bluuebunny/crossref_metadata_2025 huggingface dataset:
Levels of Lysozyme and SLPI in Bronchoalveolar Lavage: Exploring Their Role in Interstitial Lung Disease
Authors: Osuna-Gómez Rubén , Mulet Maria , Barril Silvia , Cantó Elisabet , Millan-Billi Paloma , Pardessus Ana , de la Rosa-Carrillo David , Castillo Diego , Vidal Silvia
Published: April 2024

Interstitial lung diseases (ILDs) are characterized by inflammation or fibrosis of the pulmonary parenchyma. Despite the involvement of immune cells and soluble mediators in pulmonary fibrosis, the influence of antimicrobial peptides (AMPs) remains underexplored. These effector molecules display a range of activities, which include immunomodulation and wound repair. Here, we investigate the role of AMPs in the development of fibrosis in ILD. We compare the concentration of different AMPs and different cytokines in 46 fibrotic (F-ILD) and 17 non-fibrotic (NF-ILD) patients by ELISA and using peripheral blood mononuclear cells from in vitro stimulation in the presence of lysozyme or secretory leukocyte protease inhibitor (SLPI) from 10 healthy donors. We observed that bronchoalveolar lavage (BAL) levels of AMPs were decreased in F-ILD patients (lysozyme: p < 0.001; SLPI: p < 0.001; LL-37: p < 0.001; lactoferrin: p = 0.47) and were negatively correlated with levels of TGF-β (lysozyme: p = 0.02; SLPI: p < 0.001) and IL-17 (lysozyme: p < 0.001; SLPI: p < 0.001). We observed that lysozyme increased the percentage of CD86+ macrophages (p < 0.001) and the production of TNF-α (p < 0.001). We showed that lysozyme and SLPI were associated with clinical parameters (lysozyme: p < 0.001; SLPI: p < 0.001) and disease progression (lysozyme: p < 0.001; SLPI: p = 0.01). These results suggest that AMPs may play an important role in the anti-fibrotic response, regulating the effect of pro-fibrotic cytokines. In addition, levels of lysozyme in BAL may be a potential biomarker to predict the progression in F-ILD patients.
Enhancing Flexural Strength of RC Beams with Different Steel–Glass Fiber-Reinforced Polymer Composite Laminate Configurations: Experimental and Analytical Approach
Authors: Pour Arash , Karami Mehrdad , Karakouzian Moses
Published: April 2024

This study intended to measure the efficiency of different strengthening techniques to advance the flexural characteristics of reinforced concrete (RC) beams using glass fiber-reinforced polymer (GFRP) laminates, including externally bonded reinforcement (EBR), externally bonded reinforcement on grooves (EBROG), externally bonded reinforcement in grooves (EBRIG), and the near-surface mounted (NSM) system. A new NSM technique was also established using an anchorage rebar. Then, the effect of the NSM method with and without externally strengthening GFRP laminates was studied. Twelve RC beams (150 × 200 × 1500 mm) were manufactured and examined under a bending system. One specimen was designated as the control with no GFRP laminate. To perform the NSM method, both steel and GFRP rebars were used. In the experiments, capability, as well as the deformation and ductileness of specimens, were evaluated, and a comparison was made between the experimental consequences and existing standards. Finally, a new regression was generated to predict the final resistance of RC beams bound with various retrofitting techniques. The findings exhibited that the NSM technique, besides preserving the strengthening materials, could enhance the load-bearing capacity and ductileness of RC beams up to 42.3% more than the EBR, EBROG, and EBRIG performances.
Identification and Functional Analysis of the fruitless Gene in a Hemimetabolous Insect, Nilaparvata lugens
Authors: Wang Biyun , Mao Zeping , Chen Youyuan , Ying Jinjun , Wang Haiqiang , Sun Zongtao , Li Junmin , Zhang Chuanxi , Zhuo Jichong
Published: April 2024

The fruitless (fru) gene functions as a crucial “tuner” in male insect courtship behavior through distinct expression patterns. In Nilaparvata lugens, our previous research showed doublesex (dsx) influencing male courtship songs, causing mating failures with virgin females. However, the impact of fru on N. lugens mating remains unexplored. In this study, the fru homolog (Nlfru) in N. lugens yielded four spliceosomes: Nlfru-374-a/b, Nlfru-377, and Nlfru-433, encoding proteins of 374aa, 377aa, and 433aa, respectively. Notably, only Nlfru-374b exhibited male bias, while the others were non-sex-specific. All NlFRU proteins featured the BTB conserved domain, with NlFRU-374 and NlFRU-377 possessing the ZnF domain with different sequences. RNAi-mediated Nlfru or its isoforms’ knockdown in nymph stages blocked wing-flapping behavior in mating males, while embryonic knockdown via maternal RNAi resulted in over 80% of males losing wing-flapping ability, and female receptivity was reduced. Nlfru expression was Nldsx-regulated, and yet courtship signals and mating success were unaffected. Remarkably, RNAi-mediated Nlfru knockdown up-regulated the expression of flightin in macropterous males, which regulated muscle stiffness and delayed force response, suggesting Nlfru’s involvement in muscle development regulation. Collectively, our results indicate that Nlfru functions in N. lugens exhibit a combination of conservation and species specificity, contributing insights into fru evolution, particularly in Hemiptera species.
The Bombyx mori singed Gene Is Involved in the High-Temperature Resistance of Silkworms
Authors: Liu Zhenye , Li Cong , Yang Wenyu , Wu Qiao , Xiao Wenfu , Zhu Yan , Wei Qiongqiong , Dong Zhanqi , Zhang Guizheng , Lu Cheng , Pan Minhui , Chen Peng
Published: April 2024

Temperature is an important factor in the growth, development, survival, and reproduction of organisms. The high-temperature resistance mechanism of insects may be significant for use in the prevention and control of insect pests. The silkworm, Bombyx mori, is an important Lepidoptera model species for studies on pest control in agriculture and forestry. We identified a gene in B. mori, the B. mori singed (Bmsn) gene, which is involved in the high-temperature resistance of silkworms. Sn proteins are highly conserved among species in many taxonomic groups. The overexpression of the Bmsn gene promoted the proliferation of silkworm cells, reduced oxidation, and reduced the accumulation of reactive oxygen species under stress. Interfering with the Bmsn gene had the opposite result. We constructed a transgenic B. mori strain that overexpressed the Bmsn gene. The physiological traits of the transgenic strain were significantly improved, and it had stronger high-temperature resistance. The Bmsn gene is involved in the process by which fat bodies respond to high-temperature stress. These findings provide insights into the mechanism of high-temperature resistance of insects and offer a new perspective on agricultural and forestry pest control.
Effects of Disinfectants on Bacterium Paenibacillus larvae in Laboratory Conditions
Authors: Tlak Gajger Ivana , Tomljanović Zlatko , Mutinelli Franco , Granato Anna , Vlainić Josipa
Published: April 2024

American foulbrood is an infectious disease of the honeybee brood that causes multiple types of damage to beekeeping. The causative agent of the disease is the bacterium Paenibacillus larvae, which forms resistant infective spores and is viable for decades. After the eradication measures have been implemented, in cases of clinically visible disease, it is necessary to conduct effective final disinfections of equipment and tools. This study aimed to determine the effect of ten commercially available and commonly used disinfectants on certified strains of P. larvae under laboratory conditions, as well as to compare the obtained results among individual genotypes of P. larvae. Selected products were tested by determining the zone of inhibition using an agar diffusion test, a suspension test for viable bacteria, a surface disinfectant test, and a sporicidal effect in the suspension test. Incidin OxyFoam S and Sekusept Aktiv are both effective against all examined genotypes of P. larvae. Despadac and Despadac Secure have a bactericidal effect, but their sporocidal effect is not as satisfactory as that of Genox. Genoll does not exhibit a sporicidal effect, and Ecocide S at 1%, Bee protect H forte, and Bee protect F did not exhibit a satisfactory sporocidal effect. Additionally, EM® PROBIOTIC FOR BEES did not exhibit any bactericidal effect. The effective application of control measures and proper application of final disinfection can reduce the reoccurrence of visible clinical signs of disease, whereas methods of early diagnosis can significantly reduce the incidence of the disease.
Recurrent Laryngeal Nerve Intraoperative Neuromonitoring Indications in Non-Thyroid and Non-Parathyroid Surgery
Authors: Brunet Aina , Rovira Aleix , Quer Miquel , Sanabria Alvaro , Guntinas-Lichius Orlando , Zafereo Mark , Hartl Dana M. , Coca-Pelaz Andrés , Shaha Ashok R. , Marie Jean-Paul , Vander Poorten Vincent , Piazza Cesare , Kowalski Luiz P. , Randolph Gregory W. , Shah Jatin P. , Rinaldo Alessandra , Simo Ricard
Published: April 2024

Introperative nerve monitoring (IONM) of the recurrent laryngeal nerve (RLN) is a well-established technique to aid in thyroid/parathyroid surgery. However, there is little evidence to support its use in non-thyroid or non-parathyroid surgery. The aim of this paper was to review the current evidence regarding the use of IONM in non-thyroid/non-parathyroid surgery in the head and neck and thorax. A literature search was performed from their inception up to January 2024, including the term “recurrent laryngeal nerve monitoring”. IONM in non-thyroid/non-parathyroid surgery has mainly been previously described in oesophageal surgery and in tracheal resections. However, there is little published evidence on the role of IONM with other resections in the vicinity of the RLN. Current evidence is low-level for the use of RLN IONM in non-thyroid/non-parathyroid surgery. However, clinicians should consider its use in surgery for pathologies where the RLN is exposed and could be injured.
Maxillary Sinus Floor Elevation and Simultaneous Implant Installation via Osseodensification Drills: A Retrospective Analysis of Bone Gain in 72 Patients Followed for 6 Months
Authors: Saglanmak Alper , Cinar Ihsan Caglar , Zboun Mohammed , Arisan Volkan , Mijiritsky Eitan
Published: April 2024

Background/Objectives: The aim of this retrospective study was to radiographically evaluate the endo-sinus bone gain (ESBG) following osseodensification procedures using CBCT and compare the results to more conventional sinus lifting techniques. Methods: A total of 72 patients underwent crestal sinus floor elevation procedures and were provided with 102 implants with a sand-blasted and acid-etched surface with microthreads (Medentika® Microcone Implants, Hugelsheim, Germany). Patients were divided into two groups; the osseodensification group (OD; n = 36) and the osseodensified augmentation group (ODA; n = 36). Results: The mean residual bone height (RBH) was 5.71 (1.77) and 4.30 (0.94) mm in the OD and ODA groups, respectively. An ESBG of 3.45 (1.18) and 5.74 (1.31) mm was observed in the OD and ODA groups, respectively, and as compared to the baseline RBH, the ESBG was statistically significant in both groups after 6 months (p < 0.001). Conclusions: Within the limits of this retrospective study, crestal sinus lifting with the osseodensification technique seems to be a fast, effective, and safe method. Longer follow-up studies with full intrasinus bone topography and structure analyses are needed to prove the success rate of endo-sinus bone gain.
Skill Transfer from Laparoscopic Partial Nephrectomy to the Hugo™ RAS System: A Novel Proficiency Score to Assess Surgical Quality during the Learning Curve
Authors: Prata Francesco , Basile Salvatore , Tedesco Francesco , Ragusa Alberto , Pira Matteo , Iannuzzi Andrea , Fantozzi Marco , Civitella Angelo , Scarpa Roberto Mario , Papalia Rocco
Published: April 2024

Background/Objectives: The absence of validated tools to assess the skill transfer from laparoscopy to robotic surgery remains an unsolved issue in the context of robot-assisted partial nephrectomy (RAPN). We aimed to describe and validate a novel proficiency score to critically evaluate the surgical quality of RAPN with the Hugo™ RAS System (Medtronic, Minneapolis, MN, USA). Methods: Between October 2022 and September 2023, 27 consecutive patients underwent off-clamp RAPN for localized renal tumors at our institution. To analyze the learning curve (LC), the cohort was chronologically divided into two phases of 6 months each. Proficiency was defined as the achievement of trifecta while maintaining a comparable intraoperative time in the interquartile range of laparoscopic partial nephrectomy performed by the same surgeon. A logistic binary regression model was built to identify predictors of proficiency achievement. Results: A proficiency score was achieved in 14 patients (74.1%). At univariable analysis, number of consecutive procedures > 12 (OR 13.7; 95%CI 2.05–21.1, p = 0.007), pathological tumor size (OR 0.92; 95%CI 0.89–0.99, p = 0.04) and essential blood hypertension (OR 0.16; 95%CI 0.03–0.82, p = 0.02) were found to be predictors of proficiency score. At multivariable analysis, after adjusting for potential confounding factors, number of consecutive procedures > 12 (OR 8.1; 95%CI 1.44–14.6, p = 0.03) was the only independent predictor of proficiency score achievement. Conclusions: Our results showed that the skills of an experienced laparoscopic surgeon are transferrable to the novel Hugo™ RAS System in the context of nephron-sparing surgery. Improved surgical quality may be expected after completing the first 12 consecutive procedures.
Sexual Function in Women with Polycystic Ovary Syndrome Living in Stable Heterosexual Relationships: A Cross-Sectional Study
Authors: Warchala Anna , Madej Paweł , Kochanowicz Marta , Krzystanek Marek
Published: April 2024

Background/Objective: The prevalence and character of female sexual dysfunction (FSD) in polycystic ovary syndrome (PCOS) have not been precisely determined. The aim of this study was to assess FSD using the Changes in Sexual Functioning Questionnaire (CSFQ-14) in women with PCOS and their partners compared to a control group, as well as correlations between five subscales, the total score of the CSFQ, and seven questions of the Visual Analogue Scale (VAS). Methods: The study sample (N = 160) comprised two groups: (1) women with PCOS and their partners (n = 91) and (2) women without PCOS and their partners (control group; n = 69). Results: The total scores of the CSFQ did not reveal FSD in either group of women. Regarding all subscales and the total score, the analysis showed a statistically significant difference between women and their partners (in all cases: p < 0.001). The discrepancy in arousal between women and men in the PCOS group was large (the mean difference was −2.32; t = −11.29, p < 0.001, Cohen’s d = −1.26). The importance (VAS1), the level (VAS7) of sexual satisfaction, and the intensity of sexual thoughts (VAS2) correlated with almost all domains of the CSFQ. Conclusions: In conclusion, normal sexual function in PCOS does not mean proper sexual functioning in a sexual relationship.
Autonomic Function and Baroreflex Control in COVID-19 Patients Admitted to the Intensive Care Unit
Authors: Gelpi Francesca , Wu Maddalena Alessandra , Bari Vlasta , Cairo Beatrice , De Maria Beatrice , Fossali Tommaso , Colombo Riccardo , Porta Alberto
Published: April 2024

Background: Autonomic function and baroreflex control might influence the survival rate of coronavirus disease 2019 (COVID-19) patients admitted to the intensive care unit (ICU) compared to respiratory failure patients without COVID-19 (non-COVID-19). This study describes physiological control mechanisms in critically ill COVID-19 patients admitted to the ICU in comparison to non-COVID-19 individuals with the aim of improving stratification of mortality risk. Methods: We evaluated autonomic and baroreflex control markers extracted from heart period (HP) and systolic arterial pressure (SAP) variability acquired at rest in the supine position (REST) and during a modified head-up tilt (MHUT) in 17 COVID-19 patients (age: 63 ± 10 years, 14 men) and 33 non-COVID-19 patients (age: 60 ± 12 years, 23 men) during their ICU stays. Patients were categorized as survivors (SURVs) or non-survivors (non-SURVs). Results: We found that COVID-19 and non-COVID-19 populations exhibited similar vagal and sympathetic control markers; however, non-COVID-19 individuals featured a smaller baroreflex sensitivity and an unexpected reduction in the HP-SAP association during the MHUT compared to the COVID-19 group. Nevertheless, none of the markers of the autonomic and baroreflex functions could distinguish SURVs from non-SURVs in either population. Conclusions: We concluded that COVID-19 patients exhibited a more preserved baroreflex control compared to non-COVID-19 individuals, even though this information is ineffective in stratifying mortality risk.
Assessment of the Impact of SARS-CoV-2 Infection on the Sexual Function of Women, Levels of Oxytocin and Prolactin: A Prospective Cohort Study
Authors: Żak Klaudia , Starek Ernest , Korga-Plewko Agnieszka , Rasoul-Pelińska Karolina , Abramiuk Monika , Michalczuk Mariola , Rajtak Alicja , Kotarski Jan , Frankowska Karolina , Bis Liliana , Ostrowska-Leśko Marta , Bobiński Marcin
Published: April 2024

(1) Background: There is a lack of direct evidence on whether SARS-CoV-2 affects women’s sexual function through a biological-organic mechanism. Existing studies on the topic are few and have produced contradictory results. This study aims to explore the possible relationship between sex hormones and sexual function in patients who have been infected with SARS-CoV-2. Moreover, we aimed to determine whether these changes are related to the clinical course of COVID-19 and whether they are temporary or long-lasting. (2) Methods: A study was conducted on 104 women, including 64 women infected with COVID-19 and a control group of 40 healthy women, between January 2021 and August 2022. Blood samples were collected to measure prolactin and oxytocin levels, and a clinical assessment was performed 3 and 6 months later. Sexual function self-assessment was captured based on the FSFI scale. (3) Results: Our study found that patients with severe COVID-19 had better sexual satisfaction scores one month after recovery but no discernible difference after six months. High levels of serum prolactin were observed in patients with active COVID-19 but became similar to a control group after one month and remained stable over time. Higher prolactin levels were significantly associated with increased arousal and hydration. Individuals with severe COVID-19 had notably low levels of plasma oxytocin, but there was no correlation between oxytocin levels and sexual satisfaction. (4) Conclusions: The gynecologic symptoms, as well as disturbances in oxytocin and prolactin levels, might be observed in a short time after infection. However, SARS-CoV-2 infection has no lasting effect on sexual function, oxytocin, and prolactin levels among women.
Sepsis in Patients Hospitalized in Sicily, Italy, over the Period of 2016–2020: A Retrospective Study
Authors: Pipitò Luca , Puccio Romano , Marrali Domenico , Mancuso Alessandro , Gagliano Maria Chiara , Gaudiano Roberta , Piccione Manfredi , Iaria Chiara , Cascio Antonio
Published: April 2024

Background: Epidemiological data regarding the incidence and mortality of sepsis are scarcely available. The present study aimed to delineate the epidemiology of sepsis and related mortality among patients hospitalized in Sicily, Italy. Methods: Data on the discharge forms of all patients with sepsis in all Sicilian hospitals from January 2016 to December 2020 were retrospectively collected. Results: In Sicily, 15,373 hospitalizations associated with sepsis occurred from 2016 to 2020, with an overall in-hospital mortality rate of 36.3%. The percentage of hospitalizations associated with sepsis represented 0.65% of all admissions, with an increase over the years. Most patients were admitted to non-surgical and non-infectious disease units, accounting for 50.3% of total admissions. Stratification of patients according to age, intensive care unit (ICU) admission, and presence of septic shock revealed variations in in-hospital mortality rates. Among adult ICU-admitted patients with septic shock, mortality was highest at 81.0%, followed by non-ICU adult patients with septic shock (63.5%), ICU pediatric patients with septic shock (56.7%), ICU adult patients without septic shock (43.9%), non-ICU pediatric patients with septic shock (37.9%), non-ICU adult patients without septic shock (17.9%), ICU pediatric patients without septic shock (10.4%), and non-ICU pediatric patients without septic shock (1%).
A Misdiagnosed Familiar Brooke–Spiegler Syndrome: Case Report and Review of the Literature
Authors: Brambullo Tito , De Lazzari Alberto , Franchi Arianna , Trevisson Eva , Garau Maria Luisa , Scarmozzino Federico , Vindigni Vincenzo , Bassetto Franco
Published: April 2024

Aim of the report: Brooke–Spiegler syndrome (BSS) is a rare autosomal dominant disease characterized by the growth of cylindromas, spiradenomas, trichoepitheliomas, or their combination. These neoplasms usually begin in the second decade and progressively increase in number and size over the years. Diagnosis necessitates consideration of family history, clinical examination, histological findings, and genetic analysis. The aim of this paper is to explore the clinical overlap between Brooke–Spiegler syndrome (BSS) and neurofibromatosis type 1 (NF1). We aim to highlight the challenges associated with their differential diagnosis and emphasize the lack of standardized diagnostic criteria and treatment approaches. Case presentation: Hereby, we introduce the case of a 28-year-old male referred for suspicion of neurofibromatosis type 1 (NF1) who initially declined the recommended surgical excision for a scalp mass. After four years, he returned with larger masses of the scalp, and underwent excision of multiple masses, revealing cylindromas, spiradenomas, and spiradenocylindromas. Family history reported similar tumors in his father, who was also diagnosed with NF1 for the presence of multiple subcutaneous lesions on the scalp. Clinical overlap led to a genetic consultation, but testing for CYLD mutations yielded no significant variations. Despite this, the strong family history and consistent findings led to a revised diagnosis of Brooke–Spiegler syndrome, correcting the initial misdiagnosis of NF1 syndrome. Conclusions: Thanks to the evolving landscape of BSS research over the past two decades, its molecular underpinnings, clinical presentation, and histopathological features are now clearer. However, a thorough family history assessment is mandatory when BSS is suspected. It is our belief that a multidisciplinary approach and cooperation between specialists are essential when dealing with BSS. By sharing this case, we hope to underscore the importance of considering BSS as a differential diagnosis, especially in cases with atypical presentations or overlapping features with other syndromes like NF1.
Evaluation of the Comparability of Wantai Wan200+ Instrument with Routine Laboratory Assays for 21 Different Analytes
Authors: Talli Ilaria , Padoan Andrea , Cosma Chiara , Furlan Giulia , Zaninotto Martina , Marchioro Lucio , Galozzi Paola , Basso Daniela , Plebani Mario
Published: April 2024

Background: We compared the performance of 21 different assays performed by the Wantai Wan200+ (Wantai BioPharm, Beijing, China) with respect to other methods in use at the University Hospital of Padova (AOPD), Italy. Methods: The plasma (P) or serum (S) of 5027 leftover samples, collected from May to Sept 2023, was either analyzed or frozen at −20 °C. Beckman DXI800 (DXI), Roche Cobas 8000 e801 (RC), Snibe Maglumi 4000 plus (SM), DiaSorin Liaison XL (DL) and Binding Site Optilite (BS) equipment were used at the AOPD. P-procalcitonin (PCT), DXI; P-Troponin I (TnI), DXI; S-CA125, DXI; S-free PSA (f-PSA), DXI; S-total PSA (t-PSA), DXI; S-IL6, SM; P-Troponin T (TnT), RC; P-NT-proBNP, RC; P-Neuron-Specific Enolase (NSE), RC; S-CA15-3, DL; S-CA19-9, DL; S-AFP, DL; and S-CEA, DL were tested in fresh samples. P-Myoglobin (Myo), DXI; P-Cyfra21-1, RC; S-β2 microglobulin (B2MIC), BS; S-HE4, SM; S-PGI, SM; S-PGII, SM; S-CA72-4, SM; and S-CA50, SM were analyzed in frozen and thawed samples. Bland–Altman (BA), Passing–Bablok (PB) and Cohen’s Kappa (CKa) metrics were used as statistics. Results: An excellent comparability profile was found for 11 analytes. For example, the t-PSA CKa was 0.94 (95%CI: 0.90 to 0.98), and the PB slope and intercept were 1.02 (95%CI: 0.99 to 1.03) and 0.02 (95%CI: 0.01 to 0.03), respectively; the BA bias was 2.25 (95%CI: −0.43 to 4.93). Ten tested measurands demonstrated a suboptimal comparability profile. Biological variation in EFLM (EuBIVAS) performance specifications was evaluated to assess the clinical relevance of measured biases. Conclusions: Evaluation of the Wantai Wan200+’s performance suggests that between-method differences did not exceed the calculated bias. Metrological traceability may influence the comparisons obtained for some measurands.
Effect of Daytime versus Nighttime on Prehospital Care and Outcomes after Severe Traumatic Brain Injury
Authors: Bulte Carolien S. E. , Mansvelder Floor J. , Loer Stephan A. , Bloemers Frank W. , Den Hartog Dennis , Van Lieshout Esther M. M. , Hoogerwerf Nico , van der Naalt Joukje , Absalom Anthony R. , Peerdeman Saskia M. , Giannakopoulos Georgios F. , Schwarte Lothar A. , Schober Patrick , Bossers Sebastiaan M.
Published: April 2024

Background/Objectives: Severe traumatic brain injury (TBI) is a frequent cause of morbidity and mortality worldwide. In the Netherlands, suspected TBI is a criterion for the dispatch of the physician-staffed helicopter emergency medical services (HEMS) which are operational 24 h per day. It is unknown if patient outcome is influenced by the time of day during which the incident occurs. Therefore, we investigated the association between the time of day of the prehospital treatment of severe TBI and 30-day mortality. Methods: A retrospective analysis of prospectively collected data from the BRAIN-PROTECT study was performed. Patients with severe TBI treated by one of the four Dutch helicopter emergency medical services were included and followed up to one year. The association between prehospital treatment during day- versus nighttime, according to the universal daylight period, and 30-day mortality was analyzed with multivariable logistic regression. A planned subgroup analysis was performed in patients with TBI with or without any other injury. Results: A total of 1794 patients were included in the analysis, of which 1142 (63.7%) were categorized as daytime and 652 (36.3%) as nighttime. Univariable analysis showed a lower 30-day mortality in patients with severe TBI treated during nighttime (OR 0.74, 95% CI 0.60–0.91, p = 0.004); this association was no longer present in the multivariable model (OR 0.82, 95% CI 0.59–1.16, p = 0.262). In a subgroup analysis, no association was found between mortality rates and the time of prehospital treatment in patients with combined injuries (TBI and any other injury). Patients with isolated TBI had a lower mortality rate when treated during nighttime than when treated during daytime (OR 0.51, 95% CI 0.34–0.76, p = 0.001). Within the whole cohort, daytime versus nighttime treatments were not associated with differences in functional outcome defined by the Glasgow Outcome Scale. Conclusions: In the overall study population, no difference was found in 30-day mortality between patients with severe TBI treated during day or night in the multivariable model. Patients with isolated severe TBI had lower mortality rates at 30 days when treated at nighttime.
Case Series of Endoscopic Papillary Balloon Dilation for Children with Common Bile Duct Stones and a Review of the Literature
Authors: Kouchi Katsunori , Takenouchi Ayako , Matsuoka Aki , Yabe Kiyoaki , Yoshizawa Hiroko , Nakata Chikako , Fujishiro Jun , Sugiyama Harutoshi
Published: April 2024

Background: Endoscopic sphincterotomy (EST) has been employed for the endoscopic treatment of common bile duct stones (CBDSs) and has been reported to have a high success rate for stone removal. However, EST is associated with a risk of bleeding, perforation, and sphincter of Oddi function disruption. To avoid these risks, endoscopic papillary balloon dilation (EPBD) is an option for CBDS. Sphincter of Oddi function preservation decreases long-term biliary infection and gallstone recurrence. EPBD may have advantages in children who require a long follow up. However, there have been few reports on pediatric cases, particularly in infants. Methods: From September 2017 to December 2023, we performed EPBD for four pediatric CBDSs. The patients were aged from 5 months to 8 years, including two infants aged 5 and 6 months. Furthermore, we reviewed the stone removal rate and complications of 545 ESTs performed at high-volume centers and 13 EPBD-reported cases in children with CBDSs. Results: CBDSs of all patients who underwent EPBD in our institution were successfully removed. No bleeding or perforation was noted; pancreatitis was observed in three patients. In an analysis of 545 ESTs in children, the stone removal rate was high, ranging from 83% to 100% (mean 96%). The incidence of pancreatitis was 0–9.6% (mean 4.4%), and the grade of pancreatitis was almost mild. The bleeding frequency was 1.3–5.4% (mean 2.7%). With regards to the grade of bleeding, seven cases were mild (64%) and four were moderate (36%). Compared with adults who underwent EST, the frequencies of pancreatitis and bleeding were almost equal in children; however, in children, once bleeding occurs, it has a higher risk of leading to blood transfusion. Stone removal via EPBD in children has a 100% success rate. Pancreatitis was responsible for all complications were related; its frequency was 46% (6/13 patients, including five mild cases and one moderate case), which is higher than that of EST and adult cases who underwent EPBD. In most children with pancreatitis, pancreatic enzyme levels returned to normal within 2–3 days following EPBD, and no severe cases caused by EPBD were reported. Conclusions: CBDS removal via EPBD in children has a high success rate with very low risk of bleeding and perforation. Although pancreatitis frequently occurs, most cases are mild. Sphincter of Oddi function preservation via EPBD is expected to prevent long-term stone recurrence and biliary tract infection, and EPBD is considered to be an effective method for CBDS removal in children.
Obesity Surgery Mortality Risk Score as a Predictor for Intensive Care Unit Admission in Patients Undergoing Laparoscopic Bariatric Surgery
Authors: Aceto Paola , De Cicco Roberto , Calabrese Claudia , Marusco Irene , Del Tedesco Filippo , Luca Ersilia , Modesti Cristina , Sacco Teresa , Sollazzi Liliana , Ciccoritti Luigi , Greco Francesco , Giustacchini Piero , Pennestrì Francesco , Gallucci Pierpaolo , Raffaelli Marco
Published: April 2024

Background: Laparoscopic bariatric surgery provides many benefits including lower postoperative pain scores, reduced opioid consumption, shorter hospital stays, and improved quality of recovery. However, the anaesthetic management of obese patients requires caution in determining postoperative risk and in planning adequate postoperative pathways. Currently, there are no specific indications for intensive care unit (ICU) admission in this surgical population and most decisions are made on a case-by-case basis. The aim of this study is to investigate whether Obesity Surgery Mortality Risk Score (OS-MRS) is able to predict ICU admission in patients undergoing laparoscopic bariatric surgery (LBS). Methods: We retrospectively reviewed data of patients who underwent LBS during a 2-year period (2017–2019). The collected data included demographics, comorbidities and surgery-related variables. Postoperative ICU admission was decided via bariatric anaesthesiologists’ evaluations, based on the high risk of postoperative cardiac or respiratory complications. Anaesthesia protocol was standardized. Logistic regression was used for statistical analysis. Results: ICU admission was required in 2% (n = 15) of the 763 patients. The intermediate risk group of the OS-MRS was detected in 84% of patients, while the American Society of Anaesthesiologists class III was reported in 80% of patients. A greater OS-MRS (p = 0.01), advanced age (p = 0.04), male gender (p = 0.001), longer duration of surgery (p = 0.0001), increased number of patient comorbidities (p = 0.002), and previous abdominal surgeries (p = 0.003) were predictive factors for ICU admission. Conclusions: ICU admission in obese patients undergoing LBS is predicted by OS-MRS together with age, male gender, number of comorbidities, previous abdominal surgeries, and duration of surgery.
Evaluation of Motion Artifact Correction Technique for Cone-Beam Computed Tomography Image Considering Blood Vessel Geometry
Authors: Jung Yunsub , Lee Ho , Jun Hoyong , Cho Soobuem
Published: April 2024

Background: In this study, we present a quantitative method to evaluate the motion artifact correction (MAC) technique through the morphological analysis of blood vessels in the images before and after MAC. Methods: Cone-beam computed tomography (CBCT) scans of 37 patients who underwent transcatheter chemoembolization were obtained, and images were reconstructed with and without the MAC technique. First, two interventional radiologists selected the blood vessels corrected by MAC. We devised a motion-corrected index (MCI) metric that analyzed the morphology of blood vessels in 3D space using information on the centerline of blood vessels, and the blood vessels selected by the interventional radiologists were quantitatively evaluated using MCI. In addition, these blood vessels were qualitatively evaluated by two interventional radiologists. To validate the effectiveness of the devised MCI, we compared the MCI values in a blood vessel corrected by MAC and one non-corrected by MAC. Results: The visual evaluation revealed that motion correction was found in the images of 23 of 37 patients (62.2%), and a performance evaluation of MAC was performed with 54 blood vessels in 23 patients. The visual grading analysis score was 1.56 ± 0.57 (radiologist 1) and 1.56 ± 0.63 (radiologist 2), and the proposed MCI was 0.67 ± 0.11, indicating that the vascular morphology was well corrected by the MAC. Conclusions: We verified that our proposed method is useful for evaluating the MAC technique of CBCT, and the MAC technique can correct the blood vessels distorted by the patient’s movement and respiration.
Diagnostic Ability of Manual Calcification Length Assessment on Non-Electrocardiographically Gated Computed Tomography for Estimating the Presence of Coronary Artery Disease
Authors: Watanabe Ryota , Saito Yuichi , Tokimasa Satoshi , Takaoka Hiroyuki , Kitahara Hideki , Yamanouchi Masato , Kobayashi Yoshio
Published: April 2024

Background: Coronary artery calcification score (CACS) on electrocardiography (ECG)-gated computed tomography (CT) is used for risk stratification of atherosclerotic cardiovascular disease, which requires dedicated analytic software. In this study, we evaluated the diagnostic ability of manual calcification length assessment on non-ECG-gated CT for epicardial coronary artery disease (CAD). Methods: A total of 100 patients undergoing both non-ECG-gated plain CT scans with a slice interval of 1.25 mm and invasive coronary angiography were retrospectively included. We manually measured the length of the longest calcified lesions of coronary arteries on each branch. The relationship between the number of coronary arteries with the length of coronary calcium > 5, 10, or 15 mm and the presence of epicardial CAD on invasive angiography was evaluated. Standard CACS was also evaluated using established software. Results: Of 100 patients, 49 (49.0%) had significant epicardial CAD on angiography. The median standard CACS was 346 [7, 1965]. In both manual calcium assessment and standard CACS, the increase in calcium burden was progressively associated with the presence of epicardial CAD on angiography. The receiver operating characteristic curve analysis showed similar diagnostic abilities of the two diagnostic methods. The best cut-off values for CAD were 2, 1, and 1 for the number of vessels with calcium > 5, 10, and 15 mm, respectively. Overall, the diagnostic ability of manual calcium assessment was similar to that of standard CACS > 400. Conclusions: Manual assessment of coronary calcium length on non-ECG-gated plain CT provided similar diagnostic ability for the presence of significant epicardial CAD on invasive angiography, as compared to standard CACS.
Lp(a) Levels in Relatives of Patients with Acute Coronary Syndrome and Elevated Lp(a): HER(a) Study
Authors: Fernández-Olmo M. Rosa , Bailen Magdalena Carrillo , Martínez Quesada Mar , Rus Mansilla Carmen , Martin Toro Miriam , López Suarez Ana , Lucas García Marta , Cortez Quiroga Gustavo , Calvo Bernal Beatriz , Ortiz Cruces Samuel , Torres Llergo Javier , García Ruano Ana , Fernández Anguita Manuel , Franco Diego , Cordero Alberto
Published: April 2024

Background: Lipoprotein(a) [Lp(a)] is a proatherogenic particle associated with increased cardiovascular risk. It is mainly genetically determined; so, the aim of our study is to evaluate the levels of Lp(a) in the relatives of a prospective cohort of patients who have suffered from an acute coronary syndrome (ACS) with Lp(a) ≥ 50 mg/dL. Methods: We conducted a multicenter prospective study, in which consecutive patients who had suffered from an ACS and presented Lp(a) ≥ 50 mg/dL and their first-degree relatives were included. Results: We included 413 subjects, of which 56.4% were relatives of the patients. Family history of early ischemic heart disease was present in 57.5%, and only 20.6% were receiving statin treatment. The family cohort was younger (37.5 vs. 59.1 years; p < 0.001), and 4% had ischemic heart disease and fewer cardiovascular risk factors. Mean Lp(a) levels were 64.9 mg/dL, 59.4% had levels ≥ 50 mg/dL, and 16.1% had levels ≥ 100 mg/dL. When comparing the patients with respect to their relatives, the mean level of Lp(a) was lower but without significant differences regarding the levels of LDLc, ApoB, and non-HDL. However, relatives with Lp(a) ≥ 50 mg/dL, had values similar to the group of patients with ACS (96.8 vs. 103.8 mg/dL; p = 0.18). No differences were found in Lp(a) levels in relatives based on the other lipid parameters. Conclusions: Overall, 59.4% of the first-degree relatives of patients who suffered from an ACS with Lp(a) ≥ 50 mg/dL also had elevated levels. Relatives with elevated Lp(a) had similar levels as patients.
Punching Shear of FRP-RC Slab–Column Connections: A Comprehensive Database
Authors: Almomani Yazan , Alawadi Roaa , Tarawneh Ahmad , Alghossoon Abdullah , Aldiabat Ahmad
Published: April 2024

Several design standards have been developed in the last two decades to estimate the punching capacity of two-way reinforced concrete (RC) slabs reinforced with fiber-reinforced polymer (FRP) reinforcement. FRP-RC design standards include the recently published ACI 440.11-22, CSA/S806-12, and JSCE-2007. These models are either based on empirical data or semi-empirical methods and calibrated using different databases. Additionally, these standards do not have provisions for connections with shear reinforcement. Therefore, a reliable worldwide database for developing and assessing the applicability of such provisions with test results is vital. This study presents a worldwide and up-to-date database for punching shear of FRP-RC slabs. The database includes 197 tested connections, comprising interior and edge connections, with and without shear reinforcement, and a wide range of materials and cross-sectional properties. The database was used to evaluate the accuracy of the mentioned standards in predicting the punching shear capacity. For connections without shear reinforcement, it was determined that the three design standards yielded similar performance with different conservatism levels. ACI 440.11-22 yielded the most conservative results, with average Vexp/Vpred ratios of 2.04 compared to 1.28 and 1.3 for other models. For connection with shear reinforcement, specimens with Evf> 100 GPa resulted in Vexp/Vpred ratios less than 1.0 for ACI and CSA standards.
One-Piece Mini Dental Implant-Retained Mandibular Overdentures: 10-Year Clinical and Radiological Outcomes of a Non-Comparative Longitudinal Observational Study
Authors: Schenk Nicole , Bukvic Hristina , Schimmel Martin , Abou-Ayash Samir , Enkling Norbert
Published: April 2024

This study presents the first 10-year follow-up investigation of the implant survival and peri-implant outcomes of one-piece mini dental implants (MDIs) retaining mandibular implant overdentures (IODs), including marginal bone level alterations (ΔMBLs), clinical peri-implant parameters, and complications. Twenty participants with horizontally atrophied mandibles received complete dentures and four MDIs (diameter 1.8 mm) at baseline. The dentures were converted into IODs with O-ring attachments. The 10-year follow-up comprised a radiological assessment of ΔMBLs, peri-implant parameters, as well as biological and technical complications. Results from a 10-year follow-up of 14 participants showed a 100% implant survival rate for all 56 implants. The mean ΔMBL after 10 years was −1.12 ± 0.80 mm, with 49 implants classified as successful (ΔMBL < 2 mm) and 7 implants with satisfactory survival (ΔMBL 2–4 mm). Time after implant placement significantly influenced ΔMBL, with stable MBLs after 5 years. The prosthetic survival rate after 10 years was 93%. ΔMBLs were not influenced by implant position or gender but were significantly smaller in subjects older than 65 years. Conclusively, one-piece MDIs with O-ring attachments offer a reliable treatment option for horizontally atrophied mandibles after 10 years, with high implant and prosthetic survival rates, potentially benefiting from advanced age regarding peri-implant bone stability.
Rolling Eccentric Steel Rings on an Industrial Radial–Axial Ring Rolling Mill
Authors: Gröper Mirko , Quadfasel Marten , Bailly David , Hirt Gerhard
Published: April 2024

Various industries, including mechanical engineering, utilize steel rings featuring variable cross-sectional profiles, such as eccentric rings. Presently employed methods for producing eccentric rings possess drawbacks like restricted geometries, significant material wastage or uneven microstructures. The radial–axial ring rolling process serves to create seamless rolled steel rings with near-net-shaped cross-sections. A novel technique involves achieving eccentricity by dynamically adjusting the mandrel’s position during the ring rolling process. This method’s fundamental feasibility has previously been showcased using a blend of oil clay and a labor test bench. Transferring the possibility of manufacturing eccentric rings on industrial radial–axial ring rolling mills would expand the product range of ring manufacturers without encountering drawbacks associated with existing manufacturing processes. The objective of this paper is to demonstrate the basic feasibility of the concept of an industrial radial–axial ring rolling mill. In the first step, FEA simulation studies were carried out to develop the rolling strategy and estimate the achievable eccentricity on the institute’s radial–axial ring mill. Subsequently, the rolling strategy was implemented on an industrial ring rolling mill with the help of a unique technology module programmed in C++. Finally, an eccentric ring was ring rolled and compared with the FEA simulation, and the reproducibility was demonstrated to be successful.
Enhancing Marina Sustainability: Water Quality and Flushing Efficiency in Marinas
Authors: Alkhalidi Mohamad , Alsulaili Abdalrahman
Published: April 2024

Coastal marinas are particularly susceptible to pollution due to their limited flushing capabilities and ineffective management practices. Therefore, it is necessary to implement measures that promote enhanced sustainability. This study aims to explore the intricate relationship between tidal flushing characteristics and water quality within marinas to foster sustainable development and management practices that mitigate environmental impacts. The research scrutinized seven marinas along the Kuwait coastline, each exhibiting unique hydrodynamic conditions and geometric configurations. Water quality indicators such as BOD, COD, DO, and SO42− were evaluated concerning each marina’s flushing efficiency through field assessments and hydrodynamic numerical modeling. An empirical formula was developed to predict and optimize flushing mechanisms, which provided critical insights into the design and management of marinas to enhance water quality. The study revealed significant disparities in water quality across the examined marinas as the hydrodynamic and geometric conditions differed. The empirical formula developed offers a novel approach to quantitatively assessing flushing efficiency, which is valuable for marina designers and managers, facilitating informed decisions, and promoting environmental sustainability. This study underscores the critical importance of integrating hydrodynamic and geometric considerations in the design and management of marinas to improve water quality and sustainability. It advocates for a multifaceted strategy that includes advanced design solutions, rigorous policy implementation, and active community engagement to safeguard coastal marine environments. The findings emphasize the need for comprehensive environmental management plans.
Sunken Riches: Ascomycete Diversity in the Western Mediterranean Coast through Direct Plating and Flocculation, and Description of Four New Taxa
Authors: Guerra-Mateo Daniel , Cano-Lira José F. , Fernández-Bravo Ana , Gené Josepa
Published: April 2024

The Mediterranean Sea stands out as a hotspot of biodiversity, whose fungal composition remains underexplored. Marine sediments represent the most diverse substrate; however, the challenge of recovering fungi in culture hinders the precise identification of this diversity. Concentration techniques like skimmed milk flocculation (SMF) could represent a suitable solution. Here, we compare the effectiveness in recovering filamentous ascomycetes of direct plating and SMF in combination with three culture media and two incubation temperatures, and we describe the fungal diversity detected in marine sediments. Sediments were collected at different depths on two beaches (Miracle and Arrabassada) on the Spanish western Mediterranean coast between 2021 and 2022. We recovered 362 strains, and after a morphological selection, 188 were identified primarily with the LSU and ITS barcodes, representing 54 genera and 94 species. Aspergillus, Penicillium, and Scedosporium were the most common genera, with different percentages of abundance between both beaches. Arrabassada Beach was more heterogeneous, with 42 genera representing 60 species (Miracle Beach, 28 genera and 54 species). Although most species were recovered with direct plating (70 species), 20 species were exclusively obtained using SMF as a sample pre-treatment, improving our ability to detect fungi in culture. In addition, we propose three new species in the genera Exophiala, Nigrocephalum, and Queenslandipenidiella, and a fourth representing the novel genus Schizochlamydosporiella. We concluded that SMF is a useful technique that, in combination with direct plating, including different culture media and incubation temperatures, improves the chance of recovering marine fungal communities in culture-dependent studies.