bluuebunny/crossref_metadata_2025 huggingface dataset:
Novel Slippery Liquid-Infused Porous Surfaces (SLIPS) Based on Electrospun Polydimethylsiloxane/Polystyrene Fibrous Structures Infused with Natural Blackseed Oil
Authors: Abdulkareem Asma , Abusrafa Aya E. , Zavahir Sifani , Habib Salma , Sobolčiak Patrik , Lehocky Marian , Pištěková Hana , Humpolíček Petr , Popelka Anton
Published: March 2022

Hydrophobic fibrous slippery liquid-infused porous surfaces (SLIPS) were fabricated by electrospinning polydimethylsiloxane (PDMS) and polystyrene (PS) as a carrier polymer on plasma-treated polyethylene (PE) and polyurethane (PU) substrates. Subsequent infusion of blackseed oil (BSO) into the porous structures was applied for the preparation of the SLIPS. SLIPS with infused lubricants can act as a repellency layer and play an important role in the prevention of biofilm formation. The effect of polymer solutions used in the electrospinning process was investigated to obtain well-defined hydrophobic fibrous structures. The surface properties were analyzed through various optical, macroscopic and spectroscopic techniques. A comprehensive investigation of the surface chemistry, surface morphology/topography, and mechanical properties was carried out on selected samples at optimized conditions. The electrospun fibers prepared using a mixture of PDMS/PS in the ratio of 1:1:10 (g/g/mL) using tetrahydrofuran (THF) solvent showed the best results in terms of fiber uniformity. The subsequent infusion of BSO into the fabricated PDMS/PS fiber mats exhibited slippery behavior regarding water droplets. Moreover, prepared SLIPS exhibited antibacterial activity against Staphylococcus aureus and Escherichia coli bacterium strains.
Clinical Outcomes with Targeted Temperature Management (TTM) in Comatose Out-of-Hospital Cardiac Arrest Patients—A Retrospective Cohort Study
Authors: Scholte Niels T. B. , van Wees Christiaan , Rietdijk Wim J. R. , van der Graaf Marisa , Jewbali Lucia S. D. , van der Jagt Mathieu , van den Berg Remco C. M. , Lenzen Mattie J. , den Uil Corstiaan A.
Published: March 2022

Purpose: we evaluated the effects of the shift of a targeted temperature management (TTM) strategy from 33 °C to 36 °C in comatose out-of-hospital cardiac arrest (OHCA) patients admitted to the Intensive Care Unit (ICU). Methods: we performed a retrospective study of all comatose (GCS < 8) OHCA patients treated with TTM from 2010 to 2018 (n = 798) from a single-center academic hospital. We analyzed 90-day mortality, and neurological outcome (CPC score) at ICU discharge and ICU length of stay, as primary and secondary outcomes, respectively. Results: we included 798 OHCA patients (583 in the TTM33 group and 215 in the TTM36 group). We found no association between the TTM strategy (TTM33 and TTM36) and 90-day mortality (hazard ratio (HR)] 0.877, 95% CI 0.677–1.135, with TTM36 as reference). Also, no association was found between TTM strategy and favorable neurological outcome at ICU discharge (odds ratio (OR) 1.330, 95% CI 0.941–1.879). Patients in the TTM33 group had on average a longer ICU LOS (beta 1.180, 95% CI 0.222–2.138). Conclusion: no differences in clinical outcomes—both 90-day mortality and favorable neurological outcome at ICU discharge—were found between targeted temperature at 33 °C and 36 °C. These results may help to corroborate previous trial findings and assist in implementation of TTM.
Management of Acute Coronary Syndrome in Cancer Patients: It’s High Time We Dealt with It
Authors: Lucà Fabiana , Parrini Iris , Abrignani Maurizio Giuseppe , Rao Carmelo Massimiliano , Piccioni Laura , Di Fusco Stefania Angela , Ceravolo Roberto , Bisceglia Irma , Riccio Carmine , Gelsomino Sandro , Colivicchi Furio , Gulizia Michele Massimo
Published: March 2022

Cancer patients have an increased risk of cardiovascular disease and, notably, a significant prevalence of acute coronary syndrome (ACS). It has been shown that an elevated presence of cardiovascular risk factors in this setting leads to an interaction between these two conditions, influencing their therapeutic strategies and contributing to higher mortality. Nonetheless, cancer patients have generally not been evaluated in ACS trials, so that the treatment in these cases is still not fully known. We reviewed the current literature and discussed the best management for these very high-risk patients. The treatment strategy must be tailored based on the cancer type and stage, balancing thrombotic and bleeding risks. When the prognosis is longer than six months, especially if a clinical instability coexists, patients with ACS and cancer should be referred for percutaneous coronary intervention (PCI) as soon as possible. Moreover, an invasive strategy should be preferred in STEMI patients as well as in NSTEMI patients who are considered as high risk. On the contrary, in clinically stable NSTEMI patients, a conservative non-invasive strategy could be adopted, especially in cases of a poor life expectancy and/or of high risk of bleeding. Drug-Eluting-Stents (DES) should be the first choice if an invasive strategy is adopted. Conservative therapy could instead be considered in cancer patients with more stable CAD at an increased risk of major bleeding complications. However, the duration of dual antiplatelet therapy (DAPT) with aspirin and clopidogrel is recommended, but it should be as short as possible, whereas triple antithrombotic therapy is non-advised because it significantly increases the risk of bleeding. ACS management among cancer patients should be based on an accurate evaluation of the risk of thrombosis and bleeding. Future studies focused on choosing optimal strategies in tumor patients with ACS should be performed to treat this subset of patients better.
Malignant Transformation Rate of Oral Submucous Fibrosis: A Systematic Review and Meta-Analysis
Authors: Murthy Vignesh , Mylonas Petros , Carey Barbara , Yogarajah Sangeetha , Farnell Damian , Addison Owen , Cook Richard , Escudier Michael , Diniz-Freitas Marcio , Limeres Jacobo , Monteiro Luis , Silva Luis , Fricain Jean-Cristophe , Catros Sylvain , Fenelon Mathilde , Lodi Giovanni , Lombardi Niccolò , Brailo Vlaho , Ariyaratnam Raj , López-López José , Albuquerque Rui
Published: March 2022

Oral submucous fibrosis (OSF) is a chronic progressive condition affecting the oral cavity, oropharynx and upper third of the oesophagus. It is a potentially malignant disorder. The authors collated and analysed the existing literature to establish the overall malignant transformation rate (MTR). A retrospective analysis of medical and dental scientific literature using online indexed databases was conducted for the period 1956 to 2021. The quality of the enrolled studies was assessed by the Newcastle-Ottawa Scale (NOS). A meta-analysis using a random effects model of a single proportion was performed along with statistical tests for heterogeneity. The overall proportion of malignancy across all studies was 0.06 (95% CI, 0.02–0.10), indicating an overall 6% risk of malignant transformation across all studies and cohorts. Sub-group analyses revealed strong differences in proportion of malignancy according to ethnicity/cohort; Chinese = 0.02 (95% CI 0.01–0.02), Taiwanese = 0.06 (95% CI, 0.03–0.10), Indian = 0.08 (95% CI, 0.03–0.14) and Pakistani = 0.27 (95% CI 0.25–0.29). Overall, the MTR was 6%; however, wide heterogeneity of the included studies was noted. Geographic variations in MTR were noted but were not statistically significant. Further studies are required to analyse the difference between cohort groups.
Cranial Shape in Infants Aged One Month Can Predict the Severity of Deformational Plagiocephaly at the Age of Six Months
Authors: Miyabayashi Hiroshi , Nagano Nobuhiko , Kato Risa , Noto Takanori , Hashimoto Shin , Saito Katsuya , Morioka Ichiro
Published: March 2022

In this study, we aimed to monitor changes in cranial shape using three-dimensional (3D) scanning to determine whether the severity of deformational plagiocephaly (DP) at the age of 6 months could be predicted at the age of 1 month. The cranial shape was measured at the ages of 1, 3, and 6 months (T1, T2, and T3, respectively) in 92 infants. We excluded those who received helmet treatment before T3. The cranial vault asymmetry index (CVAI) using 3D scanning was evaluated in all infants. DP was defined as a CVAI > 5.0% with mild (CVAI ≤ 6.25%) or moderate/severe severity (CVAI > 6.25%). The CVAI cut-off value at T1 for severe DP at T3 was determined using receiver operating characteristic (ROC) curves. At T1, T2, and T3, the respective CVAI median values were 5.0%, 5.8%, and 4.7% and the DP incidence was 50.0%, 56.8%, and 43.2%, respectively. The DP severity temporarily worsened from T1 to T2 but then improved at T3. Among the infants, 73.9% had a similar DP severity at T1 and T3 (p = 1.0). A ROC curve analysis revealed a CVAI cut-off value of 7.8% at T1 predicted severe DP. It was concluded that later DP severity could be predicted using 3D scanning at T1 with properly defined cut-off values.
Chronic Myeloid Leukemia and Pregnancy: When Dreams Meet Reality. State of the Art, Management and Outcome of 41 Cases, Nilotinib Placental Transfer
Authors: Abruzzese Elisabetta , Aureli Stefano , Bondanini Francesco , Ciccarone Mariavita , Cortis Elisabetta , Di Paolo Antonello , Fabiani Cristina , Galimberti Sara , Malagola Michele , Malato Alessandra , Martino Bruno , Trawinska Malgorzata Monika , Russo Domenico , de Fabritiis Paolo
Published: March 2022

The overwhelming success of tyrosine kinase inhibitor (TKI) therapy in chronic myeloid leukemia (CML) patients has opened a discussion among medical practitioners and the lay public on the real possibility of pregnancy and conception in females and males with CML. In the past 10 years this subject has acquired growing interest in the scientific community and specific knowledge has been obtained “from bench to bedside”. Embryological, pharmacological, and pathophysiological studies have merged with worldwide patient databases to provide a roadmap to a successful pregnancy and birth in CML patients. Male conception does not seem to be affected by TKI therapy, since this class of drugs is neither genotoxic nor mutagenic, however, caution should be used specially with newer drugs for which little or no data are available. In contrast, female patients should avoid TKI therapy specifically during the embryonic stage of organogenesis (5–12 weeks) because TKIs can be teratogenic. In the last 15 years, 41 pregnancies have been followed in our center. A total of 11 male conceptions and 30 female pregnancies are described. TKI treatment was generally terminated as soon as the pregnancy was discovered (3–5 weeks), to avoid exposure during embryonic period and to reduce the risk of needing treatment in the first trimester. Eleven pregnancies were treated with interferon, imatinib or nilotinib during gestation. Nilotinib plasma levels in cord blood and maternal blood at delivery were studied in 2 patients and reduced or absent placental crossing of nilotinib was observed. All of the patients were managed by a multidisciplinary team of physicians with obligatory hematological and obgyn consultations. This work provides an update on the state of the art and detailed description of pregnancy management and outcomes in CML patients.
Subjective Sound Quality Detection (HISQUI) over Time after Vibrant Soundbridge Implantation
Authors: Buhl Christof , Schindler Valeria , Pfiffner Flurin , Veraguth Dorothe , Huber Alexander , Röösli Christof
Published: March 2022

Background: To evaluate the long-term audiological outcomes combined with the Hearing Implant Sound Quality Index (HISQUI) after Vibrant Soundbridge (VSB) implantation. Methods: Prospective recall cohort study of patients who received a VSB in a tertiary academic medical center between 1996 and 2017. Air conduction (AC) and bone conduction (BC), sound field thresholds in aided and unaided conditions, and speech discrimination in noise (Oldenburger sentence test) were measured. Postoperative results were compared with preoperative audiograms. Furthermore, the HISQUI was evaluated. Results: Ten patients (eleven implants) were included, the mean follow up period was nine years. The mean AC threshold preoperatively was between 63 and 70 dB, and the BC was between 38 and 49 dB from 500 to 4000 Hz. In the free-field audiogram, the mean threshold was between 61 and 77 dB unaided vs. between 28 and 52 dB in the aided condition. The average signal to noise ratio (SNR) in the Oldenburger sentence test in the unaided condition was 10 dB ± 6.7 dB vs. 2 dB ± 5.4 dB in the aided condition. Three patients reported a good to very good hearing result, four patients a moderate, and three patients a poor hearing result. There was a significant association between the years of implantation and the HISQUI (p = 0.013), as well as a significant decrease by 14 HISQUI points per 10 dB SPL decline (SE 5.2, p = 0.023). There was a significant difference between the change of BC over the years and the HISQUI, as well as the number of years after implantation and the HISQUI. On average, per dB decrease in BC, the HISQUI decreases by 1.4 points, and every year after implantation the HISQUI decreases by 2.7 points. Conclusions: The aided threshold in free field and speech understanding in noise improved significantly with VSB. An increase over time of BC thresholds was observed as well as a decrease in HISQUI score. This decrease in BC thresholds over time may be due to presbycusis. Therefore, monitoring of these patients over time should be considered to discuss alternative hearing rehabilitation measures in a timely manner.
Effects of Vaccination against COVID-19 in Chronic Spontaneous and Inducible Urticaria (CSU/CIU) Patients: A Monocentric Study
Authors: Grieco Teresa , Ambrosio Luca , Trovato Federica , Vitiello Martina , Demofonte Ilaria , Fanto Marta , Paolino Giovanni , Pellacani Giovanni
Published: March 2022

Background: Patients affected by pre-existing chronic spontaneous/Inducible urticaria (CSU/CIU) still feel unsafe due to the potential risk of an Adverse Event Following Immunization (AEFI) and Cutaneous Adverse Reactions (CARs) of COVID-19 vaccines. The appropriate management in this field remains debated and evidence is still lacking. Methods: We considered 160 CSU/CIU patients in Omalizumab/antihistamine therapy who received two doses of Comirnaty/Moderna mRNA vaccines; 20 of them also received a booster dose. Urticaria Activity Score-7 (UAS7) was used to assess the severity of the disease. Demographics, medical history, AEFI and CARs outcome after vaccination were collected by administering a web-based questionnaire completed by phone interview. Results: In total, 147 patients did not show urticaria relapse (91.88%). Worsening cutaneous symptoms were experienced by 13 of our patients (8.12%). Exacerbation had a mean duration of 2 days and 11 h and mostly occurred after the first dose (69.23%). Systemic mild side effects were experienced by 9 patients (5.62%). No severe reactions were observed. Conclusions: Omalizumab can potentially prevent CARs and AEFI; however, major problems were registered during the 2-month stop period scheduled in the treatment. We suggest patients should not undergo vaccination during this period. CSU/CIU exacerbations appear to be transient and can be managed by antihistamines.
RETRACTED: Validation of the CHA2DS2-VA Score (Excluding Female Sex) in Nonvalvular Atrial Fibrillation Patients: A Nationwide Population-Based Study
Authors: Choi Sun , Kim Moo , Kim Hyo , Kang Sa , Lee Kwang , Hyun Kyung-Yae , Yun Sung-Cheol
Published: March 2022

Sex (i.e., female sex) confers one point for the CHA2DS2-VASc score. For this reason, females with atrial fibrillation (AF) always have a CHA2DS2-VASc score of at least 1. To compare the CHA2DS2-VA (excluding female sex) and CHA2DS2-VASc scores in Korean AF patients using the Korean National Health Insurance Service database, we analyzed the risk of ischemic stroke in nonvalvular AF patients between 2013 and 2017. The predictive values of the CHA2DS2-VA and CHA2DS2-VASc scores for ischemic stroke were evaluated using the C-statistic and net reclassification improvement (NRI). The primary outcome was the occurrence of ischemic stroke. A total of 185,637 patients with AF (49.7% women) were included in this study. The mean ages were 66.5 years for females and 64.9 years for males. The incidence of ischemic stroke in male patients was similar to females (3.63%/year vs. 3.72%/year, p = 0.273, respectively). In addition, no sex difference was apparent for stroke risk in AF patients stratified by risk factor component and age group. In the C-statistic analysis, the predictive ability of the CHA2DS2-VA score for ischemic stroke was similar to the CHA2DS2-VASc score. Additionally, CHA2DS2-VA performed better for predicting ischemic stroke in AF patients with risk scores of ≥2 (AUC 0.701 vs. 0.689, z = 4.596, p < 0.001) or those aged ≥75 years (AUC 0.715 vs. 0.701, z = 4.957, p < 0.001). In Korean AF patients, female sex is not a specific risk factor that contributes to the development of ischemic stroke. The CHA2DS2-VA score, which excludes female sex, may be a more suitable risk score for guiding anticoagulation decisions in Korean AF patients.
Smartphone-Guided Educational Counseling and Self-Help for Chronic Tinnitus
Authors: Schlee Winfried , Neff Patrick , Simoes Jorge , Langguth Berthold , Schoisswohl Stefan , Steinberger Heidi , Norman Marie , Spiliopoulou Myra , Schobel Johannes , Hannemann Ronny , Pryss Rüdiger
Published: March 2022

Tinnitus is an auditory phantom perception in the ears or head in the absence of a corresponding external stimulus. There is currently no effective treatment available that reliably reduces tinnitus. Educational counseling is a treatment approach that aims to educate patients and inform them about possible coping strategies. For this feasibility study, we implemented educational material and self-help advice in a smartphone app. Participants used the educational smartphone app unsupervised during their daily routine over a period of four months. Comparing the tinnitus outcome measures before and after smartphone-guided treatment, we measured changes in tinnitus-related distress, but not in tinnitus loudness. Improvements on the Tinnitus Severity numeric rating scale reached an effect size of 0.408, while the improvements on the Tinnitus Handicap Inventory (THI) were much smaller with an effect size of 0.168. An analysis of user behavior showed that frequent and intensive use of the app is a crucial factor for treatment success: participants that used the app more often and interacted with the app intensively reported a stronger improvement in the tinnitus. Between study allocation and final assessment, 26 of 52 participants dropped out of the study. Reasons for the dropouts and lessons for future studies are discussed in this paper.
Robot-Assisted Minimally Invasive Breast Surgery: Recent Evidence with Comparative Clinical Outcomes
Authors: Chen Kuo , Zhang Jin , Beeraka Narasimha M. , Sinelnikov Mikhail Y. , Zhang Xinliang , Cao Yu , Lu Pengwei
Published: March 2022

In recent times, robot-assisted surgery has been prominently gaining pace to minimize overall postsurgical complications with minimal traumatization, due to technical advancements in telerobotics and ergonomics. The aim of this review is to explore the efficiency of robot-assisted systems for executing breast surgeries, including microsurgeries, direct-to-implant breast reconstruction, deep inferior epigastric perforators-based surgery, latissimus dorsi breast reconstruction, and nipple-sparing mastectomy. Robot-assisted surgery systems are efficient due to 3D-based visualization, dexterity, and range of motion while executing breast surgery. The review describes the comparative efficiency of robot-assisted surgery in relation to conventional or open surgery, in terms of clinical outcomes, morbidity rates, and overall postsurgical complication rates. Potential cost-effective barriers and technical skills were also delineated as the major limitations associated with these systems in the clinical sector. Furthermore, instrument articulation of robot-assisted surgical systems (for example, da Vinci systems) can enable high accuracy and precision surgery due to its promising ability to mitigate tremors at the time of surgery, and shortened learning curve, making it more beneficial than other open surgery procedures.
PSMA PET/CT in Renal Cell Carcinoma: An Overview of Current Literature
Authors: Muselaers Stijn , Erdem Selcuk , Bertolo Riccardo , Ingels Alexandre , Kara Önder , Pavan Nicola , Roussel Eduard , Pecoraro Angela , Marchioni Michele , Carbonara Umberto , Marandino Laura , Amparore Daniele , Campi Riccardo ,   on behalf of the European Association of Urology (EAU) Young Academic Urologists (YAU) Renal Cancer Working Group
Published: March 2022

Although the vast majority of prostate-specific membrane antigen (PSMA) positron emission tomography (PET) imaging occurs in the field of prostate cancer, PSMA is also highly expressed on the cell surface of the microvasculature of several other solid tumors, including renal cell carcinoma (RCC). This makes it a potentially interesting imaging target for the staging and monitoring of RCC. The objective of this review is to provide an overview of the current evidence regarding the use of PSMA PET/Computed Tomography in RCC patients.
Analysis of Korean Retinal Specialists’ Opinions on Implanting Diffractive Multifocal Intraocular Lenses in Eyes with Underlying Retinal Diseases
Authors: Lee Jung-Hwa , Kong Mingui , Sohn Joon-Hong , Cho Beom-Jin , Choi Kee-Yong , Lee Sang-Mok
Published: March 2022

Multifocal intraocular lenses (MF-IOLs) are increasingly implanted as the need for good near- and intermediate-distance vision increases. Although retinal disease is known to be a relative contraindication for MF-IOL implantation, there are no detailed guidelines for MF-IOL implantation with respect to the type and severity of retinal diseases/statuses. In this study, because retinal diseases can affect the performance of MF-IOLs, we analyzed the opinions of 111 retinal specialists, who were members of the Korean Retina Society, on the implantation of diffractive MF-IOLs in eyes with 15 retinal diseases/statuses using a web-based survey. For each underlying condition, retinal specialists were asked to rate their approval regarding implantation of MF-IOLs on a scale from 1 (completely disapprove) to 7 (completely approve), under the assumption that there were no known contraindications except for a given retinal disease/status. As a result, retinal specialists disapproved MF-IOL implantation (median value of Likert score < 4) in the eyes with wet age-related macular degeneration, dry age-related macular degeneration with geographic atrophy, proliferative diabetic retinopathy, nonproliferative diabetic retinopathy with macular edema, previous macula-off retinal detachment, previous retinal vein occlusion, and epiretinal membrane, but the scores varied by disease/status. The factors that affected the specialists’ opinions were the type of practice and the frequency of MF-IOL implantation (p = 0.013 and p = 0.021, respectively; one-way ANOVA).
Bone Alterations in Inflammatory Bowel Diseases: Role of Osteoprotegerin
Authors: Priadko Kateryna , Moretti Antimo , Iolascon Giovanni , Gravina Antonietta Gerarda , Miranda Agnese , Sgambato Dolores , De Musis Cristiana , Romano Marco , Gimigliano Francesca
Published: March 2022

Metabolic bone disorders are one of the most frequent extra-intestinal manifestations in patients with inflammatory bowel diseases (IBD) that might result in an increase of skeletal fragility and risk of fracture. These disorders are a consequence of bone–gut crosstalk alterations, particularly due to inflammation, which involves the RANK-RANKL-Osteoprotegerin (OPG) pathway. This cross-sectional study investigates the role of serum OPG on bone health in IBD patients. In all patients, we carried out BMD measurements at the lumbar spine and femoral neck by the dual-energy X-ray absorptiometry (DXA), and evaluation of serum OPG, 25(OH)D, and PTH. We also divided all IBD patients into two groups: group 1 consisted of premenopausal women and men younger than 50 years old, while group 2 included postmenopausal women and men aged more than 50 years old. We enrolled 36 UC patients (51%), 34 CD patients (49%), and 70 healthy controls. IBD group mean age was 44 ± 17.3 years old, with a mean disease duration of 6 years. IBD patients had a mean value of OPG of 48.1 ± 26.64 pg/mL, while mean OPG in the control group was 61.35 ± 47.19 pg/mL (p < 0.05). In group 1, there was a correlation between BMD Z-scores at the lumbar spine and femoral neck and mean OPG levels in UC subjects (r = 0.47 and r = −0.21, respectively; p < 0.05), and only between Z-score at the lumbar spine and OPG level in the CD group (r = 0.83, p < 0.05). For the patients of group 2, we report a statistically significant correlation between T-score measured at the lumbar site in both UC and CD patients (r = −0.79 and r = 0.77, respectively; p < 0.05). In our study, we demonstrated serum OPG levels to be significantly decreased in IBD subjects compared to healthy age-matched individuals. However, according to our data, it seems that the measurement of serum OPG levels is not useful to better define metabolic bone disorders in IBD patients.
Inhaled Corticosteroids, Vitamin K Antagonists and Amlodipine Were Associated with an Increased Risk of Acute Periprosthetic Joint Infection in Patients with Total Hip Arthroplasty: A Retrospective Case–Cohort Study
Authors: Bruin Maarten M. , Deijkers Ruud L. M. , Bus Michaël P. A. , van Elzakker Erika P. M. , Bazuin Roos , Nelissen Rob G. , Pijls Bart G.
Published: March 2022

The perioperative use of certain medication may influence the risk of developing a periprosthetic joint infection (PJI). Inhaled corticosteroids (ICSs) and cardiovascular drugs are widely used against pulmonary and cardiovascular diseases. While oral corticosteroids and anticoagulants have been shown to increase the risk of developing PJI, this is not clear for ICSs. In contrast, some cardiovascular drugs, such as amlodipine, nifedipine and statins, have been documented to show an antimicrobial effect, suggesting a synergistic effect with antibiotics in the treatment of (multi-resistant) microorganisms. We performed a case–cohort study to assess the association between the occurrence of PJI after THA and the use of inhaled corticosteroids, anticoagulants, or previously mentioned cardiovascular agents. In a cohort of 5512 primary THAs, we identified 75 patients with a PJI (1.4%), and randomly selected 302 controls. A weighted Cox proportional hazard regression model was used for the study design and to adjust for potential confounders (age, sex, smoking, and cardiovascular/pulmonary disease). We found ICS use (HR 2.6 [95% CI 1.1–5.9]), vitamin K antagonist use (HR 5.3 [95% CI 2.5–11]), and amlodipine use (HR 3.1 [95% CI 1.4–6.9]) to be associated with an increased risk of developing PJI after THA. The effect remained after correction for the mentioned possible confounders. The underlying diseases for which the medications are prescribed could also play a role in the mentioned association; we believe, however, that the usages of ICSs, vitamin K antagonists and amlodipine appear to be potential modifiable risk factors for PJI, and therefore have to be questioned during preoperative screening and consultation.
Prognostic Impact of Hybrid Comprehensive Telerehabilitation Regarding Diastolic Dysfunction in Patients with Heart Failure with Reduced Ejection Fraction—Subanalysis of the TELEREH-HF Randomized Clinical Trial
Authors: Irzmański Robert , Glowczynska Renata , Banach Maciej , Szalewska Dominika , Piotrowicz Ryszard , Kowalik Ilona , Pencina Michael J. , Zareba Wojciech , Orzechowski Piotr , Pluta Slawomir , Kalarus Zbigniew , Opolski Grzegorz , Piotrowicz Ewa
Published: March 2022

Aims: The objective of the study was to evaluate the effects of individually prescribed hybrid comprehensive telerehabilitation (HCTR) implemented at patients’ homes on left ventricular (LV) diastolic function in heart failure (HF) patients. Methods and results: The Telerehabilitation in Heart Failure Patients trial (TELEREH-HF) is a multicenter, prospective, randomized (1:1), open-label, parallel-group, controlled trial involving HF patients assigned either to HCTR involving a remotely monitored home training program in conjunction with usual care (HCTR group) or usual care only (UC group). The patient in the HCTR group underwent a 9-week HCTR program consisting of two stages: an initial stage (1 week) conducted in hospital and the subsequent stage (eight weeks) of home-based HCTR five times weekly. Due to difficulties of proper assessment and differences in the evaluation of diastolic function in patients with atrial fibrillation, we included in our subanalysis only patients with sinus rhythm. Depending on the grade of diastolic dysfunction, patients were assigned to subgroups with mild diastolic (MDD) or severe diastolic dysfunction (SDD), both in HCTR (HCTR-MDD and HCTR-SDD) and UC groups (UC-MDD and UC-SDD). Changes from baseline to 9 weeks in echocardiographic parameters were seen only in A velocities in HCTR-MDD vs. UC-MDD; no significant shifts between groups of different diastolic dysfunction grades were observed after HCTR. All-cause mortality was higher in UC-SDD vs. UC-MDD with no difference between HCTR-SDD and HCTR-MDD. Higher probability of HF hospitalization was observed in HCTR-SDD than HCTR-MDD and in UC-SDD than UC-MDD. No differences in the probability of cardiovascular mortality and hospitalization were found. Conclusions: HCTR did not influence diastolic function in HF patients in a significant manner. The grade of diastolic dysfunction had an impact on mortality only in the UC group and HF hospitalization over a 12–24-month follow-up in HCTR and UC groups.
A Multivariate Analysis of “Metabolic Phenotype” Patterns in Children and Adolescents with Obesity for the Early Stratification of Patients at Risk of Metabolic Syndrome
Authors: Calcaterra Valeria , Biganzoli Giacomo , Ferraro Simona , Verduci Elvira , Rossi Virginia , Vizzuso Sara , Bosetti Alessandra , Borsani Barbara , Biganzoli Elia , Zuccotti Gianvincenzo
Published: March 2022

Background: Metabolic syndrome (MS) is closely linked to obesity; however, not all individuals with obesity will develop obesity-related complications and a metabolically healthy obesity (MHO) group is also described. Objective: To perform a multivariate analysis (MVA) of the anthropometric and biochemical data in pediatric patients with obesity to reveal a “phenotype” predictive for MS. Methods: We analyzed 528 children with obesity (OB) and 119 normal-weight pediatric patients (NW). Adiposity indices were recorded, and MS was detected. MVA was performed. Results: Analysis of the structure of correlation of the variables showed that the variables of waist circumference (WC), body mass index (BMI), and estimated fat mass (eFM) were positively correlated with each other as a whole. In addition, the variables of the triglycerides (TG), triglyceride–glucose (TyG) index, and visceral adiposity index were positively correlated with each other as a whole, although none were correlated with the variables of BMI z-score, waist-to-height ratio, WC, eFM, or weight. The variables that related to insulin resistance (IR) and dyslipidemia were crucial for the early stratification of patients at risk of MS. Conclusions: Independently of body weight, IR, dyslipidemia, hypertriglyceridemia, and fat distribution seem to be the strongest MS risk factors. The early detection of and intervention in these modifiable risk factors are useful to protect children’s health.
How Can We Enhance Adherence to Medications in Patients with Systemic Lupus Erythematosus? Results from a Qualitative Study
Authors: Emamikia Sharzad , Gentline Cidem , Enman Yvonne , Parodis Ioannis
Published: March 2022

Medication non-adherence is common among patients with systemic lupus erythematosus (SLE) and may lead to poor clinical outcomes. Our aim was to identify influenceable contributors to medication non-adherence and suggest interventions that could increase adherence. Patients with SLE from two Swedish tertiary referral centres (n = 205) participated in a survey assessing self-reported adherence to medications. Responses were used to select patients for qualitative interviews (n = 15). Verbatim interview transcripts were analysed by two researchers using content analysis methodology. The median age of the interviewees was 32 years, 87% were women, and their median SLE duration was nine years. Reasons for non-adherence were complex and multifaceted; we categorised them thematically into (i) patient-related (e.g., unintentional non-adherence due to forgetfulness or intentional non-adherence due to disbelief in medications); (ii) healthcare-related (e.g., untrustworthy relationship with the treating physician, authority fear, and poor information about the prescribed medications or the disease); (iii) medication-related (e.g., fear of side-effects); and (iv) disease-related reasons (e.g., lacking acceptance of a chronic illness or perceived disease quiescence). Interventions identified that healthcare could implement to improve patient adherence to medications included (i) increased communication between healthcare professionals and patients; (ii) patient education; (iii) accessible healthcare, preferably with the same personnel; (iv) well-coordinated transition from paediatric to adult care; (v) regularity in addressing adherence to medications; (vi) psychological support; and (vii) involvement of family members or people who are close to the patient.
Adverse Effects of Sarcopenic Obesity on Postoperative Complications after Major Hepatectomy in Patients with Hilar Cholangiocarcinoma
Authors: Lee Okjoo , Shin Yong Chan , Ryu Youngju , Shin Sang Hyun , Heo Jin Seok , Lim Chang-Sup , Han In Woong
Published: March 2022

Sarcopenic obesity (SO), which is defined as a high ratio of visceral adipose tissue to skeletal muscle, is a well-known risk factor for post-hepatectomy outcomes in patients with hepatocellular carcinoma. However, few studies have evaluated the effect of SO on postoperative outcomes in patients with hilar cholangiocarcinoma (CCC). This retrospective study aimed to evaluate the effect of preoperative SO on postoperative outcomes in patients with hilar CCC following major hepatectomy. Preoperative SO was assessed in 328 patients undergoing hepatectomy for hilar CCC at three institutions between 2006 and 2016. SO was calculated from cross-sectional visceral fat and muscle area displayed on preoperative CT imaging. Preoperative SO was present in 98 patients (29.9%). The major complication rate in patients with SO was higher than in those without SO (54.1% vs. 37.0%, p = 0.004). Additionally, postoperative hospital stays were prolonged in patients with SO (18.5 vs. 16.5 days, p = 0.038). After multivariable analysis, SO was identified as an independent risk factor for major complications after hepatectomy in hilar CCC patients (OR = 0.866, 95% CI: 1.148–3.034, p = 0.012). Careful postoperative management is needed after major hepatectomy in hilar CCC patients with SO.
Membrane Hormone Receptors and Their Signaling Pathways as Targets for Endocrine Disruptors
Authors: Combarnous Yves , Nguyen Thi Mong Diep
Published: March 2022

The endocrine disruptors are mostly small organic molecules developed for numerous and very diverse industrial applications. They essentially act through nuclear receptors with small and hydrophobic endogenous ligands. Nevertheless, potential adverse effects through membrane hormone receptors cannot be ruled out, and have indeed been observed. The present paper reviews how orthosteric and allosteric binding sites of the different families of membrane receptors can be targets for man-made hydrophobic molecules (components of plastics, paints, flame retardants, herbicides, pesticides, etc.). We also review potential target proteins for such small hydrophobic molecules downstream of membrane receptors at the level of their intracellular signaling pathways. From the currently available information, although endocrine disruptors primarily affect nuclear receptors’ signaling, membrane receptors for hormones, cytokines, neuro-mediators, and growth factors can be affected as well and deserve attention.
Endoglin and Other Angiogenesis Markers in Recurrent Varicose Veins
Authors: Sánchez Francisco S. Lozano , Martínez José A. Carnicero , Méndez-García Lucía , García-Cenador M. Begoña , Pericacho Miguel
Published: March 2022

Background: Surgery on varicose veins (crossectomy and stripping) may lead to recurrence, with clinical and socioeconomic repercussions. The etiopathogenesis of varicose veins has yet to be fully understood. Objective: Study the expression of endoglin and other molecules involved in the neovascularisation process in patients suffering from this disease. Methods: Total of 43 patients that have undergone surgery for varicose veins (24 primary and 19 recurrent). Endoglin and other molecules were identified on the venous wall (proximal -saphenofemoral junction- and distal), via real-time RT-PCR, and in serum, via ELISA: endoglin (Eng), vascular endothelial growth factor (VEGF-A), its receptors 1 and 2 (VEGFR1 or FLT1), (VEGFR2 or FLK), and the hypoxia-inducible factor (HIF-1A). All the patients signed a consent form. Results: The recurrent group recorded a higher expression of Eng, VEGF-A, VEGFR1, and VEGFR2 at the level of proximal venous wall compared to the primary group. HIF-1A did not record any differences. As regards the determination of the distal venous wall, no markers recorded differences between the groups. Among the serum determinations, only sFLT1 recorded a significant drop among the patients with recurrent varicose veins. Conclusions: Patients with recurrent varicose veins record a higher expression of endoglin and other markers of angiogenesis in proximal veins. Endoglin in the blood (sEng) serves no apparent purpose in recurrent varicose veins.
Healthcare Professional Perspectives on the Use of Remote Patient-Monitoring Platforms during the COVID-19 Pandemic: A Cross-Sectional Study
Authors: Bouabida Khayreddine , Malas Kathy , Talbot Annie , Desrosiers Marie-Ève , Lavoie Frédéric , Lebouché Bertrand , Taghizadeh Niloofar , Normandin Louise , Vialaron Cécile , Fortin Olivier , Lessard David , Pomey Marie-Pascale
Published: March 2022

The COVID-19 pandemic created an urgent need to act to reduce the spread of the virus and alleviate congestion in healthcare services, protect health professionals, and help them maintain satisfactory quality and safety of care. Remote monitoring platforms (RPM) emerged as potential solutions. In this study, we evaluate, from health professionals’ perspectives, the capacity and contribution of two different digital platforms to maintain quality, safety, and patient engagement in care. A cross-sectional study was conducted using a survey in which a total of 491 health professionals participated. The results show that, in general, user perceptions of the quality and safety of care provided through the platforms were positive. The ease of access to health professionals’ services in general and shorter waiting times for patients were the two main features that were highly appreciated by most participants. However, some problems were encountered during the use of these two platforms, such as a lack of training and/or direct support for users. To improve the two platforms and maximize their use, the areas for improvement and the issues identified should be addressed as part of a collaborative process involving health professionals and patients as well as health system leaders, decision-makers, and digital platform providers.
Stakeholders’ Attitudes toward Protected Areas: The Case of Tara National Park (Serbia)
Authors: Brankov Jovana , Micić Jasna , Ćalić Jelena , Kovačević-Majkić Jelena , Milanović Ranko , Telbisz Tamás
Published: March 2022

This paper represents a case study examining attitudes of various stakeholders about Tara National Park (NP) (Serbia), identifying also the factors that shape these attitudes. The survey method was applied to a sample of 405 respondents (197 community members and 208 visitors). In addition, 15 interviews with specific key actors (NP executives and local key persons) were performed. The research confirmed the presence of different types of conflicts among stakeholders, mostly between the NP and the local population (primarily farmers) associated with land use in agriculture and the ban on the construction of facilities. The community recognizes tourism as the highest priority, unlike the NP leaders and visitors, who emphasize protection and conservation (especially biodiversity) as the primary goals of future NP development. The opinions of the local population are divided concerning support for the existence of the NP and the importance of it as a part of the national heritage. Most of them do not recognize the economic benefits resulting from the proclamation of the NP and do not see themselves as participants in the decision-making process. The findings also reveal that visitors strongly support tourism development and activities following the principles of nature protection. This category of respondents is only partly affected by the fact that this area has been declared a NP. The analysis shows that certain socioeconomic factors considerably influence the opinions of both community and visitors. Results suggest that future actions should be aimed at improving the coordination of various stakeholders, especially the NP and the community, through different social mobilization activities. Stimulating small businesses and providing incentives for agriculture and nature tourism development could be a useful step forward.
An Ecosystem Service Approach to Assessing Agro-Ecosystems in Urban Landscapes
Authors: Thiesen Thais , Bhat Mahadev G. , Liu Hong , Rovira Roberto
Published: March 2022

Creating sustainable urban landscapes in light of growing population pressures requires interdisciplinary multi-functional solutions. Alternative agro-ecosystems described as food forests, permaculture gardens, and/or edible landscapes among others could offer potential ways to address the social, economic, and ecological goals of various stakeholders simultaneously. Current research is lacking a comprehensive tool that can assess the performance of alternative agro-ecosystems that have both functional and aesthetic values. The present research uses a novel rubric, the Permaculture and Agro-ecosystems Sustainability Scorecard (PASS) that combines agricultural sustainability and ecosystem services (ES) indicators in order to assess alternative agro-ecosystems. The rubric evaluates provisioning, regulating, supporting, economic and cultural ES and includes benefits such as pollinator presence, increased biodiversity, alternative pesticides and fertilizer use, carbon sequestration, food security, and human interactions. Based on the concepts and principles drawn from four popular frameworks and sub-disciplines, namely, SAFE, SITES, permaculture, and agroecology, we identify sixteen broad ES indicators and 59 sub-indices and measure them using data collected through site observation, survey, interviews, and documentary research. For easy comparison across different urban agriculture sites, the above sub-indices are further aggregated into five ES criteria using stakeholder-informed weights. The weights are developed through pair-wise comparison of criteria by sample survey respondents. The PASS framework is used to score twelve sites in South Florida that meet specific criteria in the small farm, residential, and public space categories. Sample respondents place the highest weight on cultural services. Contrary to the popular notion of promoting urban agriculture for food security, the results show that the majority of the sites score highest in the supporting services provided, followed by regulating and cultural services, and lowest in the economic services category. The supporting service for most of the sample sites score consistently very high, close to the highest possible level of 5.0. There is a wide variation in provisioning and economic values across the study sites. The paper offers several ideas for mainstreaming the ES indicators into urban planning and decision-making and some of the practical difficulties one might face along the way. We conclude that in order to realize the broader ES benefits of urban agriculture in particular and agro-ecosystems in general, a multi-pronged policy and planning approach is necessary.
Biochar Application Increases Labile Carbon and Inorganic Nitrogen Supply in a Continuous Monocropping Soil
Authors: Huang Rong , Li Bing , Chen Yulan , Tao Qi , Xu Qiang , Wen Denghong , Gao Xuesong , Li Qiquan , Tang Xiaoyan , Wang Changquan
Published: March 2022

Biochar is an effective method for increasing soil carbon (C) sequestration and nitrogen (N) supply under continuous monocropping. To investigate the impact of biochar placement methods on soil C and N, a one-year field experiment with five treatments was conducted including control, mineral fertilizers only (F), biochar hole placement (BFH; biochar applied to the soil layer at 5–10 cm) + F, biochar band placement (BFB; biochar applied to the soil layer at 15–20 cm) + F, and biochar band and hole placement + F (BFBH). The results showed that, regardless of the placement method, biochar application increased soil total organic C (TOC) and C pool management index by 6.9–39.7% and 4.1–36.1%, respectively, especially for dissolved organic C (DOC; 6.9–51.3%), readily oxidizable C (ROC; 2.4–46.4%), and microbial biomass C (MBC; 10.4–41.7%). Single biochar placement methods significantly influenced DOC, MBC, and ROC contents of both soil layers in the rank order of BFH ≈ BFBH > BFB at 0–15 cm and BFB ≈ BFBH > BFH at 15–30 cm. Soil TN and microbial biomass N (MBN) mainly accumulated at the site of biochar placement. The increased soil TOC:TN and MBC:N ratios under biochar treatments promoted inorganic N immobilization and reduced the loss of ammonium N and nitrate N (NO3−-N) through leaching at the early stage of tobacco growth. Biochar-adsorbed N was remobilized at a later period (vigorous growth stage and maturity), possibly causing the slow decrease in NO3−-N content. Additionally, soil C and N pools were significantly influenced by the main effects of soil layer and growth stage. Overall, biochar application increased soil C and N pools and inorganic N supply through N remobilization. However, the increased labile organic C content and microbial activity may prevent C sequestration in biochar-amended soils.
An Overview of Fractal Geometry Applied to Urban Planning
Authors: Jahanmiri Fatemeh , Parker Dawn Cassandra
Published: March 2022

Since computing advances in the last 30 years have allowed automated calculation of fractal dimensions, fractals have been established as ubiquitous signatures of urban form and socioeconomic function. Yet, applications of fractal concepts in urban planning have lagged the evolution of technical analysis methods. Through a narrative literature review around a series of “big questions” and automated bibliometric analysis, we offer a primer on fractal applications in urban planning, targeted to urban scholars and participatory planners. We find that developing evidence demonstrates linkages between urban history, planning context, and urban form and between “ideal” fractal dimension values and urban aesthetics. However, we identify gaps in the literature around findings that directly link planning regulations to fractal patterns, from both positive and normative lenses. We also find an increasing trend of most literature on fractals in planning being published outside of planning. We hypothesize that this trend results from communication gaps between technical analysts and applied planners, and hope that our overview will help to bridge that gap.