bluuebunny/crossref_metadata_2025 huggingface dataset:
Association between Metabolic Obesity Phenotypes and the Burden of Hospitalized Postmenopausal Patients Concomitant with Osteoporosis: A Retrospective Cohort Study Based on the National Readmission Database
Authors: Jiang Jie , Xu Chao , Yuan Zinuo , Han Junming , Wang Zhixiang , Tian Yang , Dong Yingchun , Xia Weibo , Fan Xiude , Zhao Jiajun
Published: February 2023

Background: The present definition of obesity based on body mass index (BMI) is not accurate and effective enough to identify hospitalized patients with a heavier burden, especially for postmenopausal hospitalized patients concomitant with osteoporosis. The link between common concomitant disorders of major chronic diseases such as osteoporosis, obesity, and metabolic syndrome (MS) remains unclear. Here, we aim to evaluate the impact of different metabolic obesity phenotypes on the burden of postmenopausal hospitalized patients concomitant with osteoporosis in view of unplanned readmissions. Methods: Data was acquired from the National Readmission Database 2018. The study population was classified into metabolically healthy non-obese (MHNO), metabolically unhealthy non-obese (MUNO), metabolically healthy obese (MHO), and metabolically unhealthy obese (MUO) patients. We estimated the associations between metabolic obesity phenotypes and 30- and 90-day unplanned readmissions. A multivariate Cox Proportional Hazards (PH) model was used to assess the effect of factors on endpoints, with results expressed as HR and 95% CI. Results: The 30-day and 90-day readmission rates for the MUNO and MUO phenotypes were higher than that of the MHNO group (all p < 0.05), whereas no significant difference was found between the MHNO and MHO groups. For 30-day readmissions, MUNO raised the risk mildly (hazard ratio [HR] = 1.110, p < 0.001), MHO had a higher risk (HR = 1.145, p = 0.002), and MUO further elevated this risk (HR = 1.238, p < 0.001). As for 90-day readmissions, both MUNO and MHO raised the risk slightly (HR = 1.134, p < 0.001; HR = 1.093, p = 0.014, respectively), and MUO had the highest risk (HR = 1.263, p < 0.001). Conclusions: Metabolic abnormalities were associated with elevated rates and risks of 30- or 90-day readmission among postmenopausal hospitalized women complicated with osteoporosis, whereas obesity did not seem to be innocent, and the combination of these factors led to an additional burden on healthcare systems and individuals. These findings indicate that clinicians and researchers should focus not only on weight management but also metabolism intervention among patients with postmenopausal osteoporosis.
Growth Differentiation Factor 15 Is Associated with Platelet Reactivity in Patients with Acute Coronary Syndrome
Authors: Mutschlechner David , Tscharre Maximilian , Wadowski Patricia P. , Pultar Joseph , Weikert Constantin , Lee Silvia , Eichelberger Beate , Panzer Simon , Perkmann Thomas , Gremmel Thomas
Published: February 2023

Bleeding events in patients with acute coronary syndrome (ACS) are a risk factor for adverse outcomes, including mortality. We investigated the association of growth differentiation factor (GDF)-15, an established predictor of bleeding complications, with on-treatment platelet reactivity in ACS patients undergoing coronary stenting receiving prasugrel or ticagrelor. Platelet aggregation was measured by multiple electrode aggregometry (MEA) in response to adenosine diphosphate (ADP), arachidonic acid (AA), thrombin receptor-activating peptide (TRAP, a protease-activated receptor-1 (PAR-1) agonist), AYPGKF (a PAR-4 agonist) and collagen (COL). GDF-15 levels were measured using a commercially available assay. GDF-15 correlated inversely with MEA ADP (r = −0.202, p = 0.004), MEA AA (r = −0.139, p = 0.048) and MEA TRAP (r = −0.190, p = 0.007). After adjustment, GDF-15 was significantly associated with MEA TRAP (β = −0.150, p = 0.044), whereas no significant associations were detectable for the other agonists. Patients with low platelet reactivity in response to ADP had significantly higher GDF-15 levels (p = 0.005). In conclusion, GDF-15 is inversely associated with TRAP-inducible platelet aggregation in ACS patients treated with state-of-the-art antiplatelet therapy and significantly elevated in patients with low platelet reactivity in response to ADP.
Evaluation of Lower Leg Arteries and Fibular Perforators before Microsurgical Fibular Transfer Using Noncontrast-Enhanced Quiescent-Interval Slice-Selective (QISS) Magnetic Resonance Angiography
Authors: Lebenatus Annett , Tesch Karolin , Rudolph Wiebke , Naujokat Hendrik , Koktzoglou Ioannis , Edelman Robert R. , Graessner Joachim , Jansen Olav , Salehi Ravesh Mona
Published: February 2023

(1) Background: Preoperative imaging of the lower leg arteries is essential for planning fibular grafting. The aim of this study was to evaluate the feasibility and clinical value of non-contrast-enhanced (CE) Quiescent-Interval Slice-Selective (QISS)-magnetic resonance angiography (MRA) for reliably visualizing the anatomy and patency of the lower leg arteries and for preoperatively determining the presence, number, and location of fibular perforators. (2) Methods: The anatomy and stenoses of the lower leg arteries and the presence, number, and location of fibular perforators were determined in fifty patients with oral and maxillofacial tumors. Postoperative outcomes of patients after fibula grafting were correlated with preoperative imaging, demographic, and clinical parameters. (3) Results: A regular three-vessel supply was present in 87% of the 100 legs. QISS-MRA was able to accurately assign the branching pattern in patients with aberrant anatomy. Fibular perforators were found in 87% of legs. More than 94% of the lower leg arteries had no relevant stenoses. Fibular grafting was performed in 50% of patients with a 92% success rate. (4) Conclusions: QISS-MRA has the potential to be used as a preoperative non-CE MRA technique for the diagnosis and detection of anatomic variants of lower leg arteries and their pathologies, as well as for the assessment of fibular perforators.
Geriatric Assessment Implementation before Chemotherapy in MEtastatic Prostate Cancer, Results from the Real-Life Study GAMERS
Authors: Gluszak Cassandre , Campion Loïc , Seegers Valérie , Cojocarasu Oana , Commer Jean-Marie , Priou Frank , Rolland Frédéric , Terret Catherine , Abadie-Lacourtoisie Sophie
Published: February 2023

Geriatric assessment (GA) can predict and improve treatment tolerance and estimate overall survival in older patients with cancer. Several international organizations promote GA; however, data related to its implementation in daily clinical practice are still limited. We aimed to describe GA implementation in patients over 75 years old with metastatic prostate cancer treated with docetaxel as first-line treatment, and with positive G8 screening test or frailty criteria. This retrospective real-world study included 224 patients treated from 2014 to 2021 in four French centers, including 131 patients with a theoretical indication of GA. Among the latter, 51 (38.9%) patients had GA. The main barriers to GA were the lack of systematic screening (32/80, 40.0%), unavailability of geriatric physician (20/80, 25.0%), and absence of referral despite a positive screening test (12/80, 15.0%). With GA performed in only one-third of the patients with a theoretical indication in daily clinical practice, mostly due to an absence of screening test, the use of GA is currently sub-optimal.
Survival of Visual Function in Patients with Advanced Glaucoma after Standard Guarded Trabeculectomy with MMC
Authors: Filippopoulos Theodoros , Tsoukanas Dimitrios , Kandarakis Stylianos A. , Salonikiou Angeliki , Georgiou Michalis , Topouzis Fotis
Published: February 2023

Surgical intervention in patients with severe glaucoma remains controversial, especially in unilateral cases with a minimally affected fellow eye. Many question the benefit of trabeculectomy in such cases due to high complication rates and prolonged recovery. In this retrospective, non-comparative, interventional case series we aimed to determine the effect of trabeculectomy or combined phaco-trabeculectomy on the visual function of advanced glaucoma patients. Consecutive cases with perimetric mean deviation loss worse than −20 dB were included. Survival of visual function according to five predetermined visual acuity and perimetric criteria was set as the primary outcome. Qualified surgical success utilizing two different sets of criteria commonly used in the literature constituted secondary outcomes. Forty eyes with average baseline visual field mean deviation −26.3 ± 4.1 dB were identified. The average pre-operative intraocular pressure was 26.5 ± 11.4 mmHg and decreased to 11.4 ± 4.0 mmHg (p < 0.001) after an average follow-up of 23.3 ± 15.5 months. Visual function was preserved at two years in 77% or 66% of eyes respectively according to two different sets of visual acuity and perimetric criteria. Qualified surgical success was 89%, 72% at 1 and 3 years respectively. Trabeculectomy and/or phaco-trabeculectomy is associated with meaningful visual outcomes in patients with uncontrolled advanced glaucoma.
Considerations for Intravenous Anesthesia Dose in Obese Children: Understanding PKPD
Authors: Morse James Denzil , Cortinez Luis Ignacio , Anderson Brian Joseph
Published: February 2023

The intravenous induction or loading dose in children is commonly prescribed per kilogram. That dose recognizes the linear relationship between volume of distribution and total body weight. Total body weight comprises both fat and fat-free mass. Fat mass influences the volume of distribution and the use of total body weight fails to recognize the impact of fat mass on pharmacokinetics in children. Size metrics alternative to total body mass (e.g., fat-free and normal fat mass, ideal body weight and lean body weight) have been proposed to scale pharmacokinetic parameters (clearance, volume of distribution) for size. Clearance is the key parameter used to calculate infusion rates or maintenance dosing at steady state. Dosing schedules recognize the curvilinear relationship, described using allometric theory, between clearance and size. Fat mass also has an indirect influence on clearance through both metabolic and renal function that is independent of its effects due to increased body mass. Fat-free mass, lean body mass and ideal body mass are not drug specific and fail to recognize the variable impact of fat mass contributing to body composition in children, both lean and obese. Normal fat mass, used in conjunction with allometry, may prove a useful size metric but computation by clinicians for the individual child is not facile. Dosing is further complicated by the need for multicompartment models to describe intravenous drug pharmacokinetics and the concentration effect relationship, both beneficial and adverse, is often poorly understood. Obesity is also associated with other morbidity that may also influence pharmacokinetics. Dose is best determined using pharmacokinetic–pharmacodynamic (PKPD) models that account for these varied factors. These models, along with covariates (age, weight, body composition), can be incorporated into programmable target-controlled infusion pumps. The use of target-controlled infusion pumps, assuming practitioners have a sound understanding of the PKPD within programs, provide the best available guide to intravenous dose in obese children.
Serial Non-Invasive Myocardial Work Measurements for Patient Risk Stratification and Early Detection of Cancer Therapeutics-Related Cardiac Dysfunction in Breast Cancer Patients: A Single-Centre Observational Study
Authors: Moya Ana , Buytaert Dimitri , Beles Monika , Paolisso Pasquale , Duchenne Jürgen , Huygh Greet , Langmans Ciska , Roelstraete Adelheid , Verstreken Sofie , Goethals Marc , Dierckx Riet , Bartunek Jozef , Penicka Martin , Van Camp Guy , Heggermont Ward A. , Vanderheyden Marc
Published: February 2023

Serial transthoracic echocardiographic (TTE) assessment of LVEF and GLS are the gold standard in screening Cancer Therapeutics-Related Cardiac Dysfunction (CTRCD). Non-invasive left-ventricle (LV) pressure–strain loop (PSL) emerged as a novel method to quantify Myocardial Work (MW). This study aims to describe the temporal changes and longitudinal trajectories of MW indices during cardiotoxic treatment. We included 50 breast cancer patients with normal LV function referred for anthracycline therapy w/wo Trastuzumab. Medical therapy, clinical and echocardiographic data were recorded before and 3, 6, and 12 months after initiation of the chemotherapy. MW indices were calculated through PSL analysis. According to ESC guidelines, mild and moderated CTRCD was detected in 10 and 9 patients, respectively (20% CTRCDmild, 18% CTRCDmod), while 31 patients remained free of CTRCD (62% CTRCDneg). Prior to chemotherapy MWI, MWE and CW were significantly lower in CTRCDmod than in CTRCDneg and CTRCDmild. Overt cardiac dysfunction in CTRCDmod at 6 months was accompanied by significant worse values in MWI, MWE and WW compared to CTRCDneg and CTRCDmild. MW features such as low baseline CW, especially when associated with a rise in WW at follow-up, may identify patients at risk for CTRCD. Additional studies are needed to explore the role of MW in CRTCD.
Interleukin-17 vs. Interleukin-23 Inhibitors in Pustular and Erythrodermic Psoriasis: A Retrospective, Multicentre Cohort Study
Authors: Avallone Gianluca , Maronese Carlo Alberto , Murgia Giulia , Carrera Carlo Giovanni , Mastorino Luca , Roccuzzo Gabriele , Dapavo Paolo , Alberti-Violetti Silvia , Quaglino Pietro , Ribero Simone , Marzano Angelo Valerio
Published: February 2023

Pustular and erythrodermic psoriasis are rare and difficult-to-treat conditions. It has recently been shown that interleukin (IL)-17 inhibitors can be very effective among patients with these forms of psoriasis; however, the potential of IL-23 inhibitors is largely unknown. The aim of this multicentre, retrospective study was to compare the safety, effectiveness, and drug survival of IL-17 and IL-23 inhibitors among patients affected by these rare forms of psoriasis. The study involved 27 patients with erythrodermic psoriasis and 59 with pustular psoriasis (36 with generalised pustular psoriasis and 23 with palmoplantar pustular psoriasis) treated with an IL-17 or IL-23 inhibitor. The effectiveness of the two drug classes was assessed using the disease-specific Psoriasis Area Severity Index (PASI) and the Investigator Global Assessment, which were evaluated at different time points. There was a consistent trend towards a higher rate of PASI 100 responses in the patients treated with IL-17 inhibitors compared with those treated with IL-23 inhibitors, and the other efficacy outcomes showed a similar trend. There was no significant between-drug class difference in efficacy at any of the time points in the erythrodermic psoriasis cohort, whereas PASI 90 and PASI 100 response rates were significantly higher among the pustular psoriasis patients receiving IL-17 inhibitors at week 12 (IL-23 19% vs. IL-17 54% and IL-23 6% vs. IL-17 40%, respectively) and the percentage of responders to IL-17 inhibition was significantly higher at week 24 (IL-23 25% vs. IL-17 74%). In conclusion, it is therefore reasonable to assume that IL-17 and IL-23 inhibitors are both effective when treating pustular and erythrodermic psoriasis.
Clinical Significance of Trace Element Zinc in Patients with Chronic Kidney Disease
Authors: Fukasawa Hirotaka , Furuya Ryuichi , Kaneko Mai , Nakagami Daisuke , Ishino Yuri , Kitamoto Shuhei , Omata Kyosuke , Yasuda Hideo
Published: February 2023

The trace element zinc is essential for diverse physiological processes in humans. Zinc deficiency can impair growth, skin reproduction, immune function, maintenance of taste, glucose metabolism, and neurological function. Patients with chronic kidney disease (CKD) are susceptible to zinc deficiency, which is associated with erythropoiesis-stimulating agent (ESA) hypo-responsive anemia, nutritional problems, and cardiovascular diseases as well as non-specific symptoms such as dermatitis, prolonged wound healing, taste disturbance, appetite loss, or cognitive decline. Thus, zinc supplementation may be useful for the treatment of its deficiency, although it often causes copper deficiency, which is characterized by several severe disorders including cytopenia and myelopathy. In this review article, we mainly discuss the significant roles of zinc and the association between zinc deficiency and the pathogenesis of complications in patients with CKD.
Liver X Receptor Agonist Inhibits Oxidized Low-Density Lipoprotein Induced Choroidal Neovascularization via the NF-κB Signaling Pathway
Authors: Wu Tong , Wei Xinli , Dang Kuanrong , Tao Mengzhang , Lv Baozhen , Chen Tao , Zhang Zuoming , Zhou Jian , Du Hongjun
Published: February 2023

Age-related macular degeneration (AMD) is the most common blindness-causing disease among the elderly. Under oxidative stress, low-density lipoprotein in the outer layer of the retina is easily converted into oxidized low-density lipoprotein (OxLDL), which promotes the development of choroidal neovascularization (CNV), the main pathological change in wet AMD. Liver X receptor (LXR), a ligand-activated nuclear transcription factor, regulates various processes related to CNV, including lipid metabolism, cholesterol transport, inflammation, and angiogenesis. In this study, we evaluated the effects of the LXR agonist TO901317 (TO) on CNV. Our results demonstrated that the TO could inhibit OxLDL-induced CNV in mice as well as inflammation and angiogenesis in vitro. Using siRNA transfection in cells and Vldlr−/− mice, we further confirmed the inhibitory effects of TO against the inflammatory response and oxidative stress. Mechanistically, the LXR agonist reduces the inflammatory response via the nuclear translocation of NF-κB p65 in the pathway for NF-κB activation and by enhancing ABCG1-dependent lipid transportation. Therefore, an LXR agonist is a promising therapeutic candidate for AMD, especially for wet AMD.
Predictive Role of hsCRP in Recurrent Stroke Differed According to Severity of Cerebrovascular Disease: Analysis from a Prospective Cohort Study
Authors: Li Jiejie , Pan Yuesong , Wang Mengxing , Meng Xia , Lin Jinxi , Li Zixiao , Li Hao , Wang Yilong , Zhao Xingquan , Liu Liping , Wang Yongjun
Published: February 2023

Elevated levels of high-sensitivity C-reactive protein (hsCRP) were associated with an increased risk of recurrent stroke. However, it is still unknown whether the predictive value of hsCRP differed according to the severity of cerebrovascular disease. We used the cohort of the prospective multicenter cohort study of the Third China National Stroke Registry (CNSR-III), in which 10,765 consecutive patients with acute ischemic stroke or transient ischemic attack (TIA) had hsCRP levels measured. Patients were classified into minor stroke, or TIA, and non-minor stroke. The primary outcome was a new stroke within 1 year. Cox proportional hazards models were used to assess the association of hsCRP and its outcome. Elevated levels of hsCRP were associated with an increased risk of recurrent stroke in minor stroke or TIA patients, irrespective of using a National Institutes of Health Stroke Scale (NIHSS) score of ≤3 (the highest quartile vs. the lowest quartile: adjusted hazard ratio, 1.48; 95% CI, 1.12–1.97; p = 0.007) or ≤5 (the highest quartile vs. the lowest quartile: adjusted hazard ratio, 1.45; 95% CI, 1.15–1.84; p = 0.002) to define minor stroke. Such association was more apparent in the large-artery atherosclerosis subtype. However, for the patients with non-minor stroke, the association of hsCRP with recurrent stroke disappeared.
Endometriosis in Adolescents: Diagnostics, Clinical and Laparoscopic Features
Authors: Khashchenko Elena P. , Uvarova Elena V. , Fatkhudinov Timur Kh. , Chuprynin Vladimir D. , Asaturova Aleksandra V. , Kulabukhova Elena A. , Vysokikh Mikhail Yu. , Allakhverdieva Elvina Z. , Alekseeva Maria N. , Adamyan Leila V. , Sukhikh Gennady T.
Published: February 2023

Background: The early diagnosis of endometriosis in adolescents is not developed. Objective: We aim to conduct clinical, imaging, laparoscopic and histological analyses of peritoneal endometriosis (PE) in adolescents in order to improve early diagnosis. Methods: In total, 134 girls (from menarche to 17 years old) were included in a case–control study: 90 with laparoscopically (LS) confirmed PE, 44 healthy controls underwent full examination and LS was analyzed in the PE group. Results: Patients with PE were characterized with heredity for endometriosis, persistent dysmenorrhea, decreased daily activity, gastrointestinal symptoms, higher LH, estradiol, prolactin and Ca-125 (<0.05 for each). Ultrasound detected PE in 3.3% and MRI in 78.9%. The most essential MRI signs are as follows: hypointense foci, the heterogeneity of the pelvic tissue (paraovarian, parametrial and rectouterine pouch) and sacro-uterine ligaments lesions (<0.05 for each). Adolescents with PE mostly exhibit initial rASRM stages. Red implants correlated with the rASRM score, and sheer implants correlated with pain (VAS score) (<0.05). In 32.2%, foci consisted of fibrous, adipose and muscle tissue; black lesions were more likely to be histologically verified (0.001). Conclusion: Adolescents exhibit mostly initial PE stages, which are associated with greater pain. Persistent dysmenorrhea and detected MRI parameters predict the laparoscopic confirmation of initial PE in adolescents in 84.3% (OR 15.4; <0.01), justifying the early surgical diagnostics and shortening the time delay and suffering of the young patients.
Predictability of Radiologically Measured Psoas Muscle Area for Intraoperative Hypotension in Older Adult Patients Undergoing Femur Fracture Surgery
Authors: Lee Youn Young , Woo Jae Hee , Yoon In-Young , Lee Hyun Jung , Ahn Sang-Mee , Chae Ji Seon , Kim Youn Jin
Published: February 2023

This retrospective study aimed to determine the predictive value of radiologically measured psoas muscle area (PMA) for intraoperative hypotension (IOH) using receiver operating characteristic (ROC) curves in older adult patients with hip fractures. The cross-sectional axial area of the psoas muscle was measured by CT at the level of the 4th lumbar vertebrae and normalized by body surface area (BSA). The modified frailty index (mFI) was used to assess frailty. IOH was defined as an absolute threshold of mean arterial blood pressure (MAP) < 65 mmHg or a relative decrease in MAP > 30% from baseline MAP. Among the 403 patients, 286 (71.7%) had developed IOH. PMA normalized by BSA in male patients was 6.90 ± 0.73 in the no-IOH group and 4.95 ± 1.20 in the IOH group (p < 0.001). PMA normalized by BSA in female patients was 5.18 ± 0.81 in the no-IOH group and 3.78 ± 0.75 in the IOH group (p < 0.001). The ROC curves showed that the area under the curve for PMA normalized by BSA and modified frailty index (mFI) were 0.94 for male patients, 0.91 for female patients, and 0.81 for mFI (p < 0.001). In multivariate logistic regression, low PMA normalized by BSA, high baseline systolic blood pressure, and old age were significant independent predictors of IOH (adjusted odds ratio: 3.86, 1.03, and 1.06, respectively). PMA measured by computed tomography showed an excellent predictive value for IOH. Low PMA was associated with developing IOH in older adult patients with hip fractures.
Neurogenin 2 and Neuronal Differentiation 1 Control Proper Development of the Chick Trigeminal Ganglion and Its Nerve Branches
Authors: Bina Parinaz , Hines Margaret A. , Sanyal Johena , Taneyhill Lisa A.
Published: February 2023

The trigeminal ganglion contains the cell bodies of sensory neurons comprising cranial nerve V, which relays information related to pain, touch, and temperature from the face and head to the brain. Like other cranial ganglia, the trigeminal ganglion is composed of neuronal derivatives of two critical embryonic cell types, neural crest and placode cells. Neurogenesis within the cranial ganglia is promoted by Neurogenin 2 (Neurog2), which is expressed in trigeminal placode cells and their neuronal derivatives, and transcriptionally activates neuronal differentiation genes such as Neuronal Differentiation 1 (NeuroD1). Little is known, however, about the role of Neurog2 and NeuroD1 during chick trigeminal gangliogenesis. To address this, we depleted Neurog2 and NeuroD1 from trigeminal placode cells with morpholinos and demonstrated that Neurog2 and NeuroD1 influence trigeminal ganglion development. While knockdown of both Neurog2 and NeuroD1 affected innervation of the eye, Neurog2 and NeuroD1 had opposite effects on ophthalmic nerve branch organization. Taken together, our results highlight, for the first time, functional roles for Neurog2 and NeuroD1 during chick trigeminal gangliogenesis. These studies shed new light on the molecular mechanisms underlying trigeminal ganglion formation and may also provide insight into general cranial gangliogenesis and diseases of the peripheral nervous system.
UMGAN: Underwater Image Enhancement Network for Unpaired Image-to-Image Translation
Authors: Sun Boyang , Mei Yupeng , Yan Ni , Chen Yingyi
Published: February 2023

Due to light absorption and scattering underwater images suffer from low contrast, color distortion, blurred details, and uneven illumination, which affect underwater vision tasks and research. Therefore, underwater image enhancement is of great significance in vision applications. In contrast to existing methods for specific underwater environments or reliance on paired datasets, this study proposes an underwater multiscene generative adversarial network (UMGAN) to enhance underwater images. The network implements unpaired image-to-image translation between the underwater turbid domain and the underwater clear domain. It has a great enhancement impact on several underwater image types. Feedback mechanisms and a noise reduction network are designed to optimize the generator and address the issue of noise and artifacts in GAN-produced images. Furthermore, a global–local discriminator is employed to improve the overall image while adaptively modifying the local region image effect. It resolves the issue of over- and underenhancement in local regions. The reliance on paired training data is eliminated through a cycle consistency network structure. UMGAN performs satisfactorily on various types of data when compared quantitatively and qualitatively to other state-of-the-art algorithms. It has strong robustness and can be applied to various enhancement tasks in different scenes.
Efficiency Evaluation of a Small Container Terminal with Perpendicular Yard Layout Using Shuttle Carriers
Authors: Stojaković Maja , Twrdy Elen
Published: February 2023

Productivity is an extremely important factor in the competitiveness of a container terminal. Productivity itself is largely influenced by the handling mechanisation, the main task of which is to serve the quay cranes on one side and the yard cranes on the other. One of the most effective types of mechanisation in this segment is shuttle carriers, which are used primarily in the larger terminals. The objective of this study was to determine if they can also be used effectively in smaller container terminals with different yard layouts. Therefore, this study shows the impact of the selected layout and handling mechanisation on terminal productivity. The focus is on the berth productivity, as it has the greatest impact on the handling of the vessel in the port. To this end, a discrete-event simulation modelling approach was used in a container terminal of small capacity. The performed simulations included all operations between berth and yard, focusing on the correct allocation of shuttle carriers to ensure optimal results on the sea side of the terminal. The result showed that the use of shuttle carriers brings a substantial performance effect to the container terminal and also has a different effect considering different terminal layouts in terminals with an annual throughput not exceeding 1 million TEU.
State Compensation for Maritime Autonomous Surface Ships’ Remote Control
Authors: Chen Shijun , Xiong Xin , Wen Yuanqiao , Jian Jiaxin , Huang Yamin
Published: February 2023

With the development of emerging techniques, maritime autonomous surface ships (MASS) have attracted much attention, and the remote control ships’ future seems promising. However, due to communication issues, ship–shore transmission faces the challenge of time delay. The use of the transmitted information without compensation could reduce the effectiveness of controlling or could cause the remote control to be unstable. To eliminate the negative effects of uncertain delays during navigation, an Augmented State Cubature Kalman Filter (AS-CKF) is proposed. First, the uncertainty of the transmission delays is modeled using a probability density function (PDF). Second, the ship’s states are updated and estimated using the delayed observed data, and then the real state of the ship is simultaneously corrected in the augmented state vector. In this way, the delay compensation problem becomes a one-step prediction problem. To test the proposed AS-CKF for MASS, we simulate scenarios with the remote control ship under different communication time delays. The results show improvements compared to the traditional CKF, EKF, or AS-EKF, which indicates the potential of the proposed methods in remote control MASS.
Phytoplankton of the High-Latitude Arctic: Intensive Growth Large Diatoms Porosira glacialis in the Nansen Basin
Authors: Pautova Larisa , Silkin Vladimir , Kravchishina Marina , Klyuvitkin Alexey , Kudryavtseva Elena , Glukhovets Dmitry , Chultsova Anna , Politova Nadezhda
Published: February 2023

In August 2020, during a dramatical summer retreat of sea ice in the Nansen Basin, a study of phytoplankton was conducted on the transect from two northern stations in the marginal ice zone (MIZ) (north of 83° N m and east of 38° E) through the open water to the southern station located in the Franz Victoria Trench. The presence of melted polar surface waters (mPSW), polar surface waters (PSW), and Atlantic waters (AW) were characteristic of the MIZ. There are only two water masses in open water, namely PSW and AW, at the southernmost station; the contribution of AW was minimal. In the MIZ, first-year and multiyear ice species and Atlantic species were noted; Atlantic species and first-year ice species were in open water, and only ice flora was at the southernmost station. The maximum phytoplankton biomass (30 g · m−3) was recorded at the northernmost station of the MIZ, and 99% of the phytoplankton consisted of a large diatom Porosira glacialis. Intensive growth of this species occurred on the subsurface halocline separating mPSW from PSW. A thermocline was formed in open water south of the MIZ towards the Franz Victoria Trench. A strong stratification decreases vertical nutrient fluxes, so phytoplankton biomass decreases significantly. Phytoplankton formed the maximum biomass in the thermocline. When moving south, biomass decreased and its minimum values were observed at the southernmost station where the influence of AW is minimal or completely absent. A transition from the silicon-limited state of phytoplankton (MIZ area) to nitrogen-limited (open water) was noted.
Seaweed Extracts to Control Postharvest Phytopathogenic Fungi in Rocha Pear
Authors: Toledo Eloísa , Félix Carina , Vicente Tânia F. L. , Augusto Ana , Félix Rafael , Toledo Bernardo , Silva Joana , Trindade Carina , Raimundo Délio , Lemos Marco F. L.
Published: February 2023

Fungal infections cause losses amounting to between 20 and 25% of the fruit industry’s total outcome, with an escalating impact on agriculture in the last decades. As seaweeds have long demonstrated relevant antimicrobial properties against a wide variety of microorganisms, extracts from Asparagopsis armata, Codium sp., Fucus vesiculosus, and Sargassum muticum were used to find sustainable, ecofriendly, and safe solutions against Rocha pear postharvest fungal infections. Alternaria alternata, Botrytis cinerea, Fusarium oxysporum, and Penicillium expansum mycelial growth and spore germination inhibition activities were tested in vitro with five different extracts of each seaweed (n-hexane, ethyl acetate, aqueous, ethanolic, and hydroethanolic). An in vivo assay was then performed using the aqueous extracts against B. cinerea and F. oxysporum in Rocha pear. The n-hexane, ethyl acetate, and ethanolic extracts from A. armata showed the best in vitro inhibitory activity against B. cinerea, F. oxysporum, and P. expansum, and promising in vivo results against B. cinerea using S. muticum aqueous extract were also found. The present work highlights the contribution of seaweeds to tackle agricultural problems, namely postharvest phytopathogenic fungal diseases, contributing to a greener and more sustainable bioeconomy from the sea to the farm.
Invasive Fungal Breakthrough Infections under Targeted Echinocandin Prophylaxis in High-Risk Liver Transplant Recipients
Authors: Breitkopf Robert , Treml Benedikt , Senoner Thomas , Bukumirić Zoran , Rajsic Sasa
Published: February 2023

Invasive fungal infections (IFIs) are frequent and outcome-relevant complications in the early postoperative period after orthotopic liver transplantation (OLT). Recent guidelines recommend targeted antimycotic prophylaxis (TAP) for high-risk liver transplant recipients (HR-LTRs). However, the choice of antimycotic agent is still a subject of discussion. Echinocandins are increasingly being used due to their advantageous safety profile and the increasing number of non-albicans Candida infections. However, the evidence justifying their use remains rather sparse. Recently published data on breakthrough IFI (b-IFI) raise concerns about echinocandin efficacy, especially in the case of intra-abdominal candidiasis (IAC), which is the most common infection site after OLT. In this retrospective study, we analyzed 100 adult HR-LTRs undergoing first-time OLT and receiving echinocandin prophylaxis between 2017 and 2020 in a tertiary university hospital. We found a breakthrough incidence of 16%, having a significant impact on postoperative complications, graft survival, and mortality. The reasons for this may be multifactorial. Among the pathogen-related factors, we identified the breakthrough of Candida parapsilosis in 11% of patients and one case of persistent IFI due to the development of a secondary echinocandin resistance of an IAC caused by Candida glabrata. Consequently, the efficacy of echinocandin prophylaxis in liver transplantation should be questioned. Further studies are necessary to clarify the matter of breakthrough infections under echinocandin prophylaxis.
The Antidepressant Sertraline Affects Cell Signaling and Metabolism in Trichophyton rubrum
Authors: Galvão-Rocha Flaviane M. , Rocha Carlos H. L. , Martins Maíra P. , Sanches Pablo R. , Bitencourt Tamires A. , Sachs Matthew S. , Martinez-Rossi Nilce M. , Rossi Antonio
Published: February 2023

The dermatophyte Trichophyton rubrum is responsible for most human cutaneous infections. Its treatment is complex, mainly because there are only a few structural classes of fungal inhibitors. Therefore, new strategies addressing these problems are essential. The development of new drugs is time-consuming and expensive. The repositioning of drugs already used in medical practice has emerged as an alternative to discovering new drugs. The antidepressant sertraline (SRT) kills several important fungal pathogens. Accordingly, we investigated the inhibitory mechanism of SRT in T. rubrum to broaden the knowledge of its impact on eukaryotic microorganisms and to assess its potential for future use in dermatophytosis treatments. We performed next-generation sequencing (RNA-seq) to identify the genes responding to SRT at the transcript level. We identified that a major effect of SRT was to alter expression for genes involved in maintaining fungal cell wall and plasma membrane stability, including ergosterol biosynthetic genes. SRT also altered the expression of genes encoding enzymes related to fungal energy metabolism, cellular detoxification, and defense against oxidative stress. Our findings provide insights into a specific molecular network interaction that maintains metabolic stability and is perturbed by SRT, showing potential targets for its strategic use in dermatophytosis.
Yeast Bloodstream Infections in the COVID-19 Patient: A Multicenter Italian Study (FiCoV Study)
Authors: Prigitano Anna , Blasi Elisabetta , Calabrò Maria , Cavanna Caterina , Cornetta Maria , Farina Claudio , Grancini Anna , Innocenti Patrizia , Lo Cascio Giuliana , Nicola Lucia , Trovato Laura , Cogliati Massimo , Esposto Maria Carmela , Tortorano Anna Maria , Romanò Luisa ,   on behalf of the FiCoV Study Group
Published: February 2023

Fungemia is a co-infection contributing to the worsening of the critically ill COVID-19 patient. The multicenter Italian observational study FiCoV aims to estimate the frequency of yeast bloodstream infections (BSIs), to describe the factors associated with yeast BSIs in COVID-19 patients hospitalized in 10 hospitals, and to analyze the antifungal susceptibility profiles of the yeasts isolated from blood cultures. The study included all hospitalized adult COVID-19 patients with a yeast BSI; anonymous data was collected from each patient and data about antifungal susceptibility was collected. Yeast BSI occurred in 1.06% of patients, from 0.14% to 3.39% among the 10 participating centers. Patients were mainly admitted to intensive or sub-intensive care units (68.6%), over 60 years of age (73%), with a mean and median time from the hospitalization to fungemia of 29 and 22 days, respectively. Regarding risk factors for fungemia, most patients received corticosteroid therapy during hospitalization (61.8%) and had a comorbidity (25.3% diabetes, 11.5% chronic respiratory disorder, 9.5% cancer, 6% haematological malignancies, 1.4% organ transplantation). Antifungal therapy was administered to 75.6% of patients, mostly echinocandins (64.5%). The fatality rate observed in COVID-19 patients with yeast BSI was significantly higher than that of COVID-19 patients without yeast BSI (45.5% versus 30.5%). Candida parapsilosis (49.8%) and C. albicans (35.2%) were the most fungal species isolated; 72% of C. parapsilosis strains were fluconazole-resistant (range 0–93.2% among the centers). The FiCoV study highlights a high prevalence of Candida BSIs in critically ill COVID-19 patients, especially hospitalized in an intensive care unit, a high fatality rate associated with the fungal co-infection, and the worrying spread of azole-resistant C. parapsilosis.
Identification of the Magna Radicular Artery Entry Foramen and Adamkiewicz System: Patient Selection for Open versus Full-Endoscopic Thoracic Spinal Decompression Surgery
Authors: Vargas Roth Antonio , De Olinveira Eduardo Miquelino , Moscatelli Marco , Ramírez León Jorge Felipe , Lorio Morgan P. , Fiorelli Rossano Kepler , Telfeian Albert E. , Braxton Ernest , Song Michael , Lewandrowski Kai-Uwe
Published: February 2023

Background: Casually cauterizing the radicular magna during routine thoracic discectomy may have dire consequences. Methods: We performed a retrospective observational cohort study on patients scheduled for decompression of symptomatic thoracic herniated discs and spinal stenosis who underwent a preoperative computed tomography angiography (CTA) to assess the surgical risks by anatomically defining the foraminal entry level of the magna radicularis artery into the thoracic spinal cord and its relationship to the surgical level. Results: Fifteen patients aged 58.53 ± 19.57, ranging from 31 to 89 years, with an average follow-up of 30.13 ± 13.42 months, were enrolled in this observational cohort study. The mean preoperative VAS for axial back pain was VAS of 8.53 ± 2.06 and reduced to a postoperative VAS of 1.60 ± 0.92 (p < 0.0001) at the final follow-up. The Adamkiewicz was most frequently found at T10/11 (15.4%), T11/12 (23.1%), and T9/10 (30.8%). There were eight patients where the painful pathology was found far from the AKA foraminal entry-level (type 1), three patients with near location (type 2), and another four patients needing decompression at the foraminal (type 3) entry-level. In five of the fifteen patients, the magna radicularis entered the spinal canal on the ventral surface of the exiting nerve root through the neuroforamen at the surgical level requiring a change of surgical strategy to prevent injury to this important contributor to the spinal cord’s blood supply. Conclusions: The authors recommend stratifying patients according to the proximity of the magna radicularis artery to the compressive pathology with CTA to assess the surgical risk with targeted thoracic discectomy methods.
High Complication Rate and High Percentage of Regressing Radiolucency in Magnesium Screw Fixation in 18 Consecutive Patients
Authors: Haslhofer David J. , Gotterbarm Tobias , Klasan Antonio
Published: February 2023

(1) Background: Magnesium-based implants use has become a research focus in recent years. Radiolucent areas around inserted screws are still worrisome. The objective of this study was to investigate the first 18 patients treated using MAGNEZIX® CS screws. (2) Methods: This retrospective case series included all 18 consecutive patients treated using MAGNEZIX® CS screws at our Level-1 trauma center. Radiographs were taken at 3-, 6- and 9-month follow-ups. Osteolysis, radiolucency and material failure were assessed, as were infection and revision surgery. (3) Results: Most patients (61.1%) had surgery in the shoulder region. Radiolucency regressed from 55.6% at 3-month follow-ups to 11.1% at 9-month follow-ups. Material failure occurred in four patients (22.22%) and infection occurred in two patients, yielding a 33.33% complication rate. (4) Conclusion: MAGNEZIX® CS screws demonstrated a high percentage of radiolucency that regressed and seems to be clinically irrelevant. The material failure rate and infection rate require further research.
Monitoring Perfusion Index in Patients Presenting to the Emergency Department Due to Drug Use
Authors: Grigorasi Gabriela Raluca , Corlade-Andrei Mihaela , Ciumanghel Irina , Sova Ivona , Blaga Teofil , Carp Claudiu , Cimpoesu Diana
Published: February 2023

(1) Background: The perfusion index (PI) represents the ratio between pulsatile blood flow and non-pulsatile blood flow in the peripheral tissue. (2) We aimed to investigate the blood pressure perfusion of tissues and organs in ethnobotanical, synthetic cannabinoid and cannabis derivative consumers through the value of perfusion index. (3) Results: The patients enrolled were divided into two groups: group A, which included all patients who presented in the ED within the first three hours after consumption, and group B, which included those patients who presented more than three hours and up to 12 h after drug consumption. The average values of the PI in the case of group A/group B were 1.51 ± 1.07/4.55 ± 3.66. Statistically significant correlations in both groups were recorded between the drug intake ED admission, respiratory rate, peripheral blood oxygen saturation and tissue perfusion index (p < 0.001). The average value of the PI measured in group A was significantly lower compared to that measured in patients in group B. Therefore, we concluded that the perfusion of peripheral organs and tissues was lower in the first 3 h after drug administration. (4) Conclusions: PI plays an important role in the early detection of impaired organ perfusion and in monitoring tissue hypoxia. A decreased PI value may be an early indication of decreased perfusion organ damage.
Impact of Land Tenure Security Perception on Tree Planting Investment in Vietnam
Authors: Dinh Hoang Huu , Basnet Shyam , Wesseler Justus
Published: February 2023

With over 14 million hectares allocated, Vietnam’s forest and forestland allocation has been one of the largest natural resource decentralization programs in the developing world over the last three decades. Given this remarkable achievement, critics are concerned about the low rates of household tree planting investment and question the roles and effects of land institutions on investment. Using nested logit and ordered probit models, this study examined the effects of household perceptions of forestland tenure security on tree investment and the causal effects among 239 households in 11 communes in the Central Highlands. The findings suggested that, given the land titling in hand, household perceptions of potential land expropriation in the next five years did not thwart investments in both short-term acacia and long-term cashew horizons. The number of laborers, cost of plantations, off-farm and agricultural incomes, migrant status, soil condition, plot location, government subsidies, and a positive market outlook all played a significant role in this investment. Interestingly, we found that short-term tree planting had the reverse impact on decreasing land users’ perceptions of land tenure security, possibly because each tree rotation shortens the 50-year land use period recorded in the Land Use Right Certificate. However, market prospects and government subsidies may significantly counteract the negative perception of LTS and encourage households to plant trees. The policy implication is that, in addition to strengthening LTS to ensure households’ current and future land use rights, tree investment-incentivized policies should be implemented.
COVID-19 and Urban Food Security in Ghana during the Third Wave
Authors: Onyango Elizabeth Opiyo , Owusu Bernard , Crush Jonathan S.
Published: February 2023

While the effects of the COVID-19 pandemic on household food security have been documented, the intensity and forms of food insecurity in urban households in the Global South have not been adequately explored. This is despite the emerging consensus that impacts of the pandemic were more severe in urban than rural Africa. This paper addresses this knowledge gap by examining the relationship between pandemic precarity and food insecurity in Ghana’s urban areas during the COVID-19 pandemic in 2020. This study is based on the World Bank (WB) and Ghana Statistical Service (GSS) COVID-19 High-Frequency Phone Survey. Using a sub-sample of 1423 urban households, the paper evaluates household experiences of the pandemic. Our findings show that household demographic characteristics are not a major predictor of food insecurity. Economic factors, especially the impact of the pandemic on wage income and total household income, were far more important, with those most affected being most food insecure. Additionally, food-insecure households were most aware of and were affected by food-price increases during the pandemic. These findings are important in planning the post-pandemic recovery initiatives and in addressing current and future emergencies and shocks to urban food systems.