bluuebunny/crossref_metadata_2025 huggingface dataset:
Public Attitudes toward Pharmacogenomic Testing and Establishing a Statewide Pharmacogenomics Database in the State of Minnesota
Authors: Zhang Lusi , Jacobson Pamala A. , Johnson Alyssa N. K. , Gregornik David B. , Johnson Steven G. , McCarty Catherine A. , Bishop Jeffrey R.
Published: October 2022

The clinical adoption and implementation of pharmacogenomics (PGx) beyond academic medical centers remains slow, restricting the general population from benefitting from this important component of personalized medicine. As an initial step in the statewide initiative of PGx implementation in Minnesota, we engaged community members and assessed attitudes towards PGx testing and acceptability of establishing a secure statewide PGx database for clinical and research use among Minnesota residents. Data was collected from 808 adult attendees at the 2021 Minnesota State Fair through an electronic survey. Eighty-four percent of respondents felt comfortable getting a PGx test for clinical care. Most respondents trusted health professionals (78.2%) and researchers (73.0%) to keep their PGx data private. The majority expressed their support and interest in participating in a statewide PGx database for clinical and research use (64–72%). Higher acceptability of the statewide PGx database was associated with younger age, higher education, higher health literacy, having health insurance, and prior genetic testing. The study sample representing Minnesota residents expressed high acceptability of receiving PGx testing and willingness to participate in PGx data sharing for clinical and research use. Community support and engagement are needed to advance PGx implementation and research on the state scale.
High Throughput Genetic Characterisation of Caucasian Patients Affected by Multi-Drug Resistant Rheumatoid or Psoriatic Arthritis
Authors: Tesolin Paola , Bertinetto Francesca Eleonora , Sonaglia Arianna , Cappellani Stefania , Concas Maria Pina , Morgan Anna , Ferrero Norma Maria , Zabotti Alen , Gasparini Paolo , Amoroso Antonio , Quartuccio Luca , Girotto Giorgia
Published: October 2022

Rheumatoid and psoriatic arthritis (RA and PsA) are inflammatory rheumatic disorders characterised by a multifactorial etiology. To date, the genetic contributions to the disease onset, severity and drug response are not clearly defined, and despite the development of novel targeted therapies, ~10% of patients still display poor treatment responses. We characterised a selected cohort of eleven non-responder patients aiming to define the genetic contribution to drug resistance. An accurate clinical examination of the patients was coupled with several high-throughput genetic testing, including HLA typing, SNPs-array and Whole Exome Sequencing (WES). The analyses revealed that all the subjects carry very rare HLA phenotypes which contain HLA alleles associated with RA development (e.g., HLA-DRB1*04, DRB1*10:01 and DRB1*01). Additionally, six patients also carry PsA risk alleles (e.g., HLA-B*27:02 and B*38:01). WES analysis and SNPs-array revealed 23 damaging variants with 18 novel “drug-resistance” RA/PsA candidate genes. Eight patients carry likely pathogenic variants within common genes (CYP21A2, DVL1, PRKDC, ORAI1, UGT2B17, MSR1). Furthermore, “private” damaging variants were identified within 12 additional genes (WNT10A, ABCB7, SERPING1, GNRHR, NCAPD3, CLCF1, HACE1, NCAPD2, ESR1, SAMHD1, CYP27A1, CCDC88C). This multistep approach highlighted novel RA/PsA candidate genes and genotype-phenotype correlations potentially useful for clinicians in selecting the best therapeutic strategy.
Endometriosis and Infertility: Prognostic Value of #Enzian Classification Compared to rASRM and EFI Score
Authors: Fruscalzo Arrigo , Dayer Arnaud , Londero Ambrogio Pietro , Guani Benedetta , Khomsi Fathi , Ayoubi Jean-Marc , Feki Anis
Published: October 2022

This study’s objective was to compare the predictive validity of the three most utilized classification scores for endometriosis, #Enzian, EFI, and rASRM, in achieving a spontaneous pregnancy or pregnancy via assisted reproductive technology (ART) after surgery for endometriosis. The monocentric retrospective study was carried out from January 2012 to December 2021 at the gynaecology department of the cantonal hospital of Fribourg. Patients consulting for infertility and operated on for endometriosis with histological confirmation were included. The predictive value of #Enzian, rASRM, and EFI was evaluated and compared concerning the prediction of fertility after surgery, both spontaneous and ART, during the following 12 months. A total of 58 women (mean age 33.1 ± 4.57 years) were included. Overall, 30 women achieved a pregnancy, seven spontaneously. Among all women who achieved a pregnancy, there was a lower prevalence of rASRM stage III–IV (16.67% vs. 39.29%, p = 0.054). Women achieving a pregnancy had a significantly higher EFI score than others (p < 0.05). No significant differences were observed concerning the #Enzian score. In conclusion, the revised #Enzian score is not correlated with pregnancy achievement; EFI score is the only score significantly associated with the pregnancy outcome in women affected by endometriosis.
Long-Term Results of Complex Abdominal Aortic Aneurysm Open Repair
Authors: Tshomba Yamume , Sica Simona , Minelli Fabrizio , Ferraresi Marco , de Waure Chiara , Donati Tommaso , De Nigris Francesca , Vincenzoni Claudio , Snider Francesco , Tinelli Giovanni
Published: October 2022

This study investigated the long-term outcomes of patients treated with open surgical repair for complex abdominal aortic aneurysms (c-AAAs). A total of 119 patients with c-AAAs undergoing repair between January 2010 and June 2016 in a high-volume aortic center were included. The long-term imaging follow-up consisted of yearly abdominal ultrasound examinations and 5-year computed tomography angiography. At a median follow-up of 76 months (IQR 38 months), forty-three deaths (37%) and three (2.5%) aortic-related deaths were observed. Long-term chronic renal decline was observed in fifty (43.8%) patients, significantly correlated with post-operative acute kidney injury. During the follow-up, five reinterventions (4.3%) were performed. The present study suggests that open c-AAA repair can be performed with acceptable operative risk with durable results. To achieve the best possible long-term outcome, the open surgery repair of complex AAA should be performed in high-volume aortic centers and tailored to the patient.
Distal Lung Inflammation Assessed by Alveolar Concentration of Nitric Oxide Is an Individualised Biomarker of Severe COVID-19 Pneumonia
Authors: Hua-Huy Thông , Günther Sven , Lorut Christine , Subileau Marielle , Aubourg Frédérique , Morbieu Caroline , Marey Jonathan , Texereau Joëlle , Fajac Isabelle , Mouthon Luc , Roche Nicolas , Dinh-Xuan Anh Tuan
Published: October 2022

Pulmonary sequelae as assessed by pulmonary function tests (PFTs) are often reported in patients infected by SARS-CoV-2 during the post-COVID-19 period. Little is known, however, about the status of pulmonary inflammation during clinical recovery after patients’ discharge from the hospitals. We prospectively measured PFTs coupled with the exhaled nitric oxide (NO) stemming from the proximal airways (FeNO) and the distal lung (CaNO) in 169 consecutive patients with varying degrees of the severity of COVID-19 six weeks to one year after acute infection by SARS-CoV-2. The proportions of patients with abnormal PFTs, defined as the presence of either obstructive/restrictive patterns or impaired lung gas transfer, or both, increased with the severity of the initial lung disease (15, 30, and 52% in patients with mild, moderate, and severe COVID-19). FeNO values remained within normal ranges and did not differ between the three groups of patients. CaNO, however, was significantly higher in patients with severe or critical COVID-19, compared with patients with milder forms of the disease. There was also an inverse relationship between CaNO and DLCO. We conclude that the residual inflammation of the distal lung is still present in the post-COVID-19 follow-up period, in particular, in those patients with an initially severe form of COVID-19. This long-lasting alveolar inflammation might contribute to the long-term development of pulmonary fibrosis and warrants the regular monitoring of exhaled NO together with PFTs in patients with COVID-19.
The Impact of Radiographic, Metabolic and Demographic Characteristics on Kidney Stone Recurrence
Authors: Shpunt Igal , Pratt Aloni Hadar , Khanukaeva Nelli , Herskovitz Pearl , Dror Ishai , Berkowitz Brian , Leibovici Dan , Shilo Yaniv
Published: October 2022

Urolithiasis is a frequent disease with cited rates of recurrence after initial diagnosis that vary widely and range between 35% and 50%. We assessed the radiographic recurrence rate in patients with urinary stones and its risk factors. We retrospectively identified patients who were diagnosed with urinary stones on non-contrast computed tomography from 2010 to 2011, and underwent another imaging examination at least six months afterwards. We collected patient demographic, clinical, laboratory and radiologic data and compared patients with and without urinary stone recurrence. Ultimately, 237 patients were included in the study; the mean follow-up was 6.7 years; 88 patients (37.1%) had recurrence based on our recurrence criteria. On univariate analysis, the significant parameters for recurrence were baseline serum calcium and uric acid, stone location in the kidney, surgical intervention and stone burden volume. On multivariate analysis, surgical intervention (OR 3.07, p = 0.001), baseline calcium (OR 2.56, p = 0.011), baseline uric acid (OR 1.30, p = 0.021) and stone location in the kidney (OR 2.16, p = 0.012) were associated with higher risk of recurrence. These findings may guide personalized follow-up protocols for patients with urolithiasis based on their risk factors.
Measurement of Exhaled Volatile Organic Compounds as a Biomarker for Personalised Medicine: Assessment of Short-Term Repeatability in Severe Asthma
Authors: Azim Adnan , Rezwan Faisal , Barber Clair , Harvey Matthew , Kurukulaaratchy Ramesh , Holloway John , Howarth Peter
Published: October 2022

The measurement of exhaled volatile organic compounds (VOCs) in exhaled breath (breathomics) represents an exciting biomarker matrix for airways disease, with early research indicating a sensitivity to airway inflammation. One of the key aspects to analytical validity for any clinical biomarker is an understanding of the short-term repeatability of measures. We collected exhaled breath samples on 5 consecutive days in 14 subjects with severe asthma who had undergone extensive clinical characterisation. Principal component analysis on VOC abundance across all breath samples revealed no variance due to the day of sampling. Samples from the same patients clustered together and there was some separation according to T2 inflammatory markers. The intra-subject and between-subject variability of each VOC was calculated across the 70 samples and identified 30.35% of VOCs to be erratic: variable between subjects but also variable in the same subject. Exclusion of these erratic VOCs from machine learning approaches revealed no apparent loss of structure to the underlying data or loss of relationship with salient clinical characteristics. Moreover, cluster evaluation by the silhouette coefficient indicates more distinct clustering. We are able to describe the short-term repeatability of breath samples in a severe asthma population and corroborate its sensitivity to airway inflammation. We also describe a novel variance-based feature selection tool that, when applied to larger clinical studies, could improve machine learning model predictions.
Predictive Value of Basal Serum Progesterone for Successful IVF in Endometriosis Patients: The Need for a Personalized Approach
Authors: Bila Jovan , Dotlic Jelena , Radjenovic Svetlana Spremovic , Vidakovic Snezana , Tulic Lidija , Micic Jelena , Stojnic Jelena , Babovic Ivana , Dmitrovic Aleksandar , Chiantera Vito , Laganà Antonio Simone , Terzic Milan
Published: October 2022

The data regarding the role of progesterone (P4) in reproductive events of endometriosis patients are limited. This prospective study aimed to examine the predictive value of basal P4 serum levels for successful in vitro fertilization (IVF) in patients with primary infertility and endometriosis. The study included 73 patients divided according to endometriosis treatment (surgery vs. control—no treatment). The general data, basal hormonal status, and pregnancy rates were determined for every patient. Clinical pregnancy was achieved in 40.3% of patients, and more often in patients treated for endometriosis before IVF. The regression analysis showed that higher basal P4 serum levels were associated with achieving pregnancy through IVF. When regression was adjusted for the patient and IVF characteristics, higher basal P4 serum levels were associated with pregnancy achievement in both groups of women, along with the basal serum levels of FSH, LH, and AMH; EFI score; and stimulation protocol. The ROC analysis showed that the basal P4 serum level for successful IVF should be ≥0.7ng/mL. The basal P4 serum level cut-off for IVF success in endometriosis patients was determined for the first time. Constructed models for IVF success prediction emphasize the importance of determining the basal P4 serum levels for the personalized treatment of endometriosis-related infertility.
Psychiatric Symptoms in Parkinson’s Disease Patients before and One Year after Subthalamic Nucleus Deep Brain Stimulation Therapy: Role of Lead Positioning and Not of Total Electrical Energy Delivered
Authors: Somma Teresa , Esposito Felice , Scala Maria Rosaria , Scelzo Antonio , Baiano Cinzia , Patti Sara , Meglio Vincenzo , Iasevoli Felice , Cavallo Luigi M. , Solari Domenico , De Bartolomeis Andrea , Cappabianca Paolo , D’Urso Giordano
Published: October 2022

Parkinson’s disease (PD) patients may experience neuropsychiatric symptoms, including depression, anxiety, sleep disturbances, psychosis, as well as behavioral and cognitive symptoms during all the different stages of the illness. Deep Brain Stimulation (DBS) therapy has proven to be successful in controlling the motor symptoms of PD and its possible correlation with the occurrence or worsening of neuropsychiatric symptoms has been reported. We aimed to assess the neuropsychiatric symptoms of 14 PD patients before and after one year of Subthalamic Nucleus (STN)-DBS and to correlate the possible changes to the lead placement and to the total electrical energy delivered. We assessed PD motor symptoms, depression, anxiety, apathy, impulsivity, and suicidality using clinician- and/or self-administered rating scales and correlated the results to the lead position using the Medtronic SuretuneTM software and to the total electrical energy delivered (TEED). At the 12-month follow-up, the patients showed a significant improvement in PD symptoms on the UPDRS (Unified Parkinson’s disease Rating Scale) (−38.5%; p < 0.001) and in anxiety on the Hamilton Anxiety Rating Scale (HAM-A) (−29%; p = 0.041), with the most significant reduction in the physiological anxiety subscore (−36.26%; p < 0.001). A mild worsening of impulsivity was detected on the Barratt Impulsiveness Scale (BIS-11) (+9%; p = 0.048), with the greatest increase in the attentional impulsiveness subscore (+13.60%; p = 0.050). No statistically significant differences were found for the other scales. No correlation was found between TEED and scales’ scores, while the positioning of the stimulating electrodes in the different portions of the STN was shown to considerably influence the outcome, with more anterior and/or medial lead position negatively influencing psychiatric symptoms.
Towards Precision Oncology: The Role of Smoothened and Its Variants in Cancer
Authors: Nicheperovich Alina , Townsend-Nicholson Andrea
Published: October 2022

The G protein-coupled receptor Smoothened (Smo) is a central signal transducer of the Hedgehog (Hh) pathway which has been linked to diverse forms of tumours. Stimulated by advancements in structural and functional characterisation, the Smo receptor has been recognised as an important therapeutic target in Hh-driven cancers, and several Smo inhibitors have now been approved for cancer therapy. This receptor is also known to be an oncoprotein itself and its gain-of-function variants have been associated with skin, brain, and liver cancers. According to the COSMIC database, oncogenic mutations of Smo have been identified in various other tumours, although their oncogenic effect remains unknown in these tissues. Drug resistance is a common challenge in cancer therapies targeting Smo, and data analysis shows that healthy individuals also harbour resistance mutations. Based on the importance of Smo in cancer progression and the high incidence of resistance towards Smo inhibitors, this review suggests that detection of Smo variants through tumour profiling could lead to increased precision and improved outcomes of anti-cancer treatments.
Deciphering the Impact of HER2 Alterations on Non-Small-Cell Lung Cancer: From Biological Mechanisms to Therapeutic Approaches
Authors: Bontoux Christophe , Benzaquen Jonathan , Hofman Véronique , Heeke Simon , Hannetel Paul , Capela-Brosseau-Laborde Pierre , Marquette Charles-Hugo , Ilié Marius , Hofman Paul
Published: October 2022

Despite the recent increase in the number of types of treatments, non-small-cell lung cancer (NSCLC) remains the major cause of death from cancer worldwide. So, there is an urgent need to develop new therapeutic strategies. The HER2 gene codes for tyrosine kinase receptor whose alterations are known to drive carcinogenesis. HER2 alterations, including amplification, mutations, and overexpression, have been mainly described in breast and gastric cancers, but up to 4% of NSCLC harbor actionable HER2 mutations. HER2-targeted therapy for NSCLC with trastuzumab, pertuzumab, and trastuzumab emtansine has failed to demonstrate an improvement in survival. Nevertheless, recent data from phase II trials have shed light on promising specific therapies for HER2-mutant NSCLC such as trastuzumab deruxtecan. Herein, we aimed to provide an updated review on the biology, epidemiology, molecular testing, and therapeutic strategies for NSCLC with HER2 molecular alterations.
Idiopathic Sudden Sensorineural Hearing Loss: Is Hyperbaric Oxygen Treatment the Sooner and Longer, the Better?
Authors: Chin Chun-Shih , Lee Tsai-Yun , Chen Yi-Wen , Wu Ming-Feng
Published: October 2022

(1) Background: We aimed to evaluate hearing benefits from hyperbaric oxygen (HBO) therapy in patients with Idiopathic Sudden Sensorineural Hearing Loss (ISSHL). (2) Methods: We performed a retrospective analysis of chart reviews on patients with ISSHL between Jan 2016 and Dec 2021. All patients were referred to receive HBO therapy by the department of Ear, Nose and Throat (ENT). Hearing gain was assessed based on pure-tone audiometry (PTA). Data were analyzed for 102 patients after 1 to 5 therapy sessions, and for 46 patients after 6 to 10 therapy sessions. (3) Results: After 1–5 HBO sessions, patients (N = 102) showed an improvement in 45 (44.1%) of the patients (p < 0.000). Also, improvements were found with patients showing different grades of ISSHL: 11 (26.8%) with slight-moderate, 11 (40.7%) with severe, and 23 (67.6%) with profound ISSHL. Significant treatment effects were found at different affected frequencies, especially the low frequency range. After 6–10 HBO sessions, patients (N = 46) showed similar treatment effects as after 1–5 HBO sessions, but no additional improvement. Moreover, patients who received HBO treatment within 12 days showed improvement effects 6.484 times greater (p < 0.000) compared with those who received treatment after 13 days. (4) Conclusions: The improvement of HBO therapy on ISSHL was significant after 1–5 sessions, with larger improvements for those suffering more serious symptoms. Further adding more HBO treatment sessions to 6–10, no further improvement was found. Patients starting HBO therapy within 12 days of ISSHL showed 6.484 times greater improvements compared with those starting HBO therapy later.
A Proposal of a New Nomogram to Predict the Need for Testosterone ReplACEment (TRACE): A Simple Tool for Everyday Clinical Practice
Authors: Cai Tommaso , Privitera Salvatore , Trovato Federica , Capogrosso Paolo , Dehò Federico , Cimino Sebastiano , Rizzo Michele , Liguori Giovanni , Salonia Andrea , Palmieri Alessandro , Verze Paolo , Johansen Truls E. Bjerklund
Published: October 2022

International guidelines suggest to use testosterone therapy (TTh) in hypogonadal men presenting symptoms of testosterone deficiency (TD), even if there is no fixed threshold level of T at which TTh should be started. We aimed to develop and validate a nomogram named TRACE (Testosterone ReplACEment) for predicting the need of TTh in patients with “low–normal” total testosterone levels. The following nomogram variables were used: serum T level; serum LH level; BMI; state of nocturnal erections; metabolic comorbidities; and IPSS total score. The nomogram has been tested by calculating concordance probabilities, as well as assaying the calibration of predicted probability of clinical testosterone deficiency and need for TTh, together with the clinical outcome of the TTh. A cohort of 141 patients was used for the development of the nomogram, while a cohort of 123 patients attending another institution was used to externally validate and calibrate it. Sixty-four patients (45.3%) received TTh. Among them, sixty patients (93.7%) reported a significant clinical improvement after TTh. The nomogram had a concordance index of 0.83 [area under the ROC curve 0.81 (95% CI 0.71–0.83)]. In conclusion, the TRACE nomogram accurately predicted the probability of clinical impairment related to TD, and resulted in a simple and reliable method to use to select hypogonadal patients with not clearly pathological testosterone values who will benefit from TTh.
A Review of Digital Health and Biotelemetry: Modern Approaches towards Personalized Medicine and Remote Health Assessment
Authors: Busnatu Ștefan Sebastian , Niculescu Adelina-Gabriela , Bolocan Alexandra , Andronic Octavian , Pantea Stoian Anca Mihaela , Scafa-Udriște Alexandru , Stănescu Ana Maria Alexandra , Păduraru Dan Nicolae , Nicolescu Mihnea Ioan , Grumezescu Alexandru Mihai , Jinga Viorel
Published: October 2022

With the prevalence of digitalization in all aspects of modern society, health assessment is becoming digital too. Taking advantage of the most recent technological advances and approaching medicine from an interdisciplinary perspective has allowed for important progress in healthcare services. Digital health technologies and biotelemetry devices have been more extensively employed for preventing, detecting, diagnosing, monitoring, and predicting the evolution of various diseases, without requiring wires, invasive procedures, or face-to-face interaction with medical personnel. This paper aims to review the concepts correlated to digital health, classify and describe biotelemetry devices, and present the potential of digitalization for remote health assessment, the transition to personalized medicine, and the streamlining of clinical trials.
Current Approaches in the Allocation of Liver Transplantation
Authors: Ionescu Vlad Alexandru , Diaconu Camelia Cristina , Bungau Simona , Jinga Viorel , Gheorghe Gina
Published: October 2022

In recent decades, important advances have been made in the field of liver transplantation. One of the major problems remaining in this area is the small number of donors. Thus, recent data bring multiple updates of the indications and contraindications of this therapeutic method. The main goal is to increase the number of patients who can benefit from liver transplantation, a therapeutic method that can improve life expectancy and the quality of life of patients with end-stage liver disease. Another goal in the management of these patients is represented by the optimal care of those on the waiting list during that period. A multidisciplinary team approach is necessary to obtain the best results for both the donor and the recipient.
Nanomedicines Meet Disordered Proteins: A Shift from Traditional Materials and Concepts to Innovative Polymers
Authors: Rizzuti Bruno
Published: October 2022

Water-soluble nanomedicines have been widely studied for the targeted delivery of drugs for a very long time. As a notable example, biomaterials based on N-(2-hydroxypropyl) methacrylamide (HPMA) copolymers have been under investigation for nearly half a century. In particular, anticancer drug carriers have been developed under the assumption that the leading mechanism with a therapeutic impact on solid tumors is the enhanced permeability and retention (EPR) effect, which dates back more than three decades. Nevertheless, these (and other) materials and concepts have encountered several barriers in their successful translation into clinical practice, and future nanomedicines need improvements in both passive and active targeting to their site of action. Notions borrowed from recent studies on intrinsically disordered proteins (IDPs) seem promising for enhancing the self-assembly, stimuli-responsiveness, and recognition properties of protein/peptide-based copolymers. Accordingly, IDP-based nanomedicines are ready to give new impetus to more traditional research in this field.
Transient Cytolysis after Transarterial Chemoembolization in Patients with Hepatocellular Carcinoma
Authors: Rodríguez-Perálvarez Manuel
Published: October 2022

Transarterial chemoembolization (TACE) is a minimally invasive radiological procedure which consists of infusing a chemotherapeutic agent in the main arterial supplier of the liver tumor, usually emulsion-based doxorubicin, followed by the occlusion of the involved vessel with 100–500 micron-sized embolic particles [...]
Weight Recidivism and Dumping Syndrome after Roux-En-Y Gastric Bypass: Exploring the Therapeutic Role of Transoral Outlet Reduction
Authors: Matteo Maria Valeria , Gallo Camilla , Pontecorvi Valerio , Bove Vincenzo , De Siena Martina , Carlino Giorgio , Costamagna Guido , Boškoski Ivo
Published: October 2022

Obesity is a chronic, relapsing disease representing a global epidemic. To date, bariatric surgery is the most effective treatment for morbid obesity in the long-term. Roux-en-Y gastric bypass (RYGB) is one of the most performed bariatric interventions, with excellent long-term outcomes. However, about one-third of patients may experience weight regain over time, as well as dumping syndrome. Both these conditions are challenging to manage and require a multidisciplinary and personalized approach. The dilation of the gastro-jejunal anastomosis is a recognized etiological factor for both weight regain and dumping syndrome. Dietary modifications, behavioral interventions, and medications represent the first therapeutic step. Revisional surgery is the traditional approach when non-invasive treatments fail. However, re-interventions may be technically difficult and are associated with increased morbidity and mortality. Transoral outlet reduction (TORe) is an endoscopic procedure aimed at reducing the size of the anastomosis and is proposed as a minimally invasive treatment of weight regain and/or dumping syndrome refractory to conservative therapies. This review is aimed at providing a narrative overview of the role of TORe as part of the multidisciplinary therapeutic toolkit nowadays available to approach weight regain and dumping syndrome after RYGB.
Depressive Pseudodementia with Reversible AD-like Brain Hypometabolism: A Case Report and a Review of the Literature
Authors: Pozzi Federico Emanuele , Licciardo Daniele , Musarra Monica , Jonghi-Lavarini Lorenzo , Crivellaro Cinzia , Basso Gianpaolo , Appollonio Ildebrando , Ferrarese Carlo
Published: October 2022

Recent European guidelines recommend using brain FDG-PET to differentiate between Alzheimer’s disease (AD) and depressive pseudodementia (DP), with specific hypometabolism patterns across the former group, and typically normal or frontal hypometabolism in the latter. We report the case of a 74 years-old man with DP (MMSE 16/30), whose FDG-PET visual rating and semiquantitative analysis closely mimicked the typical AD pattern, showing severe hypometabolism in bilateral precuneus, parietal and temporal lobes, and sparing frontal areas, suggesting the diagnosis of moderate AD. Shortly after starting antidepressant polytherapy, he underwent formal NPS testing, which revealed moderate impairment of episodic memory and mild impairment on executive and visuospatial tests, judged consistent with neurodegenerative dementia and concomitant depression. Over the following two years, he improved dramatically: repeated NPS assessment did not show significant deficits, and FDG-PET showed restoration of cerebral metabolism. The confirmation of PET findings via semiquantitative analysis, and their reversion to normality with antidepressant treatment, proved the non-neurodegenerative origin of the initial AD-like FDG-PET abnormalities. We review similar cases and provide a comprehensive analysis of their implications, concluding that reversible FDG-PET widespread hypometabolism might represent a biomarker of pseudodementia. Therefore, we suggest caution when interpreting FDG-PET scans of depressed patients with cognitive impairment.
Analysis of Cochlear Parameters in Paediatric Inner Ears with Enlarged Vestibular Aqueduct and Patent Cochlea
Authors: Li Jianan , Kang Shuoshuo , Du Haiqiao , Wang Shuwei , Wang Dandan , Liu Mengyu , Yang Shiming
Published: October 2022

Is cochlear implant (CI) electrode selection for cochleae with an enlarged vestibular aqueduct (EVA) the same as that for patent cochleae with a normal inner ear structure? Preoperative high-resolution computed tomography (HRCT) images of 247 ears were assessed retrospectively. The A-value, B-value, and H-value were measured with OTOPLAN, and Bell curves were created to show the distribution. All ears with EVA were re-evaluated using a 3D slicer to confirm whether incomplete partition type II (IP II) existed. The Mann–Whitney U-test was applied to determine a statistically significant difference. After adjustment with the Bonferroni correction method, a p-value ≤ 0.006 was considered significant. In total, 157 ears with patent cochlea and 90 ears with EVA were assessed. Seventy (82%) of the EVA ears had an IP II malformation, and 14 (19%) of these were not detected by CT scan but were later seen through the 3D reconstruction. A significant difference was found for the A value and B value between the patent cochleae and EVA-only and between the patent cochleae and EVA with IP II. Most EVA cases had an IP II malformation. The basal turn of the cochlea may be smaller in EVA cases than in the patent cochleae. Electrode selection should be adjusted accordingly.
Efficacy of an Online Educational Intervention in Reducing Body Weight in the Pre-Diabetic Population of 18–45 Years Old, a Randomized Trial Protocol
Authors: Ramírez-Durán María del Valle , Basilio-Fernández Belinda , Gómez-Luque Adela , Alfageme-García Pilar , Clavijo-Chamorro María Zoraida , Jiménez-Cano Víctor Manuel , Fabregat-Fernández Juan , Robles-Alonso Vicente , Hidalgo-Ruiz Sonia
Published: October 2022

Aim: to analyze the efficacy of an educational online intervention focused on lifestyle changes in reducing body weight from baseline to 6 months in the pre-diabetic population of 18–45 years old in Extremadura (Spain). Methods: a single-blind, multicenter randomized parallel-comparison trial with two intervention groups in a 1:1 ratio will be carried out. Participants will be randomly assigned to intervention A or B with 37 cases in each group according to inclusion criteria of being enrolled or working at Extremadura University, scoring >7 points on the Findrisc test and not having diagnosed diabetes mellitus or physical disabilities. Intervention-A group will have access to online information about healthy diet and exercise. Intervention-B group will have access to a six-session educational program regarding behavioral changes in diet and exercise habits. They will complete follow-up activities and have a personal trainer and motivation. The primary outcome will be identifying changes in body weight from baseline to 1 and 6 months and between groups. The secondary outcomes will be accomplishing regular physical activity (>30 min/day or >4 h/week), decreasing sugary food intake or avoiding it altogether, increasing vegetable/fruit intake and lowering HbA1c levels to non-diabetic status when necessary.
Cutting-Edge Approaches in Arthroplasty: Before, during and after Surgery
Authors: Beckmann Johannes , Barrett David , Thienpont Emmanuel
Published: October 2022

Personalised medicine was introduced in arthroplasty a long time ago with the aim of respecting each individual person for their unique personal characteristics in order to further improve outcomes [...]
Clinical Significance of the Histone Deacetylase 2 (HDAC-2) Expression in Human Breast Cancer
Authors: Garmpis Nikolaos , Damaskos Christos , Dimitroulis Dimitrios , Kouraklis Gregory , Garmpi Anna , Sarantis Panagiotis , Koustas Evangelos , Patsouras Alexandros , Psilopatis Iason , Antoniou Efstathios A. , Karamouzis Michail V. , Kontzoglou Konstantinos , Nonni Afroditi
Published: October 2022

Background/Aim: There is a strong association between malignancy and histone deacetylases (HDACs). Histone deacetylase inhibitors (HDACIs) are now being tested as antitumor agents in various clinical trials. We aimed to assess the clinical importance of HDAC-2 in breast cancer (BC). Materials and Methods: A total of 118 BC specimens were examined immunohistochemically. A statistical analysis was conducted in order to examine the relation between HDAC-2 and the clinicopathological features and survival of the patients. Results: Higher HDAC-2 expression was related to lobular histological type of cancer, grade III, and stage III BC. In addition, the disease-free period and overall survival were curtailed and negatively related to the over-expression of HDAC-2. Other factors correlating with worse survival were histological types other than ductal or lobular, and the stage of the disease. Conclusions: This study showed a relationship between HDAC-2 and BC. Further studies are required in order to eventually potentiate the role of HDACIs as anticancer agents in BC.
An Epidemiological and Etiological Analysis of 5026 Peripheral Nerve Lesions from a European Level I Trauma Center
Authors: Aman Martin , Zimmermann Kim S. , Thielen Mirjam , Thomas Benjamin , Daeschler Simeon , Boecker Arne H. , Stolle Annette , Bigdeli Amir K. , Kneser Ulrich , Harhaus Leila
Published: October 2022

Background: Peripheral nerve lesions are associated with debilitating long-term consequences. Albeit being essential for evidence-based clinical decision making, epidemiological and etiological data are scarce. We therefore aimed to comprehensively analyze epidemiological and etiological factors of peripheral nerve lesions in one of the largest cohorts. Methods: We screened a total of 110,667 patients treated at our level I trauma center between January 2012 and July 2020 for nerve lesions. Subsequently, demographics, etiologies, concomitant injuries, and lesion characteristics were analyzed. Results: A total of 5026 patients, predominantly young males suffering from non-work-related nerve injuries, were treated. Proximal levels of injury were more likely to be accompanied by fractures, whereas more distal injuries with concomitant vessel or tendon injury. Main causes were 54.6% lacerations. Acute traumatic nerve injury was treated within 24 h in 55.9% of cases. Conclusions: Given the young age of affected patients, early diagnosis and treatment in specialized centers may facilitate their early return to work and improve long-term functional outcomes. The data show the importance of a special attention on nerve injuries, which may be masked by large accompanying injuries. New findings on lesion characteristics of selected subgroups and accompanying circumstances can support a change in treatment strategies.
Job-Related Performance and Quality of Life Benefits in First Responders Given Access to H-Wave® Device Stimulation: A Retrospective Cohort Study
Authors: Williamson Tyler K. , Rodriguez Hugo C. , Han David , Norwood Stephen M. , Gupta Ashim
Published: October 2022

Current chronic pain treatments primarily target symptoms and are often associated with harmful side-effects and complications, while safer non-invasive electrotherapies like H-Wave® device stimulation (HWDS) have been less explored. The goal of this study is to evaluate first responder-reported effects of HWDS on job-related and quality-of-life measures. This is a retrospective cohort study where first responders were surveyed following voluntary use of HWDS regarding participant experience, frequency of use, job-related performance, and quality-of-life. Responses were analyzed using means comparison tests, while bivariate analysis assessed responses associated with HWDS usage. Overall, 92.9% of first responder HWDS users (26/28) reported a positive experience (p < 0.0001), with 82.1% citing pain reduction (p = 0.0013), while 78.6% indicated it would be beneficial to have future device access (p = 0.0046). Participants using H-Wave® were at least six times more likely to report higher rates of benefit (100% vs. 0%, p = 0.022), including pain reduction (91.3% vs. 8.7%, p = 0.021) and improved range-of-motion (93.3% vs. 69.2%, p = 0.044). Spending more time with family was associated with better job performance following frequent HWDS use (50% vs. 8.3%, p = 0.032). Repetitive first responder H-Wave® use, with minimal side effects and easy utilization, resulted in significant pain reduction, improvements in job performance and range-of-motion, and increased time spent with family, resulting in overall positive experiences and health benefits. Level of Evidence: III.
Firm Performance during COVID-19 Pandemic: Does Ownership Identity Matter? Evidence from Indonesia
Authors: Perwitasari Dian , Setiawan Doddy , Nurrahmawati An , Rahmawati Isna Putri
Published: October 2022

This study aimed to examine the importance of shareholder identity in improving company performance during shock events such as the COVID-19 pandemic. The outbreak poses threats and opportunities for businesses in various countries including Indonesia. Subsequently, companies must adapt to address the consequences of the economic disruption and lockdown policies imposed by the local government. The study sample comprised companies listed on the Indonesia Stock Exchange (IDX) during the COVID-19 pandemic from 2020 to 2021. Fixed effects model regression was employed to examine the effect of family, government, and institutional ownership on company performance. The results showed that family and institutional ownership positively affected company performance during the pandemic. The mechanisms of direct supervision and control by family members could potentially increase the benefits of their businesses. Furthermore, high institutional ownership makes the role of investors substantial in reducing business risk and increasing company performance. Furthermore, the results revealed that government ownership negatively affected company performance. As owners, the government has different strategic objectives, where companies are more oriented toward better public services than financial gains. Therefore, it is essential to consider the impact of shareholder involvement on company performance, especially during a pandemic because they are treated differently. The research suggests that organizations are responding and adapting to the uncertainties in the business environment they face through a variety of mechanisms, including developing public and corporate governance strategies to prepare for and respond to future emergencies.
The Robustness of the Determinants of Overall Bank Risks in the MENA Region
Authors: Eldomiaty Tarek , Youssef Amr , Mahrous Heba
Published: October 2022

Purpose: The banking sector in the MENA region is exposed to financial risks that originate from both the internal and external environment. Related studies in the literature have reached inconclusive determinants of the overall risks to banks. This paper examines the robustness of the determinants cited in the related literature. Design/methodology/approach: This paper examines the country-specific and bank-specific factors that affect banks’ Z-score (being a proxy for the overall bank risks) in the MENA region. The sample banks consist of 33 listed commercial banks operating in six countries in the MENA region. Balanced panel data over 20 years (2000 to 2020) was examined, having a total of 660 observations. The Pooled Ordinary Least Square estimation (OLS) was used to carry out the empirical analysis. Findings: The findings of this paper showed that the robust determinants of overall bank risks are follows: (a) The unemployment rate had a negative effect on high overall bank risks in the period 2000–2010, (b) The financial crisis had a positive effect on the MENA overall bank risks in the period 2000–2010, but only for the low overall bank risks, (c) A robust and negative effect of cost/income ratio was observed in the period 2010–2020 only for high overall bank risk, (d) Low overall-risk banks were able to manage overall risks in a shorter time than high overall bank risks, and (e) In terms of the country-wide effect, the results for Egypt only showed that the overall bank risk had positive effects in the period 2000–2010, but negative and significant effects in the period 2011–2020 where overall bank risks reduced. Originality: This paper offers robust findings in the controversy around the determinants of overall bank risks in the MENA region, which is beneficial in light of the fact that the literature thus far has not reached a consensus regarding this issue.
Digital Economy and the Upgrading of the Global Value Chain of China’s Service Industry
Authors: Kan Daxue , Lyu Lianju , Huang Weichiao , Yao Wenqing
Published: October 2022

China’s service trade competitiveness is weak, and the service industry occupies a low position in the GVC (Global Value Chain); therefore, promoting the upgrade of the GVC of China’s service industry is worth studying. Under the new situation of the continuous integration of the digital economy and the real economy, the digital economy has injected new momentum into the mid-to-high end of the GVC of China’s service industry. Based on the panel data of the service industry sub-sectors, the mediating effect model is constructed, and the system GMM (Generalized Method of Moments) is used to empirically determine whether the digital economy can significantly improve the participation and position of China’s service industry in the GVC, and promote the upgrading of the GVC of China’s service industry. This conclusion still holds after replacing the independent variable measurement indicator, adding control variables, considering changes in industry trends, and using quantile regression and other robustness tests. The promotion effect of the digital economy on the upgrading of the GVC of China’s service industry shows heterogeneity in different service objects and service industries with different factor intensities, indicating that the digital economy will affect the internal structure of the upgrading of the GVC of China’s service industry. The results of the mediation test found that the service trade cost, multilateral resistance to service trade, service industry structure, financial development level, human capital and service export complexity are the mechanisms for the digital economy to enable the upgrading of the GVC of China’s service industry. This study improves the analysis of the impact factors of the GVC in the service industry, enriches the theory of the GVC, and improves the research content of digital economy theory. This study also provides a reference for other developing countries similar to China on how to promote the upgrading of the GVC of the service industry in the process of digital economy development.
Connecting Perceived Service Quality, Value and Shopping Behavior: An Analysis on Chinese College Students Traveling Overseas
Authors: Panarello Demetrio , Gatto Andrea
Published: October 2022

In recent years, tourist destinations around the world have witnessed an exponential growth in the number of Chinese tourists. With a view of understanding the consequences of their shopping activity in terms of behavioral response, this study inspects Chinese college students traveling overseas by analyzing 180 questionnaires. The reasoned action theory is applied to examine the impact of a number of factors influencing shopping behavior. The inquiry at hand makes use of methods, including factor analysis, regression analysis, and moderation analysis, to explore the relationship among perceived service quality, perceived value and shopping behavioral intention of tourists. The results show, inter alia, that service quality is a relevant dimension influencing the likelihood of tourists to share their shopping experience with friends and relatives, encouraging them to shop in the same destination, and to continue to shop in the same destination themselves in the future, regardless of the costs of visiting. Therefore, improving service quality may increase college students’ consumption during travel as well as their word of mouth after returning home. The outcomes of this study may contribute to the existing tourism economics and management scholarship and the tourism industry.
Managerial Control in an Online Constructivist Learning Environment: A Teacher’s Perspective
Authors: Le Corre Jean-Yves , Burger-Helmchen Thierry
Published: October 2022

This article presents the lessons learned from an online teaching experience in the field of managerial control. The study aims to identify the determinants which influence collaborative behaviors between students in management studies and more specifically during the construction of performance measures. A business simulation specifically elaborated for this study is used. The study is conducted through a particular research design consisting of an online learning environment built on constructivist learning principles. The learning environment simulates the different steps of a performance dashboard creation (a set of performance indicators) for a fictitious organization. The study adopts an exploratory sequential design to explore and examine social behaviors during the process of knowledge construction related to performance measures. It contributes to a better understanding of the role of cognitive and behavioral skills in the profession of management accounting and how teachers can incorporate such aspects into their courses. It helps to build awareness among educators about the benefits of using digital learning solutions to help students in accounting and managerial control develop their professional skills most effectively.