bluuebunny/crossref_metadata_2025 huggingface dataset:
Time-Varying Hazard of Patient Falls in Hospital: A Retrospective Case–Control Study
Authors: Lee Mi-Joon , Seo Bum-Jeun , Kim Myo-Youn
Published: August 2023

This study aims to evaluate the association between patient falls and relevant factors and to quantify their effect on fall risk. This is a retrospective case–control study using the secondary data collected from a tertiary general hospital. Study subjects were 450 patients who were admitted to the hospital between January 2016 and December 2020. The prevalence of falls was associated with the fall risk level by the Morse Fall Scale (MFS) and individual status at admission including history of admission, dizziness, sleep disorder, bowel dysfunction, and urinary incontinence. The odds ratios of patient falls were higher in the low-risk group by the MFS score (odds ratio (OR) = 2.61, p < 0.001) and the high-risk group (OR = 5.51, p < 0.001) compared to the no-risk group. The hazard ratio of patient falls was higher in the high-risk group by the MFS score (hazard ratio (HR) = 3.85, p < 0.001). The MFS had a significant explanatory power to predict fall risk. Sleep disorder and urinary incontinence were the significant factors influencing patient falls.
Is Your Pregnancy Unwanted or Unhappy? Psychological Correlates of a Cluster of Pregnant Women Who Need Professional Care
Authors: Ohashi Yukiko , Takegata Mizuki , Takeda Satoru , Hada Ayako , Usui Yuriko , Kitamura Toshinori
Published: August 2023

Background: A negative response towards a current pregnancy consists of two elements: unwantedness of and unhappiness about the current pregnancy. Little is clear about whether pregnant women can be categorized in terms of unwantedness and unhappiness as well as what the correlates are of these categories. Methods: An internet survey of 696 women in their first trimester of pregnancy examined the participants’ intention of and emotional reaction towards pregnancy, borderline personality traits, adult attachment style, depression, fear of childbirth, obsessive-compulsive symptoms, fetal bonding disorder, avoidance of taking part in child care, and consideration about termination of pregnancy (TOP). About one third of the participants were followed up with in their second trimester. Results: Two-step cluster analysis using the participants’ intention of and emotional reaction towards pregnancy revealed three groups of pregnant women: those who wanted and were happy about the pregnancy (Cluster 1), those who were unhappy about the pregnancy (Cluster 2), and those who did not intend to be pregnant but were happy about pregnancy (Cluster 3). Cluster 2 women, but not Cluster 3 women, were likely to be single, with borderline personality traits as well as unstable adult attachment styles, accompanied by depression, fear of childbirth, obsessive-compulsive symptoms, and fetal bonding disorder. They were more likely to avoid caring for the baby after childbirth and consider TOP. Conclusion: Expectant women who were unhappy about their pregnancy were at risk of psychological adjustment and need specific perinatal mental health assessment and care.
Taxonomic Comparison, Antioxidant and Antibacterial Activities of Three Ebenus pinnata Ait. ecotypes (Fabaceae) from Algeria
Authors: Zemouri Tassadit , Chikhoune Amirouche , Benmouhoub Hassina , Sahnoune Mohamed
Published: August 2023

Ebenus pinnata is not known as a traditional medicinal plant, but modern research has revealed its richness in components of medicinal value. Yet, the species remains understudied. Here, we assess the climate effect on its morphology, pollen grains size, chromosome numbers, pollen fertility, and antioxidant and antibacterial activities. Plant material was collected from the humid, sub-humid, and semi-arid areas of Northeastern Algeria. Data treatment by principal component analysis and/or cluster analysis and ANOVA post hoc tests revealed three significantly discriminated ecotypes correlated with the climate stage. Significant differences were detected for whole plant morphology, pollen size, and antioxidant activity. No differences were revealed for chromosome numbers, pollen fertility, and antibacterial activity. The studied material showed a chromosome number of 2n = 14, high pollen fertility (94.04 ± 2.64–95.01 ± 2.02%), small pollen grains (polar axis: 17.95 ± 1.10–19.47 ± 1.27 µm; equatorial axis: 12.80 ± 1.18–13.03 ± 0.99 µm), high antioxidant activity (TPC: 50.79 ± 0.51–56.89 ± 0.46 mg/g; DPPH: 71.18 ± 2.24–95.67 ± 2.02 mg/g; RP: 11.09 ± 1.24–25.88 ± 0.26 mg/g), and efficient antibacterial activity (Inhibition area diameter: 9.25 ± 1.06–12.00 ± 1.41 mm). The climate seems to exert a significant impact on multiple aspects of the plant’s biology. It would be interesting to assess the genetic basis of this phenomenon in E. pinnata and other species.
Morphological and Biochemical Response of Potatoes to Exogenous Application of ZnO and SiO2 Nanoparticles in a Water Deficit Environment
Authors: Al-Selwey Wadei A. , Alsadon Abdullah A. , Alenazi Mekhled M. , Tarroum Mohamed , Ibrahim Abdullah A. , Ahmad Awais , Osman Mohamed , Seleiman Mahmoud F.
Published: August 2023

A field study was conducted to understand the effectiveness of foliar applications of ZnO-NPs (0, 50, 100 mg L−1) and SiO2-NPs (0, 25, 50 mg L−1) on potato plant growth, morphology, nutrient uptake, oxidative stress, and antioxidative response under drought conditions (i.e., 100% crop evapotranspiration ETc, 75% ETc, and 50% ETc). Results revealed that water deficiency significantly hampered plant growth and biomass production and stimulated oxidative stress in potatoes. However, the exogenous application of ZnO-NPs and SiO2-NPs significantly improved plant growth attributes such as the number of branches, plant height, fresh and dry biomass, leaf area, and leaf area index as compared with untreated plants. The foliar application of ZnO-NPs (i.e., 100 and 50 mg L−1) and SiO2-NPs (50 mg L−1) promoted the mineral ion accumulation in plants grown under water deficiency and thus resulted in higher NPK, Zn2+, Fe2+, and Mn2+ contents. A significant reduction in malondialdehyde (MDA) and hydrogen peroxide (H2O2) was found in plants treated with 100 mg L−1 ZnO followed by 50 mg L−1 SiO2 and 50 mg L−1 ZnO nanoparticles as compared with untreated plants, respectively. Furthermore, the aforesaid treatments resulted in the maximum activity of antioxidant enzymes (i.e., superoxide dismutase SOD, catalase CAT, polyphenol oxidase PPO, and ascorbate peroxidase APX) under water deficit stress. Similarly, the foliar application of ZnO and SiO2 nanoparticles improved nonenzymatic antioxidants such as total flavonoid content (TFC) and total phenolic compounds (TPC) as compared with untreated plants (control). Moreover, plant growth traits were significantly and positively correlated with mineral contents, while they were negatively correlated with MDA and H2O2. ZnO-NPs and SiO2-NPs applications improved biochemical traits, which might lead to enhancements in plant tolerance and improvements in potato growth, productivity, and quality traits under water shortage conditions.
Assessing Motor Function in Frail Older Adults in Their Home Settings: Challenges, Strategies and Recommendations
Authors: Yin Lijuan , Caceres Maria , Skowronski Jordan , Muramatsu Naoko
Published: August 2023

Assessing motor competence is essential for evaluating the effectiveness of physical activity interventions that aim to maintain or improve older adults’ function. However, assessing motor competence in older adults who have difficulties walking or standing is challenging, because few instruments or guidelines are appropriate for these frail older adults. This article aims to describe challenges in evaluating motor function among frail older adults, discuss strategies for adapting motor function assessments to their home settings, and provide recommendations for future clinical trials so that older adults with ambulatory difficulties can benefit from motor function assessment and physical activity programs. Data came from the baseline assessment of 116 participants of an ongoing clinical trial, “Promoting Seniors’ Health with Home Care Aides (Pro-Home)”. Our results demonstrated that the Pro-Home study involved participants who would be typically excluded from clinical trials and that the two instruments selected or developed for Pro-Home (Short Physical Performance Battery, Pro-Home Ankle Range of Motion Measure) captured a wide range of lower extremity motor competence with no or few missing data. Recommendations for future studies include knowing the target population thoroughly, developing trust and rapport with all parties involved, and continuously collaborating with interviewers who conduct assessments.
A Multi-Level Grid Database for Protecting and Sharing Historical Geographic Urban Data: A Case Study of Shanghai
Authors: Li Shuang
Published: August 2023

Historical geographic data play an important supporting role in the study of long-term geographic studies, such as climate change, urban expansion and land-use and land-cover change. These data vary in source, format and accuracy and are widely found in historical documents, old maps, produced vector data, aerial photographs, old photographs, etc. The complex nature of data makes it difficult for researchers to organize, store and manage in a unified manner. Thus, GIS practitioners and social scientists will collectively face the challenge of integrating historical data into spatial databases. Herein, we introduced the concept of a multi-level spatial grid, selecting Shanghai as the study area, to construct the Shanghai historical geographic database and give the conceptual model and processing method. The experiment was performed using the China Historical Geographic Information System (CHGIS), which showed the historical evolution of Shanghai more conveniently. Meanwhile, we simulated one million rows of historical geographic data in Shanghai and compared the retrieval efficiency of the encoding method with the latitude–longitude and geometric object indexing methods, which demonstrated that our method was very effective. This research is important for the construction of a historical urban database, which can better preserve historical resources and promote urban culture with information science and technology.
Prostaglandin E2 (PGE2) and Roflumilast Involvement in IPF Progression
Authors: Moshkovitz Noa , Epstein Shochet Gali , Shitrit David
Published: August 2023

The ECM propagates processes in idiopathic pulmonary fibrosis (IPF), leading to progressive lung scarring. We established an IPF-conditioned matrix (IPF-CM) system as a platform for testing drug candidates. Here, we tested the involvement of a PGE2 and PDE4 inhibitor, Roflumilast, in the IPF-CM system. Primary normal/IPF tissue-derived human lung fibroblasts (N/IPF-HLFs) were cultured on Matrigel and then removed to create the IPF-CM. N-HLFs were exposed to the IPF-CM/N-CM with/without PGE2 (1 nM) and Roflumilast (1 µM) for 24 h. The effect of the IPF-CM on cell phenotype and pro-fibrotic gene expression was tested. In addition, electronic records of 107 patients with up to 15-year follow-up were retrospectively reviewed. Patients were defined as slow/rapid progressors using forced vital capacity (FVC) annual decline. Medication exposure was examined. N-HLFs cultured on IPF-CM were arranged in large aggregates as a result of increased proliferation, migration and differentiation. A PGE2 and Roflumilast combination blocked the large aggregate formation induced by the IPF-CM (p < 0.001) as well as cell migration, proliferation, and pro-fibrotic gene expression. A review of patient records showed that significantly more slow-progressing patients were exposed to NSAIDs (p = 0.003). PGE2/PDE4 signaling may be involved in IPF progression. These findings should be further studied.
Combining Ability Analysis of Yield-Related Traits of Two Elite Rice Restorer Lines in Chinese Hybrid Rice
Authors: Wang Shiguang , Wu Haoxiang , Lu Zhanhua , Liu Wei , Wang Xiaofei , Fang Zhiqiang , He Xiuying
Published: August 2023

Hybrid rice breeding is an important strategy for enhancing grain yield. Breeding high-performance parental lines and identifying combining abilities is a top priority for hybrid breeding. Yuenongsimiao (YNSM) and its derivative variety Yuehesimiao (YHSM) are elite restorer lines with a high ability of fertility restoration, from which 67 derived hybrid combinations have been authorized to different degrees in more than 110 instances in China. In this study, we found that YNSM and YHSM contained three candidate restorer-of-fertility (Rf) genes, Rf3, Rf4, and Rf5/Rf1a, that might confer their restoration ability. Subsequently, we investigated heterosis and combining ability of YNSM and YHSM using 50 F1 hybrids from a 5 × 10 incomplete diallelic mating design. Our results indicated that hybrid combinations exhibited significant genetic differences, and the additive effects of the parental genes played a preponderant role in the inheritance of observed traits. The metrics of plant height (PH), 1000-grain weight (TGW), panicle length (PL), and the number of spikelets per panicle (NSP) were mainly affected by genetic inheritance with higher heritability. Notably, the general combining ability (GCA) of YHSM exhibited the largest positive effect on the number of grains per panicle (NGP), NSP, PL, and TGW. Thus, YHSM had the largest GCA effect on yield per plant (YPP). In addition, the GCA of YNSM exhibited a positive impact on YPP, mainly due to the critical contribution of seed setting percentage (SSP). Moreover, YNSM and YHSM exhibited negative GCA effects on PH, implying that YNSM and YHSM could effectively enhance plant lodging resistance by reducing the plant height of the derived hybrids. Remarkably, among the hybrids, Yuanxiang A/YNSM (YXA/YNSM), Shen 08S/Yuemeizhan (S08S/YMZ), and Quan 9311A/YHSM (Q9311A/YHSM) represent promising new combinations with a higher specific combining ability (SCA) effect value on YPP with a value more than 3.50. Our research thus highlights the promising application for the rational utilization of YNSM and YHSM in hybrid rice breeding.
Soybean (Glycine max) INFOGEST Colonic Digests Attenuated Inflammatory Responses Based on Protein Profiles of Different Varieties
Authors: Kusumah Jennifer , Castañeda-Reyes Erick Damian , Bringe Neal A. , Gonzalez de Mejia Elvira
Published: August 2023

Soybean compounds have been established to modulate inflammation, but less is known about how whole soybean compositions work together after digestion. The objective was to evaluate and compare the anti-inflammatory responses of different soybean varieties under simulated gastrointestinal digestion, with additional consideration of the glycinin:β-conglycinin ratio (GBR). Soybean colonic digests (SCD) inhibited cyclooxygenase (COX)-2 (25–82%), 5-lipoxidase (LOX) (18–35%), and inducible nitric oxide (iNOS) (8–61%). Varieties 88, GN3, and 93 were the most effective inhibitors. SCD (1 mg/mL) of varieties 81 and GN1 significantly (p < 0.05) reduced nitrite production by 44 and 47%, respectively, compared to lipopolysaccharide (LPS)-stimulated macrophages. SCD effectively reduced pro-inflammatory cytokine interleukin (IL)-6 (50 and 80% for 96 and GN1, respectively). Western blot results showed a decrease in the expression of iNOS, p65, and p50. The GBR was in the range of 0.05–1.57. Higher ratio correlated with higher production of IL-1β (r = 0.44) and tumor necrosis factor-alpha (TNF-α, r = 0.56). Inflammatory microarray results showed a significant decrease in expression of markers granulocyte-macrophage colony-stimulating factor (GM-CSF) and IL-6 in cells treated with GN1 SCD compared to LPS. The results suggested that SCD exerted its anti-inflammatory potential through nuclear factor kappa B (NF-κΒ) pathway inhibition by decreasing the levels of NF-κB-dependent cytokines and subunits, and inhibition of pro-inflammatory enzyme activity.
Protein Profiling of Aedes aegypti Treated with Streptomyces sp. KSF103 Ethyl Acetate Extract Reveals Potential Insecticidal Targets and Metabolic Pathways
Authors: Tan Ker Shien , Azman Adzzie Shazleen , Hassandarvish Pouya , Amelia-Yap Zheng Hua , Tan Tiong Kai , Low Van Lun
Published: August 2023

The insecticidal activity of Streptomyces sp. KSF103 ethyl acetate (EA) extract against mosquitoes is known; however, the underlying mechanism behind this activity remains elusive. In this study, liquid chromatography with tandem mass spectrometry (LC-MS/MS) was employed to investigate changes in the protein profile of Aedes aegypti larvae and adults treated with lethal concentrations of 50 (LC50) EA extract. By comparing the treated and untreated mosquitoes, this study aimed to identify proteins or pathways that exhibit alterations, potentially serving as targets for future insecticide development. Treatment with a lethal concentration of EA extract upregulated 15 proteins in larvae, while in adults, 16 proteins were upregulated, and two proteins were downregulated. These proteins were associated with metabolism, protein regulation/degradation, energy production, cellular organization and structure, enzyme activity, and catalysis, as well as calcium ion transport and homeostasis. Notably, ATP synthase, fructose-bisphosphate aldolase (FBA), and ATP citrate synthase were significantly expressed in both groups. Gene ontology analysis indicated a focus on energy metabolic processes. Molecular docking revealed a strong interaction between dodemorph, selagine (compounds from the EA extract), and FBA, suggesting FBA as a potential protein target for insecticide development. Further studies such as Western blot and transcriptomic analyses are warranted to validate the findings.
Mesoporous Silica Particle as an RNA Adsorbent for Facile Purification of In Vitro-Transcribed RNA
Authors: Cho Eunbin , Namgung Jayoung , Lee Jong Sam , Jang Jinmin , Jun Bong-Hyun , Kim Dong-Eun
Published: August 2023

Messenger RNA vaccines against SARS-CoV-2 hold great promise for the treatment of a wide range of diseases by using mRNA as a tool for generating vaccination antigens as well as therapeutic proteins in vivo. Increasing interest in mRNA preparation warrants reliable methods for in vitro transcription (IVT) of mRNA, which must entail the elimination of surplus side products such as immunogenic double-stranded RNA (dsRNA). We developed a facile method for the removal of dsRNA from in vitro transcribed RNA with mesoporous silica particles as RNA adsorbents. Various polyamines were tested for the facilitation of RNA adsorption onto mesoporous silica particles in the chromatography. Among the polyamines tested for RNA adsorption, spermidine showed a superior capability of RNA binding to the silica matrix. Mesoporous silica-adsorbed RNA was readily desorbed with elution buffer containing either salt, EDTA, or urea, possibly by disrupting electrostatic interaction and hydrogen bonding between RNA and the silica matrix. Purification of IVT RNA was enabled with the adsorption of RNA to mesoporous silica in a spermidine-containing buffer and subsequent elution with EDTA. By differing EDTA concentration in the eluting buffer, we demonstrated that at least 80% of the dsRNA can be removed from the mesoporous silica-adsorbed RNA. When compared with the cellulose-based removal of dsRNA from IVT RNA, the mesoporous silica-based purification of IVT RNA using spermidine and EDTA in binding and elution, respectively, exhibited more effective removal of dsRNA contaminants from IVT RNA. Thus, mRNA purification with mesoporous silica particles as RNA adsorbents is applicable for the facile preparation of nonimmunogenic RNA suitable for in vivo uses.
Ultrastructural and Descriptive Study on the Adult Body Surface of Heortia vitessoides (Lepidoptera: Crambidae)
Authors: Liu Lei , Zhang Yan , Yan Shan-Chun , Yang Bin , Wang Gui-Rong
Published: August 2023

Heortia vitessoides Moore, 1885 (Lepidoptera: Crambidae) is an economically important lepidopteran pest that caused severe damage to the plantation area of Aquilaria sinensis (Lour.) Gilg, 1825 (Thymelaeaceae), resulting in extensive defoliation of the trees during an epidemic. In this study, we used scanning electron microscopy (SEM) to analyze the external morphology and ultrastructure of sensilla on various body parts of H. vitessoides. Specifically, seven, four, four, and five types of sensilla were found, respectively, on the antennae, proboscis, labial palps, and legs. We described the types, distributions, and sexual dimorphism of these sensilla on antennae, and found that the number and size of sensilla differed significantly between males and females. This study provides crucial information for future investigations into the function of these sensilla in H. vitessoides.
The Perioperative Use of Levosimendan as a Means of Optimizing the Surgical Outcome in Patients with Severe Heart Insufficiency Undergoing Cardiac Surgery
Authors: Leivaditis Vasileios , Grapatsas Konstantinos , Papaporfyriou Anastasia , Galanis Michail , Koletsis Efstratios , Charokopos Nikolaos , Haussmann Erich , Kaplunov Vladislav , Papatriantafyllou Athanasios , Dahm Manfred
Published: August 2023

Background: Postoperative myocardial dysfunction following cardiac surgery is a relatively common occurrence. Levosimendan, a calcium sensitizer and inotropic drug, has shown potential in improving outcomes for patients with low preoperative ejection fraction (EF) and myocardial dysfunction after cardiac surgery. This study aims to evaluate the efficacy of levosimendan in optimizing the surgical outcome for such patients. Methods: A retrospective analysis was conducted on 314 patients with preoperative severe heart failure who underwent cardiac surgery. Among them, 184 patients received perioperative adjunctive therapy with levosimendan, while a comparable group of 130 patients received conventional treatment. Results: The use of levosimendan demonstrated several advantages in postoperative outcomes. It significantly improved short- and long-term survival rates after cardiac surgery, enhanced hemodynamic stability, reduced the requirement for inotropic support, and facilitated faster weaning from ventilator support. Patients who received levosimendan reported reduced angina and dyspnea symptoms, as well as fewer postoperative arrhythmias. Furthermore, levosimendan helped minimize myocardial injury inevitable after cardiac surgery. The levosimendan group also exhibited a notable reduction in hospital readmissions. Conclusions: This study provides evidence of several benefits associated with the perioperative use of levosimendan. However, further prospective randomized studies are warranted to standardize and comprehensively document the other perioperative therapies, in order to validate these findings and establish stronger conclusions.
Unique Pulmonary Hypertensive Vascular Diseases Associated with Heart and Lung Developmental Defects
Authors: Ishida Hidekazu , Maeda Jun , Uchida Keiko , Yamagishi Hiroyuki
Published: August 2023

Although pediatric pulmonary hypertension (PH) shares features and mechanisms with adult PH, there are also some significant differences between the two conditions. Segmental PH is a unique pediatric subtype of PH with unclear and/or multifactorial pathophysiological mechanisms, and is often associated with complex congenital heart disease (CHD), pulmonary atresia with ventricular septal defect, and aortopulmonary collateral arteries. Some cases of complex CHD, associated with a single ventricle after Fontan operation, show pathological changes in the small peripheral pulmonary arteries and pulmonary vascular resistance similar to those observed in pulmonary arterial hypertension (PAH). This condition is termed as the pediatric pulmonary hypertensive vascular disease (PPHVD). Recent advances in genetics have identified the genes responsible for PAH associated with developmental defects of the heart and lungs, such as TBX4 and SOX17. Targeted therapies for PAH have been developed; however, their effects on PH associated with developmental heart and lung defects remain to be established. Real-world data analyses on the anatomy, pathophysiology, genetics, and molecular biology of unique PPHVD cases associated with developmental defects of the heart and lungs, using nationwide and/or international registries, should be conducted in order to improve the treatments and prognosis of patients with these types of pediatric PH.
Electrocardiographic Characteristics of Ventricular Arrhythmias Originating from Different Areas Adjacent to the Mitral Annulus
Authors: Lin Yi-Fan , Xu Que , Zheng Cheng , Shao Jia-Meng , Shen Bing , He Rui-Lin , Lin Jia-Feng , Chen Yan-Ru
Published: August 2023

Background: This study aimed to explore the electrocardiographic (ECG) characteristics of ventricular arrhythmias (VAs) arising from epicardial and endocardial areas adjacent to the mitral annulus (MA). Methods: This study involved 283 patients with MA-VAs who received radiofrequency catheter ablation at the center. The ECG characteristics of these patients were analyzed retrospectively. Results: The origin of MA-VAs was judged based on the ECG variables. Among all MA-VAs, intrinsicoid deflection time (IDT) > 77 ms or maximum deflection index (MDI) > 0.505 predicted the VAs arising from the epicardium (sensitivity of 70.20% and 73.51%, specificity of 94.70% and 82.58%, positive predictive value (PPV) of 93.81% and 82.84%, and negative predictive value (NPV) of 73.53% and 73.15%). Among all epicardial MA-VAs, the RV1/RV2 ratio > 0.87 predicted the VAs originating from the epicardial anteroseptal wall adjacent to the MA. It had a sensitivity, specificity, PPV, and NPV of 62.86%, 98.06%, 91.67%, and 88.60%, respectively. Among all endocardial MA-VAs, Q(q)R(r) morphology in lead V1 predicted the VAs arising from the endocardial septal wall adjacent to the MA. It had a sensitivity, specificity, PPV, and NPV of 92.98%, 100%, 100%, and 94.94%, respectively. Among all endocardial septal MA-VAs, a predominant positive wave in lead II and a predominant negative wave in lead III predicted the VAs arising from the endocardial midseptal portion adjacent to the MA. It had a sensitivity, specificity, PPV, and NPV of 86.04%, 100%, 100%, and 70.00%, respectively. Conclusion: the ECG characteristics of VAs from the different sites adjacent to the MA can enable judging the arrhythmia’s origin and designing the ablation plan accordingly.
Comparing Left Ventricular Diastolic Function between Peritoneal Dialysis and Non-Dialysis Patients with Stage 5 Chronic Kidney Disease: A Propensity Score-Matched Analysis
Authors: Han Byoung-Geun , Seol Jae Hee , Choi Sooyeon , Shin Donghui , Kim Jae-Seok , Kim Yong Hyuk
Published: August 2023

Patients with chronic kidney disease (CKD) have a high incidence of left ventricular diastolic dysfunction (LVDD), which increases the risk of heart failure and mortality. We assessed fluid overload as an independent risk factor for LVDD in patients with decreased kidney function and compared its impact on the E/e′ ratio as a parameter for assessing left ventricular diastolic functions between patients undergoing continuous ambulatory peritoneal dialysis (CAPD) and those with non-dialysis CKD stage 5 (CKD5) using propensity score matching (PSM). After PSM, 222 patients (CAPD, n = 111; CKD5, n = 111) were included. Fluid balance was assessed using bio-impedance spectroscopy and LVDD was determined by echocardiography based on an E/e′ ratio of >15. The CKD5 group had a significantly higher E/e′ ratio (p = 0.002), while fluid overload (OH/ECW) did not differ significantly between the groups. In the CAPD group, there were no significant differences in OH/ECW between patients with and without LVDD (p = 0.517). However, in the CKD5 group, patients with LVDD showed a significantly higher OH/ECW (p = 0.001). In a regression analysis investigating factors associated with the E/e′ ratio, OH/ECW was not significantly associated with the E/e′ ratio in the CAPD group (p = 0.087), but in the CKD5 group, it was independently correlated (p = 0.047). The factors closely associated with LVDD varied depending on dialysis dependence. While fluid overload independently influenced LVDD in non-dialysis patients, it was not statistically significant in patients with CAPD. Early assessment and management of volume status are crucial in addressing LVDD in patients with advanced-stage CKD.
Sex-Based Differences in Clinical Characteristics and Outcomes among Patients with Peripheral Artery Disease: A Retrospective Analysis
Authors: De Matteis Giuseppe , Biscetti Federico , Della Polla Davide Antonio , Serra Amato , Burzo Maria Livia , Fuorlo Mariella , Nicolazzi Maria Anna , Novelli Angela , Santoliquido Angelo , Gambassi Giovanni , Gasbarrini Antonio , Flex Andrea , Franceschi Francesco , Covino Marcello
Published: August 2023

Peripheral arterial disease (PAD) is a prevalent medical condition associated with high mortality and morbidity rates. Despite the high clinical burden, sex-based differences among PAD patients are not well defined yet, in contrast to other atherosclerotic diseases. This study aimed to describe sex-based differences in clinical characteristics and outcomes among hospitalized patients affected by PAD. This was a retrospective study evaluating all patients with a diagnosis of PAD admitted to the Emergency Department from 1 December 2013 to 31 December 2021. The primary endpoint of the study was the difference between male and female PAD patients in cumulative occurrence of Major Adverse Cardiovascular Events (MACEs) and Major Adverse Limb Events. A total of 1640 patients were enrolled. Among them, 1103 (67.3%) were males while females were significantly older (median age of 75 years vs. 71 years; p =< 0.001). Females underwent more angioplasty treatments for revascularization than men (29.8% vs. 25.6%; p = 0.04); males were treated with more amputations (19.9% vs. 15.3%; p = 0.012). A trend toward more MALEs and MACEs reported in the male group did not reach statistical significance (OR 1.27 [0.99–1.64]; p = 0.059) (OR 0.75 [0.50–1.11]; p = 0.153). However, despite lower extremity PAD severity seeming similar between the two sexes, among these patients males had a higher probability of undergoing lower limb amputations, of cardiovascular death and of myocardial infarction. Among hospitalized patients affected by PAD, even if there was not a sex-based significant difference in the incidence of MALEs and MACEs, adverse clinical outcomes were more common in males.
Prevalence of Parent-Reported Food Allergy in a Mexican Pre-School Population
Authors: Arámburo-Gálvez Jesús Gilberto , Figueroa-Salcido Oscar Gerardo , Ramírez-Torres Giovanni Isaí , Terán-Cabanillas Elí , Gracia-Valenzuela Martina Hilda , Arvizu-Flores Aldo Alejandro , Sánchez-Cárdenas Cesar Antonio , Mora-Melgem José Antonio , Valdez-Zavala Luisamaria , Cárdenas-Torres Feliznando Isidro , Ontiveros Noé
Published: August 2023

The magnitude and relevance of food allergies in the preschool population remain unknown in most regions of Mexico and Latin America. Thus, our aim was to estimate the parent-reported prevalence of food allergies in a Mexican preschool population and to characterize their clinical diagnosis and presentation. A cross-sectional survey was conducted in Culiacán City. A validated questionnaire was utilized. A total of 810 parents responded to the questionnaire (valid response rate, 40.7%). The estimated prevalence rates (95% CI) were: “physician-diagnosed Food Allergy (FA), ever” 5.30% (3.86–7.08); “immediate-type FA, ever” 2.96% (1.91–4.38); “immediate-type FA, current” 1.60% (0.86–2.73); and food-dependent anaphylaxis 1.11% (0.51–2.01). The main food allergens were milk (0.49%), strawberries (0.37%), egg, and soy (0.25% each). Atopic diseases and a family history of allergies were significantly associated with immediate-type FA. Among “immediate-type FA, current” cases, 76.9% required emergency room visits, but the prescription of epinephrine autoinjectors was reported in one case only. The food reactions occurred at home (92.35%), in a relative’s house (38.5), and at restaurants (23%). Immediate-type FA reactions requiring emergency room visits are not uncommon among the studied population. Actions like proper anaphylaxis management and the prevention of cross-contamination of foods should be encouraged.
Glidescope Video Laryngoscopy in Patients with Severely Restricted Mouth Opening—A Pilot Study
Authors: Popal Zohal , Dankert André , Hilz Philip , Wünsch Viktor Alexander , Grensemann Jörn , Plümer Lili , Nawrath Lars , Krause Linda , Zöllner Christian , Petzoldt Martin
Published: August 2023

Background: An inter-incisor gap <3 cm is considered critical for videolaryngoscopy. It is unknown if new generation GlideScope Spectrum™ videolaryngoscopes with low-profile hyperangulated blades might facilitate safe tracheal intubation in these patients. This prospective pilot study aims to evaluate feasibility and safety of GlideScopeTM videolaryngoscopes in severely restricted mouth opening. Methods: Feasibility study in 30 adults with inter-incisor gaps between 1.0 and 3.0 cm scheduled for ENT or maxillofacial surgery. Individuals at risk for aspiration or rapid desaturation were excluded. Results: The mean mouth opening was 2.2 ± 0.5 cm (range 1.1–3.0 cm). First attempt success rate was 90% and overall success was 100%. A glottis view grade 1 or 2a was achieved in all patients. Nasotracheal intubation was particularly difficult if Magill forceps were required (n = 4). Intubation time differed between orotracheal (n = 9; 33 (25; 39) s) and nasotracheal (n = 21; 55 (38; 94) s); p = 0.049 intubations. The airway operator’s subjective ratings on visual analogue scales (0–100) revealed that tube placement was more difficult in individuals with an inter-incisor gap <2.0 cm (n = 10; 35 (29; 54)) versus ≥2.0 cm (n = 20; 20 (10; 30)), p = 0.007, while quality of glottis exposure did not differ. Conclusions: GlidescopeTM videolaryngoscopy is feasible and safe in patients with severely restricted mouth opening if given limitations are respected.
Investigation of the Prevalence of Diminished Ovarian Reserve in Korean Women of Reproductive Age
Authors: Choi Rihwa , Park Wonseo , Chun Gayoung , Lee Sang Gon , Lee Eun Hee
Published: August 2023

Diminished ovarian reserve can be assessed biochemically using serum anti-Müllerian hormone (AMH) and follicle-stimulating hormone (FSH) tests. This study aimed to evaluate the prevalence of diminished ovarian reserve in a large population of reproductive-aged women by age and geographic region in Korea using different cutoffs of serum AMH and FSH levels. In 2022, 13,351 women underwent both AMH and FSH tests. The prevalence of diminished ovarian reserve increased markedly with age. Although cutoffs for AMH and FSH levels are different in USA and Korean guidelines, the overall prevalence of diminished ovarian reserve was comparable. The maximum prevalence was 3.8%, 6.0%, 11.0%, 28.6%, 69.3%, and 95.0% in women aged 20–24, 25–29, 30–34, 35–39, 40–44, and 45–49 years, respectively. The overall prevalence and age-adjusted prevalence of diminished ovarian reserve were 37.2% and 38.4%, respectively. Women who had only increased serum FSH without decreased AMH represented 1.1% (by Korean guidelines) and 2.5% (by USA guidelines) of all women. Serum AMH and FSH tests were underutilized on Jeju Island. The results of this study provide basic knowledge about diminished ovarian reserve for use in infertility support programs and the field of maternal aging.
Osteoarthritis: The Most Common Joint Disease and Outcome of Sports Injury
Authors: Chen Bowen , Huang Wei , Liao Junyi
Published: August 2023

Osteoarthritis (OA) is the most common joint disease and affects an estimated 240 million people worldwide [...]
Superomedial Scapula Angle Osteochondroma with Winging in a Young Female Patient—Case Report and Literature Review
Authors: Faur Cosmin , Abu-Awwad Ahmed , Patrascu Jenel-Marian , Abu-Awwad Simona-Alina , Tudoran Cristina
Published: August 2023

(1) Background: Osteochondromas are the most common benign bone tumors, primarily found in long bones, while scapular osteochondromas are rare and account for less than 1% of all osteochondromas. (2) Methods: We present a case of a young female patient with a unique presentation of scapular osteochondroma. The patient exhibited superomedial scapula angle osteochondroma with winging, a rare manifestation of scapular osteochondroma. The patient had a slow-growing mass on the left scapula for several years. Physical examination revealed a visible deformity with significant winging of the scapula. Imaging studies demonstrated a large osteochondroma arising from the superomedial angle of the left scapula, with a bony stalk. (3) Results: Surgical excision was performed, and histopathological analysis confirmed the diagnosis of osteochondroma. Following the surgery, the patient experienced a significant improvement in scapular winging. A comprehensive literature review revealed only a limited number of reported cases of scapular osteochondroma with winging, underscoring the significance of this case report as a valuable addition to the existing literature. The diagnosis of scapular osteochondroma should be considered in the differential diagnosis of patients presenting with a scapular mass, particularly when associated with winging. Surgical excision is the recommended treatment, and complete excision is crucial to prevent recurrence. (4) Conclusions: This case report highlights a rare presentation of scapular osteochondroma with winging and emphasizes the importance of considering this diagnosis in patients with scapular masses accompanied by winging. The successful surgical intervention in our case resulted in significant improvement. Clinicians should be aware of this entity and consider prompt surgical intervention for complete excision, ensuring optimal patient outcomes and preventing recurrence. Further research and additional case reports are necessary to enhance our understanding of scapular osteochondroma and its varied clinical presentations. Furthermore, comprehensive studies involving larger patient cohorts are necessary to explore the full spectrum of clinical presentations of scapular osteochondromas. By documenting and analyzing a wider range of cases, including variations in tumor location, size, and associated symptoms, researchers can identify patterns and establish more accurate diagnostic criteria. This will facilitate early detection and appropriate management of scapular osteochondromas, ultimately improving patient outcomes.
Comparison of Corvis ST Parameters between Primary Open-Angle Glaucoma and Primary Angle-Closure Glaucoma
Authors: Nakaniida Yuta , Tokumo Kana , Onoe Hiromitsu , Okada Naoki , Nakakura Shunsuke , Asaoka Ryo , Kiuchi Yoshiaki
Published: August 2023

Background: We compared corneal visualization Scheimpflug technology (CST) parameters between eyes with primary open-angle glaucoma (POAG) and primary angle-closure glaucoma (PACG). Methods: A retrospective analysis was performed on data from 89 eyes with POAG and 83 eyes with PACG that had CST examinations. CST parameters were compared between eyes with POAG and those with PACG using a linear mixed model (LMM). Results: No differences were observed in age, central corneal thickness, intraocular pressure, or use of antiglaucoma eye drops between the two groups. Patients with PACG had a significantly shorter axial length (AL), a higher proportion of females, CST parameters, longer applanation 2 (A2) time, deeper A2 deformation amplitude, shorter peak distance, longer whole eye movement, and longer whole eye movement time than patients with POAG. The highest concavity (HC) length and PD showed a significant positive correlation with AL. However, A1 length, A1 deformation amplitude, A2 time, A2 velocity, A2 length, A2 deformation amplitude, HC time, whole eye movement, and whole eye movement time were negatively correlated with AL. Conclusions: The biomechanical properties of the cornea differed between POAG and PACG. In some parts, AL differences between the POAG and PACG groups might contribute to the variation in CST parameters.
Swiss Vascular Biobank: Evaluation of Optimal Extraction Method and Admission Solution for Preserving RNA from Human Vascular Tissue
Authors: Pelisek Jaroslav , Yundung Yankey , Reutersberg Benedikt , Meuli Lorenz , Rössler Fabian , Rabin Laetitia , Kopp Reinhard , Zimmermann Alexander
Published: August 2023

Proper biobanking is essential for obtaining reliable data, particularly for next-generation sequencing approaches. Diseased vascular tissues, having extended atherosclerotic pathologies, represent a particular challenge due to low RNA quality. In order to address this issue, we isolated RNA from vascular samples collected in our Swiss Vascular Biobank (SVB); these included abdominal aortic aneurysm (AAA), peripheral arterial disease (PAD), healthy aorta (HA), and muscle samples. We used different methods, investigated various admission solutions, determined RNA integrity numbers (RINs), and performed expression analyses of housekeeping genes (ACTB, GAPDH), ribosomal genes (18S, 28S), and long non-coding RNAs (MALAT1, H19). Our results show that RINs from diseased vascular tissue are low (2–4). If the isolation of primary cells is intended, as in our SVB, a cryoprotective solution is a better option for tissue preservation than RNAlater. Because RNA degradation proceeds randomly, controls with similar RINs are recommended. Otherwise, the data might convey differences in RNA degradation rather than the expressions of the corresponding genes. Moreover, since the 18S and 28S genes in the diseased vascular samples were degraded and corresponded with the low RINs, we believe that DV200, which represents the total RNA’s disintegration state, is a better decision-making aid in choosing samples for omics analyses.
Everyday Cardiac Surgery in Jehovah‘s Witnesses of Typically Advanced Age: Clinical Outcome and Matched Comparison
Authors: Hartrumpf Martin , Kuehnel Ralf-Uwe , Ostovar Roya , Schroeter Filip , Albes Johannes M.
Published: August 2023

Background and Objectives: Jehovah’s Witnesses (JW) reject the transfusion of blood components based on their religious beliefs, even if they are in danger of harm or death. In cardiac surgery, this significantly reduces the margin of safety and leads to ethical conflicts. Informed consent should be carefully documented and the patient’s family should be involved. This study aims to compare the postoperative course of JW who underwent major cardiac surgery with a similar population of non-Witnesses (NW). Patients and Methods: Demographic, procedural, and postoperative data of all consecutive JW who underwent cardiac surgery at our institution were obtained from the records. They were compared with a propensity-score-matched group of NW. Anemic JW were treated with erythropoietin and/or iron as needed. Cardiac surgery was performed by experienced surgeons using median sternotomy and cardiopulmonary bypass. Common blood-sparing techniques were routinely used. Periprocedural morbidity and mortality were statistically evaluated for both groups. Results: A total of 32 JW and 64 NW were part of the matched dataset, showing no demographic or procedural differences. EPO was used preoperatively in 34.4% and postoperatively in 15.6% of JW but not in NW. Preoperative hemoglobin levels were similar (JW, 8.09 ± 0.99 mmol/L; NW, 8.18 ± 1.06; p = 0.683). JW did not receive any transfusions except for one who revoked, while NW transfusion rates were 2.5 ± 3.1 units for red cells (p < 0.001) and 0.3 ± 0.8 for platelets (p = 0.018). Postoperative levels differed significantly for hemoglobin (JW, 6.05 ± 1.00 mmol/L; NW, 6.88 ± 0.87; p < 0.001), and hematocrit (JW, 0.29 ± 0.04; NW, 0.33 ± 0.04; p < 0.001) but not for creatinine. Early mortality was similar (JW, 6.3%; NW, 4.7%; p = 0.745). There were more pacemakers and pneumonias in JW, while all other postoperative conditions were not different. Conclusions: Real-world data indicate that Jehovah’s Witnesses can safely undergo cardiac surgery provided that patients are preconditioned and treated by experienced surgeons who use blood-saving strategies. Postoperative anemia is observed but does not translate into a worse clinical outcome. This is consistent with other studies. Finally, the results of this study suggest that all patients should benefit from optimal pretreatment and blood-sparing strategies in cardiac surgery, not just Jehovah’s Witnesses.
Effect of Injury Patterns on the Development of Complications and Trauma-Induced Mortality in Patients Suffering Multiple Trauma
Authors: Becker Nils , Hammen Antonia , Bläsius Felix , Weber Christian David , Hildebrand Frank , Horst Klemens
Published: August 2023

Patients that suffer from severe multiple trauma are highly vulnerable to the development of complications that influence their outcomes. Therefore, this study aimed to evaluate the risk factors that can facilitate an early recognition of adult patients at risk. The inclusion criteria were as follows: admission to a level 1 trauma center, injury severity score (ISS) ≥ 16 (severe injury was defined by an abbreviated injury score (AIS) ≥ 3) and ≥18 years of age. Injury- and patient-associated factors were correlated with the development of four complication clusters (surgery-related, infection, thromboembolic events and organ failure) and three mortality time points (immediate (6 h after admission), early (>6 h–72 h) and late (>72 h) mortality). Statistical analysis was performed using a Chi-square, Mann–Whitney U test, Cox hazard regression analysis and binominal logistic regression analysis. In total, 383 patients with a median ISS of 24 (interquartile range (IQR) 17–27) were included. The overall mortality rate (27.4%) peaked in the early mortality group. Lactate on admission significantly correlated with immediate and early mortality. Late mortality was significantly influenced by severe head injuries in patients with a moderate ISS (ISS 16–24). In patients with a high ISS (≥25), late mortality was influenced by a higher ISS, older age and higher rates of organ failure. Complications were observed in 47.5% of all patients, with infections being seen most often. The development of complications was significantly influenced by severe extremity injuries, the duration of mechanical ventilation and length of ICU stay. Infection remains the predominant posttraumatic complication. While immediate and early mortality is mainly influenced by the severity of the initial trauma, the rates of severe head injuries influence late mortality in moderate trauma severity, while organ failure remains a relevant factor in patients with a high injury severity.