bluuebunny/crossref_metadata_2025 huggingface dataset:
Coronary microvascular dysfunction is a hallmark of all subtypes of MINOCA
Authors: Milzi Andrea , Dettori Rosalia , Lubberich Richard Karl , Reith Sebastian , Frick Michael , Burgmaier Kathrin , Marx Nikolaus , Burgmaier Mathias
Published: September 2023

Introduction

Myocardial infarction without obstructive coronary artery disease (MINOCA) is a heterogeneous clinical condition presenting with myocardial necrosis not due to an obstruction of a major coronary artery. Recently, a relevant role of coronary microvascular dysfunction (CMD) in the pathogenesis of MINOCA has been suggested; however, data on this are scarce. Particularly, it is unclear if CMD is equally present in all subtypes of MINOCA or differentially identifies one or more of these conditions. Therefore, the aim of this study was to assess CMD in all three coronary vessels of MINOCA patients, relating it with the clinical subtype.

Methods

We retrospectively assessed coronary microvascular function in all three coronary territories by means of angiography-based index of microvascular resistance (aIMR) in 92 patients (64 with working diagnosis of MINOCA, 28 control patients). To further assess the association of CMD with MINOCA subtypes, MINOCA patients were subdivided according to clinical data in coronary cause (n = 13), takotsubo (n = 13), infiltrative or inflammatory cardiomyopathy (n = 9) or unclear (n = 29).

Results

Patients with working diagnosis of MINOCA showed a significantly elevated average aIMR compared to control patients (30.5 ± 7.6 vs. 22.1 ± 5.9, p < 0.001) as a marker of a relevant CMD; these data were consistent in all vessels. Among MINOCA subtypes, no significant difference in average aIMR could be detected between patients with coronary cause (33.2 ± 6.6), takotsubo cardiomyopathy (29.2 ± 6.9), infiltrative or inflammatory cardiomyopathy (28.1 ± 6.8) or unclear cause (30.6 ± 8.5; p = 0.412). Interestingly, aIMR was significantly elevated in the coronary vessel supplying the diseased myocardium compared with other vessels (31.9 ± 11.4 vs. 27.8 ± 8.2, p = 0.049).

Conclusion

Coronary microvascular dysfunction is a hallmark of all MINOCA subtypes. This study adds to the pathophysiological understanding of MINOCA and sheds light into the role of CMD in MINOCA.
Plant-based dietary indices and biomarkers of chronic low-grade inflammation: a cross-sectional analysis of adults in Ireland
Authors: Kharaty Soraeya , Harrington Janas M. , Millar Seán R. , Perry Ivan J. , Phillips Catherine M.
Published: September 2023

Purpose

There is increasing interest in the health benefits of plant-based diets (PBDs). Evidence reports favourable associations with inflammatory profiles and reduced cardiovascular disease risk. However, limited studies have examined relationships between PBD indices (PDIs) and inflammatory biomarkers. We explored overall PDI, healthful PDI (hPDI) and unhealthful PDI (uPDI) associations with inflammatory biomarker profiles.

Methods

This cross-sectional analysis included 1986 middle- to older-aged adults from the Mitchelstown Cohort. PDI scores were calculated using validated food frequency questionnaires. PDI score associations with inflammatory biomarkers were assessed via linear regression analysis, with adjustment for potential confounders.

Results

Comparison of quintiles (Q5 vs Q1) revealed lower concentrations of C-reactive protein (CRP), interleukin 6 (IL-6), white blood cells (WBCs), neutrophils and monocytes, and the leptin-to-adiponectin ratio (PDI and hPDI P < 0.05); lower leptin (PDI, P < 0.05), and complement component 3 (C3), tumour necrosis factor alpha (TNF-α), plasminogen activator inhibitor 1, lymphocytes and eosinophils (hPDI, P < 0.05); and higher concentrations of adiponectin (PDI and hPDI, P < 0.05). Conversely, higher concentrations of C3, CRP, IL-6, TNF-α, resistin, WBCs, neutrophils, lymphocytes, monocytes and eosinophils, and the neutrophil-to-lymphocyte ratio, and lower adiponectin concentrations were observed comparing uPDI quintiles (P < 0.05). In fully adjusted regression models, higher hPDI scores were associated with lower concentrations of C3, TNF-α, WBCs, neutrophils and monocytes (all P < 0.01). Higher uPDI scores were associated with higher C3 and TNF-α concentrations (all P < 0.01).

Conclusion

This study provides evidence that a more healthful PBD is associated with a more favourable inflammatory profile and that a more unhealthful PBD is associated with the reverse.
Factors influencing choice of treatment for proximal humeral fractures elaborated in a Delphi consensus process
Authors: Klute Lisa , Henssler Leopold , Schliemann Benedikt , Königshausen Matthias , Weber Nadine , Alt Volker , Kerschbaum Maximilian
Published: September 2023

Introduction

Hitherto, the decision-making process for treatment of proximal humerus fractures (PHF) remains controversial, with no established or commonly used treatment regimens. Identifying fracture- and patient-related factors that influence treatment decisions is crucial for the development of such treatment algorithms. The objective of this study was to define a Delphi consensus of clinically relevant fracture- and patient-related factors of PHF for clinical application and scientific research.

Methods

An online survey was conducted among an international panel of preselected experienced shoulder surgeons. An evidence-based list of fracture-related and patient-related factors affecting treatment outcome after PHF was generated and reviewed by the members of the committee through online surveys. The proposed factors were revised for definitions, and suggestions from the first round mentioned in the free text were included as possible factors in the second round of surveys. Consensus was defined as having at least a two-thirds majority agreement.

Results

The Delphi consensus panel consisted of 18 shoulder surgeons who completed 2 rounds of online surveys. There was an agreement of more than two-thirds of the panel for three fracture-related factors affecting treatment decision in the case of PHF: head-split fracture, dislocated tuberosities, and fracture dislocation. Of all patient-related factors, a two-thirds consensus was reached for two factors: age and rotator cuff tear arthropathy.

Conclusion

This study successfully conducted a Delphi consensus on factors influencing decision-making in the treatment of proximal humeral fractures. The documented factors will be useful for clinical evaluation and scientific validation in future studies.
Frequency and predictors of poststroke epilepsy after mechanical thrombectomy for large vessel occlusion stroke: results from a multicenter cohort study
Authors: Gruber Joachim , Gattringer Thomas , Mayr Georg , Schwarzenhofer Daniel , Kneihsl Markus , Wagner Judith , Sonnberger Michael , Deutschmann Hannes , Haidegger Melanie , Fandler-Höfler Simon , Ropele Stefan , Enzinger Christian , von Oertzen Tim
Published: September 2023

Background

Poststroke epilepsy (PSE) represents an important complication of stroke. Data regarding the frequency and predictors of PSE in patients with large-vessel occlusion stroke receiving mechanical thrombectomy (MT) are scarce. Furthermore, information on acute and preexisting lesion characteristics on brain MRI has not yet been systematically considered in risk prediction of PSE. This study thus aims to assess PSE risk after acute ischemic stroke treated with MT, based on clinical and MRI features.

Methods

In this multicenter study from two tertiary stroke centers, we included consecutive acute ischemic stroke patients who had received MT for acute intracranial large vessel occlusion (LVO) between 2011 and 2017, in whom post-interventional brain MRI and long term-follow-up data were available. Infarct size, affected cerebrovascular territory, hemorrhagic complications and chronic cerebrovascular disease features were assessed on MRI (blinded to clinical information). The primary outcome was the occurrence of PSE (> 7 days after stroke onset) assessed by systematic follow-up via phone interview or electronic records.

Results

Our final study cohort comprised 348 thrombectomy patients (median age: 67 years, 45% women) with a median long-term follow-up of 78 months (range 0–125). 32 patients (9%) developed PSE after a median of 477 days (range 9–2577 days). In univariable analyses, larger postinterventional infarct size, infarct location in the parietal, frontal or temporal lobes and cerebral microbleeds were associated with PSE. Multivariable Cox regression analysis confirmed larger infarct size (HR 3.49; 95% CI 1.67–7.30) and presence of cerebral microbleeds (HR 2.56; 95% CI 1.18–5.56) as independent predictors of PSE.

Conclusion

In our study, patients with large vessel occlusion stroke receiving MT had a 9% prevalence of PSE over a median follow-up period of 6.5 years. Besides larger infarct size, presence of cerebral microbleeds on brain MRI predicted PSE occurrence.
Molecular neuropathology: an essential and evolving toolbox for the diagnosis and clinical management of central nervous system tumors
Authors: Bertero Luca , Mangherini Luca , Ricci Alessia Andrea , Cassoni Paola , Sahm Felix
Published: September 2023

Molecular profiling has transformed the diagnostic workflow of CNS tumors during the last years. The latest WHO classification of CNS tumors (5th edition), published in 2021, pushed forward the integration between histopathological features and molecular hallmarks to achieve reproducible and clinically relevant diagnoses. To address these demands, pathologists have to appropriately deal with multiple molecular assays mainly including DNA methylation profiling and DNA/RNA next generation sequencing. Tumor classification by DNA methylation profiling is now a critical tool for many diagnostic tasks in neuropathology including the assessment of complex cases, to evaluate novel tumor types and to perform tumor subgrouping in hetereogenous entities like medulloblastoma or ependymoma. DNA/RNA NGS allow the detection of multiple molecular alterations including single nucleotide variations, small insertions/deletions (InDel), and gene fusions. These molecular markers can provide key insights for diagnosis, for example, if a tumor-specific mutation is detected, but also for treatment since targeted therapies are progressively entering the clinical practice. In the present review, a brief, but comprehensive overview of these tools will be provided, discussing their technical specifications, diagnostic value, and potential limitations. Moreover, the importance of molecular profiling will be shown in a representative series of CNS neoplasms including both the most frequent tumor types and other selected entities for which molecular characterization plays a critical role.
Cardiovascular outcomes improve in children with renovascular hypertension following endovascular and surgical interventions
Authors: Redhead Emily C. G. , Paessler Alicia , Arslan Zainab , Patel Premal , Minhas Kishore , Forman Colin , Hollis Paolo , Lava Sebastiano , Ionescu Florin , Manuel Devi , Ray Samiran , Kessaris Nicos , Giardini Alessandro , Ratnamma Vineetha , Dobby Nadine , Tullus Kjell , Simmonds Jacob , Stojanovic Jelena
Published: September 2023

Background

Renovascular hypertension (RenoVH) is a cause of hypertension in children. A common cause of RenoVH is renal artery stenosis which acts by reducing blood supply to renal parenchyma and activating the renin–angiotensin–aldosterone axis, often leading to cardiac remodelling. This longitudinal observational study aims to describe occurrence of cardiovascular changes secondary to RenoVH and also any improvement in cardiac remodelling after successful endovascular and/or surgical intervention.

Methods

All patients with RenoVH referred to our centre, who received ≥ 1 endovascular intervention (some had also undergone surgical interventions) were included. Data were collected by retrospective database review over a 22-year period. We assessed oscillometric blood pressure and eight echocardiographic parameters pre- and post-intervention.

Results

One hundred fifty-two patients met inclusion criteria and had on average two endovascular interventions; of these children, six presented in heart failure. Blood pressure (BP) control was achieved by 54.4% of patients post-intervention. Average z-scores improved in interventricular septal thickness in diastole (IVSD), posterior Wall thickness in diastole (PWD) and fractional shortening (FS); left ventricular mass index (LVMI) and relative wall thickness (RWT) also improved. PWD saw the greatest reduction in mean difference in children with abnormal (z-score reduction 0.25, p < 0.001) and severely abnormal (z-score reduction 0.23, p < 0.001) z-scores between pre- and post-intervention echocardiograms. Almost half (45.9%) had reduction in prescribed antihypertensive medications, and 21.3% could discontinue all antihypertensive therapy.

Conclusions

Our study reports improvement in cardiac outcomes after endovascular + / − surgical interventions. This is evidenced by BP control, and echocardiogram changes in which almost half achieved normalisation in systolic BP readings and reduction in the number of children with abnormal echocardiographic parameters.

Graphical abstract
Kidney transplantation in low- and middle-income countries: the Transplant Links experience
Authors: Roberts Lydia E. , Kaur Amrit , Jewitt-Harris Jennie , Ready Andrew , Milford David V.
Published: September 2023

Paediatric kidney failure is a global problem responsible for significant childhood morbidity and mortality. The gold-standard treatment is kidney transplantation. However, the availability of kidney transplantation remains limited in some low- and middle-income countries (LMICs). Transplant Links Community (TLC) is a UK-based charity that mentors units in LMICs wishing to start kidney transplantation; the ultimate goal is for these units to become self-sufficient. TLC provides this support through in-person training visits and skill transfer, plus direct mentorship from the UK that is maintained over many years. From such mentoring programmes, it is evident that there are numerous challenges in the initial establishment and long-term maintenance of kidney transplant services, with specific and unique barriers applying to setting up paediatric transplant programmes compared to their adult counterparts. This review summarises TLC’s first-hand experience of developing paediatric kidney transplantation services in LMICs over the past 15 years, the challenges encountered, and the major ongoing barriers that must be addressed to facilitate further progress in delivering transplantation services to children globally.
How does pollen production of allergenic species differ between urban and rural environments?
Authors: Jetschni Johanna , Fritsch Markus , Jochner-Oette Susanne
Published: September 2023

Pollen production is one plant characteristic that is considered to be altered by changes in environmental conditions. In this study, we investigated pollen production of the three anemophilous species Betula pendula, Plantago lanceolata, and Dactylis glomerata along an urbanization gradient in Ingolstadt, Germany. We compared pollen production with the potential influencing factors urbanization, air temperature, and the air pollutants nitrogen dioxide (NO2) and ozone (O3). While we measured air temperature in the field, we computed concentration levels of NO2 and O3 from a land use regression model. The results showed that average pollen production (in million pollen grains) was 1.2 ± 1.0 per catkin of Betula pendula, 5.0 ± 2.4 per inflorescence of Plantago lanceolata, and 0.7 ± 0.5 per spikelet of Dactylis glomerata. Pollen production was higher in rural compared to urban locations on average for B. pendula (+ 73%) and P. lanceolata (+ 31%), while the opposite was the case for D. glomerata (− 14%). We found that there was substantial heterogeneity across the three species with respect to the association of pollen production and environmental influences. Pollen production decreased for all species with increasing temperature and urbanization, while for increasing pollutant concentrations, decreases were observed for B. pendula, P. lanceolata, and increases for D. glomerata. Additionally, pollen production was found to be highly variable across species and within species—even at small spatial distances. Experiments should be conducted to further explore plant responses to altering environmental conditions.
An improved rough set strategy-based sine cosine algorithm for engineering optimization problems
Authors: Rizk-Allah Rizk M. , Elsodany E.
Published: September 2023

In this paper, a hybrid algorithm called rough sine cosine algorithm (RSCA) is introduced for solving engineering optimization problems by merging the sine cosine algorithm (SCA) with the rough set theory concepts (RST). RSCA combines the benefits of SCA and RST to focus the search for a promising region where the global solution can be found. Due to imprecise information on the optimization problems, efficient algorithms roughly identify the optimal solution for this type of uncertain data. The fundamental motive for adding the RST is to deal with the imprecision and roughness of the available information regarding the global optimal, especially for large dimensional problems. The cut concept of RST targeted the more interesting search region so the optimal operation could be sped up, and the global optimum could be reached at a low computational cost. The proposed RSCA algorithm is tested on 23 benchmark functions and 3 design problems. RSCA’s obtained results are mainly compared to the SCA, which is used as a first level of the proposed algorithm in this work and those of other algorithms in the literature. According to the comparisons, the RSCA can provide very competitive performance with different algorithms.
Prevalence and consequences of spinal pain among people with type 1 and type 2 diabetes mellitus in Denmark
Authors: Liaghat Behnam , Folkestad Lars , Skou Søren T. , Koes Bart , Stammerjohan Amalie Frost , Hartvigsen Jan
Published: September 2023

Purpose

To describe 1-week and 1-year prevalence of spinal pain and its consequences in relation to leisure activity, work-life, and care-seeking in people with type 1 and 2 diabetes mellitus (DM).

Methods

A cross-sectional survey including adults diagnosed with DM from two Danish secondary care centres. Using the Standardised Nordic Questionnaire, spinal pain prevalence (cervical, thoracic, lumbar) and its consequences were evaluated (proportions, 95% confidence intervals) and compared to the general population.

Results

Among 3767 people, 1-week and 1-year spinal pain prevalence were 11.6–32.4 and 18.5–49.6%, respectively, highest for lumbar pain (24.6–49.6%). The prevalence was similar between DM types for cervical and thoracic pain, but higher in type 2 for lumbar spine. Women had higher pain prevalence across spinal regions and DM types, while cervical and thoracic pain estimates were higher for age < 60 vs. ≥ 60. Within the past year, > 50% reported pain > 30 days, high proportions had reduced their activities (leisure time, 43.7–63.9%; work, 20.7–33.3%), 13.3–28.1% reported sick-leave > 30 days, and 44.3–48.5% had sought care due to spinal pain.

Conclusion

Spinal pain is common in people with type 1 and 2 DM, resulting in considerable consequences for work/leisure activities, sick-leave, and healthcare utilisation as compared to the general population.
Prospective randomized controlled trial: early weight bearing after conservative treatment of Weber B ankle fractures (pancake trial)
Authors: Stassen R. C. , Franssen S. , Meesters B. , Boonen B. , de Loos E. R. , van Vugt R.
Published: September 2023

Purpose

Different studies have shown that weightbearing is safe in stable transsyndesmotic, isolated lateral simple ankle fractures. Despite this evidence, AO guidelines still recommend immobilization with above-the-knee cast for 4–6 weeks for these fractures. The objective of this study was to compare the outcomes of mobilization and weightbearing to those of immobilization and non-weightbearing in patients with stable transsyndesmotic, lateral isolated simple ankle fractures.

Methods

Fifty patients were randomly assigned to permissive weightbearing in a walking boot or non-weightbearing immobilization using a below-the-knee cast. Primary outcome was ankle functionality as scored by the Olerud-Molander Ankle Score (OMAS). Secondary outcomes were radiological displacement of fracture, range of motion (ROM), calf circumference, and RAND 36-item health survey. Patients were in follow-up for 24 months.

Results

Ankle functionality after six and twelve weeks was significantly higher for the intervention group, with respectively 30 points (p = 0.001) and 10 points (p = 0.015) of difference. ROM improved significantly in the intervention group after six weeks. All fractures showed radiological progression of fracture healing. RAND 36-item showed differences in both physical (60.3 vs. 46.3, p = 0.017) and mental (78.5 vs. 58.2, p = 0.034) components in favor of the intervention group. In 16% of patients who initially showed stable fractures on radiographic imaging, joint dislocation was identified on weightbearing radiographs prior to randomization, leading to exclusion.

Conclusion

Weightbearing and mobilization using a walking boot may be a safe treatment for patients with stable Weber B fractures.
An Improved Model for Evaluating the Hydraulic Behaviour of a Single Rock Joint Considering Contact Area Evolution During Shearing
Authors: Zhu X. , Gao M. , Si G. , Zhang C. , Moon J.-S. , Oh J.
Published: September 2023

The contact of rock joints during shearing induced by underground excavation significantly impacts the hydro-mechanical behaviour of fractured rock mass, since fluid tends to flow through a rough-walled fracture along connected channels while bypassing the contact areas with tortuosity. However, previous research mostly considered joint roughness or aperture changes based on 2D joint profiles, while the contact and tortuosity using 3D surfaces were often overlooked. This paper considers the evolution of contact area and aperture distribution during shearing. The concept of the critical inclination angle is introduced and correlated with the contact area during shearing based on Grasselli’s criterion. The standard deviation of the mean mechanical aperture is calculated using the modified algorithm. An improved model for estimating the hydraulic aperture with the mechanical aperture is then developed, applying an aperture correction term and a contact correction term. A number of shear-flow tests on artificial joint samples under constant normal loads are conducted. The accuracy and reliability of the proposed model are verified by comparing it against the experimental results and by comparing the prediction performance with other published models. Results show that the proposed model can improve the prediction of the hydraulic aperture and hydraulic conductivity of a single rock joint during shearing.
The clinical course and outcomes of non-aneurysmal subarachnoid hemorrhages in a single-center retrospective study
Authors: Tarkiainen Jeremias , Hovi Valtteri , Pyysalo Liisa , Ronkainen Antti , Frösen Juhana
Published: September 2023

Background

Non-aneurysmal subarachnoid hemorrhages (SAHs) are thought to have a benign clinical course compared to aneurysmal SAHs. The aim of this study is to report the clinical course and outcomes of non-aneurysmal SAHs in a large single-center study.

Methods

The patients with non-aneurysmal SAHs were screened from Tampere University Hospital from 2005 to 2020. The clinical data were collected from the patient’s medical records and from the imaging studies. The primary interest was the neurological outcome assessed by dichotomized GOS at 2 months. Multivariable logistic regression was used to study the factors associated with unfavorable outcome.

Results

We found 216 non-aneurysmal SAHs in 214 patients (2 patients with > 1 bleed). Ninety-seven percent of patients with a typical perimesencephalic bleeding pattern SAH (PSAH) (75/77) had a favorable outcome, while 86% of patients with non-perimesencephalic SAH (NPSAH) had a favorable outcome (84/98). In a multivariable logistic regression analysis, loss of consciousness (LOC) (aOR 214.67, 95% CI 17.62–2615.89) and Fisher grade 4 bleeding pattern (aOR 23.32, 95% CI 1.40–387.98) were associated with increased risk for unfavorable outcome (GOS 1–3). Vasospasm was seen in 20% of non-aneurysmal SAH patients, hydrocephalus in 17%, and 13% needed ventriculostomy.

Conclusions

Non-aneurysmal SAH seems to have a good prognosis for majority of patients, especially for patients with a PSAH. Non-aneurysmal SAH patients are however affected by vasospasm and hydrocephalus and have similar risk factors for poor outcome as patients with aneurysmal SAH. This suggests that it is the severity of the bleed rather than the etiology that associates with poor outcome.
Novelties for increased safety in cranio-vertebral surgery: a review
Authors: Tessitore Enrico , Mastantuoni Ciro , Cabrilo Ivan , Schonauer Claudio
Published: September 2023

The cranio-vertebral junction (CVJ) was formerly considered a surgical “no man’s land” due to its complex anatomical and biomechanical features. Surgical approaches and hardware instrumentation have had to be tailored in order to achieve successful outcomes. Nowadays, thanks to the ongoing development of new technologies and surgical techniques, CVJ surgery has come to be widely performed in many spine centers. Accordingly, there is a drive to explore novel solutions and technological nuances that make CVJ surgery safer, faster, and more precise. Improved outcome in CVJ surgery has been achieved thanks to increased safety allowing for reduction in complication rates. The Authors present the latest technological advancements in CVJ surgery in terms of imaging, biomaterials, navigation, robotics, customized implants, 3D-printed technology, video-assisted approaches and neuromonitoring.
Constitutive modeling of orthotropic nonlinear mechanical behavior of hardened 3D printed concrete
Authors: Mader Thomas , Schreter-Fleischhacker Magdalena , Shkundalova Olena , Neuner Matthias , Hofstetter Günter
Published: September 2023

3D printing of concrete is a promising construction technology, offering the potential to build geometrically complex structures without the use of cost-intensive formwork. The layer-wise deposit of filaments during the 3D printing process results in an intrinsic orthotropic mechanical behavior in the hardened state. Beyond that, the material behavior of 3D printed concrete (3DPC) is governed by a highly nonlinear behavior, characterized by irreversible deformations, strain hardening, strain softening and a degradation of the material stiffness. In this contribution, a new constitutive model for describing the orthotropic and highly nonlinear material behavior of 3DPC will be presented. It is formulated by the extension of a well-established isotropic damage plasticity model for concrete to orthotropic material behavior by linear mapping of the stress tensor into a fictitious isotropic configuration. The performance of the new model will be evaluated by finite element simulations of three-point bending tests of 3DPC samples, performed for different orientations of the loading direction relative to the printing direction and comparison with experimental results. In addition, the applicability of the model to replicate the mechanical behavior of 3DPC, manufactured by the alternative 3D printing process of binder jetting of cementitious powders, will be demonstrated by 3D finite element simulations of an arch structure with varying orientations of the loading direction relative to the layering. Overall, the proposed model provides a computationally efficient modeling approach for large-scale finite element simulations of 3DPC structures, being a promising alternative to complex and computationally expensive finite element models considering distinct interfacial planes.
Pregnancy, fertile life factors, and associated clinical course in PRKN early-onset Parkinson’s disease
Authors: Bovenzi Roberta , Conti Matteo , Degoli Giulia Rebecca , Cerroni Rocco , Artusi Carlo Alberto , Pierantozzi Mariangela , Stefani Alessandro , Mercuri Nicola Biagio , Schirinzi Tommaso
Published: September 2023

Introduction

As the most common cause of autosomal recessive early onset Parkinson’s disease (EOPD), parkin type Parkinson’s disease (PRKN-PD) may affect female patients in childbearing age. Accordingly, issues related to fertility must be adequately addressed. Here, we landscaped fertile life factors and pregnancy course of a PRKN-PD cohort, including both novel cases directly observed at our center and published ones.

Methods

Six patients with confirmed PRKN-PD were examined by a structured interview on reproductive factors and associated modifications of PD disturbances, including one case followed up throughout pregnancy which was described in greater detail. Six studies reporting fertile life factors of nine PRKN-PD patients were reviewed collecting homogeneous data on fertile life and pregnancy course.

Results

PRKN-PD female patients experienced motor fluctuations with the menstrual cycle, pregnancy, and puerperium, which suggests a role for sex hormones in PD clinical burden. In some cases, abortion and miscarriages occurred during the organogenesis phase in patients receiving oral antiparkinsonian therapy; however, levodopa/benserazide monotherapy resulted to be the safest choice in pregnancy.

Conclusion

Collectively these data disclose the importance of pre-conception counseling in childbearing age PRKN-PD patients and EOPD in general.
A template-based approach for question answering over knowledge bases
Authors: Formica Anna , Mele Ida , Taglino Francesco
Published: September 2023

In this paper, we address the problem of answering complex questions formulated by users in natural language. Since traditional information retrieval systems are not suitable for complex questions, these questions are usually run over knowledge bases, such as Wikidata or DBpedia. We propose a semi-automatic approach for transforming a natural language question into a SPARQL query that can be easily processed over a knowledge base. The approach applies classification techniques to associate a natural language question with a proper query template from a set of predefined templates. The nature of our approach is semi-automatic as the query templates are manually written by human assessors, who are the experts of the knowledge bases, whereas the classification and query processing steps are completely automatic. Our experiments on the large-scale CSQA dataset for question-answering corroborate the effectiveness of our approach.
CLASRP oncogene as a novel target for colorectal cancer
Authors: Gu Quan , Wu Jianzhong , Xu Heng , Cao Haixia , Zhang Junying , Jing Changwen , Wang Zhuo , Du Mengjie , Ma Rong , Feng Jifeng
Published: September 2023

Clk4-associated serine/arginine-rich protein (CLASRP), an alternative splicing regulator, may be involved in the development and progression of cancer by regulating the activity of the CDC-like kinase (Clk) family. This study explored the biological function of CLASRP in colorectal cancer (CRC). The expression of CLASRP, which is associated with clinicopathological features, was analysed in CRC tissues and paired noncancer tissues by RT–PCR. The roles of CLASRP were investigated in CRC cells transfected with plasmids or shRNA through proliferation, migration and invasion assays in vitro and a xenograft model in vivo. Apoptosis was analysed using CLASRP-overexpressing CRC cells by western blotting. Clk inhibitors were used to perform functional research on CLASRP in CLASRP-overexpressing CRC cells. CLASRP was significantly upregulated in CRC cell lines, while high CLASRP expression was correlated with metastasis in CRC patients. Functionally, overexpression of CLASRP significantly promoted the proliferation, migration and invasion of CRC cells in vitro and tumour growth in vivo. Mechanistically, the proliferation, migration and invasion of CLASRP-overexpressing CRC cells were inhibited by Clk inhibitors, accompanied by low expression of CLASRP at the gene and protein levels. Clk inhibitors induced apoptosis of CLASRP-overexpressing CRC cells, resulting in direct blockade of cell growth. The expression levels of cleaved caspase 3 and cleaved caspase 8 were increased in CLASRP-overexpressing CRC cells treated with Clk inhibitors. CLASRP might serve as a promotional oncogene in CRC cells and be suppressed by Clk inhibitors through activation of caspase pathways.
Evaluation of cardiovascular autonomic dysfunction in symptomatic post-COVID-19 patients using the heart rate variability (HRV) and detection of subtle LV dysfunction using 2D global longitudinal strain (GLS)
Authors: Nour Amira , Fouad Mirna , Salam Zeinab Abdel
Published: September 2023

Aim

The COVID-19 disease primarily affects the respiratory system; however, cardiac involvement has been documented in the acute phase. We aimed to evaluate the cardiac autonomic function and subtle left ventricular dysfunction in those subjects recovered from mild to moderate acute COVID-19 patients but still symptomatic.

Methods and results

The study group was composed of 50 subjects with confirmed mild to moderate COVID-19. All subjects underwent routine 2D echocardiography assessment in addition to 2D speckle tracking and 24 h Holter monitoring for HRV analysis. The mean age of the study population was 42 ± 18 years; symptoms were reported as follows 27 (54%) had dyspnoea, 17 (34%) had palpitation, and 7 (14%) had dizziness. Time domain parameters Standard Deviation of NN intervals (SDNN), Standard Deviation of the Average NN intervals for each 5 min segment of a 24 h HRV recording (SDANN), and Root Mean Square of Successive RR interval Differences (rMSSD) were diminished with mean SDNN value being markedly impaired in 12 (24%) patients, while frequency domain parameters as assessed by the ratio of the Low-Frequency band power to the High-Frequency band power (LF/HF) with the mean of 1.837 with 8% of the patients being impaired. SDNN was significantly reduced in patients with impaired global longitudinal strain (p 0.000). The global longitudinal strain was diminished in 10 patients (20%); also, 80% of the patients with impaired GLS had decreased SDNN.

Conclusion

Our study targeted patients experiencing prolonged symptoms after COVID-19 illness. We detected a high incidence of GLS impairment using Speckle Tracking Echocardiography (STE) and a significant prevalence of diminished HRV. HRV (especially SDNN) and GLS were found to be significantly correlated.

Graphical abstract
Epigenetic control of pancreatic cancer metastasis
Authors: Krauß Lukas , Schneider Carolin , Hessmann Elisabeth , Saur Dieter , Schneider Günter
Published: September 2023

Surgical resection, when combined with chemotherapy, has been shown to significantly improve the survival rate of patients with pancreatic ductal adenocarcinoma (PDAC). However, this treatment option is only feasible for a fraction of patients, as more than 50% of cases are diagnosed with metastasis. The multifaceted process of metastasis is still not fully understood, but recent data suggest that transcriptional and epigenetic plasticity play significant roles. Interfering with epigenetic reprogramming can potentially control the adaptive processes responsible for metastatic progression and therapy resistance, thereby enhancing treatment responses and preventing recurrence. This review will focus on the relevance of histone-modifying enzymes in pancreatic cancer, specifically on their impact on the metastatic cascade. Additionally, it will also provide a brief update on the current clinical developments in epigenetic therapies.
Viscose nonwoven fabric with copper and its multifunctional properties
Authors: Cieślak Małgorzata , Kowalczyk Dorota , Baranowska-Korczyc Anna , Kamińska Irena , Krzyżowska Małgorzata , Janicka Martyna , Kubacki Jerzy
Published: September 2023

The antimicrobial functionalization of textile structures with copper and its compounds carried out by various methods increased significantly during the SARS-CoV-2 pandemic. So far, in order to obtain antiviral properties the magnetron technique using copper was applied mainly to flat textile structures; polypropylene, polyester and cotton nonwovens, and polyester and cotton woven fabrics. In this study, magnetron sputtering with copper was applied to modify the spatial viscose needle-punched nonwoven fabric. We found that the spatial nonwoven structure made of regenerated cellulose fibers and one-side sputtered with copper has strong antimicrobial activity against Gram-positive Staphylococcus aureus and Gram-negative Klebsiella pneumoniae. In the case of herpes simplex virus type 1 (HSV-1) McKrae strain, vaccinia virus (VACV) WR strain, influenza A virus H1N1 (IFV) and mouse coronavirus (MHV) JHV strain used in the study, Cu modified nonwoven fabric has only weak activity against herpes simplex virus type 1 (HSV-1). It also has no significant toxicity compared to the control medium and pristine nonwoven fabric. The modified nonwoven fabric is characterized also by hydrophobic properties, high electrical conductivity, good air and water vapor permeability, and meets the requirements of breathing resistance for all protection classes (FFP1, FFP2 and FFP3) specified in the EN 149-2001 standard.
Meiotic segregation and post-meiotic drive of the Festuca pratensis B chromosome
Authors: Ebrahimzadegan Rahman , Fuchs Jörg , Chen Jianyong , Schubert Veit , Meister Armin , Houben Andreas , Mirzaghaderi Ghader
Published: September 2023

In many species, the transmission of B chromosomes (Bs) does not follow the Mendelian laws of equal segregation and independent assortment. This deviation results in transmission rates of Bs higher than 0.5, a process known as “chromosome drive”. Here, we studied the behavior of the 103 Mbp-large B chromosome of Festuca pratensis during all meiotic and mitotic stages of microsporogenesis. Mostly, the B chromosome of F. pratensis segregates during meiosis like standard A chromosomes (As). In some cases, the B passes through meiosis in a non-Mendelian segregation leading to their accumulation already in meiosis. However, a true drive of the B happens during the first pollen mitosis, by which the B preferentially migrates to the generative nucleus. During second pollen mitosis, B divides equally between the two sperms. Despite some differences in the frequency of drive between individuals with different numbers of Bs, at least 82% of drive was observed. Flow cytometry-based quantification of B-containing sperm nuclei agrees with the FISH data.
Wordless Picturebooks as Resources for the Construction of the Pedagogy of Multiliteracies. The Case of Migrants, by Issa Watanabe
Authors: Pereira Íris Susana Pires , Gil Maitê , Bunzen Clecio
Published: September 2023

This article presents the study of Migrants (2019), a wordless picturebook by Peruvian author Issa Watanabe, developed to answer the following research question: To what extent can this visual text become a resource for the learning of multiliteracies? A visual discourse analysis of the narrative was performed, focusing on the identification of key meanings and semiotic resources used in their visual construction. Our findings unveil the prominent role of semiotic resources such as anthropomorphism, vectors, colours, position and unboundedness of the page frame, in the visual realization of key meanings such as diversity, journeys, death, and empathy. Upon these findings, we present Migrants as an extraordinary literary text to initiate children in learning the visual mode, one of the multiple modes currently used in the representation of meaning. We discuss our findings with reference to the main question leading the study, the pedagogical conceptualizations endorsed by the multiliteracies theoretical framework and other relevant research. While the study suggests that wordless picturebooks are called to play a prominent role in the construction of the multiliteracies pedagogical agenda, it furthermore points to the potential of the pedagogy of multiliteracies in the conceptualization of literary pedagogy itself.
Opinion Dynamics with Preference Matching: How the Desire to Meet Facilitates Opinion Exchange
Authors: Steinbacher Mitja , Steinbacher Matjaž , Knoppe Clemens
Published: September 2023

The paper reexamines an agent-based model of opinion formation under bounded confidence with heterogeneous agents. The paper is novel in that it extends the standard model of opinion dynamics with the assumption that interacting agents share the desire to exchange opinion. In particular, the interaction between agents in the paper is modeled via a dynamic preferential-matching process wherein agents reveal their preferences to meet according to three features: coherence, opinion difference, and agents’ positive sentiments towards others. Only preferred matches meet and exchange opinion. Through an extensive series of simulation treatments, it follows that the presence of sentiments, on one hand, hardens the matching process between agents, which leads to less communication. But, on the other hand, it increases the diversity in preferred matches between agents and thereby leads to a better-integrated social network structure, which reflects in a reduction of the opinion variance between agents. Moreover, at combinations of (a) high tolerance, (b) low sensitivity of agents to opinion volatility, and (c) low levels of confidence, agents are occasionally drawn away from the consensus, forming small groups that hold extreme opinions.
Potential to use metaverse for future teaching and learning
Authors: Onu Peter , Pradhan Anup , Mbohwa Charles
Published: September 2023

Metaverse, a virtual shared space integrating augmented reality and virtual reality technologies, is often hailed as the “Internet of the future” for its potential to revolutionize online communication, collaboration, learning, and work. However, despite its promising strategic and business applications, there is a dearth of empirical evidence for evaluating its educational value. This qualitative study examined the impact of Metaverse on teaching and learning by examining its advantages and challenges. The outcomes highlight Metaverse’s remarkable potential for personalized and adaptive learning thanks to its immersive and interactive capabilities. An analysis of the existing literature suggests that Metaverse can create engaging learning experiences in which students can explore tailored virtual environments and interact within them. Semi-structured in-depth interviews were conducted to confirm the perception of metaverse-based education among students, educators, and program administrators, who view it as an innovative and effective educational delivery method. Several barriers require attention to ensure the successful integration of Metaverse in education, such as network connectivity, reliability, standardization and certification, organizational readiness, and the specialized skills necessary to leverage Metaverse’s potential. This study offers a comprehensive understanding of Metaverse’s potential, limitations, and critical factors contributing to its education success. By providing immersive and interactive learning experiences tailored to individual student needs, Metaverse holds the power to revolutionize teaching and learning. However, addressing challenges related to interoperability and the need for more evidence on its efficacy requires further research and development efforts. The significance of this study hinges on the continued exploration of Metaverse to enhance educational experiences, offering a novel and innovative approach to teaching and learning.
The Reversibility Paradox: Role of the Velocity Reversal Step
Authors: Binder P.M.
Published: September 2023

The reversibility, or Loschmidt paradox, is a thought experiment in which microscopic reversibility is exploited to generate an apparently spontaneous trajectory in which entropy decreases, thus violating the Second Law of Thermodynamics (SLT). To achieve this, the system is allowed to evolve from a low-entropy to a high-entropy configuration, at which point all velocities of its molecules are reversed, thus producing the desired effect. In this paper we focus on the velocity reversal step. Implementing this step requires the measurement of velocities and positions, which must be stored in a memory. Even in the case of a reversible measurement, the erasure of the stored information, necessary to reset the measuring device to its original state, has an entropy cost that offsets the entropy decrease during the reverse evolution of the system. This cost is sufficient to explain why the described procedure does not violate the SLT.
Is body condition of Mexican rubyspot (Odonata:Zygoptera) associated with urbanization?
Authors: Suárez-Tovar Catalina M. , Rocha-Ortega Maya , Córdoba-Aguilar Alex
Published: September 2023

Urbanized areas can impose selective pressures on insects which can be identified at the individual level based on animal physiological condition. Physiological condition can be measured from variables such as body size, body mass or energetic budget of individuals. We examined whether body mass, wing spot size and energy reserves (proteins, lipids and carbohydrates) were reduced as urbanization increases, using adults of two damselflies, Hetaerina americana and H. vulnerata, in Central Mexico. We used a Habitat Integrity Index to assess the degree of urbanization in our sampled sites, considering biophysical attributes and the impact of anthropogenic activities. We did not find relation of above individual variables with urbanization degree. These results support possible resilience of rubyspot damselflies in the face of radical changes such as urbanization. Our finding echoes other results in damselflies research.

Implications for insect conservation

Our results highlight the resilience of these damselflies species in the face of urban disturbances. Thus design cities considering not only requirements of humans is essential to promote the presence and conservation of these and other species of insects in cities.

Graphical abstract
LiMeS-Lab: An Integrated Laboratory for the Development of Liquid–Metal Shield Technologies for Fusion Reactors
Authors: Tanke V. F. B. , Al R. S. , Alonso van der Westen S. , Brons S. , Classen I. G. J. , van Dommelen J. A. W. , van Eck H. J. N. , Geers M. G. D. , Lopes Cardozo N. J. , van der Meiden H. J. , Orrico C. A. , van de Pol M. J. , Riepen M. , Rindt P. , de Rooij T. P. , Scholten J. , Timmer R. H. M. , Vernimmen J. W. M. , Vos E. G. P. , Morgan T. W.
Published: September 2023

The liquid metal shield laboratory (LiMeS-Lab) will provide the infrastructure to develop, test, and compare liquid metal divertor designs for future fusion reactors. The main research topics of LiMeS-lab will be liquid metal interactions with the substrate material of the divertor, the continuous circulation and capillary refilling of the liquid metal during intense plasma heat loading and the retention of plasma particles in the liquid metal. To facilitate the research, four new devices are in development at the Dutch Institute for Fundamental Energy Research and the Eindhoven University of Technology: LiMeS-AM: a custom metal 3D printer based on powder bed fusion; LiMeS-Wetting, a plasma device to study the wetting of liquid metals on various substrates with different surface treatments; LiMeS-PSI, a linear plasma generator specifically adapted to operate continuous liquid metal loops. Special diagnostic protection will also be implemented to perform measurements in long duration shots without being affected by the liquid metal vapor; LiMeS-TDS, a thermal desorption spectroscopy system to characterize deuterium retention in a metal vapor environment. Each of these devices has specific challenges due to the presence and deposition of metal vapors that need to be addressed in order to function. In this paper, an overview of LiMeS-Lab will be given and the conceptual designs of the last three devices will be presented.