bluuebunny/crossref_metadata_2025 huggingface dataset:
MRI-Based Phenotyping for Osteosarcopenic Adiposity in Subjects from a Population-Based Cohort
Authors: Maurer Elke , Rospleszcz Susanne , Rathmann Wolfgang , Thorand Barbara , Peters Annette , Schlett Christopher L. , Bamberg Fabian , Kiefer Lena Sophie
Published: November 2024

Objective: Imaging biomarkers of bone, muscle, and fat by magnetic resonance imaging (MRI) may depict osteopenia, sarcopenia, and adiposity as the three different conditions of osteosarcopenic adiposity (OSA). Methods: Subjects from a prospective, population-based case–control study underwent a health assessment and 3 Tesla whole-body MRI scan. Imaging biomarkers of bone (bone marrow fat-fraction (BMFF)), skeletal muscle (skeletal muscle FF (SMFF)), and fat (total adipose tissue (TAT)) were determined. Participants were allocated to one phenotype according to the OSA complex. Results: Among 363 participants forming the study cohort, 81 (22.3%, 48.1% males, 62.4 ± 6.9 years) were allocated into the OSA subgroup. Participants with an OSA phenotype were significantly older compared to all remaining subjects and showed the highest grades of SMFF (all p < 0.005). Together with subjects from the osteopenic sarcopenia group, OSA subjects exhibited the highest amounts of BMFF and together with the three other adiposity-containing subgroups also exhibited the highest BMIs. The highest prevalence of an impaired glucose tolerance as well as significantly higher blood pressure, blood dyslipidemia, and hepatic steatosis was found in the OSA subgroup (all p < 0.005). Conclusions: MR biomarkers of bone, skeletal muscle and fat are feasible for body composition phenotyping and may allow for targeted risk stratification in suspected OSA syndrome.
Correction: Shin, S.-H.; Baek, O.-J. A Study on Internet News for Patient Safety Campaigns: Focusing on Text Network Analysis and Topic Modeling. Healthcare 2024, 12, 1914
Authors: Shin Sun-Hwa , Baek On-Jeon
Published: November 2024

In the original publication [...]
Development and Validation of a Visualized Posture Risk Assessment Questionnaire for Low Back Pain in Daily Activities: A Study in Taiwan
Authors: Chang Yu-Tzu , Chen Yi-Ju , Ho Chinyu , Yeh Chienyu , Huang Cheng-Jung , Lee Jason Jiunshiou
Published: November 2024

Background/Objectives: A proper posture is essential for musculoskeletal health, and a poor posture can lead to low back pain. To address the limitations of traditional text-based questionnaires, this study developed and validated a visualized posture assessment questionnaire for evaluating daily postures related to low back pain. The questionnaire was administered in Taiwan and designed using Traditional Chinese language. Methods: The proposed questionnaire evaluates six categories of daily activities including lifting heavy objects, sitting, putting on shoes, face washing and tooth brushing, getting out of bed, and doing sit-ups, or similar actions. Each category comprises an ergonomic posture and a non-ergonomic posture with corresponding illustrations. The questionnaire was administered to 100 participants, and its internal consistency was evaluated using Cronbach’s α, while test–retest reliability was assessed using intraclass correlation coefficients (ICCs). An expert panel reviewed the content validity, and the item-level content validity index (I-CVI) was calculated for each item and illustration. Results: Testing revealed a Cronbach’s α of 0.808, indicating high internal consistency, and a test–retest reliability, as measured by ICCs, of 0.78, indicating high stability over time. The I-CVI scores were high across all items, with the illustrations unanimously rated by the experts as highly relevant, supporting the effectiveness of the questionnaire’s visualized format for enhanced comprehension. Conclusions: The proposed questionnaire exhibits high reliability and validity, rendering it effective in evaluating posture-related risks of low back pain. This questionnaire also offers a more accessible and intuitive alternative to text-based questionnaires, with potential applications in clinical and research settings.
Assessing Barriers and Difficulties to Healthcare Access Among Syrian Refugees in Jordan: An Observational Study
Authors: Gougazeh Yazid Mohammed , AlHussami Mahmoud Ola , Tsaras Konstantinos , Almegewly Wafa Hamad , Karavasileiadou Savvato , Kleisiaris Christos
Published: November 2024

(1) Background: Worldwide, refugees may have some difficulties in accessing healthcare services. However, little is known about the factors that may predict the level of accessibility to the public healthcare system in the host countries. (2) Aim: To examine the level of accessibility of Syrian refugees to the public healthcare system in Jordan and further to identify the prediction of socioeconomic factors and barriers to healthcare access. (3) Methods: A cross-sectional study was conducted with a convenient sample of 356 Syrian refugees residing outside camps (Irbid, Ajloun, and Jarash). Data were collected using the Access to Healthcare Services Scale instrument (adopted from the Canadian Community Health Survey), which is composed of 2 sections: the general access scale (8 items) and the difficulties scale (20 items). One-way ANOVA test and independent t-test were used to examine epidemiological correlations among variables, whereas a hierarchical linear regression model was used to examine the predictability of socioeconomic factors and barriers to overall access to the public healthcare system by exploring the incremental impact of additional predictors. (4) Results: the mean age of the 356 participants was 35.22 years old, 56.5% were female, 67.4% were married, most of them 46.1% have secondary education, and non-employed 69.9%. Significant associations were observed among participants with different marital status (p < 0.001), educational level (mean 11.85 vs. 19.85, p < 0.001), working status (15.47 vs. 17.93, p < 0.001), family household number (16.42 vs. 17.0, p < 0.001), and health insurance (none: 15.50 vs. governmental 24.50, p < 0.001). Multivariate analysis revealed that the most important factors that may predict the overall access to healthcare services were: family monthly income (beta −0.19, p < 0.001), household family number (beta 0.17, <0.001), health insurance (beta −0.09, p = 0.047), and barriers (beta −0.43, <0.001), even after adjusting for potential confounding effects: sex, age, educational level, and place of residence. (5) Conclusions: Our findings indicate that socioeconomic factors and barriers may considerably predict overall access to public healthcare in Jordan. It is crucially important, therefore, for the Jordanian government and international organizations to create and develop strategic plans and programs that enhance refugees’ access to health services, positively impacting their health and wellness.
Are Healthcare Organizations Healthy Work Ecosystems? Health and Well-Being of Health Professionals
Authors: Gaspar Tânia , Sousa Barbara , Alves Elisabete , Coelho Anabela
Published: November 2024

Background: Health professionals are at high risk of poor mental health and well-being. Faced with this challenge, healthcare organizations must be healthy and safe work environments. Objectives: This study aims to take an in-depth, systemic look at whether healthcare organizations are healthy workplaces. Methods: The study involved 2190 participants aged between 19 and 71 (M = 44.73, SD = 10.29) and data were collected in 12 public hospitals between November 2021 and December 2023. The study used the Ecosystems of Healthy Workplaces instrument, which consists of a total of 62 items organized into nine dimensions based on the Healthy Workplaces model proposed by the World Health Organization. Results: Most dimensions revealed a moderate risk in terms of whether they were healthy work environments, while the dimension that revealed a high risk was related to psychosocial risks at work in relation to well-being and mental health. A total of 87% of the professionals reported at least one symptom of burnout and 61.4% reported having all three symptoms of burnout. Additionally, 25.4% reported having been victims of harassment at work. When comparing the groups, we identified that the higher risk groups were namely women, generation Z and X professionals, doctors (compared to the different professional groups under analysis such as nurses, operational assistants, psychologists, administrators, senior technicians, and managers), professionals with chronic illnesses, and those who reported harassment at work. Conclusions: We conclude that the work environment must be understood ecologically, by analyzing the different systems and their relationships. This makes it possible to identify priority factors and groups for intervention.
Healthcare Utilization Among Youth with Chronic Illness Receiving Care at a Large Urban Academic Healthcare System
Authors: Soulsby William Daniel , Franck Linda S. , Perito Emily , Brakeman Paul , Cuneo Addison , Quill Laura , Boscardin John , von Scheven Emily
Published: November 2024

Background/Objective: We sought to understand healthcare utilization and barriers to care among youth with chronic illness who interact frequently with the healthcare system. Methods: This was a retrospective analysis of healthcare utilization for youth ≤25 years of age with chronic illness during one calendar year (1 January 2021–31 December 2021) in a single urban academic healthcare system. Inclusion criteria were (1) having at least one healthcare encounter in the calendar year of 2021 and (2) having at least six healthcare encounters over the preceding 3-year period or having a qualifying chronic illness. Demographic and clinical characteristics were collected along with self-reported and derived social determinants of health. Univariable and multivariable regression models were created to identify predictors of missed clinic visits, telehealth use, and activated patient portal accounts. Results: The cohort (N = 14,245) was demographically, clinically, and socioeconomically diverse. The youth had frequent clinic visits (median 9, IQR 4–18), multiple subspecialty care referrals (median 4, 1–8), were prescribed multiple medications (median 6, 3–10), and a high proportion received emergency department (18%) or inpatient treatment (15%). Race and public insurance were significant predictors of missed clinic visits and telehealth use. Primary language was a significant predictor of patient portal activation. Conclusions: Youth with chronic illness who are high users of the healthcare system face a high burden of clinic, emergency room, and hospital visits, referrals, and medications. Systematic efforts to lower the healthcare burden and improve care access should address existing racial and socioeconomic disparities affecting this patient population, who are likely to need frequent healthcare over their lifetime.
Illustrations of Coping and Mental Well-Being of Adolescents Living with HIV in Cape Town, South Africa During COVID: A Photovoice Study
Authors: Mayman Yolanda , Crowley Talitha , van Wyk Brian
Published: November 2024

Adolescents living with HIV (ALHIV) are the fastest-growing population living with HIV globally. The COVID-19 pandemic disrupted health systems, thereby negatively affecting the quality and availability of HIV care and support services. This study describes the challenges and treatment experiences of ALHIV on ART at a public primary healthcare facility in a low-socioeconomic community in Cape Town, South Africa during the COVID-19 pandemic. A qualitative photovoice study was conducted with 21 adolescents (aged 14–19 years; 13 females and 8 males). Participants shared pictures illustrating their experiences during the COVID-19 pandemic in groups. Group discussions were audio-recorded and transcribed in full and subjected to content analysis. Seven themes emerged describing ALHIV’s personal, social, and economic challenges, their means of coping, and feelings of vulnerability. Challenges included the loss of significant others, lack of social support and opportunities, experiences of HIV-related stigma and discrimination in the household, loneliness, and isolation. In spite of difficulties, some ALHIV displayed resilience by continuing their medication routines during lockdown periods. After the COVID-19 pandemic, there is a need for the restoration of the health system and services, including psychosocial support to re-engage ALHIV in care and treatment.
COVID-19 in Children and Vitamin D
Authors: Durá-Travé Teodoro , Gallinas-Victoriano Fidel
Published: November 2024

In December 2019, the so-called “coronavirus disease 2019” (COVID-19) began. This disease is characterized by heterogeneous clinical manifestations, ranging from an asymptomatic process to life-threatening conditions associated with a “cytokine storm”. This article (narrative review) summarizes the epidemiologic characteristics and clinical manifestations of COVID-19 and multi-system inflammatory syndrome in children (MIS-C). The effect of the pandemic confinement on vitamin D status and the hypotheses proposed to explain the age-related difference in the severity of COVID-19 are discussed. The role of vitamin D as a critical regulator of both innate and adaptive immune responses and the COVID-19 cytokine storm is analyzed. Vitamin D and its links to both COVID-19 (low levels of vitamin D appear to worsen COVID-19 outcomes) and the cytokine storm (anti-inflammatory activity) are detailed. Finally, the efficacy of vitamin D supplementation in COVID-19 is evaluated, but the evidence supporting vitamin D supplementation as an adjuvant treatment for COVID-19 remains uncertain.
Novel DNA Aptamers to Dickkopf-1 Protein and Their Application in Colorimetric Sandwich Assays for Target Detection in Patients with Axial Spondyloarthritis
Authors: Shatunova Elizaveta A. , Rychkova Anastasia S. , Meschaninova Mariya I. , Kabilov Marsel R. , Tupikin Alexey E. , Kurochkina Yuliya D. , Korolev Maksim A. , Vorobyeva Mariya A.
Published: November 2024

Chronic immunoinflammatory rheumatic diseases, such as axial spondyloarthritis (AxSpA), are accompanied by a dysregulation of bone remodeling. Among potential biomarkers of bone metabolism, the Wnt pathway antagonist, Dickkopf-1 (DKK-1), is of particular interest because of its potential to reflect a shift towards joint ossification or osteoporosis, but its diagnostic value needs validation. There is still a lack of stable and efficient methods of measuring serum DKK-1 levels suitable for longitude studies. The use of aptamer-based diagnostic assays could be very promising for this purpose. We generated novel anti-DKK-1 DNA aptamers from a combinatorial library with a pre-defined sequence pattern in the randomized region. This approach showed high efficacy, as only four SELEX rounds of selection produced high-affinity aptamers with dissociation constants ranging from 1.3 to 3.7 nM. A family of their truncated versions was also developed by rational design. Novel DNA aptamers functioned as capture components in a microplate ELISA-like assay with HRP-conjugated anti-DKK-1 antibody as a reporter component. We succeeded in revealing the aptamer/aptamer sandwich pairs that provided an aptamer-only sandwich colorimetric assay. The aptamer/antibody colorimetric test systems were also examined in the analyses of blood serum from AxSpA patients and shown sufficient workability. However, in a number of cases we registered significant differences between assays based on TD10 and DK4 aptamers and made some suggestions about the origin of this effect.
Exploring Cannabidiol (CBD) and Cannabigerol (CBG) Safety Profile and Skincare Potential
Authors: Luz-Veiga Mariana , Mendes Adélia , Tavares-Valente Diana , Amorim Manuela , Conde António , Pintado Manuela Estevez , Moreira Helena R. , Azevedo-Silva João , Fernandes João
Published: November 2024

Cannabinoids have long been known for their bioactive properties, with their topical application as anti-inflammatory compounds being at the forefront of research for the past decade. Concurrently, the cosmetic market is a fast-growing industry in constant need of new biomolecules. In this work, we studied the safety profile for topical applications of two cannabinoids: cannabidiol (CBD) and cannabigerol (CBG) and assessed their potential as skin care ingredients. The CBG used in this work resulted from bio-fermentation, and to the best of our knowledge, there are no extensive reports on its safety and usage as a cosmetic ingredient. Our results show that CBD and CBG do not exhibit cytotoxicity, mutagenicity, or skin sensitization. Moreover, we verified an absence of primary irritability, accumulated irritability, phototoxicity and photosensitization, supporting the claims of dermatologically tested, hypoallergenic and non-irritating. While these cannabinoids did not show significant anti-aging effects by altering the extracellular matrix components (both in vitro and ex vivo), they demonstrated promise as protective agents against inflammation caused by air pollution. Specifically, they reduced the levels of pro-inflammatory cytokines, making them valuable in combating environmental skin damage. Overall, our results validate the safety of topical use of cannabinoids, while paving the way for further research in the beauty and personal care market as soothing agents.
Molecules That Have Rarely Been Studied in Lymphatic Endothelial Cells
Authors: Becker Jürgen , Wilting Jörg
Published: November 2024

A number of standard molecules are used for the molecular and histological characterization of lymphatic endothelial cells (LECs), including lymphatic vessel endothelial hyaluronan receptor 1 (LYVE1), Podoplanin (D2-40), VEGFR3, Prospero homeobox protein 1 (PROX1), and CD31. The number of molecules whose mutations cause lymphatic malformations or primary congenital lymphedema is considerable, but the majority of these diseases have not yet been characterized at the molecular level. Therefore, there is still considerable scope for molecular and functional studies of the lymphatic vasculature. Using RNASeq, we have previously characterized lymphatic endothelial cells (LECs) under normoxic and hypoxic conditions. We used this information to compare it with immunohistochemical data. We carried out some of the immunohistology ourselves, and systematically studied the Human Protein Atlas, a cell and tissue database based in Sweden. Here we describe molecules that are expressed at RNA and protein levels in LECs, hoping to stimulate future functional studies of these molecules.
The Effect of the Optogenetic Stimulation of Astrocytes on Neural Network Activity in an In Vitro Model of Alzheimer’s Disease
Authors: Mitroshina Elena V. , Kalinina Elizaveta P. , Kalyakulina Alena I. , Teplyakova Alexandra V. , Vedunova Maria V.
Published: November 2024

Optogenetics is a combination of optical and genetic technologies used to activate or, conversely, inhibit specific cells in living tissues. The possibilities of using optogenetics approaches for the treatment of epilepsy, Parkinson’s and Alzheimer’s disease (AD) are being actively researched. In recent years, it has become clear that one of the most important players in the development of AD is astrocytes. Astrocytes affect amyloid clearance, participate in the development of neuroinflammation, and regulate the functioning of neural networks. We used an adeno-associated virus carrying the glial fibrillary acidic protein (GFAP) promoter driving the optogenetic channelrhodopsin-2 (ChR2) gene to transduce astrocytes in primary mouse hippocampal cultures. We recorded the bioelectrical activity of neural networks from day 14 to day 21 of cultivation using multielectrode arrays. A single optogenetic stimulation of astrocytes at 14 day of cultivation (DIV14) did not cause significant changes in neural network bioelectrical activity. Chronic optogenetic stimulation from DIV14 to DIV21 exerts a stimulatory effect on the bioelectrical activity of primary hippocampal cultures (the proportion of spikes included in network bursts significantly increased since DIV19). Moreover, chronic optogenetic stimulation over seven days partially preserved the activity and functional architecture of neuronal network in amyloidosis modeling. These results suggest that the selective optogenetic activation of astrocytes may represent a promising novel therapeutic strategy for combating AD.
Synthesis of New 1,4-Naphthoquinone Fluorosulfate Derivatives and the Study of Their Biological and Electrochemical Properties
Authors: Aseeva Natalia V. , Danilenko Nadezhda V. , Plotnikov Evgenii V. , Korotkova Elena I. , Lipskikh Olga I. , Solomonenko Anna N. , Erkovich Alina V. , Eskova Daria D. , Khlebnikov Andrei I.
Published: November 2024

This study presents the synthesis of new fluorosulfate derivatives of 1,4-naphthoquinone by the SuFEx reaction. Anticancer properties of obtained compounds were studied on PC-3 (prostate adenocarcinoma), SKOV-3 (ovarian cancer), MCF-7 (breast cancer), and Jurkat cell lines. All the studied compounds showed higher cytotoxic effects than Cisplatin. The DFT method was applied to determine the electronic structure characteristics of 1,4-naphthoquinone derivatives associated with cytotoxicity. A method of determination of 2,3-dichloro-1,4-naphthoquinone (NQ), 3-chloro-2-((4-hydroxyphenylamino)-1,4-naphthoquinone (NQ1), and 4-((3-chloro-1,4-naphthoquinon-2-yl)amino)phenyl fluorosulfate (NQS) in a pharmaceutical substance using an impregnated graphite electrode (IMGE) was developed. The morphology of the IMGE surface was studied using scanning electron microscopy (SEM). The electrochemical behavior of NQ, NQ1, and NQS was studied by cyclic voltammetry (CV) in 0.1 M NaClO4 (96% ethanol solution) at pH 4.0 in a potential range from −1 to +1.2 V. Electrochemical redox mechanisms for the investigated compounds were proposed based on the determining main features of the electrochemical processes. Calibration curves were obtained by linear scan voltammetry in the first derivative mode (LSVFD) with the detection limit (LOD) 7.2 × 10−6 mol·L−1 for NQ, 8 × 10−7 mol·L−1 for NQ1, and 8.6 × 10−8 mol·L−1 for NQS, respectively.
The Effect of Pomegranate Peel Extract on the Oxidative and Inflammatory Status in the Spleens of Rats with Metabolic Syndrome
Authors: Rak-Pasikowska Alina , Hałucha Kornela , Kamińska Marta , Niewiadomska Joanna , Noszczyk-Nowak Agnieszka , Bil-Lula Iwona
Published: November 2024

Polyphenols have antioxidant and anti-inflammatory properties and maintain the immune system in balance; therefore, the aim of the study was to investigate the effect of polyphenols present in pomegranate peel extract on the spleens of rats with metabolic syndrome. The study objects were adult male Zucker Diabetic Fatty (ZDF-Leprfa/Crl, fa/fa) rats. The rats were divided into a control group (MetS) consisting of rats with metabolic syndrome and four study groups consisting of rats with metabolic syndrome (MetS + 100 mg and MetS + 200 mg) or healthy animals (H + 100 mg and H + 200 mg) receiving polyphenol extract at a dose of 100 mg or 200 mg/kg, respectively. Concentrations of IL-6, NF-κB, NFATc1, Cyt-C, TNFα, MMP-2, ROS/RNS, and MDA were measured; the activities of GPX, SOD, CAT, MMP-2, and MMP-9 were assessed; and the expression of the BAX and BCL-2 genes was evaluated in homogenized spleens. In conclusion, pomegranate extract may lead to an increase in catalase and glutathione peroxidase activity. Additionally, it may have a reducing effect on the ROS/RNS level, leading to a reduction in the activity of SOD in the MetS groups with PPE administration. Moreover, the BCL-2 gene showed lower expression in the MetS + 100 mg group compared to the H + 100 mg group, indicating that the balance between pro- and antiapoptotic factors of the BCL-2 family may be disrupted by the metabolic syndrome promoting the proapoptotic pathway.
Mast Cell Carboxypeptidase A3 Is Associated with Pulmonary Fibrosis Secondary to COVID-19
Authors: Meneses-Preza Yatsiri G. , Martínez-Martínez Ricardo , Meixueiro-Calderón Claudia , Hernández Ulises Manuel , Retana Elizabeth Angelica , Ponce-Regalado María Dolores , Gamboa-Domínguez Armando , León-Contreras Juan Carlos , Muñoz-Cruz Samira , Hernández-Pando Rogelio , Pérez-Tapia Sonia M. , Chávez-Blanco Alma D. , Becerril-Villanueva Enrique , Chacón-Salinas Rommel
Published: November 2024

COVID-19 is an infectious disease caused by SARS-CoV-2; over the course of the disease, a dysregulated immune response leads to excessive inflammation that damages lung parenchyma and compromises its function. One of the cell lineages classically associated with pathological inflammatory processes is mast cells (MCs). MCs and their mediators have been associated with COVID-19; we previously reported the role of carboxypeptidase A3 (CPA3) in severe COVID-19. However, sequelae of SARS-CoV-2 infection have been poorly studied. In patients who successfully resolve the infection, one of the reported sequelae is pulmonary fibrosis (PF). The etiology and exact mechanisms are unknown, and few studies exist. Therefore, the aim of this study was to evaluate whether MCs are associated with PF development after SARS-CoV-2 infection. Our findings demonstrate that during severe cases of SARS-CoV-2 infection, there is an increased amount of CPA3+ MCs in areas with pneumonia, around thrombotic blood vessels, and in fibrotic tissue. Moreover, higher numbers of CPA3-expressing MCs correlate with fibrotic tissue development (r = 0.8323; p = 0.001170). These results suggest that during COVID-19, exacerbated inflammation favors the recruitment or expansion of MCs and CPA3 expression in the lungs, which favors tissue damage and a failure of repair mechanisms, leading to fibrosis.
Oxymatrine Ameliorates Lupus Nephritis by Targeting the YY1-Mediated IL-6/STAT3 Axis
Authors: Yuan Haoxing , Peng Zheng , Li Honglian , Rao Yuzhen , Lu Kunyu , Yang Chan , Cheng Chen , Liu Shuwen
Published: November 2024

Lupus nephritis (LN) is a severe form of systemic lupus erythematosus (SLE), characterized by inflammation in the renal glomeruli and tubules. Previous research has demonstrated that dihydroartemisinin (DHA) can reduce inflammatory damage in LN mouse models. Oxymatrine, which has similar biological properties to DHA, may also provide therapeutic benefits. This study aims to investigate the effects of oxymatrine on LN using a murine model and examines its molecular mechanisms through an analysis of microarray datasets from LN patients. The analysis identified differentially expressed genes (DEGs) in renal tissues, regulated by the transcription factor Yin Yang 1 (YY1), which was found to be significantly upregulated in LN patient kidneys. The results indicate that oxymatrine targets the YY1/IL-6/STAT3 signaling pathway. In cell models simulating renal inflammation, oxymatrine reduced YY1 expression and inhibited the secretion of inflammatory factors (IFs), thereby diminishing inflammation. YY1 is crucial in modulating IFs’ secretion and contributing to LN pathogenesis. Additionally, oxymatrine’s interaction with YY1, leading to its downregulation, appears to be a key mechanism in alleviating LN symptoms. These findings support oxymatrine as a promising therapeutic agent for LN, offering new avenues for treating this autoimmune kidney disorder.
Inflammatory Bowel Diseases in Spain: A View from the Present to the Future
Authors: Francés Raquel , Fu Yuanji , Desterke Christophe , Mata-Garrido Jorge
Published: November 2024

Inflammatory bowel disease (IBD), encompassing Crohn’s disease and ulcerative colitis, presents a growing health challenge in Spain. This review examines the current understanding of IBD through the lens of genetics, epigenetics, and metabolism, offering insights into future directions for research and clinical management. Recent advancements in genetic studies have identified numerous susceptibility loci, highlighting the complex interplay between genetic predisposition and environmental triggers. Epigenetic modifications, including DNA methylation and histone modification, further elucidate the pathogenesis of IBD, underscoring the role of gene–environment interactions. Metabolic alterations, particularly in the gut microbiome, emerge as crucial factors influencing disease onset and progression. The integration of multi-omics approaches has enhanced our comprehension of the molecular mechanisms underlying IBD, paving the way for personalized medicine. Looking forward, this review emphasizes the need for longitudinal studies and advanced bioinformatics tools to decode the intricate networks involved in IBD. Additionally, we discuss the potential of novel therapeutic strategies, including epigenetic drugs and microbiome modulation, as promising avenues for improved patient outcomes. This comprehensive overview provides a foundation for future research aimed at unraveling the complexities of IBD and developing innovative treatments tailored to the Spanish population.
The Nuchal Cord Conundrum: Understanding and Addressing Umbilical Entanglement in the Third Trimester of Pregnancy
Authors: Murlewska Julia , Witkowski Sławomir , Respondek-Liberska Maria , Strzelecka Iwona
Published: November 2024

Background/Objectives: Better understanding of and addressing umbilical entanglement in the third trimester of pregnancy is necessary to estimate its impact on fetal circulation. An analysis of single physiological pregnancies wrapped with one or two coils of the umbilical cord around the neck makes it possible to understand the severity of the problem and distinguish it from perinatal umbilical strangulation. Methods: In an echocardiographic study performed at 32.1 weeks of pregnancy in fetuses with one and two coils of the umbilical cord around the neck, the pulsatility index (PI) and the Tei index for the left (Tei LV) and right ventricle (Tei RV) of the heart were measured to evaluate cardiac function. Results: The study showed significantly higher Tei RV and Tei LV for fetuses with one (93 cases) and two coils of the umbilical cord around the fetal neck (26 cases) with respect to the control group of fetuses (680 cases) with no umbilical cord around the fetal neck, whereas PI UMBA did not differ significantly. Conclusions: Wrapping of the umbilical cord around the fetal neck may affect the study of the fetal heart without any mechanically induced compression of the umbilical vessels in normal pregnancy.
The Unique Challenge of Coronary Artery Disease in Adult Patients with Congenital Heart Disease
Authors: Borrelli Nunzia , Merola Assunta , Barracano Rosaria , Palma Michela , Altobelli Ippolita , Abbate Massimiliana , Papaccioli Giovanni , Ciriello Giovanni Domenico , Liguori Carmen , Sorice Davide , De Luca Lorenzo , Scognamiglio Giancarlo , Sarubbi Berardo
Published: November 2024

Advances in medical and surgical interventions have resulted in a steady increase in the number of patients with congenital heart disease (CHD) reaching adult age. Unfortunately, this ever-growing population faces an added challenge: an increased risk of acquiring coronary artery disease. This review provides insight into the complex interactions between coronary artery disease and CHD in adults. We describe the peculiar features of cardiac anatomy in these patients, the possible role cardiac sequelae may play in an increased risk of myocardial ischemia, and the diagnostic challenges in this patient group. Furthermore, this review outlines the risk factors and potential mechanisms of accelerated atherosclerosis in adults with CHD by pointing out areas where current knowledge is incomplete and highlighting areas for further research. The review concludes by examining potential management strategies for this particular population, emphasizing the necessity for a multidisciplinary approach. Understanding the unique coronary risks that adults with CHD experience can enhance patient care and improve long-term results.
Moderately Increased Left Ventricular Filling Pressure Suggesting Early Stage of Heart Failure with Preserved Ejection Fraction in Patients with Invasively Assessed Coronary Microvascular Dysfunction
Authors: Arkowski Jacek , Obremska Marta , Sareło Przemysław , Wawrzyńska Magdalena
Published: November 2024

Background: With modern diagnostic tools, incidence ischemia with no obstructive coronary atherosclerosis (INOCA) and heart failure with preserved ejection fraction (HFpEF) are found to be much higher than previously believed, and—as they lead to adverse cardiovascular outcomes—their causes and development are subjects of ongoing research. There is growing evidence that coronary microvascular dysfunction might be the underlying cause of both INOCA and HFpEF. Methods: In 65 patients with effort angina but no obstructive coronary artery disease, the index of microvascular resistance and coronary flow reserve were measured invasively in the LAD. The echocardiographic parameters, including left atrial strain, left ventricular strain, and indices of left ventricular diastolic dysfunction, were compared between two groups of patients: those with normal coronary microcirculation parameters and those with impaired coronary microvascular function. Results: Patients with coronary microvascular dysfunction had higher a E/E′ index than those with normal microvessel reactivity. This finding was further confirmed by ROC analysis. The groups did not differ significantly in values of other echocardiographic parameters, including the left ventricular and left atrial strain. The prevalence of classical cardiovascular risk factors was similar in both groups. Conclusions: The coexistence of impaired coronary microvascular function with moderately elevated left ventricular filling pressures might correspond to the co-development of early stages of coronary microvascular dysfunction and HFpEF.
Effectiveness and Personalized Approaches in the Correction of Gummy Smile: A Systematic Review of Orthodontic and Surgical Treatments
Authors: Inchingolo Alessio Danilo , Inchingolo Angelo Michele , Viapiano Fabio , Netti Anna , Ciocia Anna Maria , Ferrara Irene , Mancini Antonio , Palermo Andrea , Inchingolo Francesco , Dipalma Gianna
Published: November 2024

Background/Objectives: This systematic review seeks to assess the effectiveness of different orthodontic and combined orthodontic–surgical approaches for correcting gummy smile, with a focus on treatment efficacy, duration, and the potential for integrating various techniques. The objective is to offer evidence-based recommendations for the optimal management of gummy smile. Methods: A thorough search of the literature was conducted in the PubMed, Cochrane Library, Scopus, and Web of Science databases, covering publications from 1 January 1982 to 4 November 2024. Only randomized controlled trials involving adult human subjects with available full-text articles were included, while systematic reviews, editorials, case reports, and studies involving animals or in vitro experiments were excluded. Studies were selected based on their relevance to orthodontic or combined orthodontic–surgical treatments for correcting excessive gingival display (gummy smile), particularly in cases where residual growth does not impact treatment outcomes. The primary focus was on evaluating the efficacy of these interventions in improving smile aesthetics. Follow-up data were considered when available, though not required for inclusion. Results: The findings revealed that both orthodontic and surgical methods are effective in reducing gingival display. Orthognathic surgery offers lasting outcomes, particularly for patients with vertical maxillary excess, whereas orthodontic treatments, including the use of skeletal anchorage devices, are particularly effective for less severe cases. Minimally invasive approaches, such as botulinum toxin injections, provided temporary but promising results for patients reluctant to undergo surgery. Conclusions: Orthodontic and surgical techniques are viable options for treating gummy smile, with treatment choices depending on the condition’s severity. Future research, particularly long-term randomized studies, is required to further refine treatment protocols and improve patient outcomes.
Comparative Effects of Spinal Anesthesia and Combined Spinal with Peripheral Nerve Blocks on Postoperative Outcomes in Anterior Cruciate Ligament Repair
Authors: Berić Sanja , Murselović Tamara , Žižak Mark , Bulat Stjepan , Vrgoč Goran
Published: November 2024

Objectives: This study aimed to compare the effectiveness of spinal anesthesia (SA) alone versus combined spinal anesthesia with adductor canal block (ACB) and sciatic nerve block (SNB) (SA + ACB + SNB) in patients undergoing arthroscopic anterior cruciate ligament (ACL) reconstruction. We hypothesized that SA + ACB + SNB would provide better analgesia, greater patient satisfaction, and shorter postanesthesia recovery times than SA alone. Methods: A prospective randomized controlled trial was conducted with 60 patients aged 15–49 years scheduled for elective arthroscopic ACL reconstruction. Participants were randomly assigned to receive either SA or SA + ACB + SNB. Postoperative pain was assessed using the Visual Analog Scale (VAS) at 4, 12, and 24 h post-operation. General health was evaluated using the 12-item Short Form Survey (SF-12) at 1 month postoperatively. Range of motion and analgesic consumption were also recorded. Results: The median VAS score at 4 h post-operation was significantly lower in the SA + ACB + SNB group compared to the SA group (0 [IQR: 0–1] vs. 2 [IQR: 1–3], p = 0.0137). No significant differences in VAS scores were found at 12 h (p = 0.9282) and 24 h (p = 0.5809). PCS-12 and MCS-12 scores did not differ significantly between groups. The SA group had a lower postoperative range of motion (ROM) compared to the SA + ACB + SNB group, with a mean active ROM of 40.67 degrees (±23.52) versus 72.17 degrees (±24.69), respectively (p < 0.0001). Analgesic consumption was similar, with 53.33% of participants in each group using postoperative analgesics (p = 1.0). The mean surgery duration was 74.6 min. The gender distribution was 83% male and 17% female, with an average age of 27.7 years. Conclusions: Adding ACB and SNB to spinal anesthesia improved immediate postoperative pain relief and preserved range of motion in patients undergoing ACL reconstruction, suggesting potential clinical benefits in pain management and functional recovery.
Characterizing Cerebral Perfusion Changes in Subjective Cognitive Decline Using Single Photon Emission Computed Tomography: A Case-Control Study
Authors: Lin Yu-Kai , Lin Li-Fan , Kao Chun-Hao , Chen Ing-Jou , Cheng Cheng-Yi , Tsai Chia-Lin , Lee Jiunn-Tay , Sung Yueh-Feng , Chou Chung-Hsing , Yen Shang-Yi , Chiu Chuang-Hsin , Yang Fu-Chi
Published: November 2024

Background/Objectives: Subjective cognitive decline (SCD) may serve as an early indicator of Alzheimer’s disease (AD). This study investigates regional cerebral blood flow (rCBF) alterations in individuals with SCD using single photon emission computed tomography (SPECT). To characterize rCBF patterns in SCD patients compared to healthy controls and examine the relationship between rCBF and cognitive function. Methods: We compared rCBF in 20 SCD patients and 20 age- and sex-matched healthy controls using 99mTc-ECD SPECT imaging. Cognitive function was assessed using the Mini-Mental State Examination (MMSE), Clinical Dementia Rating (CDR), Geriatric Depression Scale (GDS), and Cognitive Abilities Screening Instrument (CASI). Results: SCD patients demonstrated significantly reduced rCBF in the right superior temporal gyrus (rSTG) (mean uptake ratio [UR] = 0.864 ± 0.090 vs. 1.030 ± 0.074, p < 0.001) and right caudate (mean UR = 0.783 ± 0.068 vs. 0.947 ± 0.062, p < 0.001) compared to controls. Additionally, negative correlations were observed between rCBF in these regions and CDR scores, particularly in the memory domain (rSTG: r = −0.37, p = 0.016; right caudate: r = −0.39, p = 0.011). Conclusions: Reduced rCBF in the rSTG and right caudate may represent early biomarkers for SCD, which could aid in the early detection of AD. These findings suggest that SPECT imaging might be a valuable tool for identifying individuals at risk of cognitive decline, potentially allowing for earlier intervention and targeted preventive strategies in the management of AD.
The Social Determinants of Health in a Cohort of Romanian Patients with Diabetic and Nondiabetic Neuropathy
Authors: Inceu Georgeta , Rusu Adriana , Gavan Norina Alinta , Bala Cornelia
Published: November 2024

Background/Objectives: The importance of the social determinants of health (SODHs) in diabetic and nondiabetic neuropathy has recently gained more attention. This retrospective study examined the correlation of incident diabetic neuropathy and neuropathy of other etiologies with SODH in Romania. Methods: All cases with the primary or secondary discharge diagnosis codes of neuropathy reported across Romania in 2019 were analyzed. The crude incidence rate was calculated per 100,000 persons for the whole population resident in Romania on the 1 July 2019. As SODHs sex, gross domestic product (GDP) per capita, unemployment rate, and the number of physicians/1000 persons were evaluated. Results: In total, 207,026 hospitalizations with a discharge diagnosis of neuropathy were recorded. Of these, 80,480 had a discharge diagnosis of diabetic neuropathy, with an incidence rate of 414.97 cases/100,000 persons. The incidence rate of diabetic neuropathy by county was correlated with the corresponding GDP (p = 0.013) and unemployment rate (p = 0.001). By sex, the correlation with GDP remained significant only for women (p = 0.010), while the correlation with unemployment rate remained significant in both sexes. No correlation was observed with the number of physicians/1000 persons/county. The incidence rate of neuropathy of other etiology was 652.49 cases/100,000 persons. No correlation between the incidence rate of neuropathy of other etiology by county and the corresponding GDP, unemployment rate or number of physicians/1000 persons was observed neither in the total sample nor by sex. Conclusions: Lower socioeconomic status was correlated with a higher incidence rate of hospitalized diabetic neuropathy and not with neuropathies of other etiologies.
Intraoperative Periprosthetic Fractures in Total Hip Arthroplasty: A 1.6-Million-Patient Analysis of Complications, Costs, and the Challenges in AI-Based Prediction
Authors: Maman David , Steinfeld Yaniv , Yonai Yaniv , Fournier Linor , Bar Ofek , Safir Oleg , Berkovich Yaron
Published: November 2024

Background: Periprosthetic fractures following total hip arthroplasty are serious complications occurring in up to 2.4% of primary cases, contributing to significant morbidity, extended hospital stays, and elevated healthcare costs. Predicting these fractures remains a challenge despite advances in surgical techniques and prosthetic materials. Methods: This study analyzed 1,634,615 cases of primary THA from the NIS database (2016–2019) using propensity score matching to compare outcomes between patients with and without intraoperative periprosthetic fractures. Predictive models, including logistic regression, decision tree, and deep neural network, were evaluated for their ability to predict fracture risk. Results: Patients with periprosthetic fractures exhibited a 14-fold increase in pulmonary embolism risk, a 12-fold increase in infections, and a 5-fold increase in hip dislocations. Fractures extended hospital stays (3.8 vs. 2.5 days) and added approximately USD 32,000 in costs per patient. The predictive models yielded low accuracy (AUC max = 0.605), underscoring the complexity of predicting periprosthetic fractures. Conclusions: Intraoperative periprosthetic fractures in THA significantly elevate complication rates, costs, and length of stay. Despite extensive modeling efforts, accurate prediction remains difficult, highlighting the need to focus on preventive strategies, such as improved surgical techniques and real-time intraoperative monitoring.
Performance of EuroSCORE II in Octogenarians Undergoing Coronary Artery Surgery (from the KROK Registry)
Authors: Hirnle Grzegorz , Aboul-Hassan Sleiman Sebastian , Knapik Piotr , Tobota Zdzisław , Maruszewski Bohdan , Rogowski Jan , Pawliszak Wojciech , Bugajski Paweł , Deja Marek , Hrapkowicz Tomasz ,   on behalf of the KROK Investigators
Published: November 2024

Background: Octogenarians constitute the fastest-growing segment within contemporary cardiac surgery, yet precise risk assessment in this age group remains challenging. Aims: This study aimed to evaluate EuroSCORE II reliability in octogenarians undergoing isolated coronary surgery and to create an adjustment formula if necessary. Patients and Methods: All octogenarians who had isolated coronary surgery in Poland from January 2012 to December 2023, recorded in the Polish National Registry of Cardiac Surgical Procedures (KROK registry), were retrospectively assessed. EuroSCORE II’s reliability was measured using the ROC curve area and observed-to-predicted mortality ratio, differentiating on-pump and off-pump cases. A nomogram was developed to enhance predictive accuracy. Results: Among 5771 octogenarians, 2729 (47.3%) underwent on-pump and 3042 (52.7%) underwent off-pump surgery. EuroSCORE II demonstrated reliability in off-pump patients (AUC:0.72, O/E ratio:0.98) but underestimated mortality for on-pump cases (AUC:0.73, O/E ratio:1.62). The lowest predicted mortality group (0.50–1.82%) showed the greatest discrepancies. Calibration was improved by adding a coefficient and creating a nomogram. Conclusions: EuroSCORE II was dependable in predicting outcomes for Polish octogenarians undergoing isolated coronary surgery. Observed mortality following on-pump surgeries was higher than expected, which was corrected by adding a coefficient to the initial EuroSCORE II calculation.