bluuebunny/crossref_metadata_2025 huggingface dataset:
Toward Tailoring the Degradation Rate of Magnesium-Based Biomaterials for Various Medical Applications: Assessing Corrosion, Cytocompatibility and Immunological Effects
Authors: Hartjen Philip , Wegner Nils , Ahmadi Parimah , Matthies Levi , Nada Ola , Fuest Sandra , Yan Ming , Knipfer Christian , Gosau Martin , Walther Frank , Smeets Ralf
Published: January 2021

Magnesium (Mg)-based biomaterials hold considerable promise for applications in regenerative medicine. However, the degradation of Mg needs to be reduced to control toxicity caused by its rapid natural corrosion. In the process of developing new Mg alloys with various surface modifications, an efficient assessment of the relevant properties is essential. In the present study, a WE43 Mg alloy with a plasma electrolytic oxidation (PEO)-generated surface was investigated. Surface microstructure, hydrogen gas evolution in immersion tests and cytocompatibility were assessed. In addition, a novel in vitro immunological test using primary human lymphocytes was introduced. On PEO-treated WE43, a larger number of pores and microcracks, as well as increased roughness, were observed compared to untreated WE43. Hydrogen gas evolution after two weeks was reduced by 40.7% through PEO treatment, indicating a significantly reduced corrosion rate. In contrast to untreated WE43, PEO-treated WE43 exhibited excellent cytocompatibility. After incubation for three days, untreated WE43 killed over 90% of lymphocytes while more than 80% of the cells were still vital after incubation with the PEO-treated WE43. PEO-treated WE43 slightly stimulated the activation, proliferation and toxin (perforin and granzyme B) expression of CD8+ T cells. This study demonstrates that the combined assessment of corrosion, cytocompatibility and immunological effects on primary human lymphocytes provide a comprehensive and effective procedure for characterizing Mg variants with tailorable degradation and other features. PEO-treated WE43 is a promising candidate for further development as a degradable biomaterial.
NECTIN4: A Novel Therapeutic Target for Melanoma
Authors: Tanaka Yuka , Murata Maho , Shen Che-Hung , Furue Masutaka , Ito Takamichi
Published: January 2021

Malignant melanoma is the most common lethal skin cancer and causes death in a short time when metastasized. Although BRAF inhibitors (BRAFi) have greatly improved the prognosis of BRAF-mutated melanoma, drug resistance is a major concern even when they are combined with MEK inhibitors. Alternative treatments for BRAFi-resistant melanoma are highly anticipated. Nectin cell adhesion molecule 4 (NECTIN4) is highly expressed and associated with progression in tumors. We aimed to investigate the role of NECTIN4 in melanoma and its potency as a therapeutic target using 126 melanoma samples and BRAFi-resistant cells. Immunohistochemically, most of the clinical samples expressed NECTIN4, at least in part. NECTIN4 was highly expressed in BRAF-mutated melanoma and its high expression was associated with disease-free survival. In BRAFi-resistant melanoma cells, NECTIN4 and the PI3K/Akt pathway were upregulated, along with the acquisition of BRAFi resistance. Monomethyl auristatin E, a cytotoxic part of NECTIN4-targeted antibody–drug conjugate, was effective for BRAF-mutated or BRAFi-resistant melanoma cells. NECTIN4 inhibition increased the sensitivity of BRAFi-resistant cells to BRAFi and induced apoptosis. In conclusion, we revealed the expression and roles of NECTIN4 in melanoma. Targeted therapies against NECTIN4 can be a novel treatment strategy for melanoma, even after the acquisition of BRAFi resistance.
Venous and Arterial Endothelial Cells from Human Umbilical Cords: Potential Cell Sources for Cardiovascular Research
Authors: Lau Skadi , Gossen Manfred , Lendlein Andreas , Jung Friedrich
Published: January 2021

Although cardiovascular devices are mostly implanted in arteries or to replace arteries, in vitro studies on implant endothelialization are commonly performed with human umbilical cord-derived venous endothelial cells (HUVEC). In light of considerable differences, both morphologically and functionally, between arterial and venous endothelial cells, we here compare HUVEC and human umbilical cord-derived arterial endothelial cells (HUAEC) regarding their equivalence as an endothelial cell in vitro model for cardiovascular research. No differences were found in either for the tested parameters. The metabolic activity and lactate dehydrogenase, an indicator for the membrane integrity, slightly decreased over seven days of cultivation upon normalization to the cell number. The amount of secreted nitrite and nitrate, as well as prostacyclin per cell, also decreased slightly over time. Thromboxane B2 was secreted in constant amounts per cell at all time points. The Von Willebrand factor remained mainly intracellularly up to seven days of cultivation. In contrast, collagen and laminin were secreted into the extracellular space with increasing cell density. Based on these results one might argue that both cell types are equally suited for cardiovascular research. However, future studies should investigate further cell functionalities, and whether arterial endothelial cells from implantation-relevant areas, such as coronary arteries in the heart, are superior to umbilical cord-derived endothelial cells.
A Semantic Model for Interchangeable Microservices in Cloud Continuum Computing
Authors: Taherizadeh Salman , Apostolou Dimitris , Verginadis Yiannis , Grobelnik Marko , Mentzas Gregoris
Published: January 2021

The rapid growth of new computing models that exploit the cloud continuum has a big impact on the adoption of microservices, especially in dynamic environments where the amount of workload varies over time or when Internet of Things (IoT) devices dynamically change their geographic location. In order to exploit the true potential of cloud continuum computing applications, it is essential to use a comprehensive set of various intricate technologies together. This complex blend of technologies currently raises data interoperability problems in such modern computing frameworks. Therefore, a semantic model is required to unambiguously specify notions of various concepts employed in cloud applications. The goal of the present paper is therefore twofold: (i) offering a new model, which allows an easier understanding of microservices within adaptive fog computing frameworks, and (ii) presenting the latest open standards and tools which are now widely used to implement each class defined in our proposed model.
Narrative Construction of Product Reviews Reveals the Level of Post-Decisional Cognitive Dissonance
Authors: Pólya Tibor , Kengyel Gabriella Judith , Budai Tímea
Published: January 2021

Social media platforms host an increasing amount of costumer reviews on a wide range of products. While most studies on product reviews focus on the sentiments expressed or helpfulness judged by readers and on their impact on subsequent buying this study aims at uncovering the psychological state of the persons making the reviews. More specifically, the study applies a narrative approach to the analysis of product reviews and addresses the question what the narrative construction of product reviews reveals about the level of post-decisional cognitive dissonance experienced by reviewers. The study involved 94 participants, who were asked to write a product review on their recently bought cell phones. The level of cognitive dissonance was measured by a self-report scale. The product reviews were analyzed by the Narrative Categorical Content Analytical Toolkit. The analysis revealed that agency, spatio-temporal perspective, and psychological perspective reflected the level of cognitive dissonance of the reviewers. The results are interpreted by elaborating on the idea that narratives have affordance to express affect.
Ticks and Tick-Borne Diseases of Livestock in the Middle East and North Africa: A Review
Authors: Perveen Nighat , Muzaffar Sabir Bin , Al-Deeb Mohammad Ali
Published: January 2021

Ticks are important vectors of an array of viral, bacterial and protozoan pathogens resulting in a wide range of animal and human diseases. There is limited information in the literature about tick species in the Middle East and North Africa (MENA) countries, even though they have suitable climate and vegetation for ticks and their hosts. We reviewed the occurrence of tick species and the pathogens they transmit from the MENA on published papers from 1901–2020. We found taxonomic records of 55 tick species infesting livestock representing the following eight genera: Ornithodoros, Otobius, Amblyomma, Dermacentor, Haemaphysalis, Hyalomma, Ixodes, and Rhipicephalus. In addition, 15 pathogens were recorded causing diseases of significance, with Crimean–Congo hemorrhagic fever, theileriosis, babesiosis and anaplasmosis being widely distributed diseases in the region. In recent decades, there has been increasing trends in disease occurrence and movement associated with global movement of humans and global trade of animals. We suggest that disease control and prevention could be achieved effectively through good integration between public health, veterinary medicine and animal management, and ecological approaches. We recommend further research in the areas of tick ecology and tick born-disease transmission. Furthermore, we suggest evaluation and improvement of disease control policies in the region.
Relicts from Glacial Times: The Ground Beetle Pterostichus adstrictus Eschscholtz, 1823 (Coleoptera: Carabidae) in the Austrian Alps
Authors: Paill Wolfgang , Koblmüller Stephan , Friess Thomas , Gereben-Krenn Barbara-Amina , Mairhuber Christian , Raupach Michael J. , Zangl Lukas
Published: January 2021

The last ice age considerably influenced distribution patterns of extant species of plants and animals, with some of them now inhabiting disjunct areas in the subarctic/arctic and alpine regions. This arctic-alpine distribution is characteristic for many cold-adapted species with a limited dispersal ability and can be found in many invertebrate taxa, including ground beetles. The ground beetle Pterostichus adstrictus Eschscholtz, 1823 of the subgenus Bothriopterus was previously known to have a holarctic-circumpolar distribution, in Europe reaching its southern borders in Wales and southern Scandinavia. Here, we report the first findings of this species from the Austrian Ötztal Alps, representing also the southernmost edge of its currently known distribution, confirmed by the comparison of morphological characters to other Bothriopterus species and DNA barcoding data. Molecular data revealed a separation of the Austrian and Finish specimens with limited to no gene flow at all. Furthermore, we present the first data on habitat preference and seasonality of P. adstrictus in the Austrian Alps.
The Editors’ Personal Biography of Professor Robert Anderson
Authors: Brown Nigel A. , Henderson Deborah J.
Published: January 2021

Robert (Bob) Henry Anderson was born in Wellington, Shropshire, UK, in 1942 and he completed his medical training in Manchester (UK) in 1966 [...]
Evaluation of Myocardial Strain Using Cardiac Magnetic Resonance in Patients with Wilson’s Disease
Authors: Zhang Kun , Reuner Ulrike , Hempel Charlotte , Speiser Uwe , Ibrahim Karim , Heinzel Frank R. , Pieske Burkert , Christoph Marian , Heidrich Felix M. , Quick Silvio
Published: January 2021

(1) Background: Wilson’s disease (WD) is an inherited autosomal recessive disorder with the excessive deposition of copper into different organs, including the heart. Previous studies showed structural cardiac changes even in patients with no signs of heart failure. The aim of this study was to perform cardiac magnetic resonance-based strain analysis in WD patients, as it is a powerful independent predictor of mortality. (2) Methods: We conducted a prospective cardiac magnetic resonance study that included 61 patients and 61 age and sex-matched controls, and performed strain analysis of the left and right ventricle. (3) Results: Left ventricular global longitudinal strain (GLS) as a prognostic marker of increased mortality was not altered (control −22.8 (4.8) % vs. WD patients −21.8 (5.1) %, p = 0.124). However, 4 of the 61 patients had a markedly reduced GLS. Global circumferential strain did not significantly differ between the groups either (p = 0.534). WD patients had significantly reduced global radial strain (p = 0.002). Right ventricular GLS was also significantly reduced in WD patients (p = 0.01). (4) Conclusions: Strain analysis revealed functional impairment of the left and right ventricle in a small number of patients as a potential early sign of cardiac manifestation in asymptomatic WD patients.
Impella CP Implantation during Cardiopulmonary Resuscitation for Cardiac Arrest: A Multicenter Experience
Authors: Panagides Vassili , Vase Henrik , Shah Sachin P. , Basir Mir B. , Mancini Julien , Kamran Hayaan , Batra Supria , Laine Marc , Eiskjær Hans , Christensen Steffen , Karami Mina , Paganelli Franck , Henriques Jose P. S. , Bonello Laurent
Published: January 2021

Background: Impella CP is a left ventricular pump which may serve as a circulatory support during cardiopulmonary resuscitation (CPR) for cardiac arrest (CA). Nevertheless, the survival rate and factors associated with survival in patients undergoing Impella insertion during CPR for CA are unknown. Methods: We performed a retrospective multicenter international registry of patients undergoing Impella insertion during on-going CPR for in- or out-of-hospital CA. We recorded immediate and 30-day survival with and without neurologic impairment using the cerebral performance category score and evaluated the factors associated with survival. Results: Thirty-five patients had an Impella CP implanted during CPR for CA. Refractory ventricular arrhythmias were the most frequent initial rhythm (65.7%). In total, 65.7% of patients immediately survived. At 30 days, 45.7% of patients were still alive. The 30-day survival rate without neurological impairment was 37.1%. In univariate analysis, survival was associated with both an age < 75 years and a time from arrest to CPR ≤ 5 min (p = 0.035 and p = 0.008, respectively). Conclusions: In our multicenter registry, Impella CP insertion during ongoing CPR for CA was associated with a 37.1% rate of 30-day survival without neurological impairment. The factors associated with survival were a young age and a time from arrest to CPR ≤ 5 min.
Comparing the Clinical and Laboratory Features of Remitting Seronegative Symmetrical Synovitis with Pitting Edema and Seronegative Rheumatoid Arthritis: Stage 1
Authors: Higashida-Konishi Misako , Izumi Keisuke , Hama Satoshi , Takei Hiroshi , Oshima Hisaji , Okano Yutaka
Published: January 2021

In seronegative arthritis with extremity edema, the differential diagnosis between remitting seronegative symmetrical synovitis with pitting edema syndrome (RS3PE) and seronegative rheumatoid arthritis (SNRA) is difficult. We compared the clinical characteristics of RS3PE and SNRA and those of such patients with and without malignancies. We retrospectively examined patients diagnosed with RS3PE (McCarty criteria) and SNRA at our hospital in 2007–2020. Malignancy was diagnosed within 2 years before or after RS3PE or SNRA diagnosis. Overall, 24 RS3PE and 124 SNRA patients were enrolled. The mean ages were 79.0 and 66.5 years, and men comprised 54.2% and 37.1% of RS3PE and SNRA patients, respectively. RS3PE patients had higher inflammation levels (p < 0.01) and more incidences of malignancy (p < 0.01). Matching for age and sex, RS3PE patients had higher inflammation levels (p < 0.01) and more incidences of malignancy (p = 0.02). Overall, odds ratios (ORs) for malignancy were higher for older age (OR 1.06, p = 0.04), male sex (OR 4.34, p = 0.02), RS3PE patients (OR 4.83, p = 0.01), and patients with extremity edema (OR 4.83, p = 0.01). RS3PE patients had higher inflammation levels and associated factors of malignancy than SNRA patients. Patients who are older, male, with extremity edema, or with RS3PE should be screened for malignancies.
Lights and Shadows in Hepatic Encephalopathy Diagnosis
Authors: Amodio Piero , Montagnese Sara
Published: January 2021

Hepatic encephalopathy (HE) is a form of brain dysfunction that is caused by liver insufficiency and/or portal-systemic shunting. The exact nature of HE is debated; as such, conflicting uses of the term “HE” may cause inconsistencies in its detection and management. This review highlights the meaning of the term “HE” on the basis of its historical origins and current consensus. It also provides criteria for the diagnosis of the condition based on its phenotypes and risk factors for its occurrence. The procedure for differential diagnosis from other conditions which result in similar phenotypes is considered, together with precipitants and confounders. Finally, the current multidimensional approach for the correct clinical reporting of HE episodes is discussed.
Familial Multiple Coagulation Factor Deficiencies (FMCFDs) in a Large Cohort of Patients—A Single-Center Experience in Genetic Diagnosis
Authors: Preisler Barbara , Pezeshkpoor Behnaz , Banchev Atanas , Fischer Ronald , Zieger Barbara , Scholz Ute , Rühl Heiko , Kemkes-Matthes Bettina , Schmitt Ursula , Redlich Antje , Unal Sule , Laws Hans-Jürgen , Olivieri Martin , Oldenburg Johannes , Pavlova Anna
Published: January 2021

Background: Familial multiple coagulation factor deficiencies (FMCFDs) are a group of inherited hemostatic disorders with the simultaneous reduction of plasma activity of at least two coagulation factors. As consequence, the type and severity of symptoms and the management of bleeding/thrombotic episodes vary among patients. The aim of this study was to identify the underlying genetic defect in patients with FMCFDs. Methods: Activity levels were collected from the largest cohort of laboratory-diagnosed FMCFD patients described so far. Genetic analysis was performed using next-generation sequencing. Results: In total, 52 FMCFDs resulted from coincidental co-inheritance of single-factor deficiencies. All coagulation factors (except factor XII (FXII)) were involved in different combinations. Factor VII (FVII) deficiency showed the highest prevalence. The second group summarized 21 patients with FMCFDs due to a single-gene defect resulting in combined FV/FVIII deficiency or vitamin K–dependent coagulation factor deficiency. In the third group, nine patients with a combined deficiency of FVII and FX caused by the partial deletion of chromosome 13 were identified. The majority of patients exhibited bleeding symptoms while thrombotic events were uncommon. Conclusions: FMCFDs are heritable abnormalities of hemostasis with a very low population frequency rendering them orphan diseases. A combination of comprehensive screening of residual activities and molecular genetic analysis could avoid under- and misdiagnosis.
Relation of Dietary Fatty Acids and Vitamin D to the Prevalence of Meibomian Gland Dysfunction in Japanese Adults: The Hirado–Takushima Study
Authors: Fukuoka Shima , Arita Reiko , Mizoguchi Takanori , Kawashima Motoko , Koh Shizuka , Shirakawa Rika , Suzuki Takashi , Sasaki Satoshi , Morishige Naoyuki
Published: January 2021

Intervention studies have shown that n-3 polyunsaturated fatty acid (PUFA) supplementation is effective for the treatment of meibomian gland dysfunction (MGD). Ointment containing an analog of vitamin D has also been found to improve symptoms and signs of MGD. We have now evaluated the relation of MGD prevalence to dietary intake of fatty acids (FAs) and vitamin D among a Japanese population. Subjects comprised 300 adults aged 20 to 92 years residing on Takushima Island. MGD was diagnosed on the basis of subjective symptoms, lid margin abnormalities, and meibomian gland obstruction. Dietary FA and vitamin D intake was estimated with a brief-type self-administered diet history questionnaire. MGD prevalence was 35.3%. Multivariate adjusted odds ratios (95% confidence intervals) between extreme quintiles of intake for MGD prevalence were 0.40 (0.16–0.97) for total fat, 0.40 (0.17–0.97) for saturated FAs, 0.40 (0.17–0.97) for oleic acid, 0.52 (0.23–1.18) for n-3 PUFAs, 0.63 (0.27–1.49) for n-6 PUFAs, 1.32 (0.59–2.95) for the n-6/n-3 PUFA ratio, and 0.38 (0.17–0.87) for vitamin D. Total fat, saturated FA, oleic acid, and vitamin D intake may thus be negatively associated with MGD prevalence in the Japanese.
Immune Tolerance of the Human Decidua
Authors: Murata Hiromi , Tanaka Susumu , Okada Hidetaka
Published: January 2021

The endometrium is necessary for implantation, complete development of the placenta, and a successful pregnancy. The endometrium undergoes repeated cycles of proliferation, decidualization (differentiation), and shedding during each menstrual cycle. The endometrium—including stromal, epithelial, vascular endothelial, and immune cells—is both functionally and morphologically altered in response to progesterone, causing changes in the number and types of immune cells. Immune cells make up half of the total number of endometrial cells during implantation and menstruation. Surprisingly, immune tolerant cells in the endometrium (uterine natural killer cells, T cells, and macrophages) have two conflicting functions: to protect the body by eliminating pathogenic microorganisms and other pathogens and to foster immunological change to tolerate the embryo during pregnancy. One of the key molecules involved in this control is the cytokine interleukin-15 (IL-15), which is secreted by endometrial stromal cells. Recently, it has been reported that IL-15 is directly regulated by the transcription factor heart- and neural crest derivatives-expressed protein 2 in endometrial stromal cells. In this review, we outline the significance of the endometrium and immune cell population during menstruation and early pregnancy and describe the factors involved in immune tolerance and their involvement in the establishment and maintenance of pregnancy.
Evaluation of the Efficacy of Immersive Virtual Reality Therapy as a Method Supporting Pulmonary Rehabilitation: A Randomized Controlled Trial
Authors: Rutkowski Sebastian , Szczegielniak Jan , Szczepańska-Gieracha Joanna
Published: January 2021

Anxiety has been estimated to occur in 21–96% and depression in 27–79% of patients with chronic obstructive pulmonary disorder (COPD). We found a scarcity of literature providing evidence on how virtual reality (VR) therapy affects the intensity of depressive and anxiety symptoms and stress levels in COPD patients undergoing in-hospital pulmonary rehabilitation (PR). This study enrolled 50 COPD patients with symptoms of stress, depression, and anxiety, randomly assigned to one of two groups. The two groups participated in the traditional PR programme additionally: the VR-group performed 10 sessions of immersive VR-therapy and the control group performed 10 sessions of Schultz autogenic training. Comparison of the changes in stress levels and depressive and anxiety symptoms was the primary outcome. Analysis of the results showed a reduction in stress levels only in the VR-group (p < 0.0069), with a medium effect size (d = 0.353). The symptoms of depression (p < 0.001, d = 0.836) and anxiety (p < 0.0009, d = 0.631) were statistically significantly reduced only in the VR-group, with a strong effect size. The enrichment of pulmonary rehabilitation with immersive VR therapy brings benefits in terms of mood improvement and reduction in anxiety and stress in patients with COPD.
Assessing the Role of Pericardial Fat as a Biomarker Connected to Coronary Calcification—A Deep Learning Based Approach Using Fully Automated Body Composition Analysis
Authors: Kroll Lennard , Nassenstein Kai , Jochims Markus , Koitka Sven , Nensa Felix
Published: January 2021

(1) Background: Epi- and Paracardial Adipose Tissue (EAT, PAT) have been spotlighted as important biomarkers in cardiological assessment in recent years. Since biomarker quantification is an increasingly important method for clinical use, we wanted to examine fully automated EAT and PAT quantification for possible use in cardiovascular risk stratification. (2) Methods: 966 patients with intermediate Framingham risk scores for Coronary Artery Disease referred for coronary calcium scans were included in clinical routine retrospectively. The Coronary Artery Calcium Score (CACS) was extracted and tissue quantification was performed by a deep learning network. (3) Results: The Computed Tomography (CT) segmentations predicted by the network indicated no significant correlation between EAT volume and EAT radiodensity when compared to Agatston score (r = 0.18, r = −0.09). CACS 0 category patients showed significantly lower levels of total EAT and PAT volumes and higher EAT and PAT densities than CACS 1–99 category patients (p < 0.01). Notably, this difference did not reach significance regarding EAT attenuation in male patients. Women older than 50 years, thus more likely to be postmenopausal, were shown to be at higher risk of coronary calcification (p < 0.01, OR = 4.59). CACS 1–99 vs. CACS ≥100 category patients remained below significance level (EAT volume: p = 0.087, EAT attenuation: p = 0.98). (4) Conclusions: Our study proves the feasibility of a fully automated adipose tissue analysis in clinical cardiac CT and confirms in a large clinical cohort that volume and attenuation of EAT and PAT are not correlated with CACS. Broadly available deep learning based rapid and reliable tissue quantification should thus be discussed as a method to assess this biomarker as a supplementary risk predictor in cardiac CT.
Transient Increase and Delay of Multifocal Electroretinograms Following Laser Photocoagulations for Diabetic Macular Edema
Authors: Shimada Yoshiaki , Shibuya Masayuki , Shinoda Kei
Published: January 2021

Background: The acute physiological changes induced by focal retinal photocoagulation (PC) have been largely unexplored. Methods: This was a case-series study. We recorded multifocal electroretinograms (mfERGs) just before PC, and mfERGs were also recorded 5′, 15′, one hour, 24 h, and one week after the PCs. Transient changes of mfERGs were analyzed in eyes which underwent PCs to treat diabetic macular edema. The mfERGs recorded from the predominantly irradiated area and that from non-irradiated areas were analyzed separately. Results: Fifteen eyes of 15 patients were included in this study. The mfERGs elicited from non-irradiated areas did not change after PC, but the mfERGs elicited from the irradiated area changed with time; the amplitude was larger at 60′ than that before (p < 0.05) and at 5′ after PC (p < 0.01) and significantly smaller at 24 h and 1 week than that before and at 60′ after the PC (p < 0.01). The implicit time was significantly prolonged after PC. mfERG on irradiated area with the severe diabetic change was less altered after PCs. Conclusions: The transient increase in the amplitude at 60′ likely resulted from a biological amplification of partially damaged cells adjacent to the PC spots. The mfERGs manifested the dynamic alterations of the retinal function following PCs.
Low Luminance Visual Acuity and Low Luminance Deficit in Proliferative Diabetic Retinopathy
Authors: Karatsai Eleni , Sen Piyali , Gurudas Sarega , Sivaprasad Sobha
Published: January 2021

This study aimed to determine the relation of best corrected visual acuity (BCVA) and low luminance visual acuity (LLVA) in proliferative diabetic retinopathy (PDR) following treatment with either aflibercept or pan-retinal photocoagulation (PRP). The study was conducted as a post-hoc analysis of the CLARITY trial in which naïve and PRP treated PDR patients were randomised to receive either aflibercept or PRP. BCVA and LLVA were assessed at baseline and at week 52. Our analyses showed that the BCVA and LLVA correlate well in treatment naïve PDR with an average low luminance deficit of 11.79 Early Treatment Diabetic Retinopathy Score (ETDRS) letters. However, LLVA at lower levels of BCVA showed more variance. Post aflibercept therapy, the mean change in BCVA and LLVA at 52 weeks after aflibercept was +2.1 (SD 6.05) letters and +0.39 (SD 5.6) letters, respectively. Similarly, after PRP, it was −2.5 (SD 4.9) letters and −1.9 (SD 8.7) letters, respectively. When comparing treatment arms, BCVA change was found to be statistically significant (p < 0.001) whereas LLVA was not (p = 0.11). These findings show that LLVA does not respond as well as BCVA following any treatment for PDR, even though BCVA and LLVA both test foveal function.
The Profile of the Obstetric Patients with SARS-CoV-2 Infection According to Country of Origin of the Publication: A Systematic Review of the Literature
Authors: Cuñarro-López Yolanda , Pintado-Recarte Pilar , Cueto-Hernández Ignacio , Hernández-Martín Concepción , Payá-Martínez María Pilar , Muñóz-Chápuli María del Mar , Cano-Valderrama Óscar , Bravo Coral , Bujan Julia , Álvarez-Mon Melchor , Ortega Miguel A. , De León-Luis Juan Antonio
Published: January 2021

SARS-CoV-2 is the novel member of coronavirus responsible for the worldwide pandemic COVID-19, affecting all types of people. In this context, established research identified pregnant women as a susceptible group of SARS-CoV-2 infection, although there is still limited data regarding the real impact of COVID-19 in this group. With that purpose, we conducted a systematic review describing the maternal-fetal results of pregnant women infected by SARS-CoV-2, in aim to analyze the profile of the obstetric patients according to the country of origin of the publication. A total of 38 articles were included in this systematic review with 2670 patients from 7 countries, with 20 works published from China (52.6%). We reported significative differences according to the median maternal age, with Spain as the country with the highest age (34.6 years); The percentage of tabaquism; proportion of symptomatic patients in the triage; type of radiological exam (China and France conduct CT scans on all their patients in comparison to the use of chest X-Ray in the rest of the countries studied); percentages of C-sections (83.9% in China; 35.9% Spain, p < 0.001); maternal mortality rate, proportion of patients who need treatments, the use of antivirals, antibiotics, and anticoagulants as well as measurements of the newborns. Perinatal results are favorable in the majority of countries, with very low rates of vertical transmission in the majority of works. The studies collected in this review showed moderate to high index of quality. The different works describe the affectation during the first wave of the pandemic, where the pregnant woman with SARS-CoV-2 infection is generally symptomatic during the third trimester of gestation along with other factors associated with worse prognosis of the disease, such as higher age, body mass index, and further comorbidities developed during pregnancy. In the obstetric patient, proportion of C-sections are elevated together with prematurity, increasing maternal perinatal morbimortality. Differences found between countries could be based on the proper profile of the patient in each region, the period of the pandemic directly affecting how it was managed, and the variations regarding in situ medical attention.
Semi-Quantitative Characterization of Post-Transplant Lymphoproliferative Disorder Morphological Subtypes with [18F]FDG PET/CT
Authors: Montes de Jesus Filipe , Vergote Vibeke , Noordzij Walter , Dierickx Daan , Dierckx Rudi , Diepstra Arjan , Tousseyn Thomas , Gheysens Olivier , Kwee Thomas , Deroose Christophe , Glaudemans Andor
Published: January 2021

Background: Post-transplant lymphoproliferative disorder (PTLD) is a complication of organ transplantation classified according to the WHO as nondestructive, polymorphic, monomorphic, and classic Hodgkin Lymphoma subtypes. In this retrospective study, we investigated the potential of semi-quantitative 2-[18F]fluoro-2-deoxy-D-glucose ([18F]FDG) PET/computed tomography (CT)-based parameters to differentiate between the PTLD morphological subtypes. Methods: 96 patients with histopathologically confirmed PTLD and baseline [18F]FDG PET/CT between 2009 and 2019 were included. Extracted semi-quantitative measurements included: Maximum, peak, and mean standardized uptake value (SUVmax, SUVpeak, and SUVmean). Results: Median SUVs were highest for monomorphic PTLD followed by polymorphic and nondestructive subtypes. The median SUVpeak at the biopsy site was significantly higher in monomorphic PTLD (17.8, interquartile range (IQR):16) than in polymorphic subtypes (9.8, IQR:13.4) and nondestructive (4.1, IQR:6.1) (p = 0.04 and p ≤ 0.01, respectively). An SUVpeak ≥ 24.8 was always indicative of a monomorphic PTLD in our dataset. Nevertheless, there was a considerable overlap in SUV across the different morphologies. Conclusion: The median SUVpeak at the biopsy site was significantly higher in monomorphic PTLD than polymorphic and nondestructive subtypes. However, due to significant SUV overlap across the different subtypes, these values may only serve as an indication of PTLD morphology, and SUV-based parameters cannot replace histopathological classification.
The European Perspective on the Management of Acute Major Hemorrhage and Coagulopathy after Trauma: Summary of the 2019 Updated European Guideline
Authors: Maegele Marc
Published: January 2021

Non-controlled hemorrhage with accompanying trauma-induced coagulopathy (TIC) remains the most common cause of preventable death after multiple injury. Rapid identification followed by aggressive treatment is the key for improved outcomes. Treatment of trauma hemorrhage begins at the scene, with manual compression, the use of tourniquets and (non) commercial pelvic slings, and rapid transfer to an adequate trauma center. Upon hospital admission, coagulation monitoring and support are to be initiated immediately. Bleeding is controlled surgically following damage control principles. Modern coagulation management includes goal-oriented, individualized therapies, guided by point-of-care viscoelastic assays. Idarucizumab can be used as an antidote to the thrombin inhibitor dabigatran, andexanet alpha as an antidote to factor Xa inhibitors. This review summarizes the key recommendations of the 2019 updated European guideline on the management of major bleeding and coagulopathy following trauma. These evidence-based recommendations may form the backbone of algorithms adapted to local logistics and infrastructure.
Comparison of First- and Second-Generation Drug-Eluting Stents in Patients with ST-Segment Elevation Myocardial Infarction Based on Pre-Percutaneous Coronary Intervention Thrombolysis in Myocardial Infarction Flow Grade
Authors: Kim Yong Hoon , Her Ae-Young , Jeong Myung Ho , Kim Byeong-Keuk , Hong Sung-Jin , Kim Seunghwan , Ahn Chul-Min , Kim Jung-Sun , Ko Young-Guk , Choi Donghoon , Hong Myeong-Ki , Jang Yangsoo
Published: January 2021

This study aims to investigate the two-year clinical outcomes between first-generation (1G) and second-generation (2G) drug-eluting stents (DES) based on pre-percutaneous coronary intervention (PCI) thrombolysis in myocardial infarction (TIMI) flow grade (pre-TIMI) in patients with ST-segment elevation myocardial infarction (STEMI). Overall, 17,891 STEMI patients were classified into two groups: pre-TIMI 0/1 group (n = 12,862; 1G-DES (n = 4318), 2G-DES (n = 8544)) and pre-TIMI 2/3 group (n = 5029; 1G-DES (n = 2046), 2G-DES (n = 2983)). During a two-year follow-up period, major adverse cardiac events (MACEs) defined as all-cause death, recurrent myocardial infarction (re-MI), or any repeat revascularization and stent thrombosis (ST) were considered as the primary and the secondary outcomes. In the pre-TIMI 0/1 and 2/3 groups, the cumulative incidences of MACEs (adjusted hazard ratio (aHR): 1.348, p < 0.001, and aHR: 1.415, p = 0.02, respectively) and any repeat revascularization (aHR: 1.938, p < 0.001, and aHR: 1.674, p = 0.001, respectively) were significantly higher in the 1G-DES than in the 2G-DES. However, sirolimus-eluting stent showed similar cumulative incidence of any repeat revascularization compared with zotarolimus-eluting stent and biolimus-eluting stent in both pre-TIMI 0/1 and 2/3 groups. The cumulative incidences of all-cause death, re-MI, and ST were similar between the 1G-DES and 2G-DES groups. In this study, 2G-DES showed better clinical outcomes than 1G-DES concerning MACEs and any repeat revascularization regardless of pre-TIMI. However, more research is needed to support these results.
Thyroid Autoimmune Disease—Impact on Sexual Function in Young Women
Authors: Bortun Ana-Maria Cristina , Ivan Viviana , Navolan Dan-Bogdan , Dehelean Liana , Borlea Andreea , Stoian Dana
Published: January 2021

The important prevalence of autoimmune thyroid disease (AITD) in the general population was the main motivation for conducting the present study. The present paper aims to estimate the possible comorbidities related to female sexual dysfunction (FSD) and depression related to AITD. The study group consisted of 320 patients: 250 cases known with untreated AITD, divided into subgroups (euthyroid subgroup, subclinical hypothyroidism subgroup and clinical hypothyroidism subgroup); respectively 70 healthy females in the control group. Patients underwent thyroid evaluation, ovarian evaluation and laboratory assays. At the time of the diagnosis of autoimmune thyroid disease, psychometric scales were filled in by the patients: the Female Sexual Function Index 6 (FSFI-6) and the Beck’s Depression Inventory-II (BDI-II). It was observed that healthy patients had significantly higher FSFI scores than patients with AITD (28 vs. 27; p = 0.006). In the AITD group, the risk of FSD increases with the severity of thyroid disease. The most affected areas were: sexual desire (p < 0.001), lubrication (p = 0.001) and orgasm (p = 0.008), followed by excitability and sexual satisfaction. The severity of hypothyroidism influences the degree of decrease in libido, central and peripheral excitability. Sexual satisfaction and orgasm were less influenced. The field related to pain seems uninfluenced by the presence of thyroid disease. The concomitant presence of depression and the value of thyroid-stimulating hormone (TSH) are risk factors in the development of FSD. Higher TSH value and BDI-II score increase the risk of female sexual dysfunction by 1.083 and 1.295 times, respectively. Our findings are significant and promising; they may help professionals dealing with sexual and reproductive health. Despite the importance of female sexual dysfunction and its prevalence, clinicians and patients often ignore it. In fact, only a small percentage of patients consult their doctors about sexual health, and their doctors do not often ask them questions related to this aspect.
Intercostal Catheters for Postoperative Pain Management in VATS Reduce Opioid Consumption
Authors: Ponholzer Florian , Ng Caecilia , Maier Herbert , Dejaco Hannes , Schlager Andreas , Lucciarini Paolo , Öfner Dietmar , Augustin Florian
Published: January 2021

Background: Postoperative pain after video-assisted thoracoscopic surgery (VATS) affects patients’ recovery, postoperative complications, and length of stay (LOS). Despite its relevance, there are no guidelines on optimal perioperative pain management. This study aims to analyse the effects of an additional intercostal catheter (ICC) in comparison to a single shot intraoperative intercostal nerve block (SSINB). Methods: All patients receiving an anatomic VATS resection between June 2019 and May 2020 were analysed retrospectively. The ICC cohort included 51 patients, the SSINB cohort included 44 patients. Results: There was no difference in age, gender, comorbidities, or duration of surgery between cohorts. Pain scores on the first postoperative day, after chest drain removal, and highest pain score measured did not differ between groups. The overall amount of opioids (morphine equivalent: 3.034 mg vs. 7.727 mg; p = 0.002) as well as the duration of opioid usage (0.59 days vs. 1.25 days; p = 0.005) was significantly less in the ICC cohort. There was no difference in chest drain duration, postoperative complications, and postoperative LOS. Conclusions: Pain management with ICC reduces the amount of opioids and number of days with opioids patients require to achieve sufficient analgesia. In conclusion, ICC is an effective regional anaesthesia tool in postoperative pain management in minimally invasive thoracic surgery.
Study on the Propagation of Stress Waves in Natural Fiber Composite Strips
Authors: Barouni Antigoni K. , Rekatsinas Christoforos S.
Published: January 2021

The propagation of Lamb waves within the structure of natural fiber reinforced composite strips is investigated using a semi-analytical solution and a time domain spectral finite element numerical method. The need to monitor the structural health of natural fiber reinforced composites is becoming greater, as these sustainable composites are being increasingly used in various industrial applications in automotive and marine structures. Three different types of flax fiber composites were studied and the fundamental wave modes were excited on the structure. Both methods under consideration were able to capture the symmetric and antisymmetric wave modes for all the material configurations. Especially the complex nature of a hybrid flax/glass fiber composite was studied and results were very promising for future damage investigation. Further to this, an attempt was made to excite the hybrid strip at higher frequency and the study revealed the potential to capture all the existing wave modes.
Designing Sensing Devices Using Porous Composite Materials
Authors: Wang Chang-Ming , Liao Wei-Ssu
Published: January 2021

The need for portable and inexpensive analytical devices for various critical issues has led researchers to seek novel materials to construct them. Soft porous materials, such as paper and sponges, are ideal candidates for fabricating such devices due to their light weight and high availability. More importantly, their great compatibility toward modifications and add-ons allows them to be customized to match different objectives. As a result, porous material-based composites have been extensively used to construct sensing devices applied in various fields, such as point-of-care testing, environmental sensing, and human motion detection. In this article, we present fundamental thoughts on how to design a sensing device based on these interesting composite materials and provide correlated examples for reader’s references. First, a rundown of devices made with porous composite materials starting from their fabrication techniques and compatible detection methods is given. Thereafter, illustrations are provided on how device function and property improvements are achieved with a delicate use of composite materials. This includes extending device lifetime by using polymer films to protect the base material, while signal readout can be enhanced by a careful selection of protective cover and the application of advanced photo image analysis techniques. In addition to chemical sensors, mechanical responsive devices based on conductive composite materials are also discussed with a focus on base material selection and platform design. We hope the ideas and discussions presented in this article can help researchers interested in designing sensing devices understand the importance and usefulness of composite materials.
Microplastics in Mediterranean Coastal Countries: A Recent Overview
Authors: Fytianos Georgios , Ioannidou Efthimia , Thysiadou Anna , Mitropoulos Athanasios C. , Kyzas George Z.
Published: January 2021

The aim of this paper is to present information gathered from studies regarding the current status and challenges of microplastics (MPs) in Mediterranean coastal counties. MPs are considered emerging pollutants, and their effect on fish and on the final consumer through the trophic food chain are of great concern. Studies from almost all of the Mediterranean coastal countries are gathered and discussed. The source of MPs, as well as their transfer and accumulation are reviewed. In addition, the laboratory techniques for sampling, analysis and characterization of MPs are presented. Moreover, the current regulations for MPs restrictions in Europe will be discussed. Finally, the authors present the current challenges on the topic and provide recommendations for future work.
3D FE-Informed Laboratory Soil Testing for the Design of Offshore Wind Turbine Monopiles
Authors: Cheng Xiaoyang , Diambra Andrea , Ibraim Erdin , Liu Haoyuan , Pisanò Federico
Published: January 2021

Based on advanced 3D finite element modelling, this paper analyses the stress paths experienced by soil elements in the vicinity of a monopile foundation for offshore wind turbines subjected to cyclic loading with the aim of informing soil laboratory testing in support of monopile foundation design. It is shown that the soil elements in front of the laterally loaded monopile are subjected to complex stress variations, which gradually evolve towards steady stress cycles as the cyclic lateral pile loading proceeds. The amplitude, direction and average value of such steady stress cycles are dependent on the depth and radial distance from the pile of the soil element, but it also invariably involves the cyclic rotation of principal stress axes. Complementary laboratory testing using the hollow-cylinder torsional apparatus was carried out on granular soil samples imposing cyclic stress paths (with up to about 3 × 104 cycles) which resemble those determined after 3D finite element analysis. The importance of considering the cyclic rotation of principal stress axes when investigating the response of soil elements under stress conditions mimicking those around a monopile foundation subjected to cyclic lateral loading is emphasised.
Identification and Characterization of Leaf-Inhabiting Fungi from Castanea Plantations in China
Authors: Jiang Ning , Fan Xinlei , Tian Chengming
Published: January 2021

Two Castanea plant species, C. henryi and C. mollissima, are cultivated in China to produce chestnut crops. Leaf spot diseases commonly occur in Castanea plantations, however, little is known about the fungal species associated with chestnut leaf spots. In this study, leaf samples of C. henryi and C. mollissima were collected from Beijing, Guizhou, Hunan, Sichuan and Yunnan Provinces, and leaf-inhabiting fungi were identified based on morphology and phylogeny. As a result, twenty-six fungal species were confirmed, including one new family, one new genus, and five new species. The new taxa are Pyrisporaceae fam. nov., Pyrispora gen. nov., Aureobasidium castaneae sp. nov., Discosia castaneae sp. nov., Monochaetia castaneae sp. nov., Neopestalotiopsis sichuanensis sp. nov. and Pyrispora castaneae sp. nov.