bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of Mesh Closure of Laparotomy and Extraction Incisions in Open and Laparoscopic Colorectal Surgery: A Systematic Review and Meta-Analysis
Authors: Albendary Mohamed , Mohamedahmed Ali Yasen , Mohamedahmed Marwa Yassin , Ihedioha Ugochukwu , Rout Shantanu , Van Der Avoirt Anouk
Published: November 2024

Background and Objectives: Evisceration and incisional hernia (IH) represent a significant morbidity following open or laparoscopic colorectal surgery where midline laparotomy or extraction incision (EI) are performed. We executed a systematic review to evaluate primary mesh closure of laparotomy or EI in colorectal resections of benign or malignant conditions. Methods: A comprehensive literature search was performed using PubMed, Science Direct, Cochrane, and Google Scholar databases for studies comparing prophylactic mesh to traditional suture techniques in closing laparotomy in open approach or EI when minimally invasive surgery was adopted in colorectal procedures, regardless of the diagnosis. Both IH and evisceration were identified as primary outcomes. Secondary outcomes included surgical site infections (SSI), postoperative seroma, and length of hospital stay (LOS). Results: Six studies were included in our analysis with a total population of 1398 patients, of whom 411 patients had prophylactic mesh augmentation when closing laparotomy or EI, and 987 underwent suture closure. The mesh closure group had a significantly lower risk of developing IH compared to the conventional closure group (OR 0.23, p = 0.00001). This result was significantly consistent in subgroup analysis of open laparotomy or EI of laparoscopic surgery subgroups. There was no statistically notable difference in evisceration incidence (OR 0.51, p = 0.25). Secondary endpoints did not significantly differ between both groups in terms of SSI (OR 1.20, p = 0.54), postoperative seroma (OR 1.80, p = 0.13), and LOS (MD −0.54, p = 0.63). Conclusions: primary mesh reinforcement of laparotomy or EI closure in colorectal resections lessens IH occurrence. No safety concerns were identified; however, further high-quality research may provide more solid conclusions.
Late-Onset Femoroacetabular Impingement Syndrome Following Knee Arthroscopy in a Retrospective Cohort
Authors: Rynecki Nicole D. , Kingery Matthew T. , Roller Rachel , Berzolla Emily , Colasanti Christopher A. , Youm Thomas
Published: November 2024

Background/Objectives: Hip–knee coupling is a well-documented phenomenon, and interventions to one joint can alter biomechanics at the other. The purpose of this study was to investigate if knee surgery is associated with later onset of femoroacetabular impingement syndrome (FAIS). Methods: A retrospective chart review was conducted regarding patients at a single academic institution who underwent hip arthroscopy for FAIS between January 2011–October 2021. Patient charts were queried for past surgical history of knee arthroscopy before hip arthroscopy. Patients who previously underwent hip arthroscopy with no history of knee arthroscopy served as controls. Details about demographics and the onset of hip symptoms were abstracted from patient charts. Statistical analysis was conducted using Mann–Whitney testing and binary logistic regression. Results: Of the 1569 patients identified, 127 had a history of knee arthroscopy and reported no hip symptoms at or prior to the time of surgery. Patients who had undergone prior knee arthroscopy were significantly older at onset of initial hip symptoms (42.15 ± 11.80 years versus 34.62 ± 12.49 years, p < 0.001) and at the time of hip arthroscopy (44.12 ± 11.85 years versus 36.90 ± 12.14 years, p < 0.001) when controlling for age, sex, and BMI. These patients first developed hip symptoms at a mean of 8.57 ± 8.53 years following knee arthroscopy (median 6.10 years) and underwent operative treatment 1.76 ± 1.96 years later. Conclusions: Patients with a history of prior knee arthroscopy are older at the time of hip symptom onset and subsequent hip arthroscopy for the treatment of FAIS.
Highlights of Transesophageal Echocardiography During Interventions for Adult Congenital Heart Disease
Authors: Ghantous Eihab , Lluri Gentian
Published: November 2024

Significant advances in the diagnosis and treatment of congenital heart disease have transformed patient outcomes, leading to an expanding adult congenital heart disease population. Many of these adults require lifelong procedural interventions, frequently performed in catheterization labs under the guidance of echocardiography. This review explores the transesophageal echocardiographic aspect in key catheterization-based procedures.
Effect of Cochlear Implantation on Air Conduction and Bone Conduction Elicited Vestibular Evoked Myogenic Potentials—A Scoping Review
Authors: Ayas Muhammed , Muzaffar Jameel , Phillips Veronica , Smith Mathew E. , Borsetto Daniele , Bance Manohar L.
Published: November 2024

Background/Objectives: Cochlear implantation (CI) is an effective intervention for individuals with severe to profound hearing loss; however, it may impact vestibular function due to its proximity to related anatomical structures. Vestibular evoked myogenic potentials (VEMPs) assess the function of the saccule and utricle, critical components of the vestibular system. This review examines CI’s impact on air conduction (AC) and bone conduction (BC) VEMP responses. Methods: A scoping review was conducted following PRISMA guidelines, using databases such as Medline, Embase, Cochrane Library, Scopus, and ProQuest Dissertations. Studies reporting on AC and/or BC-VEMP in CI recipients were included. Data extraction focused on VEMP response rates, amplitudes, and latencies pre- and post-CI. Risk of bias/quality assessment was performed using the Newcastle–Ottawa Scale. Results: Out of 961 studies identified, 4 met the inclusion criteria, encompassing a total of 245 CI-implanted ears. Results indicated that AC-VEMP responses were often reduced or absent post-CI, reflecting the influence of surgical changes in the middle ear mechanics rather than otolith dysfunction. In contrast, BC-VEMP responses were more consistently preserved, suggesting that BC stimuli bypass the middle ear and more accurately delineate otolith function. Variations in VEMP outcomes were noted depending on the surgical approach and individual patient factors. Conclusions: CI impacts vestibular function as measured by VEMP, with AC-VEMP showing greater susceptibility to postoperative changes compared to BC-VEMP. The presence of preserved BC-VEMP alongside absent AC-VEMP underscores the need to differentiate between these measures in assessing vestibular function.
Strontium- and Copper-Doped Ceramic Granules in Bone Regeneration-Associated Cellular Processes
Authors: Safarova (Yantsen) Yuliya , Nessipbekova Assem , Syzdykova Aizhan , Olzhayev Farkhad , Umbayev Bauyrzhan , Kassenova Aliya , Fadeeva Inna V. , Askarova Sholpan , Rau Julietta V.
Published: November 2024

Background: Pathological bone fracturing is an escalating problem driven by increasing aging and obesity. Bioceramics, particularly tricalcium-phosphate-based materials (TCP), are renowned for their exceptional biocompatibility, osteoconductivity, and ability to promote biomineralization. In the present study, we designed and characterized TCP porous granules doped with strontium (Sr) and copper (Cu) (CuSr TCP). Sr2+ ions were selected as Sr plays a crucial role in early bone formation, osteogenesis, and angiogenesis; Cu2+ ions possess antibacterial properties. Materials: The synthesized CuSr TCP granules were characterized by X-ray diffraction. Cytotoxicity and cell proliferation analyses’ assays were performed through the lactate dehydrogenase (LDH) activity and CCK-8 viability tests in rat bone marrow-derived mesenchymal stem cells (BM-MSCs). Hemolytic activity was carried out with human red blood cells (RBCs). Early and late osteogenesis were assessed with alkaline phosphatase (ALP) and Alizarin Red S activity in human osteoblast progenitor cells and rat BM-MSCs. The influence of CuSr TCP on angiogenesis was investigated in human umbilical vein endothelial cells (HUVECs). Results: We have demonstrated that media enriched with CuSr TCP in concentrations ranging from 0.1 mg/mL to 1 mg/mL were not cytotoxic and did not significantly affect cell proliferation rate motility. Moreover, a concentration of 0.5 mg/mL showed a 2.5-fold increase in the migration potential of BM-MSCs. We also found that CuSr TCP-enriched media slightly increased early osteogenesis. We also found that Sr and Cu substitutions in TCP particles significantly enhanced the measured angiogenic parameters compared to control and unsubstituted TCP granules. Conclusion: Our results demonstrate that TCP porous granules doped with Sr and Cu are biocompatible, promote osteodifferentiation and angiogenesis, and could be recommended for further in vivo studies.
Electrophysiologic Considerations in Adult Patients with Ebstein’s Anomaly
Authors: Hsiung Ingrid , Fatunde Olubadewa A. , Srivathsan Komandoor , Madhavan Malini , Majdalany David S.
Published: November 2024

Ebstein’s anomaly (EA) is a rare cyanotic form of congenital heart disease (CHD) characterized by apical displacement of the tricuspid valve, with resultant hemodynamic and electrical manifestations. The severity of symptoms is determined by the degree of apical displacement and deformity and incompetence of the tricuspid valve. As a result, patients with EA can be severely symptomatic during infancy and childhood or can be incidentally discovered in the sixth or seventh decade of life. Hallmarks of Ebstein’s anomaly include progressive cyanosis, right-sided heart failure, and tachyarrhythmias, among which tachyarrhythmias (most commonly atrial, but also ventricular) are the most common presenting symptoms in Ebstein’s anomaly patients during adulthood. This review aims to provide insight into the genetic and electrophysiological (EP) basis underlying the tachyarrhythmias encountered when managing patients with EA.
Audio Features and Crowdfunding Success: An Empirical Study Using Audio Mining
Authors: Miao Miao , Wang Yudan , Li Jingpeng , Jiang Yushi , Yang Qiang
Published: November 2024

Crowdfunding videos have become a crucial tool for entrepreneurs seeking financial support, with audio design playing a critical role in attracting potential investors. However, research on how audio features influence crowdfunding success remains limited. This study uses audio analysis techniques to examine data from 4500 crowdfunding campaigns on the Kickstarter platform between 2013 and 2016, investigating the impact of audio features on crowdfunding success rates. Grounded in the signaling theory, we posited four hypotheses suggesting that speech rate, loudness, pitch, and emotional arousal would each exhibit an inverted U-shaped relationship with crowdfunding success rates. Through data analysis, we found that moderate levels of speech rate, loudness, pitch, and emotional arousal significantly enhanced crowdfunding success, whereas extremes in these vocal characteristics had a detrimental effect. Our findings not only extend the application of audio analysis in the crowdfunding domain, but also provide empirical evidence for the influence of audio features on crowdfunding success. This research offers practical guidance for project initiators in developing promotional strategies and for platforms in optimizing user experience.
Effects of Climate Change and Human Activities on Streamflow in Arid Alpine Water Source Regions: A Case Study of the Shiyang River, China
Authors: Xia Honghua , Su Yingqing , Yang Linshan , Feng Qi , Liu Wei , Ma Jian
Published: November 2024

Climate change and human activities were identified as the primary drivers of streamflow in arid alpine regions. However, limitations in observational data have resulted in a limited understanding of streamflow changes in these water sources, which hinders efforts to adapt to ongoing climate change and to formulate effective streamflow management policies. Here, we use the four main tributaries in the upper reach of the Shiyang River in China as a case study to investigate the long-term trends in streamflow within arid alpine water sources, quantifying the individual contributions of climate change and human activities to these changes. The findings revealed that temperatures and precipitation in arid alpine regions have risen over the past 40 years. Although the warming trend has been significant, it has slowed in recent years. Nevertheless, three-quarters of the rivers are experiencing a decline in streamflow. The land types within the watershed remain relatively stable, with land use and cover change (LUCC) primarily occurring in the Gulang River watershed. Climate change has significantly affected streamflow change in high and rugged terrains, with an influence exceeding 70%. For example, Jingta River showed an impact of 118.79%, Zamu River 84.00%, and Huangyang River 71.43%. Human-driven LUCC, such as the expansion of cultivated and urban land, have led to increased water consumption, resulting in reduced streamflow. This effect is particularly pronounced in the low-lying and gently undulating areas of the Gulang River, where LUCC account for 78.68% of the change in streamflow. As human activities intensify and temperatures continue to rise, further declines in streamflow are projected, highlighting the urgent need for effective water resource management. These insights highlight the urgent need for targeted mitigation and adaptation strategies to confront the water scarcity challenges faced by these vulnerable regions.
Bio-Food Quality, Environmental Pollution, and the Role of Algae in Promoting Human Health and Sustainability
Authors: Pruteanu Lavinia-Lorena , Mare Roxana , Mihalescu Beatrice , Jäntschi Lorentz
Published: November 2024

Healthcare resources have changed fundamentally compared to decades ago. Modern bio-food products and sustainable solutions for their production have increased the attention of researchers, taking into account the current level of pollution of the earth and atmosphere along with modern technologies applied to processed foods. Therefore, this review aims to highlight: (1) the impact and relationship between the physiological parameters of the atmosphere, solar radiation and soil, (in terms of their composition and stages of formation and organization) along with the evolution to modern life; (2) the environmental impacts on algae, living organisms, food, and human health and sustainability. In addition, we address the significant impact of algae as a sustainable resource in reducing environmental pollution contributing to a healthier life.
A Gram Scale Synthesis of 3,4-Dihalogen Substituted 1,8-Naphthalimides
Authors: Anastasova Denitsa , Mutovska Monika , Simeonova Natali , Zagranyarska Irena , Vlahova Zlatina , Stoyanov Stanimir , Zagranyarski Yulian
Published: November 2024

A general protocol for the synthesis of 3,4-dihalogen substituted 1,8-naphthalimides is proposed, starting from available and cheap 1,8-naphthalic anhydride. The reported new compounds have only bromine or chlorine atoms as substituents, in contrast to the known iodo-containing analogues. This is an advantage in possible aryl nucleophilic substitution or cross-coupling modifications, making them interesting and important building-block molecules in naphthalimide chemistry. Although the procedure includes five synthetic steps, they are quick and straightforward. The overall yields are relatively high (48–62%), and only one column of chromatographic purification is needed. All the reactions were carried out on a multigram scale to allow the target building-block compounds to be obtained in sufficient amounts for further derivatizations.
Multiscale Modeling of Nanoparticle Precipitation in Oxide Dispersion-Strengthened Steels Produced by Laser Powder Bed Fusion
Authors: Wang Zhengming , Yang Seongun , Lawson Stephanie B. , Tsai Cheng-Hsiao , Doddapaneni V. Vinay K. , Albert Marc , Sutton Benjamin , Chang Chih-Hung , Pasebani Somayeh , Xu Donghua
Published: November 2024

Laser Powder Bed Fusion (LPBF) enables the efficient production of near-net-shape oxide dispersion-strengthened (ODS) alloys, which possess superior mechanical properties due to oxide nanoparticles (e.g., yttrium oxide, Y-O, and yttrium-titanium oxide, Y-Ti-O) embedded in the alloy matrix. To better understand the precipitation mechanisms of the oxide nanoparticles and predict their size distribution under LPBF conditions, we developed an innovative physics-based multiscale modeling strategy that incorporates multiple computational approaches. These include a finite volume method model (Flow3D) to analyze the temperature field and cooling rate of the melt pool during the LPBF process, a density functional theory model to calculate the binding energy of Y-O particles and the temperature-dependent diffusivities of Y and O in molten 316L stainless steel (SS), and a cluster dynamics model to evaluate the kinetic evolution and size distribution of Y-O nanoparticles in as-fabricated 316L SS ODS alloys. The model-predicted particle sizes exhibit good agreement with experimental measurements across various LPBF process parameters, i.e., laser power (110–220 W) and scanning speed (150–900 mm/s), demonstrating the reliability and predictive power of the modeling approach. The multiscale approach can be used to guide the future design of experimental process parameters to control oxide nanoparticle characteristics in LPBF-manufactured ODS alloys. Additionally, our approach introduces a novel strategy for understanding and modeling the thermodynamics and kinetics of precipitation in high-temperature systems, particularly molten alloys.
Microstructural and Morphological Properties of AlNiCo and CoNi Alloys: An In-Depth Study Based on Low-Energy Mechanical Alloying
Authors: Cruz Nieto Gilberto , Rivera Olvera Jesús Noé , Díaz de la Torre Sebastián , Garibay Febles Vicente , Palacios Gómez Jesús , Gonzalez Reyes Leonardo , Diaz Barriga Arceo Lucía Graciela
Published: November 2024

This study focused on synthesizing AlNiCo and CoNi materials using a low-energy milling process. The aim was to explore the formation of low-energy phases in both systems, contrasting with the typical research on phases formed under high-energy conditions. In the Co-20 wt% Ni system, the phases Co0.75Ni0.25 and Ni were identified, as well as the FCC cubic phase of CoNi, using X-ray diffraction (XRD) with a molybdenum radiation source. The observed behavior aligned closely with the miscibility curve in the equilibrium phase diagram, which included a region of alloys with varying structures and similar compositions. A notable feature was the presence of a predominantly dispersed hexagonal Ni zone, consisting of nanoparticles. Transmission electron microscopy (TEM) was employed to observe the FCC CoNi phase, which displayed a specific arrangement. AlNiCo and CoNi alloys were successfully synthesized through mechanical alloying, incorporating equilibrium and non-equilibrium phases.
Influence of Uric Acid on Vascular and Cognitive Functions: Evidence for an Ambivalent Relationship
Authors: Baratta Francesco , Moscucci Federica , Ettorre Evaristo , Bocale Raffaella , Cicero Arrigo F. G. , Cirillo Pietro , Fogacci Federica , Lospinuso Ilaria , Savoia Carmine , Mengozzi Alessandro , Virdis Agostino , Borghi Claudio , Desideri Giovambattista
Published: November 2024

The growing recognition of the public health impact of cognitive impairment and dementia has sparked a global initiative to identify risk factors and develop strategies to prevent or slow the progression of these cognitive disorders. Uric acid, the end product of the metabolism of purine nucleotides, has been reported as a key factor of many conditions potentially involved in cognitive dysfunction/dementia. In addition, some studies support the hypothesis that elevated uric acid levels could reduce the risk of Alzheimer’s disease, slow down the decline of cognition, and delay the progression of Alzheimer’s disease, while other evidence achieves opposite positions. These discrepancies might reflect a biological ambivalence for uric acid depending on a very complex interplay of factors that include its concentrations achieved in biological fluids, the nature, and concentration of free radicals, the presence and concentration of other antioxidant molecules, potentially responsible for bi-directional effects of uric acid on brain health/functioning. In this narrative review, we attempt to elucidate the influential role of uric acid metabolism in cognitive functioning by discussing pathophysiological mechanisms putatively involved, being well aware that none of them can be considered one-sided due to the complexity of the human organism.
A High-Performance Micro Differential Pressure Sensor
Authors: Fan Xutao , Wang Lei , Zhang Songsong
Published: November 2024

With the development of the micro electromechanical system (MEMS), which widely adopts micro differential pressure sensors (MDPSs), the demand for high-performance MDPSs had continuously increased. Pressure sensors realized using MEMS technology integrated with biomedical catheters are of significant importance in the detection and treatment of various biological diseases. Biomedical catheters used in low-Fr applications (1Fr = 0.33 mm outer diameter) require miniaturized sensors that do not compromise their performance. For instance, catheters (5Fr) used for central venous pressure (CVP) monitoring require the integration of high-performance sensors with total dimensions smaller than 1.65 mm along at least two directions (length, width, or height). In this paper, a silicon-on-insulator (SOI)-based MDPS was designed and fabricated for micro-pressure detection in the range of 0–1 kPa. The dimension of the sensor is only 1 mm × 1 mm × 0.4 mm, with a sensitivity of 3.401 mV/V/kPa at room temperature, nonlinearity of 0.376% FS (full scale), and an overall accuracy of 0.59% FS. The sensor operates normally when the temperature is even increased to 160 °C, and its temperature coefficient of zero output (TCO) and temperature coefficient of sensitivity (TCS) are 0.093% FS/°C and −0.144% FS/°C. The dimension and performance results of this MDPS demonstrate its potential to play a significant role in biomedical catheters. In addition, it is fabricated using an 8-inch MEMS process, which significantly reduces the cost.
Replication of Leaf Surface Structures on Flat Phosphor-Converted LEDs for Enhanced Angular Color Uniformity
Authors: Chen Bing-Mau , Chen Chiu-Hsiang , Ying Shang-Ping , Chang Yu-Kang
Published: November 2024

We explored the use of biomimetic structures, including those that mimic leaf structures, to enhance the angular color uniformity of flat phosphor-converted light-emitting diodes (pcLEDs). The distinct microstructures found on natural leaf surfaces, such as micro-scale bumps, ridges, and hierarchical patterns, have inspired the design of artificial microstructures that can improve light extraction, scattering, and overall optical performance in LED applications. The effects of these leaf surface microstructures on the phosphor layer of flat pcLEDs were evaluated. An imprinting technique was employed to directly replicate the surface morphology structures from fresh plant leaves. The results indicated that this method provided excellent scattering capability and reduced the disparity in light output between blue and yellow light emissions from flat pcLEDs at various angles. Subsequently, uniform correlated color temperature in the flat pcLEDs was achieved, reducing the yellow ring effect. Furthermore, the availability of diverse wrinkle and surface patterns from a wide range of natural prototypes could reduce design costs compared with traditional mold fabrication, making the method suitable for application in mass production.
Effect of an Add-On Multi-Strain Probiotic Formulation in the Prevention of Recurrent Urinary Tract Infections: A Double-Blind Randomized Placebo-Controlled Trial
Authors: Mishra Archana , Jena Saubhagya Kumar , Srinivasan Anand , Tripathy Amruta , Maiti Rituparna , Hota Debasish
Published: November 2024

Urinary tract infections (UTIs) present a significant health challenge for women globally, particularly due to high recurrence rates. This randomized, double-blinded, placebo-controlled study conducted at AIIMS Bhubaneswar, India, evaluated the effectiveness of a multi-strain lactobacilli probiotic formulation as an adjunct to standard antibiotic therapy in preventing recurrent UTIs. Fifty-one adult women (18–50 years) with recurrent UTIs received either the probiotic or a placebo for 24 weeks. The primary outcome was UTI recurrence, while secondary outcomes included the number of UTI episodes and changes in urinary nerve growth factor (NGF) and serum macrophage colony-stimulating factor (M-CSF) levels. The results showed a significant reduction in UTI recurrence in the probiotic group, with 75% remaining recurrence-free, compared to 33% in the placebo group (p = 0.007). The relative risk for recurrence absence was 2.67 (95% CI: 1.19–5.99). Although the mean number of UTI episodes decreased in the probiotic group, the difference was not statistically significant (p = 0.379). The urinary NGF and serum M-CSF levels significantly decreased from baseline in both groups, but there were no significant differences between them. This study suggests probiotics may be a valuable adjunct therapy for preventing recurrent UTIs.
The Effects of Omega-3 Fatty Acids and Vitamin D Supplementation on the Nutritional Status of Women with Breast Cancer in Palestine: An Open-Label Randomized Controlled Trial
Authors: Almassri Heba F. , Abdul Kadir Azidah , Srour Mohammed , Foo Leng Huat
Published: November 2024

Background: This study emphasizes the critical role of early nutritional interventions in addressing cancer-related malnutrition. It aimed to assess the effects of omega-3 fatty acids (ω3) and vitamin D3 (VitD) supplementation on the nutritional status of newly diagnosed women with breast cancer (BC) in the Gaza Strip, Palestine. Method: A total of 88 newly diagnosed women with BC were randomly assigned into four groups: (i) Omega-3 fatty acid (ω3) group; (ii) Vitamin D (VitD) group; (iii) ω3+VitD group; and (iv) the controls. The patients took two daily 300 mg ω3 capsules and/or one weekly 50,000 IU VitD tablet for nine weeks. Nutritional status of the participants was assessed by several measurement tools, namely, the Patient-Generated Subjective Global Assessment (PG-SGA)-derived scores, anthropometric measurements, blood albumin status and dietary intakes between the baseline and after 9 weeks post-intervention. The procedures of the present study were registered on ClinicalTrial.gov with the identifier NCT05331807. Results: At the end of trial, there was a significant increase in the PG-SGA-derived nutritional risk scores (p < 0.01), body weight and body mass index (BMI) (both p < 0.05) among participants in ω3+VitD group compared to other groups. Additionally, there was a significant rise in blood albumin levels (p < 0.05), daily energy and protein intake in the ω3+VitD group (p < 0.05) compared to baseline. Conclusion: Participants with supplementation of daily ω3 and weekly VitD had improved nutritional status, assessed by the PG-SGA scores and anthropometric measures, blood albumin and dietary energy and protein intake among women with BC who were undergoing active treatment.
Prevalence and Predictors of the Use of Low-Calorie Sweeteners Among Non-Pregnant, Non-Lactating Women of Reproductive Age in Australia
Authors: Begum Mumtaz , Zhou Shao-Jia , Ali Saima Shaukat , Lassi Zohra S.
Published: November 2024

Objective: There is concern about the potential health implications of low-calorie sweetener (LCS) consumption. This study aimed to determine the prevalence and patterns of LCS use among women of reproductive age (WRA) in Australia. Methods: This cross-sectional study involved a two-stage analysis. First, latent class analyses (LCA) were employed to identify patterns of LCS use. Subsequently, regression analyses were conducted to assess the association between sociodemographic and lifestyle characteristics and the two outcomes: (1) self-reported LCS use, and (2) the identified LCS consumption patterns/classes. Results: A total of 405 WRA completed the survey (mean age 32.0 ± 8.6 years, mean BMI 28.71 ± 11.1 kg/m2), with 44.7% reporting LCS consumption. LCA analysis identified three distinct LCS consumption patterns: light users (45.9%), moderate users (26.0%) and heavy users (28.6%). A high proportion of participants did not meet the Australian dietary guidelines for recommended servings of vegetables (57.8%), dairy (44.2%), meat (48.2%) and grains (74.8%). Compared to Caucasian women, those from South Asian backgrounds (OR 4.16; 95% CI 1.71–10.1) and Aboriginal and Torres Strait Islander women (OR 1.40; 95% CI 0.42–4.63) were more likely to use LCS. Women who participated in the weight loss programs, with overweight/obesity, and those using LCS for weight loss purposes were more likely to be moderate or heavy LCS users than light users. Additionally, socioeconomically disadvantaged women were less likely to be moderate or heavy LCS users. Conclusions: This study highlights the widespread use of LCS among WRA in Australia, with distinct consumption patterns influenced by cultural, health-related, and socioeconomic factors. These findings underscore the need for targeted interventions to promote healthy eating practices within this population.
Outcomes for Patients Receiving Multi-Chamber Bags for the Delivery of Parenteral Nutrition: A Systematic Review
Authors: Jones Debra , Allsopp Karen , Sowerbutts Anne Marie , Lal Simon , Farrer Kirstine , Harrison Simon , Burden Sorrel
Published: November 2024

Background: Parenteral nutrition (PN) is required by people with intestinal failure and can be delivered as multi-chambered bags (MCBs) or individually compounded (COM) bags. This systematic review aimed to examine the evidence base for clinical outcomes and/or quality of life (QoL) in adults receiving PN as MCBs compared to COMs in hospital and community settings. Methods: A systematic database search was conducted between January 2015 and May 2024. Studies assessing adults in receipt of MCBs were included. Quality was assessed using Joanna Briggs appraisal tools. A narrative synthesis was performed due to study heterogeneity. PROSPERO: CRD42022352806. Results: Ten studies including 87,727 adults were included, with 20,192 receiving PN from MCBs and 67,535 from COMs. Eight studies reported on PN given in hospital and two in the home. Five hospital-based and one home-based study reported that MCBs were well tolerated and provided adequate nutrition. Three hospital-based studies reported that MCBs had lower post-operative infections and a lower mean risk of catheter-related bloodstream infections (CRBSIs). Two home-based studies reported no difference in CRBSI. Five hospital-based studies reported no difference between groups in length of hospital stay. Three hospital-based studies reported the cost to be lower for MCBs than COMs, and no studies reported QoL. Conclusions: The studies included show that MCBs provided in hospital are safe and non-inferior to COMs and may be more cost-effective. There were few high-quality studies and no data on QoL; therefore, further work is required to improve the certainty of the evidence and to establish the level of QoL when using MCBs.
What Is the Best Method for Diagnosing Osteosarcopenic Adiposity in Women After Long-Term Bariatric Surgery? A Comparison and Validation of Different Criteria
Authors: Araújo Maísa Miranda , Lima Ricardo Moreno , de Carvalho Kênia Mara Baiocchi , Botelho Patrícia Borges
Published: November 2024

Background/Objectives: To evaluate the agreement and discriminant validation of different osteosarcopenic adiposity (OSAd) diagnostic criteria in women post-Roux-en-Y gastric bypass (RYGB) surgery. Methods: Surgery. This is a cross-sectional study with women ≥2 years post-RYGB. OSAd was diagnosed using three criteria: Kelly for OSAd; ESPEN/EASO and SDOC for SO, associated with WHO osteopenia, respectively. Agreement was assessed with Cohen’s Kappa, and the predictive discriminatory capability was evaluated by sensitivity, specificity, and accuracy, using impairment of physical function and the increased risk of fracture as reference standards.; Results: A total of 178 women were evaluated, with a mean age of 45.2 ± 9.6 years old and postoperative time of 6.6 ± 3.6 years. The prevalence of OSAd was 2.2% [Kelly]; 2.8% [ESPEN/EASO + WHO]; 6.2% [SDOC + WHO]. Moderate agreement was found between Kelly and ESPEN/EASO (k = 0.658, p < 0.001), but agreement with SDOC was null (k = 0.104, p = 0.114). All criteria demonstrated high specificity (94.0–98.2%) and low sensitivity (0.0–16.7%), with Kelly showing the highest accuracy (92.7%); Conclusions: Among the evaluated criteria, Kelly presented the highest accuracy and 2.2% of OSAd prevalence. Despite consistently high specificity, all criteria exhibited low sensitivity. These findings highlight the need for more sensitive diagnostic approaches for OSAd in postoperative RYGB populations.
Impact of Alpha-Ketoglutarate on Skeletal Muscle Health and Exercise Performance: A Narrative Review
Authors: Xu Miaomiao , Zhang Qiao , Liu Xiaoguang , Lu Liming , Li Zhaowei
Published: November 2024

AKG, a central metabolite in the Krebs cycle, plays a vital role in cellular energy production and nitrogen metabolism. This review explores AKG’s potential therapeutic applications in skeletal muscle health and exercise performance, focusing on its mechanisms for promoting muscle regeneration and counteracting muscle atrophy. A literature search was conducted using the PubMed, Web of Science, and Scopus databases, yielding 945 articles published up to 31 October 2024. Of these, 112 peer-reviewed articles met the inclusion criteria and formed the basis of this review. AKG supports muscle recovery by stimulating muscle satellite cells (MuSCs) and macrophage polarization, aiding muscle repair and reducing fibrosis. Additionally, AKG shows promise in preventing muscle atrophy by enhancing protein synthesis, inhibiting degradation pathways, and modulating inflammatory responses, making it relevant in conditions like sarcopenia, cachexia, and injury recovery. For athletes and active individuals, AKG supplementation has enhanced endurance, reduced fatigue, and supported faster post-exercise recovery. Despite promising preliminary findings, research gaps remain in understanding AKG’s long-term effects, optimal dosage, and specific pathways, particularly across diverse populations. Further research, including large-scale clinical trials, is essential to clarify AKG’s role in muscle health and to optimize its application as a therapeutic agent for skeletal muscle diseases and an enhancer of physical performance. This review aims to provide a comprehensive overview of AKG’s benefits and identify future directions for research in both clinical and sports settings.
Integrating Endocrine, Genomic, and Extra-Skeletal Benefits of Vitamin D into National and Regional Clinical Guidelines
Authors: Wimalawansa Sunil J. , Weiss Scott T. , Hollis Bruce W.
Published: November 2024

Background/Objectives: Vitamin D is essential for bone health, immune function, and overall well-being. Numerous ecological, observational, and prospective studies, including randomized controlled clinical trials (RCTs), report an inverse association between higher serum 25-hydroxyvitamin D [25(OH)D; calcifediol] levels in various conditions, including cardiovascular disease, metabolic disorders such as diabetes and obesity, susceptibility to infection-related complications, autoimmune diseases, and all-cause mortality. Results: Vitamin D operates through two distinct systems. The endocrine system comprises the renal tubular cell-derived circulatory calcitriol, which primarily regulates calcium homeostasis and muscular functions. In contrast, intracellularly generated calcitriol in peripheral target cells is responsible for intracrine/paracrine system signaling and calcitriol–vitamin D receptor-mediated genomic effects. Government-appointed committees and health organizations have developed various clinical practice guidelines for vitamin D supplementation and management. However, these guidelines heavily relied on the 2011 Institute of Medicine (IoM) report, which focused solely on the skeletal effects of vitamin D, ignoring other body systems. Thus, they do not represent maintaining good overall health and aspects of disease prevention. Additionally, the IoM report was intended as a public health recommendation for the government and is not a clinical guideline. Discussion: New country- and regional-specific guidelines must focus on healthy nations through disease prevention and reducing healthcare costs. They should not be restricted to bone effect and must encompass all extra-skeletal benefits. Nevertheless, due to misunderstandings, medical societies and other governments have used faulty IoM report as a foundation for creating vitamin D guidelines. Consequently, they placed disproportionate emphasis on bone health while largely overlooking its benefits for other bodily systems, making current guidelines, including 2024, the Endocrine Society less applicable to the public. As a result, the utility of published guidelines has been significantly reduced for clinical practice and RCTs that designed on bone-centric are generate misleading information and remain suboptimal for public health and disease prevention. Conclusions: This review and its recommendations address the gaps in current vitamin D clinical practice guidelines and propose a framework for developing more effective, country and region-specific recommendations that capture the extra-skeletal benefits of vitamin D to prevent multiple diseases and enhance public health.
HM-Chromanone Alleviates Hyperglycemia by Activating AMPK and PI3K/AKT Pathways in Mice Fed a High-Fat Diet
Authors: Park Jae-eun , Yoo Jeong , Han Ji-sook
Published: November 2024

Objectives: We investigated potential antihyperglycemic effects of HM-chromanone (HMC), a homoisoflavonoid isolated from Portulaca oleracea, in mice fed a high-fat diet (HFD). Methods: Five-week-old male C57BL/6J mice (n = 24) were divided into three groups: controls, mice fed an HFD (11 weeks), and HFD-fed mice receiving HMC supplementation (8 weeks). Various analyses assessed liver and skeletal muscle proteins, pancreatic β-cell histology, blood glucose and HbA1c levels, and homeostatic index of insulin resistance (HOMA-IR). Results: HMC supplementation significantly reduced fasting blood glucose and postprandial blood glucose levels in HFD-fed mice. HbA1c and serum insulin levels reduced significantly, and HOMA-IR improved. Compensatory β-cell hyperplasia was reduced, and pancreatic β-cell function improved. AMP-activated protein kinase (AMPK) was significantly activated in skeletal muscle and liver tissues. IRS-1tyr612 expression increased significantly. PI3K activation and Akt phosphorylation in skeletal muscles improved insulin signaling. Forkhead box protein O1 phosphorylation increased through hepatic AMPK activation. Phosphoenolpyruvate carboxykinase and glucose-6-phosphatase expression was inhibited. Glycogen synthase kinase 3β phosphorylation increased. Conclusions: HMC supplementation alleviated hyperglycemia by activating the AMPK and PI3K/Akt pathways in skeletal muscles and the AMPK pathway in the liver of HFD-fed mice.
Development of Competencies in Emergency Nursing: Comparison Between Self-Assessment and Tutor Evaluation Before and After a Training Intervention
Authors: Manero-Solanas Marta , Navamuel-Castillo Noelia , López-Ibort Nieves , Gascón-Catalán Ana
Published: November 2024

Background/Objectives: Nursing competence encompasses the integration of knowledge, skills, and attitudes essential for comprehensive and safe patient care. This study aimed to compare self-assessment and tutor evaluation of nurses’ competencies in a hospital emergency department before and after a training intervention. Methods: A quasi-experimental design was employed, involving 63 newly hired nurses who participated in a mentorship program. The intervention included theoretical and practical sessions on critical care skills. Data were collected through self-assessment questionnaires and objective evaluations by tutors using validated rubrics. Results: The results indicated significant differences between self-assessment and tutor evaluations in pre- and post-intervention phases, particularly in competencies related to orotracheal intubation and fibrinolytic therapy for ischemic stroke. Post-intervention, discrepancies between self-assessment and tutor evaluations decreased, suggesting improved self-awareness and competence among participants. Conclusions: This study highlights the importance of combining self-assessment and external evaluation to ensure accurate competency assessment and effective educational interventions, ultimately enhancing the quality of patient care.
First Detection of West Nile Virus by Nasopharyngeal Swab, Followed by Phylogenetic Analysis
Authors: Zuddas Carlo , Piras Sergio , Cappai Stefano , Loi Federica , Murgia Giulia , Puggioni Giantonella , Savini Giovanni , Monaco Federica , Polci Andrea , Valleriani Fabrizia , Amatori Giorgia , Curini Valentina , Marcacci Maurilia , Orrù Germano , Ledda Antonio , Poma Elena , Cappai Riccardo , Coghe Ferdinando
Published: November 2024

West Nile Virus, an arthropod-borne RNA virus, may result in severe neurological disease. West Nile neuroinvasive disease is characterized by meningitis, encephalitis, and possible acute flaccid paralysis. Here, we report a case of neuroinvasive WNV in a 65-year-old woman hospitalized for hyperpyrexia, chills, intense asthenia, and continuous vomiting. Within days, her clinical condition worsened with the onset of severe neurological symptoms, leading to her death within 10 days despite supportive therapies being administered. The diagnosis of West Nile disease was made through nucleic acid amplification testing (NAAT) on blood and cerebrospinal fluid. However, in the final stages of the illness, cerebrospinal fluid collection was not possible due to the patient’s critical condition, and a nasopharyngeal swab was used instead. The nasopharyngeal swab facilitated the collection of a sample, which was subsequently analyzed for the presence of the virus and allowed for sequencing, showing that it was a strain that had been circulating in Sardinia for some time and had demonstrated its pathogenicity by causing the death of a hawk in 2021. This case report highlights the rapid progression and severity of WNV infection, particularly in vulnerable individuals, and suggests the potential utility of nasopharyngeal swabs as a less invasive option for sample collection. It also underscores the potential for the zoonotic transmission of the virus from birds to humans through vectors, emphasizing the importance of monitoring and controlling WNV outbreaks, especially in regions where such circulation is observed.
Evolving Clinical Features of Diabetic Ketoacidosis: The Impact of SGLT2 Inhibitors
Authors: Genc Selin , Evren Bahri , Yigit Onur Selcuk , Sahin Ibrahim , Dayanan Ramazan , Klisic Aleksandra , Erturk Ayse , Mercantepe Filiz
Published: November 2024

Background/Objectives: The antidiabetic effect of SGLT2 inhibitors (SGLT2-is) is based on their ability to increase glucose excretion through urine by inhibiting the kidney-resident SGLT2 protein. Euglycemic diabetic ketoacidosis (EuDKA) is an uncommon but potentially life-threatening adverse effect of these medications, which are notable for their antidiabetic, cardiovascular, and renal protective properties. This study aimed to clarify the impact of SGLT2-is on demographic, clinical, and biochemical characteristics in patients with DKA. Methods: A total of 51 individuals with a diagnosis of DKA were included in the trial; 19 of these patients were treated with SGLT2-is, while 32 were not. Patients diagnosed with DKA and treated with SGLT2-is were compared to those not treated with the medication in terms of clinical, biochemical, and laboratory characteristics. Results: The age of patients utilizing SGLT2-is was statistically considerably greater than that of non-users (p < 0.001). EuDKA was exclusively noted in the SGLT2-is cohort (p = 0.005). Urinary tract infections, vulvovaginitis, and genitourinary infections were substantially more prevalent among SGLT2-i users compared with non-users among both women and the overall patient group (p = 0.036, p = 0.001, p = 0.005, p = 0.003, respectively). Plasma glucose concentrations were significantly higher in SGLT2-i non-users (p = 0.006). Chloride (Cl−) concentrations were elevated among SGLT2-i users (p = 0.036). Conclusions: The study findings indicate that SGLT2 inhibitors may substantially influence age, serum chloride, EuDKA, and the occurrence of genitourinary infections in individuals with DKA.
Less Pain with Intra-Articular Hyaluronic Acid Injections for Knee Osteoarthritis Compared to Placebo: A Systematic Review and Meta-Analysis of Randomised Controlled Trials
Authors: Migliorini Filippo , Maffulli Nicola , Schäfer Luise , Kubach Joshua , Betsch Marcel , Pasurka Mario
Published: November 2024

The present meta-analysis investigated the efficacy of intra-articular hyaluronic acid (HA) injections for knee osteoarthritis. The outcomes of interest were the visual analogue scale (VAS) and Western Ontario McMaster Osteo-Arthritis Index (WOMAC) scores. This study was conducted according to the 2020 PRISMA statement. All the randomised controlled trials (RCTs) comparing the efficacy of intra-articular HA injections versus placebo injections for knee osteoarthritis were accessed in September 2024. Data from 3851 patients were collected. In total, 64% (2467 of 3851 patients) were women, and the mean age of the patients was 63.5 ± 4.9 years. At baseline, good comparability was found for the mean age, BMI, percentage of women, and patient-reported outcome measures (PROMs). Studies which reported data from two to four weeks of follow-up evidenced a lower value of the subscales pain (p < 0.0001) and stiffness (p = 0.01) of the WOMAC score. No difference was observed in VAS at rest (p = 0.4), VAS at exercise (p = 0.1), and subscale function (p = 0.4) of the WOMAC score. Studies which reported data from five to eight weeks of follow-up evidenced lower VAS at rest in favour of the HA group (p = 0.01). No difference in the other PROMs of interest was observed: VAS at exercise (p = 0.1), and the subscales pain (p = 0.3), function (p = 0.4), and stiffness (p = 0.4) of the WOMAC score. The current level I of evidence suggests that intra-articular HA injections in the knee might reduce pain in the short term.