bluuebunny/crossref_metadata_2025 huggingface dataset:
A 12-Year Experimental Design to Test the Recovery of Butterfly Biodiversity in an Urban Ecosystem: Lessons from the Parc Urbain des Papillons
Authors: Deschamps-Cottin Magali , Jacek Guillaume , Seguinel Louise , Le Champion Clémentine , Robles Christine , Ternisien Mélanie , Duque Chloé , Vila Bruno
Published: September 2023

Urbanization is one of the main threats to biodiversity. However, some urban green spaces could act as refuges for urban fauna if the composition of the flora were less horticultural and if a less intensive management strategy is adopted. Among the taxa, butterflies are experiencing a strong decline from European to regional scales. An ecological engineering project based on a plantation of host and nectariferous plants backed up by a well thought out management strategy was carried out in Marseille at the Parc Urbain des Papillons (the Butterflies Urban Park). We assessed its effectiveness by comparing the butterfly communities in this park before and after the engineering work, and we compared it to a neighboring wasteland with natural habitats. After 12 years of the project, the results show a significant change in the species composition. The species richness greatly increased from 25 to 42 species. Some specialist species we targeted appeared, and their numbers increased from one to five. However, three Mediterranean species are still absent compared to the wasteland with natural habitats. As the plant palette used and the management strategy implemented enabled us to significantly increase the number of species, we now plan to work on the structure of the vegetation.
Blend Sign and Haemorrhage Location and Volume Predict Late Recurrence and Mortality in Intracerebral Haemorrhage Patients
Authors: Schreiber Frank , Kuschel Jan-Niklas , Klai Marwa , Chahem Christian , Arndt Philipp , Perosa Valentina , Assmann Anne , Dörner Marc , Luchtmann Michael , Meuth Sven Günther , Vielhaber Stefan , Henneicke Solveig , Schreiber Stefanie
Published: September 2023

Background: Studies on risk factors for primary intracerebral haemorrhage (ICH) focus on short-term predictive values of distinct clinical parameters or computed tomography (CT) markers and disregard the others. We, therefore, studied independent predictive values of demographic, clinical, and CT markers regarding ICH expansion, late ICH recurrence, and late mortality. Methods: In a retrospective study of 288 patients with primary ICH, ICH localization (158 lobar, 81 deep, and 49 cerebellar), volume, blend sign, spot sign, finger-like projections, and subarachnoid haemorrhages were evaluated. ICH localization-specific differences for demographic (age, sex), clinical parameters (vascular risk factors, antiplatelet, and anticoagulation therapy), and CT markers were evaluated using logistic regression. We applied Cox proportional hazards modelling using these parameters to predict risk factors for ICH expansion, late ICH recurrence, and late mortality. Results: The blend sign in lobar ICH relates to increased risk of ICH expansion (HR2.3), late ICH recurrence (HR2.3), and mortality (HR1.6). Age, conditions requiring antiplatelet medication, deep ICH localization, volume, and blend sign represented the most important independent factors impacting overall mortality. Conclusions: Blend sign at baseline ICH is a manifestation of underlying detrimental vascular processes that signal increased ICH expansion risk, although is also indicative of long-term risks for late recurrent ICH and late mortality.
Injury Patterns and Incidence in an Elite Youth Football Academy—A Prospective Cohort Study of 138 Male Athletes
Authors: Weishorn Johannes , Jaber Ayham , Zietzschmann Severin , Spielmann Jan , Renkawitz Tobias , Bangert Yannic
Published: September 2023

Background: There is a lack of evidence regarding injury incidence in German elite youth football academies, and the risk of re-injury is unknown. Therefore, the objectives of this study were (1) to determine injury patterns and incidence in an elite youth football academy in Germany, (2) to monitor overuse-/trauma-related injuries over the course of the season, and (3) determine the risk of re-injury. Methods: A prospective cohort study was conducted in the 2012/2013 season among 138 male players from an elite youth football academy in Germany. Injuries were recorded according to the consensus statement on injury definitions and data collection in studies of football injuries. Injury incidence was reported as the number of injuries per 1000 h of exposure and the number of injuries per squad season. Results: A total of 109 injuries were reported, resulting in a cumulative time-loss of 2536 days. A squad of 25 players sustained 19.7 injuries per season, with an average of 23.3 days (15.7–30.9; 95% CI lower-upper) of absence per injury. Ligament sprains (28%), muscle strains (19%) and physeal injuries (12%) were the most common causes of time-loss. Physeal injuries were the most common severe type of injury (29%), with a mean time-loss of 29.7 days (18.2–41.2; 95% CI lower-upper). Re-injuries accounted for 3% of all injuries and resulted in significantly more time-loss than non-re-injuries (60 vs. 23 days; p = 0.01). Conclusion: In the youth academies studied, a team of 25 players sustained an average of 19.7 injuries per season, resulting in a cumulative time-loss of 459 days. Physeal injuries are a major contributor to severe injuries and therefore require special attention.
The Emotional Landscape of Pregnancy and Postpartum during the COVID-19 Pandemic in Italy: A Mixed-Method Analysis Using Artificial Intelligence
Authors: Ravaldi Claudia , Mosconi Laura , Bonaiuti Roberto , Vannacci Alfredo
Published: September 2023

The COVID-19 pandemic affected the perinatal emotional landscape in Italy, a country that had high mortality and implemented a strict lockdown during the pandemic. This study explores the emotions and challenges of pregnant and postpartum women during the pandemic, using AI-based mixed methods. The study analyzed 1774 women from the national survey COVID-ASSESS: 1136 pregnant and 638 postpartum women. The survey had qualitative questions on emotions and feelings related to birth, communication with healthcare professionals, media, and peers and family. We used natural language processing and machine learning to classify emotions, identify themes, and extract citations from the data. Fear and anxiety replaced joy as dominant emotions during the pandemic: trust and joy decreased by 49.3% and 36.4%, respectively, while sadness and fear increased by 52.3% and 49.3%, respectively. The pandemic also induced loneliness, isolation, frustration, and anger. Women faced challenges related to birth, communication with HCPs, media, and peers and family. They also used coping strategies such as self-care, news limitation, and trying to cultivate gratitude and hope. This study provides a comprehensive exploration of the perinatal emotional landscape of Italian women during the pandemic. The findings underscore the significant psychological impact of the pandemic and also highlight women’s resilience and coping strategies.
Cardiovascular Risk Factors in Transgender People after Gender-Affirming Hormone Therapy
Authors: Sánchez-Toscano Esteban , Domínguez-Riscart Jesús , Larrán-Escandón Laura , Mateo-Gavira Isabel , Aguilar-Diosdado Manuel
Published: September 2023

Introduction: In the last decade, healthcare for the transgender population has increased considerably in many countries thanks to depathologization movements and the easier accessibility of medical assistance. The age at which they request to start gender-affirming hormones (GAHs) is increasingly younger. The cardiovascular risk associated with hormonal treatment is a novel research field, and the published studies are heterogeneous and inconclusive. Our objective is to determine the metabolic impact of GAHs in the transgender people treated in our Gender Identity Treatment Unit. Methods: We designed a pre–post study to analyze changes in anthropometric parameters (weight and body mass index), analytical determinations (fasting blood glucose, glycated hemoglobin, and lipoproteins), and blood pressure control in the transgender population treated with GAHs in Puerta del Mar University Hospital. These variables were collected before and one year after hormonal therapy. Results: A total of 227 transgender people were recruited between 2017 and 2020, 97 (40.09%) transwomen and 136 (59.91%) transmen. The average age at which GAHs began was 18 years. Weight, body mass index, and blood pressure increased significantly in both genders. Transmen showed a more atherogenic lipid profile, with a decrease in cholesterol LDL (p < 0.001) and an increase in triglycerides (p < 0.001). The risk of developing prediabetes or diabetes did not increase one year after treatment, although non-specific alterations in carbohydrate metabolism were detected, such as an increase in glycated hemoglobin in transmen (p = 0.040) and fasting blood glucose in transwomen (p = 0.008). No thromboembolic processes or cardiovascular events were reported during the first year of treatment. Conclusion: In our setting, transgender people developed changes in their metabolic profiles in the first year after hormonal treatment. Both transmen and transwomen showed early alterations in lipid and carbohydrate metabolism, slight elevations in blood pressure, and a tendency to gain weight. This makes lifestyle interventions necessary from the beginning of GAHs.
Management of Constipation in Hospitalized Patients
Authors: Sayuk Gregory S. , Yu Qi T. , Shy Corey
Published: September 2023

Constipation is frequently encountered in hospital settings and can have potentially serious consequences yet is often underrecognized and undertreated. Opioid-induced constipation is a common cause of constipation in hospitalized patients. Opioids induce constipation through agonistic effects on enteric µ-opioid receptors. This review aims to provide insight on the identification and management of constipation in inpatient settings, with a particular focus on opioid-induced constipation. Constipation assessment should be routinely initiated at hospital admission and can be facilitated by thorough symptom assessments; relevant patient history, including recent medication use; physical examination; and patient assessment tools developed to evaluate the impact of constipation. Management of opioid-induced constipation should begin with ensuring adequate hydration and electrolyte balance and encouraging patient mobilization. Other treatments may include laxatives, enemas, intestinal secretagogues, peripherally acting µ-opioid receptor antagonists, and manual disimpaction. Surgical intervention may be required for some patients as a salvage therapy in severe, refractory cases.
Percutaneous Computed Tomography (CT)-Guided Localization with Indocyanine Green for the Thoracoscopic Resection of Small Pulmonary Nodules
Authors: Voulaz Emanuele , Giudici Veronica Maria , Lanza Ezio , Bottoni Edoardo , Cariboni Umberto , Crepaldi Alessandro , Ferrillo Giuseppe , Marulli Giuseppe , Alloisio Marco , Mangiameli Giuseppe , Testori Alberto
Published: September 2023

Background: The identification of small lung nodules is challenging during mini-invasive thoracic surgery. Unable to palpate them directly, surgeons have developed several methods to preoperatively localize pulmonary nodules, including the computed tomography-guided positioning of coils or metallic landmarks (hook wire) or bronchoscopic marking. Methods: We present a series of patients scheduled for the video-assisted thoracoscopic sublobar resection of small pulmonary nodules, in which we performed preoperative percutaneous computed tomography (CT)-guided nodule localization through the injection of a mixture of indocyanine green and human albumin. Results: A total of 40 patients underwent a preoperative CT-guided injection of indocyanine green followed by VATS resection within 24 h. Patients tolerated the procedure well, no pain medication was administrated, and no complications were observed during the marking procedure. All pulmonary nodules were easily detected and successfully resected. Conclusion: the near-infrared dye marking solution of indocyanine green (ICG) with diluted human albumin was safe, effective, and easy to perform. The ICG solution has the potential to facilitate the accurate localization and resection of pulmonary nodules during VATS surgery, avoiding the risk of marker displacement/migration.
Electrochemotherapy in the Treatment of Bone Metastases: A Systematic Review
Authors: Bocchi Maria Beatrice , Meschini Cesare , Pietramala Silvia , Perna Andrea , Oliva Maria Serena , Matrangolo Maria Rosaria , Ziranu Antonio , Maccauro Giulio , Vitiello Raffaele
Published: September 2023

Background and aim: Cancers are one of the most frequent causes of death and disability in humans. Skeletal involvement has a major impact on the quality of life and prognosis of cancer patients. Electrochemotherapy is a palliative and minimally invasive oncologic treatment that was first used to treat subcutaneous nodules for malignant tumors. The aim of our review is to evaluate the results of electrochemotherapy in the treatment of bone metastases. Methods: A systematic review of the literature indexed in the PubMed MEDLINE and Cochrane Library databases using the search key words “electrochemotherapy” AND (“metastasis” OR “metastases”) was performed. The Preferred Reporting Items for Systematic Reviews and MetaAnalyses was followed. Inclusion criteria were proven involvement of the appendicular skeleton in metastatic carcinoma or melanoma, through at least one percutaneous electrochemotherapy session on the metastatic bone lesion. The exclusion criterion was no skeletal metastatic involvement. Results: Eight articles were finally included. We reached a population of 246 patients. The mean age and follow up were 60.1 years old and 11.4 months, respectively. The most represented primary tumor was breast cancer (18.9%). A total of 250 bone lesions were treated with electrochemotherapy. According to RECIST criteria, in our population we observed 55.5% stable diseases. The mean pre-electrochemotherapy VAS value was 6.9, which lowered to 2.7 after treatment. Adverse events occurred in 3.4% of patients. Conclusions: Electrochemotherapy as a minimally invasive and tissue-sparing treatment should be considered for patients with no other alternative to obtain tumor control and improvement in quality of life.
Increased Prevalence of Autoimmune Gastritis in Patients with a Gastric Precancerous Lesion
Authors: Guo Xiaopei , Schreurs Marco W. J. , Marijnissen Fleur E. , Mommersteeg Michiel C. , Nieuwenburg Stella A. V. , Doukas Michail , Erler Nicole S. , Capelle Lisette G. , Bruno Marco J. , Peppelenbosch Maikel P. , Spaander Manon C. W. , Fuhler Gwenny M.
Published: September 2023

Background: Autoimmune gastritis (AIG), characterized with the presence of anti-parietal-cell antibodies (APCA), is a risk factor for gastric cancer. However, AIG may go underdiagnosed, especially in the case of H. pylori infection and the presence of gastric precancerous lesions (GPL), due to the ambiguous pathology and delayed symptom onset. Aim: Investigate the prevalence and characteristics of AIG in GPL patients. Methods: Prevalence of AIG was determined with the presence of APCA in patients with GPL (n = 256) and the control group (n = 70). Pathological characteristics and levels of gastrin 17 (G17), pepsinogen (PG) I and II and anti-Helicobacter pylori IgG were assessed in GPL cases, and the severity of intestinal metaplasia and gastric atrophy was scored by expert pathologists. Results: APCA positivity was observed in 18% of cases vs. 7% of controls (p = 0.033). Only 3/256 patients were previously diagnosed with AIG. The presence of APCA was associated with corpus-limited and extended GPL. A receiver operating curve analysis demonstrated that the G17 and PGI/II ratio could identify APCA-positive patients within GPL cases (AUC: 0.884). Conclusions: The prevalence of AIG is higher in patients with GPL but goes undiagnosed. Using G17 and PG I/II as diagnostic markers can help to identify patients with AIG and improve surveillance programs for patients with GPL.
Do Concurrent Multiple Infections with High-Risk HPVs Carry a More Malignant Potential than a Single Infection in the Uterine Cervix?
Authors: Lee Juhun , Lee Hyun Jung
Published: September 2023

The high-risk human papillomavirus (HR-HPV) has been known as the most important carcinogen in uterine cervical carcinoma. However, there is limited evidence of the malignant potential of these concurrent multiple infections. This study included women who had undergone cervical conization. They underwent an HPV test by cervical swab within 12 months before the surgery. They were divided into two groups: one with a single infection with HR-HPV16 and the other with concurrent multiple infections with HR-HPVs, including genotype 16. Pathologic examination classified cases as CIS+ to assess and compare the malignant potential in both groups, including carcinoma in situ (CIS) and invasive carcinoma. Of the 220 patients infected with HR-HPV16, the single infection group consisted of 120 patients (54.5%), whereas the concurrent multiple infections consisted of 100 (45.5%) patients. The rates of HSIL were significantly higher in the concurrent multiple infection group. However, the odds ratio for CIS+ did not show a significant difference between both groups (1.417, 95% CI = 0.831–2.414, p = 0.200). The malignant potential was not significantly different between concurrent multiple infections with HR-HPVs, including 16, and a single infection with 16 in Korean women.
Telemedicine in Elderly Hypertensive and Patients with Chronic Diseases during the COVID-19 Pandemic: A Systematic Review and Meta-Analysis
Authors: Quesada-Caballero Miguel , Carmona-García Ana , Chami-Peña Sara , Caballero-Mateos Antonio M. , Fernández-Martín Oscar , Cañadas-De la Fuente Guillermo A. , Romero-Bejar José Luis
Published: September 2023

Background: One aspect of the distancing measures imposed in response to the COVID-19 pandemic is that telemedicine consultations have increased exponentially. Among these consultations, the assessment and follow-up of patients with chronic diseases in a non-presential setting has been strengthened considerably. Nevertheless, some controversy remains about the most suitable means of patient follow-up. Objective: To analyze the impact of the telemedicine measures implemented during the COVID-19 period on chronic patients. Material and Methods: A systematic review was carried out using the following databases: PubMed, Pro-Quest, and Scopus. The systematic review followed the guidelines outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The search equation utilized descriptors sourced from the Medical Subject Headings (MeSH) thesaurus. The search equation was: “hypertension AND older AND primary care AND (COVID-19 OR coronavirus)” and its Spanish equivalent. Results: The following data were obtained: 14 articles provided data on 6,109,628 patients and another 4 articles focused on a study population of 9684 physicians. Telemedicine was less likely to be used by elderly patients (OR 0.85; 95% C.I. 0.83–0.88; p = 0.05), those of Asian race (OR 0.69; 95% C.I. 0.66–0.73; p = 0.05), and those whose native language was not English (OR 0.89; 95% C.I. 0.78–0.9; p = 0.05). In primary care, lower use of telemedicine was associated with residents of rural areas (OR 0.81; p = 0.05), patients of African American race (OR 0.65, p = 0.05), and others (OR 0.64; p = 0.05). A high proportion (40%) of physicians had no prior training in telemedicine techniques. The highest quality in terms of telephone consultation was significantly associated with physicians who did not increase their prescription of antibiotherapy during the pandemic (OR = 0.30, p = 0.05) or prescribe more tests (OR 0.06 p = 0.05), i.e., who maintained their former clinical criteria despite COVID-19. Conclusions: Telemedicine is of proven value and has been especially useful in the COVID-19 pandemic. A mixed remote–presential model is most efficient. Appropriate training in this area for physicians and patients, together with correct provision, is essential to prevent errors in implementation and use.
A Systematic Review on Postoperative Antibiotic Prophylaxis after Pediatric and Adult Male Urethral Reconstruction
Authors: Białek Łukasz , Rydzińska Marta , Vetterlein Malte W. , Dobruch Jakub , Skrzypczyk Michał A.
Published: September 2023

In the era of antibiotic overuse and increasing antibiotic resistance, there is a gap in evidence regarding antibiotic stewardship, and in particular, perioperative antibiotic prophylaxis after urethral reconstruction. The aim of this systematic review was to evaluate the effectiveness and relevance of postoperative antibiotic prophylaxis after male pediatric and adult urethral reconstruction. An online search of MEDLINE database via PubMed was performed. The systematic review was registered in PROSPERO (CRD42022348555) and was conducted according to the PRISMA guidelines and AMSTAR 2 checklist. A narrative synthesis of included studies was performed. After the screening of 1176 publications, six studies regarding antibiotic prophylaxis after hypospadias reconstruction and two studies regarding antibiotic prophylaxis after urethroplasty in adults were eligible to be included in the systematic review. All but one of the studies on hypospadias repair showed no benefit from postoperative antibiotic prophylaxis. The level of evidence on postoperative antibiotic prophylaxis after urethroplasty in adults is low. Neither of the two studies included in the review showed a benefit from antibiotic use. Postoperative prophylaxis after hypospadias repair is not effective in preventing urinary tract infections and wound infections. It seems that the use of postoperative prophylaxis after urethroplasty in adults is also not beneficial, but there is a high need for high-quality scientific data.
Comparison of McGrath Videolaryngoscope versus Macintosh Laryngoscope in Tracheal Intubation: An Updated Systematic Review
Authors: Sansone Pasquale , Giaccari Luca Gregorio , Bonomo Antonio , Gargano Francesca , Aurilio Caterina , Coppolino Francesco , Passavanti Maria Beatrice , Pota Vincenzo , Pace Maria Caterina
Published: September 2023

(1) Background: In the last few years, many randomized controlled trials (RCTs) have compared direct Macintosh laryngoscopy with McGrath videolaryngoscopy in order to assess the potential benefits of the latter; the results were sometimes controversial. (2) Methods: We conducted a comprehensive literature search to identify our articles according to inclusion and exclusion criteria: to be included, each study had to be a prospective randomized trial or comparison between the McGrath videolaryngoscope and the Macintosh laryngoscope in an adult population. We did not include manikin trials or studies involving double-lumen tubes. (3) Results: 10 studies met the inclusion criteria necessary. In total, 655 patients were intubated with the McGrath and 629 with the Macintosh. In total, 1268 of 1284 patients were successfully intubated, showing equivalent results for the two devices: 648 of 655 patients with the McGrath videolaryngoscope and 620 of 629 patients with the Macintosh laryngoscope. No differences were noted in terms of hemodynamic changes or the incidence of adverse events. (4) Conclusions: We can assert that the McGrath videolaryngoscope and Macintosh laryngoscope, even if with equivalent tracheal intubation results, supplement each other.
Complications in Post-Liver Transplant Patients
Authors: Agostini Carlotta , Buccianti Simone , Risaliti Matteo , Fortuna Laura , Tirloni Luca , Tucci Rosaria , Bartolini Ilenia , Grazi Gian Luca
Published: September 2023

Liver transplantation (LT) is the treatment of choice for liver failure and selected cases of malignancies. Transplantation activity has increased over the years, and indications for LT have been widened, leading to organ shortage. To face this condition, a high selection of recipients with prioritizing systems and an enlargement of the donor pool were necessary. Several authors published their case series reporting the results obtained with the use of marginal donors, which seem to have progressively improved over the years. The introduction of in situ and ex situ machine perfusion, although still strongly debated, and better knowledge and treatment of the complications may have a role in achieving better results. With longer survival rates, a significant number of patients will suffer from long-term complications. An extensive review of the literature concerning short- and long-term outcomes is reported trying to highlight the most recent findings. The heterogeneity of the behaviors within the different centers is evident, leading to a difficult comparison of the results and making explicit the need to obtain more consent from experts.
Diabetes Mellitus Is a Possible Risk Factor for the Development of Trochanteric Bursitis—A Large-Scale Population-Based Study
Authors: Kadar Assaf , Itzikovitch Ron , Warschawski Yaniv , Morgan Samuel , Shemesh Shai
Published: September 2023

Background: Trochanteric Bursitis (TB) is a common reason to seek primary care, previously shown to be associated with female gender and obesity. Diabetes mellitus (DM) has several musculoskeletal manifestations, but was never found to be associated with TB. Purpose: To explore the association between DM and TB, based on a large database. The secondary aim was to explore the influence of gender and insulin usage on the occurrence of TB. Study design: cross-sectional study. Methods: A population-based cohort consisting of 60,610 patients (55,428 without DM and 5182 with DM), of whom 5418 were diagnosed with TB. A logistic regression model was applied to estimate propensity scores. Results: The odds of individuals with DM being diagnosed with TB were 55.8% higher compared to the odds of patients without DM (OR: 1.558, 95% CI: [1.429, 1.70], p < 0.0001). We found that insulin users had a lower risk of TB than patients not using insulin (log-rank p < 0.0001). Females are 3.3 times more likely to have TB than males (RR: 3.337, 95% CI: [3.115, 3.584], p < 0.0001). Conclusions: DM is a risk factor for developing TB. Insulin had a protective effect against TB, suggesting that better glycemic control might prevent this painful infliction.
Red Blood Cell Transfusion after Postpartum Hemorrhage: Clinical Variables Associated with Lack of Postpartum Hemorrhage Etiology Identification
Authors: Ruiz-Labarta Francisco Javier , Aracil Rodríguez Rocío , Sáez Prat Ainoa , Pérez Burrel Laura , Pina Moreno Juan Manuel , Sánchez Rodríguez Mercedes , Pintado Recarte María Pilar , García-Honduvilla Natalio , Ortega Miguel A. , Anguita Velasco Javier , Pérez Corral Ana , Bravo Coral , De León-Luis Juan A.
Published: September 2023

Postpartum hemorrhage (PPH) remains a significant obstetric emergency worldwide and a leading cause of maternal death. However, it is commonly underreported, which can represent a major concern for maternal morbidity and mortality. This retrospective case series study analyzed patients with red blood cell transfusion (RBCt) in the postpartum period over a four-year interval at a specific center. A total of 18,674 patients delivered between January 2018 and December 2021. Patients with postpartum RBCt were classified into two groups: those with identified PPH (i-PPH) and those without (non-i-PPH). Clinical variables, delivery details, blood loss data, and treatment information were collected. Statistical analysis involved a comparison of variables between the i-PPH and non-i-PPH groups. Univariate and multivariate analyses were performed, aiming to identify significant associations between the clinical variables and a lack of PPH identification. The incidence of RBCt was 1.26% (236 cases). Patients receiving RBCt had higher rates of cesarean delivery, twin pregnancy, labor induction, and previous cesarean section. Among patients with postpartum RBCt, 34.3% lacked an identified PPH. The rarity of postpartum RBCt contrasts with the increasing rates of PPH, highlighting the importance of diagnosing PPH and postpartum anemia. A strategy of systematic quantification of blood loss during delivery could help detect PPH and anemia before adverse consequences occur.
Different Types of Vasculitis Complicated by Heparin-Induced Thrombocytopenia—Analysis of Four Cases and Literature Review
Authors: Rytel Adam , Nowak Mateusz , Kukawska-Rytel Monika , Morawiec Katarzyna , Niemczyk Stanisław
Published: September 2023

Vasculitis and HIT have different etiologies, although both involve autoimmune mechanisms. Treatment of vasculitis often requires the use of an anticoagulant such as heparin, which can lead to the development of HIT and subsequent life-threatening complications. The analysis covered patients hospitalized in the Department of Internal Medicine, Nephrology and Dialysis in the period from September 2020 to March 2023. After analyzing the data, we selected four patients in whom vasculitis treatment was complicated by HIT. These included two patients with ANCA vasculitis and two patients with anti-GBM disease. We also described similar cases reported in the literature.
Self-Retained, Sutureless Amniotic Membrane Transplantation for the Management of Ocular Surface Diseases
Authors: Chiu Hsun-I , Tsai Chieh-Chih
Published: September 2023

Amniotic membrane (AM) has anti-inflammation, anti-fibrotic, and regenerative effects. Sutureless cryopreserved AM transplantation, ProKera® (Bio-Tissue, Inc., Miami, FL, USA), is easily applied by ophthalmologists in the treatment of ocular surface diseases. This retrospective study included patients with ocular surface diseases who received ProKera® between January 2022 and May 2023. Six patients (9 eyes) with a mean age of 56.8 ± 20.8 years old (range 25–74) and a mean follow-up period of 7.8 ± 4.1 months (range 1–12) were included, including 2 of recurrent conjunctival tumors with limbal and corneal involvement (cases 1–2), 1 of pterygium with marked astigmatism (case 3) and 3 of Stevens–Johnson syndrome (SJS, cases 4–6). ProKera® was inserted after the lesion excision and deep keratectomy in cases 1–3, and no recurrence or corneal complication was noted. Cases 4–5 were discharged from the intensive care unit and presented with severe chronic SJS. Most ocular manifestations improved significantly after symblepharon release and ProKera® insertion, except for corneal conjunctivalization in 1 eye (case 5). Case 6 involved early ProKera® use at the bedside during acute SJS, resulting in complete resolution. We concluded that the adjunctive application of ProKera® can be effective for ocular surface reconstruction and provides options to intervene earlier for outpatients or patients unstable for invasive surgical intervention.
Smart Packaging for Food Spoilage Assessment Based on Hibiscus sabdariffa L. Anthocyanin-Loaded Chitosan Films
Authors: Khezerlou Arezou , Tavassoli Milad , Alizadeh Sani Mahmood , Ehsani Ali , McClements David Julian
Published: September 2023

An on-package colorimetric label was fabricated using Hibiscus sabdariffa L. anthocyanin as a freshness indicator because its color depends on pH. The anthocyanins were embedded within a chitosan matrix. The colorimetric labels were applied to estimate the spoilage of fish food during storage at 25 °C for 3 days. According to scanning electron microscopy results, the inclusion of the anthocyanins in chitosan matrix resulted in formation dense and uniform film. The chitosan colorimetric labels had acceptable thicknesses (78–85 µm), moisture contents (14–16%), swelling indices (84–102%), water vapor permeabilities (3.0–3.2 × 10−11 g m/m2 s Pa), tensile strengths (11.3–12.3 MPa), and elongation at breaks (14–39%). It is noteworthy that the label can distinguish fish spoilage by color turn from light brown (fresh) to grayish (spoiled) by the naked-eye, due to alterations in the pH content and formation of volatile basic nitrogen during storage. Our results indicate that all-natural color labels can be an effective method to monitor the fish spoilage during storage, which may improve food quality and sustainability.
On the Biomechanical Performances of Duplex Stainless Steel Graded Scaffolds Produced by Laser Powder Bed Fusion for Tissue Engineering Applications
Authors: Gatto Maria Laura , Cerqueni Giorgia , Groppo Riccardo , Tognoli Emanuele , Santoni Alberto , Cabibbo Marcello , Mattioli-Belmonte Monica , Mengucci Paolo
Published: September 2023

This experimental study aims to extend the know-how on biomechanical performances of duplex stainless steel (DSS) for tissue engineering applications to a graded lattice geometry scaffold based on the F53 DSS (UNS S32750 according to ASTM A182) produced by laser powder bed fusion (LPBF). The same dense-out graded geometry based on rhombic dodecahedral elementary unit cells investigated in previous work on 316L stainless steel (SS) was adopted here for the manufacturing of the F53 DSS scaffold (SF53). Microstructural characterization and mechanical and biological tests were carried out on the SF53 scaffold, using the in vitro behavior of the 316L stainless steel scaffold (S316L) as a control. Results show that microstructure developed as a consequence of different volume energy density (VED) values is mainly responsible for the different mechanical behaviors of SF53 and S316L, both fabricated using the same LPBF manufacturing system. Specifically, the ultimate compressive strength (σUC) and elastic moduli (E) of SF53 are three times and seven times higher than S316L, respectively. Moreover, preliminary biological tests evidenced better cell viability in SF53 than in S316L already after seven days of culture, suggesting SF53 with dense-out graded geometry as a viable alternative to 316L SS for bone tissue engineering applications.
Cryo-Electrospinning Generates Highly Porous Fiber Scaffolds Which Improves Trabecular Meshwork Cell Infiltration
Authors: Crouch Devon J. , Sheridan Carl M. , Behnsen Julia G. , D’Sa Raechelle A. , Bosworth Lucy A.
Published: September 2023

Human trabecular meshwork is a sieve-like tissue with large pores, which plays a vital role in aqueous humor outflow. Dysfunction of this tissue can occur, which leads to glaucoma and permanent vision loss. Replacement of trabecular meshwork with a tissue-engineered device is the ultimate objective. This study aimed to create a biomimetic structure of trabecular meshwork using electrospinning. Conventional electrospinning was compared to cryogenic electrospinning, the latter being an adaptation of conventional electrospinning whereby dry ice is incorporated in the fiber collector system. The dry ice causes ice crystals to form in-between the fibers, increasing the inter-fiber spacing, which is retained following sublimation. Structural characterization demonstrated cryo-scaffolds to have closer recapitulation of the trabecular meshwork, in terms of pore size, porosity, and thickness. The attachment of a healthy, human trabecular meshwork cell line (NTM5) to the scaffold was not influenced by the fabrication method. The main objective was to assess cell infiltration. Cryo-scaffolds supported cell penetration deep within their structure after seven days, whereas cells remained on the outer surface for conventional scaffolds. This study demonstrates the suitability of cryogenic electrospinning for the close recapitulation of trabecular meshwork and its potential as a 3D in vitro model and, in time, a tissue-engineered device.
Rapid Recovery after Reparation of Full-Thickness Chondral Defects of the Knee with the Use of Hyaluronan (HA)-Based 3-D Scaffold
Authors: Valladares Nicolas , Cabrero Montes Monica Araceli , Jacobo-Jimenez Gibran J. , Zavala-Cerna Maria G.
Published: September 2023

Articular cartilage injuries are found in up to 60% of patients who undergo an arthroscopic knee procedure, and those that totally affect articular cartilage (grade IV) have limited regenerative capacity and extended time for recovery. 3-D scaffolds represent a novel solution to address this type of injury. Our purpose was to analyze the MRI findings and functional status of patients that underwent repair of chondral defects either by microfractures or Hyaluronan (HA) 3-D scaffolding. We conducted a retrospective study of patients with chondral defects. The outcomes analyzed in this study included anatomical changes evaluated by the Henderson score (based on MRI findings) at baseline, 6, and 12 months after surgery, and improvement in functionality evaluated by the Modified Cincinnati Knee Rating System (MCKRS) at baseline and 6 months after surgery. Clinical and demographic characteristics were similar for both groups. There was a statistically significant improvement in Henderson score for the 3-D scaffold-treated group at 6 months versus the microfracture group (p < 0.0001). Improvement in functionality, measured by the MCKRS, was more frequently found in the 3-D scaffold-treated group. In conclusion, the use of HA 3-D scaffolding was superior, with faster recovery evident 6 months after the surgery that progressed to full recovery in all patients a year after surgery. Future studies with a randomized design might help to support our findings. This study provides level III evidence.
Power Prediction of a 15,000 TEU Containership: Deep-Learning Algorithm Compared to a Physical Model
Authors: La Ferlita Alessandro , Qi Yan , Di Nardo Emanuel , Moenster Karoline , Schellin Thomas E. , EL Moctar Ould , Rasewsky Christoph , Ciaramella Angelo
Published: September 2023

The authors proposed a direct comparison between white- and black-box models to predict the engine brake power of a 15,000 TEU (twenty-foot equivalent unit) containership. A Simplified Naval Architecture Method (SNAM), based on limited operational data, was highly enhanced by including specific operational parameters. An OAT (one-at-a-time) sensitivity analysis was performed to recognize the influences of the most relevant parameters in the white-box model. The black-box method relied on a DNN (deep neural network) composed of two fully connected layers with 4092 and 8192 units. The network consisted of a feed-forward network, and it was fed by more than 12,000 samples of data, encompassing twenty-three input features. The test data were validated against realistic operational data obtained during specific operational windows. Our results agreed favorably with the results obtained for the DNN, which relied on sufficiently observed data for the physical model.
Scattering Study of a Composite Breakwater Placed in Front of an Impermeable Back Wall under the Action of Water Waves
Authors: Cao Jiaxiu , Wang Chao , Wang Zeping
Published: September 2023

Based on the assumption of linear potential flow theory, the scattering problem of a composite breakwater placed in front of an impermeable back wall is theoretically investigated. The velocity potential in each subregion is found using the eigenfunction expansion method. The boundary conditions of the porous region are treated using Darcy’s law. The semi-analytical solution of a composite breakwater placed in front of an impermeable back wall is then obtained based on the matching conditions of the boundaries of the different regions. The effects of different parameters on the wave loads and wave amplitudes are investigated. In addition, to better understand the performance of the composite breakwater, the scattering problem of the composite breakwater without considering an impermeable back wall is also investigated. The correctness of this theoretical model is verified by comparing the results with previous work. Based on the results of hydrodynamic calculations and analysis of various aspects of a composite breakwater placed in front of an impermeable back wall, the study of the effect of a composite breakwater placed in front of an impermeable back wall allows us to propose a long-term and cost-effective solution for the protection of various marine facilities from wave attacks.
A Sparse Bayesian Learning Method for Direction of Arrival Estimation in Underwater Maneuvering Platform Noise
Authors: Wang Yan , Zhao Lei , Qiu Longhao , Wang Jinjin , Li Chenmu
Published: September 2023

The underwater maneuvering platform generates self-noise when sailing, which shows spatial directionality to the arrays fixed on the platform. In this paper, it is called spatially colored noise (SCN). The direction of arrival (DOA) estimation results are often influenced by this self-noise, leading to a decrease in estimation accuracy and to the appearance of spurious peaks. To resolve this problem, a sparse Bayesian learning (SBL) method adapted to underwater maneuvering platform noise is proposed in this paper. The SBL framework with unknown SCN is established first. Then, the SCN covariance matrix is estimated by projecting the received data covariance matrix into the noise subspace, and the DOA estimation results are finally obtained through multiple iterations. The simulation results show that the proposed method avoids spurious peaks, and compared to the existing methods, the proposed method achieves a higher accuracy in the case of low SNRs and small snapshot numbers. The sea trial data processing results show that the proposed method provides lower and flatter noise spectrum levels without spurious peaks.
Intraoperative Neuromonitoring Does Not Reduce the Risk of Temporary and Definitive Recurrent Laryngeal Nerve Damage during Thyroid Surgery: A Systematic Review and Meta-Analysis of Endoscopic Findings from 73,325 Nerves at Risk
Authors: Cozzi Anna , Ottavi Alice , Lozza Paolo , Maccari Alberto , Borloni Roberto , Nitro Letizia , Felisati Elena , Alliata Andrea , Martino Barbara , Cacioppo Giancarlo , Fuccillo Manuela , Rosso Cecilia , Pipolo Carlotta , Felisati Giovanni , De Pasquale Loredana , Saibene Alberto
Published: September 2023

Background: While intraoperative neuromonitoring (IONM) helps the early identification of recurrent laryngeal nerve (RLN) damage, IONM’s role in RLN damage prevention is not defined, given the lack of large studies on the subject. Methods: In a PRISMA-compliant framework, all original thyroid surgery prospective studies providing early postoperative endoscopic data for all patients were pooled in a random-effects meta-analysis. We compared the temporary (and definitive where available) RLN damage rates according to IONM use and IONM type (intermittent, I-IONM, or continuous, C-IONM). Results: We identified 2358 temporary and 257 definitive RLN injuries in, respectively, 73,325 and 66,476 nerves at risk. The pooled temporary and definitive RLN injury rates were, respectively, 3.15% and 0.422% considering all procedures, 3.29% and 0.409% in cases using IONM, and 3.16% and 0.463 in cases not using IONM. I-IONM and C-IONM, respectively, showed a pooled temporary RLN injury rate of 2.48% and 2.913% and a pooled definitive injury rate of 0.395% and 0.4%. All pooled rates had largely overlapping 95% confidence intervals. Conclusions: Our data suggest that IONM does not affect the temporary or definitive RLN injury rate following thyroidectomy, though its use can be advised in selected cases and for bilateral palsy prevention.
The Financial Derivatives Market and the Pandemic: BioNTech and Moderna Volatility
Authors: Manelli Alberto , Pace Roberta , Leone Maria
Published: September 2023

Global society’s comfort and well-established certainties have been unpredictably and foundationally undermined by the emergence of the COVID-19 virus. The announcement of the pandemic by the WHO has halted global economic activities, and the financial markets have recorded drastic losses. In this context of uncertainty and economic downturn, many traditional companies have been negatively impacted, but the biotechnology sector, which has already been growing for some years, registered high growth rates and earnings. In particular, this study focused on the two most significant biotech companies, BioNTech and Moderna, the two start-ups that first commercialized COVID-19 vaccines. The GARCH (1,1) model examines the relation of two stock prices and the volatility of derivatives markets before and after the outbreak of the pandemic. The variables used in the analysis are the U.S. technologic market index, the market volatility, and Brent future prices. The results suggest a different reaction of market volatility and Brent future prices on the return of both companies. Additionally, during the COVID-19 period, a contagion effect between both companies and the technological market was observed.
Financial Sustainability of Digitizing Cultural Heritage: The International Platform Europeana
Authors: Borin Elena , Donato Fabio
Published: September 2023

In recent years, the increasing demand for digital cultural content has intensified the digitization challenges for cultural organizations. Among these difficulties, cultural organizations have been struggling to find the financial resources for digitizing their cultural heritage, as well as for storing data, developing digital skills, and implementing enhancement and management processes for their digitized materials. The financial sustainability of digitization projects has therefore been problematic, especially for small and medium organizations. In this framework, among its attempts to solve these issues, the European Union has launched the project Europeana, a digital platform uniting European digitized heritage and empowering cultural organizations through a variety of services. The aim of our research was to investigate the Europeana project to understand how it eases the financial costs of digitization for cultural organizations, and how the Europeana model could bring insights into how to improve the financial sustainability of digitization of cultural heritage.
Soil Footprint and Land-Use Change to Clean Energy Production: Implications for Solar and Wind Power Plants
Authors: Cogato Alessia , Marinello Francesco , Pezzuolo Andrea
Published: September 2023

Shifting from fossil fuels to alternative energies is crucial for mitigating climate change and reducing dependence on environmentally harmful resources. Measuring the soil footprint of alternative energies is equally essential, as it helps promote sustainable development. This research proposes a methodological approach to assess the land consumed by photovoltaic panels installed on land (PVL), on roofs (PVR), and wind power systems (WP) in Italy. A sample of 186 plants was analysed, and the total area occupied by these plants was measured. Moreover, the area needed for new infrastructure and facilities serving the plants was measured. Finally, the land use change was assessed by determining the land use before installing PVL and WP. Approximately 92.8% of WP entailed the construction of new road networks, while 34.8% of PVL required the construction of new buildings. The surface area demand by the WP was lower (1.3 m2 kW−1) than PVL (21.2 m2 kW−1). Overall, a highly positive correlation was found between the nominal power of the plants and the total area occupied (R2 = 0.94, 0.95, and 0.90 for PVL, PVR, and WP, respectively). The areas occupied by new plants were mainly devoted to agriculture (75.8% for PVL and 71.4% for WP); however, WP were also located in forest areas (17.9%). The methodology proposed may be extended to assess the global footprint of alternative energies and address sustainable energy management.