bluuebunny/crossref_metadata_2025 huggingface dataset:
Hemostatic Collagen Sponge with High Porosity Promotes the Proliferation and Adhesion of Fibroblasts and Osteoblasts
Authors: D’Amico Emira , Pierfelice Tania Vanessa , Lepore Stefania , Iezzi Giovanna , D’Arcangelo Camillo , Piattelli Adriano , Covani Ugo , Petrini Morena
Published: April 2023

The use of biomaterial for tissue repair involves the interaction between materials and cells, and the coagulum formation represents the first step of tissue healing. This process is particularly critical in the oral cavity, where the wounds are immediately subjected to the masticatory mechanical stress, saliva invasion, and bacterial attack. Therefore, the present study aimed to explore the structural features and the biological activities of a hemostatic collagen sponge on human gingival fibroblasts (HGFs) and human oral osteoblasts (HOBs). The microstructure of the collagen sponge was characterized by a scanning electron microscope (SEM) and histological analysis. The porosity was also calculated. To investigate biological activities, HGFs and HOBs were cultured on the collagen sponges, and their adhesion was observed at SEM on the third day, while cell viability was investigated at the third and seventh days by Tetrazolium (MTT) assay. For osteoblasts seeded on collagen sponge the mineralization ability was also evaluated by alkaline phosphatase (ALP) assay at the seventh day, and by Alizarin red staining on the 14th. Furthermore, the gene expression of ALP and osteocalcin (OCN) was investigated after 3, 7 and 14 days. SEM images of the sponge without cells showed a highly porous 3D structure, confirmed by the measurement of porosity that was more than 90%. The samples cultured were characterized by cells uniformly distributed and adhered to the sponge surface. Proliferation ended up being promoted, as well as the mineralization ability of the osteoblasts, mainly at the mature stage. In conclusion, this collagen sponge could have a potential use for tissue healing.
Research Progress in High-Efficiency Utilization of Nitrogen in Rapeseed
Authors: Zhan Na , Xu Kun , Ji Gaoxiang , Yan Guixin , Chen Biyun , Wu Xiaoming , Cai Guangqin
Published: April 2023

Nitrogen (N) is one of the most important mineral elements for plant growth and development and a key factor for improving crop yield. Rapeseed, Brassica napus, is the largest oil crop in China, producing more than 50% of the domestic vegetable oil. However, high N fertilizer input with low utilization efficiency not only increases the production cost but also causes serious environmental pollution. Therefore, the breeding of rapeseed with high N efficiency is of great strategic significance to ensure the security of grain and oil and the sustainable development of the rapeseed industry. In order to provide reference for genetic improvement of rapeseed N-efficient utilization, in this article, we mainly reviewed the recent research progress of rapeseed N efficiency, including rapeseed N efficiency evaluation, N-efficient germplasm screening, and N-efficient physiological and molecular genetic mechanisms.
The Key Role of Chalcogenurane Intermediates in the Reduction Mechanism of Sulfoxides and Selenoxides by Thiols Explored In Silico
Authors: Madabeni Andrea , Orian Laura
Published: April 2023

Sulfoxides and selenoxides oxidize thiols to disulfides while being reduced back to sulfides and selenides. While the reduction mechanism of sulfoxides to sulfides has been thoroughly explored experimentally as well as computationally, less attention has been devoted to the heavier selenoxides. In this work, we explore the reductive mechanism of dimethyl selenoxide, as an archetypal selenoxide and, for the sake of comparison, the reductive mechanism of dimethyl sulfoxide to gain insight into the role of the chalcogen on the reaction substrate. Particular attention is devoted to the key role of sulfurane and selenurane intermediates. Moreover, the capacity of these system to oxidize selenols rather than thiols, leading to the formation of selenyl sulfide bridges, is explored in silico. Notably, this analysis provides molecular insight into the role of selenocysteine in methionine sulfoxide reductase selenoenzyme. The activation strain model of chemical reactivity is employed in the studied reactions as an intuitive tool to bridge the computationally predicted effect of the chalcogen on the chalcogenoxide as well as on the chalcogenol.
ARHGAP11A Is a Novel Prognostic and Predictive Biomarker Correlated with Immunosuppressive Microenvironment in Clear Cell Renal Cell Carcinoma
Authors: Yang Huihui , Zhang Hongning , Zhang Liuxu , Tusuphan Paizigul , Zheng Junfang
Published: April 2023

Clear cell renal cell carcinoma (ccRCC) is a highly immunogenic tumor and immune dysfunction is associated with ccRCC poor prognosis. The RhoGTPase-activating proteins (RhoGAPs) family was reported to affect ccRCC development, but its role in immunity and prognosis prediction for ccRCC remain unknown. In the current study, we found ARHGAP11A was the only independent risk factor among 33 RhoGAPs (hazard ratio [HR] 1.949, 95% confidence interval [CI] 1.364–2.785). High ARHGAP11A level was associated with shorter overall survival (OS, HR 2.040, 95% CI 1.646–3.417) and ARHGAP11A is a prognostic biomarker for ccRCC. ARHGAP11A knockdown suppressed renal cell carcinoma (RCC) cell proliferation, colony formation, and migration, suggesting the promoting role of ARHGAP11A on RCC development. Mechanistically, ARHGAP11A might contribute to the suppressive tumor immune microenvironment (TIME). High ARHGAP11A level was correlated with infiltration of immunosuppressive cells (including T helper 2 (Th2) cells, regulatory T (Treg) cells, myeloid derived suppressor cells (MDSC), and M2 macrophage cells), activation of immunosuppressive pathways (IL6-JAK-STAT3 signaling and IFNγ response), and expression of inhibitory immune checkpoints (ICs). ARHGAP11A could promote T cell exhaustion and induce immune escape. ccRCC patients with low ARHGAP11A level were more suitable for immune checkpoint inhibitors (ICIs) therapy, while those with high ARHGAP11A level might benefit from a combination of ARHGAP11A blockade and ICIs. In all, ARHGAP11A might serve as a novel prognostic marker, therapeutic target, and predictor in the clinical response to ICIs therapy for ccRCC.
Exploring the Binding of Natural Compounds to Cancer-Related G-Quadruplex Structures: From 9,10-Dihydrophenanthrenes to Their Dimeric and Glucoside Derivatives
Authors: Platella Chiara , Criscuolo Andrea , Riccardi Claudia , Gaglione Rosa , Arciello Angela , Musumeci Domenica , DellaGreca Marina , Montesarchio Daniela
Published: April 2023

In-depth studies on the interaction of natural compounds with cancer-related G-quadruplex structures have been undertaken only recently, despite their high potential as anticancer agents, especially due to their well-known and various bioactivities. In this frame, aiming at expanding the repertoire of natural compounds able to selectively recognize G-quadruplexes, and particularly focusing on phenanthrenoids, a mini-library including dimeric (1–3) and glucoside (4–5) analogues of 9,10-dihydrophenanthrenes, a related tetrahydropyrene glucoside (6) along with 9,10-dihydrophenanthrene 7 were investigated here by several biophysical techniques and molecular docking. Compounds 3 and 6 emerged as the most selective G-quadruplex ligands within the investigated series. These compounds proved to mainly target the grooves/flanking residues of the hybrid telomeric and parallel oncogenic G-quadruplex models exploiting hydrophobic, hydrogen bond and π-π interactions, without perturbing the main folds of the G-quadruplex structures. Notably, a binding preference was found for both ligands towards the hybrid telomeric G-quadruplex. Moreover, compounds 3 and 6 proved to be active on different human cancer cells in the low micromolar range. Overall, these compounds emerged as useful ligands able to target G-quadruplex structures, which are of interest as promising starting scaffolds for the design of analogues endowed with high and selective anticancer activity.
EduARdo—Unity Components for Augmented Reality Environments
Authors: Logothetis Ilias , Sfyrakis Myron , Vidakis Nikolaos
Published: April 2023

Contemporary software applications have shifted focus from 2D representations to 3D. Augmented and Virtual Reality (AR/VR) are two technologies that have captured the industry’s interest as they show great potential in many areas. This paper proposes a system that allows developers to create applications in AR and VR with a simple visual process, while also enabling all the powerful features provided by the Unity 3D game engine. The current system comprises two tools, one for the interaction and one for the behavioral configuration of 3D objects within the environment. Participants from different disciplines with a software-engineering background were asked to participate in the evaluation of the system. They were called to complete two tasks using their mobile phones and then answer a usability questionnaire to reflect on their experience using the system. The results (a) showed that the system is easy to use but still lacks some features, (b) provided insights on what educators seek from digital tools to assist them in the classroom, and (c) that educators often request a more whimsical UI as they want to use the system together with the learners.
Distilling Knowledge with a Teacher’s Multitask Model for Biomedical Named Entity Recognition
Authors: Mehmood Tahir , Gerevini Alfonso E. , Lavelli Alberto , Olivato Matteo , Serina Ivan
Published: April 2023

Single-task models (STMs) struggle to learn sophisticated representations from a finite set of annotated data. Multitask learning approaches overcome these constraints by simultaneously training various associated tasks, thereby learning generic representations among various tasks by sharing some layers of the neural network architecture. Because of this, multitask models (MTMs) have better generalization properties than those of single-task learning. Multitask model generalizations can be used to improve the results of other models. STMs can learn more sophisticated representations in the training phase by utilizing the extracted knowledge of an MTM through the knowledge distillation technique where one model supervises another model during training by using its learned generalizations. This paper proposes a knowledge distillation technique in which different MTMs are used as the teacher model to supervise different student models. Knowledge distillation is applied with different representations of the teacher model. We also investigated the effect of the conditional random field (CRF) and softmax function for the token-level knowledge distillation approach, and found that the softmax function leveraged the performance of the student model compared to CRF. The result analysis was also extended with statistical analysis by using the Friedman test.
Hydrogen Compression Materials with Output Hydrogen Pressure in a Wide Range of Pressures Using a Low-Potential Heat-Transfer Agent
Authors: Zhang Xu , Zhao Yu-Yuan , Li Bao-Quan , Prokhorenkov Mikhail , Movlaev Elshad , Xu Jin , Xiong Wei , Yan Hui-Zhong , Mitrokhin Sergey
Published: April 2023

In order to meet the demand of metal hydride–hydrogen compressors (MHHC) and their hydrogen compression materials for high-pressure hydrogen filling in a hydrogen energy field, four kinds of hydrogen storage alloys with low-grade heat source (<373 K) heating outputs and different hydrogen pressures (up to 80 MPa) were developed as hydrogen compression materials. The preliminary compositions of the hydrogen storage alloys were determined by using a statistical model and research experience. The rare earth series AB5 and Ti/Zr base AB2 hydrogen storage alloys were prepared using a high-temperature melting method. The composition, structure, and hydrogenation/dehydrogenation plateau characteristics of the alloys were tested by an inductively coupled plasma mass spectrometer (ICP-MAS), X-ray diffractometer (XRD), and pressure–composition isothermal (PCT) tester. The median output pressures of the four-stage hydrogen storage alloys at 363 K were 8.90 MPa, 25.04 MPa, 42.97 MPa, and 84.73 MPa, respectively, which met the requirements of the 20 MPa, 35 MPa, and 70 MPa high-pressure hydrogen injections for the MHHCs. In fact, due to the tilted pressure plateau of the PCT curve, the synergy between the adjacent two alloys still needed to be adjusted.
Nematode and Strepsipteran Parasitism in Bait-Trapped and Hand-Collected Hornets (Hymenoptera, Vespidae, Vespa)
Authors: Kanzaki Natsumi , Makino Shun’ichi , Kosaka Hajime , Sayama Katsuhiko , Hamaguchi Keiko , Narayama Shinji
Published: April 2023

The parasitism of two groups of host-manipulating parasites of hornets was examined in Kyoto, Japan. Vespa mandarinia (661 individuals), V. simillima (303), V. analis (457), V. ducalis (158), V. crabro (57), and V. dybowskii (4) were collected either by bait trap or hand collection with an insect net, and examined for their parasites. An endoparasitic nematode, Sphaerularia vespae was isolated from three overwintered gynes of V. mandarinia and a gyne of V. ducalis. While endoparasitic insects, Xenos spp., were recovered from 13 V. mandarinia, 77 V. analis, two V. ducalis, and three V. crabro, and those recovered from V. analis and others were molecularly identified as X. oxyodontes and X. moutoni, respectively. Comparing Xenos parasitism level and capturing methods, the parasitism level was significantly higher in trapped hosts than in hand-collected ones, suggesting that stylopized hosts are more strongly attracted to the food source (bait trap) compared with unparasitized hosts. The genotypes of S. vespae were identical to each other, and near identical to its type population. While each of the two Xenos spp. showed four mitochondrial DNA haplotypes. A phylogenetic comparison suggested that Xenos haplotypes found in the present study are close to those previously reported from Japan and other Asian countries.
Solvent Accessibility of Coronaviridae Spike Proteins through the Lens of Information Gain
Authors: Ali Sarwan , Bello Babatunde , Patterson Murray
Published: April 2023

The COVID-19 pandemic, caused by the coronavirus SARS-CoV-2, has generated a renewed interest in the larger family of Coronaviridae, which causes a variety of different respiratory infections in a variety of different hosts. Understanding the mechanisms behind the ability of a family of viruses to spill over into different hosts is an ongoing study. In this work, we studied the relationship between specific amino acid sites and the solvent accessibility of the surface (or spike) protein of different Coronaviridae. Since host specificity hinges on the portion(s) of the protein that interfaces with the host cell membrane, there could be a relationship between information gain in specific amino acid sites and solvent accessibility. We found a connection between sites with high information gain and solvent accessibility within several major subgenera of Coronaviridae. Such a connection could be used to study other lesser-known families of viruses, which is desirable because information gain is much easier to compute when the number of sequences is large, as we show. Finally, we produced a visualization of the sequences within each major subgenus and discussed several regions of interest, as well as focused on some pairs of Coronaviridae hosts of interest.
Reproductive Health in Congenital Heart Disease: Preconception, Pregnancy, and Postpartum
Authors: Halpern Dan G. , Penfield Christina A. , Feinberg Jodi L. , Small Adam J.
Published: April 2023

The prevalence of congenital heart disease (CHD) in pregnancy is rising due to the improved survival of patients with CHD into childbearing age. The profound physiological changes that occur during pregnancy may worsen or unmask CHD, affecting both mother and fetus. Successful management of CHD during pregnancy requires knowledge of both the physiological changes of pregnancy and the potential complications of congenital heart lesions. Care of the CHD patient should be based on a multidisciplinary team approach beginning with preconception counseling and continuing into conception, pregnancy, and postpartum periods. This review summarizes the published data, available guidelines and recommendations for the care of CHD during pregnancy.
Coronary Obstruction during Valve-in-Valve Transcatheter Aortic Valve Replacement: Pre-Procedural Risk Evaluation, Intra-Procedural Monitoring, and Follow-Up
Authors: Prandi Francesca Romana , Niv Granot Yoav , Margonato Davide , Belli Martina , Illuminato Federica , Vinayak Manish , Barillà Francesco , Romeo Francesco , Tang Gilbert H. L. , Sharma Samin , Kini Annapoorna , Lerakis Stamatios
Published: April 2023

Valve-in-valve (ViV) transcatheter aortic valve replacement (TAVR) is emerging as an effective treatment for patients with symptomatically failing bioprosthetic valves and a high prohibitive surgical risk; a longer life expectancy has led to a higher demand for these valve reinterventions due to the increased possibilities of outliving the bioprosthetic valve’s durability. Coronary obstruction is the most feared complication of valve-in-valve (ViV) TAVR; it is a rare but life-threatening complication and occurs most frequently at the left coronary artery ostium. Accurate pre-procedural planning, mainly based on cardiac computed tomography, is crucial to determining the feasibility of a ViV TAVR and to assessing the anticipated risk of a coronary obstruction and the eventual need for coronary protection measures. Intraprocedurally, the aortic root and a selective coronary angiography are useful for evaluating the anatomic relationship between the aortic valve and coronary ostia; transesophageal echocardiographic real-time monitoring of the coronary flow with a color Doppler and pulsed-wave Doppler is a valuable tool that allows for a determination of real-time coronary patency and the detection of asymptomatic coronary obstructions. Because of the risk of developing a delayed coronary obstruction, the close postprocedural monitoring of patients at a high risk of developing coronary obstructions is advisable. CT simulations of ViV TAVR, 3D printing models, and fusion imaging represent the future directions that may help provide a personalized lifetime strategy and tailored approach for each patient, potentially minimizing complications and improving outcomes.
Getting it Right in Obstructive Lung Disease
Authors: Carlucci Annalisa , Fusar Poli Barbara
Published: April 2023

Chronic hypercapnic respiratory failure in obstructive lung diseases may benefit from nocturnal Home non-invasive ventilation (HNIV). It has been shown that in patients with persistence of hypercapnia after an acute episode of chronic obstructive pulmonary disease (COPD) exacerbation requiring mechanical ventilation, HNIV may improve the risk for new admission and survival. The ability to reach these aims depends on the correct timing of enrolling patients, as well as a correct definition of ventilatory needing and setting of the ventilator. This review tries to define a possible home treatment path of hypercapnic respiratory failure in COPD by analyzing the main studies published in recent years.
Waist Circumference and Cardiovascular Risk Profiles after Autologous Breast Reconstruction: A Nationwide Population-Based Cohort Study
Authors: Ryu Jeong Yeop , Kang Myeong Jae , Cho Hyun Geun , Yang Jung Dug , Lee Joon Seok
Published: April 2023

To date, few studies have examined changes in waist circumference and cardiovascular risk profile (CVRP) after autologous breast reconstruction. Therefore, this study aimed to investigate the effect of flap surgery using autologous tissue on waist circumference and CVRP through a nationwide population-based cohort study. In total, 6926 patients who underwent autologous breast reconstruction between 2015 and 2019 were considered. Of them, we evaluated 3444 patients who underwent the complete Korean National Health Insurance Service Health Screening (NHIS-HealS) before and after surgery. Body measurements, including waist circumference, weight, and body mass index; and CVRP, including blood pressure, fasting blood glucose, and cholesterol levels, were analyzed by type of surgery up to 3–4 years postoperatively. The body measurements of patients who underwent abdominal-based breast reconstruction were reduced 1–2 years after surgery, but returned to preoperative values 3–4 years after surgery. Regardless of the type of surgery, CVRP was worsened at both 1–2 years and 3–4 years after surgery, except for low-density lipoprotein values. Autologous breast reconstruction did not ameliorate the deterioration of CVRP over time. In addition, the abdominoplasty effect of abdominal-based breast reconstruction disappeared 1–2 years after surgery.
Anatomical Analysis of the Gonadal Veins and Spine in Lateral Lumbar Interbody Fusion
Authors: Kagami Yujiro , Nakashima Hiroaki , Satake Kotaro , Ito Kenyu , Tsushima Mikito , Segi Naoki , Tomita Hiroyuki , Ouchida Jun , Morita Yoshinori , Ode Yukihito , Imagama Shiro , Kanemura Tokumi
Published: April 2023

Background: The current study aimed to investigate the anatomical position of the gonadal veins (GVs) from the viewpoint of spine surgery and the risk factors associated with lateral lumbar interbody fusion (LLIF). Methods: This retrospective study included 99 consecutive patients. The GV locations were divided into the ventral (V), dorsal medial (DM), and dorsal lateral (DL) sides based on lumbar disk levels on axial contrast-enhanced computed tomography images. The DM region surrounded by the vertebral body and psoas muscle had the highest risk of GV injury. The GV at each intervertebral disk level was examined in terms of laterality and sex. The patients were divided into group M (which included those with GV in the DM region at any vertebral level) and group O (which included those without GV in the DM region at any vertebral level). Then, the two groups were compared. Results: In the case of lower lumbar levels and in women, the GVs were commonly observed in the DM region. Group M had a higher incidence of degenerative scoliosis than group O and a significantly larger Cobb angle. Conclusions: We should pay close attention to the GV location on the preoperative image when using LLIF, particularly in female patients with degenerative scoliosis.
Validation of “Neurit.Space”: Three Digital Tests for the Neuropsychological Evaluation of Unilateral Spatial Neglect
Authors: Massetti Gemma , Albini Federica , Casati Carlotta , Toneatto Carlo , Terruzzi Stefano , Etzi Roberta , Tesio Luigi , Gallace Alberto , Vallar Giuseppe
Published: April 2023

Patients suffering from Unilateral Spatial Neglect (USN) fail to pay attention to, respond to, and report sensory events occurring in the contralesional side of space. The traditional neuropsychological assessment of USN is based on paper-and-pencil tests, whose data recording and scoring may be subjected to human error. The utilization of technological devices can be expected to improve the assessment of USN. Therefore, we built Neurit.Space, a modified digital version of three paper-and-pencil tests, widely used to detect signs of USN, namely: Bells Cancellation, Line Bisection and Five Elements Drawing Test. Administration and data processing is fully automatic. Twelve right brain-damaged patients (six with and six without USN) and 12 age- and education-balanced healthy participants were enrolled in the study. All participants were administered both the computerized and the paper-and-pencil versions of the tests. The results of this preliminary study showed good sensitivity, specificity, and usability of Neurit.Space, suggesting that these digital tests are a promising tool for the evaluation of USN, both in clinical and in research settings.
Acute and Chronic Effect of Physiological Factors on Arterial Stiffness
Authors: Ogoh Shigehiko
Published: April 2023

Arterial stiffness is a disease of the arterial media, and it is well known that it is accelerated by aging [...]
High Myopia Prevalence across Racial Groups in the United States: A Systematic Scoping Review
Authors: Banashefski Bryana , Rhee Michelle K. , Lema Gareth M. C.
Published: April 2023

High myopia is a significant public health issue globally and in the United States (US), where it affects ~4% of the population or 13 million people. This is a potentially blinding condition, but complications can be prevented with early intervention in childhood. Several countries have developed robust data on high myopia, but the United States' data on high myopia remains lacking. Further, underrepresented populations are at particular risk of complications due to reduced access to optometric and ophthalmic care. We performed a systematic scoping review of population-based studies that investigated the prevalence of high myopia across racial and ethnic groups in the US to identify the impact of high myopia on underrepresented communities. Only four studies were identified that met inclusion criteria, which highlights the need to further investigate the topic in the United States. The prevalence of high myopia ranged from a low of 1.8% among Hispanic populations to a high of 11.8% among Chinese populations. Our study demonstrated a paucity of high myopia data in the United States and variable rates of high myopia depending on the time and location of each study. More complete prevalence data will help identify opportunities for community-based interventions to prevent debilitating and blinding complications of high myopia.
Validation of the Modified Berlin Questionnaire for the Diagnosis of Obstructive Sleep Apnea in Patients with a History of COVID-19 Infection
Authors: Celik Yeliz , Baygül Arzu , Peker Yüksel
Published: April 2023

(1) Background: The Berlin questionnaire (BQ) is a widely used survey to predict obstructive sleep apnea (OSA). Considering the confounding effect of obesity and hypertension on the clinical course of COVID-19, we have recently developed a modified BQ (mBQ) based on the subscales snoring intensity/frequency, witnessed apneas and morning/daytime tiredness, and demonstrated that patients with high-risk OSA had worse outcomes during the COVID-19 pandemic. In the current study, we aimed to validate the mBQ in adults with a history of COVID-19 infection. (2) Method: All cases who suffered from COVID-19 infection between 10 March and 22 June 2020, and who completed the mBQ in our first study, were invited to participate. Participants refilled the questionnaires, and an attended polysomnography (PSG) was conducted. An apnea−hypopnea index (AHI) of 15 events/h or more was considered as OSA. (3) Results: Out of the 70 participants, 27 (39%) were categorized as having a high risk of OSA based on the mBQ. According to the PSG results, 24 patients with high-risk OSA (89%) and 3 patients with low-risk OSA on the mBQ (7%) had AHI ≥ 15 events/h. The mBQ had a sensitivity of 89%, a specificity of 93%, a positive predictive value of 89%, a negative predictive value of 93%, and an accuracy of 91%. The area under the curve was 0.91 confirming a very good performance of the mBQ in screening for OSA. (4) Conclusions: The mBQ has a good level of diagnostic sensitivity, specificity, and accuracy among adults with a history of COVID-19 infection. Since the confounding effects of obesity and hypertension are eliminated, the mBQ may be used not only as a screening tool for high-risk OSA but also as a prognostic survey in clinical cohorts.
The Impact of Atrial Fibrillation Treatment Strategies on Cognitive Function
Authors: Bodagh Neil , Kotadia Irum , Gharaviri Ali , Zelaya Fernando , Birns Jonathan , Bhalla Ajay , Sommerville Peter , Niederer Steven , O’Neill Mark , Williams Steven E.
Published: April 2023

There is increasing evidence to suggest that atrial fibrillation is associated with a heightened risk of dementia. The mechanism of interaction is unclear. Atrial fibrillation-induced cerebral infarcts, hypoperfusion, systemic inflammation, and anticoagulant therapy-induced cerebral microbleeds, have been proposed to explain the link between these conditions. An understanding of the pathogenesis of atrial fibrillation-associated cognitive decline may enable the development of treatment strategies targeted towards the prevention of dementia in atrial fibrillation patients. The aim of this review is to explore the impact that existing atrial fibrillation treatment strategies may have on cognition and the putative mechanisms linking the two conditions. This review examines how components of the ‘Atrial Fibrillation Better Care pathway’ (stroke risk reduction, rhythm control, rate control, and risk factor management) may influence the trajectory of atrial fibrillation-associated cognitive decline. The requirements for further prospective studies to understand the mechanistic link between atrial fibrillation and dementia and to develop treatment strategies targeted towards the prevention of atrial fibrillation-associated cognitive decline, are highlighted.
Analytical Study on Current Trends in the Clinico-Mycological Profile among Patients with Superficial Mycoses
Authors: Tiwari Shreekant , Nanda Monalisah , Pattanaik Swetalona , Shivakumar Ganiga Channaiah , Sunila Bukanakere Sangappa , Cicciù Marco , Minervini Giuseppe
Published: April 2023

Infections affecting the superficial keratinized layer of the skin, nails, and hair are referred to as dermatophytosis and dermatomycoses, which constitute the most common type of fungal infection that affects people. This clinical ailment has a prevalence of between 30 and 60% and is more common in India’s hot, muggy, tropical climate. Examining the prevalence of superficial mycoses (SM), their clinical symptoms, and the fungal species that were identified as the disease-causing agents were the main objectives of the current study. This study comprised 250 clinically confirmed patients with SM who visited our dermatology department over the course of a year. Skin scrapings, nail clippings, and hair samples were gathered, mounted, and cultured using KOH. Macroscopic examination of culture, tease mount, and phenotypic tests were used to identify the species. The age group of 11–20 years (29%) had the highest prevalence of SM out of the 250 clinically verified cases of the condition that were included in our study, followed by 21–30 years (20%) and 31–40 years (18%). Candida albicans, dermatophytes, and non-dermatophytic moulds were the three most prevalent fungal isolates. The most typical dermatophyte isolate was T. rubrum, which was primarily found in Tinea corporis (TCo), Tinea cruris (TCr), and Tinea faciei (TFa). T. mentagrophytes was the second most frequent isolate. According to our investigation, it was determined that non-dermatophytic moulds constitute a significant contributor to the development of SM in addition to dermatophytes.
The D-Dimer to Troponin Ratio Is a Novel Marker for the Differential Diagnosis of Thoracic Acute Aortic Syndrome from Non-ST Elevation Myocardial Infarction
Authors: Lee Minsik , Kim Yong Won , Lee Dayeon , Kim Tae-Youn , Lee Sanghun , Seo Jun Seok , Lee Jeong Hun
Published: April 2023

Background: Thoracic acute aortic syndrome (AAS) and non-ST elevation myocardial infarction (NSTEMI) have similar clinical presentations, making them difficult to differentiate. This study aimed to identify useful biomarkers for the differential diagnosis of thoracic AAS and NSTEMI. Methods: This was a retrospective observational study. Participants: consecutive adult patients who visited the emergency department for acute chest pain between January 2015 and December 2021 diagnosed with thoracic AAS or NSTEMI. Clinical variables, including D-dimer (μg/mL) and high-sensitivity troponin T (ng/mL, hs-TnT) levels, were compared between the groups. Results: A total of 52 (30.1%) and 121 (69.9%) patients were enrolled in the thoracic AAS and NSTEMI groups, respectively. Logistic regression analysis revealed that the D-dimer to hs-TnT (D/T) ratio (odds ratio (OR), 1.038; 95% confidence interval (CI), 1.020–1.056; p < 0.001) and the thrombolysis in myocardial infarction (TIMI) score (OR, 0.184; 95% CI, 0.054–0.621; p = 0.006) were associated with thoracic AAS. The D/T ratio had an area under the receiver operating characteristic curve (AUC) of 0.973 (95% CI, 0.930–0.998), and the optimal cutoff value was 81.3 with 91.4% sensitivity and 96.2% specificity. The TIMI score had an AUC of 0.769 (95% CI, 0.644–0.812), and the optimal cutoff value was 1.5 with 96.7% sensitivity and 38.5% specificity. Conclusion: the D/T ratio may be a simple and useful parameter for differentiating thoracic AAS from NSTEMI.
Cardiometabolic Index (CMI) and Visceral Adiposity Index (VAI) Highlight a Higher Risk of Metabolic Syndrome in Women with Severe Obesity
Authors: Lazzer Stefano , D’Alleva Mattia , Isola Miriam , De Martino Maria , Caroli Diana , Bondesan Adele , Marra Alice , Sartorio Alessandro
Published: April 2023

Recent evidence shows that simple and inexpensive anthropometric measurements can be used to identify, at an early stage, women with obesity at increased risk of developing metabolic syndrome (MetS). Thus, the aim of this study was to compare the accuracy of five different indexes of adiposity and/or body composition in identifying MetS in a group of 876 women (mean age ± SD: 52.1 ± 13.8 years; body mass index (BMI): 43.6 ± 6.1 kg m−2). The following indexes were determined for each subject: waist-to-hip ratio (WHR), waist-to-height ratio (WtHR), body mass fat index (BMFI), visceral adiposity index (VAI), and cardiometabolic index (CMI). Overall, the presence of MetS was detected in 544 patients (62%). Pearson correlation coefficients were calculated to evaluate the relationships between body composition indexes and metabolic characteristics of the women. Receiver operating characteristic (ROC) analysis was used to determine the best predictor for each adiposity index among metabolic risk factors. The ROC analysis showed VAI (AUC = 0.84) and CMI (AUC = 0.86) showed the best performance in predicting MetS. Differences were found between the ROC area of CMI and VAI with all other indexes (p < 0.05). The optimal cutoff point for early diagnosis of MetS was >0.92 for WHR, >0.76 for WtHR, >30.1 kg m−1 for BMFI, >1.94 for VAI, and >0.84 for CMI. In addition, VAI and CMI were the most sensitive and specific indexes compared with other indexes. In conclusion, VAI and CMI represent the most useful and reliable indexes to be used for detecting MetS in women suffering from obesity in clinical practice.
Predictive Power of Oxygen Desaturation Index (ODI) and Apnea-Hypopnea Index (AHI) in Detecting Long-Term Neurocognitive and Psychosocial Outcomes of Sleep-Disordered Breathing in Children: A Questionnaire-Based Study
Authors: Zaffanello Marco , Ferrante Giuliana , Zoccante Leonardo , Ciceri Marco , Nosetti Luana , Tenero Laura , Piazza Michele , Piacentini Giorgio
Published: April 2023

Pediatric obstructive sleep apnea can negatively affect children’s neurocognitive function and development, hindering academic and adaptive goals. Questionnaires are suitable for assessing neuropsychological symptoms in children with sleep-disordered breathing. The study aimed to evaluate the effectiveness of using the Oxygen Desaturation Index compared to the Obstructive Apnea–Hypopnea Index in predicting long-term consequences of sleep-disordered breathing in children. We conducted a retrospective analysis of respiratory polysomnography recordings from preschool and school-age children (mean age: 5.8 ± 2.8 years) and followed them up after an average of 3.1 ± 0.8 years from the home-based polysomnography. We administered three validated questionnaires to the parents/caregivers of the children by phone. Our results showed that children with an Oxygen Desaturation Index (ODI) greater than one event per hour exhibited symptoms in four domains (physical, school-related, Quality of Life [QoL], and attention deficit hyperactivity disorder [ADHD]) at follow-up, compared to only two symptoms (physical and school-related) found in children with an Obstructive Apnea–Hypopnea Index greater than one event per hour at the time of diagnosis. Our study also found a significant correlation between the minimum SpO2 (%) recorded at diagnosis and several outcomes, including Pediatric Sleep Questionnaire (PSQ) scores, physical, social, and school-related outcomes, and ADHD index at follow-up. These results suggest that the Oxygen Desaturation Index could serve as a valuable predictor of long-term symptoms in children with sleep-disordered breathing, which could inform treatment decisions. Additionally, measuring minimum SpO2 levels may help assess the risk of developing long-term symptoms and monitor treatment outcomes.
A Nomogram for Predicting Surgical Timing in Neonates with Necrotizing Enterocolitis
Authors: Shi Bo , Shen Leiting , Huang Wenchang , Cai Linghao , Yang Sisi , Zhang Yuanyuan , Tou Jinfa , Lai Dengming
Published: April 2023

Objective: To explore the surgical risk variables in patients with necrotizing enterocolitis (NEC) and develop a nomogram model for predicting the surgical intervention timing of NEC. Methods: Infants diagnosed with NEC were enrolled in our study. We gathered information from clinical data, laboratory examinations, and radiological manifestations. Using LASSO (least absolute shrinkage and selection operator) regression analysis and multivariate logistic regression analysis, a clinical prediction model based on the logistic nomogram was developed. The performance of the nomogram model was evaluated using the receiver operating characteristic (ROC) curve, calibration curves, and decision curve analysis (DCA). Results: A surgical intervention risk nomogram based on hypothermia, absent bowel sounds, WBC > 20 × 109/L or < 5 × 109/L, CRP > 50 mg/L, pneumatosis intestinalis, and ascites was practical, had a moderate predictive value (AUC > 0.8), improved calibration, and enhanced clinical benefit. Conclusions: This simple and reliable clinical prediction nomogram model can help physicians evaluate children with NEC in a fast and effective manner, enabling the early identification and diagnosis of children at risk for surgery. It offers clinical revolutionary value for the development of medical or surgical treatment plans for children with NEC.
Placental Chorangiocarcinoma a Specific Histological Pattern of Uncertain Incidence and Clinical Impact: Systematic Review of the Literature
Authors: Stabile Guglielmo , Scalia Maria Sole , Stampalija Tamara , Bruno Matteo , Laganà Antonio Simone , Sartore Andrea , Mangogna Alessandro , Carlucci Stefania
Published: April 2023

Chorangiocarcinoma is a very rare and misdiagnosed placental neoplasm. The unique morphologic features of the lesion distinguish it from other trophoblastic tumors and vascular abnormalities. We present a systematic review of the literature to provide clarity on chorangiocarcinoma entity and biology. A literature search was carried out in December 2022 using the keywords “Placental chorangiocarcinoma”, “Chorangioma”, “Placenta”, and “Throphoblast proliferation”. Articles published from 1988 to 2022 were obtained from Scopus, Google Scholar, and PUBMED. In our review, we examined maternal age, gestational age at the time of delivery, parity, type of pregnancy, placental weight, ultrasound features of the placenta, macroscopic examination and tumor size, microscopic examination, immunostaining, maternal beta-human chorionic gonadotropin, fetal and maternal outcome. Eight manuscripts were detected. They are all case reports. The macroscopic characteristics of the lesions were represented by the presence of a grey-yellow-white color well-demarcated round nodule. Microscopically, all the authors described typical aspects of malignancy as a high rate of mitosis, nuclear atypia and necrotic areas. In some cases, the presence of AE1/AE3 cytoplasmic positivity, p63 nuclear staining, and beta-human chorionic gonadotropin (BHCG) were reported. A good fetal outcome was reported in all cases of newborns with normal birth weight, except one with fetal growth restriction. Maternal outcome was good in all cases except one with maternal lung metastasis three months after delivery. The clinical course has probably underestimated the real incidence of the pathology. Only greater knowledge of its histology and its clinical course will allow us to evaluate the real prevalence of the disease.
The Specificities of Thrombotic Thrombocytopenic Purpura at Extreme Ages: A Narrative Review
Authors: Joseph Adrien , Joly Bérangère S. , Picod Adrien , Veyradier Agnès , Coppo Paul
Published: April 2023

Thrombotic thrombocytopenic purpura (TTP) is a rare and life-threatening thrombotic microangiopathy (TMA) related to a severe ADAMTS13 deficiency, the specific von Willebrand factor (VWF)-cleaving protease. This deficiency is often immune-mediated (iTTP) and related to the presence of anti-ADAMTS13 autoantibodies that enhance its clearance or inhibit its VWF processing activity. iTTP management may be challenging at extreme ages of life. International cohorts of people with TTP report delayed diagnoses and misdiagnoses in children and elderly people. Child-onset iTTP shares many features with adult-onset iTTP: a female predominance, an idiopathic presentation, and the presence of neurological disorders and therapeutic strategies. Long-term follow-ups and a transition from childhood to adulthood are crucial to preventing iTTP relapses, in order to identify the occurrence of other autoimmune disorders and psychosocial sequelae. In contrast, older iTTP patients have an atypical clinical presentation, with delirium, an atypical neurological presentation, and severe renal and cardiac damages. They also have a poorer response to treatment and prognosis. Long-term sequelae are highly prevalent in older patients. Prediction scores for iTTP diagnoses are not used for children and have a lower sensitivity and specificity in patients over 60 years old. ADAMTS13 remains the unique biological marker that is able to definitely confirm or rule out the diagnosis of iTTP and predict relapses during follow-ups.
Radiofrequency Ablation for Adenomyosis
Authors: Dedes Ioannis , Kolovos Georgios , Fruscalzo Arrigo , Toub David , Vaineau Cloé , Lanz Susanne , Imboden Sara , Feki Anis , Mueller Michael
Published: April 2023

Adenomyosis is a common benign gynecologic condition characterized by ectopic endometrial glands and stroma in the myometrium causing pain (dysmenorrhea) and abnormal uterine bleeding. New interventional techniques have been introduced over recent years. This study evaluates the treatment success and side effects of radiofrequency ablation. An electronic literature search in the PubMed, Scopus, and ScienceDirect databases was carried out on the outcomes of pain reduction and, secondarily, on abnormal uterine bleeding, reintervention, reproductive outcome, imaging outcome, and complications. There was a mean decrease in dysmenorrhea pain scores by −63.4 ± 9.0% at 12 months. Data on other outcome parameters were sparse. No major complications were reported. Radiofrequency ablation represents a promising minimally invasive and organ-preserving treatment in patients with symptomatic adenomyosis. It is associated with clinically meaningful improvement of adenomyosis-related pain in the short term.
Qualitative Assessment of Contrast-Enhanced Ultrasound in Differentiating Clear Cell Renal Cell Carcinoma and Oncocytoma
Authors: Tufano Antonio , Leonardo Costantino , Di Bella Chiara , Lucarelli Giuseppe , Dolcetti Vincenzo , Dipinto Piervito , Proietti Flavia , Flammia Rocco Simone , Anceschi Umberto , Perdonà Sisto , Franco Giorgio , Sciarra Alessandro , Di Pierro Giovanni Battista , Cantisani Vito
Published: April 2023

Background: We aimed to assess whether clear cell renal cell carcinoma (ccRCC) can be differentiated from renal oncocytoma (RO) on a contrast-enhanced ultrasound (CEUS). Methods: Between January 2021 and October 2022, we retrospectively queried and analyzed our prospectively maintained dataset. Renal mass features were scrutinized with conventional ultrasound imaging (CUS) and CEUS. All lesions were confirmed by histopathologic diagnoses after nephron-sparing surgery (NSS). A multivariable analysis was performed to identify the potential predictors of ccRCC. The area under the curve (AUC) was depicted in order to assess the diagnostic accuracy of the multivariable model. Results: A total of 126 renal masses, including 103 (81.7%) ccRCC and 23 (18.3%) RO, matched our inclusion criteria. Among these two groups, we found significant differences in terms of enhancement (homogeneous vs. heterogeneous) (p < 0.001), wash-in (fast vs. synchronous/slow) (p = 0.004), wash-out (fast vs. synchronous/slow) (p = 0.001), and rim-like enhancement (p < 0.001). On the multivariate logistic regression, heterogeneous enhancement (OR: 19.37; p = <0.001) and rim-like enhancement (OR: 3.73; p = 0.049) were independent predictors of ccRCC. Finally, these two variables had an AUC of 82.5% and 75.3%, respectively. Conclusions: Diagnostic imaging for presurgical planning is crucial in the choice of either conservative or radical management. CEUS, with its unique features, revealed its usefulness in differentiating ccRCC from RO.
What to Prefer in Patients with Multibracket Appliances? Digital vs. Conventional Full-Arch Impressions—A Reference Aid-Based In Vivo Study
Authors: Bock Niko Christian , Klaus Katharina , Liebel Moritz Maximilian , Ruf Sabine , Wöstmann Bernd , Schlenz Maximiliane Amelie
Published: April 2023

This study aimed to investigate the transfer accuracy and required time for digital full-arch impressions obtained from intraoral scanners (IOSs) versus conventional alginate impressions (CAIs) in patients with multibracket appliances (MBA). Thirty patients with buccal MBAs (metal brackets, archwire removed) were examined using an established reference aid method. Impression-taking using four IOSs (Primescan, Trios 4, Medit i700, Emerald S) and one CAI with subsequent plaster casting were conducted. One-hundred-twenty (n = 30 × 4) scans were analyzed with 3D software (GOM Inspect) and 30 (n = 30 × 1) casts were assessed using a coordinate measurement machine. Six distances and six angles were measured and compared to the reference aid values (ANOVA; p < 0.05). Except for the intermolar distance, transfer accuracy was significantly higher with IOSs than with CAIs (p < 0.05). No such difference was found regarding the six angles. In patients with MBAs, digital impression-taking using IOSs can be recommended. For all measured variables except one, the transfer accuracy of IOSs was better than or at least equivalent to the data from CAIs. In addition, significantly (p < 0.001) less time was necessary for all IOSs in comparison to CAIs plus plaster casting.