bluuebunny/crossref_metadata_2025 huggingface dataset:
Advances in Biodegradable Food Packaging Using Wheat-Based Materials: Fabrications and Innovations, Applications, Potentials, and Challenges
Authors: Alibekov Ravshanbek S. , Urazbayeva Klara U. , Azimov Abdugani M. , Rozman Azri Shahir , Hashim Norhashila , Maringgal Bernard
Published: September 2024

This article explores the advancements in biodegradable food packaging materials derived from wheat. Wheat, a predominant global cereal crop, offers a sustainable alternative to conventional single-use plastics through its starch, gluten, and fiber components. This study highlights the fabrication processes of wheat-based materials, including solvent casting and extrusion, and their applications in enhancing the shelf life and quality of packaged foods. Recent innovations demonstrate effectiveness in maintaining food quality, controlling moisture content, and providing microbiological protection. Despite the promising potential, challenges such as moisture content and interfacial adhesion in composites remain. This review concludes with an emphasis on the environmental benefits and future trends in wheat-based packaging materials.
Lactobacilli and Bifidobacteria: A Parapostbiotic Approach to Study and Explain Their Mutual Bioactive Influence
Authors: Altieri Clelia , Filippone Alfonso , Bevilacqua Antonio , Corbo Maria Rosaria , Sinigaglia Milena
Published: September 2024

Three strains of Lactiplantibacillus plantarum and three bifidobacteria (Bifidobacterium animalis subsp. lactis, Bifidobacterium breve, and Bifidobacterium subtile) were used as target strains; in addition, for each microorganism, the cell-free supernatant (CFS) was produced and used as an ingredient of the growth medium. Namely CFSs from lactobacilli were used on bifidobacteria and CFSs from bifidobacteria were used on lactobacilli. The viable count was assessed, and the data were modelled through a reparametrized Gompertz equation cast both in the positive and negative form to evaluate the parameters t-7log, which is the time after which the viable count was 7 log CFU/mL, and the t-7log*, which is the time after which the viable count was below 7 log CFU/mL; the difference between the t-7log* and t-7log defines the stability time. Statistics through a multiparametric ANOVA (analysis of variance) provided evidence for the presence of a bifidogenic and/or bioactive factor produced by bifidobacteria and active on lactobacilli, and vice versa (bioactive factor of lactobacilli with a functional effect on bifidobacteria), although further studies are required to better explain the mechanisms beyond the positive effects. In addition, the influence on the target strains can be found during the growth phase (stimulation), as well as during senescence and death phase (protective effect), with a strong strain/species dependence on both CFS production and target strain.
Effect of Press Cake-Based Particles on Quality and Stability of Plant Oil Emulsions
Authors: Schmid Tamara , Kinner Mathias , Stäheli Luca , Steinegger Stefanie , Hollenstein Lukas , de la Gala David , Müller Nadina
Published: September 2024

Palm fat has uniquely optimal melting characteristics that are difficult to replace in products such as baked goods and chocolate-based items. This study investigates the efficacy of using Pickering emulsions derived from Swiss plant oils and their micromilled press cakes. Emulsification was carried out at both the lab and pilot scales using sunflower- and rapeseed-based recipes, with and without additional surfactants, for both oil-in-water and water-in-oil emulsions. The resulting emulsions were measured for viscosity and short- and long-term stability and linked to the properties of the raw materials. The results indicated that the contact angle, size, and macronutrient composition of the particles significantly impact emulsion quality, though differences in oil pressing methods might predominate these effects. The combination of particles and surfactants demonstrated a clear advantage with respect to interface stabilisation, with a suggested link between the wax content of the oil and particles and the resulting emulsion quality and stability.
Study on the Inhibitory Effect of Bioactive Peptides Derived from Yak Milk Cheese on Cholesterol Esterase
Authors: Wang Peng , Song Xuemei , Liang Qi
Published: September 2024

The bioactive peptides derived from yak milk cheese exhibited cholesterol-lowering properties. However, there was limited research on their inhibitory effects on cholesterol esterase (CE) and elucidation of their potential inhibitory mechanisms. In this study, we identified CE-inhibiting peptides through virtual screening and in vitro assays. Additionally, molecular docking and molecular dynamics studies were conducted to explore the mechanisms. The results indicated that peptides RK7 (RPKHPIK), KQ7 (KVLPVPQ), QP13 (QEPVLGPVRGPFP), TL9 (TPVVVPPFL), VN10 (VYPFPGPIPN), LQ10 (LPPTVMFPPQ), and SN12 (SLVYPFPGPIPN) possessed molecular weights of less than 1.5 kDa and a high proportion of hydrophobic amino acids, demonstrating notable inhibitory effects on CE. Molecular docking and dynamics revealed that peptides RK7, KQ7, QP13, and VN10 bound to key amino acid residues Arg423, His435, and Ser422 of CE through hydrogen bonds, hydrophobic interactions, salt bridges, and π–π stacking, occupying the substrate-binding site and exerting inhibitory effects on CE. The four peptides were further synthesized to verify their CE-inhibitory effects in vitro. RK7, KQ7, QP13, and VN10 exhibited inhibitory activity on CE with IC50 values of 8.16 × 10−7 mol/L, 8.10 × 10−7 mol/L, 4.63 × 10−7 mol/L, and 7.97 × 10−7 mol/L; RK7, KQ7, QP13, and VN10 were effective in inhibiting CE after simulated gastrointestinal digestion, especially with a significant increase in the inhibitory activity of KQ7 and RK7, respectively. Our findings suggested that bioactive peptides from yak milk cheese represented a novel class of potential CE inhibitors.
Simultaneous Determination of Ethanol and Methanol in Wines Using FTIR and PLS Regression
Authors: Thanasi Vasiliki , Caldeira Ilda , Santos Luís , Ricardo-da-Silva Jorge M. , Catarino Sofia
Published: September 2024

Accurate quantification of ethanol and methanol is essential for regulatory compliance and product quality assurance. Fourier Transform Infrared Spectroscopy (FTIR) offers rapid, non-destructive analysis with minimal sample preparation, making it a promising tool for wine analysis. In this exploratory study, the use of FTIR and PLS regression for the simultaneous quantification of ethanol and methanol in wine samples of 11 different Portuguese mono-varietal wines and different vintages deriving from the same winery in Lisbon was investigated. A model was developed, demonstrating the feasibility of FTIR and PLS regression for the simultaneous quantification of ethanol and methanol in wine samples through dedicated models; it showed good prediction capacity for ethanol determination but poorer performance for methanol quantification. The model could be reliable enough for quality control in wine production, but to improve its performance should be enhanced in the future with more samples from different origins, wine types, and a wider concentration range in the case of methanol.
An In-Depth Look at Rising Temperatures: Forecasting with Advanced Time Series Models in Major US Regions
Authors: Kinast Kameron B. , Fokoué Ernest
Published: September 2024

With growing concerns over climate change, accurately predicting temperature trends is crucial for informed decision-making and policy development. In this study, we perform a comprehensive comparative analysis of four advanced time series forecasting models—Autoregressive Integrated Moving Average (ARIMA), Exponential Smoothing (ETS), Multilayer Perceptron (MLP), and Gaussian Processes (GP)—to assess changes in minimum and maximum temperatures across four key regions in the United States. Our analysis includes hyperparameter optimization for each model to ensure peak performance. The results indicate that the MLP model outperforms the other models in terms of accuracy for temperature forecasting. Utilizing this best-performing model, we conduct temperature projections to evaluate the hypothesis that the rates of change in temperatures are greater than zero. Our findings confirm a positive rate of change in both maximum and minimum temperatures, suggesting a consistent upward trend over time. This research underscores the critical importance of refining time series forecasting models to address the challenges posed by climate change and supporting the development of effective strategies to mitigate the impacts of rising temperatures. The insights gained from this work emphasize the need for continuous advancement in predictive modeling techniques to better understand and respond to the dynamics of climate change.
On Newton–Cotes Formula-Type Inequalities for Multiplicative Generalized Convex Functions via Riemann–Liouville Fractional Integrals with Applications to Quadrature Formulas and Computational Analysis
Authors: Mateen Abdul , Özcan Serap , Zhang Zhiyue , Bin-Mohsin Bandar
Published: September 2024

In this article, we develop multiplicative fractional versions of Simpson’s and Newton’s formula-type inequalities for differentiable generalized convex functions with the help of established identities. The main motivation for using generalized convex functions lies in their ability to extend results beyond traditional convex functions, encompassing a broader class of functions, and providing optimal approximations for both lower and upper bounds. These inequalities are very useful in finding the error bounds for the numerical integration formulas in multiplicative calculus. Applying these results to the Quadrature formulas demonstrates their practical utility in numerical integration. Furthermore, numerical analysis provides empirical evidence of the effectiveness of the derived findings. It is also demonstrated that the newly proven inequalities extend certain existing results in the literature.
The Impact of Retrofitting Natural Gas-Fired Power Plants on Carbon Footprint: Converting from Open-Cycle Gas Turbine to Combined-Cycle Gas Turbine
Authors: Matos Denise , Lassio João Gabriel , Garcia Katia Cristina , Raupp Igor , Medeiros Alexandre Mollica , Abreu Juliano Lucas Souza
Published: September 2024

Since retrofitting existing natural gas-fired (NGF) power plants is an essential strategy for enhancing their efficiency and controlling greenhouse gas emissions, this paper compares the carbon footprint of natural gas-fired power generation from an NGF power plant in Brazil (BR-NGF) with and without retrofitting. The former scenario entails retrofitting the BR-NGF power plant with combined-cycle gas turbine (CCGT) technology. In contrast, the latter involves continuing the BR-NGF power plant operation with open-cycle gas turbine (OCGT) technology. Our analysis considers the BR-NGF power plant’s life cycle (construction, operation, and decommissioning) and the natural gas’ life cycle (natural gas extraction and processing, liquefaction, liquefied natural gas transportation, regasification, and combustion). Moreover, it is based on data from primary and secondary sources, mainly the Ecoinvent database and the ReCiPe 2016 method. For OCGT, the results showed that the BR-NGF power plant and the natural gas life cycles are responsible for 620.87 gCO2eq./kWh and 178.58 gCO2eq./kWh, respectively. For CCGT, these values are 450.04 gCO2eq./kWh and 129.30 gCO2eq./kWh. Our findings highlight the relevance of the natural gas’ life cycle, signaling additional opportunities for reducing the overall carbon footprint of natural gas-fired power generation.
Landslide Analysis with Incomplete Data: A Framework for Critical Parameter Estimation
Authors: Guido Lauren , Santi Paul
Published: September 2024

Landslides are one of the most common geohazards, posing significant risks to infrastructure, recreation, and human life. Slope stability analyses rely on detailed data, accurate materials testing, and careful model parameter selection. These factors are not always readily available, and estimations must be made, introducing uncertainty and error to the final slope stability analysis results. The most critical slope stability parameters that are often missing or incompletely constrained include slope topography, depth to water table, depth to failure plane, and material property parameters. Though estimation of these values is common practice, there is limited guidance or best practice instruction for this important step in the analysis. Guidance is provided for the estimation of: original and/or post-failure slope topography via traditional methods as well as the use of open-source digital elevation models, water table depth across variable hydrologic settings, and the iterative estimation of depth to failure plane and slope material properties. Workflows are proposed for the systematic estimation of critical parameters based primarily on slide type and scale. The efficacy of the proposed estimation techniques, uncertainty quantification, and final parameter estimation protocol for data-sparse landslide analysis is demonstrated via application at a landslide in Colorado, USA.
Multipurpose Impacts of Silver Nitrate on Direct Organogenesis of Begonia rex cv. DS-EYWA via Transverse Thin Cell Layering (tTCL) Technique
Authors: Davoudipahnekolayi Mahboubeh , Nezamdoost Darestani Delaram , Mirshahi Homa
Published: September 2024

Begonia rex cv. DS-EYWA is an important plant for indoor and outdoor cultivation, and cv. DS-EYWA is a rare unique cultivar with curly, colorful leaves. Due to their importance, applying plant tissue culture techniques for mass and healthy production in a short period of time without seasonal limitation is of immense economic value. Applying several concentrations of silver nitrate (AgNO3) in combination with varied concentrations of cytokinins including 6-benzylaminopurine (BAP), thidiazuron (TDZ) (0, 0.5, 1, 1.5 mgL−1), and 1-naphthaleneacetic acid (NAA) auxin (0, 0.5, 1 mgL−1) via focusing on transverse thin cell layer (tTCL) petiole explants for high-scale production was used to establish an efficient in vitro propagation protocol. Our results showed that even low concentrations (25 mgL−1) can control internal bacterial infection and increase shoot direct regeneration efficiency. A combination of 1.5 mgL−1 BAP, 0.5 mgL−1 NAA, and 25 mgL−1 AgNO3 was the best treatment to increase the number of direct regenerated shoots, and a lower concentration of BAP (0.5 mgL−1) can be suggested for shoot elongation. Elongated shoots were successfully rooted in MS basal medium and acclimatized in a 1:1 peat moss/perlite sterilized pot mixture.
Profiling Metabolites Distribution among Various Leaf Layers of Chinese Cabbage
Authors: Zhao Yanting , Wang Huasen , Mei Ying , Yue Zhichen , Lei Juanli , Tao Peng , Li Biyuan , Zhao Jianjun , Hu Qizan
Published: September 2024

Chinese cabbage is an important vegetable from both a nutritional and an economic standpoint, with the leafy head serving as the primary harvested organ. However, the nutrient accumulation as well as influencing factors within the leafy head have not yet been elucidated. Thus, the distribution of metabolites (soluble sugars, minerals, carotenoids, vitamin C, flavonoid compounds, glucosinolates, and total phenolic compounds) were investigated in different leaf layers of Chinese cabbage with varying head types. The results showed that the inner leaves consistently displayed markedly higher levels of fructose and glucose when contrasted with the outer leaves. Similarly, there was an accumulation of glucosinolates in the inner leaves. By contrast, however, the antioxidants content exhibited a consistent decline from the outer leaves towards the central core, in line with the diminishing antioxidant capacity. This descending trend was also apparent in the mineral content, encompassing calcium, sodium, magnesium and sulfur. These results will provide dietary instruction, especially for consumers who have particular dietary needs.
Rootstock Effects on Tomato Fruit Composition and Pollinator Preferences in Tomato
Authors: Ormazabal Maialen , Prudencio Ángela S. , Martínez-Melgarejo Purificación A. , Martín-Rodríguez José Ángel , Ruiz-Pérez Laureano , Martínez-Andújar Cristina , Jiménez Antonio R. , Pérez-Alfocea Francisco
Published: September 2024

Food security is threatened by climate change and associated abiotic stresses that affect the flowering stage and the biochemistry of flowers and fruits. In tomato, managed insect pollination and grafting elite tomato varieties onto robust rootstocks are widely practiced commercially to enhance tomato crop profitability, particularly under suboptimal conditions. However, little is known about rootstock–pollinator interactions and their impact on the chemical composition of fruit. In this study, a commercial tomato F1 hybrid (Solanum lycopersicum L.) was self-grafted and grafted onto a set of experimental rootstocks and cultivated under optimal and saline (75 mM NaCl) conditions in the presence of managed bumblebee pollinators (Bombus terrestris). The number of visits (VN) and total visiting time (TVT) by pollinators to different grafted plants were monitored through an RFID (radio-frequency identification) tracking system, while targeted metabolites (hormones, sugars, and organic and amino acids) and mineral composition were analyzed in the fruit juice by UHPLC-MS and ICP-OES, respectively. Pollinator foraging decisions were influenced by the rootstocks genotype and salinity treatment. Experimental rootstocks predominantly increased pollinator attraction compared to the self-grafted variety. Interestingly, the pollinator parameters were positively associated with the concentration of abscisic acid, salicylic acid, malate and fumarate, and tyrosine in salinized fruits. Moreover, a high accumulation of sodium was detected in the fruits of the plants most visited by pollinators, while rootstock genotype-specific responses were found for nitrogen and potassium concentrations. In addition to the known effect on yield, these findings underscore the synergic interactions between rootstocks, pollinators, and environmental stressors on tomato fruit composition.
RNN-Based Monthly Inflow Prediction for Dez Dam in Iran Considering the Effect of Wavelet Pre-Processing and Uncertainty Analysis
Authors: Adib Arash , Pourghasemzadeh Mohammad , Lotfirad Morteza
Published: September 2024

In recent years, deep learning (DL) methods, such as recurrent neural networks (RNN). have been used for streamflow prediction. In this study, the monthly inflow into the Dez Dam reservoir from 1955 to 2018 in southwestern Iran was simulated using various types of RNNs, including long short-term memory (LSTM), bidirectional long short-term memory (Bi-LSTM), gated recurrent unit (GRU), and stacked long short-term memory (Stacked LSTM). It was observed that considering flow discharge, temperature, and precipitation as inputs to the models yields the best results. Additionally, wavelet transform was employed to enhance the accuracy of the RNNs. Among the RNNs, the GRU model exhibited the best performance in simulating monthly streamflow without using wavelet transform, with RMSE, MAE, NSE, and R2 values of 0.061 m3/s, 0.038 m3/s, 0.556, and 0.642, respectively. Moreover, in the case of using wavelet transform, the Bi-LSTM model with db5 mother wavelet and decomposition level 5 was able to simulate the monthly streamflow with high accuracy, yielding RMSE, MAE, NSE, and R2 values of 0.014 m3/s, 0.008 m3/s, 0.9983, and 0.9981, respectively. Uncertainty analysis was conducted for the two mentioned superior models. To quantify the uncertainty, the concept of the 95 percent prediction uncertainty (95PPU) and the p-factor and r-factor criteria were utilized. For the GRU, the p-factor and r-factor values were 82% and 1.28, respectively. For the Bi-LSTM model, the p-factor and r-factor values were 94% and 1.06, respectively. The obtained p-factor and r-factor values for both models are within the acceptable and reliable range.
Epidemic and Pandemic Preparedness and Response in a Multi-Hazard Context: COVID-19 Pandemic as a Point of Reference
Authors: Kamalrathne Thushara , Amaratunga Dilanthi , Haigh Richard , Kodituwakku Lahiru , Rupasinghe Chintha
Published: September 2024

Infectious diseases manifesting in the form of epidemics or pandemics do not only cause devastating impacts on public health systems but also disrupt the functioning of the socio-economic structure. Further, risks associated with pandemics and epidemics become exacerbated with coincident compound hazards. This study aims to develop a framework that captures key elements and components of epidemic and pandemic preparedness and response systems, focusing on a multi-hazard context. A systematic literature review was used to collect data through peer-reviewed journal articles using three electronic databases, and 17 experts were involved in the validation. Epidemiological surveillance and early detection, risk and vulnerability assessments, preparedness, prediction and decision making, alerts and early warning, preventive strategies, control and mitigation, response, and elimination were identified as key elements associated with epidemic and pandemic preparedness and response systems in a multi-hazard context. All elements appear integrated within three interventional phases: upstream, interface, and downstream. A holistic approach focusing on all interventional phases is required for preparedness and response to pandemics and epidemics to counter their cascading and systemic effects. Further, a paradigm shift in the preparedness for multi-hazards during an epidemic or pandemic is essential due to the multiple challenges posed by concurrent hazards.
Enzymatic Methoxycarbonylation of Tyrosol and Hydroxytyrosol
Authors: Černáková Lucia , Macková Michaela , Klempová Tatiana , Haluz Peter , Mastihuba Vladimír , Mastihubová Mária
Published: September 2024

Tyrosol and hydroxytyrosol are powerful phenolic antioxidants occurring in olive oil and in by-products from olive processing. Due to their high polarity, esterification or other lipophilization is necessary to make them compatible with lipid matrices. Hydroxytyrosol methyl carbonate is a more effective antioxidant than dibutylhydroxytoluene or α-tocopherol and together with tyrosol methyl carbonate exerts interesting pharmacological properties. The purpose of this work was the enzymatic preparation of alkyl carbonates of tyrosol and hydroxytyrosol. A set of 17 hydrolases was tested in the catalysis of tyrosol methoxycarbonylation in neat dimethyl carbonate to find an economically feasible alternative to the recently reported synthesis of methyl carbonates catalyzed by Novozym 435. Novozym 435 was, however, found to be the best performing catalyst, while Novozym 735, pig pancreatic lipase, lipase F-AK and Lipex 100T exhibited limited reactivity. No enzyme accepted 1,2-propylene carbonate as the acylation donor. Under optimized reaction conditions, Novozym 435 was used in the batch preparation of tyrosol methyl carbonate and hydroxytyrosol methyl carbonate in quantitative yields. The enzymatic methoxycarbonylation of tyrosol and hydroxytyrosol can also be used as a method for their selective protection in enzymatic syntheses of phenylethanoid glycosides catalyzed with enzymes comprising high levels of acetyl esterase side activity.
Tissue Kallikrein-1 Suppresses Type I Interferon Responses and Reduces Depressive-Like Behavior in the MRL/lpr Lupus-Prone Mouse Model
Authors: Bhoj Priyanka S. , Nocito Cassandra , Togre Namdev S. , Winfield Malika , Lubinsky Cody , Khan Sabeeya , Mogadala Nikhita , Seliga Alecia , Unterwald Ellen M. , Persidsky Yuri , Sriram Uma
Published: September 2024

Excessive production and response to Type I interferons (IFNs) is a hallmark of systemic lupus erythematosus (SLE). Neuropsychiatric lupus (NPSLE) is a common manifestation of human SLE, with major depression as the most common presentation. Clinical studies have demonstrated that IFNα can cause depressive symptoms. We have shown that the kallikrein–kinin system (KKS) [comprised of kallikreins (Klks) and bradykinins] and angiotensin-converting enzyme inhibitors suppressed Type I IFN responses in dendritic cells from lupus-prone mice and human peripheral blood mononuclear cells. Tissue Klk genes are decreased in patients with lupus, and giving exogenous Klk1 ameliorated kidney pathology in mice. We retro-orbitally administered mouse klk1 gene-carrying adenovirus in the Murphy Roths Large lymphoproliferative (MRL/lpr) lupus-prone mice at early disease onset and analyzed immune responses and depressive-like behavior. Klk1 improved depressive-like behavior, suppressed interferon-responsive genes and neuroinflammation, and reduced plasma IFNα levels and proinflammatory cytokines. Klk1 also reduced IFNAR1 and JAK1 protein expression, important upstream molecules in Type I IFN signaling. Klk1 reduced bradykinin B1 receptor expression, which is known to induce proinflammatory response. Together, these findings suggest that Klk1 may be a potential therapeutic candidate to control IFNα production/responses and other inflammatory responses in SLE and NPSLE.
Predicting Mutation-Induced Allosteric Changes in Structures and Conformational Ensembles of the ABL Kinase Using AlphaFold2 Adaptations with Alanine Sequence Scanning
Authors: Raisinghani Nishank , Alshahrani Mohammed , Gupta Grace , Verkhivker Gennady
Published: September 2024

Despite the success of AlphaFold2 approaches in predicting single protein structures, these methods showed intrinsic limitations in predicting multiple functional conformations of allosteric proteins and have been challenged to accurately capture the effects of single point mutations that induced significant structural changes. We examined several implementations of AlphaFold2 methods to predict conformational ensembles for state-switching mutants of the ABL kinase. The results revealed that a combination of randomized alanine sequence masking with shallow multiple sequence alignment subsampling can significantly expand the conformational diversity of the predicted structural ensembles and capture shifts in populations of the active and inactive ABL states. Consistent with the NMR experiments, the predicted conformational ensembles for M309L/L320I and M309L/H415P ABL mutants that perturb the regulatory spine networks featured the increased population of the fully closed inactive state. The proposed adaptation of AlphaFold can reproduce the experimentally observed mutation-induced redistributions in the relative populations of the active and inactive ABL states and capture the effects of regulatory mutations on allosteric structural rearrangements of the kinase domain. The ensemble-based network analysis complemented AlphaFold predictions by revealing allosteric hotspots that correspond to state-switching mutational sites which may explain the global effect of regulatory mutations on structural changes between the ABL states. This study suggested that attention-based learning of long-range dependencies between sequence positions in homologous folds and deciphering patterns of allosteric interactions may further augment the predictive abilities of AlphaFold methods for modeling of alternative protein sates, conformational ensembles and mutation-induced structural transformations.
Advancements in the Diagnosis and Treatment of Hypertrophic Cardiomyopathy: A Comprehensive Review
Authors: Gill Randeep , Siddiqui Arsalan , Yee Brianna , DiCaro Michael V. , Houshmand Nazanin , Tak Tahir
Published: September 2024

Hypertrophic cardiomyopathy (HCM) is characterized by excessive growth of myocardial tissue, most commonly due to genetic mutations in sarcomere proteins. This can lead to complications such as heart failure, mitral regurgitation, syncope, arrhythmias, sudden cardiac death, and myocardial ischemia. While we have come a long way in our understanding of the pathophysiology, genetics, and epidemiology of HCM, the past 10 years have seen significant advancements in diagnosis and treatment. As the body of evidence on hypertrophic cardiomyopathy continues to grow, a comprehensive review of the current literature is an invaluable resource in organizing this knowledge. By doing so, the vast progress that has been made thus far will be widely available to all experts in the field. This review provides a comprehensive analysis of the scientific literature, exploring both well-established and cutting-edge diagnostic and therapeutic options. It also presents a unique perspective by incorporating topics such as exercise testing, genetic testing, radiofrequency ablation, risk stratification, and symptomatic management in non-obstructive HCM. Lastly, this review highlights areas where current and future research is at the forefront of innovation in hypertrophic cardiomyopathy.
Symptom Burden in Patients on Maintenance Hemodialysis: Prevalence and Severity 17 Years Apart
Authors: Bossola Maurizio , Mariani Ilaria , Piccinni Carlo Pasquale , Spoliti Claudia , Di Stasio Enrico
Published: September 2024

Objectives: The aim of this study is to compare data from two cohorts separated by a 17-year interval. We assessed the prevalence and severity of symptoms with the “dialysis symptom index” in these two groups, recruited in 2007 and 2024, to determine how advancements in dialysis therapy have influenced the symptom burden’s prevalence and severity. Methods: End-stage renal diseases patients receiving maintenance hemodialysis three times a week in the hemodialysis unit of the university hospital were recruited between February and March 2007. In May 2024, in the same unit, another population sample was recruited and studied, as in 2007. The Dialysis Symptom Index (DSI) was administered to each patient, during the dialysis treatment. The DSI is made up of 30 questions, each of which addresses a specific physical or emotional symptom. The total symptom burden score, representing the total number of symptoms reported as being present, and the total symptom severity score, which represents the sum of individual severity scores, were generated for each patient. Results: We studied 71 patients in 2007 and 61 patients in 2024. The demographic, clinical and laboratory characteristics of the two study populations did not differ significantly. The total symptom burden score did not differ significantly between 2007 and 2024. The prevalence of most symptoms was similar in the two groups. The prevalence of constipation, decreased interest in sex and difficulty in becoming sexually aroused was higher in 2024 than in 2007. The total symptom severity was similar in the two periods. The severity of most symptoms was similar in the two groups. The severity of decreased interest in sex and difficulty in becoming sexually aroused was higher in 2024 than in 2007. Conclusions: The present study shows that, 17 years apart, the prevalence and severity of the symptom burden in patients on maintenance hemodialysis did not change significantly. These results suggest that studies investigating the causes and the pathogenesis of symptoms of patients on maintenance hemodialysis are urgently needed in the next future, as well as studies on therapeutic strategies.
Epicardial Fat in Heart Failure with Preserved Ejection Fraction Compared with Reduced Ejection Fraction
Authors: Sidhu Gurwinder S. , Rabkin Simon W.
Published: September 2024

Background: The role of epicardial adipose tissue (EAT) in heart failure with preserved ejection fraction (HFpEF) remains to be defined. Methods: A consecutive series of outpatients with chronic heart failure—heart failure with reduced ejection fraction (HFrEF) and HFpEF and/or diastolic dysfunction—had EAT assessed by echocardiographic measurement and related to indices of cardiac structure and function. Results: Epicardial fat thickness was significantly (p < 0.05) greater in HFpEF (N = 141) with a mean of 6.7 ± 1.6 mm compared with a mean of 5.1 ± 1.0 mm in HFrEF (n = 40). After adjusting for the relationship with BMI, in HFpEF, epicardial fat was significantly (p < 0.05) negatively correlated with left ventricular internal diameter end diastole (LVIDd), left ventricular internal diameter end systole (LVIDs), left ventricular (LV) end-diastolic volume (EDV) index, lateral e’, septal e’, right atrial (RA) volume index, and hemoglobin (Hgb). The association with Hgb was no longer significant after adjusting for the effect of age. HFpEF was associated with smaller LVIDd, LVIDs, LV EDV indexes, and left atrial (LA) and RA volume indexes. Conclusions: Epicardial fat is significantly (p < 0.05) greater in HFpEF than HFrEF. Epicardial fat is associated with smaller cardiac chamber sizes in HFpEF suggesting that epicardial fat acts as a constraint to cardiac dilation.
Measles—Clinical and Biological Manifestations in Adult Patients, Including a Focus on the Hepatic Involvement: Results from a Single-Center Observational Cohort Study from Romania
Authors: Bîrluțiu Victoria , Bîrluțiu Rares-Mircea
Published: September 2024

Background: Hepatic involvement in measles, particularly among adolescents and adults, has been recognized since 1960. This involvement typically manifests during the eruptive phase of the disease and is primarily characterized by hepatocellular dysfunction, with jaundice being a less common occurrence. Studies have reported hepatic involvement in 80–86% of measles cases among young adults associated with severe forms of the disease with intra-infectious hepatitis. Recent data from Romania indicated 20,035 confirmed measles cases between January and June 2024, including 17 fatalities and significant hepatic alterations. These findings underscore the need for the further investigation of the hepatic manifestations of measles. The primary objective of our study was to evaluate the clinical and baseline characteristics of the enrolled patients with a brief assessment of liver impairment. Methods: In light of these observations, we conducted a retrospective analysis between 1 November 2023 and 15 June 2024 in patients aged >16 years who were confirmed, by the detection of measles IgM in serum samples, to have acute measles infection and hospitalization. Results: During the study period, 71 hospitalized patients were diagnosed with measles, of whom 37 were female (52.1%), with ages ranging from 16 to 64 years (mean age 34.21 years). Most cases (77.5%) exhibited moderate clinical forms of measles, while 22.5% had severe forms. Respiratory failure requiring oxygen therapy was uncommon (25.4% of severe pneumonia cases). Although a Pearson chi-square test indicated no significant association between the presence of pneumonia and clinical form (p = 0.066), the likelihood ratio test suggested a potential link (p = 0.018). Hepatic involvement was common with elevated AST (87.3%) and ALT (76%) levels. Jaundice was observed in 12.7% of patients. GGT changes were noted in 35.2% of cases, with significant correlations between GGT levels and disease severity (p = 0.001). Analysis of various symptoms revealed significant associations between nausea, dyspnea, and severe clinical forms. Anorexia, diarrhea, and nausea were the most frequently reported symptoms. Thrombocytopenia was observed in 11 patients, with no significant correlation with disease severity. Comorbidities, such as COPD, were significantly associated with disease severity (p = 0.010). Conclusions: Our findings highlight that, while cytolytic hepatic damage is a typical response to measles infection, cholestatic involvement may serve as an indicator of more severe disease progression.
Features and Limitations of Robotically Assisted Percutaneous Coronary Intervention (R-PCI): A Systematic Review of R-PCI
Authors: Wagener Max , Onuma Yoshinobu , Sharif Ruth , Coen Eileen , Wijns William , Sharif Faisal
Published: September 2024

Background: Ischaemic heart disease is one of the major drivers of cardiovascular death in Europe. Since the first percutaneous coronary intervention (PCI) in 1977, developments and innovations in cardiology have made PCI the treatment of choice for stenotic coronary artery disease. To address the occupational hazards related to chronic exposure to radiation and wear and tear from heavy lead-based radioprotective aprons, the concept of robotically assisted PCI (R-PCI) was introduced in 2005. Aim: To explore the features and limitations of R-PCI, we first discuss the concept and evolution of R-PCI platforms and then systematically review the available clinical data. Methods: A systematic review has been performed across the Pubmed, Embase and Cochrane databases in order to assess the efficacy and safety of R-PCI. Secondary endpoints, such as operator and patient exposure to radiation, contrast volume used and procedural time, were assessed when available. Results: In selected patients, R-PCI provides high technical and clinical success rates, ranging from 81 to 98.8% and from 93.3 to 100%, respectively. In-hospital and 1-year MACE rates ranged from 0 to 10.4% and 4.8 to 10.5%, respectively. R-PCI is able to significantly reduce the operator’s exposure to radiation. Further research analysing the patient’s and cath lab staff’s exposure to radiation is needed. Therapy escalation with R-PCI seems to be limited to complex lesions. R-PCI procedures add approximately 10 min to the procedural time. Conclusions: The efficacy and safety of R-PCI have been proven, and R-PCI is able to significantly reduce occupational hazards for the first operator. The lack of adoption in the community of interventional cardiologists may be explained by the fact that current generations of R-PCI platforms are limited by their incompatibility with advanced interventional devices and techniques needed for escalation in complex interventions.
Multifocal Electroretinography Changes after UBX1325 (Foselutoclax) Treatment in Neovascular Age-Related Macular Degeneration
Authors: Macha Nathan , Yu Minzhong , Sapieha Przemyslaw , Klier Sharon , Ghosh Anirvan , White Lorraine , Maturi Raj K.
Published: September 2024

Background/Objectives: The objective of this study was to determine the treatment effect of foselutoclax in neovascular age-related macular degeneration (AMD) by multifocal electroretinography (mfERG) and evaluate mfERG as a potential clinical endpoint in AMD studies. Methods: A total of five subjects were included in the study who had active choroidal neovascularization and a history of at least two anti-vascular endothelial growth factor (VEGF) injections in the last 6 months. Subjects received a 50 µL intravitreal injection of foselutoclax at the baseline visit and Weeks 4, 24, and 28 of the study period. Results: After foselutoclax treatment, the largest improvement in the mfERG N1-P1 response density occurred at Week 8 as three of five subjects achieved a ≥20% gain. In addition, three of five subjects demonstrated a BCVA improvement of ≥5 ETDRS letters over baseline at Weeks 4, 8, and 24. The mean change in BCVA demonstrated statistical significance in Weeks 4 and 8, showing increases of 5 (p = 0.02) and 6.2 (p = 0.02) letters, respectively. Conclusions: Foselutoclax treatment was shown to have the potential to recover outer retinal function as determined by mfERG and BCVA at approximately Week 8 of treatment.
Glucose-Lowering Drugs with Proven Cardiovascular Benefit Following Acute Coronary Syndrome in Patients with Type 2 Diabetes: Treatment Gaps and Outcomes
Authors: Naoum Ibrahim , Saliba Walid , Barnett-Griness Ofra , Aker Amir , Zafrir Barak
Published: September 2024

Background: Real-world data on the implementation and prognostic impact of glucose-lowering drugs with proven cardiovascular benefits in patients with type 2 diabetes (T2D) following acute coronary syndrome (ACS) are limited. We investigated the utilization and treatment patterns of sodium–glucose contrasporter-2 inhibitors (SGLT2Is) and glucagon-like peptide-1 recepto-agonists (GLP1RAs) in patients with T2D experiencing ACS and analyzed their association with mortality and major adverse cardiovascular events (MACEs) including recurrent ACS, acute revascularization, heart failure, or ischemic stroke. Methods: We carried out a retrospective analysis of 9756 patients with T2D from a nationwide healthcare organization in Israel who were hospitalized with ACS between 01/2019 and 01/2022. Drug prescriptions were estimated pre-hospitalization, 90 days, and 1 year following hospitalization. The association between SGLT2I and/or GLP1RA treatment with MACE and mortality was investigated using a time-dependent Cox regression analysis with multivariable adjustment. Results: The prescription rates (pre-hospitalization, 90 days, and 1 year post-hospitalization) of GLP1RAs were 13%, 13.2%, and 18%, and those of SGLT2Is were 23.9%, 33.6%, and 42.7%, respectively. At 1 year, 13.9% of patients were prescribed both treatments. The use of SGLT2Is and/or GLP1RAs was higher in younger age groups and increased from 2019 to 2021 (38.1% to 59.2%). The adjusted hazard ratio for the association of pre- or post-hospitalization SGLT2I and/or GLP1RA treatment with mortality and MACE was 0.724 (0.654–0.801) and 0.974 (0.909–1.043), respectively. Conclusions: In the real-world practice of treating patients with T2D experiencing ACS, the implementation of SGLT2Is, particularly GLP1RAs, was suboptimal when prescribed both early and 1 year following hospitalization, emphasizing the need to improve medical care. Treatment with SGLT2Is and/or GLP1RAs was associated with a favorable impact on mortality but not MACE.
Fatigue Assessment in Patients with Hereditary Hemochromatosis: First Use of the Popular Diagnostic Tools
Authors: Świątczak Michał , Raczak Alicja , Świątczak Agata , Młodziński Krzysztof , Sikorska Katarzyna , Jaźwińska Anna , Kaufmann Damian , Daniłowicz-Szymanowicz Ludmiła
Published: September 2024

Background: Hereditary hemochromatosis (HH) is a genetic condition with fatigue as an essential but not precisely assessed symptom. While some well-specified scales for fatigue assessment in some pathologies exist, data on their usefulness in HH need to be collected. This research aimed to evaluate fatigue in HH using the Fatigue Assessment Scale (FAS), Fatigue Severity Scale (FSS), and Chalder Fatigue Scale (CFQ). Methodology: Seventy-nine HH patients underwent a questionnaire containing items about detailed medical history and the FAS, FSS, and CFQ scales. Twenty-five sex- and age-matched healthy persons constituted the control group (controls); additionally, thirty blood donors (donors) were compared. Results: The fatigue indices were significantly worse in the HH patients than in the controls and donors (HH vs. controls p-value: FAS = 0.003, FSS < 0.001, and CFQ = 0.003; HH vs. donors p-value: FAS = 0.025, FSS < 0.001, and CFQ = 0.041). There were no differences between the severity of fatigue and the specific genotype or the age of the patients. The HH women presented more severe fatigue than the men. High internal consistency and reliability for each scale were revealed: the Cronbach alpha values were as follows: FAS 0.92, FSS 0.95, and CFQ 0.93. Additionally, the construct validity and factorial validity of the implemented scales were confirmed. Conclusions: The HH patients exhibited significantly worse fatigue across all the scales. The FAS, FSS, and CFQ are simple and reliable diagnostic tools for assessing and quantifying fatigue for clinical and research purposes.
Effects of Home-Based Daily Respiratory Muscle Training on Swallowing Outcomes in Patients with Chronic Stroke: Protocol for a Randomized Controlled Trial
Authors: Zapata-Soria Mónica , Cabrera-Martos Irene , Heredia-Ciuró Alejandro , Prados-Román Esther , Martín-Nuñez Javier , Valenza Marie Carmen
Published: September 2024

(1) Background: Swallowing disorders are common following a stroke. This study aims to evaluate the effects of a home-based daily intervention focused on inspiratory and expiratory muscle training on swallowing outcomes in patients with chronic stroke. (2) Methods: This manuscript presents the protocol of a single-blind randomized clinical trial. Patients with chronic stroke will be randomly assigned to either an experimental or a control group. The experimental group will undergo daily home-based respiratory muscle training in addition to standard speech and language therapy, while the control group will receive only the standard intervention. The main outcome measures will include the aspiration risk, the strength of respiratory muscles, and peak cough flow. (3) Results: It is hypothesized that patients receiving home-based respiratory training in addition to standard therapy will achieve significant improvements in aspiration risk, respiratory muscle strength, and cough efficacy in comparison with those included in the control group. The results will be published as a manuscript. (4) Conclusions: This study aims to provide evidence on the effectiveness of home-based respiratory muscle training in enhancing swallowing function and respiratory parameters in patients with chronic stroke.
Cardiac Arrest Due to Perioperative Anaphylactic Shock Induced by Re-Exposure to Propofol: A Case Report
Authors: Joo Jin , Koh Hyun Jung
Published: September 2024

Anaphylaxis is a potentially life-threatening systemic allergic reaction that can result in fatal outcomes if not promptly and appropriately treated. The diagnosis of the cause of anaphylaxis during anesthesia can be challenging due to the complexity of the perioperative environment. Propofol-induced perioperative anaphylaxis is uncommon, occurring in perioperative anaphylactic shock cases. We present a case of perioperative anaphylactic shock in a patient with no known allergies who had been exposed to the same anesthetic agents, propofol, rocuronium, and remifentanil, three times previously without incident. Cardiac arrest occurred 50 min after induction, which showed pulseless electrical activity with decreasing saturation without bronchial spasm and skin erythema or edema. After prompt and appropriate management including cardiopulmonary resuscitation, the patient recovered without complications. The diagnosis was confirmed as propofol-induced anaphylactic shock by an elevated serum tryptase level, measured in a timely manner, and by skin tests (skin prick test and intradermal test), which revealed strong hypersensitivity to propofol. This case is notable for the cardiovascular collapse that occurred without respiratory symptoms or skin manifestations, as well as the delayed onset of anaphylaxis (>50 min). This case underscores the importance of vigilance for anaphylaxis, even with repeated exposure to previously well-tolerated drugs, as sensitization can lead to more severe reactions. It also highlights the potential for anaphylaxis to occur outside the acute phase and without typical clinical features.
Endocrine Disruptors in Pregnancy: Effects on Mothers and Fetuses—A Review
Authors: Hajjar Rima , Hatoum Sana , Mattar Serge , Moawad Gaby , Ayoubi Jean Marc , Feki Anis , Ghulmiyyah Labib
Published: September 2024

Background/Objectives: Endocrine disruptors are ubiquitous agents in the environment and are present in everyday consumer products. These agents can interfere with the endocrine system, and subsequently the reproductive system, especially in pregnancy. An increasing number of studies have been conducted to discover and describe the health effects of these agents on humans, including pregnant women, their fetuses, and the placenta. This review discusses prenatal exposure to various endocrine disruptors, focusing on bisphenols, phthalates, organophosphates, and perfluoroalkyl substances, and their effects on pregnancy and fetal development. Methods: We reviewed the literature via the PubMed and EBSCO databases and included the most relevant studies. Results: Our findings revealed that several negative health outcomes were linked to endocrine disruptors. However, despite the seriousness of this topic and the abundance of research on these agents, it remains challenging to draw strong conclusions about their effects from the available studies. This does not allow for strong, universal guidelines and might result in poor patient counseling and heterogeneous approaches to regulating endocrine disruptors. Conclusions: The seriousness of this matter calls for urgent efforts, and more studies are needed in this realm, to protect pregnant patients, and ultimately, in the long term, society.