bluuebunny/crossref_metadata_2025 huggingface dataset:
Transcaval versus Supra-Aortic Vascular Accesses for Transcatheter Aortic Valve Replacement: A Systematic Review with Meta-Analysis
Authors: Antiochos Panagiotis , Kirsch Matthias , Monney Pierre , Tzimas Georgios , Meier David , Fournier Stephane , Ferlay Clémence , Nowacka Anna , Rancati Valentina , Abellan Christophe , Skalidis Ioannis , Muller Olivier , Lu Henri
Published: January 2024

A growing body of evidence suggests that extrathoracic vascular accesses for transcatheter aortic valve replacement (TAVR) yield favorable outcomes and can be considered as primary alternatives when the gold-standard transfemoral access is contraindicated. Data comparing the transcaval (TCv) to supra-aortic (SAo) approaches (transcarotid, transsubclavian, and transaxillary) for TAVR are lacking. We aimed to compare the outcomes and safety of TCv and SAo accesses for TAVR as alternatives to transfemoral TAVR. A systematic review with meta-analysis was performed by searching PubMed/MEDLINE and EMBASE databases for all articles comparing TCv-TAVR against SAo-TAVR published until September 2023. Outcomes included in-hospital or 30-day all-cause mortality (ACM) and postoperative complications. A total of three studies with 318 TCv-TAVR and 179 SAo-TAVR patients were included. No statistically significant difference was found regarding in-hospital or 30-day ACM (relative risk [RR] 1.04, 95% confidence interval [CI] 0.47–2.34, p = 0.91), major bleeding, the need for blood transfusions, major vascular complications, and acute kidney injury. TCv-TAVR was associated with a non-statistically significant lower rate of neurovascular complications (RR 0.39, 95%CI 0.14–1.09, p = 0.07). These results suggest that both approaches may be considered as first-line alternatives to transfemoral TAVR, depending on local expertise and patients’ anatomy. Additional data from long-term cohort studies are needed.
Oral Contraceptives Interact with Adiposity-Associated Markers in Patients with Multiple Sclerosis
Authors: Ferret-Sena Véronique , Ramos Catarina , Cascais Maria João , Capela Carlos , Sena Armando
Published: January 2024

Growing evidence suggests the involvement of adipose tissue in modulating the clinical course of relapsing–remitting multiple sclerosis (RRMS). This study aimed to investigate whether the intake of combined oral contraceptives (COCs) affects body weight and leptin and adiponectin (APN) blood levels in these patients. Clinical data from 62 women (M = 33.23 year) were recorded prior to the initiation of disease-modifying therapy. Patients who were taking COCs at the time of experiencing the first symptoms of disease (COC user) were compared with those who never used these formulations or stopped taking them before disease onset (COC non-user). Bivariate Pearson’s correlations and hierarchical multiple linear regressions analysis were conducted. Normalized APN levels were lower in the COC-using patients (p = 0.013). Negative correlations between waist circumference and normalized APN (p = 0.001) were observed only in the COC non-user patients. A longer duration of COC intake was associated with increased body mass index and waist circumference (p = 0.003). Normalized APN predicted the MS Severity Score (MSSS) (p = 0.020), but this correlation was lost in the COC user patients. After adjusting for confounders, only age (p = 0.027) and, later, disease onset (p = 0.014) were correlated with the MSSS. Larger and prospective studies are needed to investigate the interactions of sex steroids with adipose metabolism in modulating disease progression.
Fetal and Placental Causes of Elevated Serum Alpha-Fetoprotein Levels in Pregnant Women
Authors: Głowska-Ciemny Joanna , Szmyt Konrad , Kuszerska Agata , Rzepka Rafał , von Kaisenberg Constantin , Kocyłowski Rafał
Published: January 2024

The most common association related to alpha-fetoprotein (AFP) is fetal neural tube defect (NTD), and indeed, this is where the international career of this protein began. In times when ultrasonography was not yet technically advanced, the detection of high levels of AFP in maternal serum (MS-AFP) and amniotic fluid was the basis for suspecting neural tube defects. In cases where there was no confirmation of NTD, other causes were sought. It has been established that high titers of MS-AFP could originate in other defects or diseases, such as (1) increased proteinuria in severe fetal kidney diseases; (2) pathological overproduction in liver diseases; (3) penetration through the membranes of gastrointestinal organs exposed to amniotic fluid; (4) passage through the walls of skin vessels; and as a side effect of (5) hepatic hematopoiesis and increased transfer through the edematous placenta in fetal anemia. This article provides a review of the current literature on congenital defects and genetic diseases in the fetus where an elevated level of MS-AFP may serve as the initial diagnostic clue for their detection.
Extracellular DNA and Markers of Neutrophil Extracellular Traps in Saliva from Patients with Periodontitis—A Case–Control Study
Authors: Kovalčíková Alexandra Gaál , Novák Bohuslav , Roshko Oksana , Kovaľová Eva , Pastorek Michal , Vlková Barbora , Celec Peter
Published: January 2024

Periodontitis is a chronic inflammatory disease. We have previously shown that salivary DNA is higher in patients with periodontitis. Neutrophil extracellular traps (NETs) are involved in the pathogenesis of chronic inflammatory diseases. The objective of this case–control study was to compare patients with periodontitis and healthy controls regarding the salivary concentrations of extracellular DNA and NET components. Unstimulated saliva samples were collected from 49 patients with periodontitis and 71 controls before an oral examination. Salivary extracellular DNA was isolated and quantified fluorometrically and using PCR. NET-associated markers were assessed using ELISA. We have found significantly higher concentrations of salivary extracellular DNA in samples from periodontitis patients (five-times higher for supernatant and three times for pellet). Our results show that patients also have three-times-higher salivary nucleosomes and NET-associated enzymes—myeloperoxidase and neutrophil elastase (both two-times higher). Neutrophil elastase and salivary DNA in the pellet correlated positively with the pocket depth/clinical attachment level in periodontitis patients (r = 0.31—weak correlation; p = 0.03 and r = 0.41—moderate correlation, p = 0.004). Correlations between salivary extracellular DNA and NET enzymes were positive and significant. Based on our results, the higher salivary extracellular DNA in periodontitis seems to be related to components of NETs, albeit with weak to moderate correlations indicating that NETs are produced in periodontitis and can play a role in its pathogenesis similarly to other inflammatory diseases. Further studies should prove this assumption with potential diagnostic and therapeutic consequences.
Effect of Respiratory Failure on Peripheral and Organ Perfusion Markers in Severe COVID-19: A Prospective Cohort Study
Authors: Gutowski Mateusz , Klimkiewicz Jakub , Rustecki Bartosz , Michałowski Andrzej , Paryż Kamil , Lubas Arkadiusz
Published: January 2024

Microvascular dysfunction and inflammation caused by COVID-19 disrupt organ function. The study aimed to investigate the association between the severity of SARS-CoV-2 pneumonia and peripheral and organ perfusion as a consequence of altered microcirculation. A total of 116 patients hospitalized due to severe COVID-19 were enrolled in the study. On admission, the patients underwent a Capillary Refill Time (CRT) examination, finger oxygen saturation measurement, thermal imaging of the hand (FIT), and a kidney Doppler ultrasound. Medical data were collected from the medical history. From the evaluated perfusion parameters, only renal cortex perfusion (RCP) was substantially correlated with the CT score (p < 0.010). The peripheral perfusion parameters of Sat., FIT, CRT, and RCP correlated with the ARDS stages (p = 0.0021; p = 0.038; p < 0.0006; p < 0.0002, respectively). The Oxygenation Ratio value (p < 0.001) was significantly associated with all the perfusion parameters (saturation, CRT, FIT, and RCP) in the multivariable regression analysis model. According to the stepwise retrograde regression analysis, RCP was an independent parameter linked with the Oxygenation Ratio (p < 0.001). Severe COVID-19 can result in microvascular dysfunction influencing peripheral and organ perfusion, which can be measured with various methods. The staging of COVID-19 assessed by CT and the Oxygenation Ratio correlates with RCP, CRT, FIT, and oxygen saturation.
Transcatheter Aortic Valve Replacement as a bridge to minimally invasive endoscopic mitral valve surgery in Elderly Patients in the era of ERAS and Fast Track TAVI concepts
Authors: Owais Tamer , Bisht Osama , Polat Emre , Abdelmoteleb Noureldin , El Garhy Mohammad , Lauten Phillip , Kuntze Thomas , Girdauskas Evaldas
Published: January 2024

In this bicentric study, we report the outcomes of combined transcatheter aortic valve replacement combined with minimally invasive mitral valve surgery. We included a cohort of six patients (79.6 ± 3.2 years, 83% women) with high-risk profiles and deemed to be non-operable with combined mitral and aortic valvular disease. All patients had unsuitable anatomies for transcatheter mitral valve edge-to-edge repair (TEER). Moreover, most of the patients (5/6) suffered a combined aortic valve lesion, which complicates the efficiency of cardioplegia in the case of CBP through minimally invasive incisions. The first stage was implanting a TAVI valve to achieve aortic valve competency and hence facilitate the infusion of cardioplegia after clamping the aorta during endoscopic mitral valve surgery. After one week, we performed the minimally invasive mitral valve repair. Most patients (n = 5; 83%) underwent successful endoscopic mitral valve repair. Intraoperatively, the mean ischemic time was 42 min, and the total bypass time was 72 min. Postoperatively, the mean intubation time was 0 h. Postoperative complications included reoperation for bleeding in one patient (16.7%) and a new heart block requiring pacemaker implantation in one patient (16.7%). There was neither in-hospital mortality nor 1-year mortality.
A Systematic Review of the Pulmonary Microbiome in Patients with Acute Exacerbation COPD Requiring ICU Admission
Authors: van der Bie Sjoerd , Haaksma Mark E. , Vermin Ben , van Assema Hidde , van Gorp Eric C. M. , Langerak Thomas , Endeman Henrik , Snijders Dominic , van den Akker Johannes P. C. , van Houten Marlies A. , van Lelyveld Steven F. L. , Goeijenbier Marco
Published: January 2024

Background: Chronic obstructive pulmonary disease (COPD) is a major health concern. Acute exacerbations (AECOPD) may require intensive care unit (ICU) admission and mechanical ventilation. Acute infections and chronic colonization of the respiratory system are known to precipitate AECOPD. Detailed knowledge of the respiratory microbiome could lead to effective treatment and prevention of exacerbations. Objective: The aim of this review is to summarize the available evidence on the respiratory microbiome of patients with a severe AECOPD requiring mechanical ventilation and intensive care admission. Methods: A systematic literature search was conducted to identify the published papers until January 2023. The collected data were then subjected to qualitative analysis. After the first analysis, a secondary focused review of the most recent publications studying the relationship between microbiome and mortality in AECOPD was performed. Results: Out of 120 screened articles six articles were included in this review. Potentially pathogenic microorganisms (PPMs) were identified in 30% to 72% of the patients with community-acquired bacteria, gram-negative enteric bacilli, Stenotrophomonas and Pseudomonas being the most frequently isolated. During hospitalization, 21% of patients experienced colonization by PPMs. Adequate antimicrobial therapy resulted in the eradication of 77% of the identified PPMs. However, 24% of the bacteria displayed multi-drug resistance leading to prolonged or failure of eradication. Conclusion: PPMs are prevalent in a significant proportion of patients experiencing an AECOPD. The most identified PPMs include community-acquired pathogens and gram-negative enteric bacilli. Notably, no differences in mortality or duration of ventilation were observed between patients with and without isolated PPMs. However, the included studies did not investigate the virome of the patients, which may influence the microbiome and the outcome of infection. Therefore, further research is essential to comprehensively investigate the complete microbial and viral composition of the lower respiratory system in COPD patients admitted to the ICU.
Mechanical Circulatory Support Strategies in Takotsubo Syndrome with Cardiogenic Shock: A Systematic Review
Authors: von Mackensen Johanna K. R. , Zwaans Vanessa I. T. , El Shazly Ahmed , Van Praet Karel M. , Heck Roland , Starck Christoph T. , Schoenrath Felix , Potapov Evgenij V. , Kempfert Joerg , Jacobs Stephan , Falk Volkmar , Wert Leonhard
Published: January 2024

Background: Takotsubo syndrome is, by definition, a reversible form of acute heart failure. If cardiac output is severely reduced, Takotsubo syndrome can cause cardiogenic shock, and mechanical circulatory support can serve as a bridge to recovery. To date, there are no recommendations on when to use mechanical circulatory support and on which device is particularly effective in this context. Our aim was to determine the best treatment strategy. Methods: A systematic literature research and analysis of individual patient data was performed in MEDLINE/PubMed according to PRISMA guidelines. Our research considered original works published until 31 July 2023. Results: A total of 93 publications that met the inclusion criteria were identified, providing individual data from 124 patients. Of these, 62 (50%) were treated with veno-arterial extracorporeal life support (va-ECLS), and 44 (35.5%) received a microaxial left ventricular assist device (Impella). Eighteen patients received an Impella CP and twenty-one an Impella 2.5. An intra-aortic balloon pump (IABP) without other devices was used in only 13 patients (10.5%), while other devices (BiVAD or Tandem Heart) were used in 5 patients (4%). The median initial left ventricular ejection fraction was 20%, with no difference between the four device groups except for the IABP group, which was less affected by cardiac output failure (p = 0.015). The overall survival was 86.3%. Compared to the other groups, the time to cardiac recovery was shorter with Impella (p < 0.001). Conclusions: Though the Impella treatment is new, our analysis may show a significant benefit of Impella compared to other MCS strategies for cardiogenic shock in Takotsubo syndrome.
The Occurrence of Atopy in Patients with Isolated Spontaneous Mast Cell (or Nonallergic) Angioedema
Authors: Zajac Magdalena , Bozek Andrzej , Grzanka Alicja
Published: January 2024

Background: Isolated mast cell angioedema (MC-AE) can be divided into allergic and nonallergic (spontaneous) forms. The former is often associated with food, Hymenoptera venoms or drug allergies. This study aimed to evaluate the relationship between the occurrence of atopic diseases and the risk of angioedema. Methods: A retrospective study analyzed 304 patients with confirmed MC-AE and 1066 controls. All were analyzed for allergic asthma (AA), atopic dermatitis (AD) and allergic rhinitis (AR) based on ICD-10 codes. In addition, total IgE and peripheral eosinophilia were calculated. Results: The analyzed atopic diseases were more frequent in the group of patients diagnosed with MC-AE than in the controls: 78 (25.7%) vs. 173 (16.2%) for p < 0.01. Patients diagnosed with AD had a higher risk of MC-AE (hazard ratio (HR) = 1.48,) similar to those diagnosed with AR (HR = 1.51). However, in patients with two or three atopic comorbidities, the risk increased significantly to HR = 2.45 or HR = 4.1, respectively. There was a positive correlation between the serum total IgE concentration or eosinophilia and the risk of angioedema (p < 0.01). Conclusion: Patients with MC-AE had a more frequent occurrence of atopic diseases associated with inhalant allergies. This risk increased in patients with IgE-mediated polymorphic disease.
Artificial Intelligence-Based Aquaculture System for Optimizing the Quality of Water: A Systematic Analysis
Authors: Capetillo-Contreras Omar , Pérez-Reynoso Francisco David , Zamora-Antuñano Marco Antonio , Álvarez-Alvarado José Manuel , Rodríguez-Reséndiz Juvenal
Published: January 2024

The world population is expected to grow to around 9 billion by 2050. The growing need for foods with high protein levels makes aquaculture one of the fastest-growing food industries in the world. Some challenges of fishing production are related to obsolete aquaculture techniques, overexploitation of marine species, and lack of water quality control. This research systematically analyzes aquaculture technologies, such as sensors, artificial intelligence (AI), and image processing. Through the systematic PRISMA process, 753 investigations published from 2012 to 2023 were analyzed based on a search in Scopus and Web of Science. It revealed a significant 70.5% increase in the number of articles published compared to the previous year, indicating a growing interest in this field. The results indicate that current aquaculture technologies are water monitoring sensors, AI methodologies such as K-means, and contour segmentation for computer vision. Also, it is reported that K means technologies offer an efficiency from 95% to 98%. These methods allow decisions based on data patterns and aquaculture insights. Improving aquaculture methodologies will allow adequate management of economic and environmental resources to promote fishing and satisfy nutritional needs.
Estimating Total Suspended Matter and Analyzing Influencing Factors in the Pearl River Estuary (China)
Authors: Ma Zhaoyue , Zhao Yong , Zhao Wenjing , Feng Jiajun , Liu Yingying , Tsou Jin Yeu , Zhang Yuanzhi
Published: January 2024

This study on total suspended matter (TSM) in the Pearl River Estuary established a regression analysis model using Landsat 8 reflectance and measured TSM data, crucial for environmental management and engineering projects. High coefficients of determination (>0.6) were reported for the selected models. TSM concentration was notably high in 2013, peaking at 180 mg/L during the flood season and 80 mg/L in the dry season. In contrast, 2020 saw lower concentrations. Similar spatial distribution patterns were observed during dry and flood seasons, with high nearshore and low offshore TSM concentrations. Statistical analyses revealed natural factors (precipitation and runoff) as major influencers of the TSM distribution, with human activities presenting localized, limited impacts, except under long-term and large-scale conditions. Over time, the influence of large-scale water-based construction, such as the Hong Kong–Zhuhai–Macao Bridge, on TSM distribution became significant.
The Diverse Mycorrizal Morphology of Rhododendron dauricum, the Fungal Communities Structure and Dynamics from the Mycorrhizosphere
Authors: Liu Jin , Xu Yang , Si Yan-Ji , Li Bin-Qi , Chen Peng , Wu Ling-Ling , Guo Pu , Ji Rui-Qing
Published: January 2024

It is generally believed that mycorrhiza is a microecosystem composed of mycorrhizal fungi, host plants and other microscopic organisms. The mycorrhiza of Rhododendron dauricum is more complex and the diverse morphology of our investigated results displays both typical ericoid mycorrhizal characteristics and ectomycorrhizal traits. The characteristics of ectendoomycorrhiza, where mycelial invade from the outside into the root cells, have also been observed. In order to further clarify the mycorrhizal fungi members and other fungal communities of R. dauricum mycorrhiza, and explore the effects of vegetation and soil biological factors on their community structure, we selected two woodlands in the northeast of China as samples—one is a mixed forest of R. dauricum and Quercus mongolica, and the other a mixed forest of R. dauricum, Q. mongolica, and Pinus densiflor. The sampling time was during the local growing season, from June to September. High-throughput sequencing yielded a total of 3020 fungal amplicon sequence variants (ASVs), which were based on sequencing of the internal transcribed spacer ribosomal RNA (ITS rRNA) via the Illumina NovaSeq platform. In the different habitats of R. dauricum, there are differences in the diversity of fungi obtained from mycorrhizal niches, and specifically the mycorrhizal fungal community structure in the complex vegetation of mixed forests, where R. dauricum is found, exhibits greater stability, with relatively minor changes over time. Soil fungi are identified as the primary source of fungi within the mycorrhizal niche, and the abundance of mycorrhizal fungi from mycorrhizal niches in R. dauricum is significantly influenced by soil pH, organic matter, and available nitrogen. The relationship between soil fungi and mycorrhizal fungi from mycorrhizal niches is simultaneously found to be intricate, while the genus Hydnellum emerges as a central genus among mycorrhizal fungi from mycorrhizal niches. However, there is currently a substantial gap in the foundational research of this genus, including the fact that mycorrhizal fungi from mycorrhizal niches have, compared to fungi present in the soil, proven to be more sensitive to changes in soil moisture.
Disinformation and Local Media in the Iberian Context: How to Protect News Credibility
Authors: Fernández-Barrero Ángeles , Rivas-de-Roca Rubén , Pérez-Curiel Concha
Published: January 2024

Regional and local media outlets have much more credibility than news organizations placed at a national level, according to polls. In a context fueled by the spread of disinformation, audiences seem to trust close journalistic sources, while national and international leaders are seen as polarized. However, local journalism has few resources for fact checking. In this context, we explore some of the strategies developed by local news organizations to avoid the proliferation of fake news. This study uses a multiple-case study on four local media outlets from similar media systems (Spain and Portugal) as a qualitative research strategy. Drawing upon in-depth interviews with local journalists and secondary data analysis, we examine how these media outlets deal with fake news, shedding light on internal fact-checking resources and other original strategies applied. From our interviews, their journalists are aware of the problem, asking for more training; whereas their organizations have different approaches to the digital platforms where most of disinformation circulates. These findings contribute to the scant literature on the role of the local field in disinformation, arguing that the social mission of local journalism may be a guarantee against fake news if their journalists are trained.
The Validation of the Speech, Spatial and Qualities of Hearing Scale SSQ12 for Native Romanian Speakers with and without Hearing Impairment
Authors: Radulescu Luminita , Astefanei Oana , Serban Roxana , Cozma Sebastian , Butnaru Corina , Martu Cristian
Published: January 2024

Background: The perceived impact of hearing loss varies considerably among those affected due to the heterogeneous types of hearing loss, their diverse etiologies, and the different rehabilitation possibilities. Therefore, assessing listening skills in a daily context using questionnaires is essential. This study aimed to investigate the validity and reliability of the adapted version of the Speech, Spatial and Qualities of Hearing Scale 12 (SSQ12) in the Romanian language. Materials and Methods: The SSQ12 is a 12-item self-reporting questionnaire that assesses a range of everyday listening situations. The internal consistency, test–retest reliability, and validity of the r-SSQ12 questionnaire resulting from the adaptation of the original scale were investigated. Results: The responses of 183 subjects aged between 11 and 79 years were evaluated. In total, 121 subjects had hearing loss (19 adolescents), and 62 subjects had normal hearing (11 adolescents). Significant differences were observed in the means of the overall score and for individual items between normal-hearing subjects and subjects with hearing loss. The SSQ12 had high internal consistency (Cronbach’s alpha = 0.97), and the test–retest scores were highly correlated. Conclusions: The SSQ12 scale can be used to investigate the self-reporting of hearing quality in both general populations to identify hearing disorders and populations with hearing loss.
Stockholder Wealth Maximization during the Troubled Asset Relief Program Period: Is Executive Pay Harmful?
Authors: Junarsin Eddy , Pelawi Rizky Yusviento , Pelawi Jeffrey Bastanta , Kristanto Jordan
Published: January 2024

This study investigates governance mechanisms and their relation to firm value, i.e., executive compensation restrictions during the regulatory period and their effects on the performance of firms that received Troubled Asset Relief Program (TARP) funds. We employ an event study to investigate the market reactions for TARP recipients, followed by OLS regression to examine the stock return effects of 10 announcements. For comparison, we also employ a multivariate regression model (MVRM) based on a system of equations with seemingly unrelated regressions (SURs). Our evidence shows that changes in firm value have a negative and significant relationship with changes in total compensation for TARP companies that have paid back their debts to the government. However, the relationship is weaker than that for TARP companies that have not paid back the bailout money.
The Effect of Myopic Control between the Dual-Focus Contact Lenses and High-Concentration Atropine in an Asian Population
Authors: Lee Chia-Yi , Yang Shun-Fa , Chang Yu-Ling , Huang Jing-Yang , Lian Ie-Bin , Chang Chao-Kai
Published: January 2024

We aim to investigate the myopic control effect of high-concentration atropine (ATR) and dual-focus contact lenses (DFCLs). A retrospective cohort study was conducted. A total of 182 eyes in 91 individuals who used high-concentration ATR (0.125%) and another 70 eyes in 35 individuals who used DFCLs were enrolled in the ATR and DFCL groups, respectively. The primary outcomes were spherical equivalent refraction (SER) progression and axial length (AXL) elongation. The generalized estimate equation was utilized to yield the adjusted odds ratio (aOR) and 95% confidence interval (CI) of cycloplegic SER progression and AXL elongation between groups. According to the multivariable analysis, the change in cycloplegic SER progression was similar between the DFCL and ATR groups (aOR: 1.305, 95% CI: 0.247–2.515, p = 0.803). The DFCL group demonstrated a numerically higher rate of AXL elongation compared to the ATR group (aOR: 1.530, 95% CI: 0.980–1.894, p = 0.051). In the subgroup analysis, cycloplegic SER progression was insignificant between ATR and DFCL users in different subgroups (all p > 0.05). The DFCL patients with moderate astigmatism and high AXL (both p < 0.001) presented a high risk of AXL elongation. In conclusion, DFCL usage demonstrated similar myopic control of cycloplegic SER and AXL compared to high-concentration ATR, while DFCLs showed lower AXL control, mainly in patients with moderate astigmatism and high AXL.
Primary Role of the Kidney in Pathogenesis of Hypertension
Authors: Kim Gheun-Ho
Published: January 2024

Previous transplantation studies and the concept of ‘nephron underdosing’ support the idea that the kidney plays a crucial role in the development of essential hypertension. This suggests that there are genetic factors in the kidney that can either elevate or decrease blood pressure. The kidney normally maintains arterial pressure within a narrow range by employing the mechanism of pressure-natriuresis. Hypertension is induced when the pressure-natriuresis mechanism fails due to both subtle and overt kidney abnormalities. The inheritance of hypertension is believed to be polygenic, and essential hypertension may result from a combination of genetic variants that code for renal tubular sodium transporters or proteins involved in regulatory pathways. The renin-angiotensin-aldosterone system (RAAS) and sympathetic nervous system (SNS) are the major regulators of renal sodium reabsorption. Hyperactivity of either the RAAS or SNS leads to a rightward shift in the pressure-natriuresis curve. In other words, hypertension is induced when the activity of RAAS and SNS is not suppressed despite increased salt intake. Sodium overload, caused by increased intake and/or reduced renal excretion, not only leads to an expansion of plasma volume but also to an increase in systemic vascular resistance. Endothelial dysfunction is caused by an increased intracellular Na+ concentration, which inhibits endothelial nitric oxide (NO) synthase and reduces NO production. The stiffness of vascular smooth muscle cells is increased by the accumulation of intracellular Na+ and subsequent elevation of cytoplasmic Ca++ concentration. In contrast to the hemodynamic effects of osmotically active Na+, osmotically inactive Na+ stimulates immune cells and produces proinflammatory cytokines, which contribute to hypertension. When this occurs in the gut, the microbiota may become imbalanced, leading to intestinal inflammation and systemic hypertension. In conclusion, the primary cause of hypertension is sodium overload resulting from kidney dysregulation.
Laparoscopic Approach to Primary Splenic Cyst: Case Report and Review of the Literature
Authors: Tiutiuca Razvan , Nastase Puscasu Alina , Stoenescu Nicoleta , Moscalu Mihaela , Bradea Costel , Eva Iuliana , Lupascu Cristian , Ivan Luminita , Palaghia Madalina , Prisecariu Denisa , Târcoveanu Eugen , Vâță Andrei , Bejan Valentin , Vasilescu Alin
Published: January 2024

Splenic cysts are rare benign lesions of the spleen, often asymptomatic and incidentally discovered during imaging studies. While many splenic cysts remain asymptomatic and do not require intervention, surgical management becomes essential in cases of symptomatic cysts, large cysts, or when malignancy cannot be ruled out. Laparoscopic surgery has emerged as a minimally invasive and effective approach for treating splenic cysts, offering advantages such as shorter hospital stays, reduced postoperative pain, and faster recovery. In this case report, we describe our experience with laparoscopic surgery for a symptomatic splenic cyst in a young patient.
Novel Activity of Oral Hypoglycemic Agents Linked with Decreased Formation of Tryptophan Metabolite, Kynurenic Acid
Authors: Bednarz Kinga , Kozieł Kamila , Urbańska Ewa M.
Published: January 2024

Kynurenic acid is a tryptophan (Trp) metabolite formed along the kynurenine (KYN) pathway in the brain and in peripheral tissues. The disturbed formation of kynurenic acid, which targets glutamate-mediated neurotransmission, GPR35, and aryl hydrocarbon receptors of immune or redox status, was implicated in the development of neuropsychiatric and metabolic disorders among others. Kynurenic acid exerts neuroprotective and immunomodulatory effects, yet its high brain levels may negatively impact cognition. Changes in the Trp–KYN pathway are also linked with the pathogenesis of diabetes mellitus, which is an established risk factor for cardiovascular and neurological diseases or cognitive deficits. Here, the effects of metformin and glibenclamide on the brain synthesis of kynurenic acid were evaluated. Acute exposure of rat cortical slices in vitro to either of the drugs reduced kynurenic acid production de novo. Glibenclamide, but not metformin, inhibited the activity of kynurenic acid biosynthetic enzymes, kynurenine aminotransferases (KATs) I and II, in semi-purified cortical homogenates. The reduced availability of kynurenic acid may be regarded as an unwanted effect, possibly alleviating the neuroprotective action of oral hypoglycemic agents. On the other hand, considering that both compounds ameliorate the cognitive deficits in animal and human studies and that high brain kynurenic acid may hamper learning and memory, its diminished synthesis may improve cognition.
Adopting New Machine Learning Approaches on Cox’s Partial Likelihood Parameter Estimation for Predictive Maintenance Decisions
Authors: Godoy David R. , Álvarez Víctor , Mena Rodrigo , Viveros Pablo , Kristjanpoller Fredy
Published: January 2024

The Proportional Hazards Model (PHM) under a Condition-Based Maintenance (CBM) policy is used by asset-intensive industries to predict failure rate, reliability function, and maintenance decisions based on vital covariates data. Cox’s partial likelihood optimization is a method to assess the weight of time and conditions into the hazard rate; however, parameter estimation with diverse covariates problem could have multiple and feasible solutions. Therefore, the boundary assessment and the initial value strategy are critical matters to consider. This paper analyzes innovative non/semi-parametric approaches to address this problem. Specifically, we incorporate IPCRidge for defining boundaries and use Gradient Boosting and Random Forest for estimating seed values for covariates weighting. When applied to a real case study, the integration of data scaling streamlines the handling of condition data with diverse orders of magnitude and units. This enhancement simplifies the modeling process and ensures a more comprehensive and accurate underlying data analysis. Finally, the proposed method shows an innovative path for assessing condition weights and Weibull parameters with data-driven approaches and advanced algorithms, increasing the robustness of non-convex log-likelihood optimization, and strengthening the PHM model with multiple covariates by easing its interpretation for predictive maintenance purposes.
Numerical Analysis of Blood Clot Mechanical Behavior in Relation to Blood Flow Inside the Popliteal Vein
Authors: Brusokas Mantas , Jasevičius Raimondas
Published: January 2024

In this work, blood clot behavior under the influence of the mechanical effect of blood flow was analyzed. Attention is mainly paid to the deformation of the thrombus in the event of an alternating effect of blood flow in the blood vessel of the human leg. It is assumed that the higher stress accumulation is associated with a decrease in the width of the lumen of the blood vessel. The idea is to represent a critical case when embolus can form. The geometry of the thrombus is selected on the basis of existing blood patterns. Modeling is performed using COMSOL Multiphysics software. The results reflect the distribution of stress and blood velocity over time. The work selected a critical case, when the formation of an embolus is possible due to the deformation of the thrombus by the blood flow. Research is important for studying the behavior of thrombus formation at different periods of time, and also taking into account the specific geometry of thrombus deformation for the purpose of predicting embolisms. The results are observed due to increased deformations in the appropriate areas of the clot, whose tests show specific blood deformation from the alternating effects of blood on different sections of the vessels.
A Validation of the Phenomenon of Linearly Many Faults on Burnt Pancake Graphs with Its Applications
Authors: Gu Mei-Mei , Yan Hong-Xia , Chang Jou-Ming
Published: January 2024

“Linearly many faults” is a phenomenon observed by Cheng and Lipták in which a specific structure emerges when a graph is disconnected and often occurs in various interconnection networks. This phenomenon means that if a certain number of vertices or edges are deleted from a graph, the remaining part either stays connected or breaks into one large component along with smaller components with just a few vertices. This phenomenon can be observed in many types of graphs and has important implications for network analysis and optimization. In this paper, we first validate the phenomenon of linearly many faults for surviving graph of a burnt pancake graph BPn when removing any edge subset with a size of approximately six times λ(BPn). For graph G, the ℓ-component edge connectivity denoted as λℓ(G) (resp., the ℓ-extra edge connectivity denoted as λ(ℓ)(G)) is the cardinality of a minimum edge subset S such that G−S is disconnected and has at least ℓ components (resp., each component of G−S has at least ℓ+1 vertices). Both λℓ(G) and eλ(ℓ)(G) are essential metrics for network reliability assessment. Specifically, from the property of “linearly many faults”, we may further prove that λ5(BPn)=λ(3)(BPn)+3=4n−3 for n⩾5; λ6(BPn)=λ(4)(BPn)+4=5n−4 and λ7(BPn)=λ(5)(BPn)+5=6n−5 for n⩾6.
Predicting Critical Path of Labor Dispute Resolution in Legal Domain by Machine Learning Models Based on SHapley Additive exPlanations and Soft Voting Strategy
Authors: Guan Jianhua , Yu Zuguo , Liao Yongan , Tang Runbin , Duan Ming , Han Guosheng
Published: January 2024

The labor dispute is one of the most common civil disputes. It can be resolved in the order of the following steps, which include mediation in arbitration, arbitration award, first-instance mediation, first-instance judgment, and second-instance judgment. The process can cease at any step when it is successfully resolved. In recent years, due to the increasing rights awareness of employees, the number of labor disputes has been rising annually. However, resolving labor disputes is time-consuming and labor-intensive, which brings a heavy burden to employees and dispute resolution institutions. Using artificial intelligence algorithms to identify and predict the critical path of labor dispute resolution is helpful for saving resources and improving the efficiency of, and reducing the cost of dispute resolution. In this study, a machine learning approach based on Shapley Additive exPlanations (SHAP) and a soft voting strategy is applied to predict the critical path of labor dispute resolution. We name our approach LDMLSV (stands for Labor Dispute Machine Learning based on SHapley additive exPlanations and Voting). This approach employs three machine learning models (Random Forest, Extra Trees, and CatBoost) and then integrates them using a soft voting strategy. Additionally, SHAP is used to explain the model and analyze the feature contribution. Based on the ranking of feature importance obtained from SHAP and an incremental feature selection method, we obtained an optimal feature subset comprising 33 features. The LDMLSV achieves an accuracy of 0.90 on this optimal feature subset. Therefore, the proposed approach is a highly effective method for predicting the critical path of labor dispute resolution.
Neural Network Algorithm with Reinforcement Learning for Microgrid Techno-Economic Optimization
Authors: Hussein Farh Hassan
Published: January 2024

Hybrid energy systems (HESs) are gaining prominence as a practical solution for powering remote and rural areas, overcoming limitations of conventional energy generation methods, and offering a blend of technical and economic benefits. This study focuses on optimizing the sizes of an autonomous microgrid/HES in the Kingdom of Saudi Arabia, incorporating solar photovoltaic energy, wind turbine generators, batteries, and a diesel generator. The innovative reinforcement learning neural network algorithm (RLNNA) is applied to minimize the annualized system cost (ASC) and enhance system reliability, utilizing hourly wind speed, solar irradiance, and load behavior data throughout the year. This study validates RLNNA against five other metaheuristic/soft-computing approaches, demonstrating RLNNA’s superior performance in achieving the lowest ASC at USD 1,219,744. This outperforms SDO and PSO, which yield an ASC of USD 1,222,098.2, and MRFO, resulting in an ASC of USD 1,222,098.4, while maintaining a loss of power supply probability (LPSP) of 0%. RLNNA exhibits faster convergence to the global solution than other algorithms, including PSO, MRFO, and SDO, while MRFO, PSO, and SDO show the ability to converge to the optimal global solution. This study concludes by emphasizing RLNNA’s effectiveness in optimizing HES sizing, contributing valuable insights for off-grid energy systems in remote regions.
Role of Elevated Serum TGF-β1 and the Common Promoter TGFB1-509C/T Polymorphism in the Development and Progression of Primary Glial Tumors and Brain Metastases
Authors: Aleksandrova Elina , Mindov Ivan , Petrov Bozhidar , Dimitrova Ivelina , Petrov Nikolay , Ananiev Julian , Vlaykova Tatyana , Valkanov Stefan
Published: January 2024

Background and Objectives: The role of transforming growth factor-beta1 (TGF-β1) has been widely studied in the context of carcinogenesis. It has been involved in the pathogenesis of primary brain tumors or brain metastases due to its pleiotropic effects on immune regulation and tissue homeostasis. In line with recent findings, the aim of the current study was to examine the role of circulating TGF-β1 and the -509C/T functional polymorphism (rs1800469) in the TGFB1 gene promoter in the susceptibility and progression of primary brain tumors and brain metastases among patients from the Bulgarian population. Materials and Methods: Cases with a confirmed diagnosis were genotyped by the polymerase chain reaction-restriction fragment length polymorphism assay (PCR-RFLP). Serum TGF-β1 levels were determined by ELISA. Immunohistochemical evaluation of the expression of TGF-β1 and the TGF-β1 receptor-type II was conducted. Results: We observed that TGF-β1 serum levels correlate with the genotype and are sex-related. TGF-β1 serum levels were significantly elevated in patients compared to controls. Additionally, the T/T-genotype determined higher circulating levels of the cytokine. The same genotype determined the shorter median survival after surgery for the patients. The immunohistochemical analysis revealed a statistical tendency: cases expressing TGF-β1 in the cytoplasm had elevated levels of the cytokine in the serum compared to the negative cases. Conclusions: Overall, our results indicate a negative effect of the T-allele on the predisposition and prognosis of brain malignancies, and the genetically determined higher TGF-β1 serum levels might contribute to the worse prognosis and metastatic capacity of brain malignancies.
Clinical Investigation of the Inhibitory Effects of Tooth-Coating Materials on Initial Active Root Caries: A Pilot Randomized Controlled Trial
Authors: Asahi Yoko , Naito Katsuaki , Kanda Hikaru , Niwano Kazuaki , Takegawa Daisuke , Yumoto Hiromichi , Noiri Yuichiro , Hayashi Mikako
Published: January 2024

Background and Objectives: Caredyne ZIF-C is a novel, capsule-mixed zinc-containing prototype glass ionomer cement (GIC). Zinc ions are reported to inhibit root dentin demineralization, dentin collagen degradation, bacterial growth, acid production, and in vitro bacterial biofilm formation. However, the effectiveness of GICs against initial root caries lesions is unclear. Therefore, this study aimed to evaluate the efficacy of GICs, especially the new zinc-containing Caredyne ZIF-C GIC, as tooth-coating materials in patients with initial active root caries. Materials and Methods: A total of 58 lesions in 47 older adults (age > 65 years) were randomly allocated to one of the following three groups: Caredyne ZIF-C, Fuji VII (a conventional GIC), and sodium fluoride (NaF). All the lesions were treated with the assigned materials without removing the infected dentin, and the rates of dental plaque attachment and coating material fall-out were evaluated after 3, 6, and 12 months. The failure rate was defined as the number of teeth that needed restoration due to caries progression. Results: The plaque attachment rates tended to be lower in the material-coated root surfaces than in the healthy exposed root surfaces after 3, 6, and 12 months, although the differences among the three groups were not significant. Moreover, the coating material fall-out rate tended to be lower in the Caredyne ZIF-C group than in the Fuji VII group. There was no significant difference in the failure rate among the three groups at the 12 months mark. Conclusions: Though this pilot study offers a new direction for suppressing the progression of initial active root caries by controlling plaque attachment using GICs including Caredyne ZIF-C, clinical studies with a larger sample size are needed.
Spine Metastasis Is Associated with the Development of Brain Metastasis in Non-Small-Cell Lung Cancer Patients
Authors: Cha Hyung-Keun , Ryu Woo-Kyung , Lee Ha-Young , Kim Hyun-Jung , Ryu Jeong-Seon , Lim Jun-Hyeok
Published: January 2024

Background and Objectives: The mechanisms involved in the development of brain metastasis (BM) remain elusive. Here, we investigated whether BM is associated with spine involvement in patients with non-small-cell lung cancer (NSCLC). Materials and Methods: A consecutive 902 patients with metastatic NSCLC were included from the Inha Lung Cancer Cohort. Patients with BM at diagnosis or subsequent BM development were evaluated for both spine involvement in NSCLC and anatomic proximity of BM to the cerebrospinal fluid (CSF) space. Results: At diagnosis, BM was found in 238 patients (26.4%) and bone metastasis was found in 393 patients (43.6%). In patients with bone metastasis, spine involvement was present in 280 patients. BM subsequently developed in 82 (28.9%) of 284 patients without BM at diagnosis. The presence of spine metastasis was associated with BM at diagnosis and subsequent BM development (adjusted odd ratios and 95% confidence intervals = 2.42 and 1.74–3.37, p < 0.001; 1.94 and 1.19–3.18, p = 0.008, respectively). Most patients with spine metastasis, either with BM at diagnosis or subsequent BM, showed BM lesions located adjacent (within 5mm) to the CSF space (93.8% of BM at the diagnosis, 100% of subsequent BM). Conclusions: These findings suggest that the presence of spine involvement is a risk factor for BM development in NSCLC patients with bone metastasis.