bluuebunny/crossref_metadata_2025 huggingface dataset:
Urinary Dickkopf-3 (DKK3) Is Associated with Greater eGFR Loss in Patients with Resistant Hypertension
Authors: Schäfer Ann-Kathrin C. , Pieper Dennis , Dihazi Hassan , Dihazi Gry H. , Lüders Stephan , Koziolek Michael J. , Wallbach Manuel
Published: January 2023

Patients with resistant hypertension (HTN) demonstrate an increased risk of chronic kidney disease and progression to end-stage renal disease; however, the individual course of progression is hard to predict. Assessing the stress-induced, urinary glycoprotein Dickkopf-3 (uDKK3) may indicate ongoing renal damage and consecutive estimated glomerular filtration rate (eGFR) decline. The present study aimed to determine the association between uDKK3 levels and further eGFR changes in patients with resistant HTN. In total, 31 patients with resistant HTN were included. Blood pressure and renal function were measured at baseline and up to 24 months after (at months 12 and 24). uDKK3 levels were determined exclusively from the first available spot urine sample at baseline or up to a period of 6 months after, using a commercial ELISA kit. Distinctions between different patient groups were analyzed using the unpaired t-test or Mann–Whitney test. Correlation analysis was performed using Spearman’s correlation. The median uDKK3 level was 303 (interquartile range (IQR) 150–865) pg/mg creatinine. Patients were divided into those with high and low eGFR loss (≥3 vs. <3 mL/min/1.73 m²/year). Patients with high eGFR loss showed a significantly higher median baseline uDKK3 level (646 (IQR 249–2555) (n = 13) vs. 180 (IQR 123–365) pg/mg creatinine (n = 18), p = 0.0412 (Mann–Whitney U)). Alternatively, patients could be classified into those with high and low uDKK3 levels (≥400 vs. <400 pg/mg creatinine). Patients with high uDKK3 levels showed significantly higher eGFR loss (−6.4 ± 4.7 (n = 11) vs. 0.0 ± 7.6 mL/min/1.73 m2/year (n = 20), p = 0.0172 (2-sided, independent t-test)). Within the entire cohort, there was a significant correlation between the uDKK3 levels and change in eGFR at the latest follow-up (Spearman’s r = −0.3714, p = 0.0397). In patients with resistant HTN, high levels of uDKK3 are associated with higher eGFR loss up to 24 months later.
Microcirculation Improvement in Diabetic Foot Patients after Treatment with Sucrose Octasulfate-Impregnated Dressings
Authors: Lázaro-Martínez José Luis , García-Madrid Marta , Bohbot Serge , López-Moral Mateo , Álvaro-Afonso Francisco Javier , García-Álvarez Yolanda
Published: January 2023

To assess the patients’ microcirculation evolution during the treatment with a sucrose octasulfate-impregnated dressing, fifty patients with neuroischaemic DFU treated with TLC-NOSF dressing were included in a prospective study between November 2020 and February 2022. TcpO2 values were measured on the dorsalis pedis or tibial posterior arteries’ angiosome according to the ulcer location. TcpO2 values were assessed at day 0 and every 4 weeks during 20 weeks of the follow-up or until the wound healed. A cut-off point of tcpO2 < 30 mmHg was defined for patients with impaired microcirculation. The TcpO2 values showed an increase between day 0 and the end of the study, 33.04 ± 12.27 mmHg and 40.89 ± 13.06 mmHg, respectively, p < 0.001. Patients with impaired microcirculation showed an increase in the tcpO2 values from day 0 to the end of the study (p = 0.023). Furthermore, we observed a significant increase in the TcpO2 values in the forefoot DFU (p = 0.002) and in the rearfoot DFU (p = 0.071), with no difference between the ulcer locations (p = 0.694). The local treatment with TLC-NOSF dressing improved the microcirculation in patients with neuroischaemic DFU, regardless of microcirculation status at the baseline, and in the forefoot, regardless of the location.
Newly Proposed Diagnostic Criteria for Acute Respiratory Distress Syndrome: Does Inclusion of High Flow Nasal Cannula Solve the Problem?
Authors: Liufu Rong , Wang Chun-Yao , Weng Li , Du Bin
Published: January 2023

Acute respiratory distress syndrome (ARDS) is a common life-threatening clinical syndrome which accounts for 10% of intensive care unit admissions. Since the Berlin definition was developed, the clinical diagnosis and therapy have changed dramatically by adding a minimum positive end-expiratory pressure (PEEP) to the assessment of hypoxemia compared to the American-European Consensus Conference (AECC) definition in 1994. High-flow nasal cannulas (HFNC) have become widely used as an effective respiratory support for hypoxemia to the extent that their use was proposed in the expansion of the ARDS criteria. However, there would be problems if the diagnosis of a specific disease or clinical syndrome occurred, based on therapeutic strategies.
Bowel Perforation after Extracorporeal Wave Lithotripsy: A Review of the Literature
Authors: Fontanet Sofia , Farré Alba , Angerri Oriol , Kanashiro Andrés , Suquilanda Edgar , Bollo Jesús , Gallego Maria , Sánchez-Martín Francisco Maria , Millán Félix , Palou Joan , Bonnin Diana , Emiliani Esteban
Published: January 2023

Introduction: Extracorporeal wave lithotripsy (ESWL) is considered a first-line treatment for renal and ureteral stones up to 10–20 mm in diameter. Complications are uncommon, with a reported rate of 0–6% in the literature. Bowel perforation has only been described in a few case reports but requires rapid diagnosis and treatment. Methods: A review of the literature from PubMed/Medline, Embase, Cochrane, and Web of Science databases was performed including studies reporting bowel perforation secondary to ESWL between January 1990 and June 2022. Results: We found 16 case reports of intestinal perforation in the literature. Although some patients had previously undergone abdominal surgery or had inflammatory intestinal disease, others were without comorbidities that could lead to complications. Abdominal pain was the main symptom and imaging was required to confirm the diagnosis, which usually necessitated a surgical intervention. As regards the ESWL technique, it appears that the combination of a high energy level and the prone position constitutes a risk factor for these rare complications. At the authors’ centre, only one case has been reported among 24,000 ESWL procedures over 20 years: A 59-year-old female who underwent ESWL for a distal right ureteral stone presented acute abdominal pain and free intraperitoneal pelvic fluid on ultrasound. A CT scan revealed a small bowel perforation requiring open laparotomy with primary closure. Conclusions: In conclusion, although bowel perforation after ESWL is rare, progressive abdominal pain with tenderness at physical examination requires proper imaging evaluation to exclude bowel perforation and prompt intervention if required.
A Deep Learning Model for Evaluating Meibomian Glands Morphology from Meibography
Authors: Wang Yuexin , Shi Faqiang , Wei Shanshan , Li Xuemin
Published: January 2023

To develop a deep learning model for automatically segmenting tarsus and meibomian gland areas on meibography, we included 1087 meibography images from dry eye patients. The contour of the tarsus and each meibomian gland was labeled manually by human experts. The dataset was divided into training, validation, and test sets. We built a convolutional neural network-based U-net and trained the model to segment the tarsus and meibomian gland area. Accuracy, sensitivity, specificity, and receiver operating characteristic curve (ROC) were calculated to evaluate the model. The area under the curve (AUC) values for models segmenting the tarsus and meibomian gland area were 0.985 and 0.938, respectively. The deep learning model achieved a sensitivity and specificity of 0.975 and 0.99, respectively, with an accuracy of 0.985 for segmenting the tarsus area. For meibomian gland area segmentation, the model obtained a high specificity of 0.96, with high accuracy of 0.937 and a moderate sensitivity of 0.751. The present research trained a deep learning model to automatically segment tarsus and the meibomian gland area from infrared meibography, and the model demonstrated outstanding accuracy in segmentation. With further improvement, the model could potentially be applied to assess the meibomian gland that facilitates dry eye evaluation in various clinical and research scenarios.
Ultrasound during the COVID-19 Pandemic: A Global Approach
Authors: Lombardi Anna , De Luca Mariarosaria , Fabiani Dario , Sabatella Francesco , Del Giudice Carmen , Caputo Adriano , Cante Luigi , Gambardella Michele , Palermi Stefano , Tavarozzi Rita , Russo Vincenzo , D’Andrea Antonello
Published: January 2023

SARS-CoV-2 (severe acute respiratory syndrome Coronavirus-2) rapidly spread worldwide as COVID-19 (Coronavirus disease 2019), causing a costly and deadly pandemic. Different pulmonary manifestations represent this syndrome’s most common clinical manifestations, together with the cardiovascular complications frequently observed in these patients. Ultrasound (US) evaluations of the lungs, heart, and lower limbs may be helpful in the diagnosis, follow-up, and prognosis of patients with COVID-19. Moreover, POCUS (point-of-care ultrasound) protocols are particularly useful for patients admitted to intensive care units. The present review aimed to highlight the clinical conditions during the SARS-CoV-2 pandemic in which the US represents a crucial diagnostic tool.
Comparison of Contributors to Mortality Differences in SLE Patients with Different Initial Disease Activity: A Larger Multicenter Cohort Study
Authors: Jin Ziyi , Chen Zheng , Pan Wenyou , Liu Lin , Wu Min , Hu Huaixia , Ding Xiang , Wei Hua , Zou Yaohong , Qian Xian , Wang Meimei , Wu Jian , Tao Juan , Tan Jun , Da Zhanyun , Zhang Miaojia , Li Jing , Feng Xuebing , Sun Lingyun
Published: January 2023

To explore the etiology of risk factors and quantify the mortality differences in systemic lupus erythematosus (SLE) patients with different initial disease activity. The Jiangsu Lupus database was established by collecting medical records from first-hospitalized SLE patients during 1999–2009 from 26 centers in Jiangsu province, China, and their survival status every five years. The initial SLEDAI scores [high (>12) vs. low–moderate (≤12)] differences in mortality attributable to risk factors were quantified using population attributable fraction (PAF), relative attributable risk (RAR) and adjusted relative risk (ARR). Among 2446 SLE patients, 83 and 176 deaths were observed in the low–moderate and high activity groups, with mortality rates of 7.7 and 14.0 per 1000 person years, respectively. Anemia was the leading contributor to mortality, with PAFs of 40.4 and 37.5 in the low–moderate and high activity groups, respectively, and explained 23.2% of the mortality differences with an ARR of 1.66 between the two groups. Cardiopulmonary involvement caused the highest PAFs in the low–moderate (20.5%) and high activity (13.6%) groups, explaining 18.3% of the mortality differences. The combination of anemia and cardiopulmonary involvement had the highest RAR, causing 39.8% of the mortality differences (ARR = 1.52) between the two groups. In addition, hypoalbuminemia and a decrease in the creatinine clearance rate accounted for 20–30% of deaths and explained 10–20% of the mortality differences between the two groups, while antimalarial drug nonuse accounted for about 35% of deaths and explained 3.6% of the mortality differences. Anemia, cardiopulmonary involvement and hypoalbuminemia may cause substantial mortality differences across disease activity states, suggesting additional strategies beyond disease activity assessment to monitor SLE outcomes.
Prevalence and Clinical Characteristics of Patients with Torsades de Pointes Complicating Acquired Atrioventricular Block
Authors: Bun Sok-Sithikun , Heme Nathan , Asarisi Florian , Squara Fabien , Scarlatti Didier , Moceri Pamela , Ferrari Emile
Published: January 2023

Background: Female gender, degree of QT prolongation, and genetic susceptibility are known risk factors for developing torsades de pointes (TdP) during high-grade atrioventricular block (HG-AVB). Our objective was to analyze the prevalence and clinical characteristics of patients presenting with TdP and AVB (TdP [+]) in comparison with non-TdP patients with AVB (TdP [−]). Methods: All the ECGs from patients prospectively admitted for AVB (2 to 1, HG, and complete) at the University Hospital of Nice were analyzed. Automated corrected QT (QTc), manual measurements of QT and JT intervals, and Tpeak-to-end were performed at the time of the most severe bradycardia. Results: From September 2020 to November 2021, 100 patients were admitted for HG-AVB. Among them, 17 patients with TdP were identified (8 men; 81 ± 10 years). No differences could be identified concerning automated QTc, manual QTc (Bazett correction), baseline QRS width, or mean left ventricular ejection fraction between the two groups. Potassium serum level on admission and mean number of QT-prolonging drugs per patient were not significantly different between the two groups, respectively: 4.34 ± 0.5 mmol/L in TdP [+] versus 4.52 ± 0.6 mmol/L (p = 0.33); and 0.6 ± 0.7 in TdP [+] versus 0.3 ± 0.5 (p = 0.15). In contrast, manual QTcFR (Fridericia correction), JT (Fridericia correction), Tpeak-to-end, and Tpe/QT ratio were significantly increased in the TdP [+] group, respectively: 486 ± 70 ms versus 456 ± 53 ms (p = 0.04); 433 ± 98 ms versus 381 ± 80 ms (p = 0.02); 153 ± 57 ms versus 110 ± 40 ms (p < 0.001); and 0.27 ± 0.08 versus 0.22 ± 0.06 (p < 0.001). Conclusions: The incidence of TdP complicating acquired AVB was 17%. Longer QTcFR, JT, and Tpeak-to-end were significantly increased in the case of TdP but also in the presence of permanent AVB during the hospitalization.
Relationship between Middle Cerebral Artery Pulsatility Index and Delayed Neurocognitive Recovery in Patients undergoing Robot-Assisted Laparoscopic Prostatectomy
Authors: Aceto Paola , Russo Andrea , Galletta Claudia , Schipa Chiara , Romanò Bruno , Luca Ersilia , Sacco Emilio , Totaro Angelo , Lai Carlo , Mazza Marianna , Federico Bruno , Sollazzi Liliana
Published: January 2023

A steep Trendelenburg (ST) position combined with pneumoperitoneum may cause alterations in cerebral blood flow with the possible occurrence of postoperative cognitive disorders. No studies have yet investigated if these alterations may be associated with the occurrence of postoperative cognitive disorders. The aim of the study was to evaluate the association between an increased middle cerebral artery pulsatility index (Pi), measured by transcranial doppler (TCD) 1 h after ST combined with pneumoperitoneum, and delayed neurocognitive recovery (dNCR) in 60 elderly patients undergoing robotic-assisted laparoscopic prostatectomy (RALP). Inclusion criteria were: ≥65 years; ASA class II–III; Mini-Mental Examination score > 23. Exclusion criteria were: neurological or psychiatric pathologies; any conditions that could interfere with test performance; severe hypertension or vascular diseases; alcohol or substance abuse; chronic pain; and an inability to understand Italian. dNCR was evaluated via neuropsychological test battery before and after surgery. Anesthesia protocol and monitoring were standardized. The middle cerebral artery Pi was measured by TCD, through the trans-temporal window and using a 2.5 MHz ultrasound probe at specific time points before and during surgery. In total, 20 patients experiencing dNCR showed a significantly higher Pi after 1 h from ST compared with patients without dNCR (1.10 (1.0–1.19 95% CI) vs. 0.87 (0.80–0.93 95% CI); p = 0.003). These results support a great vulnerability of the cerebral circulation to combined ST and pneumoperitoneum in patients who developed dNCR. TCD could be used as an intraoperative tool to prevent the occurrence of dNCR in patients undergoing RALP.
Evolution of the Incidence of Oral Cavity Cancers in the Elderly from 1990 to 2018
Authors: Renou Alice , Guizard Anne-Valérie , Chabrillac Emilien , Defossez Gautier , Grosclaude Pascale , Deneuve Sophie , Vergez Sébastien , Lapotre-Ledoux Bénédicte , Plouvier Sandrine , Dupret-Bories Agnès ,   FRANCIM Network
Published: January 2023

Objectives: To describe the evolution of the incidence of oral cavity cancers (OCC) among elderly patients in France between 1990 and 2018 and to compare it to the incidence of other cancers sharing the same main risk factors. Material and Methods: The incidence of cancers in mainland France from 1990 to 2018 was estimated from incidence data observed in every cancer registry of the Francim network. Incidence was modeled by a 2-dimensional penalized spline of age and year of diagnosis, associated with a random effect corresponding to the registry. The elderly population was divided into two groups: 70–79 years old and ≥80 years old. Results: There was a 72% increase in the number of OCC cases in women over 70 years of age between the periods 1990–1999 and 2010–2018. As for men, there was a stabilization in the number of cases (+2%). Over the same period, for laryngeal and hypopharyngeal cancers, there was a decrease in incidence in elderly men and an increase in elderly women, although less marked than for OCC. Conclusions: Since the 1990s, the incidence of OCC has been increasing in elderly subjects in France, particularly in women. Population aging and growth or alcohol and tobacco consumption alone do not seem to explain this increase, which is not observed in the same proportions for other upper aerodigestive tract cancer subsites sharing the same main risk factors.
Humoral and T-Cell Mediated Response after the Third Dose of mRNA Vaccines in Patients with Systemic Lupus Erythematosus on Belimumab
Authors: Quartuccio Luca , De Marchi Ginevra , Domenis Rossana , Cabas Nicola , Guella Silvia , Paradiso Antonella , Fabro Cinzia , Beltrami Antonio Paolo , De Vita Salvatore , Curcio Francesco
Published: January 2023

Objective: To evaluate humoral and T-cell cellular-mediated immune response after three doses of SARS-CoV-2 mRNA vaccines in patients with systemic lupus erythematosus (SLE) under Belimumab. Patients and methods: 12 patients on Belimumab and 13 age-matched healthy volunteers were recruited. Patients were in remission or in low disease activity, and they were taking no corticosteroids or only low doses. None of the patients and controls had detectable anti-SARS-CoV-2 antibodies due to previous exposure to the virus. All the patients received three doses of mRNA anti-SARS-CoV-2 vaccines and the humoral and cellular-mediated response were tested 4 weeks after the second dose (T0), 6 months after the second dose (T1) and 4 weeks after the third dose (T2). Comparison with the control group was performed at time T0 (i.e., 4 weeks after the second dose). Total anti-SARS-CoV-2 RBD antibodies were analyzed using a diagnostic assay, while cellular-mediated response was evaluated using the interferon-gamma release assay (IGRA). Results: A humoral response was documented in all the patients at T0 (median 459; IQR 225.25–758.5), but the antibody titer significantly declined from T0 to T1 (median 44.7; IQR: 30.3–202; p = 0.0066). At T2, the antibody titer significantly increased from T1 (median 2500; IQR: 2500–2500), and it was not different from T0 (respectively p < 0.0001, p = 0.66). Cellular-mediated response significantly declined from T0 to T1 (p = 0.003) but not from T0 to T2 (p = 0.3). No differences were found between patients and controls at T0 as regards both humoral and cellular responses (p = 1.0 and p = 0.09 for humoral and cellular responses, respectively). Conclusion: The third dose of mRNA COVID-19 vaccine can restore both humoral and cellular immune response in SLE patients on Belimumab.
Left Atrial Functional Remodeling in Patients with Chronic Heart Failure Treated with Sacubitril/Valsartan
Authors: Correale Michele , Magnesa Michele , Mazzeo Pietro , Fortunato Martino , Tricarico Lucia , Leopizzi Alessandra , Mallardi Adriana , Mennella Raffaele , Croella Francesca , Iacoviello Massimo , Di Biase Matteo , Brunetti Natale Daniele
Published: January 2023

(1) Background: Previous studies showed left ventricular (LV) and left atrial (LA) improvement and reverse remodeling after therapy with Sacubitril/Valsartan (S/V) in patients affected by heart failure with reduced ejection fraction (HFrEF). Therefore, we sought to investigate predictors of LA structural and functional reverse remodeling (LARR) in this setting of patients after therapy with S/V, focusing on left atrial strain parameters, such as peak atrial longitudinal strain (PALS). (2) Methods: Patients with HFrEF underwent clinical and echocardiographic evaluation at baseline and after six months of therapy with S/V. Measures of LA structure (LA volume index, LAVi) and function (LA emptying fraction (LAEF), PALS, LA conduit strain and peak atrial contraction strain (PACS) were also analyzed. Patients were divided in two groups, those with a LARR (relative reduction in LAVi > 15%, LARR+) and those without (LARR−). (3) Results: A total of 47 consecutive patients (66 ± 8 years, 85% male, mean LVEF 28 ± 6%) were enrolled in the study and followed up. A significant increase of LAEF (46 ± 13 vs. 37 ± 11%, p < 0.001) and a significant reduction of LAVi (42 ± 15 vs. 45 ± 15 mL/m2, p = 0.008) were found after 6 months of S/V therapy; 47% of the population showed LA reverse remodeling. LA strain parameters, PALS (19 ± 8 vs. 15 ± 7 %, p < 0.001) and LA conduit (−9.7 ± 5.2% vs. −7.6 ± 4.1%, p = 0.007) significantly improved after 6 months of S/V therapy. At multivariable stepwise regression analysis, changes in LV End Diastolic Volume (LVEDV) and PALS were significantly proportional to changes in LAVi values. (4) Conclusions: Six months of treatment with S/V in patients with HFrEF was associated with an improvement in LA functional reverse remodeling in a real-world scenario. LARR was not significantly correlated to baseline echocardiographic variables, but was proportional to changes in LV volumes and LA strain parameters. Finally, after S/V therapy, a strict connection between LA and LV reverse remodeling and between LA anatomical and functional reverse remodeling seems to be outlined.
The Story of the Finest Armor: Developmental Aspects of Reptile Skin
Authors: Yenmiş Melodi , Ayaz Dinçer
Published: January 2023

The reptile skin is a barrier against water loss and pathogens and an armor for mechanical damages. The integument of reptiles consists of two main layers: the epidermis and the dermis. The epidermis, the hard cover of the body which has an armor-like role, varies among extant reptiles in terms of structural aspects such as thickness, hardness or the kinds of appendages it constitutes. The reptile epithelial cells of the epidermis (keratinocytes) are composed of two main proteins: intermediate filament keratins (IFKs) and corneous beta proteins (CBPs). The outer horny layer of the epidermis, stratum corneum, is constituted of keratinocytes by means of terminal differentiation or cornification which is a result of the protein interactions where CBPs associate with and coat the initial scaffold of IFKs. Reptiles were able to colonize the terrestrial environment due to the changes in these epidermal structures, which led to various cornified epidermal appendages such as scales and scutes, a beak, claws or setae. Developmental and structural aspects of the epidermal CBPs as well as their shared chromosomal locus (EDC) indicate an ancestral origin that gave rise to the finest armor of reptilians.
Developing a Novel Enamel Adhesive with Amorphous Calcium Phosphate and Silver Nanoparticles to Prevent Demineralization during Orthodontic Treatment
Authors: Jia Ao , Wang Pei , Tong Fei , Chen Ziqiang , Deng Yunyun , Yao Haiyan , Wang Lianguo , Liu Yifan , Ge Hongshan
Published: January 2023

During fixed orthodontic treatment, white spot lesions are prevalent issues associated with cariogenic bacteria. This study aims to construct an orthodontic adhesive containing nanoparticles of amorphous calcium phosphate-polydopamine-Ag (NPA) fillers to combat white spot lesions. The NPA fillers were prepared and characterized by scanning electron microscopy (SEM), transmission electron microscopy (TEM), Fourier transform infrared spectroscopy (FTIR), and X-ray photoelectron spectroscopy (XPS). The biocompatibility of the fillers was evaluated. A colony counting test evaluated the antibacterial property of the fillers against Streptococcus mutans (S. mutans). NPA fillers were mixed with orthodontic adhesive (Transbond XT) at different weight ratios (0, 0.1, 0.2, 0.3, and 0.5 wt.%). The shear bond strength and antibacterial properties were then further investigated. The results showed that NPA was prepared successfully, with good antibacterial properties. The cell survival rate of all groups of fillers was higher than 70%, showing good biocompatibility. Moreover, the shear bond strength of the orthodontic adhesive with 0.2 wt.% NPA fillers was 11.89 ± 1.27 MPa, meeting the minimal clinical bond strength requirements of 7.8 MPa. Furthermore, the orthodontic adhesive resin blocks and the extract displayed good antibacterial properties, with the number of colonies decreasing significantly (p < 0.001). Taken together, we think that an orthodontic adhesive with NPA may have a good application potential for the prevention and treatment of white spot lesions.
OMNI-CONV: Generalization of the Omnidirectional Distortion-Aware Convolutions
Authors: Artizzu Charles-Olivier , Allibert Guillaume , Demonceaux Cédric
Published: January 2023

Omnidirectional images have drawn great research attention recently thanks to their great potential and performance in various computer vision tasks. However, processing such a type of image requires an adaptation to take into account spherical distortions. Therefore, it is not trivial to directly extend the conventional convolutional neural networks on omnidirectional images because CNNs were initially developed for perspective images. In this paper, we present a general method to adapt perspective convolutional networks to equirectangular images, forming a novel distortion-aware convolution. Our proposed solution can be regarded as a replacement for the existing convolutional network without requiring any additional training cost. To verify the generalization of our method, we conduct an analysis on three basic vision tasks, i.e., semantic segmentation, optical flow, and monocular depth. The experiments on both virtual and real outdoor scenarios show our adapted spherical models consistently outperform their counterparts.
Impact of Wavelet Kernels on Predictive Capability of Radiomic Features: A Case Study on COVID-19 Chest X-ray Images
Authors: Prinzi Francesco , Militello Carmelo , Conti Vincenzo , Vitabile Salvatore
Published: January 2023

Radiomic analysis allows for the detection of imaging biomarkers supporting decision-making processes in clinical environments, from diagnosis to prognosis. Frequently, the original set of radiomic features is augmented by considering high-level features, such as wavelet transforms. However, several wavelets families (so called kernels) are able to generate different multi-resolution representations of the original image, and which of them produces more salient images is not yet clear. In this study, an in-depth analysis is performed by comparing different wavelet kernels and by evaluating their impact on predictive capabilities of radiomic models. A dataset composed of 1589 chest X-ray images was used for COVID-19 prognosis prediction as a case study. Random forest, support vector machine, and XGBoost were trained (on a subset of 1103 images) after a rigorous feature selection strategy to build-up the predictive models. Next, to evaluate the models generalization capability on unseen data, a test phase was performed (on a subset of 486 images). The experimental findings showed that Bior1.5, Coif1, Haar, and Sym2 kernels guarantee better and similar performance for all three machine learning models considered. Support vector machine and random forest showed comparable performance, and they were better than XGBoost. Additionally, random forest proved to be the most stable model, ensuring an appropriate balance between sensitivity and specificity.
Acknowledgment to the Reviewers of JMSE in 2022
Authors:   JMSE Editorial Office
Published: January 2023

High-quality academic publishing is built on rigorous peer review [...]
When Does a Light Sphere Break Ice Plate Most by Using Its Net Buoyance?
Authors: Ni Bao-Yu , Tan Hao , Di Shao-Cheng , Zhang Chen-Xi , Li Zhiyuan , Huang Luofeng , Xue Yan-Zhuo
Published: January 2023

A free-rising buoyant sphere can break an ice plate floating above it. The problem is when the light sphere breaks the ice plate most, or the optimal relative density of the sphere which can break the ice plate the most severely. This experimental study was done to answer this problem. A set of experimental devices were designed, and a high-speed camera system was adopted to record the whole dynamic process, including the free-rising of the sphere, the collision between the sphere and the ice plate, the crack initiation and propagation, as well as the breakup of the ice plate. The failure mode of the ice plate under impact load was analyzed. It was found that conical cracks were formed under the reflected tensile wave at the top surface of the ice plate. On this basis, the influences of ice thickness, the initial submergence depth, and the relative density of the sphere on icebreaking were further investigated. An optimal relative density of the sphere was found when the sphere was released at a certain initial submergence depth, at which point the ice was damaged the most severely. For example, when the dimensionless initial submergence depth of the sphere was 2.31, the optimal relative density of the sphere was close to 0.4, with the probability of the ice plate breakup as high as 91.7%. It was also found from the experiments that the degree of damage to the ice plate correlated well with the kinetic energy of the sphere just before collision. Results showed that the optimal relative density can be estimated by theoretical analysis of the kinetic energy of the sphere, which will provide a reference for potential icebreaking applications in the future.
Investigation of Electromagnetic Sub-Modeling Procedure for the Breeding Blanket System
Authors: Maione Ivan Alessio , Roccella Massimo , Lucca Flavio
Published: January 2023

The outcome of the electromagnetic (EM) analyses carried out during the DEMO pre-conceptual phase demonstrated that EM loads are relevant for the structural assessment of the breeding blanket (BB) and, in particular, for the definition of the boundary conditions at the attachment system with the vacuum vessel. However, within the scope of the previous campaign, the results obtained using simplified models only give a rough estimation of the EM loads inside the BB structure. This kind of data has been considered suitable for a preliminary assessment of the BB segments, but it is not considered representative as input for structural analysis in which a detailed BB internal structure (that considers cooling channels, thin plates, etc.) is analyzed. Indeed, mesh dimensions and computational time usually limit EM models that simulate a whole DEMO sector. In many cases, these constraints lead to a strong homogenization of the BB structure, not allowing the calculation of the EM loads on the internal structure with high precision. To overcome such limitations, an EM sub-modeling procedure was investigated using ANSYS EMAG. The sub-modeling feasibility is studied using the rigid boundary condition method. This method consists of running a global “coarse” mesh, including all the conducting structures that can have some impact on the component under investigation and inputting the obtained results on the detailed sub-model of the structure of interest as time-varying boundary conditions. The procedure was tested on the BB internal structure, taking as reference a DEMO 2017 baseline sector and the helium cooled pebble bed (HCPB) concept with its complex internal structure made by pins. The obtained results show that the method is also reliable in the presence of non-linear magnetic behaviour. The methodology is proposed for application in future BB system assessments.
Two Strains of Lentinula edodes Differ in Their Transcriptional and Metabolic Patterns and Respond Differently to Thermostress
Authors: Guo Yuan , Gao Qi , Fan Yangyang , Song Shuang , Yan Dong , Zhao Jing , Chen Yulin , Liu Yu , Wang Shouxian
Published: January 2023

Temperature type is one of the key traits determining the cultivation regime of Lentinula edodes. However, the molecular and metabolic basis underling temperature type remain unclear. Here, we investigated the phenotypic, transcriptomic, and metabolic features of L. edodes with different temperature types under both control (25 °C) and high (37 °C) temperature conditions. We found that under the control condition, the high- and low-temperature types of L. edodes harbored distinct transcriptional and metabolic profiles. The high-temperature (H-)-type strain had a higher expression level of genes involved in the toxin processes and carbohydrate binding, while the low-temperature (L-)-type strain had a high expression level of oxidoreductase activity. Heat stress significantly inhibited the growth of both H- and L-type strains, while the latter had a higher growth inhibition rate. Upon exposure to heat, the H-type strain significantly up-regulated genes associated with the components of the cellular membrane, whereas the L-type strain markedly up-regulated genes involved in the extracellular region and carbohydrate binding. Metabolome data showed that thermostress altered purine and pyrimidine metabolism in the H-type strain, whereas it altered cysteine, methionine, and glycerophospholipid metabolism in the L-type strain. Transcriptome and metabolome integrative analysis was able to identify three independent thermotolerance-related gene–metabolite regulatory networks. Our results deepen the current understanding of the molecular and metabolic basis underlying temperature type and suggest, for the first time, that thermotolerance mechanisms can be temperature-type-dependent for L. edodes.
Fungal Whole-Genome Sequencing for Species Identification: From Test Development to Clinical Utilization
Authors: Salem-Bango Zackary , Price Travis K , Chan June L , Chandrasekaran Sukantha , Garner Omai B , Yang Shangxin
Published: January 2023

Using next-generation sequencing (NGS), we developed and validated a whole-genome sequencing (WGS)-based clinical test for fungal species identification on clinical isolates. The identification is mainly based on the fungal ribosomal internal transcribed spacer (ITS) region as the primary marker, and additional marker and genomic analysis applied for species within the Mucorales family (using the 28S rRNA gene) and Aspergillus genus (using the beta-tubulin gene and k-mer tree-based phylogenetic clustering). The validation study involving 74 unique fungal isolates (22 yeasts, 51 molds, and 1 mushroom-forming fungus) showed high accuracy, with 100% (74/74) concordance on the genus-level identifications and 89.2% (66/74) concordance on the species level. The 8 discrepant results were due to either the limitation of conventional morphology-based methodology or taxonomic changes. After one year of implementation in our clinical laboratory, this fungal NGS test was utilized in 29 cases; the majority of them were transplant and cancer patients. We demonstrated the utility of this test by detailing five case studies, in which accurate fungal species identification led to correct diagnosis, treatment adjustment or was ruled out for hospital acquired infection. This study provides a model for validation and implementation of WGS for fungal identification in a complex health system that serves a large immunocompromised patient population.
Mobile Selective Exposure: Confirmation Bias and Impact of Social Cues during Mobile News Consumption in the United States
Authors: Ross Morgan Quinn , Crum Jarod , Wang Shengkai , Knobloch-Westerwick Silvia
Published: January 2023

Concerns about online news consumption have proliferated, with some evidence suggesting a heightened impact of the confirmation bias and social cues online. This paper argues that mobile media may further shape selective exposure to political content. We conducted two online selective exposure experiments to investigate whether browsing political content on smartphones (vs. computers) facilitates selective exposure to attitude-consistent vs. attitude-discrepant articles (confirmation bias) with high vs. low views (impact of social cues). Notably, these studies leveraged novel random assignment techniques and a custom-designed, mobile-compatible news website. Using a student sample, Study 1 (N = 157) revealed weak evidence that the confirmation bias is stronger on smartphones than computers, and the impact of social cues was similar across devices. Study 2 (N = 156) attempted to replicate these findings in a general population sample. The impact of social cues remained similar across devices, but the confirmation bias was not stronger on smartphones than computers. Overall, the confirmation bias (but not the impact of social cues) manifested on smartphones, and neither outcome was consistently stronger on smartphones than computers.
Safety and Efficacy of Tyrosine Kinase Inhibitors in Immune Thrombocytopenic Purpura: A Systematic Review of Clinical Trials
Authors: Ali Muhammad Ashar , Anwar Muhammad Yasir , Aiman Wajeeha , Dhanesar Gurneel , Omar Zainab , Hamza Mohammad , Zafar Maha , Rengarajan Harish Kumar , Maroules Michael
Published: January 2023

Immune thrombocytopenic purpura (ITP) is an acquired antibody or cell-mediated platelet damage or decreased platelet production. Steroids, IV immunoglobulins (IVIG), and Rho-anti-D antibodies are the commonly used initial treatments for ITP. However, many ITP patients either do not respond or do not maintain a response to initial therapy. Splenectomy, rituximab, and thrombomimetics are the commonly used second-line treatment. More treatment options include tyrosine kinases inhibitors (TKI), including spleen tyrosine kinase (Syk) and Bruton’s tyrosine kinase (BTK) inhibitors. This review aims to assess the safety and efficacy of TKIs. Methods: Literature was searched on PubMed, Embase, WOS, and clinicaltrials.gov using keywords, “tyrosine kinase” and “idiopathic thrombocytopenic purpura”. PRISMA guidelines were followed. Results: In total, 4 clinical trials were included with 255 adult patients with relapsed/refractory ITP. In all, 101 (39.6%) patients were treated with fostamatinib, 60 (23%) patients with rilzabrutinib, and 34 (13%) with HMPL-523. Patients treated with fostamatinib achieved a stable response (SR) and overall response (OR) in 18/101 (17.8%) and 43/101 (42.5%) of the patients, respectively, while SR and OR were achieved in 1/49 (2%) and 7/49 (14%) of the patients, respectively, in the placebo group. Patients treated with HMPL-523 (300 mg dose expansion) achieved an SR and OR in 5/20 (25%) and 11/20 (55%) of the patients, respectively, while SR and OR were achieved in 1/11 (9%) of the patients treated with the placebo. Patients treated with rilzabrutinib achieved an SR in 17/60 (28%) patients. Dizziness (1%), hypertension (2%), diarrhea (1%), and neutropenia (1%) were serious adverse events in fostamatinib patients. Rilzabrutinib or HMPL-523 patients did not require a dose reduction due to drug-related adverse effects. Conclusions: Rilzabrutinib, fostamatinib, and HMPL-523 were safe and effective in the treatment of relapsed/refractory ITP.
Radiomics in Lung Metastases: A Systematic Review
Authors: Gabelloni Michela , Faggioni Lorenzo , Fusco Roberta , Simonetti Igino , De Muzio Federica , Giacobbe Giuliana , Borgheresi Alessandra , Bruno Federico , Cozzi Diletta , Grassi Francesca , Scaglione Mariano , Giovagnoni Andrea , Barile Antonio , Miele Vittorio , Gandolfo Nicoletta , Granata Vincenza
Published: January 2023

Due to the rich vascularization and lymphatic drainage of the pulmonary tissue, lung metastases (LM) are not uncommon in patients with cancer. Radiomics is an active research field aimed at the extraction of quantitative data from diagnostic images, which can serve as useful imaging biomarkers for a more effective, personalized patient care. Our purpose is to illustrate the current applications, strengths and weaknesses of radiomics for lesion characterization, treatment planning and prognostic assessment in patients with LM, based on a systematic review of the literature.
Mammography in Breast Disease Screening and Diagnosis
Authors: Tari Daniele Ugo , Pinto Fabio
Published: January 2023

Female breasts can suffer from a wide spectrum of pathologies, ranging from inflammatory diseases to benign and malignant tumors [...]
Metallic Artifact Reduction in Midfacial CT Scans Using Patient-Specific Polymer Implants Enhances Image Quality
Authors: Lommen Julian , Schorn Lara , Sproll Christoph , Kerkfeld Valentin , Aksu Adem , Reinauer Frank , Kübler Norbert R. , Budach Wilfried , Rana Majeed , Tamaskovics Bálint
Published: January 2023

Midfacial reconstruction after tumor resection surgery is commonly conducted by using autologous bone grafts or alloplastic implants. Titanium is the most frequently used osteosynthesis material in these cases but causes disturbing metallic artifacts in CT imaging. The purpose of this experimental study was to evaluate whether the use of midfacial polymer implants reduces metallic artifacts in CT imaging to improve image quality. Zygomatic titanium (n = 1) and polymer (n = 12) implants were successively implanted in a human skull specimen. Implants were analyzed for their effect on Hounsfield Unit values (streak artifacts) and virtual growth in CT images (blooming artifacts) as well as image quality. Multi-factorial ANOVA and Bonferroni’s post hoc test were used. Titanium (173.7 HU; SD ± 5.1) and hydroxyapatite containing polymers (155.3 HU; SD ± 5.9) were associated with significantly more streak artifacts compared to all other polymer materials. There was no significant difference in blooming artifacts between materials. The metallic artifact reduction algorithm showed no significant difference. Image quality was slightly better for polymer implants compared to titanium. Personalized polymer implants for midfacial reconstruction significantly reduce metallic artifacts in CT imaging which improves image quality. Hence, postoperative radiation therapy planning and radiological tumor aftercare around the implants are facilitated.
Emergency Care for Burn Patients—A Single-Center Report
Authors: Niculae Andrei , Peride Ileana , Tiglis Mirela , Nechita Ana Maria , Petcu Lucian Cristian , Neagu Tiberiu Paul
Published: January 2023

Burns, one of the main public health problems, lead to significant mortality and morbidity. Epidemiological studies regarding burn patients in Romania are scarce. The aim of this study is to identify the burn etiology, demographics, clinical characteristics, and outcomes in patients requiring treatment in a regional burn unit. Design. We performed a retrospective observational study of 2021. Patients. All patients admitted to our six-bed intensive care unit (ICU) were included. Interventions. The following data were collected for further analysis: demographics, burn pattern (etiology, size, depth, affected body region), type of ventilation, ABSI (Abbreviated Burn Severity Index) score, comorbidities, bioumoral parameters, and hospitalization days. Results. There were 93 burned patients included in our study that were divided into two groups: alive patients’ group (63.4%) and deceased patients’ group (36.6%). The mean age was 55.80 ± 17.16 (SD). There were 65.6% male patients, and 39.8% of the patients were admitted by transfer from another hospital. Further, 59 patients presented third-degree burns, from which 32.3% died. Burns affecting >37% of the total body surface area (TBSA) were noticed in 30 patients. The most vulnerable regions of the body were the trunk (p = 0.003), the legs (p = 0.004), the neck (p = 0.011), and the arms (p = 0.020). Inhalation injury was found in 60.2% of the patients. The risk of death in a patient with an ABSI score > 9 points was 72 times higher. Comorbidities were present in 44.1% of the patients. We observed a median LOS (length of stay) of 23 days and an ICU-LOS of 11 days. Logistic regression analysis showed that admission protein, creatinkinase, and leukocytes were independent risk factors for mortality. The general mortality rate was 36.6%. Conclusion. A thermal factor was responsible for the vast majority of burns, 94.6% of cases being accidents. Extensive and full-thickness burns, burns affecting the arms, inhalation injuries, the need for mechanical ventilation, and a high ABSI score represent important risk factors for mortality. Considering the results, it appears that prompt correction of protein, creatinkinase, and leukocytes levels may contribute to improvement in severe burn patients’ outcomes.
The Impact of the COVID-19 Pandemic on Mental Health and Quality of Life in COVID-19 Department Healthcare Workers in Central Greece
Authors: Aslanidis Vasileios , Tsolaki Vasiliki , Papadonta Maria Eirini , Amanatidis Theofilos , Parisi Kyriaki , Makris Demosthenes , Zakynthinos Epaminondas
Published: January 2023

Background: The pandemic crisis created conditions of insecurity and threat and brought about changes in social contacts and everyday life. Frontline healthcare workers (HCW) were mostly affected. We aimed to evaluate the quality of life and negative emotions in COVID-19 HCW and searched for factors influencing the above. Methods: The present study was conducted among three different academic hospitals in central Greece (04/2020–03/2021). Demographics, attitude towards COVID-19, quality of life, depression, anxiety, stress (using the WHOQOL-BREF and DASS21 questionnaire) and the fear of COVID-19 were assessed. Factors affecting the reported quality of life were also assessed. Results: The study involved 170 HCW in COVID-19 dedicated departments. Moderate levels of quality of life (62.4%), satisfaction with social relations (42.4%), working environment (55.9%) and mental health (59.4%) were reported. Stress was present in 30.6% of HCW; 20.6% reported fear for COVID-19, depression (10.6%) and anxiety (8.2%). HCW in the tertiary hospital were more satisfied with social relations and working environment and had less anxiety. Personal Protective Equipment (PPE) availability affected the quality of life, satisfaction in the work environment and the presence of anxiety and stress. Feeling safe during work influenced social relations and fear of COVID-19 Conclusion: The HCW quality of life is affected in the pandemic. Feelings of safety during work related to the reported quality of life.
Posttraumatic Osteomyelitis Risks Associated with NLRP3 Gene Polymorphisms in the Chinese Population
Authors: Qu Yudun , Li Jiaxuan , Zhang Wei , Xia Changliang , Ou Shuanji , Yang Yang , Jiang Nan , Ma Yunfei , Qi Yong , Xu Changpeng
Published: January 2023

The purpose of this case–control study was to examine possible links between NLRP3 gene polymorphisms and the risk of developing posttraumatic osteomyelitis (PTOM) in the Chinese population. A total of 306 patients with PTOM and 368 normal controls were genotyped for NLRP3 (rs35829419, rs10754558, rs7525979, rs4612666), ELP2 (rs1785929, rs1789547, rs1785928, rs12185396, rs681757, rs8299, rs2032206, rs559289), STAT3 (rs4796793, rs744166, rs1026916, rs2293152, rs1053004), CASP1 (rs501192, rs580253, rs556205, rs530537), NFKBIA (rs696), NFKB1 (rs4648068), CARD8 (rs204321), and CD14 (rs2569190) using the genotyping technique SNaPshot. The genotype distributions of NLRP3 gene rs10754558 (p = 0.047) and rs7525979 (p = 0.048) significantly differed between the patients and the healthy controls. Additionally, heterozygous models indicated a significant association between NLRP3 rs10754558 and the likelihood of developing PTOM (OR = 1.600, p = 0.039), as did recessive and homozygous models of NLRP3 rs7525979 (OR = 0.248, p = 0.019 and 0.239, p = 0.016, respectively). Collectively, our findings suggest that, in the Chinese population, the risk of developing PTOM was increased by the association between NLRP3 rs10754558 and rs7525979. Therefore, our findings may provide novel insights and guidance in the prevention and development of PTOM.