bluuebunny/crossref_metadata_2025 huggingface dataset:
The Adhesiveness of Chickpea (Cicer arietinum) Seeds Is Conditioned by Their Shape
Authors: Sinjushin Andrey A. , Uhlarik Ana , Stepanova Irina L.
Published: February 2025

The seeds of some chickpea (Cicer arietinum L.) accessions are prone to sticking in twos or threes in a pod in the course of their maturation. Such seeds are usually easy to detach although their coats often become damaged due to forcible separation. Sticking is observed both in fields and glasshouses, with frequency potentially increasing in dry hot climates. Our morphometric survey of non-desi seeds (kabuli and intermediate types) suggests that it is seed shape, rather than size or color, that determines seed adhesiveness, with rounder seeds being the most prone to sticking. A similar phenomenon is known in pea (Pisum sativum L.) where it is conditioned by a single rare mutation affecting seed coat features. Unlike pea, numerous chickpea lines and cultivars of different origin have intrinsic susceptibility to seed adhesion, although to a variable extent depending on environment and seed shape, so this feature is multifactorial rather than solely genetic in C. arietinum. Although stuck seeds are mostly detached during mechanical harvesting, the accompanying seed coat lesions may be potentially undesired for seed storage and germination characteristics.
Structural and Morphological Investigation of Calcium-Silicate-Based Bioceramics Prepared from Eggshell via Conventional Approach
Authors: Kaou Maroua H. , Balázsi Csaba , Balázsi Katalin
Published: February 2025

Calcium-silicate-based ceramic composites with different CaO/SiO2 weight ratios (10/90, 20/80, 30/70, 40/60, 50/50, 60/40, 70/30, 80/20, and 90/10) have been prepared from chicken eggshells and silica gel using attrition milling for 3 h in wet conditions and conventional pressing–heat treatment in the air at 800 °C for 1 h. The effect of the CaO/SiO2 weight ratio and the calcination period of the eggshells on the microstructural features including apparent density, phase evolution, and morphological properties were investigated. The phase transformation of the powder mixtures after attrition milling for 3 h in ethanol with powder/ball milling mass ratio of 0.0996 (110/1104.7) revealed to have calcium hydroxide (Ca(OH)2) as a dominate phase, which was observed to increase with the increase in calcium oxide (CaO) amount in the powder mixtures. The phase transformation of ceramic samples after heat treatment at 800 °C for 1 h, on the other hand, showed different phases depending on the CaO/SiO2 weight ratio. The results also show a linear relationship between the CaO/SiO2 weight ratio and apparent density when the CaO/SiO2 ratio increase from 0.11 (10/90) to 0.67 (40/60) due to the densification of ceramics. An inversely proportional relationship was found between CaO/SiO2 and density when the CaO/SiO2 weight ratio increased from 0.67 (40/60) to 9 (90/10).
A Platform Integrating Biophysical and Biochemical Stimuli to Enhance Differentiation and Maturation of Cardiomyocyte Subtypes Derived from Human Induced Pluripotent Stem Cells
Authors: Feng Zhonggang , Sawada Kota , Ando Iori , Yoshinari Riku , Sato Daisuke , Kosawada Tadashi
Published: February 2025

To enhance the differentiation and maturation of cardiomyocytes derived from human induced pluripotent stem cells, we developed a bioreactor system that simultaneously imposes biophysical and biochemical stimuli on these committed cardiomyocytes. The cells were cultured within biohydrogels composed of the extracellular matrix extracted from goat ventricles and purchased rat-origin collagen, which were housed in the elastic PDMS culture chambers of the bioreactor. Elastic and flexible electrodes composed of PEDOT/PSS, latex, and graphene flakes were embedded in the hydrogels and chamber walls, allowing cyclic stretch and electrical pulses to be simultaneously and coordinately applied to the cultured cells. Furthermore, a dynamic analysis method employing the transverse forced oscillation theory of a cantilever was used to analyze and discriminate the subtype-specific beating behavior of the cardiomyocytes. It was found that myosin light chain 2v (MLC2v), a ventricular cell marker, was primarily upregulated in cells aggregated on the (+) electrode side, while cardiomyocytes with faint MLC2v but strong cardiac troponin T (cTNT) expression aggregated at the ground electrode (GND) side. mRNA analysis using rtPCR and the gel beating dynamics further suggested a subtype deviation on the different electrode sides. This study demonstrated the potential of our bioreactor system in enhancing cardiac differentiation and maturation, and it showed an intriguing phenomenon of cardiomyocyte subtype aggregation on different electrodes, which may be developed into a new method to enhance the maturation and separation of cardiomyocyte subtypes.
Immunotherapy Improves Clinical Outcome in Kirsten Rat Sarcoma Virus-Mutated Patients with Unresectable Non-Small Cell Lung Cancer Stage III: A Subcohort Analysis of the Austrian Radio-Oncological Lung Cancer Study Association Registry (ALLSTAR)
Authors: Ruznic Elvis , Klebermass Marisa , Zellinger Barbara , Langer Brigitte , Grambozov Brane , Purevdorj Ayurzana , Karner Josef , Gruber Georg , Stana Markus , Minasch Danijela , Kirchhammer Karoline , Steffal Claudia , Stranzl Heidi , Moosbrugger Raphaela , Feurstein Petra , Dieckmann Karin , Zehentmayr Franz
Published: February 2025

Background/Objectives: Current evidence suggests that patients with unresectable non-small cell lung cancer (NSCLC) whose tumours harbour driver mutations do not benefit from immune checkpoint inhibition. Kirsten rat sarcoma virus mutations (KRASmts), however, seem to be the exceptions to the rule. To this end, we compared KRASmt patients who were treated with immunotherapy to those without. Methods: ALLSTAR is a nationwide registry for patients with histologically verified non-operable NSCLC aged 18 or older having a curative treatment option. This report presents a subcohort of KRASmt patients who were recruited between 2020/03 and 2023/04. The diagnostic work-up included 18F-FDG-PET-CT scan and contrast-enhanced cranial CT or—preferably—MRI. Patients were treated with chemoradiotherapy (CRT) either followed by immune checkpoint inhibition (ICI) or not. Results: Thirty-two KRASmt patients with a median follow-up of 25.9 months were included in this analysis. After CRT, 27/32 (84%) patients received ICI. The 2-year overall survival rate in KRASmt patients who received immunotherapy was significantly better compared to those without ICI (N = 32; 84% versus 20%; p < 0.001). Likewise, the 2-year progression-free-survival with immunotherapy was also significantly better than in those without ICI (N = 32; 75% versus 20%; p < 0.001). Of the 12/32 patients (38%) who had received radiation doses > 66 Gy, none had a locoregional relapse, whereas in the other 20 patients, 5 (25%) events occurred (p-value = 0.116). Conclusions: Since KRASmt patients could benefit from ICI treatment, immunotherapy should be offered to these patients, similar to those without actionable genetic drivers. Additionally, radiation dose escalation > 66 Gy may also improve locoregional control in this subset of patients.
Association Between Triglyceride/High-Density Lipoprotein Ratio and Incidence Risk of Heart Failure: A Population-Based Cohort Study
Authors: Chang Yoon-Kyung , Park Ju-Young , Song Tae-Jin
Published: February 2025

Background/Objectives: The triglyceride/high-density lipoprotein (TG/HDL) ratio serves as a simple marker for insulin resistance. We investigated whether the TG/HDL ratio would be associated with the incidence risk of heart failure (HF). Methods: The study utilized data from the National Health Insurance Service-Health Screening Cohort database of South Korea from 2002 to 2019. The TG/HDL ratio was utilized as a time-dependent covariate or average value of at least three times throughout the follow-up period. The outcome of interest was incident heart failure (HF) corresponding with the International Classification of Disease, Tenth Revision code of I50. Results: A total of 293,968 individuals were included in this study. During the median 9.6 years (interquartile range 9.2–10.13), 27,852 individuals (9.47%) had a cumulative incidence of HF. Considering the multivariable time-dependent Cox proportional hazard model with the repeated measures of the TG/HDL ratio, per unit increase in the TG/HDL ratio significantly increased the risk of HF in the entire cohort (hazard ratio (HR): 1.007, 95% confidence interval (CI): 1.002–1.011), diabetes mellitus (DM) cohort (HR: 1.006. 95% CI: 1.002–1.010), and non-DM cohort (HR: 1.008, 95% CI: 1.003–1.013). Regarding average TG/HDL ratio quartiles, compared to the lowest quartiles (Q1), the highest quartiles (Q4) were positively associated with the incidence risk of HF accompanied by a significant p for trend (HR: 1.114, 95% CI: 1.075–1.155) in fully adjusted multivariable analysis. Conclusions: Our study demonstrated that the repeatedly measured TG/HDL ratio was associated with the incidence risk of HF regardless of the presence of DM history in the general population.
Subthreshold Laser Titration Database in a Population with Central Serous Chorioretinopathy and Dome-Shaped Macula
Authors: Enríquez-Fuentes Jacobo Emilio , Valverde-Megías Alicia , Alarcón-García Antonio Domingo , Oribio-Quinto Carlos , Chhablani Jay , Fernández-Vigo José Ignacio
Published: February 2025

Objectives: This study aimed to describe the laser titration needed to create a safe and effective subthreshold laser (STL) for use in patients with chronic central serous chorioretinopathy (CSCR) and dome-shaped macula (DSM) and to investigate the possible factors influencing titration. Methods: This was a prospective single-center study that recruited 92 eyes of 87 patients that presented with CSCR (84.8%) and DSM (15.2%) for a 577 nm STL treatment for persistent subretinal fluid. Age, sex, and the spherical equivalent (SE) were collected. Titration was performed by applying various impacts, beginning at 800 mW and increasing in 100 mW steps. The photocoagulation threshold (PT) was assessed as the minimum power at which faint whitening was observed in fundus retinography. Results: The mean age was 53.5 ± 10.3 years and 78.3% of patients were male. The mean SE was 0.3 ± 3.0 D (range −9.5–+11.0). The overall mean power to reach PT was 1102.7 ± 183.0 mW (range 800–1600). In the multivariate analysis, age and SE were associated with PT (p = 0.022 and 0.011, respectively). On the contrary, no association was observed between PT and sex (p = 0.924), macular disease (CSCR vs. DSM, p = 0.416), or central macular thickness (CMT) (p = 0.667). Conclusions: This study highlights the broad power range required for effective subthreshold laser (STL) titration and emphasizes the need for individualized treatment parameters to optimize outcomes. No significant differences in titration power were found regarding macular disease type, CMT, or sex. However, a mild correlation between PT, SE, and age was observed.
Efficacy and Safety of Adjunctive Aripiprazole LAI or Paliperidone LAI for the Management of Patients Suffering from Bipolar I Disorder with Comorbid Obsessive-Compulsive Disorder
Authors: Martiadis Vassilis , Pessina Enrico , Raffone Fabiola , Martini Azzurra , Di Vincenzo Matteo , Della Rocca Bianca , De Berardis Domenico , Cattaneo Carlo Ignazio , Sampogna Gaia
Published: February 2025

Background/Objectives: Bipolar disorder (BD) and obsessive-compulsive disorder (OCD) often coexist, presenting significant challenges in treatment. OCD comorbidity in BD is associated with severe clinical features such as increased suicidality and impaired functioning. While selective serotonin reuptake inhibitors (SSRIs) are effective for OCD, they may increase manic shifts in BD patients. The use of long-acting injectable (LAI) antipsychotics such as monthly aripiprazole (ARI-LAI) and monthly paliperidone (PP-LAI) has been proposed as a promising alternative for BD treatment, while their efficacy and safety in BD-OCD remain understudied. This study investigated the effectiveness and tolerability of ARI-LAI and PP-LAI as adjunctive therapies in this population. Methods: 27 BD-OCD patients were treated with ARI-LAI or PP-LAI, alongside mood stabilizers (MS) (lithium or sodium valproate), over a 24 week period. Clinical and psychopathological assessments were performed at baseline and regular intervals using the Yale-Brown Obsessive Compulsive Scale and the Hamilton Depression Rating Scale. Safety and tolerability were evaluated using the UKU Side Effect Rating Scale. Results: Both treatments led to significant reductions in obsessive-compulsive symptoms and mood stabilization without manic episodes. ARI-LAI showed superior tolerability in terms of body weight gain compared to PP-LAI, with no significant differences in overall efficacy between the groups. Conclusions: This study is the first that investigated the efficacy and safety of adjunctive PP-LAI and ARI-LAI in this population highlighting their potential as effective and well-tolerated options for managing BD-OCD. Further studies are needed to confirm these results and refine treatment strategies for this complex population.
Predictors of Cardiovascular Symptoms Among Long COVID Patients: Data from the Polish Long COVID Cardiovascular (PoLoCOV-CVD) Study
Authors: Kapusta Joanna , Sinnadurai Siamala , Babicki Mateusz , Kałuzińska-Kołat Żaneta , Meijers Wouter C. , Kołat Damian , Manintveld Olivier C. , Jankowski Piotr , Chudzik Michał
Published: February 2025

Background and aims: Long COVID symptoms persist globally, with a notable rise in cardiovascular disease (CVD) among COVID-19 survivors, including those without prior risk factors or hospitalizations. This study aims to identify predictors of cardiovascular-related Long COVID symptoms. Methods: This study included subjects with post-SARS-CoV-2 infections, categorizing them into three groups: non-Long COVID (non-LC), Long COVID (LC), and Long COVID with cardiovascular symptoms (cardio-LC) as part of the Polish Long COVID Cardiovascular (PoLoCOV-CVD) study collected between the years 2020 and 2022, comprising 4000 participants. Chi-square tests and logistic regression were used to report the prevalence and determinants of quality of life in cardio-LC, based on patient self-reported data including comorbidities and medications. Results: Of the 704 patients analyzed, 71.9% were female with a median age of 54 years (IQR: 45–64). Cardio-LC patients had statistically significant differences relative to the non-LC group in terms of blood pressure, elevated LDL cholesterol (p = 0.010), and non-HDL cholesterol (p = 0.013). In addition, cardio-LC patients were more likely to be female (p < 0.001) who exhibited psychological conditions, such as sleep disturbances (p < 0.001), anxiety (p < 0.001), and depression (p < 0.001) compared to the non-LC group. However, the multivariable logistic regression analysis revealed that only the female gender and sleep disturbances remained an independent predictor associated with cardio-LC (OR: 1.66, CI 1.12–2.46; OR: 1.742, CI 1.12–2.70) compared to participants without Long COVID. Conclusions: The significant positive association of female gender and sleep disturbances with cardiovascular complications during Long COVID highlights critical demographic and psychological factors that deserve attention in clinical practice.
IgG4-RD-Associated Mikulicz Syndrome Without Classic Systemic Involvement—A Case Report
Authors: Mendoza-Vargas Luis Ángel , Sevilla-Fuentes Samuel , Bautista-Becerril Brandon , Berthaúd-González Bertha , Falfán-Valencia Ramcés , Félix-Martínez Linda P. , Avila-Páez Mauricio , Manilla-González Jennifer
Published: February 2025

Background: IgG4-related disease is a rare, chronic inflammatory disorder characterized by lymphoplasmacytic infiltration, ‘storiform’ fibrosis, and elevated IgG4 levels in affected tissues. This disease has a broad and heterogeneous clinical spectrum that includes four main phenotypes: pancreatic–hepatobiliary disease, retroperitoneal/aortic fibrosis, head and neck disease, and Mikulicz syndrome. Case Description: An 85-year-old male patient with a clinical presentation, which is unusual outside Asia, of IgG4-related disease phenotype Mikulicz syndrome, characterized by bilateral dacryoadenitis, orbital pseudotumor, and no evidence of significant systemic participation. Despite extensive involvement in the orbital and glandular region, the patient did not develop serious organ complications, a behavior rarely documented in the literature. Despite the serum IgG4 levels being normal (<135 mg/dL), the clinical and radiological picture suggested IgG4-RD, emphasizing the need for a biopsy for a definitive diagnosis. Histopathological examination revealed a dense lymphoplasmacytic infiltrate, storiform fibrosis, and more than 40% IgG4-positive cells, confirming the diagnosis. Results: Treatment with prednisone was initiated alongside azathioprine for long-term control. Calcium and vitamin D3 supplementation were added to prevent glucocorticoid-induced osteoporosis. Remarkable clinical improvement was observed within 24 h, with progressive orbital and glandular symptoms resolution. Over a year, the patient exhibited complete resolution of the orbital tumors, total recovery of vision, and no relapses. The only sequelae observed were dry eye. Conclusions: This case highlights the need to consider IgG4-RD with normal serum IgG4 levels, the importance of histopathology for diagnosis, and the efficacy of steroids as first-line treatment. A multidisciplinary approach is essential for timely treatment.
In-Office Hyaluronic Acid Injection of Vocal Folds in Patients with Presbyphonia
Authors: Avdiyuk Anastasiya , Garnica Patricia , González-Herranz Ramón , Miranda Estefanía , García-García Cristina , Plaza Guillermo
Published: February 2025

Objective: to evaluate the advantages and disadvantages of injection laryngoplasty with hyaluronic acid in patients older than 65 years with presbyphonia. Study Design: a retrospective observational study. Setting: an academic secondary medical center. Methods: This study was performed using a group of patients diagnosed with presbyphonia who were treated using injection laryngoplasty with hyaluronic acid and underwent a minimum follow-up of 12 months. Subjective parameters such as the Voice Handicap Index–10 (VHI-10) and the GRBAS scale (grade, roughness, breathiness, asthenia, strain) were measured, as well as objective parameters such as the closure defect area. The medical records of patients undergoing this procedure during the 2020–2023 period were reviewed. An analysis of the demographic and clinical variables of the group was performed, as well as the values of the VHI-10, GRBAS, difference, and improvement of the area of closure defect before and after the procedure, along with the treatment duration and sensation of improvement. Results: The mean pre- and postoperative VHI-10 decreased from 26.8 to 19.6, showing significant differences (p = 0.007). The postoperative GRBAS mean score was 5.6 and normality can be assumed when it is below 9. Out of the 16 patients, 11 of them reported subjective improvement in their symptoms. More than half of them showed an improvement in the closure defect greater than 80%, with a significant reduction in the area (p < 0.001). Conclusions: hyaluronic acid injection in patients with presbyphonia produced a clear subjective improvement in voice quality and a decrease in the closure defect area.
Bilateral Simultaneous Cochlear Implants: How Early Activation Influences Wearing Hours
Authors: Tawakkul Qusai , Almuhawas Fida , Alarifi Sarah , Fatani Nawaf , Hagr Abdulrahman
Published: February 2025

Background/Objectives: Cochlear implantation (CI) is a transformative intervention for individuals with sensorineural hearing loss, providing auditory and speech perception improvements. Traditional CI activation occurs 4–6 weeks post-surgery; however, recent advancements allow for early activation within 1–2 days. The integration of data logging in modern CI systems offers objective insights into processor usage and auditory exposure, which are crucial for optimizing rehabilitation outcomes. Methods: A retrospective study was conducted on 63 patients with bilateral simultaneous CIs using MED-EL SONNET2/RONDO3 devices. Patients were classified into early activation (n = 30, activation within 1–2 days) and classical activation groups (n = 33, activation after day 2). Data logging metrics, patient demographics, and implant details were analyzed using the Wilcoxon rank-sum test and Poisson regression. Results: Daily processor usage did not significantly differ between groups (9.5 ± 3.0 h/day for classical vs. 9.4 ± 3.7 h/day for early activation, p = 0.927). Subgroup analysis showed a significant 18% increase in processor usage with each additional year of patient age (IRR = 1.18, p < 0.001) and a 15% decrease in usage with each year delay in implantation age (IRR = 0.85, p < 0.001) among early activation users. Switch-on frequencies were comparable between groups, with no significant differences observed (p = 1.0). Conclusions: Early activation is feasible and associated with consistent CI usage, providing potential benefits in auditory rehabilitation. Future research should explore its impact on long-term speech and language outcomes to inform evidence-based practices.
Novel Gait Training with a Hybrid Assistive Limb Improved Delayed Progressive Spastic Paraplegia After a Lightning Strike
Authors: Soma Yuichiro , Kubota Shigeki , Kadone Hideki , Shimizu Yukiyo , Miura Kousei , Hada Yasushi , Sankai Yoshiyuki , Yamazaki Masashi
Published: February 2025

Background/Objectives: A 68-year-old man presented with progressive walking difficulty that developed into spastic paraplegia. This condition was a long-term consequence of a lightning strike injury sustained at the age of 22 years. His symptoms progressively deteriorated, eventually requiring double crutches for ambulation at approximately 40 years of age. A physical evaluation prior to hybrid assistive limb (HAL) training revealed a T10 level neurological injury and an American Spinal Cord Injury Association impairment scale grade D. Here, we aimed to evaluate the therapeutic effects of novel gait training with an HAL in this patient with chronic and progressive neural damage caused by a lightning strike. Methods: The HAL training program is composed of two sections. In the first section, one month of gait training with HAL was conducted across 10 sessions, with 2–3 sessions weekly. The second section followed 6 months later. A final evaluation was performed three months after the second section. Results: Electromyographic and kinematic evaluation showed that the HAL gait training inhibited abnormal antagonistic muscle activation in his lower extremities, especially after the first section. Our results collectively indicate that the repeated HAL gait training improved the gait pattern of this patient. Conclusions: Our results suggest that HAL gait training may improve the gait pattern in patients with delayed progressive spastic paraplegia, as observed in this case. In addition, a longer intervention period is recommended to facilitate better adaptation to HAL training. Hence, neurorehabilitation with an HAL could be an innovative treatment approach for delayed progressive spastic paraplegia.
Cardiac Arrest: Can Technology Be the Solution?
Authors: Lapostolle Frédéric , Agostinucci Jean-Marc , Petrovic Tomislav , Feral-Pierssens Anne-Laure
Published: February 2025

Out-of-hospital cardiac arrest (OHCA) mortality remains alarmingly high in most countries. The majority of pharmacological attempts to improve outcomes have failed. Randomized trials have shown limited survival benefits with vasopressin, fibrinolysis, amiodarone, or lidocaine. Even the benefits of adrenaline remain a matter of debate. In this context, relying on technology may seem appealing. However, technological strategies have also yielded disappointing results. This is exemplified by automated external chest compression devices. When first introduced, theoretical models, animal studies, and early clinical trials suggested they could improve survival. Yet, randomized trials failed to confirm this benefit. Similarly, to date, extracorporeal membrane oxygenation (ECMO), therapeutic hypothermia, and primary angioplasty have demonstrated inconsistent survival advantage. Other technological innovations continue to be explored, such as artificial intelligence to improve the diagnosis of cardiac arrest during emergency calls, mobile applications to dispatch citizen responders to patients in cardiac arrest, geolocation of defibrillators, and even the delivery of defibrillators via drones. Nevertheless, it is clear that the focus and investment should prioritize the initial links in the chain of survival: early alerting, chest compressions, and defibrillation. Significant improvements in these critical steps can be achieved through the education of children. Modern technological tools must be leveraged to enhance this training by incorporating gamification and democratizing access to education. These strategies hold the potential to fundamentally improve the management of cardiac arrest.
Perspectives on the Role of Thoracic Fascial Blocks in Cardiac Anaesthesia: Will They Represent a New Era?
Authors: Sepolvere Giuseppe , Marianello Daniele , Santonocito Cristina , Messina Simone , Silvetti Simona , Franchi Federico , Paternoster Gianluca , Sanfilippo Filippo
Published: February 2025

Cardiac surgery is continuously evolving, with increasing skills required by the cardiac anaesthesiologist. Following the advent of intraoperative echocardiography, we are witnessing a potential new revolution for the cardiac anaesthesiologist. A new era has indeed started with the implementation of thoracic fascial blocks (TFBs) in the field of cardiac surgery. TFBs provide several advantages in the context of multimodal analgesia, with improved pain control and reduction of the side effects related to large doses of opioids. We envisage that implementation of TFBs is likely to become a pivotal concept in the field of enhanced recovery after cardiac surgery. We describe the main TFBs for the anterior and/or antero-lateral chest wall, and their peculiar use in cardiac surgery. In particular, we discuss indications and tips and tricks to enhance clinical results for the following blocks: (1) Pecto-Intercostal Plane (superficial and deep); (2) Rectus Sheath; (3) Interpectoral Plane and Pectoserratus Plane; (4) Serratus Anterior Plane; (5) Erector Spinae Plane. Nonetheless, the scientific evidence for the use of TFBs in the field of cardiac anaesthesia is not robust yet, mostly based on small-sized single-centre studies, making it difficult to achieve a high quality of evidence. Further, it remains unclear which cardiac surgery patients may benefit the most from these techniques.
Advancements in Artificial Intelligence for Kidney Transplantology: A Comprehensive Review of Current Applications and Predictive Models
Authors: Mizera Jakub , Pondel Maciej , Kepinska Marta , Jerzak Patryk , Banasik Mirosław
Published: February 2025

Background: Artificial intelligence is rapidly advancing within the domains of medicine and transplantology. In this comprehensive review, we provide an in-depth exploration of current AI methodologies, with a particular emphasis on machine learning and deep learning techniques, and their diverse subtypes. These technologies are revolutionizing how data are processed, analyzed, and applied in clinical decision making. Methods: A meticulous literature review was conducted with a focus on the application of artificial intelligence in kidney transplantation. Four research questions were formulated to establish the aim of the review. Results: We thoroughly examined the general applications of AI in the medical field, such as feature selection, dimensionality reduction, and clustering, which serve as foundational tools for complex data analysis. This includes the development of predictive models for transplant rejection, the optimization of personalized immunosuppressive therapies, the algorithmic matching of donors and recipients based on multidimensional criteria, and the sophisticated analysis of histopathological images to improve the diagnostic accuracy. Moreover, we present a detailed comparison of existing AI-based algorithms designed to predict kidney graft survival in transplant recipients. In this context, we focus on the variables incorporated into these predictive models, providing a critical analysis of their relative importance and contribution to model performance. Conclusions: This review highlights the significant advancements made possible through AI and underscores its potential to enhance both clinical outcomes and the precision of medical interventions in the field of transplantology.
Septic Cardiomyopathy: Difficult Definition, Challenging Diagnosis, Unclear Treatment
Authors: Zakynthinos George E. , Giamouzis Grigorios , Xanthopoulos Andrew , Oikonomou Evangelos , Kalogeras Konstantinos , Karavidas Nikitas , Dimeas Ilias E. , Gialamas Ioannis , Gounaridi Maria Ioanna , Siasos Gerasimos , Vavuranakis Manolis , Zakynthinos Epaminondas , Tsolaki Vasiliki
Published: February 2025

Sepsis is a systemic inflammatory response syndrome of suspected or confirmed infectious origin, which frequently culminates in multiorgan failure, including cardiac involvement. Septic cardiomyopathy (SCM) remains a poorly defined clinical entity, lacking a formal or consensus definition and representing a significant knowledge gap in critical care medicine. It is an often-underdiagnosed complication of sepsis. The only widely accepted aspect of its definition is that SCM is a transient myocardial dysfunction occurring in patients with sepsis, which cannot be attributed to ischemia or pre-existing cardiac disease. The pathogenesis of SCM appears to be multifactorial, involving inflammatory cytokines, overproduction of nitric oxide, mitochondrial dysfunction, calcium homeostasis dysregulation, autonomic imbalance, and myocardial edema. Diagnosis primarily relies on echocardiography, with advanced tools such as tissue Doppler imaging (TDI) and global longitudinal strain (GLS) providing greater sensitivity for detecting subclinical dysfunction and guiding therapeutic decisions. Traditional echocardiographic findings, such as left ventricular ejection fraction measured by 2D echocardiography, often reflect systemic vasoplegia rather than intrinsic myocardial dysfunction, complicating accurate diagnosis. Right ventricular (RV) dysfunction, identified as a critical component of SCM in many studies, has multifactorial pathophysiology. Factors including septic cardiomyopathy itself, mechanical ventilation, hypoxemia, and hypercapnia—particularly in cases complicated by acute respiratory distress syndrome (ARDS)—increase RV afterload and exacerbate RV dysfunction. The prognostic value of cardiac biomarkers, such as troponins and natriuretic peptides, remains uncertain, as these markers primarily reflect illness severity rather than being specific to SCM. Treatment focuses on the early recognition of sepsis, hemodynamic optimization, and etiological interventions, as no targeted therapies currently exist. Emerging therapies, such as levosimendan and VA-ECMO, show potential in severe SCM cases, though further validation is needed. The lack of standardized diagnostic criteria, combined with the heterogeneity of sepsis presentations, poses significant challenges to the effective management of SCM. Future research should focus on developing cluster-based classification systems for septic shock patients by integrating biomarkers, echocardiographic findings, and clinical parameters. These advancements could clarify the underlying pathophysiology and enable tailored therapeutic strategies to improve outcomes for SCM patients.
Bone Resorption Assessment Following Zygomatic Implants Surgery over 10 Years of Follow-Up
Authors: Duarte Fernando , Ramos Carina , Santos-Marino Juan , Martínez-Rodriguez Natalia , Barona-Dorado Cristina , Martínez-González José María
Published: February 2025

The presence of sufficient bone volumes is one of the most important criteria for the success of oral implant osseointegration. Therefore, the rehabilitation of edentulous atrophic maxillae represents the greatest challenge in terms of oral rehabilitation. Techniques such as bone grafts, angled implants, short implants, tuberosity, and pterygoid implants may not always be a viable alternative in the subsequent rehabilitation of the posterior atrophic maxilla. A breakthrough occurred when Brånemark first introduced longer, custom-designed implants inserted into the zygomatic bone to support craniofacial prosthesis in the 1980s. When used in the treatment of atrophic jaws, zygomatic implants provide a safe and effective alternative, with stable long-term results. Objectives: We aimed to retrospectively evaluate zygomatic bone resorption ten years after the placement of zygomatic implants. Methods: A retrospective observational study was designed to evaluate bone resorption over ten years following the placement of zygomatic implants. In a study group of 50 patients, using Hounsfield scales, the area of the zygoma and its bone density were established and evaluated. The NewTom NNT Analysis software (NewTom®, Imola, Italy) was employed to trace the bone and implant limits on CBCT scans. Using this software, the three-dimensional information of the postoperative CBCT image was compared with the ten-year postoperative CBCT image, allowing for the assessment of the zygomatic bone resorption and bone density. Results: Highly significant statistical differences to an alpha level of 0.01 were identified between T0 (pre-op), T1 (12 months), and T2 (120 months) concerning zygomatic bone density, both in the first and in the second quadrants. The post hoc Bonferroni test revealed that significant statistical differences were observed between T0 and the remaining timepoints (T1 and T2), with the latter two exhibiting similar values. Conclusions: The evaluation of the resorption at the level of the zygoma, ten years after the placement of zygomatic implants, reveals that there are no significant losses between the initial and final controls. Therefore, it follows that this type of implant rehabilitation represents a viable alternative approach in patients with bone atrophy of the maxilla, offering a predictable therapeutic solution that enables immediate full function and excellent long-term success rates. However, we must not neglect the potential for future innovations in GBR involving the use of barrier membranes, either resorbable or non-resorbable, and even the application of titanium alveolar customized osteogenic scaffold, in conjunction with autologous bone grafts or biomaterials.
Physiotherapists’ Experiences with the Hip Disability and Knee Injury Osteoarthritis Outcome Score Following Total Hip and Knee Arthroplasty: A Qualitative Interview Study
Authors: van den Berg Dennis J. , Maas Esther T. , Edelaar Rosa-Lynn , Arendsen Mathijs B. , de Louw Elizabeth J. , Kiers Henri , Vliet Vlieland Thea P. M. , Ostelo Raymond W. J. G. , Donker Marianne H.
Published: February 2025

Background: Clinical guidelines for physiotherapy following total hip and knee arthroplasty (THA/TKA) recommend using Patient-Reported Outcome Measures (PROMs) like the Hip disability and Knee injury Osteoarthritis Outcome Score (HOOS/KOOS). However, it remains unclear how physiotherapists use these PROMs in daily clinical practice. Objective: To explore primary care physiotherapists’ experiences with the HOOS/KOOS in daily clinical practice following THA and TKA. Methods: Thirteen physiotherapists in the Netherlands were recruited via convenience sampling. Data were collected through semi-structured interviews, which explored HOOS/KOOS use in clinical practice, administrative regulations, and applications beyond patient care, as well as think-aloud interviews to capture perceptions of the content of these PROMs and interpretations of hypothetical patient scores. Interviews were analysed using reflexive thematic analysis. Results: The physiotherapists’ ages ranged from 25 to 54y, with annual THA/TKA volumes from 5 to 50 patients. Three themes emerged, as follows: (1) “Physiotherapists use the HOOS/KOOS for various purposes in daily clinical practice”, including complementing history taking and monitoring patient progress; (2) “Perceptions of the relevance of the HOOS/KOOS for daily clinical practice vary per item, domain, and version,” with items related to daily life activities and psychosocial factors being perceived as more valuable; and (3) “Practical aspects of HOOS/KOOS administration influence their use in daily clinical practice,” with electronic health records (EHRs) that facilitate PROM administration enhancing their use, while administrative regulations limit this. Conclusions: Physiotherapists experience HOOS/KOOS items related to daily life activities and psychosocial factors useful for history-taking and monitoring patient progress, particularly when embedded in EHRs that facilitate PROM administration.
Analysis of Clinical and Biochemical Parameters and the Effectiveness of Surgical Treatment in Patients with Primary Hyperparathyroidism: A Single-Center Study
Authors: Migoń Jakub , Miciak Michał , Pupka Dominika , Biernat Szymon , Nowak Łukasz , Kaliszewski Krzysztof
Published: February 2025

Background: Primary hyperparathyroidism (PHPT) causes an imbalance of calcium-phosphate metabolism in the form of hypercalcemia and hypophosphatemia, leading to dysfunction in various organs. The main cause is a benign tumor of the parathyroid gland (adenoma), leading to excessive and uncontrolled secretion of parathyroid hormone (PTH). Difficulties in diagnosing PTHP are also compounded by the possibility of asymptomatic course at the early disease stages. The gold standard treatment involves removing the pathological gland, while pharmacological options are reserved for candidates ineligible for surgery. Methods: In our study, we assessed the effectiveness of surgical treatment and the factors influencing outcomes and complications by analyzing the records of 125 patients with PHPT who underwent parathyroidectomy at the University Centre of General and Oncological Surgery of the Wroclaw Medical University from 2008 to 2017. We considered sociodemographics, laboratory results, comorbidities, complications, procedure details, and outcomes. The procedures included 93 open minimally invasive parathyroidectomies (OMIPs), 11 unilateral neck explorations, and 21 bilateral neck explorations. Results: Single-gland pathology was common (101 patients), while 24 had involvement of two glands. The left inferior parathyroid gland was the most frequently affected (n = 65; 43.6%). Histopathological examination consistently indicated the presence of parathyroid adenoma in all patients. Complications following parathyroidectomy were observed in 11 (8.8%) patients. Calcium normalization after six months was observed in 119 patients (95.2%). The surgical technique, the location of the adenoma, and the sex and age of the patient did not appear to affect the effectiveness of treatment. Conclusions: Parathyroidectomy is highly effective in treating PHPT, irrespective of patient age, sex, or gland location. It leads to decreased serum PTH and total calcium levels while increasing the inorganic phosphate concentration.
Ventilator-Associated Pneumonia in Intensive Care Units: A Comparison of Pre-Pandemic and COVID-19 Periods
Authors: Hlinkova Sona , Moraucikova Eva , Strzelecka Agnieszka , Mrazova Mariana , Littva Vladimir
Published: February 2025

Background/Objectives: The COVID-19 pandemic has significantly increased the burden of ventilator-associated pneumonia (VAP) in intensive care units (ICUs) globally. However, epidemiological data on VAP in Slovak ICUs, particularly in the context of the pandemic, remain limited. This study aimed to evaluate the incidence, microbial profiles, and risk factors of VAP in Slovak ICU settings, particularly during the COVID-19 pandemic. Methods: A retrospective analysis of VAP data was conducted for respiratory intensive care unit (ICU) patients in a Slovak university hospital, comparing data from the pre-pandemic and pandemic periods. The CDC/NHSN definitions for VAP were applied, and statistical analyses were performed using STATISTICA 13.1. Results: A total of 803 patients were analyzed, representing 8385 bed days and 5836 mechanical ventilator days. VAP rates increased significantly during the pandemic by 111%, from 8.46 to 17.86 events per 1000 MV days (p < 0.001). VAP rates in non-COVID-19 patients increased by 86% during the pandemic compared to pre-pandemic levels. Pandemic conditions also increased ICU mortality from 25.66% to 40.52% (p < 0.001). VAP was identified as a critical determinant of ICU mortality, contributing to a 21.62% higher mortality rate among patients during the pandemic. Younger age, prolonged mechanical ventilation, and medical (vs. surgical) hospitalizations were associated with higher VAP incidence. Gram-negative bacteria dominated the pathogen profiles, with significant increases observed in Pseudomonas aeruginosa (183%), Klebsiella pneumoniae (150%), and Acinetobacter spp. (100%). Conclusions: The COVID-19 pandemic has significantly affected the incidence and epidemiology of VAP in Slovak ICUs, highlighting systemic vulnerabilities in HAI surveillance and IPC practices.
Thermal, Mechanical, and Microstructural Properties of Novel Light Expanded Clay Aggregate (LECA)-Based Geopolymer Concretes
Authors: Podnar Tinkara Marija , Kravanja Gregor
Published: February 2025

The construction sector’s reliance on traditional cement significantly contributes to CO2 emissions, underscoring the urgent need for sustainable alternatives. This study investigates fine (0–4 mm), rounded, uncoated, porous-surfaced lightweight expanded clay aggregate (LECA)-based geopolymers, which combine the low-carbon benefits of geopolymers with LECA’s lightweight and insulating properties. Geopolymers were synthesized using lignite-rich fly ash with varying ratios of LECA to aggregate. Mechanical testing revealed that the reference mixture without LECA (REF-GEO) achieved the highest compressive strength of 37.89 ± 0.75 MPa and flexural strength of 7.62 ± 0.11 MPa, while complete substitution of the aggregate with LECA (LECA-100%) reduced the compressive strength to 17.31 ± 0.88 MPa and flexural strength to 3.41 ± 0.11 MPa. The density of the samples decreased from 2.06 g/cm3 for REF-GEO to 1.31 g/cm3 for LECA-100%, and thermal conductivity dropped significantly from 1.15 ± 0.07 W/mK to 0.38 ± 0.01 W/mK. Microstructural analysis using XRD and SEM-EDX highlighted changes in the material’s internal structure and the increase in porosity with higher LECA content. Water vapor permeability increases over time, particularly in samples with higher LECA content. These findings suggest that LECA-based geopolymers are suitable for low-load or non-structural elements. They are ideal for sustainable, energy-efficient construction that requires lightweight, insulating, and breathable materials.
Impact on Body Composition and Physical Fitness of an Exercise Program Based on Immersive Virtual Reality: A Case Report
Authors: Godoy-Cumillaf Andrés , Fuentes-Merino Paola , Giakoni-Ramírez Frano , Maldonado-Sandoval Marcelo , Bruneau-Chávez José , Merellano-Navarro Eugenio
Published: February 2025

Background/Objectives: The practice of physical activity contributes to obtaining adequate values of body composition and physical fitness, which is beneficial for people’s health. However, a large part of the adult population does not comply with the recommendations for physical activity, due to factors such as lack of time and nearby sports venues. Immersive virtual reality is a tool that allows individuals to immerse themselves in a simulated world and perceive visual, auditory, and tactile sensations. Its use in physical activity interventions favors exercise in situations that, due to time and space, could be limited in real life. The objective of this case report is to measure the impact on body composition and physical fitness of an exercise program executed through immersive virtual reality. Methods: The design is a case study with a quantitative approach developed through a physical activity intervention with immersive virtual reality in which body composition was evaluated considering fat and muscle components, and physical fitness considering cardiorespiratory fitness, speed-agility, and hand grip strength, through pre- and post-testing. The physical exercise program based on immersive virtual reality lasted 8 weeks. The subject of the study was a 24-year-old man, a second-year student of Pedagogy in Physical Education at a Chilean university, with no previous experience in this virtual tool. Results: The results indicate that for body composition the study subject decreased the fat component and slightly improved the musculature, while for physical fitness cardiorespiratory fitness and speed-agility improved, but manual grip strength decreased. Conclusions: It is concluded that the training developed through immersive virtual reality proves to be a tool that can promote improvements in body composition and physical fitness; it is necessary to carry out more research to validate the potential of this instrument as a means of contributing to the health of the population.
Musculoskeletal Magazine Advertising Focuses on White Individuals and Overlooks Minority Consumers
Authors: Tung Wei Shao , Rankin Kelsey A. , Oris Robert John , Wijesekera Adithi , Wiznia Daniel H.
Published: February 2025

Introduction: Demographic disparities in musculoskeletal (MSK) health exist in the US. Racial representation in advertising has been shown to influence consumer behavior and buying patterns. Direct-to-consumer advertising that does not target a racially diverse audience may exacerbate MSK disparities by failing to reach minorities. We explore the hypothesis that minorities are underrepresented in direct-to-consumer MSK advertisements in this cross-sectional analysis. Methods: Using magazines from four databases, eight health-related magazine types were selected and advertisement categories were established. Racial distribution was analyzed using Pearson’s Chi-squared and Chi-squared tests. Fisher’s Exact test was used when >20% of cells had expected frequencies <5. Significance was set at α = 0.05. Results: Of the advertisements featuring at least one model, 68.5% featured a white-presenting model, followed by 17.6% with a black model. Further, 92.7% of advertisements were monoethnic or monoracial with an overrepresentation of white models (p < 0.001). Black models were overrepresented as athletes (p < 0.001) and underrepresented in advertisements for pain relief (p < 0.001). Hispanic/Latinx and Asian models were underrepresented across all advertisement categories (p < 0.001). Discussion: The causes of musculoskeletal health disparities are multifactorial. One potential influence is adjacent industries such as MSK health-related advertisements. When controlling for US population demographics, white models were overrepresented and minority race models were underrepresented, demonstrating racioethnic disparities in MSK advertising. Improving the racial and ethnic diversity of models within MSK advertisements may serve to improve patient perceptions of orthopaedic products and services and improve MSK disparities.