bluuebunny/crossref_metadata_2025 huggingface dataset:
Classical vs. Retrograde Endoscopic Dacryocystorhinostomy: Analyses and Comparison of the Results
Authors: Alicandri-Ciufelli Matteo , Lucidi Daniela , Aggazzotti Cavazza Elisa , Russo Paolo , Del Giovane Cinzia , Marchioni Daniele , Calvaruso Federico
Published: July 2024

Background: In endoscopic dacryocystorhinostomy (DCR), surgical landmarks such as the maxillary line (ML) and the axilla of the middle turbinate (MT) guide the surgeon in identifying the lacrimal sac. The primary surgical risk associated with the classical technique, which involves directly opening the lacrimal sac, is the height of the bone drilling on the projection of the lateral wall of the nasal fossa. This poses a significant risk of damaging the orbit, the floor of the frontal sinus, and the anterior skull base. Furthermore, the anatomical variability in size and location of the lacrimal sac poses a risk for difficult and precise surgical identification. Recently, a ‘retrograde’ technique has been introduced to safely identify and expose the lacrimal sac. The aim of this study is to compare the results of retrograde DCR (rDCR) to a classic technique (clDCR), in terms of clinical recurrence and complications. Methods: A retrospective study on a cohort of 35 patients who underwent DCR at the ENT Department of the Modena University Hospital between January 2010 and October 2022 (18 clDCR and 17 rDCR) was performed. Minimum postoperative follow-up for inclusion was 12 months. We used the Fisher’s exact test to compare the two techniques, comparing functional outcomes and clinical recurrence rates. Results: Clinical recurrence of nasolacrimal stenosis in clDCR patients was 50%, compared to 6% in those who underwent rDCR (p-value 0.005). Postoperative surgical complications were not significantly different between the two groups (p > 0.05). Conclusions: rDCR is a safe technique and has been shown to be a statistically more effective surgical technique than clDCR in reducing clinical recurrence rates.
Safety of an Early Discharge Strategy (≤48 h) after ST-Elevation Myocardial Infarction
Authors: Piris Antonio , Garcia-Linacero Luis Manuel , Ortega-Perez Rodrigo , Rivas-Garcia Sonia , Martinez-Moya Rafael , Sanmartin Marcelo , Zamorano Jose Luis
Published: July 2024

Background: Early discharge following ST-segment-elevation myocardial infarction (STEMI) confers notable advantages for both patients and healthcare systems. However, the adoption of a very early discharge strategy for selected patients remains limited due to safety considerations. We aimed to provide some insight into the safety of a discharge program with a hospital stay lasting <48 h after a primary percutaneous coronary intervention (PCI). Methods: Using a registry of 1105 patients undergoing primary PCI for STEMI in our hospital between January 2015 and October 2023, we enrolled all the patients who had a hospital stay ≤48 h, according to a prespecified institutional protocol. The primary objective was a combined rate of non-fatal stroke, non-fatal acute myocardial infarction, or cardiovascular death within 30 days of discharge. Emergency department visits or hospitalizations due to cardiovascular causes, along with the all-cause mortality, were measured during the same period. Results: A total of 453 (41%) patients were discharged ≤48 h after admission for a STEMI. The mean age was 62.4 (±12.5 years), 24.3% were women, and 17.9% were people with diabetes. Up to 96% of the procedures had been performed through radial artery access, and there were no major vascular complications. Regarding the primary endpoint, there was one event (0.2%; one patient suffered a non-fatal myocardial infarction). There were no cardiovascular deaths or deaths from other causes. Only five patients (1.1%) were re-hospitalized or visited the emergency department due to cardiovascular causes. Conclusions: An early discharge strategy for patients within 48 h of experiencing STEMI and undergoing primary PCI appears feasible and safe.
One-Stop Shop: Diagnosis and Treatment of Basal Cell Carcinoma in One Step
Authors: Fünfer Kristina , Mozaffari Marco , Mayer Oliver , Schlingmann Sophia , Welzel Julia , Schuh Sandra
Published: July 2024

Monitoring the tumor margins of basal cell carcinomas is still a challenge in everyday clinical practice. Usually, the clinical margins of the tumor are marked by the naked eye or, even better, with dermoscopy before surgery and then examined in detail after the operation using histological examination. In order to achieve tumor freedom, several surgical steps are sometimes necessary, meaning that patients spend longer periods in hospital and the healthcare system is burdened more as a result. One way to improve this is the one-stop shop method, which requires precise diagnostics and margin marking before and during surgery so that tumor freedom can be achieved after just one surgery. For this reason, the current status of the diagnosis and treatment of basal cell carcinomas before and after surgery is to be examined following extensive literature research using devices and methods that have already been tested in order to determine how a simplified process of tumor margin control of basal cell carcinomas can be made possible both in vivo and ex vivo.
Incidence of Subclinical Deep Vein Thrombosis after Total Hip and Knee Arthroplasty Is Not Correlated with Number of Tranexamic Acid Doses
Authors: Bocea Bogdan-Axente , Catrina Bianca-Iulia , Roman Mihai-Dan , Ion Nicolas Catalin Ionut , Fleaca Sorin Radu , Mohor Cosmin-Ioan , Raluca Antonescu Oana , Moga Sergiu-Ioan , Mihaila Romeo Gabriel
Published: July 2024

Background: Recent studies increasingly highlight the efficacy of tranexamic acid administration in total hip arthroplasty (THA) and total knee arthroplasty (TKA). However, the optimal dosage of tranexamic acid is still controversial. Methods: The current study analyzes the efficiency of tranexamic acid dosage and the number of administrations in THA and TKA. The objective of this study is to compare the incidence of deep vein thrombosis (DVT) based on the number of dosages. We divided the patients into two groups; one group received a single dosage, and the other group received two dosages. Doppler ultrasound examinations were conducted on the lower limbs of all patients at both six and thirty days postoperatively. The second objective is to compare the decrease in hemoglobin (Hb) in the two groups. Results: The results show that there is no difference in DVT incidence between the patients with different TXA numbers of dosages. There is no statistically significant decrease in Hb between the two groups at day one and day five postoperatively. Day one shows a statistically higher average in the two-dose group, approximately 0.06 g/dL, and day five shows a slightly elevated average in the single-dose group, approximately 0.06 g/dL. Blood transfusion requirements show no significant differences in the groups; one patient in the single-dose tranexamic acid group needed transfusion at day five postoperatively, while two patients in each group required immediate postoperative transfusion. Conclusion: There was no increase in the incidence of deep vein thrombosis among patients receiving two dosages of tranexamic acid.
Sleep Bruxism and Obstructive Sleep Apnea Are Not Risk Factors for Tension-Type Headache (TTH): A Polysomnographic Study
Authors: Błaszczyk Bartłomiej , Martynowicz Helena , Niemiec Piotr , Przegrałek Jakub , Staszkiewicz Martyna , Wojakowska Anna , Budrewicz Sławomir , Waliszewska-Prosół Marta
Published: July 2024

Background: Tension-type headache (TTH) is the most common primary headache. Obstructive sleep apnea (OSA) and sleep bruxism (SB) are two of the most common sleep disorders; however, the relationship between TTH, OSA, and SB has not been conclusively proved in the literature. The objective of our study was to estimate potential associations with OSA and SB in TTH subjects. Methods: 108 adult individuals who underwent polysomnography (vPSG) were included, and the group was divided into two subgroups: TTH (n = 34) and control (n = 74). The International Classification of Headache Disorders (ICHD-3) guidelines were used to diagnose TTH. OSA and SB diagnoses were based on vPSG examination with electromyographic (EMG) recordings and the American Academy of Sleep Medicine (AASM) criteria. The results were analyzed, where p < 0.05 was considered to be statistically significant. Results: In the TTH group, the incidence of SB was more than two times lower than the control (OR = 0.41, 95% CI: 0.17–0.96, p < 0.05). However, the incidence of severe SB (BEI > 4) was similar in the TTH and control groups (OR = 0.54, 95% CI: 0.21–1.35, p > 0.05). Additionally, phasic and tonic SB episodes were less frequent in the TTH group compared to the controls (p < 0.05). The mean apnea–hypopnea index (AHI) was not significantly different between the TTH and control groups (p > 0.05). The sleep architecture and respiratory disturbances did not differ between the examined groups (p > 0.05). Conclusions: SB is not a risk factor for TTH. Moreover, severe SB is not connected with TTH. OSA is not a risk factor for TTH. Sleep quality did not differ between both groups during PSG; therefore, TTH may not change sleep structure. The mechanism of these findings is still unclear, and further studies should explain in detail the association between TTH and OSA.
Influencing Factors of Survival in Hypopharyngeal Squamous Cell Cancer
Authors: Répássy Gábor Dénes , Hargas Dóra , Molnár András , Maihoub Stefani , Tamás László
Published: July 2024

Objectives: This study examined the effects of various factors on survival in hypopharyngeal cancer, involving a total of 100 patients. Methods: Comorbidities, treatment modalities, survival times, and potential factors affecting survival were retrospectively analysed. The expression of p16 was also examined. A statistical analysis was conducted using IBM SPSS V25 software. Results: The mean overall survival time was determined to be 30.8 months. Smoking was observed in 95%, and regular alcohol consumption was reported in 75% of the cases. The expression of p16 did not significantly affect survival (p = 0.74) or the maximum tumour size (p = 0.21). The Kaplan–Meier method demonstrated significantly longer survival times (p = 0.047 *) in the group that underwent partial pharyngolaryngectomy with or without adjuvant therapy (median: 75.25 months, 95% CI: 31.57–118.93), compared to the other four treatment groups (i.e., total laryngectomy with pharyngectomy with or without adjuvant therapy, chemoradiation, chemotherapy, and radiotherapy). Conclusions: The study found that factors such as sex, comorbidities (e.g., type 2 diabetes and chronic obstructive pulmonary disease), TNM and stage, weight loss, smoking, and alcohol consumption did not have a significant effect on survival. In conclusion, the longest survival was observed after partial pharyngolaryngectomy with or without adjuvant therapy. Risk factors and comorbidities did not show a significant effect on survival. p16 expression was not a factor that affected either survival or tumour size.
CRP, Fibrinogen, White Blood Cells, and Blood Cell Indices as Prognostic Biomarkers of Future COPD Exacerbation Frequency: The TIE Cohort Study
Authors: Ellingsen Jens , Janson Christer , Bröms Kristina , Hårdstedt Maria , Högman Marieann , Lisspers Karin , Palm Andreas , Ställberg Björn , Malinovschi Andrei
Published: July 2024

Background/Objective: Systemic inflammation is common in chronic obstructive pulmonary disease (COPD), and evidence suggests that inflammatory biomarkers can predict acute exacerbations (AECOPDs). The aim of this study was to analyse whether C-reactive protein (CRP), fibrinogen, white blood cell count (WBC), or the blood cell indices PLR (platelet-to-lymphocyte ratio), SII (systemic immune inflammation index), SIRI (systemic inflammation response index), and AISI (aggregate index of systemic inflammation) can predict future AECOPDs. Methods: In the Tools Identifying Exacerbations (TIE) cohort study, participants with spirometry-confirmed COPD were recruited from primary and secondary care in three Swedish regions and assessed during a stable phase of COPD. AECOPD frequency during the three-year follow-up was reviewed in medical records. Associations were analysed via ordinal logistic regressions. Results: Of the 571 participants, 46% had ≥1 AECOPD during follow-up, and the mean ± SD AECOPD frequency was 0.63 ± 1.2/year. In unadjusted analyses, high levels of CRP (odds ratio 1.86, 95% CI 1.29–2.67), fibrinogen (2.09, 1.38–3.16), WBCs (2.18, 1.52–3.13), SII (1.52, 1.05–2.19), SIRI (1.76, 1.23–2.52), and AISI (1.99, 1.38–2.87) were associated with a higher AECOPD frequency. After adjustment for AECOPD history, age, sex, smoking, body mass index, COPD Assessment Test score, lung function, and inhaled corticosteroid use, associations remained for high levels of CRP (adjusted odds ratio of 1.64; 95% CI of 1.08–2.49), fibrinogen (1.55; 1.07–2.24), and WBC (1.65; 1.10–2.47). Conclusions: CRP, fibrinogen, and WBC, assessed during stable-phase COPD, enhanced AECOPD prediction, whereas PLR, SII, SIRI, and AISI did not.
Class 3 Obesity and Oral Health in Adults: A Scoping Review of the Challenges for Oral Healthcare Services
Authors: Malik Zanab , Sohn Woosung , Williams Kathryn
Published: July 2024

Background: Obesity is one of the most neglected public health problems affecting both developed and developing countries. The most clinically severe obesity (Class 3 obesity) has both clinical and service delivery implications on dental services. However, associations between Class 3 obesity and oral health are minimally explored in the literature and thus poorly understood. Aims: This scoping review aimed to explore the existing evidence on Class 3 obesity and oral health. Methods: A literature search was performed via Medline, Scopus, Google scholar and Embase research databases. Results: A total of 375 papers were sourced from the database search. Twenty seven full-text papers were included in the final literature review. Results revealed findings from both quantitative and qualitative studies. Papers included results pertaining to associations with dental disease, oral health and associated behaviours, oral health-related quality of life and the barriers experienced by adults with Class 3 obesity in accessing dental services. Conclusions: While mixed findings were identified, this scoping review reports associations between Class 3 obesity and poor oral health across various domains including clinical parameters and oral health related quality of life. The literature has also highlighted important barriers to dental care in those with the most severe Class 3 obesity. Based upon our findings, we have summarised current oral health management implications and directions for future research.
Procedural Outcome and 1-Year Follow-Up of Young Patients Undergoing Implantable Cardioverter–Defibrillator Implantation—Insights from the German DEVICE I+II Registry
Authors: Chung Da-Un , Hochadel Matthias , Senges Jochen , Kleemann Thomas , Eckardt Lars , Brachmann Johannes , Steinbeck Gerhard , Larbig Robert , Butter Christian , Uher Thomas , Willems Stephan , Hakmi Samer
Published: July 2024

Background: The number of young patients receiving ICDs or CRT-Ds has been increasing in recent decades and understanding the key characteristics of this special population is paramount to optimized patient care. Methods: The DEVICE I+II registry prospectively enrolled patients undergoing ICD/CRT-D implantation or revision from 50 German centers between 2007 and 2014 Data on patient characteristics, procedural outcome, adverse events, and mortality during the initial stay and 1-year follow-up were collected. All patients under the age of 45 years were identified and included in a comparative analysis with the remaining population. Results: A total number of 5313 patients were enrolled into the registry, of which 339 patients (6.4%) were under the age of 45 years. Mean age was 35.0 ± 8.2 vs. 67.5 ± 9.7 years, compared to older patients (≥45 years). Young patients were more likely to receive an ICD (90.9 vs. 69.9%, p < 0.001) than a CRT-D device (9.1 vs. 30.1%). Coronary artery disease was less common in younger patients (13.6 vs. 63.9%, p < 0.001), whereas hypertrophic cardiomyopathy (10.9 vs. 2.7%, p < 0.001) and primary cardiac electrical diseases (11.2 vs. 1.5%, p < 0.001) were encountered more often. Secondary preventive ICD was more common in younger patients (51.6 vs. 39.9%, p < 0.001). Among those patients, survival of sudden cardiac death (66.7 vs. 45.4%, p < 0.001) due to ventricular fibrillation (60.6 vs. 37.9%, p < 0.001) was the leading cause for admission. There were no detectable differences in postoperative complications requiring intervention (1.5 vs. 1.9%, p = 0.68) or in-hospital mortality (0.0 vs. 0.3%, p = 0.62). Median follow-up duration was 17.9 [13.4–22.9] vs. 16.9 [13.1–23.1] months (p = 0.13). In younger patients, device-associated complications requiring revision were more common (14.1 vs. 8.3%, p < 0.001) and all-cause 1-year-mortality after implantation was lower (2.9 vs. 7.3%, p = 0.003; HR 0.39, 95%CI: 0.2–0.75) than in older patients. Conclusions: Young patients < 45 years of age received defibrillator therapy more often for secondary prevention. Rates for periprocedural complications and in-hospital mortality were very low and without differences between groups. Young patients have lower mortality during follow-up but experienced a higher rate of postoperative complications requiring revision, potentially due to a more active lifestyle.
The Cardiac Pulsed Wave Doppler Pattern of the Common Femoral Vein in Diagnosing the Likelihood of Severe Pulmonary Hypertension: Results from a Prospective Multicentric Study
Authors: Torres-Arrese Marta , Barberá-Rausell Pablo , Li-Zhu Jie-Wei Oscar , Salas-Dueñas Rocío , Real-Martín Alma Elena , Mata-Martínez Arantzazu , Gonzalo-Moreno Begoña , Núñez Joaquín Hernández , Luordo Davide , Cano Juan Gabriel Sánchez , Villén Villegas Tomás , Caurcel-Díaz Luis , Casasola-Sánchez Gonzalo García de , Tung-Chen Yale
Published: July 2024

Background and Objectives: Pulmonary hypertension (PH) is a clinical condition with high mortality rates, particularly in patients over 65. Current guidelines recommend assessing the likelihood of pulmonary hypertension (LPH) using advanced echocardiography before proceeding to right heart catheterization. This study proposed using the common femoral vein (CFV), an accessible vein that reflects right atrial pressure, as an alternative method to assess the high likelihood of pulmonary hypertension (H-LPH). Materials and Methods: This prospective observational study included 175 emergency patients from three hospitals. Ultrasound assessed the pulsed wave Doppler (PW-Doppler) morphology of the CFV. This diagnostic yield for H-LPH was evaluated alongside traditional ultrasound parameters (right-to-left ventricular basal diameter ratio greater than 1 (RV > LV), septal flattening, right ventricular outflow acceleration time (RVOT) of less than 105 ms and/or mesosystolic notching, pulmonary artery diameter greater than the aortic root (AR) diameter or over 25 mm, early pulmonary regurgitation maximum velocity > 2.2 m/s; TAPSE/PASP less than 0.55, inferior vena cava (IVC) diameter over 21 mm with decreased inspiratory collapse, and right atrial (RA) area over 18 cm2). Results: The CFV’s PW-Doppler cardiac pattern correlated strongly with H-LPH, showing a sensitivity (Sn) of 72% and a specificity (Sp) of 96%. RA dilation and TAPSE/PASP < 0.55 also played significant diagnostic roles. Conclusions: The CFV’s PW-Doppler cardiac pattern is an effective indicator of H-LPH, allowing reliable exclusion of this condition when absent. This approach could simplify initial LPH evaluation in emergency settings or where echocardiographic resources are limited.
Long-Term Persistence Rate of Secukinumab in Psoriatic Patients: A Six-Year Multicenter, Real-World Experience, Retrospective Study
Authors: Galluzzo Marco , Trovato Emanuele , Talamonti Marina , Caldarola Giacomo , Di Nardo Lucia , Lazzeri Laura , Mugheddu Cristina , Burlando Martina , Balestri Riccardo , Bernardini Nicoletta , Biondi Gabriele , Vellucci Laura , Russo Filomena , De Simone Clara , Paganini Claudia , Rech Giulia , Cozzani Emanuele Claudio , Atzori Laura , Montesu Maria Antonia , Potenza Concetta , Chiricozzi Andrea , Rubegni Pietro
Published: July 2024

Background: Psoriatic disease, a chronic immune-mediated systemic inflammatory condition, significantly impairs patients’ quality of life. The advent of highly targeted biological therapies has transformed treatment strategies, emphasizing the importance of selecting the most effective and cost-efficient option. Secukinumab, an IL-17A inhibitor, has demonstrated efficacy and safety in treating moderate-to-severe plaque psoriasis (PsO). However, long-term real-world data on its effectiveness and persistence rate are limited. Methods: This retrospective study, conducted across eight Italian dermatology centers, aimed to evaluate the 6-year persistence rate and effectiveness of secukinumab in patients with PsO. Additionally, the study investigated the onset of psoriatic arthritis during treatment. Results: Overall, 166 adult patients were analyzed. Their median age was 53.9 years. The mean BMI was 26.5. Of the 166 patients, 64 were bio-experienced while 102 were bio-naïve. A progressive reduction in PsO severity measured by PASI scores over 6 years of treatment was revealed: the PASI score decreased from a baseline value of 18.1 (±9.1) to 0.7 (±1.6) after 6 years of follow-up. Adverse events, including mucocutaneous fungal infections and cardiovascular disturbances, were reported in 19.9% of patients. The persistence rate was 86.8% at 24 months, decreasing to 66.4% at 72 months. Psoriatic arthritis onset during treatment was observed in 15 (9.0%) of patients. Conclusions: This study highlights the sustained effectiveness and favorable safety profile of secukinumab over 6 years, providing valuable real-world evidence. Understanding the long-term persistence rate and predictors of discontinuation could help clinicians optimize treatment decisions and improve patient outcomes in PsO management. We found that the absence of scalp PsO, no involvement of the genital area and normal weight were the best factors of persistence in secukinumab treatment in the long term.
Identifying Gaps in the Treatment Guidelines for Hepatitis C in Peru to Meet International Standards: A Narrative Review
Authors: Gonzales-Zamora Jose A. , Quispe-Vicuña Carlos , Reategui-Garcia Martín E. , Araoz-Salinas Julieta M. , Ccami-Bernal Fabricio , Morocho-Alburqueque Noelia , Espinoza-Herreros Jian Pierre , Layme Josue , Aquino-Sandoval Gabriel , Campos Victor Y. Melt , Alave Jorge
Published: July 2024

Hepatitis C virus still represents a major cause of morbidity and mortality worldwide. In Peru, two national practice guidelines for the management of this infection were published more than 5 years ago; however, the latest breakthroughs in the treatment make it necessary to update these guidelines. We reviewed the most recent recommendations of the international guidelines and compared them with the current Peruvian guidelines. We found major differences, such as the use of Glecaprevir/Pibrentasvir as a first-line therapy, which is contemplated in the World Health Organization guideline, and recommended by American and European guidelines, but is not considered in the Peruvian guidelines. Another crucial difference lies in the management of patients with chronic kidney disease, who are treated nowadays with a variety of direct-acting antivirals, with no restrictions on the use of Sofosbuvir-based regimens in first-world countries, an approach that has not been adopted in Peru. We believe that standardization of the recommendations of the Peruvian guidelines is imperative, including the new therapeutic strategies that have emerged in recent years. We also suggest conducting a cost effectiveness analysis in the Peruvian context to allow for the implementation of new antivirals, and to achieve a better control of hepatitis C in the country.
Influence of Education on Dental Anxiety and Fear in Mental Disorders after Viewing a Molar Extraction in Three Types of Mental Disorder Compared to Persons with No Mental Disorder
Authors: Bermúdez-Bejarano Elena , Bermúdez-Sánchez Juan-Antonio , Ruiz-Rey Francisco-José , Baus-Domínguez María , Serrera-Figallo María-Ángeles , Gutiérrez-Pérez José-Luis , Torres-Lagares Daniel
Published: July 2024

Objective: The goal of this study is to validate the psychometric properties of the Modified Dental Anxiety Scale (MDAS) and the Dental Fear Scale (DFS) at three different times: seven days before, immediately after, and seven days after watching a video of surgical extraction of a lower third molar in a sample with four strata: anxiety disorder, adjustment disorder, mixed anxiety-depressive disorder, and no mental disorder ages 18–70 in a psychiatric clinic in Malaga. Methods: The Research Ethics Committee of the Virgen Macarena-Virgen del Rocío Hospitals approved the study. After being interviewed by a psychiatrist and subsequently completing the Hamilton Rating Scales for Anxiety and Depression, the participants were divided into 4 strata (60 persons in each). The influence of education level was then analyzed. Results: The scales demonstrated good psychometric properties, with higher MDAS and DFS scores for lower levels of education and mixed anxiety-depressive disorder. Conclusions: Patients who show higher levels of dental anxiety and dental fear will be those with lower education levels, as well as those who suffer from mixed anxiety-depressive disorder.
The Effects of Sarcopenia on Overall Survival and Postoperative Complications of Patients Undergoing Hepatic Resection for Primary or Metastatic Liver Cancer: A Systematic Review and Meta-Analysis
Authors: Giakoustidis Alexandros , Papakonstantinou Menelaos , Chatzikomnitsa Paraskevi , Gkaitatzi Areti Danai , Bangeas Petros , Loufopoulos Panagiotis Dimitrios , Louri Eleni , Myriskou Athanasia , Moschos Ioannis , Antoniadis Diomidis , Giakoustidis Dimitrios , Papadopoulos Vasileios N.
Published: July 2024

Background: Colorectal cancer is the third most common cancer worldwide, and 20–30% of patients will develop liver metastases (CRLM) during their lifetime. Hepatocellular carcinoma (HCC) is also one of the most common cancers worldwide with increasing incidence. Hepatic resection represents the most effective treatment approach for both CRLM and HCC. Recently, sarcopenia has gained popularity as a prognostic index in order to assess the perioperative risk of hepatectomies. The aim of this study is to assess the effects of sarcopenia on the overall survival (OS), complication rates and mortality of patients undergoing liver resections for HCC or CRLM. Methods: A systematic literature search was performed for studies including patients undergoing hepatectomy for HCC or CRLM, and a meta-analysis of the data was performed. Results: Sarcopenic patients had a significantly lower 5-year OS compared to non-sarcopenic patients (43.8% vs. 63.6%, respectively; p < 0.01) and a significantly higher complication rate (35.4% vs. 23.1%, respectively; p = 0.002). Finally, no statistical correlation was found in mortality between sarcopenic and non-sarcopenic patients (p > 0.1). Conclusions: Sarcopenia was significantly associated with decreased 5-year OS and increased morbidity, but no difference was found with regard to postoperative mortality.
The Incidence and Outcomes of Major Limb Amputation in New Zealand from 2010 to 2021
Authors: Hart Odette , Bernau Oliver , Khashram Manar
Published: July 2024

Background: Major limb amputation (MLA) can be a common outcome due to severe peripheral artery disease (PAD) and diabetic foot disease (DFD), and it carries a significant mortality burden. In New Zealand (NZ), there is little documentation of the incidence rate and mortality after MLA. The aim was to report the national crude and standardised rates and the mortality post MLA. Methods: This retrospective observational study included all MLAs that occurred within NZ from 1/1/2010 to 31/12/2021 due to DFD and/or PAD. Two national databases (National Minimum Dataset and the Australasian Vascular Audit) were utilised. The crude rates were calculated as cases per 100,000 in the NZ population per year including all ages (using the 2013 and 2018 NZ census figures). The age-standardised rates used the World Health Organization standard population. Post-operative mortality was calculated from the date of first hospitalisation for MLA. Results: From 2010 to 2021, there were 5293 MLA procedures in 4242 patients. On average, there were 8.5 MLAs per week and 441.1 MLAs annually. The overall crude rate was 9.44 per 100,000, and the standardised rate was 6.12 per 100,000. Over the 12 years, the crude rate decreased by 22% (p < 0.001), and the standardised rate decreased by 20.4% (p < 0.001). After MLA, the 30-day and 1-year mortality was 9.5% and 29.6%, respectively. From 2010 to 2021, the relative reduction in 30-day mortality was 45.1% (p < 0.001), and the reduction in 1-year mortality was 24.5% (p < 0.001). Increasing age, female sex and end-stage renal failure were predictors of 30-day and 1-year mortality. Conclusions: A considerable number of MLAs occur in NZ, with substantial perioperative mortality; however, the national incidence rates and mortality have improved over the last 12 years. This data might serve as benchmark to further reduce MLAs and improve patient outcomes.
The Impact of Obesity as a Peripheral Disruptor of Brain Inhibitory Mechanisms in Fibromyalgia: A Cross-Sectional Study
Authors: Fabris-Moraes Walter , Lacerda Guilherme J. M. , Pacheco-Barrios Kevin , Fregni Felipe
Published: July 2024

Background/Objective: Obesity, characterized by chronic inflammation, may serve as a surrogate marker for more dysfunctional peripheral inflammation, potentially exacerbating FM symptomatology. Given this premise, this study aimed to investigate the effects of obesity as an effect modifier on neural and clinical variables, specifically those indexing pain-compensatory mechanisms in FM symptoms. Methods: A cross-sectional study was conducted with 108 participants who underwent a standardized TMS protocol assessment to measure resting motor threshold (MT), intracortical facilitation (ICF), and intracortical inhibition (ICI). Clinical data were collected using Beck’s Depression Index (BDI), PROMIS, the Brief Pain Inventory (BPI), and conditioned pain modulation (CPM). Linear regression models were used to explore the relationship between these variables while examining Body Mass Index (BMI) as a potential effect modifier. If it was found to be a modifier, we stratified the sample into two groups with a BMI cutoff of 30 and performed another regression model within the subgroups. Results: BMI was identified as an effect modifier in the relationships between ICI and BDI, PROMIS fatigue, and CPM and in MT versus CPM. After stratification, non-obese fibromyalgia subjects demonstrated significant correlations between clinical symptoms and CPM and ICI activity. However, these correlations were absent in the obese group, suggesting obesity disrupts pain mechanisms and their compensatory effects. Higher MT values were associated with weaker endogenous pain control, particularly evident in the obese group. Conclusions: Obesity appears to be a significant effect modifier and delineates two patient groups across multiple clinical and neural assessments of fibromyalgia. Additionally, it suggests a role for obesity in exacerbating fibromyalgia symptoms and disrupting physiological pain-inhibitory mechanisms.
Alzheimer’s Disease and Epilepsy: Exploring Shared Pathways and Promising Biomarkers for Future Treatments
Authors: Kalyvas Athanasios-Christos , Dimitriou Maria , Ioannidis Panagiotis , Grigoriadis Nikolaos , Afrantou Theodora
Published: July 2024

Background: Alzheimer’s disease (AD) and epilepsy represent two complex neurological disorders with distinct clinical manifestations, yet recent research has highlighted their intricate interplay. This review examines the association between AD and epilepsy, with particular emphasis on late-onset epilepsy of unknown etiology, increasingly acknowledged as a prodrome of AD. It delves into epidemiology, pathogenic mechanisms, clinical features, diagnostic characteristics, treatment strategies, and emerging biomarkers to provide a comprehensive understanding of this relationship. Methods: A comprehensive literature search was conducted, identifying 128 relevant articles published between 2018 and 2024. Results: Findings underscore a bidirectional relationship between AD and epilepsy, indicating shared pathogenic pathways that extend beyond traditional amyloid-beta and Tau protein pathology. These pathways encompass neuroinflammation, synaptic dysfunction, structural and network alterations, as well as molecular mechanisms. Notably, epileptic activity in AD patients may exacerbate cognitive decline, necessitating prompt detection and treatment. Novel biomarkers, such as subclinical epileptiform activity detected via advanced electroencephalographic techniques, offer promise for early diagnosis and targeted interventions. Furthermore, emerging therapeutic approaches targeting shared pathogenic mechanisms hold potential for disease modification in both AD and epilepsy. Conclusions: This review highlights the importance of understanding the relationship between AD and epilepsy, providing insights into future research directions. Clinical data and diagnostic methods are also reviewed, enabling clinicians to implement more effective treatment strategies.
In Search of Variables Affecting Mental Adjustment and Acceptance of Cancer among Urological Patients
Authors: Królikowska Adrianna , Stanisławska Marzanna , Starczewska Małgorzata , Rybicka Anita , Rachubińska Kamila
Published: July 2024

Background/Objectives: Genitourinary cancers are now considered a major problem in modern medicine. In urological oncology, the most frequently occurring diseases are prostate, bladder and renal cancer. Any cancer has a profound effect on the life of a patient. Therefore, disease acceptance and mental adjustment to the condition are the key elements in coping with cancer. Aim: The main aim of the study was the determination of the level of acceptance of illness and mental adjustment to cancer in urological patients undergoing surgical treatment and the assessment of the effect of mental adjustment on disease acceptance. Material and Methods: The study group comprised 150 patients treated at the Department of Urology and Urological Oncology at the Independent Public Clinical Hospital No 2 in Szczecin. The study made use of the diagnostic survey method with the original questionnaire and standardized research tools: Acceptance of Illness Scale (AIS) and Mental Adjustment to Cancer Scale (Mini-MAC). Results: The analysis of mental adjustment to cancer according to Mini-MAC revealed that the respondents most frequently adopted the fighting spirit strategy (M; 22.22). Slightly less frequently adopted strategies were positive re-evaluation (M; 21.28) and anxious preoccupation (M; 17.07). The least frequently adopted strategy was the helplessness-hopelessness strategy (M; 13.14). The analysis of data showed a statistically significant negative correlation (r = −0.245; p = 0.003) between disease acceptance according to AIS and age. The data analysis revealed a statistically significant positive correlation with helplessness-hopelessness and destructive style (p < 0.05). Conclusions: Mental adjustment to cancer was found to affect the acceptance of illness. When providing comprehensive care to cancer patients, it is equally crucial to consider the physical as well as mental health aspect, taking into account the aforementioned factors which affect both acceptance as well as adjustment to disease.
Distributed Consensus Multi-Distribution Filter for Heavy-Tailed Noise
Authors: Chang Guan-Nan , Fu Wen-Xing , Cui Tao , Song Ling-Yun , Dong Peng
Published: July 2024

Distributed state estimation is one of the critical technologies in the field of target tracking, where the process noise and measurement noise may have a heavy-tailed distribution. Traditionally, heavy-tailed distributions like the student-t distribution are employed, but our observation reveals that Gaussian noise predominates in many instances, with occasional outliers. This sporadic reliance on heavy-tailed distributions can degrade performances or necessitate frequent parameter adjustments. To overcome this, we introduce a novel distributed consensus multi-distribution state estimation method that combines Gaussian and student-t filters. Our approach establishes a system model using both Gaussian and student-t distributions. We derive a multi-distribution filter for a single sensor, assigning probabilities to Gaussian and student-t noise models. Parallel estimation under both distributions, utilizing Gaussian and student-t filters, allows us to calculate the likelihood of each distribution. The fusion of these results yields a mixed-state estimation and corresponding error matrix. Recognizing the increasing degrees of freedom in the student-t distribution over time, we provide an effective approximation. An information consensus strategy for multi-distribution filters is introduced, achieving global estimation through consensus on fused local filter results via interaction with neighboring nodes. This methodology is extended to the distributed case, and the recursive process of the distributed multi-distribution consensus state estimation method is presented. Simulation results demonstrate that the estimation accuracy of the proposed algorithm improved by at least 20% compared to that of the traditional algorithm in scenarios involving both Gaussian and heavy-tailed distributions.
National Parks and Protected Areas: A Comparison of the Approach Taken in the UK and France for the Protection of Green Spaces
Authors: Cox Caroline , Natali Meganne
Published: July 2024

Across the globe, national parks are frequently described in terms of their diverse wildlife, spectacular scenery, and cultural heritage. These extraordinary land (and sea) scapes are known to be important for the health and mental wellbeing of the people who visit them, but for many, they are also the place where they live and work. The COVID-19 pandemic lockdowns of 2020 and 2021 witnessed the importance of being in nature and exercising in green spaces, and part of the COVID-19 inheritance has been the rise of the so-called “staycation”, which has seen people becoming less inclined to travel overseas and more inclined to the explore nature and landscapes closer to home. While this has undoubtedly meant economic benefits to National Parks, it has also brought challenges that are yet to be fully realised and dealt with. This paper considers the laws and regulations in place to protect these special places in two jurisdictions, France and the United Kingdom, through the lens of two of those countries’ National Parks—the New Forest and the Calanques.
An Extensive Study of the Influence of Key Flow Variables on Printed Line Quality Outcomes during Aerosol Jet Printing Using Coupled Three-Dimensional Numerical Models
Authors: Zhang Haining , Xu Haifeng , Cui Lin , Pan Zhenggao , Lee Pil-Ho , Jung Min-Kyo , Choi Joon-Phil
Published: July 2024

A three-dimensional (3D) numerical model was developed to explore the intricate aerodynamic mechanisms associated with aerosol jet printing (AJP). The proposed approach integrates computational fluid dynamics and discrete phase modeling, offering a comprehensive understanding of the deposition mechanisms of the AJP process. Initially, numerical solutions of the governing equations were obtained under the assumptions of compressible and laminar flows, facilitating an analysis of certain key flow variables, in this case, the sheath gas flow rate and carrier gas flow rate across the fluid domain. Subsequently, incorporating a Lagrangian discrete phase model allowed a detailed examination of the droplet behavior after nozzle ejection, considering the influence of the Saffman lift force. Finally, experiments were performed to elucidate the influence of key flow variables on the printed width. Generally, the measured printed line morphology and corresponding line electrical performance exhibited close conformity with the numerical model, demonstrating that the proposed numerical model is important for making well-informed decisions during process optimization.
Hot Deformation Constitutive Analysis and Processing Maps of Ultrasonic Melt Treated A5052 Alloy
Authors: Kim Sun-Ki , Koo Seung-Hyun , Cho Hoon , Ha Seong-Ho
Published: July 2024

Hot deformation constitutive analysis and processing maps of ultrasonic melt treated (UST) A5052 alloy were carried out based on a hot torsion test in this study. The addition of the Al–Ti master alloy as a grain refiner with no UST produced a finer grain size than the UST and pure Ti sonotrode. The Al3Ti phase particles in the case of the Al–10Ti master alloy acted as a nucleus for grain refinement, while the Ti atoms dissolved in the melt from the sonotrode were considered to have less of a grain refinement effect, even under UST conditions, than the Al3Ti phase particles in the Al–Ti master alloy. The constitutive equations for each experimental condition by torsion test were derived. In the processing maps examined in this study, the flow instability region was not present under UST in the as-cast condition, but it existed under the no UST condition. The effects of UST examined in this study are considered as (i) the uniform distribution of Ti solutes from the sonotrode and (ii) the reduction of pores by the degassing effect. After the homogenization heat treatment, most instability regions disappeared because the microstructures became uniform following the decomposition of intermetallic compounds and distribution of solute elements.
Phosphor Ceramic Composite for Tunable Warm White Light
Authors: Osborne Ross A. , Cherepy Nerine J. , Bleier Peter S. , Gaume Romain M. , Payne Stephen A.
Published: July 2024

Composite phosphor ceramics for warm white LED lighting were fabricated with K2SiF6:Mn4+ (KSF) as both a narrowband red phosphor and a translucent matrix in which yellow-emitting Y3Al5O12:Ce3+ (YAG) particles were dispersed. The emission spectra of these composites under blue LED excitation were studied as a function of YAG loading and thickness. Warm white light with a color temperature of 2716 K, a high CRI of 92.6, and an R9 of 77.6 was achieved. A modest improvement in the thermal conductivity of the KSF ceramic of up to 9% was observed with the addition of YAG particles. In addition, a simple model was developed for predicting the emission spectra based on several parameters of the composite ceramics and validated with the experimental results. The emission spectrum can be tuned by varying the dopant concentrations, thickness, YAG loading, and YAG particle size. This work demonstrates the utility of KSF/YAG composite phosphor ceramics as a means of producing warm white light, which are potentially suitable for higher-drive applications due to their increased thermal conductivity and reduced droop compared with silicone-dispersed phosphor powders.
Silver-Assisted Chemical Etching for the Fabrication of Porous Silicon N-Doped Nanohollow Carbon Spheres Composite Anodes to Enhance Electrochemical Performance
Authors: Zhang Zimu , Zhang Yuqi , Chen Weixuan , Zhang Xiang , Yu Le , Guan Zisheng
Published: July 2024

Silicon (Si) shows great potential as an anode material for lithium-ion batteries. However, it experiences significant expansion in volume as it undergoes the charging and discharging cycles, presenting challenges for practical implementation. Nanostructured Si has emerged as a viable solution to address these challenges. However, it requires a complex preparation process and high costs. In order to explore the above problems, this study devised an innovative approach to create Si/C composite anodes: micron-porous silicon (p-Si) was synthesized at low cost at a lower silver ion concentration, and then porous silicon-coated carbon (p-Si@C) composites were prepared by compositing nanohollow carbon spheres with porous silicon, which had good electrochemical properties. The initial coulombic efficiency of the composite was 76.51%. After undergoing 250 cycles at a current density of 0.2 A·g−1, the composites exhibited a capacity of 1008.84 mAh·g−1. Even when subjected to a current density of 1 A·g−1, the composites sustained a discharge capacity of 485.93 mAh·g−1 even after completing 1000 cycles. The employment of micron-structured p-Si improves cycling stability, which is primarily due to the porous space it provides. This porous structure helps alleviate the mechanical stress caused by volume expansion and prevents Si particles from detaching from the electrodes. The increased surface area facilitates a longer pathway for lithium-ion transport, thereby encouraging a more even distribution of lithium ions and mitigating the localized expansion of Si particles during cycling. Additionally, when Si particles expand, the hollow carbon nanospheres are capable of absorbing the resulting stress, thus preventing the electrode from cracking. The as-prepared p-Si utilizing metal-assisted chemical etching holds promising prospects as an anode material for lithium-ion batteries.
Material Testing of Historic Bricks and Mortars in Degraded Masonry Structures
Authors: Bajno Dariusz , Schabowicz Krzysztof , Grzybowska Agnieszka
Published: July 2024

The subject of this article is material research carried out on the ruins of a medieval castle located in west-central Poland. This facility was built at the beginning of the 15th century by the Order of St. John, and during its long life, it was subjected to many reconstructions. Unfortunately, in 1975, it was destroyed by fire. Since then, it has been left in a state of advanced ruin, exposed to climatic influences without any protection. The subject of the research was to assess the possibility of maintaining such buildings in a severely degraded condition while ensuring their technical efficiency. The article discusses a particular instance of “consolidation” applied to a structure in a state of historical, architectural, and structural ruin. After the diagnosis, it was determined that the structure should be safeguarded using a minimally invasive method. The purpose of these activities was to answer the question of whether the structure could be left to continue operating despite failing to meet the requirements of current standards and regulations while posing an additional danger to itself and the environment,. This goal was achieved by obtaining a considerable amount of data on the condition of the materials embedded in the masonry structure, thanks to which the initial parameters for conducting an assessment of the technical condition of the damaged masonry structure and evaluating the degree of its danger were developed. The results of the research and analysis carried out and described in this article can be used in other similar situations where saving national heritage objects through “artificial modern” strengthening will be unsafe and will lead to a loss of their authenticity. We still have a long way to go to develop a comprehensive method for “in situ” diagnosis of heterogeneous masonry structures, so we should use possible techniques and knowledge to conduct such assessments and propose rescue methods for historically valuable objects in a way that could minimize the damage and that can “easily” disappear from our surroundings. Each study should have a specific purpose, not only research but also a long-term perspective, making it possible to leave material for further research and analysis, including testing new research methods in real conditions of its installation.