bluuebunny/crossref_metadata_2025 huggingface dataset:
Neurodevelopmental Outcome after Culture-Proven or So-Called Culture-Negative Sepsis in Preterm Infants
Authors: Bedetti Luca , Corso Lucia , Miselli Francesca , Guidotti Isotta , Toffoli Carlotta , Miglio Rossella , Roversi Maria Federica , Muttini Elisa della Casa , Pugliese Marisa , Bertoncelli Natascia , Zini Tommaso , Mazzotti Sofia , Lugli Licia , Lucaccioni Laura , Berardi Alberto
Published: February 2024

(1) Background: Prematurity is a serious condition associated with long-term neurological disability. This study aimed to compare the neurodevelopmental outcomes of preterm neonates with or without sepsis. (2) Methods: This single-center retrospective case–control study included infants with birth weight < 1500 g and/or gestational age ≤ 30 weeks. Short-term outcomes, brain MRI findings, and severe functional disability (SFD) at age 24 months were compared between infants with culture-proven or culture-negative sepsis or without sepsis. A chi-squared test or Mann–Whitney U test was used to compare the clinical and instrumental characteristics and the outcomes between cases and controls. (3) Results: Infants with sepsis (all sepsis n = 76; of which culture-proven n = 33 and culture-negative n = 43) were matched with infants without sepsis (n = 76). Compared with infants without sepsis, both all sepsis and culture-proven sepsis were associated with SFD. In multivariate logistic regression analysis, SFD was associated with intraventricular hemorrhage (OR 4.7, CI 1.7–13.1, p = 0.002) and all sepsis (OR 3.68, CI 1.2–11.2, p = 0.021). (4) Conclusions: All sepsis and culture-proven sepsis were associated with SFD. Compared with infants without sepsis, culture-negative sepsis was not associated with an increased risk of SFD. Given the association between poor outcomes and culture-proven sepsis, its prevention in the neonatal intensive care unit is a priority.
Monitoring of Women with Anti-Ro/SSA and Anti-La/SSB Antibodies in Germany—Status Quo and Intensified Monitoring Concepts
Authors: Bedei Ivonne Alexandra , Kniess David , Keil Corinna , Wolter Aline , Schenk Johanna , Sachs Ulrich J. , Axt-Fliedner Roland
Published: February 2024

Background: The fetuses of pregnant women affected by anti-Ro/anti-La antibodies are at risk of developing complete atrioventricular heart block (CAVB) and other potentially life-threatening cardiac affections. CAVB can develop in less than 24 h. Treatment with anti-inflammatory drugs and immunoglobulins (IVIG) can restore the normal rhythm if applied in the transition period. Routine weekly echocardiography, as often recommended, will rarely detect emergent AVB. The surveillance of these pregnancies is controversial. Home-monitoring using a hand-held Doppler is a promising new approach. Methods: To obtain an overview of the current practice in Germany, we developed a web-based survey sent by the DEGUM (German Society of Ultrasound in Medicine) to ultrasound specialists. With the intention to evaluate practicability of home-monitoring, we instructed at-risk pregnant women to use a hand-held Doppler in the vulnerable period between 18 and 26 weeks at our university center. Results: There are trends but no clear consensus on surveillance, prophylaxis, and treatment of anti-Ro/La positive pregnant between specialists in Germany. Currently most experts do not offer home-monitoring but have a positive attitude towards its prospective use. Intensified fetal monitoring using a hand-held Doppler is feasible for pregnant women at risk and does not lead to frequent and unnecessary contact with the center. Conclusion: Evidence-based guidelines are needed to optimize the care of anti-Ro/La-positive pregnant women. Individual risk stratification could help pregnancy care of women at risk and is welcmed by most experts. Hand-held doppler monitoring is accepted by patients and prenatal medicine specialists as an option for intensified monitoring and can be included in an algorithm for surveillance.
Developing a Nomogram for Prioritizing Hysteroscopy in Endometrial Cancer Diagnosis: A Case-Control Study
Authors: Bottura Bruna , Haddad Raphael Federicci , Alvarenga-Bezerra Vanessa , Campos Vinicius , Perez Luiza , Resende Carolina , Asencio Fernanda de Almeida , Liao Adolfo Wenjaw , Gomes Mariano Tamura Vieira , Zlotnik Eduardo , Moretti-Marques Renato
Published: February 2024

(1) Background: The pandemic led to significant healthcare disruptions, resulting in postponed surgeries and extended waiting times for non-urgent treatments, including hysteroscopies essential for diagnosing endometrial cancer. This study aims to formulate a risk stratification model to enhance the prioritization of hysteroscopy procedures in Brazil; (2) Methods: A case-control study was conducted at Vila Santa Catarina Hospital in São Paulo, analyzing the medical records of 2103 women who underwent hysteroscopy between March 2019 and March 2022. We used bivariate analysis and multivariate linear regression to identify risk factors associated with endometrial cancer and formulate a nomogram; (3) Results: The findings revealed a 5.5% incidence of pre-invasive and invasive endometrial disease in the study population, with an average waiting time of 120 days for hysteroscopy procedures. The main risk factors identified were hypertension, diabetes, postmenopausal bleeding, and obesity; (4) Conclusions: This research highlights the urgent need for efficient prioritization of hysteroscopy procedures in the wake of the pandemic. The developed nomogram is an innovative tool for identifying patients at higher risk of endometrial cancer, thus facilitating timely diagnosis and treatment and improving overall patient outcomes in a strained healthcare system.
Exploring the Therapeutic Potential of Ganoderma lucidum in Cancer
Authors: Cancemi Gabriella , Caserta Santino , Gangemi Sebastiano , Pioggia Giovanni , Allegra Alessandro
Published: February 2024

Triterpenoids, such as ganoderic acid, and polysaccharides, including β-D-glucans, α-D-glucans, and α-D-mannans, are the main secondary metabolites of the medicinal fungus Ganoderma lucidum. There is evidence of the effects of ganoderic acid in hematological malignancies, whose mechanisms involve the stimulation of immune response, the macrophage-like differentiation, the activation of MAP-K pathway, an IL3-dependent cytotoxic action, the induction of cytoprotective autophagy, and the induction of apoptosis. In fact, this compound has been tested in twenty-six different human cancer cell types and has shown an anti-proliferative activity, especially in leukemia, lymphoma, and myeloma lines. Moreover, research clarified the capability of molecules from Ganoderma lucidum to induce mitochondrial damage in acute promyelocytic leukemia cells, without cytotoxic effects in normal mononuclear cells. Active lipids extracted from the spores of this fungus have also been shown to induce apoptosis mediated by downregulation of P-Akt and upregulation of caspases-3, -8, and -9. Among in vivo studies, a study in BALB/c mice injected with WEHI-3 leukemic cells suggested that treatment with Ganoderma lucidum promotes differentiation of T- and B-cell precursors, phagocytosis by PBMCs, and NK cell activity. Our review presents data revealing the possibility of employing Ganoderma lucidum in hematological malignancies and incorporating it into clinical practice.
Caries Experience before and after COVID-19 Restrictions: An Observational Study
Authors: Guerreiro Eduardo , Botelho João , Machado Vanessa , Proença Luís , Mendes José , Manso Ana
Published: February 2024

Background: The declaration of COVID-19 as a pandemic by the World Health Organization in 2020 led to the suspension of several clinical practices globally, including dentistry. This study investigates the impact of these restrictions on dental caries experience. Methods: A retrospective cross-sectional study was conducted at Egas Moniz University’s dental hospital in the Lisbon Metropolitan Area from June 2019 to June 2021. The study involved 3380 participants who were divided into two cohorts: after and before COVID-19 restrictions. Data collection included a questionnaire, full-mouth clinical examinations, and radiographs (panoramic X-rays, bitewings). Results: Before the COVID-19 restrictions, the prevalence of dental caries was 91.8%, with an average DMFT (decayed, missing, and filled teeth) index of 12.13. Post-restrictions, the prevalence decreased to 84.5%, with a DMFT index of 10.99. There was an increase in missing teeth and a decrease in decayed and filled teeth. Additionally, the frequency of toothbrushing declined among participants. Conclusions: The COVID-19 pandemic restrictions have significantly impacted dental caries experiences and oral health, highlighting a decrease in dental caries, but also a concerning reduction in oral hygiene practices. These results emphasize the importance of customized dental healthcare during public health emergencies to reduce impacts and maintain oral health.
Efficacy and Safety of Antidiabetic Agents for Major Depressive Disorder and Bipolar Depression: A Meta-Analysis of Randomized, Double-Blind, Placebo-Controlled Trials
Authors: Zhang Jian , Sun Rongyi , Cai Yang , Peng Bo , Yang Xi , Gao Keming
Published: February 2024

Background: This meta-analysis aimed to determine the efficacy and safety of antidiabetic agents in the treatment of major depressive disorder and bipolar depression. Methods: Randomized controlled trials (RCTs) of antidiabetic agents in major depressive disorder or bipolar depression were searched in three electronic databases and three clinical trial registry websites from their inception up to October 2023. The differences in changes in the depression rating scale scores from baseline to endpoint or pre-defined sessions, response rate, remission rate, rate of side effects and dropout rate between antidiabetic agents and placebo were meta-analyzed. Results: Six RCTs involving 399 participants were included in the final meta-analysis, which did not find that antidiabetics outperformed the placebo in reducing depressive symptoms. The standardized mean difference (SMD) in the depression scores from baseline to endpoint was 0.25 (95% CI −0.1, 0.61). However, a subgroup analysis found a significant difference between antidiabetics and placebos in reducing depressive symptoms in Middle Eastern populations, with an SMD of 0.89 (95% CI 0.44, 1.34). Conclusions: The current meta-analysis does not support the efficacy of antidiabetics being superior to the placebo in the treatment of unipolar and bipolar depression. However, a subgroup analysis indicates that patients from the Middle East may benefit from adding an antidiabetic medication to their ongoing medication(s) for their depression. Larger studies with good-quality study designs are warranted.
Evaluating the Correlation between Ptosis Improvement and Immediate Postoperative Lagophthalmos following Blepharoptosis Surgery under General Anesthesia in Pediatric Patients
Authors: Jeong Jae Hoon , Park Chong Soo
Published: February 2024

Background: The objective of this study is to establish a potential correlation between postoperative improvement in upper eyelid ptosis, measured by the marginal reflex distance 1 (MRD1), and the immediate postoperative degrees of lagophthalmos (IPDL). The established correlation is then used to assess whether IPDL can be used as a reliable indicator of successful treatment of eyelid ptosis. Methods: This retrospective study involved 19 patients, aged 1 to 11, with a total of 28 eyes affected by ptosis, who underwent surgery under general anesthesia at Seoul National University Bundang Hospital from January 2018 to December 2022. We monitored the MRD1 of the patients for over six months postoperatively and measured the IPDL. Results: After ptosis correction surgery, no statistically significant correlation was observed between the improvement in MRD1 and IPDL. Furthermore, the degree of postoperative eyelid ptosis improvement was found to vary and was not consistently sustained, attributable to a range of factors. Conclusions: Our study did not establish a statistically significant correlation between IPDL and ptosis improvement as measured by MRD1. Further research is needed to draw definitive conclusions about their correlation.
Treatment and Rehabilitation of a Patient with Neuromyelitis Optica Spectrum Disorder-Induced Complete Spinal Cord Injury Following COVID-19 Vaccination: A Case Report
Authors: Han Jun-Sang , Ryu Seong-Mun , Lim Young-Hwan , Kim Ae-Ryoung , Jung Tae-Du
Published: February 2024

Neuromyelitis optica spectrum disease (NMOSD) is a rare autoimmune disorder of the central nervous system characterized by optic neuritis, myelitis, or brain lesions. Its symptoms overlap with those of multiple sclerosis (MS), making a diagnosis of NMOSD challenging. Here, we report a rare case of NMOSD-induced complete spinal cord injury following COVID-19 vaccination. A 52-year-old female patient developed NMOSD-induced complete spinal cord injury after receiving their third dose of the Pfizer–BioNTech COVID-19 vaccine (BNT162b2). Despite the initial diagnosis of complete spinal cord injury, the patient underwent intensive treatment, including rituximab therapy and rehabilitation. As a result, she made a full recovery and transitioned from the ASIA Impairment Scale(AIS)-A to AIS-E. The remarkable neurological recovery from complete spinal cord injury to functional independence highlights the efficacy of a comprehensive treatment approach. In addition, this case emphasizes the need to recognize NMOSD as a potential adverse outcome of COVID-19 vaccination and emphasizes the importance of early diagnosis, timely intervention, and thorough rehabilitation for optimizing patient results. Further case reports and studies are needed to investigate the association between COVID-19 vaccination and the occurrence of NMOSD.
Behavioral Disorders of Spatial Cognition in Patients with Mild Cognitive Impairment due to Alzheimer’s Disease: Preliminary Findings from the BDSC-MCI Project
Authors: Cammisuli Davide Maria , Isella Valeria , Verde Federico , Silani Vincenzo , Ticozzi Nicola , Pomati Simone , Bellocchio Virginia , Granese Valentina , Vignati Benedetta , Marchesi Gloria , Prete Lorenzo Augusto , Pavanello Giada , Castelnuovo Gianluca
Published: February 2024

(1) Background: Spatial cognition (SC) is one of the earliest cognitive domains to be impaired in the course of Alzheimer’s disease (AD), resulting in spatial disorientation and becoming lost even in familiar surroundings as later dementia symptoms. To date, few studies have identified initial alterations of spatial navigation (SN) in the premorbid AD phase by real-world paradigms, and none have adopted an innovative technological apparatus to better detect gait alterations as well as physiological aspects correlated to spatial disorientation (SD). The present study aimed at exploring initial SN defects in patients with prodromal AD via a naturalistic task by using a sensory garment. (2) Methods: 20 community-dwelling patients with Mild Cognitive Impairment (MCI) due to AD and 20 age/education controls were assessed on their sequential egocentric and allocentric navigation abilities by using a modified version of the Detour Navigation Test (DNT-mv). (3) Results: When compared to controls, patients with MCI due to AD exhibited higher wrong turns (WT) and moments of hesitation (MsH) in the DNT-mv, reflecting difficulties both in sequential egocentric and allocentric navigation, depending on hippocampal deterioration. Moreover, they reported more complaints about their SN competencies and lower long-term visuospatial memory abilities than controls. Remarkably, WTs and MsH manifested in the allocentric naturalistic task of the DNT-mv were associated with autonomic nervous system alteration pertaining to cardiac functioning in the whole sample. (4) Conclusions: Naturalistic navigation tests of hippocampal function using a continuous non-invasive monitoring device can provide early markers of spatial disorientation in patients with MCI due to AD. Future studies should develop cognitive remediation techniques able to enhance SC residual abilities in patients at high risk of conversion into dementia and ecological paradigms to be replicated on a large scale.
Extrema-Triggered Conversion for Non-Stationary Signal Acquisition in Wireless Sensor Nodes
Authors: Bhattacharyya Swagat , Hasler Jennifer O.
Published: February 2024

While wireless sensor node (WSNs) have proliferated with the rise of the Internet of Things (IoT), uniformly sampled analog–digital converters (ADCs) have traditionally reigned paramount in the signal processing pipeline. The large volume of data generated by uniformly sampled ADCs while capturing most real-world signals, which are highly non-stationary and sparse in information content, considerably strains the power budget of WSNs during data transmission. Given the pressing need for intelligent sampling, this work proposes an extrema pulse generator devised to trigger ADCs at significant signal extrema, thereby curbing the volume of data points collected and transmitted, and mitigating transmission power draw. After providing a comprehensive signal-theoretic rationale, we construct and experimentally validate these circuits on a system-on-chip field-programmable analog array in a 350 nm complementary metal-oxide-semiconductor (MOS) process. Operating within a power range of 4.3–12.3 µW (contingent on the input bandwidth requirements), the extrema pulse generator has proven to be capable of effectively sampling both synthetic and natural signals, achieving significant reductions in data volume and signal reconstruction error. Using a nonideality-resilient reconstruction algorithm, that we develop in this work, experimental comparisons between extrema and uniform sampling show that extrema sampling achieves an 18-fold lower normalized root mean square reconstruction error for a quadratic chirp signal, despite requiring 5-fold fewer sample points. Similar improvements in both the reconstruction error and effective sampling rate objectives are found experimentally for an electrocardiogram signal. Using both theoretical and experimental methods, this work demonstrates the potential of extrema-triggered systems for extending Pareto frontiers in modern, resource-constrained sensing scenarios.
A Low-Power BL Path Design for NAND Flash Based on an Existing NAND Interface
Authors: Makino Hikaru , Tanzawa Toru
Published: February 2024

This paper is an extended version of a previously reported conference paper regarding a low-power design for NAND Flash. As the number of bits per NAND Flash die increases with cost scaling, the IO data path speed increases to minimize the page access time with a scaled CMOS in IOs. The power supply for IO buffers, namely, VDDQ, decreases from 3 V to 1.2 V, accordingly. In this paper, the way in which a reduction in VDDQ can contribute to power reduction in the BL path is discussed and validated. Conventionally, a BL voltage of about 0.5 V has been supplied from a supply voltage source (VDD) of 3 V. The BL path power can be reduced by a factor of VDDQ to VDD when the BL voltage is supplied by VDDQ. To maintain a sense margin at the sense amplifiers, the supply source for BLs is switched from VDDQ to VDD before sensing. As a result, power reduction and an equivalent sense margin can be realized at the same time. The overhead of implementing this operation is an increase in the BL access time of about 2% for switching the power supply from VDDQ to VDD and an increase in the die size of about 0.01% for adding the switching circuit, both of which are not significant in comparison to the significant power reduction in the BL path power of the NAND die of about 60%. The BL path is then designed in 180 nm CMOS to validate the design. When the cost for powering the SSD becomes quite significant, especially for data centers, an additional lower voltage supply, such as 0.8 V, dedicated to BL charging for read and program verifying operations may be the best option for future applications.
Performance in Behavioral Testing in an Animal Model of Post-Surgical Hypoparathyroidism
Authors: Dettori Cristina , Ronca Francesca , Di Buono Giulia , Saba Alessandro , Di Lupo Francesca , Polini Beatrice , Ricardi Caterina , Frascarelli Sabina , Cetani Filomena , Marcocci Claudio , Zucchi Riccardo , Chiellini Grazia , Scalese Marco , Saponaro Federica
Published: February 2024

Background: Hypoparathyroidism (HypoPT) is characterized by hypocalcemia and undetectable/inappropriately low PTH. Post-surgical HypoPT (PS-HypoPT) is the most common cause. Patients with PS-HypoPT present neuropsychological symptoms, probably due to the PTH deprivation in the central nervous system (CNS). However, these mechanisms are still not elucidated. The aim of this study was to evaluate the effects of PTH deprivation on CNS in an animal model of PS-HypoPT via a cognitive/behavioral assessment approach. Methods: A surgical rat model of PS-HypoPT was obtained and treated with calcium to maintain normocalcemia. Twenty PS-HypoPT rats and twenty sham-operated controls (Crl) underwent behavioral testing in a Morris Water Maze (MWM), Open Field (OF), and Elevated Plus Maze (EPM). Results: In the MWM, PTx rats showed a higher Escape Latency Time compared to Crl rats (p < 0.05); we observed a statistically significant improvement in the performance (day 1 to 8 p < 0.001), which was less pronounced in PTx group. In the OF test, the time and distance spent in the zone of interest were significantly lower in the PTx group compared with the Crl (p < 0.01 and p < 0.01). In the EPM experiment, the time spent in the close arm was significantly higher in the PTx group compared with the Crl (p < 0.01). Conclusions: This animal model of PS-HypoPT shows an impairment in spatial memory, which improved after training, and a marked anxiety-like behavior, resembling the condition of patients with PS-HypoPT. Further studies are needed to elucidate mechanisms.
Impacts of Changing Livestock Farming Practices on the Biocultural Heritage and Landscape Configuration of Italian Anti-Apennine
Authors: Primi Riccardo , Viola Paolo , Rossi Carlo Maria , Ripert Stefano , Ripa Maria Nicolina , Spina Raffaello , Ronchi Bruno
Published: February 2024

This research article focuses on the evolution of a Mediterranean landscapes and the intricate interplay between natural and human-induced processes in the context of the Italian Anti-Apennine mountains. The study employs a multi-temporal approach to analyze changes in land use and landscape ecology, livestock activities, and agro-pastoral practices over seven decades. We noted a 18% decrease in animal units, particularly in goat and pig farming, accompanied by a 10% reduction in horse populations. Farmers’ adaptation strategies involve increasing animals per farm, aligning with broader agricultural trends toward intensification and specialization. In parallel, we observed a 22% reduction in grassland surfaces juxtaposed with an overall 15% increase in woodlands and shrublands, a 13% decreasing trend in habitat edge, and an overall 18% increase in patches aggregation at the landscape scale. The decline in anthropogenic pressures linked to depopulation triggered secondary successions, resulting in a 25% increase in homogeneous closed woodlands. These landscape alterations contribute to a 19% decrease in ecosystem heterogeneity and complexity, favoring ecological connectivity for forest-linked species but posing challenges for open meadow species. This, coupled with the loss of biocultural heritage, including traditional settlements dating back to the Bronze Age and Roman times, as well as pastoral traditions and knowledge, underscores the need to rethink future development strategies with a focus on retaining younger generations and preventing the loss of crucial ecosystem services.
Measuring Perceived Walkability at the City Scale Using Open Data
Authors: Ye Yang , Jia Chaozhi , Winter Stephan
Published: February 2024

The walkability of the built environment has been shown to be critical to the health of residents, and open data have been widely used to assess walkability. However, previous research has focused on the relationship between the built environment and walking behavior rather than perceived walkability, and there is a lack of systematic research on walkability at the urban scale using open data. This paper presents a methodological framework for systematically measuring and assessing perceived walkability at the urban scale, considering general and specific features. The walkability indices are obtained using variables from open data or calculated automatically through machine learning and algorithms to ensure they can be evaluated at a larger urban scale. The proposed method is applied to Harbin, China, to assess the perceived walkability of streets using hundreds of thousands of street view images and points of interest obtained from open data. The results are compared with a subjective evaluation of walkability to validate the proposed method. The results demonstrate that measures of the urban built environment can describe perceived walkability. Thus, the proposed framework shows promise for assessing the walkability of urban spaces, supporting policy proposals, and establishing design guidelines for optimising urban spaces.
Investigation of Vitamin D Levels in Men with Suspected Infertility
Authors: Aşır Fırat , Duran Senem Çetin , Afşin Muhammet , Duran Enis , Korak Tuğcan , Şahin Fırat
Published: February 2024

Male infertility may be caused by an impaired sperm functionality, with insufficient vitamin D levels affecting the quantity and development of motile sperm. Given the influence of vitamin D on vital aspects of male infertility, this study aimed to investigate the correlation between vitamin D levels and male infertility, along with exploring the possible mechanism of action. A total of 306 male participants were included. Semen samples were collected and analyzed for semen parameters with demographic features. Patients were classified into two groups based on vitamin D levels of <20 ng/mL (low) and ≥20 ng/mL (high). The Super-PRED, Swiss TargetPrediction, GeneCards, and DisGeNET databases were utilized to retrieve potential molecular targets associated with both vitamin D and male infertility, while the STRING database was employed for constructing protein–protein interaction (PPI) networks and conducting a functional enrichment analysis. A total of 146 patients (47.71%) showed low vitamin D levels and 160 patients (52.29%) had high vitamin D levels. Vitamin D was not strongly influenced by demographic parameters. Vitamin D demonstrated significant positive correlations with type A and B sperm motility. Conversely, it exhibited significant negative correlations with type C and D sperm motility. Hormones (thyroid-stimulating hormone, follicle-stimulating hormone, prolactin, luteinizing hormone, estradiol) were not significantly associated with vitamin D; however, testosterone was significantly positive correlated with vitamin D. Notably, no significant correlation was found between vitamin D levels and iron, ferritin, hemoglobin, hematocrit, calcium, magnesium, and phosphorus levels. The functional annotations of potential vitamin D targets associated with male infertility primarily indicated involvement in regulating infection, the immune response, forkhead box O (FOXO) and hypoxia-inducible factor 1 (HIF1) signals in male infertility. Adequate vitamin D levels are associated with an improved reproductive health, evidenced by positive correlations with hormone levels and sperm motility. Specifically, the FOXO and HIF-1 signaling pathways may be effective in the potential molecular mechanisms underlying the impact of vitamin D on male infertility and/or in the significant correlations identified.
Cytotoxic Effects of Ardisiacrispin A from Labisia pumila on A549 Human Lung Cancer Cells
Authors: Lee Yeong-Geun , Kim Tae Hyun , Kwon Jeong Eun , Kim Hyunggun , Kang Se Chan
Published: February 2024

Background: Lung cancer is the predominant cause of cancer-related fatalities. This prompted our exploration into the anti-lung cancer efficacy of Labisia pumila, a species meticulously selected from the preliminary screening of 600 plants. Methods: Through the strategic implementation of activity-guided fractionation, ardisiacrispin A (1) was isolated utilizing sequential column chromatography. Structural characterization was achieved employing various spectroscopic methods, including nuclear magnetic resonance (NMR), mass spectrometry (MS), and infrared spectroscopy (IR). Results: L. pumila 70% EtOH extract showed significant toxicity in A549 lung cancer cells, with an IC50 value of 57.04 ± 10.28 µg/mL, as well as decreased expression of oncogenes and induced apoptosis. Compound 1, ardisiacrispin A, induced a 50% cell death response in A549 cells at a concentration of 11.94 ± 1.14 µg/mL. Conclusions: The present study successfully investigated ardisiacrispin A extracted from L. pumila leaves, employing a comprehensive spectroscopic approach encompassing NMR, IR, and MS analyses. The anti-lung cancer efficacy of ardisiacrispin A and L. pumila extract was successfully demonstrated for the first time, to the best of our knowledge.
Simulation and Validation of an 8 × 8 Scaled Electric Combat Vehicle
Authors: Kim Junwoo , El-Gindy Moustafa , El-Sayegh Zeinab
Published: February 2024

In this research, an 8 × 8 scaled electric combat vehicle (SECV) is built. The scaled vehicle is evaluated in both experimental and simulated methods to analyze its performance. The scaled vehicle is developed to apply the Ackermann condition by implementing the individual steering and individual wheel speed control system at low speed. Individual eight-wheel rotational velocity control and individual eight-wheel steering angle control in real time are developed and installed on the remotely controlled scaled vehicle to meet a perfect Ackermann condition. Three different steering scenarios are developed and applied: a traditional steering scenario (first and second axle steering), fixed third axle steering scenario (first, second, and fourth axle steering), and all-wheel steering scenario. Stationary evaluation, turn radius evaluation, and double lane change evaluation are conducted to verify the application of the Ackermann condition. The differences between the experimental results and the simulated data are within an acceptable range. An important demonstration of this research is the novel validation of physical and simulated data in the application of the Ackermann condition for eight-wheel steering and velocity control for the three steering scenarios.
Complications Subsequent to Urinary Tract Stent Placement: An Overview Focusing on the Imaging of Cancer Patients
Authors: Corvino Antonio , Basile Luigi , Cocco Giulio , Delli Pizzi Andrea , Tafuri Domenico , Corvino Fabio , Catalano Orlando
Published: February 2024

Ureteral involvement by a tumor is common, and both partial and complete obstructions can result in symptoms that are distressing and debilitating, especially in cancer patients for whom the resection of the primary tumor is not considered an option. Maintaining ureteric patency in these patients is a challenge. In addition, in cases where a patient has undergone nephroureterectomy due to primary transitional cell cancer, it becomes necessary to decompress the urinary tract to preserve the contralateral kidney from irreversible damage. This is possibly due to ureteral stenting, both retrograde and anterograde, and percutaneous nephrostomy (PCN). Since imaging plays an important role in the routine monitoring of stents, their more and more increasing use requires radiologists to be familiar with these devices, their correct position, their potential complications, and their consequences. The aim of this review is to offer a comprehensive review of the imaging features of some urinary stents and to show the complications encountered in cancer patients as a direct consequence of an invasive diagnostic or therapeutic procedure. Specifically, we focus on ureteral stents and PCN.
Virtual Surgical Planning for Temporomandibular Joint Reconstruction with Stock TMJ Prostheses: Pilot Study
Authors: del Castillo Pardo de Vera José Luis , Cebrián Carretero José Luis , Aragón Niño Íñigo , Pampín Martínez Marta María , Borjas Gómez José Tadeo , Navarro Cuéllar Ignacio , López López Ana María , Gómez Larren Estela , Navarro Vila Carlos , Montes Fernández-Micheltorena Pablo , Pérez Sala Álvaro , Navarro Cuéllar Carlos
Published: February 2024

The temporomandibular joint (TMJ) is one of the most complex joints in the human anatomy. In advanced degenerative stages, conservative or minimally invasive surgical therapies have failed to restore joint function, and joint replacement with prostheses has been required. Stock prostheses, compared to custom-made prostheses, are much less expensive and require less pre-operative preparation time. Four patients followed for years for temporomandibular dysfunction and previously operated on by arthroscopy or open joint surgery that have been reconstructed with stock TMJ prostheses (STMJP) through virtual surgical planning (VSP) and an STL model with surgical and positioning guides were included. The median follow-up was 15 months; the median number of previous TMJ surgeries was 2. The mean preoperative MIO was 24.6 mm and at longest follow-up was 36.4 mm. The median preoperative TMJ pain score was 8, and the median postoperative TMJ pain was 3. All patients have improved their mandibular function with a clear improvement of their initial situation. In conclusion, we believe that stock TMJ prostheses with virtual surgical planning and surgical guides are a good alternative for TMJ reconstruction at the present time. Nonetheless, prospective and randomized trials are required with long-term follow up to assess their performance and safety.
Different Chemotherapy Regimens and Pathologic Complete Response in Triple-Negative Breast Cancer: An Updated Network Meta-Analysis of Phase 3 Trials
Authors: Petrelli Fausto , Tomasello Gianluca , Parati Maria Chiara , Ghidini Antonio , Ghidini Michele , Borgonovo Karen , Cabiddu Mary , Ghilardi Mara , Reduzzi Roberto , Gambini Donatella , Zaniboni Alberto , Faustinelli Giovanni , Garrone Ornella
Published: February 2024

Background and Objectives: Currently, the standard treatment for non-metastatic triple-negative breast cancer (TNBC) consists of a systemic neoadjuvant (or perioperative) anthracycline plus taxane-based chemotherapy, delivered either sequentially or concomitantly. We performed a network meta-analysis (NMA) to compare the relative efficacy of different neoadjuvant treatments for TNBC in terms of pathologic complete response (pCR). Materials and Methods: The MEDLINE, Embase, and Cochrane databases were searched from database inception to 1 November 2023. Randomized clinical trials were used that enrolled adults with stage I-III TNBC and provided data on pCR defined as residual ypT0/TisN0M0. Between-group comparisons were estimated using risk ratios (RRs) with 95% credible intervals (95% CrIs). The primary outcome was the pCR rate. Results: 1129 citations were screened, and 12 randomized clinical trials were included. In Bayesian comparisons, all regimens, except anthracycline/taxanes plus gemcitabine or capecitabine, resulted in a higher pCR than the standard regimen in both direct and indirect comparisons. In particular, immunotherapy-based regimens resulted in more than double the pCR compared to historical regimens (RR = 2.3, 95% CI 1.9–2.9) and ranked as being the optimal regimen with a probability of 97%. Disease-free survival was better for immune checkpoint inhibitor-based chemotherapy (HR = 0.36, 95% 1.21–2.09) than for historical regimens. Conclusion: This meta-analysis confirmed that incorporating immunotherapy with neoadjuvant platinum-based chemotherapy is the best option to guarantee remarkable pathologic downstaging and improve clinical outcomes.
Harmony in Chaos: Deciphering the Influence of Ischemic Cardiomyopathy and Non-Cardiac Comorbidities on Holter ECG Parameters in Chronic Heart Failure Patients: A Pilot Study
Authors: Duca Ștefania-Teodora , Badescu Minerva Codruta , Costache Alexandru-Dan , Chetran Adriana , Miftode Radu Ștefan , Tudorancea Ionuț , Mitu Ovidiu , Afrăsânie Irina , Ciorap Radu-George , Șerban Ionela-Lăcrămioara , Pavăl D. Robert , Dmour Bianca , Cepoi Maria-Ruxandra , Costache-Enache Irina-Iuliana
Published: February 2024

Background and Objective: In the landscape of heart failure, non-cardiac comorbidities represent a formidable challenge, imparting adverse prognostic implications. Holter ECG monitoring assumes a supplementary role in delineating myocardial susceptibility and autonomic nervous system dynamics. This study aims to explore the potential correlation between Holter ECG parameters and comorbidities in individuals with ischemic cardiomyopathy experiencing heart failure (HF), with a particular focus on the primary utility of these parameters as prognostic indicators. Materials and Methods: In this prospective inquiry, a cohort of 60 individuals diagnosed with heart failure underwent stratification into subgroups based on the presence of comorbidities, including diabetes, chronic kidney disease, obesity, or hyperuricemia. Upon admission, a thorough evaluation of all participants encompassed echocardiography, laboratory panel analysis, and 24 h Holter monitoring. Results: Significant associations were uncovered between diabetes and unconventional physiological indicators, specifically the Triangular index (p = 0.035) and deceleration capacity (p = 0.002). Pertaining to creatinine clearance, notable correlations surfaced with RMSSD (p = 0.026), PNN50 (p = 0.013), and high-frequency power (p = 0.026). An examination of uric acid levels and distinctive Holter ECG patterns unveiled statistical significance, particularly regarding the deceleration capacity (p = 0.045). Nevertheless, in the evaluation of the Body Mass Index, no statistically significant findings emerged concerning Holter ECG parameters. Conclusions: The identified statistical correlations between non-cardiac comorbidities and patterns elucidated in Holter ECG recordings underscore the heightened diagnostic utility of this investigative modality in the comprehensive evaluation of individuals grappling with HF. Furthermore, we underscore the critical importance of the thorough analysis of Holter ECG recordings, particularly with regard to subtle and emerging parameters that may be overlooked or insufficiently acknowledged.
A Novel Approach for the Treatment of Recurrent Oroantral Fistula Occurring at an Infected Sinus Augmentation Site
Authors: Park Won-Bae , Bae Min-Soo , Park Wonhee , Lim Hyun-Chang , Han Ji-Young
Published: February 2024

Closing a recurrent oroantral fistula (OAF) that occurs at an infected sinus augmentation site is a challenge for clinicians. The recurrent OAF has a detrimental impact on bone regeneration and subsequent implant placement. This case report includes three cases in which sinus graft infection and OAF occurred after maxillary sinus augmentation (MSA). In these cases, treatments to control sinus infection were performed using an otolaryngologist; then, intraoral interventions comprising mucosal flap procedures, bone grafts, and barrier membrane applications were performed 2–5 times by oral surgeons. Nevertheless, OAF recurred persistently. The failure to stop OAF recurrence may be due to the inability to effectively block air pressure at the OAF site. Following a comprehensive debridement of the infected tissue at the previous sinus augmentation site, a pouch was created through sinus mucosal elevation. The perforated sinus mucosa at the OAF site was covered with a non-resorbable membrane in one case and with resorbable collagen membranes in the other two cases, followed by bone grafting within the pouch. Lastly, this procedure was completed by blocking the entrance of the pouch with a cortical bone shell graft and a resorbable collagen membrane. The cortical bone shell graft, obstructing the air pressure from the nasal cavity, facilitated bone formation, and, ultimately, allowed for implant placement. Within the limitations of the present case report, the application of a guided bone regeneration technique involving a cortical bone shell graft and a barrier membrane enabled the closure of the recurrent OAF and subsequent implant placement.
Influence of the COVID-19 Outbreak in Vulnerable Patients (Pediatric Patients, Pregnant Women, and Elderly Patients) on an Emergency Medical Service System: A Pre- and Post-COVID-19 Pandemic Comparative Study Using the Population-Based ORION Registry
Authors: Ota Koshi , Nitta Masahiko , Komeya Tomonobu , Matsuoka Tetsuya , Takasu Akira
Published: February 2024

Background and Objective: Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has spread all over the world. To assess the influence of the COVID-19 pandemic on emergency medical services (EMS) for vulnerable patients transported by ambulance. Materials and Methods: This study was a retrospective, descriptive study with a study period from 1 January 2019 to 31 December 2021 using the Osaka Emergency Information Research Intelligent Operation Network (ORION) system. We included all pediatric patients, pregnant women, and elderly patients ≥ 65 years of age transported by ambulance in Osaka Prefecture. The main outcome of this study was difficult-to-transport cases. We calculated the rate of difficult-to-transport cases under several conditions. Results: For the two year-long periods of 1 January 2019 to 31 December 2019 and 1 January 2021 to 31 December 2021, a total of 887,647 patients were transported to hospital by ambulance in Osaka Prefecture. The total number of vulnerable patients was 579,815 (304,882 in 2019 and 274,933 in 2021). Multivariate logistic regression analysis showed that difficult-to-transport cases were significantly more frequent in 2021 than in 2019. Difficult-to-transport cases were significantly less frequent in the vulnerable population than in the non-vulnerable population (adjusted odds ratio 0.81, 95% confidence interval 0.80–0.83; p < 0.001). Conclusion: During the pandemic (2021), difficult-to-transport cases were more frequent compared to before the pandemic (2019); however, vulnerable patients were not the cause of difficulties in obtaining hospital acceptance for transport.
Safety Parameters for the Use of Holmium:YAG Laser in the Treatment of Biliary Calculi: The Ex-Vivo Model
Authors: Patel Sandeep , Kiker Dustin , Mondal Utpal , Sayana Hari , Saligram Shreyas , Rosenkranz Laura , Han Samuel
Published: February 2024

Background and Objectives: While studies have demonstrated the efficacy of cholangioscopy-guided Holmium-Yttrium aluminum garnet (Ho:YAG) laser lithotripsy for the treatment of refractory bile duct stones, data regarding the safety of the operating parameters for laser lithotripsy are lacking. The aim of this study was to determine safe, yet effective, energy settings for Ho:YAG laser in the ex-vivo model. Materials and Methods: This ex vivo experimental study utilized the Ho:YAG laser on porcine bile duct epithelium and human gallstones. Ho:YAG laser lithotripsy was applied in different power settings from 8 to 15 Watts (W) to six explanted porcine bile ducts. Settings that appeared safe were then utilized to fragment seventy-three human gallstones. Results: The median bile duct perforation times with the Ho:YAG laser between 8–15 W were: >60 s (8 W); 23 s (9 W); 29 s (10 W); 27 s (12 W); 12 s (14 W); and 8 s (15 W). Statistically significant differences in the median perforation times were noted between 8 W vs. 15 W, 9 W vs. 15 W, 10 W vs. 15 W, and 12 W vs. 15 W (p < 0.05). When using a 365 µm Ho:YAG laser probe at 8–12 W, the fragmentation rates on various size stones were: 100% (<1.5 cm); 80–100% (1.6–2.0 cm) and 0–32% (>2.0 cm). Optimal fragmentation was seen utilizing 12 W with high energy (2.4 J) and low frequency (5 Hz) settings. Using a larger 550 µm probe at these settings resulted in 100% fragmentation of stones larger than 2 cm. Conclusions: The Ho:YAG laser appears to be safe and effective in the treatment of large bile duct stones when used between 8–12 W in 5 s bursts in an ex vivo model utilizing porcine bile ducts and human gallstones.
Surface Modification of Diatomite-Based Micro-Arc Coatings for Magnesium Implants Using a Low-Energy High-Current Electron Beam Processing Technique
Authors: Sedelnikova Mariya B. , Kashin Alexander D. , Bakina Olga V. , Uvarkin Pavel V. , Luginin Nikita A. , Sharkeev Yurii P. , Khimich Margarita A. , Kazmina Olga V. , Dvilis Edgar S. , Ivanov Konstantin V.
Published: February 2024

The present study showcases a novel effective technique for the surface modification of micro-arc diatomite coatings using low-energy, high-current electron beams (LEHCEBs). A variety of methods such as scanning electron microscopy, energy-dispersive X-ray spectroscopy, the X-ray diffraction method, scratch testing, the potentiodynamic polarization method, immersion testing in SBF, and flow cytometry have been used to study the coatings. During processing, the electron beams’ energy density ranged between 2.5–7.5 J/cm2. After the LEHCEB treatment, the surface morphology of the coatings changed completely. The corrosion resistance of the LEHCEB-treated coated samples increased significantly, as evidenced by the decrease in corrosion current to 4.6 × 10−10 A·cm−2 and the increase in polarization resistance to 1.4 × 108 Ω·cm2. The electron beam treatment also increased the adhesion strength of the coatings to the magnesium substrate by 1.8–2.5 times compared to untreated coatings. Additionally, biological studies have shown the high viability of the NIH/3T3 cell line after contact with the samples of the coating extracts.
Effect of Coiling Temperature on Microstructures and Precipitates in High-Strength Low-Alloy Pipeline Steel after Heavy Reduction during a Six-Pass Rolling Thermo-Mechanical Controlled Process
Authors: Lei Yicong , Yang Wen , Siyasiya Charles W. , Tang Zhenghua
Published: February 2024

Nb-Ti high-strength low-alloy pipeline steel was subjected to a six-pass rolling process followed by the coiling process at different temperatures between 600 and 650 °C using the thermo-mechanical testing system Gleeble 3500 (Gleeble, New York, NY, USA). This experimental steel was subjected to 72% heavy reduction through a thermos-mechanical controlled process. Thereafter, the microstructures were observed using optical microscopy, scanning electron microscopy, electron backscatter scanning diffraction, and transmission electron microscopy coupled with energy dispersive spectrometry and selected area electron diffraction. For the selected three coiling temperatures of 600, 625, and 650 °C, acicular ferrite, polygonal ferrite, and pearlite were observed, and morphology and statistical analysis were adopted for the study of precipitates. Based on the estimation by the Ashby–Orowan formula, the incremental strength through precipitation strengthening decreases with coiling temperatures and reaches 26.67 Mpa at a coiling temperature of 600 °C. Precipitation-time-temperature curves were obtained to explain the transformation of precipitates. The (Nb, Ti)(C, N) particles tended to precipitate in the acicular ferrite with [011](Nb, Ti)(C, N)//[011]α-Fe orientation. The lower coiling temperature provided enough driving force for the nucleation of precipitates while inhibiting their growth.