazzini Luca , Campana Nicola , Cossu Stefano , Deidda Martino , Madaudo Cristina , Quagliariello Vincenzo , Maurea Nicola , Di Lisi Daniela , Novo Giuseppina , Zito Concetta , Cadeddu Dessalvi Christian
Published: February 2025

Emerging evidence indicates that specific genetic variants are associated with an increased risk of toxicity from anticancer treatments and cancer-related cardiovascular complications. These genetic factors influence drug metabolism, efficacy, and susceptibility to adverse effects. For cancer patients, the genetic background can have two major cardiovascular implications, namely therapy-related cardiotoxicity and cancer-related cardiovascular complications. Baseline risk stratification is essential to identify higher-risk individuals and ensure they receive appropriate preventive and therapeutic interventions and more frequent follow-up. Current guidelines recommend stratification based on cardiovascular risk factors, but these factors alone cannot accurately define individual risk. Genetic background has been shown to enhance risk stratification. Beyond rare genetic variants, recent genome-wide association studies have identified single nucleotide polymorphisms implicated in cancer therapy toxicity. Despite their current limitations, polygenic risk scores are expected to play a significant role in risk stratification. This review aims to summarize the current evidence on the role of the genetic background of patients with cancer treated with potentially cardiotoxic drugs who develop cardiotoxicity, aiming to provide insights to refine risk stratification further and tailor the management of these patients.
Non-Criteria Obstetric Antiphospholipid Syndrome: Myth or Reality?
Authors: Beça Sara , Borrell Maria , Cervera Ricard , Figueras Francesc , Nadal Alfons , Espinosa Gerard , Baños Núria
Published: February 2025

Women with adverse pregnancy outcomes suggestive of obstetric antiphospholipid syndrome (OAPS), but not fulfilling clinical and/or laboratory international classification criteria, are increasingly recognized both in clinical practice and in the literature. This entity is termed non-criteria OAPS (NC-OAPS). It includes clinical scenarios such as two unexplained pregnancy losses, three non-consecutive pregnancy losses, late pre-eclampsia/eclampsia/signs of placental insufficiency, or recurrent implantation failure, as well as positive low-titers of antiphospholipid antibodies (aPLs) and non-classical aPLs. To address the NC-OAPS heterogeneity, a nomenclature proposal was developed. In recent years, retrospective and prospective cohort studies have been designed to clarify the characteristics and outcomes of the different subsets of NC-OAPS. In general, the studies support that NC-OAPS may benefit from treatment with antithrombotic, anticoagulant and/or immunomodulator agents, but several considerations must be made on the robustness and nuances of the scientific evidence. The objective of this review is to critically analyze the available evidence supporting the diagnosis of NC-OAPS, categorize its subsets, and evaluate the impact of treatment strategies on its outcome. We also remark on questions that are still unanswered, such as the lack of consensus on diagnostic criteria or treatment protocols.
Relationship of Tumor Localization and Lipid Parameters with Survival in Patients with Colorectal Cancer
Authors: Sever Özlem Nuray , Başoğlu Tuğba , Yıldırım Sedat
Published: February 2025

Background: Colorectal cancer (CRC) remains a global health challenge. Metabolic disorders, including dyslipidemia, have been linked to CRC progression, yet the relationship between lipid profiles, tumor location, and survival outcomes remains controversial. This study investigates the association between blood lipid parameters, tumor localization, and survival in CRC patients. Methods: A retrospective analysis was conducted on 126 CRC patients diagnosed between 2017 and 2024 at Kartal Dr. Lütfi Kırdar City Hospital. Patients with comorbidities affecting lipid metabolism or who were on lipid-lowering drugs were excluded. Clinical, pathological, and lipid data, including total cholesterol (TC), triglycerides (TGs), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and carcinoembryonic antigen (CEA), were analyzed. Tumor location was categorized as right-sided or left-sided. Overall survival (OS) was evaluated with a statistical analysis using Kaplan–Meier and Cox regression models. Results: Higher HDL-C levels and a lower TC/HDL-C ratio were significantly associated with improved OS (p: 0.004 and p: 0.016, respectively). This relationship remained significant in early- and advanced-stage disease (p: 0.04 for HDL-C and p: 0.03 for TC/HDL-C). In patients with tumors located in the right colon, LDL-C levels of 150 mg/dL and below were found to be statistically positively correlated with overall survival, while in patients with tumors located in the left colon, HDL-C levels of 45 mg/dL and above and TC/HDL-C levels of 4.16 and above were found to be statistically positively correlated with overall survival. A multivariate analysis confirmed that age, stage, HDL-C, and TC/HDL-C were independent predictors of OS. Conclusions: Our study highlights the potential role of lipid profiles, particularly HDL-C and the TC/HDL-C ratio, as prognostic factors in CRC. Further research, including molecular and genetic analyses, is needed to better understand the mechanisms underlying the relationship between lipid metabolism and CRC progression.
Free Flap Reconstruction of Traumatic Skin Defects of the Entire Hand Dorsum
Authors: Jung Soyeon , Lee Seungjun , Eun Seokchan
Published: February 2025

Background/Objectives: The reconstruction of hand defects, especially involving the dorsal region of the hand, has remained a challenge for surgeons because of its anatomical features and complex functions. The goal of reconstruction should include functional restoration as well as being esthetically pleasing. The flap transfer reconstruction strategy is essential for satisfying these requirements. Methods: Free flaps were used to cover traumatic defects of the hand dorsum in eleven patients from 2016 to 2022. Eight males and three females with a mean age of 41 years were enrolled. The size of the flaps ranged from 6 × 5 cm to 20 × 9 cm, and the selected flaps included five anterolateral thigh flaps, three lateral arm flaps, and three superficial circumflex iliac artery flaps. Results: All flaps survived, with one case of partial necrosis. One patient experienced joint stiffness during recovery. The donor sites were closed primarily, and there was no need for skin grafting. Secondary debulking or thinning was also not required. The majority of cases recovered excellent function of the hand (mean Q_DASH: 2.5) with satisfactory esthetic outcomes. The postoperative observations were followed by more than six months. Conclusions: Small defects can be treated using local, pedicled, and island-type flaps. However, larger defects involving the exposure of tendons, nerves, and other critical structures commonly require free tissue transfers. The flap reconstruction for hand dorsum in the study is feasible to produce acceptable outcomes in large sized defects.
From Planning to Practice: Impact of Achieved Proximal Sealing Zone in Endovascular Aneurysm Repair (EVAR)
Authors: Accarino Giulio , Silverio Angelo , Bellino Michele , Furgiuele Sergio , Fimiani Mario , Sica Mattia , De Vuono Francesco , Fornino Giovanni , Turchino Davide , Accarino Giancarlo , Serra Raffaele , Galasso Gennaro , Vecchione Carmine , Bracale Umberto Marcello
Published: February 2025

Background: Endovascular aneurysm repair (EVAR) is the preferred treatment for abdominal aortic aneurysms (AAAs). This study evaluated the differences between the anticipated and actual achieved proximal sealing zones for standard EVAR endografts and their potential implications in a real-world AAA population. Methods: Data from 275 consecutive EVAR patients treated with the Endurant endograft (Medtronic, Minneapolis, MN, USA) between 2009 and 2022 were retrospectively analyzed. The proximal sealing zone was calculated preoperatively (target anticipated sealing zone, TASZ) and postoperatively (real achieved sealing zone, RASZ) from computed tomography angiography (CTA) images. These metrics were evaluated by assuming that they had a truncated cone shape, calculating the cone’s lateral surface by measuring the proximal and distal centerline areas and the distance between the planes. The primary outcome was the occurrence of type 1A endoleak at the longest available follow-up. Results: RASZ was significantly smaller and shorter than TASZ (p = 0.001), with an average area reduction of 24.5 mm2 and a median length reduction of 3 mm. Area and cranial length loss were present even when correcting for graft positioning imperfections. In the Cox proportional hazard regression model, TASZ and RASZ lengths were both independently associated with a lower risk of type 1A endoleak (HR: 0.88, 95% CI 0.80–0.96 and HR: 0.92, 95% CI 0.86–0.99, respectively). A Kaplan–Meier analysis confirmed that patients with RASZ > 5.5 mm had a survival free from endoleak higher than patients with RASZ ≤ 5.5 mm. Conclusions: In this real-world AAA population, the achieved proximal sealing zone was significantly shorter and smaller than planned, regardless of optimal endograft placement. The early calculation of RASZ, i.e., the PSZ achieved via CTA, is critical for risk stratification and follow-up.
Cardioprotective Effects of Dapagliflozin and Trimetazidine on Doxorubicin-Induced Cardiotoxicity in Streptozotocin-Induced Type 1 Diabetic Rats via Endoplasmic Reticulum Stress
Authors: Ogutveren Muhammed Mursel , Satiroglu Omer , Ozden Zulkar , Akyildiz Kerimali , Yilmaz Adnan , Mercantepe Filiz , Yilmaz Ahmet Seyda , Koc Haldun , Mercantepe Tolga
Published: February 2025

Background/Objectives: Diabetic cardiomyopathy is a distinct myocardial dysfunction characterized by structural and functional changes in the heart that occur in diabetic patients independently of coronary artery disease or hypertension. It is closely associated with oxidative stress, inflammation, mitochondrial dysfunction, and endoplasmic reticulum (ER) stress, and contributes to progressive cardiac damage. This study aimed to evaluate the cardioprotective effects of dapagliflozin (DAPA) and trimetazidine (TMZ) in a rat model of doxorubicin-induced cardiomyopathy with streptozotocin-induced diabetes, focusing on their potential mechanisms related to ER stress. Methods: A total of 48 Sprague Dawley rats aged 6–8 weeks were randomly distributed equally into six cages. The diabetes model was induced by intraperitoneal administration of streptozotocin (STZ) and rats with blood glucose levels above 250 mg/dL were considered diabetic. For those rats with diabetes, cardiotoxicity was induced by intraperitoneal injection of 5 mg/kg/week doxorubicin (DOXO) for 4 weeks. After a cumulative dose of 20 mg/kg doxorubicin, a week break was given, followed by the administration of TMZ (10 mg/kg) and/or DAPA (10 mg/kg) to the treatment groups. Results: STZ administration caused diabetes and significant degeneration in cardiomyocytes. With the addition of DOXO (STZ + DOXO), cardiomyocyte degeneration became more severe. When the study groups were histopathologically evaluated based on parameters of degenerative cardiomyocytes, vascular congestion, and edema, it was shown that both TMZ and DAPA, whether applied alone or in combination, reduced damage in heart tissue. Both TMZ and DAPA reduced cardiomyocyte damage, and their combination provided the lowest level of damage through the reduced ER stress pathway by reducing GRP 78 and CHOP positivity. Conclusions: TMZ and DAPA reduce ER stress and have protective effects against diabetic-induced cardiotoxicity. Combination therapy or TMZ was found to be more effective than DAPA in alleviating ER stress. Combination therapy appears to carry potential effects for reducing cardiac cell damage in individuals with diabetes.
Resolution of Pyoderma Gangrenosum During Adjuvant Breast Cancer Therapy
Authors: Lauder Abigail P. , Nwiloh Anita , Eximond Matthew , LeBlanc Robert E. , Dagrosa Alicia T. , Barth Richard , Chamberlin Mary , McVorran Shauna
Published: February 2025

Background/Objectives: Pyoderma gangrenosum (PG) is a rare neutrophilic dermatosis characterized by rapidly developing, painful ulcerative lesions. It exhibits pathergy, a phenomenon in which minor trauma or injury to the skin triggers an exaggerated inflammatory response. This leads to the development of new skin lesions or the worsening of existing ones. Treatment typically involves a combination of corticosteroids and immunosuppressive agents. However, even with effective therapy, the overall management of pyoderma gangrenosum remains challenging, and wound healing can be prolonged. The development of pyoderma gangrenosum after breast cancer surgery is rare, and its presence complicates the treatment of patients requiring additional oncologic therapy. In particular, the effect of radiation on these lesions is not well documented. Given the known skin toxicity of radiotherapy and its negative impact on wound healing, the use of adjuvant breast radiation raises significant concerns in this context. Methods: We present the case of a 66-year-old female with Stage IIB invasive ductal carcinoma of the left breast who developed postoperative pyoderma gangrenosum after breast-conserving surgery. The patient was treated with systemic corticosteroids and cyclosporine, and then subsequently underwent standard-of-care adjuvant chemotherapy and radiation. Results: During therapy, she demonstrated rapid resolution of her pyoderma gangrenosum without experiencing excess skin toxicity. Conclusions: While the literature on the direct application of radiation in pyoderma gangrenosum is limited, our case provides evidence supporting the safety of radiation therapy in oncologic cases complicated by this disease. In addition to receiving the benefit of adjuvant therapy for her breast cancer, our patient demonstrated an improvement in her postoperative PG with no adverse skin effects.
High-Risk Outcomes in In Vitro Fertilization Pregnancies for Women of a Very Advanced Maternal Age: Insights from a Multi-Hospital Study in Greece
Authors: Loukopoulos Themistoklis , Zikopoulos Athanasios , Kolibianakis Efstratios , Vatopoulou Anastasia , Gkrozou Fani , Sotiriou Sotirios , Zachariou Athanasios , Skentou Charikleia
Published: February 2025

Background: In vitro fertilization (IVF) has transformed infertility treatment, yet it is associated with increased risks of adverse perinatal outcomes, particularly in women of advanced maternal age. This study aimed to investigate the prevalence of complications such as preeclampsia (PE), gestational diabetes mellitus (GDM), preterm labor (PTL), low birth weight (LBW), and placental abnormalities (PA) among women over 50 undergoing assisted reproductive technology (ART) in Greece, where the eligibility age limit has been recently raised to 54 years. Methods: We conducted a retrospective analysis of pregnancy outcomes in women over 50 compared to those under 50, utilizing medical records mainly from University Hospital of Ioannina but also from other public hospitals and private clinics in Greece. Results: Our findings indicate that women over 50 face an increased risk of developing preeclampsia (PE) by 4.61 times, GDM by 1.69 times, PTL by 1.82 times, LBW by 1.67 times, and PA by 3.92 times. Conclusions: These results underscore the need for heightened awareness and the monitoring of pregnancy complications in this demographic, informing clinical strategies to improve maternal and neonatal outcomes.
Bisphenol A Release from Fiber-Reinforced vs. Conventional Stainless-Steel Fixed Retainers: An In Vitro Study
Authors: Tsoukala Efthimia , Maragou Niki , Antonelaki Andriani-Paraskevi , Thomaidis Nikolaos , Sifakakis Iosif
Published: February 2025

Objectives: The objectives of this study were to investigate in vitro BPA release from two common fiberglass fixed lingual canine-to-canine retainers and to compare these amounts with those released from a conventional multistranded stainless-steel orthodontic retainer. Methods: Fifty-four recently extracted teeth were divided into groups of six teeth each, formed in an arch shape. Three different retainer types were evaluated: Ribbond, EverStick Ortho and Wildcut wire. Three identical specimens were constructed for each retainer type. BPA release was determined with validated the liquid chromatography–tandem mass spectrometry method at 1 and 24 h, as well as at 7, 14 and 30 days. The method’s limits of detection and quantification were 0.32 ng/mL and 0.96 ng/mL, respectively. A two-way mixed, repeated-measures analysis of variance with Greenhouse–Geisser correction was employed to verify the existence of any significant differences. Results: Higher levels of BPA were released from the polyethylene fiber and glass fiber retainer in comparison with the conventional retainer in the present study. The differences between the systems over time were not statistically significant at the 95% confidence level. Conclusions: In vitro BPA release during the first month did not differ between the examined retainer types. The highest BPA concentrations were observed at 1 month.
The Features of Children with Juvenile Idiopathic Arthritis with Cervical Spine Involvement in the Data from a Retrospective Study Cohort
Authors: Sorokina Lubov S. , Artamonov Artem K. , Kaneva Maria A. , Gordeeva Natalia A. , Raupov Rinat K. , Mushkin Alexander Yu. , Ivanov Dmitri O. , Kostik Mikhail M.
Published: February 2025

Background/Objectives: Cervical spine arthritis (CSA) in children with juvenile idiopathic arthritis (JIA) can lead to clinically significant and irreversible functional impairment. Our study aimed to evaluate the features of the JIA disease course in children with CSA. Methods: In the retrospective cohort study, the data from medical charts of children with JIA (n = 753) who corresponded to the ILAR criteria and were treated from 2007 to 2016 were included. CSA was diagnosed by clinical manifestations (pain and limited range of motion) with radiological confirmation in the available cases. Results: CSA had 101 JIA patients (13.4%), predominantly with polyarticular (48%, OR = 1.8 (1.2; 2.7), p < 0.001) and systemic (18.9%, OR = 3.6 [2.0; 6.6], p < 0.001) JIA categories. CSA was associated with longer disease duration, higher inflammatory activity, a higher number of active joints, a lower probability of achieving remission (HR = 1.33 (95% CI: 1.01; 1.76, p = 0.04)), and a higher probability of being treated with biologics (HR = 1.78 (95% CI: 1.22; 2.59, p = 0.002)). Patients with temporomandibular arthritis (OR = 10.4 [5.4; 19.8], p < 0.001) and shoulder arthritis (OR = 14.1 [7.5; 26.3], p < 0.001) had the highest risk of having CSA. Conclusions: CSA was an independent predictor of treatment with biologics and failure to achieve remission. Identified predictors can help to find the group of patients with higher suspicion for whom the functional tests and MRI are required to not miss the CSA. A radiology assessment of CSA should be performed as far as possible in children, unless there are risks of general anesthesia for younger patients.
Vision-Based Collision Warning Systems with Deep Learning: A Systematic Review
Authors: Chitraranjan Charith , Vipulananthan Vipooshan , Sritharan Thuvarakan
Published: February 2025

Timely prediction of collisions enables advanced driver assistance systems to issue warnings and initiate emergency maneuvers as needed to avoid collisions. With recent developments in computer vision and deep learning, collision warning systems that use vision as the only sensory input have emerged. They are less expensive than those that use multiple sensors, but their effectiveness must be thoroughly assessed. We systematically searched academic literature for studies proposing ego-centric, vision-based collision warning systems that use deep learning techniques. Thirty-one studies among the search results satisfied our inclusion criteria. Risk of bias was assessed with PROBAST. We reviewed the selected studies and answer three primary questions: What are the (1) deep learning techniques used and how are they used? (2) datasets and experiments used to evaluate? (3) results achieved? We identified two main categories of methods: Those that use deep learning models to directly predict the probability of a future collision from input video, and those that use deep learning models at one or more stages of a pipeline to compute a threat metric before predicting collisions. More importantly, we show that the experimental evaluation of most systems is inadequate due to either not performing quantitative experiments or various biases present in the datasets used. Lack of suitable datasets is a major challenge to the evaluation of these systems and we suggest future work to address this issue.
Knowledge-Based Adaptive Design of Experiments (KADoE) for Grinding Process Optimization Using an Expert System in the Context of Industry 4.0
Authors: Fattahi Saman , Azarhoushang Bahman , Kitzig-Frank Heike
Published: February 2025

The integration of human–cyber–physical systems (HCPSs), IoT, digital twins, and big data analytics underpins Industry 4.0, transforming traditional manufacturing into smart manufacturing with capabilities for real-time monitoring, quality assessment, and anomaly detection. A key advancement is the transition from static to adaptive design of experiments (DoE), using real-time analytics for iterative refinement. This paper introduces an innovative adaptive DoE embedded in an expert system for grinding, combining data-driven and knowledge-based methodologies. The KSF Grinding Expert™ system recommends optimized grinding control variables, guided by a multi-objective optimization framework using Non-dominated Sorting Genetic Algorithm II (NSGA-II) and Gray Relational Analysis (GRA). The rule-based adaptive DoE iteratively refines recommendations through feedback and historical insights, reducing the number of trials by excluding suboptimal parameters. A case study validates the approach, demonstrating significant enhancements in process efficiency and precision. This knowledge-based adaptive strategy reduces experimental trials, adapts DoE according to different grinding processes, and can prevent critical defects such as surface cracks. In the case study, optimized results which are offered by the expert system and validated with over 90% accuracy are incorporated into the system’s knowledge base, enabling continuous improvement and reduced experimentation in future iterations.
A Historical Overview of Methods for the Estimation of Erosion Processes on the Territory of the Republic of Serbia
Authors: Malušević Ivan , Ristić Ratko , Radić Boris , Polovina Siniša , Milčanović Vukašin , Nešković Petar
Published: February 2025

Erosion is a significant environmental challenge in Serbia, shaped by natural and human factors. Pronounced relief, fragile geological substrate, a developed hydrographic network, and a climate characterized by an uneven distribution of precipitation throughout the year make this area prone to activating erosion processes and flash floods whenever there is a significant disruption in ecological balance, whether due to the removal of vegetation cover or inadequate land use. Researchers have recorded approximately 11,500 torrents in Serbia, most of which were activated during the 19th century, a period of significant social and political change, as well as intensive deforestation and the irrational exploitation of natural resources. By the mid-19th century, the effects of land degradation were impossible to ignore. As the adequate assessment of soil erosion intensity is the initial step in developing a prevention and protection strategy and the type and scope of anti-erosion works and measures, this article presents the path that the anti-erosion field in Serbia has taken from the initial observations of erosion processes through the first attempts to create the Barren Land Cadastre and Torrent Cadastre to the creation of the Erosion Potential Method (EPM) and its modification by Dr. Lazarević that resulted in the creation of the first Erosion Map of SR Serbia in 1971 (published in 1983). In 2020, a new Erosion Map of Serbia was created with the application of Geographic Information System (GIS) technologies and based on the original method by Professor Slobodan Gavrilović—the EPM—without the modifications introduced by Lazarević. We compared the 1983 and 2020 erosion maps in a GIS environment, where the change in soil erosion categories was analyzed using a confusion matrix. The updated erosion maps mirror the shift in methodology from a traditional approach (Lazarević’s modification) to the modern GIS-based method (Gavrilović’s original EPM) and reflect technological improvements and changes in land use, conservation practices, and environmental awareness.