bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of the Existing Electrophysiological Severity Classifications in Carpal Tunnel Syndrome
Authors: Sasaki Toru , Koyama Takafumi , Kuroiwa Tomoyuki , Nimura Akimoto , Okawa Atsushi , Wakabayashi Yoshiaki , Fujita Koji
Published: March 2022

Electrophysiological examination is important for the diagnosis and evaluation of nerve function in carpal tunnel syndrome (CTS). Electrophysiological severity classifications of CTS using a nerve conduction study (NCS) have been reported, and there are many reports on the relationship between severity classifications and clinical symptoms. The existing electrophysiological severity classifications have several problems, such as cases that do not fit into a classification and unclear reasons for the boundary value. The purpose of this study was to clarify the relationship between sensory nerve conduction velocity (SCV) and distal motor latency (DML) and to evaluate whether the existing severity classification method is appropriate. We created a scatter diagram between SCV and DML for our NCSs and found a negative correlation between SCV and DML (correlation coefficient, −0.786). When we applied our NCSs to the existing classifications (Padua and Bland classifications), there were many unclassifiable cases (15.2%; Padua classification), and the number of Grade 3 cases was significantly higher than that of Grade 2 or 4 cases (Bland classification). Our large dataset revealed a strong negative correlation between SCV and DML, indicating that the existing severity classifications do not always accurately reflect the severity of the disease.
Clinical Application of Factor VIII:C to VWF:Ag Ratio for the Screening of Haemophilia A Carriers
Authors: Yoo Ki-Young , Jung Soo-Young , Choi Jin-Young , Park Hye-Ryeon , Park Young-Shil
Published: March 2022

Analyses of factor VIII procoagulant activity (FVIII:C) and the FVIII:C to VWF:Ag ratio (FVIII:C/VWF:Ag ratio) have been investigated as screening bioassays to detect haemophilia carriers. This study aimed to determine the validity of the FVIII:C/VWF:Ag ratio and FVIII:C analyses as screening tests. We reviewed the medical records of 137 genetically confirmed, proband haemophilia A patients and 179 of their familial females who had undergone carrier testing. The collected data included the severity and mutation type of F8 gene from probands and age, ABO blood type, FVIII:C, VWF:Ag, and the result of targeted gene analysis in females. We diagnosed 110 females as carriers, and their FVIII:C and FVIII:C/VWF:Ag ratio were lower than those in 69 non-carriers (FVIII:C: 59.3 IU/dL vs. 106.1 IU/dL, p = 0.000; FVIII:C/VWF:Ag ratio: 0.62 vs. 1.08, p = 0.000). In receiver operating characteristic analysis, the areas under the curve (AUC) of the FVIII:C/VWF:Ag ratio and FVIII:C were 0.936 and 0.876, respectively. The cut-off value of FVIII:C/VWF:Ag ratio (0.81) at the maximum Youden J index provided a sensitivity of 82.8% and specificity of 96.6%. The cut-off value of FVIII:C (83.8 IU/dL) showed a sensitivity of 81.8% and specificity of 79.7%. Considering the AUC, the FVIII:C/VWF:Ag ratio is a good screening test to detect haemophilia A carriers, as evidenced by its specificity of 96.6%; however, it may also induce false-negative results.
A Statistical Shape Model of the Morphological Variation of the Infrarenal Abdominal Aortic Aneurysm Neck
Authors: van Veldhuizen Willemina A. , Schuurmann Richte C. L. , IJpma Frank F. A. , Kropman Rogier H. J. , Antoniou George A. , Wolterink Jelmer M. , de Vries Jean-Paul P. M.
Published: March 2022

Hostile aortic neck characteristics, such as short length and large diameter, have been associated with type Ia endoleaks and reintervention after endovascular aneurysm repair (EVAR). However, such characteristics partially describe the complex aortic neck morphology. A more comprehensive quantitative description of 3D neck shape might lead to new insights into the relationship between aortic neck morphology and EVAR outcomes in individual patients. This study identifies the 3D morphological shape components that describe the infrarenal aortic neck through a statistical shape model (SSM). Pre-EVAR CT scans of 97 patients were used to develop the SSM. Parameterization of the morphology was based on the center lumen line reconstruction, a triangular surface mesh of the aortic lumen, 3D coordinates of the renal arteries, and the distal end of the aortic neck. A principal component analysis of the parametrization of the aortic neck coordinates was used as input for the SSM. The SSM consisted of 96 principal components (PCs) that each described a unique shape feature. The first five PCs represented 95% of the total morphological variation in the dataset. The SSM is an objective model that provides a quantitative description of the neck morphology of an individual patient.
Child Anthropometrics and Neurodevelopment at 2 and 3 Years of Age Following an Antenatal Lifestyle Intervention in Routine Care—A Secondary Analysis from the Cluster-Randomised GeliS Trial
Authors: Spies Monika , Geyer Kristina , Raab Roxana , Brandt Stephanie , Meyer Dorothy , Günther Julia , Hoffmann Julia , Hauner Hans
Published: March 2022

Maternal characteristics around pregnancy may influence obesity risk and neurodevelopment in children. To date, the effect of antenatal lifestyle interventions on long-term child development is unclear. The objective was to investigate the potential long-term effects of an antenatal lifestyle intervention programme conducted alongside routine care on child anthropometrics and neurodevelopment up to 3 years of age. Mother-child pairs from the cluster-randomised GeliS trial were followed up to 3 years of age. Data on child anthropometrics in both groups were collected from routine health examinations. Neurodevelopment was assessed via questionnaire. Of the 2286 study participants, 1644 mother-child pairs were included in the analysis. Children from the intervention group were less likely to score below the cut-off in Fine motor (p = 0.002), and more likely to have a score below the cut-off in Problem-solving (p < 0.001) compared to the control group at 3 years of age. Mean weight, height, head circumference, body mass index, and the respective z-scores and percentiles were comparable between the groups at 2 and 3 years of age. We found no evidence that the lifestyle intervention affected offspring development up to 3 years of age. Further innovative intervention approaches are required to improve child health in the long-term.
Efficacy of Pre-Procedural Mouthwashes against SARS-CoV-2: A Systematic Review of Randomized Controlled Trials
Authors: Garcia-Sanchez Alvaro , Peña-Cardelles Juan-Francisco , Ruiz Steve , Robles Flor , Ordonez-Fernandez Esther , Salgado-Peralvo Angel-Orión , Balloch James , Simon Jacob C.
Published: March 2022

The oral mucosa is one of the first sites to be affected by the SARS-CoV-2. For this reason, healthcare providers performing aerosol-generating procedures (AGPs) in the oral cavity are at high risk of infection with COVID-19. The aim of this systematic review is to verify whether there is evidence in the literature describing a decrease in the salivary viral load of SARS-CoV-2 after using different mouthwashes. An electronic search of the MEDLINE database (via PubMed), Web of Science, SCOPUS, and the Cochrane library database was carried out. The criteria used were those described by the PRISMA® Statement. Randomized controlled trial studies that have used mouthwashes as a form of intervention to reduce the viral load in saliva were included. The risk of bias was analyzed using the Joanna Briggs Institute Critical Appraisal Tool. Ultimately, eight articles were included that met the established criteria. Based on the evidence currently available in the literature, PVP-I, CHX and CPC present significant virucidal activity against SARS-CoV-2 in saliva and could be used as pre-procedural mouthwashes to reduce the risk of cross-infection.
The Risk of Spontaneous Abortion Does Not Increase Following First Trimester mRNA COVID-19 Vaccination
Authors: Citu Ioana Mihaela , Citu Cosmin , Gorun Florin , Sas Ioan , Bratosin Felix , Motoc Andrei , Burlea Bogdan , Rosca Ovidiu , Malita Daniel , Gorun Oana Maria
Published: March 2022

Clinical trials for COVID-19 vaccines initially excluded pregnant women due to safety concerns, and when the vaccines were authorized for emergency use, they were not recommended for this population. However, observational studies discovered that pregnant women infected with COVID-19 have higher risks of negative pregnancy and delivery outcomes compared to non-pregnant women, raising the question of the risks–benefits of administering COVID-19 vaccines to pregnant women. By mid-2021, there was general consensus on the relative safety of COVID-19 vaccination during pregnancy; therefore, it is critical to investigate the safety issues related to these vaccines, considering the increasing acceptance among pregnant women. To address these concerns, we developed a research project to study the short-term effects and outcomes of COVID-19 vaccination during the first trimester of pregnancy. Our research followed an observational retrospective design for 12 months from the beginning of the vaccination campaign, and included 124 cases of spontaneous abortions and 927 ongoing pregnancies. The odds of spontaneous abortion were non-significant for both versions of the mRNA vaccine (Pfizer BNT162b2 AOR = 1.04, CI = 0.91–1.12; Moderna mRNA-1273 AOR = 1.02, CI = 0.89–1.08). Overall, our data indicated that the risk of spontaneous abortion after mRNA COVID-19 immunization during the first trimester of pregnancy is commensurate with the predicted risk in non-vaccinated pregnant women. These findings contribute to the growing body of information regarding the safety of mRNA COVID-19 vaccination during pregnancy.
Chewing Patterns and Muscular Activation in Deep Bite Malocclusion
Authors: Piancino Maria Grazia , Tortarolo Alessandro , Di Benedetto Laura , Crincoli Vito , Falla Deborah
Published: March 2022

Background: Deep bite, a frequent malocclusion with a high relapse rate, is associated with craniofacial features that need to be considered in the course of orthodontic treatment. Methods: This study included 81 patients with deep bite malocclusion (11.4 ± 1.1 [yr.mo]; M = 32 and F = 49), and 14 age- and gender-matched controls (9.11 ± 1 [yr.mo]; M = 5 and F = 9). The patients with deep bite malocclusion were treated with functional therapy. The chewing cycles and masticatory muscle EMG activity were recorded concomitantly before treatment in both groups (n = 95). Following correction of the malocclusion, a second recording took place (n = 25). Results: The kinematic variables showed the same dependency on bolus hardness in those with deep bite and in the controls. The masticatory muscle EMG activity was increased in those with deep bite, but decreased as a result of functional treatment. The chewing patterns showed a tendency towards a reduced lateral component, which significantly increased after treatment, indicating that functional therapy impacts the neuromuscular coordination of mastication, as well as dental positioning. Conclusions: Deep bite is a complex malocclusion, involving alterations in chewing and masticatory muscle activity. Orthognathodontic treatment should not only consider and correct the teeth position, but should also address muscular hyperactivity.
Determinants of Adherence to a “GRADIOR” Computer-Based Cognitive Training Program in People with Mild Cognitive Impairment (MCI) and Mild Dementia
Authors: Diaz Baquero Angie A. , Perea Bartolomé María V. , Toribio-Guzmán José Miguel , Martínez-Abad Fernando , Parra Vidales Esther , Bueno Aguado Yolanda , van der Roest Henriëtte G. , Franco-Martín Manuel A.
Published: March 2022

Background: Computer-based programs have been implemented from a psychosocial approach for the care of people with dementia (PwD). However, several factors may determine adherence of older PwD to this type of treatment. The aim of this paper was to identify the sociodemographic, cognitive, psychological, and physical-health determinants that helped predict adherence or not to a “GRADIOR” computerized cognitive training (CCT) program in people with mild cognitive impairment (MCI) and mild dementia. Method: This study was part of a randomized clinical trial (RCT) (ISRCTN: 15742788). However, this study will only focus on the experimental group (n = 43) included in the RCT. This group was divided into adherent people (compliance: ≥60% of the sessions and persistence in treatment up to 4 months) and non-adherent. The participants were 60–90 age and diagnosed with MCI and mild dementia. We selected from the evaluation protocol for the RCT, tests that evaluated cognitive aspects (memory and executive functioning), psychological and physical health. The CCT with GRADIOR consisted of attending 2–3 weekly sessions for 4 months with a duration of 30 min Data analysis: Phi and Biserial-point correlations, a multiple logical regression analysis was obtained to find the adherence model and U Mann–Whitney was used. Results: The adherence model was made up of the Digit Symbol and Arithmetic of Wechsler Adult Intelligence Scale (WAIS-III) and Lexical Verbal Fluency (LVF) -R tests. This model had 90% sensitivity, 50% specificity and 75% precision. The goodness-of-fit p-value of the model was 0.02. Conclusions: good executive functioning in attention, working memory (WM), phonological verbal fluency and cognitive flexibility predicted a greater probability that a person would be adherent.
Soluble Urokinase-Type Plasminogen Activator Receptor Levels as a Predictor of Kidney Replacement Therapy in Septic Patients with Acute Kidney Injury: An Observational Study
Authors: Skalec Tomasz , Adamik Barbara , Kobylinska Katarzyna , Gozdzik Waldemar
Published: March 2022

The soluble urokinase-type plasminogen activator receptor (suPAR) is involved in the pathogenesis of acute kidney injury (AKI). Our goal was to establish the optimal suPAR cut-off point for predicting the need for kidney replacement therapy (KRT) use in sepsis patients and to analyze survival rates based on the suPAR level, AKI diagnosis, and the requirement for KRT. In total, 51 septic patients were included (82% septic shock; 96% mechanically ventilated, 35% KRT). Patients were stratified according to the AKI diagnosis and the need for KRT into three groups: AKI(+)/KRT(+), AKI(+)/KRT(−), and AKI(−)/KRT(−). A control group (N = 20) without sepsis and kidney failure was included. Sepsis patients had higher levels of the suPAR than control (13.01 vs. 4.05 ng/mL, p < 0.001). On ICU admission, the suPAR level was significantly higher in the AKI(+)/KRT(+) group than in the AKI(+)/KRT(−) and AKI(−)/KRT(−) groups (18.5 vs. 10.6 and 9.5 ng/mL, respectively; p = 0.001). The optimal suPAR cut-off point for predicting the need for KRT was established at 10.422 ng/mL (area under the curve 0.801, sensitivity 0.889, specificity 0.636). Moreover, patients AKI(+)/KRT(+) had the lowest probability of survival compared to patients AKI(+)/KRT(−) and AKI(−)/KRT(−) (p = 0.0003). The results indicate that the suPAR measurements may constitute an important element in the diagnosis of a patient with sepsis.
Epidural Catheterization in Obstetrics: A Checklist-Based Video Assessment of Free Available Video Material
Authors: Flinspach Armin N. , Raimann Florian J. , Schalk Richard , Bepler Lena , Ruesseler Miriam , Flinspach Mairen H. , Zacharowski Kai , Sterz Jasmina
Published: March 2022

Epidural catheterization has become an indispensable part of modern pain therapy, for example, in obstetrics. Learning how to master this skill is an important competency. Videos are among the information sources with the highest information content for learning such skills. The present study aims to analyze videos regarding epidural catheter placement provided on the YouTube platform based on a validated checklist. An expert workshop selected crucial items for learning epidural catheterization in obstetrics. Items were identified and optimized in a five-step testing process. Using this checklist, videos from YouTube were evaluated by eleven health care professionals. Sixteen videos were identified and analyzed. Concerning the catheterization-specific part of the checklist, only two videos showed satisfactory quality. In the didactic part, eleven out of 21 items reached a mean score >50% of the points. Regarding interrater reliability, the catheterization-specific checklist was shown to be substantial (Fleiss’ kappa = 0.610), and the didactic part was shown to be fair (Fleiss’ kappa = 0.401). Overall, standard monitoring and appropriate aseptic technique were followed in only 42% and 49% for the procedure. There was a significant correlation between the runtime and the content quality (p < 0.001). No correlation could be found in terms of platform rating parameters. The video quality varied highly in terms of the requirements of this practical skill. The majority appear unsuitable for self-study due to serious errors and deficiencies regarding patient safety. However, there is no quality control on free platforms. Accordingly, it is difficult to identify suitable videos for educational purposes.
Analysis of Telomere Length and Its Implication in Neurocognitive Functions in Elderly Women
Authors: Sánchez-González Juan Luis , Sánchez-Rodríguez Juan Luis , Juárez-Vela Raúl , Ruiz de Viñaspre-Hernandez Regina , González-Sarmiento Rogelio , Martin-Vallejo Francisco Javier
Published: March 2022

During the normal aging process, a series of events occur, such as a decrease in telomere length and a decrease in various cognitive functions, such as attention, memory, or perceptual-motor speed. Several studies have attempted to establish a correlation between both variables; however, there is considerable controversy in the scientific literature. The aim of our study was to establish a correlation between the scores obtained in the following different cognitive tests: the Mini-Mental State Examination, the Benton Visual Retention Test, the Trail Making Test, the Rey Auditory Verbal Learning Test, the Stroop Test, and the measurement of telomere length. The sample consisted of a total of 41 physically active, healthy women, with a mean age of 71.21 (±4.32) and of 33 physically inactive, healthy women, with a mean age of 72.70 (±4.13). Our results indicate that there is no correlation between the scores obtained by the women in either group and their telomere length. Therefore, it is not possible to conclude that telomere length can be correlated with cognitive performance.
Hepatitis B Core-Related Antigen Is Useful for Predicting Phase and Prognosis of Hepatitis B e Antigen-Positive Patients
Authors: Lee Han Ah , Lee Hyun Woong , Park Younhee , Kim Hyon-Suk , Seo Yeon Seok
Published: March 2022

The role of hepatitis B core-related antigen (HBcrAg) level in defining clinical phase and predicting prognosis of chronic hepatitis B (CHB) has not been fully studied. CHB patients who had undergone liver biopsy in Korea University Medical Center were included. Patients with liver cirrhosis were excluded. The associations of HBcrAg level with CHB phase, and nucleos(t)ide analogue (NA)-induced hepatitis B e antigen (HBeAg) seroconversion were analyzed. In total, 387 patients (median follow-up of 82.4 months) were included. The CHB phases of patients were defined histologically as immune-tolerant (IT, n = 32, 8.3%), HBeAg-positive and immune-active (PIA, n = 211, 54.5%), HBeAg-negative and immune-active (n = 125, 32.3%), and inactive (n = 19, 4.9%), respectively. In HBeAg-positive patients, the mean HBV DNA levels were comparable between the two groups (p = 0.990). However, the mean HBsAg (7.4 log IU/mL and 6.9 log IU/mL, p = 0.002) and HBcrAg levels (8.2 log U/mL vs. 7.6 log U/mL, p < 0.001) of IT patients were significantly higher than that of PIA patients. In multivariate analysis, younger age (odds ratio [OR] 0.949, p = 0.025), lower alanine aminotransferase (OR 0.988, p = 0.002) and higher HBcrAg level (OR = 2.745 p = 0.022) were independent predictors of the IT phase. Of the patients in the PIA phase, 194 received NA after liver biopsy, and 61 (31.4%) had achieved HBeAg seroconversion after antiviral therapy. In Cox regression analysis, the higher HBcrAg level was the only independent predictor of the NA-induced HBeAg seroconversion (hazard ratio 1.285, p = 0.028). The HBcrAg level is useful for predicting clinical phase of CHB and NA-induced HBeAg seroconversion in HBeAg-positive patients.
A Systematic Review and Meta-Analysis of Nature Walk as an Intervention for Anxiety and Depression
Authors: Grassini Simone
Published: March 2022

Scientific research has widely examined the therapeutic and health benefits of being in contact with natural environments. Nature walk have been proposed as a cost-effective and inclusive method for successfully exploiting nature for the promotion of health and well-being. Depression and anxiety symptoms have been shown to benefit from nature walk. Despite recent empirical findings published in the scientific literature, a summary quantitative work on the effect of nature walk on depression and anxiety does not yet exist. The present systematic review and meta-analysis quantitatively analyze and qualitatively discuss the studies published on the effect of nature walk on depression and anxiety published during the past decade. A database search as well as snowballing methods were used to retrieve eligible articles. The research question and literature search were based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Based on screening and retrieval processes, seven studies met the eligibility criteria and were then included in the quantitative meta-analysis. Risk of bias (RoB) analysis was used to evaluate the quality of the included studies using the Newcastle–Ottawa Scale. After a qualitative evaluation of the studies, data from six experiments were included in the meta-analysis. The meta-analysis show that nature walk effectively improve mental health. The findings were confirmed for the experiments reporting the quantitative data within groups (pre- and post-test) and between groups (experimental vs. control group).
The Differential Prognostic Impact of Long-Duration Atrial High-Rate Episodes Detected by Cardiac Implantable Electronic Devices between Patients with and without a History of Atrial Fibrillation
Authors: Ishiguchi Hironori , Yoshiga Yasuhiro , Shimizu Akihiko , Ueyama Takeshi , Ono Makoto , Fukuda Masakazu , Kato Takayoshi , Fujii Shohei , Hisaoka Masahiro , Uchida Tomoyuki , Omuro Takuya , Okamura Takayuki , Kobayashi Shigeki , Yano Masafumi
Published: March 2022

Long-duration atrial high-rate episodes (AHREs) monitored using cardiac implantable electronic devices (CIEDs) can predict long-term major adverse cardiovascular events (MACEs). This study aimed to compare the impact of long-duration AHRE on MACE development between patients with and without a history of atrial fibrillation (AF). This single-center observational study included 132 CIED-implanted patients with AHREs detected via remote monitoring. The population was dichotomized into groups: with (n = 69) and without (n = 63) AF. In each group, cumulative incidences of MACEs comprising all-cause deaths, heart failure hospitalizations, strokes, and acute coronary syndromes were compared between patients with AHRE durations of ≥24 h and <24 h. Multivariate analysis was performed to identify predictors of MACEs among patients without AF. MACE incidence was significantly higher in patients with AHRE ≥24 h than in those with <24 h in the group without AF (92% vs. 30%, p = 0.005). MACE incidence did not significantly differ between AHRE ≥24 h and <24 h in the group with AF (54% vs. 26%, p = 0.44). After a multivariate adjustment, AHRE duration of ≥24 h emerged as the only independent predictor of MACEs among patients without AF (p = 0.03). In conclusion, a long-duration AHRE was prognostic in patients without a history of AF but not in patients with a history of AHREs.
PARP Inhibitors as Monotherapy in Daily Practice for Advanced Prostate Cancers
Authors: Teyssonneau Diego , Thiery-Vuillemin Antoine , Dariane Charles , Barret Eric , Beauval Jean-Baptiste , Brureau Laurent , Créhange Gilles , Fiard Gaëlle , Fromont Gaëlle , Gauthé Mathieu , Ruffion Alain , Renard-Penna Raphaële , Mathieu Romain , Sargos Paul , Rouprêt Morgan , Ploussard Guillaume , Roubaud Guilhem ,   on behalf of the CC-AFU, Cancerology Committee of the Association Française d’Urologie
Published: March 2022

Despite recent improvements in survival, metastatic castration-resistant prostate cancers (mCRPCs) remain lethal. Alterations in genes involved in the homologous recombination repair (HRR) pathway are associated with poor prognosis. Poly-ADP-ribose polymerase (PARP) inhibitors (PARPis) have demonstrated anti-tumoral effects by synthetic lethality in patients with mCRPCs harboring HRR gene alterations, in particular BRCA2. While both olaparib and rucaparib have obtained government approvals for use, the selection of eligible patients as well as the prescription of these treatments within the clinical urology community are challenging. This review proposes a brief review of the rationale and outcomes of PARPi treatment, then a pragmatic vision of PARPi use in terms of prescription and the selection of patients based on molecular screening, which can involve potential genetic counseling in the case of associated germinal alterations.
Predictors of Repeat Medical Emergency Team Activation in Deteriorating Ward Patients: A Retrospective Cohort Study
Authors: Lee Ju-Ry , Jung Youn-Kyung , Hong Sang-Bum , Huh Jin Won
Published: March 2022

Recurrent clinical deterioration and repeat medical emergency team (MET) activation are common and associated with high in-hospital mortality. This study assessed the predictors for repeat MET activation in deteriorating patients admitted to a general ward. We retrospectively analyzed the data of 5512 consecutive deteriorating hospitalized adult patients who required MET activation in the general ward. The patients were divided into two groups according to repeat MET activation. Multivariate logistic regression analyses were used to identify the predictors for repeat MET activation. Hematological malignancies (odds ratio, 2.07; 95% confidence interval, 1.54–2.79) and chronic lung disease (1.49; 1.07–2.06) were associated with a high risk of repeat MET activation. Among the causes for MET activation, respiratory distress (1.76; 1.19–2.60) increased the risk of repeat MET activation. A low oxygen saturation-to-fraction of inspired oxygen ratio (0.97; 0.95–0.98), high-flow nasal cannula oxygenation (4.52; 3.56–5.74), airway suctioning (4.63; 3.59–5.98), noninvasive mechanical ventilation (1.52; 1.07–2.68), and vasopressor support (1.76; 1.22–2.54) at first MET activation increased the risk of repeat MET activation. The risk factors identified in this study may be useful to identify patients at risk of repeat MET activation at the first MET activation. This would allow the classification of high-risk patients and the application of aggressive interventions to improve outcomes.
Mathematical Modeling to Predict COVID-19 Infection and Vaccination Trends
Authors: Doroftei Bogdan , Ilie Ovidiu-Dumitru , Anton Nicoleta , Timofte Sergiu-Ioan , Ilea Ciprian
Published: March 2022

Background: COVID-19 caused by the Severe Acute Respiratory Syndrome Coronavirus 2 placed the health systems around the entire world in a battle against the clock. While most of the existing studies aimed at forecasting the infections trends, our study focuses on vaccination trend(s). Material and methods: Based on these considerations, we used standard analyses and ARIMA modeling to predict possible scenarios in Romania, the second-lowest country regarding vaccinations from the entire European Union. Results: With approximately 16 million doses of vaccine against COVID-19 administered, 7,791,250 individuals had completed the vaccination scheme. From the total, 5,058,908 choose Pfizer–BioNTech, 399,327 Moderna, 419,037 AstraZeneca, and 1,913,978 Johnson & Johnson. With a cumulative 2147 local and 17,542 general adverse reactions, the most numerous were reported in recipients of Pfizer–BioNTech (1581 vs. 8451), followed by AstraZeneca (138 vs. 6033), Moderna (332 vs. 1936), and Johnson & Johnson (96 vs. 1122). On three distinct occasions have been reported >50,000 individuals who received the first or second dose of a vaccine and >30,000 of a booster dose in a single day. Due to high reactogenicity in case of AZD1222, and time of launching between the Pfizer–BioNTech and Moderna vaccine could be explained differences in terms doses administered. Furthermore, ARIMA(1,1,0), ARIMA(1,1,1), ARIMA(0,2,0), ARIMA(2,1,0), ARIMA(1,2,2), ARI-MA(2,2,2), ARIMA(0,2,2), ARIMA(2,2,2), ARIMA(1,1,2), ARIMA(2,2,2), ARIMA(2,1,1), ARIMA(2,2,1), and ARIMA (2,0,2) for all twelve months and in total fitted the best models. These were regarded according to the lowest MAPE, p-value (p < 0.05, p < 0.01, and p < 0.001) and through the Ljung–Box test (p < 0.05, p < 0.01, and p < 0.001) for autocorrelations. Conclusions: Statistical modeling and mathematical analyses are suitable not only for forecasting the infection trends but the course of a vaccination rate as well.
Real-World Journey of Unresectable Stage III NSCLC Patients: Current Dilemmas for Disease Staging and Treatment
Authors: Agbarya Abed , Shalata Walid , Addeo Alfredo , Charpidou Andriani , Cuppens Kristof , Brustugun Odd Terje , Rajer Mirjana , Jakopovic Marco , Marinca Mihai V. , Pluzanski Adam , Hiltermann Jeroen , Araújo António
Published: March 2022

Daily-practice challenges in oncology have been intensified by the approval of immune checkpoint inhibitors (ICI). We aimed to outline current therapy policies and management of locally advanced unresectable stage III non-small-cell lung cancer (NSCLC) in different countries. One thoracic oncologist from each of the following countries—Belgium, Croatia, Greece, Israel, the Netherlands, Norway, Poland, Portugal, Romania, Slovenia, and Switzerland—participated in an electronic survey. Descriptive statistics were conducted with categorical variables reported as frequencies and continuous variables as median and interquartile range (IQR) (StataSE-v15). EBUS (endobronchial ultrasound bronchoscopy) was used either upfront or for N2 confirmation. Resectability is still a source of disagreement; thus, decisions vary within each multidisciplinary team. Overall, 66% of stage III patients [IQR 60–75] undergo chemoradiation therapy (CRT); concurrent CRT (cCRT) accounts for most cases (~70%). Performance status is universally used for cCRT eligibility. Induction chemotherapy is fairly weighted based on radiotherapy (RT) availability. Mean time to evaluation after RT completion is less than a month; ICI consolidation is started within six weeks. Durvamulab expenditures are reimbursed in all countries, yet some limiting criteria exist (PD-L1 ≥ 1%, cCRT). No clear guidance on therapies at Durvamulab progression exist; experts agree that it depends on progression timing. Given the high heterogeneity in real-world practices, standardized evidence-based decisions and healthcare provision in NSCLC are needed.
Impaired Neutralizing Antibody Activity against B.1.617.2 (Delta) after Anti-SARS-CoV-2 Vaccination in Patients Receiving Anti-CD20 Therapy
Authors: Töllner Maximilian , Speer Claudius , Benning Louise , Bartenschlager Marie , Nusshag Christian , Morath Christian , Zeier Martin , Süsal Caner , Schnitzler Paul , Schmitt Wilhelm , Bergner Raoul , Bartenschlager Ralf , Lorenz Hanns-Martin , Schaier Matthias
Published: March 2022

Background: To characterize humoral response after standard anti-SARS-CoV-2 vaccination in Rituximab-treated patients and to determine the optimal time point after last Rituximab treatment for appropriate immunization. Methods: Sixty-four patients who received Rituximab within the last seven years prior to the first anti-SARS-CoV-2 vaccination were recruited in a prospective observational study. Anti-S1 IgG, SARS-CoV-2 specific neutralization, and various SARS-CoV-2 target antibodies were determined. A live virus assay was used to assess neutralizing antibody activity against B.1.617.2 (delta). In Rituximab-treated patients, CD19+ peripheral B-cells were quantified using flow cytometry. Results: After second vaccination, all antibodies were significantly reduced compared to healthy controls. Neutralizing antibody activity against B.1.617.2 (delta) was detectable with a median (IQR) ID50 of 0 (0–1:20) compared to 1:320 (1:160–1:320) in healthy controls (for all p < 0.001). Longer time period since last Rituximab administration correlated with higher anti-SARS-CoV-2 antibody levels and a stronger neutralization of B.1.617.2 (delta). With one exception, only patients with a CD19+ cell proportion ≥ 1% had detectable neutralizing antibodies. Conclusion: Our data indicate that a reconstitution of the B-cell population to >1% seems crucial in developing neutralizing antibodies against SARS-CoV-2. We suggest that anti-SARS-CoV-2 vaccination should be administered at least 8–12 months after the last Rituximab treatment for sufficient humoral responses.
The Multifaceted Presentation of the Multisystem Inflammatory Syndrome in Children: Data from a Cluster Analysis
Authors: Sönmez Hafize Emine , Çağlayan Şengül , Otar Yener Gülçin , Başar Eviç Zeynep , Ulu Kadir , Çakan Mustafa , Guliyeva Vafa , Bağlan Esra , Öztürk Kübra , Demirkol Demet , Demir Ferhat , Karadağ Şerife Gül , Özdel Semanur , Aktay Ayaz Nuray , Sözeri Betül
Published: March 2022

Background: The aim of this study was to evaluate the outcomes of patients with the multisystem inflammatory syndrome in children (MIS-C) according to phenotypes of disease and define the prognostic factors for the severe course. Methods: This cross-sectional study included 293 patients with MIS-C from seven pediatric rheumatology centers. A two-step cluster analysis was performed to define the spectrum of disease and their outcomes were compared between each group. Results: Four subgroups were identified as follows: cluster I, predominantly Kawasaki-like features (n = 100); cluster II, predominantly MAS-like features (n = 34); cluster III, predominantly LV dysfunction (n = 47); cluster IV, other presentations (n = 112). The duration of fever was longer in cluster II and the length of hospitalization was longer in both clusters II and III. Laboratory findings revealed lower lymphocyte and platelet counts and higher acute phase reactants (APRs) in cluster II, while patients in cluster IV showed less inflammation with lower APRs. The resolution of abnormal laboratory findings was longer in clusters II and III, while it was shortest in cluster IV. Seven patients died. Among them, four belonged to cluster II, while three were labeled as cluster III. Patients with severe course had higher levels of neutrophil–lymphocyte ratio, mean platelet volume, procalcitonin, ferritin, interleukin-6, fibrinogen, D-Dimer, BNP, and troponin-I, and lower levels of lymphocyte and platelet counts. Conclusion: As shown, MIS-C is not a single disease presenting with various clinical features and outcomes. Understanding the disease spectrum will provide individualized management.
Visualization of Inferior Alveolar and Lingual Nerve Pathology by 3D Double-Echo Steady-State MRI: Two Case Reports with Literature Review
Authors: Al-Haj Husain Adib , Schönegg Daphne , Valdec Silvio , Stadlinger Bernd , Gander Thomas , Essig Harald , Piccirelli Marco , Winklhofer Sebastian
Published: March 2022

Injury to the peripheral branches of the trigeminal nerve, particularly the lingual nerve (LN) and the inferior alveolar nerve (IAN), is a rare but serious complication that can occur during oral and maxillofacial surgery. Mandibular third molar surgery, one of the most common surgical procedures in dentistry, is most often associated with such a nerve injury. Proper preoperative radiologic assessment is hence key to avoiding neurosensory dysfunction. In addition to the well-established conventional X-ray-based imaging modalities, such as panoramic radiography and cone-beam computed tomography, radiation-free magnetic resonance imaging (MRI) with the recently introduced black-bone MRI sequences offers the possibility to simultaneously visualize osseous structures and neural tissue in the oral cavity with high spatial resolution and excellent soft-tissue contrast. Fortunately, most LN and IAN injuries recover spontaneously within six months. However, permanent damage may cause significant loss of quality of life for affected patients. Therefore, therapy should be initiated early in indicated cases, despite the inconsistency in the literature regarding the therapeutic time window. In this report, we present the visualization of two cases of nerve pathology using 3D double-echo steady-state MRI and evaluate evidence-based decision-making for iatrogenic nerve injury regarding a wait-and-see strategy, conservative drug treatment, or surgical re-intervention.
A New Approach in Detectability of Microcalcifications in the Placenta during Pregnancy Using Textural Features and K-Nearest Neighbors Algorithm
Authors: Miron Mihaela , Moldovanu Simona , Ștefănescu Bogdan Ioan , Culea Mihai , Pavel Sorin Marius , Culea-Florescu Anisia Luiza
Published: March 2022

(1) Background: Ultrasonography is the main method used during pregnancy to assess the fetal growth, amniotic fluid, umbilical cord and placenta. The placenta’s structure suffers dynamic modifications throughout the whole pregnancy and many of these changes, in which placental microcalcifications are by far the most prominent, are related to the process of aging and maturation and have no effect on fetal wellbeing. However, when placental microcalcifications are noticed earlier during pregnancy, they could suggest a major placental dysfunction with serious consequences for the fetus and mother. For better detectability of microcalcifications, we propose a new approach based on improving the clarity of details and the analysis of the placental structure using first and second order statistics, and fractal dimension. (2) Methods: The methodology is based on four stages: (i) cropping the region of interest and preprocessing steps; (ii) feature extraction, first order—standard deviation (SD), skewness (SK) and kurtosis (KR)—and second order—contrast (C), homogeneity (H), correlation (CR), energy (E) and entropy (EN)—are computed from a gray level co-occurrence matrix (GLCM) and fractal dimension (FD); (iii) statistical analysis (t-test); (iv) classification with the K-Nearest Neighbors algorithm (K-NN algorithm) and performance comparison with results from the support vector machine algorithm (SVM algorithm). (3) Results: Experimental results obtained from real clinical data show an improvement in the detectability and visibility of placental microcalcifications.
Top Surface Roughness Modeling for Robotic Wire Arc Additive Manufacturing
Authors: Chen  Heping , Yaseer Ahmed , Zhang  Yuming
Published: March 2022

Wire Arc Additive Manufacturing (WAAM) has many applications in fabricating complex metal parts. However, controlling surface roughness is very challenging in WAAM processes. Typically, machining methods are applied to reduce the surface roughness after a part is fabricated, which is costly and ineffective. Therefore, controlling the WAAM process parameters to achieve better surface roughness is important. This paper proposes a machine learning method based on Gaussian Process Regression to construct a model between the WAAM process parameters and top surface roughness. In order to measure the top surface roughness of a manufactured part, a 3D laser measurement system is developed. The experimental datasets are collected and then divided into training and testing datasets. A top surface roughness model is then constructed using the training datasets and verified using the testing datasets. Experimental results demonstrate that the proposed method achieves less than 50 μm accuracy in surface roughness prediction.
Estimation of the Efficiency of Vessel Speed Reduction to Mitigate Gas Emission in Busan Port Using the AIS Database
Authors: Woo Donghan , Im Namkyun
Published: March 2022

To mitigate marine atmospheric pollution causing greenhouse gas (GHG) and a threat to coastal residents’ health in dense hub port cities, the Vessel Speed Reduction (VSR) programs were implemented in the Republic of Korea. Spatial analysis of the efficiency of the VSR programs is essential to monitor and improve the present programs. In the present study, the efficiency of the VSRs from the Busan Port (BP), including North Port (NP) and Gamcheon Port (GP), were analyzed. A bottom-up activity-based approach using automatic identification system (AIS) data was introduced herein for the estimation of spatial marine gas emission in real time. The BP has implemented the VSR program since 2020; thus, this study spatially analyzed marine gas emissions in the areas in 2019 and 2020 to demonstrate the efficiency of VSR. To demonstrate the VSR programs in the aspect of the comparison of gas emissions in each year, the total annual fuel consumption in each year is divided by the total arrival ships’ GT respectively. According to the comparison of the spatial gas emission inventory between two years in the designed area, 19.2% of the annual marine gas emissions per ships’ GT in BP in 2020 were reduced with the implementation of the VSR program. The spatial analysis clearly showed the mitigation of the ships’ gas emissions along the passageway to BP. The spatial analysis of the efficiency of the VSR program will be useful basic data to reflect the local gas emission state on the improvement of the VSR program and newly established environmental regulations.
Hydrogen Sulfide Production with a Microbial Consortium Isolated from Marine Sediments Offshore
Authors: Briones-Gallardo Roberto , González-Muñoz Muriel , García-Bautista Itza , Valdés-Lozano David , Toledano-Thompson Tanit , Polanco-Lugo Erik , Rivera-Madrid Renata , Valdez-Ojeda Ruby
Published: March 2022

Hydrogen, electric energy production, and metal toxic bioremediation are some of the biotechnological applications of sulfate-reducing organisms, which potentially depend on the sulfide produced. In this study, offshore of Yucatan, the capacity to produce hydrogen sulfide using microbial consortia from marine sediment (SC469, PD102, SD636) in batch reactors was evaluated. Kinetic tests were characterized by lactate oxidation to acetate, propionate, CO2 and methane. The inoculum SC469, located in open-ocean, differed strongly in microbial diversity and showed better performance in substrate utilization with the highest hydrogen sulfide production (246 mmolg−1 VSS) at a specific hydrogen sulfide rate of 113 mmol g−1 VSS d−1 with a 0.79 molar ratio of sulfate/lactate. Sulfate-reducing microbial consortia enriched in the laboratory from marine sediments collected offshore in Yucatan and with a moderate eutrophication index, differed strongly in microbial diversity with loss of microorganisms with greater capacity for degradation of organic macromolecules. The sulfate-reducing microorganisms were characterized using Illumina MiSeq technology and were mainly Desulfomicrobium, Clostridium and Desulfobacter.
Revisiting the Carbonate Chemistry of the Sea of Japan (East Sea): From Water Column to Sediment
Authors: Tishchenko Pavel , Zhang Jing , Pavlova Galina , Tishchenko Petr , Sagalaev Sergey , Shvetsova Mariya
Published: March 2022

In this study, we investigated the carbonate system in sediments and water columns from five stations in the Sea of Japan (East Sea) (JES) during the R/V Hakuho Maru KH-10-2 research cruise in the summer of 2010. The total alkalinity (TA) and pH were measured. Adopting a saturation degree of 91% and 80% for the lysocline depth and calcite compensation depth (CCD), respectively, we found that those depths corresponded to 1360 and 1980 m. A comparison of the calcite saturation depths, lysocline depths, and CCD depths obtained for 1999 and 2010 suggests that acidification of the interior of the JES occurred. Sediment cores were retrieved using a multi-corer. In the sediment cores, a sharp decrease in the pH by 0.3–0.4 pH units was observed in the subsurface horizons (0–10 cm) compared with the pH of the seawater from the bottom horizons. The TA in the porewaters was significantly higher than that in the overlying seawater. The anaerobic degradation of organic matter is probably the main cause for the increasing TA in the sediments. The porewaters were significantly undersaturated with calcite and aragonite, except in that from the shallowest station, where the sediments below 7.5 cm were saturated, and even supersaturated, with calcite and aragonite. A linear correlation between the dissolved inorganic carbon and the TA for sediments with a slope of 0.9993 was found, despite there being potentially different ways for the diagenesis of the organic matter to occur. The diagenesis of organic matter in the top sediments of the JES forms gradients of TA and CO2* concentrations on the interface of “bottom water–sediments”. Averaged fluxes of TA and dissolved inorganic carbon (DIC) from the sediments to the bottom waters estimated by means of Fickian diffusion were calculated as 44 and 89 mmol/(m2 year) for TA and DIC, respectively.
Using an Adaptive Neuro-Fuzzy Inference System to Predict Dilution Characteristics of Vertical Buoyant Jets Subjected to Lateral Confinement
Authors: Zhao Yufeng , He Junshi , Yan Xiaohui , Liu Jianwei
Published: March 2022

In order to predict the dilution characteristics of vertical buoyant jets constrained by lateral obstructions, we propose a new method based on a commonly used machine learning algorithm: the adaptive neuro-fuzzy inference system (ANFIS). By using experimental data to train and test the ANFIS model, this study shows that it had better performance than commonly used empirical equations for laterally confined jets and another artificial intelligence technique—genetic programming. The RMSE values of the ANFIS-based model were lower, and the R2 values were higher, compared with those of the empirical equation and genetic programming models. The reduction in RMSE achieved by using ANFIS to replace the empirical equations or genetic programming algorithm exceeded 20%. This research confirms that the ANFIS technique has real potential in the development of effective and accurate models that can be used to estimate the dilution characteristics of a vertical buoyant jet subjected to lateral confinement, providing a new avenue for the prediction of dilution characteristics using artificial intelligence techniques, which can also be utilized for other effluent mixing problems in marine systems.