bluuebunny/crossref_metadata_2025 huggingface dataset:
Physical Function Trajectory among High-Functioning Long-Term Care Facility Residents: Utilizing Japanese National Data
Authors: Ikuta Kasumi , Noguchi-Watanabe Maiko , Aishima Miya , Anzai Tatsuhiko , Takahashi Kunihiko , Fukui Sakiko
Published: September 2024

Physical function trajectory (PFT) is associated with mortality and hospitalization risks. We aimed to identify and compare the PFTs of newly admitted high-functioning older adults during their first six months at long-term care (LTC) facilities. In this multicenter retrospective cohort study, we included newly admitted high-functioning older adults (Barthel index > 60) from 47 Japanese LTC facilities. The primary outcome was physical function changes after admission. Data were collected from the Long-Term Care Information System for Evidence (LIFE), which monitored LTC facility residents’ function between 1 January 2021 and 31 January 2022. A group-based trajectory model and binomial logistic regression analyses were applied to identify and compare residents’ PFTs. Among the 718 residents included, the average age was 85.69 years and 64.5% were female. PFTs were classified as maintenance (66.0%), improvement (9.5%), slight decline (16.6%), and large decline (7.9%). The improvement group had significantly fewer residents who expressed a lack of interest in daily activities (odds ratio (OR) 0.45; 95% confidence interval (CI) 0.21–0.97) compared to the maintenance group. The large decline group had significantly more residents with a low BMI at admission (OR 2.42; 95% CI 1.29–4.55) and residents who did not use dentures (OR 0.49; 95% CI 0.26–0.95), compared to the maintenance group. Considering future PFTs may aid the development of care plans and the provision of appropriate interventions. Moreover, utilizing existing data has the potential to maintain residents’ physical independence and enhance the quality of care without burdening residents themselves or staff.
The 15th European Crystal Network (ECN) Workshop—2024 ECN Abstract Proceedings
Authors: Lioté Frédéric , Perez-Ruiz Fernando , Ea Hang-Korng , Pascart Tristan , Merriman Tony , So Alexander
Published: September 2024

15th Anniversary this year: the ECN workshop is set up in Paris, down town. Every year ECN workshop offers a unique opportunity for clinicians and researchers interested in crystals, inflammation, crystal-induced diseases including gout, to present their latest results and discuss novel concepts. Twenty nine out of 52 accepted abstracts are reported here.
Perinatal Exposure to Tobacco Smoke and Its Association with the Maternal and Offspring Microbiome: A Systematic Review
Authors: Falara Eleni , Metallinou Dimitra , Nanou Christina , Vlachou Maria , Diamanti Athina
Published: September 2024

Background: The human microbiome, comprising trillions of microorganisms, significantly influences human health and disease. During critical periods like the perinatal phase, the microbiome undergoes significant changes, impacting lifelong health. Tobacco smoke, a known environmental pollutant, has adverse effects on health, particularly during pregnancy. Despite this, its association with the perinatal microbiome remains understudied. Methods: We conducted a systematic review to integrate findings on perinatal tobacco smoke exposure and its association with the maternal and neonatal microbiomes. We conducted a comprehensive literature search in the PubMed, Scopus, and Web of Science databases from January 2000 to February 2024. We selected studies that met predefined inclusion criteria and performed data extraction. Results: The review included eight studies that revealed diverse associations of perinatal tobacco exposure with the maternal and neonatal microbiome. Active smoking during pregnancy was linked to alterations in microbiome composition and diversity in children. Maternal smoking correlated with increased Firmicutes abundance and decreased Akkermansia muciniphila abundance in offspring. Additionally, exposure to thirdhand smoke in neonatal intensive care units was related to infant microbiome diversity. Infants exposed to tobacco smoke showed various microbial changes, suggesting potential implications for childhood health outcomes, including obesity risk. Conclusions: Perinatal exposure to tobacco smoke exerts significant influence on the maternal and neonatal microbiomes, with potential implications for long-term health outcomes. Addressing socioeconomic and psychological barriers to smoking cessation, implementing stricter smoking regulations, and promoting public health campaigns are essential steps towards reducing tobacco-related harm during the perinatal period. Further longitudinal studies and standardized assessment methods are needed to validate these findings and guide the development of effective preventive measures.
Reframing Unseen Exams in Post-Pandemic Pedagogy Based on Student Perceptions
Authors: Lyddon Charlotte E.
Published: September 2024

The COVID-19 pandemic had unprecedented impacts, both directly and indirectly, on student populations across the UK. As teaching has returned to ‘normal’, in person exams have made a comeback and so has the debate about the value of unseen exams as a method of assessment. This research provides a comprehensive insight into student perception of exams in light of their COVID-19 educational experiences. This research combines student perspectives on unseen exams, considering this is a generation of students who have perhaps never sat a regular written exam before due to pandemic. Student perceptions are combined with academic staff experience on delivering unseen exams to identify their suitability within curriculums that promote authentic assessment and research-led teaching. The thematic analysis of results identifies that students feel strongly about the purpose, fairness, and authenticity of unseen exams, and the COVID-19 pandemic is likely to have lasting impacts on student perception of their university experience. The themes identify practical considerations for academic staff when considering the inclusion of unseen exams in their teaching, most notably with respect to accessibility, support needs, and assessment design.
Utopia and Religion in Europe in the Seventeenth and Eighteenth Centuries
Authors: Laursen John Christian
Published: September 2024

When European writers of the seventeenth and eighteenth centuries wrote about utopia or their vision of the best possible way to live, they usually included reflections on religion. Religion as it was known in their day was not perfect and had been criticized for causing numerous abuses. If a perfect or near-perfect society were to be imagined, it would have to include a perfect or near-perfect understanding of religion. This could range from atheism to a minimal religion which avoided all the institutional factors, to one in which detailed regulations governed all facets of religion and life. This article reviews and interprets the treatment of religion in a wide range of seventeenth- and eighteenth-century utopias. It concludes that some utopian writers set high goals for change, some settled for lesser reforms, and some left religion as it was while changing other parts of life.
Genome-Wide Identification and Expression Analysis of ‘NanGuo’ Pear Revealed Key MYB Transcription Factor Family Genes Involved in Anthocyanin Accumulation
Authors: Liu Xiangyu , Huang Qian , Liang Yongqi , Lu Zhe , Liu Weiting , Yuan Hui , Li Hongjian
Published: September 2024

The MYB gene family, widely distributed across a variety of plants, plays a crucial role in the phenylpropane metabolic pathway. In this study, we identified 146 R2R3-MYB genes in the ‘NanGuo’ pear genome by screening its gene sequences. Phylogenetic analysis divided these genes into seven subfamilies, and we examined each for stability through analyses of conserved structural domains and motifs. In addition, differences in the expression levels between two varieties, the ‘NanGuo’ pear and its red bud sport variant ‘NanHong’ pear, were investigated using quantitative real-time PCR (qRT-PCR). The results revealed that the expression levels of 12 R2R3-MYB transcription factors (TFs) corresponded with the trends in anthocyanin content. Specifically, the expression trends of eight R2R3-MYB TFs positively correlated with anthocyanin accumulation, whereas four exhibited opposite trends, suggesting their negatively regulatory role in anthocyanin accumulation. This study not only enhances our understanding of the MYB gene family in the ‘NanGuo’ pear genome but also lays a solid foundation for future research into the functional roles of PuMYBs.
Influence of Combined Supplemental Lighting and Nutrient Solution Concentration on Fruit Production and Quality of Cherry Tomato
Authors: Xie Zhenbin , Chen Jinxiang , Liu Houcheng , Chen Riyuan , Yang Xiaolong , Song Shiwei , Zhang Yiting
Published: September 2024

We conducted an analysis on the combined effects of two light conditions (L1: greenhouse natural lighting; L2: greenhouse natural lighting plus supplemental lighting (SL)) and three nutrient solution concentrations (EC, NS1: 3.2 dS/m; NS2: 3.7 dS/m; NS3: 4.2 dS/m) on the growth, fruit production, and quality of two cherry tomato cultivars with different fruit coloring (‘Baiyu’ and ‘Qianxi’). The plants subjected to NS2 exhibited enhanced growth, photosynthetic parameters, and fruit production. The utilization of SL further enhanced stem diameter, leaf number, and single fruit weight, resulting in higher fruit weight per plant in ‘Baiyu’, which was not observed in ‘Qianxi’. The growth, fruit size, and fruit weight of both cultivars cultivated under NS3 conditions were suppressed, while these fruits exhibited elevated levels of total soluble solids (TSS), soluble sugars, vitamin C, polyphenols, fructose, glucose, sucrose, citric acid, and carotenoids. These levels were further enhanced by SL treatment. The improvement of fruit quality through the application of SL was found to be cultivar and EC dependent. In ‘Baiyu’, SL at NS1 significantly enhanced the accumulation of fruit water, minerals (N, P, K, Ca, and Mg), TSS, vitamin C, fructose, sucrose, and carotenoids. However, this effect was not observed in ‘Qianxi’. The combination of SL and EC 4.2 dS/m (NS3) generally contributes to the enhancement of fruit quality, while SL and EC 3.7 dS/m can ensure consistent fruit production. The yellowish-white fruit cultivar exhibited higher levels of soluble sugars, vitamin C, and polyphenols under L2NS3 conditions compared to the red fruit cultivar, whereas the carotenoid content showed an opposite trend. The findings are anticipated to establish a theoretical foundation for the consistent annual cultivation of cherry tomatoes in protected horticultural settings.
Geographical Entity Management Model Based on Multi-Classification
Authors: Shi Lin , Lan Xiaoji , Xiao Ming , Liu Ning
Published: September 2024

Scientific and logical classification is crucial for efficient information storage, management, and sharing. However, there are numerous existing classification systems for geographical entities, and the categories to which the same geographical entity belongs are often different in the business databases constructed according to different classification systems, which brings great obstacles to the management and sharing of geographical information. This study analyzes the complexities of multiple classifications of geographical entities and proposes a multi-classification model for geographical entities based on directed hypergraph theory. This model integrates and transforms different classification systems for the same geographical entity, creating a unified method for expressing multiple classifications. We also designed a data structure to support this unified expression. By implementing this model, the study enables the effective management of geographical entity data, facilitating improved sharing and the exchange of geographical information across different industries and applications. In practical, the multi-classification model proposed in this paper allows geographical entities from different classification systems to be stored and managed within a single geographical database. Data views are then used to provide tailored services to various industry sectors and business applications. This approach effectively reduces data duplication and enhances the efficiency of managing and sharing geographical information. Using land use classification as an example, this study constructs a unified expression of three different land use classification systems based on the multi-classification model. An experiment managing land use data for a specific city was conducted using this model in PostgreSQL. The results indicate that the proposed method not only reduces data redundancy but also improves the query efficiency by over 10% on average compared to the mainstream relational database management mode. This confirms the effectiveness and practical value of the proposed method.
Challenging the Norm: The Unrecognized Impact of Soluble Guanylyl Cyclase Subunits in Cancer
Authors: Pino María Teresa L. , Rocca María Victoria , Acosta Lucas H. , Cabilla Jimena P.
Published: September 2024

Since the discovery of nitric oxide (NO), a long journey has led us to the present, during which much knowledge has been gained about its pathway members and their roles in physiological and various pathophysiological conditions. Soluble guanylyl cyclase (sGC), the main NO receptor composed of the sGCα1 and sGCβ1 subunits, has been one of the central figures in this narrative. However, the sGCα1 and sGCβ1 subunits remained obscured by the focus on sGC’s enzymatic activity for many years. In this review, we restore the significance of the sGCα1 and sGCβ1 subunits by compiling and analyzing available but previously overlooked information regarding their roles beyond enzymatic activity. We delve into the basics of sGC expression regulation, from its transcriptional regulation to its interaction with proteins, placing particular emphasis on evidence thus far demonstrating the actions of each sGC subunit in different tumor models. Exploring the roles of sGC subunits in cancer offers a valuable opportunity to enhance our understanding of tumor biology and discover new therapeutic avenues.
Non-Invasive In Vivo Bioimaging in Pigs
Authors: Abe Tomoyuki , Endo Kazuhiro , Hanazono Yutaka , Kobayashi Eiji
Published: September 2024

Imaging technologies are used to observe the morphology and function of various organs in the body and have become indispensable in a multitude of fields, ranging from basic research to clinical medicine. The luminescence technology based on the luciferin–luciferase reaction has been used in many research fields as an imaging technique, enabling quantitative analysis and detection at high sensitivity. Specifically in gene therapy and cell therapy, it has been developed as an in vivo bioimaging technique mainly for small animal models because of its non-invasive and time-sequential analysis. Currently, translational research using this luminescence imaging technology in pigs for clinical applications is ongoing. In this review, we discuss the progress of these technologies and issues for their clinical application, focusing on pigs, by comparing conventional imaging techniques, including fluorescent probes, with luminescence imaging techniques.
Challenges and Trends in Student Evaluation of Teaching: Analysis of SET Data from the University of Peloponnese
Authors: Papadogiannis Ilias , Vassilakis Costas , Wallace Manolis , Katsis Athanassios
Published: September 2024

This study examines the effectiveness of Student Evaluations of Teaching at the University of Peloponnese, which has systematically collected anonymous evaluations since 2015. The analysis focused on participation rates, average scores, and the correlation between student evaluations and their academic performance. Participation rates were notably low, averaging 14.63%, with postgraduate students showing higher rates (27.33%) than undergraduates (10.77%). The average SET scores were moderately high, with postgraduates rating their courses slightly better (M = 4.137) than undergraduates (M = 3.899). A weak positive correlation was found between course grades and evaluations among undergraduates, whereas no significant correlation was observed for postgraduates. These findings highlight challenges in using SETs as reliable measures of teaching effectiveness and suggest the need for improved participation and more comprehensive evaluation methods. The results provide insights into enhancing assessment practices and contribute to the broader discourse on the validity of student evaluations in higher education.
User Experience and Usability of Voice User Interfaces: A Systematic Literature Review
Authors: Deshmukh Akshay Madhav , Chalmeta Ricardo
Published: September 2024

As voice user interfaces (VUIs) rapidly transform the landscape of human–computer interaction, their potential to revolutionize user engagement is becoming increasingly evident. This paper aims to advance the field of human–computer interaction by conducting a bibliometric analysis of the user experience associated with VUIs. It proposes a classification framework comprising six research categories to systematically organize the existing literature, analyzes the primary research streams, and identifies future research directions within each category. This systematic literature review provides a comprehensive analysis of the development and effectiveness of VUIs in facilitating natural human–machine interaction. It offers critical insights into the user experience of VUIs, contributing to the refinement of VUI design to optimize overall user interaction and satisfaction.
Development of Tools to Understand the Relationship between Good Management Practices and Nest Losses in Meliponiculture: A Pilot Study in Latin American Countries
Authors: Ocaña-Cabrera Joseline Sofía , Martin-Solano Sarah , Saegerman Claude
Published: September 2024

Insect pollination services amount to USD 235–577 billion. Seventy five percent of agricultural production for human consumption depends on pollination, mainly by bees. A decline in pollinators, including Meliponini tribe bees, will impact the economy, food security, human health, and ecosystem stability, especially in tropical forests where stingless bees are the main pollinators. The objective of this survey was to understand the relationship between good management practices and nest losses in meliponiculture, encompassing biosecurity and conservation criteria. A 36-question survey was organized and spread. We received 92 responses, representing 4548 managed nests. The primary motivation for engaging in meliponiculture was biodiversity conservation (92%). More than 50% of the questions on biosecurity were answered as “applied”. Hand washing before any activity with bees was the main rule, followed by material sterilization and personal protective equipment use. The annual mortality rate of stingless bee nests was estimated at 15%. Nest invaders (72%) and nearby sources of pollution (60%) were identified as the main potential causes of nest losses. From a general perspective, meliponiculture practices continue to expand remarkably. The implementation of effective nest management strategies is associated with a reduction in nest losses. It is important to consider One Health’s perspective to ensure optimal management practices.
Simultaneous Silencing of Gut Nucleases and a Vital Target Gene by Adult dsRNA Feeding Enhances RNAi Efficiency and Mortality in Ceratitis capitata
Authors: Volpe Gennaro , Mazzucchiello Sarah Maria , Rosati Noemi , Lucibelli Francesca , Varone Marianna , Baccaro Dora , Mattei Ilaria , Di Lelio Ilaria , Becchimanzi Andrea , Giordano Ennio , Salvemini Marco , Aceto Serena , Pennacchio Francesco , Saccone Giuseppe
Published: September 2024

Ceratitis capitata, known as the Mediterranean fruit fly (Medfly), is a major dipteran pest significantly impacting fruit and vegetable farming. Currently, its control heavily relies mainly on chemical insecticides, which pose health risks and have effects on pollinators. A more sustainable and species-specific alternative strategy may be based on double-stranded RNA (dsRNA) delivery through feeding to disrupt essential functions in pest insects, which is poorly reported in dipteran species. Previous reports in Orthoptera and Coleoptera species suggested that dsRNA degradation by specific nucleases in the intestinal lumen is among the major obstacles to feeding-mediated RNAi in insects. In our study, we experimented with three-day adult feeding using a combination of dsRNA molecules that target the expression of the ATPase vital gene and two intestinal dsRNA nucleases. These dsRNA molecules were recently tested separately in two Tephritidae species, showing limited effectiveness. In contrast, by simultaneously feeding dsRNA against the CcVha68-1, CcdsRNase1, and CcdsRNase2 genes, we observed 79% mortality over seven days, which was associated with a decrease in mRNA levels of the three targeted genes. As expected, we also observed a reduction in dsRNA degradation following RNAi against nucleases. This research illustrates the potential of utilizing molecules as pesticides to achieve mortality rates in Medfly adults by targeting crucial genes and intestinal nucleases. Furthermore, it underscores the importance of exploring RNAi-based approaches for pest management.
The Association between Aortic Valve Stenosis and a Subsequent Diagnosis of Depression in Germany
Authors: Niepmann Sven Thomas , Roderburg Christoph , Luedde Mark , Nickenig Georg , Loosen Sven H. , Kostev Karel
Published: September 2024

Background/Objectives: Aortic valve stenosis (AS) represents one of the most common valve diseases in the western world. It often leads to severe symptoms that can lead to a restriction of everyday life and thus to psychological stress. Therefore, we aimed to investigate the association between AS and depression in outpatients in Germany. Methods: The IQVIATM Disease Analyzer database was used to identify 14,681 individuals with non-rheumatic AS (ICD-10: I35.0 or I35.2). They were propensity score matched (1:1) based on age, sex, average yearly consultation frequency during the follow-up, and co-diagnoses to 14,681 patients without AS. Cox regression models were used to analyze the association between aortic stenosis and depression. Results: Within the follow-up period of up to 10 years, depression was diagnosed in 20.6% of AS patients compared to 20.0% in the matched cohort (p = 0.351). In the regression analysis, we were not able to discover an association between AS and a subsequent diagnosis of depression (HR: 1.03; 95% CI: 0.96–1.11). This effect was consistent among different age and sex groups. Conclusions: In the broad population of patients treated outside of hospital settings in Germany, AS was not associated with a higher incidence of depression.
Nociception Coma Scale—Revised with Personalized Painful Stimulus Versus Standard Stimulation in Persons with Disorders of Consciousness: An International Multicenter Study
Authors: Formisano Rita , Aloisi Marta , Ferri Giulia , Schiattone Sara , Estraneo Anna , Magliacano Alfonso , Noé Enrique , Pérez Maria Dolores Navarro , Hakiki Bahia , Romoli Anna Maria , Bertoletti Erik , Leonardi Gloria , Thibaut Aurore , Martial Charlotte , Gosseries Olivia , Brisbois Marie , Lejeune Nicolas , O’Valle Myrtha , Ferri Joan , Frédérick Anne , Zasler Nathan , Schnakers Caroline , Iosa Marco
Published: September 2024

Background/Objectives: Persons with disorders of consciousness (DoCs) may perceive pain without being able to communicate their discomfort. The Nociception Coma Scale (NCS) and its revised form (NCS-R) have been proposed to assess nociception in persons with DoCs. The main aim of this international multicenter study was to confirm (or not) our preliminary results and compare the NCS-R scores of standard stimulus (NCS-R-SS) to scores of personalized painful stimuli (NCS-R-PS). A secondary aim of the study was to verify possible correlations between the NCS-R-PS and Coma Recovery Scale—Revised (CRS-R) and to estimate convergent validity. Methods: Sixty-one patients with prolonged DoCs (pDoCs) were enrolled from seven European post-acute rehabilitation centers. Responsiveness and pain perception were assessed by CRS-R and NCS-R with standard stimulus (NCS-R-SS) and personalized stimulation (NCS-R-PS). ClinicalTrials.gov Identifier: NCT06012357. Results: our results support our prior findings on the superiority and the validity of the personalized painful stimulus approach in assessment of pain in persons with DoCs in comparison with the standardized pain assessment methodology. Conclusions: A more in-depth and tailored assessment of pain perception in persons with a DoC may lead to better acknowledgment of its presence and by extension an objective foundation for more aggressive and appropriate pain management.
Life-Threatening Conditions and Preoperative Complications Associated with Cardiac Neoplasm Do Not Affect Surgical Outcomes or Mortality
Authors: Suzuki Kenji , Sakamoto Shun-Ichiro , Hiromoto Atsushi , Maeda Motohiro , Yamaguchi Takako , Yamada Naoki , Ueda Hitomi , Matsuyama Takayoshi , Osaka Shin-Ichi , Ishii Yosuke
Published: September 2024

Background: Cardiac neoplasms may cause life-threatening symptoms associated with cerebral infarction, ventricular arrhythmias, and heart failure. Emergency surgery or preoperative treatment may be required for these patients. However, no study has reported the surgical outcomes in cases involving cardiac neoplasms with life-threatening complications. The current study investigated the mid- to long-term outcomes of surgery in patients with cardiac neoplasms in life-threatening conditions. Methods: This study retrospectively analyzed 36 consecutive patients who underwent resection for cardiac neoplasms with life-threatening cardiovascular, respiratory, and cerebral nervous system complications from January 2000 to December 2022. Their mean age at surgery was 54.9 years. In terms of fatal events, one patient who experienced a ventricular tachycardia storm caused by a left ventricular neoplasm was placed under deep sedation and managed with a ventilator preoperatively. Seven patients who presented with limb motor paralysis and visual defects had cerebral infarction. Two of the seven patients with cerebral infarction received cerebrovascular treatment before cardiac surgery. Results: During the follow-up period, cerebral- and cardiovascular-related deaths were not recorded. All postoperative cerebral and cardiovascular complications were new-onset cerebral infarction (n = 2) (with symptoms that improved during the long term). The mean follow-up period was 6.2 years. The 5- and 10-year survival rates of all patients were 89.8% and 78.7%, respectively. There were no significant differences in postoperative prognosis between patients with preoperative cerebral infarctions and those without. Conclusions: The long-term surgical outcome of patients with life-threatening symptomatic cardiac neoplasm was good. Thus, preoperative complications did not affect prognosis.
Renal Manifestations of Chronic Hepatitis C: A Review
Authors: Sohal Aalam , Singh Carol , Bhalla Akshita , Kalsi Harsimran , Roytman Marina
Published: September 2024

Hepatitis C virus (HCV) has emerged as a major global health concern and, if left untreated, can lead to significant liver damage, including cirrhosis, decompensated liver disease, and hepatocellular carcinoma (HCC). Approximately 40% of patients with HCV infection experience extrahepatic manifestations, including renal involvement. HCV-related renal disease is of significant importance among patients with chronic kidney disease (CKD), leading to higher morbidity and mortality. The renal damage due to HCV infection primarily results from cryoglobulinemia and glomerulonephritis, with conditions such as membranoproliferative glomerulonephritis (MPGN) and membranous nephropathy (MN) being most prevalent. Despite advancements in treatment, including the use of directly acting antiviral agents (DAAs), renal complications remain a significant burden in untreated patients. HCV-positive patients on hemodialysis (HD) or those who have undergone kidney transplantation face increased mortality rates compared to their HCV-negative counterparts. Managing HCV infection before kidney transplantation is crucial to mitigate the risk of HCV-related renal complications. Conversely, kidney transplantation from HCV-infected donors is well established, as post-transplant treatment for HCV is safe and effective, potentially reducing mortality and morbidity for patients on transplant waiting lists. This review aims to provide a comprehensive analysis of the renal manifestations of HCV, emphasizing the importance of early diagnosis and treatment to improve patient outcomes.
Pulmonary Rehabilitation Program Is an Effective Treatment Approach for Post-COVID-19 Syndrome Patients
Authors: Pádua Karina , Rosa Karissa Yasmim Araújo , Leal Silvania , Oliveira Silva Iransé , Oliveira Rodrigo Franco de , Oliveira Deise Aparecida de Almeida Pires , Oliveira Luís Vicente , Santos Dante Brasil
Published: September 2024

Background/Objectives: Patients with post-COVID-2019 syndrome may have reduced functional capacity and physical activity levels. The pulmonary rehabilitation program (PRP)—an exercise training program—is designed to restore these functions and has been shown to improve dyspnea, exercise capacity, and other measures in these patients. This study aimed to analyze the effects of the RP on post-COVID-19 syndrome patients with respect to objective and subjective functional capacity, balance, and musculoskeletal strength. Methods: A prospective interventional trial was conducted before and after this phase. Patients were referred to the hospital with a confirmed diagnosis of SARS-CoV-2 and subsequently directed to the RP. These patients underwent an 8-week pulmonary rehabilitation program (45-min sessions 3 times/week). Each session consisted of stationary cycle-ergometer and resistance musculoskeletal exercises tailored to individuals’ performance. They were evaluated pre- and post-PRP using the maximal handgrip strength (HGS) test, timed up-and-go test, 6-min walk test and its derived variables, and Duke Activity Status Index questionnaire. Results: From 142 hospitalized patients admitted with a diagnosis of SARS-CoV-2 infection, 60 completed the program, with an attendance rate of 85%. Nineteen patients were categorized as severe/critical, with a significantly higher hospital stay, compared to mild/moderate patients, and there were no differences in terms of sex distribution, age, or BMI between groups. Compared to the pre-PRP evaluation, both groups showed significant (p < 0.001) improvements in TUG, HGS, DASI D6MWT, 6MWS, and DSP variables after the PRP conduction. In addition, the groups exhibited similar improvement patterns following PRP (intragroup analysis), with no intergroup differences. Conclusions: RPs promote both objective and subjective functional capacity in patients with post-COVID-19 syndrome, with no difference in improvement regardless of the severity of the initial infection.
Tricuspid Regurgitation Associated with Implantable Cardiac Devices: A Double-Edged Sword
Authors: Iliescu Ștefan , Voroneanu Luminita , Covic Alexandra Maria , Scripcariu Dragos Viorel , Stătescu Cristian , Covic Adrian C.
Published: September 2024

The use of cardiac implantable electronic devices (CIEDs) has increased considerably, becoming a cornerstone of management for patients with brady- or tachyarrhythmia or for the prevention of sudden cardiac death. On the other hand, tricuspid regurgitation (TR) associated with CIEDs is progressively accepted as a serious clinical issue; the prognostic impact of TR is profound, as it is independently associated with increased mortality and a higher risk of heart failure hospitalization. Additionally, the management of established CIED-related TR continues to be challenging, with limited options for intervention once significant TR has developed. The balance between the lifesaving benefits of CIEDs and the risk of TR underlines the necessity for cautious patient selection and innovative approaches to device implantation and management. This review highlights the clinical importance, underlying mechanisms and challenges associated with lead-related tricuspid regurgitation in patients with CIEDs.
Simultaneous Percutaneous Coronary Intervention (PCI) and Endovascular Aneurysm Repair (EVAR): A Preliminary Report
Authors: Nardi Priscilla , Rinaldi Valerio , Costanzo Maria Ludovica , Pasqua Rocco , Loiacono Francesco , Palumbo Piergaspare , Miraldi Fabio , Tanzilli Gaetano , D’Andrea Vito , Illuminati Giulio
Published: September 2024

Background: Performing percutaneous coronary intervention (PCI) and endovascular aneurysm repair (EVAR) at the same time represents a groundbreaking development in the multidisciplinary treatment of cardiovascular disease. This combined PCI–EVAR approach bridges a critical gap by offering treatment for patients who have both coronary artery disease and aortic aneurysms. This innovative strategy exemplifies the evolving landscape of cardiovascular care, providing a new solution for complex clinical situations that previously required separate procedures. Methods: Six patients with critical coronary artery lesions and asymptomatic infrarenal aortic aneurysms (AAAs) ≥ 6 cm diameter, as well as one patient with critical coronary artery lesions and endoleak type 1A with aneurysms ≥ 6 cm, underwent simultaneous coronary artery revascularization through percutaneous intervention (PCI) and endovascular aneurysm repair (EVAR). The occurrence of any intraoperative or postoperative complication was considered to be the primary endpoint of the study, including the abortion or failure of either PCI or EVAR, bleeding requiring a conversion to open surgical procedures, the failure of local anesthesia, postoperative myocardial or lower limb ischemia, and a postoperative serum creatinine level of >125 mmol/L or of >180 mmol/L in patients affected by chronic renal failure. The overall length of the procedure, X-ray exposure, the quantity of iodine contrast medium administered, and the length of recovery were considered to be secondary endpoints. Results: Postoperative complications included two episodes of acute renal failure in the two patients already affected by chronic renal failure, which were easily resolved with adequate daily hydration and the elimination of nephrotoxic drugs. In no cases did cardiac ischemia or lower limb ischemia occur. The average procedure duration was 198 min (range: 180–240 min), the average fluoroscopy duration was 41.7 min (range: 35–50 min), the average amount of iodinated contrast medium was 34.8 mL (range: 30–40 mL), and the mean length of hospitalization was 2.7 days (range: 2–5 days). Conclusions: In selected patients, this surgical approach has demonstrated safety, reduced hospitalization times, minimized risks associated with complications from the untreated condition if procedures were performed at different times, and facilitated the effective management of intraoperative complications due to the presence of a multidisciplinary team. However, the limited number of patients necessitates further research.
Nailfold Capillaroscopy Changes in Patients with Idiopathic Inflammatory Myopathies
Authors: Bogojevic Milan , Markovic Vlaisavljevic Milica , Medjedovic Rifat , Strujic Elvira , Pravilovic Lutovac Dragana , Pavlov-Dolijanovic Slavica
Published: September 2024

Background/Objectives: Idiopathic inflammatory myopathies (IIMs) are rare autoimmune disorders characterized by progressive proximal muscle weakness and varying extra-muscular manifestations. The latest 2017 EULAR/ACR criteria classify them into subgroups. This study aims to evaluate the role of nailfold capillaroscopy (NFC) as a diagnostic and prognostic tool in IIMs by comparing capillaroscopic patterns across different IIM subtypes. Methods: We conducted an observational, cross-sectional study at the Institute of Rheumatology in Belgrade, analyzing 90 patients diagnosed with IIMs per the 2017 EULAR/ACR criteria. Patients were categorized into dermatomyositis (DM) (n = 37), polymyositis (PM) (n = 35), amyopathic dermatomyositis (ADM) (n = 13), and juvenile dermatomyositis (JDM) (n = 5). A control group of 35 patients with primary Raynaud’s phenomenon was also included. NFC findings, clinical manifestations, and laboratory data were compared across the groups. Results: In DM, 81.9% exhibited a scleroderma capillaroscopic pattern, which was also present in 76.9% of ADM patients. In PM, the most common pattern was nonspecific changes (48.6%). JDM patients showed a high prevalence of scleroderma changes (n = 4 (80%)). Scleroderma patterns correlated with Gottron’s papules, heliotrope rash, periungual erythema, Raynaud’s phenomenon, and interstitial lung disease (ILD). No significant differences were found in laboratory parameters across capillaroscopic groups, except for a higher prevalence of anti-Jo1 antibodies in patients with nonspecific capillaroscopic changes. Conclusions: NFC is a valuable tool for differentiating IIM subtypes and correlating clinical manifestations with specific capillaroscopic patterns. The high prevalence of scleroderma changes in DM and ADM suggests their potential as a diagnostic and prognostic marker in IIMs. Further research with larger cohorts is warranted to validate these findings.
Risk Factors of Velamentous Cord Insertion in Singleton Pregnancies—A Systematic Review and Meta-Analysis
Authors: Siargkas Antonios , Tsakiridis Ioannis , Gatsis Athanasios , De Paco Matallana Catalina , Gil Maria Mar , Chaveeva Petya , Dagklis Themistoklis
Published: September 2024

Objective: This meta-analysis aims to quantitatively summarize current data on various potential risk factors of velamentous cord insertion (VCI). A better understanding of these risk factors could enhance prenatal identification both in settings with routine screening and in those where universal screening for cord insertion anomalies is not yet recommended. Methods: A systematic search was conducted in MEDLINE, Cochrane Library, and Scopus from their inception until 7 February 2024. Eligible studies included observational studies of singleton pregnancies with VCI, identified either prenatally or postnatally, compared with pregnancies with central or eccentric cord insertion. Analyses were performed using DerSimonian and Laird random-effects models, with outcomes reported as risk ratios (RR) or mean differences with 95% confidence intervals (CI). Results: In total, 14 cohort and 4 case-control studies were included, reporting on 952,163 singleton pregnancies. Based on the cohort studies, the overall prevalence of VCI among singleton pregnancies was calculated to be 1.54%. The risk of VCI was significantly higher among pregnancies conceived using assisted reproductive technology (RR, 2.32; 95% CI: 1.77–3.05), nulliparous women (RR, 1.21; 95% CI: 1.15–1.28), women who smoked (RR, 1.14; 95% CI: 1.08–1.19), and pregnancies diagnosed with placenta previa (RR, 3.60; 95% CI: 3.04–4.28). Conclusions: This meta-analysis identified assisted reproductive technology, nulliparity, smoking, and placenta previa as significant risk factors of VCI among singleton pregnancies. These findings could inform screening policies in settings where universal screening for cord insertion is not routinely performed, suggesting a targeted approach for women with these specific risk factors.
Is Total Joint Arthroplasty an Effective and Safe Option for Psoriatic Arthritis Patients? A Scoping Review
Authors: Ciaffi Jacopo , Bianchi Lorenzo , Di Martino Alberto , Faldini Cesare , Ursini Francesco
Published: September 2024

Recent advancements in the treatment of psoriatic arthritis (PsA) have improved patient outcomes, but many still experience disease progression, potentially leading to joint replacement surgery. In this scoping review, we examine the relationship between PsA and orthopedic surgery, focusing on the risks and temporal trends of total hip arthroplasty (THA) and total knee arthroplasty (TKA), the prevalence of postoperative complications, and the effectiveness of these procedures in PsA. The included studies suggest that PsA patients have an overall higher risk of undergoing THA and TKA compared to the general population, but with temporal trends showing a decreased risk for patients diagnosed in recent years. Acute complications, such as renal failure, stroke, and postoperative infections, may be more common in PsA patients than in those with osteoarthritis after THA and TKA. No significant differences were found in pain, function, or satisfaction between PsA, skin psoriasis, and osteoarthritis patients after THA. A key conclusion from our review is the need to strengthen the collaboration between rheumatologists and orthopedic surgeons, as interdisciplinary evaluation is crucial for improving the outcomes of PsA patients undergoing orthopedic surgery.
Radiological Assessment of Different Retroperitoneal Lymph Node Measurements in Stage 1 Testicular Cancer Patients: Impact on Clinical Stage and Treatment
Authors: Strauch Angelina , Nestler Kai , Schoch Justine , Kubitscheck Laura , Waldeck Stephan , Schmelz Hans , Nestler Tim
Published: September 2024

Background: In staging for testicular germ cell tumor (GCT), current guidelines lack consensus regarding the measurement of retroperitoneal lymph node metastasis, concerning the recommended plane and dimension. This exploratory study aimed to assess its impact on clinical stage (cS) and therapy. Methods: We retrospectively examined 154 cSI (retroperitoneal lymph nodes < 10 mm in axial short-axis diameter (SAD)) GCT patients, without adjuvant therapy and a follow-up ≥ 24 months. Retroperitoneal lymph nodes were measured in staging images in different dimensions (SAD and long-axis diameter (LAD)) and planes (axial, sagittal and coronal). Results: Overall survival was 100%, with 82% free of recurrence after a median follow-up of 83 months. All patients were classified as cSI, based on axial SAD (RECIST 1.1). However, significantly more patients would have been classified as cSIIA (0% vs. 38% vs. 52%) or even cSIIB (0% vs. 1% vs. 25%) according to axial LAD (SWENOTECA, German S3 guideline) or maximum LAD in any plane (EAU, ESMO, AJCC and onkopedia) (p < 0.001). Overtreatment was predicted in 0%, 31% and 61% of patients based on axial SAD, axial LAD and maximum LAD, while undertreatment was estimated at 18%, 10% and 2%, respectively, (p < 0.001). Conclusions: These findings indicate considerable variability in cS based on current lymph node staging recommendations, suggesting that axial SAD (RECIST 1.1) could be the most appropriate parameter for standardized guideline recommendations.
A Comparative Analysis of the SARC-F Questionnaire and the Malnutrition–Inflammation Score for Sarcopenia Risk Assessment and Negative Outcome Probability in Chronic Hemodialysis Patients
Authors: Katalinic Lea , Juric Ivana , Furic Cunko Vesna , Premuzic Vedran , Jelakovic Bojan , Basic-Jukic Nikolina
Published: September 2024

Background/Objectives: Protein–energy wasting (PEW) and sarcopenia are common in chronic hemodialysis (HD) patients, leading to numerous complications and increased mortality. This study aimed to compare the reliability of the SARC-F (Strength, Assistance in walking, Rise from a chair, Climb stairs, and Falls) and the Malnutrition–Inflammation Score (MIS) in assessing sarcopenia and predicting negative outcomes in HD patients. Methods: This cross-sectional study enrolled 109 HD patients. Nutritional assessments were performed, and blood samples were taken for routine blood laboratory investigations. The MIS was used as a scoring system to represent the severity of PEW, while the SARC-F was applied as an indicator of sarcopenia risk and general functional capacity. A multivariable logistic regression was conducted to analyze the association of several predictors with a negative cross-sectional outcome (death). Results: Patients with SARC-F scores ≥ 4 and MISs ≥ 6 were older, had significantly lower albumin and prealbumin levels, and more severe anemia. They were also more likely to report weight loss and poor appetite. A higher MIS was closely associated with unfavourable nutritional status according to the International Society of Renal Nutrition and Metabolism (ISRNM) criteria for PEW. However, in 71.25% of patients with satisfactory functional capacity (SARC-F scores 0–3), some form of PEW was still observed. After performing logistic regression modelling, only the MIS remained strongly associated with the probability of a negative outcome. Conclusions: The SARC-F alone often did not correspond to an increased sarcopenia risk or clear clinical and biochemical indicators of PEW in HD patients. When assessing nutritional risk in this group, it is recommended to use more detailed tools, such as the MIS, to ensure the accurate identification of those at the highest risk for negative outcomes.
Retinal and Corneal OCT Results of Patients Hospitalized and Treated in the Acute Phase of COVID-19
Authors: Wylęgała Edward , Prus-Ludwig Aleksandra , Mocek Patrycja , Tomczyk Tomasz , Dugiełło Bogdan , Madej Andrzej , Orzechowska-Wylęgała Bogusława , Wylęgała Adam
Published: September 2024

Objective: This study aimed to assess changes in the morphology of the retina and cornea in patients treated and hospitalized during the acute active phase of SARS-CoV-2 infection. Methods: A total of 24 patients with symptomatic early COVID-19 disease and 38 healthy participants from a control group were enrolled in our study. Among them, 20 received oxygen therapy at flow rates ranging from 1–10 L, while four received high-flow intranasal oxygen therapy (HFNOT). Some patients were treated with other types of therapy, such as Remdesivir, COVID-19 convalescent plasma therapy, or Tocilizumab. In the study, we focused on the analysis of optical coherence tomography (OCT) images of the cornea and retina including corneal thickness, central retinal thickness, retinal nerve fiber layer (RNFL), and optic disc parameters. The measurements were acquired using Spectral-domain OCT REVO FC 130. Results: The analysis did not show significant changes between the examined ophthalmological parameters before and after therapy. Furthermore, there were no detected significant differences between the tested parameters of the retina and cornea in COVID-19-positive patients compared to the control group. Conclusions: No ophthalmological manifestations of COVID-19 disease were observed during the study. Taking into account the results of other publications, the lack of an unambiguous position on this topic requires further research.
Neurodevelopmental Impairments in Adult Psychosomatic Patients
Authors: Christensen Nils , Linden Michael , Muschalla Beate
Published: September 2024

Background/Objectives: Neuropsychological, neurodevelopmental, or minimal cerebral dysfunctions (MCD) can be found in many patients with mental disorders. They can be masked by other symptoms, impair the course of the illness, and impair work and social participation. Despite a long history of research, there is still a lack of data on the spectrum, prevalence, and consequences of these dysfunctions in patients with chronic illness. In this study, we compared patients with and without a history of neurocognitive problems in childhood for present neuropsychological dysfunctions. Methods: A convenience sample of 1453 psychosomatic inpatients completed the MCD scale, assessing neurodevelopmental issues in childhood and current neuropsychological dysfunctions. Additional assessments were the Attention Deficit Hyperactivity Self Rating Scale (ADHS-SB) and the Symptom Checklist 90 (SCL-90). Results: Significant early neurodevelopmental problems were reported by 8.87% of the patients. This group also reported a significantly higher rate of MCD symptoms and general psychosomatic symptoms (SCL-90) as compared with other patients. Conclusions: There is a notable prevalence of neuropsychological dysfunctions in psychosomatic patients in general, and especially in those with early neurodevelopmental problems. To adequately address specific potentially participation-relevant impairments, a broader diagnostic approach is necessary, including exploration of MCD history and present neuropsychological dysfunctions.