bluuebunny/crossref_metadata_2025 huggingface dataset:
Predictive Value of the D-Dimer-to-Fibrinogen Ratio for Acute Kidney Injury after Living-Donor Liver Transplantation: A Retrospective Observational Cohort Study Using Logistic Regression and Propensity Score Matching Analyses
Authors: Park Jaesik , Kim Minju , Kim Jong-Woan , Choi Ho Joong , Hong Sang Hyun
Published: September 2024

Background/Objectives: Liver transplantation (LT) is typically performed as a surgery to treat end-stage liver disease (ESLD). Factors influencing acute kidney injury (AKI) post-living-donor LT (LDLT) have been identified; however, the potential role of the D-dimer-to-fibrinogen ratio (DFR) in predicting AKI remains unexplored. Therefore, we analyzed the relationship between DFR levels and the occurrence of AKI following LT. Methods: We retrospectively analyzed 648 recipients after 76 were excluded based on the exclusion criteria. Multivariate logistic regression and propensity score (PS) matching analyses were performed to evaluate the association between a high DFR (>1.05) and AKI. Results: After LDLT, AKI was observed in 148 patients (22.8%). A high DFR (>1.05) was independently associated with AKI. Multivariate logistic regression analysis showed that patients with a DFR above this threshold were four times more susceptible to AKI than those with a low DFR. A high DFR was also significantly associated with AKI in the propensity score-matched patients. Conclusions: Our findings suggest that incorporating preoperative DFR assessment into the management of patients undergoing LDLT could enhance the risk stratification for postoperative AKI.
Ultrastructural Analysis of the Large Neuronal Perikarya in an Injured Dentate Nucleus Using an Experimental Model of Hyperthermia-Induced Convulsions: The First Qualitative and Quantitative Study
Authors: Łotowska Joanna Maria , Borowska Marta , Żochowska-Sobaniec Milena , Sendrowski Krzysztof , Sobaniec-Łotowska Maria Elżbieta
Published: September 2024

Background: Febrile seizures are a common form of convulsions in childhood, with poorly known cellular mechanisms. The objective of this pioneering study was to provide qualitative and quantitative ultrastructural research on the large neuronal perikarya in the cerebellar dentate nucleus (DN), using an experimental model of hyperthermia-induced seizures (HSs), comparable to febrile seizures in children. Methods: The study used young male Wistar rats, divided into experimental and control groups. The HSs were evoked by a hyperthermic water bath at 45 °C for 4 min for four consecutive days. Specimens (1 mm3) collected from the DN were routinely processed for transmission electron microscopy studies. Results: The ultrastructure of the large neurons in the DN affected by hyperthermic stress showed variously pronounced lesions in the perikarya, including total cell disintegration. The most pronounced neuronal lesions exhibited specific morphological signs of aponecrosis, i.e., dark cell degeneration (‘dark neurons’). In close vicinity to the ‘dark neurons’, the aponecrotic bodies were found. The findings of this qualitative ultrastructural study correspond with the results of the morphometric analysis of the neuronal perikarya. Conclusions: Our results may constitute interesting comparative material for similar submicroscopic observations on large DN neurons in HS morphogenesis and, in the future, may help to find potential treatment targets to prevent febrile seizures or reduce recurrent seizures in children.
Predicting ICU Readmission from Electronic Health Records via BERTopic with Long Short Term Memory Network Approach
Authors: Chiu Chih-Chou , Wu Chung-Min , Chien Te-Nien , Kao Ling-Jing , Li Chengcheng
Published: September 2024

Background: The increasing rate of intensive care unit (ICU) readmissions poses significant challenges in healthcare, impacting both costs and patient outcomes. Predicting patient readmission after discharge is crucial for improving medical quality and reducing expenses. Traditional analyses of electronic health record (EHR) data have primarily focused on numerical data, often neglecting valuable text data. Methods: This study employs a hybrid model combining BERTopic and Long Short-Term Memory (LSTM) networks to predict ICU readmissions. Leveraging the MIMIC-III database, we utilize both quantitative and text data to enhance predictive capabilities. Our approach integrates the strengths of unsupervised topic modeling with supervised deep learning, extracting potential topics from patient records and transforming discharge summaries into topic vectors for more interpretable and personalized predictions. Results: Utilizing a comprehensive dataset of 36,232 ICU patient records, our model achieved an AUROC score of 0.80, thereby surpassing the performance of traditional machine learning models. The implementation of BERTopic facilitated effective utilization of unstructured data, generating themes that effectively guide the selection of relevant predictive factors for patient readmission prognosis. This significantly enhanced the model’s interpretative accuracy and predictive capability. Additionally, the integration of importance ranking methods into our machine learning framework allowed for an in-depth analysis of the significance of various variables. This approach provided crucial insights into how different input variables interact and impact predictions of patient readmission across various clinical contexts. Conclusions: The practical application of BERTopic technology in our hybrid model contributes to more efficient patient management and serves as a valuable tool for developing tailored treatment strategies and resource optimization. This study highlights the significance of integrating unstructured text data with traditional quantitative data to develop more accurate and interpretable predictive models in healthcare, emphasizing the importance of individualized care and cost-effective healthcare paradigms.
Evaluation of Intra- and Inter-Network Connectivity within Major Brain Networks in Drug-Resistant Depression Using rs-fMRI
Authors: Machaj Weronika , Podgórski Przemysław , Maciaszek Julian , Piotrowski Patryk , Szcześniak Dorota , Korbecki Adrian , Rymaszewska Joanna , Zimny Anna
Published: September 2024

Background: Major Depressive Disorder (MDD) is a significant challenge in modern medicine due to its unclear underlying causes. Brain network dysfunction is believed to play a key role in its pathophysiology. Resting-state functional MRI (rs-fMRI), a neuroimaging technique, enables the in vivo assessment of functional connectivity (FC) between brain regions, offering insights into these network dysfunctions. The aim of this study was to evaluate abnormalities in FC within major brain networks in patients with drug-resistant MDD. Methods: The study group consisted of 26 patients with drug-resistant MDD and an age-matched control group (CG) of 26 healthy subjects. The rs-fMRI studies were performed on a 3T MR scanner (Philips, Ingenia) using a 32-channel head and neck coil. Imaging data were statistically analyzed, focusing on the intra- and inter-network FC of the following networks: default mode (DMN), sensorimotor (SMN), visual (VN), salience (SN), cerebellar (CN), dorsal attention (DAN), language (LN), and frontoparietal (FPN). Results: In patients with MDD, the intra-network analysis showed significantly decreased FC between nodes within VN compared to CG. In contrast, the inter-network analysis showed significantly increased FC between nodes from VN and SN or VN and DAN compared to CG. Decreased FC was found between SN and CN or SN and FPN as well as VN and DAN nodes compared to CG. Conclusions: Patients with MDD showed significant abnormalities in resting-state cortical activity, mainly regarding inter-network functional connectivity. These results contribute to the knowledge on the pathomechanism of MDD and may also be useful for developing new treatments.
Childhood Multiple Endocrine Neoplasia (MEN) Syndromes: Genetics, Clinical Heterogeneity and Modifying Genes
Authors: Lanzaro Francesca , De Biasio Delia , Cesaro Francesco Giustino , Stampone Emanuela , Tartaglione Immacolata , Casale Maddalena , Bencivenga Debora , Marzuillo Pierluigi , Roberti Domenico
Published: September 2024

Multiple endocrine neoplasia (MEN) syndromes are part of a spectrum of clinically well-defined tumor syndromes ultimately characterized by histologically similar tumors arising in patients and families with mutations in one of the following four genes: MEN1, RET, CDKN1B, and MAX. The high level of genetic and phenotypic heterogeneity has been linked to phenocopies and modifying genes, as well as unknown mechanisms that might be investigated in the future based on preclinical and translational considerations. MEN1, also known as Wermer’s syndrome (OMIM *131100), is an autosomal dominant syndrome codifying for the most frequent MEN syndrome showing high penetrance due to mutations in the MEN1 gene; nevertheless, clinical manifestations vary among patients in terms of tumor localization, age of onset, and clinical aggressiveness/severity, even within the same families. This has been linked to the effect of modifying genes, as described in the review. MEN 2-2b-4 and 5 also show remarkable clinical heterogeneity. The traditional view of genetically predisposing monogenic or multifactorial disorders is no longer valid, and mandates a change in scientific focus. Phenotypes are indeed rarely consistent across genetic backgrounds and environments. In the future, understanding factors and genetic variants that control cellular functions and the expression of disease genes should provide insights into fundamental disease processes, providing implications for counseling and therapeutic and prophylactic possibilities.
Three-Dimensional Analysis of the First Metacarpal Axes in Healthy Individuals and Early-Stage Thumb Carpometacarpal Osteoarthritis Patients—Potential Implication on First Metacarpal Corrective Osteotomy
Authors: Keller Marco , Rueegg Jasmine , Haefeli Mathias , Honigmann Philipp
Published: September 2024

Background: Numerous anatomical features of the first carpometacarpal (CMC I) joint have been investigated as potential predispositions for CMC I osteoarthritis (OA). Even though load transmission through the CMC I joint—and, therefore, the development of osteoarthritis—is believed to be influenced by the geometry of the first metacarpal (MC I) bone, there is no common definition of the MC I axes. Methods: CT scans of twenty healthy volunteers and pre- and postoperative CT scans of six patients with CMC I OA undergoing Wilson osteotomy were analyzed. We proposed a calculation method based on anatomical landmarks for the proximal joint surface axis (PA) angle and the definition of an anatomical (AA) and a mechanical (MA) longitudinal axis. We hypothesized that for an MC I extension osteotomy to be effective, the AA and MA need to be aligned surgically. Results: To align AA and MA, an average correction angle of 22.60° (SD 2.53°) at 1 cm and 26.73° (SD 2.55°) at 1.5 cm distal to the CMC I joint line is required. Conclusions: The hereby proposed method for patient-specific calculation of the correction can be used to improve the surgical technique.
Maternal–Fetal Complications in Renal Colic during Pregnancy: A Scoping Review
Authors: Machura Paulina , Gąsior Jakub S. , Ciebiera Michał , Dąbkowska Sylwia , Massalska Diana
Published: September 2024

Renal colic is one of the most common non-obstetric causes of hospitalization in pregnant women. Its management is often a challenge for obstetricians/gynecologists, urologists and neonatologists due to the complexity of the problem. The aim of this study was to analyze the possible maternal–fetal complications in renal colic during pregnancy. The authors performed a scoping review of the current literature regarding the analyzed issues. The review was conducted using the PubMed/MEDLINE and Web of Science databases. The search generated a total of 237 articles, out of which 7 original studies were ultimately included in the scoping review. In the women affected by renal colic, the incidence of perinatal complications such as urinary tract infections (UTIs), premature rupture of membranes (pPROM), and preterm birth is markedly higher than reported in the general population of pregnant women. Data regarding the recurrence of other perinatal complications such as gestational diabetes mellitus (GDM), pregnancy-induced hypertension (PIH), preeclampsia (PE), and intrauterine growth restriction (IUGR) are scarce and ambiguous. Further research on these issues is needed to improve the perinatal outcomes of the affected pregnancies.
Safety and Efficacy of Minimally Invasive Sacrospinous Ligament Fixation for Apical Pelvic Organ Prolapse in Older Women
Authors: Gold Ronen S. , Neuman Jonatan , Baruch Yoav , Neuman Menahem , Groutz Asnat
Published: September 2024

Background: This study aimed to evaluate the safety and efficacy of minimally invasive sacrospinous ligament (SSL) fixation of apical pelvic organ prolapse (POP) in older patients compared to younger patients. Methods: A cohort of 271 older (≥65 years) patients (mean age 71.8 ± 5.2 years) and 60 younger patients (mean age 47.6 ± 7.1 years) with stage III or IV apical POP who underwent SSL fixation by the EnPlace® device was retrospectively analyzed. The age range of older patients was further divided into early old (65–74 y, N = 209), old (75–84 y, N = 58), and late old (>85 y, N = 4). Patient characteristics, surgical safety, and 6-month postoperative outcomes were compared between the four age groups. Results: Duration of surgery and blood loss were similar among all age groups. Most patients (99.4%) were discharged on the day of surgery or the day after. Subjective patient satisfaction rates were high among all patients. Point C measurements at six months postoperatively were less favorable among the younger patients. Furthermore, four (6.7%) younger patients versus six (2.2%) older patients required surgical repair of recurrent apical POP within the follow-up period. Conclusions: The short-term outcomes of minimally invasive SSL fixation suggest that it is a safe and effective procedure for significant apical POP repair among older patients.
Investigation of Injection Repair Technique for Non-Visible Damages in Automotive Composites
Authors: Papa Ilaria , Langella Antonio , Ricciardi Maria Rosaria
Published: September 2024

In recent decades, composite materials have been widely used in several fields. The challenge in recent years has been to find an effective and automatable repair technique for these materials. Low-speed impact tests were carried out on panels made from prepregs in carbon fibre and epoxy resin. An innovative repair technique has been tested by injecting resin into the delamination due to the impact event. After the first impact, some panels were repaired and re-impacted, while others were impacted twice consecutively. The data analysis and damage detection by an ultrasound technique demonstrate that the absorbed energy of the twice-impacted panels is lower than that of the repaired ones, demonstrating a configuration similar to that of the panels impacted only once. The results of this research have demonstrated the effectiveness of the repairs.
In Situ Microscopy of Fatigue-Loaded Embedded Transverse Layers of Cross-Ply Laminates: The Role of an Inhomogeneous Fiber Distribution
Authors: Baumann Andreas , Duhovic Miro , Hausmann Joachim
Published: September 2024

Composites with continuous fiber reinforcement offer excellent fatigue properties but are tedious to characterize due to anisotropy and the interplay of fatigue properties, processing conditions, and the constituents. The global fiber volume content can affect both monotonic and fatigue strength. This dependence can increase the necessary testing effort even when processing conditions and constituents remain identical. This work presents an in situ edge observation method, enabling light microscopy during loading. As a result, digital image correlation can be employed to study local strains at cracking sites on the scale of fiber bundles. The geometric influence on fatigue damage is examined in non-crimp fabrics of glass and carbon fibers. Two epoxy resins (one modified by irradiation) are investigated to verify the geometric influence under changed polymer properties. The microscopy-based image correlation revealed that damage forms at very low global strains of only 0.2–0.3% in glass fiber-reinforced epoxy laminates. For carbon fiber-reinforced epoxy, laminate cracking was found to emanate mainly from regions containing stitching fibers. Across both reinforcements, irradiation treatment led to delayed cracks, emanating from interfaces. This detailed analysis of the damage formation is used as a basis for proposed applications of the in situ strain information.
Handgrip Strength and Upper Limb Anthropometric Characteristics among Latin American Female Volleyball Players
Authors: Camacho-Villa María Alejandra , Hurtado-Alcoser Jhon , Jerez Andrés Santiago , Saavedra Juan Carlos , Paredes Prada Erika Tatiana , Merchán Jeimy Andrea , Millan-Domingo Fernando , Silva-Polanía Carlos , De la Rosa Adrián
Published: September 2024

Background: In volleyball, the upper limb dimensions and grip strength greatly influence offensive and defensive movements during a match. However, the relationship between these parameters remains underexplored in elite female volleyball players. Objective: This study aimed to contrast the upper limb anthropometric characteristics and handgrip strength (HGS) of female elite volleyball players against a control group. Methods: Selected upper limb anthropometric parameters and maximal HGS of 42 female volleyball players and 40 non-athletes were measured. Results: Players exhibited higher values in almost all variables studied than non-athletes. The differences were statistically significant (p < 0.001) except for body mass index and elbow and wrist diameters. Players showed a moderate correlation between dominant HGS and hand parameters (length r = 0.43 and breadth r = 0.63; p < 0.05). Weak correlations were identified with height, upper arm length, elbow diameter, and hand shape index (r = 0.32 to 0.38; p < 0.05). In the non-dominant hand, a moderate correlation with handbreadth (r = 0.55, p ≤ 0.01) and weak correlations with upper arm length, wrist diameter, hand length, and hand shape index (r = 0.32 to 0.35; p ≤ 0.05) was found. Conclusions: These findings underscore the importance of the upper limb anthropometric parameters as predictors of HGS and their utility in athlete selection. Future research should investigate biomechanical factors influencing HGS and injury prevention.
American Football Headgear Impairs Visuomotor Drill Performance in Division I NCAA Football Athletes
Authors: Ballmann Christopher G. , Rogers Rebecca R.
Published: September 2024

Background/Objectives: Previous evidence has shown that American football headgear (e.g., facemasks, visors/eye shields) differentially impairs reaction time (RT) to visual stimuli, most notably in peripheral fields of view. However, this has only been established with stationary RT testing, which may not translate to gameplay situations that require gross motor skills. Therefore, the purpose of this study was to build upon previous findings to elucidate the effects of various American football headgear on gross motor visuomotor drill performance. Methods: Division 1 NCAA football players (n = 16) with normal/corrected-to-normal vision participated and completed two experiments (EXP), each with differing conditions: EXP1- Varying facemask reinforcement and EXP2- Varying visor/eye shield light transmittance. In EXP1, participants completed an agility test for the following conditions: baseline/no helmet (BL), helmet + light (HL), helmet + medium (HM), and helmet + heavy (HH) face mask reinforcement. In EXP2, participants completed an agility test for the following conditions: baseline/no helmet (BL), helmet + clear visor (HCV), helmet + smoke-tinted visor (HSV), and helmet + mirrored visor (HMV). For each condition in EXP1 and EXP2, participants completed a reactive agility task using a FITLIGHT trainer system where five poles were equipped with a total of ten LED sensors and were placed in a semi-circle 1 m around a center point. Participants were asked to step and reach with their hands to hit each ten lights individually as fast as possible upon illumination. Each reactive agility test was repeated for a total of three attempts. Results: Average reaction time was analyzed and compared between conditions and according to visual fields of interest (e.g., central vs. peripheral). Results from EXP1 showed that compared to BL, reactive agility was worsened by HL (p = 0.030), HM (p = 0.034), and HH (p = 0.003) conditions. No differences between facemask conditions existed for overall performance (p > 0.05). For EXP2, HCV (p < 0.001), HSV (p < 0.001), and HMV (p < 0.001) conditions resulted in worsened reactive agility performance compared to BL. No differences between visor conditions existed for overall performance (p > 0.05). Conclusions: Overall, these findings suggest that American football headgear impairs reactive agility, which could result in worsened game performance and safety. Future studies investigating training strategies to overcome impairments are warranted.
Enhancing Deep Learning Model Explainability in Brain Tumor Datasets Using Post-Heuristic Approaches
Authors: Pasvantis Konstantinos , Protopapadakis Eftychios
Published: September 2024

The application of deep learning models in medical diagnosis has showcased considerable efficacy in recent years. Nevertheless, a notable limitation involves the inherent lack of explainability during decision-making processes. This study addresses such a constraint by enhancing the interpretability robustness. The primary focus is directed towards refining the explanations generated by the LIME Library and LIME image explainer. This is achieved through post-processing mechanisms based on scenario-specific rules. Multiple experiments have been conducted using publicly accessible datasets related to brain tumor detection. Our proposed post-heuristic approach demonstrates significant advancements, yielding more robust and concrete results in the context of medical diagnosis.
Revised Friction Groups for Evaluating Hydraulic Parameters: Pressure Drop, Flow, and Diameter Estimation
Authors: Brkić Dejan
Published: September 2024

Suitable friction groups are provided for solving three typical hydraulic problems. While the friction group based on viscous forces is used for calculating the pressure drop or head loss in pipes and open channels, commonly referred to as the Type 1 problem in hydraulic engineering, additional friction groups with similar behaviors are introduced for calculating steady flow discharge as the Type 2 problem and, for estimating hydraulic diameter as the Type 3 problem. Contrary to the viscous friction group, the traditional Darcy–Weisbach friction factor demonstrates a negative correlation with the Reynolds number. This results in curves that slope downward from small to large Reynolds numbers on the well-known Moody chart. In contrast, the friction group used here, based on viscous forces, establishes a more appropriate relationship. In this case, the friction and Reynolds number are positively correlated, meaning that both increase or decrease simultaneously. Here, rearranged diagrams for all three mentioned problems show similar behaviors. This paper compares the Moody diagram with the diagram for the viscous force friction group. The turbulent parts of both diagrams are based on the Colebrook equation, with the newly reformulated version using the viscous force friction group. As the Colebrook equation is implicit with respect to friction, requiring an iterative solution, an explicit solution using the Lambert W-function for the reformulated version is offered. Examples are provided for both pipes and open channel flow.
Dynamic Response Analysis and Liquefaction Potential Evaluation of Riverbed Induced by Tidal Bore
Authors: Pan Dongzi , Li Ying
Published: September 2024

Tidal bores, defined by sudden upstream surges of tidal water in estuaries, exert significant hydrodynamic forces on riverbeds, leading to complex sedimentary responses. This study examines the dynamic response and liquefaction potential of riverbeds subjected to tidal bores in macro-tidal estuaries. An analytical model, developed using the generalized Biot theory and integral transform methods, evaluates the dynamic behavior of riverbed sediments. Key factors such as permeability, saturation, and sediment properties are analyzed for their influence on momentary liquefaction. The results indicate that fine sand reduces liquefaction risk by facilitating pore water discharge, while silt soil increases sediment instability. Additionally, the study reveals that pressure gradients induced by tidal bores can trigger momentary liquefaction, with the maximum liquefaction depth predicted based on horizontal pressure gradients being five times that predicted based on vertical pressure gradients. This research highlights the critical role of sediment characteristics in riverbed stability, providing a comprehensive understanding of the interactions between tidal bores and riverbed dynamics. The findings contribute to the development of predictive models and guidelines for managing the risks of tidal bore-induced liquefaction in coastal and estuarine environments.
Outcomes of Free Vascularized Fibular Grafts in Treating Massive Forearm Skeletal Defects
Authors: Konstantinou Panagiotis , Kostretzis Lazaros , Ditsiou Athina Zacharoula , Samaras Ioannis , Papadopoulos Pericles , Ditsios Konstantinos
Published: September 2024

Introduction: Reconstructing long bone defects in the upper limbs, particularly the radius and ulna, poses significant challenges. These defects, resulting from trauma, tumors, infections, or congenital anomalies, require precise surgical intervention for functional restoration. Traditional non-vascularized autogenous bone grafts have limitations, such as resorption and limited biological activity. To address these challenges, free vascularized fibular grafts (FVFGs) have been developed, offering enhanced recovery by supplying nutrients and structural support, particularly in large defects or compromised vascularity. Materials and Methods: This retrospective study reviewed patients with significant forearm skeletal defects treated with FVFGs at our institution from January 2008 to January 2019. Included were patients with radius or ulna defects exceeding 8 cm due to trauma, tumor excision, or non-union fractures. Data on demographics, clinical details, surgical techniques, and outcomes—including graft union time, complications, range of motion, and the disabilities of the arm, shoulder and hand (DASH) scores—were analyzed. Results: Eight patients, with a mean age of 27.6 years and an average defect length of 9.8 cm, were included. All patients achieved graft union within an average of 4 months, with no tumor recurrence or significant complications. Functional outcomes showed mean forearm pronation of 56.9 degrees, supination of 52.5 degrees, and a mean DASH score of 17.7. Conclusions: FVFG is a safe and effective technique for managing complex forearm bone defects, providing high union rates and good functional outcomes. It should be considered a primary option for large forearm skeletal defects.
Effects of Haptic Feedback Interventions in Post-Stroke Gait and Balance Disorders: A Systematic Review and Meta-Analysis
Authors: Gomez-Risquet Maria , Cáceres-Matos Rocío , Magni Eleonora , Luque-Moreno Carlos
Published: September 2024

Background: Haptic feedback is an established method to provide sensory information (tactile or kinesthetic) about the performance of an activity that an individual can not consciously detect. After a stroke, hemiparesis usually leads to gait and balance disorders, where haptic feedback can be a promising approach to promote recovery. The aim of the present study is to understand its potential effects on gait and balance impairments, both after interventions and in terms of immediate effects. Methods: This research was carried out using the following scientific databases: Embase, Scopus, Web of Science, and Medline/PubMed from inception to May 2024. The Checklist for Measuring quality, PEDro scale, and the Cochrane collaboration tool were used to assess the methodological quality and risk of bias of the studies. Results: Thirteen articles were chosen for qualitative analysis, with four providing data for the meta-analysis. The findings did not yield definitive evidence on the effectiveness of haptic feedback for treating balance and gait disorders following a stroke. Conclusions: Further research is necessary in order to determine the effectiveness of haptic feedback mechanisms, with larger sample sizes and more robust methodologies. Longer interventions and pre–post design in gait training with haptic feedback are necessary.
Advancing Cancer Care in Colombia: Results of the First In Situ Implementation of Comprehensive Genomic Profiling
Authors: López Rivera Juan Javier , Rueda-Gaitán Paula , Rios Pinto Laura Camila , Rodríguez Gutiérrez Diego Alejandro , Gomez-Lopera Natalia , Lamilla Julian , Rojas Aguirre Fabio Andrés , Bernal Vaca Laura , Isaza-Ruget Mario Arturo
Published: September 2024

Background: Comprehensive genomic profiling (CGP) identifies genetic alterations and patterns that are crucial for therapy selection and precise treatment development. In Colombia, limited access to CGP tests underscores the necessity of documenting the prevalence of treatable genetic alterations. This study aimed to describe the somatic genetic profile of specific cancer types in Colombian patients and assess its impact on treatment selection. Methods: A retrospective cohort study was conducted at Clínica Colsanitas S.A. from March 2023 to June 2024. Sequencing was performed on the NextSeq2000 platform with the TruSight Oncology 500 (TSO500) assay, which simultaneously evaluates 523 genes for DNA analysis and 55 for RNA; additionally, analyses were performed with the SOPHiA DDM software. The tumor mutational burden (TMB), microsatellite instability (MSI), and programmed cell death ligand 1 (PDL1) were assessed. Results: Among 111 patients, 103 were evaluated, with gastrointestinal (27.93%), respiratory (13.51%), and central nervous system cancers (10.81%) being the most prevalent. TP53 (37%), KMT2C (28%), and KRAS (21%) were frequent mutations. Actionable findings were detected in 76.7% of cases, notably in digestive (20 patients) and lung cancers (8 patients). MSI was stable at 82.52% and high at 2.91%, whilst TMB was predominantly low (91.26%). Conclusions: The test has facilitated access to targeted therapies, improving clinical outcomes in Colombian patients. This profiling test is expected to increase opportunities for personalized medicine in Colombia.
Characterization and Automatic Discrimination between Predominant Hypoperfusion and Hyperperfusion Stages of NPDR
Authors: Mendes Luís , Ribeiro Luísa , Marques Inês , Lobo Conceição , Cunha-Vaz José
Published: September 2024

Background/Objectives: Diabetic retinopathy (DR) is a common diabetes complication that can lead to blindness through vision-threatening complications like clinically significant macular edema and proliferative retinopathy. Identifying eyes at risk of progression using non-invasive methods could help develop targeted therapies to halt diabetic retinal disease progression. Methods: A set of 82 imaging and systemic features was used to characterize the progression of nonproliferative diabetic retinopathy (NPDR). These features include baseline measurements (static features) and those capturing the temporal dynamic behavior of these static features within one year (dynamic features). Interpretable models were trained to distinguish between eyes with Early Treatment Diabetic Retinopathy Study (ETDRS) level 35 and eyes with ETDRS levels 43–47. The data used in this research were collected from 109 diabetic type 2 patients (67.26 ± 2.70 years; diabetes duration 19.6 ± 7.26 years) and acquired over 2 years. Results: The characterization of the data indicates that NPDR progresses from an initial stage of hypoperfusion to a hyperperfusion response. The performance of the classification model using static features achieved an area under the curve (AUC) of the receiver operating characteristics equal to 0.84 ± 0.07, while the model using both static and dynamic features achieved an AUC of 0.91 ± 0.05. Conclusion: NPDR progresses through an initial hypoperfusion stage followed by a hyperperfusion response. Characterizing and automatically identifying this disease progression stage is valuable and necessary. The results indicate that achieving this goal is feasible, paving the way for the improved evaluation of progression risk and the development of better-targeted therapies to prevent vision-threatening complications.
Clinical Outcomes and Cost Analysis in Patients with Heart Failure Undergoing Transcatheter Edge-to-Edge Repair for Mitral Valve Regurgitation
Authors: Dokollari Aleksander , Sicouri Serge , Rodriguez Roberto , Gnall Eric , Coady Paul , Mahmud Farah , Kjelstrom Stephanie , Montone Georgia , Yamashita Yoshiyuki , Harish Jarrett , Bacchi Beatrice , Arora Rakesh C , Shah Ashish , Ghorpade Nitin , Abramson Sandra , Hawthorne Katie , Goldman Scott , Gray William , Cabrucci Francesco , Bonacchi Massimo , Ramlawi Basel
Published: September 2024

Objective: To analyze the clinical and cost outcomes of transcatheter edge-to-edge repair (TEER) for mitral regurgitation (MR) in heart failure (HF) patients. Methods: All 162 HF patients undergoing TEER for MR between January 2019 and March 2023 were included. A propensity-adjusted analysis was used to compare 32 systolic vs. 97 diastolic vs. 33 mixed (systolic + diastolic) HF patients. Systolic, diastolic, and mixed HF patients were defined according to AHA guidelines. The primary outcome was the long-term incidence of all-cause death and major adverse cardiovascular and cerebrovascular events (MACCEs, all-cause mortality + stroke + myocardial infarction + repeat intervention). Results: The mean age was 76.3 vs. 80.9 vs. 76 years old, and the mean ejection fraction (EF) was 39.5% vs. 59.8% vs. 39.7% in systolic vs. diastolic vs. mixed HF, respectively. Postoperatively, the diastolic vs. systolic HF group had a higher intensive care unit stay (21 vs. 0 h; HR 67.5 (23.7, 111.4)]; lower ventilation time [2 vs. 2.3 h; HR 49.4 (8.6, 90.2)]; lower EF [38% vs. 58.5%; HR 9.9 (3.7, 16.1)]. In addition, the diastolic vs. mixed HF groups had a lower incidence of EF < 50% (11 vs. 27 patients; HR 6.6 (1.6, 27.3) and a lower use of dialysis (one vs. three patients; HR 18.1 (1.1, 287.3), respectively. At a mean 1.6 years follow-up, all-cause death [HR 39.8 (26.2, 60.5)], MACCEs [HR 50.3 (33.7–75.1)], and new pacemaker implantations [HR 17.3 (8.7, 34.6)] were higher in the mixed group. There was no significant total hospital cost difference among the systolic (USD 106,859) vs. diastolic (USD 91,731) vs. mixed (USD 120,522) HF groups (p = 0.08). Conclusions: TEER for MR evidenced the worst postoperative and follow-up clinical outcomes in the mixed HF group compared to diastolic and systolic HF groups. No total hospital cost differences were observed.
The 3-Steps Approach for Lumbar Stenosis with Anatomical Insights, Tailored for Young Spine Surgeons
Authors: Rocca Giuseppe La , Galieri Gianluca , Mazzucchi Edoardo , Pignotti Fabrizio , Orlando Vittorio , Pappalardo Simona , Olivi Alessandro , Sabatino Giovanni
Published: September 2024

Background/Objectives: Lumbar decompression surgery for degenerative lumbar stenosis is an intervention which addresses a degenerative condition affecting many patients. This article presents a meticulous three-phase surgical approach, derived from our clinical experiences and intertwining anatomical insights, offering a nuanced perspective tailored for the educational needs of young spinal surgeons. Methods: Six hundred and eighty-seven patients who underwent lumbar decompression surgery at a single institution were included in the present study. A retrospective analysis of patient demographics and surgical techniques was performed. All surgeries were performed by a consistent surgical team, emphasizing uniformity in approach. The surgical technique involves a meticulous three-phase process comprising exposure and skeletal visualization; microscopic identification and decompression; and undermining of the spinous process base and contralateral decompression. Results: Presenting results from 530 patients, the study examines demographic characteristics, health profiles, operative details, complications, and clinical assessments. The three-phase approach demonstrates low complication rates, absence of recurrences, and improved clinical outcomes, emphasizing its efficacy. Conclusions: The three-phase surgical approach emerges as a valuable educational tool for both novice and seasoned spinal surgeons. Rooted in anatomical insights, the structured methodology not only caters to the educational needs of young surgeons, but also ensures a standardized and safe procedure. The emphasis on tissue preservation and anatomical points aligns with current trends toward minimally invasive techniques, promising enhanced patient outcomes and satisfaction.
Standardized Usage of Electronic Patient-Reported Outcome Measurements is Time-Efficient and Feasible
Authors: Khakzad Thilo , Putzier Michael , Bartschke Alexander , Poyraz Rasim Atakan , Taheri Nima
Published: September 2024

(1) Background: Digitization is of the utmost importance in improving the transfer of medical data. In order to emphasize the need for the greater implementation of digital solutions, we compared analog PROMs (aPROMs) to electronic PROMs (ePROMs) to emphasize the time benefits for clinical everyday life. (2) Methods: This prospective, observational study compared the evaluation of SF-36 in patients between 18 and 80 years old with musculoskeletal pathologies. We performed an age-independent and age-dependent analysis. (3) Results: After the import of aPROMs data, ePROMs took significantly less time (11.97 ± 3.00 min vs. 9.41 ± 3.12 min, p = 0.002, d = 0.797). There were no significant differences associated with age for aPROMs (7.23 ± 2.57 min vs. 8.38 ± 2.71 min, p = 0.061, d = −0.607) or ePROMs (8.72 ± 2.19 min vs. 10.09 ± 3.80 min, p = 0.130, d = −0.436), respectively. (4) Conclusions: This study indicates that ePROMs are a time-feasible method for collecting data to guide patient-personalized treatment approaches.
Numerical Simulation of Maxillary Anterior Teeth Retraction Utilizing Power Arms in Lingual Orthodontic Technique
Authors: Alhiraky Shaher , Konermann Anna , Keilig Ludger , Bourauel Christoph
Published: September 2024

Aims: It was the scope of this study to explore the biomechanical implications of retraction force application point modifications in lingual orthodontics, aiming to mitigate the bowing effect and enhance anchorage stability in the anterior teeth. Methods: Using the FE method on an idealized maxillary model, en masse retraction was simulated using a modified lingual fixed appliance including edgewise lingual brackets, a 0.017″ × 0.025″ mushroom-shaped archwire, and power arms between lateral incisors and canines, with a transpalatal arch (TPA) connecting the first molars. Applying bilateral retraction forces of 1.5 N at twelve positions, initial tooth displacements during space closure were evaluated. Results: Shifting power arms gingivally did not effectively counteract palatal tipping of incisors but reduced posterior and palatal tipping of canines with a power arm length of 11.3 mm preventing posterior tipping. Apically displacing the TPA retraction force increased mesiobuccal rotation while preventing mesial molar tipping for retraction forces applied 12.6 mm from the archwire. Conclusions: Apically shifting retraction forces can mitigate vertical bowing effects in lingual orthodontics, yet it also highlights the challenges in maintaining torque in the anterior teeth. Further research and clinical validation are essential in order to confirm these results, emphasizing the complexity and need for advanced biomechanical strategies in personalized lingual orthodontic treatments.
Development and Validation of an Evaluation Questionnaire for the Healthy Early Life Moments in Singapore (HELMS) Program
Authors: Ku Chee Wai , Yusoff Muhammad Ashraf , Ng Elvia Chin Boon , Zheng Ruther Teo , Yap Fabian , Chan Jerry Kok Yen , Loy See Ling
Published: September 2024

Background/Objectives: Global fertility rates are declining due to metabolic and mental health challenges in women trying to conceive. The Healthy Early Life Moments in Singapore (HELMS) program aims to address these challenges through mobile health (mHealth)-enabled lifestyle interventions. However, the lack of validated evaluation tools for such programs makes it difficult to assess their feasibility and acceptability. To tackle this, a comprehensive evaluation questionnaire was developed and validated to determine if the HELMS preconception program’s implementation outcomes were achieved. Methods: The questionnaire development process included a literature review and a two-step validation process: content validation by five content experts and face validation by 20 HELMS participants. Content validation was assessed using the scale content validity index (S-CVI) based on relevance, clarity, simplicity, and ambiguity. Face validation with participants evaluated these criteria and the ease of completing the questionnaire. Internal consistency was assessed using Cronbach’s alpha among 49 participants. Results: The questionnaire achieved good S-CVI values for relevance (0.93), clarity (0.91), simplicity (0.94), and ambiguity (0.71). After expert feedback, the revised version scored highly among HELMS participants for relevance (100%), clarity (95%), simplicity (95%), and non-ambiguity (90%). A Cronbach’s alpha of 0.93 indicated good internal consistency. Conclusion: The HELMS evaluation questionnaire shows promise for evaluating similar mHealth-based lifestyle intervention programs globally.
Complement Inhibitors for Geographic Atrophy in Age-Related Macular Degeneration—A Systematic Review
Authors: Dascalu Ana Maria , Grigorescu Catalin Cicerone , Serban Dragos , Tudor Corneliu , Alexandrescu Cristina , Stana Daniela , Jurja Sanda , Costea Andreea Cristina , Alius Catalin , Tribus Laura Carina , Dumitrescu Dan , Bratu Dan , Cristea Bogdan Mihai
Published: September 2024

Background/Objectives: Age-related macular degeneration (AMD) is one of the main causes of blindness and visual impairment worldwide. Intravitreal complement inhibitors are an emergent approach in the treatment of AMD, which have had encouraging results. This systematic review analyzes the outcomes and safety of complement inhibitor therapies for GA in AMD cases. Methods: A comprehensive search on the PubMed and Web of Science databases returned 18 studies involving various complement inhibitor agents, with a total of 4272 patients and a mean follow-up of 68.2 ± 20.4 weeks. Results: Most treated patients were white (96.8%) and female (55.8%), with a mean age of 78.3 ± 7.8 years and a mean GA area of 8.0 ± 3.9 mm2. There were no differences in visual function change between treated and control participants. The mean GA area change was 2.4 ± 0.7 mm2 in treated participants vs. 2.7 ± 0.8 mm2 in control groups (p < 0.001). The ocular and systemic side effects were similar to those of intravitreal anti-VEGF. A less-understood effect was that of the onset of choroidal neovascularization (CNV) in 1.1–13% of patients; this effect was found to be more frequent in patients with neovascular AMD in the fellow eye or nonexudative CNV in the study eye at baseline. Conclusions: Complement inhibitors may represent a useful therapy for GA in AMD, but a personalized approach to patient selection is necessary to optimize the outcomes.
Correction: Yan, S.; Growe, A. Regional Planning, Land-Use Management, and Governance in German Metropolitan Regions—The Case of Rhine–Neckar Metropolitan Region. Land 2022, 11, 2088
Authors: Yan Simin , Growe Anna
Published: September 2024

In the original publication [...]
A Cost–Benefit Analysis for the Economic Evaluation of Ecosystem Services Lost Due to Erosion in a Mediterranean River Basin
Authors: Romanazzi Giuliano Rocco , Ottomano Palmisano Giovanni , Cioffi Marilisa , Leronni Vincenzo , Toromani Ervin , Koto Romina , De Boni Annalisa , Acciani Claudio , Roma Rocco
Published: September 2024

Soil degradation in Europe is mostly represented by soil erosion that, as a sediment production mechanism, is the main environmental threat to many watersheds, including the Bovilla watershed (Tirana), useful for the supply of drinking water to the city, and therefore, the care of water quality is of particular interest. The soil erosion of the Bovilla watershed was monitored in a work set up in June 2017. Following this work, this research updates the previous data on soil loss at the Bovilla watershed in t/ha/year to September 2019 and focuses on the identification and monetary evaluation of the ecosystem services (ESs) linked to soil erosion (loss of carbon, loss of mineral elements, habitat quality, crop productivity, and sustainable tourism suitability). Then, we applied the replacement cost analysis to test the economic convenience and suggest the adoption of sustainable land management practices (e.g., reforestation) able to improve the quality water in this watershed. The study carried out demonstrates that the values of soil lost due to erosion vary depending on the type of land use (ranging from average values of 120.32 t/ha for bare land to values of 8.16 t/ha for wooded areas). Furthermore, from the application of monetary methods for the evaluation of some ecosystem services linked to erosion (loss of carbonaceous and mineral elements, habitat quality, productivity, suitability for sustainable tourism), it clearly emerges that the value of the productivity of agricultural crops varies from EUR 0 to 35,320.50/ha and that the service represents a more incisive service than the previous ones, so much so as to make the conversion of some agricultural land with high productivity values into wooded areas economically disadvantageous. The data from this study may help to develop Bovilla watershed management strategies for erosion and pollution control and sediment remediation mainly in agricultural lands. A program of measures can be effective for controlling soil erosion, but it must be implemented over long time frames, and it requires relevant investments from the public and private sectors, also with a view to increase the allocation of economic values of monetary compensation aimed at those who decide to start forestation projects on highly productive soils.
The RING-Type E3 Ligase BOI Interacts with EXO70E2 and Mediates Its Ubiquitination in Arabidopsis
Authors: Li Zhaowu , Huang Jianzhong , Hu Yue , Zhou Xiaojie , Tan Xiao , Wang Zhangying , Gao Zhiyong , Wu Xiaoqiu
Published: September 2024

The exocyst is a hetero-octameric complex that exhibits significant functional diversity in regulating biological processes and defense responses. In plants, the EXO70 proteins are important components of the exocyst complex and are involved in membrane trafficking, biotic and abiotic interactions, as well as cell wall formation. A previous study has indicated that a member of the EXO subfamily, EXO70E2, interacts with RIN4 to mediate plant immunity. In this study, we found that EXO70E2 interacts with the RING-type E3 ligase Botrytis susceptible1 interactor (BOI), and the C-terminal domain of BOI is necessary for its interaction with EXO70E2. Moreover, the protein level of EXO70E2 was degraded and ubiquitinated by BOI in vitro. Collectively, our study reveals a mechanism for regulating the stability of EXO70E2 by a RING-type E3 ligase BOI-mediated ubiquitination.