bluuebunny/crossref_metadata_2025 huggingface dataset:
Promotion of Colitis in B Cell-Deficient C57BL/6 Mice Infected with Enterotoxigenic Bacteroides fragilis
Authors: Jo Minjeong , Hwang Soonjae , Lee Chang-Gun , Hong Ju-Eun , Kang Da-Hye , Yoo Sang-Hyeon , Kim Woo-Seung , Yoo Jung-Yoon , Rhee Ki-Jong
Published: December 2023

Enterotoxigenic Bacteroides fragilis (ETBF) causes colitis and is implicated in inflammatory bowel diseases and colorectal cancer. The ETBF-secreted B. fragilis toxin (BFT) causes cleavage of the adherence junction, the E-cadherin, resulting in the large intestine showing IL-17A inflammation in wild-type (WT) mice. However, intestinal pathology by ETBF infection is not fully understood in B-cell-deficient mice. In this study, ETBF-mediated inflammation was characterized in B-cell-deficient mice (muMT). WT or muMT C57BL/6J mice were orally inoculated with ETBF and examined for intestinal inflammation. The indirect indicators for colitis (loss of body weight and cecum weight, as well as mortality) were increased in muMT mice compared to WT mice. Histopathology and inflammatory genes (Nos2, Il-1β, Tnf-α, and Cxcl1) were elevated and persisted in the large intestine of muMT mice compared with WT mice during chronic ETBF infection. However, intestinal IL-17A expression was comparable between WT and muMT mice during infection. Consistently, flow cytometry analysis applied to the mesenteric lymph nodes showed a similar Th17 immune response in both WT and muMT mice. Despite elevated ETBF colonization, the ETBF-infected muMT mice showed no histopathology or inflammation in the small intestine. In conclusion, B cells play a protective role in ETBF-induced colitis, and IL-17A inflammation is not attributed to prompted colitis in B-cell-deficient mice. Our data support the fact that B cells are required to ameliorate ETBF infection-induced colitis in the host.
VEGFC Gene Expression Is Associated with Tumor Progression and Disease-Free Survival in Cutaneous Squamous Cell Carcinoma
Authors: García-Pérez Omar , Melgar-Vilaplana Leticia , Sifaoui Inés , Śmietańska Aleksandra , Córdoba-Lanús Elizabeth , Fernández-de-Misa Ricardo
Published: December 2023

Cutaneous squamous cell carcinoma (CSCC) is one of the most common cancers in the skin. CSCC belongs to the non-melanoma skin cancers, and its incidence is increasing every year around the world. The principal routes of tumor progression are related to angiogenesis and lymphangiogenesis. In this study, we assess the gene expression of the relevant biomarkers of both routes in 49 formalin-fixed paraffin-embedded (FFPE) CSCC samples in an attempt to determine a molecular profile that correlates with the tumor progression and disease-free survival (DFS). The results were enhanced by a posttranscriptional analysis using an immunofluorescence assay. Overexpression of the vascular endothelial growth factor C (VEGFC) gene was found in patients with tumor progression (p = 0.022) and in patients with perineural invasion (p = 0.030). An increased expression of protein VEGFC in samples with tumor progression supported these results (p = 0.050). In addition, DFS curves showed differences (p = 0.027) for tumors with absent-low VEGFC expression versus those with high levels of VEGFC expression. No significant influence on DFS was detected for the remaining analyzed genes. VEGFC expression was found to be a risk factor in the disease progression (HR = 2.675; 95% CI: 1.089–6.570; p = 0.032). Our main results suggest that VEGFC gene expression is closely related to tumor progression, DFS, and the presence of perineural invasion.
Towards Enhancing Automated Defect Recognition (ADR) in Digital X-ray Radiography Applications: Synthesizing Training Data through X-ray Intensity Distribution Modeling for Deep Learning Algorithms
Authors: Hena Bata , Wei Ziang , Perron Luc , Castanedo Clemente Ibarra , Maldague Xavier
Published: December 2023

Industrial radiography is a pivotal non-destructive testing (NDT) method that ensures quality and safety in a wide range of industrial sectors. Conventional human-based approaches, however, are prone to challenges in defect detection accuracy and efficiency, primarily due to the high inspection demand from manufacturing industries with high production throughput. To solve this challenge, numerous computer-based alternatives have been developed, including Automated Defect Recognition (ADR) using deep learning algorithms. At the core of training, these algorithms demand large volumes of data that should be representative of real-world cases. However, the availability of digital X-ray radiography data for open research is limited by non-disclosure contractual terms in the industry. This study presents a pipeline that is capable of modeling synthetic images based on statistical information acquired from X-ray intensity distribution from real digital X-ray radiography images. Through meticulous analysis of the intensity distribution in digital X-ray images, the unique statistical patterns associated with the exposure conditions used during image acquisition, type of component, thickness variations, beam divergence, anode heel effect, etc., are extracted. The realized synthetic images were utilized to train deep learning models, yielding an impressive model performance with a mean intersection over union (IoU) of 0.93 and a mean dice coefficient of 0.96 on real unseen digital X-ray radiography images. This methodology is scalable and adaptable, making it suitable for diverse industrial applications.
Effect of Self-Adhesive Resin Cement Film Thickness on the Shear Bond Strength of Lithium Disilicate Ceramic–Cement–Tooth Triplex
Authors: Alrabeah Ghada , Binhassan Faisal , Al Khaldi Sultan , Al Saleh Ahmed , Al Habeeb Khaled , Anwar Saqib , Habib Syed Rashid
Published: December 2023

Cement film thickness may have an impact on the shear bond strength (SBS) of lithium disilicate dental ceramics luted to human enamel with resin cement. The objective of this study was to evaluate SBS of lithium disilicate ceramics adhered to enamel using resin cement at different thicknesses. In total, 50 ceramic specimens (3 × 3 × 3 mm) and 50 premolar teeth were prepared and randomly assigned to 5 groups (n = 10 each). Ceramic specimens were designed with five cement film thicknesses (50 μm; 100 μm; 150 μm; 200 μm; and 300 μm). Teeth surfaces (4 × 4 mm) were prepared with a high-speed handpiece mounted on a dental surveyor. Ceramic specimens were cemented to teeth with resin cement (3MTM RelyXTM U200, Resin-Self-Adhesive-Cement). The specimens were then thermocycled for 6000 cycles with a 30 s dwell time and a 5 s transfer time in water (5 °C and 55 °C). A Universal-Testing-Machine was used to measure SBS (MPa). Statistical analysis in SPSS included Anova and Tukey’s tests. The SBSs of ceramics adhered to teeth revealed significantly different values across all test groups (p = 0.000). The findings showed that as cement layer thickness increased, so did the SBS. The cement spaces at 50 and 300 μm had the lowest SBS (9.40 + 1.15 MPa) and maximum SBS (21.98 + 1.27 MPa), respectively. The SBS of the lithium disilicate ceramic luted to natural human enamel increased along with the cement layer thickness.
Blue Light Exposure Caused Large-Scale Transcriptional Changes in the Abdomen and Reduced the Reproductive Fitness of the Fall Armyworm Spodoptera frugiperda
Authors: Liu Yu , Tao Yi-Dong , Zhang Li-Bao , Wang Fen , Xu Jin , Zhang Jun-Zhong , Fu Da-Ying
Published: December 2023

In the present study, we found that blue light stress negatively affected the development periods, body weight, survival and reproduction of Spodoptera frugiperda, and it showed a dose-dependent reaction, as longer irradiation caused severer effects. Further transcriptome analysis found blue light stress induced fast and large-scale transcriptional changes in the head, thorax and, particularly, the abdomen of female S. frugiperda adults. A functional enrichment analysis indicated that shorter durations of blue light irradiation induced the upregulation of more stress response- and defense-related genes or pathways, such as abiotic stimuli detection and response, oxidative stress, ion channels and protein-kinase-based signal pathways. In the abdomen, however, different durations of blue-light-exposure treatments all induced the downregulation of a large number genes and pathways related to cellular processes, metabolism, catalysis and reproduction, which may be a trade-off between antistress defense and other processes or a strategy to escape stressful conditions. These results indicate irradiation duration- and tissue-specific blue light stress responses and consequences, as well as suggest that the stress that results in transcriptional alterations is associated with the stress that causes a fitness reduction in S. frugiperda females.
Placenta Accreta Spectrum Prophylactic Therapy for Hyperfibrinolysis with Tranexamic Acid
Authors: Ayub Tiyasha Hosne , Strizek Brigitte , Poetzsch Bernd , Kosian Philipp , Gembruch Ulrich , Merz Waltraut M.
Published: December 2023

Background: To report on prophylactic therapy for hyperfibrinolysis with tranexamic acid (TXA) during expectant management (EM) in the placenta accreta spectrum (PAS). Methods: This is a monocentric retrospective study of women with PAS presenting at our hospital between 2005 and 2021. All data were retrospectively collected through the departmental database. Results: 35 patients with PAS were included. EM was planned in 25 patients prior to delivery. Complete absorption of the retained placenta was seen in two patients (8%). Curettage was performed in 14 patients (56%). A hysterectomy (HE) was needed in seven (28%) patients; 18 patients (72%) underwent uterus-preserving treatment without severe complications. The mean duration of EM was 107 days. The mean day of onset of hyperfibrinolysis and beginning of TXA treatment was day 45. The mean nadir of fibrinogen level before TXA was 242.4 mg/dL, with a mean drop of 29.7% in fibrinogen level. Conclusions: Our data support EM as a safe treatment option in PAS. Hyperfibrinolysis can be a cause of hemorrhage during EM and can be treated with TXA. To our knowledge, this is the first cohort of patients with EM of PAS in whom coagulation monitoring and use of TXA have been shown to successfully treat hyperfibrinolysis.
Intrathecal Morphine and Post-Operative Pain Relief in Robotic Surgeries: A Systematic Review and Meta-Analysis
Authors: Tee Zi Heng , Tsoi Erica Ho Ching , Lee Quinston , Wong Yen Sin , Gibson Arron , Parsons Niamh , Shaikh Shafaque , Forget Patrice
Published: December 2023

Despite the potential benefits of intrathecal morphine (ITM), the precise role and dosing of ITM in robotic assisted surgery (RAS) remains unclear. This systematic review explores real-world evidence to evaluate the efficacy and outcomes of ITM in patients undergoing RAS. In accordance with PRISMA guidelines, a comprehensive search was conducted on four databases: MEDLINE, Embase, Cochrane Library and APA PsycInfo. Primary outcomes included pain scores at rest and on exertion at 24- and 48-h time intervals, and secondary outcomes aimed to explore the side effects of ITM. A meta-analysis was conducted to determine mean differences. A risk of bias assessment was conducted via the Cochrane Risk of Bias 2 tool. A total of 9 RCTs involving 619 patients were included in this review, of which 298 patients were administered ITM. Significant pain score reductions were observed both at rest (MD = −27.15; 95% CI [−43.97, −10.33]; I2 = 95%; p = 0.002) and on exertion (MD = −25.88; 95% CI [−37.03, −14.72]; I2 = 79%; p = 0.0003) 24 h postoperatively in the ITM groups, accompanied by a notable decrease in postoperative IV morphine equivalent consumption at 24 h (MD = −20.13; 95% CI [−30.74, −9.52]; I2 = 77%; p = 0.0002). ITM improved pain scores both at rest and on exertion at 24 and 48 h intervals, concurrently reducing the need for postoperative opioid consumption, but at the cost of an increased incidence of adverse events.
Gout and Migraines: Exploring the Complex Link in a 16-Year Longitudinal Study of the Korean Population
Authors: Kang Ho Suk , Kim Ji Hee , Kim Joo-Hee , Bang Woo Jin , Choi Hyo Geun , Kim Nan Young , Park Ha Young , Choi Kyung Chan , Choi Younghee , Kwon Mi Jung
Published: December 2023

Despite the growing prevalence of gout and its associated health concerns as a chronic disorder, population-based studies on its link to migraines are scarce. We conducted a 16-year longitudinal study in a Korean population to investigate the relationship between gout and migraines, including different subtypes. We enrolled 23,137 patients with gout and matched them with 92,548 controls based on age, sex, income, and residence. Using Cox proportional hazards models, we calculated hazard ratios to assess the likelihood of migraines while considering relevant factors. During the follow-up, 1000 gout patients and 3214 controls experienced migraines. After adjusting for various factors, including demographics, health-related variables, and weight categories, the gout group had a 1.26-fold higher likelihood of developing migraines compared to the group without gout. This association was particularly strong for migraines without aura, while it was not significant for migraines with aura. In summary, our study reveals a significant link between gout and migraines in the Korean population, emphasizing the complex relationship among chronic disorders, with a specific focus on migraine subtypes.
Efficacy and Safety of Vedolizumab in Patients with Inflammatory Bowel Disease in Association with Vedolizumab Drug Levels
Authors: Hüttemann Eva , Muzalyova Anna , Gröhl Katharina , Nagl Sandra , Fleischmann Carola , Ebigbo Alanna , Classen Johanna , Wanzl Julia , Prinz Friederike , Mayr Patrick , Schnoy Elisabeth
Published: December 2023

Background: Vedolizumab (VDZ) is a well-established and important therapeutic option in the treatment of patients with inflammatory bowel disease (IBD). However, the significance of therapeutic drug monitoring (TDM) with VDZ remains a contradictory field in daily clinical practice. Our study aims to clarify the predictive impact of VDZ drug levels in long-term clinical outcomes in a real-world cohort. Methods: Patients with moderate to severe ulcerative colitis (UC) and Crohn’s disease (CD) from a tertiary IBD referral center at the University Hospital Augsburg, Germany, were enrolled in this single-center retrospective data analysis. Clinical and endoscopic data were collected at month 6, month 12, and at the last time of follow-up, and outcomes were correlated with VDZ levels at week 6. Results: This study included 95 patients, 68.4% (n = 65) with UC, 24.2% (n = 23) with CD, and 7.4% (n = 7) with indeterminate colitis (CI). Patients with a mean VDZ treatment time of 17.83 months ± 14.56 showed clinical response in 29.5% (n = 28) and clinical remission in 45.3% (n = 43) at the end of the study. Endoscopic response occurred in 20.0% (n = 19) and endoscopic remission in 29.5% (n = 28) at the end of the study. The sustained beneficial effect of VDZ was also reflected in a significant change in biomarker levels. VDZ trough level at week 6 was determined in 48.4% (n = 46) with a mean of 41.79 µg/mL ± 24.58. A significant association between VDZ level at week 6 and both short and long-term outcomes could not be demonstrated. However, numerically higher VDZ levels were seen in patients with endoscopic and clinical improvement at month 6 and at the time of last follow-up. Conclusions: This study demonstrated efficacy and safety for VDZ in a real-world cohort. Although, for some parameters, a clear trend for higher VDZ levels at week 6 was seen, the efficacy of VDZ was not significantly correlated to VDZ level at week 6, which questions the predictive value of VDZ levels in the real world.
Advancements in Methods of Classification and Measurement Used to Assess Tooth Mobility: A Narrative Review
Authors: Kim Gi Youn , Kim Sunjai , Chang Jae-Seung , Pyo Se-Wook
Published: December 2023

Evaluating tooth mobility is clinically significant, not only for diagnosing periodontal tissues but also in determining the overall periodontal treatment plan. Numerous studies related to tooth mobility have been conducted over the years, including the proposal of various classifications as well as the development of electronic devices for objective measurement. However, there is still no consensus on the measurement methods and criteria for assessing tooth mobility. In this study, we provide a comprehensive review of past and current tooth mobility classification and measurement methods. In order to propose a new method to intuitively evaluate tooth mobility based on previous studies, a digital approach capable of recording tooth micromovements induced by dynamic load should be considered.
The Nexus of Hyperparathyroidism and Thyroid Carcinoma: Insights into Pathogenesis and Diagnostic Challenges—A Narrative Review
Authors: Scerrino Gregorio , Paladino Nunzia Cinzia , Orlando Giuseppina , Salamone Giuseppe , Richiusa Pierina , Radellini Stefano , Melfa Giuseppina , Graceffa Giuseppa
Published: December 2023

This review investigates the intricate relationship between hyperparathyroidism (HPT) and thyroid carcinoma (TC), aiming to elucidate their coexistence, potential pathogenetic mechanisms, and clinical implications. A systematic search strategy, employing the MeSH terms ‘Hyperparathyroidism’ and ‘Thyroid Carcinoma’, spanned publications from 2013 to 2023 across the PubMed, Web of Science, and Scopus databases. Fifteen selected articles were analyzed. Studies unanimously confirm the notable association between primary hyperparathyroidism (PHPT) and thyroid nodules/cancer, with incidences ranging from 2.8% to 47.1%. Key findings reveal a predilection for papillary thyroid carcinoma (PTC) in this association, showcasing varying tumor characteristics and gender disparities. Lower preoperative serum parathyroid hormone (PTH) levels are a potential risk factor for thyroid cancer in PHPT patients. Diverse surgical approaches and tumor characteristics between PHPT and secondary hyperparathyroidism (SHPT) cases were noted. Moreover, this review underscores the scarcity of definitive guidelines in managing concurrent PHPT and thyroid conditions, advocating for comprehensive assessments to enhance diagnostic accuracy and refine therapeutic interventions. Rare coincidental associations, as highlighted by case reports, shed light on unique clinical scenarios. In essence, this review amalgamates evidence to deepen the understanding of the interplay between HPT and TC, emphasizing the need for further research to elucidate underlying mechanisms and guide clinical management.
COVID-19 in a Dutch Nursing Home: A Longitudinal Retrospective Care-Home-Level Case Study on Infection Rate, Survival Rate, and Daily Functioning
Authors: Vries Danielle de , Röhlinger Darwin , Everink Irma , Winkens Bjorn , Heffels Joyce , Gordon Adam , Schols Jos
Published: December 2023

During the pandemic, nursing homes in the Netherlands were heavily affected by COVID-19. This study assesses the impact of COVID-19 on infection rate, survival rate, and daily functioning over the course of two years among residents of a nursing home in the Netherlands that was amongst the first nursing homes to be affected by the pandemic. This retrospective study followed 70 residents during a two-year period, starting in March 2020. Data were collected on baseline characteristics of participants and the onset, duration, and sequelae of COVID-19 infections. Primary outcomes were mortality and infection rate. The secondary outcome was daily functioning using the Barthel Index at intervals of six months. Within two years, 44 (62.9%) residents were diagnosed with COVID-19. During this study, 72.7% (n = 32) of the COVID-positive residents died, of which 22 deaths were related to the COVID-19 infection. Overall mortality was 60% (n = 42), while COVID-related mortality was 31.4% (n = 22). COVID-19 and multimorbidity (>3 morbidities) were independent risk factors for mortality. Barthel Index scores showed no significant difference in daily functioning. Overall, a high COVID-19 infection rate was seen and was the most common cause of death. COVID-19 did not affect functional status over time.
Effects of Different Kinds of Physical Activity on Vascular Function
Authors: Saladini Francesca
Published: December 2023

Regular exercise is one of the main non-pharmacological measures suggested by several guidelines to prevent and treat the development of hypertension and cardiovascular disease through its impact on the vascular system. Routine aerobic training exerts its beneficial effects by means of several mechanisms: decreasing the heart rate and arterial pressure as well as reducing the activation of the sympathetic system and inflammation process without ignoring the important role that it plays in the metabolic profile. Through all these actions, physical training counteracts the arterial stiffening and aging that underlie the development of future cardiovascular events. While the role of aerobic training is undoubted, the effects of resistance training or combined-training exercise on arterial distensibility are still questioned. Moreover, whether different levels of physical activity have a different impact on normotensive and hypertensive subjects is still debated.
Survival and Recurrence of Endocarditis following Mechanical vs. Biological Aortic Valve Replacement for Endocarditis in Patients Aged 40 to 65 Years: Data from the INFECT-Registry
Authors: Salsano Antonio , Di Mauro Michele , Labate Laura , Della Corte Alessandro , Lo Presti Federica , De Bonis Michele , Trumello Cinzia , Rinaldi Mauro , Cura Stura Erik , Actis Dato Guglielmo , Punta Giuseppe , Nicolini Francesco , Carino Davide , De Vincentiis Carlo , Garatti Andrea , Cappabianca Giangiuseppe , Musazzi Andrea , Cugola Diego , Merlo Maurizio , Pacini Davide , Folesani Gianluca , Sponga Sandro , Vendramin Igor , Pilozzi Casado Alberto , Rosato Francesco , Mikus Elisa , Savini Carlo , Onorati Francesco , Luciani Giovanni Battista , Scrofani Roberto , Epifani Francesco , Musumeci Francesco , Lio Antonio , Colli Andrea , Falcetta Giosuè , Nicolardi Salvatore , Zaccaria Salvatore , Vizzardi Enrico , Pantaleo Antonio , Minniti Giuseppe , Villa Emmanuel , Dalla Tomba Margherita , Pollari Francesco , Barili Fabio , Parolari Alessandro , Lorusso Roberto , Santini Francesco
Published: December 2023

Background: Infective endocarditis (IE) is a serious disease, and in many cases, surgery is necessary. Whether the type of prosthesis implanted for aortic valve replacement (AVR) for IE impacts patient survival is a matter of debate. The aim of the present study is to quantify differences in long-term survival and recurrence of endocarditis AVR for IE according to prosthesis type among patients aged 40 to 65 years. Methods: This was an analysis of the INFECT-REGISTRY. Trends in proportion to the use of mechanical prostheses versus biological ones over time were tested by applying the sieve bootstrapped t-test. Confounders were adjusted using the optimal full-matching propensity score. The difference in overall survival was compared using the Cox model, whereas the differences in recurrence of endocarditis were evaluated using the Gray test. Results: Overall, 4365 patients were diagnosed and operated on for IE from 2000 to 2021. Of these, 549, aged between 40 and 65 years, underwent AVR. A total of 268 (48.8%) received mechanical prostheses, and 281 (51.2%) received biological ones. A significant trend in the reduction of implantation of mechanical vs. biological prostheses was observed during the study period (p < 0.0001). Long-term survival was significantly higher among patients receiving a mechanical prosthesis than those receiving a biological prosthesis (hazard ratio [HR] 0.546, 95% CI: 0.322–0.926, p = 0.025). Mechanical prostheses were associated with significantly less recurrent endocarditis after AVR than biological prostheses (HR 0.268, 95%CI: 0.077–0.933, p = 0.039). Conclusions: The present analysis of the INFECT-REGISTRY shows increased survival and reduced recurrence of endocarditis after a mechanical aortic valve prosthesis implant for IE in middle-aged patients.
Innovations in Positron Emission Tomography and State of the Art in the Evaluation of Breast Cancer Treatment Response
Authors: Castorina Luigi , Comis Alessio Danilo , Prestifilippo Angela , Quartuccio Natale , Panareo Stefano , Filippi Luca , Castorina Serena , Giuffrida Dario
Published: December 2023

The advent of hybrid Positron Emission Tomography/Computed Tomography (PET/CT) and PET/Magnetic Resonance Imaging (MRI) scanners resulted in an increased clinical relevance of nuclear medicine in oncology. The use of [18F]-Fluorodeoxyglucose ([18F]FDG) has also made it possible to study tumors (including breast cancer) from not only a dimensional perspective but also from a metabolic point of view. In particular, the use of [18F]FDG PET allowed early confirmation of the efficacy or failure of therapy. The purpose of this review was to assess the literature concerning the response to various therapies for different subtypes of breast cancer through PET. We start by summarizing studies that investigate the validation of PET/CT for the assessment of the response to therapy in breast cancer; then, we present studies that compare PET imaging (including PET devices dedicated to the breast) with CT and MRI, focusing on the identification of the most useful parameters obtainable from PET/CT. We also focus on novel non-FDG radiotracers, as they allow for the acquisition of information on specific aspects of the new therapies.
Same Journey, Different Paths: Caregiver Burden among Informal Caregivers of Adolescent and Young Adult Patients with an Uncertain or Poor Cancer Prognosis (UPCP)
Authors: Reuvers Milou J. P. , Burgers Vivian W. G. , Vlooswijk Carla , Verhees Bram , Husson Olga , van der Graaf Winette T. A.
Published: December 2023

A minority of adolescent and young adult cancer patients (AYA) live with an uncertain or poor prognosis (UPCP). Caring for a young, advanced cancer patient can lead to caregiver burden. This study aims to provide insight into burden on informal caregivers of AYA cancer patients with UPCP. In-depth, semistructured interviews were conducted with parents (n = 12), siblings (n = 7), friends (n = 7), and partners (n = 13). Thematic analysis was performed to derive themes from the data. Participants reported sleeping problems and stress. They struggle with uncertainty, fear, loss, and negative emotions. Family life is altered due to solely taking care of the children, but also the AYA. Contact with friends and family is changed. The relationship to the AYA can shift positively (e.g., becoming closer) or negatively (e.g., more conflict or no longer being attracted). Participants were under pressure, having to take on many responsibilities and multiple roles. In the financial domain, they report less income and often must continue working. A high amount of caregiver burden is experienced among informal caregivers of AYAs with UPCP. Yet only part of the impact appears to be age specific. Specific, age-adjusted interventions can be developed to lower the burden.
Reperfusion Injury: How Can We Reduce It by Pre-, Per-, and Postconditioning
Authors: Buske Maria , Desch Steffen , Heusch Gerd , Rassaf Tienush , Eitel Ingo , Thiele Holger , Feistritzer Hans-Josef
Published: December 2023

While early coronary reperfusion via primary percutaneous coronary intervention (pPCI) is established as the most efficacious therapy for minimizing infarct size (IS) in acute ST-elevation myocardial infarction (STEMI), the restoration of blood flow also introduces myocardial ischemia-reperfusion injury (IRI), leading to cardiomyocyte death. Among diverse methods, ischemic conditioning (IC), achieved through repetitive cycles of ischemia and reperfusion, has emerged as the most promising method to mitigate IRI. IC can be performed by applying the protective stimulus directly to the affected myocardium or indirectly to non-affected tissue, which is known as remote ischemic conditioning (RIC). In clinical practice, RIC is often applied by serial inflations and deflations of a blood pressure cuff on a limb. Despite encouraging preclinical studies, as well as clinical studies demonstrating reductions in enzymatic IS and myocardial injury on imaging, the observed impact on clinical outcome has been disappointing so far. Nevertheless, previous studies indicate a potential benefit of IC in high-risk STEMI patients. Additional research is needed to evaluate the impact of IC in such high-risk cohorts. The objective of this review is to summarize the pathophysiological background and preclinical and clinical data of IRI reduction by IC.
Incidence and Clinical Risk Factors of Post-Operative Complications following Primary Total Hip Arthroplasty: A 10-Year Population-Based Cohort Study
Authors: Lin Yen-Sheng , DeClercq Joshua J. , Ayers Gregory D. , Gilmor Ruby J. , Collett Garen , Jain Nitin B.
Published: December 2023

Background: Total hip arthroplasty (THA) has become a growing treatment procedure for debilitating hip pathologies. Patients experienced post-operative complications and revision surgeries according to large THA registries. To fully understand the short-term and long-term post-operative outcomes following THA, the purpose of this study is to examine the incidence of post-operative complications following primary THA and to examine how this trend has changed over 10 years within community hospitals in the US using large databases. Methods: This study queried the State Inpatient Database (SID) for primary THA between 2006 and 2015. Individual patients were followed forward in time until the first instance of a post-operative complication. The multivariable logistic regression analyses were computed to examine which post-operative complications were independent predictors of pre-operative comorbidities. Results: Median age of patients was 67 years, and 56% of patients were female. Females with avascular necrosis (AVN) as an indication for THA had a 27% higher risk of complication. Females with osteoarthritis (OA) as an indication for THA had a 6% higher risk of complication. Post-operative complications occurred with higher frequencies in the first two months of THA and the highest risks of THA complications within the first 6 months. Conclusion: The most common indication is OA in elders with primary THA. Females and those of black ethnicity showed the greatest risks of THA complications. Data from our large study can be used to understand post-operative complications and readmissions after THA. Our study also provides data on risk factors associated with these complications.
Hyperthermic Intraperitoneal Chemotherapy (HIPEC), Oncological Outcomes and Long-Term Survival among Patients with Gastric Cancer and Limited Peritoneal Disease Progression after Neoadjuvant Chemotherapy
Authors: Kobiałka Sebastian , Sędłak Katarzyna , Pelc Zuzanna , Mlak Radosław , Endo Yutaka , Bogacz Paweł , Kurylcio Andrzej , Polkowski Wojciech P. , Pawlik Timothy M. , Rawicz-Pruszyński Karol
Published: December 2023

Introduction: The role of surgery in stage IV gastric cancer with peritoneal metastasis (PM) remains unclear. The objective of the current single-center study was to define the impact of gastrectomy with cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) on outcomes among Central European GC patients with limited peritoneal disease progression after neoadjuvant chemotherapy (NAC). Methods: Patients with histologically confirmed GC who underwent curative-intent multimodal treatment between 2013 and 2023 were included. Patients without adenocarcinoma, who did not undergo gastrectomy, had early (cT1) or metastatic GC at the time of initial diagnosis, who underwent multivisceral resection, incomplete cytoreduction or palliative care, died before planned curative-intent treatment, or had incomplete clinical or pathological missing information were excluded. Results: A total of 74 patients who underwent curative-intent treatment for GC with PM were included in the final analytic cohort. Patients who underwent gastrectomy with CRS+HIPEC were less likely to achieve TOO (CRS+HIPEC: 28% vs. CRS: 57.1%, p = 0.033) compared with individuals after CRS alone. Specifically, patients who underwent gastrectomy with CRS+HIPEC had a higher likelihood of postoperative complications (CRS+HIPEC: 48% vs. CRS: 20.4%, p = 0.018) and longer hospital LOS (median, CRS+HIPEC: 12 vs. CRS: 10, p = 0.019). While administration of HIPEC did not impact long-term survival (median OS, CRS+HIPEC: 16 months vs. CRS: 12 months, p = 0.55), postoperative complications (median OS, CCI < 30:16 months vs. CCI > 30:5 months, p = 0.024) and ICU stay (median OS, no ICU stay: 16 months vs. ICU stay: 5 months, p = 0.008) were associated with worsened long-term survival among GC patients with PM. Conclusions: Data from the current study demonstrated a lack of survival benefit among advanced GC patients with PM undergoing gastrectomy with CRS+HIPEC when compared with individuals after gastrectomy with CRS alone. Administration of perioperative chemotherapy and achievement of TO failed to withstand the peritoneal disease progression during NAC.
Anatomic Feasibility of In-Situ Fenestration for Isolate Left Subclavian Artery Preservation during Thoracic Endovascular Aortic Repair Using an Adjustable Needle Puncturing System
Authors: Piffaretti Gabriele , Franchin Marco , Gnesutta Aroa , Gatta Tonia , Piacentino Filippo , Rivolta Nicola , Lomazzi Chiara , Bissacco Daniele , Fontana Federico , Trimarchi Santi
Published: December 2023

Objectives: To evaluate the feasibility of thoracic endovascular aortic repair (TEVAR) using the Ankura™ device (Lifetech Scientific, Shenzhen, China) with left subclavian artery (LSA) in-situ fenestration (ISF) using an adjustable puncture device system. Methods: It is a single center, retrospective, financially unsupported cohort study of TEVAR performed from 16 February 2007 to 10 January 2023. Inclusion criteria were isolate LSA revascularization for elective or urgent/emergent “zone 2” TEVAR, and the availability of the preoperative computed tomography angiography. Results: Post-hoc analysis identified 52 TEVARs. There were 39 (75.0%) males, and 13 (25.0%) females: median age was 74.5 years (IQR, 65.5–78). Index TEVAR was performed for atherosclerotic aneurysm in 27 (51.9%) cases, dissection-related diseases in 18 (34.6%), penetrating aortic ulcer in 5 (9.6%), and blunt traumatic aortic injury in 2 (3.8%). Access-vessel feasibility rate of TEVAR using the Ankura™ device would have been 98.1% (51/52). Considering the morphology of the aortic arch, ISF TEVAR feasibility would have been 61.5% (32/52). Binary logistic regression analysis identified LSA angulation (OR: 1.1, 95%CI: 1.03–1.14, p = 0.003) to be associated with ISF feasibility using this endograft and a self-centering adjustable needle-based puncture device. Conclusions: Potential feasibility of TEVAR using the Ankura™ endograft with ISF using a self-centering adjustable needle system was 61.5%. Left subclavian artery angulation seems to be the most important and limiting anatomical constraint.
Targeting Interleukin-17 as a Novel Treatment Option for Fibrotic Diseases
Authors: Sisto Margherita , Lisi Sabrina
Published: December 2023

Fibrosis is the end result of persistent inflammatory responses induced by a variety of stimuli, including chronic infections, autoimmune reactions, and tissue injury. Fibrotic diseases affect all vital organs and are characterized by a high rate of morbidity and mortality in the developed world. Until recently, there were no approved antifibrotic therapies. In recent years, high levels of interleukin-17 (IL-17) have been associated with chronic inflammatory diseases with fibrotic complications that culminate in organ failure. In this review, we provide an update on the role of IL-17 in fibrotic diseases, with particular attention to the most recent lines of research in the therapeutic field represented by the epigenetic mechanisms that control IL-17 levels in fibrosis. A better knowledge of the IL-17 signaling pathway implications in fibrosis could design new strategies for therapeutic benefits.
A Critical Analysis of Pharyngeal Patterns of Collapse in Obstructive Sleep Apnea: Beyond the Endoscopic Classification Systems
Authors: De Vito Andrea , Olszewska Ewa , Kotecha Bhik , Thuler Eric , Casale Manuele , Cammaroto Giovanni , Vicini Claudio , Vanderveken Olivier M.
Published: December 2023

(1) Background: Drug-Induced Sleep Endoscopy (DISE) enables the three-dimensional and dynamic visualization of the upper airway (UA) during sleep, which is useful in selecting the best treatment option for obstructive sleep apnea (OSA) patients, particularly for surgical procedures. Despite international consensus statements or position papers, a universally accepted DISE methodology and classification system remain a controversial open question. (2) Methods: A review of the English scientific literature on DISE related to endoscopic classification systems and surgical outcome predictors (3) Results: Of the 105 articles, 47 were included in the analysis based on their content’s relevance to the searched keywords. (4) Conclusions: A final report and scoring classification system is not universally accepted; the most internationally applied endoscopic classification system during DISE does not cover all patterns of events that occur simultaneously during the endoscopic examination, highlighting that several configurations of collapse and obstruction at different UA levels could be observed during DISE, which should be described in detail if DISE has to be considered in the decision-making process for the UA surgical treatment in OSA patients and if DISE has to have a role as a predictive factor for surgical outcomes analysis.
Orthodontic Bracket Rebonding with and without Fluoride: A Pilot Study
Authors: Vale Francisco , Travassos Raquel , Pinto Mariana Diogo , Ribeiro Madalena Prata , Marques Filipa , Ramalho Amílcar , Antunes Pedro , Marto Carlos Miguel , Paula Anabela Baptista , Nunes Catarina , Francisco Inês
Published: December 2023

Adhesion between orthodontic brackets and conditioned enamel surfaces is essential for treatment success with fixed appliances. During treatment, enamel demineralization lesions commonly appear although remineralization is possible through fluoride application. Aim: Evaluation of the surface rugosity in bracket rebonding, specifically the influence of fluoride application before the bonding protocol. In total, 30 human premolars extracted for orthodontic reasons were used and divided into three groups. The control group was not submitted to any experimental manipulation; group 1 and 2 were placed in a demineralization solution and group 2 was additionally subjected to a subsequent fluoride application. The surface rugosity was measured at different timings: T0—before bracket bonding; T1—first bracket debonding after composite removal; and T2—second bracket debonding after composite removal. For the statistical analysis, the Kruskal–Wallis test, Mann-Whitney test, and Student’s t-test were used. Regarding the comparison between groups, at T0 and T1, no statistically significant differences were observed. However, at T2, statistically significant differences were verified between the control group and group 1 for the parameters: Ra (p = 0.0043), Rq (p = 0.0043), Rqmax (p = 0.0043), Rp (p = 0.0087), and Rv (p = 0.026). Regarding the evaluation between time points, in the control group, no statistically significant differences were observed. In group 1, statistically significant results were found between T0 and T1 for the parameters: Rq (p = 0.0451), Rqmax (p = 0.0451), Rp (p = 0.0091), and Rvk (p = 0.0433) and between T1 and T2 for the parameters: Ra (p = 0.0465), Rq (p = 0.0433), Rqmax (p = 0.0433), and Rp (p = 0.0155). In group 2, statistically significant differences were found between T0 and T1 for the parameter Rvk (p = 0.0405). A decrease In surface rugosity was observed during multiple bracket rebonding procedures. Therefore, this study suggests that rebonding procedures alter the enamel surface rugosity. The need for rebonding should be avoided, opting for a more effective and correct first bonding. In the case of multiple rebonding, enamel remineralization maneuvers must be applied to recover the surface, since the results of this study suggest that the application of fluoride prior to bracket adhesion promotes lower surface roughness.
The Fatigue Response’s Fingerprint of Composite Materials Subjected to Constant and Variable Amplitude Loadings
Authors: D’Amore Alberto , Grassia Luigi
Published: December 2023

This paper discusses the theoretical and experimental correlations between fatigue and static strength statistical distributions. We use a two-parameter residual strength model that obeys the qualitative strength-life equal rank assumption (SLERA) for guidance. The modeling approach consists of recovering the model’s parameters by best fitting the constant amplitude (CA) fatigue data at a given stress ratio, R, and the experimental Weibull parameters of the static strength distribution function. An extensive set of fatigue life and residual strength data for AS4 carbon/epoxy 3k/E7K8 Plain Weave Fabric with [45/−45/90/45/−45/45/−45/0/45/−45]S layups, obtained at different stress ratios, R, have been analyzed. The modeling approach consists of recovering the model’s parameters from pure tension or compression fatigue data at R = 0.1 and R = 5, respectively. Once the parameters are fixed, the model’s capabilities, potential, and limits are discussed by comparing its predictions with residual strength and fatigue life data obtained at stress ratios with mixed tension/compression loadings, namely R = −0,2 and R = −1. Moreover, from a preliminary analysis, the theoretical extension of the model’s capabilities to variable amplitude loadings is conceptualized. The application of Miner’s rule is also discussed and compared with a new damage rule to analyze the fatigue responses under variable amplitude loadings.
Hydroxyapatite-Based Coatings on Silicon Wafers and Printed Zirconia
Authors: Chauvin Antoine , Garda Marie-Rose , Snyder Nathan , Cui Bai , Delpouve Nicolas , Tan Li
Published: December 2023

Dental surgery needs a biocompatible implant design that can ensure both osseointegration and soft tissue integration. This study aims to investigate the behavior of a hydroxyapatite-based coating, specifically designed to be deposited onto a zirconia substrate that was intentionally made porous through additive manufacturing for the purpose of reducing the cost of material. Layers were made via sol–gel dip coating by immersing the porous substrates into solutions of hydroxyapatite that were mixed with polyethyleneimine to improve the adhesion of hydroxyapatite to the substrate. The microstructure was determined by using X-ray diffraction, which showed the adhesion of hydroxyapatite; and atomic force microscopy was used to highlight the homogeneity of the coating repartition. Thermogravimetric analysis, differential scanning calorimetry, and Fourier transform infrared spectroscopy showed successful, selective removal of the polymer and a preserved hydroxyapatite coating. Finally, scanning electron microscopy pictures of the printed zirconia ceramics, which were obtained through the digital light processing additive manufacturing method, revealed that the mixed coating leads to a thicker, more uniform layer in comparison with a pure hydroxyapatite coating. Therefore, homogeneous coatings can be added to porous zirconia by combining polyethyleneimine with hydroxyapatite. This result has implications for improving global access to dental care.
Trajectory-Following Control of an Unmanned Aerial–Aquatic Vehicle under Complex Coupling Interferences
Authors: Cao Jian , Mao Jiayuan , Li Yueming , Wang Le , Cao Biao
Published: December 2023

This article explores trajectory-following control for an unmanned aerial–aquatic vehicle (UAAV) navigating complex ocean disturbances and the interplay of air–seawater coupling factors. First, leveraging the backstepping technology, an adaptive algorithm is proposed to tackle the attitude and position following. Additionally, a nonlinear observer is crafted to estimate complex ocean disturbances. The UAAV model, characterized by six degrees of freedom (DOF) and nonlinear properties, experiences significant pose changes when emerging from water, underscoring the critical importance of precise pose control. Finally, stability analysis and numerical simulations are demonstrated to verify the feasibility and validity of the proposed control strategies.
Research on Obstacle Avoidance Planning for UUV Based on A3C Algorithm
Authors: Wang Hongjian , Gao Wei , Wang Zhao , Zhang Kai , Ren Jingfei , Deng Lihui , He Shanshan
Published: December 2023

Deep reinforcement learning is an artificial intelligence technology that combines deep learning and reinforcement learning and has been widely applied in multiple fields. As a type of deep reinforcement learning algorithm, the A3C (Asynchronous Advantage Actor-Critic) algorithm can effectively utilize computer resources and improve training efficiency by synchronously training Actor-Critic in multiple threads. Inspired by the excellent performance of the A3C algorithm, this paper uses the A3C algorithm to solve the UUV (Unmanned Underwater Vehicle) collision avoidance planning problem in unknown environments. This collision avoidance planning algorithm can have the ability to plan in real-time while ensuring a shorter path length, and the output action space can meet the kinematic constraints of UUVs. In response to the problem of UUV collision avoidance planning, this paper designs the state space, action space, and reward function. The simulation results show that the A3C collision avoidance planning algorithm can guide a UUV to avoid obstacles and reach the preset target point. The path planned by this algorithm meets the heading constraints of the UUV, and the planning time is short, which can meet the requirements of real-time planning.
Estimating Spatiotemporal Fishing Effort of Trawlers with Vessel-Monitoring System Data: A Case Study of the Sea Area of the Bohai Sea and the Yellow Sea, China
Authors: Li Dan , Lu Feng , Xu Shuo , Liu Huiyuan , Xue Muhan , Cui Guohui , Ma Zhenhua , Fang Hui , Wang Yu
Published: December 2023

Measuring the distribution of the fishing effort of trawlers is of great significance for describing marine fishery activities, quantifying fishing systems in terms of marine ecological pressure, and revising the regulations of fishing. The purpose of this paper is to develop an efficient learning algorithm to detect the fishing behavior of trawlers to analyze the distribution of fishing effort. The vessel-monitoring system data of more than 4600 trawlers from September 2019 to April 2023 were used for feature extraction. According to the spatiotemporal information provided by the vessel position data, 11-dimensional features were extracted to form the feature vectors. A Slime Mould Algorithm-optimized Light Gradient-Boosting Machine (SMA-LightGBM) algorithm was proposed to classify the feature vectors to recognize fishing behavior. The presented method showed a remarkable generalization ability and high accuracy, sensitivity, specificity, and Matthews correlation coefficient in the test results, with scores of 98.23%, 98.75%, 97.75%, and 0.9646, respectively. Subsequently, the trained model was used to identify the fishing behavior of trawlers belonging to the coastal provinces of the Bohai Sea and the Yellow Sea in the sea area of 117° E~132° E, 26° N~41° N. The fishing effort was calculated and evaluated according to the fishing behavior recognition results. The mean absolute error was 0.3031 kW·h, and the coefficient of determination score was 0.9772. The thermal map of the fishing effort of the trawler was mapped, and the spatiotemporal characteristics were estimated in the region of interest from 2019 to 2023 with a spatial resolution of 18 degree × 18 degree. This method is an efficient way of analyzing the spatiotemporal characteristics of the fishing effort of trawlers. It provides a quantitative basis for the assessment of fishery resources and can inform fishing policies.