bluuebunny/crossref_metadata_2025 huggingface dataset:
Sex Differences in the Brain Transcriptomes of Adult Blue Gourami Fish (Trichogaster trichopterus)
Authors: Degani Gad , Meerson Ari
Published: July 2024

Blue gourami (gourami, Trichogaster trichopterus) is a model for labyrinth fishes (Anabantoidei) adapted to partial air breathing. Its reproductive endocrinology has been extensively studied, and transcriptomic sex differences in the gonads were described. Nevertheless, sex differences in gene expression in non-gonadal tissues ostensibly affected by the sex-specific hormonal balance, e.g., the brain, are unknown. To assess such differences, we used bulk RNA-seq to assemble and compare polyA+ transcriptomes between whole brains of four adult male and five adult female gourami, in addition to other tissues (three dorsal fin and five ovary samples) from the same female group. While all nine brain transcriptomes clustered together relative to the other tissues, they showed separation according to sex. A total of 3568 genes were differentially expressed between male and female brains; of these, 1962 and 1606 showed lower and higher expression in males, respectively. Male brains showed stronger down-regulation of specific genes, which included hormone receptors, e.g., pituitary adenylate cyclase-activating polypeptide receptor (pacap-r1). Among the genes with lower expression in male brains, multiple pathways essential to brain function were over-represented, including GABA, acetylcholine and glutamate receptor signaling, calcium and potassium transmembrane transport, and neurogenesis. In contrast, genes with higher expression in male brains showed no significant over-representation of brain-specific functions. To measure the mRNA levels of specific hormone receptors known from prior studies to regulate reproductive function and behavior in gourami and to validate RNA-seq results for these specific genes, we performed RT-qPCR for five receptors, pacap-r1, gonadotropin-releasing hormone 2 receptor (gnrh2r), kisspeptin receptor 1 (gpαr1/kiss1), insulin-like growth factor 1 receptor (igf1r), and membrane progesterone receptor 1 (mpr1), in the brain RNA sample groups. Of these, pacap-r1 showed a significant, three-fold down-regulation, while gpαr1/kiss1 showed a significant two-fold down-regulation in male vs. female gourami brains. Our results are novel in describing the suppression of brain function-related gene expression in male, as compared to female, gourami brains. Further research is needed to assess the behavioral significance of this effect and its prevalence in other vertebrate groups.
Use of Different O/W or W/O Emulsions as Functional Ingredients to Reduce Fat Content and Improve Lipid Profile in Spanish Cured Processed Meat Product (‘Chorizo’)
Authors: Martínez Elena , Vieira Júnior Wagner Goncalves , Álvarez-Ortí Manuel , Rabadán Adrián , Pardo José Emilio
Published: July 2024

In this work, three out of five types of oil-in-water and water-in-oil emulsions were selected to replace pork backfat to reduce the fat content and the improve monounsaturated and polyunsaturated fatty acid content in dry cured sausage (‘chorizo’). Different characteristics of the new product were studied: the texture profile, color, nutritional value, lipid profile, vitamin E and thiobarbituric acid (TBA) and sensory qualities. The use of emulsions to replace the animal fat affected all color parameters, obtaining darker, less red and yellow products, which could impact the consumer’s purchase intention. This replacement also altered the texture parameters, increasing or decreasing the hardness in comparison with the control sample. The cohesiveness, however, decreased in all cases, which meant that when the samples are cut for consumption, they disintegrated more than the traditional ones. The most relevant aspect for nutritional value is that the use of the new emulsions helped to reduce the total fat and energy value of the reformulated samples. The most significant aspect is that this reformulation helped to reduce the fat content—specifically, saturated fat—while increasing the content of Omega 3/6. The new formulas contained significant quantities of TBA and vitamin E when comparing them with the traditional product.
Effects of Different Soybean and Coconut Oil Additions on the Physicochemical and Sensory Properties of Soy Protein–Wheat Protein Mixture Subjected to High-Moisture Extrusion
Authors: Zhang Wentao , Hui Bowen , Li Xuejie , Guo Zengwang , Ma Jian , Li Jian
Published: July 2024

A protein mixture was prepared using a blend of soybean protein isolate, soybean protein concentrate, and wheat protein through high-moisture extrusion. This study investigated the effects of soybean oil/coconut oil additions (2%, 5%, and 8%) on the physiochemical properties of a soy protein–wheat protein mixture subjected to high-moisture extrusion. The protein extrudates underwent assessment for textural properties, fiber degree, sensory evaluation, microstructure, protein solubility, and protein secondary structure. The findings indicated that plant oils significantly reduced the hardness, springiness, and chewiness of the extrudates, and 5% plant oil significantly increased the fiber degree of the extrudates. In addition, the highest fiber degree and sensory evaluation score were achieved with 5% coconut oil. Observation of the macro- and microstructure indicated that the presence of unsaturated fatty acids in soybean oil did not benefit the improvement of the fibrous structure of protein extrudates during high-moisture extrusion processing. SDS-PAGE and FTIR results revealed that coconut oil, rich in saturated fatty acids, caused the clustering of medium- and low-molecular-weight subunits in texturized protein. Additionally, coconut oil elevated the ratio of 11S protein subunits containing sulfur-based amino acids and facilitated a shift from β-turn to β-sheet. The inclusion of plant oils increased the development of hydrogen and disulfide bonds, resulting in a denser, fibrous structure. DSC demonstrated that plant oils reduced the thermal stability of the texturized proteins but enhanced the order of protein structure.
Dietary Energy and Protein Levels Influence the Mutton Quality and Metabolomic Profile of the Yunshang Black Goat
Authors: Li Zijian , Jiang Yanting , Khan Muhammad , Xue Bai , Zhao Xiaoqi , Fu Binlong , Li Weijuan , Danzeng Baiji , Ni Xiaojun , Shao Qingyong , Ouyang Yina
Published: July 2024

This study aimed to evaluate the impact of dietary energy and protein levels on the meat quality and metabolomic profile of Yunshang black goats. For this, 80 Yunshang black goats (male, 6 months old, with a mean live body weight of 35.82 ± 2.79 kg) were used in a completely randomized design with a 2 × 2 factorial dietary arrangement. The dietary treatments were (1) high energy (9.74 MJ/kg) with high protein (12.99%) (HEHP), (2) high energy (9.76 MJ/kg) with low protein (10.01%) (HELP), (3) low energy (8.18 MJ/kg) with high protein (13.04%) (LEHP), and (4) low energy (8.14 MJ/kg) with low protein (10.05%) (LELP). The experiment lasted 64 days, including 14 days for dietary adaptation and a 50-day feeding trial. At the end of the experiment, four animals from each treatment were slaughtered to assess their meat quality and metabolomic profiles. The pH value was greater for the goats fed the LELP diet compared with the other treatments. The LEHP-fed group’s meat was brighter (L*) than that of the other three groups. The HEHP-fed group had considerably more tender meat (p < 0.05) compared with the LEHP-fed group. Moreover, 72 and 183 differentiated metabolites were detected in the longissimus muscle samples by using gas chromatography–mass spectrometry and liquid chromatography–tandem mass spectrometry, respectively. The hydropathy and volatilities of raw meat were different (p < 0.05), suggesting changes in the meat flavor because of the dietary treatments. Based on the results, it can be concluded that feeding a high-energy- and high-protein-containing diet improved the tenderness, flavor, and fatty acid contents of mutton.
Light Flux Density and Photoperiod Affect Growth and Secondary Metabolism in Fully Expanded Basil Plants
Authors: d’Aquino Luigi , Cozzolino Rosaria , Malorni Livia , Bodhuin Thierry , Gambale Emilia , Sighicelli Maria , Della Mura Brigida , Matarazzo Cristina , Piacente Sonia , Montoro Paola
Published: July 2024

Indoor production of basil (Ocimum basilicum L.) is influenced by light spectrum, photosynthetic photon flux density (PPFD), and the photoperiod. To investigate the effects of different lighting on growth, chlorophyll content, and secondary metabolism, basil plants were grown from seedlings to fully expanded plants in microcosm devices under different light conditions: (a) white light at 250 and 380 μmol·m−2·s−1 under 16/8 h light/dark and (b) white light at 380 μmol·m−2·s−1 under 16/8 and 24/0 h light/dark. A higher yield was recorded under 380 μmol·m−2·s−1 compared to 250 μmol·m−2·s−1 (fresh and dry biomasses 260.6 ± 11.3 g vs. 144.9 ± 14.6 g and 34.1 ± 2.6 g vs. 13.2 ± 1.4 g, respectively), but not under longer photoperiods. No differences in plant height and chlorophyll content index were recorded, regardless of the PPFD level and photoperiod length. Almost the same volatile organic compounds (VOCs) were detected under the different lighting treatments, belonging to terpenes, aldehydes, alcohols, esters, and ketones. Linalool, eucalyptol, and eugenol were the main VOCs regardless of the lighting conditions. The multivariate data analysis showed a sharp separation of non-volatile metabolites in apical and middle leaves, but this was not related to different PPFD levels. Higher levels of sesquiterpenes and monoterpenes were detected in plants grown under 250 μmol·m−2·s−1 and 380 μmol·m−2·s−1, respectively. A low separation of non-volatile metabolites based on the photoperiod length and VOC overexpression under longer photoperiods were also highlighted.
Enhancing Transient Stability in Multi-Machine Power Systems through a Model-Free Fractional-Order Excitation Stabilizer
Authors: Fathollahi Arman , Andresen Björn
Published: July 2024

The effective operation of model-based control strategies in modern energy systems, characterized by significant complexity, is contingent upon highly accurate large-scale models. However, achieving such precision becomes challenging in complex energy systems rife with uncertainties and disturbances. Controlling different parts of the energy system poses a challenge to achieving optimal power system efficiency, particularly when employing model-based control strategies, thereby adding complexity to current systems. This paper proposes a novel model-independent control approach aimed at augmenting transient stability and voltage regulation performance in multi machine energy systems. The approach involves the introduction of an optimized model-free fractional-order-based excitation system stabilizer for synchronous generators in a multi machine energy system. To overcome the limitations associated with complex system model identification, which add degrees of simplification at defined operating conditions and assume the system model remains fixed despite high uncertainty and numerous disturbances, an optimal model-independent fractional-order-based excitation control strategy is introduced. The efficacy of the proposed approach is validated through comparative numerical analyses using the MATLAB/Simulink environment. These simulations were conducted on a two-area, 12-bus multi-machine power system. Simulation results demonstrate that the presented excitation system stabilizer outperforms conventional controllers in terms of transient and small-signal stability. It also suppresses the low-frequency electromechanical oscillations within the multimachine energy system.
Fractal Operators Abstracted from Arterial Blood Flow
Authors: Zhou Tianyi , Yin Yajun , Peng Gang , Luo Chaoqian , Jian Zhimo
Published: July 2024

In this paper, we present a re-established functional fractal circuit model of arterial blood flow that incorporates the shunt effect of the branch vessels. Under the background of hemodynamics, we abstracted a family of fractal operators and investigate the kernel function and properties thereof. Based on fractal operators, the intrinsic relation between Bessel function and Struve function was revealed, and some new special functions were found. The results provide mathematical tools for biomechanics and automatic control.
Planning of Urban Freight Innovation Ecosystems: A Systematic Literature Review from a Public Authority Perspective
Authors: Pana Tronca Luciano Agustin , Rotaris Lucia
Published: July 2024

This study explores the role of local authorities in achieving net zero emissions in the context of the climate crisis, with a particular focus on the freight transport sector. The study identifies the challenges of decarbonising urban freight transport and highlights the need for planning frameworks to facilitate this transition. The authors examine freight innovation ecosystems and the various actors involved in designing public policies that incentivise the creation or enhancement of these ecosystems. Through a systematic literature review, bibliometric analysis, and content analysis, this study identifies a lack of connection between the literature on these topics. However, it also highlights the potential for lessons to be learned from successful incentive frameworks in the four clusters identified. The authors propose a comprehensive incentives framework that includes both direct and indirect incentives aimed at the ecosystem and the public sector, respectively, as well as city conditions that can facilitate systemic change. Overall, this study provides valuable insights for policymakers and stakeholders seeking to promote sustainable transport and achieve net zero emissions.
Effect of Drying Methods on the Thermal and Mechanical Behavior of Bacterial Cellulose Aerogel
Authors: Sozcu Sebnem , Frajova Jaroslava , Wiener Jakub , Venkataraman Mohanapriya , Tomkova Blanka , Militky Jiri
Published: July 2024

Bacterial cellulose (BC) presents significant promise as a biomaterial, boasting unique qualities such as exceptional cellulose purity, robust mechanical strength, heightened crystalline structure, and biodegradability. Several studies have highlighted specific effects, such as the impact of dehydration/rehydration on BC tensile strength, the influence of polymer treatment methods on mechanical properties, the correlation between microorganism type, drying method, and Young’s modulus value, and the relationship between culture medium composition, pH, and crystallinity. Drying methods are crucial to the structure, performance, and application of BC films. Research findings indicate that the method used for drying can influence the mechanical properties of BC films, including parameters such as tensile strength, Young’s modulus, and water absorption capacity, as well as the micromorphology, crystallinity, and thermal characteristics of the material. Their versatility makes them potential biomaterials applicable in various fields, including thermal and acoustic insulation, owing to their distinct thermal and mechanical attributes. This review delves into the thermal and mechanical behavior of bacterial cellulose aerogels, which are profoundly impacted by their drying mechanism.
Stimuli-Responsive Nanocomposite Hydrogels for Oral Diseases
Authors: Conte Raffaele , Valentino Anna , Romano Silvia , Margarucci Sabrina , Petillo Orsolina , Calarco Anna
Published: July 2024

Oral diseases encompassing conditions such as oral cancer, periodontitis, and endodontic infections pose significant challenges due to the oral cavity’s susceptibility to pathogenic bacteria and infectious agents. Saliva, a key component of the oral environment, can compromise drug efficacy during oral disease treatment by diluting drug formulations and reducing drug-site interactions. Thus, it is imperative to develop effective drug delivery methods. Stimuli-responsive nanocomposite hydrogels offer a promising solution by adapting to changes in environmental conditions during disease states, thereby enabling targeted drug delivery. These smart drug delivery systems have the potential to enhance drug efficacy, minimize adverse reactions, reduce administration frequency, and improve patient compliance, thus facilitating a faster recovery. This review explores various types of stimuli-responsive nanocomposite hydrogels tailored for smart drug delivery, with a specific focus on their applications in managing oral diseases.
Replication of Known and Identification of Novel Associations in Biobank-Scale Datasets: A Survey Using UK Biobank and FinnGen
Authors: Tkachenko Alexander A. , Changalidis Anton I. , Maksiutenko Evgeniia M. , Nasykhova Yulia A. , Barbitoff Yury A. , Glotov Andrey S.
Published: July 2024

Over the last two decades, numerous genome-wide association studies (GWAS) have been performed to unveil the genetic architecture of human complex traits. Despite multiple efforts aimed at the trans-biobank integration of GWAS results, no systematic analysis of the variant-level properties affecting the replication of known associations (or identifying novel ones) in genome-wide meta-analysis has yet been performed using biobank-scale data. To address this issue, we performed a systematic comparison of GWAS summary statistics for 679 complex traits in the UK Biobank (UKB) and FinnGen (FG) cohorts. We identified 37,148 index variants with genome-wide associations with at least one trait in either cohort or in the meta-analysis, only 3528 (9.5%) of which were shared between UKB and FG. Nearly twice as many variants (6577) were replicated in another dataset at the significance level adjusted for the number of variants selected for replication. However, as many as 9230 loci failed to be replicated. Moreover, as many as 5813 loci were observed as significant associations only in meta-analysis results, highlighting the importance of trans-biobank meta-analysis efforts. We showed that variants that failed to replicate in UKB or FG tend to correspond to rare, less pleiotropic variants with lower effect sizes and lower LD score values. Genome-wide associations specific to meta-analysis were also enriched in low-effect variants; however, such variants tended to be more common and have more consistent frequencies between populations. Taken together, our results show a relatively high rate of non-replication of genome-wide associations in the studied cohorts and highlight both widely appreciated and less acknowledged properties of the associations affecting their identification and replication.
Interstitial Lung Diseases and Non-Small Cell Lung Cancer: Particularities in Pathogenesis and Expression of Driver Mutations
Authors: Sampsonas Fotios , Bosgana Pinelopi , Bravou Vasiliki , Tzouvelekis Argyrios , Dimitrakopoulos Foteinos-Ioannis , Kokkotou Eleni
Published: July 2024

Introduction: Interstitial lung diseases are a varied group of diseases associated with chronic inflammation and fibrosis. With the emerging and current treatment options, survival rates have vastly improved. Having in mind that the most common type is idiopathic pulmonary fibrosis and that a significant proportion of these patients will develop lung cancer as the disease progresses, prompt diagnosis and personalized treatment of these patients are fundamental. Scope and methods: The scope of this review is to identify and characterize molecular and pathogenetic pathways that can interconnect Interstitial Lung Diseases and lung cancer, especially driver mutations in patients with NSCLC, and to highlight new and emerging treatment options in that view. Results: Common pathogenetic pathways have been identified in sites of chronic inflammation in patients with interstitial lung diseases and lung cancer. Of note, the expression of driver mutations in EGFR, BRAF, and KRAS G12C in patients with NSCLC with concurrent interstitial lung disease is vastly different compared to those patients with NSCLC without Interstitial Lung Disease. Conclusions: NSCLC in patients with Interstitial Lung Disease is a challenging diagnostic and clinical entity, and a personalized medicine approach is fundamental to improving survival and quality of life. Newer anti-fibrotic medications have improved survival in IPF/ILD patients; thus, the incidence of lung cancer is going to vastly increase in the next 5–10 years.
Intraspecific Differentiation of Styrax japonicus (Styracaceae) as Revealed by Comparative Chloroplast and Evolutionary Analyses
Authors: Zheng Hao-Zhi , Dai Wei , Xu Meng-Han , Lin Yu-Ye , Zhu Xing-Li , Long Hui , Tong Li-Li , Xu Xiao-Gang
Published: July 2024

Styrax japonicus is a medicinal and ornamental shrub belonging to the Styracaceae family. To explore the diversity and characteristics of the chloroplast genome of S. japonicus, we conducted sequencing and comparison of the chloroplast genomes of four naturally distributed S. japonicus. The results demonstrated that the four chloroplast genomes (157,914–157,962 bp) exhibited a typical quadripartite structure consisting of a large single copy (LSC) region, a small single copy (SSC) region, and a pair of reverse repeats (IRa and IRb), and the structure was highly conserved. DNA polymorphism analysis revealed that three coding genes (infA, psbK, and rpl33) and five intergene regions (petA-psbJ, trnC-petN, trnD-trnY, trnE-trnT, and trnY-trnE) were identified as mutation hotspots. These genetic fragments have the potential to be utilized as DNA barcodes for future identification purposes. When comparing the boundary genes, a small contraction was observed in the IR region of four S. japonicus. Selection pressure analysis indicated positive selection for ycf1 and ndhD. These findings collectively suggest the adaptive evolution of S. japonicus. The phylogenetic structure revealed conflicting relationships among several S. japonicus, indicating divergent evolutionary paths within this species. Our study concludes by uncovering the genetic traits of the chloroplast genome in the differentiation of S. japonicus variety, offering fresh perspectives on the evolutionary lineage of this species.
‘Frail Warrior’: Stevenson as Manly Invalid at Saranac Lake
Authors: Rieger Christy
Published: July 2024

Although “frail warrior” appears a contradiction in terms, the epithet captures how Robert Louis Stevenson’s admirers sought to reconcile a late-nineteenth-century ideal of physical manliness with the reality of the adventure writer’s debilitating illness. This construction of the writer’s public image is evident in accounts of his stay at the Saranac Lake, NY, tuberculosis sanatorium during the frigid winter of 1887–1888. The institution’s distinctive wilderness setting for medical treatment enabled a heroic model of disabled masculinity, one that is framed by American national identity. This archetype informs the author’s posthumous reputation and shows how gender and nationality shape metaphoric thinking about illness and authorship.
The Social Mobility and “Hidalguía” of the Villafañe y Guzmán Family Reflect the Intricacies of Social and Colonial Dynamics over Five Centuries
Authors: Villafañe Jorge Hugo
Published: July 2024

This study examines the relationship between social mobility and hidalguía (noble status) in Castile and America over five centuries, focusing on a specific family of peninsular hidalgo individuals, the Villafañe y Guzmán family, who exerted significant influence in the provinces of La Rioja and Córdoba (Argentina) through their kinship ties. The distribution of resources, power, and opportunities has been instrumental in determining the social status and opportunities available to individuals and groups. The study confirms that the limited social mobility in colonial society and the advantages of accessing certain activities may explain the enduring nature of socioeconomic inequality in Latin America.
San Bushman Human–Lion Transformation and the “Credulity of Others”
Authors: Guenther Mathias
Published: July 2024

Lion transformation, among San-Bushmen, is arguably the most dramatic and spectacular instance of animal transformation. Transformation is a central component of San curing and initiation ritual and of certain San hunting practices. Moreover, it is a recurrent theme in San mythology, art and cosmology, all of them domains of San expressive and symbolic culture that are pervaded by ontological mutability (manifested most strikingly in the therianthropes of San myth and art). Lion transformation is a phenomenon that has received much mention in the ethnographic literature on Khoisan ritual and belief, through information that is based not on first-hand but second- or third-hand ethnographic and ethno-historical information. In the paper, I describe my own eye-witness account of what San people deemed a lion transformation by a trance dancer, which I observed in my early field work among Ghanzi (Botswana) Naro and = Au//eisi San in the 1970s. This is followed by my own musings on the actuality or reality of lion transformation, from both my own perspective and from what I understand to be the indigenous perspective. In terms of the latter, lion transformation—and animal transformation in general—is a plausible proposition. Indigenous doubt and scepticism, deriving from a rarely if ever fully conclusive witnessing of such transformations, are assuaged in a number of epistemological, cosmological and phenomenological ways. These are not available to a Western cultural outsider with a Cartesian mindset, nor to a Westernized—and perhaps also Christianized—insider, whose cosmos has become “disenchanted” through historical–colonial and contemporary–acculturational influences.
Food Consumption Inequalities in Primary Care in a Large Metropolis
Authors: Lopes Mariana Souza , dos Santos Priscila Lenita Candida , Lopes Aline Cristine Souza
Published: July 2024

The aim of this study was to examine the association between health vulnerability and food consumption according to the NOVA classification within primary care in a major Brazilian city. A cross-sectional study was conducted among adults over 20 years old. These participants were part of a representative sample from the Health Academy Program (PAS) in Belo Horizonte, Brazil. We evaluated socio-demographic variables, self-reported illnesses, perceived health and quality of life, and the length of participation in PAS. Health vulnerability was gauged through the Health Vulnerability Index (HVI), which is calculated for each census sector and classified as low, medium, and high/very high. On the other hand, food consumption was determined by evaluating the average consumption described in a 24 h diet recall (24HR) and categorizing it under the NOVA classification: culinary preparations, processed foods, and ultra-processed foods (UPFs). The average calorie intake was 1429.7 kcal, primarily from culinary preparations (61.6%) and UPFs (27.4%). After adjustments, individuals residing in high/very high-HVI areas consumed more culinary preparations (β = 2.7; 95%CI: 4.7; 0.7) and fewer UPFs (β = −2.7; 95%CI: −4.7; −0.7) compared to those from low-vulnerability areas. PAS participants residing in more vulnerable areas reported healthier dietary habits, consuming more homecooked meals and fewer UPFs. These findings underscore the importance of concentrating efforts on promoting and preserving healthy eating habits and emphasizing the value of home cooking in the most vulnerable regions.
A Randomized Controlled Trial Testing the Effects of a Social Needs Navigation Intervention on Health Outcomes and Healthcare Utilization among Medicaid Members with Type 2 Diabetes
Authors: McQueen Amy , von Nordheim David , Caburnay Charlene , Li Linda , Herrick Cynthia , Grimes Lauren , Broussard Darrell , Smith Rachel E. , Lawson Dana , Yan Yan , Kreuter Matthew
Published: July 2024

Health systems are increasingly assessing and addressing social needs with referrals to community resources. The objective of this randomized controlled trial was to randomize adult Medicaid members with type 2 diabetes to receive usual care (n = 239) or social needs navigation (n = 234) for 6 months and compare HbA1c (primary outcome), quality of life (secondary outcome), and other exploratory outcomes with t-tests and mixed-effects regression. Eligible participants had an HbA1c test in claims in the past 120 days and reported 1+ social needs. Data were collected from November 2019 to July 2023. Surveys were completed at baseline and at 3-, 6-, and 12-month follow-up. Health plan data included care management records and medical and pharmacy claims. The sample was from Louisiana, USA, M = 51.6 (SD = 9.5) years old, 76.1% female, 66.5% Black, 29.4% White, and 3.0% Hispanic. By design, more navigation (91.5%) vs. usual care (6.7%) participants had a care plan. Social needs persisted for both groups. No group differences in HbA1c tests and values were observed, though the large amount of missing HbA1c lab values reduced statistical power. No group differences were observed for other outcomes. Proactively eliciting and attempting to provide referrals and resources for social needs did not demonstrate significant health benefits or decrease healthcare utilization in this sample.
Impact of Lowering TSH Cut-Off on Neonatal Screening for Congenital Hypothyroidism in Minas Gerais, Brazil
Authors: Teixeira Palla Braga Nathalia , Vilela Antunes Jáderson Mateus , Colosimo Enrico Antônio , Alves Dias Vera Maria , Januário José Nélio , Novato Silva Ivani
Published: July 2024

A higher incidence of primary congenital hypothyroidism (CH) has been related to increased sensitivity in neonatal screening tests. The benefit of treatment in mild cases remains a topic of debate. We evaluated the impact of reducing the blood-spot TSH cut-off (b-TSH) from 10 (Group 2) to 6 mIU/L (Group 1) in a public neonatal screening program. During the study period, 40% of 123 newborns with CH (n = 162,729; incidence = 1:1323) had b-TSH between 6 and 10 mIU/L. Group 1 patients had fewer clinical signs (p = 0.02), lower serum TSH (p < 0.01), and higher free T4 (p < 0.01) compared to those in Group 2 at diagnosis. Reducing the b-TSH cut-off from 10 to 6 mIU/L increased screening sensitivity, allowing a third of diagnoses, mainly mild cases, not being missed. However, when evaluating the performances of b-TSH cut-offs (6, 7, 8, 9, and 10 mIU/L), the lower values were associated with low positive predictive values (PPVs) and unacceptable increased recall rates (0.57%) for a public health care program. A proposed strategy is to adopt a higher b-TSH cut-off in the first sample and a lower one in the subsequent samples from the same child, which yields a greater number of diagnoses with an acceptable PPV.
Beekeepers Support the Use of RNA Interference (RNAi) to Control Varroa destructor
Authors: McGruddy Rose , Haywood John , Lester Philip J.
Published: July 2024

Current Varroa mite management strategies rely heavily on the use of pesticides, adversely affecting honey bee health and leaving toxic residues in hive products. To explore the likelihood of RNAi technology being utilised as an alternative control method for pests like Varroa, the opinions of beekeepers on the use of this new biotechnology were obtained using a mixed-methodology approach. In-person surveys and focus groups using the Q method were conducted to discover the willingness of beekeepers to utilise Varroa-targeting RNAi treatments in their hives, and to gain feedback to inform decisions before the implementation of this new technology. Overall, the beekeepers saw potential in RNAi being used to control Varroa in their hives and were eager to have access to an alternative to pesticide treatments. Participants raised concerns about unknown long-term effects on bees and other non-target species, and the potential of an uninformed public preventing them from accessing a new Varroa treatment. While further research and discussion is needed before RNAi treatments for Varroa become commercially available, RNAi technology presents a promising, species-specific and non-toxic solution for Varroa management.
Music Therapy as Non-Pharmacological Treatment in Alzheimer’s Disease—Effects on Memory—Systematic Review
Authors: Madera-Cimadevilla Tania , Cantero-García María , Rueda-Extremera María
Published: July 2024

Alzheimer’s disease (AD) is a neurocognitive disorder characterized by gradual onset and gradual progression, presenting a wide range of symptoms, with one of its main features being episodic memory impairment, present from the early stages of the disease. Currently, there is no cure for AD, so a multidimensional approach combining pharmacology with other non-pharmacological treatments is recommended to halt or delay cognitive and functional decline in patients. In this regard, music therapy emerges as a promising non-pharmacological treatment for memory in patients with AD, as musical memory appears to be preserved, retaining the ability to recall familiar songs and the memories associated with them. Therefore, the aim of this study is to conduct a systematic review of the current state of scientific research on the effects of music therapy on the memory of patients with AD in mild and moderate stages. A search was conducted in the Google Scholar, ProQuest, Summon, Web of Science, and Scopus databases, finding 15 articles that met the inclusion and exclusion criteria. The results seem to support the use of music-based interventions for memory in patients with AD, especially regarding autobiographical memory. However, given the limitations encountered, we consider that the results pave the way for future research rather than providing solid conclusions about their effectiveness.
Age-Specific Outcomes of Bioprosthetic vs. Mechanical Aortic Valve Replacement: Balancing Reoperation Risk with Anticoagulation Burden
Authors: Alhijab Fatimah A. , Alfayez Latifa A. , Hassan Essam , Albabtain Monirah A. , Elnaggar Ismail M. , Alotaibi Khaled A. , Adam Adam I. , Pragliola Claudio , Ismail Huda H. , Arafat Amr A.
Published: July 2024

Background: The choice of prosthesis for aortic valve replacement (AVR) remains challenging. The risk of anticoagulation complications vs. the risk of aortic valve reintervention should be weighed. This study compared the outcomes of bioprosthetic vs. mechanical AVR in patients older and younger than 50. Methods: This retrospective study was conducted from 2009 to 2019 and involved 292 adult patients who underwent isolated AVR. The patients were divided according to their age (above 50 years or 50 years and younger) and the type of valves used in each age group. The outcomes of bioprosthetic valves (Groups 1a (>50 years) and 1b (≤50 years)) were compared with those of mechanical valves (Groups 2a (>50 years) and 2b (≤50 years)) in each age group. Results: The groups had nearly equal rates of preexisting comorbidities except for Group 1b, in which the rate of hypertension was greater (32.6% vs. 14.7%; p = 0.025). This group also had higher rates of old stroke (8.7% vs. 0%, p = 0.011) and higher creatinine clearance (127.62 (108.82–150.23) vs. 110.02 (84.87–144.49) mL/min; p = 0.026) than Group 1b. Patients in Group 1a were significantly older than Group 2a (64 (58–71) vs. 58 (54–67) years; p = 0.002). There was no significant difference in the NYHA class between the groups. The preoperative ejection fraction and other echocardiographic parameters did not differ significantly between the groups. Re-exploration for bleeding was more common in patients older than 50 years who underwent mechanical valve replacement (p = 0.021). There was no difference in other postoperative complications between the groups. The groups had no differences in survival, stroke, or bleeding rates. Aortic valve reintervention was significantly greater in patients ≤ 50 years old with bioprosthetic valves. There were no differences between groups in the changes in left ventricular mass, ejection fraction, or peak aortic valve pressure during the 5-year follow-up. Conclusions: The outcomes of mechanical and bioprosthetic valve replacement were comparable in patients older than 50 years. Using bioprosthetic valves in patients younger than 50 years was associated with a greater rate of valve reintervention, with no beneficial effect on the risk of bleeding or stroke.
Diagnostic Capability of OCTA-Derived Macular Biomarkers for Early to Moderate Primary Open Angle Glaucoma
Authors: Verticchio Vercellin Alice , Harris Alon , Oddone Francesco , Carnevale Carmela , Siesky Brent A. , Arciero Julia , Fry Brendan , Eckert George , Sidoti Paul A. , Antman Gal , Alabi Denise , Coleman-Belin Janet C. , Pasquale Louis R.
Published: July 2024

Background/Objectives: To investigate macular vascular biomarkers for the detection of primary open-angle glaucoma (POAG). Methods: A total of 56 POAG patients and 94 non-glaucomatous controls underwent optical coherence tomography angiography (OCTA) assessment of macular vessel density (VD) in the superficial (SCP), and deep (DCP) capillary plexus, foveal avascular zone (FAZ) area, perimeter, VD, choriocapillaris and outer retina flow area. POAG patients were classified for severity based on the Glaucoma Staging System 2 of Brusini. ANCOVA comparisons adjusted for age, sex, race, hypertension, diabetes, and areas under the receiver operating characteristic curves (AUCs) for POAG/control differentiation were compared using the DeLong method. Results: Global, hemispheric, and quadrant SCP VD was significantly lower in POAG patients in the whole image, parafovea, and perifovea (p < 0.001). No significant differences were found between POAG and controls for DCP VD, FAZ parameters, and the retinal and choriocapillaris flow area (p > 0.05). SCP VD in the whole image and perifovea were significantly lower in POAG patients in stage 2 than stage 0 (p < 0.001). The AUCs of SCP VD in the whole image (0.86) and perifovea (0.84) were significantly higher than the AUCs of all DCP VD (p < 0.05), FAZ parameters (p < 0.001), and retinal (p < 0.001) and choriocapillaris flow areas (p < 0.05). Whole image SCP VD was similar to the AUC of the global retinal nerve fiber layer (RNFL) (AUC = 0.89, p = 0.53) and ganglion cell complex (GCC) thickness (AUC = 0.83, p = 0.42). Conclusions: SCP VD is lower with increasing functional damage in POAG patients. The AUC for SCP VD was similar to RNFL and GCC using clinical diagnosis as the reference standard.
Assessment of Obesity as Risk Factor of Lumbar Disc Surgery: Retrospective Analysis of 598 Cases and Simulated Surgery on 3D-Printed Models
Authors: Stroop Ralf , Carballar Fernando , Zawy Alsofy Samer , Sarkis Hraq , Nakamura Makoto , Greiner Christoph , Dorweiler Bernhard , Wegner Moritz
Published: July 2024

(1) Background: Obesity poses known risks in surgery, including a prolonged operation time and postoperative complications. Given the rising obesity rates and frequent lumbar disc surgeries, understanding these risks is crucial. This study aims to assess the impact of obesity on operation duration and postoperative complications in lumbar disc prolapse surgery. (2) Methods: We retrospectively analyzed 598 patients with monosegmental disc herniation, correlating their body mass index (BMI) as a surrogate parameter for obesity with operation time. Excluding complex cases (multi-segmental herniations or recurrent herniations), complication rates and hospital stays were recorded. Simulated surgeries on 3D-printed models of varying obesity levels examined operation times and instrument suitability. (3) Results: Of these patients, 438 patients had a BMI of <30, and 160 patients had a BMI of ≥30. Complication rates showed no significant differences between groups. Linear regression analysis failed to establish a sole dependency of operation time on BMI, with R2 = 0.039 for the normal-weight group (BMI < 30) and R2 = 0.059 for the obese group (BMI ≥ 30). The simulation operations on the 3D-printed models of varying degrees of obesity showed a significant increase in the simulated operation time with higher levels of obesity. A geometrically inadequate set of surgical instruments was assumed to be a significant factor in the simulated increase in operating time. (4) Conclusions: While various factors influence operation time, obesity alone does not significantly increase it. However, simulated surgeries highlighted the impact of obesity, particularly on instrument limitations. Understanding these complexities is vital for optimizing surgical outcomes in obese patients.
Predictors and Outcomes Associated with Bariatric Robotic Delivery: An MBSAQIP Analysis of 318,151 Patients
Authors: Nasser Khadija , Jatana Sukhdeep , Switzer Noah J. , Karmali Shahzeer , Birch Daniel W. , Mocanu Valentin
Published: July 2024

Background: The adoption of robotic bariatric surgery has increased dramatically over the last decade. While outcomes comparing bariatric and laparoscopic approaches are debated, little is known about patient factors responsible for the growing delivery of robotic surgery. A better understanding of these factors will help guide the planning of bariatric delivery and resource allocation. Methods: Data were extracted from the MBSAQIP registry from 2020 to 2021. The patient population was organized into primary robot-assisted sleeve gastrectomy or Roux-en-Y gastric bypass (RYGB) versus those who underwent laparoscopic procedures. Bivariate analysis and multivariable logistic regression modeling were conducted to characterize cohort differences and identify independent patient predictors of robotic selection. Results: Of 318,151, 65,951 (20.7%) underwent robot-assisted surgery. Patients undergoing robotic procedures were older (43.4 ± 11.8 vs. 43.1 ± 11.8; p < 0.001) and had higher body mass index (BMI; 45.4 ± 7.9 vs. 45.0 ± 7.6; p < 0.001). Robotic cases had higher rates of medical comorbidities, including sleep apnea, hyperlipidemia, gastroesophageal reflux disease (GERD), and diabetes mellitus. Robotic cases were more likely to undergo RYGB (27.4% vs. 26.4%; p < 0.001). Robotic patients had higher rates of numerous complications, including bleed, reoperation, and reintervention, resulting in higher serious complication rates on multivariate analysis. Independent predictors of robotic selection included increased BMI (aOR 1.02), female sex (aOR 1.04), GERD (aOR 1.12), metabolic dysfunction, RYGB (aOR 1.08), black racial status (aOR 1.11), and lower albumin (aOR 0.84). Conclusions: After adjusting for comorbidities, patients with greater metabolic comorbidities, black racial status, and those undergoing RYGB were more likely to receive robotic surgery. A more comprehensive understanding of patient factors fueling the adoption of robotic delivery, as well as those expected to benefit most, is needed to better guide healthcare resources as the landscape of bariatric surgery continues to evolve.
Arterial Stiffness Predicts the Outcome of Endovascular Treatment in Patients with Acute Ischemic Stroke
Authors: Han Minho , Joo Haram , Lee Hyungwoo , Heo JoonNyung , Jung Jae Wook , Kim Young Dae , Park Eunjeong , Nam Hyo Suk
Published: July 2024

Background: The association between arterial stiffness and outcome after endovascular treatment (EVT) is unknown. This study investigated whether arterial stiffness predicts post-EVT outcome in patients with acute ischemic stroke. Methods: This retrospective and observational cohort study included consecutive patients treated with EVT for acute ischemic stroke from June 2020 to November 2022. Arterial stiffness was assessed by brachial–ankle pulse wave velocity. Poor functional outcome was defined as a modified Rankin Scale score ≥3 at 3 months. Results: The mean age of patients included in this study was 71.9 ± 11.8 years, and 57.3% were men. Poor functional outcome was present in 46.8%. Multivariable logistic regression analysis showed that arterial stiffness was independently associated with poor functional outcome (odds ratio 8.640, 95% confidence interval [CI] 1.581–47.228) after adjusting for age, initial stroke severity, hypertension, atrial fibrillation, device pass number, and successful recanalization. A nomogram based on the multivariable statistic model showed a better prediction of poor functional outcome compared to classic risk factor models without arterial stiffness (net reclassification improvement 0.529, 95% CI 0.186–0.873; integrated discrimination improvement 0.046, 95% CI 0.009–0.083). Conclusions: We found that arterial stiffness was an independent predictor of poor functional outcome in patients treated with EVT following acute ischemic stroke.
Risk Factors and Prognostic Factors in GBC
Authors: Tirca Luiza , Savin Catalin , Stroescu Cezar , Balescu Irina , Petrea Sorin , Diaconu Camelia , Gaspar Bogdan , Pop Lucian , Varlas Valentin , Hasegan Adrian , Martac Cristina , Bolca Ciprian , Stoian Marilena , Zgura Anca , Gorecki Gabriel Petre , Bacalbasa Nicolae
Published: July 2024

Background: Gallbladder cancer (GBC) is a rare entity with a poor prognosis, usually discovered late due to nonspecific symptoms; therefore, over the last years, attention has been focused on identifying the risk factors for developing this malignancy in order to provide an early diagnosis, as well as new prognostic factors in order to modulate the long-term evolution of such cases. The aim of this review is to discuss both major risk factors and prognostic factors in GBC for a better understanding and integration of relevant and currently available information. Methods: A literature search was performed using Cochrane Library, PubMed, Google Scholar, Elsevier, and Web of Science; studies published after the year of 2000, in English, were reviewed. Results: Over time, risk factors associated with the development of GBC have been identified, which outline the profile of patients with this disease. The most important prognostic factors in GBC remain TNM staging, safety margin, and R0 status, along with perineural invasion and lymphovascular invasion. Both the technique and experience of the surgeons and a pathological examination that ensures final staging are particularly important and increase the chances of survival of the patients. Conclusions: improvements in surgical techniques and pathological analyses might provide better and more consistent guidance for medical staff in the management of patients with GBC.
Essential New Complexity-Based Themes for Patient-Centered Diagnosis and Treatment of Dementia and Predementia in Older People: Multimorbidity and Multilevel Phenomenology
Authors: Wertman Eli
Published: July 2024

Dementia is a highly prevalent condition with devastating clinical and socioeconomic sequela. It is expected to triple in prevalence by 2050. No treatment is currently known to be effective. Symptomatic late-onset dementia and predementia (SLODP) affects 95% of patients with the syndrome. In contrast to trials of pharmacological prevention, no treatment is suggested to remediate or cure these symptomatic patients. SLODP but not young onset dementia is intensely associated with multimorbidity (MUM), including brain-perturbating conditions (BPCs). Recent studies showed that MUM/BPCs have a major role in the pathogenesis of SLODP. Fortunately, most MUM/BPCs are medically treatable, and thus, their treatment may modify and improve SLODP, relieving suffering and reducing its clinical and socioeconomic threats. Regrettably, the complex system features of SLODP impede the diagnosis and treatment of the potentially remediable conditions (PRCs) associated with them, mainly due to failure of pattern recognition and a flawed diagnostic workup. We suggest incorporating two SLODP-specific conceptual themes into the diagnostic workup: MUM/BPC and multilevel phenomenological themes. By doing so, we were able to improve the diagnostic accuracy of SLODP components and optimize detecting and favorably treating PRCs. These revolutionary concepts and their implications for remediability and other parameters are discussed in the paper.