bluuebunny/crossref_metadata_2025 huggingface dataset:
siRNA-Mediated BmAurora B Depletion Impedes the Formation of Holocentric Square Spindles in Silkworm Metaphase BmN4 Cells
Authors: Zhang Bing , Ayra-Pardo Camilo , Liu Xiaoning , Song Meiting , Li Dandan , Kan Yunchao
Published: January 2024

Silkworm ovary-derived BmN4 cells rely on chromatin-induced spindle assembly to form microtubule-based square mitotic spindles that ensure accurate segregation of holocentric chromosomes during cell division. The chromosome passenger protein Aurora B regulates chromosomal condensation and segregation, spindle assembly checkpoint activation, and cytokinesis; however, its role in holocentric organisms needs further clarification. This study examined the architecture and dynamics of spindle microtubules during prophase and metaphase in BmN4 cells and those with siRNA-mediated BmAurora B knockdown using immunofluorescence labeling. Anti-α-tubulin and anti-γ-tubulin antibodies revealed faint γ-tubulin signals colocalized with α-tubulin in early prophase during nuclear membrane rupture, which intensified as prophase progressed. At this stage, bright regions of α-tubulin around and on the nuclear membrane surrounding the chromatin suggested the start of microtubules assembling in the microtubule-organizing centers (MTOCs). In metaphase, fewer but larger γ-tubulin foci were detected on both sides of the chromosomes. This resulted in a distinctive multipolar square spindle with holocentric chromosomes aligned at the metaphase plate. siRNA-mediated BmAurora B knockdown significantly reduced the γ-tubulin foci during prophase, impacting microtubule nucleation and spindle structure in metaphase. Spatiotemporal BmAurora B expression analysis provided new insights into the regulation of this mitotic kinase in silkworm larval gonads during gametogenesis. Our results suggest that BmAurora B is crucial for the formation of multipolar square spindles in holocentric insects, possibly through the activation of γ-tubulin ring complexes in multiple centrosome-like MTOCs.
Demography and Population Projection of Tetranychus urticae (Tetranychidae) on Phaseolus vulgaris (Fabaceae) Colonized by Entomopathogenic Fungal Endophytes
Authors: Hong Pengxiang , Dash Chandra Kanta , Ghafar Muhammad Adeel , Haq Inzamam Ul , Lu Liuyang , Zhou Chenghua , Wu Qing , Wang Liande
Published: January 2024

Tetranychus urticae is a highly polyphagous and global pest. Spider mites primarily feed on the underside of leaves, resulting in decreased photosynthesis, nutritional loss, and the development of chlorotic patches. We investigated the life tables of the two-spotted spider mite T. urticae on fungal endophyte Beauveria bassiana colonized and untreated plants of the common Phaseolus vulgaris L., a bean plant. Based on the age-stage, two-sex life table theory, data were evaluated. The mites raised on untreated plants had protonymphs, deutonymphs, and total pre-adult stage durations that were considerably shorter (1.76, 2.14, and 9.77 d, respectively) than the mites raised on plants that had been colonized (2.02, 2.45, and 10.49 d, respectively). The fecundity (F) varied from 28.01 eggs per female of colonized plants to 57.67 eggs per female of endophyte-untreated plants. The net reproductive rate (R0) in the plants with and without endophytes was 19.26 and 42.53 brood, respectively. The untreated plants had an intrinsic rate of increase (rm) of 0.245 days as opposed to the colonized plants, which had an r of 0.196 days and a finite rate of increase (λ) (1.27 and 1.21, respectively). Population forecasts based on a two-sex, age-stage life table demonstrated the dynamism and variability of the stage structure. Furthermore, the colonization of B. bassiana had a negative impact on the growth and development of T. urticae. It lowered the adult mite life span, female fecundity, net reproduction rate, and intrinsic growth rate. We propose that future research should better use entomopathogenic fungal endophytes to understand host plant resistance strategies in integrated pest management.
Bridging the Gap between Field Experiments and Machine Learning: The EC H2020 B-GOOD Project as a Case Study towards Automated Predictive Health Monitoring of Honey Bee Colonies
Authors: van Dooremalen Coby , Ulgezen Zeynep N. , Dall’Olio Raffaele , Godeau Ugoline , Duan Xiaodong , Sousa José Paulo , Schäfer Marc O. , Beaurepaire Alexis , van Gennip Pim , Schoonman Marten , Flener Claude , Matthijs Severine , Claeys Boúúaert David , Verbeke Wim , Freshley Dana , Valkenburg Dirk-Jan , van den Bosch Trudy , Schaafsma Famke , Peters Jeroen , Xu Mang , Le Conte Yves , Alaux Cedric , Dalmon Anne , Paxton Robert J. , Tehel Anja , Streicher Tabea , Dezmirean Daniel S. , Giurgiu Alexandru I. , Topping Christopher J. , Williams James Henty , Capela Nuno , Lopes Sara , Alves Fátima , Alves Joana , Bica João , Simões Sandra , Alves da Silva António , Castro Sílvia , Loureiro João , Horčičková Eva , Bencsik Martin , McVeigh Adam , Kumar Tarun , Moro Arrigo , van Delden April , Ziółkowska Elżbieta , Filipiak Michał , Mikołajczyk Łukasz , Leufgen Kirsten , De Smet Lina , de Graaf Dirk C.
Published: January 2024

Honey bee colonies have great societal and economic importance. The main challenge that beekeepers face is keeping bee colonies healthy under ever-changing environmental conditions. In the past two decades, beekeepers that manage colonies of Western honey bees (Apis mellifera) have become increasingly concerned by the presence of parasites and pathogens affecting the bees, the reduction in pollen and nectar availability, and the colonies’ exposure to pesticides, among others. Hence, beekeepers need to know the health condition of their colonies and how to keep them alive and thriving, which creates a need for a new holistic data collection method to harmonize the flow of information from various sources that can be linked at the colony level for different health determinants, such as bee colony, environmental, socioeconomic, and genetic statuses. For this purpose, we have developed and implemented the B-GOOD (Giving Beekeeping Guidance by computational-assisted Decision Making) project as a case study to categorize the colony’s health condition and find a Health Status Index (HSI). Using a 3-tier setup guided by work plans and standardized protocols, we have collected data from inside the colonies (amount of brood, disease load, honey harvest, etc.) and from their environment (floral resource availability). Most of the project’s data was automatically collected by the BEEP Base Sensor System. This continuous stream of data served as the basis to determine and validate an algorithm to calculate the HSI using machine learning. In this article, we share our insights on this holistic methodology and also highlight the importance of using a standardized data language to increase the compatibility between different current and future studies. We argue that the combined management of big data will be an essential building block in the development of targeted guidance for beekeepers and for the future of sustainable beekeeping.
Combination Insecticide Treatments with Methoprene and Pyrethrin for Control of Khapra Beetle Larvae on Different Commodities
Authors: Scheff Deanna S. , Arthur Frank H. , Domingue Michael J. , Myers Scott W.
Published: January 2024

Trogoderma granarium Everts, the khapra beetle, is a serious pest of stored products throughout the world. Larvae pose a significant threat to stored products because they feed on >100 different commodities, possess the ability to enter facultative diapause, and are difficult to detect. Control methods for T. granarium include fumigation, contact insecticides, trapping, and insecticide-incorporated packaging. The objective of this study was to determine the residual efficacy of two insecticide formulations (methoprene + deltamethrin + piperonyl butoxide synergist Gravista® and methoprene + deltamethrin, DiaconIGR®Plus). These insecticides were evaluated on three stored product commodities, corn, wheat, and brown rice, by exposing T. granarium larvae during a 12-month testing period. Both formulations significantly reduced adult emergence on corn and wheat for 12 months and on brown rice for up to 6 months. Adult emergence was highest at month 12 for corn (8.41%), and brown rice (85.88%), and month 9 for wheat (39.52%), treated with DiaconIGR®Plus or Gravista®, respectively. A biological index used to measure the development of exposed larvae on the treated grain from the larval stage (low values) to adult emergence (high values) was lower (fewer adults) on corn and wheat compared to controls. Despite differences in formulations, each of these grain protectants could be utilized by stored commodity managers to protect commodities during storage and transportation for T. granarium when and if this pest is detected at USA ports of entry.
The True Dislocation Incidence following Elective Total Hip Replacement in Sweden: How Does It Relate to the Revision Rate?
Authors: Cnudde Peter H. J. , Nåtman Jonatan , Rolfson Ola , Hailer Nils P.
Published: January 2024

(1) Background: The true dislocation incidence following THA is difficult to ascertain in population-based cohorts. In this study, we explored the cumulative dislocation incidence (CDI), the relationship between the incidence of dislocation and revision surgery, patient- and surgery-related factors in patients dislocating once or multiple times, and differences between patients being revised for dislocation or not. (2) Methods: We designed an observational longitudinal cohort study linking registers. All patients with a full dataset who underwent an elective unilateral THA between 1999 and 2014 were included. The CDI and the time from the index THA to the first dislocation or to revision were estimated using the Kaplan–Meier (KM) method, giving cumulative dislocation and revision incidences at different time points. (3) Results: 136,810 patients undergoing elective unilateral THA were available for the analysis. The 30-day CDI was estimated at 0.9% (0.9–1.0). The revision rate for dislocation throughout the study period remained much lower. A total of 51.2% (CI 49.6–52.8) suffered a further dislocation within 1 year. Only 10.9% of the patients with a dislocation within the first year postoperatively underwent a revision for dislocation. (4) Discussion: The CDI after elective THA was expectedly considerably higher than the revision incidence. Further studies investigating differences between single and multiple dislocators and the criteria by which patients are offered revision surgery following dislocation are urgently needed.
Clinical Applications of “In-Hospital” 3D Printing in Hip Surgery: A Systematic Narrative Review
Authors: Aguado-Maestro Ignacio , Simón-Pérez Clarisa , García-Alonso Manuel , Ailagas-De Las Heras Juan José , Paredes-Herrero Elena
Published: January 2024

Introduction: Interest in 3D printing for orthopedic surgery has been increasing since its progressive adoption in most of the hospitals around the world. The aim of the study is to describe all the current applications of 3D printing in patients undergoing hip surgery of any type at the present time. Materials and Methods: We conducted a systematic narrative review of publications indexed in MedLine through the search engine PubMed, with the following parameters: 3D printing AND (orthopedics OR traumatology) NOT tissue engineering NOT scaffold NOT in vitro and deadline 31 July 2023. After reading the abstracts of the articles, papers were selected according to the following criteria: full text in English or Spanish and content related to hip surgery. Those publications involving experimental studies (in vitro or with anatomical specimens) or 3D printing outside of hospital facilities as well as 3D-printed commercial implants were excluded. Results are presented as a reference guide classified by disease, including the used software and the steps required for the development of the idea. Results: We found a total of 27 indications for in-house 3D printing for hip surgery, which are described in the article. Conclusions: There are many surgical applications of 3D printing in hip surgery, most of them based on CT images. Most of the publications lack evidence, and further randomized studies should be encouraged to assess the advantages of these indications.
Role of Transjugular Intrahepatic Portosystemic Shunt in the Liver Transplant Setting
Authors: Di Cola Simone , Lapenna Lucia , Gazda Jakub , Fonte Stefano , Cusi Giulia , Esposito Samuele , Mattana Marco , Merli Manuela
Published: January 2024

Liver transplantation is currently the only curative therapy for patients with liver cirrhosis. Not all patients in the natural course of the disease will undergo transplantation, but the majority of them will experience portal hypertension and its complications. In addition to medical and endoscopic therapy, a key role in managing these complications is played by the placement of a transjugular intrahepatic portosystemic shunt (TIPS). Some indications for TIPS placement are well-established, and they are expanding and broadening over time. This review aims to describe the role of TIPS in managing patients with liver cirrhosis, in light of liver transplantation. As far as it is known, TIPS placement seems not to affect the surgical aspects of liver transplantation, in terms of intraoperative bleeding rates, postoperative complications, or length of stay in the Intensive Care Unit. However, the placement of a TIPS “towards transplant” can offer advantages in terms of ameliorating a patient’s clinical condition at the time of transplantation and improving patient survival. Additionally, the TIPS procedure can help preserve the technical feasibility of the transplant itself. In this context, indications for TIPS placement at an earlier stage are drawing particular attention. However, TIPS insertion in decompensated patients can also lead to serious adverse events. For these reasons, further studies are needed to make reliable recommendations for TIPS in the pre-transplant setting.
Recurrence-Free Survival after Synovectomy and Subsequent Radiosynoviorthesis in Patients with Synovitis of the Knee—A Retrospective Data Analysis
Authors: Schindler Melanie , Puchner Stephan , Reinhard Jan , Leiss Franziska , Windhager Reinhard , Lass Richard
Published: January 2024

Background: Persistent knee synovitis leads to joint discomfort, incapacitating inflammation, and functional limitations. The conventional approach has involved surgical procedures to eliminate the actively inflamed synovial membrane. This study aims to investigate the recurrence-free survival and functional outcome after synovectomy and subsequent radiosynoviorthesis (RSO) in patients with knee synovitis. Methods: Thirty-seven knees diagnosed with pigmented villonodular synovitis (PVNS), rheumatoid arthritis (RA), and peripheral spondyloarthritis underwent synovectomy and subsequent RSO between May 2005 and October 2016. The mean age was 34.9 ± 15.1 years, and the mean follow-up period was 84 ± 36.4 months. Clinical outcomes were assessed using the Oxford Knee Score and the presence of swelling and pain at the last follow-up. Recurrence-free survival denotes the duration from synovectomy to surgical re-synovectomy. Results: In general, twelve knees underwent re-synovectomy after a mean follow-up of 34.8 ± 24.9 months. The recurrence-free survival was 83.8% at two years, 71.3% at five years, and 61.7% at ten years. The subgroup analysis revealed recurrence-free survival at two years in 63.6% of patients with PVNS, 86.7% of those with RA, and 100% of individuals with peripheral spondyloarthritis. Conclusions: This study demonstrates that combined therapy for synovitis is an effective approach, significantly improving clinical outcomes.
Predicting Functional Outcomes of Total Hip Arthroplasty Using Machine Learning: A Systematic Review
Authors: Clement Nick D. , Clement Rosie , Clement Abigail
Published: January 2024

The aim of this review was to assess the reliability of machine learning (ML) techniques to predict the functional outcome of total hip arthroplasty. The literature search was performed up to October 2023, using MEDLINE/PubMed, Embase, Web of Science, and NIH Clinical Trials. Level I to IV evidence was included. Seven studies were identified that included 44,121 patients. The time to follow-up varied from 3 months to more than 2 years. Each study employed one to six ML techniques. The best-performing models were for health-related quality of life (HRQoL) outcomes, with an area under the curve (AUC) of more than 84%. In contrast, predicting the outcome of hip-specific measures was less reliable, with an AUC of between 71% to 87%. Random forest and neural networks were generally the best-performing models. Three studies compared the reliability of ML with traditional regression analysis: one found in favour of ML, one was not clear and stated regression closely followed the best-performing ML model, and one showed a similar AUC for HRQoL outcomes but did show a greater reliability for ML to predict a clinically significant change in the hip-specific function. ML offers acceptable-to-excellent discrimination of predicting functional outcomes and may have a marginal advantage over traditional regression analysis, especially in relation to hip-specific hip functional outcomes.
Do Neutrophil–Lymphocyte Ratio and Platelet–Lymphocyte Ratio Need to Be Stratified for Age and Comorbidities in COVID-19 Disease? A Subgroup Analysis of Two Distinct Cohorts over Disease Course
Authors: Kagansky Nadya , Levy Yochai , Awar Anas , Derazne Estela , Shilovsky Alexander , Kagansky Dana , Chepelev Victor , Mazurez Evelina , Stambler Ilia , Levtzion-Korach Osnat
Published: January 2024

Several studies described neutrophil–lymphocyte ratio (NLR) and platelet–lymphocyte ratio (PLR) as markers of COVID-19 severity. In a recently published study, age and frailty affected NLR and PLR more than disease severity. The study compared two distinct cohorts. The first comprised older frailer patients positive for SARS-CoV-2, with mild or asymptomatic disease, admitted to designated COVID-19 departments in a large geriatric medical center (GMC). The second cohort comprised COVID-19 patients admitted to a large general hospital (GH) for symptomatic disease. This was a follow-up study comparing a subgroup of patients who had NLR and PLR values measured a week after admission. Only 100 of 177 patients in the original GMC cohort had a second NLR test compared to almost all (287 of 289) patients in the general hospital (GH) cohort. The subgroup baseline characteristics did not change significantly from that of the original cohort. Disease symptoms were more prevalent in the GH cohort. In the GMC group, the median second NLR rose from 3.9 to 4.6, while in the GH cohort, the NLR value dropped from 3.5 to 2.8, enhancing the NLR differences between the groups. Smaller changes were observed in the second PLR. These results strengthen the prior results that age and frailty seem to have a stronger impact on NLR and PLR than disease severity.
A Cohort of 469 Mayer–Rokitansky–Küster–Hauser Syndrome Patients—Associated Malformations, Syndromes, and Heterogeneity of the Phenotype
Authors: Pietzsch Martin , Schönfisch Birgitt , Höller Alice , Koch André , Staebler Annette , Dreser Katharina , Bettecken Kristina , Schaak Lisa , Brucker Sara Yvonne , Rall Katharina
Published: January 2024

The Mayer–Rokitansky–Küster–Hauser syndrome is characterized by aplasia of the uterus and upper two-thirds of the vagina. While it can appear as an isolated genital malformation, it is often associated with extragenital abnormalities, with little still known about the pathogenetic background. To provide an overview of associated malformations and syndromes as well as to examine possible ties between the rudimentary tissue and patient characteristics, we analyzed a cohort of 469 patients with MRKHS as well as 298 uterine rudiments removed during surgery. A total of 165 of our patients (35.2%) had associated malformations (MRKHS type II). Renal defects were the most common associated malformation followed by skeletal abnormalities. Several patients had atypical associated malformations or combined syndromes. Uterine rudiments were rarer in patients with associated malformations than in patients without them. Rudiment size ranged from 0.3 cm3 to 184.3 cm3 with a mean value of 7.9 cm3. Importantly, MRKHS subtype or concomitant malformations were associated with a different frequency of uterine tissue as well as a different rudiment size and incidence of endometrial tissue, thereby indicating a clear heterogeneity of the phenotype. Further research into the associated molecular pathways and potential differences between MRKHS subtypes is needed.
SYK-623, a δ Opioid Receptor Inverse Agonist, Mitigates Chronic Stress-Induced Behavioral Abnormalities and Disrupted Neurogenesis
Authors: Iwai Takashi , Mishima Rei , Hirayama Shigeto , Nakajima Honoka , Oyama Misa , Watanabe Shun , Fujii Hideaki , Tanabe Mitsuo
Published: January 2024

The δ opioid receptor (DOR) inverse agonist has been demonstrated to improve learning and memory impairment in mice subjected to restraint stress. Here, we investigated the effects of SYK-623, a new DOR inverse agonist, on behavioral, immunohistochemical, and biochemical abnormalities in a mouse model of imipramine treatment-resistant depression. Male ddY mice received daily treatment of adrenocorticotropic hormone (ACTH) combined with chronic mild stress exposure (ACMS). SYK-623, imipramine, or the vehicle was administered once daily before ACMS. After three weeks, ACMS mice showed impaired learning and memory in the Y-maze test and increased immobility time in the forced swim test. SYK-623, but not imipramine, significantly suppressed behavioral abnormalities caused by ACMS. Based on the fluorescent immunohistochemical analysis of the hippocampus, ACMS induced a reduction in astrocytes and newborn neurons, similar to the reported findings observed in the postmortem brains of depressed patients. In addition, the number of parvalbumin-positive GABA neurons, which play a crucial role in neurogenesis, was reduced in the hippocampus, and western blot analysis showed decreased glutamic acid decarboxylase protein levels. These changes, except for the decrease in astrocytes, were suppressed by SYK-623. Thus, SYK-623 mitigates behavioral abnormalities and disturbed neurogenesis caused by chronic stress.
Bronchial Progenitor Cells in Obstructive and Neoplastic Lung Disease: A Pilot Study
Authors: Ragnoli Beatrice , Fusco Federica , Pignatti Patrizia , Cena Tiziana , Valente Guido , Malerba Mario
Published: January 2024

The alteration of progenitor/stem cells present in the airway epithelium has been observed in patients with COPD. Smoking exposure induces remodeling patterns in bronchial progenitor cells (BPCs), encompassing squamous metaplasia, hyperplasia of basal and of mucus-secreting cells, and the depletion of ciliated and non-mucous secretory cells. Our aim was to assess the expression of p63 and vimentin as potential markers of airway remodeling and the regulation of stem cell populations in obstructive and neoplastic lung disease patients. A retrospective single-center observational study was conducted, including patients undergoing bronchoscopy with bronchial biopsies for suspected lung cancer. p63 and vimentin expression were evaluated via immunohistochemical analysis. There were 25 patients, of which 21 with COPD were included, and 17 were diagnosed with lung cancer. We observed that FEV1% was negatively correlated with p63+ basal cell number (r = −0.614, p = 0.019) and positively correlated with vimentin expression (r = 0.670; p = 0.008). p63 was significantly higher in biopsies from the trachea and main bronchi compared to more distal areas (p = 0.040), whereas vimentin was prevalent in the more distal areas (p = 0.042). Our preliminary data suggest the initial evidence of structural changes in BPCs among patients with COPD and lung cancer. Further research efforts are warranted to investigate additional morphologic and functional respiratory parameters in these patients.
TNM Staging System in Thymoma: A Critical Appraisal?
Authors: Ambrogi Marcello Carlo , Aprile Vittorio , Lenzini Alessandra , Bacchin Diana , Mastromarino Maria Giovanna , Korasidis Stylianos , Lucchi Marco
Published: January 2024

Thymomas are rare tumors of the anterior mediastinum with peculiar clinical and pathological features. They have been deeply analyzed by pioneer authors, who strictly linked their name to the main pathological and staging classifications. Before the latest edition of the WHO classification of thymic epithelial tumors, the history of thymoma pathological classification inherited the name of the pathologists who systematically addressed the issue, from Levine-Rosai to Muller-Hermelink. Similarly, the thymoma staging system is intimately related to the name of two surgeons, Masaoka and Koga, who historically dealt with this disease. More recently, the traditional tumor-nodes-metastasis (TNM) system has been developed for the staging of this condition, in a rational attempt to put thymomas in conformity with the other solid tumors. The efforts of the International Thymic Malignancies Interest Group (ITMIG) and the Thymic Domain of the Staging and Prognostic Factors Committee (TD-SPFC) of the International Association for the Study of Lung Cancer (IASLC) resulted in the TNM classification of thymic tumors, which have been included in the eighth edition of the American Joint Committee on Cancer’s (AJCC) Cancer Staging Manual. Herein, we report a narrative review of the evolution of the thymic epithelial tumors (TET) staging system and present a critical appraisal of the actual TNM classification compared with the historical Masaoka-Koga classification, with special focus on the proposal for the ninth edition of the TNM, expected in 2024.
Developing a Virtual Reality Simulation System for Preoperative Planning of Robotic-Assisted Thoracic Surgery
Authors: Ujiie Hideki , Chiba Ryohei , Yamaguchi Aogu , Nomura Shunsuke , Shiiya Haruhiko , Fujiwara-Kuroda Aki , Kaga Kichizo , Eitel Chad , Clapp Tod R. , Kato Tatsuya
Published: January 2024

Background. Robotic-assisted thoracic surgery (RATS) is now standard for lung cancer treatment, offering advantages over traditional methods. However, RATS’s minimally invasive approach poses challenges like limited visibility and tactile feedback, affecting surgeons’ navigation through com-plex anatomy. To enhance preoperative familiarization with patient-specific anatomy, we devel-oped a virtual reality (VR) surgical navigation system. Using head-mounted displays (HMDs), this system provides a comprehensive, interactive view of the patient’s anatomy pre-surgery, aiming to improve preoperative simulation and intraoperative navigation. Methods. We integrated 3D data from preoperative CT scans into Perspectus VR Education software, displayed via HMDs for in-teractive 3D reconstruction of pulmonary structures. This detailed visualization aids in tailored preoperative resection simulations. During RATS, surgeons access these 3D images through Tile-ProTM multi-display for real-time guidance. Results. The VR system enabled precise visualization of pulmonary structures and lesion relations, enhancing surgical safety and accuracy. The HMDs offered true 3D interaction with patient data, facilitating surgical planning. Conclusions. VR sim-ulation with HMDs, akin to a robotic 3D viewer, offers a novel approach to developing robotic surgical skills. Integrated with routine imaging, it improves preoperative planning, safety, and accuracy of anatomical resections. This technology particularly aids in lesion identification in RATS, optimizing surgical outcomes.
Chronic Liver Diseases: What is Up?
Authors: Fagoonee Sharmila , Invernizzi Pietro
Published: January 2024

During the preparation of this Special Issue, Dr [...]
A Qualitative Exploration of Prominent Factors Contributing to the Aetiology of Child and Adolescent Eating Disorder Presentations during the COVID-19 Pandemic: The Perspectives of Patients, Parents and Clinicians
Authors: Murray Finán , Houghton Sharon , Murphy Fay , Clancy Emma , Fortune Dónal , McNicholas Fiona
Published: January 2024

Aim: The aim of this study was to explore the prominent factors that contributed to the development of child and adolescent eating disorder presentations during the COVID-19 pandemic. Methods: This was achieved through a qualitative analysis of interviews gathered from (1) adolescent patients diagnosed with an eating disorder (ED) during the COVID-19 pandemic (aged 13–18) (n = 4), (2) parents of patients attending an ED service (n = 7) and (3) clinicians working within a specialist child and adolescent ED support service (n = 7). Reflexive thematic analysis was used to analyse the data and establish the most prominent aetiological factors reported. Results: The most prominent aetiological factors reported were (1) the accumulation of risk factors; (2) seeking control amid increased anxiety, stress and uncertainty; (3) social isolation; (4) an increased focus on exercise and “healthy eating”; (5) increased social media use promoting unhelpful attention towards ED triggers; and (6) a lack of both awareness and support services. Conclusion: During the COVID-19 pandemic, the quantity and severity of ED presentations increased. The current study uncovered six themes perceived by patients, parents and clinical staff that contributed to the aetiology of ED presentations during the COVID-19 pandemic. It is hoped that the insight gained through this research study into ED aetiology may act as a basis for further research and support ED awareness, prevention and intervention in the future.
The Impact of Nociception Monitor-Guided Multimodal General Anesthesia on Postoperative Outcomes in Patients Undergoing Laparoscopic Bowel Surgery: A Randomized Controlled Trial
Authors: Okamoto Satoshi , Ogata Hiroki , Ooba Shohei , Saeki Ayano , Sato Fumiya , Miyamoto Kazunori , Kobata Mayu , Okutani Hiroai , Ueki Ryusuke , Kariya Nobutaka , Hirose Munetaka
Published: January 2024

Background: Excess surgical stress responses, caused by heightened nociception, can lead to elevated levels of postoperative inflammation, resulting in an increased incidence of complications after surgery. We hypothesized that utilizing nociception monitor-guided multimodal general anesthesia would exert effects on postoperative outcomes (e.g., serum concentrations of C-reactive protein (CRP) after surgery, postoperative complications). Methods: This single-center, double-blinded, randomized trial enrolled ASA class I/II adult patients with normal preoperative CRP levels, scheduled for laparoscopic bowel surgery. Patients were randomized to receive either standard care (control group) or nociception monitor-guided multimodal general anesthesia using the nociceptive response (NR) index (NR group), where NR index was kept below 0.85 as possible. The co-primary endpoint was serum concentrations of CRP after surgery or rates of 30-day postoperative complications (defined as Clavien–Dindo grades ≥ II). Main Results: One hundred and four patients (control group, n = 52; NR group, n = 52) were enrolled for analysis. The serum CRP level on postoperative day (POD) 1 was significantly lower in the NR group (2.70 mg·dL−1 [95% confidence interval (CI), 2.19–3.20]) than in the control group (3.66 mg·dL−1 [95% CI, 2.98–4.34], p = 0.024). The postoperative complication rate was also significantly lower in the NR group (11.5% [95% CI, 5.4–23.0]) than in the control group (38.5% [95% CI, 26.5–52.0], p = 0.002). Conclusions: Nociception monitor-guided multimodal general anesthesia, which suppressed intraoperative nociception, mitigated serum concentrations of CRP level, and decreased postoperative complications after laparoscopic bowel surgery.
Ultrasound-Assisted, Catheter-Directed Thrombolysis for Acute Intermediate/High-Risk Pulmonary Embolism: Design of the Multicenter USAT IH-PE Registry and Preliminary Results
Authors: Colombo Claudia , Capsoni Nicolò , Russo Filippo , Iannaccone Mario , Adamo Marianna , Viola Giovanna , Bossi Ilaria Emanuela , Villanova Luca , Tognola Chiara , Curci Camilla , Morelli Francesco , Guerrieri Rossella , Occhi Lucia , Chizzola Giuliano , Rampoldi Antonio , Musca Francesco , De Nittis Giuseppe , Galli Mario , Boccuzzi Giacomo , Savio Daniele , Bernasconi Davide , D’Angelo Luciana , Garascia Andrea , Chieffo Alaide , Montorfano Matteo , Oliva Fabrizio , Sacco Alice
Published: January 2024

Catheter-based revascularization procedures were developed as an alternative to systemic thrombolysis for patients with intermediate-high- and high-risk pulmonary embolisms. USAT IH-PE is a retrospective and prospective multicenter registry of such patients treated with ultrasound-facilitated, catheter-directed thrombolysis, whose preliminary results are presented in this study. The primary endpoint was the incidence of pulmonary hypertension (PH) at follow-up. Secondary endpoints were short- and mid-term changes in the echocardiographic parameters of right ventricle (RV) function, in-hospital and all-cause mortality, and procedure-related bleeding events. Between March 2018 and July 2023, 102 patients were included. The majority were at intermediate–high-risk PE (86%), were mostly female (57%), and had a mean age of 63.7 ± 14.5 years, and 28.4% had active cancer. Echocardiographic follow-up was available for 70 patients, and in only one, the diagnosis of PH was confirmed by right heart catheterization, resulting in an incidence of 1.43% (CI 95%, 0.036–7.7). RV echocardiographic parameters improved both at 24 h and at follow-up. In-hospital mortality was 3.9% (CI 95%, 1.08–9.74), while all-cause mortality was 11% (CI 95%, 5.4–19.2). Only 12% had bleeding complications, of whom 4.9% were BARC ≥ 3. Preliminary results from the USAT IH-PE registry showed a low incidence of PH, improvement in RV function, and a safe profile.
Long-Term Evaluation of the Shape of the Reconstructed Diaphragm in Patients with Left-Sided Congenital Diaphragmatic Hernia Using Serial Chest Radiographs and Correlation to Further Complications
Authors: von Schrottenberg Christoph , Lindacker Maren , Weis Meike , Büttner Sylvia , Schaible Thomas , Boettcher Michael , Wessel Lucas M. , Zahn Katrin B.
Published: January 2024

Background: Defining risk factors for long-term comorbidities in patients after neonatal repair of congenital diaphragmatic hernia (CDH) is an important cornerstone of the implementation of targeted longitudinal follow-up programs. Methods: This study systematically assessed serial chest radiographs of 89 patients with left-sided CDH throughout a mean follow-up of 8.2 years. These geometrical variables for the left and right side were recorded: diaphragmatic angle (LDA, RDA), diaphragmatic diameter (LDD, RDD), diaphragmatic height (LDH, RDH), diaphragmatic curvature index (LDCI, RDCI), lower lung diameter (LLLD, RLLD) and thoracic area (LTA, RTA). Results: It was demonstrated that the shape of the diaphragm in patients with large defects systematically differs from that of patients with small defects. Characteristically, patients with large defects present with a smaller LDCI (5.1 vs. 8.4, p < 0.001) at 6 months of age, which increases over time (11.4 vs. 7.0 at the age of 15.5 years, p = 0.727), representing a flattening of the patch and the attached rudimentary diaphragm as the child grows. Conclusions: Multiple variables during early follow-up were significantly associated with comorbidities such as recurrence, scoliotic curves of the spine and a reduced thoracic area. Some geometrical variables may serve as surrogate parameters for disease severity, which is associated with long-term comorbidities.
Nonpapillary Prone Endoscopic Combined Intrarenal Surgery (ECIRS): Five-Year Experience and Outcomes from a High-Volume Center
Authors: Kallidonis Panagiotis , Spinos Theodoros , Tatanis Vasileios , Skarimpa Anna , Vrettos Theofanis , Katsakiori Paraskevi , Liatsikos Evangelos
Published: January 2024

Endoscopic combined intrarenal surgery (ECIRS) provides simultaneous retrograde and percutaneous access to the upper urinary tract. The purpose of this study is to present revised data, tips and tricks, and technique modifications arising from our five-year experience with ECIRS. The data of 62 patients who underwent nonpapillary prone ECIRS from January 2019 to November 2023 were prospectively collected. All cases were performed in the prone position. Inclusion criteria were complex stone cases with stones in multiple calyces requiring either multiple accesses or multiple sessions to achieve stone-free status. Patients’ mean age was 54.4 ± 12.39 years, while the mean stone size was 39.03 ± 13.93 mm. The mean operative time was 51.23 ± 17.75 min. Primary and final stone-free rates were 83.8% and 90.3%, respectively. In total, nine patients presented with postoperative complications, which were all Grade II ones. The holmium-YAG laser type during retrograde lithotripsy was associated with significantly shorter operative times compared to the thulium fiber laser. Nonpapillary prone ECIRS is a feasible, safe, and efficient approach for patients with specific stone and anatomy characteristics. The implementation of more, higher-evidence studies is of utmost importance so that safer conclusions can be drawn.
The Impact of Previous Comorbidities on New Comorbidities and Medications after a Mild SARS-CoV-2 Infection in a Lithuanian Cohort
Authors: Važgėlienė Dovilė , Kubilius Raimondas , Bileviciute-Ljungar Indre
Published: January 2024

This cross-sectional study investigates new comorbidities and new medications after a mild SARS-CoV-2 infection. Data were collected after an acute SARS-CoV-2 infection by online survey in a Lithuanian cohort. Sociodemographic data, SARS-CoV-2-related symptoms, previous and new comorbidities, and medications were analysed. The results of 895 participants (mean age: 44 years) show that 91% were women, 58% had higher education, and 84% were working. Among those, 473 (52.8%) answered being “healthy” before infection; 823 (92%) indicated being positive on diagnostic tests; and 841 (94%) were non-hospitalized. Asymptomatic infection was reported by 17 participants (1.9%). Participants reporting any comorbidity before a SARS-CoV-2 infection reported more frequently having remaining symptoms compared to those who were “healthy”, particularly in relation to neurological symptoms. Thirteen percent of participants reported new comorbidities, and thirty-five percent started new medication. Among new medications, an intake of vitamins/supplements (21%) and anti-inflammatory drugs (4%) was more often reported by “unhealthy” participants. Regression analysis revealed that new cardiovascular and pulmonary diagnoses predicted each other. Participants reporting prior neurological disorders tended to have an increased risk of intaking new vitamins/supplements and anti-inflammatory drugs after infection. The results indicate a significantly increased consumption of medication, particularly unprescribed substances, after SARS-CoV-2, indicating a need of more research in this area.
Post-Capillary Pulmonary Hypertension: Clinical Review
Authors: Riley Joshua M. , Fradin James J. , Russ Douglas H. , Warner Eric D. , Brailovsky Yevgeniy , Rajapreyar Indranee
Published: January 2024

Pulmonary hypertension (PH) caused by left heart disease, also known as post-capillary PH, is the most common etiology of PH. Left heart disease due to systolic dysfunction or heart failure with preserved ejection fraction, valvular heart disease, and left atrial myopathy due to atrial fibrillation are causes of post-capillary PH. Elevated left-sided filling pressures cause pulmonary venous congestion due to backward transmission of pressures and post-capillary PH. In advanced left-sided heart disease or valvular heart disease, chronic uncontrolled venous congestion may lead to remodeling of the pulmonary arterial system, causing combined pre-capillary and post-capillary PH. The hemodynamic definition of post-capillary PH includes a mean pulmonary arterial pressure > 20 mmHg, pulmonary vascular resistance < 3 Wood units, and pulmonary capillary wedge pressure > 15 mmHg. Echocardiography is important in the identification and management of the underlying cause of post-capillary PH. Management of post-capillary PH is focused on the treatment of the underlying condition. Strategies are geared towards pharmacotherapy and guideline-directed medical therapy for heart failure, surgical or percutaneous management of valvular disorders, and control of modifiable risk factors and comorbid conditions. Referral to centers with advanced heart and pulmonary teams has shown to improve morbidity and mortality. There is emerging interest in the use of targeted agents classically used in pulmonary arterial hypertension, but current data remain limited and conflicting. This review aims to serve as a comprehensive summary of postcapillary PH and its etiologies, pathophysiology, diagnosis, and management, particularly as it pertains to advanced heart failure.
Relationship between Handgrip Strength and Incident Diabetes in Korean Adults According to Gender: A Population-Based Prospective Cohort Study
Authors: Lee Sung-Bum , Jo Min-Kyeung , Moon Ji-Eun , Lee Hui-Jeong , Kim Jong-Koo
Published: January 2024

(1) Background: Diabetes mellitus (DM) is a well-known disease that causes comorbidities such as chronic kidney disease (CKD) and cardiovascular disease. Therefore, it is necessary to develop diagnostic tools to prevent DM. Handgrip strength, a known diagnostic tool for sarcopenia, is a predictor of several diseases. However, the value of handgrip strength as an indicator of incident DM in Asian populations remains unknown. This study aimed to identify the relationship between handgrip strength and incidence of DM in Korean adults according to sex. (2) Methods: A total of 173,195 participants registered in a nationwide cohort were included in this study. After applying the exclusion criteria, 33,326 participants remained. DM occurred in 1473 individuals during the follow-up period (mean follow-up period, 4.1 years). To reduce the impact of body size, the study population was subdivided into quartiles of relative handgrip strength, defined as absolute handgrip strength divided by body mass index. Multivariate Cox regression analysis revealed that the relative handgrip strength was inversely associated with new-onset DM. (3) Results: Compared with the lowest quartile (Q1), the hazard ratios (HRs) [95% confidence intervals (CIs)] for new-onset DM for the highest quartiles (Q4) was 0.60 (0.43–0.84) in men and 0.72 (0.52–0.99) in women after adjusting for confounding factors. The incidence of DM decreased with the increase in the relative handgrip strength. These inverse relationships were statistically more significant in men than in women. (4) Conclusions: This novel study revealed that relative handgrip strength is related to incident DM in both men and women. Relative handgrip strength can be used as a practical tool to prevent DM. Regular measurement of handgrip strength can be used to detect DM.
Novel Artificial Intelligence-Based Assessment of Imaging Biomarkers in Full-Thickness Macular Holes: Preliminary Data from a Pivotal Trial
Authors: Mariotti Cesare , Mangoni Lorenzo , Iorio Silvia , Lombardo Veronica , Fruttini Daniela , Rizzo Clara , Chhablani Jay , Midena Edoardo , Lupidi Marco
Published: January 2024

Artificial intelligence (AI)- and deep learning (DL)-based systems have shown significant progress in the field of macular disorders, demonstrating high performance in detecting retinal fluid and assessing anatomical changes during disease progression. This study aimed to validate an AI algorithm for identifying and quantifying prognostic factors in visual recovery after macular hole (MH) surgery by analyzing major optical coherence tomography (OCT) biomarkers. This study included 20 patients who underwent vitrectomy for a full-thickness macular hole (FTMH). The mean diameter of the FTMH was measured at 285.36 ± 97.4 μm. The preoperative best-corrected visual acuity (BCVA) was 0.76 ± 0.06 logMAR, improving to 0.38 ± 0.16 postoperatively, with a statistically significant difference (p = 0.001). AI software was utilized to assess biomarkers, such as intraretinal fluid (IRF) and subretinal fluid (SRF) volume, external limiting membrane (ELM) and ellipsoid zone (EZ) integrity, and retinal hyperreflective foci (HRF). The AI analysis showed a significant decrease in IRF volume, from 0.08 ± 0.12 mm3 preoperatively to 0.01 ± 0.01 mm3 postoperatively. ELM interruption improved from 79% ± 18% to 34% ± 37% after surgery (p = 0.006), whereas EZ interruption improved from 80% ± 22% to 40% ± 36% (p = 0.007) postoperatively. Additionally, the study revealed a negative correlation between preoperative IRF volume and postoperative BCVA recovery, suggesting that greater preoperative fluid volumes may hinder visual improvement. The integrity of the ELM and EZ was found to be essential for postoperative visual acuity improvement, with their disruption negatively impacting visual recovery. The study highlights the potential of AI in quantifying OCT biomarkers for managing MHs and improving patient care.
Autophagy-Related Gene ATG7 Polymorphism Could Potentially Serve as a Biomarker of the Progression of Atrophic Gastritis
Authors: Yamaguchi Naoyuki , Sakaguchi Takuki , Taira Miki , Fukuda Daisuke , Ohnita Ken , Hirayama Tatsuro , Yashima Kazuo , Isomoto Hajime , Tsukamoto Kazuhiro
Published: January 2024

Cytotoxin-associated gene A (CagA) is an oncoprotein that H. pylori injects into the host’s gastric epithelial cells and that induces proinflammatory cytokines, such as interleukin (IL)-18 and IL-1β. As a result, it leads to atrophic gastritis (AG), a precancerous lesion of gastric cancer. On the other hand, host cells degrade CagA using autophagy systems. However, few studies exist about the single nucleotide polymorphisms (SNPs) in MAP1LC3A, MAP1LC3B, ATG4A, ATG4B, ATG4C, ATG7, and ATG13, which belong to the autophagy-related genes concerning AG. This study aimed to detect biomarkers associated with AG. Herein, H. pylori-positive subjects (n = 200) were divided into the AG (n = 94) and non-AG (n = 106) groups. Thirty tag SNPs were selected from the above seven candidate genes. The SNP frequency between the two groups was analyzed. The frequency of the C/T or T/T genotype at rs4683787 of ATG7 was significantly lower in the AG group than in the non-AG group (p = 0.034, odds ratio = 0.535). Based on multivariate analysis, the C/C genotype of rs4684787 and age were independently associated with gastric mucosal atrophy. This finding helps stratify the patients needing timely endoscopic screening or early eradication of H. pylori.