bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of Ending the Nationwide Free School Fruit Scheme on the Intake of Fruits, Vegetables, and Unhealthy Snacks in Norwegian School Children Aged 10–12 Years
Authors: Richardsen Helene Kristin , Bere Elling Tufte , Stea Tonje Holte , Klepp Knut-Inge , Engeset Dagrun
Published: January 2023

The Norwegian authorities started a nationwide free school fruit program in 2007, implemented in all secondary schools (grades 8–10) and combined schools (grades 1–10) in Norway. The program ended in 2014. This study evaluates the effect of ending the nationwide free school fruit program on the consumption of fruit, vegetables, and unhealthy snacks among Norwegian sixth and seventh graders. The study sample consists of pupils at 18 schools that participated in all data collections in the Fruits and Vegetables Make the Marks project (FVMM), initiated in 2001, with new data collections in 2008 and 2018. Four of the schools were combined schools, therefore children in sixth and seventh grade at these schools received free fruit in 2008 (intervention schools), and fourteen schools did not (control schools). Between 2008 and 2018, pupils at the intervention schools ate a lower proportion of fruits and vegetables per school week, and the consumption of unhealthy snacks increased compared to the control schools. Completion of the free fruit program was not significantly different for boys and girls, or low and high parental education. The results indicate that the end of the free school fruit program resulted in less healthy eating habits among children.
Megasporogenesis and Megagametogenesis in Coelogyne speciosa subsp. fimbriata (J.J.Sm.) Gravendeel (Orchidaceae Juss.)
Authors: Kolomeitseva Galina , Koval Vladimir , Ryabchenko Andrey , Babosha Alexander
Published: January 2023

Understanding the critical stages in ovule development is essential for optimizing in vitro seed propagation, cryopreservation, and indirect somatic plant embryogenesis. We studied the main stages of the megasporogenesis and megagametogenesis of Coelogyne speciosa subsp. fimbriata (J.J.Sm.) Gravendeel by confocal laser scanning microscopy. The ovule is anatropic, tenuinucellate, bitegmal, and funicular. The embryo sac is monosporic, Polygonum-type, bipolar, and usually 8-nuclear, but in cases of a reduction in the last mitotic division, it is 6-nuclear. Endosperm formation was not detected. The formation of a functional megaspore occurred 65–70 days after pollination (DAP), while the formation of a mature embryo sac and fertilization occurred after 85–100 DAP.
Polarity-Based Sentiment Analysis of Georeferenced Tweets Related to the 2022 Twitter Acquisition
Authors: Schmidt Sebastian , Zorenböhmer Christina , Arifi Dorian , Resch Bernd
Published: January 2023

Twitter, one of the most important social media platforms, has been in the headlines regularly since its acquisition by Elon Musk in October 2022. This acquisition has had a strong impact on the employees, functionality, and discourse on Twitter. So far, however, there has been no analysis that examines the perception of the acquisition by the users on the platform itself. For this purpose, in this paper, we use georeferenced Tweets from the US and classify them using a polarity-based sentiment analysis. We find that the number of Tweets about Twitter and Elon Musk has increased significantly, as have negative sentiments on the subject. Using a spatial hot spot analysis, we find distinct centres of discourse, but no clear evidence of their significant change over time. On the West Coast, however, we suspect the first signs of polarisation, which could be an important indication for the future development of discourse on Twitter.
Measuring the Level of Responsible Consumption Influenced by the Digital Environment: A Case Study of University of Barcelona and Bielefeld University Students
Authors: Terenteva Daria , Rodionov Dmitry , Konnikova Olga , Konnikov Evgenii
Published: January 2023

The problem of consumerism is very relevant in the global context, as it is directly linked to the deteriorating ecological situation. Since the physical and digital environments are closely linked, the authors try to explore their interdependence in the context of responsible consumption. This research aimed to construct a tool for a comparative assessment of responsible consumption within physical and digital environments. Based on deep theoretical analysis, the authors developed the methodology of measuring the level of responsible consumption represented by the following categories: food, waste, transport, clothing, energy and water consumption, and active participation. According to this analytical system, a survey was developed and conducted among students at the University of Barcelona and the University of Bielefeld, and the results were transformed into a fuzzy-multiple model. In the digital environment analysis, the authors used an algorithm for assessing the relative presence of certain tonal and content-thematic components in the digital background of the subject under study through using the Python 3 programming language. The algorithm was tested for the assessment of the level of responsible consumption among members of two social network student communities, represented by the official accounts of the University of Barcelona and the University of Bielefeld on Instagram. The correlation between the indicators of the physical and digital environment was proved as a result of comparative analysis. The scientific novelty of the study lies in the proposed methodology, which aims to conduct a comparative analysis of responsible consumption in the physical and digital environments, while using valid but different indicators to assess consumer behavior in each of the environments. The practical implementation of the study is that the proposed methodology allows universities to investigate how their students adhere to responsible consumption and to what extent the topic of responsible consumption is expressed in informational accounts of universities and, in accordance with this, to develop measures to influence both of these parameters.
An Efficient Two-Stage Network Intrusion Detection System in the Internet of Things
Authors: Zhang Hongpo , Zhang Bo , Huang Lulu , Zhang Zhaozhe , Huang Haizhaoyang
Published: January 2023

Internet of Things (IoT) devices and services provide convenience but face serious security threats. The network intrusion detection system is vital in ensuring the security of the IoT environment. In the IoT environment, we propose a novel two-stage intrusion detection model that combines machine learning and deep learning to deal with the class imbalance of network traffic data and achieve fine-grained intrusion detection on large-scale flow data. The superiority of the model is verified on the newer and larger CSE-CIC-IDS2018 dataset. In Stage-1, the LightGBM algorithm recognizes normal and abnormal network traffic data and compares six classic machine learning techniques. In Stage-2, the Convolutional Neural Network (CNN) performs fine-grained attack class detection on the samples predicted to be abnormal in Stage-1. The Stage-2 multiclass classification achieves a detection rate of 99.896%, F1score of 99.862%, and an MCC of 95.922%. The total training time of the two-stage model is 74.876 s. The detection time of a sample is 0.0172 milliseconds. Moreover, we set up an optional Synthetic Minority Over-sampling Technique based on the imbalance ratio (IR-SMOTE) of the dataset in Stage-2. Experimental results show that, compared with SMOTE technology, the two-stage intrusion detection model can adapt to imbalanced datasets well and reveal higher efficiency and better performance when processing large-scale flow data, outperforming state-of-the-art intrusion detection systems.
Automatic Identification and Geo-Validation of Event-Related Images for Emergency Management
Authors: Vernier Marco , Farinosi Manuela , Foresti Alberto , Foresti Gian Luca
Published: January 2023

In recent years, social platforms have become integrated in a variety of economic, political and cultural domains. Social media have become the primary outlets for many citizens to consume news and information, and, at the same time, to produce and share online a large amount of data and meta-data. This paper presents an innovative system able to analyze visual information shared by citizens on social media during extreme events for contributing to the situational awareness and supporting people in charge of coordinating the emergency management. The system analyzes all posts containing images shared by users by taking into account: (a) the event class and (b) the GPS coordinates of the geographical area affected by the event. Then, a Single Shot Multibox Detector (SSD) network is applied to select only the posted images correctly related to the event class and an advanced image processing procedure is used to verify if these images are correlated with the geographical area where the emergency event is ongoing. Several experiments have been carried out to evaluate the performance of the proposed system in the context of different emergency situations caused by earthquakes, floods and terrorist attacks.
Proteome Analysis of Male Accessory Gland Secretions in the Diamondback Moth, Plutella xylostella (Lepidoptera: Plutellidae)
Authors: Wu Li-Juan , Li Fan , Song Yue , Zhang Zhan-Feng , Fan Yong-Liang , Liu Tong-Xian
Published: January 2023

In insects, male accessory gland proteins (ACPs) are important reproductive proteins secreted by male accessory glands (MAGs) of the internal male reproductive system. During mating, ACPs are transferred along with sperms inside female bodies and have a significant impact on the post-mating physiology changes of the females. Under sexual selection pressures, the ACPs exhibit remarkably rapid and divergent evolution and vary from species to species. The diamondback moth, Plutella xylostella (L.) (Lepidoptera: Plutellidae), is a major insect pest of cruciferous vegetables worldwide. Mating has a profound impact on the females’ behavior and physiology in this species. It is still unclear what the ACPs are in this species. In this study, two different proteomic methods were used to identify ACPs in P. xylostella. The proteins of MAGs were compared immediately before and after mating by using a tandem mass tags (TMT) quantitative proteomic analysis. The proteomes of copulatory bursas (CB) in mated females shortly after mating were also analyzed by the shotgun LC-MS/MS technique. In total, we identified 123 putative secreted ACPs. Comparing P. xylostella with other four insect ACPs, trypsins were the only ACPs detected in all insect species. We also identified some new insect ACPs, including proteins with chitin binding Peritrophin-A domain, PMP-22/ EMP/ MP20/ Claudin tight junction domain-containing protein, netrin-1, type II inositol 1,4,5-trisphosphate 5-phosphatase, two spaetzles, allatostatin-CC, and cuticular protein. This is the first time that ACPs have been identified and analyzed in P. xylostella. Our results have provided an important list of putative secreted ACPs, and have set the stage for further exploration of the functions of these putative proteins in P. xylostella reproduction.
Mating Competitiveness of Male Spodoptera frugiperda (Smith) Irradiated by X-rays
Authors: Jiang Shan , Sun Xiao-Ting , Ge Shi-Shuai , Yang Xian-Ming , Wu Kong-Ming
Published: January 2023

Spodoptera frugiperda, an invasive pest, has a huge impact on food production in Asia and Africa. The potential and advantages of sterile insect techniques for the permanent control of S. frugiperda have been demonstrated, but the methods for their field application are still unavailable. For the purposes of this study, male pupae of S. frugiperda were irradiated with an X-ray dose of 250 Gy to examine the effects of both the release ratio and the age of the irradiated males on the sterility of their offspring. The control effect of the irradiated male release ratio on S. frugiperda was evaluated using field-cage experiments in a cornfield. The results showed that when the ratio of irradiated males to non-irradiated males reached 12:1, the egg-hatching rate of the offspring of S. frugiperda decreased to less than 26%, and there was also no significant difference in mating competitiveness among the different ages. Field-cage testing showed that when irradiated males were released at ratios of 12:1–20:1 to normal males, the leaf protection effect for the corn reached 48–69% and the reduction in the insect population reached 58–83%. In this study, an appropriate release ratio is suggested, and the mating competitiveness of irradiated and non-irradiated males of S. frugiperda is investigated, thus providing a theoretical basis for the use of sterile insect techniques to control S. frugiperda.
Density, Temperature, and Comingled Species Affect Fitness within Carrion Communities: Coexistence in Phormia regina and Lucilia sericata (Diptera: Calliphoridae)
Authors: Okpara Patricia , VanLaerhoven Sherah
Published: January 2023

Blow fly (Diptera: Calliphoridae) interactions vary between competition and facilitation. Female blow flies engage in aggregated egg-laying, resulting in larval feeding masses differing in density and species composition. Numerous species are abundant within the same season, and some oviposit near or directly on eggs of other species, modifying their oviposition location choice depending on the presence or absence of other species. The ability to coexist on carrion, a temporary resource, was successfully attributed to resource, spatial, and temporal heterogeneity. Despite these broad categorizations, the specific mechanisms of coexistence within blow fly communities require further investigation. This study investigates variation in temperature and larval density as potential mechanisms of coexistence between two forensically important blow fly species: Lucilia sericata Meigen and Phormia regina Meigen (Diptera: Calliphoridae). Larval density, species ratio mix, and ambient temperature during development were manipulated in the presence of conspecifics and heterospecifics in the laboratory, and the fitness of each species was measured. In heterospecific treatments, the survival and body size of P. regina increased even at high ambient temperatures. In contrast, the survival of L. sericata remained unaffected by density or presence of heterospecifics, whereas body size increased in L. sericata-dominated heterospecific treatments depending on temperature and density. The negative effects of density were observed at high ambient temperatures, suggesting that density impacts are a function of ambient temperature. Overall, species coexistence was dependent on temperature, which mediated the outcome of species interactions.
Biomarkers and Predictive Factors for Treatment Response to Tumor Necrosis Factor-α Inhibitors in Patients with Psoriasis
Authors: Hagino Teppei , Saeki Hidehisa , Kanda Naoko
Published: January 2023

We performed a retrospective and observational study of patients with psoriasis. The aim of this study was to define the laboratory indicators reflecting the treatment response to tumor necrosis factor (TNF)-α inhibitors and the predictors for the treatment response. From January 2010 to June 2022, 28, 15 and 12 patients with psoriasis were treated with infliximab (IFX), adalimumab (ADA) and certolizumab pegol (CZP), respectively. The values of C-reactive protein (CRP), platelet to lymphocyte ratio (PLR), neutrophil to lymphocyte ratio and monocyte to lymphocyte ratio decreased in parallel with psoriasis area and severity index (PASI) at weeks 12 and 52 of treatment. The percentage reduction of the CRP was correlated with that of the PASI at week 52 in all patients and subgroups treated with IFX. The percentage reduction of the PLR was correlated with that of the PASI at week 52 in all patients. Linear multivariate regression analyses revealed that the presence of scalp lesions was associated with a high percentage reduction of the PASI at week 52 in the ADA subgroup. The CRP and PLR might act as biomarkers reflecting the treatment response to TNF-α inhibitors in patients with psoriasis. The presence of scalp lesions might be a predictive factor for a high treatment response to ADA in patients with psoriasis.
Term Idiopathic Polyhydramnios, and Labor Complications
Authors: Bas Lando Maayan , Urman Marnina , Weiss Yifat , Srebnik Naama , Grisaru-Granovsky Sorina , Farkash Rivka , Sela Hen Y.
Published: January 2023

Background and Aim: Polyhydramnios is associated with an increased risk of various adverse pregnancy outcomes, yet complications during labor have not been sufficiently studied. We assessed the labor and perinatal outcomes of idiopathic polyhydramnios during term labor. Methods: Retrospective cohort study at a tertiary medical center between 2010 and 2014. Women with idiopathic polyhydramnios defined as an amniotic fluid index (AFI) greater than 24 cm or a deep vertical pocket (DVP) > 8 cm (cases) were compared with women with a normal AFI (5–24 cm) (controls). Statistics: Descriptive, means ± SDs, medians + IQR. Comparisons: chi-square, Fisher’s exact test, Mann–Whitney Test, multivariate logistic models. Results: During the study period 11,065 women had ultrasound evaluation completed by a sonographer within two weeks of delivery. After excluding pregnancies complicated by diabetes (pre-gestational or gestational), fetal anomalies, IUFD, multifetal pregnancies, elective cesarean deliveries (CD) or missing data, we included 750 cases and 7000 controls. The degree of polyhydramnios was mild in 559 (75.0%) cases (AFI 24–30 cm or DVP 8–12 cm), moderate in 137 (18.0%) cases (30–35 cm or DVP 12–15 cm) and severe in 54 (7.0%) cases (AFI >35 cm or DVP > 15 cm). Idiopathic polyhydramnios was associated with a higher rate of CD 9.3% vs. 6.2%, p = 0.004; a higher rate of macrosomia 22.8% vs. 7.0%, p < 0.0001; and a higher rate of neonatal respiratory complications 2.0% vs. 0.8%, p = 0.0001. A multivariate regression analysis demonstrated an independent relation between polyhydramnios and higher rates of CD, aOR 1.62 (CI 1.20–2.19 p = 0.002) and composite adverse neonatal outcome aOR 1.28 (CI 1.01–1.63 p = 0.043). Severity of polyhydramnios was significantly associated with higher rates of macrosomia and CD (p for trend <0.01 in both). Conclusions: The term idiopathic polyhydramnios is independently associated with macrosomia, CD and neonatal complications. The severity of polyhydramnios is also associated with macrosomia and CD.
Three Types of Endometriosis: Pathogenesis, Diagnosis and Treatment. State of the Art
Authors: Imperiale Ludovica , Nisolle Michelle , Noël Jean-Christophe , Fastrez Maxime
Published: January 2023

At present, there is no curative treatment for endometriosis. Medical management and surgical treatment do not provide long-term relief. A detailed understanding of its pathophysiology is mandatory in order to facilitate both the diagnosis and treatment. The delay that typically precedes proper diagnosis (6 to 7 years) is probably one of the most challenging aspects of endometriosis management. In 2012, the total cost per woman due to endometriosis was estimated to be 9579€ per year in a multicenter study across the USA and Europe. According to their physiopathology and their localization, ectopic endometrial lesions, consisting of endometrial glands and stroma, can be divided into three different types: superficial peritoneal endometriosis (SPE), ovarian endometrioma (OMA), and deep infiltrating endometriosis (DIE). The following paper aims to review the available data in the literature on the pathogenesis, diagnosis, and treatment of different types of endometriosis.
Controversial Outcomes in Neck Rehabilitation between Surgically and Conservatively Treated Patients—Results of an Observational Study
Authors: Missmann Martin , Grote Vincent , Riedl David , Grenier Jean-Pascal , Fischer Michael J.
Published: January 2023

The present study aimed to compare changes during inpatient rehabilitation between conservatively and surgically treated patients. A total of n = 162 patients with cervical spine complaints were included in the study (n = 107 conservatively treated, n = 55 after surgery). Patients completed disease-specific (NDI) and generic (NPRS, EQ-5D-5L, HAQ) patient reported outcome measures (PROMs) before and after rehabilitation. In addition, the range of motion (ROM) in the transversal plane of the cervical spine was measured. Changes and correlations between PROMs and ROM values during rehabilitation were assessed. The influence of moderating factors on NDI outcomes was examined. Significant improvements with large effect sizes were found in PROMs and ROM (all p < 0.001). The conservatively treated patients showed significantly greater NDI improvements than operated patients (p = 0.050), but a greater proportion of poor performance in ROM (p = 0.035). Baseline NDI (β = 0.66), HAQ (β = 0.14), and ROM scores (β = −0.17) explained 63.7% of the variance in NDI after rehabilitation. Both patient groups showed different outcomes. The findings of this study indicate that the unique needs of patients may require different therapeutic interventions and highlight the importance of using multidimensional outcome measures when implementing a multimodal rehabilitation approach.
Detecting Macular Disease Based on Optical Coherence Tomography Using a Deep Convolutional Network
Authors: Han Jinyoung , Choi Seong , Park Ji In , Hwang Joon Seo , Han Jeong Mo , Ko Junseo , Yoon Jeewoo , Hwang Daniel Duck-Jin
Published: January 2023

Neovascular age-related macular degeneration (nAMD) and central serous chorioretinopathy (CSC) are two of the most common macular diseases. This study proposes a convolutional neural network (CNN)-based deep learning model for classifying the subtypes of nAMD (polypoidal choroidal vasculopathy, retinal angiomatous proliferation, and typical nAMD) and CSC (chronic CSC and acute CSC) and healthy individuals using single spectral–domain optical coherence tomography (SD–OCT) images. The proposed model was trained and tested using 6063 SD–OCT images from 521 patients and 47 healthy participants. We used three well-known CNN architectures (VGG–16, VGG–19, and ResNet) and two customized classification layers. Additionally, transfer learning and mix–up-based data augmentation were applied to improve robustness and accuracy. Our model demonstrated high accuracies of 99.7% and 91.1% in the nAMD and CSC classification and retinopathy (nAMD and CSC) subtype classification, including normal participants, respectively. Furthermore, we performed an external test to compare the classification accuracy with that of eight ophthalmologists, and our model showed the highest accuracy. The region determined to be important for classification by the model was confirmed using gradient-weighted class activation mapping. The model’s clinical criteria were similar to that of the ophthalmologists.
Implant-Supported Overdentures: Current Status and Preclinical Testing of a Novel Attachment System
Authors: Wendler Frank , Diehl Lisa , Shayanfard Pejman , Karl Matthias
Published: January 2023

Numerous attachment systems exist for implant-supported overdentures, with each having specific limitations in terms of retention, cost, wear, maintenance and cleanability. A retrospective analysis of patients restored with implant-supported overdentures using bars, telescopic crowns and Locator-type attachments was performed and the patients were interviewed. An in vitro strain gauge study compared telescopic crowns, Locator-type attachments and a novel flexible attachment system employing a shape memory alloy (NiTi) with respect to peri-implant strain development during insertion, loading and removal of an overdenture. A significantly lower number of attachment-related complications was observed in bars as compared to telescopic crowns (p = 0.00007) and Locator-type attachments (p = 0.00000), respectively. Greater overall patient satisfaction was noted in bar-retained restorations while Locator-type attachments led to lower levels of satisfaction regarding prosthesis retention. In vitro, telescopic crowns caused maximum strain development during prosthesis insertion and loading, while during removal this was observed in Locators with white retentive inserts. NiTi attachments caused significantly lower strain development during insertion as compared to telescopic crowns (p = 0.027). During loading, NiTi attachments caused significantly lower strain development than Locators with blue retentive inserts (p = 0.039). During removal, NiTi attachments caused significantly less strain development as compared to Locators with white retentive inserts (p = 0.027). Positional discrepancies between male and female attachment parts affected the retention and reaction force between both components, which may be minimized by using the novel NiTi attachment system. This may be beneficial in terms of component wear and implant loading.
A Systematic Review on Add-On Psychotherapy in Schizophrenia Spectrum Disorders
Authors: Modesti Martina Nicole , Arena Jan Francesco , Palermo Natalia , Del Casale Antonio
Published: January 2023

Schizophrenia spectrum disorders represent a varied class of mental illnesses characterised by psychosis. In addition to negative and positive symptoms, a significant lack of insight often hinders the therapeutic process. We performed an overview of the existing literature concerning these disorders to summarise the state of knowledge in the psychotherapies applied to treating psychotic symptoms. We searched the PubMed database, including randomised controlled and clinical trials, including 17 studies conducted on 1203 subjects. Psychotherapy of schizophrenia spectrum disorders can improve social functioning and positive symptoms, as well as many other symptomatic areas, and could therefore be considered a helpful adjunctive treatment of schizophrenia spectrum disorders. Among cognitive-behavioural therapies and the newest derived approaches, there is evidence that they can improve different psychotic symptoms. On the other hand, psychodynamic psychotherapies can have a positive influence on psychotic symptoms as well. Further studies are needed to identify better-tailored treatment protocols for schizophrenia spectrum disorders.
The Belgian Diabetes in Pregnancy Follow-Up Study (BEDIP-FUS): A Multi-Centric Prospective Cohort Study on the Long-Term Metabolic Risk across Different Degrees of Gestational Glucose Intolerance: Methodology and Design
Authors: Raets Lore , Van Hoorenbeeck Kim , Maes Toon , Vercammen Chris , De Block Christophe , Dirinck Eveline , Van Pottelbergh Inge , Wierckx Katrien , Laenen Annouschka , Bogaerts Annick , Mathieu Chantal , Benhalima Katrien
Published: January 2023

The Belgian Diabetes in Pregnancy follow-up study (BEDIP-FUS) aims to investigate the impact of body mass index (BMI), adiposity and different degrees of glucose intolerance on the metabolic profile and future risk for type 2 diabetes (T2D) in women and offspring five years after delivery in the BEDIP study. The BEDIP study was a prospective cohort study to evaluate different screening strategies for gestational diabetes (GDM) based on the 2013 WHO criteria. The aim of the BEDIP-FUS is to recruit 375 women–offspring pairs, stratified according to three different subgroups based on the antenatal result of the glucose challenge test (GCT) and oral glucose tolerance test (OGTT) during the BEDIP pregnancy. The follow-up visit consists of a 75 g OGTT, anthropometric measurements and questionnaires for the mothers, and a fasting blood sample with anthropometric measurements for the child. Primary outcome for the mother is glucose intolerance defined by the American Diabetes Association criteria and for the offspring the BMI z-score. Recruitment began in January 2021. The BEDIP-FUS study will help to better individualize follow-up in women with different degrees of hyperglycemia in pregnancy and their offspring.
Problematic Internet Use among Adults: A Cross-Cultural Study in 15 Countries
Authors: Lopez-Fernandez Olatz , Romo Lucia , Kern Laurence , Rousseau Amélie , Lelonek-Kuleta Bernadeta , Chwaszcz Joanna , Männikkö Niko , Rumpf Hans-Jürgen , Bischof Anja , Király Orsolya , Gässler Ann-Kathrin , Graziani Pierluigi , Kääriäinen Maria , Landrø Nils Inge , Zacarés Juan José , Chóliz Mariano , Dufour Magali , Rochat Lucien , Zullino Daniele , Achab Sophia , Demetrovics Zsolt , Griffiths Mark D. , Kuss Daria J.
Published: January 2023

Background: The present study compared adult usage patterns of online activities, the frequency rate of problematic internet use (PIU), and risk factors (including the psychopathology associated with PIU, i.e., distress and impulsivity) among adults in 15 countries from Europe, America, and Asia. Methods: A total of 5130 adults from Belgium, Finland, Germany, Italy, Spain, France, Switzerland, Hungary, Poland, UK, Norway, Peru, Canada, US, and Indonesia completed an online survey assessing PIU and a number of psychological variables (i.e., depression, anxiety, stress, and impulsivity). The sample included more females, with a mean age of 24.71 years (SD = 8.70). Results: PIU was slightly lower in European countries (rates ranged from 1.1% in Finland to 10.1% in the UK, compared to 2.9% in Canada and 10.4% in the US). There were differences in specific PIU rates (e.g., problematic gaming ranged from 0.4% in Poland to 4.7% in Indonesia). Regression analyses showed that PIU was predicted by problematic social networking and gaming, lack of perseverance, positive urgency, and depression. Conclusions: The differences in PIU between countries were significant for those between continental regions (Europe versus non-European countries). One of the most interesting findings is that the specific PIU risks were generally low compared to contemporary literature. However, higher levels of PIU were present in countries outside of Europe, although intra-European differences existed.
Assessment of Changes in Serum C-Reactive Protein Levels in Patients after Ischemic Stroke Undergoing Rehabilitation—A Retrospective Observational Study
Authors: Borowicz Wojciech , Ptaszkowski Kuba , Ptaszkowska Lucyna , Murawska-Ciałowicz Eugenia , Rosińczuk Joanna
Published: January 2023

Inflammation plays a key role in the pathogenesis and prognosis of ischemic stroke. C-reactive protein (CRP) is an inflammatory biomarker of inflammation and may reflect the progression of vascular disease. Using a biomarker such as CRP to predict recovery rather than mortality may present clinical value in providing rehabilitation. The primary aim of the study was to analyze changes in serum CRP levels in patients after ischemic stroke during the regenerative-compensatory period and to assess the usefulness of CRP as a potential biomarker during the rehabilitation period. The project was carried out as a retrospective analysis of prospectively collected data from post-stroke patients from the Department of Neurological Rehabilitation of the Regional Specialist Hospital in Wrocław. A group of 52 patients, after their first-ever ischemic stroke with subsequent hemiplegia, was finally qualified to participate in the study. Serum CRP levels were determined during blood laboratory tests. The Modified Rankin Scale (mRS) and Barthel Index (BI) were used to assess functional outcomes. Rehabilitation using neurophysiological methods was applied five days a week (each session lasted 60 min, and the entire period was 42 days). At the first test, serum CRP levels were found to be above 5 mg/L in 19 patients, the second test in 12 patients, the third test in five patients, and the fourth test in 9 patients. Only three patients had values higher than 5 mg/L in all consecutive assessments (p > 0.05). There was a statistically significant increase in BI scores after therapy (p < 0.001) as well as a decrease in the mRS score by 2.2 points (p < 0.001), in CRP values by 5.02 mg/L (p = 0.019), and in cortisol levels by 2.5 nmol/L (p = 0.002). Statistically significant relationships were observed between the CRP levels after rehabilitation and the corresponding mRS scores (rs = 0.29, p = 0.038). Furthermore, the effect of BMI on CRP levels was demonstrated (B = 0.20, p = 0.038). In conclusion, despite demonstrating a significant relationship between CRP levels and corresponding mRS scores, CRP levels alone may not serve as an independent predictor of long-term functional outcomes in ischemic stroke patients undergoing rehabilitation.
Bilateral Atypical Femoral Fractures after Bisphosphonate Treatment for Osteoporosis: A Literature Review
Authors: Hwang SeokJoon , Seo Minsu , Lim Dongin , Choi Min Suk , Park Jin-Woo , Nam Kiyeun
Published: January 2023

Introduction: This literature review aimed to investigate the incidence, anatomical concerns, etiology, symptoms, diagnostic tools, management, and prognosis of bisphosphonate (BP)—associated bilateral atypical femoral fractures (AFFs). Methods: The PubMed, Cochrane Library, Web of Sciences, and CINAHL databases were searched up to 20 March 2022. All cases of bilateral AFFs were included, excluding those without any bisphosphonate treatment information and those in which the femoral fracture did not precisely fit into the diagnostic criteria for AFF. Results: We identified 43 patients with bilateral AFFs associated with BP use and conducted a comprehensive analysis. Among 43 patients, 29 (67%) had prodromal symptoms. Regarding the simultaneity of fracture, 21 cases (49%) occurred simultaneously, and 22 cases (51%) occurred sequentially. Alendronate was the most commonly used BP treatment (59%). Regardless of the medication type, BP intake duration was more than 5 years in 77%. The initial diagnosis was performed using X-rays in all cases. A total of 53% of patients had complete fractures, and all patients underwent surgical treatment. Among the remaining patients with incomplete fractures, 18% and 29% received surgical and medical treatments, respectively. After BP discontinuation, teriparatide was most commonly used (63%). Conclusions: The careful evaluation of relevant imaging findings in patients with thigh/groin pain allows the identification of early incomplete fractures and timely management. Since the rate of contralateral side fractures is also high, imaging studies should be performed on the asymptomatic contralateral side.
The Correlation between the Results of the Sniffin’ Sticks Test, Demographic Data, and Questionnaire of Olfactory Disorders in a Hungarian Population after a SARS-CoV-2 Infection
Authors: Molnár András , Maihoub Stefani , Mavrogeni Panayiota , Krasznai Magdolna , Tamás László , Kraxner Helga
Published: January 2023

Background: After a severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection, smell disorders frequently occur, significantly affecting patients’ quality of life (QoL). Methods: 110 patients with persistent olfactory disorder after coronavirus infection were enrolled. These patients underwent chemosensory testing using the Sniffin’ Sticks test, and completed the Questionnaire of Olfactory Disorders (QOD). Results: 30% of the patients reported anosmia, and 70% reported hyposmia. Upon comparing subjective and chemosensory testing categories, good category matching was observed in 75.3% (i.e., anosmia based on both methods in 10 and hyposmia in 48 cases). Statistical analysis using the Chi-square test revealed a significant result (p = 0.001 *). Between the TDI (i.e., Threshold, Discrimination, Identification) results of the three subjective report groups (i.e., hyposmia, anosmia, and parosmia), no significant differences were observed. When the TDI and QOD results were compared, no consistent significant correlations were found in most TDI and QOD outcomes. Between the TDI and Scale 2 results, a significant, although slight correlation was observed by the Spearman’s (rho = 0.213, p = 0.027 *) and Pearson’s (rho = 0.201, p = 0.037 *) tests. Conclusions: The nonsignificant correlation between objective and subjective methods suggests that these results should be interpreted independently. Moreover, adequate management is essential even in mild cases.
Towards the Clinical Application of Gene Therapy for Genetic Inner Ear Diseases
Authors: Lahlou Ghizlene , Calvet Charlotte , Giorgi Marie , Lecomte Marie-José , Safieddine Saaid
Published: January 2023

Hearing loss, the most common human sensory defect worldwide, is a major public health problem. About 70% of congenital forms and 25% of adult-onset forms of deafness are of genetic origin. In total, 136 deafness genes have already been identified and there are thought to be several hundred more awaiting identification. However, there is currently no cure for sensorineural deafness. In recent years, translational research studies have shown gene therapy to be effective against inherited inner ear diseases, and the application of this technology to humans is now within reach. We provide here a comprehensive and practical overview of current advances in gene therapy for inherited deafness, with and without an associated vestibular defect. We focus on the different gene therapy approaches, considering their prospects, including the viral vector used, and the delivery route. We also discuss the clinical application of the various strategies, their strengths, weaknesses, and the challenges to be overcome.
Long Pentraxin 3 as a New Biomarker for Diagnosis of Hip and Knee Periprosthetic Joint Infections
Authors: Loppini Mattia , Di Maio Marco , Avigni Roberta , Leone Roberto , Inforzato Antonio , Grappiolo Guido , Mantovani Alberto , Bottazzi Barbara
Published: January 2023

Background: Preoperative diagnosis of periprosthetic joint infections (PJIs) poses an unmet clinical challenge. The long pentraxin PTX3 is a component of the innate immune system involved in infection immunity. This study evaluated the potential of synovial and plasmatic PTX3 in the diagnosis of hip and knee PJIs. Methods: Consecutive total hip and knee arthroplasty (THA/TKA) revisions were prospectively included and classified as septic or aseptic according to the European Bone and Joint Infection Society (EBJIS) and Musculoskeletal Infection Society (MSIS) criteria. The concentration of PTX3 in plasma and synovial fluid samples was measured with ELISA. The AUC, threshold value, sensitivity, specificity, and positive and negative likelihood ratios were calculated using the ROC (receiver operating characteristic) curve method. Results: The study population included 128 patients (94 THAs; 34 TKAs). The AUC of the synovial PTX3 based on EBJIS criteria was 0.85 (p < 0.0001), with a sensitivity of 81.13% and a specificity of 93.33%. The AUC based on MSIS criteria was 0.95 (p < 0.001), with a sensitivity of 91.43% and a specificity of 89.25%. Plasmatic PTX3 failed to discriminate infected from non-infected patients. Conclusions: Synovial PTX3 demonstrated an excellent diagnostic potential in hip and knee PJIs, with a very high specificity irrespective of the diagnostic criteria for PJI.
Differential Modulation of the Excitatory and Inhibitory Synaptic Circuits of Retinal Ganglion Cells via Asiatic Acid in a Chronic Glaucoma Rat Model
Authors: Zhang Yinglei , Hu Chunyan , Niu Cong , Hong Jiaxu , Zhou Xujiao
Published: January 2023

Purpose: To investigate whether asiatic acid (AA) can improve the quantity and function of retinal ganglion cells (RGCs), as well as how AA regulates synaptic pathways in rat models with chronic glaucoma. Methods: In our study, a rat model of chronic glaucoma was prepared via the electrocoagulation of the episcleral veins. The numbers of surviving RGCs were counted via retrograde Fluorogold labeling, and a whole-cell patch clamp was used to clamp RGCs in normal retinal sections and in retinal sections 4 weeks after glaucoma induction. Results: Retrograde-Fluorogold-labeled RGC loss caused by persistent glaucoma was decreased by AA. Additionally, AA reduced the postsynaptic current produced by N-methyl-D-aspartate (NMDA) and diminished miniature glutamatergic excitatory neurotransmission to RGCs. On the other hand, AA increased miniature gamma-aminobutyric acid (GABA)-ergic inhibitory neurotransmission to RGCs and enhanced the GABA-induced postsynaptic current. The excitability of the RGC itself was also decreased by AA. RGCs in glaucomatous slices were less excitable because AA decreased their spontaneous action potential frequency and membrane potential, which led to a hyperpolarized condition. Conclusions: AA directly protected RGCs in a chronic glaucoma rat model by lowering their hyperexcitability. To enhance RGCs’ survival and function in glaucoma, AA may be a viable therapeutic drug.
Development of a Machine-Learning Model for Prediction of Extubation Failure in Patients with Difficult Airways after General Anesthesia of Head, Neck, and Maxillofacial Surgeries
Authors: Huang Huimin , Wang Jiayi , Zhu Ying , Liu Jinxing , Zhang Ling , Shi Wei , Hu Wenyue , Ding Yi , Zhou Ren , Jiang Hong
Published: January 2023

(1) Background: Extubation failure after general anesthesia is significantly associated with morbidity and mortality. The risk of a difficult airway after the general anesthesia of head, neck, and maxillofacial surgeries is significantly higher than that after general surgery, increasing the incidence of extubation failure. This study aimed to develop a multivariable prediction model based on a supervised machine-learning algorithm to predict extubation failure in adult patients after head, neck, and maxillofacial surgeries. (2) Methods: A single-center retrospective study was conducted in adult patients who underwent head, neck, and maxillofacial general anesthesia between July 2015 and July 2022 at the Shanghai Ninth People’s Hospital. The primary outcome was extubation failure after general anesthesia. The dataset was divided into training (70%) and final test sets (30%). A five-fold cross-validation was conducted in the training set to reduce bias caused by the randomly divided dataset. Clinical data related to extubation failure were collected and a stepwise logistic regression was performed to screen out the key features. Six machine-learning methods were introduced for modeling, including random forest (RF), k-nearest neighbor (KNN), logistic regression (LOG), support vector machine (SVM), extreme gradient boosting (XGB), and optical gradient boosting machine (GBM). The best performance model in the first cross-validation dataset was further optimized and the final performance was assessed using the final test set. (3) Results: In total, 89,279 patients over seven years were reviewed. Extubation failure occurred in 77 patients. Next, 186 patients with a successful extubation were screened as the control group according to the surgery type for patients with extubation failure. Based on the stepwise regression, seven variables were screened for subsequent analysis. After training, SVM and LOG models showed better prediction ability. In the k-fold dataset, the area under the curve using SVM and LOG were 0.74 (95% confidence interval, 0.55–0.93) and 0.71 (95% confidence interval, 0.59–0.82), respectively, in the k-fold dataset. (4) Conclusion: Applying our machine-learning model to predict extubation failure after general anesthesia in clinical practice might help to reduce morbidity and mortality of patients with difficult airways after head, neck, and maxillofacial surgeries.
Primary Stereotactic Radiosurgery Provides Favorable Tumor Control for Intraventricular Meningioma: A Retrospective Analysis
Authors: Umekawa Motoyuki , Shinya Yuki , Hasegawa Hirotaka , Katano Atsuto , Saito Nobuhito
Published: January 2023

The surgical resection of intraventricular meningiomas (IVMs) remains challenging because of their anatomically deep locations and proximity to vital structures, resulting in non-negligible morbidity and mortality rates. Stereotactic radiosurgery (SRS) is a safe and effective treatment option, providing durable tumor control for benign brain tumors, but its outcomes for IVMs have rarely been reported. Therefore, the goal of the present study was to evaluate the SRS outcomes for IVMs at our institution. This retrospective observational study included 11 patients with 12 IVMs with a median follow-up period of 52 months (range, 3–353 months) treated with SRS using the Leksell Gamma Knife. Nine (75%) tumors were located in the trigone of the lateral ventricle, two (17%) in the body of the lateral ventricle, and one (8%) in the third ventricle. Tumor control was achieved in all cases, and seven (55%) decreased in size. Post-SRS perifocal edema was observed in four (37%; three asymptomatic and one symptomatic but transient) patients, all of which were resolved by the last follow-up. SRS appears to provide safe and excellent tumor control for IVMs. A longer follow-up with a larger number of cases is desired for a more solid conclusion.
Atrial Fibrillation and the Risk of Ventricular Arrhythmias and Cardiac Arrest: A Nationwide Population-Based Study
Authors: Fawzy Ameenathul M. , Bisson Arnaud , Bodin Alexandre , Herbert Julien , Lip Gregory Y. H. , Fauchier Laurent
Published: January 2023

Background: Atrial fibrillation (AF) has been linked to an increased risk of ventricular arrhythmias (VAs) and sudden death. We investigated this association in hospitalised patients in France. Methods: All hospitalised patients from 2013 were identified from the French National database and included if they had at least 5 years of follow-up data. Results: Overall, 3,381,472 patients were identified. After excluding 35,834 with a history of VAs and cardiac arrest, 3,345,638 patients were categorised into two groups: no AF (n = 3,033,412; mean age 57.2 ± 21.4; 54.3% female) and AF (n = 312,226; 78.1 ± 10.6; 44.0% female). Over a median follow-up period of 5.4 years (interquartile range (IQR) 5.0–5.8 years), the incidence (2.23%/year vs. 0.56%/year) and risk (hazard ratio (HR) 3.657 (95% confidence interval (CI) 3.604–3.711)) of VAs and cardiac arrest were significantly higher in AF patients compared to non-AF patients. This was still significant after adjusting for confounders, with a HR of 1.167 (95% CI 1.111–1.226) and in the 1:1 propensity score-matched analysis (n = 289,332 per group), with a HR of 1.339 (95% CI 1.313–1.366). In the mediation analysis, the odds of cardiac arrest were significantly mediated by AF-associated VAs, with an OR of 1.041 (95% CI 1.040–1.042). Conclusion: In hospitalised French patients, AF was associated with an increased risk of VAs and sudden death.
Incidence of Febrile Seizures in Children with COVID-19
Authors: Han Min Jeong , Heo Jun Ho , Hwang Ji Seong , Jang Young-Taek , Lee Min , Kim Sun Jun
Published: January 2023

The coronavirus disease 2019 (COVID-19) has become a common cause of febrile seizures (FS), especially after the Omicron surge. This study aimed to determine the incidence of COVID-19-associated FS in children. The number of confirmed COVID-19 cases in patients aged below five years residing in the Jeonbuk province from January 2020 to June 2022 was obtained from official data provided by the Ministry of Public Administration and Security. During the same period, data on FS patients with COVID-19 were obtained from all local hospitals capable of FS treatment and were analyzed retrospectively. The number of children under five years of age in Jeonbuk was 62,772, of which 33,457 (53.2%) were diagnosed with COVID-19 during the study period. Of these, 476 patients (1.4%) required hospitalization, and 64 (0.19%, 44 boys; 68.8%: 20 girls; 31.2%) developed FS. All patients with FS presented with symptoms after the Omicron surge. Before the Omicron variant, 23.4% of the patients (89 of 381) required hospitalization; however, no children with COVID-19 were hospitalized for FS. Twenty-five patients (39.1%) had complex FS while one (1.6%) presented with febrile status epilepticus. Forty-two patients (65.6%) experienced first-time FS with an average of 1.5 convulsive events.
Non-Invasive Diagnostic Techniques in Dermatology
Authors: Mandel Victor Desmond , Ardigò Marco
Published: January 2023

The search to enhance the clinical diagnostic accuracy for identifying skin cancer has led to the development of non-invasive diagnostic techniques in dermatology including dermoscopy, reflectance confocal microscopy (RCM) and optical coherence tomography (OCT) [...]