bluuebunny/crossref_metadata_2025 huggingface dataset:
Three-Dimensional-Bioprinted Non-Small Cell Lung Cancer Models in a Mouse Phantom for Radiotherapy Research
Authors: Mei Yikun , Lakotsenina Elena , Wegner Marie , Hehne Timon , Krause Dieter , Hakimeh Dani , Wu Dongwei , Schültke Elisabeth , Hausmann Franziska , Kurreck Jens , Tolksdorf Beatrice
Published: September 2024

Lung cancer continues to have one of the highest morbidity and mortality rates of any cancer. Although radiochemotherapy, in combination with immunotherapy, has significantly improved overall survival, new treatment options are urgently needed. However, preclinical radiotherapy testing is often performed in animal models, which has several drawbacks, including species-specific differences and ethical concerns. To replace animal models, this study used a micro-extrusion bioprinting approach to generate a three-dimensional (3D) human lung cancer model consisting of lung tumor cells embedded in human primary lung fibroblasts for radiotherapy research. The models were placed in a mouse phantom, i.e., a 3D-printed mouse model made of materials that mimic the X-ray radiation attenuation rates found in mice. In radiotherapy experiments, the model demonstrated a selective cytotoxic effect of X-rays on tumor cells, consistent with findings in 2D cells. Furthermore, the analysis of metabolic activity, cell death, apoptosis, and DNA damage-induced γH2AX foci formation revealed different results in the 3D model inside the phantom compared to those observed in irradiated models without phantom and 2D cells. The proposed setup of the bioprinted 3D lung model inside the mouse phantom provides a physiologically relevant model system to study radiation effects.
Polymyxin B Peptide Hydrogel Coating: A Novel Approach to Prevent Ventilator-Associated Pneumonia
Authors: Wouters Milan , Van Moll Laurence , De Vooght Linda , Choińska Emilia , Idaszek Joanna , Szlązak Karol , Heljak Marcin K. , Święszkowski Wojciech , Cos Paul
Published: September 2024

Ventilator-associated pneumonia (VAP) remains one of the most common hospital-acquired infections (HAI). Considering the complicated diagnosis and the lack of effective treatment, prophylactic measures are suggested as the new standard to prevent the disease. Although VAP often manifests a polymicrobial nature, Pseudomonas aeruginosa remains one of the pathogens associated with the highest morbidity and mortality rates within these mechanically ventilated patients. In this paper, we report on the development of an antibacterial hydrogel coating using the polymyxin B (PMB) peptide to prevent bacterial adhesion to the polymeric substrate. We fully characterized the properties of the coating using atomic force microscopy (AFM), scanning electron microscopy (SEM), wettability analyses and Fourier-transform infrared (FTIR) and Raman spectroscopy. Furthermore, several biological assays confirmed the antibacterial and anti-biofilm effect of the tubing for at least 8 days against P. aeruginosa. On top of that, the produced coating is compliant with the requirements regarding cytocompatibility stated in the ISO (International Organization for Standardization) 10993 guidelines and an extended release of PMB over a period of at least 42 days was detected. In conclusion, this study serves as a foundation for peptide-releasing hydrogel formulas in the prevention of VAP.
Germline DNA Damage Repair Gene Alterations in Patients with Metachronous Breast and Colorectal Cancer
Authors: Villacis Rolando André Rios , Côrtes Luiza , Basso Tatiane Ramos , do Canto Luisa Matos , Souza Jeferson Santos , Aagaard Mads Malik , da Cruz Formiga Maria Nirvana , Aguiar Samuel , Achatz Maria Isabel , Rogatto Silvia Regina
Published: September 2024

A hereditary component of breast (BC) and colorectal cancer (CRC) has been described in approximately one-third of these tumor types. BC patients have an increased risk of developing CRC as a second primary tumor and vice versa. Germline genomic variants (NextSeq550, Illumina) were investigated in 24 unrelated BC and/or CRC patients and 7 relatives from 3 index patients. Fifty-six pathogenic or likely pathogenic variants were identified in 19 of 24 patients. We detected single-nucleotide variants (SNVs) in CRC predisposition genes (MLH1 and MUTYH) and other promising candidates (CDK5RAP3, MAD1L1, NOS3, and POLM). Eighteen patients presented SNVs or copy number variants (CNVs) in DNA damage repair genes. We also identified SNVs recently associated with BC or CRC predisposition (PABPC1, TYRO3, MAP3K1, SLC15A4, and LAMA1). The PABPC1c.1255C>T variant was detected in nine unrelated patients. Each patient presented at least one SNV/CNV in a candidate gene, and most had alterations in more than one gene, reinforcing a polygenic model for BC/CRC predisposition. A significant fraction of BC/CRC patients with a family history of these tumors harbored deleterious germline variants in DNA repair genes. Our findings can lead to strategies to improve the diagnosis, genetic counseling, and treatment of patients and their relatives.
Assessing Biomarkers of Porcine Kidneys under Normothermic Machine Perfusion—Can We Gain Insight into a Marginal Organ?
Authors: Steinhauser Carla , Yakac Abdulbaki , Markgraf Wenke , Kromnik Susanne , Döcke Andreas , Talhofer Philipp , Thiele Christine , Malberg Hagen , Sommer Ulrich , Baretton Gustavo B. , Füssel Susanne , Thomas Christian , Putz Juliane
Published: September 2024

To identify potentially transplantable organs in a pool of marginal kidneys, 33 porcine slaughterhouse kidneys were perfused for 4 h with whole blood. During the normothermic perfusion, plasma, urine, and tissue samples were taken. Several biomarkers for tubule injury, endothelial activation, and inflammatory response were evaluated for a potential correlation with macroscopic appearance, histology, and filtration activity. Generally, biomarker levels increased during perfusion. TLR-4, EDN-1, and NGAL were not associated with any classification. In contrast, a steeper increase in NAG and IL-6 in plasma correlated with a poor macroscopic appearance at 4 h, indicating a higher inflammatory response in the kidneys with worse macroscopy early on, potentially due to more damage at the tubules. Although long-term effects on the graft could not be assessed in this setting, early observation under machine perfusion with whole blood was feasible. It allowed the assessment of kidneys under conditions comparable to reperfusion. This setting could give surgeons further insight into the quality of marginal kidneys and an opportunity to pre-treat them.
Methamphetamine-Induced Blood Pressure Sensitization Correlates with Morphological Alterations within A1/C1 Catecholamine Neurons
Authors: Busceti Carla Letizia , Bucci Domenico , Damato Antonio , De Lucia Massimiliano , Venturini Eleonora , Ferrucci Michela , Lazzeri Gloria , Puglisi-Allegra Stefano , Scioli Mariarosaria , Carrizzo Albino , Nicoletti Ferdinando , Vecchione Carmine , Fornai Francesco
Published: September 2024

Methamphetamine (METH) is a drug of abuse, which induces behavioral sensitization following repeated doses. Since METH alters blood pressure, in the present study we assessed whether systolic and diastolic blood pressure (SBP and DBP, respectively) are sensitized as well. In this context, we investigated whether alterations develop within A1/C1 neurons in the vasomotor center. C57Bl/6J male mice were administered METH (5 mg/kg, daily for 5 consecutive days). Blood pressure was measured by tail-cuff plethysmography. We found a sensitized response both to SBP and DBP, along with a significant decrease of catecholamine neurons within A1/C1 (both in the rostral and caudal ventrolateral medulla), while no changes were detected in glutamic acid decarboxylase. The decrease of catecholamine neurons was neither associated with the appearance of degeneration-related marker Fluoro-Jade B nor with altered expression of α-synuclein. Rather, it was associated with reduced free radicals and phospho-cJun and increased heat shock protein-70 and p62/sequestosome within A1/C1 cells. Blood pressure sensitization was not associated with altered arterial reactivity. These data indicate that reiterated METH administration may increase blood pressure persistently and may predispose to an increased cardiovascular response to METH. These data may be relevant to explain cardiovascular events following METH administration and stressful conditions.
Smart Collaborative Intrusion Detection System for Securing Vehicular Networks Using Ensemble Machine Learning Model
Authors: El-Gayar Mostafa Mahmoud , Alrslani Faheed A. F. , El-Sappagh Shaker
Published: September 2024

The advent of the Fourth Industrial Revolution has positioned the Internet of Things as a pivotal force in intelligent vehicles. With the source of vehicle-to-everything (V2X), Internet of Things (IoT) networks, and inter-vehicle communication, intelligent connected vehicles are at the forefront of this transformation, leading to complex vehicular networks that are crucial yet susceptible to cyber threats. The complexity and openness of these networks expose them to a plethora of cyber-attacks, from passive eavesdropping to active disruptions like Denial of Service and Sybil attacks. These not only compromise the safety and efficiency of vehicular networks but also pose a significant risk to the stability and resilience of the Internet of Vehicles. Addressing these vulnerabilities, this paper proposes a Dynamic Forest-Structured Ensemble Network (DFSENet) specifically tailored for the Internet of Vehicles (IoV). By leveraging data-balancing techniques and dimensionality reduction, the DFSENet model is designed to detect a wide range of cyber threats effectively. The proposed model demonstrates high efficacy, with an accuracy of 99.2% on the CICIDS dataset and 98% on the car-hacking dataset. The precision, recall, and f-measure metrics stand at 95.6%, 98.8%, and 96.9%, respectively, establishing the DFSENet model as a robust solution for securing the IoV against cyber-attacks.
Effect of Olive Fruit Volatiles on Landing, Egg Production, and Longevity of Bactrocera oleae Females under Different Temperatures
Authors: Kokkari Anastasia , Kouloussis Nikos A. , Floros George , Koveos Dimitrios S.
Published: September 2024

Females of the olive fruit fly Bactrocera oleae use various contact and volatile plant stimuli to find olive fruits and lay their eggs on them. We detected certain volatile organic compounds (VOCs) emitted from the olive fruit and studied their effect on female landings on olive fruits, egg production, and longevity under a series of different temperatures from 15 °C to 35 °C. When female flies were maintained at temperatures from 17 °C to 30 °C and exposed to different fruit VOCs either increased or decreased, depending on the substance tested, their landings on olives, egg production, and longevity. Temperature significantly affected the females’ responses to fruit VOCs. The highest responses of the flies to fruit VOCs were observed at 30 °C, except for longevity. By contrast, at 15 °C or 35 °C, the flies did not show any response to VOCs. Our results may contribute to a better understanding of the olive fly positive or negative responses to fruit VOCs and the improvement of its control.
A Pilot Study on the Effects of Exercise Training on Cardiorespiratory Performance, Quality of Life, and Immunologic Variables in Long COVID
Authors: Abbasi Asghar , Gattoni Chiara , Iacovino Michelina , Ferguson Carrie , Tosolini Jacqueline , Singh Ashrita , Soe Kyaw Khaing , Porszasz Janos , Lanks Charles , Rossiter Harry B. , Casaburi Richard , Stringer William W.
Published: September 2024

Objectives: Fatigue is a prominent feature of long COVID (LC) and may be related to several pathophysiologic mechanisms, including immune hyperstimulation. Aerobic endurance exercise training may be a useful therapy, with appropriate attention to preventing post-exertional malaise. Methods: Fourteen participants completed a pilot study of aerobic exercise training (twenty 1.5 h sessions of over 10 weeks). Cardiorespiratory fitness, 6 min walk distance, quality of life, symptoms, 7-day physical activity, immunophenotype, and inflammatory biomarkers were measured before and after exercise training. Results: The participant characteristics at baseline were as follows: 53.5 ± 11.6 yrs, 53% f, BMI 32.5 ± 8.4, 42% ex-smokers, 15.1 ± 8.8 months since initial COVID-19 infection, low normal pulmonary function testing, V.O2peak 19.3 ± 5.1 mL/kg/min, 87 ± 17% predicted. After exercise training, participants significantly increased their peak work rate (+16 ± 20 W, p = 0.010) and V.O2peak (+1.55 ± 2.4 mL/kg/min, p = 0.030). Patients reported improvements in fatigue severity (−11%), depression (−42%), anxiety (−29%), and dyspnea level (−46%). There were no changes in 6MW distance or physical activity. The circulating number of CD3+, CD4+, CD19+, CD14++CD16, and CD16++CD14+ monocytes and CD56+ cells (assessed with flow cytometry) increased with acute exercise (rest to peak) and was not diminished or augmented by exercise training. Plasma concentrations of TNF-α, IL-6, IL-8, IL-10, INF-γ, and INF-λ were normal at study entry and not affected by training. Conclusions: Aerobic endurance exercise training in individuals with LC delivered beneficial effects on cardiorespiratory fitness, quality of life, anxiety, depression, and fatigue without detrimental effects on immunologic function.
Factors Affecting Wound Healing after the Wide Surgical Excision of Hidradenitis Suppurativa Lesions
Authors: Ezanno Anne-Cecile , Texier Gaëtan , Marchi Joffrey , Fougerousse Anne-Claire
Published: September 2024

Background: Hidradenitis suppurativa (HS) is a chronic and inflammatory disease. Its management depends on the stage and extent of the disease. Surgery plays an important role in treatment options. This study explores the factors influencing healing after wide excision. Methods: This study analyzed data from patients who underwent wide excision for HS between 2016 and 2021. Results: A total of 160 patients (64.4% women) were included, with surgeries performed in the axillae (70), inguinal-ano-genital (73), and other locations (17, including gluteal). The mean TTWC was 74 ± 6 days, varying from 11 to 445 days. Factors negatively influencing TTWC included axillary localization (p < 0.001) and the presence of another inflammatory disease (p = 0.017). Factors positively influencing healing were smoking (<0.001) and previous or ongoing medical treatment (antibiotherapy or biologics) (p = 0.011). Obesity or being overweight did not impact the TTWC in multivariate analysis, although overweight was significant in univariate analysis. Conclusions: While smoking cessation remains important in the management of HS, it does not appear to be a prerequisite for successful surgical treatment. Conversely, patients with an inflammatory disease or those undergoing surgery for an axillary lesion exhibit slower healing and should be informed of potential healing delays before surgery.
Role of Lung Ultrasound in the Detection of Lung Sequelae in Post-COVID-19 Patients: A Systematic Review and Meta-Analysis
Authors: Boccatonda Andrea , D’Ardes Damiano , Tallarico Viola , Guagnano Maria Teresa , Cipollone Francesco , Schiavone Cosima , Piscaglia Fabio , Serra Carla
Published: September 2024

Background: During the COVID-19 pandemic, several studies demonstrated the effectiveness of lung ultrasound (LUS) as a frontline tool in diagnosing and managing acute SARS-CoV-2 pneumonia. However, its role in detecting post-COVID-19 lung sequelae remains to be fully determined. This study aims to evaluate the diagnostic accuracy of LUS in identifying lung parenchymal damage, particularly fibrotic-like changes, following COVID-19 pneumonia, comparing its performance to that of CT. Methods: Relevant studies published before July 2024 were identified through a comprehensive search of PubMed, Embase, and Cochrane library. The search terms were combinations of the relevant medical subject heading (MeSH) terms, key words and word variants for “lung”, “post-COVID”, “long-COVID”, and “ultrasound”. The pooled sensitivity, specificity, diagnostic odds ratio (DOR), and summary receiver-operating characteristic (SROC) curve were used to examine the accuracy of CEUS. The selected works used different thresholds for the detection and counting of B-lines by ultrasound. This led to dividing our analysis into two models, the first based on the lower thresholds for detection of B-lines found in the works, and the second on data obtained using a higher detection threshold. Results: In terms of the diagnostic accuracy of LUS in detecting residual fibrotic-like changes in patients post-COVID-19 infection, a low-threshold model displayed a pooled sensitivity of 0.98 [95% confidence interval (CI): 0.95–0.99] and a pooled specificity of 0.54 (95% CI: 0.49–0.59). The DOR was 44.9 (95% CI: 10.8–187.1). The area under the curve (AUC) of SROC was 0.90. In the second analysis, the model with the higher threshold to detect B-lines showed a pooled sensitivity of 0.90 (95% CI: 0.85–0.94) and a pooled specificity of 0.88 (95% CI: 0.84–0.91). The DOR was 50.4 (95% CI: 15.9–159.3). The AUC of SROC was 0.93. Conclusions: In both analyses (even using the high threshold for the detection of B-lines), excellent sensitivity (98% in model 1 and 90% in model 2) is maintained. The specificity has a significant variation between the two models from 54 (model 1) to 87% (model 2). The model with the highest threshold for the detection of B-lines displayed the best diagnostic accuracy, as confirmed by the AUC values of the SROC (0.93).
Omalizumab for the Treatment of Chronic Spontaneous Urticaria in Adults and Adolescents: An Eight-Year Real-Life Experience
Authors: Calzari Paolo , Chiei Gallo Alessandra , Barei Francesca , Bono Eleonora , Cugno Massimo , Marzano Angelo Valerio , Ferrucci Silvia Mariel
Published: September 2024

Background: Omalizumab, an anti-IgE monoclonal antibody, is an effective treatment for patients with chronic spontaneous urticaria (CSU) resistant to antihistamines, but about 10% are unresponsive. Our aim was to assess the effectiveness, safety, and drug survival (DS) of omalizumab by considering clinical and laboratory characteristics. Methods: We conducted a retrospective study on 296 patients with severe CSU treated with omalizumab. Disease activity, comorbidities, and serum levels of total IgE and anti-thyroid autoantibodies were evaluated over a period of up to 8 years. DS was analyzed using unadjusted Kaplan–Meier survival curves. When applicable, the risk of discontinuation was assessed using Cox regression analysis. Results: Out of 296 patients, 118 (40.4%) were early responders, 72 (25.0%) were late responders, 76 (26.0%) were partial responders, and 25 (8.6%) were non-responders. Early responders were more likely to be patients without associated inducible urticaria (p = 0.021, χ2 = 9.692), without autoimmune thyroiditis (p = 0.007, χ2 = 12.037), and those with higher IgE levels (p = 0.039, χ2 = 8.385). Overall, DS was 53.5% at 8 years, primarily due to clinical remission. DS due to inefficacy and clinical remission were 83.9% and 62.1%, respectively, at 8 years. No patients discontinued omalizumab due to adverse events. Patients with normal IgE levels (p = 0.012, HR = 4.639, CI: 1.393–15.445) and those with autoimmune thyroiditis (p = 0.028, HR = 3.316, CI: 1.128–8.718) had a higher risk of discontinuing omalizumab due to inefficacy. Conclusions: This study confirms the long-term effectiveness and safety of omalizumab in the treatment of CSU over a period of up to 8 years. Most patients discontinued omalizumab due to clinical remission, while only 5.1% discontinued it due to ineffectiveness.
Permanent Makeup Removal Severe Complication—Case Report and Proposal of the Protocol for Its Management
Authors: Pióro Weronika , Antoszewski Bogusław , Kasielska-Trojan Anna
Published: September 2024

Background: The purpose of this paper is to report the case of a patient who developed a local allergic reaction to the pigment used for permanent eyebrow makeup. In addition, the authors’ protocol for the treatment of such a complication is proposed. Methods: A patient visited the clinic to remove permanent eyebrow makeup. In the patient’s opinion, the eyebrows were too dark and incorrectly shaped. Upon physical examination of the brows, they were found to be over-pigmented and drawn outside the area of hair growth of the natural brow. Results: The patient underwent 24 treatment procedures to remove the pigmentation including four sessions of laser therapy and subsequent treatments using a chemical substance (remover). No adverse effects occurred during the initial phase of makeup removal (black pigment removal), but an allergic reaction appeared with the removal of the red-orange colored pigment (after the fourth laser therapy session). The following symptoms appeared: redness, swelling, and the appearance of papules filled with both serous fluid and pigment used for the permanent makeup. After each remover treatment, the allergic reaction decreased, and local symptoms gradually subsided. Additionally, topical corticosteroid treatment was implemented peri-procedurally. The patient’s case suggests a secondary allergic reaction to the red-orange pigment used for permanent makeup. Conclusions: The literature on this topic is scarce; therefore, we present a regimen for the management of such complications. In addition, we draw attention to the fact that allergic reactions to pigment may not always occur immediately following skin pigmentation but may become apparent long after the procedure, such as when the allergen is “exposed” during an attempt to remove or correct the makeup.
Association of Physical Performance with Mental and Physical Health-Related Quality of Life and Low Back Pain-Related Disabilities among Older Adults with Severe Obesity
Authors: Bayartai Munkh-Erdene , Tringali Gabriella , De Micheli Roberta , Danielewicz Ana Lúcia , Sartorio Alessandro
Published: September 2024

Background: Low back pain is one of the most prevalent musculoskeletal problems and continues to be the leading cause of disabilities worldwide. The aim of this study was to cross-sectionally investigate the association of physical performance with mental and physical health-related quality of life and low back pain-related disabilities among older adults with severe obesity. Methods: A total of 96 hospitalized older adults with severe obesity (45 males, 51 females, age: 69.7 ± 5.4 years; BMI: 43.7 ± 5.7 kg/m2) were recruited into the study. Physical performance, health-related quality of life, and low back pain-related disability were measured through physical performance tests, the 12-item short-form survey (SF-12), and the Oswestry disability index, respectively. Results: LBP-related disabilities, as well as physical health-related quality of life, were associated with all the physiological parameters measured by physical performance tests, including muscular strength, aerobic capacity, balance, and lower body flexibility (p < 0.05). In contrast, mental health-related quality of life was associated with fewer physiological parameters, such as primarily muscular strength (p < 0.05). Conclusions: These findings could provide important insights for developing rehabilitation strategies designed to improve LBP-related disabilities, as well as the physical and mental health-related quality of life, in older adults with severe obesity.
Comparison between Substance P and Calcitonin Gene-Related Peptide and Their Receptors in Colorectal Adenocarcinoma
Authors: Șerban Robert-Emmanuel , Boldeanu Mihail Virgil , Florescu Dan Nicolae , Ionescu Mihaela , Șerbănescu Mircea-Sebastian , Boldeanu Lidia , Florescu Mirela-Marinela , Stepan Mioara-Desdemona , Obleagă Vasile-Cosmin , Constantin Cristian , Popescu Dragoş-Marian , Streba Costin Teodor , Vere Cristin Constantin
Published: September 2024

Background: Colorectal cancer is a major health problem that still causes many deaths worldwide. Neuropeptides, such as substance P and calcitonin gene-related peptide, play the neurotransmitter and neurohormone roles that increase tumor invasiveness and metastasis potential. This study aimed to see whether these neuropeptides and their receptors—neurokinin 1 receptor and calcitonin receptor-like receptor—correlate with the diagnosis stage, tumor differentiation grade, and different patient characteristics in colorectal cancer and also to compare them. Methods: We performed serum analyses of substance P and CGRP levels in patients with colorectal cancer and also the immunohistochemical analysis of their receptors in colorectal tumors and then correlated them with the disease stage and with different tumor characteristics. Results: We demonstrated that both substance P and calcitonin gene-related peptide had increased levels in colorectal cancer and that their levels correlated with the stage of the disease and with the tumor differentiation grade. We also demonstrated the correlation of NK-1R and CRLR higher immunohistochemical scores with advanced and poorly differentiated tumors. Conclusions: This study demonstrates that the neuropeptides SP and CGRP and their receptors NK-1R and CRLR could play a role in the pathogenesis of colorectal cancer, and they could be used as diagnostic and prognostic markers and could represent potential therapeutic targets.
Impact of GLP-1 Receptor Agonists in Gastrointestinal Endoscopy: An Updated Review
Authors: Singh Sahib , Chandan Saurabh , Dahiya Dushyant Singh , Aswath Ganesh , Ramai Daryl , Maida Marcello , Anderloni Andrea , Muscatiello Nicola , Facciorusso Antonio
Published: September 2024

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have become one of the most popular medications for patients with diabetes and obesity. Due to their effects on gut motility via central or parasympathetic pathways, there have been concerns about an increased incidence of retained gastric contents and risk of aspiration in the perioperative period. Hence, the American Society of Anesthesiologists (ASA) recommends holding GLP-1 RAs on the procedure day or a week before the elective procedure based on the respective daily or weekly formulations, regardless of the dose, indication (obesity or diabetes), or procedure type. On the contrary, the American Gastroenterological Association (AGA) advises an individualized approach, stating that more data are needed to decide if and when the GLP-1 RAs should be held prior to elective endoscopy. Several retrospective and prospective studies, along with meta-analyses, have been published since then evaluating the role of GLP-1 RAs in patients scheduled for endoscopic procedures. In this review, we discuss the current clinical guidelines and available studies regarding the effect of GLP-1 RAs on GI endoscopies.
Allograft Screws as Fixation of the Scarf Osteotomy
Authors: Döring Kevin , Apprich Sebastian , Hanna Markus , Windhager Reinhard , Puchner Stephan
Published: September 2024

Background: In comparison to titanium screws, novel cortical bone allograft screws may come with advantages in osseointegration and with avoidance of potential material removal surgery after scarf osteotomy. Methods: A scarf osteotomy with allograft bone screws as fixation was performed in 21 patients (30 feet). Clinical and radiological parameters were prospectively collected until one year after surgery. A retrospective control group, consisting of 75 patients (82 feet) after scarf osteotomy using headless compression screws, was used to compare clinical outcomes. Results: After fixation with allograft bone screws, the mean preoperative AOFAS score increased from 51.5 points preoperatively to 93.5 points one year after surgery. In radiological assessments, a continuous osseointegration with the remodeling of the bone screw was observed in all patients that finished follow-up. However, four metatarsal fractures occurred early postoperatively after fixation using allograft bone screws. There were only three material removal surgeries in patients treated with headless compression screws. Conclusions: Allograft bone screws display a safe fixation and are a biological alternative for scarf osteotomy. Enough distance between the screw and the proximal osteotomy should be ensured to avoid fractures.
The Efficacy of Eye Movement Desensitization and Reprocessing Treatment for Depression: A Meta-Analysis and Meta-Regression of Randomized Controlled Trials
Authors: Seok Ji-Woo , Kim Joong Il
Published: September 2024

Background: Eye Movement Desensitization and Reprocessing (EMDR) therapy has gained attention for its potential effectiveness in treating depression beyond its initial use for PTSD. This systematic review and meta-analysis aims to evaluate the efficacy of EMDR in treating depression and to identify the variables influencing its effectiveness. Methods: A comprehensive search was conducted across databases, including MEDLINE, PubMed, and EMBASE, covering studies up to January 2023. A total of 521 studies were screened, and 25 studies with 1042 participants (522 EMDR, 520 control) met the inclusion criteria and were included in the meta-analysis. The inclusion criteria involved randomized controlled trials (RCTs) comparing EMDR to control conditions such as usual care or waitlist groups, with outcomes focused on changes in depression symptoms. Results: The results show that EMDR had a significant effect on reducing depression symptoms (Hedges’ g = 0.75), with moderate heterogeneity being observed. The meta-regression indicated that the severity of depression was a significant predictor of EMDR’s effectiveness, with greater effects in severe cases. Additionally, the systematic review analyzed and evaluated various theoretical models and related studies that explain how EMDR works for the treatment of depression, reporting on neurobiological models proposed in previous research. Conclusions: This study confirms that EMDR is effective in treating depression, particularly in severe cases, and highlights its potential as a non-pharmacological intervention. However, this study highlights the need for more standardized research and long-term evaluations to assess EMDR’s lasting impact. Integrating EMDR into multimodal treatment plans and primary care, especially for treatment-resistant depression, could significantly improve patient outcomes.
Common Cancer-Related Factors and the Risk of Developing Kaposi Sarcoma in Individuals without AIDS: Korea National Health Insurance Services Claims Database
Authors: Shin Ji Eun , Han Kyungdo , An Ho Jung , Park Hyung Soon , Shim Byoung Yong , Kim Hyunho
Published: September 2024

Backgrounds: Kaposi sarcoma (KS) is a unique form of cancer with epidemiological characteristics distinct from those of other solid cancers. While common risk factors including alcohol consumption, smoking, and metabolic disorders have been well studied in various cancers, their relationship with KS remains unclear. Methods: This study used a cohort approach with adults without AIDS, utilizing data from the National Health Insurance Service in South Korea. This study examined various conventional cancer-related risk factors related to the incidence of KS, including psoriasis. Results: Alcohol consumption, smoking, body mass index, diabetes mellitus, hypertension, hypercholesterolemia, and regular exercise were not significantly associated with the incidence of KS. Additionally, older age and male sex were associated with a higher incidence of KS. KS risk was increased in pathological conditions such as psoriasis and proteinuria, which require immunosuppressive medication. Conclusions: Our study suggests that traditional cancer-related risk factors may not play a significant role in the pathogenesis of KS, unlike other cancers. This, in turn, emphasizes the importance of immunosuppression and HHV-8 infection in the development of KS.
Return to Work Following Anterior Lumbar Interbody Fusion with Percutaneous Posterior Pedicle Fixation: A Retrospective Analysis from Two Academic Centers in Germany
Authors: Behmanesh Bedjan , Wempe Helen , Kilinc Fatma , Dubinski Daniel , Won Sae-Yeon , Czabanka Marcus , Setzer Matthias , Schuss Patrick , Schneider Matthias , Freiman Thomas , Gessler Florian
Published: September 2024

Objective: Return to work after spinal surgery is a crucial factor in the recovery process. It can contribute not only to physical rehabilitation but also to psychological well-being. This study aims to evaluate the rate of return to work following elective lumbar spine surgery and identify predictors that predict failure of return to work. Methods: Adult patients who underwent anterior lumbar interbody fusion at two medical centers were retrospectively identified. A standardized telephone interview was conducted for the final analysis to assess the clinical outcomes of these patients. Results: Out of a total of 159 patients, 104 were of working age at the time of the elective surgery. Data were missing for 35 patients, who were thus excluded from the analysis. All patients had a minimum follow-up period of one year. After surgery, 75% of the patients returned to work within a median time of 3 months. Quality of life, back pain, leg pain, and ODI scores, as well as self-reported satisfaction, were significantly better in patients who returned to work (p < 0.05). Tobacco use and previous musculoskeletal surgery were significant predictive factors of failure to return to work. None of the patients who were unemployed prior to surgery returned to work. Conclusions: Our study reveals that 75% of patients returned to work within three months after surgery. The most significant predictor of failure to return to work is being unemployed before surgery. Additionally, preoperative education about postoperative behavior and physical activity could potentially increase the rate.
Impact of Serum Phosphate on Hemoglobin Level: A Longitudinal Analysis on a Large Cohort of Dialysis Patients
Authors: Calabrese Vincenzo , Tripepi Giovanni Luigi , Santoro Domenico , Cernaro Valeria , Panuccio Vincenzo Antonio , Mezzatesta Sabrina , Mattace-Raso Francesco , Torino Claudia ,   on behalf of the Sicilian Registry of Nephrology, Dialysis and Transplantation
Published: September 2024

Background/Objectives: Phosphate is a macro-element involved in all cellular energetic processes. As about 90% of the phosphate filtered by the glomerulus is excreted by kidneys, the impairment of renal function and the consequent over-secretion of parathyroid hormone and fibroblast growth factor 23 results in the increase in the serum phosphate levels. The association between phosphate and hemoglobin is controversial, as both direct and indirect relationships have been reported. The present study aims to investigate the relationship between phosphate and hemoglobin in a large prospective, longitudinal cohort including dialysis patients from the Sicilian Registry of Nephrology, Dialysis, and Transplantation. Methods: In this prospective cohort study, we included 6263 hemodialysis patients to achieve a total of 120,462 repeated measurements of serum phosphate and hemoglobin over time. The longitudinal association between phosphate and hemoglobin was analyzed by univariate and multivariate Linear Mixed Models. Results: The mean age was 66 ± 16 years and the median dialysis vintage was 5 months [IQR: 2–16]. Mean and median values of hemoglobin and phosphate were 10.7 g/dL (SD 1.3 g/dL) and 4.6 mg/dL [IQR 3.9–5.5 mg/dL], respectively. The multivariate model, adjusted for potential confounders, confirmed the positive association between serum phosphate and hemoglobin [adjβ = 0.13, 95%CI 0.03–0.23, p = 0.01)]. These results were confirmed in analyses stratified for the use of phosphate binders. Conclusions: In our large cohort of dialysis patients, we found a linear, direct relationship between phosphate and hemoglobin levels. As a reduction in phosphate is associated with a parallel reduction in hemoglobin levels, hypophosphatemia can accentuate anemia in dialysis patients. Our results generate the hypothesis that monitoring serum phosphate in clinical practice might provide a better management of anemia.
Comment on Plutecki et al. The Anatomy of the Thoracic Duct and Cisterna Chyli: A Meta-Analysis with Surgical Implications. J. Clin. Med. 2024, 13, 4285
Authors: O’Hagan Lomani A. , Phillips Anthony R. J. , Windsor John A. , Mirjalili S. Ali
Published: September 2024

We read, with interest, Plutecki and colleagues’ systematic review of the anatomy of the thoracic duct and cisterna chyli, recently published in JCM [...]
Biomarkers as Predictors of Mortality in Sepsis and Septic Shock for Patients Admitted to Emergency Department: Who Is the Winner? A Prospective Study
Authors: Luka Sonia , Golea Adela , Tat Raluca Mihaela , Lupan Mureșan Eugenia Maria , Voicescu George Teo , Vesa Ștefan Cristian , Ionescu Daniela
Published: September 2024

Background/Objectives: Sepsis and septic shock remain significant contributors to high early mortality rates among patients admitted to the emergency department (ED). The objective of this study was to identify among newer biomarkers those with the highest sensitivity in early mortality prediction. Methods: This prospective, unicentric, observational study enrolled 47 adult patients admitted to the ED between November 2020 and December 2022. This study monitored the kinetics of the older and newer biomarkers, including azurocidin (AZU1), soluble triggering receptor expressed on myeloid cells (sTREM), soluble urokinase-type plasminogen activator receptor (suPAR), high-sensitivity C-reactive protein (hsCRP), procalcitonin (PCT), and interleukin-6 (IL-6), and their capacity in predicting mortality. Results: SuPAR showed the most significant predictive utility for early prognosis of mortality in the ED, with an area under the curve (AUC) of 0.813 (95% CI: 0.672 to 0.912), a cutoff value > 8168 ng/mL, sensitivity of 75%, and specificity of 81.48% (p < 0.001). IL-6 and PCT showed comparable prognostic accuracy, whereas hsCRP and AZU1 demonstrated lower predictive performance. Conclusions: In our study, suPAR, IL-6, and PCT showed good predictive value for short-term mortality in sepsis and septic shock patients.
High-Intensity Interval Training, but Not Whole-Body Cryostimulation, Affects Bone-Mechanosensing Markers and Induces the Expression of Differentiation Markers in Osteoblasts Cultured with Sera from Overweight-to-Obese Subjects
Authors: Gomarasca Marta , Ziemann Ewa , Sansoni Veronica , Flis Marta , Perego Silvia , Jaworska Joanna , Gerosa Laura , Faraldi Martina , Lombardi Giovanni
Published: September 2024

Background/Objectives: Although there have been some clinical observations made, the mechanistic effects on bone metabolism of whole-body cryostimulation and high-intensity interval training (HIIT), either alone or in combination, are still debated. Here, we have investigated their effects on circulating osteo-immune and bone metabolic markers (osteopontin, osteocalcin, sclerostin, dikkopf-related protein 1, and fibroblast-growth factor 23) and their potential effects on osteoblast differentiation and function, in vitro, by treating SaOS-2 osteoblast-like cells with the sera obtained from the subjects who had undergone the different interventions or untreated control subjects. Methods: Sixty-seven inactive, overweight-to-obese participants (body mass index = 31.9 ± 5.0 kg·m−2, 42 ± 13 years old) were recruited and randomly assigned to one group: control (CTRL, n = 14), training (HIIT, 6 sessions, n = 13), WBC (CRYO, 10 sessions, n = 17) or training combined with WBC (CRYO-HIIT, n = 23). The interventions lasted 14 days. Results: While circulating markers analysis revealed more protective potential against resorption in HIIT than in WBC alone or combined, gene expression from in vitro analysis showed an induction of late bone metabolic markers in the HIIT group. Conclusions: These data suggest a potentially protective effect of HIIT in bone against resorption, while WBC maintains homeostasis by preventing any resorptive phenomena and limiting any anabolic activity even when stimulated by intensive exercise.
Statistical Analysis of nnU-Net Models for Lung Nodule Segmentation
Authors: Jerónimo Alejandro , Valenzuela Olga , Rojas Ignacio
Published: September 2024

This paper aims to conduct a statistical analysis of different components of nnU-Net models to build an optimal pipeline for lung nodule segmentation in computed tomography images (CT scan). This study focuses on semantic segmentation of lung nodules, using the UniToChest dataset. Our approach is based on the nnU-Net framework and is designed to configure a whole segmentation pipeline, thereby avoiding many complex design choices, such as data properties and architecture configuration. Although these framework results provide a good starting point, many configurations in this problem can be optimized. In this study, we tested two U-Net-based architectures, using different preprocessing techniques, and we modified the existing hyperparameters provided by nnU-Net. To study the impact of different settings on model segmentation accuracy, we conducted an analysis of variance (ANOVA) statistical analysis. The factors studied included the datasets according to nodule diameter size, model, preprocessing, polynomial learning rate scheduler, and number of epochs. The results of the ANOVA analysis revealed significant differences in the datasets, models, and preprocessing.
Preoperative Embolization in the Management of Giant Thoracic Tumors: A Case Series
Authors: Lucarelli Nicola Maria , Maggialetti Nicola , Marulli Giuseppe , Mariani Pierluigi , Villanova Ilaria , Mirabile Alessandra , Morelli Chiara , De Palma Angela , Stabile Ianora Amato Antonio
Published: September 2024

Objectives: The aim of this paper is to describe our experience in the embolization of hypervascular giant thoracic tumors before surgical excision. Methods: A single-center retrospective review of five trans-arterial preoperative embolization procedures executed between October 2020 and July 2024. Patients’ demographics, anatomical aspects, feasibility, technique, and outcomes were reviewed. Results: In all cases, accurate targeting and safe embolization was achieved, with satisfactory devascularization evaluated with post-procedural angiography and with minimal blood loss during subsequent surgical operation. Conclusions: In our experience, preoperative embolization of giant thoracic masses has been technically feasible, safe, and effective in reducing tumor vascularization, thus facilitating surgical treatment. This approach should be evaluated as an option, especially in patients with hypervascular thoracic tumors.
Soundscape Design in an Urban Natural Park
Authors: Cristea Laurentiu , Deaconu Marius , Dragasanu Luminita , Tărăbîc Cornel Mihai , Barbulescu Dan
Published: September 2024

Urban natural parks represent a remarkable concept that evokes the coexistence of human habitation with a wild environment, and the associated interactions between human and natural territories. In this context, urban noise infringes upon the natural soundscape, leading to various consequences for both realms. This study seeks to characterize the impact of anthropic noise levels on biodiversity in the urban natural Văcărești Park (Bucharest, Romania), utilizing on-site measurements and software simulation techniques. The study seeks to develop a method for evaluating integrative strategies to mitigate the impact of traffic noise on wildlife in an urban wild park, without addressing the specific effects of noise on the perception and communication of individual species. By calibrating field measurements with laboratory results, a more reliable data set will be used to identify areas where the biophonic environment is impacted by anthropogenic noise. Since human-generated noise in an urban natural park predominantly originates from road traffic and industrial sites, managing traffic noise and its propagation pathways could substantially improve the park’s soundscape. Additionally, this study will apply software simulations for noise reduction strategies, such as vegetation planting and earthen embankments, to obtain suitable solutions and propose plausible and effective actions to authorities for improving the biophonic environment. This research could also serve as the basis for long-term monitoring, allowing for the assessment of the evolution and impact of implemented measures over time.
Research on the Correlation between the Dynamic Distribution Patterns of Urban Population Density and Land Use Morphology Based on Human–Land Big Data: A Case Study of the Shanghai Central Urban Area
Authors: Shi Yi , Zheng Yi , Chen Daijun , Yang Junyan , Cao Yue , Cui Ao
Published: September 2024

The dynamic distribution of urban population density and the interaction with land use elements involve mutual constraints and guidance. However, in the existing research on the relationship between urban population density and land use, the discussion on the distribution patterns of urban population density typically spans long time periods and uses large spatial units, lacking analysis of the dynamic changes in population density within high granularity land parcels over a day. In studies related to the urban built environment, the complex relationships between different-dimensional land use elements and the dynamic distribution of population density also need further exploration. To address these bottlenecks, this study takes Shanghai’s central urban area as an example. Based on 24 h mobile signaling data on weekdays, weekends, and typical holidays, as well as urban land use data, clustering algorithms are used to summarize patterns of dynamic population density distribution. Pearson correlation analysis is then employed to study the correlation between dynamic population density distribution patterns and different land use elements. The results indicate that various urban land use factors such as locational centrality, functional diversity, transportation accessibility, compactness, and landscape quality have different impacts on the dynamic distribution of population density in spatial units, and the dynamic distribution patterns of population density in different land use types also vary. This research contributes to guiding the optimization of spatial quality and formulating planning and management measures that more effectively match construction intensity with population activity density.
Building Resilience through Territorial Planning: Water Management Infrastructure and Settlement Design in the Coastal Wetlands of Northern Apulia (Salpia vetus-Salapia) from the Hellenistic Period to Late Antiquity
Authors: Goffredo Roberto , Totten Darian Marie
Published: September 2024

This Gulf of Manfredonia has, for millennia, been the primary water feature of the coastal wetland of Northern Apulia, Italy, although modern reclamation works make writing its long-term history challenging. Our recent paleoenvironmental research has reconstructed the evolution of the southern half of this lagoon since the Neolithic period. Here, we write a history of water management and environmental change in this landscape from the perspective of two key urban sites: pre-Roman Salpia vetus and Roman Salapia. The Roman architectural historian Vitruvius recounts the abandonment of Salpia vetus and the refoundation of Salapia. We employ his narrative as a frame for a more complex environmental history, starting from a historiography of this landscape’s study and a summary of our interdisciplinary research agenda, which unifies environmental, topographical, remote sensing, and archaeological approaches. Resilience in this changeable wetland environment was only possible through an integrated and intentional management of water among rivers, the lagoon, and the Adriatic Sea. While Salpia vetus exploited this wetland and thrived for centuries, the settlement eventually collapsed due to human and environmentally impelled factors. Roman Salapia subsequently emerged with a different approach, new infrastructure, and a new location. This blueprint would sustain urban life in this wetland for six centuries and lay the groundwork for the Medieval town.