bluuebunny/crossref_metadata_2025 huggingface dataset:
Tissue Transglutaminase but Not Microbial Transglutaminase Is Inhibited by Exogenous Oxidative Substances in Celiac Disease
Authors: Stricker Sebastian , Rudloff Silvia , De Laffolie Jan , Zimmer Klaus-Peter
Published: February 2022

Enzymatic modification of gliadin peptides by human transglutaminase 2 (TG2) is a central step in celiac disease (CD) pathogenesis. Microbial transglutaminase (mTG) mimics the enzymatic function of TG2 and might play a role in CD. TG2 is inhibited by endogenous oxidative endoplasmic reticulum-resident protein 57 (ERp57), but data about mTG are lacking. We investigated the localization of ERp57 in duodenal biopsies and examined inhibition of TG2, and mTG by competitive, and oxidative molecules. Localization of ERp57 was investigated in duodenal biopsies from CD, and control patients by electron microcopy. Inhibition of TG2 and mTG was analyzed on an in vitro level using a photometric assay. ERp57 was observed within the lamina propria and its abundance within the endoplasmic reticulum (ER) was reduced in CD patients. TG2 was oxidatively inhibited by up to 95% by PX12 (p < 0.001) and L-cystine (p < 0.001), whereas mTG remained unaffected. The reduced presence of ERp57 within the ER of CD biopsies suggests a regulatory function of this protein within CD pathogenesis. PX12 and L-cystine oxidatively inhibit TG2 and might serve as treatment options in CD. mTG is poorly regulated and could contribute to the accumulation of immunogenic peptides within the gut with potential pathogenic effects.
DCHS1, Lix1L, and the Septin Cytoskeleton: Molecular and Developmental Etiology of Mitral Valve Prolapse
Authors: Moore Kelsey S. , Moore Reece , Fulmer Diana B. , Guo Lilong , Gensemer Cortney , Stairley Rebecca , Glover Janiece , Beck Tyler C. , Morningstar Jordan E. , Biggs Rachel , Muhkerjee Rupak , Awgulewitsch Alexander , Norris Russell A.
Published: February 2022

Mitral valve prolapse (MVP) is a common cardiac valve disease that often progresses to serious secondary complications requiring surgery. MVP manifests as extracellular matrix disorganization and biomechanically incompetent tissues in the adult setting. However, MVP has recently been shown to have a developmental basis, as multiple causal genes expressed during embryonic development have been identified. Disease phenotypes have been observed in mouse models with human MVP mutations as early as birth. This study focuses on the developmental function of DCHS1, one of the first genes to be shown as causal in multiple families with non-syndromic MVP. By using various biochemical techniques as well as mouse and cell culture models, we demonstrate a unique link between DCHS1-based cell adhesions and the septin-actin cytoskeleton through interactions with cytoplasmic protein Lix1-Like (LIX1L). This DCHS1-LIX1L-SEPT9 axis interacts with and promotes filamentous actin organization to direct cell-ECM alignment and valve tissue shape.
Liquid Biopsy in Type 2 Diabetes Mellitus Management: Building Specific Biosignatures via Machine Learning
Authors: Karaglani Makrina , Panagopoulou Maria , Cheimonidi Christina , Tsamardinos Ioannis , Maltezos Efstratios , Papanas Nikolaos , Papazoglou Dimitrios , Mastorakos George , Chatzaki Ekaterini
Published: February 2022

Background: The need for minimally invasive biomarkers for the early diagnosis of type 2 diabetes (T2DM) prior to the clinical onset and monitoring of β-pancreatic cell loss is emerging. Here, we focused on studying circulating cell-free DNA (ccfDNA) as a liquid biopsy biomaterial for accurate diagnosis/monitoring of T2DM. Methods: ccfDNA levels were directly quantified in sera from 96 T2DM patients and 71 healthy individuals via fluorometry, and then fragment DNA size profiling was performed by capillary electrophoresis. Following this, ccfDNA methylation levels of five β-cell-related genes were measured via qPCR. Data were analyzed by automated machine learning to build classifying predictive models. Results: ccfDNA levels were found to be similar between groups but indicative of apoptosis in T2DM. INS (Insulin), IAPP (Islet Amyloid Polypeptide-Amylin), GCK (Glucokinase), and KCNJ11 (Potassium Inwardly Rectifying Channel Subfamily J member 11) levels differed significantly between groups. AutoML analysis delivered biosignatures including GCK, IAPP and KCNJ11 methylation, with the highest ever reported discriminating performance of T2DM from healthy individuals (AUC 0.927). Conclusions: Our data unravel the value of ccfDNA as a minimally invasive biomaterial carrying important clinical information for T2DM. Upon prospective clinical evaluation, the built biosignature can be disruptive for T2DM clinical management.
Biomarkers for Transient Ischemic Attack: A Brief Perspective of Current Reports and Future Horizons
Authors: Nouri-Vaskeh Masoud , Khalili Neda , Sadighi Alireza , Yazdani Yalda , Zand Ramin
Published: February 2022

Cerebrovascular disease is the leading cause of long-term disability in the world and the third-leading cause of death in the United States. The early diagnosis of transient ischemic attack (TIA) is of great importance for reducing the mortality and morbidity of cerebrovascular diseases. Patients with TIA have a high risk of early subsequent ischemic stroke and the development of permanent nervous system lesions. The diagnosis of TIA remains a clinical diagnosis that highly relies on the patient’s medical history assessment. There is a growing list of biomarkers associated with different components of the ischemic cascade in the brain. In this review, we take a closer look at the biomarkers of TIA and their validity with a focus on the more clinically important ones using recent evidence of their reliability for practical usage.
Chronic Critical Illness in Patients with COVID-19: Characteristics and Outcome of Prolonged Intensive Care Therapy
Authors: Roedl Kevin , Jarczak Dominik , Boenisch Olaf , de Heer Geraldine , Burdelski Christoph , Frings Daniel , Sensen Barbara , Nierhaus Axel , Kluge Stefan , Wichmann Dominic
Published: February 2022

The spread of SARS-CoV-2 caused a worldwide healthcare threat. High critical care admission rates related to Coronavirus Disease 2019 (COVID-19) respiratory failure were observed. Medical advances helped increase the number of patients surviving the acute critical illness. However, some patients require prolonged critical care. Data on the outcome of patients with a chronic critical illness (CCI) are scarce. Single-center retrospective study including all adult critically ill patients with confirmed COVID-19 treated at the Department of Intensive Care Medicine at the University Medical Center Hamburg-Eppendorf, Germany, between 1 March 2020 and 8 August 2021. We identified 304 critically ill patients with COVID-19 during the study period. Of those, 55% (n = 167) had an ICU stay ≥21 days and were defined as chronic critical illness, and 45% (n = 137) had an ICU stay <21 days. Age, sex and BMI were distributed equally between both groups. Patients with CCI had a higher median SAPS II (CCI: 39.5 vs. no-CCI: 38 points, p = 0.140) and SOFA score (10 vs. 6, p < 0.001) on admission. Seventy-three per cent (n = 223) of patients required invasive mechanical ventilation (MV) (86% vs. 58%; p < 0.001). The median duration of MV was 30 (17–49) days and 7 (4–12) days in patients with and without CCI, respectively (p < 0.001). The regression analysis identified ARDS (OR 3.238, 95% CI 1.827–5.740, p < 0.001) and referral from another ICU (OR 2.097, 95% CI 1.203–3.654, p = 0.009) as factors significantly associated with new-onset of CCI. Overall, we observed an ICU mortality of 38% (n = 115) in the study cohort. In patients with CCI we observed an ICU mortality of 28% (n = 46) compared to 50% (n = 69) in patients without CCI (p < 0.001). The 90-day mortality was 28% (n = 46) compared to 50% (n = 70), respectively (p < 0.001). More than half of critically ill patients with COVID-19 suffer from CCI. Short and long-term survival rates in patients with CCI were high compared to patients without CCI, and prolonged therapy should not be withheld when resources permit prolonged therapy.
Donor Screening Revisions of Fecal Microbiota Transplantation in Patients with Ulcerative Colitis
Authors: Zhang Xiaochen , Ishikawa Dai , Nomura Kei , Fukuda Naoyuki , Haraikawa Mayuko , Haga Keiichi , Shibuya Tomoyoshi , Mita Toshihiro , Nagahara Akihito
Published: February 2022

Fecal microbiota transplantation (FMT) has been recognized as a promising treatment for dysbiosis-related diseases. Since 2014, FMT has been utilized to treat ulcerative colitis (UC) in our clinical studies and has shown efficacy and safety. As donor screening (DS) is the primary step to ensure the safety of FMT, we report our experience with DS and present the screening results to improve the prospective DS criteria and provide references for future studies. The donor candidates were screened according to the DS criteria. The first DS criteria were proposed in June 2014 and revised substantially in May 2018. We further sorted the screening results and costs of laboratory tests. From June 2014 to April 2018, the DS eligibility rate was 50%. The total laboratory testing cost for each candidate was JPY 17,580/USD 160.21. From May 2018 to September 2021, the DS eligibility rate was 25.6%. The total laboratory testing cost for each candidate was JPY 40,740/USD 371.36. The reduction in donor eligibility rates due to more stringent criteria should be considered for cost and safety. Studies must consider the latest updates and make timely modifications in the DS criteria to ensure patient safety.
Comparison of the Effect of MFAT and MFAT + PRP on Treatment of Hip Osteoarthritis: An Observational, Intention-to-Treat Study at One Year
Authors: Heidari Nima , Slevin Mark , Zeinolabediny Yasmin , Meloni Davide , Olgiati Stefano , Wilson Adrian , Noorani Ali , Azamfirei Leonard
Published: February 2022

Hip osteoarthritis (OA) is a major contributor to reduced quality of life and concomitant disability associated with lost working life months. Intra-articular injection of various biological materials has shown promise in alleviating symptoms and potentially slowing down the degenerative process. Here, we compared the effects of treatment of a cohort of 147 patients suffering from grade 1–4 hip OA; with either micro-fragmented adipose tissue (MFAT), or a combination of MFAT with platelet-rich plasma (PRP). We found significant improvements in both the visual analogue score for pain (VAS) and Oxford hip score (OHS) that were similar for both treatments with over 60% having an improvement in the VAS score of 20 points or more. These results suggest a positive role for intra-articular injection of MFAT + PRP as a treatment for hip osteoarthritis which may be important particularly in low body mass index (BMI) patients where the difficulty in obtaining sufficient MFAT for treatment could be offset by using this combination of biologicals.
Validation of Deep Learning Segmentation of CT Images of Fiber-Reinforced Composites
Authors: Badran Aly , Parkinson Dula , Ushizima Daniela , Marshall David , Maillet Emmanuel
Published: February 2022

Micro-computed tomography (µCT) is a valuable tool for visualizing microstructures and damage in fiber-reinforced composites. However, the large sets of data generated by µCT present a barrier to extracting quantitative information. Deep learning models have shown promise for overcoming this barrier by enabling automated segmentation of features of interest from the images. However, robust validation methods have not yet been used to quantify the success rate of the models and the ability to extract accurate measurements from the segmented image. In this paper, we evaluate the detection rate for segmenting fibers in low-contrast CT images using a deep learning model with three different approaches for defining the reference (ground-truth) image. The feasibility of measuring sub-pixel feature dimensions from the µCT image, in certain cases where the µCT image intensity is dependent on the feature dimensions, is assessed and calibrated using a higher-resolution image from a polished cross-section of the test specimen in the same location as the µCT image.
Simplified Approach for the Seismic Assessment of Existing X Shaped CBFs: Examples and Numerical Applications
Authors: Montuori Rosario , Nastri Elide , Piluso Vincenzo , Todisco Paolo
Published: February 2022

The capacity of a structure can be assessed using inelastic analyses, requiring sophisticated numerical procedures such as pushover and incremental dynamic analyses. A simplified method for the evaluation of the seismic performance of steel Concentrically Braced Frames (CBFs) to be used in everyday practice and the immediate aftermath of an earthquake has been recently proposed. This method evaluates the capacity of an existing building employing an analytical trilinear model without resorting to any non-linear analysis. The proposed methodology has been set up through a large parametric analysis, carried out on 420 frames designed according to three different approaches: the first one is the Theory of Plastic Mechanism Control (TPMC), ensuring the design of structures showing global collapse mechanisms (GCBFs), the second one is based on the Eurocode 8 design requirements (SCBFs), and the third is a non-seismic design, based on a non-seismic design (OCBFs). In this paper, some examples of the application of this simplified methodology are proposed with references to structures that are supposed to exhibit global, partial, and soft storey mechanisms.
Damage Evolution Analysis on Compression-Loaded Multidirectional Carbon Fiber Laminates Using Ex-Situ CT Scans
Authors: D’haen Jonas J. A. , May Michael , Boegle Christian , Hiermaier Stefan
Published: February 2022

Damage evolution inside compression-loaded laminates is a crucial aspect when designing crash structures. In this study, ex situ CT scanning is used to identify damage evolution in multidirectional composite laminates. Multiple CT scans throughout the stress–strain envelope are used to quantify the internal damage and failure propagation of a [45, −45, 90]s carbon fiber laminate. Initially, observed damage occurs in form of delamination between the −45° and 90° layers. Afterward, shear failure propagates from the central layers throughout the entire laminate. Shear failure in the middle two layers expands after continued loading up to double shear failure. The same distinct failure sequence is observed in multiple specimens, and the small deviation supports consistency. Furthermore, the stress–strain envelope of the successive load cycles matches closely with reference measurements.
Experimental Evaluation of Shear Properties of Lightweight PVC Core for Marine Application Using Digital Image Correlation System
Authors: Bolf Davor , Zamarin Albert , Krolo Paulina , Hadjina Marko
Published: February 2022

Sandwich structures are well-known and frequently used solutions in marine applications, especially when structural stiffness is required. An important part of the sandwich structure is the core, which usually carries shear loads. Therefore, choosing a reliable test method and knowing the exact shear properties of the particular core used in the structural design is beneficial for every engineer. Shear properties of the FlexyFoam M-55, a closed-cell, lightweight PVC foam with an apparent density of 60 kg/m3, have been investigated according to the ASTM C273 standard, using the tensile and compressive loading of metal supporting plates glued to the PVC foam sample. A digital image correlation (DIC) technique was used to monitor the crack propagation, and the appearance of secondary stresses at the foam-adhesive interface and strain field for the representative sample was presented. Displacement was measured using the testing machine sensors and compared to the measurements from the DIC technique. Specimen manufacturing details, surface preparation, and the gluing sequence were described, and measuring equipment and experiment settings were presented. Stress-strain curves have been presented and shear modulus and ultimate shear strength of the foam were compared for each test approach. The results were discussed and compared with the manufacturer’s data, as well as with foams of similar densities. The well-established approach in testing the core material was discussed, and recommendations were given to improve the testing procedure.
The Relationship between Cardiac Magnetic Resonance-Assessed Replacement and Interstitial Fibrosis and Ventricular Arrhythmias in Hypertrophic Cardiomyopathy
Authors: Karabinowska-Małocha Aleksandra , Dziewięcka Ewa , Banyś Paweł , Urbańczyk-Zawadzka Małgorzata , Krupiński Maciej , Mielnik Małgorzata , Łach Jacek , Budkiewicz Aleksandra , Podolec Piotr , Żydzik Łukasz , Wiśniowska-Śmiałek Sylwia , Holcman Katarzyna , Kostkiewicz Magdalena , Rubiś Paweł
Published: February 2022

Non-sustained ventricular tachycardia (nsVT) creates the electrical basis for sudden cardiac death (SCD) in hypertrophic cardiomyopathy (HCM). We aimed to evaluate the relationship between interstitial fibrosis on cardiac magnetic resonance (CMR) and nsVT in HCM. A total of 50 HCM patients underwent CMR with a 3 T scanner to determine the presence of replacement fibrosis expressed by late gadolinium enhancement (LGE), and interstitial fibrosis expressed by native T₁, post-contrast T₁, and extracellular volume (ECV). The incidence of nsVT was assessed by Holter monitoring. We detected nsVT in 14 (28%) out of 50 HCM patients. Replacement fibrosis expressed by LGE was present in 37 (74%) patients and only showed a trend towards a differentiation between the groups with and without nsVT (p = 0.07). However, the extent of LGE was clearly higher in the nsVT group (3.8 ± 4.9% vs. 7.94 ± 4.5%, p = 0.002) and was an independent predictor of nsVT in a multivariable regression analysis (OR 1.2; 95%CI 1.02–1.4; p = 0.02). No relationship was observed between interstitial fibrosis and nsVT. To conclude, it was found that it is not the mere presence but the actual extent of LGE that determines the occurrence of nsVT in HCM patients; the role of interstitial fibrosis remains unclear.
A Systematic Review and Meta-Analysis of the Direct Comparison of Second-Generation Cryoballoon Ablation and Contact Force-Sensing Radiofrequency Ablation in Patients with Paroxysmal Atrial Fibrillation
Authors: Waranugraha Yoga , Rizal Ardian , Yuniadi Yoga
Published: February 2022

The superiority of second-generation cryoballoon (2G-CB) ablation versus contact force-sensing radiofrequency (CF-RF) ablation in patients with paroxysmal atrial fibrillation (AF) was assessed in this systematic review and meta-analysis. Freedom from atrial tachyarrhythmias (ATAs) (OR = 0.89; 95% confidence interval [CI] = 0.68 to 1.17; p = 0.41), freedom from AF (OR = 0.93; 95% CI = 0.65 to 1.35; p = 0.72), and acute pulmonary vein isolation (PVI) (OR = 1.17; 95% CI = 0.54 to 2.53; p = 0.70) between 2G-CB ablation and CF-RF ablation were not different. The procedure time for the 2G-CB ablation was shorter (MD = −18.78 min; 95% CI = −27.72 to −9.85 min; p < 0.01), while the fluoroscopy time was similar (MD = 2.66 min; 95% CI = −0.52 to 5.83 min; p = 0.10). In the 2G-CB ablation group, phrenic nerve paralysis was more common (OR = 5.74; 95% CI = 1.80 to 18.31; p = < 0.01). Regarding freedom from ATAs, freedom from AF, and acute PVI, these findings imply that 2G-CB ablation is not superior to CF-RF ablation in paroxysmal AF. Although faster than CF-RF ablation, 2G-CB ablation has a greater risk of phrenic nerve paralysis.
The Impact of Foreign Capital on the Level of ERM Implementation in Czech SMEs
Authors: Syrová Lenka , Špička Jindřich
Published: February 2022

The COVID-19 pandemic has had a devastating impact on many small and medium-sized businesses around the world. Enterprise risk management (ERM) is a conceptual framework that encompasses the systematic and comprehensive identification, analysis, and management of risks in an enterprise. In the post-communist countries of Central Europe, the level of ERM is still relatively low, especially in small and medium-sized enterprises (SMEs). This study fills a gap in the existing knowledge on ERM by shedding light on the influence of foreign capital on the level of ERM implementation in Czech SMEs. The aim of the study is to assess the influence of the share of foreign capital in Czech SMEs on the level of ERM implementation. A validated self-report of 296 non-financial SMEs in the Czech Republic was analyzed using latent class analysis (LCA) and multiple linear regression. The results of the study contribute to the literature by enriching the empirical analysis of ERM in emerging markets. The originality of the results lies in the identification of three distinct groups of firms according to the combination of implemented ERM elements—“no ERM”, “best practice ERM”, and “pretended ERM”—and the finding that the share of foreign capital, age, and firm size influence the level of ERM implementation. In particular, the positive influence of foreign capital in younger companies makes it possible to overcome the barrier of traditionalist thinking of old-school Czech managers influenced by the period of economic transition in post-communist countries. The paper builds on the existing evidence with new empirical conclusions and argues for a greater inflow of foreign direct investment into emerging markets.
State Health Insurance Benefit Mandates and Health Care Affordability
Authors: Bailey James
Published: February 2022

Every US state requires private health insurers to cover certain conditions, treatments, and providers. These benefit mandates were rare as recently as the 1960s, but the average state now has more than forty. These mandates are intended to promote the affordability of necessary health care. This study aims to determine the extent to which benefit mandates succeed at this goal. Using fixed effects and difference-in-difference research designs with data from the restricted Medical Expenditure Panel Survey—Household Component (MEPS-HC), it provides the first empirical estimates of how health insurance benefit mandates affect out-of-pocket costs and total spending on health care. Both strategies find that mandates significantly reduce out-of-pocket spending, but they are divided on whether mandates also reduce overall health care spending and spending by private insurers.
Expiratory Peak Flow and Minute Ventilation Are Significantly Increased at High Altitude versus Simulated Altitude in Normobaria
Authors: Netzer Nikolaus C. , Rausch Linda K. , Frieß Matthias , Strohl Kingman P. , Schilz Robert , Decker Michael , Pramsohler Stephan
Published: February 2022

Simulated altitude (normobaric hypoxia, NH) is used to study physiologic hypoxia responses of altitude. However, several publications show differences in physiological responses between NH and hypobaric conditions at altitude (hypobaric hypoxia, HH). The causality for these differences is controversially discussed. One theory is that the lower air density and environmental pressure in HH compared to NH lead to lower alveolar pressure and therefore lower oxygen diffusion in the lung. We hypothesized that, if this theory is correct, due to physical laws (Hagen-Poiseuille, Boyle), resistance respectively air compression (Boyle) at expiration should be lower, expiratory flow higher, and therefore peak flow and maximum expiratory flow (MEF) 75–50 increased in hypobaric hypoxia (HH) vs. normobaric hypoxia (NH). To prove the hypothesis of differences in respiratory flow as a result of lower alveolar pressure between HH and NH, we performed spirography in NH at different simulated altitudes and the corresponding altitudes in HH. In a cross over study, 6 healthy subjects (2 f/4 m, 28.3 ± 8.2 years, BMI: 23.2 ± 1.9) performed spirography as part of spiroergometry in a normobaric hypoxic room at a simulated altitude of 2800 m and after a seven-hour hike on a treadmill (average incline 14%, average walking speed 1.6 km/h) to the simulated summit of Mauna Kea at 4200 m. After a two-month washout, we repeated the spirometry in HH on the start and top of the Mauna Kea hiking trail, HI/USA. Comparison of NH (simulated 4200 m) and HH at 4200 m resulted in increased pulmonary ventilation during exercise (VE) (11.5%, p < 0.01), breathing-frequency (7.8%, p < 0.01), peak expiratory flow PEF (13.4%, p = 0.028), and MEF50 (15.9%, p = 0.028) in HH compared to NH, whereas VO2max decreased by 2%. At 2800 m, differences were only trendy, and at no altitude were differences in volume parameters. Spirography expresses higher mid expiratory flows and peak flows in HH vs. NH. This supports the theory of lower alveolar and small airway pressure due to a lower air density resulting in a lower resistance.
Characterization of Serum Metabolome and Proteome Profiles Identifies SNX5 Specific for Pregnancy Failure in Holstein Heifers
Authors: Kusama Kazuya , Bai Rulan , Matsuno Yuta , Ideta Atsushi , Sakurai Toshihiro , Nagaoka Kentaro , Hori Masatoshi , Imakawa Kazuhiko
Published: February 2022

Pregnancy loss predominantly occurs during the first 3–4 weeks due to fertilization failure or early embryonic losses in cattle. Insufficient biochemical communication between conceptus (embryo plus extraembryonic membranes) and endometrium has been suspected as the primary cause for early embryonic losses. If molecules regulating this communication were identified, molecular mechanisms associated with early pregnancy losses could be better understood. To identify candidate molecules as detection markers of non-pregnant or females undergoing embryonic loss, peripheral blood from embryo-transferred heifers on day 7 (day 0 = day of estrus) were collected on days 17 (pre-attachment), 20 (during attachment), and 22 (post-attachment), which were subjected to metabolome and global proteome iTRAQ analyses. The metabolome analysis partly divided serum components into pregnant or not. In the iTRAQ analysis, heatmap analysis with top 25 proteins was separated into pregnant or not on day 20 or 22. Furthermore, receiver operating characteristic curve (ROC) analysis identified five candidate proteins detecting non-pregnant heifers, of which SNX5 in day 22 serum had the highest area under the curve (AUC): 0.983. We also detected SNX5 in day 22 serum from non-pregnant heifers using western blotting. These results suggest that high SNX5 in day 22 serum could predict early pregnancy loss in heifers.
PHILOS Synthesis for Proximal Humerus Fractures Has High Complications and Reintervention Rates: A Systematic Review and Meta-Analysis
Authors: Oldrini Lorenzo Massimo , Feltri Pietro , Albanese Jacopo , Marbach Francesco , Filardo Giuseppe , Candrian Christian
Published: February 2022

Purpose: The aim of this study was to quantify the rate of complications and reinterventions in patients treated with PHILOS plate for proximal humerus fractures (PHFs) synthesis. Methods: A comprehensive literature search was performed on the PubMed, Web of Science, Embase, and Cochrane databases up to 7 October 2021. Studies describing medium and long-term complications in PHF synthesis using the PHILOS plate were included. A systematic review and meta-analysis were performed on complications and causes of reinterventions. Assessment of risk of bias and quality of evidence was performed with the Downs and Black’s “Checklist for Measuring Quality”. Results: Seventy-six studies including 4200 patients met the inclusion criteria. The complication rate was 23.8%, and the main cause was screw cut-out (4.1%), followed by avascular necrosis (AVN) (3.1%) and subacromial impingement (1.5%). In patients over 55 years, the complication rate was 29.5%. In the deltopectoral (DP) approach the complication rate was 23.8%, and in the delto-split (DS) it was 17.5%, but no difference between the two approaches was seen when considering the type of fracture. The overall reintervention rate was 10.5% in the overall population and 19.0% in older patients. Conclusions: Proximal humerus synthesis with a PHILOS plate has high complications and reintervention rates. The most frequent complication was screw cut-out, followed by humeral head AVN and subacromial impingement. These results need to be further investigated to better understand both the type of patient and fracture that is more at risk of complications and reintervention and to compare pros and cons of the PHILOS plate with respect to the other solutions to manage PHFs.
Postoperative Delirium and Postoperative Cognitive Dysfunction in Patients with Elective Hip or Knee Arthroplasty: A Narrative Review of the Literature
Authors: Kitsis Petros , Zisimou Theopisti , Gkiatas Ioannis , Kostas-Agnantis Ioannis , Gelalis Ioannis , Korompilias Anastasios , Pakos Emilios
Published: February 2022

Postoperative delirium (POD) and postoperative cognitive dysfunction (POCD) are common complications following total knee arthroplasty (TKA) and total hip arthroplasty (THA), affecting the length of hospital stay and increasing medical complications. Although many papers have been published on both conditions in this setting, no reviews have currently been written. Thus, the purpose of our study is to summarize the current literature and provide information about POD and POCD following elective THA or TKA. Our literature search was conducted in the electronic databases PubMed and the Cochrane library. We found that POD is a common complication following elective THA or TKA, with a median incidence of 14.8%. Major risk factors include older age, cognitive impairment, dementia, preoperative (pre-op) comorbidities, substance abuse, and surgery for fracture. Diagnosis can be achieved using tools such as the confusion assessment method (CAM), which is sensitive, specific, reliable, and easy to use, for the identification of POD. Treatment consists of risk stratification and the implementation of a multiple component prevention protocol. POCD has a median incidence of 19.3% at 1 week, and 10% at 3 months. Risk factors include older age, high BMI, and cognitive impairment. Treatment consists of reversing risk factors and implementing protocols in order to preserve physiological stability. POD and POCD are common and preventable complications following TKA and THA. Risk stratification and specific interventions can lower the incidence of both syndromes. Every physician involved in the care of such patients should be informed on every aspect of these conditions in order to provide the best care for their patients.
Neutrophil Extracellular Traps in ANCA-Associated Vasculitis and Interstitial Lung Disease: A Scoping Review
Authors: d’Alessandro Miriana , Conticini Edoardo , Bergantini Laura , Cameli Paolo , Cantarini Luca , Frediani Bruno , Bargagli Elena
Published: February 2022

Background: Deregulated neutrophil extracellular traps (NETs) formation is implicated in various diseases, including ANCA-associated vasculitis and pulmonary fibrosis (PF). Lung involvement is frequent in AAV, and interstitial lung diseases (ILDs) are strongly related to MPO-ANCA positivity and mainly reported in microscopic polyangiitis. The association between AAV and ILD is a strong indicator of poor prognosis and limited survival. Neutrophils, ANCA and NET interplay in PF development in AAV. This study aimed to review the literature concerning the implications of NET in lung fibrogenesis specifically focused on AAV associated with ILD, and the potential of NET as a theranostic marker. Methods: Through scoping review methodology, we used a descriptive thematic analysis to understand the pathogenic role of NETs in patients with AAV and pulmonary fibrosis and their further role as a theranostic marker of this disease. Results: The implications of NET in the pathogenesis of AAV and ILD, as well as an association between these two diseases, have been identified, but the underlying pathophysiological mechanisms are still unknown. The pharmacological or genetic inhibition of NET release reduces disease severity in multiple inflammatory disease models, indicating that NETs are potential therapeutic targets. In this regard, despite the lack of clinical data, we may hypothesise that an optimal management of AAV-ILD patients would require not only B-cells targeted therapy, but also NETs inhibition. Conclusion: Preliminary findings seem to display a lack of efficacy of traditional immunosuppressants, such as Rituximab, in this subset of patients, while to date no patients suffering from a definite ILD have been enrolled in clinical trials. Further insights would be provided by their employment, as a combination treatment, in common clinical practice. Although we can imagine that the inhibition of NETs in patients with AAV-ILD could reduce severity and mortality, we still lack the scientific basis that could improve our understanding of the disease from a molecular point of view.
Achieving High-Strength and Toughness in a Mg-Gd-Y Alloy Using Multidirectional Impact Forging
Authors: Lu Songhe , Wu Di , Yan Ming , Chen Rongshi
Published: February 2022

High strength and toughness are achieved in the Mg-4.96Gd-2.44Y-0.43Zr alloy by multidirectional impact forging (MDIF). The forged sample has a fine-grained microstructure with an average grain size of ~5.7 µm and a weak non-basal texture, and it was characterized by an optical microscope (OM), scanning electron microscope (SEM), and electron back-scattering diffraction (EBSD). Tensile results exhibit the tensile yield strength (TYS) and static toughness (ST) of as-homogenized alloy dramatically increased after forging and aging, i.e., the TYS increased from 135−5+4 MPa to 337−2+2 MPa, and the ST enhanced from 22.0−0.5+0.3 MJ/m3 to 50.4−5.4+5.3 MJ/m3. Specifically, the forged Mg-Gd-Y-Zr alloy owns higher TYS than that of commercial rolled WE54 (Mg-5.25Y-3.5Nd-0.5Zr) and WE43 (Mg-4.0Y-3.0Nd-0.5Zr) alloys.
A Method for Determination of the Transmission Efficiency of a Silica Optical Fiber Cable Using a Solar Power Tower
Authors: Rosa Luís Guerra , De Almeida Guilherme , Garcia Pereira José Carlos , Martínez-Hernández Alejandro , González-Aguilar José
Published: February 2022

After being adequately captured and concentrated, solar radiation can be conducted by optical fiber bundles/cables and directly used for illumination (lighting) or heating of confined spaces, or indirectly used by converting it in other forms of energy (e.g., for producing electricity). This article reports preliminary tests conducted on a 7-m-long optical fiber bundle/cable with an effective aperture circular area of 14 mm in diameter, specially designed and manufactured by a leading company to transmit up to 1000 Wth of unfiltered concentrated sunlight. The cable was tested in the typical receiver position at the top of a solar concentration central tower. The main purpose was the experimental determination of the transmission efficiency of the cable in function of the incidence angle using selected groups of heliostats belonging to the heliostat field. The testing methodology proved to be capable of evaluating the performance of the cable. The cable withstood the tests without revealing any type of damage. The results obtained showed that the transmissivity of the cable is higher than 50% when the incidence angle of the solar radiation is lower than 14.7°, increasing sharply to circa 95% when the incidence angle is lower than 4.5°.
Improved Wafer Map Inspection Using Attention Mechanism and Cosine Normalization
Authors: Xu Qiao , Yu Naigong , Essaf Firdaous
Published: February 2022

Wafer map inspection is essential for semiconductor manufacturing quality control and analysis. The deep convolutional neural network (DCNN) is the most effective algorithm in wafer defect pattern analysis. Traditional DCNNs rely heavily on high quality datasets for training. However, obtaining balanced and sufficient labeled data is difficult in practice. This paper reconsiders the causes of the imbalance and proposes a deep learning method that can learn robust knowledge from an imbalanced dataset using the attention mechanism and cosine normalization. We interpret the dataset imbalance as both a feature and a quantity distribution imbalance. To compensate for feature distribution imbalance, we add an improved convolutional attention module to the DCNN to enhance representation. In particular, a feature-map-specific direction mapping module is developed to amplify the positional information of defect clusters. For quantity distribution imbalance, the cosine normalization algorithm is proposed to replace the fully connected layer, and classifier fine-tuning is realized through a small amount of iterative training, which decreases the sensitivity to the quantitative distribution. The experimental results on real-world datasets demonstrate that the proposed method significantly improves the robustness of wafer map inspection and outperforms existing algorithms when trained on imbalanced datasets.
Optimal Placement of Sensors Based on Data Fusion for Condition Monitoring of Pulley Group under Speed Variation Condition
Authors: Wu Jie , Zi Yanyang , Ma Hongru , Wu Yaochun , Xue Xiaofeng
Published: February 2022

Pulley group plays an important role in the transmission of large mechanical equipment. To obtain informative data for condition monitoring, it is very important to optimize sensor placement on the pulley group. However, due to sharp speed fluctuation, heavy load and complex internal structure, sensor placement for acquiring optimal monitoring points is still a challenging task. Therefore, a novel sensor optimization method based on data fusion is proposed. In this method, the Kalman filter is firstly used to refine the collected signal for dealing with the variable noises. Subsequently, the variable periodicity strength of the signal is calculated to recognize the non-stationary characteristics of the measured signal. A data fusion technique based on maximum likelihood estimation (MLE) is then introduced to estimate sensitive components from the multi-source sensor signals for finding out optimal sensor placement points. The method is validated experimentally on a test rig of the pulley group with variable speed conditions. Analysis results show that the proposed method can recognize the optimal sensor placement points for the pulley group.
A New Construction and Convergence Analysis of Non-Monotonic Iterative Methods for Solving ρ-Demicontractive Fixed Point Problems and Variational Inequalities Involving Pseudomonotone Mapping
Authors: Khunpanuk Chainarong , Panyanak Bancha , Pakkaranang Nuttapol
Published: February 2022

Two new inertial-type extragradient methods are proposed to find a numerical common solution to the variational inequality problem involving a pseudomonotone and Lipschitz continuous operator, as well as the fixed point problem in real Hilbert spaces with a ρ-demicontractive mapping. These inertial-type iterative methods use self-adaptive step size rules that do not require previous knowledge of the Lipschitz constant. We also show that the proposed methods strongly converge to a solution of the variational inequality and fixed point problems under appropriate standard test conditions. Finally, we present several numerical examples to show the effectiveness and validation of the proposed methods.
Dynamical Investigation, Electronic Circuit Realization and Emulation of a Fractional-Order Chaotic Three-Echelon Supply Chain System
Authors: Ding Qing , Abba Oumate Alhadji , Jahanshahi Hadi , Alassafi Madini O. , Huang Wen-Hua
Published: February 2022

This study is concerned with dynamical investigation, electrical circuit realization, and emulation of a fractional three-echelon supply chain system. In the financial realm, long-term memory effects play important roles. On the other hand, most financial systems are uncertain with unknown nonlinear dynamics. However, most studies on nonlinear supply chains neither consider the fractional calculus nor take advantage of state-of-the-art emulation methods. These issues motivated the current study. A fractional-order chaotic three-echelon supply chain system is studied. At first, the system’s dynamic is studied through Lyapunov exponent and bifurcation diagrams. It is shown that a slight deferent in some parameters of the system can dramatically change the behavior of the system. Then, a real-time analog circuit is designed and implemented to investigate the system’s chaotic behavior. This way, the system’s chaotic attractors are empirically demonstrated. Finally, emulation and interpolation of the fractional-order chaotic system using the Gaussian process have been studied, and its luminous results have been presented.
Ensemble of 2D Residual Neural Networks Integrated with Atrous Spatial Pyramid Pooling Module for Myocardium Segmentation of Left Ventricle Cardiac MRI
Authors: Ahmad Iftikhar , Qayyum Abdul , Gupta Brij B. , Alassafi Madini O. , AlGhamdi Rayed A.
Published: February 2022

Cardiac disease diagnosis and identification is problematic mostly by inaccurate segmentation of the cardiac left ventricle (LV). Besides, LV segmentation is challenging since it involves complex and variable cardiac structures in terms of components and the intricacy of time-based crescendos. In addition, full segmentation and quantification of the LV myocardium border is even more challenging because of different shapes and sizes of the myocardium border zone. The foremost purpose of this research is to design a precise automatic segmentation technique employing deep learning models for the myocardium border using cardiac magnetic resonance imaging (MRI). The ASPP module (Atrous Spatial Pyramid Pooling) was integrated with a proposed 2D-residual neural network for segmentation of the myocardium border using a cardiac MRI dataset. Further, the ensemble technique based on a majority voting ensemble method was used to blend the results of recent deep learning models on different set of hyperparameters. The proposed model produced an 85.43% dice score on validation samples and 98.23% on training samples and provided excellent performance compared to recent deep learning models. The myocardium border was successfully segmented across diverse subject slices with different shapes, sizes and contrast using the proposed deep learning ensemble models. The proposed model can be employed for automatic detection and segmentation of the myocardium border for precise quantification of reflow, myocardial infarction, myocarditis, and h cardiomyopathy (HCM) for clinical applications.
Regressive and Big-Data-Based Analyses of Rock Drillability Based on Drilling Process Monitoring (DPM) Parameters
Authors: Wang Shaofeng , Tang Yu , Cao Ruilang , Zhou Zilong , Cai Xin
Published: February 2022

Accurate, rapid and effective analysis of rock drillability is very important for mining, civil and petroleum engineering. In this study, a method of rock drillability evaluation based on drilling process monitoring (DPM) parameters is proposed by using the field drilling test data. The revolutions per minute (N), thrust, torque and rate of penetration (ROP) were recorded in real time. Then, the two-dimensional regression analysis was utilized to investigate the relationships between the drilling parameters, and the three-dimensional regression analysis was used to establish models of ROP and specific energy (SE), in which the N-F-ROP, N-T-ROP and the improved SE model were obtained. In addition, the random forest (RF) and support vector machine combined with genetic algorithm (GA-SVM) were applied to predict rock drillability. Finally, a prediction model of uniaxial compressive strength (UCS) was established based on the SE and drillability index, Id. The results show that both regression models and prediction models have good performance, which can provide important guidance and a data source for field drilling and excavation processes.
The Minimum Lindley Lomax Distribution: Properties and Applications
Authors: Khan Sadaf , Hamedani Gholamhossein G. , Reyad Hesham Mohamed , Jamal Farrukh , Shafiq Shakaiba , Othman Soha
Published: February 2022

By fusing the Lindley and Lomax distributions, we present a unique three-parameter continuous model titled the minimum Lindley Lomax distribution. The quantile function, ordinary and incomplete moments, moment generating function, Lorenz and Bonferroni curves, order statistics, Rényi entropy, stress strength model, and stochastic sequencing are all carefully examined as basic statistical aspects of the new distribution. The characterizations of the new model are investigated. The proposed distribution’s parameters were evaluated using the maximum likelihood procedures. The stability of the parameter estimations is explored using a Monte Carlo simulation. Two applications are used to objectively assess the new model’s extensibility.
Cross-Sectional Study to Evaluate Knowledge on Hand Hygiene in a Pandemic Context with SARS-CoV-2
Authors: Săveanu Cătălina Iulia , Porsega Andreea , Anistoroaei Daniela , Iordache Cristina , Bobu Livia , Săveanu Alexandra Ecaterina
Published: February 2022

Background and Objectives: The basis of any infection control program is hand hygiene (HH). The aim of this study was to investigate knowledge of HH among medical students. Materials and Methods: Students were randomly selected from two Romanian universities and a cross-sectional, questionnaire-based study was conducted between January and May 2021. The answers regarding demographic data and knowledge concerning the methods, the time and the antiseptics used for HH were collected. The selection of the study group was made according to selection criteria in accordance with ethical issues. A descriptive statistical analysis was performed, and a chi-square test was used for data comparison, with a cut-off point of 0.05 for statistical significance. Results: The results indicated that the attitude of the students towards the practice of HH improved significantly. Most students believe that simple HH can control infections. Significant differences were found by the year of study in terms of the hand surfaces included and recommended duration (p < 0.05). Conclusions: In conclusion, the study shows that most respondents have sufficient knowledge on HH, meaning that a higher compliance is required to control infections. The indicated reasons of non-compliance with HH are emergencies and other priorities.
Ofeleein i mi Vlaptin—Volume II: Immunity Following Infection or mRNA Vaccination, Drug Therapies and Non-Pharmacological Management at Post-Two Years SARS-CoV-2 Pandemic
Authors: Kountouras Jannis , Gialamprinou Dimitra , Kotronis Georgios , Papaefthymiou Apostolis , Economidou Eleftheria , Soteriades Elpidoforos S. , Vardaka Elisabeth , Chatzopoulos Dimitrios , Tzitiridou-Chatzopoulou Maria , Papazoglou Dimitrios David , Doulberis Michael
Published: February 2022

The persistence of the coronavirus disease 2019 (COVID-19) pandemic has triggered research into limiting transmission, morbidity and mortality, thus warranting a comprehensive approach to guide balanced healthcare policies with respect to people’s physical and mental health. The mainstay priority during COVID-19 is to achieve widespread immunity, which could be established through natural contact or vaccination. Deep knowledge of the immune response combined with recent specific data indicates the potential inferiority of induced immunity against infection. Moreover, the prevention of transmission has been founded on general non-pharmacological measures of protection, albeit debate exists considering their efficacy and, among other issues, their socio-psychological burden. The second line of defense is engaged after infection and is supported by a plethora of studied agents, such as antibiotics, steroids and non-steroid anti-inflammatory drugs, antiviral medications and other biological agents that have been proposed, though variability in terms of benefits and adverse events has not allowed distinct solutions, albeit certain treatments might have a role in prevention and/or treatment of the disease. This narrative review summarizes the existing literature on the advantages and weaknesses of current COVID-19 management measures, thus underlining the necessity of acting based on the classical principle of “ofeleein i mi vlaptin”, that is, to help or not to harm.