bluuebunny/crossref_metadata_2025 huggingface dataset:
Association Between Anaesthesiologists’ Sex and Anaesthesiology Quality Metrics and Postoperative Outcomes: A Retrospective Analysis
Authors: Zeiner Sebastian , Maleczek Mathias , Laxar Daniel , Bologheanu Razvan , Schaden Eva , Kimberger Oliver
Published: November 2024

Background: Evidence suggests differences in medical practice and patient outcomes between male and female physicians and surgeons. To date, no such relationships were investigated in anaesthesiologists. This study aimed to investigate an association between anaesthesiologists’ sex and anaesthesia quality metrics as well as outcomes. Methods: We performed a population-based, single-centre, retrospective cohort study. Data were gathered from all patients undergoing anaesthesia between 1 January 2014 and 31 March 2022 at a large tertiary centre in Vienna, Austria. We examined 30-day mortality in relation to the sex of the anaesthesiologist after adjusting for various patient, physician, and hospital factors. Additionally, we assessed anaesthesiologists’ sex and several anaesthesia quality benchmarks. Results: The final dataset included 94,254 cases. The study showed a very small but statistically significant correlation between male anaesthesia providers and an elevated risk for all-cause mortality within 30 days (adjusted odds ratio [aOR]: 1.0026; 95% confidence interval [CI], 1.0003–1.0048). Both male and female anaesthesiologists demonstrated similar proficiency in managing hemodynamic stability, blood glucose levels, preventing postoperative acute kidney injury (AKI) and lung-protective ventilation. However, male anaesthesiologists showed slightly higher adherence to guidelines for PONV prophylaxis. Conclusions: In a dataset of nearly 95,000 cases, there was a clinically marginal but statistically significant association between male provider sex and 30-day mortality.
Evaluating Surgical Approaches for Hemimandibular Hyperplasia Associated with Osteochondroma: A Systematic Literature Review
Authors: Almeida Luis Eduardo , Zammuto Samuel , Lopez Diego Fernando
Published: November 2024

Background/Objectives: Hemimandibular hyperplasia (HH) associated with osteochondroma presents complex challenges in maxillofacial surgery, including facial asymmetry, occlusal instability, and temporomandibular joint (TMJ) dysfunction. Surgical interventions vary widely in approach and outcomes, underscoring the need for a systematic evaluation of effectiveness. This systematic review assesses the effectiveness of surgical approaches for managing HH associated with osteochondroma, focusing on techniques including condylectomy, orthognathic surgery, distraction osteogenesis, total joint replacement (TJR), and genioplasty. Methods: Following PRISMA 2020 guidelines, a comprehensive search was conducted in PubMed, Scopus, and Web of Science for studies published from 2000 to 2023. Eligibility criteria were based on the PICO framework, with primary outcomes evaluated for facial symmetry, occlusal correction, mandibular function, and recurrence rates. The Cochrane Risk of Bias Tool assessed study quality, while the GRADE framework evaluated the certainty of evidence. This review was not registered due to exclusion criteria for certain dental topics in PROSPERO. Results: Of 145 studies identified, 18 met inclusion criteria, totaling 214 patients. High and low condylectomy both effectively corrected asymmetry, with high condylectomy reducing recurrence risk but often requiring reconstruction. Orthognathic surgery, combined with condylectomy, significantly enhanced facial symmetry and occlusal function. Distraction osteogenesis proved valuable for mandibular lengthening in cases of severe deformities, while TJR offered definitive solutions for extensive joint involvement. Genioplasty corrected chin asymmetry, contributing to improved facial balance. Limitations included small sample sizes and variable follow-up durations. Conclusions: Surgical approaches tailored to individual patient needs show effectiveness in treating HH associated with osteochondroma, achieving functional and esthetic outcomes. Future studies should prioritize larger cohorts and standardized follow-up protocols to better assess long-term efficacy. Advances in 3D surgical planning and individualized treatment strategies show promise for optimized patient-specific care.
Resection of Early Colorectal Neoplasms Using Endoscopic Submucosal Dissection: A Retrospective Multicenter Cohort Study
Authors: Winter Katarzyna , Kasprzyk Przemysław , Nowicka Zuzanna , Noriko Suzuki , Herreros-de-Tejada Alberto , Spychalski Michał
Published: November 2024

Background: Endoscopic submucosal dissection (ESD) is a reliable method that can replace surgery in the treatment of early colorectal cancer under certain conditions. Aim: The aim of the study was to analyze factors influencing the ESD procedure in early colorectal cancer, with the intention of improving its effectiveness. Patients and Methods: We conducted a multicenter, retrospective cohort study on 214 patients who underwent ESD procedures for early colorectal cancer from January 2016 to October 2023. Results:En bloc resection was achieved in 197 (92.1%) of ESD procedures, R0 resection in 149 (69.6%), and curative resection in 54 (40.9%). The submucosal invasion was classified as level 1 (SM1) in 96 cases (45.3%), level 2 (SM2) in 61 cases (28.8%), and level 3 (SM3) in 36 cases (17%). R0 resection was achieved more often in the rectum—92 (81.4%), compared to the right—24 (64.9%) and left colon—33 (61.1%), p = 0.009. In rectal tumors, R0 resection was achieved in 51 (98.1%) SM1 invasion, 27 (73%) SM2 invasion, and 13 (65%) SM3 invasion (p < 0.001). Lateral and vertical resection margins were positive in 12 (7.7%) and 52 (25.2%) cases, respectively. Vertical resection margins were statistically more often positive in lesions located in the right colon—11 cases (28.9%) and left colon—21 cases (38.9%), than in rectum—20 cases (17.5%); p = 0.010. Complications were found in 32 (15%) cases of ESD procedure—perforation in 12 cases (5.6%) and delayed bleeding in four cases (1.9%). Procedures performed in the right colon were associated with a significantly higher risk of any complications (30%) and perforations (15%) than those performed in the rectum (10.3% and 2.6%) or the left colon (13.8% and 5.2%; p = 0.016; p = 0.015), respectively. Conclusions: ESD for early colon cancer is a viable strategy due to its effectiveness and low complication rate. The ESD technique performed in the rectum yields the best results; however, in the right colon, it still requires careful attention.
Echocardiographic Screening of Liver Transplant Candidates—Prevalence of Features of Portopulmonary Hypertension
Authors: Dzikowska-Diduch Olga , Cader Tomasz , Jankowski Krzysztof , Ou-Pokrzewińska Aisha , Sznajder Monika , Siwiec Jan , Pucyło Szymon , Sikora Aleksandra , Pacholczyk Marek , Lisik Wojciech , Pruszczyk Piotr , Kurnicka Katarzyna
Published: November 2024

Background: The prevalence of portopulmonary hypertension (PoPH) is relatively low; however, its presence significantly worsens patients’ prognosis. When diagnosed, PoPH can be effectively treated, and specific therapies can lead to a substantial reduction in pulmonary circulation pressure, facilitating the safe performance of liver transplantation. Echocardiography is recommended as a first-line method for the non-invasive diagnosis of pulmonary hypertension and serves as a valuable screening tool for patients being evaluated for liver transplantation (LT). The objective of this study was to thoroughly assess the occurrence of echocardiographic signs indicative of pulmonary hypertension and hepatopulmonary syndrome (HPS) in candidates for LT. We assumed that our analysis also made it possible to assess how frequently these candidates require further invasive diagnostics for pulmonary hypertension at specialized centers and how often they may need targeted treatment for pulmonary arterioles as a bridge to transplantation, which could improve patient outcomes. Additionally, this study included a comprehensive review of the current literature. Methods: All LT candidates underwent standardized transthoracic echocardiography and contrast evaluation to identify intrapulmonary vascular shunts. Results: A total of 152 liver transplantation candidates (67 women, mean age 50.6 years) were included in the analysis. The estimated echocardiographic probability of pulmonary hypertension was classified as high in only one patient. However, 63 patients exhibited the visualization of microbubbles in the left heart chambers after an average of six cardiac cycles (ranging from three to nine cycles) following their appearance in the right heart. Conclusions: Our analysis shows that the features of PoPH and a high probability of PH were very rare in the LT candidates, and echocardiographic signs suggestive of hepatopulmonary syndrome were more prevalent. Liver transplant candidates need screening for PoPH and HPS, as both PoPH and HPS significantly worsen their prognosis, but specific PH treatment as a bridge to transplantation improves PoPH patients’ survival.
Co-Occurrence of Psoriasis and Asthma in the Pediatric Population: A Systematic Review and Meta-Analysis
Authors: Mleczko Mateusz , Gerkowicz Agnieszka , Krasowska Dorota
Published: November 2024

Introduction: The risk of asthma in patients with psoriasis and that of psoriasis in patients with asthma have increased, but relevant data for the pediatric population are lacking. Therefore, we performed a meta-analysis to assess the pooled association between psoriasis and asthma in children and adolescents. Methods: We conducted an extensive search of the medical literature databases through to July 2024. The estimated risk ratios (RRs) and corresponding 95% confidence intervals (CIs) were computed. Results: Three studies, involving 5310 children with psoriasis and 1,539,029 control participants, were included to evaluate the incidence of asthma in children with psoriasis. The meta-analysis indicated a significantly increased risk of asthma in children with psoriasis [RR 1.38 (95% CI, 1.28–1.49)]. Additionally, two studies involving 104,369 asthmatic children and 1,539,029 controls were included to evaluate the incidence of psoriasis in children with asthma. The meta-analysis indicated a significant increase in the risk of psoriasis in children with asthma [RR 1.17 (95% CI, 0.70–1.95)]. Conclusions: This meta-analysis offers evidence supporting the association between psoriasis and asthma in pediatric populations. Therefore, physicians should make patients aware of the connection between these two chronic diseases.
Non-Pharmacological Therapy in Heart Failure and Management of Heart Failure in Special Populations—A Review
Authors: Dugal Jasmine K. , Malhi Arpinder S. , Ramazani Noyan , Yee Brianna , DiCaro Michael V. , Lei KaChon
Published: November 2024

Non-pharmacological therapies play an essential role in the management of heart failure, complementing pharmacological treatments to mitigate disease progression and improve patient outcomes. This review provides an updated perspective on non-pharmacological interventions with a focus on lifestyle modifications, device therapies, and the management of heart failure in special populations, such as the elderly, women, and patients with comorbid conditions like renal dysfunction and diabetes. Key lifestyle interventions, including sodium and fluid restriction, dietary changes, and physical activity, are explored for their impact on symptom reduction, hospital readmissions, and quality of life. Device therapies like cardiac resynchronization therapy (CRT) and implantable cardioverter defibrillators (ICD) are also evaluated for their effectiveness in reducing mortality in patients with advanced HF. Special attention is given to vulnerable populations, emphasizing the need for individualized approaches tailored to specific pathophysiological mechanisms and socioeconomic factors. By integrating these strategies, healthcare providers can optimize care and enhance patient adherence, reducing the overall burden of heart failure.
Physical Activity Measurement in People with Spinal Cord Injury: A Comparative Review of Different Questionnaires
Authors: Úbeda-Colomer Joan , Castan Alex
Published: November 2024

Physical activity (PA) provides great health benefits for people with spinal cord injury (SCI). Consequently, the design and implementation of PA interventions addressed to this population is needed. To rigorously evaluate these interventions, the use of valid and comprehensive PA measures is crucial. Since the suitability of PA assessment tools might differ among different populations, and considering that questionnaires are one of the most frequently used tools to quantify PA, the purpose of this comparative review was to examine nine questionnaires that have been used to assess PA in people with SCI. All the questionnaires were analyzed in depth in regard to three main dimensions: (1) SCI-specific development; (2) PA domains measured and PA intensity classification; and (3) reliability and validity. After careful consideration of the evidence available on all these aspects, it is suggested that the most suitable questionnaires to be used in PA research in the SCI population are the PARA-SCI and the LTPAQ-SCI[R]. To conclude, the strengths and limitations of these two questionnaires are discussed, and specific recommendations to SCI researchers and practitioners regarding the suitability, according to the context and characteristics, of the research/intervention are provided.
AQSA—Algorithm for Automatic Quantification of Spheres Derived from Cancer Cells in Microfluidic Devices
Authors: Peñaherrera-Pazmiño Ana Belén , Isa-Jara Ramiro Fernando , Hincapié-Arias Elsa , Gómez Silvia , Belgorosky Denise , Agüero Eduardo Imanol , Tellado Matías , Eiján Ana María , Lerner Betiana , Pérez Maximiliano
Published: November 2024

Sphere formation assay is an accepted cancer stem cell (CSC) enrichment method. CSCs play a crucial role in chemoresistance and cancer recurrence. Therefore, CSC growth is studied in plates and microdevices to develop prediction chemotherapy assays in cancer. As counting spheres cultured in devices is laborious, time-consuming, and operator-dependent, a computational program called the Automatic Quantification of Spheres Algorithm (ASQA) that detects, identifies, counts, and measures spheres automatically was developed. The algorithm and manual counts were compared, and there was no statistically significant difference (p = 0.167). The performance of the AQSA is better when the input image has a uniform background, whereas, with a nonuniform background, artifacts can be interpreted as spheres according to image characteristics. The areas of spheres derived from LN229 cells and CSCs from primary cultures were measured. For images with one sphere, area measurements obtained with the AQSA and SpheroidJ were compared, and there was no statistically significant difference between them (p = 0.173). Notably, the AQSA detects more than one sphere, compared to other approaches available in the literature, and computes the sphere area automatically, which enables the observation of treatment response in the sphere derived from the human glioblastoma LN229 cell line. In addition, the algorithm identifies spheres with numbers to identify each one over time. The AQSA analyzes many images in 0.3 s per image with a low computational cost, enabling laboratories from developing countries to perform sphere counts and area measurements without needing a powerful computer. Consequently, it can be a useful tool for automated CSC quantification from cancer cell lines, and it can be adjusted to quantify CSCs from primary culture cells. CSC-derived sphere detection is highly relevant as it avoids expensive treatments and unnecessary toxicity.
Design and Experimental Study of a Robotic Tuna with Shell-like Tensegrity Joints
Authors: Liu Yanwen , Jin Guangyuan , Cao Jiekai , Zhou Liang , Jiang Hongzhou
Published: November 2024

We developed an untethered robotic tuna featuring tensegrity joints for the purposes of simplifying the design procedure, reserving enough internal space, reducing the frictional loss of structures and generating a relatively smooth fish body wave. To achieve these objectives, a novel shell-like tensegrity joint was introduced, paired with a single-motor multiple-joint driving mechanism. The morphology matching design method of the tensegrity joint was proposed to fit the streamlined fish body, where the deflection angles of each joint were predetermined to generate the specific body waveform. Stiffness analysis shows that the tensegrity joint could function equivalently to a traditional rotational joint, given certain geometric conditions. Based on the fabricated robotic tuna prototype, extensive free-swimming experiments were performed to optimize its swimming performance by varying key parameters, including the caudal fin‘s shape, flexibility and rotational stiffness and joint deflection angles. The results reveal that the robotic tuna achieved the highest swimming speed of 1.31 body lengths per second (BL/s) at a driving frequency of 2.4 Hz, and the maximum stride length increased to 0.81 BL/cycle at 1 Hz, demonstrating the effectiveness of the proposed design scheme. This study provides valuable insight for developing high-performance bio-inspired autonomous underwater vehicles.
Acoustic Transmission Loss of a Cylindrical Silencer Filled with Multilayer Poroelastic Materials Based on Mode-Matching Method
Authors: Yang Haesang , Seong Woojae
Published: November 2024

The efficacy of silencers in reducing piping noise is contingent upon the specific installation and operating environment. Among the various forms of silencers, the acoustic characteristics of dissipative silencers with sound-absorbing materials attached internally exist in an area that is difficult to explain by existing theories. This is dependent upon the specific type and placement of the attached sound-absorbing materials. This paper presents a methodology for calculating the acoustic transmission loss (TL) of a cylindrical silencer filled with a multilayer poroelastic material, employing the mode-matching method. To describe the numerical process of treating waves propagating within a poroelastic material and determine the modes in accordance with the boundary conditions necessary for analyzing the acoustic performance of the silencer, the Biot model and the Johnson–Champoux–Allard–Lafarge model were employed. The obtained modes were utilized to calculate the acoustic TL of silencers filled with single, double, and triple layers of poroelastic materials. In particular, the results obtained for the single layer were validated by comparing them with the results of a finite element analysis, and the results obtained for multiple layers with the same material were validated by comparing them with the equivalent single-layer results. Moreover, the results of the numerical calculations of the acoustic TLs of the silencer for three distinct types of poroelastic materials, including those with varying degrees of frame rigidity or softness, were compared, and the acoustic characteristics were analyzed in relation to the intrinsic properties of the materials and their arrangement. It is anticipated that the methodology presented in this paper will facilitate the design of silencers using poroelastic materials in accordance with the specific requirements of users or designers by allowing for a comprehensive consideration of the thickness of layers and the arrangement of materials.
Exploring the Structural and Functional Consequences of Deleterious Missense Nonsynonymous SNPs in the EPOR Gene: A Computational Approach
Authors: Ali Elshazali Widaa , Adam Khalid Mohamed , Elangeeb Mohamed E. , Ahmed Elsadig Mohamed , Abuagla Hytham Ahmed , MohamedAhmed Abubakr Ali Elamin , Edris Ali M. , Eltieb Elmoiz Idris , Osman Hiba Mahgoub Ali , Idris Ebtehal Saleh
Published: November 2024

Background: Mutations in the EPOR gene can disrupt its normal signaling pathways, leading to hematological disorders such as polycythemia vera and other myeloproliferative diseases. Methodology: In this study, a range of bioinformatics tools, including SIFT, PolyPhen-2, SNAP2, SNPs & Go, PhD-SNP, I-Mutant2.0, MuPro, MutPred, ConSurf, HOPE, and Interpro were used to assess the deleterious effects of missense nonsynonymous single nucleotide polymorphisms (nsSNPs) on protein structure and function. Furthermore, molecular dynamics simulations (MDS) were conducted to assess the structural deviations of the identified mutant variants in comparison to the wild type. Results: The results identified two nsSNPs, R223P and G302S, as deleterious, significantly affecting protein structure and function. Both substitutions occur in functionally conserved regions and are predicted to be pathogenic, associated with altered molecular mechanisms. The MDSs indicated that while the wild-type EPOR maintained optimal stability, the G302S and R223P variants exhibited substantial deviations, adversely affecting overall protein stability and compactness. Conclusions: The computational analysis of missense nsSNPs in the EPOR gene identified two missense SNPs, R223P and G302S, as deleterious, occurring at highly conserved regions, and having substantial effects on erythropoietin receptor (EPO-R) protein structure and function, suggesting their potential pathogenic consequences.
The Effects of Mepolizumab on CRSwNP: Real-Life Evidence
Authors: Cantone Elena , Cassiano Bernardino , Pezzella Paolo , Russo Mario Brandon , Detoraki Aikaterini
Published: November 2024

Background: This study aims to evaluate the efficacy and safety of mepolizumab in the treatment of severe uncontrolled CRSwNP with or without comorbid asthma in a real-life setting over the first six months of therapy. Methods: A total of 45 patients with nasal polyps with or without comorbid asthma were treated with mepolizumab (100 mg q4w) for 6 months. The following outcomes were assessed before therapy (V0), and after 6 months (V1): endoscopic nasal polyp score (NPS), nasal congestion score (NCS), sinonasal outcome test (SNOT-22), visual analog scale (VAS), nasal flow rate (PNIF), olfactory test (SS-I), and asthma control test (ACT). Blood eosinophil count, oral steroid intake, and rescue surgery were also measured. Results: We found a statistically significant improvement in NPS, NCS, SNOT-22, overall VAS, PNIF, SS-I, and ACT. In addition, we observed a decrease in blood eosinophils count. Mepolizumab was well tolerated, and no patients interrupted the treatment during the follow up. Conclusions: Our real-life study confirmed the efficacy and tolerance of mepolizumab prescribed for CRSwNP with or without asthma. The safety profile of mepolizumab was consistent with previous reports.
The Effects of Key Audit Matters and Stock Ownership on Audit Committee Members’ Accounting Preferences
Authors: Höfmann Michelle , Pott Christiane , Chrzan Sandra
Published: November 2024

This study investigated the interactive effect of key audit matters (KAMs) and stock ownership on German audit committee (AC) members’ preferences regarding accounting issues in an experimental setting. Specifically, we explored whether the increased accountability of AC members to investors, resulting from KAM disclosures, is influenced by whether an AC member owns shares in the audited company. Our findings suggest that the disclosure of KAMs supports a conservative management accounting preference. However, KAMs can be used by stock-owning AC members as disclaimers that inform the investing public and might serve as legitimation tools for ACs with a preference for less conservative accounting. Hence, our study provides evidence from a two-tier governance country that audit committee members’ accounting preferences based on disclosed KAMs depend on their financial independence.
Ecological Functional Zoning in Urban Fringe Areas Based on the Trade-Offs Between Ecological–Social Values in Ecosystem Services: A Case Study of Jiangning District, Nanjing
Authors: Xu Ning , Duan Haoran
Published: November 2024

Amid the rapid socio-economic development of urban fringe areas, promoting the multi-functional supply of ecosystems and sustainable development is essential. Taking Jiangning District in Nanjing as a case study, this study explores the relationships and spatial clustering characteristics among various ecosystem service values in urban fringe areas, focusing on the trade-offs between ecological and social values. Ecological functional zones were delineated based on the ecosystem service clustering results and regional conjugation principles, followed by an analysis of the trade-offs and synergies among the values within each zone. The findings reveal the following: (1) trade-offs between ecological and social ecosystem service values are prevalent across the entire region, as well as within sub-regions in urban fringe areas; (2) Jiangning District can be divided into five key ecological functional zones—the Vibrant Industry-Urbanization Integration Zone, Important Habitat Conservation Zone, Livable Organic Renewal Zone, Characteristic Rural Landscape Development Zone, and Riparian Recreation and Ecological Conservation Zone. Each zone exhibits significant differences in the types and features of the services provided; and (3) understanding the relationships among ecological and social values within each zone may help to resolve trade-offs between them. This progressive trade-off analysis, from the regional to sub-regional level, enables more precise identification of ecosystem functions, providing reference for decision-making to enhance the overall regional value and guide sustainable planning and management practices in urban fringe areas.
Continuity and Change in the Ricote Valley Region (Southeastern Spain): An Integrated Analysis of Socio-Demographic, Territorial and Landscape Transformations
Authors: Giménez-García Rubén , García-Marín Ramón , Molina-Ruiz José
Published: November 2024

Historically, the Ricote Valley Region (Region of Murcia) has based its economic development on traditional agriculture based on the exploitation of water resources for the cultivation of citrus and fruit trees. Since the middle of the last century, industrial and service development, urban attraction and agricultural policies have generated a multitude of social, population and territorial transformations in this geographical area. The Ricote Valley Region has suffered an unprecedented demographic decline, making it one of the areas with the greatest depopulation problem in SE Spain. The demographic emptying of this region brings with it other associated problems, such as the abandonment of the land and traditional farming systems, with the consequent change in land use. This work aims to analyse both the demographic transition experienced by this Murcian region, the changes in land use/land cover generated and the possible relationship between both phenomena. In order to address these objectives, the methodology and sources used have been diverse. In this regard, population dynamics have been assessed by analysing the evolution experienced by different demographic indicators whose information has been obtained from the National Institute of Statistics (NIS) and the Murcia Regional Statistics Centre (MRSC). In turn, the transformations of the territorial surface have been obtained by comparing the representation of land cover/use present in the years 1990 and 2018 by means of georeferenced spatial information elaborated by the Corine Land Cover project (CLC). The results obtained show that, despite the fact that the region as a whole has experienced a positive population evolution, three of the seven municipalities that comprise it have been suffering the most significant depopulation process in their history for decades. In addition, the analysis of changes in land cover/land use revealed that 27.5% of the territory of the region has been transformed over the last 30 years, with a significant increase in permanently irrigated land. Finally, the correlation of information derived from the two proposed objectives shows a significant relationship between demographic evolution and the degree of territorial transformation suffered by each of the municipalities studied.
Spatiotemporal Variations in Water Physicochemical Status in Pinios River Catchment, at Eastern Mediterranean Region
Authors: Giakoumatos Stephanos D. V. , Skoulikidis Nikolaos T. , Karavoltsos Sotirios , Sakellari Aikaterini , Dimitriou Elias
Published: November 2024

Analyzing water quality variations is essential for the allocation of water to different uses and for applying remedial measures. Thessaly Plain was extremely fertile, and up until the early 20th century, the area was a breadbasket for Greece. The highly important for the national agricultural production, albeit severely degraded Pinios River, has been assessed for its chemical–physicochemical (C-P) status. The research was based on the results of the national monitoring program for the years 2018–2020, considering 218 seasonal samples. A total of 39% of the total samples and 70% of the 30 monitoring stations revealed a lower-than-good C-P status based on Water Framework Directive (2000/60/EC) boundaries. The exceedances are attributed predominately to elevated phosphate, total phosphorous, and nitrate concentrations. Exceptionally, the Pinios River seems to be mainly affected by point sources of organic pollution and secondarily by agricultural return flows and drainage processes, whereas dominant mineralization and nitrification processes control the concentration and type of nitrogen and phosphorus compounds. The coronavirus lockdown seems not to have affected aquatic quality significantly, whereas the improvement of C-P status at the river outflow via dilution by local mountain springs is threatened by an ongoing dry spell affecting the country. Within the upcoming river basin management plans, prompt remediation measures in the Pinios basin should target point sources of pollution and control agrochemicals, particularly focusing on adaptation strategies for extreme weather events.
Monitoring of Habitats in a Coastal Dune System Within the “Arco Ionico” Site (Taranto, Apulia)
Authors: Todaro Francesco Maria , Adamo Maria , Tavilla Gianmarco , Meireles Catarina , Tomaselli Valeria
Published: November 2024

Although dune systems play a crucial ecological role and offer various ecosystem services, they are listed among the habitat types of community interest in the European Union that are undergoing the most severe conservation challenges. The subject of this study was the monitoring of habitat types protected under Directive 92/43/EEC (Habitats Directive) along the coastal dune systems of the Taranto Ionian Arc. Vegetation sociological surveys, GIS mapping, landscape metrics, NBR and dNBR indices were employed to assess the conservation status of the dune system and the impact of disturbance factors. Special attention was given to habitat 2250* (Coastal dunes with Juniperus spp.), revealing that it expanded from 2006 to 2019 but then significantly reduced between 2019 and 2022, with increasing fragmentation, mainly due to wildfires. The study also highlighted the impact of invasive species such as Acacia saligna and Carpobrotus acinaciformis, which compete for space and vital resources. These findings provide scientific evidence for the management and restoration of coastal dune ecosystems, emphasizing the need for targeted conservation strategies to mitigate the effects of these disturbances.
Integrating System Dynamics, Land Change Models, and Machine Learning to Simulate and Predict Ecosystem Carbon Sequestration Under RCP-SSP Scenarios: Fusing Land and Climate Changes
Authors: Zhang Yuzhou , Zhang Yiyang , Yang Jianxin , Wu Weilong , Tao Rong
Published: November 2024

Understanding the impacts of land use and vegetation carbon sequestration under varying climate scenarios is essential for optimizing regional ecosystem services and shaping sustainable socioeconomic policies. This study presents a novel research framework that integrates a system dynamics (SD) model, a patch generation land use simulation (PLUS) model, and the random forest algorithm, coupled with SSP-RCP scenarios from Coupled Model Intercomparison Project Phase 6 (CMIP6), to simulate future vegetation net primary production (NPP). A case study in Hubei Province, central China, demonstrates the framework’s effectiveness in elucidating the interactions between land use change, climate change, topography, and vegetation conditions on carbon sequestration. The integration of SSP-RCP scenarios provides a clear understanding of how different climate conditions influence regional carbon sinks, offering valuable scientific insights for regional carbon neutrality and sustainable development policymaking. The simulation results for Hubei Province across the years 2030, 2040, 2050, and 2060, under three pathways—SSP1-1.9, SSP2-4.5, and SSP5-8.5—reveal that SSP1-1.9 leads to the highest carbon sequestration, while SSP5-8.5 results in the lowest. The annual total carbon sink ranges from 115.99 TgC to 117.59 TgC, with trends varying across scenarios, underscoring the significant impact of policy choices on local ecosystems. The findings suggest that under low-carbon emission scenarios, there is greater potential for NPP growth, making carbon neutrality goals more achievable.
Design of Ctenophore Ca2+-Regulated Photoprotein Berovin Capable of Being Converted into Active Protein Under Physiological Conditions: Computational and Experimental Approaches
Authors: Burakova Ludmila P. , Ivanisenko Nikita V. , Rukosueva Natalia V. , Ivanisenko Vladimir A. , Vysotski Eugene S.
Published: November 2024

Here, we describe (1) the AlphaFold-based structural modeling approach to identify amino acids of the photoprotein berovin that are crucial for coelenterazine binding, and (2) the production and characterization of berovin mutants with substitutions of the identified residues regarding their effects on the ability to form an active photoprotein under physiological conditions and stability to light irradiation. The combination of mutations K90M, N107S, and W103F is demonstrated to cause a shift of optimal conditions for the conversion of apo-berovin into active photoprotein towards near-neutral pH and low ionic strength, and to reduce the sensitivity of active berovin to light. According to the berovin spatial structure model, these residues are found in close proximity to the 6-(p-hydroxy)-phenyl group of the coelenterazine peroxyanion.
Fresh Hemorrhages in Intestinal Resection Margins Are Associated with Unfavorable Clinical Outcomes in Preterm Infants with Necrotizing Enterocolitis with Surgical Intervention
Authors: Schickedanz Ole , Friedmacher Florian , Gretser Steffen , Braun Yannick , Wild Peter Johanes , Rolle Udo , Gradhand Elise
Published: November 2024

Background: Necrotizing enterocolitis (NEC) is a common disease in premature infants. If conservative treatment does not respond, surgical removal of the necrotic section of bowel is common practice. This study investigates whether there is a correlation between the histopathological findings and the postoperative clinical course of the children who have undergone surgery. To date, only a few detailed studies on a possible correlation have been published. Methods: The surgical specimens of 49 infants diagnosed with NEC in the years 2010–2019 were re-evaluated. The histologic specimens were examined for tissue viability and hemorrhage of the resection margins, peritonitis or perforation of the central resection segment. The groups were divided according to the clinical outcome: death, postoperative complications and patients without complications. Results: 5 of 49 (10.2%) children died, 22 children (44.9%) required reoperation, while 22 (44.9%) had no complications. Univariate and multivariate analyses showed a significant association between fresh hemorrhage in the resection margins and postoperative outcome. In our data, correlation between the vitality of the resection margins or the extent of necrosis and the postoperative course was not seen. Conclusion: This retrospective study shows a significant correlation between a fresh hematoma in the tissue of the resection margin and the clinical prognosis. Fresh bleeding in the resection margins was associated with increased morbidity with stenosis and possibly another surgical intervention. In contrast, no further correlation was found between the vitality of the tunica mucosae, the tunica muscularis or peritonitis in the resection margin or central part of the NEC specimen and the clinical course. In summary, it can be said that the presence of a fresh hematoma at the resection margin is significantly linked to a poorer clinical outcome for the infants with NEC surgery. Other histopathological findings of the surgical specimen with regard to the clinical course show now significant correlation and, therefore, the histological examination mainly serves the medico-legal documentation and quality assurance of the NEC operation.
Phase Angle (PhA) Is an Easy and Complementary Tool for Assessing Nutritional Status in Ulcerative Colitis (UC) Patients: A Cross-Sectional Study
Authors: Mendoza-Martínez Viridiana Montsserrat , Baños-Vázquez Roberto , Melendez-Mier Guillermo , Carrillo-Rojas Javier Ivanovychs , Santoyo-Chávez Martha Alison , Ontiveros-López Sarahi , Gómez-Coello Annel , Escobedo Galileo , de León-Rendón Jorge Luis , Bueno-Hernández Nallely
Published: November 2024

Background: Accumulating evidence has proposed phase angle (PhA) as a marker for assessing cellular integrity and nutritional status in ulcerative colitis (UC) patients; the aim of the study was to evaluate the efficacy of PhA in assessing nutritional status in patients with UC, investigating its potential as a biomarker of disease activity. Methods: We conducted a cross-sectional study in patients with UC and healthy controls. We determined PhA by electrical bioimpedance and categorized participants through bioelectrical impedance analysis. They were classified as normal PhA > 6.1° and low PhA < 6.1° in men and normal PhA > 5.6° and low PhA < 5.6° in women. Results: PhA was significantly lower in UC patients than in controls (5.8 ± 0.8 vs. 6.6 ± 0.7°; p < 0.001). Among UC patients, participants with low PhA showed a decrease in lean, dry mass (LDM) (p < 0.001), total body water (p = 0.008), and intracellular water (p = 0.005), accompanied by an increase in extracellular water (p = 0.001) compared to UC patients with normal PhA. Conclusions: PhA significantly decreases in UC patients compared to healthy controls and is even more reduced when UC is active. A cut-off point of <6.1 for men and <5.6 for women could be suitable for nutritional diagnosis in patients with UC, but it still needs to be validated.
Assessment of Endothelial Function in Patients with COVID-19 Using Peripheral Arterial Tonometry
Authors: Moulias Athanasios , Koros Rafail , Papageorgiou Angeliki , Katechis Spyridon , Patrinos Panagiotis , Trigka-Vasilakopoulou Aikaterini , Papageorgiou Athanasios , Papaioannou Ourania , Akinosoglou Karolina , Leventopoulos Georgios , Tsigkas Grigorios , Tzouvelekis Argyrios , Davlouros Periklis
Published: November 2024

There is increasing evidence that COVID-19 induces endothelial dysfunction that may precede thrombotic and cardiovascular complications. The aim of this study is to evaluate endothelial function using peripheral arterial tonometry (EndoPAT). The primary endpoint is the hyperemic vascular response index (LnRHI) at two months post-discharge. Secondary endpoints include the LnRHI during hospitalization and at six-month follow-up, the proportion of patients with endothelial dysfunction (LnRHI ≤ 0.51), and the incidence of thrombotic events, cardiovascular complications, and mortality during the follow-up period. The study included 23 COVID-19 patients and 22 COVID-19-negative, matched controls. The patients exhibited a significant reduction in the LnRHI at two months post-discharge compared to the controls (median = 0.55 [IQR: 0.49–0.68] vs. median = 0.70 [IQR: 0.62–0.83]; p = 0.012). The difference in the LnRHI between patients and controls was evident from hospitalization and persisted at two and six months without significant temporal changes. The proportion of COVID-19 patients with endothelial dysfunction (LnRHI ≤ 0.51) was 61% during hospitalization and 55% at six months. There was no significant difference in thrombotic or cardiovascular events, nor in mortality. This study demonstrates that COVID-19 adversely affects endothelial function, as evidenced by a reduction in the hyperemic vascular response index, and endothelial dysfunction may also persist.
The Role of the Six-Minute Walk Test in the Functional Evaluation of the Efficacy of Rehabilitation Programs After COVID-19
Authors: Tache-Codreanu Diana-Lidia , Bobocea Lucian , David Iuliana , Burcea Claudia-Camelia , Sporea Corina
Published: November 2024

Patients with COVID-19 suffering in the acute phase from both the sequelae of the disease and prolonged immobilization require a rehabilitation phase for functional recovery and a comprehensive functional evaluation. This study proposes using the 6-Minute Walk Test (6MWT) as a global functional assessment tool to quantify rehabilitation outcomes in post-COVID patients. Additionally, investigating the effect of High-Intensity Laser Therapy (HILT) on patients with musculoskeletal comorbidities was another key research question. Two post-COVID rehabilitation programs were retrospectively analyzed as follows: one consisting of kinesiotherapy combined with High-Intensity Laser Therapy for patients with musculoskeletal comorbidities and the other consisting of kinesiotherapy alone. Functional evaluation using 6MWT was conducted before and after 10 daily therapeutic sessions with 33 ambulatory patients divided into 2 groups (18 patients treated with HILT and kinesiotherapy vs. 15 patients treated with kinesiotherapy only). The 6MWT was successfully completed by 32 out of 33 patients (96.96%), with performance improvements ranging from 3% to 60% among patients. Statistical differences were also observed between the groups, suggesting that the 6MWT is a sensitive, objective, and valuable tool for functional assessment of post-COVID rehabilitation, supporting the potential benefits of HILT in enhancing functional recovery.
Pharmacological Activity of Cha-Miang (Camellia sinensis var. assamica) in High Fat Diet-Induced Insulin-Resistant Rats
Authors: Laoung-on Jiraporn , Anuduang Artorn , Saenjum Chalermpong , Srichairatanakool Somdet , Boonyapranai Kongsak , Ounjaijean Sakaewan
Published: November 2024

Obesity, a major global health concern, is represented by an accumulation of adipose tissue and body mass, leading to a higher incidence of non-communicable diseases (NCDs). Camellia sinensis var. assamica, known as cha-miang, contains catechin and its derivatives, which have been reported to affect several health-related concerns such as anti-cancer, anti-inflammatory, anti-hyperlipidemia, and against cardiovascular disease. The research aimed to examine the anti-obesity and insulin resistance effects of fresh cha-miang extract (CME) and fermented cha-miang extract (FCME), and to investigate the anti-obesity and anti-diabetic effects of CME and FCME in obese rats generated by a high-fat diet. The extracts demonstrated significant antioxidant potential, with CME demonstrating greater DPPH radical scavenging activity, whereas FCME excelled in ABTS radical scavenging. In the animal model, CME and FCME significantly reduced body weight, plasma insulin levels, insulin resistance, and accumulation of fat compared to the obese control group. Moreover, plasma biochemical analysis indicated that both extracts enhanced lipid profiles by reducing cholesterol, triglycerides, and LDL-cholesterol levels, while elevating HDL-cholesterol. Histological analysis revealed decreased hepatic fat accumulation, especially when extracts were concurrently treated with metformin. The research indicates that CME and FCME, especially in conjunction with metformin, have potential anti-obesity and anti-insulin resistance benefits attributed to their abundant polyphenolic content and antioxidant characteristics. This indicates that cha-miang may serve as an effective option for the management of obesity and metabolic diseases.
Catheter-Directed Arterial Thrombolysis with a Low-Dose Recombinant Tissue Plasminogen Activator Regimen for Acute Lower Limb Ischemia—Results of the First Regional Registry of Acute Limb Ischemia in Romania
Authors: Barac Sorin , Onofrei Roxana Ramona , Barbu Octavian , Pantea Stelian , Pleșoianu Cristina , Gîndac Ciprian , Timar Bogdan , Rață Andreea Luciana
Published: November 2024

Acute limb ischemia is a limb-threatening condition that is associated with a high degree of mortality and morbidity, with the latter related to acute kidney injury and rhabdomyolysis that can rapidly lead to multiple organ failure. The aim of this study was to assess the efficacy and safety of catheter-directed arterial thrombolysis in acute lower limb ischemia in the Department of Vascular Surgery, Timișoara, Romania. A total of 158 patients (114 males—72.15% and 44 females—27.85%) with symptoms of acute lower limb ischemia were admitted and treated with catheter-directed arterial thrombolysis following our protocol. The amputation-free survival rate at 1 month after the thrombolysis was 82.3%, and at 6 months it was 77.85%. The performance of additional procedures to obtain distal perfusion was predictive of an improved outcome at 30 days. The estimated survival rate at 6 months was 84.81% (SE 0.02). The mean survival time was 158.74 days. We recommend the usage of a thrombolytic regimen in patients with a life expectancy of more than 6 months, even in Rutherford stage IIb patients, if there is no major impairment in the sensorial and mobility function of the ischemic leg.
Spinal Neuromodulation for Respiratory Rehabilitation in Patients with Post-Acute COVID-19 Syndrome
Authors: Ovechkin Alexander , Moshonkina Tatiana , Shamantseva Natalia , Lyakhovetskii Vsevolod , Suthar Aastha , Tharu Niraj , Ng Alex , Gerasimenko Yury
Published: November 2024

(1) Background: Neurological deficits associated with coronavirus disease (COVID-19) exacerbate respiratory dysfunction, necessitating rehabilitation strategies that address both. Previous studies have demonstrated that spinal cord transcutaneous stimulation (scTS) can facilitate the excitation of respiratory spinal neural networks in patients with post-COVID-19 syndrome. This study evaluates the efficacy of combining scTS with respiratory training (RT) to improve respiratory function in individuals with post-COVID-19 pulmonary deficits; (2) Methods: In this before–after, case-controlled clinical trial, five individuals with post-acute COVID-19 respiratory deficits participated in two interventional programs: 10 daily sessions of respiratory training (RT), followed by 10 daily sessions of scTS combined with RT (scTS + RT). Forced vital capacity (FVC), peak inspiratory flow (PIF), peak expiratory flow (PEF), time-to-peak inspiratory flow (tPIF), and time-to-peak expiratory flow (tPEF) were assessed at baseline and after each program; (3) Results: Compared to RT alone, the scTS + RT intervention resulted in an average effect size that was twice as large, with significant increases in FVC and PEF, and a significant decrease in tPEF; (4) Conclusions: The scTS-induced activation of respiratory neuronal networks, when combined with respiratory training, offers a promising therapeutic approach for treating persistent respiratory deficits in patients with post-acute COVID-19 syndrome.