bluuebunny/crossref_metadata_2025 huggingface dataset:
Heavy Rainfall Events in Selected Geographic Regions of Mexico, Associated with Hail Cannons
Authors: Rodríguez-Moreno Victor M. , Estrada-Ávalos Juan
Published: June 2024

In this article, we document the use of hail cannons in Mexico to dispel or suppress heavy rain episodes, a common practice among farmers, without scientific evidence to support its effectiveness. This study uses two rain databases: one compiled from the Global Precipitation Measurement (GPM) mission and the other generated with the implementation of the Weather Research and Forecasting (WRF) model. The aim is to explore the association between heavy rain episodes and hail cannon locations. The analysis includes two geographic features: a pair of coordinates and a 3 km radius area of influence around each hail cannon. This dimension is based on the size and distribution of the heavy rainfall events. This study analyzes four years of half-hourly rain data using the Python ecosystem environment with machine learning libraries. The results show no relationship between the operation of hail cannons and the dissipation or attenuation of heavy rainfall events. However, this study highlights that the significant differences between the GPM and WRF databases in registering heavy rain events may be attributable to their own uncertainty. Despite the unavailability of ground-based observations, the inefficiency of hail cannons in affecting the occurrence of heavy rain events is evident. Overall, this study provides scientific evidence that hail cannons are inefficient in preventing the occurrence of heavy rain episodes.
Pre-Procedural Predictors of Successful Endoscopic Sleeve Gastroplasty: A Retrospective Study
Authors: Charach Lior , Peleg Noam , Abuhasira Ran , Shamah Steven
Published: June 2024

Objective: Obesity is a major risk factor for the morbidity and mortality of cardiovascular disease and predicts the development of hypertension, diabetes mellitus and other various diseases. Methods: A retrospective study evaluated predictors for higher total body weight loss following endoscopic sleeve gastroplasty (ESG). Adults (>18 years old) with BMI > 30 kg/m2 who underwent ESG from January 2019 to July 2022 were included. Patients under the age of 18 were excluded from the study. Results: This retrospective cohort included 76 patients, of whom 62 women (81.6%) and 14 were men (18.4%) with a mean age of 46.3 ± 10.4. The mean BMI baseline was 36.6 ± 4.21. Out of the included patients, 10% were lost to follow-up at 1 month, 33% at 3 months, 50% after 6 months, and only 30% met 12 months follow-up. During the follow-up period, no mortality was documented. Three major adverse events (3.9%) were documented (one mediastinal abscess, one lower gastrointestinal bleeding and one pulmonary embolism), all of them in female patients. Among the demographic clinical and laboratory data examined, smoking (N = 6, p < 0.001) was associated with successful ESG, which was determined as total body weight loss (TBWL) above 15%. The rest of the variables examined were not shown to be statistically significant to sleeve success. Overall, 65 of the 76 patients which were studied in this research had more than 5% TBWL, 42 patients had more than 10% TBWL, 21 patients had more than 15% TBWL and 7 patients lost more than 20% of their weight during 1 year of follow-up. Maximal TBWL was achieved 3 months following the procedure. During the first month following ESG, the average weight lost was 8.6% (N = 69); at 3 months, it was 12.3% (N = 48); at 6 months, it was 11.3% (N = 33); and at 12 months, it was 9.8% (N = 13). Smoking was associated with higher weight loss. Conclusions: The current study showed a positive correlation between ESG weight loss above 15% and smoking. Older patients (>50) gained weight earlier, within 3 months, and by 1 year of follow-up almost returned back to their original weight. Females sustained weight loss over 1 year of follow-up compared to males. Patients with lower BMI continued losing weight during the follow-up period (12 months). This study tries to summarize pre-procedural prediction of ESG success.
Development and Characterization of a Sol–Gel-Functionalized Glass Carbon Electrode Probe for Sensing Ultra-Trace Amounts of NH3 and NH4+ in Water
Authors: Alwael H. , Oubaha M. , El-Shahawi M. S.
Published: June 2024

This study centers on the development and characterization of an innovative electrochemical sensing probe composed of a sensing mesoporous functional sol–gel coating integrated onto a glassy carbon electrode (sol–gel/GCE) for the detection of NH3 and/or NH4+ in water. The main interest for integrating a functional sol–gel coating onto a GCE is to increase the selective and sensing properties of the GCE probe towards NH3 and/or NH4+ ions. The structure and surface morphology of the newly developed sol–gel/GCE probe were characterized employing scanning electron microscopy (SEM), atomic force microscopy (AFM), dynamic light scattering (DLS), and Fourier-transform infrared (FTIR), while the electrochemical sensing properties were evaluated by Berthelot’s reaction, cyclic voltammetry (CV), and adsorptive square wave–anodic striping voltammetry (Ads SW–ASV). It is shown that the newly developed sol–gel coating is homogeneously deposited on the GCE with a sub-micron and uniform thickness close to 630 nm and a surface roughness of 25 nm. The sensing testing of the sol–gel/GCE probe showed limits of detection and limits of quantitation of 1.7 and 5.56 nM of NH4+, respectively, as well as a probe sensitivity of 5.74 × 10−1 μA/μM cm−2. The developed probe was fruitfully validated for the selective detection of NH3/NH4+ in fresh and sea water samples. Computed Student texp (0.45–1.25) and Fexp (1.69–1.78) (n = 5) tests were less than the theoretical ttab (2.78) and Ftab (6.39) at 95% probability.
Effects of Pathogenic Mutants of the Neuroprotective RNase 5-Angiogenin in Amyotrophic Lateral Sclerosis (ALS)
Authors: Gotte Giovanni
Published: June 2024

Amyotrophic Lateral Sclerosis (ALS) is a fatal neurodegenerative disease that affects the motoneurons. More than 40 genes are related with ALS, and amyloidogenic proteins like SOD1 and/or TDP-43 mutants are directly involved in the onset of ALS through the formation of polymorphic fibrillogenic aggregates. However, efficacious therapeutic approaches are still lacking. Notably, heterozygous missense mutations affecting the gene coding for RNase 5, an enzyme also called angiogenin (ANG), were found to favor ALS onset. This is also true for the less-studied but angiogenic RNase 4. This review reports the substrate targets and illustrates the neuroprotective role of native ANG in the neo-vascularization of motoneurons. Then, it discusses the molecular determinants of many pathogenic ANG mutants, which almost always cause loss of function related to ALS, resulting in failures in angiogenesis and motoneuron protection. In addition, ANG mutations are sometimes combined with variants of other factors, thereby potentiating ALS effects. However, the activity of the native ANG enzyme should be finely balanced, and not excessive, to avoid possible harmful effects. Considering the interplay of these angiogenic RNases in many cellular processes, this review aims to stimulate further investigations to better elucidate the consequences of mutations in ANG and/or RNase 4 genes, in order to achieve early diagnosis and, possibly, successful therapies against ALS.
Continuity and Innovation in Pottery Technology: The Karst Region (North-East Italy) from Neolithic to Early Bronze Age
Authors: Bernardini Federico , Montagnari Kokelj Manuela , Velicogna Matteo , Barago Nicolò , Lenaz Davide , De Min Angelo , Leghissa Elena
Published: June 2024

This paper explores the development of pottery technology in the Trieste Karst region (North-East Italy) from the Neolithic to the Early Bronze Age (EBA). It also seeks to identify cultural links with other areas by examining potentially imported vessels. Archaeometric analyses (X-ray diffraction and optical microscopy) reveal significant differences between Neolithic ceramics (Danilo–Vlaška Group) and the majority of Late Copper Age (LCA)/Early Bronze Age (EBA) pottery (primarily associated with the Ljubljana Culture and a few with the Cetina Culture). Neolithic pottery displays consistent characteristics across all vessel types, including coarse grain, prevalent sparry calcite temper, and the absence of grog. In contrast, most LCA and EBA vessels exhibit distinct features such as very fine-grained paste, no sparry calcite, notable use of grog temper, higher quartz, muscovite, and flint content. Notably, from a technological perspective, the analyzed Cetina vessels bear a strong resemblance to the majority of LCA ceramics. The differences between Neolithic and LCA/EBA vessels clearly suggest the use of new raw materials, recipes, and techniques, likely reflecting changes in cultural and social contexts and potential connections with the core area of the Ljubljana Culture.
Iris typhifolia Responses to Saline–Alkali Stress: Germination, Antioxidant Activity, Hormones, and Photosynthetic Performance
Authors: Chen Lifei , Yu Jiahui , Lu Xi , Wang Qi , Wang Shizhuo , Shan Yuze , Liu Yang , Meng Yuan , Zhou Yunwei
Published: June 2024

Iris typhifolia Kitag is a perennial herbaceous species with high ornamental and applied value. Elucidating the mechanism of saline–alkali tolerance in Iris is crucial for their promotion in saline–alkali areas. Saline–alkali stress is one of the factors that affects plant growth, which has become a significant global issue. In this study, we measured the physiological and biochemical indexes of I. typhifolia, through germination and potting trials, to evaluate the resistance of I. typhifolia to different levels of artificial saline–alkali stress (0, 50, 100, 150, and 200 mmol·L−1). The results showed that artificial saline–alkali stress negatively impacted germination parameters, cell membrane integrity, and photosynthetic parameters. Different trends in osmoregulatory substances and endogenous hormones were observed. It was shown that I. typhifolia had a potential adaptability to the saline–alkali environment by enhancing its internal defense mechanism. Based on regression analyses, the germination threshold of I. typhifolia was calculated to be 87.15 mmol·L−1, which provided a theoretical basis for the application in soil saline–alkalization areas.
Arginine Regulates Skeletal Muscle Fiber Type Formation via mTOR Signaling Pathway
Authors: Zhou Min , Wei Yihan , Feng Yue , Zhang Shumin , Ma Ning , Wang Kaige , Tan Peng , Zhao Ying , Zhao Jinbiao , Ma Xi
Published: June 2024

The composition of skeletal muscle fiber types affects the quality of livestock meat and human athletic performance and health. L-arginine (Arg), a semi-essential amino acid, has been observed to promote the formation of slow-twitch muscle fibers in animal models. However, the precise molecular mechanisms are still unclear. This study investigates the role of Arg in skeletal muscle fiber composition and mitochondrial function through the mTOR signaling pathway. In vivo, 4-week C56BL/6J male mice were divided into three treatment groups and fed a basal diet supplemented with different concentrations of Arg in their drinking water. The trial lasted 7 weeks. The results show that Arg supplementation significantly improved endurance exercise performance, along with increased SDH enzyme activity and upregulated expression of the MyHC I, MyHC IIA, PGC-1α, and NRF1 genes in the gastrocnemius (GAS) and quadriceps (QUA) muscles compared to the control group. In addition, Arg activated the mTOR signaling pathway in the skeletal muscle of mice. In vitro experiments using cultured C2C12 myotubes demonstrated that Arg elevated the expression of slow-fiber genes (MyHC I and Tnnt1) as well as mitochondrial genes (PGC-1α, TFAM, MEF2C, and NRF1), whereas the effects of Arg were inhibited by the mTOR inhibitor rapamycin. In conclusion, these findings suggest that Arg modulates skeletal muscle fiber type towards slow-twitch fibers and enhances mitochondrial functions by upregulating gene expression through the mTOR signaling pathway.
Melatonin Delays Arthritis Inflammation and Reduces Cartilage Matrix Degradation through the SIRT1-Mediated NF-κB/Nrf2/TGF-β/BMPs Pathway
Authors: Zhao Mingchao , Qiu Di , Miao Xue , Yang Wenyue , Li Siyao , Cheng Xin , Tang Jilang , Chen Hong , Ruan Hongri , Liu Ying , Wei Chengwei , Xiao Jianhua
Published: June 2024

Cartilage, a flexible and smooth connective tissue that envelops the surfaces of synovial joints, relies on chondrocytes for extracellular matrix (ECM) production and the maintenance of its structural and functional integrity. Melatonin (MT), renowned for its anti-inflammatory and antioxidant properties, holds the potential to modulate cartilage regeneration and degradation. Therefore, the present study was devoted to elucidating the mechanism of MT on chondrocytes. The in vivo experiment consisted of three groups: Sham (only the skin tissue was incised), Model (using the anterior cruciate ligament transection (ACLT) method), and MT (30 mg/kg), with sample extraction following 12 weeks of administration. Pathological alterations in articular cartilage, synovium, and subchondral bone were evaluated using Safranin O-fast green staining. Immunohistochemistry (ICH) analysis was employed to assess the expression of matrix degradation-related markers. The levels of serum cytokines were quantified via Enzyme-linked immunosorbent assay (ELISA) assays. In in vitro experiments, primary chondrocytes were divided into Control, Model, MT, negative control, and inhibitor groups. Western blotting (WB) and Quantitative RT-PCR (q-PCR) were used to detect Silent information regulator transcript-1 (SIRT1)/Nuclear factor kappa-B (NF-κB)/Nuclear factor erythroid-2-related factor 2 (Nrf2)/Transforming growth factor-beta (TGF-β)/Bone morphogenetic proteins (BMPs)-related indicators. Immunofluorescence (IF) analysis was employed to examine the status of type II collagen (COL2A1), SIRT1, phosphorylated NF-κB p65 (p-p65), and phosphorylated mothers against decapentaplegic homolog 2 (p-Smad2). In vivo results revealed that the MT group exhibited a relatively smooth cartilage surface, modest chondrocyte loss, mild synovial hyperplasia, and increased subchondral bone thickness. ICH results showed that MT downregulated the expression of components related to matrix degradation. ELISA results showed that MT reduced serum inflammatory cytokine levels. In vitro experiments confirmed that MT upregulated the expression of SIRT1/Nrf2/TGF-β/BMPs while inhibiting the NF-κB pathway and matrix degradation-related components. The introduction of the SIRT1 inhibitor Selisistat (EX527) reversed the effects of MT. Together, these findings suggest that MT has the potential to ameliorate inflammation, inhibit the release of matrix-degrading enzymes, and improve the cartilage condition. This study provides a new theoretical basis for understanding the role of MT in decelerating cartilage degradation and promoting chondrocyte repair in in vivo and in vitro cultured chondrocytes.
Rotating Stall Inception Prediction Using an Eigenvalue-Based Global Instability Analysis Method
Authors: Xu Shenren , Yuan Caijia , He Chen , Cao Dongming , Sun Dakun , Martel Carlos , Chen Huihao , Wang Dingxi
Published: June 2024

The accurate prediction of rotating stall inception is critical for determining the stable operating regime of a compressor. Among the two widely accepted pathways to stall, namely, modal and spike, the former is plausibly believed to originate from a global linear instability, and experiments have partially confirmed it. As for the latter, recent computational and experimental findings have shown it to exhibit itself as a rapidly amplified flow perturbation. However, rigorous analysis has yet to be performed to prove that this is due to global linear instability. In this work, an eigenanalysis approach is used to investigate the rotating stall inception of a transonic annular cascade. Steady analyses were performed to compute the performance characteristics at a given rotational speed. A numerical stall boundary was first estimated based on the residual convergence behavior of the steady solver. Eigenanalyses were then performed for flow solutions at a few near-stall points to determine their global linear stability. Once the relevant unstable modes were identified according to the signs of real parts of eigenvalues, they were examined in detail to understand the flow destabilizing mechanism. Furthermore, time-accurate unsteady simulations were performed to verify the obtained eigenvalues and eigenvectors. The eigenanalysis results reveal that at the rotating stall inception condition, multiple unstable modes appear almost simultaneously with a leading mode that grows most rapidly. In addition, it was found that the unstable modes are continuous in their nodal diameters, and are members of a particular family of modes typical of a dynamic system with cyclic symmetries. This is the first time such an interesting structure of the unstable modes is found numerically, which to some extent explains the rich and complex results constantly observed from experiments but have never been consistently explained. The verified eigenanalysis method can be used to predict the onset of a rotating stall with a CPU time cost orders of magnitude lower than time-accurate simulations, thus making compressor stall onset prediction based on the global linear instability approach feasible in engineering practice.
Buzzing with Intelligence: Current Issues in Apiculture and the Role of Artificial Intelligence (AI) to Tackle It
Authors: Astuti Putri Kusuma , Hegedűs Bettina , Oleksa Andrzej , Bagi Zoltán , Kusza Szilvia
Published: June 2024

Honeybees (Apis mellifera L.) are important for agriculture and ecosystems; however, they are threatened by the changing climate. In order to adapt and respond to emerging difficulties, beekeepers require the ability to continuously monitor their beehives. To carry out this, the utilization of advanced machine learning techniques proves to be an exceptional tool. This review provides a comprehensive analysis of the available research on the different applications of artificial intelligence (AI) in beekeeping that are relevant to climate change. Presented studies have shown that AI can be used in various scientific aspects of beekeeping and can work with several data types (e.g., sound, sensor readings, images) to investigate, model, predict, and help make decisions in apiaries. Research articles related to various aspects of apiculture, e.g., managing hives, maintaining their health, detecting pests and diseases, and climate and habitat management, were analyzed. It was found that several environmental, behavioral, and physical attributes needed to be monitored in real-time to be able to understand and fully predict the state of the hives. Finally, it could be concluded that even if there is not yet a full-scale monitoring method for apiculture, the already available approaches (even with their identified shortcomings) can help maintain sustainability in the changing apiculture.
Benefits of Taurisolo in Diabetic Patients with Peripheral Artery Disease
Authors: Amato Bruno , Novellino Ettore , Morlando Davide , Vanoli Camilla , Vanoli Emilio , Ferrara Fulvio , Difruscolo Rossana , Goffredo Vito Maria , Compagna Rita , Tenore Gian Carlo , Stornaiuolo Mariano , Fordellone Mario , Caradonna Eugenio
Published: June 2024

Trimethyl-N-oxide (TMAO) has been linked to peripheral artery disease (PAD). TaurisoloⓇ is a natural, balanced phytocomplex containing resveratrol, quercetin, catechins, procianidins, gallic acid, and caffeic acid. Numerous studies have shown that TaurisoloⓇ reduces the damage of TMAO and exerts a protective effect on endothelial cells (ECs). The aim of this randomized, double-blind, single-center study was to evaluate the effects of TaurisoloⓇ on claudication in patients with PAD (Rutheford grade I, category II, Fontaine Classification: Stage IIA, American Medical Association Whole Person Impairment Classification: Class 0—WPI 0%) in two parallel groups of 31 patients. The primary outcomes were an increase in the pain-free walking distance and the ankle/brachial pressure index at the beginning and at the end of the treatment with Taurisolo. The secondary endpoint was the serum TMAO changes. The claudication distance improved by 14.1% in the Taurisolo group and by 2.0% in the placebo group, while the maximal distance increased by 15.8% and 0.6% only, respectively (both p < 0.05). The TMAO plasma levels decreased from 3.97 ± 2.13 micromole/L to 0.87 ± 0.48 (p < 0.0001) in the treated group. All these changes were highly significant both in univariate mixed models as well as in the adjusted model. Ultimately, TaurisoloⓇ might be an effective intervention to ameliorate intermittent claudication.
Postoperative Astigmatism after Keratoplasty: A Systematic Review Meta-Analysis Based on PRISMA
Authors: Kijonka Magdalena , Nowińska Anna , Wylęgała Edward , Wylęgała Adam , Wróblewska-Czajka Ewa , Kryszan Katarzyna , Dugiełło Bogdan , Orzechowska-Wylęgała Bogusława
Published: June 2024

Background: The number of corneal transplants is rising, with the aim to treat a spectrum of diseases ranging from dystrophies to corneal opacities caused by trauma or chemical burns. Refractive outcomes after this procedure are often impossible to predict and associated with high levels of astigmatism. However, there are many techniques that affect the reduction of astigmatism and improve the quality of life of patients. Objectives: The aim was to compare the improvement in postoperative visual acuity (logMAR) and amount of corneal astigmatism (Diopters) after corneal keratoplasty in patients who additionally underwent a surgical procedure, which affects the reduction in postoperative astigmatism, and to determine the most effective method. Search Methods and Selection Criteria: A thorough search was carried out across online electronic databases including PubMed, Embrase, Ovid MEDLINE, Scopus, and Web of Science, using combinations containing the following phrases: postoperative astigmatism, post-keratoplasty astigmatism, anterior lamellar keratoplasty (ALK), deep anterior lamellar keratoplasty (DALK), posterior lamellar keratoplasty, endothelial keratoplasty (EK), penetrating keratoplasty (PK), corneal transplant, keratoplasty, refractive surgery, kerato-refractive surgery, laser in situ keratomileusis (LASIK), and femtosecond LASIK. This was to determine all English-language publications that discuss refractive operations for postoperative or post-keratoplasty astigmatism. These bibliographies were searched for English-language publications published between 2010 and 2023. We proceeded to review each detected record’s reference list. Data Extraction: Study characteristics such as study design, sample size, participant information, operations performed, and clinical outcomes were all extracted. Data Statistical Analyses: The Comprehensive Meta-Analysis software (version 3.3.070, 2014) was used to perform the analysis. The threshold of 0.05 for p-values was considered statistically significant. All effect sizes are reported as standardized differences (Std diff) in means with a 95% confidence interval (CI) and visualized graphically as forest plots. Publication bias is presented as a funnel plot of standard error by Std diff in means. Four methods were used to evaluate the heterogeneity among the studies: Q-value, I2, chi-square (χ2), and tau-squared. Main Results: We included 21 studies that randomized 1539 eyes that underwent corneal transplantation surgery either by PKP, DALK, or DSEAK techniques. The results showed the most significant improvement in the visual acuity and significant decrease in the corneal astigmatism after laser surgery procedures, like femtosecond-assisted keratotomy after DALK and PKP and LASIK after DSEAK.
Left Bundle Branch Area Pacing to Overcome Coronary Sinus Anatomy-Related Technical Problems Encountered during Implantation of Biventricular CRT—A Case Report
Authors: Michalik Jędrzej , Moroz Roman , Szołkiewicz Marek , Dąbrowska-Kugacka Alicja , Daniłowicz-Szymanowicz Ludmiła
Published: June 2024

The results of clinical trials show that up to one-third of patients who are eligible for cardiac resynchronization therapy (CRT) do not benefit from biventricular pacing. The reasons vary, including technical problems related to left ventricle pacing lead placement in the appropriate branch of the coronary sinus. Herein, we present a case report of a patient with heart failure with reduced ejection fraction and left bundle branch block, in whom a poor coronary sinus bed made implantation of classic biventricular CRT impossible, but in whom, alternatively, rescue-performed left bundle branch area pacing allowed effective electrical and mechanical cardiac resynchronization. The report confirms that left bundle branch area pacing may be a rational alternative in such cases.
Multidisciplinary Care for Moebius Syndrome and Related Disorders: Building a Management Protocol
Authors: Odedra Amar , Blumenow Wendy , Dainty Jennifer , Dasgupta Soumit , Dominguez-Gonzalez Susana , Gonzalez-Martin Jose , Hartley Helen , Kelly Maria , McKay Victoria H. , Sharma Ravi , Spinty Stefan , Fattah Adel Y.
Published: June 2024

Moebius syndrome is a collection of orofacial anomalies with highly variable features affecting many different systems but characterised by bilateral facial palsy and absent eye abduction. We largely regard Moebius syndrome as a diagnosis of exclusion. Lack of awareness and knowledge means that children often fall between services, leading to treatment delays and difficulty interfacing with social care and schools, with long-term impact on physical health and psychosocial development. We developed a multidisciplinary team comprising core clinicians (lead physician, geneticist, speech and language therapist, psychologist and specialist nurse) and an expanded group to encompass the other affected systems. The interactions between our specialties lead to the development of a treatment protocol, which we present. The protocol harnesses the aspects of care of children with a range of other rare diseases at a specialised paediatric centre and synthesises them into a holistic approach for MBS and related conditions. Management is sequenced on an “ABC-style” basis, with airway, feeding, vision and speech taking priority in the early years. We define management priorities as airway stabilisation with swallow assessment, ocular surface protection and maintenance of nutritional support. Management principles for issues such as speech, reflux, drooling and sleep issues are outlined. In later years, psychological support has a prominent role geared towards monitoring and interventions for low mood, self-esteem and bullying.
Does Concomitant Meniscectomy or Meniscus Repair Affect Muscle Strength, Lower Extremity Balance, and Functional Tests after Anterior Cruciate Ligament Reconstruction?
Authors: Biały Maciej , Kublin Kamil , Wilczyński Bartosz , Forelli Florian , Gnat Rafał
Published: June 2024

Background/Objective: The effects of concomitant meniscal tears and their associated treatment on strength, lower extremity balance, and functional status after anterior cruciate ligament reconstruction (ACLR) have not been widely investigated. This study aimed to compare the functional outcomes in patients who underwent ACLR with concomitant treatment of the medial meniscus repair versus meniscectomy when returning to unrestricted physical activity. Methods: A total of 85 patients who underwent primary ACLR with combined meniscal repair (MREP; n = 39) or meniscectomy (MRES; n = 46) were assessed. The dataset included the Functional Movement ScreenTM (FMS) outcomes and single-leg balance test (SLBT) with anterior–posterior, medial–lateral, and overall stability indexes. Isokinetic knee extension and flexion strengths were tested at velocities of 60 deg·s−1 and 180 deg·s−1. The peak torque-to-body weight ratio (PT/BW) and limb symmetry index (LSI) were calculated. Results: In the functional assessment, there was no significant inter-group difference in the composite score of the FMS (MREP: 15.08 pts vs. MRES: 15.13 pts; p > 0.05). The SLBT outcomes in inter-group and inter-extremity comparisons were irrelevant (p > 0.05), too. Significant differences emerged in the inter-group comparison of the knee extension strength in the non-operated extremity at both 60 deg·s−1 and 180 deg·s−1 (p = 0.02). Inter-extremity differences were significant in both the MREP and MRES groups for knee extension and flexion at both angular velocities (all p values < 0.05). For knee extension, the LSI values ranged from 82% to 87%, and for flexion, from 77% to 84%, with no significant inter-group differences. Conclusions: Patients undergoing ACLR with concomitant meniscal repair or resection did not exhibit differences in isokinetic muscle strength, lower extremity balance, and functional tests upon returning to activity. However, participants in both groups demonstrated significant differences between the operated and non-operated extremities as far as the knee joint extensor and flexor strengths are concerned. Therefore, rehabilitation protocols should prioritize equalizing inter-extremity strength differences after the ACLR with additional treatment procedures addressing the menisci.
Magnetic Resonance Imaging of Central Nervous System Manifestations of Type 1 Neurofibromatosis: Pictorial Review and Retrospective Study of Their Frequency in a Cohort of Patients
Authors: Di Pietro Stefano , Reali Linda , Tona Emanuela , Belfiore Giuseppe , Praticò Andrea Domenico , Ruggieri Martino , David Emanuele , Foti Pietro Valerio , Santonocito Orazio Giuseppe , Basile Antonio , Palmucci Stefano
Published: June 2024

Background: type 1 neurofibromatosis (NF1) is the most common neurocutaneous disorder, and it is an inherited condition that causes a tumour predisposition. Central nervous system (CNS) manifestations are a significant cause of morbidity and mortality in NF1. We provide a pictorial review of neuroradiological features of NF1, with emphasis on magnetic resonance imaging (MRI), and we assess the frequency of those features on a cohort of NF1 patients. Methods: we retrospectively evaluated all patients with a diagnosis of NF1 who underwent MRI of the spine and brain in our centre over a period of almost 5 years. A total of 74 patients were enrolled, 28 males and 46 females, with a mean age of 21 ± 12.67 years. The frequency of CNS manifestations encountered in our cohort of NF1 patients was assessed and compared with the data found in other studies published in the literature. Results: many of our findings were in line with the literature, and possible interpretations for those that turned out to be different were suggested in the discussion. Conclusion: imaging plays a central role in the diagnosis and management of NF1, and the knowledge of CNS manifestations could be critical for its early detection and identification, such as for treatment planning and prognostic implications.
Drug Use Patterns in Myasthenia Gravis: A Real-World Population-Based Cohort Study in Italy
Authors: Finocchietti Marco , Crescioli Giada , Paoletti Olga , Brunori Paola , Sciancalepore Francesco , Tuccori Marco , Addis Antonio , Vannacci Alfredo , Lombardi Niccolò , Kirchmayer Ursula ,   The CAESAR Study Group
Published: June 2024

Background: In the context of a comparative study of efficacy and safety of drugs used in rare neuromuscular and neurodegenerative diseases (CAESAR—call AIFA_FV_2012-13-14), we assessed the use patterns of drugs indicated for myasthenia gravis (MG). Methods: A retrospective cohort study was conducted based on administrative healthcare data. For a cohort of MG patients, prevalent and incident use of pyridostigmine (Py) and other indicated drugs in the first year after case identification was evaluated. Prevalent combined use of major therapies (azathioprine (Az), prednisone (Pr), vitamin D (Vd)) stratified by Py use was assessed, and a comparison between therapies at the time of MG identification and during the first year of follow-up was performed. Results: We included 2369 MG patients between 2013 and 2019. Among them, prevalent and incident Py users were 38.4% and 22.0%, respectively. In the first year of follow-up, the use of Pr was observed in 74.5% of Py prevalent users and in 82.0% of Py incident users, respectively; the use of Az was observed in 24.9% and 23.0%, respectively; and the use of Vd was observed in 53.3% and 48.2%, respectively. Among 910 Py prevalent users, 13.1% also used Az, Pr, and Vd, while 15.3% used none of these. Among 938 non-Py users, 2.7% used Az, Pr, and Vd, while 53.8% used none of these. During the first year, an increase in combined therapies was evident in incident Py users. Conclusions: Our results suggest that, for some MG patients, there may be a need for treatments that combine a rapid onset of benefit with long-term and consistent disease control. These issues may be addressed by the new treatments currently being developed. To date, more studies are needed to address the heterogeneity, quality, and generalizability of the existing data and to evaluate patterns of use, efficacy, and safety of new or emerging therapies for MG.
Beyond the Slopes and Highways: Endovascular Repair of Blunt Traumatic Aortic Injuries after Skiing versus Motor Vehicle Accidents
Authors: Wippel David , Lutz Maximilian , Kluckner Michaela , Gruber Leonhard , Loizides Alexander , Fischer Jennifer , Gizewski Elke R. , Enzmann Florian K. , Wipper Sabine
Published: June 2024

Background: Blunt traumatic aortic injury (BTAI) is a potentially fatal condition, typically resulting from high-velocity trauma. To date, little is known about this type of injury among skiers, who form the largest patient cohort with aortic injuries in the alpine region of Tyrol, Austria. Methods: This retrospective, single-center study at the University Hospital of Innsbruck analyzed patients who underwent endovascular treatment for blunt traumatic aortic injury from 2005 to 2023. Patient data were extracted from electronic and digitalized medical history records. Subsequent analyses compared the baseline characteristics and clinical results of the skiing accident (SA) group to the motor vehicle accident (MVA) group. Results: A total of 48 BTAI patients receiving TEVAR were included, 25 (52%) from SAs versus 23 (48%) from MVAs, who were predominantly male (92% vs. 78.3%). Despite similar preoperative risk profiles and ASA Scores (1.44 vs. 1.74) and no marked differences in BTAI injury grades or the affected aortic zones, significant disparities emerged: the SA group experienced shorter median ICU stays (3 vs. 11 days, p = 0.0007), fewer concomitant injuries (5 vs. 7, p = 0.005), and lower Injury Severity Scores (ISSs) (29 vs. 33, p = 0.003) than their MVA counterparts. The presence of rib fractures alongside other thoracic injuries, such as lung injury, pneumothorax, or hemothorax, was strongly correlated with BTAI in patients following skiing accidents (OR = 128.5). Conclusions: The injury severities and locations of BTAI in SA patients were comparable to those in MVA patients, indicating similar mechanisms of thoracic trauma. However, the SA patients experienced fewer concurrent pelvic and extremity fractures, had less post-procedural morbidity, and required shorter ICU stays. The presence of rib fractures combined with other thoracic injuries strongly suggests BTAI. These indicators should lead to prompt imaging and appropriate therapy.
Carotid Arterial Compliance during Different Intensities of Submaximal Endurance Exercise
Authors: Gurovich Alvaro N. , Montalvo Samuel , Hassan Progga F. , Gomez Manuel
Published: June 2024

Background: The purpose of this investigation was to determine the elastic characteristics of the common carotid artery (CCA) during endurance exercise at 3 different intensities. Methods: Twenty young healthy participants (10 males and 10 females) participated in this quasi-experimental cross-sectional study. Participants were tested in two sessions: (1) we took resting measurements of the elastic characteristics of the CCA and performed a cardiopulmonary exercise test (CPET) on a cycle ergometer to determine submaximal exercise intensities, and we conducted (2) measurements of the elastic characteristics of the CCA while exercising in a cycle ergometer at 3 intensities based on blood lactate levels of low (<2 mmol/L), moderate (2–4 mmol/L), and high (>4 mmol/L). Beta stiffness was calculated using CCA diameters during systole and diastole, measured with high-definition ultrasound imaging, and CCA systolic and diastolic pressures were measured via applanation tonometry. Results: Overall, there were no differences between males and females in terms of any of the studied variables (p > 0.05). In addition, no significant changes were found in the CCA beta stiffness and vessel diameter (p > 0.05) between exercise intensities. There was a significant exercise intensity effect on CCA systolic pressure (p < 0.05), but not on CCA diastolic pressure (p > 0.05). Conclusions: The biomechanical characteristics of the CCA, determined via compliance and beta-stiffness, do not change during cyclical aerobic exercise, regardless of exercise intensity.
Eccentric Muscle Strengthening Using Maximal Contractions Is Deleterious in Knee Osteoarthritis: A Randomized Clinical Trial
Authors: Coudeyre Emmanuel , Pereira Bruno , Lechauve Jean-Baptiste , Girold Sebastien , Richard Ruddy , Dobija Lech , Lanhers Charlotte
Published: June 2024

Objectives: To show the superiority of eccentric versus concentric strengthening in terms of improving quadriceps strength in knee osteoarthritis (OA), a randomized controlled study was conducted to perform 12 sessions of either eccentric or concentric isokinetic muscle strengthening over 6 weeks. Methods: We recruited males and females, aged between 40 and 70 years, with predominantly unilateral femorotibial OA. Exclusion criteria were having a prosthesis, inflammatory arthritis or flare-up of OA, symptomatic patellofemoral OA, cardiovascular or pulmonary disease that could be a contraindication to the study treatment, and any pathology that could cause muscle weakness. The primary endpoint was the between-group difference in change in maximum concentric isokinetic knee extension peak torque (PT) at 60°/s on the OA side at 6 weeks. Secondary endpoints were between-group difference in change in concentric hamstring PT at 60°/s; eccentric quadriceps and hamstring PT at 30°/s; 10 m and 200 m walking speeds; pain and functional status (WOMAC score) at 6 weeks and 6 months. Results: The sample consisted of 11 females and 27 males, with a mean age of 57.7 ± 7.52 years and a body mass index (BMI) of 25.95 ± 3.93 kg/m2. Quadriceps strength increased more at 6 weeks in the concentric than the eccentric group with no statistical difference. There was a rate of 25% major adverse events in the eccentric group. Conclusions: Eccentric training resulted in a smaller improvement in quadriceps strength than concentric training and was associated with a high risk of muscle injury, particularly to the hamstring muscles.
Impact of Cognitive Impairment on Quality of Life in Multiple Sclerosis Patients—A Comprehensive Review
Authors: Gómez-Melero Sara , Caballero-Villarraso Javier , Escribano Begoña Mª , Galvao-Carmona Alejandro , Túnez Isaac , Agüera-Morales Eduardo
Published: June 2024

Multiple sclerosis (MS) is characterized by a variety of symptoms that have a major impact on quality of life (QoL) even in early stages. In addition to individual motor, sensory, visual disturbances, and brainstem and sphincter disorders, which are expressed through the widely used Expanded Disability Status Scale (EDSS), other manifestations of MS have a detrimental effect on overall functioning and quality of life, such as cognitive impairment, depression, anxiety, fatigue, and pain. However, when talking about QoL, categorical definitions cannot be used because although the concept is generally understood, it is highly nuanced. Suffering from MS can significantly reduce QoL. Numerous research studies have focused on trying to identify and assess which are the elements that most affect the loss of QoL in MS people. However, in addition to the fact that the measurement of QoL can be subjective, it is very difficult to consider these elements in isolation, as they are interrelated. One such limiting factor of QoL that has been investigated is cognitive impairment (CI). This has been shown to have an impact on the lives of MS people, although the different approaches that have been taken to assess CI have evident limitations.
Multi-Objective Optimization of Novel Aluminum Welding Fillers Reinforced with Niobium Diboride Nanoparticles
Authors: Calle-Hoyos Andrés F. , Burgos-León Norman A. , Feliciano-Cruz Luisa I. , Florián-Algarín David , Rivera Christian Vázquez , De Jesús-Silva Jorge D. , Suárez Oscar Marcelo
Published: June 2024

New and innovative technologies have expanded the quality and applications of aluminum welding in the maritime, aerospace, and automotive industries. One such technology is the addition of nanoparticles to aluminum matrices, resulting in improved strength, operating temperature, and stiffness. Furthermore, researchers continue to assess pertinent factors that improve the microstructure and mechanical characteristics of aluminum welding by enabling the optimization of the manufacturing process. Hence, this research explores alternatives, namely cost-effective aluminum welding fillers reinforced with niobium diboride nanoparticles. The goal has been to improve weld quality by employing multi-objective optimization, attained through a central composite design with a response surface model. The model considered three factors: the amount (weight percent) of nanoparticles, melt stirring speed, and melt stirring time. Filler hardness and porosity percentage served as response variables. The optimal parameters for manufacturing this novel filler for the processing conditions studied are 2% nanoparticles present in a melt stirred at 750 rpm for 35.2 s. The resulting filler possessed a 687.4 MPA Brinell hardness and low porosity, i.e., 3.9%. Overall, the results prove that the proposed experimental design successfully identified the optimal processing factors for manufacturing novel nanoparticle-reinforced fillers with improved mechanical properties for potential innovative applications across diverse industries.
A Power-Efficient 16-bit 1-MS/s Successive Approximation Register Analog-to-Digital Converter with Digital Calibration in 0.18 μm Complementary Metal Oxide Semiconductor
Authors: He Xinyuan , Qiao Weifeng , Xing Xinpeng , Feng Haigang
Published: June 2024

A power-efficient 16-bit 1-MS/s successive approximation register (SAR) analog-to-digital converter (ADC) is presented in this paper. High-bit sampling makes the bridge capacitance in the digital-to-analog converter (DAC) a unit one, eliminating fractional capacitance mismatch. The high-precision comparator is composed of a four-stage preamplifier and a strong-arm latch, with auto-zeroing used to mitigate input offset further. Digital foreground calibration based on low-bit weight is implemented to correct DAC capacitance mismatch. The post-layout simulation results show that the core ADC achieves 95.61 dB SNDR and 105.1 dB SFDR with calibration, consuming 5.4 mW power under a 3.3 V supply voltage, corresponding to a Schreier figure of merit (FoM) of 175.3 dB. The ADC core area is 1.06 mm2 in the 180 nm CMOS technology.
How Molecular and Ancillary Tests Can Help in Challenging Cytopathology Cases: Insights from the International Molecular Cytopathology Meeting
Authors: Vigliar Elena , Bellevicine Claudio , Acanfora Gennaro , Morales Allan Argueta , Carillo Anna Maria , Cozzolino Domenico , Nacchio Mariantonia , Luca Caterina De , Pisapia Pasquale , Lozano Maria D. , Roy-Chowdhuri Sinchita , Troncone Giancarlo
Published: June 2024

Over the past decade, molecular cytopathology has emerged as a relevant area of modern pathology. Notably, in patients with advanced-stage cancer, cytological samples could be the only material available for diagnosis and molecular biomarker testing to identify patients suitable for targeted therapies. As a result, the contemporary cytopathologist’s role extends beyond morphological assessments to include critical skills such as evaluating the adequacy of the cytological samples and managing these specimens for molecular testing. This case collection can be a valuable source of insight, especially for young pathologists, who should learn to combine the opportunities offered by molecular biology with the basis of morphological evaluation.
Comparison of Long-Term Outcomes in Early-Stage Endometrial Cancer: Robotic Single-Site vs. Multiport Laparoscopic Surgery
Authors: Kang Heeju , Chung Hyewon , Lee Seungmee , Jang Tae-Kyu , Shin So-Jin , Kwon Sang-Hoon , Cho Chi-Heum
Published: June 2024

The purpose of this study was to establish the noninferiority of robotic single-site (RSS) surgery compared with multiport laparoscopic (MPL) surgery in surgical outcomes and overall survival for early endometrial cancer. This study was conducted retrospectively in a single center and included 421 patients who underwent either RSS (n = 146) or MPL (n = 275) surgery between 2014 and 2022. In terms of perioperative outcomes, the RSS group had a longer operating time than the MPL surgery group (mean (standard deviation [SD]) RSS 97.55 [29.79] vs. MPL 85.56 [26.13], p < 0.001). However, no significant differences in estimated blood loss or perioperative complications were found between the groups (p = 0.196 and p = 0.080, respectively). The patients in the RSS group were discharged earlier than those in the MPL group (mean [SD]): 4.06 [3.24] vs. 9.39 [4.76], p < 0.001). Regarding oncologic outcomes, no significant differences in the type of therapy, disease stage, tumor grade, histopathological type, or lymphovascular invasion were found between the groups. No statistically significant differences were found in the disease-free (p = 0.27) and overall survival rates (p = 0.5) either. In conclusion, this study suggests that RSS and MPL surgery are both safe and effective options for staging operations in patients with early-stage endometrial cancer.
The Principle of Proportionality: Unraveling the Practical Application of Proportionality in the EU Regulations and the Solvency II Directive for Insurance Undertakings
Authors: Baldacchino Aaron , Grima Simon , Sood Kiran
Published: June 2024

Proportionality, pivotal to EU regulations and Solvency II, tailors rules to insurers’ size and complexity. Inconsistent application by supervisory authorities (NSAs) necessitates clarity to prevent undue costs. This study examines the issue via a review of the literature and industry discussions, emphasizing Solvency II’s introduction of proportionality and the varied interpretations it evokes. Transparent communication is crucial, and regulatory evolution must align with market dynamics, with the European Insurance and Occupational Pensions Authority (EIOPA) fostering convergence. Assessing proportionality mandates a comprehensive evaluation of an insurer’s nature, scale, and complexity. Regulatory distinctions between first-party and third-party risks could enhance market efficiency. Ultimately, a holistic, market-oriented approach is essential for proportionate regulation in the insurance sector, requiring concerted efforts to elucidate frameworks, foster transparency, and align regulatory evolution with market dynamics.