bluuebunny/crossref_metadata_2025 huggingface dataset:
When the Past Teaches the Future: Earthquake and Tsunami Risk Reduction through Episodes of Situated Learning (ESL)
Authors: Piangiamore Giovanna Lucia , Maramai Alessandra
Published: February 2024

The past offers important lessons with regard to facing the future with greater awareness. In this context, school plays a key role in spreading knowledge of natural phenomena and in promoting behavior change. Together with researchers, teachers can be strong allies to build more resilient future citizens. The Istituto Nazionale di Geofisica e Vulcanologia (INGV) school training activities provide tools to prepare for the next earthquake and/or tsunami. Approximately 5000 students, from both middle schools (ISCED 2) and high schools (ISCED 3), were involved in active learning activities based on a flipped-up approach during specific online scientific events during the pandemic. Online lab activities were conducted during European Researchers’ Night (“Earthquakes: history teaches us the future: researchers for a day with experimentation in didactics for ESL”) and during both World Water Day 2021 and World Earth Day 2021 (“Tsunamis: history teaches us the future researchers for a day with experimentation in didactics for ESL”). These two Episodes of Situated Learning (ESL) experiences triggered students’ interest, favoring remote learning, developing life skills, and focusing on historical seismic studies of both past earthquakes and tsunamis.
Modelling of Truck Tire–Rim Slip on Sandy Loam Using Advanced Computational Techniques
Authors: Collings William , El-Sayegh Zeinab , Ren Jing , El-Gindy Moustafa
Published: February 2024

Vehicles often experience low tire pressures and high torques in off-road operations, making tire–rim slip likely. Tire–rim slip is undesirable relative rotation between the tire and rim, which, in this study, is measured by the relative tire–rim slip rate. There is little research on the effect of different terrains on tire–rim slip despite its significance for off-road driving; therefore, this topic was explored through Finite Element Analysis (FEA) simulations. An upland sandy loam soil was modelled and calibrated using Smoothed-Particle Hydrodynamics (SPH), and then a Regional Haul Drive (RHD) truck tire was simulated driving over this terrain, with a drawbar load added to increase drive torque. To examine their effects, five parameters were changed: tire–rim friction coefficient, longitudinal wheel speed, drawbar load, vertical load, and inflation pressure. The simulations showed that increasing the tire–rim friction coefficient and the inflation pressure decreased the tire–rim slip while increasing the vertical and drawbar loads increased the tire–rim slip. Varying the longitudinal wheel speed had no significant effect. Tire–rim slip was more likely to occur on the soil because it happened at lower drawbar loads on the soil than on the hard surface. These research results increased knowledge of tire–rim slip mechanics and provided a foundation for exploring tire–rim slip on other terrains, such as clays or sands.
Residents’ Environmentally Responsible Behavior and Tourists’ Sustainable Use of Cultural Heritage: Mediation of Destination Identification and Self-Congruity as a Moderator
Authors: Elshaer Ibrahim A. , Azazz Alaa M. S. , Fayyad Sameh
Published: February 2024

In the face of escalating global concerns surrounding environmental sustainability and the preservation of cultural heritage, this research explores the intricate connection between residents’ environmentally responsible conduct (ERB) and tourists’ sustainable involvement with cultural heritage sites (SU). Highlighting the pivotal importance of destination identification (DI) as a mediator and self-congruity (SC) as a moderator, our study utilizes a quantitative data approach to investigate the nuanced relationships inherent in the domain of tourism destinations. The data were collected from 324 tourists (visiting Luxor heritage city in Egypt) and analyzed by PLS-SEM, and the results showed a positive correlation between residents who strongly identify with their local environment and an increased dedication to environmentally responsible actions. Moreover, tourists who demonstrate elevated levels of self-congruity with the cultural heritage destination are inclined to embrace more sustainable behaviors, thereby making positive contributions to heritage preservation initiatives. This study enriches the evolving domain of sustainable tourism by providing insights into the intricate interactions between residents and tourists, fostering environmentally responsible behavior, and promoting the sustainable utilization of cultural heritage. Practical applications encompass the formulation of community-based interventions, the design of destination marketing strategies, and the proposal of policy recommendations. These initiatives aim to enhance the engagement of both residents and tourists, fostering the long-term preservation of cultural and environmental assets. Ultimately, the research seeks to guide sustainable tourism practices that strike a balance between the economic advantages of tourism and the essential preservation of cultural heritage and natural environments for future generations.
β-Aminobutyric Acid Effectively Postpones Senescence of Strawberry Fruit by Regulating Metabolism of NO, H2S, Ascorbic Acid, and ABA
Authors: Wang Lei , Liu Jingru , Li Meilin , Liu Li , Zheng Yonghua , Zhang Hua
Published: February 2024

Current researchis focused on the influence of β-aminobutyric acid (BABA) on the metabolism of nitric oxide (NO), hydrogen sulfide (H2S), ascorbic acid, and abscisic acid (ABA) in strawberry fruit. The increases in ion leakage and malondialdehyde (MDA) concentration in strawberry fruit and the degradation of chlorophyll in the sepals of the fruit were markedly inhibited by BABA at 20 mM. BABA-immersed fruit exhibited lower activities and expressions of polygalacturonase (PG), pectinmethylesterase (PME), and ethylene biosynthetic enzymes compared to the control. Furthermore, BABA immersion evidently upgraded the metabolic levels of NO and H2S, including the enzymatic activities and intermediary contents of metabolites, which collectively enhanced the levels of endogenous NO and H2S contents in strawberry fruit. The high enzymatic activities and gene expressions of the AsA biosynthesis pathway jointly maintained AsA accumulation in the BABA-treated sample. The application of BABA led to a decrease in ABA concentration, which was associated with reduced activities and gene expression levels of key enzymes participating in ABA metabolism. Our experimental observations showed that immersion with BABA may be a highly promising means to delay senescence and reduce natural decay in strawberry fruit, and the alleviation in senescence using BABA may be attributed to the modulation of NO, H2S, AsA, and ABA metabolism.
Genome-Wide Identification and Expression Analysis of Beta-Galactosidase Family Members in Chinese Bayberry (Myrica rubra)
Authors: Sun Li , Yu Qinpei , Zhang Shuwen , Yu Zheping , Liang Senmiao , Zheng Xiliang , Ren Haiying , Qi Xingjiang
Published: February 2024

Fruit development and softening play pivotal roles in determining fruit quality and post-harvest shelf life in Chinese bayberry (Myrica rubra). However, the specific role of beta (β)-galactosidase, particularly β-galactosidase of M. rubra (MrBGAL), in facilitating fruit softening remains unclear. In this study, we aimed to address this gap by investigating the involvement of MrBGALs genes in fruit softening. We identified all 15 MrBGALs and conducted a comprehensive analysis, including phylogenetic relationships, gene structure, protein motifs, co-linearity, and expression patterns. Using phylogenetic analysis, we classified all MrBGALs into five distinct groups. Additionally, cis-element prediction and comparative genome analysis provided insightful clues about the functionality of MrBGALs. Transcriptome data revealed unique expression patterns of MrBGALs throughout various fruit development stages. These findings introduce valuable candidate genes that can contribute to unraveling the functions and molecular mechanisms governing fruit development and softening in Chinese bayberry.
The Use of Economic Indicators as Early Signals of Stock Market Progress: Perspectives from Market Potential Index
Authors: Eldomiaty Tarek , Azzam Islam , Fouad Mostafa , Said Yasmeen
Published: February 2024

The progress of financial markets depends on the way world investors foresee the market potential of the country of choice. Countries that are associated with favorable economic incentives are able to motivate investments in their respective stock markets. The objective of this paper is to examine the role of the many economic components which constitute the Market Potential Index in enhancing stock market progress. The methodology goes through testing and estimation. The tests include linearity versus nonlinearity (RESET), normality, and cointegration. The estimation includes cointegration regression and discriminant analysis to distinguish between high and low stock market progress. This study examines unbalanced panel data that covers the years 1996–2022 for 54 countries where a stock market exists. The results show the following: (a) increases in people’s expenditure result in decreases in consumption of investment in financial securities; (b) the investments in infrastructure technology is positively associated with stock market progress; (c) the positive effect of economic freedom indicates that further adaptive trading regulations are beneficial to stock market progress; (d) increases in imports consume large proportions of people’s income, coming at the expense of investment in financial securities; (e) stock markets that are associated with high country risk are characterized by a positive risk–return tradeoff, i.e., a high risk premium; (f) the stock markets listed in the MPI can reach high progress by improving three indicators, namely commercial infrastructure, market receptivity, and country risk. This paper offers a thorough and unique examination of the institutional arrangements and stock market progress. The paper offers a guide to policy makers about how economic institutional arrangements can be promoted in order to reach high stock market progress.
Cartographic Metadata for Improving Accessibility and Facilitating Knowledge Extraction and Validation in Planetary Mapping Based on Remote-Sensing Observations
Authors: van Gasselt Stephan , Naß Andrea
Published: February 2024

The field of planetary mapping and cartography builds almost exclusively on remote-sensing data and can be defined by three distinct concepts: systematic imaging as performed through spacecraft surveying, reference mapping as performed through the compilation of reference maps, i.e., regional to global image and topographic maps, and thematic mapping, which aims at abstracting and contextualizing spatial information to generate complex thematic maps, such as geologic or geomorphologic maps. While thematic mapping represents the highest form of abstraction of information that is provided through systematic mapping, thematic mapping also provides scientific reasoning in support of systematic mapping and exploration through spatially contextualized knowledge. For the development of knowledge, it is paramount to manage and exploit the value of thematic maps as research products, and to design a reliable and transparent development process from the beginning of the mapping phase as there is almost no validation for thematic maps. A key element in accomplishing these objectives is well-designed structures and metadata which are maintained within spatial data infrastructures (SDI) and shared as a coordinated process in research data management through data models. In this contribution, we focus on the need to transfer planetary thematic maps into findable, accessible, interoperable, reusable (FAIR), as well as transparent research data assets to facilitate improved knowledge extraction and also to compensate for limitations caused by the lack of conventional validation options. We review the current status of planetary thematic mapping, and we discuss the principles and roles of mappers and publishers in the process of creating and stewarding digital planetary maps and associated data products. We then present and discuss a set of recommendations that are closely tied to the FAIR concepts in research data management to accomplish such tasks.
Metformin and Glucose Concentration as Limiting Factors in Retinal Pigment Epithelial Cell Viability and Proliferation
Authors: Villa-Fernández Elsa , García Ana Victoria , Fernández-Fernández Alejandra , García-Villarino Miguel , Ares-Blanco Jessica , Pujante Pedro , González-Vidal Tomás , Fraga Mario F. , Torre Edelmiro Menéndez , Delgado Elias , Lambert Carmen
Published: February 2024

Metformin is a well-established drug for the treatment of type 2 diabetes; however, the mechanism of action has not been well described and many aspects of how it truly acts are still unknown. Moreover, regarding in vitro experiments, the glycaemic status when metformin is used is generally not considered, which, added to the suprapharmacological drug concentrations that are commonly employed in research, has resulted in gaps of its mechanism of action. The aim of this study was to determine how glucose and metformin concentrations influence cell culture. Considering that diabetic retinopathy is one of the most common complications of diabetes, a retinal pigment epithelial cell line was selected, and cell viability and proliferation rates were measured at different glucose and metformin concentrations. As expected, glucose concentration by itself positively influenced cell proliferation rates. When the metformin was considered, results were conditioned, as well, by metformin concentration. This conditioning resulted in cell death when high concentrations of metformin were used under physiological concentrations of glucose, while this did not happen when clinically relevant concentrations of metformin were used independently of glucose status. Our study shows the importance of in vitro cell growth conditions when drug effects such as metformin’s are being analysed.
MiR-290 Family Maintains Pluripotency and Self-Renewal by Regulating MAPK Signaling Pathway in Intermediate Pluripotent Stem Cells
Authors: Liu Yueshi , Li Xiangnan , Ma Xiaozhuang , Du Qiankun , Wang Jiemin , Yu Haiquan
Published: February 2024

Mouse embryonic stem cells (ESCs) and epiblast stem cells (EpiSCs) are derived from pre- and post-implantation embryos, representing the initial “naïve” and final “primed” states of pluripotency, respectively. In this study, novel reprogrammed pluripotent stem cells (rPSCs) were induced from mouse EpiSCs using a chemically defined medium containing mouse LIF, BMP4, CHIR99021, XAV939, and SB203580. The rPSCs exhibited domed clones and expressed key pluripotency genes, with both X chromosomes active in female cells. Furthermore, rPSCs differentiated into cells of all three germ layers in vivo through teratoma formation. Regarding epigenetic modifications, the DNA methylation of Oct4, Sox2, and Nanog promoter regions and the mRNA levels of Dnmt3a, Dnmt3b, and Dnmt1 were reduced in rPSCs compared with EpiSCs. However, the miR-290 family was significantly upregulated in rPSCs. After removing SB203580, an inhibitor of the p38 MAPK pathway, the cell colonies changed from domed to flat, with a significant decrease in the expression of pluripotency genes and the miR-290 family. Conversely, overexpression of pri-miR-290 reversed these changes. In addition, Map2k6 was identified as a direct target gene of miR-291b-3p, indicating that the miR-290 family maintains pluripotency and self-renewal in rPSCs by regulating the MAPK signaling pathway.
Studying the Effect of MBNL1 and MBNL2 Loss in Skeletal Muscle Regeneration
Authors: Yadava Ramesh S. , Mandal Mahua , Mahadevan Mani S.
Published: February 2024

Loss of function of members of the muscleblind-like (MBNL) family of RNA binding proteins has been shown to play a key role in the spliceopathy of RNA toxicity in myotonic dystrophy type 1 (DM1), the most common muscular dystrophy affecting adults and children. MBNL1 and MBNL2 are the most abundantly expressed members in skeletal muscle. A key aspect of DM1 is poor muscle regeneration and repair, leading to dystrophy. We used a BaCl2-induced damage model of muscle injury to study regeneration and effects on skeletal muscle satellite cells (MuSCs) in Mbnl1∆E3/∆E3 and Mbnl2∆E2/∆E2 knockout mice. Similar experiments have previously shown deleterious effects on these parameters in mouse models of RNA toxicity. Muscle regeneration in Mbnl1 and Mbnl2 knockout mice progressed normally with no obvious deleterious effects on MuSC numbers or increased expression of markers of fibrosis. Skeletal muscles in Mbnl1∆E3/∆E3/ Mbnl2∆E2/+ mice showed increased histopathology but no deleterious reductions in MuSC numbers and only a slight increase in collagen deposition. These results suggest that factors beyond the loss of MBNL1/MBNL2 and the associated spliceopathy are likely to play a key role in the defects in skeletal muscle regeneration and deleterious effects on MuSCs that are seen in mouse models of RNA toxicity due to expanded CUG repeats.
Multi-Omics Analysis Reveals the IFI6 Gene as a Prognostic Indicator and Therapeutic Target in Esophageal Cancer
Authors: Viet-Nhi Nguyen-Kieu , Minh Quan Tran , Cong Truc Vu , Anh Bich Tran , Hoang Nam Pham , Le Nguyen Quoc Khanh , Chen Po-Yueh , Hung Shih-Han
Published: February 2024

The role of the IFI6 gene has been described in several cancers, but its involvement in esophageal cancer (ESCA) remains unclear. This study aimed to identify novel prognostic indicators for ESCA-targeted therapy by investigating IFI6’s expression, epigenetic mechanisms, and signaling activities. We utilized public data from the Gene Expression Omnibus (GEO) and the Cancer Genome Atlas (TCGA) to analyze IFI6’s expression, clinical characteristics, gene function, pathways, and correlation with different immune cells in ESCA. The TIMER2.0 database was employed to assess the pan-cancer expression of IFI6, while UALCAN was used to examine its expression across tumor stages and histology subtypes. Additionally, the KEGG database helped identify related pathways. Our findings revealed 95 genes positively correlated and 15 genes negatively correlated with IFI6 in ESCA. IFI6 was over-expressed in ESCA and other cancers, impacting patient survival and showing higher expression in tumor tissues than normal tissues. IFI6 was also correlated with CD4+ T cells and B cell receptors (BCRs), both essential in immune response. GO Biological Process (GO BP) enrichment analysis indicated that IFI6 was primarily associated with the Type I interferon signaling pathway and the defense response to viruses. Intriguingly, KEGG pathway analysis demonstrated that IFI6 and its positively correlated genes in ESCA were mostly linked to the Cytosolic DNA-sensing pathway, which plays a crucial role in innate immunity and viral defense, and the RIG-I-like receptor (RLR) signaling pathway, which detects viral infections and activates immune responses. Pathways related to various viral infections were also identified. It is important to note that our study relied on online databases. Given that ESCA consists of two distinct subgroups (ESCC and EAC), most databases combine them into a single category. Future research should focus on evaluating IFI6 expression and its impact on each subgroup to gain more specific insights. In conclusion, inhibiting IFI6 using targeted therapy could be an effective strategy for treating ESCA considering its potential as a biomarker and correlation with immune cell factors.
Transcriptome Analysis of Compensatory Growth and Meat Quality Alteration after Varied Restricted Feeding Conditions in Beef Cattle
Authors: Deng Tianyu , Liang Mang , Du Lili , Li Keanning , Li Jinnan , Qian Li , Xue Qingqing , Qiu Shiyuan , Xu Lingyang , Zhang Lupei , Gao Xue , Li Junya , Lan Xianyong , Gao Huijiang
Published: February 2024

Compensatory growth (CG) is a physiological response that accelerates growth following a period of nutrient limitation, with the potential to improve growth efficiency and meat quality in cattle. However, the underlying molecular mechanisms remain poorly understood. In this study, 60 Huaxi cattle were divided into one ad libitum feeding (ALF) group and two restricted feeding groups (75% restricted, RF75; 50% restricted, RF50) undergoing a short-term restriction period followed by evaluation of CG. Detailed comparisons of growth performance during the experimental period, as well as carcass and meat quality traits, were conducted, complemented by a comprehensive transcriptome analysis of the longissimus dorsi muscle using differential expression analysis, gene set enrichment analysis (GSEA), gene set variation analysis (GSVA), and weighted correlation network analysis (WGCNA). The results showed that irrespective of the restriction degree, the restricted animals exhibited CG, achieving final body weights comparable to the ALF group. Compensating animals showed differences in meat quality traits, such as pH, cooking loss, and fat content, compared to the ALF group. Transcriptomic analysis revealed 57 genes and 31 pathways differentially regulated during CG, covering immune response, acid-lipid metabolism, and protein synthesis. Notably, complement–coagulation–fibrinolytic system synergy was identified as potentially responsible for meat quality optimization in RF75. This study provides novel and valuable genetic insights into the regulatory mechanisms of CG in beef cattle.
Detecting Moral Features in TV Series with a Transformer Architecture through Dictionary-Based Word Embedding
Authors: Fantozzi Paolo , Rotondi Valentina , Rizzolli Matteo , Dalla Torre Paola , Naldi Maurizio
Published: February 2024

Moral features are essential components of TV series, helping the audience to engage with the story, exploring themes beyond sheer entertainment, reflecting current social issues, and leaving a long-lasting impact on the viewers. Their presence shows through the language employed in the plot description. Their detection helps regarding understanding the series writers’ underlying message. In this paper, we propose an approach to detect moral features in TV series. We rely on the Moral Foundations Theory (MFT) framework to classify moral features and use the associated MFT dictionary to identify the words expressing those features. Our approach combines that dictionary with word embedding and similarity analysis through a deep learning SBERT (Sentence-Bidirectional Encoder Representations from Transformers) architecture to quantify the comparative prominence of moral features. We validate the approach by applying it to the definition of the MFT moral feature labels as appearing in general authoritative dictionaries. We apply our technique to the summaries of a selection of TV series representative of several genres and relate the results to the actual content of each series, showing the consistency of results.
Walkability Infrastructures and Urban Rebalancing: The Case Study of L’Aquila City under Post-Earthquake Reconstruction
Authors: Eugeni Federico , Sacco Sara , Di Ludovico Donato , D’Ovidio Gino
Published: February 2024

This paper describes the first results of the application of an innovative methodology for the development of a walkability overall index for urban street infrastructure, aimed at the application of urban design techniques to improve the urban form and its use by pedestrians. The general objective of the research is to identify the performance of the current city walkable network, to structure public policies and strategies consistent with it aimed at rebalancing settlements and infrastructure, and above all at the development of active mobility. The methodology defined integrates three approaches on walkability analysis: geometric–morphological, proximity, and sociality. In this paper, the analysis process related to the geometric–morphological component and partly to that of proximity will be described. It will be applied to the case study of the city of L’Aquila (Italy), a city undergoing reconstruction after the 2009 earthquake. From the first results of the application of the methodology to the case study, it emerges that the urban area analyzed is not capable of hosting walkable infrastructures unless urban design interventions are aimed at structuring an efficient network of pedestrian paths. In the future development of the study, it is expected to conclude the analysis of the proximity and social components, the other two groups of analysis considerations for walkability, which will complete the experimentation of the general methodology.
Calcium Ferrite Nanoparticles: A Simple Synthesis Approach for the Effective Disposal of Congo Red Dye from Aqueous Environments
Authors: Al-Kadhi Nada S. , Al-Senani Ghadah M. , Algethami Faisal K. , Shah Reem K. , Saad Fawaz A. , Munshi Alaa M. , Rehman Khalil ur , Khezami Lotfi , Abdelrahman Ehab A.
Published: February 2024

Congo red dye is classified as a toxic chemical and can be harmful if ingested, inhaled, or in contact with the skin or eyes. It can cause irritation, allergic reactions, and skin sensitization in some individuals. Thus, in this paper, CaFe2O4 nanoparticles were produced by a simple Pechini sol-gel approach and used as an adsorbent material for the efficient disposal of Congo red dye from aqueous solutions. The maximum adsorption capacity of the CaFe2O4 towards Congo red dye is 318.47 mg/g. Furthermore, the synthesized CaFe2O4 nanoparticles exhibit an average crystal size of 24.34 nm. Scanning electron microscopy (SEM) examination showed that the CaFe2O4 nanoparticles are basically ball-like particles with a mean grain size of 540.54 nm. Moreover, transmission electron microscopy (TEM) examination showed that the CaFe2O4 sample revealed aggregated spherical particles with a mean diameter of 27.48 nm. The Energy-dispersive X-ray spectroscopy (EDS) pattern reveals that the produced CaFe2O4 nanoparticles are composed of Ca, Fe, and O elements, with an atomic ratio of 1:2:4 of these elements, respectively. The disposal of Congo red dye by the synthesized CaFe2O4 nanoparticles is chemical, spontaneous, exothermic, perfectly aligned with the pseudo-second-order kinetic model, and exhibited excellent conformity with the Langmuir equilibrium isotherm.
Improving Cathode Testing with a High-Gradient Cryogenic Normal Conducting RF Photogun
Authors: Lawler Gerard Emile , Bosco Fabio , Carillo Martina , Fukasawa Atsushi , Li Zenghai , Majernik Nathan , Sakai Yusuke , Tantawi Sami , Williams Oliver , Yadav Monika , Rosenzweig James
Published: February 2024

Future electron accelerator applications such as X-ray free electron lasers and colliders are dependent on significantly increasing beam brightness. With the observation that linac beam manipulation’s best preservation of max brightness is at the cathode, we are incentivized to create an environment where we can study how to achieve the highest possible photogun brightness. In order to do so, we intend to extract beams from high-brightness photocathodes with the highest achievable accelerating gradients we can manage in a klystron-powered radiofrequency (RF) photogun. We utilize here cryogenic normal conducting cavities to achieve ultra-high gradients via limitation of breakdown rates (BDR). The low temperatures should also reduce cathode emittance by reducing the mean transverse energy (MTE) of electrons near the photoemission threshold. To this end, we have designed and produced a new CrYogenic Brightness-Optimized Radiofrequency Gun (CYBORG) for use in a new beamline at UCLA. We will introduce the enabling RF and photoemission physics as a primer for the new regime of high field low temperature cathodes we intend to enter. We further report the current status of the beamline commissioning, including the cooling of the photogun to 100 K, and producing 0.5 MW of RF feed power, which corresponds to cathode accelerating fields in the range of 80–90 MV/m. We further plan iterative improvements to both to 77 K and 1 MW corresponding to our ultimate goal >120 MV/m. Our discussion will include future beamline tests and the consideration of the initial realization of an ultra-high-gradient photoinjector concept.
Medial Patellofemoral Ligament and Lateral Patellofemoral Ligament Reconstruction after Tibial Tuberosity Transposition in a Young Woman with Patellar Instability
Authors: Merkač Jakob , Sirše Mateja
Published: February 2024

In patients with reccurent lateral and medial patellar instability, isolated medial patellofemoral ligament (MPFL) reconstruction may be insufficient due to poor lateral retinacular tissue quality. In this report, we describe a case of a patient that underwent simultaneous MPFL and lateral patellofemoral ligament (LPFL) reconstruction on the left knee due to chronic bidirectional patellar instability. A 29-year-old female patient presented with first-time lateral patellar dislocation five years ago due to acute strain. She underwent a tibial tuberosity transposition in another hospital. After the surgery, she suffered from recurrent medial and lateral patellar dislocation and presented to our center. MPFL and concomitant LPFL reconstruction on the left knee was simultaneously performed due to bilateral patellar dislocation. The patella was stable postoperatively, and the patient underwent physiotherapy with successful results to date. Single-time patellar dislocation should be treated conservatively. Surgical treatment after the first episode of dislocation can magnitude the risk of postoperative complications. The simultaneous reconstructing of the LPFL yields patellar fixation indistinguishable from the native LPFL. These grafts provide separate tensioning depending on body anatomy, allowing for individualized stability. Anatomical MPFL reconstruction is supported by well-established high-quality research. Reconstructing the LPFL anatomically yields patellar fixation indistinguishable from the native LPFL.
Prognostic Significance of Heart Failure in Acute Pulmonary Embolism: A Comprehensive Assessment of 30-Day Outcomes
Authors: Farid-Zahran Mariam , Méndez-Bailón Manuel , Pedrajas José María , Alonso-Beato Rubén , Galeano-Valle Francisco , Sendín Martín Vanesa , Marco-Martínez Javier , Demelo-Rodríguez Pablo
Published: February 2024

Introduction: Patients with heart failure (HF) are known to have an increased risk of pulmonary embolism (PE), but there is limited evidence regarding the prognostic implications of HF in patients with acute PE and the relationship between PE prognosis and left ventricular ejection fraction (LVEF). The primary objective of this study was the development of a composite outcome (mortality, major bleeding, and recurrence) within the first 30 days. The secondary objective was to identify the role of LVEF in predicting the development of early complications in patients with both HF and reduced LVEF. Material and Methods: A prospective study was conducted at two tertiary hospitals between January 2012 and December 2022 to assess differences among patients diagnosed with acute PE based on the presence or absence of a history of HF. Cox regression models were employed to assess the impact of HF and reduced LVEF on the composite outcome at 30 days. Results: Out of 1991 patients with acute symptomatic PE, 7.13% had a history of HF. Patients with HF were older and had more comorbidities. The HF group exhibited higher mortality (11.27% vs. 4.33%, p < 0.001) and a higher incidence of major bleeding (9.86% vs. 4.54%, p = 0.005). In the multivariate analysis, HF was an independent risk factor for the development of the composite outcome (HR 1.93; 95% CI 1.35–2.76). Reduced LVEF was independently associated with a higher risk of major bleeding (HR 3.44; 95% CI 1.34–8.81). Conclusion: In patients with acute pulmonary embolism, heart failure is independently associated with a higher risk of early complications. Additionally, heart failure with reduced LVEF is an independent risk factor for major bleeding.
Navigating Complexity: A Comprehensive Approach to Middle Cerebral Artery Aneurysms
Authors: Auricchio Anna Maria , Di Bonaventura Rina , Marchese Enrico , Della Pepa Giuseppe Maria , Sturiale Carmelo Lucio , Menna Grazia , Skrap Benjamin , Olivi Alessandro , Albanese Alessio
Published: February 2024

Background: The concept of aneurysm “complexity” has undergone significant changes in recent years, with advancements in endovascular treatments. However, surgical clipping remains a relevant option for middle cerebral artery (MCA) aneurysms. Hence, the classical criteria used to define surgically complex MCA aneurysms require updating. Our objective is to review our institutional series, considering the impacts of various complexity features, and provide a treatment strategy algorithm. Methods: We conducted a retrospective review of our institutional experience with “complex MCA” aneurysms and analyzed single aneurysmal-related factors influencing treatment decisions. Results: We identified 14 complex cases, each exhibiting at least two complexity criteria, including fusiform shape (57%), large size (35%), giant size (21%), vessel branching from the sac (50%), intrasaccular thrombi (35%), and previous clipping/coiling (14%). In 92% of cases, the aneurysm had a wide neck, and 28% exhibited tortuosity or stenosis of proximal vessels. Conclusions: The optimal management of complex MCA aneurysms depends on a decision-making algorithm that considers various complexity criteria. In a modern medical setting, this process helps clarify the choice of treatment strategy, which should be tailored to factors such as aneurysm morphology and patient characteristics, including a combination of endovascular and surgical techniques.
Microvascular Muscle vs. Fascio-Cutaneous Free Flaps for Reconstruction of Plantar Load-Bearing Foot Defects—An International Survey
Authors: Mert Sinan , Heidekrueger Paul I. , Fuchs Benedikt , Nuernberger Tim , Haas-Lützenberger Elisabeth M. , Giunta Riccardo E. , Ehrl Denis , Demmer Wolfram
Published: February 2024

Background: The reconstruction of plantar load-bearing foot defects faces many plastic surgeons with a major challenge. The optimal patient- and defect-oriented reconstructive strategy must be selected. Methods: To analyze the current trends and recommendations in reconstruction of plantar load-bearing foot defects, we conducted an international survey among plastic surgeons querying them about their recommendations and experiences. Results: The survey revealed that the most common strategies for reconstruction of the foot sole are locoregional and microvascular free flaps, emphasizing the relevance of plastic surgery. Among microvascular free flaps, muscle and fascio-cutaneous free flaps are by far the most frequently used. The target qualities of the reconstructed tissue to be considered are manifold, with adherence being the most frequently mentioned. We observed a noteworthy correlation between the utilization of muscle flaps and a preference for adherence. In addition, we identified a substantial correlation between the usage of fascio-cutaneous free flaps and further target qualities, such as good skin quality and sensitivity. Conclusions: Our findings provide insights into the clinical reality and highlight important aspects that must be considered in reconstruction of the weight-bearing areas of the foot providing support in the selection of the appropriate therapy.
Test–Retest Reliability of Isokinetic Strength in Lower Limbs under Single and Dual Task Conditions in Women with Fibromyalgia
Authors: Gomez-Alvaro Mari Carmen , Leon-Llamas Juan Luis , Melo-Alonso Maria , Villafaina Santos , Domínguez-Muñoz Francisco Javier , Gusi Narcis
Published: February 2024

Background: Previous research has established good test–retest reliability for isokinetic dynamometry in fibromyalgia. However, the reliability of this test under dual-task conditions has not been investigated in fibromyalgia. Methods: A total of 10 women with fibromyalgia participated in this study. Participants completed the concentric/concentric test. The dual-task condition involved subtracting two by two while performing the test. Results: Reliability analysis under the single condition showed “poor” to “excellent” values for maximum peak torque in knee extension and “moderate” to “excellent” values for average. “Poor” to “excellent” reliability values were found in knee flexion for the maximum and average. Dual-task condition in knee extension ranged from “moderate” to “excellent” for maximum and average values, and in knee flexion, it ranged from “poor” to “excellent” for maximum value and from “moderate” to “excellent” for average value. Conclusions: Isokinetic dynamometry demonstrated sufficient reliability for measuring strength in knee extension maximum and average during single-task and dual-task conditions, along with knee flexion dual-task average in fibromyalgia. For knee flexion single-task maximum and average and knee flexion dual-task maximum, we did not obtain sufficiently reliable measurements. Only the concentric/concentric test has been studied, and future studies with a larger sample size are needed in order to generalize the results.
The Role of Metacognition in the Prediction of Depressive and Anxiety Symptoms in Chronically Ill Patients
Authors: Kołodziejczyk Agata , Krawczyk Julia , Tkaczyszyn-Mika Elżbieta , Gniewczyńska Julia , Ziarko Michał , Zozulińska-Ziółkiewicz Dorota , Pawłowski Tomasz
Published: February 2024

Introduction: Cancer, diabetes, and heart diseases are frequent causes of depression and anxiety. The study explored the metacognitive beliefs manifested by chronically ill patients and the presence of depressive or anxiety symptoms and the predictive role of metacognition in both. Methods: A total of 254 chronically ill patients participated in the study. The Metacognitive Questionnaire was used to measure the patients’ metacognitive beliefs, whereas the Hospital Anxiety and Depression Scale was applied to evaluate their psychopathological symptoms. A correlation analysis was performed to explore the relationships between metacognition and psychopathological symptoms. Regression analyses were conducted to examine the predictive role of metacognition in anxiety and depression. Results: The Negative Beliefs about Uncontrollability and Danger scale correlated with both anxiety and depression scales, and the Cognitive Confidence scale correlated with the depression scale. Linear regression analyses indicated that metacognitive beliefs were responsible for 32.2% of the variance of anxiety symptoms among all the chronically ill. Metacognitive beliefs accounted for 48.8% of the variance in anxiety symptoms and 36.6% in depressive symptoms among diabetes patients. Conclusions: There are specific correlations between psychopathological symptoms and metacognition among chronically ill patients. Metacognitions have a moderate role in developing and sustaining anxiety and depressive symptoms.
Treatment with Umbilical Cord Blood Platelet Lysate Gel Improves Healing of Diabetic Foot Ulcer
Authors: Lambadiari Vaia , Kountouri Aikaterini , Psahoulia Fοteini , Koliou Georgia-Angeliki , Lazaris Andreas , Michalopoulos Efstathios , Mallis Panagiotis , Korakas Emmanouil , Eleftheriadou Ioanna , Balampanis Konstantinos , Sarris Markos , Tsirigotis Panagiotis , Geroulakos George , Stavropoulos-Giokas Catherine , Dimitriadis George D. , Tentolouris Nikolaos
Published: February 2024

Background: This study was conducted to examine the hypothesis that umbilical cord blood platelet lysate (UCB-PL) gel has a significant impact on the healing rate of DFU. Μethods: In this open-labeled, randomized controlled trial, 110 patients were randomized to treatment with UCB-PL gel (UCB-PL group, n = 52) every three days for one month or dressing with normal saline (control group, n = 58). All participants were followed up for 20 weeks post treatment. Ulcer surface area was assessed with the imitoMeasure application at two, four, and six weeks, and two, four and six months. This study’s main outcome was the reduction in ulcer size over the six-month study period. Results: The mean ulcer area at baseline was 4.1 cm2 in the UCB-PL group and 1.7 cm2 in the control group. At six months post treatment, patients on the UCB-PL treatment displayed a significant reduction in ulcer size compared to baseline 0.12 (0–8.16) in contrast to a more modest change in the control group 1.05 (0–24.7). The ulcer area was decreased at the end of the study in 40 patients (97.6%) in the UCB-PL group and 27 (73%) in the control group (Fisher’s p = 0.002). Conclusions: The application of UCB-PL gel in DFU resulted in a significant reduction in ulcer size compared to regular saline dressing.
Many Models, Little Adoption—What Accounts for Low Uptake of Machine Learning Models for Atrial Fibrillation Prediction and Detection?
Authors: Kawamura Yuki , Vafaei Sadr Alireza , Abedi Vida , Zand Ramin
Published: February 2024

(1) Background: Atrial fibrillation (AF) is a major risk factor for stroke and is often underdiagnosed, despite being present in 13–26% of ischemic stroke patients. Recently, a significant number of machine learning (ML)-based models have been proposed for AF prediction and detection for primary and secondary stroke prevention. However, clinical translation of these technological innovations to close the AF care gap has been scant. Herein, we sought to systematically examine studies, employing ML models to predict incident AF in a population without prior AF or to detect paroxysmal AF in stroke cohorts to identify key reasons for the lack of translation into the clinical workflow. We conclude with a set of recommendations to improve the clinical translatability of ML-based models for AF. (2) Methods: MEDLINE, Embase, Web of Science, Clinicaltrials.gov, and ICTRP databases were searched for relevant articles from the inception of the databases up to September 2022 to identify peer-reviewed articles in English that used ML methods to predict incident AF or detect AF after stroke and reported adequate performance metrics. The search yielded 2815 articles, of which 16 studies using ML models to predict incident AF and three studies focusing on ML models to detect AF post-stroke were included. (3) Conclusions: This study highlights that (1) many models utilized only a limited subset of variables available from patients’ health records; (2) only 37% of models were externally validated, and stratified analysis was often lacking; (3) 0% of models and 53% of datasets were explicitly made available, limiting reproducibility and transparency; and (4) data pre-processing did not include bias mitigation and sufficient details, leading to potential selection bias. Low generalizability, high false alarm rate, and lack of interpretability were identified as additional factors to be addressed before ML models can be widely deployed in the clinical care setting. Given these limitations, our recommendations to improve the uptake of ML models for better AF outcomes include improving generalizability, reducing potential systemic biases, and investing in external validation studies whilst developing a transparent modeling pipeline to ensure reproducibility.
Characteristics and Risk Factors of Delayed Perforation in Endoscopic Submucosal Dissection for Early Gastric Cancer
Authors: Akashi Taro , Yamaguchi Naoyuki , Shiota Junya , Tabuchi Maiko , Kitayama Moto , Hashiguchi Keiichi , Matsushima Kayoko , Akazawa Yuko , Nakao Kazuhiko
Published: February 2024

(1) Background: Delayed perforation after gastric endoscopic submucosal dissection (ESD) for early gastric cancer is a relatively uncommon and serious complication that sometimes requires emergency surgery. This study aimed to determine the clinicopathological features, risk factors, and appropriate management strategies for delayed perforation. (2) Methods: This study included 735 patients with 791 lesions who underwent ESD for early gastric cancer at a single institution between July 2009 and June 2019. We retrospectively compared the clinical features of patients with and without delayed perforations. (3) Results: The incidence of delayed perforations was 0.91%. The identified risk factors included a postoperative stomach condition and histopathological ulceration. A comparison between delayed and intraoperative perforations revealed a postoperative stomach condition as a characteristic risk factor for delayed perforation. Patients with delayed perforation who avoided emergency surgery tended to exhibit an earlier onset of symptoms such as abdominal pain and fever. No peritoneal seeding following delayed perforation was observed for any patient. (4) Conclusions: A postoperative stomach condition and histopathological ulceration were risk factors for delayed perforation. Delayed perforation is a significant complication that requires careful monitoring after gastric ESD for early gastric cancer, particularly in patients with postoperative gastric conditions.
The Use of Venous Catheter and Irrigation with Povidone-Iodine 0.6% in Patients with Punctal and Proximal Canalicular Stenosis: Preliminary Report
Authors: Azzaro Claudia , Meduri Alessandro , Oliverio Giovanni William , De Luca Laura , Gazia Francesco , Franchina Francesco , Aragona Pasquale
Published: February 2024

Background: This study aimed to evaluate the safety and efficacy of povidone-iodine 0.6% (PVI) irrigation for preventing recurrence of stenosis after punctoplasty in patients with punctal and proximal canalicular stenosis treated using a venous catheter as a stent. Methods: Twenty patients were enrolled and divided into two groups. Group 1 received irrigation of 1 mL 0.6% PVI, while Group 2 received 1 mL of balanced salt solution (BSS). The patients underwent baseline, 15-, 30-, and 90-day assessments using the Ocular Surface Disease Index (OSDI) questionnaire, Symptoms Assessment in Dry Eye (SANDE), Schirmer I test, tear meniscus height (TMH), bulbar redness, meibography, and non-invasive breakup time (NIKBUT) through Keratograph 5M (Oculus, Germany). Results: At three months, both groups demonstrated statistically significant improvements in symptoms and ocular surface parameters. However, Group 1 showed statistically significant improvements in OSDI, SANDE scores, bulbar redness, and NIKBUT compared to Group 2. Additionally, no patients in Group 1 presented a recurrence of stenosis, while three patients in Group 2 demonstrated stenosis relapse at the end of the follow-up period. Conclusions: The application of a venous catheter and PVI 0.6% irrigations proved to be effective in treating proximal lacrimal duct stenosis, reducing the risk of recurrence and improving tear film stability, ocular discomfort symptoms, and ocular surface parameters.
Functional Recovery and Regenerative Effects of Direct Transcutaneous Electrical Nerve Stimulation in Treatment of Post-COVID-19 Guillain–Barré and Acute Transverse Myelitis Overlap Syndrome: A Clinical Case
Authors: Al-Zamil Mustafa , Kulikova Natalia G. , Minenko Inessa A. , Mansur Numman , Zalozhnev Denis M. , Uzdenov Marat B. , Dzhanibekova Alina A. , Gochiyayev Alikhan A. , Shnayder Natalia A.
Published: February 2024

Transcutaneous electrical nerve stimulation (TENS) has proven effective in treating pain in many experimental and clinical studies. In addition to the analgesic effect, direct TENS of peripheral nerves had anti-inflammatory and regenerative effects in the treatment of distal polyneuropathy and spinal cord injury. This work demonstrates the experience of using direct TENS in the treatment of a 52-year-old patient with post-COVID-19 Guillain–Barré (GBS) and acute transverse myelitis (ATM) overlap syndrome. Direct TENS of peripheral nerves showed high efficiency in enhancing the therapeutic effect of combined plasma exchange and pharmacotherapy by 89.5% with a significant reduction in neuropathic pain, motor and sensory deficits, bladder and bowel disorders and regression of neurophysiological changes. We suggest that direct TENS of peripheral nerves can be a promising option for combined therapy of GBS and ATM overlap syndrome and other diseases with the simultaneous development of distal polyneuropathy and spinal cord injury. Further trial studies are required.