bluuebunny/crossref_metadata_2025 huggingface dataset:
Advances in the Treatment of Implant-Associated Infections of the Pelvis: Eradication Rates, Recurrence of Infection, and Outcome
Authors: Kellermann Florian , Hackl Simon , Leister Iris , Hungerer Sven , Militz Matthias , Stuby Fabian , Holzmann Bernhard , Friederichs Jan
Published: April 2023

Introduction: Surgical site infections after operative stabilization of pelvic and acetabular fractures are rare but serious complications. The treatment of these infections involves additional surgical procedures, high health care costs, a prolonged stay, and often a worse outcome. In this study, we focused on the impact of the different causing bacteria, negative microbiological results with wound closure, and recurrence rates of patients with implant-associated infections after pelvic surgery. Material and Methods: We retrospectively analyzed a study group of 43 patients with microbiologically proven surgical site infections (SSI) after surgery of the pelvic ring or the acetabulum treated in our clinic between 2009 and 2019. Epidemiological data, injury pattern, surgical approach, and microbiological data were analyzed and correlated with long-term follow-up and recurrence of infection. Results: Almost two thirds of the patients presented with polymicrobial infections, with staphylococci being the most common causing agents. An average of 5.7 (±5.4) surgical procedures were performed until definitive wound closure. Negative microbiological swabs at time of wound closure were only achieved in 9 patients (21%). Long-term follow-up revealed a recurrence of infection in only seven patients (16%) with an average interval between revision surgery and recurrence of 4.7 months. There was no significant difference of recurrence rate for the groups of patients with positive/negative microbiology in the last operative revision (71% vs. 78%). A positive trend for a correlation with recurrent infection was only found for patients with a Morel–Lavallée lesion due to run-over injuries (30% vs. 5%). Identified causing bacteria did not influence the outcome and rate of recurrence. Conclusion: Recurrence rates after surgical revision of implant-associated infections of the pelvis and the acetabulum are low and neither the type of causing agent nor the microbiological status at the timepoint of wound closure has a significant impact on the recurrence rate.
A Cadaver Based Comparison of Two Elastic Tension Proximal Interphalangeal Joint (PIPJ) Extension Orthoses with Focus on Force Generation and Pressure Distribution
Authors: Punsola-Izard Vicenç , Carnicero Nuria , Ozaes-Lara Elena , Mendieta-Zamora Judit , Romera-Orfila Gemma , Schultz Karen S. , Llusà Manuel , Casado Aroa
Published: April 2023

Proximal interphalangeal joint flexion contracture is a frequent condition in hand therapy. Clinicians most frequently apply orthosis management for conservative treatment. Orthoses should apply forces for long periods of time following the total end range time (TERT) concept. These forces necessarily transmit through the skin; however, skin has physiological limitations determined by blood flow. Using three fresh frozen human cadavers, this study quantified and compared forces, skin contact surfaces and pressure of two finger orthoses, an elastic tension digital neoprene orthosis (ETDNO) and an LMB 501 orthosis. The study also investigated the effects of a new method of orthosis construction (serial ETDNO orthoses) that customizes forces to a specific finger position. We evaluated forces and contact surfaces for multiple ETDNO models tailored to the cadaver fingers in multiple PIP flexion positions. The results showed that the LMB 501 orthosis applied pressures beyond the recommended limits if applied for more than eight hours a day. This fact was the cause of time limited LMB orthosis application. This results also show that, at 30° of PIPJ flexion, straight ETDNOs created a mean pressure approaching the end of the recommended pressure limits. If the therapist modified the ETDNO design, the skin pressure decreased and reduced the risk of skin damage. With the results of this study, we concluded that for PIPJ flexion contracture, the upper limit of force application is 200 g (1.96 N). Forces beyond this amount would likely cause skin irritation and possibly skin injuries. This would cause a reduction in the daily TERT and limit outcomes.
Episodic and Semantic Autobiographical Memory in Mild Cognitive Impairment (MCI): A Systematic Review
Authors: Marselli Giulia , Favieri Francesca , Casagrande Maria
Published: April 2023

Introduction: Mild cognitive impairment (MCI) is a syndrome defined as a decline in cognitive performance greater than expected for an individual according to age and education level, not interfering notably with daily life activities. Many studies have focused on the memory domain in the analysis of MCI and more severe cases of dementia. One specific memory system is represented by autobiographical memory (AM), which has been largely studied in Alzheimer’s disease and its effect on AM; however, the impairment of AM in moderate forms of decline, such as MCI, is still controversial. Objective: The main aim of this systematic review is to analyze the functioning of autobiographical memory in patients with MCI, considering both the semantic and the episodic components. Materials: The review process was conducted according to the PRISMA statement. The search was conducted until 20 February 2023 in the following bibliographical databases: PubMed, Web of Science, Scopus, and PsycInfo, and twenty-one articles were included. Results: The results highlight controversial findings concerning the semantic component of AM since only seven studies have found a worse semantic AM performance in patients with MCI compared to the HC group. The results of impaired episodic AM in individuals with MCI are more consistent than those concerning semantic AM. Conclusions: Starting from the evidence of this systematic review, further studies should detect and investigate the cognitive and emotional mechanisms that undermine AM performance, allowing the development of specific interventions targeting these mechanisms.
Characteristics of Asthma Exacerbations in Emergency Care in Switzerland—Demographics, Treatment, and Burden of Disease in Patients with Asthma Exacerbations Presenting to an Emergency Department in Switzerland (CARE-S)
Authors: Rueegg Marco , Busch Jeannette-Marie , van Iperen Peter , Leuppi Joerg D. , Bingisser Roland
Published: April 2023

Emergency care for asthma is provided by general practitioners, pulmonologists, and emergency departments (EDs). Although it is known that patients presenting to EDs with acute asthma exacerbations are a vulnerable population and that this mode of presentation is a risk marker for more severe complications, research on this population is scarce. We conducted a retrospective study on patients with asthma exacerbations who presented to the ED of the University Hospital Basel, Switzerland, during 2017–2020. Of the last 200 presentations, 100 were selected and analyzed to assess demographic information, the use of previous and ED-prescribed asthma medication, and clinical outcomes after a mean period of time of 18 months. Of these 100 asthma patients, 96 were self-presenters, and 43 had the second highest degree of acuity (emergency severity index 2). Global Initiative for Asthma (GINA) step 1 and step 3 were the most common among patients with known GINA levels, accounting for 22 and 18 patients, respectively. A total of 4 patients were undergoing treatment with oral corticosteroids at presentation, and 34 were at discharge. At presentation, 38 patients used the combination therapy of inhaled corticosteroid/long-acting β2-agonist (ICS/LABA), and 6 patients underwent ICS monotherapy. At discharge, 68 patients were prescribed with ICS/LABA. At entry to the ED, about one-third of patients did not use any asthma medication. In total, 10 patients were hospitalized. None of them needed invasive or non-invasive ventilation. A follow-up for the study was precluded by the majority of patients. This group of asthma patients seemed particularly vulnerable as their asthma medication at presentation was often not according to guidelines or even lacking, and almost all the patients had self-presented to the ED without any reference from a physician. The majority of patients did not give consent to the collection of any follow-up information. These medical shortcomings reflect an urgent medical need to improve care for patients at high risk of asthma exacerbations.
High Prevalence of Severe Hepatic Fibrosis in Type 2 Diabetic Outpatients Screened for Non-Alcoholic Fatty Liver Disease
Authors: Asero Clelia , Giandalia Annalisa , Cacciola Irene , Morace Carmela , Lorello Giuseppe , Caspanello Amalia Rita , Alibrandi Angela , Squadrito Giovanni , Russo Giuseppina T.
Published: April 2023

Background: Non-alcoholic fatty liver disease (NAFLD) is a highly frequent condition in patients with type 2 diabetes (T2D), but the identification of subjects at higher risk of developing the more severe forms remains elusive in clinical practice. The aim of this study was to evaluate the occurrence and severity of liver fibrosis and its predictive factors in T2D outpatients without a known history of chronic liver disease by using recommended non-invasive methods. Methods: Consecutive T2D outpatients underwent a set of measurements of clinical and laboratory parameters, FIB-4 score (Fibrosis-4 index), and liver stiffness with controlled attenuation-parameter (CAP) performed by transient elastography (FibroScan) after excluding previous causes of liver disease. Results: Among the 205 T2D outpatients enrolled in the study (median age: 64 years, diabetes duration: 11 years, HbA1c: 7.4%, and BMI: 29.6 kg/m2), 54% had high ALT and/or AST levels, 15.6% had liver stiffness value > 10.1 kPa (severe fibrosis), 55.1% had CAP values > 290 dB/m (severe steatosis), and FIB-4 score was >2 in 11.2% of subjects (>2.67 in 15 subjects). Moreover, 49 (23.9%) T2D patients had clinically meaningful liver harm, with either a FIB-4 score > 2 and/or FibroScan > 10.1 kPa. At regression analysis, BMI, HbA1c, creatinine, and triglycerides values were independent predictors of liver fibrosis. Conclusions: Liver fibrosis is a frequent finding in T2D outpatients without a known history of liver disease, especially in those with obesity, hypertriglyceridemia, worse glycemic control, and high creatinine levels.
Lower Urinary Tract Symptoms and Overactive Bladder in a Large Cohort of Older Poles—A Representative Tele-Survey
Authors: Przydacz Mikolaj , Gasowski Jerzy , Grodzicki Tomasz , Chlosta Piotr
Published: April 2023

Background: A reliable reference of population-based parameters for lower urinary tract symptoms (LUTS) and overactive bladder (OAB) is lacking for the elderly. Thus, the objective of this study was to estimate the prevalence, bother, effect on quality of life, and treatment-related behavior for LUTS and OAB in a large population-level cohort of Polish adults aged ≥ 65 years. Methods: We used data from the telephone LUTS POLAND survey. Respondents were categorized by sex, age, and residence. All LUTS and OAB were assessed with validated questionnaires and a standard protocol based on the International Continence Society definitions. Results: The mean (standard deviation) age of 2402 participants (60.4% women) was 72.5 (6.7) years. The prevalence of LUTS was 79.5% (men: 76.6%; women: 81.4%), and the prevalence of OAB was 51.4% (men: 49.4%; women: 52.8%). The prevalence of both conditions increased with age. The most prevalent symptom was nocturia. LUTS and OAB were often bothersome, and almost half of participants who reported LUTS or OAB had decreased quality of life related to their urinary functioning. Nevertheless, only one third of participants sought treatment for their bladder problems, and most of these participants received treatment. We did not observe differences between urban and rural areas in all analyzed population-level parameters. Conclusions: LUTS and OAB were prevalent conditions with significant bother and negative effects on quality of life among Polish adults aged ≥ 65 years. Nevertheless, most affected respondents had not sought treatment. Thus, for older persons, there is a need to increase public awareness about LUTS and OAB, and the negative effects of LUTS and OAB on healthy aging. In addition, greater government and healthcare system resources are needed to better manage LUTS and OAB in older patients.
Treatment Changes and Prognoses in Patients with Incident Drug-Induced Parkinsonism Using a Korean Nationwide Healthcare Claims Database
Authors: Kim Siin , Suh Hae Sun
Published: April 2023

This retrospective cohort study assessed treatment changes and prognoses after incident drug-induced parkinsonism (DIP). We used the National Health Insurance Service’s National Sample Cohort database in South Korea. We selected patients diagnosed with incident DIP and given prescriptions to take offending drugs (antipsychotics, gastrointestinal (GI) motility drugs, or flunarizine) for a period of time that overlapped with the time of DIP diagnosis during 2004–2013. The proportion of patients experiencing each type of treatment change and prognosis was assessed for 2 years after DIP diagnosis. We identified 272 patients with incident DIP (51.9% of patients were aged ≥ 60 years and 62.5% of them were women). Switching (38.4%) and reinitiation (28.8%) were the most common modifications in GI motility drug users, whereas dose adjustment (39.8%) and switching (23.0%) were common in antipsychotic users. The proportion of persistent users was higher among antipsychotic users (7.1%) than that among GI motility drug users (2.1%). Regarding prognosis, 26.9% of patients experienced DIP recurrence or persistence, the rate being the highest in persistent users and the lowest in patients who discontinued the drug. Among patients with incident DIP diagnoses, the patterns of treatment change and prognosis differed across the types of offending drugs. Over 25% of patients experienced DIP recurrence or persistence, highlighting the need for an effective strategy to prevent DIP.
Alteration of m6A-Tagged RNA Profiles in Bone Originated from Periprosthetic Joint Infection
Authors: Cai Yuanqing , Chen Xiaoqing , Huang Changyu , Chen Yang , Zhang Chaofan , Huang Zida , Zhang Wenming , Tang Yusen , Fang Xinyu
Published: April 2023

Periprosthetic joint infection (PJI) is a devastating complication. This study aimed to unravel the veil of the N6-methyladenine (m6A) modification in PJI. Synovium, synovial fluid, sonication fluid and bone samples were collected intraoperatively from Staphylococcus aureus PJI and aseptic failure (AF) patients. The overall m6A level was detected by the m6A RNA methylation quantification kit, and the expression of m6A-related genes was quantified by real-time PCR and Western blot. Finally, an epitranscriptomic microarray and bioinformatics analysis were performed. We showed that there was a significant difference in overall m6A level between the PJI group and the AF group (PJI group had a higher overall m6A level). The expression level of METTL3 was higher in the PJI group than that in the AF group. There were 2802 differential m6A-modified mRNAs. Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis showed that differential m6A-modified mRNAs were significantly enriched in the NOD-like receptor signaling pathway, Th17 cell differentiation and the IL-17 signaling pathway, which indicates that the m6A modification might be involved in the processes of infection and immune response, bone metabolism and programmed cell death in PJI. In summary, the present work demonstrated that m6A modification plays a role in PJI and might be a therapeutic target for developing effective treatment strategies.
A Comparison of Tissue Adhesive Material and Suture as Wound-Closure Techniques following Carpal Tunnel Decompression: A Single-Center Randomized Control Trial
Authors: Sunjic Roguljic Veridijana , Roguljic Luka , Kovacic Vedran , Jukic Ivana
Published: April 2023

Background: Carpal tunnel syndrome (CTS) is the most common peripheral neuropathy caused by compression of the median nerve in the carpal tunnel. The presented study aimed to evaluate clinical outcomes by comparing two techniques of wound closure following carpal tunnel surgery in subjects randomized to the application of tissue adhesive or sutures. Methods: From April 2022 to December 2022, a single-center randomized prospective trial was conducted at the University Hospital of Split in Croatia. The study participants consisted of 100 patients (70 females) aged 61.56 ± 12.03 years, randomly assigned to suture-based wound closure (n = 50) or tissue adhesive-based wound closure (n = 50) with two-component skin adhesive Glubran Tiss 2®. The outcomes were assessed postoperatively during the follow-up period at intervals of 2, 6, and 12 weeks. A scar assessment was performed using the POSAS (Patient and Observer Scar Assessment Scale) and cosmetic VAS (Visual Analog Scale). The VNRS (Verbal Number Rating Scale) was used to assess pain. Results: There were significant differences between glue-based wound closure and suture-based wound closure at 2-week and 6-week intervals after the surgery on the POSAS and cosmetic-VAS scales (better aesthetic effect with glue-based wound closure technique where noticed), with less postoperative pain at the same intervals. With the 12-week interval, differences in outcomes were insignificant. Conclusions: This trial demonstrated that cyanoacrylate-based adhesion mixtures might be possibly superior in the short term in terms of cosmetic appearance and discomfort compared to conventional skin suturing techniques for the closing of surgical wounds following open CTS decompression, but there was no difference between both procedures in the long term.
The Use of JAK/STAT Inhibitors in Chronic Inflammatory Disorders
Authors: Caiazzo Giuseppina , Caiazzo Anna , Napolitano Maddalena , Megna Matteo , Potestio Luca , Fornaro Luigi , Parisi Melania , Luciano Maria Antonietta , Ruggiero Angelo , Testa Anna , Castiglione Fabiana , Patruno Cataldo , Quaranta Maria , Fabbrocini Gabriella
Published: April 2023

The Janus kinase (JAK)-signal transducer and activator of transcription (STAT) pathway plays a critical role in orchestrating immune and inflammatory responses, and it is essential for a wide range of cellular processes, including differentiation, cell growth, and apoptosis. Over the years, this pathway has been heavily investigated due to its key role in the pathogeneses of several chronic inflammatory conditions, e.g., psoriasis, atopic dermatitis (AD), and inflammatory bowel diseases (IBDs). Nevertheless, the impact of this pathway on the pathogenesis of inflammatory conditions remains unclear. This review describes the role of the JAK/STAT signaling pathway in the pathogenesis of inflammatory diseases such as psoriasis (Pso), psoriatic arthritis (PsA), AD, and IBD with a focus on ulcerative colitis (UC) and briefly resumes the use of JAK inhibitors in their clinical management.
White-Matter Lesions and Cortical Cerebral Blood Flow Evaluation by 3D Arterial Spin-Labeled Perfusion MRI in Asymptomatic Divers: Correlation with Patent Foramen Ovale Ocurrence
Authors: Cabrera José Ángel , Urmeneta Ulloa Javier , Jímenez de la Peña Mar , Rubio Alonso Margarita , López Gavilán Miguel , Bayona Horta Silvia , Pizarro Gonzalo , Simon Karlos , Migoya Teresa , Martínez de Vega Vicente
Published: April 2023

Cerebral white-matter lesions (cWML) can be caused by dilation of Virchow–Robin spaces or may correspond to true lacunar ischemic lesions. The aim of our study was to evaluate in asymptomatic divers the relationship between the presence of patent foramen ovale (PFO) and cWML, as well as their possible effects on cortical cerebral blood flow (CBF) by magnetic resonance (MRI) through the arterial spin labeling (ASL) sequence. Transthoracic echocardiography was performed for the identification of PFO, and cerebral magnetic resonance including the 3D-ASL sequence for CBF quantification. Thirty-eight divers, with a mean age 45.8 ± 8.6 years, were included. Nineteen healthy volunteers, mean age 41 ± 15.2 years, served as the control group. A total of 28.9% of divers had completed more than 1000 dives. It was found that 26.3% of divers presented with PFO in the echocardiographic study. cWML was evidenced in 10.5% of diver MRI studies. There was no statistically significant relationship between the presence of PFO and cWML (p = 0.95). We observed a lower blood flow in all brain areas assessed by the 3D-ASL sequence in the group of divers, compared with the control group. We did not find statistical differences in CBF as a function of the presence or absence of PFO, number of dives, or cWML evidence.
Outcomes of Endodontic-Treated Teeth Obturated with Bioceramic Sealers in Combination with Warm Gutta-Percha Obturation Techniques: A Prospective Clinical Study
Authors: Pontoriero Denise Irene Karin , Ferrari Cagidiaco Edoardo , Maccagnola Valerio , Manfredini Daniele , Ferrari Marco
Published: April 2023

The objective of this clinical study was to collect short-term endodontic outcomes of endodontic-treated teeth (ETT) obturated with different kinds of bioceramic sealers used in combination with warm gutta-percha obturation techniques. Methods: A total of 210 endodontic treatments in 168 patients were performed. At baseline, 155 sample teeth (73.8%) showed symptoms (tenderness or pain to percussion) and 125 (59.5%) showed periapical radiolucency. Periapical radiolucency was present in 125 cases (59.5%); of these, 79 showed a lesion of 5 mm or bigger (63.2%) while lower than 5 mm in 46 cases (36.8%). Regarding ETT with radiolucency, 105 of them (84%) were in coincidence with their need for retreatment and the other 20 (16%) were necrotic teeth. The obturation techniques that were used in this study were: the continuous wave of condensation technique in 75% of cases, and carrier-based technique in 25%. Four bioceramic sealers were used: CeraSeal in 115 cases, BioRoot in 35 cases, AH Plus Bio in 40 cases, and in 20 cases, BIO-C SEALER ION. Preoperative and recall radiographs of the roots were each assigned a periapical index (PAI) score by 2 blinded, independent, and calibrated examiners. The teeth were divided into outcome categories based on the following classification: healed, unhealed, and healing. The healed and healing categories were classified as success, and the unhealed category was classified as failure on the basis of loose criteria. Minimum follow-up period was 18 months. Results: The overall success rate was 99%, with 73.3% healed, 25.7% healing, and 0.95% not healed. The success rate was 100% for initial treatment and 98.2% for retreatment. Fifty-four (N = 54) teeth showed ongoing healing. All of them were retreatment cases with periapical lesions. Regarding the success (healed and healing) versus not healed, no significant difference was found between teeth with or without periapical lesions (p < 0.05). A statistically significant difference in the distribution of healed, healing, and not-healed teeth was found between the groups of teeth with baseline lesions < 5 mm and >5 mm in diameter (p < 0.01) and those with sealer groups (p < 0.01). The success rate of used bioceramic sealers was not statistically significant different (99.1%, 100%, 97.5% and 100%, respectively, for CeraSeal, BioRoot, AH Plus Bio, and BIO-C SEALER ION). Nonetheless, the distribution of healed, healing, and not-healed teeth was different between teeth sealed with different materials (p < 0.01). From the findings of this clinical study, the following conclusion can be drawn: a correct filling of root canals made with warm gutta-percha technique combined with a bioceramic sealer allows a high success rate in endodontically treated teeth.
Atrial Fibrillation and Diabetes Mellitus: Dangerous Liaisons or Innocent Bystanders?
Authors: Lorenzo-Almorós Ana , Casado Cerrada Jesús , Álvarez-Sala Walther Luis-Antonio , Méndez Bailón Manuel , Lorenzo González Óscar
Published: April 2023

Atrial fibrillation (AF) is the most common arrhythmia in adults and diabetes mellitus (DM) is a major risk factor for cardiovascular diseases. However, the relationship between both pathologies has not been fully documented and new evidence supports the existence of direct and independent links. In the myocardium, a combination of structural, electrical, and autonomic remodeling may lead to AF. Importantly, patients with AF and DM showed more dramatic alterations than those with AF or DM alone, particularly in mitochondrial respiration and atrial remodeling, which alters conductivity, thrombogenesis, and contractile function. In AF and DM, elevations of cytosolic Ca2⁺ and accumulation of extra cellular matrix (ECM) proteins at the interstitium can promote delayed afterdepolarizations. The DM-associated low-grade inflammation and deposition/infiltration of epicardial adipose tissue (EAT) enforce abnormalities in Ca2+ handling and in excitation-contraction coupling, leading to atrial myopathy. This atrial enlargement and the reduction in passive emptying volume and fraction can be key for AF maintenance and re-entry. Moreover, the stored EAT can prolong action of potential durations and progression from paroxysmal to persistent AF. In this way, DM may increase the risk of thrombogenesis as a consequence of increased glycation and oxidation of fibrinogen and plasminogen, impairing plasmin conversion and resistance to fibrinolysis. Additionally, the DM-associated autonomic remodeling may also initiate AF and its re-entry. Finally, further evidence of DM influence on AF development and maintenance are based on the anti-arrhythmogenic effects of certain anti-diabetic drugs like SGLT2 inhibitors. Therefore, AF and DM may share molecular alterations related to Ca2+ mobility, mitochondrial function and ECM composition that induce atrial remodeling and defects in autonomic stimulation and conductivity. Likely, some specific therapies could work against the associated cardiac damage to AF and/or DM.
Effect of Selenium Deficiency on the Development of Overt Hepatic Encephalopathy in Patients with Chronic Liver Disease
Authors: Nakahata Yuki , Hanai Tatsunori , Miwa Takao , Maeda Toshihide , Imai Kenji , Suetsugu Atsushi , Takai Koji , Shimizu Masahito
Published: April 2023

Selenium is an essential trace element to maintain good health. This retrospective study investigated the prevalence of selenium deficiency and its effect on overt hepatic encephalopathy (OHE) in patients with chronic liver disease (CLD). Patients who underwent serum selenium level measurement between January 2021 and April 2022 were enrolled. The factors associated with selenium deficiency (≤10 µg/dL) and the association between selenium deficiency and OHE were analyzed. Among 98 eligible patients, 24% were observed to have selenium deficiency, with a median serum selenium level of 11.8 µg/dL. The serum selenium levels were significantly lower in patients with cirrhosis than in those with chronic hepatitis (10.9 µg/dL vs. 12.4 µg/dL; p = 0.03). The serum selenium levels were negatively correlated with mac-2 binding protein glycan isomer, the FIB-4 index, albumin-bilirubin (ALBI) score, and Child–Pugh score. The ALBI score remained significantly associated with selenium deficiency (odds ratio, 3.23; 95% confidence interval [CI], 1.56–6.67). During a median follow-up period of 2.9 months, nine patients experienced OHE. Selenium deficiency was associated with OHE (hazard ratio, 12.75; 95% CI, 2.54–70.22). Selenium deficiency is highly prevalent in patients with CLD and is associated with an increased risk of OHE development.
Bruch’s Membrane: A Key Consideration with Complement-Based Therapies for Age-Related Macular Degeneration
Authors: Hammadi Sarah , Tzoumas Nikolaos , Ferrara Mariantonia , Meschede Ingrid Porpino , Lo Katharina , Harris Claire , Lako Majlinda , Steel David H.
Published: April 2023

The complement system is crucial for immune surveillance, providing the body’s first line of defence against pathogens. However, an imbalance in its regulators can lead to inappropriate overactivation, resulting in diseases such as age-related macular degeneration (AMD), a leading cause of irreversible blindness globally affecting around 200 million people. Complement activation in AMD is believed to begin in the choriocapillaris, but it also plays a critical role in the subretinal and retinal pigment epithelium (RPE) spaces. Bruch’s membrane (BrM) acts as a barrier between the retina/RPE and choroid, hindering complement protein diffusion. This impediment increases with age and AMD, leading to compartmentalisation of complement activation. In this review, we comprehensively examine the structure and function of BrM, including its age-related changes visible through in vivo imaging, and the consequences of complement dysfunction on AMD pathogenesis. We also explore the potential and limitations of various delivery routes (systemic, intravitreal, subretinal, and suprachoroidal) for safe and effective delivery of conventional and gene therapy-based complement inhibitors to treat AMD. Further research is needed to understand the diffusion of complement proteins across BrM and optimise therapeutic delivery to the retina.
Watch and Wait Approach for Rectal Cancer
Authors: Cerdan-Santacruz Carlos , São Julião Guilherme Pagin , Vailati Bruna Borba , Corbi Leonardo , Habr-Gama Angelita , Perez Rodrigo Oliva
Published: April 2023

The administration of neoadjuvant chemoradiotherapy (nCRT) followed by total mesorrectal excision (TME) and selective use of adjuvant chemotherapy can still be considered the standard of care in locally advanced rectal cancer (LARC). However, avoiding sequelae of TME and entering a narrow follow-up program of watch and wait (W&W), in select cases that achieve a comparable clinical complete response (cCR) to nCRT, is now very attractive to both patients and clinicians. Many advances based on well-designed studies and long-term data coming from big multicenter cohorts have drawn some important conclusions and warnings regarding this strategy. In order to safely implement W&W, it is important consider proper selection of cases, best treatment options, surveillance strategy and the attitudes towards near complete responses or even tumor regrowth. The present review offers a comprehensive overview of W&W strategy from its origins to the most current literature, from a practical point of view focused on daily clinical practice, without losing sight of the most important future prospects in this area.
Choroidal Thickness Measurements in the Case of Diabetic Macular Edema. Comment on Amjad et al. Choroidal Thickness in Different Patterns of Diabetic Macular Edema. J. Clin. Med. 2022, 11, 6169
Authors: Marino Andrea Valerio , De Luca Martina , Reda Ludovica , Gioia Marco
Published: April 2023

We read with great interest the article by Amjad R. et al. on “Choroidal Thickness in Different Patterns of Diabetic Macular Edema” [...]
Choline-Containing Phospholipids in Stroke Treatment: A Systematic Review and Meta-Analysis
Authors: Sagaro Getu Gamo , Amenta Francesco
Published: April 2023

Background: Globally, stroke is the second leading cause of death and disability. In different studies conducted previously, the choline-containing phospholipids citicoline and choline alphoscerate have been proposed as adjuvants in the treatment of acute strokes. A systematic review was conducted to provide updated information on the effects of citicoline and choline alphoscerate in patients with acute and hemorrhagic strokes. Methods: PubMed/Medline, Scopus, and Web of Science were searched to identify relevant materials. Data were pooled, and odds ratios (OR) were reported for binary outcomes. Using mean differences (MD), we evaluated continuous outcomes. Results: A total of 1460 studies were reviewed; 15 studies with 8357 subjects met the eligibility criteria and were included in the analysis. In our study, citicoline treatment did not result in improved neurological function (NIHSS < 1, OR = 1.05; 95% confidence interval (CI): 0.87–1.27) or functional recovery (mRS < 1, OR = 1.36; 95% CI: 0.99–1.87) in patients with acute stroke. Choline alphoscerate improved neurological function and functional recovery in stroke patients based on the Mathew’s scale and the Mini-Mental State Examination (MMSE). Conclusion: Citicoline did not improve the neurological or functional outcomes in acute stroke patients. In contrast, choline alphoscerate improved neurological function and functional recovery and reduced dependency in stroke patients.
Indications and Outcomes of Patients Receiving Therapeutic Plasma Exchange under Critical Care Conditions: A Retrospective Eleven-Year Single-Center Study at a Tertiary Care Center
Authors: Ring Alexander , Sieber Wolfgang Alexander , Studt Jan-Dirk , Schuepbach Reto A. , Ganter Christoph Camille , Manz Markus Gabriel , Müller Antonia Maria Susanne , David Sascha
Published: April 2023

Background: Therapeutic plasma exchange (TPE) is frequently performed in critical care settings for heterogenous indications. However, specific intensive care unit (ICU) data regarding TPE indications, patient characteristics and technical details are sparse. Methods: We performed a retrospective, single-center study using data from January 2010 until August 2021 for patients treated with TPE in an ICU setting at the University Hospital Zurich. Data collected included patient characteristics and outcomes, ICU-specific parameters, as well as apheresis-specific technical parameters and complications. Results: We identified n = 105 patients receiving n = 408 TPEs for n = 24 indications during the study period. The most common was thrombotic microangiopathies (TMA) (38%), transplant-associated complications (16.3%) and vasculitis (14%). One-third of indications (35.2%) could not be classified according to ASFA. Anaphylaxis was the most common TPE-related complication (6.7%), while bleeding complications were rare (1%). The median duration of ICU stay was 8 ± 14 days. Ventilator support, renal replacement therapy or vasopressors were required in 59 (56.2%), 26 (24.8%), and 35 (33.3%) patients, respectively, and 6 (5.7%) patients required extracorporeal membrane oxygenation. The overall hospital survival rate was 88.6%. Conclusion: Our study provides valuable real-world data on heterogenous TPE indications for patients in the ICU setting, potentially supporting decision-making.
Reply to Marino et al. Choroidal Thickness Measurements in the Case of Diabetic Macular Edema. Comment on “Amjad et al. Choroidal Thickness in Different Patterns of Diabetic Macular Edema. J. Clin. Med. 2022, 11, 6169”
Authors: Amjad Rida , Lee Cheong-Ah , Farooqi Hafiz Muhammad Umer , Khan Hina , Paeng Dong-Guk
Published: April 2023

We are pleased to see that Marino et al. have written a Comment: “Choroidal Thickness Measurements in the Case of Diabetic Macular Edema” [...]
Minimally Invasive Urological Procedures and Related Technological Developments—Series 2
Authors: Somani Bhaskar
Published: April 2023

The world of minimally invasive urology has experienced enormous growth in recent decades with technological innovations related to new techniques and equipment, better training, and the clinical adoption of translational research [...]
Association between Oral Hygiene Information Sources and Daily Dental and Denture Care Practices in Urban Community-Dwelling Older Adults
Authors: Konstantopoulou Kalliopi , Kossioni Anastassia E.
Published: April 2023

The purpose of this cross-sectional study was to explore the sources of daily oral hygiene information among urban community-dwelling older adults in Athens, Greece and associate them with their dental and denture care habits. One hundred and fifty-four older adults (aged 71.7 ± 9.2 years) participated in the study, and their dental status, denture use, daily oral care habits according to current gerodontology recommendations, and oral care information sources were investigated. Daily oral hygiene practices were poor, and a small number of individuals recalled having received oral hygiene advice from a dentist. Only 41.7% of the 139 dentate participants performed toothbrushing with fluoride-based toothpaste at least twice a day, and 35.9% completed regular interdental cleaning. Among 54 denture wearers, 68.5% removed their denture(s) at night, and 54% cleaned them at least twice a day. Oral hygiene information sources included dentists (for approximately half of the participants), media, friends/relatives, non-dental health care providers and dental technicians. Dentate participants who had received oral hygiene information from dentists had a greater probability of brushing their teeth with fluoride toothpaste at least twice a day (p = 0.049, OR = 2.15) and performing regular interdental cleaning (p < 0.001, OR = 29.26). Denture wearers who had received instructions about denture hygiene from dentists were more likely to use a brush and mild soap (p = 0.016, OR = 14.67) and remove their denture(s) at night (p = 0.003, OR = 8.75). Dentists should improve their oral health prevention and promotion strategies for their older patients.
Mitochondrial Dysfunction: A Cellular and Molecular Hub in Pathology of Metabolic Diseases and Infection
Authors: Behl Tapan , Makkar Rashita , Anwer Md. Khalid , Hassani Rym , Khuwaja Gulrana , Khalid Asaad , Mohan Syam , Alhazmi Hassan A. , Sachdeva Monika , Rachamalla Mahesh
Published: April 2023

Mitochondria are semiautonomous doubly membraned intracellular components of cells. The organelle comprises of an external membrane, followed by coiled structures within the membrane called cristae, which are further surrounded by the matrix spaces followed by the space between the external and internal membrane of the organelle. A typical eukaryotic cell contains thousands of mitochondria within it, which make up 25% of the cytoplasm present in the cell. The organelle acts as a common point for the metabolism of glucose, lipids, and glutamine. Mitochondria chiefly regulate oxidative phosphorylation-mediated aerobic respiration and the TCA cycle and generate energy in the form of ATP to fulfil the cellular energy needs. The organelle possesses a unique supercoiled doubly stranded mitochondrial DNA (mtDNA) which encodes several proteins, including rRNA and tRNA crucial for the transport of electrons, oxidative phosphorylation, and initiating genetic repair processors. Defects in the components of mitochondria act as the principal factor for several chronic cellular diseases. The dysfunction of mitochondria can cause a malfunction in the TCA cycle and cause the leakage of the electron respiratory chain, leading to an increase in reactive oxygen species and the signaling of aberrant oncogenic and tumor suppressor proteins, which further alter the pathways involved in metabolism, disrupt redox balance, and induce endurance towards apoptosis and several treatments which play a major role in developing several chronic metabolic conditions. The current review presents the knowledge on the aspects of mitochondrial dysfunction and its role in cancer, diabetes mellitus, infections, and obesity.
Validity of the Maximal Heart Rate Prediction Models among Runners and Cyclists
Authors: Kasiak Przemysław Seweryn , Wiecha Szczepan , Cieśliński Igor , Takken Tim , Lach Jacek , Lewandowski Marcin , Barylski Marcin , Mamcarz Artur , Śliż Daniel
Published: April 2023

Maximal heart rate (HRmax) is a widely used measure of cardiorespiratory fitness. Prediction of HRmax is an alternative to cardiopulmonary exercise testing (CPET), but its accuracy among endurance athletes (EA) requires evaluation. This study aimed to externally validate HRmax prediction models in the EA independently for running and cycling CPET. A total of 4043 runners (age = 33.6 (8.1) years; 83.5% males; BMI = 23.7 (2.5) kg·m−2) and 1026 cyclists (age = 36.9 (9.0) years; 89.7% males; BMI = 24.0 (2.7) kg·m−2) underwent maximum CPET. Student t-test, mean absolute percentage error (MAPE), and root mean square error (RMSE) were applied to validate eight running and five cycling HRmax equations externally. HRmax was 184.6 (9.8) beats·min−1 and 182.7 (10.3) beats·min−1, respectively, for running and cycling, p = 0.001. Measured and predicted HRmax differed significantly (p = 0.001) for 9 of 13 (69.2%) models. HRmax was overestimated by eight (61.5%) and underestimated by five (38.5%) formulae. Overestimated HRmax amounted to 4.9 beats·min−1 and underestimated HRmax was in the range up to 4.9 beats·min−1. RMSE was 9.1–10.5. MAPE ranged to 4.7%. Prediction models allow for limited precision of HRmax estimation and present inaccuracies. HRmax was more often underestimated than overestimated. Predicted HRmax can be implemented for EA as a supplemental method, but CPET is the preferable method.
Guided Bone Regeneration in a Periodontally Compromised Individual with Autogenous Tooth Bone Graft: A Radiomics Analysis
Authors: Li Jingyu , Jin Feifan , Wang Renfei , Shang Xiaodan , Yang Peiran , Zhu Yuchi , Tsoi James K. H. , Chan Ki , Wang Shuhua
Published: April 2023

Background: Autogenous tooth bone graft material (AutoBT) has been advocated as a bone substitute when conducting alveolar ridge preservation. This study is aimed at using a radiomics approach in order to evaluate and testify whether AutoBT can stimulate bone growth during socket preservation in severe periodontal cases. Materials and Methods: For this study, 25 cases with severe periodontal diseases were selected. The patients’ AutoBTs were inserted into the extraction sockets and covered with Bio-Gide® collagen membranes. 3D CBCT scans and 2D X-rays were taken of the patients before surgery and after 6 months post-surgery. For the retrospective radiomics analysis, the maxillary and mandibular images were compared in different groups. Maxillary bone height was analyzed at the buccal, middle, and palatal crest sites, while the mandibular bone height was compared at the buccal, center, and lingual crest sites. Results: In the maxilla, the alveolar height was increased by −2.15 ± 2.90 mm at the buccal crest; −2.45 ± 2.36 mm at the center of the socket, and −1.62 ± 3.19 mm at the palatal crest, while the height of the buccal crest was increased by 0.19 ± 3.52 mm, and the height at the center of the socket was increased by −0.70 ± 2.71 mm in the mandible. The three-dimensional radiomics analysis demonstrated significant bone growth in the local alveolar height and high density. Conclusion: Based on clinical radiomics analysis, AutoBT could be used as an alternative bone material in socket preservation after tooth extraction in patients with severe periodontitis.
Antifungal Activity of Juglans-regia-Mediated Silver Nanoparticles (AgNPs) against Aspergillus-ochraceus-Induced Toxicity in In Vitro and In Vivo Settings
Authors: Naqvi Syeda Itrat Zahra , Kausar Humera , Afzal Arooj , Hashim Mariam , Mujahid Huma , Javed Maryam , Hano Christophe , Anjum Sumaira
Published: April 2023

Aflatoxins produced by some species of Aspergillus are considered secondary toxic fungal by-products in feeds and food. Over the past few decades, many experts have focused on preventing the production of aflatoxins by Aspergillus ochraceus and also reducing its toxicity. Applications of various nanomaterials in preventing the production of these toxic aflatoxins have received a lot of attention recently. The purpose of this study was to ascertain the protective impact of Juglans-regia-mediated silver nanoparticles (AgNPs) against Aspergillus-ochraceus-induced toxicity by exhibiting strong antifungal activity in in vitro (wheat seeds) and in vivo (Albino rats) settings. For the synthesis of AgNPs, the leaf extract of J. regia enriched with high phenolic (72.68 ± 2.13 mg GAE/g DW) and flavonoid (18.89 ± 0.31 mg QE/g DW) contents was used. Synthesized AgNPs were characterized by various techniques, including TEM, EDX, FT-IR, and XRD, which revealed that the particles were spherical in shape with no agglomeration and fine particle size in the range of 16–20 nm. In vitro antifungal activity of AgNPs was tested on wheat grains by inhibiting the production of toxic aflatoxins by A. ochraceus. According to the results obtained from High-Performance Liquid Chromatography (HPLC) and Thin-Layer Chromatography (TLC) analyses, there was a correlation between the concentration of AgNPs and a decrease in the production of aflatoxin G1, B1, and G2. For in vivo antifungal activity, Albino rats were administrated with different doses of AgNPs in five groups. The results indicated that the feed concentration of 50 µg/kg feed of AgNPs was more effective in improving the disturbed levels of different functional parameters of the liver (alanine transaminase (ALT): 54.0 ± 3.79 U/L and aspartate transaminase (AST): 206 ± 8.69 U/L) and kidney (creatinine 0.49 ± 0.020 U/L and BUN 35.7 ± 1.45 U/L), as well as the lipid profile (LDL 22.3 ± 1.45 U/L and HDL 26.3 ± 2.33 U/L). Furthermore, the histopathological analysis of various organs also revealed that the production of aflatoxins was successfully inhibited by AgNPs. It was concluded that the harmful effects of aflatoxins produced by A. ochraceus can be successfully neutralized by using J. regia-mediated AgNPs.
A uw-Cellular Network: Design, Implementation and Experiments
Authors: Zhu Jifeng , Pan Xiaohe , Peng Zheng , Liu Mengzhuo , Guo Jingqian , Zhang Tong , Gou Yu , Cui Jun-Hong
Published: April 2023

The most significant increase of current task is in the desire for operational flexibility and agility in large-scale underwater network application scenarios in recent years. In order to address the challenging problems in Underwater Wireless Sensor Networks (UWSNs), we propose a large-scale UWSN based on the cellular network architecture called Underwater Cellular (uw-Cellular) network. It is designed especially for application scenarios where a large number of both fixed and mobile network nodes exist in a wide area to monitor the underwater environment. We also design protocols in each network layer in order to ensure reasonable channel sharing, data forwarding path selection and data reliability. The purpose of the simulation study we implement is to evaluate the performance of the CLA routing strategy compared to the VBF and the MFLOOD protocols in the uw-Cellular network. We also deploy a twenty-node uw-Cellular network in the real-world environment as the field case study. The experimental results showed that the Data Rate between any nodes could reach above 500 bps, and the network Average Throughput was no less than 550 bps under various load situations.
Optimized Route Planning under the Effect of Hull and Propeller Fouling and Considering Ocean Currents
Authors: Kytariolou Ageliki , Themelis Nikos
Published: April 2023

Route planning procedures for ocean-going vessels depend significantly on prevailing weather conditions, the ship’s design characteristics and the current operational state of the vessel. The operational status considers hull and propeller fouling, which significantly affects fuel oil consumption coupled with route selection. The current paper examines the effect of the fouling level on the selection of the optimized route compared with the clean hull/propeller as well as the orthodrome/loxodrome route. A developed weather routing tool is utilized, which is based on a physics-based model for the calculation of the main engine’s fuel oil consumption enriched to account for different fouling levels of the hull and the propeller. A genetic algorithm is employed to solve the optimization problem. A case regarding a containership in trans-Atlantic transit using forecasted weather data is presented. The effect of ocean currents is also examined as it was derived that they greatly affect route selection, revealing a strong dependence on the level of fouling. Ignoring the fouling impact can result in miscalculations regarding the estimated fuel oil consumption for a transit. Similarly, when ocean currents are ignored in the route planning process, the resulting optimal paths do not ensure energy saving.