bluuebunny/crossref_metadata_2025 huggingface dataset:
Design a Clinical Research Protocol: Influence of Real-World Setting
Authors: Cimino Jonathan , Braun Claude
Published: August 2023

The design of a clinical research protocol to evaluate new therapies, devices, patient quality of life, and medical practices from scratch is probably one of the greatest challenges for the majority of novice researchers. This is especially true since a high-quality methodology is required to achieve success and effectiveness in academic and hospital research centers. This review discusses the concrete steps and necessary guidelines needed to create and structure a research protocol. Along with the methodology, some administrative challenges (ethics, regulatory and people-management barriers) and possible time-saving recommendations (standardized procedures, collaborative training, and centralization) are discussed.
Styletubation in Bariatric Surgery: A Case Report
Authors: Wu Bor-Gang , Luk Hsiang-Ning , Qu Jason Zhensheng , Shikani Alan
Published: August 2023

Direct laryngoscopes and videolaryngoscopes are the dominant endotracheal intubation tools. The styletubation technique (using a video-assisted intubating stylet) has shown its advantages in terms of short intubation time, high success rate, less required stimulation, and operator satisfaction. The learning curve can be steep but is easily overcome if technical pitfalls are avoided. Conditions that make styletubation challenging include secretions/blood, short/stiff neck, restricted mouth opening and cervical spine mobility, anatomical abnormalities over head and neck regions, obesity, etc. In this clinical report, we present the effectiveness and efficiency of the routine use of the styletubation for tracheal intubation in a super-super-obese patient (BMI 103 kg/m2) undergoing bariatric surgery with laparoscopic sleeve gastrectomy.
Knowing Is Better than Wondering: The Cataloging of Natural Heritage between Museum Studies and Crime
Authors: Franza Annarita , Scali Federica , Garofano Luciano , Pratesi Giovanni
Published: August 2023

This paper aims to analyze the role of natural heritage cataloging when criminal events challenge natural history museums. This study investigates the rhino horn thefts in Italian natural history museums from 2011 to 2015 to provide a comprehensive framework for these robberies while highlighting the weaknesses and strengths to prevent thefts and safeguard both rhino horns and natural history collections from future targeting.
Hydroponic Production of Selenium-Enriched Baby Leaves of Swiss Chard (Beta vulgaris var. cicla) and Its Wild Ancestor Sea Beet (Beta vulgaris ssp. maritima)
Authors: Puccinelli Martina , Rosellini Irene , Malorgio Fernando , Pardossi Alberto , Pezzarossa Beatrice
Published: August 2023

The human intake of selenium (Se), which is an essential element in animals and humans, can be increased through the consumption of vegetables that have been biofortified during cultivation. There is increasing interest in wild edible plants (WEPs) due to their positive effects on health. In fact, many WEPs are rich in microelements, vitamins, dietary fibers, and several antioxidant compounds. Among WEPs, sea beet (Beta vulgaris ssp. maritima) is the wild ancestor of Swiss chard (Beta vulgaris var. cicla). The present study investigated the potential of fortifying Swiss chard and sea beet with Se. The two subspecies were cultivated in a floating system with a nutrient solution enriched with four concentrations of Se (0, 1, 3, and 5 mg L−1), and the production and quality of the baby leaves were evaluated. The addition of Se to the nutrient solution resulted in a higher leaf concentration of this microelement in both subspecies, with a positive effect on the yield (+20%) and leaf chlorophyll concentration (+25%) at the Se concentration of 1 mg L−1. The leaf concentration of nitrates was reduced by the Se treatment in sea beet regardless of the Se concentration (−24%, on average). Selenium biofortification was more effective in sea beet plants than in Swiss chard due to the higher ability of the wild species to acquire readily available minerals from the hydroponic nutrient solution. In conclusion, both subspecies accumulated a significant amount of Se without negative effects on yield or leaf quality, thus proving them to be suitable for the production of Se-enriched baby leaves.
Hydrological Properties of Litter in Different Vegetation Types: Implications for Ecosystem Functioning
Authors: Castagnolli Lara , Boggiani Fernando Santos , Lima Jeferson Alberto de , Lima Marcelle Teodoro , Tonello Kelly Cristina
Published: August 2023

This study investigated the hydrological properties of litter in different vegetation cover types, including Eucalyptus sp. plantation, Agroforestry, and Restoration Forest. The research focused on evaluating litter accumulation, composition, water holding capacity, and effective water retention. The results revealed variations in litter accumulation among the stands, and especially Eucalyptus sp., which had a higher proportion of branches compared to leaves. The water holding capacity of the litter differed among the stands. Agroforest and Restoration Forest showed higher litter water capacities than Eucalyptus sp. The composition and decomposition stage of the litter fractions influenced their water retention capabilities, with leaves exhibiting superior water retention. In contrast, branches had lower water absorption due to their hydrophobic nature. Despite these differences, the effective water retention, which indicates the ability of litter to intercept precipitation, was similar among the stands. The findings highlight the importance of considering litter composition and species-specific characteristics in understanding the hydrological functions of litter. This knowledge contributes to effective conservation and management strategies for sustainable land use practices and water resource management. Further research is recommended to expand the study’s scope to include a wider range of forest types and natural field conditions, providing a more comprehensive understanding of litter hydrological functions and their implications for ecosystem processes.
Development and Automation of a Photovoltaic-Powered Soil Moisture Sensor for Water Management
Authors: de Melo Denilson Alves , Silva Patrícia Costa , da Costa Adriana Rodolfo , Delmond Josué Gomes , Ferreira Ana Flávia Alves , de Souza Johnny Alves , de Oliveira-Júnior José Francisco , da Silva Jhon Lennon Bezerra , da Rosa Ferraz Jardim Alexandre Maniçoba , Giongo Pedro Rogerio , Ferreira Maria Beatriz , de Assunção Montenegro Abelardo Antônio , de Oliveira Henrique Fonseca Elias , da Silva Thieres George Freire , da Silva Marcos Vinícius
Published: August 2023

The objective of this study was to develop and calibrate a photovoltaic-powered soil moisture sensor (SMS) for irrigation management. Soil moisture readings obtained from the sensor were compared with gravimetric measurements. An automated SMS was used in two trials: (i) okra crop (Abelmoschus esculentus) and (ii) chili pepper (Capsicum frutescens). All sensors were calibrated and automated using an Arduino Mega board with C++. The soil moisture data were subjected to descriptive statistical analysis. The data recorded by the equipment was correlated with the gravimetric method. The determination coefficient (R2), Pearson correlation (r), and root mean square error (RMSE) were adopted as criteria for equipment validation. The results show that our SMS achieved an R2 value of 0.70 and an r value of 0.84. Notably, there was a striking similarity observed between SMS and gravimetric data, with RMSE values of 3.95 and 4.01, respectively. The global model developed exhibited highly efficient outcomes with R2 (0.98) and r (0.99) values. The applicability of the developed SMS facilitates irrigation management with accuracy and real-time monitoring using digital data. The automation of the SMS emerges as a real-time and precise alternative for performing irrigation at the right moment and in the correct amount, thus avoiding water losses.
Improvements and Evaluation of the Agro-Hydrologic VegET Model for Large-Area Water Budget Analysis and Drought Monitoring
Authors: Senay Gabriel B. , Kagone Stefanie , Parrish Gabriel E. L. , Khand Kul , Boiko Olena , Velpuri Naga M.
Published: August 2023

We enhanced the agro-hydrologic VegET model to include snow accumulation and melt processes and the separation of runoff into surface runoff and deep drainage. Driven by global weather datasets and parameterized by land surface phenology (LSP), the enhanced VegET model was implemented in the cloud to simulate daily soil moisture (SM), actual evapotranspiration (ETa), and runoff (R) for the conterminous United States (CONUS) and the Greater Horn of Africa (GHA). Evaluation of the VegET model with independent data showed satisfactory performance, capturing the temporal variability of SM (Pearson correlation r: 0.22–0.97), snowpack (r: 0.86–0.88), ETa (r: 0.41–0.97), and spatial variability of R (r: 0.81–0.90). Absolute magnitudes showed some biases, indicating the need of calibrating the model for water budget analysis. The seasonal Landscape Water Requirement Satisfaction Index (L-WRSI) for CONUS and GHA showed realistic depictions of drought hazard extent and severity, indicating the usefulness of the L-WRSI for the convergence of an evidence toolkit used by the Famine Early Warning System Network to monitor potential food insecurity conditions in different parts of the world. Using projected weather datasets and landcover-based LSP, the VegET model can be used not only for global monitoring of drought conditions, but also for evaluating scenarios on the effect of a changing climate and land cover on agriculture and water resources.
Morphological Variability and Adaptability and Phenolic Content of Ajuga iva Collected from Distinct Moroccan Geographical Locations
Authors: Lahrizi Laila , Errachidi Faouzi , Ousaaid Driss , El Ghadraoui Lahsen
Published: August 2023

Adaptation plasticity constitutes a key factor in the development of such plants under different ecoclimatic conditions. The current study was designed to determine the morphological and phenotypic variability of Ajuga iva collected from distinct geographical locations in Morocco and their phenolic content. Four samples of Ajuga iva were collected to evaluate the morphological variability and adaptability to ensure the sustainable growth of this medicinal plant known for its unique biological properties. Eleven morphological parameters were selected, including length, width, number, distance, and the thickness of different parts, as well as total phenolic content. Statistical tools, such as principal component analysis, and correlation were used to assess the change in the parameters under study based on the geographical origin. Treatment of the obtained results revealed a high variability of morphological parameters of different samples according to the site and altitude, and the interaction between the studied factors. The sample collected from Jbel Zerhoun registered the highest values of the following morphological parameters: APL (12.47 ± 2.09 cm), UPL (6.56 ± 0.40 cm), APW (3.28 ± 1.59 g), UPW (1.24 ± 0.19 g), LW (0.40 ± 0.10 cm), LN (44 ± 4), and NN (21.33 ± 2.51). The samples collected from an altitude above 1000 m showed the highest values of different morphological parameters (aerial part length and weight, underground part weight, leaf number and weight, and node number) and registered the maximum of TPC (124.12 mg GAE/g, 128.86 mg GAE/g, and 164.75 mg GAE/g for samples collected from Immouzzer Kander, Jbel Zerhoun, and Azrou, respectively). Therefore, the samples from high elevations can resist environmental critical conditions by the emergence of different biochemical processes to synthesize bioactive compounds with multifaceted effects.
EVCA Classifier: A MCMC-Based Classifier for Analyzing High-Dimensional Big Data
Authors: Vlachou Eleni , Karras Christos , Karras Aristeidis , Tsolis Dimitrios , Sioutas Spyros
Published: August 2023

In this work, we introduce an innovative Markov Chain Monte Carlo (MCMC) classifier, a synergistic combination of Bayesian machine learning and Apache Spark, highlighting the novel use of this methodology in the spectrum of big data management and environmental analysis. By employing a large dataset of air pollutant concentrations in Madrid from 2001 to 2018, we developed a Bayesian Logistic Regression model, capable of accurately classifying the Air Quality Index (AQI) as safe or hazardous. This mathematical formulation adeptly synthesizes prior beliefs and observed data into robust posterior distributions, enabling superior management of overfitting, enhancing the predictive accuracy, and demonstrating a scalable approach for large-scale data processing. Notably, the proposed model achieved a maximum accuracy of 87.91% and an exceptional recall value of 99.58% at a decision threshold of 0.505, reflecting its proficiency in accurately identifying true negatives and mitigating misclassification, even though it slightly underperformed in comparison to the traditional Frequentist Logistic Regression in terms of accuracy and the AUC score. Ultimately, this research underscores the efficacy of Bayesian machine learning for big data management and environmental analysis, while signifying the pivotal role of the first-ever MCMC Classifier and Apache Spark in dealing with the challenges posed by large datasets and high-dimensional data with broader implications not only in sectors such as statistics, mathematics, physics but also in practical, real-world applications.
Modeling the Biocatalytic Method of Lipid Extraction Using Artificial Neural Networks
Authors: Shafrai Anton V. , Prosekov Alexander Yu. , Vechtomova Elena A.
Published: August 2023

The paper presents the data on lipid fraction extraction from the raw fat of hibernating hunting animals. The processing of valuable raw materials must be maximized. For this purpose, various methods of rendering are used. As a result of temperature exposure, the protein part of raw fat undergoes significant changes. The protein denatures under the influence of temperature, and the dross formed during the rendering process absorbs and retains up to 30% of the fat. The authors propose using proteolytic enzyme preparations for a more complete extraction of fats, as the enzymes will hydrolyze the protein into compounds of lower molecular weight both before and during the rendering process. The experiment proved that the biocatalytic method allows achieving a fat yield of more than 95%. The best result can be obtained if the rendering is carried out at optimal parameters, which can be defined using a mathematical model. Mathematical modeling was carried out using an artificial neural network. During the study, a fully connected neural network was designed; it had eight hidden layers with 64 neurons in each, and its accuracy was measured by mean relative error, which amounted to 5.16%. With the help of the network, the optimal values of applied concentration, temperature and duration of rendering, at which a fat yield of more than 98% is achieved, were determined for each enzyme preparation. After that, the obtained values were confirmed experimentally. Thus, the study showed the efficiency of using artificial neural networks for modeling the biocatalytic method of lipid extraction.
Copper(II) and Platinum(II) Naproxenates: Insights on Synthesis, Characterization and Evaluation of Their Antiproliferative Activities
Authors: Silva Amanda A. , Frajácomo Silmara C. L. , Cruz Állefe B. , Buglio Kaio Eduardo , Affonso Daniele Daiane , Portes Marcelo Cecconi , Ruiz Ana Lúcia T. G. , de Carvalho João Ernesto , Lustri Wilton R. , Pereira Douglas H. , da Costa Ferreira Ana M. , Corbi Pedro P.
Published: August 2023

The growth of antibiotic resistance is a matter of worldwide concern. In parallel, cancer remains one of the main causes of death. In the search for new and improved antiproliferative agents, one of the strategies is the combination of bioactive ligands and metals that are already consolidated in the synthesis of metallopharmaceutical agents. Thus, this work deals with the synthesis, characterization, and study of naproxen (Nap)-based complexes of copper(II) and platinum(II) as antiproliferative agents. The copper complex (Cu–Nap) presents a binuclear paddle-wheel structure in a 1 Cu:2 Nap:1 H2O molar composition, in which Cu(II) is bonded to the carboxylate oxygens from naproxenate in a bidentate bridging mode. The platinum complex (Pt–Nap) was identified as the square planar cis-[Pt(Nap)2(DMSO)2] isomer, in which Pt(II) is bonded to the carboxylate oxygen atom of Nap in a monodentate fashion. Both complexes were inactive against the Gram-positive and Gram-negative bacterial strains assessed. Pt–Nap presented low cytostatic behavior over a set of tumor cells, but good viability for normal cells, while Cu–Nap was cytotoxic against all cells, with a cytocidal activity against glioma tumor cells.
Novel Lactone-Based Insecticides and Drosophila suzukii Management: Synthesis, Potential Action Mechanisms and Selectivity for Non-Target Parasitoids
Authors: Mantilla Afanador Javier G. , Araujo Sabrina H. C. , Teixeira Milena G. , Lopes Dayane T. , Cerceau Cristiane I. , Andreazza Felipe , Oliveira Daiana C. , Bernardi Daniel , Moura Wellington S. , Aguiar Raimundo W. S. , Oliveira Ana C. S. S. , Santos Gil R. , Alvarenga Elson S. , Oliveira Eugenio E.
Published: August 2023

Drosophila suzukii, an invasive insect pest, poses a significant threat to various fruit crops. The use of broad-spectrum insecticides to control this pest can reduce the effectiveness of biological control agents, such as the parasitoid Trichopria anastrephae. Here, we evaluated the toxicity of newly synthesized lactone derivatives on D. suzukii and their selectivity towards T. anastrephae. We used in silico approaches to identify potential targets from the most promising molecules in the D. suzukii nervous system and to understand potential differences in susceptibilities between D. suzukii and its parasitoid. Of the nine molecules tested, (rac)-8 and compound 4 demonstrated efficacy against the fly. Exposure to the estimated LC90 of (rac)-8 and compound 4 resulted in a mortality rate of less than 20% for T. anastrephae without impairing the parasitoid’s functional parasitism. The in silico predictions suggest that (rac)-8 and compound 4 target gamma amino butyric acid (GABA) receptors and transient receptor potential (TRP) channels of D. suzukii. However, only the reduced interaction with TRP channels in T. anastrephae demonstrated a potential reason for the selectivity of these compounds on the parasitoid. Our findings suggest the potential for integrating (rac)-8 and compound 4 into D. suzukii management practices.
Switching to Dupilumab from Other Biologics without a Treatment Interval in Patients with Severe Asthma: A Multi-Center Retrospective Study
Authors: Higo Hisao , Ichikawa Hirohisa , Arakawa Yukako , Mori Yoshihiro , Itano Junko , Taniguchi Akihiko , Senoo Satoru , Kimura Goro , Tanimoto Yasushi , Miyake Kohei , Katsuta Tomoya , Kataoka Mikio , Maeda Yoshinobu , Kiura Katsuyuki , Miyahara Nobuaki ,   Okayama Respiratory Disease Study Group (ORDSG)
Published: August 2023

Background: Dupilumab is a fully humanized monoclonal antibody that blocks interleukin-4 and interleukin-13 signals. Several large clinical trials have demonstrated the efficacy of dupilumab in patients with severe asthma. However, few studies have examined a switch to dupilumab from other biologics. Methods: This retrospective, multi-center observational study was conducted by the Okayama Respiratory Disease Study Group. Consecutive patients with severe asthma who were switched to dupilumab from other biologics without a treatment interval between May 2019 and September 2021 were enrolled. Patients with a treatment interval of more than twice the standard dosing interval for the previous biologic prior to dupilumab administration were excluded. Results: The median patient age of the 27 patients enrolled in this study was 57 years (IQR, 45–68 years). Eosinophilic chronic rhinosinusitis (ECRS)/chronic rhinosinusitis with nasal polyp (CRSwNP) was confirmed in 23 patients. Previous biologics consisted of omalizumab (n = 3), mepolizumab (n = 3), and benralizumab (n = 21). Dupilumab significantly improved FEV1 (median improvement: +145 mL) and the asthma control test score (median improvement: +2). The overall response rate in patients receiving dupilumab for asthma as determined using the Global Evaluations of Treatment Effectiveness (GETE) was 77.8%. There were no significant differences in the baseline characteristics of the GETE-improved group vs. the non-GETE-improved group. ECRS/CRSwNP improved in 20 of the 23 patients (87.0%). Overall, 8 of the 27 patients (29.6%) developed transient hypereosinophilia (>1500/μL), but all were asymptomatic and able to continue dupilumab therapy. Conclusions: Dupilumab was highly effective for the treatment of severe asthma and ECRS/CRSwNP, even in patients switched from other biologics without a treatment interval.
Current Evidence for Biological Biomarkers and Mechanisms Underlying Acute to Chronic Pain Transition across the Pediatric Age Spectrum
Authors: Duff Irina T. , Krolick Kristen N. , Mahmoud Hana Mohamed , Chidambaran Vidya
Published: August 2023

Chronic pain is highly prevalent in the pediatric population. Many factors are involved in the transition from acute to chronic pain. Currently, there are conceptual models proposed, but they lack a mechanistically sound integrated theory considering the stages of child development. Objective biomarkers are critically needed for the diagnosis, risk stratification, and prognosis of the pathological stages of pain chronification. In this article, we summarize the current evidence on mechanisms and biomarkers of acute to chronic pain transitions in infants and children through the developmental lens. The goal is to identify gaps and outline future directions for basic and clinical research toward a developmentally informed theory of pain chronification in the pediatric population. At the outset, the importance of objective biomarkers for chronification of pain in children is outlined, followed by a summary of the current evidence on the mechanisms of acute to chronic pain transition in adults, in order to contrast with the developmental mechanisms of pain chronification in the pediatric population. Evidence is presented to show that chronic pain may have its origin from insults early in life, which prime the child for the development of chronic pain in later life. Furthermore, available genetic, epigenetic, psychophysical, electrophysiological, neuroimaging, neuroimmune, and sex mechanisms are described in infants and older children. In conclusion, future directions are discussed with a focus on research gaps, translational and clinical implications. Utilization of developmental mechanisms framework to inform clinical decision-making and strategies for prevention and management of acute to chronic pain transitions in children, is highlighted.
Involvement of APOE in Incidence of Revascularization in Patients Affected by Peripheral Arterial Disease: A Prospective Study from Southern Italy
Authors: Di Stolfo Giuseppe , Pacilli Michele Antonio , Seripa Davide , De Luca Giovanni , Urbano Maria , Coli Carlo , Gravina Carolina , Greco Antonio , Potenza Domenico Rosario , Salvatori Mauro Pellegrino , Schernthaner Gerit-Holger , Poredos Pavel , Catalano Mariella , Mastroianno Sandra
Published: August 2023

Introduction. Atherosclerosis is a complex multifactorial disease and apolipoprotein E (APOE) polymorphism has been associated with cardiovascular events. The APOE gene, located on chromosome 19q13.2, has an important role in lipid metabolism, in particular on circulating cholesterol levels, implying further pleiotropic effects; from its polymorphism are derived three alleles (ε2, ε3 and ε4), which induce different phenotypes, while its impact on carotid and femoral atherosclerosis is still controversial. Objectives. The aim of the study is to investigate the relationship between APOE genotypes and peripheral revascularization in a cohort of patients affected by advanced peripheral arterial disease (PAD) at a prolonged follow-up. Materials and methods. Some 332 patients (259 males and 73 females; mean age 70.86 ± 7.95 years) with severe PAD were enrolled in a longitudinal study, with a 90.75 ± 32.25 month follow-up, assessing major adverse cardiovascular events (MACE). Results. As compared with ε3/ε3, in ε4 patients we observed a significant higher incidence of carotid (13.2% vs. 5.6%; HR = 2.485, 95% CI 1.062–5.814; p = 0.036) and lower limb (11.8% vs. 4.3%; HR = 2.765, 95% CI 1.091–7.008; p = 0.032) revascularizations and, accordingly, a higher incidence of total peripheral revascularizations (13.5% vs. 9.5%; HR = 2.705, 95% CI 1.420–5.151; p = 0.002). HR remained statistically significant even when adjusted for classic cardiovascular risk factors. Conclusions. In our observational study, we confirm that the ε4 allele is associated with higher total peripheral revascularization in patients with advanced atherosclerotic vascular disease at prolonged follow-up.
Right Atrial Phasic Function in Heart Failure with Preserved Ejection Fraction: Cardiac Magnetic Resonance Feature Tracking and Outcomes
Authors: Schönbauer Robert , Hana Fiona , Duca Franz , Koschutnik Matthias , Donà Carolina , Nitsche Christian , Sponder Michael , Lenz Max , Lee Jonghui , Loewe Christian , Hengstenberg Christian , Mascherbauer Julia , Kammerlander Andreas
Published: August 2023

Background: This study sought to investigate the prognostic impact of right atrial (RA) size and function in patients with heart failure with preserved ejection fraction (HFpEF) in sinus rhythm (SR) and atrial fibrillation (AF). Methods: Consecutive HFpEF patients were enrolled and indexed RA volumes and emptying fractions (RA-EF) were assessed by cardiac magnetic resonance imaging (CMR). For patients in SR, feature tracking of the RA wall was performed during CMR. In addition, all patients underwent right and left heart catheterization and 6 min walk distance (6MWD) and N-terminal prohormone of brain natriuretic peptide (NT-proBNP) evaluations. We prospectively followed patients and used Cox regression models to determine the association of RA size and function with a composite endpoint of heart failure hospitalization and cardiovascular death. Results: A total of 188 patients (71% female patients, 70 ± 8 years old) were included. Ninety-two patients (49%) were in persistent AF. Eighty-five patients reached the combined endpoint during a follow-up of 69 (42–97) months. After a multivariate cox regression analysis, the impaired RA reservoir strain (HR 0.949; 95% CI [0.909–0.990], p = 0.016), the RA reservoir strain rate (HR 0.991; 95% CI [0.983–0.999], p = 0.028), the RA conduit strain (HR 0.932; 95% CI [0.879–0.988], p = 0.019), and the RA conduit strain rate (HR 0.989; 95% CI [0.881–0.997], p = 0.011) were significantly associated with a worse outcome for patients in SR. In persistent AF, no RA imaging parameter was related to outcome after a multivariate regression analysis. Conclusions: In HFpEF patients in SR, CMR parameters of impaired RA conduit and reservoir function are associated with dismal cardiovascular outcomes. In persistent AF, RA parameters lose their prognostic ability.
Diagnostic Performance of the Radiological Society of North America Consensus Statement for Reporting COVID-19 Chest CT Findings: A Revisit
Authors: Hazem Mohammed , Ali Sayed Ibrahim , AlAlwan Qasem M. , Al Jabr Ibrahim Khalid , Alshehri Sarah Abdulrahman F. , AlAlwan Mohammed Q. , Alsaeed Mohammed Ibrahim , Aldawood Mohammed , Turkistani Jamela A. , Amin Yasser Abdelkarim
Published: August 2023

Coronavirus disease 2019 (COVID-19) is a highly contagious respiratory disease that leads to variable degrees of illness, and which may be fatal. We evaluated the diagnostic performance of each chest computed tomography (CT) reporting category recommended by the Expert Consensus of the Radiological Society of North America (RSNA) in comparison with that of reverse transcription polymerase chain reaction (RT-PCR). We aimed to add an analysis of this form of reporting in the Middle East, as few studies have been performed there. Between July 2021 and February 2022, 184 patients with a mean age of 55.56 ± 16.71 years and probable COVID-19 infections were included in this retrospective study. Approximately 64.67% (119 patients) were male, while 35.33% (65 patients) were female. Within 7 days, all patients underwent CT and RT-PCR examinations. According to a statement by the RSNA, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of each CT reporting category were calculated, and the RT-PCR results were used as a standard reference. The RT-PCR results confirmed a final diagnosis of COVID-19 infection in 60.33% of the patients. For COVID-19 diagnoses, the typical category (n = 88) had a sensitivity, specificity, PPV, and accuracy of 74.8%, 93.2%, 94.3%, and 92.5%, respectively. For non-COVID-19 diagnoses, the PPVs for the atypical (n = 22) and negative (n = 46) categories were 81.8% and 89.1%, respectively. The PPV for the indeterminate (n = 28) category was 67.9%, with a low sensitivity of 17.1%. However, the RSNA’s four chest CT reporting categories provide a strong diagnostic foundation and are highly correlated with the RT-PCR results for the typical, atypical, and negative categories, but they are weaker for the indeterminate category.
Posterior Circulation Stroke Patients Receive Less Reperfusion Therapy Because of Late Arrival and Relative Contraindications: A Retrospective Study
Authors: Ekkert Aleksandra , Milmantienė Daiva , Jokimaitytė Unė , Jatužis Dalius
Published: August 2023

Background. Reperfusion treatment (RT) is administered to individuals with posterior circulation strokes (PCS) later and less frequently. We aimed to study the impact of demographic and clinical factors on the decision for RT in PCS. Methods. We conducted a retrospective analysis of the data from 500 subjects admitted to the tertiary stroke centre’s emergency department between 2018 and 2020 due to PCS. Demographic and clinical factors were analysed among three groups: the RT group, the group with no RT because of absolute contraindications (ACI), and the group with no RT because of relative contraindications (RCI). Results. Of the patients, 202 (40.3%) were female. The median NIHSS was four (4), and the subjects’ median age was 69 (18). RT was performed on 120 (24%) subjects. FAST symptoms (OR—5.62, 95% CI [2.90–12.28]) and higher NIHSS (OR—1.13, 95% CI [1.09–1.18]) at presentation, atrial fibrillation (OR—1.56, 95% CI [1.02–2.38]), hypertension (OR—2.19, 95% CI [1.17–4.53]) and diabetes (OR—1.70, 95% CI [1.06–2.71]) increased the chance of RT. Late arrival was the most prevalent ACI for 291 (58.2%) patients. FAST-negative subjects (OR—2.92, 95% CI [1.84–4.77]) and males (OR—1.58, 95% CI [1.11–2.28]) had a higher risk of arriving late. Because of RCI, 50 (10%) subjects did not receive RT; the majority were above 80 and had NIHSS ≤ 5. Subjects with RCI who received the RT had a higher NIHSS (4 vs. 3, p < 0.001), higher hypertension (59 (92.2%) vs. 35 (77.8%), p = 0.032) and heart failure (23 (35.9%) vs. 7 (15.6%), p = 0.018) prevalence. There was a trend for less RT in females with RCI. Conclusions. Late arrival was the most common barrier to RT, and the male gender increased this risk. because of relative contraindications, 10% of subjects were not considered for RT. The presence of FAST symptoms, vascular risk factors, and a higher NIHSS increased the chance of RT.
Fetal Cardiac Hemodynamic and Sonographic Anomalies in Maternal COVID-19 Infection Depending on Vaccination Status—Polish Multicenter Cohort Study
Authors: Strzelecka Iwona , Sylwestrzak Oskar , Murlewska Julia , Węgrzynowski Jerzy , Leszczyńska Katarzyna , Preis Krzysztof , Respondek-Liberska Maria
Published: August 2023

Most obstetrical studies have focused on maternal response to the SARS-CoV-2 virus but much less is known about the effect of COVID-19 on fetal physiology. We aimed to evaluate the effect of the maternal SARS-CoV-2 infection on the fetal homeostasis with the use of detailed ultrasonography and echocardiography and consideration of the effect of vaccination. This was a multi-center study of fetuses who had prenatal detailed ultrasound and echocardiographic examinations performed by fetal cardiology specialists. The subjects were divided based on the COVID vaccination status (vaccinated women who did not have COVID-group V, unvaccinated women who had COVID-group UV, and unvaccinated women who did not have COVID-control group). We evaluated the ultrasound and echocardiography results obtained. The study group included 237 gravidas from four prenatal cardiology centers. In the group of fetuses with normal heart anatomy, normal cardiovascular function had 147 (81%) fetuses and functional cardiovascular anomalies were present in 35 (19%) cases. Functional cardiovascular anomalies were present in 11 (16%) fetuses in the V group, 19 (47%) fetuses in the UV group and 5 (8%) fetuses in the control group (p < 0.01). There were 56 (24%) fetuses with extracardiac anomalies. Extracardiac anomalies were present in 20 (22%) fetuses in the V group, 22 (45%) fetuses of the UV group and in 14 (14%) fetuses in the control group (p < 0.01). Our study has proved that maternal COVID-19 infection can affect the fetal physiology and mild cardiac and extracardiac markers detected by fetal ultrasonography and echocardiography. Moreover, maternal vaccination results in lower occurrence of these findings in fetuses.
Survival Outcomes in Palliative Sedation Based on Referring Versus On-Call Physician Prescription
Authors: Lojo-Cruz Cristina , Mora-Delgado Juan , Rivas Jiménez Víctor , Carmona Espinazo Fernando , López-Sáez Juan-Bosco
Published: August 2023

This study sought to determine the survival duration of patients who underwent palliative sedation, comparing those who received prescriptions from referring physicians versus on-call physicians. It included all patients over 18 years old who died in the Palliative Care, Internal Medicine, and Oncology units at the Hospital Universitario of Jerez de la Frontera between 1 January 2019, and 31 December 2019. Various factors were analyzed, including age, gender, oncological or non-oncological disease, type of primary tumor and refractory symptoms. Statistical analysis was employed to compare survival times between patients who received palliative sedation from referring physicians and those prescribed by on-call physicians, while accounting for other potential confounding variables. This study revealed that the median survival time after the initiation of palliative sedation was 25 h, with an interquartile range of 8 to 48 h. Notably, if the sedation was prescribed by referring physicians, the median survival time was 30 h, while it decreased to 17 h when prescribed by on-call physicians (RR 0.357; 95% CI 0.146–0.873; p = 0.024). Furthermore, dyspnea as a refractory symptom was associated with a shorter survival time (RR 0.307; 95% CI 0.095–0.985; p = 0.047). The findings suggest that the on-call physician often administered palliative sedation to rapidly deteriorating patients, particularly those experiencing dyspnea, which likely contributed to the shorter survival time following sedation initiation. This study underscores the importance of careful patient selection and prompt initiation of palliative sedation to alleviate suffering.
Acute Kidney Injury and Sepsis after Cardiac Surgery: The Roles of Tissue Inhibitor Metalloproteinase-2, Insulin-like Growth Factor Binding Protein-7, and Mid-Regional Pro-Adrenomedullin
Authors: Lacquaniti Antonio , Ceresa Fabrizio , Campo Susanna , Barbera Giovanna , Caruso Daniele , Palazzo Elenia , Patanè Francesco , Monardo Paolo
Published: August 2023

Background: Identifying a panel of markers detecting kidney injury before the glomerular filtration rate reduction is a challenge to improving the diagnosis and management of acute kidney injury (AKI) in septic patients. This study evaluated the roles of tissue inhibitor metal proteinase-2, insulin growth factor binding protein-7 (TIMP2*IGFBP7), and mid-regional pro-adrenomedullin (MR-proADM) in patients with AKI. Patients and Methods: This study was prospectively conducted in an intensive care unit (ICU) enrolling 230 patients who underwent cardiac surgery. Biomarkers were evaluated before and after 4 h of the cardiac surgery. Results: Whereas urine and creatinine alterations appeared at 23.2 (12.7–36.5) hours after cardiac surgery, urinary TIMP2*IGBP7 levels were higher at 4 h in AKI patients (1.1 ± 0.4 mg/L vs. 0.08 ± 0.02 mg/L; p < 0.001). Its concentration > 2 mg/L increases AKI risk within the following 24 h, clearly identifying the population at high risk of renal replacement therapy (RRT). In patients with sepsis, MR-proADM levels were 2.3 nmol/L (0.7–7.8 nmol/L), with the highest values observed in septic shock patients (5.6 nmol/L (3.2–18 nmol/L)) and a better diagnostic profile than procalcitonin and C-reactive protein to identify septic patients. MR-proADM values > 5.1 nmol/L and urine TIMP2*IGBP7 levels > 2 mg/L showed a significantly faster progression to RRT, with a mean follow-up time of 1.1 days. Conclusions: TIMP2*IGBP7 and MR-proADM precociously diagnose AKI in septic patients after cardiac surgery, giving prognostic information for RRT requirement.
Pre-Endoscopic Scores Predicting Low-Risk Patients with Upper Gastrointestinal Bleeding: A Systematic Review and Meta-Analysis
Authors: Boustany Antoine , Alali Ali A. , Almadi Majid , Martel Myriam , Barkun Alan N.
Published: August 2023

Background: Several risk scores have attempted to risk stratify patients with acute upper gastrointestinal bleeding (UGIB) who are at a lower risk of requiring hospital-based interventions or negative outcomes including death. This systematic review and meta-analysis aimed to compare predictive abilities of pre-endoscopic scores in prognosticating the absence of adverse events in patients with UGIB. Methods: We searched MEDLINE, EMBASE, Central, and ISI Web of knowledge from inception to February 2023. All fully published studies assessing a pre-endoscopic score in patients with UGIB were included. The primary outcome was a composite score for the need of a hospital-based intervention (endoscopic therapy, surgery, angiography, or blood transfusion). Secondary outcomes included: mortality, rebleeding, or the individual endpoints of the composite outcome. Both proportional and comparative analyses were performed. Results: Thirty-eight studies were included from 2153 citations, (n = 36,215 patients). Few patients with a low Glasgow-Blatchford score (GBS) cutoff (0, ≤1 and ≤2) required hospital-based interventions (0.02 (0.01, 0.05), 0.04 (0.02, 0.09) and 0.03 (0.02, 0.07), respectively). The proportions of patients with clinical Rockall (CRS = 0) and ABC (≤3) scores requiring hospital-based intervention were 0.19 (0.15, 0.24) and 0.69 (0.62, 0.75), respectively. GBS (cutoffs 0, ≤1 and ≤2), CRS (cutoffs 0, ≤1 and ≤2), AIMS65 (cutoffs 0 and ≤1) and ABC (cutoffs ≤1 and ≤3) scores all were associated with few patients (0.01–0.04) dying. The proportion of patients suffering other secondary outcomes varied between scoring systems but, in general, was lowest for the GBS. GBS (using cutoffs 0, ≤1 and ≤2) showed excellent discriminative ability in predicting the need for hospital-based interventions (OR 0.02, (0.00, 0.16), 0.00 (0.00, 0.02) and 0.01 (0.00, 0.01), respectively). A CRS cutoff of 0 was less discriminative. For the other secondary outcomes, discriminative abilities varied between scores but, in general, the GBS (using cutoffs up to 2) was clinically useful for most outcomes. Conclusions: A GBS cut-off of one or less prognosticated low-risk patients the best. Expanding the GBS cut-off to 2 maintains prognostic accuracy while allowing more patients to be managed safely as outpatients. The evidence is limited by the number, homogeneity, quality, and generalizability of available data and subjectivity of deciding on clinical impact. Additional, comparative and, ideally, interventional studies are needed.
Experimental Study of Improving the Durability of a Cup Cutter by Pre-Processing
Authors: Sagitov Almat , Sherov Karibek , Mardonov Bakhtiyor , Akhmetov Yerzhan , Ramazanova Zhanat , Ainabekova Saule , Tattimbek Gulerke , Tussupbekova Gulim , Esirkepov Azimbek
Published: August 2023

This article presents the results of an experimental study on improving the durability of cup cutters through pre-processing. A review of existing methods of increasing the durability of metal-cutting tools is carried out. The conducted experiments and simulations confirmed the application of pre-processing to increase the durability of cup cutters and the hardening of the cutting part after pre-processing, which approves the formation of a secondary contact structure in the pre-processing process. Dependence for determining a period of the durability of cup cutters at various regimes of pre-processing is deduced.
Disseminated Cryptococcosis Is a Common Finding among Human Immunodeficiency Virus-Infected Patients with Suspected Sepsis and Is Associated with Higher Mortality Rates
Authors: Tufa Tafese Beyene , Orth Hans Martin , Wienemann Tobias , Jensen Bjoern-Erik Ole , Mackenzie Colin R. , Boulware David R. , Luedde Tom , Feldt Torsten
Published: August 2023

Cryptococcosis is the leading cause of death among people with HIV in Sub-Saharan Africa. The lack of optimum diagnoses and medications significantly impair the management of the disease. We investigated the burden of cryptococcosis and related mortality among people with HIV and suspected sepsis in Ethiopia. We conducted a prospective study at (1) Adama Hospital Medical College and (2) Asella Referral and Teaching Hospital from September 2019 to November 2020. We enrolled adult, HIV-infected patients presenting with suspected sepsis and assessed their 28-day survival rates. We performed blood cultures and cryptococcal antigen (CrAg) testing. In total, 82 participants were enrolled with a median age of 35 years, and 61% were female. Overall, eleven (13%) had positive CrAg tests, of which five grew Cryptococcus in blood cultures. Despite high-dose fluconazole (1200 mg/d) monotherapy being given to those with positive CrAg tests, the 28-day mortality was 64% (7/11), with mortality being significantly higher than among the CrAg-negative patients (9% (6/71); p < 0.001). Cryptococcosis was the leading cause of mortality among HIV-infected sepsis patients in this Ethiopian cohort. The CrAg screening of HIV-infected patients attending an emergency department can minimize the number of missed cryptococcosis cases irrespective of the CD4 T cell count and viral load. These findings warrant the need for a bundle approach for the diagnosis of HIV-infected persons presenting with sepsis in low- and middle-income countries.
Associations of Adipocytokines and Early Renal Dysfunction in Young People on the Background of Dyslipidemia
Authors: Garbuzova Evgeniia V. , Khudiakova Alyona D. , Shcherbakova Lilia V. , Kashtanova Elena V. , Polonskaya Yana V. , Stakhneva Ekaterina M. , Ragino Yulia I.
Published: August 2023

Background: There are data supporting the idea that atherogenic dyslipidemia is a risk factor for CKD and reduced GFR. The aim was to evaluate the associations between adipocytokines and early renal dysfunction in young people with dyslipidemia. Materials and methods: A population study was conducted in IIPM—Branch of IC&G SB RAS, in 2013–2017. Furthermore, 1033 people were included in the study (469 men (45.4%) and 564 women (54.6%)). The study included blood sampling, anthropometric data, and adipokines by multiplex analysis. Results: Among people with reduced kidney function and DLP, men were 3.1 times more common than without DLP, women smoked 2 times less often, arterial hypertension was 7.8 times more common, and abdominal obesity was 2.7 times more common (and women with DLP were 3 times more likely than those without DLP). An increase in the level of resistin by 1 mcg/mL was associated with an increased chance of having renal dysfunction by 0.2%. An increase in the level of GIP was associated with an increased chance of having renal dysfunction by 1.1%. Conclusions: In young people with dyslipidemia, regardless of the presence of abdominal obesity, resistin and GIP are associated with the presence of renal dysfunction.
What Should Be Learned from the Dynamic Evolution of Cropping Patterns in the Black Soil Region of Northeast China? A Case Study of Wangkui County, Heilongjiang Province
Authors: Du Guoming , Yao Longcheng , Han Le , Bonoua Faye
Published: August 2023

Conventional and scientific cropping patterns are important in realizing the sustainable utilization of Black soil and promoting the high-quality development of agriculture. It also has far-reaching significance for protecting Black soil and constructing the crop rotation system to identify the cropping patterns in Northeast China and analyze their spatio-temporal dynamic change. Using the geo-information Tupu methods and transfer land matrix, this study identified the cropping patterns and their spatio-temporal change based on remote sensing data for three periods, namely 2002–2005, 2010–2013, and 2018–2021. The main results revealed that the maize continuous, mixed cropping, maize-soybean rotation, and soybean continuous cropping patterns were the main cropping patterns in Wangkui County, with the total area of the four patterns accounting for 95.28%, 94.66%, and 81.69%, respectively, in the three periods. Against the backdrop of global climate warming, the cropping patterns of continuous maize and soybean and the mixed cropping pattern in Wangkui County exhibited a trend towards evolving into a maize-soybean rotation in the northern region. Moreover, the maize-soybean rotation further evolved into a mixed cropping system of maize and soybean in the north. Furthermore, the spatio-temporal evolution of cropping patterns was significantly driven by natural and social factors. Specifically, natural factors influenced the spatio-temporal patterns of variation in cropping patterns, while social factors contributed to the transformation of farmers’ cropping decision-making behavior. Accordingly, new insights, institutional policies, and solid solutions, such as exploring and understanding farmers’ behavior regarding crop rotation practices and mitigating the natural and climatic factors for improving food security, are urgent in the black soil region of China.