bluuebunny/crossref_metadata_2025 huggingface dataset:
Exposure to Cyantraniliprole Adversely Impacts Fitness of Harmonia axyridis: Acute Toxicity and Sublethal Effects on Development, Fecundity and Antioxidant Responses
Authors: Zhang Tianshu , Yuan Yongda , Teng Haiyuan , Wang Dongsheng , Gu Haotian
Published: October 2024

Extensive utilization of pesticides and their persistent residues inadvertently pose threats to the effectiveness and fitness of biocontrol agents in agroecosystems. However, these ecological consequences are generally disregarded when executing integrated pest management strategies (IPM). Cyantraniliprole (CNAP) serves as a wide-spectrum diamide insecticide and its sublethal effects have been well characterized on multiple insect pests, whereas its impacts on beneficial natural enemies remain unfathomed. Herein we exposed Harmonia axyridis, a predacious generalist, to lethal and sublethal concentrations of CNAP via dipping treatment (egg stage) and topical applications (1st-instar stage + adult stage). The acute toxicity tests revealed that LC50 of CNAP were 90.11, 86.11 and 240.50 mg/L against embryos, 1st instar nymphs and female adults, respectively, with safety factors ranging from 1.14 to 5.34, suggesting its medium toxicity for H. axyridis and larval stage was the most susceptible. The embryonic, larval and pupal durations of coccinellids ecdysed from CNAP-treated eggs and 1st instars were all elongated under sublethal concentrations, of which LC30 triggered more pronounced and significant retardations relative to control. Besides, exposed coccinellids displayed substantially diminished pupal mass and pupation rate, most notably for insects molted from the 1st-instar stage upon CNAP sublethal treatments. With respect to reproductive performance, LC10 and LC30 of CNAP all significantly suppressed female fecundity, as evidenced by reduced vitellin content, a prolonged pre-oviposition period (POP), mitigated laid eggs and the egg hatching rate. Specifically, there existed positive correlations between vitellin level (Vn) and number of eggs deposited by per female, indicative of CNAP affecting fecundity by regulation of Vn. In addition, the antioxidant system was also profoundly disrupted by CNAP, with compromised POD activity at different concentrations over time and induced hormesis of SOD/CAT activities post LC10 exposure. Activities of SOD and TAC were enhanced to exert protective functions during the first 48 h, while defense collapsed at 72 h following LC30 treatments that depleted all enzymatic activities. We speculated that fitness trade-offs may occur between reproductive capacity and antioxidant defenses to sustain physiological homeostasis in response to CNAP stress. Collectively, this study evaluated the ecological risk of CNAP and unmasked its adverse implications for overall fitness of H. axyridis, which highlighted rational application of agrochemicals to conserve biocontrol agents when implementing IPM strategies for sustainable pest control.
Short Spatiotemporal Fire History Explains the Occurrence of Beetles Favoured by Fire
Authors: Milberg Per , Bergman Karl-Olof , Jansson Nicklas , Norman Henrik , Sundin Fia , Westerberg Lars , Johansson Victor
Published: October 2024

The number and area of forest fires in northern Europe have been dramatically reduced during the past century, and several fire-favoured species are now threatened. To promote the recovery of these species, prescribed burning is often used as a conservation measure, and to optimise the use of these conservation burns, knowledge is needed on suitable fire frequency, size and placement in the landscape. The aim of this study was to analyse the effect of recent fire history (12 yrs) on beetles sampled using smoke attraction traps at 21 forest sites in a 10,000 km2 region. We analysed the odds of finding a fire-favoured beetle species or individual among the beetles in each trap using a new spatiotemporal connectivity measure and compared the results to non-fire-favoured and saproxylic species. For fire-favoured beetles, both the number of species and individuals significantly increased with connectivity to previous fires, while the other two groups did not. The spatiotemporal connectivity that best explained the patterns suggests that fire-favoured beetles mainly respond to fires within a 2 km range up to 2–3 years after the fire. Hence, to preserve fire-favoured insects, prescribed fires must be close in space and time to other fires—whether prescribed or natural.
An In Situ Automated System for Real-Time Monitoring of Failures in Large-Scale Field Emitter Arrays
Authors: Farsad Asadi Reza , Zheng Tao , Wang Menglin , Gao Han , Sangston Kenneth , Gnade Bruce
Published: October 2024

Nano-scale vacuum transistors (NVCTs) based on field emission have the potential to operate at high frequencies and withstand harsh environments, such as radiation, high temperatures, and high power. However, they have demonstrated instability and failures over time. To achieve high currents from NVCTs, these devices are typically fabricated in large-scale arrays known as field emitter arrays (FEAs), which share a common gate, cathode, and anode. Consequently, the measured currents come from the entire array, providing limited information about the emission characteristics of individual tips. Arrays can exhibit nonuniform emission behavior across the emitting area. A phosphor screen can be used to monitor the emission pattern of the array. Additionally, visible damage can occur on the surface of the FEAs, potentially leading to the destruction of the gate and emitters, causing catastrophic failure of the FEAs. To monitor damage while operating the device, an ITO-coated glass anode, which is electrically conductive and visible-light-transparent, can be used. In this work, a method was developed to automatically monitor the emission pattern of the emitters and the changes in surface morphology while operating the devices and collecting electrical data, providing real-time information on the failure sequence of the FEAs.
Perceived Infant Discomfort Linked to Lower Maternal Oral Health Quality of Life: Results from a Cross-Sectional Study
Authors: Garrido Lisetty , Rodrigues Inês , Lyra Patrícia , Proença Luís , Botelho João , Frota Sónia , Mendes José João , Machado Vanessa
Published: October 2024

Aim: We aimed to explore whether there is an association between maternal perceived infant discomfort due to suggestive gastrointestinal alterations and oral-health-related quality of life (OHRQoL) through a survey. Materials and Methods: The present study included two main phases involving Portuguese-speaking parents with full-term infants aged 2–12 weeks old who were not previously hospitalized in a neonatal nursery. First, the original French Infant Colic Questionnaire (ColiQ) was translated, cross-culturally adapted and validated to Portuguese (ColiQ-PT). Then, a survey was distributed, and included sociodemographics, the ColiQ-PT, an oral health value scale, OHRQoL, self-perceived periodontal status, and smoking and oral health habits. Data were analyzed through inferential, correlation and multivariate logistic models in this cross-sectional study. Results: The ColiQ-PT revealed reliability and validity. From a total of 421 responses, higher infant discomfort was correlated with less maternal professional dental care prioritization (ρ = −0.096, p < 0.05). Self-perceived periodontitis correlated with all items of OHRQoL (p < 0.001), all seven OHIP-14 domains, and with the physical (p < 0.001), psychological (p = 0.006), and social (p = 0.011) super-domains. While the infant-related score was associated with baby age (p = 0.023) and physical pain (p = 0.040) related to OHRQoL, the parent score was associated with education (p = 0.005), unemployment (p = 0.035), and physical pain (p = 0.017). The total ColiQ-PT score was significantly associated with more deteriorated social disability related to maternal OHRQoL (ρ = −0.130, p < 0.05). Conclusions: Perceived infant discomfort seems to be linked to maternal deteriorated OHRQoL. This finding highlights the importance of prioritizing oral health in postpartum care. Further research is needed to explore the mechanisms underlying this association and to develop targeted interventions.
Effectiveness of Adult Chest Compressions during Resuscitation Performed by Children Aged 10–14 Years under Simulated Conditions
Authors: Leszczyński Piotr Konrad , Ciołek Wiktoria , Cudna Justyna , Ilczak Tomasz
Published: October 2024

Introduction: Numerous educational programs recommend implementing the teaching principles of BLS from an early age. The aim of this study was to evaluate selected parameters of the quality of resuscitation performed by children aged 10–14 years during simulated circulatory arrest in an adult. Materials and Methods: The project involved four stages, culminating in students performing thoracic compressions on an adult simulator for 2 min. A digital analysis of the quality, depth, relaxation and rate of compressions allowed us to formulate results and conclusions. The authors’ proprietary questionnaire form allowed for the correlation of criteria such as age, gender, body mass and past experience in first aid training of the participant. Results: A total of 149 girls and 130 boys were studied. The mean age was 12 years (SD ± 1.41). A directly proportional increase in body mass with participant age was observed (p < 0.000). Children as young as 10 years old achieved only 24.13% quality, while those at the age of 14 demonstrated a more than doubled value (67.61%). The minimum depth of chest compressions recommended for an adult (5–6 cm) was not reached in any age group. Girls from all grades achieved a mean quality of 44.69% (SD ± 32.57), while boys achieved a score of 60.23% (SD ± 31.74). On the other hand, in the case of evaluating thoracic relaxation, a significantly better result was achieved by girls compared to boys (66.14% vs. 56.78%; rho-Spearman test for p = 0.011). Conclusions: Age, sex and body mass play important roles in the quality of resuscitation provided by children. None of the age groups studied achieved the minimum mean depth during adult thoracic compressions under simulated conditions. It is recommended to modify school-based BLS classes to better match the exercises to students’ predispositions.
Exploring Inflammatory Markers and Risk Factors Associated with Pericarditis Development after Ablation for Atrial Fibrillation
Authors: Yakut Idris , Konte Hasan Can , Ozeke Ozcan
Published: October 2024

Background: This study aimed to explore the association between inflammatory markers and the occurrence of post-atrial fibrillation (AF) ablation pericarditis (PAP), while also examining the PAP’s incidence and contributing factors. Methods: A retrospective cohort study was conducted between January 2021 and November 2023, including patients who underwent successful AF ablation. Inflammatory markers of interest included the systemic immune-inflammation index (SII), the neutrophil-to-lymphocyte ratio (NLR), and the platelet-to-lymphocyte ratio (PLR). Results: Among the 231 patients examined, 22 (9.52%) were classified as suspected PAP, and 14 (6.06%) as definitive PAP. The median age was 58 years, with no age difference between groups. Males comprised 51.52% of the sample, with male sex frequency significantly higher in the suspected PAP group relative to the other groups (p = 0.007). Multivariable logistic regression indicated that AF duration (p = 0.026) and cavotricuspid isthmus (CTI) ablation (p = 0.001) were associated with definitive PAP, whereas analysis for any pericarditis (suspected or definitive PAP) revealed independent relationships with CTI ablation (p = 0.003) and sleep apnea (p = 0.008). SII, NLR, and PLR were not associated with PAP. Conclusions: Prolonged AF duration, CTI ablation, and sleep apnea are risk factors for PAP. The inflammatory markers (SII, NLR, and PLR) showed no association, warranting further investigation into other markers.
Acute Coronary Syndrome in Elderly Patients: How to Tackle Them?
Authors: Lucà Fabiana , Andreotti Felicita , Rao Carmelo Massimiliano , Pelaggi Giuseppe , Nucara Mariacarmela , Ammendolea Carlo , Pezzi Laura , Ingianni Nadia , Murrone Adriano , Del Sindaco Donatella , Lettino Maddalena , Geraci Giovanna , Riccio Carmine , Bilato Claudio , Colivicchi Furio , Grimaldi Massimo , Oliva Fabrizio , Gulizia Michele Massimo , Parrini Iris
Published: October 2024

Elderly patients diagnosed with acute coronary syndromes (ACS) represent a growing demographic population. These patients typically present more comorbidities and experience poorer outcomes compared to younger patients. Furthermore, they are less frequently subjected to revascularization procedures and are less likely to receive evidence-based medications in both the short and long-term periods. Assessing frailty is crucial in elderly patients with ACS because it can influence management decisions, as well as risk stratification and prognosis. Indeed, treatment decisions should consider geriatric syndromes, frailty, polypharmacy, sarcopenia, nutritional deficits, prevalence of comorbidities, thrombotic risk, and, at the same time, an increased risk of bleeding. Rigorous clinical assessments, clear revascularization criteria, and tailored approaches to antithrombotic therapy are essential for guiding personalized treatment decisions in these individuals. Assessing frailty helps healthcare providers identify patients who may benefit from targeted interventions to improve their outcomes and quality of life. Elderly individuals who experience ACS remain significantly underrepresented and understudied in randomized controlled trials. For this reason, the occurrence of ACS in the elderly continues to be a particularly complex issue in clinical practice, and one that clinicians increasingly have to address, given the general ageing of populations. This review aims to address the complex aspects of elderly patients with ACS to help clinicians make therapeutic decisions when faced with such situations.
Stent-Induced Inflammation: A Comparative Cross-Sectional Study of Post-Implantation Syndrome in Venous and Arterial Procedures
Authors: Dikmen Nur , Ozcinar Evren , Hasde Ali Ihsan , Kayan Ahmet , Polat Nadir , Ardakani Ali , Kadiroğlu Yuruyen Ezel , Eyileten Zeynep
Published: October 2024

Background: Postimplantation syndrome (PIS) is a known inflammatory response following endovascular stent placement, yet comparative data between venous and arterial stenting remains limited. This study seeks to evaluate the incidence, characteristics, and clinical implications of PIS across these two distinct vascular territories. Methods: We retrospectively analyzed 191 patients who underwent either venous (n = 36) or arterial (n = 155) stent placement. Data collection encompassed demographic profiles, perioperative laboratory findings, and clinical outcomes. The primary endpoint was the incidence of PIS, defined as the presence of fever (≥38 °C), leukocytosis, and elevated C-reactive protein (CRP) within 30 days postprocedure. Secondary outcomes included length of hospital and ICU stay, incidence of endoleaks, reintervention rates, and 30-day mortality. Comparative statistical analyses were conducted to assess differences between the venous and arterial stent groups. Results: PIS was observed more frequently in arterial stent patients, as evidenced by significantly elevated postoperative white blood cell counts at 24 and 48 h (p = 0.046 and p = 0.014, respectively), along with borderline CRP increases (p = 0.052). Fever occurrence peaked at 72 and 96 h postprocedure, predominantly in the arterial cohort. Furthermore, patients with arterial stents had significantly longer hospital stays (5.59 ± 0.46 days vs. 3.42 ± 0.36 days; p = 0.0018) and a higher rate of 30-day endoleaks (7.1% vs. 0%; p = 0.005). Despite similar mortality and major adverse cardiac event (MACE) rates between groups, arterial stent patients exhibited a greater need for reintervention. While PIS was less common among venous stent recipients, its potential impact on postoperative recovery warrants careful monitoring. Conclusions: Arterial stenting is associated with a higher incidence of PIS and a more pronounced systemic inflammatory response, contributing to longer hospitalization and increased postoperative complications. Although venous stent patients experience PIS less frequently, its occurrence should not be overlooked, as it may influence overall recovery and clinical outcomes. Recognition and management of PIS in both venous and arterial stent patients are critical to improving patient care and optimizing procedural success.
Seasonal Impact on Wound Healing and Surgical Site Infections after Reduction Mammoplasty
Authors: Mahrhofer Maximilian , Caputo Glenda Giorgia , Fierdel Frederic , Reichert Raphael , Russe Elisabeth , Wimmer Florian , Schoeller Thomas , Weitgasser Laurenz
Published: October 2024

Background: The incidence of reduction mammoplasty has been steadily increasing over recent decades. Surgical site infections (SSIs) represent a common yet preventable complication across surgical disciplines. Studies across various surgical specialties have indicated a seasonal influence on SSIs, primarily correlated with higher temperatures and humidity. However, there remains a scarcity of clear data regarding the seasonal effects on complications specifically in breast surgery. Methods: We conducted a retrospective review encompassing all patients who underwent primary bilateral reduction mammoplasties at our institution between 1 June 2016, and 1 September 2019. The data collected included patient demographics, surgical details, and postoperative complications. The rates of SSIs and wound healing disturbances (WHDs) were correlated with local meteorological data at the time of surgery. Results: A total of 808 patients (1616 breasts) met the inclusion criteria. The mean age was 41 ± 14.8 years, with a mean BMI of 28.9 ± 5.2 kg/m2 and a mean follow-up duration of 8.9 ± 9.8 months. Nineteen cases (2.35%) of surgical site infections and 77 cases (9.52%) of wound healing disturbances were reported. No statistically significant increase in the risk of SSIs (p = 0.928) or WHDs (p = 0.078) was observed during the warmer months of the year. Although no specific risk factors were identified for surgical site infections, both resection weight (p < 0.001) and diabetes mellitus (p = 0.001) demonstrated increased risks for wound healing disturbances. Conclusions: While seasonal temperature variations have been shown to impact SSIs and WHDs in body contouring procedures, our findings suggest that breast reduction surgery may not be similarly affected.
Evaluation of Inflammatory Markers in Predicting Coronary Complexity: Insights from the SYNTAX II Score in NSTEMI Patients
Authors: Bilgin Murat , Akkaya Emre , Dokuyucu Recep
Published: October 2024

Objectives: Non-ST-elevation myocardial infarction (NSTEMI) is characterized by the absence of pathological ST segment elevation but an increase in biological markers. The SYNTAX II score (SS-II) is calculated to evaluate the complexity of coronary artery disease and to guide treatment decisions between percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG). The aim of this study is to evaluate the relationship of socio-demographic data and biochemical markers with SS-II in NSTEMI patients. Materials and Methods: Six hundred patients who were admitted to the private Aktif International Hospital cardiology clinic between January 2020 and January 2024 and were diagnosed with NSTEMI were included in the study. Severity, extent, and clinical evaluation of atherosclerosis were determined using risk factors, laboratory tests, and coronary angiography. Patients were divided into two groups according to their SS-II score: low (≤ 22) and high SS-II (> 32). Socio-demographic data, neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and monocyte-to-HDL-C ratio (MHR) were compared between the two groups. Results: Group 1 (SS-II ≤ 22) included 380 patients, and group 2 (SS-II > 32) included 220 patients. There was a statistically significant difference in HDL, creatine value, white blood cell, troponin I, hs-TnT, and monocyte values in group 2 compared with group 1 (p = 0.001, p = 0.018, p = 0.031, and p = 0.001, respectively). NLR, MLR, MHR, and SS values were statistically significantly higher in group 2 compared with group 1 (p = 0.015, p = 0.002, p = 0.001, and p = 0.001, respectively). The risk factors were found to be significantly associated with high-risk NSTEMI (SS-II > 32) in a logistic regression analysis and included peripheral artery disease (PAD) (OR: 3.028, p = 0.040), troponin I (OR: 3.575, p = 0.015), hs-TnT (OR: 4.221, p = 0.010), NLR (OR: 1.528, p = 0.024). MLR (OR: 5.248, p = 0.012), and MHR (OR: 7.122, p = 0.010). ROC analysis revealed that NLR (AUC: 0.691, p = 0.016), MLR (AUC: 0.731, p = 0.004), and MHR (AUC: 0.824, p = 0.003) had higher predictive power than other parameters in patients with high-risk NSTEMI (SS-II > 32). Conclusions: We found that NLR, MLR, and MHR levels are associated with the severity of coronary artery disease. We think that adding these easily and quickly measurable parameters to routine laboratory results may support the clinician in evaluating the complexity of coronary artery disease and guiding treatment decisions in NSTEMI patients.
Disease Associations among Patients Afflicted with Both Glaucoma and Age-Related Macular Degeneration
Authors: Dimalanta Lauren , Pithadia Kishan , Shenkute Nathan T. , Strelow Bryan , Zhang Zhidong , Ulrich Jan , Zhang Alice Y. , Fleischman David
Published: October 2024

Background/Objectives: This study investigates whether there is an increased propensity to systemic conditions in patients with both age-related macular degeneration (AMD) and glaucoma in order to provide greater insight into patients’ overall health and response to physiologic stress. Methods: A large retrospective dataset review was conducted between April 2004 and June 2018, distinguishing four groups based on international classification of diseases (ICD) codes: glaucoma only, AMD only, glaucoma and AMD, and cataracts only (as an age-matched control). The systemic disease prevalence of each group was calculated, and a Friedman analysis was used to compare the prevalence between the groups. Results: This study identified 5243 patients with glaucoma only, 6726 with AMD only, 402 with combined disease, and 25,450 with cataracts only. Age and racial distributions varied between groups in a predictable manner. Two conditions, heart failure (HF) and dementia, had a statistically higher prevalence in patients with both glaucoma and AMD compared to those with glaucoma alone (HF p = 0.036, dementia p = 0.024) and cataracts alone (HF p = 0.003, dementia p = 0.036). There was no significant difference observed in terms of ethnicity and gender among the different disease groups (p > 0.05). Conclusions: Both AMD and glaucoma individually portend a higher rate of comorbidities than age-matched controls. Patients with concomitant AMD and glaucoma demonstrate a uniquely higher prevalence of heart failure and dementia than those with either disease alone. The underlying association and pathologic mechanisms warrant further investigation to improve the overall health management and prognostication for these individuals.
Characteristics of Non-Therapeutic Pregabalin Users Detected by a Community Pharmacies Network in a Region of Southern Europe
Authors: Perelló Maria , Rio-Aige Karla , Rius Pilar , Pérez-Cano Francisco J. , Rabanal Manel
Published: October 2024

Background: Since 2008, several cases of pregabalin abuse have been reported to the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA). Despite this evidence, gabapentinoids are increasingly being prescribed. Moreover, pregabalin is being used in a recreational setting for its dissociative effects and euphoria. Objectives: To assess the characteristics of non-therapeutic users of pregabalin and to show behavioral trends associated with requests for the medicine at community pharmacies. Methods: The Medicine Abuse Observatory (MAO), an epidemiological surveillance system, was able to analyze trends about the most diverted drugs and the behavioral patterns of the population from community pharmacies. We have conducted an observational and cross-sectional study from January 2022 to April 2023, to determinate trends in the behavior of patients who have requested pregabalin in the Catalan Sephanet. Results: Behavior with respect to sex was similar in all health problems, although one difference was raised when considering neuropathic pain, in which the females were more involved (72.7%), especially around 2.5 times more than the males (27.3%, p < 0.05). The study showed a potential recreational use related to patients aged <25 years and patients aged 25–35 years (p < 0.05). Neuropathic pain was mainly identified in patients >65 years. In 75% of the cases, there was a preceding prescription. Conclusions: This study underlines the evidence of non-therapeutic use of pregabalin among the Catalan population and the need to take control measures. Actions should be promoted, both at the level of prescription and dispensing, and focusing on education and knowledge about the risks that may appear with the use of pregabalin.
Single-Taper Conical Tapered Stem in Total Hip Arthroplasty for Primary Osteoarthritis: A Comparative Long-Term Registry Evaluation
Authors: Castagnini Francesco , Bordini Barbara , Cosentino Monica , Gorgone Mara , Minerba Andrea , Rotini Marco , Diquattro Emanuele , Traina Francesco
Published: October 2024

Background/Objectives: Single-taper conical tapered stems (STCTSs) are possible options for femoral reconstruction in THA performed for primary osteoarthritis, but outcomes are poorly ascertained. A specific STCTS in THA performed for primary osteoarthritis was investigated and compared to a control group including all the other cementless stems, aiming to assess the following: (1) the survival rates of the two cohorts and the hazard ratios for failure; (2) the survival rates and the hazard ratios for failures for stem failure, stem aseptic loosening, and periprosthetic fracture. Methods: A regional arthroplasty registry study evaluating a specific STCTS in THA performed for primary osteoarthritis was designed. A control group including all the other cementless stems was considered. Results: In total, 1773 STCTSs were compared to 37,944 cementless stems. The cumulative survivorship of the STCTS cohort was 95.6% at 10 years and 92.7% at 15 years, which was not different to the control group (p = 0.252). After age stratification, the hazard ratio for STCTS failure was not different to the control group. With stem revision as the endpoint, the STCTS cohort outperformed the control group (at 10 years, 98% versus 96.8%; p < 0.001). The STCTSs achieved better survival rates in females <65 years (p = 0.023). With stem aseptic loosening as the endpoint, the survival rates did not differ between the two cohorts (p = 0.085), as well as the adjusted hazard ratios (p = 0.264). With periprosthetic fracture as the endpoint, the survival rates were better for the STCTSs (p < 0.001). Conclusions: STCTSs in THA for primary osteoarthritis provided dependable long-term outcomes, not inferior to all the other cementless stems with various designs.
Clinical, Diagnostic, and Metabolic Characteristics Associated with Nephrolithiasis in the Black Women’s Health Study
Authors: D’Amico Maria , Babayan Richard K. , Wang David S. , Wason Shaun , Cozier Yvette C.
Published: October 2024

Background/Objectives: Nephrolithiasis (kidney stones) is a frequently occurring urologic condition resulting in significant patient morbidity and healthcare costs. Despite the higher prevalence of metabolic risk factors for nephrolithiasis among Black women, there have been few epidemiologic studies of kidney stones focusing on this group. Methods: We describe demographic and health characteristics, diagnostics, and metabolic profiles of US Black women with self-reported kidney stones. The women were participants in the Black Women’s Health Study (BWHS), a large prospective cohort of US Black women (median age 38 years) begun in 1995. Results: Among the 2750 BWHS participants who completed an online supplemental questionnaire assessing urologic health, 201 women reported nephrolithiasis. Of this number, 62% had completed ≥ 16 years of education, and 82% reported access to health care. Overall, 39% reported experiencing ≥ 2 stones in their lifetime, and 29% required surgery to treat the condition. Thirty-two percent reported having completed a metabolic evaluation, while 70% had undergone a CT scan to diagnose nephrolithiasis. The frequency of metabolic evaluation increased with the number of metabolic components reported: 3% (0 components) to 43% (3–4 components). Conclusions: Our findings are consistent with reports of lower rates of metabolic evaluation among Black patients despite their having multiple risk factors for nephrolithiasis. Further study is needed to identify the barriers and facilitators of metabolic and diagnostic workup of nephrolithiasis in Black women.
A Prospective, Randomized Trial of Bioresorbable Polymer Drug-Eluting Stents versus Fully Bioresorbable Scaffolds in Patients Undergoing Coronary Stenting
Authors: Wiebe Jens , Byrne Robert A. , Bradaric Christian , Kuna Constantin , Kessler Thorsten , Pfleiderer Mathieu , Kufner Sebastian , Xhepa Erion , Hoppmann Petra , Joner Michael , Schunkert Heribert , Laugwitz Karl-Ludwig , Kastrati Adnan , Cassese Salvatore
Published: October 2024

Background: The performance of an everolimus-eluting bioresorbable scaffold (BRS) was inferior to an everolimus-eluting metallic drug-eluting stent (DES) with permanent polymer, mainly due the mechanical features of BRS technology. The performance of BRS as compared to metallic DES with bioresorbable polymers remains unstudied. Methods: This prospective, randomized, multicenter, clinical trial enrolled patients who underwent coronary stenting for de novo coronary lesions. Patients were randomly assigned to bioresorbable polymer everolimus-eluting stents (BP-EES) or everolimus-eluting BRS. The primary endpoint was percentage diameter stenosis (in-device) at 6- to 8-month angiographic surveillance. The main secondary endpoint was the device-oriented composite endpoint (DOCE) of cardiac death/target vessel-myocardial infarction/target lesion revascularization assessed after 12 months and 5 years. Results: The trial was prematurely terminated after the enrollment of 117 of 230 patients (BP-EES, n = 60; BRS, n = 57) due to safety issues associated with BRS technology. The primary endpoint of in-device diameter stenosis at angiographic surveillance was 12.5 ± 7.7% with BP-EES versus 19.3 ± 16.5% with BRS (p = 0.01). The DOCE occurred in 5.0% in the BP-EES group versus 12.3% of patients in the BRS group (hazard ratio [HR] 2.48, 95% confidence interval [CI] 0.64–9.58, p = 0.19) after 12 months and in 11.7% in the BP-EES group versus 26.4% of patients in the BRS group (HR 2.38, 95% CI 0.97–5.84, p = 0.06) after 5 years. Conclusions: BP-EES showed superior mid-term angiographic performance compared with BRS. Clinical event rates did not differ significantly between the groups up to 5 years of follow-up. These results should be interpreted with caution in view of the premature discontinuation of the study.
Therapeutic Effectiveness of a Novel Cranial Remolding Helmet (baby band2) for Positional Plagiocephaly: A Multicenter Clinical Observational Study
Authors: Nagano Nobuhiko , Kato Risa , Noto Takanori , Hijikata Midori , Okahashi Aya , Nakanomori Aya , Miyabayashi Hiroshi , Yoshikawa Kayo , Ichiwata Nobutaka , Saito Hiroshi , Sasano Mari , Sumi Koichiro , Morioka Ichiro
Published: October 2024

This multicenter study evaluated the efficacy and safety of a novel cranial remolding helmet (baby band2), which is completely custom-made based on the shape of an infant’s cranium. The study included 224 full-term infants from moderate to very severe positional plagiocephaly in Japan. Cranial geometry was assessed before and after helmet therapy using a three-dimensional scanner, and changes in the cranial vault asymmetry index (CVAI) were analyzed. The CVAI improved significantly in all patients, with the most significant improvement observed in the most severely affected group [very severe group: −9.1, severe group: −6.6, moderate group: −4.4 (mean values), p < 0.001]. The group that started therapy before the age of 7 months showed greater improvement compared to those who started therapy at the age of 7 months or older; however, both groups demonstrated significant improvement (<7 months group: −6.6, ≥7 months group: −4.4 (mean values), p < 0.001). No significant differences were observed in therapy efficacy between the centers (p = 0.402) and sex (p = 0.131). During the study period, helmet therapy did not lead to head circumference stunting, and the incidence of redness with baby band2 was five patients (2.2%). This study demonstrated that baby band2 is effective and safe for the therapy of positional plagiocephaly.
Acute Changes in Myocardial Work during Isometric Exercise in Hypertensive Patients with Ischemic Heart Disease: A Case–Control Study
Authors: Caminiti Giuseppe , Volterrani Maurizio , Iellamo Ferdinando , Marazzi Giuseppe , D’Antoni Valentino , Calandri Camilla , Vadalà Sara , Catena Matteo , Di Biasio Deborah , Manzi Vincenzo , Morsella Valentina , Perrone Marco Alfonso
Published: October 2024

Background: The acute hemodynamic response to isometric exercise in hypertensive patients’ ischemic heart disease (IHD) has been poorly investigated. The aim of this study was to assess acute changes in left ventricular myocardial work (MW) during isometric bilateral knee extension in patients with IHD. Methods: Twenty stable hypertensive patients with IHD and ten healthy, age-matched controls (HC) were enrolled. All subjects performed an isometric knee extension exercise at 30% of their maximal voluntary contraction. The effort was maintained for three minutes or until exhaustion. At baseline, at peak exercise, and after 10 min of recovery, echocardiography evaluation was performed and blood pressure (BP) and heart rate (HR) were measured. Results: The exercise was well tolerated by all subjects. At peak exercise, systolic BP in the IHD was significantly higher than HC (37.6 ± 7.2 vs. 8.4 ± 2.3 mmHg; p 0.002). The HC group had a greater increase in HR than IHD (19.7 ± 6.2 vs. 8.4 ± 2.2 bpm; p 0.009). The E/E′ ratio increased in IHD and was unchanged in the control group. The global work index increased significantly in IHD compared to HC (+15% vs. +3%; p 0.026). Global constructive work increased significantly in IHD compared to HC (+29.8% vs. +7.4 respectively, p 0.031). Global wasted work increased by 92.3% in IHD and was unchanged in HC. The global work efficiency decreased in IHD (−18%), but was unchanged in HC (between-groups p 0.019). Stroke volume decreased in IHD and was unchanged in HC. Cardiac output was unchanged in IHD, while it increased in HC. Conclusion: In patients with hypertension and underlying IHD, an acute isometric load causes a great increase in systolic BP and LV filling pressure. It follows a mostly ineffective increase in MW that fails to maintain stroke volume.
Low Serum Alanine Aminotransferase Blood Activity Is Associated with Shortened Survival of Renal Cell Cancer Patients and Survivors: Retrospective Analysis of 1830 Patients
Authors: Laufer Menachem , Sarfaty Michal , Jacobi Eyal , Itelman Edward , Segal Gad , Perelman Maxim
Published: October 2024

Background: Sarcopenia is characterized by a loss of muscle mass and function and is often associated with frailty, a syndrome linked to physical disability and shortened survival in various patient populations, including cancer patients. Low serum alanine aminotransferase (ALT) values, serving as a biomarker for sarcopenia, were previously associated with frailty and shortened survival in several cancers. In the current study, we aimed to test the association between low ALT and shorter survival in renal cell carcinoma (RCC) patients and survivors. Methods: This was a retrospective analysis of RCC patients and survivors, both in- and outpatients. We defined patients with sarcopenia as those presenting with ALT < 17 IU/L. Results: We identified records of 3012 RCC patients. The cohort included 1830 patients (mean age 65.6 ± 13.3 years, 68% were men) of whom only 179 underwent surgical treatment. Out of the eligible cohort, 811 patients (44.3%) had ALT < 17 IU/L, with a mean ALT value of patients within the low-ALT group of 11.79 IU/L, while the mean value in the higher ALT level group was 24.44 IU/L (p < 0.001). Patients in the low-ALT group were older (67.9 vs. 63.7 years; p < 0.001) and had lower BMIs (26.6 vs. 28; p < 0.001). In addition, patients with low ALT had lower hemoglobin values (12.14 vs. 12.91 g/dL; p < 0.001), higher serum creatinine (1.49 vs. 1.14; p < 0.001) and higher platelet to lymphocyte ratios (178 vs. 156; p < 0.001). In a univariate analysis, low ALT levels were associated with a 72% increase in mortality (95% CI 1.46–2.02, p < 0.001). In a multivariate model controlled for age, gender, hemoglobin, platelets, LDH, neutrophil to lymphocyte ratios and platelet to lymphocyte ratios, low ALT levels were still associated with a 27% increase in mortality (HR = 1.27, 95% CI 1.08–1.51; p = 0.005). Conclusion. Low ALT values, associated with sarcopenia and frailty, are also associated with shortened survival in RCC patients, and survivors and could potentially be applied for optimizing individual treatment decisions.
Evaluating Ocular Healthcare Accessibility and the Severity of Emergencies during Times of Crisis
Authors: Neubauer Jonas , Richter Paul , Strudel Lisa , Ziemssen Focke , Dimopoulos Spyridon
Published: October 2024

Background/Objectives: The COVID-19 pandemic has profoundly impacted healthcare systems worldwide, including the delivery of ophthalmic emergency services. This study examines the impact of the COVID-19 pandemic on the clinical presentation of emergencies and the accessibility of healthcare in ophthalmology. Methods: The study employed a single-center, consecutive case series design with historical controls to examine electronic health records over a 21-day period during the COVID-19 pandemic and a matched period from the preceding year. Records were analyzed for demographic variables, diagnosis, length of stay, travel distance, and referral status. The urgency of cases was evaluated by three independent graders using the BaSe SCOrE (BAsic SEverity Score for Common OculaR Emergencies). Results: A total of 1229 patients were included in the study, with 786 patients in the 2019 cohort and 443 patients in the 2020 cohort. During the pandemic period, there was a significant decrease in the number of patients and the duration of their visits (p < 0.0001, p < 0.0001, respectively). There was an increase in walk-in patients (p = 0.03), who took significantly longer journeys to be treated as compared to referred patients (p < 0.01). At the same time, the severity of emergencies increased (p = 0.02). The 2019 logistic regression model found that age (p = 0.003), referral status (p < 0.001), distance (p = 0.009), and first presentation (p = 0.02) were significant predictors of the severity, while gender was not (p = 0.78). The 2020 model found that only age (p < 0.001) and referral status (p < 0.001) were significant predictors of severity. Conclusions: The observed decline in patient volume, increased severity of emergencies, and shifts in predictive variables within the logistic regression models are indicative of significant barriers to healthcare access. Therefore, enhancing health literacy and ensuring low-threshold access to emergency services are crucial, especially during crises.
The Creative Awareness Theory: A Grounded Theory Study of Inherent Self-Regulation in Attention Deficit Hyperactivity Disorder
Authors: Champ Rebecca E. , Adamou Marios , Gillibrand Warren , Arrey Sally , Tolchard Barry
Published: October 2024

Objectives: The aim of this study was to determine why and how adults with attention deficit hyperactivity disorder (ADHD) experience variable impairment and identify the processes and strategies adults with ADHD use to develop positive self-regulation skills. Methods: A mixed cohort of 11 participants (6 female and 5 male) from a university, an adult ADHD clinic and an ADHD support group in the UK were interviewed online between September 2021 and February 2022. Data were collected and analysed simultaneously, inspired by a constructivist grounded theory methodology. Results: Participants described a “polar awareness of difference” from others in terms of engagement and ADHD characteristics, and a “polar awareness of consciousness” experienced as the states of chaotic attention and hyperfocus, both of which impact core perceptions of self. Using an infinity paradigm, the results demonstrate unskilled attempts to self-regulate within and between these states using self-absorption or self-transcendence strategies, including their inherent challenges and energetic cost. Our results further indicate that at the centre of this dynamic paradigm, creative awareness strategies exist, which exemplify polarity awareness and the regulation of that awareness supported by an authentic inner compass (AIC). Conclusions: This paper presents the empirical foundation for the ADHD Creative Awareness Theory (CAT)—a new theory for understanding the experience of ADHD consciousness and environmental engagement. Practical implications are explored, and recommendations include use of the CAT as a framework for understanding and development of inherent self-regulation skills for adults with ADHD.
Double Row Hip Abductor Reconstruction with Fasciae Latae Transfer for Severe Trendelenburg after Hip Arthroplasty
Authors: Capurro-Soler Bruno , Pizarro-Geraldo Wilson , Badillo-Pérez Eduardo , González-Vonder Meden Sebastián , Rivera-Mora Omar , García-Salas Emerson , Vecchi Francesco , Arguelles Aldo
Published: October 2024

Background/Objectives: Tendinopathy of the gluteus medius and minimus tendons is a primary source of lateral hip pain, ranging from interstitial and partial-thickness tears to complete tears. Treatments include muscle transfers, Achilles tendon allograft procedures, and primary repairs with allografts. This study evaluated the one-year outcomes of gluteus medius and minimus reconstruction using an open double-row technique with a partial tensor fasciae latae transfer for severe Trendelenburg post-total hip arthroplasty. Methods: A prospective study involving eight patients who underwent surgery from April to December 2023 was conducted. The surgery involved an open technique with double-row suture reinforcement and tensor fasciae latae autograft. Outcomes were measured using strength, the Harris Hip Score (HHS), 12-Item Short Form Health Survey (SF-12), Hip Outcome Tool (HOT), International Hip Outcome Tool (iHOT), and Visual Analog Scale (VAS). Follow-ups occurred at 1, 3, 6, 9, and 12 months postoperatively. Results: At an average follow-up of 7.17 months, significant improvements in both hip function and quality of life were observed. The SF-12 quality of life score increased from 27 preoperatively to 34 by month 12. Hip functionality, as measured by the HHS, showed a marked improvement from 48 to 94 points, particularly after six months. The HOT score for hip functionality rose by 23 points by the third month, reaching an average of 86 points. Similarly, the iHOT score increased from 20 to 83 points starting at month 3, reflecting substantial improvements in hip function. Statistically significant improvements were noted at as early as month 3 (p = 0.02), with highly significant gains by month 6 (p < 0.01), which remained stable through month 12 (p < 0.01). Conclusions: Reconstruction of the gluteus medius and minimus tendons using an open double-row technique with a partial tensor fasciae latae transfer significantly enhances hip function and quality of life. Over an average follow-up period of 7.17 months, patients experienced notable improvements. This technique is an effective option for treating lateral hip pain due to tendinopathy.
3D-Printable Gelatin Methacrylate-Xanthan Gum Hydrogel Bioink Enabling Human Induced Pluripotent Stem Cell Differentiation into Cardiomyocytes
Authors: Deidda Virginia , Ventisette Isabel , Langione Marianna , Giammarino Lucrezia , Pioner Josè Manuel , Credi Caterina , Carpi Federico
Published: October 2024

We describe the development of a bioink to bioprint human induced pluripotent stem cells (hiPSCs) for possible cardiac tissue engineering using a gelatin methacrylate (GelMA)-based hydrogel. While previous studies have shown that GelMA at a low concentration (5% w/v) allows for the growth of diverse cells, its 3D printability has been found to be limited by its low viscosity. To overcome that drawback, making the hydrogel both compatible with hiPSCs and 3D-printable, we developed an extrudable GelMA-based bioink by adding xanthan gum (XG). The GelMA-XG composite hydrogel had an elastic modulus (~9 kPa) comparable to that of cardiac tissue, and enabled 3D printing with high values of printing accuracy (83%) and printability (0.98). Tests with hiPSCs showed the hydrogel’s ability to promote their proliferation within both 2D and 3D cell cultures. The tests also showed that hiPSCs inside hemispheres of the hydrogel were able to differentiate into cardiomyocytes, capable of spontaneous contractions (average frequency of ~0.5 Hz and amplitude of ~2%). Furthermore, bioprinting tests proved the possibility of fabricating 3D constructs of the hiPSC-laden hydrogel, with well-defined line widths (~800 μm).
The Mechanical and Clinical Properties of Customized Orthodontic Bracket Systems—A Comprehensive Review
Authors: Elabed Issa , Zheng Zhong , Zhang Yu , Chung Chun-Hsi , Li Chenshuang
Published: October 2024

The rise of computer-aided design and computer-aided manufacturing (CAD/CAM) and 3D printing technologies in orthodontics has revolutionized the development of customized labial and lingual bracket systems with a variety of materials, which offer potential advantages over traditional orthodontic brackets. To highlight the current state of knowledge regarding the mechanical and clinical properties of CAD/CAM and 3D-printed custom bracket systems, we conducted a comprehensive search across the PubMed, Embase, Cochrane Library, Web of Science, and Scopus databases to identify relevant articles published before April 2024. Mechanical (including fracture toughness, hardness, modulus of elasticity, frictional resistance, slot accuracy, torque transmission, and shear bond strength) and clinical (including treatment efficiency and duration, cost, and comfort) properties were compared between traditional and customized orthodontic bracket systems in the current review. Our findings suggest that customized brackets have the potential to increase bracket slot precision, reduce treatment time, and offer cost-efficiency. However, it is worth noting that the advantages and disadvantages of customized bracket systems vary depending on the bracket material and the manufacturing methods, warranting comprehensively controlled investigations in the future.