bluuebunny/crossref_metadata_2025 huggingface dataset:
HIF-1α-Dependent Metabolic Reprogramming, Oxidative Stress, and Bioenergetic Dysfunction in SARS-CoV-2-Infected Hamsters
Authors: Jana Sirsendu , Heaven Michael R. , Stauft Charles B. , Wang Tony T. , Williams Matthew C. , D’Agnillo Felice , Alayash Abdu I.
Published: December 2022

The mechanistic interplay between SARS-CoV-2 infection, inflammation, and oxygen homeostasis is not well defined. Here, we show that the hypoxia-inducible factor (HIF-1α) transcriptional pathway is activated, perhaps due to a lack of oxygen or an accumulation of mitochondrial reactive oxygen species (ROS) in the lungs of adult Syrian hamsters infected with SARS-CoV-2. Prominent nuclear localization of HIF-1α and increased expression of HIF-1α target proteins, including glucose transporter 1 (Glut1), lactate dehydrogenase (LDH), and pyruvate dehydrogenase kinase-1 (PDK1), were observed in areas of lung consolidation filled with infiltrating monocytes/macrophages. Upregulation of these HIF-1α target proteins was accompanied by a rise in glycolysis as measured by extracellular acidification rate (ECAR) in lung homogenates. A concomitant reduction in mitochondrial respiration was also observed as indicated by a partial loss of oxygen consumption rates (OCR) in isolated mitochondrial fractions of SARS-CoV-2-infected hamster lungs. Proteomic analysis further revealed specific deficits in the mitochondrial ATP synthase (Atp5a1) within complex V and in the ATP/ADP translocase (Slc25a4). The activation of HIF-1α in inflammatory macrophages may also drive proinflammatory cytokine production and complement activation and oxidative stress in infected lungs. Together, these findings support a role for HIF-1α as a central mediator of the metabolic reprogramming, inflammation, and bioenergetic dysfunction associated with SARS-CoV-2 infection.
The Enrichment of Specific Hair Follicle-Associated Cell Populations in Plucked Hairs Offers an Opportunity to Study Gene Expression Underlying Hair Traits
Authors: Naboulsi Rakan , Cieślak Jakub , Headon Denis , Jouni Ahmad , Negro Juan J. , Andersson Göran , Lindgren Gabriella
Published: December 2022

Gene expression differences can assist in characterizing important underlying genetic mechanisms between different phenotypic traits. However, when population-dense tissues are studied, the signals from scarce populations are diluted. Therefore, appropriately choosing a sample collection method that enriches a particular type of effector cells might yield more specific results. To address this issue, we performed a polyA-selected RNA-seq experiment of domestic horse (Equus ferus caballus) plucked-hair samples and skin biopsies. Then, we layered the horse gene abundance results against cell type-specific marker genes generated from a scRNA-seq supported with spatial mapping of laboratory mouse (Mus musculus) skin to identify the captured populations. The hair-plucking and skin-biopsy sample-collection methods yielded comparable quality and quantity of RNA-seq results. Keratin-related genes, such as KRT84 and KRT75, were among the genes that showed higher abundance in plucked hairs, while genes involved in cellular processes and enzymatic activities, such as MGST1, had higher abundance in skin biopsies. We found an enrichment of hair-follicle keratinocytes in plucked hairs, but detected an enrichment of other populations, including epidermis keratinocytes, in skin biopsies. In mammalian models, biopsies are often the method of choice for a plethora of gene expression studies and to our knowledge, this is a novel study that compares the cell-type enrichment between the non-invasive hair-plucking and the invasive skin-biopsy sample-collection methods. Here, we show that the non-invasive and ethically uncontroversial plucked-hair method is recommended depending on the research question. In conclusion, our study will allow downstream -omics approaches to better understand integumentary conditions in both health and disease in horses as well as other mammals.
Interfering with Color Response by Porphyrin-Related Compounds in the MTT Tetrazolium-Based Colorimetric Assay
Authors: Choi Bo Hee , Kim Mi-Ri , Jung Yu Na , Kang Smee , Hong Jungil
Published: December 2022

Porphyrin compounds are widely distributed in various natural products and biological systems. In this study, effects of porphyrin-related compounds including zinc protoporphyrin (ZnPP), protoporphyrin IX (PPIX), cyanocobalamin (CBL), hemin, and zinc phthalocyanine (ZnPC) were analyzed on color response of 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) tetrazolium-based assay, a commonly-used method for analyzing cell viability. Color responses of MTT formazan formed in cells treated with ZnPP, PPIX, or ZnPC were significantly reduced even at submicromolar concentrations without affecting cell viability, whereas hemin and CBL did not. ZnPP, PPIX, and ZnPC rapidly induced degradation of MTT formazan already-produced by cells when exposed to light, but not under a dark condition. Photosensitizing properties of the three compounds were also verified through extensive generation of reactive oxygen species under light. The porphyrins did not affect the stability of water-soluble formazans including XTT, WST-1, WST-8, and MTS formazans. Several factors including different light sources and antioxidants modulated the degradation process of MTT formazan by the porphyrins. The results suggest that certain porphyrin compounds could cause a severe artifact in the MTT assay through rapid degradation of formazan dye due to their photosensitizing property, which needs to be considered carefully in the related assays.
Newborn Screening Long-Term Follow-Up Clinics (Continuity Clinics) in the Philippines during the COVID-19 Pandemic: Continuing Quality Patient Care
Authors: Maceda Ebner Bon G. , Abadingo Michelle E. , Panol Karen Asuncion R. , Beltran Frederick David E. , Valdez-Acosta Ivy Rose C. , Taquiqui Grandelee D. , Gawigawen Sharon B. , Macalino Maria Victoria L. , Aguirre-Aguinaldo Laura Maria Soledad M. , Flores-Declaro Marive A. , Ventilacion Karen June V. , Boligao Ma. Rita Anna Salve R. , Honor Nancy G. , Ellong Mirasol S. , Ocho-Ortencio Rona D. , Beley Genelynne J. , Bondoc-Eran Maria Christina N. , Therrell Bradford L. , Padilla Carmencita D.
Published: December 2022

The COVID-19 pandemic has challenged healthcare systems worldwide. In the Philippines, long-term care for patients with conditions identified through newborn screening (NBS) is coordinated through Newborn Screening Continuity Clinics (NBSCCs). These clinics are integral to achieving optimal outcomes by providing follow-up oversight and assistance for individuals identified through screening. Continuity of NBSCC care for NBS during the COVID-19 pandemic was both challenging and necessary and was accomplished through innovative strategies of dedicated personnel. Following the discontinuation of the community quarantine, a situation assessment survey was completed by each NBSCC to better understand the challenges encountered and their effect on patient care. Performance data from each NBSCC were reviewed both before and after an extended community quarantine (2018–2021) to evaluate the impact of NBSCC disaster contingency plans in overcoming the resultant challenges (transportation, supply chain, etc.). Thematic analysis of the survey showed three primary challenges: Operations, communications, and safety. In 2018 and 2019, successful patient contacts were 70.6% and 70.2%, respectively. During the pandemic, successful contacts were 74.9% in 2020 and 76.8% in 2021, demonstrating that the contact approaches taken by the NBSCCs were sufficient to maintain (and even improve) patient contacts. The number of unresponsive patients decreased during the pandemic likely due to decreased mobility and improved follow-up actions from the NBSCCs.
Production of Recombinant Biopharmaceuticals in Chlamydomonas reinhardtii
Authors: Arias Cesar Andres Diaz , Oliveira Caroline Frere Martiniuc de , Molino João Vitor Dutra , Ferreira-Camargo Livia Seno , Matsudo Marcelo Chuei , Carvalho João Carlos Monteiro de
Published: December 2022

This review aimed to present Chlamydomonas reinhardtii as an alternative for heterologous protein production, especially for biopharmaceuticals, and its general characteristics when compared with other expression systems. The need to produce heterologous proteins for industrial interest, therapeutic ends, and diagnostic kits has led to the development of recombinant microalgal technology. This technology presents some interesting features, such as rapid growth and low transgene dispersion compared to plants, the ability to fold complex proteins compared to bacteria, and low production costs compared to other expression systems, such as yeast and mammalian cells. Overall, C. reinhardtii heterologous protein expression is coming of age with several research groups focused on developing an optimal producer strain.
A Survey on Quantum Computing for Recommendation Systems
Authors: Pilato Giovanni , Vella Filippo
Published: December 2022

Recommendation systems play a key role in everyday life; they are used to suggest items that are selected among many candidates that usually belong to huge datasets. The recommendations require a good performance both in terms of speed and the effectiveness of the provided suggestions. At the same time, one of the most challenging approaches in computer science is quantum computing. This computational paradigm can provide significant acceleration for resource-demanding and time-consuming algorithms. It has become very popular in recent years, thanks to the different tools available to the scientific and technical communities. Since performance has great relevance in recommendation systems, many researchers in the scientific community have recently proposed different improvements that exploit quantum approaches to provide better performance in recommendation systems. This paper gives an overview of the current state of the art in the literature, outlining the different proposed methodologies and techniques and highlighting the challenges that arise from this new approach to the recommendation systems domain.
A Burn-in Test Station for the ATLAS Phase-II Tile-Calorimeter Low-Voltage Power Supply Transformer-Coupled Buck Converters
Authors: Mckenzie Ryan Peter
Published: December 2022

The upgrade of the ATLAS hadronic tile-calorimeter (TileCal) Low-Voltage Power Supply (LVPS) falls under the high-luminosity LHC upgrade project. This article serves to provide an overview of the development of a burn-in test station for a Phase-II upgrade LVPS component known as a Brick. These Bricks are radiation hard transformer-coupled buck converters that function to step-down bulk 200 V DC power to the 10 V DC power required by the on-detector electronics. To ensure the high reliability of the Bricks, once installed within the TileCal, a burn-in test station has been designed and built. The Burn-in procedure subjects the Bricks to sub-optimal operating conditions that function to accelerate their aging as well as to stimulate failure mechanisms. This results in elements of the Brick that would fail prematurely within the TileCal failing within the burn-in station or to experience performance degradation that can be detected by followup testing effectively screening out the ’weak’ sub-population. The burn-in station is of a fully custom design in both its hardware and software. The development of the test station will be explored and the preliminary burn-in procedure to be employed will be presented. The commissioning of the burn-in station will be presented along with a summary and outlook of the project.
Spontaneous Lymph Flow Restoration in Free Flaps: A Pilot Study
Authors: Sedbon Théo , Azuelos Arié , Bosc Romain , D’Andrea Francesco , Pensato Rosita , Maruccia Michele , Meningaud Jean Paul , Hersant Barbara , La Padula Simone
Published: December 2022

Background: Oncologic excision and trauma can be responsible for major defects and lymphedema. Free flaps are commonly used for reconstruction. We aimed to determine if lymphatic flow between flap and recipient site can be restored without lymphatic surgery. Methods: 15 free flaps were performed in different patients in our center. Infrared-based lymphography was used to plan surgery. Indocyanine green (ICG) was injected in the flap’s subdermal tissue and also at the edges of the skin defect. Circumferential lymphatic channels were marked 5 min after the ICG injection. Fluorescent images were recorded with an infrared camera system. The flap inset was obtained by putting side to side the flap markings and the recipient site markings. Infrared-based lymphography was performed on every patient one year after surgery. Spontaneous lymph flow restoration was judged positive if lymphatic connections were observed between the flap and the recipient site. Results: seven free ALT and eight DIEP flaps were performed. All ALT flaps were designed following the limb axis which is the lymphatic axiality. Spontaneous lymph flow restoration was observed for the seven ALT flaps. Eight DIEP flaps were designed upside down and one was designed following the lymph axiality. Spontaneous lymph flow restoration was only observed for the one designed following the lymph axiality. Conclusions: designing reconstructive free flap regarding lymph axiality seems to improve spontaneous lymph flow restoration between flap and recipient site without any specific lymphatic surgery.
Reactivation of Hepatitis B Virus in Lung Cancer Patients Receiving Tyrosine Kinase Inhibitor Treatment
Authors: Lee Po-Hsin , Huang Yen-Hsiang , Hsu Yu-Wei , Chen Kun-Chieh , Hsu Kuo-Hsuan , Lin Ho , Lee Teng-Yu , Tseng Jeng-Sen , Chang Gee-Chen , Yang Tsung-Ying
Published: December 2022

(1) Background: We aimed to evaluate the risk of hepatitis B virus (HBV) reactivation in lung cancer patients treated with tyrosine kinase inhibitor (TKI), particularly in those with resolved HBV infection. (2) Methods: In this retrospective hospital-based cohort study, we screened all lung cancer patients with positive hepatitis B core antibodies (anti-HBc) receiving systemic antineoplastic treatment during the period from January 2011 to December 2020. Cumulative incidences of HBV reactivation, and their hazard ratios (HRs), were evaluated after adjusting patient mortality as a competing risk. (3) Results: Among 1960 anti-HBc-positive patients receiving systemic therapy, 366 were HBsAg-positive and 1594 were HBsAg-negative. In HBsAg-positive patients without prophylactic NUC, 3-year cumulative incidences of HBV reactivation were similar between patients receiving chemotherapy and patients receiving TKI (15.0%, 95% confidence interval (CI): 0–31.2% vs. 21.2%, 95% CI: 10.8–31.7%; p = 0.680). Likewise, 3-year cumulative incidences of HBV-related hepatitis were similar between the two groups (chemotherapy vs. TKI: 15.0%, 95% CI: 0–31.2% vs. 9.3%, 95% CI: 2.8–15.7%; p = 0.441). In 521 HBsAg-negative TKI users, the 3-year cumulative incidence of HBV reactivation was only 0.6% (95% CI: 0.0–1.9%). From multivariable regression analysis, we found that the only independent risk factor for HBV reactivation in TKI users was HBsAg positivity (HR 53.8, 95% CI: 7.0–412.9; p < 0.001). (4) Conclusion: Due to high risks of HBV reactivation in HBsAg-positive TKI users, NUC prophylaxis can be considered. However, in patients with resolved HBV infection, such risks are lower, and therefore regular monitoring is recommended.
Implementation of an Early Communication Intervention for Young Children with Cerebral Palsy Using Single-Subject Research Design
Authors: Ward Roslyn , Barty Elizabeth , Hennessey Neville , Elliott Catherine , Valentine Jane
Published: December 2022

The implementation of an intervention protocol aimed at increasing vocal complexity in three pre-linguistic children with cerebral palsy (two males, starting age 15 months, and one female, starting age 16 months) was evaluated utilising a repeated ABA case series design. The study progressed until the children were 36 months of age. Weekly probes with trained and untrained items were administered across each of three intervention blocks. Successive blocks targeted more advanced protophone production and speech movement patterns, individualised for each participant. Positive treatment effects were seen for all participants in terms of a greater rate of achievement of target protophone categories and speech movement patterns. Tau coefficients for trained items demonstrated overall moderate to large AB phase contrast effect sizes, with limited evidence of generalisation to untrained items. Control items featuring protophones and speech movements not targeted for intervention showed no change across phases for any participant. Our data suggest that emerging speech-production skills in prelinguistic infants with CP can be positively influenced through a multimodal intervention focused on capitalising on early periods of plasticity when language learning is most sensitive.
Acromial Morphology and Its Relation to the Glenoid Is Associated with Different Partial Rotator Cuff Tear Patterns
Authors: Borbas Paul , Hartmann Rebecca , Ehrmann Christine , Ernstbrunner Lukas , Wieser Karl , Bouaicha Samy
Published: December 2022

The pathogenesis of subacromial impingement syndrome is controversially discussed. Assuming that bursal sided partial tears of the supraspinatus tendons are rather the result of a direct subacromial impact, the question arises whether there is a morphological risk configuration of the acromion and its spatial relation to the glenoid. Patients who underwent arthroscopic repair of either a partial articular supraspinatus tendon avulsion (PASTA) or bursal-sided supraspinatus tear (BURSA) were retrospectively allocated to two groups. Various previously described and new omometric parameters on standard anteroposterior and axial shoulder radiographs were analyzed. We hypothesized that acromial shape and its spatial relation to the glenoid may predispose to a specific partial supraspinatus tendon tear pattern. The measurements included the critical shoulder angle (CSA), the acromion index (AI), Bigliani acromial type and the new short sclerotic line, acromioclavicular offset angle (ACOA), and AC offset. The ratio length/width of acromion and the medial acromial offset were measured on axial radiographs. A total of 73 patients were allocated to either PASTA (n = 45) or BURSA (n = 28). The short sclerotic line showed a statistically significant difference between PASTA and BURSA (16.2 mm versus 13.1 mm, p = 0.008). The ratio acromial width/length was statistically significant (p = 0.021), with BURSA having slightly greater acromial length (59 vs. 56 mm). The mean acromial offset was 42.9 mm for BURSA vs. 37.7 mm for PASTA (p = 0.021). ACOA and AC offset were both higher for BURSA, without reaching statistical significance. The CSA did not differ significantly between PASTA and BURSA (33.73° vs. 34.56°, p = 0.062). The results revealed an association between a narrow acromial morphology, increased medial offset of the acromion in relation to the glenoid, and the presence of a short sclerotic line in the anteroposterior radiograph in bursal-sided tears of the supraspinatus tendon. Assuming that bursal-sided tears are rather the result of a direct conflict of the tendon with the undersurface of the acromion, this small subgroup of patients presenting with impingement syndrome might benefit from removing a harming acromial spur.
Innovations in the Realm of Shoulder Arthroplasty
Authors: Lädermann Alexandre , Audigé Laurent , Scheibel Markus
Published: December 2022

Most of the surgeries regarding the shoulder were established over a century ago [...]
Management of Tooth Extraction in Patients Taking Antiresorptive Drugs: An Evidence Mapping Review and Meta-Analysis
Authors: Liu Chang , Xiong Yu-Tao , Zhu Tao , Liu Wei , Tang Wei , Zeng Wei
Published: December 2022

Background: Medication-related osteonecrosis of the jaw (MRONJ) is a well-known severe adverse reaction of antiresorptive, antiangiogenic or targeted therapies, and usually occurs after tooth extraction. This review is aimed at determining the efficacy of any intervention of tooth extraction to reduce the risk of MRONJ in patients taking antiresorptive drugs, and present the distribution of evidence in these clinical questions. Methods: Primary studies and reviews were searched from nine databases (Medline, EMBase, Cochrane Library, Scopus, WOSCC, Inspec, KCI-KJD, SciELO and GIM) and two registers (ICTRP and ClinicalTrials.gov) to 30 November 2022. The risk of bias was assessed with the ROBIS tool in reviews, and the RoB 2 tool and ROBINS-I tool in primary studies. Data were extracted and then a meta-analysis was undertaken between primary studies where appropriate. Results: Fifteen primary studies and five reviews were included in this evidence mapping. One review was at low risk of bias, and one randomized controlled trial was at moderate risk, while the other eighteen studies were at high, serious or critical risk. Results of syntheses: (1) there was no significant risk difference found between drug holiday and drug continuation except for a subgroup in which drug continuation was supported in the reduced incidence proportion of MRONJ for over a 3-month follow-up; (2) the efficacy of the application of autologous platelet concentrates in tooth extraction was uncertain; (3) there was no significant difference found between different surgical techniques in any subgroup analysis; and (4) the risk difference with antibacterial prophylaxis versus control was −0.57, 95% CI −0.85 to −0.29. Conclusions: There is limited evidence to demonstrate that a drug holiday is unnecessary (and may in fact be potentially harmful) in dental practice. Primary closure and antibacterial prophylaxis are recommended despite limited evidences. All evidence have been graded as either of a low or very low quality, and thus further high-quality randomized controlled trials are needed to answer this clinical question.
Clinical Evaluation of Corneal Biomechanics following Laser Refractive Surgery in Myopic Eyes: A Review of the Literature
Authors: Pniakowska Zofia , Jurowski Piotr , Wierzbowska Joanna
Published: December 2022

The role of corneal biomechanics in laser vision correction (LVC) is currently being raised in the assessment of postoperative corneal ectasia risk. The aim of the paper was to evaluate the changes in corneal biomechanics after LVC procedures based on a systematic review of current studies. The results of a search of the literature in the PubMed, Science Direct, Google Scholar, and Web of Science databases were selected for final consideration according to the PRISMA 2020 flow diagram. Included in our review were 17 prospective clinical studies, with at least 6 months of follow-up time. Corneal biomechanical properties were assessed by Ocular Response Analyzer (ORA), or Corvis ST. The results of the study revealed the highest corneal biomechanics reduction after laser in situ keratomileusis (LASIK) followed by small incision lenticule extraction (SMILE) and surface procedures, such as photorefractive keratectomy (PRK) or laser-assisted sub-epithelial keratectomy (LASEK). In SMILE procedure treatment planning, the use of thicker caps preserves the corneal biomechanics. Similarly, reduction of flap thickness in LASIK surgery maintains the corneal biomechanical strength. Future prospective clinical trials with standardization of the study groups and surgical parameters are needed to confirm the results of the current review.
Peri-Procedural Troponin Elevation after Percutaneous Coronary Intervention for Left Main Coronary Artery Disease
Authors: Skorupski Wojciech Jan , Kałużna-Oleksy Marta , Mitkowski Przemysław , Skorupski Włodzimierz , Grajek Stefan , Pyda Małgorzata , Araszkiewicz Aleksander , Lesiak Maciej , Grygier Marek
Published: December 2022

Left main (LM) percutaneous coronary interventions (PCI) are challenging and highly invasive procedures. Periprocedural myocardial injury (Troponin (Tn) elevation > 99th percentile) is frequently detected after LM PCI, being identified even in up to 67% of patients. However, the prognostic implications of periprocedural Tn elevation after LM PCI remain controversial. We aim to assess the impact and prognostic significance of the periprocedural troponin elevation on long-term outcomes in patients undergoing LM PCI in a real-world setting. Consecutive 673 patients who underwent LM PCI in our department between January 2015 to February 2021 were included in a prospective registry. The first group consisted of 323 patients with major cardiac Troponin I elevation defined as an elevation of Tn values > 5× the 99th percentile in patients with normal baseline values or post-procedure Tn rise by >20% in patients with elevated pre-procedure Tn in whom the Tn level was stable or falling (based on the fourth universal definition of myocardial infarction). The second group consisted of patients without major cardiac Troponin I elevation. Seven-year long-term all-cause mortality was not higher in the group with major Tn elevation (36.9% vs. 40.6%; p = 0.818). Naturally, periprocedural myocardial infarction was diagnosed only in patients from groups with major Tn elevation (4.9% of all patients). In-hospital death and other periprocedural complications did not differ significantly between the two study groups. The adjusted HRs for mortality post-PCI in patients with a periprocedural myocardial infarction were not significant. Long-term mortality subanalysis for the group with criteria for cardiac procedural myocardial injury showed no significant differences (39.5% vs. 38.8%; p = 0.997). The occurrence of Tn elevation (>1×; >5×; >35× and >70× URL) after LM PCI was not associated with adverse long-term outcomes. The results of the study suggest that the isolated periprocedural troponin elevation is not clinically significant.
Growth Differentiation Factor 15 as a Predictor of the No-Reflow Phenomenon in Patients with ST-Segment Elevation Myocardial Infarction
Authors: Kożuch Marcin , Południewski Maciej , Dąbrowski Emil Julian , Tarasiuk Ewa , Dobrzycki Sławomir
Published: December 2022

Growth differentiation factor 15 (GDF-15) and the no-reflow phenomenon are predictors of mortality after ST-segment elevation myocardial infarction (STEMI). We aimed to assess the relation between GDF-15 concentration on admission and the no-reflow phenomenon. The study was conducted prospectively among 80 consecutive STEMI patients who underwent primary PCI. No-reflow was defined as a corrected TIMI frame count > 27 and myocardial blush grade < 3 after PCI. GDF-15 was measured on admission. We assessed long-term (1.3 years) total mortality and the risk factors of no-reflow. The mean age was 65 (SD 12) years. Mortality rates were 2.5% and 7.5% for in-hospital and long-term observations, respectively. No-reflow occurred in 24% of patients. A negative correlation between TIMI flow after PCI and GDF-15 concentration (R = −0.2540, p = 0.023) was found. Receiver operating characteristic (ROC) analysis revealed GDF-15 as a predictor of no-reflow (AUC-0.698, 95%CI-0.552–0.843, p < 0.05). The multivariate logistic regression analysis revealed that the risk factors for no-reflow occurrence were higher age, a concentration of GDF-15 > 1503 pg/mL, lower systolic blood pressure, and higher troponin I concentration on admission. A higher concentration of GDF-15 can be used as an additional marker of ischemia/reoxygenation injury, subsequent no-reflow phenomenon, and worse long-term outcomes in patients with STEMI.
Electromyographic Assessment of Masseter Muscle Activity: A Proposal for a 24 h Recording Device with Preliminary Data
Authors: Colonna Anna , Noveri Lorenzo , Ferrari Marco , Bracci Alessandro , Manfredini Daniele
Published: December 2022

Objective: The instrumental measurement of electromyographic (EMG) activity in the natural environment is the best strategy available to collect information on bruxism. The twofold aim of this study was to (1) introduce and discuss a novel EMG device for the assessment of awake (AB) and sleep bruxism (SB) in the home environment over 24 h and (2) present some preliminary data. Methods: Fifteen healthy volunteers (eight males and seven females; mean age: 48.2 ± 4.1 years) underwent 24 h EMG recording trials of their masseter muscle activity (MMA) with a miniaturized wireless device. This device allowed us to measure the durations of the different phases of the recordings (total duration, awake time, sleep time, and electrode dislodgement time) as well as the bruxism time index (BTI) and bruxism work index (BWI) for both the waking and sleeping hours. Results: For the healthy volunteers, on average, the bruxism work index (BWI) values were 0.4 ± 0.2 and 0.1 ± 0.1 for awake and sleep, respectively, while the mean bruxism time index (BTI) values were 0.9 ± 0.5 for awake and 0.3 ± 0.1 for sleep. Conclusions: This investigation describes the technical features of a novel EMG recording device that permits the evaluation of masseter muscle activity in the home environment over 24 h. For the first time, a dedicated elaboration of the EMG signal allowed an assessment of muscle work and not just a count of purported SB/EMG events. Clinical significance: Based on the multidisciplinary approach in the study of bruxism, such a methodology, thanks to its peculiar features, will allow researchers and clinicians to monitor the epidemiology of MMA and delve deeper into the awake and sleep bruxism correlates for tailored management in clinical settings.
Oxygen–Ozone Therapy in Cervicobrachial Pain: A Real-Life Experience
Authors: Rania Vincenzo , Marcianò Gianmarco , Casarella Alessandro , Vocca Cristina , Palleria Caterina , Calabria Elena , Spaziano Giuseppe , Citraro Rita , De Sarro Giovambattista , Monea Francesco , Gallelli Luca
Published: December 2022

This prospective, open-label clinical study was carried out to evaluate both the efficacy and safety of intramuscular paravertebral injections of an oxygen–ozone (O2–O3) mixture in patients with cervicobrachial pain. We enrolled 540 subjects affected by cervicobrachial pain referred to the Ozone Therapy Ambulatory at the Mater Domini Hospital of Catanzaro (Italy) and to the Center of Pain in Taurianova (Reggio Calabria, Italy). All the subjects (n = 540) completed the treatment and the follow-up visits. The subjects received a mean of 11 cervical intramuscular treatments with an O2–O3 mixture (5 mL) with an O3 concentration of 10 μg/mL bis a week. The improvement of pain was measured by a change in the mean of the Visual Analog Scale (VAS) score from baseline to the end of treatment and during follow-ups. Patient satisfaction was assessed at the end of treatment using the SF-36 Questionnaire. The development of adverse drug reactions was recorded. The mean (±standard deviation) VAS pain score at baseline, at the end of treatment, and during follow-ups showed a significant reduction in pain over time (p < 0.001). All the patients who were enrolled (n: 540) were pain-free after one year. According to the pain distribution, all subjects showed a significant reduction in pain over time in each group (p < 0.05). No significant differences were observed with respect to sex or age. No adverse events were observed during the study. In conclusion, we documented that the intramuscular injection of an O2–O3 mixture is an effective and safe treatment option for patients with cervicobrachial pain.
Worsened Anxiety and Loneliness Influenced Gaming and Gambling during the COVID-19 Pandemic
Authors: Mohamed Mohamed S. , Rukh Gull , Schiöth Helgi B. , Vadlin Sofia , Olofsdotter Susanne , Åslund Cecilia , Nilsson Kent W.
Published: December 2022

Aim: To study the prevalence and patterns of problematic gaming and gambling during the COVID-19 pandemic and the association with psychiatric traits and major types of anxiety categories. Method: 1067 young adults participated in both wave 3 (2018) and wave 4 (2021) of the SALVe Cohort. Associations with psychiatric symptoms and anxiety were examined using logistic regression and Chi-square tests. Results: Problematic gaming decreased by 1.3 percentage points to 23.2% since the start of the pandemic, while problematic gambling increased by 0.9 percentage points to 6.5% in w4. Average time spent playing video games/day decreased from 2.2 h (w3) to 1.7 h (w4), while increases in gaming activity were associated with worsened feelings of loneliness (p = 0.002), depression (p < 0.001), and anxiety (p < 0.01) during the pandemic. Predictors for problematic gaming at w4 were previous problematic gaming and social anxiety (p = < 0.001 and 0.01, respectively). Moreover, previous problem gambling also predicted problem gambling at w4 p < 0.001. All anxiety categories were associated with both problematic gaming and gambling when adjusted for age and sex. However, after adjusting for depression and insomnia, social anxiety was associated with problematic gaming (p < 0.001), while panic was associated with problem gambling (p < 0.001). Conclusion: Overall, problematic gaming has decreased since the start of the pandemic, while problem gambling has increased. Worsened feelings of loneliness, depression, and anxiety during the pandemic are associated with increased gaming. Moreover, the association between problematic gaming and gambling and anxiety is independent of depression and sleep problems.
Management of Small Nonfunctioning Pancreatic Neuroendocrine Neoplasms: Current Opinion and Controversies
Authors: Paik Woo , Lee Kyong
Published: December 2022

The incidence of small and asymptomatic pancreatic neuroendocrine neoplasms (PNENs) has increased due to the widespread use of high-resolution diagnostic imaging in screening programs. Most PNENs are slow-growing indolent neoplasms. However, a local invasion or metastasis can sometimes occur with PNENs, leading to a poor prognosis. The management of small, nonfunctioning PNENs remains under debate. The National Comprehensive Cancer Network guidelines recommend observation in selected cases of small PNENs less than 2 cm. Pancreatic surgery remains a high-risk operation with a 28–30% morbidity and 1% mortality. Therefore, the decision on how to manage small PNENs is challenging. This review focuses on the management of small nonfunctioning PNENs. We also highlight the malignant potential of small PNENs according to tumor size, tumor grade, and tumor biomarker. Endoscopic-ultrasound-guided biopsy is recommended to evaluate the potential risk of malignancy. Furthermore, we discuss the current guidelines and future directions for the management of small PNENs.
Role of Radiomics Features and Machine Learning for the Histological Classification of Stage I and Stage II NSCLC at [18F]FDG PET/CT: A Comparison between Two PET/CT Scanners
Authors: Dondi Francesco , Gatta Roberto , Albano Domenico , Bellini Pietro , Camoni Luca , Treglia Giorgio , Bertagna Francesco
Published: December 2022

The aim of this study was to compare two different PET/CT tomographs for the evaluation of the role of radiomics features (RaF) and machine learning (ML) in the prediction of the histological classification of stage I and II non-small-cell lung cancer (NSCLC) at baseline [18F]FDG PET/CT. A total of 227 patients were retrospectively included and, after volumetric segmentation, RaF were extracted. All of the features were tested for significant differences between the two scanners and considering both the scanners together, and their performances in predicting the histology of NSCLC were analyzed by testing of different ML approaches: Logistic Regressor (LR), k-Nearest Neighbors (kNN), Decision Tree (DT) and Random Forest (RF). In general, the models with best performances for all the scanners were kNN and LR and moreover the kNN model had better performances compared to the other. The impact of the PET/CT scanner used for the acquisition of the scans on the performances of RaF was evident: mean area under the curve (AUC) values for scanner 2 were lower compared to scanner 1 and both the scanner considered together. In conclusion, our study enabled the selection of some [18F]FDG PET/CT RaF and ML models that are able to predict with good performances the histological subtype of NSCLC. Furthermore, the type of PET/CT scanner may influence these performances.
Comparison of Remimazolam-Flumazenil versus Propofol for Rigid Bronchoscopy: A Prospective Randomized Controlled Trial
Authors: Pan Yafei , Chen Mo , Gu Fulei , Chen Jinyan , Zhang Wen , Huang Zhangxiang , Zhu Dapeng , Song Jia , Fang Jun , Yu Weifeng , Xie Kangjie
Published: December 2022

Background: Remimazolam is a novel ultrashort-acting intravenous benzodiazepine sedative–hypnotic that significantly reduces the times to sedation onset and recovery. This trial was conducted to confirm the recovery time from anesthesia of remimazolam-flumazenil versus propofol in patients undergoing endotracheal surgery under rigid bronchoscopy. Methods: Patients undergoing endotracheal tumor resection or stent implantation were randomly allocated into a remimazolam group (Group R) or a propofol group (Group P). The primary outcome was the recovery time from general anesthesia. The secondary outcomes were the time to loss of consciousness (LoC), hemodynamic fluctuations, and adverse events. Results: A total of 34 patients were screened, and 30 patients were enrolled in the study. The recovery time was significantly shorter for Group R (140 ± 52 s) than for Group P (374 ± 195 s) (p < 0.001). The times to LoC were 76 ± 40 s in Group R and 75 ± 25 s in Group P and were not significantly different. There were also no significant differences in hemodynamic fluctuations or adverse events between the two groups. Conclusions: The recovery time from general anesthesia in rigid bronchoscopy patients was shorter using remimazolam-flumazenil than with propofol, with no dramatic hemodynamic fluctuations and adverse events or differences between the agents. Remimazolam-flumazenil allows for faster recovery from anesthesia than propofol.
Hypercapnic Failure in Acute Exacerbated COPD Patients: Severe Airflow Limitation as an Early Warning Signal
Authors: Grünewaldt Achim , Fritsch Norbert , Rohde Gernot
Published: December 2022

Background: Hypercapnic failure is a severe complication of COPD disease progression, which is associated with a high morbidity and mortality. The aim of this study was to examine the association of comorbidity and clinical risk factors with the development of hypercapnia in acute exacerbated COPD patients. Methods: In this retrospective monocentric cohort study, we examined the influence of the clinical parameters and the comorbidity of hospitalized patients with the acute exacerbation of COPD on the development of hypercapnia by performing multivariate logistic regression and a receiver operating characteristic analysis. Results: In total, 275 patient cases with COPD exacerbation were enrolled during the period from January 2011 until March 2015, where 104 patients (37.8%) with hypercapnia were identified. The logistic regression analysis revealed severe airflow limitation (decreased FEV1) as the main factor associated with the development of hypercapnia. In the ROC analysis, we determined an FEV1 of 42.12%, which was predicted with a sensitivity of 82.6% and specificity of 55%, and an absolute value of FEV1 of 0.8 L, with a sensitivity of 0.62 and specificity of 0.79 as the cut off points, respectively. We could not verify an association with the patient’s condition or the laboratory surrogate parameters of organ failure. Conclusion: Severe airflow limitation is an important risk factor that is associated with hypercapnic failure in acute exacerbated COPD patients. Validation in prospective cohorts is warranted and should focus on more intensive monitoring of these at-risk patients.
Management of Hemorrhagic Shock: Physiology Approach, Timing and Strategies
Authors: Bonanno Fabrizio G.
Published: December 2022

Hemorrhagic shock (HS) management is based on a timely, rapid, definitive source control of bleeding/s and on blood loss replacement. Stopping the hemorrhage from progressing from any named and visible vessel is the main stem fundamental praxis of efficacy and effectiveness and an essential, obligatory, life-saving step. Blood loss replacement serves the purpose of preventing ischemia/reperfusion toxemia and optimizing tissue oxygenation and microcirculation dynamics. The “physiological classification of HS” dictates the timely management and suits the ‘titrated hypotensive resuscitation’ tactics and the ‘damage control surgery’ strategy. In any hypotensive but not yet critical shock, the body’s response to a fluid load test determines the cut-off point between compensation and progression between the time for adopting conservative treatment and preparing for surgery or rushing to the theater for rapid bleeding source control. Up to 20% of the total blood volume is given to refill the unstressed venous return volume. In any critical level of shock where, ab initio, the patient manifests signs indicating critical physiology and impending cardiac arrest or cardiovascular accident, the balance between the life-saving reflexes stretched to the maximum and the insufficient distal perfusion (blood, oxygen, and substrates) remains in a liable and delicate equilibrium, susceptible to any minimal change or interfering variable. In a cardiac arrest by exsanguination, the core of the physiological issue remains the rapid restoration of a sufficient venous return, allowing the heart to pump it back into systemic circulation either by open massage via sternotomy or anterolateral thoracotomy or spontaneously after aorta clamping in the chest or in the abdomen at the epigastrium under extracorporeal resuscitation and induced hypothermia. This is the only way to prevent ischemic damage to the brain and the heart. This is accomplishable rapidly and efficiently only by a direct approach, which is a crush laparotomy if the bleeding is coming from an abdominal +/− lower limb site or rapid sternotomy/anterolateral thoracotomy if the bleeding is coming from a chest +/− upper limbs site. Without first stopping the bleeding and refilling the heart, any further exercise is doomed to failure. Direct source control via laparotomy/thoracotomy, with the concomitant or soon following venous refilling, are the two essential, initial life-saving steps.
Effects of Severe Varus Deformity on Soft Tissue Balancing in Total Knee Arthroplasty
Authors: Kwak Il-Hoon , Lee Sung-Sahn , Lee Jeounghun , Lee Dae-Hee
Published: December 2022

This study aimed to establish the effect of severe varus deformity on soft tissue balance in total knee arthroplasty (TKA), which is not yet well established. We retrospectively enrolled 205 patients (270 knees) who underwent primary TKA using the measured resection technique. Four intraoperatively measured TKA gaps and gap differences were compared between the severe varus deformity group (Hip-knee-ankle [HKA] varus angle ≥ 10°) and the mild varus deformity group (HKA varus angle < 10°). Pearson’s correlation analysis and multiple linear regression analysis were used to investigate the factors affecting flexion and extension gap differences (FGD and EGD). A receiver operating characteristic curve was applied to assess the cut-off value of the HKA varus angle to discriminate the rectangular gap. The FGD (1.42 ± 1.35 mm vs. 1.05 ± 1.16 mm, p = 0.019) and the EGD (1.45 ± 1.32 mm vs. 0.97 ± 1.53 mm, p = 0.006) were significantly larger in severe varus deformity group than in mild varus deformity group. The HKA varus angle was positively correlated with both FGD (r = 0.264, p < 0.001) and EGD (r = 0.319, p < 0.001) and was an influencing factor for FGD (β = 0.232, p = 0.040) and EGD (β = 0.229, p = 0.037). A preoperative HKA angle of 12.4° was selected as the cutoff value to discriminate between rectangular and trapezoidal gaps. Thus, the severity of varus deformity (HKA varus angle) was found to be a significant factor affecting the mediolateral gap difference in TKA. When performing TKA in a knee with an HKA varus angle ≥ 12.4°, a trapezoidal gap is more likely to be expected. Level of evidence III, case–control study.
Tube Joining by a Sheet Flange Connection
Authors: Afonso Rafael M. , Alves Luís M.
Published: December 2022

Joining of tubes to tubes by means of plastic deformation at ambient temperature allows one to solve the main limitations produced by the necessity of joining thin-walled tubes of low-to-medium diameter size made from materials that are not suitable to be welded and/or have reduced contact interfaces. The new joining solution allows one to obtain permanent mechanical joints of tubes or pipes by means of an accessory lightweight sheet metal flange subjected to annular indentation and subsequent injection of its material towards the tube walls to produce a mechanical interlock between the different elements. The sheet-flange connection can then be utilized to affix the joined tube assembly to walls or other different structures and equipment, by means of fasteners or other joining accessories attached to the sheet flange. Similar or dissimilar material combinations can be easily and safely produced while guaranteeing levels of leak-tightness within the maximum internal operating pressure of the individual tubes. A combined numerical–experimental approach is employed to identify the operative parameters as well as to explain the deformation conditions. Pull-out loads and internal fluid pressure are applied to the manufactured joint to evaluate its behavior under typical operating conditions that it may be subjected to during its service life depending on the application.
A Wave Directionality and a Within-Year Wave Climate Variability Effects on the Long-Term Extreme Significant Wave Heights Prediction in the Adriatic Sea
Authors: Mikulić Antonio , Parunov Joško
Published: December 2022

The extreme significant wave height predictions often neglect within-year wave climate variability and wave directionality. Depending on a geographical region, local wind patterns and year climate variability could have an influence on the long-term prediction of waves. The Adriatic Sea having two dominant wind patterns of different characteristics, Bura and Jugo, is a great example for the case study. The 23-year hindcast wave data used in the presented study is extracted from the WorldWaves database. Based on wind and wave data, annual extreme significant wave heights generated by different wind patterns and for different months are fitted by Gumbel distribution using maximum likelihood estimation. Combined long-term extremes are then predicted by calculating system probability. It was found that considering the wave directionality, and especially the seasonality of wave climate, leads to a larger prediction of extreme significant wave heights. The extreme value prediction considering wave directionality on average yields 4% larger significant wave heights, while considering within-year climate variability leads to, on average, 8% larger extremes compared to the predictions when both effects are neglected.