bluuebunny/crossref_metadata_2025 huggingface dataset:
Tsunami Wave Characteristics from the 1674 Ambon Earthquake Event Based on Landslide Scenarios
Authors: Pakoksung Kwanchai , Suppasri Anawat , Imamura Fumihiko
Published: July 2023

This study focuses on understanding the historical tsunami events in Eastern Indonesia, specifically the Banda Sea region, by extracting information from the limited and challenging-to-interpret historical records. The oldest detailed account of a tsunami in Indonesia dates back to 1674, documented in the book Waerachtigh Verhael Van de Schlickelijcke Aerdbebinge by Rumphius. The study aims to comprehend the primary source of the tsunami and analyze its characteristics to facilitate future tsunami risk reduction. The methodology includes collecting topography and bathymetry data, conducting landslide scenario analysis, employing a two-layer wave propagation model, and performing spectral analysis. The study utilizes comprehensive datasets, investigates potential landslide scenarios, simulates tsunami propagation, and analyzes frequency characteristics using the fast Fourier transform. The 1674 event yielded a runup height of approximately 50–100 m, whereas this study underestimated the actual runup. To illustrate the tsunami wave along the bay’s coastline, a Hovmöller diagram was employed. By analyzing the Hovmöller diagram, the power spectral density was computed, revealing five prominent period bands: 6.96, 5.16, 4.1, 3.75, and 3.36 min. The integration of these components provides a rigorous approach to understanding tsunami dynamics and enhancing risk assessment and mitigation in the study area.
Prescription and Effects of Cardiorespiratory Training in Individuals with Intellectual Disability: A Systematic Review
Authors: Jacinto Miguel , Oliveira Rafael , Martins Alexandre D. , Brito João Paulo , Matos Rui , Ferreira José Pedro
Published: July 2023

This study aims to systematize effects of cardiorespiratory training (CT) programs in individuals with intellectual disability (ID) and identifying the fundamental and structuring aspects for the prescription of CT. This systematic review was carried out through four databases (Pubmed, Web of Science, Scopus, and SPORTDiscus), considering data from the period between 2013 and 2022. From 257 studies, 12 studies were included in this systematic review. Three studies used interval CT, while seven used continuous CT. Seven were carried out in the population with Down syndrome, while only three were carried out with participants with ID. The CT programs had the following characteristics: duration of 8 to 12 weeks, weekly frequency of three sessions, for 20 to 60 min, the intensity of 50% to 80% of maximal heart rate or 70% to 80% of peak oxygen consumption, using an ergometer cycle or an outdoor walking. The studies reported improvements in cardiorespiratory function, lipid, hemodynamic and metabolic profile, body composition, and neuromuscular and cognitive capacity. This review presents characteristics and recommendations that technicians can follow when structuring, prescribing, and implementing CT programs to individuals with ID.
A Bibliometric Analysis of Research on Temporomandibular Joint Disc Displacement from 1992 to 2022
Authors: Wang Qiuhao , Jia Jin , Zhou Changhan , Ye Wang , Bi Ruiye
Published: July 2023

The temporomandibular joint (TMJ) disc displacement is the most common temporomandibular disorders (TMD) condition. It causes clicking, pain, limited mandibular movements, and even masticatory difficulties in many people. The aim of this study is showcasing hotspots and frontiers in the field and providing a reference for the future research by a bibliometric analysis. Studies published from 1992 to 2022 were retrieved from Web of Science Core Collection on 23 April 2023. A total of 1882 studies (1739 articles and 143 reviews) were included in the bibliometric analysis. From 1992 to 2022, the annual number of publications and citations greatly increased. The United States of America (USA) contributed the most publications about TMJ disc displacement. Shanghai Jiao Tong University was the most productive institution; meanwhile, Yang, C. from this institution was the most prolific author. The University of Washington was the most influential institution, and Brooks, S. was the most influential author. Diagnostic criteria and management of TMJ disc displacement, as well as TMJ disc displacement-associated conditions, might be a hotspot for current global research. We provided an objective and valuable reference for future research on TMJ disc displacement.
COVID-19 Pandemic: Did Strict Mobility Restrictions Save Lives and Healthcare Costs in Maharashtra, India?
Authors: Ambade Preshit Nemdas , Thavorn Kednapa , Pakhale Smita
Published: July 2023

Introduction: Maharashtra, India, remained a hotspot during the COVID-19 pandemic. After the initial complete lockdown, the state slowly relaxed restrictions. We aim to estimate the lockdown’s impact on COVID-19 cases and associated healthcare costs. Methods: Using daily case data for 84 days (9 March–31 May 2020), we modeled the epidemic’s trajectory and predicted new cases for different phases of lockdown. We fitted log-linear models to estimate the growth rate, basic (R0), daily reproduction number (Re), and case doubling time. Based on pre-restriction and Phase 1 R0, we predicted new cases for the rest of the restriction phases, and we compared them with the actual number of cases during each phase. Furthermore, using the published and gray literature, we estimated the costs and savings of implementing these restrictions for the projected period, and we performed a sensitivity analysis. Results: The estimated median R0 during the different phases was 1.14 (95% CI: 0.85, 1.45) for pre-lockdown, 1.67 (95% CI: 1.50, 1.82) for phase 1 (strict mobility restrictions), 1.24 (95% CI: 1.12, 1.35) for phase 2 (extension of phase 1 with no restrictions on agricultural and essential services), 1.12 (95% CI: 1.01, 1.23) for phase 3 (extension of phase 2 with mobility relaxations in areas with few infections), and 1.05 (95% CI: 0.99, 1.123) for phase 4 (implementation of localized lockdowns in high-case-load areas with fewer restrictions on other areas), respectively. The corresponding doubling time rate for cases (in days) was 17.78 (95% CI: 5.61, −15.19), 3.87 (95% CI: 3.15, 5.00), 10.37 (95% CI: 7.10, 19.30), 20.31 (95% CI: 10.70, 212.50), and 45.56 (95% CI: 20.50, –204.52). For the projected period, the cases could have reached 631,819 without the lockdown, as the actual reported number of cases was 64,975. From a healthcare perspective, the estimated total value of averted cases was INR 194.73 billion (USD 2.60 billion), resulting in net cost savings of 84.05%. The Incremental Cost-Effectiveness Ratio (ICER) per Quality Adjusted Life Year (QALY) for implementing the lockdown, rather than observing the natural course of the pandemic, was INR 33,812.15 (USD 450.83). Conclusion: Maharashtra’s early public health response delayed the pandemic and averted new cases and deaths during the first wave of the pandemic. However, we recommend that such restrictions be carefully used while considering the local socio-economic realities in countries like India.
The Non-Invasive Characterization of Iron Age Glass Finds from the “Gaetano Chierici” Collection in Reggio Emilia (Italy)
Authors: Yatsuk Oleh , Fiocco Giacomo , Malagodi Marco , Re Alessandro , Lo Giudice Alessandro , Iaia Cristiano , Gulmini Monica
Published: July 2023

This work reports the results of the analyses performed on a set of glass finds from the “Gaetano Chierici” collection in the Civic Museums of Reggio Emilia. Forty-eight typologically heterogeneous glass finds were included in the list of the analyzed objects, dating from the fifth century BCE to the first century CE. The objects primarily consisted of glass beads; however, bangles, pinheads, and one vessel fragment were also included in the set. The items were analyzed using non-invasive spectroscopic methods that were implemented with portable equipment on the museum’s premises. Fiber optic reflectance spectroscopy was used to identify the coloring species in the glass matrix, while X-ray fluorescence spectrometry provided compositional information. Both techniques allowed for a discussion of the mechanisms of coloring and opacification, as well as the raw materials used for this purpose. The results provided a complex picture of the various colorants used to manipulate the appearance of the glass, which was a crucial aspect in the creation of the personal adornments represented by these glass items. The data revealed evidence of different sources of raw glass and colorants. Most of the samples were colored with cobalt, but iron and copper also influenced the color of many of them. Both white and yellow were utilized for the glass decorations, and these colors were achieved with the addition of either antimony-containing crystals or tin-containing ones. This finding suggests that the transition from antimonate to stannate started as early as the second century BCE. The “Gaetano Chierici” collection contains representative objects distributed throughout the investigated period. The results obtained here are a starting point for future studies of glass technology and provenance in the area.
Genome-Wide Identification, Phylogenetic and Expression Analysis of the B-Box Gene Family in the Woodland Strawberry (Fragaria vesca)
Authors: Xu Dong , Wang Hongkun , Feng Xiaotian , Ma Yuqing , Huang Yirui , Wang Yushan , Ding Jing , Chen Hong , Wu Han
Published: July 2023

The strawberry (Fragaria × ananassa Duch.) is an important horticultural crop that is widely grown all over the world. Its sweetness, aroma, nutritional value and bright color make it popular. The woodland strawberry (Fragaria vesca) is a model plant for studying non-climacteric fruits because its respiration rate does not change significantly during fruit ripening. The B-box (BBX) protein family is made up of zinc-finger transcription factors important in plant growth and development. In this study, we identified 22 FveBBX genes from the newly released woodland strawberry genome database by comprehensive bioinformatics analysis. Phylogenetic analysis divided these FveBBX genes into five subfamilies. A promoter cis-acting element analysis detected 29 elements related to plant development, light response, abiotic stress and hormone response in the promoter of FveBBX genes. According to transcriptome data, relatively few BBX genes had tissue-specific expression, with examples including FveBBX12, which was expressed only in pre-fertilization cortex and pitch, and FveBBX19, which was specifically expressed in mature anthers. During fruit ripening, the expressions of eight FveBBX genes decreased by more than two-fold, and three FveBBX gene expressions increased more than two-fold both in “Ruegen” and “Yellow Wonder”. After cold and heat stresses, around half of the FveBBX genes displayed altered expression, especially FveBBX16 which showed an 8.3-fold increase in expression after heat treatment, while FveBBX14 showed at least an 11-fold decrease in expression after cold treatment. According to the result of quantitative real-time PCR (qRT-PCR), FveBBX genes’ expression differed depending on the photoperiod. Notably, FveBBX7 gene expression was the opposite during the first 16 h of the long-day (LD) and short-day (SD) conditions. This study provides helpful information for further research on BBX gene activity of the woodland strawberry in plant growth and development and adaptation to temperature and photoperiod environmental conditions.
Board Compensation in Financial Sectors: A Systematic Review of Twenty-Four Years of Research
Authors: Khatib Saleh F. A. , Al Amosh Hamzeh , Ananzeh Husam
Published: July 2023

We aim to provide a comprehensive systematic analysis of scholarly publications in the field of board compensation in financial sectors extending through the years 1987 to 2021. Hence, the most notable themes, theories, and contributions to the literature are identified, and research developments over time are evaluated. With the identification of a final sample of 87 research papers indexed in Scopus, we identify research gaps to provide insight into future research following a systematic method. The results revealed that the United States of America received the broadest research interest, along with cross-country research. While the literature lacked to provide investigations for other countries of the world. Although the effect of compensation on organizational outcomes (performance and grow) is still unclear in the literature, several factors have been introduced as key drivers of the compensation, including the country’s level of development, the development of equity markets, the development of banking system, its dependence on foreign capital, collective rights empowering labor, the strength of a country’s welfare institutions, employment market forces, and social order and authority relations. On a theoretical level, agency theory has been most popular in the literature, along with providing multiple theoretical frameworks with agency theory as a slack resources theory, managerial talent theory, and managerial power theory. This is the first research to our knowledge that used a systematic review (SR) of literature to give a complete and comprehensive evaluation of the literature on board compensation in the financial sector. The current study documents the flow of literature on the board’s compensation in the financial sectors over 24 years and establishes future research opportunities.
The Impacts of Public Schools on Housing Prices of Residential Properties: A Case Study of Greater Sydney, Australia
Authors: Lu Yi , Shi Vivien , Pettit Christopher James
Published: July 2023

Residential property values are influenced by a combination of physical, socio-economic and neighbourhood factors. This study investigated the influence of public schools on residential property prices. Relatively few existing models have taken the spatial heterogeneity of different submarkets into account. To fill this gap, three types of valuation models were applied to sales data from both non-strata and strata properties, and how the proximity and quality of public schools have influenced the prices of different residential property types was examined. The findings demonstrate that an increase of one unit in the normalised NAPLAN score of primary and high schools will lead to a 3.9% and 1.4%, 2.7% and 2.8% rise in housing prices for non-strata and strata properties, respectively. It is also indicated that the application of geographically weighted regression (GWR) can better capture the varying effects of schools across space. Moreover, properties located in the catchment of high-scoring schools in northern Greater Sydney are consistently the most influenced by school quality, regardless of the property type. These findings contribute to a comprehensive understanding of the relationships between public schools and the various submarkets of Greater Sydney. This is valuable for the decision-making processes of home buyers, developers and policymakers.
The Use of Photodynamic Therapy for Head, Neck, and Brain Diseases
Authors: Domka Wojciech , Bartusik-Aebisher Dorota , Mytych Wiktoria , Dynarowicz Klaudia , Aebisher David
Published: July 2023

Head–neck cancers as a group have the 7th highest rate of incidence worldwide. The most often diagnosed disease of the head and neck is squamous cell carcinoma (90% of cases). Another specific group of tumors is brain tumors. These can be divided into primary tumors and secondary tumors associated with metastasis. Research shows that treating head and neck cancers continues to be problematic and challenging, and researchers are actively seeking new treatments that would improve survival rates and reduce side effects. Irradiation of tumor tissue with the optimal wavelength of light in photodynamic therapy (PDT) generates predominantly singlet oxygen in tissue-based photosensitizers (PSs) or reactive oxygen radicals in the case of vascular PSs leading to cellular apoptosis and necrosis. A very important feature of PDT is that cells cannot become immune to the effects of singlet oxygen or reactive oxygen radicals. However, photosensitizer (PS) transport is influenced by the specific structures of cancer tumors and the concentration of PS decreases in cells far from the vessel lumen. Therefore, PSs may not reach tumor interiors, which decreases therapy effectiveness. The use of drug carriers and 3rd generation PSs that contain biocompatible functional groups makes it possible to control transport. This review of the current literature on PDT was conducted through databases such as PubMed and Scopus. The types of publications considered included clinical studies and most of the articles included were published in English. Based on the publications collected, we conclude that researchers have demonstrated the potential of PDT as a therapeutic platform for head, neck, and brain diseases.
Effects of γ-Irradiation on Mating Behavior of Red Palm Weevil, Rhynchophorus ferrugineus (Olivier, 1790) (Coleoptera: Dryophthoridae)
Authors: Cristofaro Massimo , Fornari Chiara , Mariani Flaminia , Cemmi Alessia , Guedj Michèle , Ben Jamaa Mohamed Lahbib , Msaad Guerfali Meriem , Tabone Elisabeth , Castellana Robert , Sasso Raffaele , Musmeci Sergio
Published: July 2023

Red palm weevil (RPW) Rhynchophorus ferrugineus (Olivier 1790) is a highly invasive species originating from Southeast Asia and Melanesia. Over the past 30 years, this alien pest has spread extensively in the Middle East and the Mediterranean basin. Its endophagous larvae feed on various palm species, causing significant damage that leads to the death of palm trees. Controlling RPW infestations is challenging due to their gregarious nature and the lack of detectable early symptoms. Systemic insecticides are effective means of control, but their use in urban areas is prohibited and resistance can develop. Considering alternative options with minimal environmental impact, the Sterile Insect Technique (SIT) has been explored. Previous research has shown that male RPWs irradiated at 80 Gy or higher achieve full sterility. This study aimed to investigate in laboratory conditions whether RPW sterile males (irradiated at 60 and 80 Gy) could compete sexually with non-irradiate males. Laboratory bio-assays under both no-choice and choice conditions assessed sexual performance in terms of number of matings, mating duration and time elapsed until the first mating. The results confirmed that irradiation does not negatively affect the mating performance of sterile males, demonstrating their ability to compete successfully with non-irradiated males in both experimental setups.
Determination of a Discriminant Dose to Identify Resistance to Amitraz in Rhipicephalus sanguineus s.l. (Acari: Ixodidae) from Mexico
Authors: Martínez-Ibañez Francisco , Cruz-Vázquez Carlos , Osorio-Miranda Jorge , Vitela-Mendoza Irene , Medina-Esparza Leticia , Lagunes-Quintanilla Rodolfo , Chávez-Rodríguez Arturo
Published: July 2023

The brown dog tick, Rhipicephalus sanguineus s.l., is considered the most widely distributed three-host tick in the world and has medical and veterinary importance; the control of infestation is carried out with acaricides, towards which it can develop resistance. This study aimed to determine the discriminant dose (d.d) of amitraz to identify resistance in R. sanguineus s.l. larvae natives from Mexico and to evaluate its application in field-collected ticks. Engorged ticks were collected from naturally infested dogs residing in rural communities and were incubated for 25 days, and their progeny was used in a larval immersion test (LIT) to be exposed to the d.d. determined in Rhipicephalus microplus, and those that were susceptible were analyzed using the LIT in six concentrations. Mortality was analyzed through probit methodology to calculate the lethal concentration (LC) 50 and 99. The d.d. was determined as a consensus value by multiplying the LC99 × 2, and then, we proceeded to evaluate it in in-field samples by using the LIT technique. The d.d. calculated was 4 ppm. The in-field evaluation found 64% of the resistant samples to amitraz with mortality percentages between 98.3% and 0.35%. This dose can be used to rapidly and inexpensively identify resistant populations in samples collected in the field.
Unilateral Non-Hemorrhagic Adrenal Infarction in Pregnancy: Case Series and Literature Review
Authors: Tschuertz Nikolai , Kupczyk Patrick , Poetzsch Bernd , Gembruch Ulrich , Merz Waltraut M.
Published: July 2023

To summarize the evidence on non-hemorrhagic adrenal infarction (NHAI) and identify questions arising in diagnosis and management, cases in the PubMed database were merged with our case series. A total of 92 publications were retrieved, 15 of which reported on NHAI during pregnancy. Including the four in our case series, 24 cases have been described so far. Severe, unremitting pain requiring opioid analgesia was the leading symptom, often combined with nausea and vomiting. Laboratory results were non-contributory in most cases. Diagnosis was established via MRI in nine cases (37.5%) and via CT in six (25%); nine patients (37.5%) underwent both investigations. Location was predominantly on the right side (n = 16, 66.7%). In addition to analgesia, anticoagulation with heparin was commenced in 18 cases (75%). When thrombophilia screening was performed, major thrombogenic polymorphisms were detected in six cases (33.3%). One woman developed signs of adrenal insufficiency. The reported perinatal outcome was unremarkable. Unilateral NHAI has emerged as a rare but important cause of severe abdominal pain in pregnancy. The threshold to perform an MRI in pregnant women with characteristic clinical findings should be low. To prevent fetal radiation exposure, diagnostic imaging via CT should be avoided. In addition to symptomatic treatment with opioid analgesia, initiation of anticoagulant treatment should be strongly considered.
Reverse Triggered Breath during Pressure Support Ventilation and Neurally Adjusted Ventilatory Assist at Increasing Propofol Infusion
Authors: Longhini Federico , Simonte Rachele , Vaschetto Rosanna , Navalesi Paolo , Cammarota Gianmaria
Published: July 2023

Background: Reverse triggered breath (RTB) has been extensively described during assisted-controlled modes of ventilation. We aimed to assess whether RTB occurs during Pressure Support Ventilation (PSV) and Neurally Adjusted Ventilatory Assist (NAVA) at varying depths of propofol sedation. Methods: This is a retrospective analysis of a prospective crossover randomized controlled trial conducted in an Intensive Care Unit (ICU) of a university hospital. Fourteen intubated patients for acute respiratory failure received six trials of 25 minutes randomly applying PSV and NAVA at three different propofol infusions: awake, light, and deep sedation. We assessed the occurrence of RTBs at each protocol step. The incidence level of RTBs was determined through the RTB index, which was calculated by dividing RTBs by the total number of breaths triggered and not triggered. Results: RTBs occurred during both PSV and NAVA. The RTB index was greater during PSV than during NAVA at mild (1.5 [0.0; 5.3]% vs. 0.6 [0.0; 1.1]%) and deep (5.9 [0.7; 9.0]% vs. 1.7 [0.9; 3.5]%) sedation. Conclusions: RTB occurs in patients undergoing assisted mechanical ventilation. The level of propofol sedation and the mode of ventilation may influence the incidence of RTBs.
Robotic Total Mesorectal Excision for Low Rectal Cancer: A Narrative Review and Description of the Technique
Authors: Formisano Giampaolo , Ferraro Luca , Salaj Adelona , Giuratrabocchetta Simona , Piccolo Gaetano , Di Raimondo Giulia , Bianchi Paolo Pietro
Published: July 2023

Robotic surgery may offer significant advantages for treating extraperitoneal rectal cancer. Although laparoscopy has been shown to be safe and effective, laparoscopic total mesorectal excision (TME) remains technically challenging and is still performed in selected centers. Robotic anterior resection (RAR) may overcome the drawback of conventional laparoscopy, providing high-quality surgery with favorable oncological outcomes. Moreover, recent data show how RAR offers clinical and oncological benefits when affording difficult TMEs, such as low and advanced rectal tumors, in terms of complication rate, specimen quality, recurrence rate, and survival. This series aims to review the most recent and relevant literature, reporting mid- and long-term oncological outcomes and focusing on minimally invasive RAR for low rectal cancer.
The Outcome Relevance of Pre-ECMO Liver Impairment in Adults with Acute Respiratory Distress Syndrome
Authors: Sandrio Stany , Thiel Manfred , Krebs Joerg
Published: July 2023

We hypothesize that (1) a significant pre-ECMO liver impairment, which is evident in the presence of pre-ECMO acute liver injury and a higher pre-ECMO MELD (model for end-stage liver disease) score, is associated with increased mortality; and (2) the requirement of veno-veno-arterial (V-VA) ECMO support is linked to a higher prevalence of pre-ECMO acute liver injury, a higher pre-ECMO MELD score, and increased mortality. We analyze 187 ECMO runs (42 V-VA and 145 veno-venous (V-V) ECMO) between January 2017 and December 2020. The SAPS II score is calculated at ICU admission; hepatic function and MELD score are assessed at ECMO initiation (pre-ECMO) and during the first five days on ECMO. SOFA, PRESERVE and RESP scores are calculated at ECMO initiation. Pre-ECMO cardiac failure, acute liver injury, ECMO type, SAPS II and MELD, SOFA, PRESERVE, and RESP scores are associated with mortality. However, only the pre-ECMO MELD score independently predicts mortality (p = 0.04). In patients with a pre-ECMO MELD score > 16, V-VA ECMO is associated with a higher mortality risk (p = 0.0003). The requirement of V-VA ECMO is associated with the development of acute liver injury during ECMO support, a higher pre-ECMO MELD score, and increased mortality.
Differences in the Time Course of Recovery from Brain and Liver Dysfunction in Conventional Long-Term Treatment of Wilson Disease
Authors: Hefter Harald , Kruschel Theodor S. , Novak Max , Rosenthal Dietmar , Luedde Tom , Meuth Sven G. , Albrecht Philipp , Hartmann Christian J. , Samadzadeh Sara
Published: July 2023

Background: The aim of this study was to demonstrate that both neurological and hepatic symptoms respond to copper chelation therapy in Wilson disease (WD). However, the time course of their recovery is different. Methods: Eighteen patients with neurological WD from a single specialized center who had been listed for liver transplantation during the last ten years and two newly diagnosed homozygous twins were recruited for this retrospective study. The mean duration of conventional treatment was 7.3 years (range: 0.25 to 36.2 years). A custom Wilson disease score with seven motor items, three non-motor items, and 33 biochemical parameters of the blood and urine, as well as the MELD score, was determined at various checkup visits during treatment. These data were extracted from the charts of the patients. Results: Treatment was initiated with severity-dependent doses (≥900 mg) of D-penicillamine (DPA) or triethylene-tetramin-dihydrochloride (TRIEN). The motor score improved in 10 and remained constant in 8 patients. Worsening of neurological symptoms was observed only in two patients who developed comorbidities (myasthenia gravis or hemispheric stroke). The neurological symptoms continuously improved over the years until the majority of patients became only mildly affected. In contrast to this slow recovery of the neurological symptoms, the MELD score and liver enzymes had already started to improve after 1 month and rapidly improved over the next 6 months in 19 patients. The cholinesterase levels continued to increase significantly (p < 0.0074) even further. One patient whose MELD score indicated further progression of liver disease received an orthotopic liver transplantation 3 months after the diagnosis of WD and the onset of DPA treatment. Conclusions: Neurological and hepatic symptoms both respond to copper chelation therapy. For patients with acute liver failure, the first 4 months are critical. This is the time span in which patients have to wait either for a donor organ or until significant improvement has occurred under conventional therapy. For patients with severe neurological symptoms, it is important that they are treated with fairly high doses over several years.
Relationship between Q-Tip Test and Urethral Hypermobility on Perineal Ultrasound
Authors: Long Cheng-Yu , Loo Zi-Xi , Wu Ching-Hu , Lin Kun-Ling , Yeh Chang-Lin , Feng Chien-Wei , Wu Pei-Chi
Published: July 2023

Background: The aim of this study was to assess the correlation between the overall rest–stress distance measured by transperineal ultrasound (TPUS) and Q-tip test angle in women with urodynamic stress incontinence (USI), and determine a cut-off value of rest–stress distance for predicting urethral hypermobility (UH). Methods: Women with USI scheduled for mid-urethral sling surgery were retrospectively recruited. UH was defined as a Q-tip angle more than or equal to 30 degrees. Ultrasonic measurement of the overall rest–stress distance was defined as the linear distance of bladder-neck position change from resting status to maximal strain. Results: Among the 132 enrolled women, the Pearson correlation coefficient between the overall rest–stress distance in TPUS and Q-tip test angle was 0.9104 (95% CI, 0.8758–0.9357, p < 0.001). In receiver-operating-characteristic-curve analysis, a rest–stress distance of more than 13.3 mm was an optimal cut-off value to predict UH (sensitivity = 76.47%, specificity = 93.3%; area = 0.937, 95% confidence interval: 0.881–0.972). Conclusions: The overall rest–stress distance in TPUS correlated well with the Q-tip test angle, indicating that it can be an alternative method for the assessment of USI. A rest–stress distance of more than 13.3 mm was an optimal cut-off value to predict UH in women with USI.
Coronary Vascular (DYS) Function and Invasive Physiology Assessment: Insights into Bolus and Continuous Thermodilution Methods
Authors: Maurina Matteo , Benedetti Alice , Stefanini Giulio , Condorelli Gianluigi , Collet Carlos , Zivelonghi Carlo , Smits Pieter C. , Paradies Valeria
Published: July 2023

A considerable number of patients with angina or myocardial ischemia have no significant coronary artery disease on invasive angiography. In recent years, several steps towards a better comprehension of the pathophysiology of these conditions, angina or ischemia with non-obstructive coronary arteries (ANOCA/INOCA), have been made. Nevertheless, several gaps in knowledge still remain. This review is intended to provide a comprehensive overview of ANOCA and INOCA, with a particular focus on pathophysiology, recent diagnostic innovations, gaps in knowledge and treatment modalities.
Postoperative Rehabilitation after Anterior Cruciate Ligament Reconstruction through Telerehabilitation with Artificial Intelligence Brace during COVID-19 Pandemic
Authors: Liao Wei-Jen , Lee Kun-Tsan , Chiang Liang-Yu , Liang Che-Han , Chen Chao-Ping
Published: July 2023

Background: Due to the rapid spread of the coronavirus disease-19 (COVID-19), most of the patients expressed a reluctance to undergo postoperative rehabilitation at a rehabilitation clinic. Therefore, in this scenario it was necessary to reshape the crucial role of postoperative rehabilitation of these patients. We conducted a telerehabilitation program based on an artificial intelligence brace (AI brace) which can monitor the progress of rehabilitation through an app and an internet server. Our hypothesis was that home-based telerehabilitation might provide clinical outcomes comparable to face-to-face, hospital-based rehabilitation programs in terms of effectiveness. Methods: A retrospective cohort study enrolled patients who received anterior cruciate ligament reconstruction (ACLR) between January and September 2020. Patients were divided into two groups: the tele-AI group received telerehabilitation with an AI brace while the FTF group had face-to-face, hospital-based rehabilitation. Clinical knee functional scores and Tegner Activity Scale (TAS) were assessed and analyzed until 12 months after the operation. Results: The tele-AI group had higher IKDC scores at 3 months (p = 0.0443) and 6 months (p = 0.0052) after surgery and higher KOOS scores at 1 month (p = 0.0365) and 6 months (p = 0.0375) after surgery. However, no significant difference between the two groups was detected at the end of the follow-up. The tele-AI group had higher TAS than FTF group after 1 year. Conclusions: Telerehabilitation after ACLR seems to provide a superior short-term outcome compared to hospital-based rehabilitation during the COVID-19 pandemic.
Three-Year Real-World Outcomes of Interwoven Nitinol Supera Stent Implantation in Long and Complex Femoropopliteal Lesions
Authors: Salamaga Szymon , Stępak Hubert , Żołyński Mikołaj , Kaczmarek Jagoda , Błaszyk Maciej , Stanišić Michał-Goran , Krasiński Zbigniew
Published: July 2023

Background: Peripheral artery disease (PAD) remains a major issue in modern societies and affects more than 200 million people around the world. Endovascular methods have been evaluated to be safe and effective in limb salvage. The Supera is able to withstand increased compression, biomechanical stress and to have higher radial force. The objective of this study is to evaluate performance, durability and 3-year patency of Supera stent implantation in severe femoropopliteal disease. Methods: A retrospective real-world analysis was performed with consideration of 77 patients that had a Supera stent implanted with femoropopliteal atherosclerotic disease at a single center. Among the 77 individuals, 92 Supera stents were implanted. Analysis of patients’ demographics, lesions characteristics, reintervention rates and patency rates was performed. Results: The median follow-up was 33 months and ranged from 0 to 84 months. Chronic limb-threatening ischemia was observed among 43 patients. Mean lesion length was 152.8 ± 94.6 mm. Chronic total occlusions were observed in a majority of lesions. Overall, primary patency rates at 6, 12, 24 and 36 months were 85.0%, 73.6%, 59.2% and 53.2%, respectively. Conclusions: The Supera stent is effective in the management of long and complex lesions. The results of patency rates were evaluated to be worse among lesions extending to the popliteal artery.
Gliflozins, Erythropoietin, and Erythrocytosis: Is It Renal Normoxia- or Hypoxia-Driven?
Authors: Heyman Samuel N. , Abassi Zaid
Published: July 2023

The introduction of gliflozins in the management of type 2 diabetes mellitus leads to a better control of hyperglycemia, obesity, hypertension, dyslipidemia, and fluid retention. Most importantly, it also improves renal survival and reduces major cardiovascular events and mortality. Gliflozins were also found to induce erythropoietin (EPO) synthesis, leading to reticulocytosis and erythropoiesis. The mechanism(s) by which gliflozins induce erythropoiesis is a matter of debate. Although the canonical pathway of triggering EPO synthesis is through renal tissue hypoxia, it has been suggested that improved renal oxygenation may facilitate EPO synthesis via non-canonical routes. The latter proposes that the recovery of peritubular interstitial fibroblasts producing erythropoietin (EPO) is responsible for enhanced erythropoiesis. According to this hypothesis, enhanced glucose/sodium re-uptake by proximal tubules in uncontrolled diabetes generates cortical hypoxia, with injury to these cells. Once transport workload declines with the use of SGLT2i, they recover and regain their capacity to produce EPO. In this short communication, we argue that this hypothesis may be wrong and propose that gliflozins likely induce EPO through the documented intensification of renal hypoxia at the corticomedullary junction, related to the translocation of tubular transport from cortical segments to medullary thick ascending limbs. We propose that gliflozins, through intensified hypoxia in this region, trigger local EPO synthesis in peritubular interstitial cells via the canonical pathway of blocking HIF-prolyl hydroxylases (that initiate HIF alpha degradation), with the consequent stabilization of HIF-2 signal and an apocrinic induction of EPO in these same cells.
Analysis of Why Alzheimer’s Dementia Never Spontaneously Reverses, Suggests the Basis for Curative Treatment
Authors: Fessel Jeffrey
Published: July 2023

A paradox regarding Alzheimer’s dementia (AD) and mild cognitive impairment (MCI) is thats spontaneous cure of AD has never been reported, whereas spontaneous cure for MCI occurs fequently. This article analyzes what accounts for this difference. It holds that it is not merely because, for any condition, a stage is reached beyond which it cannot be reversed, since even widely metastatic cancer would be curable were there effective chemotherapy and rheumatoid arthritis became controllable when immune-suppressant treatment was introduced; thus, so could AD be reversible via effective therapy. The analysis presented leads to an explanation of the paradox that is in four categories: (1) levels of transforming growth factor-β are significantly reduced after the transition from MCI to AD; (2) levels of Wnt/β-catenin are significantly reduced after the transition; (3) there is altered epidermal-mesenchymal transition (EMT) in neurons after the transition; (4) there may be risk factors that are either newly operative or pre-existing but worsened at the time of transition, that are particular to individual patients. It is suggested that addressing and ameliorating all of those four categories might cure AD. Medications to address and ameliorate each of the four categories are described.
The Risk of Retinal Vein Occlusion in Young Patients with Mental Disorders: A Nationwide Cohort Study
Authors: Lee Ji-young , Wang Sheng-min , Jeon Seung-hee , Kim Min-hee , Han Kyung-do , Roh Young-jung
Published: July 2023

We investigated the association between mental disorders and the incidence rate of retinal vein occlusion (RVO) in young Korean adults. This nationwide cohort study included subjects aged 20–40 years who underwent the Korean National Health Examination between 2009 and 2012. The diagnoses of RVO and mental disorders were based on the International Classification of Diseases Tenth Revision codes. Multivariate Cox proportional hazard regression models were used to evaluate the objective. In total, 6,891,399 subjects were included at baseline and 6,597,803 subjects (mean age, 30.86 ± 4.99) were finally analyzed for a mean follow-up duration of 7.36 ± 1.13 years, with the mental disorders group followed for 7.27 ± 1.15 years and the non-diagnosed group for 7.37 ± 1.12 years. Among a total of 10,145 subjects diagnosed with RVO, 1304 had been diagnosed with mental disorders, while 8841 had not. Cumulative incidence of RVO demonstrated a substantially higher incidence probability in subjects with mental disorders (log-rank p < 0.0001). Mental disorders were associated with an increased incidence rate of RVO (hazard ratio [HR]: 1.268; 95% confidence interval; [CI]: 1.196–1.344). In the subgroup analysis, subjects with depression, sleep disorder, and anxiety disorder exhibited an increased risk of incidence of RVO in all regression models (all p < 0.001). In conclusion, mental disorders and the incidence rate of RVO were significantly positively correlated in a Korean nationwide population-based cohort study. These findings suggest that mental disorders may also be associated with the pathophysiology of RVO in young adults.
Relationship between Changes in Condylar Morphology and Masticatory Muscle Volume after Skeletal Class II Surgery
Authors: Lekroengsin Bunpout , Tachiki Chie , Takaki Takashi , Nishii Yasushi
Published: July 2023

The treatment of dentofacial deformities generally includes orthognathic surgery in which mandibular condyle changes following surgery are a common cause of relapse. This study investigated the changes in the mandibular condyle and related muscles to identify the factors that affected the changes in the mandibular condyle after orthognathic surgery in skeletal class II patients. This research studied 60 joints in 30 patients with skeletal class II dentofacial deformities who received surgical orthodontic treatment, including bilateral sagittal split ramus osteotomy, and underwent computed tomography before and after orthodontic treatment. The mandibular condyle, masseter, and medial pterygoid muscles were reconstructed and measured in 3D. Condylar positional and morphology changes, masseter and medial pterygoid muscle volume, temporomandibular joint (TMJ) pain, and distal segment movement were analyzed. The study observed that both the masseter and medial pterygoid muscle volumes decreased with statistical significance. The changes in the horizontal direction were positively correlated with the amount of movement. The findings indicated that mandibular condyle changes were significantly affected by the movement of the distal segment, the medial pterygoid muscle volume, and the direction of the distal segment, which influenced the treatment’s long-term stability after orthognathic surgery.
Prediction of New-Onset Diabetes Mellitus within 12 Months after Liver Transplantation—A Machine Learning Approach
Authors: Loosen Sven H. , Krieg Sarah , Chaudhari Saket , Upadhyaya Swati , Krieg Andreas , Luedde Tom , Kostev Karel , Roderburg Christoph
Published: July 2023

Background: Liver transplantation (LT) is a routine therapeutic approach for patients with acute liver failure, end-stage liver disease and/or early-stage liver cancer. While 5-year survival rates have increased to over 80%, long-term outcomes are critically influenced by extrahepatic sequelae of LT and immunosuppressive therapy, including diabetes mellitus (DM). In this study, we used machine learning (ML) to predict the probability of new-onset DM following LT. Methods: A cohort of 216 LT patients was identified from the Disease Analyzer (DA) database (IQVIA) between 2005 and 2020. Three ML models comprising random forest (RF), logistic regression (LR), and eXtreme Gradient Boosting (XGBoost) were tested as predictors of new-onset DM within 12 months after LT. Results: 18 out of 216 LT patients (8.3%) were diagnosed with DM within 12 months after the index date. The performance of the RF model in predicting the development of DM was the highest (accuracy = 79.5%, AUC 77.5%). It correctly identified 75.0% of the DM patients and 80.0% of the non-DM patients in the testing dataset. In terms of predictive variables, patients’ age, frequency and time of proton pump inhibitor prescription as well as prescriptions of analgesics, immunosuppressants, vitamin D, and two antibiotic drugs (broad spectrum penicillins, fluocinolone) were identified. Conclusions: Pending external validation, our data suggest that ML models can be used to predict the occurrence of new-onset DM following LT. Such tools could help to identify LT patients at risk of unfavorable outcomes and to implement respective clinical strategies of prevention.
Early Internal Fixation of Concomitant Clavicle Fractures in Severe Thoracic Trauma Prevents Posttraumatic Pneumonia
Authors: Rehme-Röhrl Julia , Sicklinger Korbinian , Brand Andreas , Fürmetz Julian , Neuerburg Carl , Stuby Fabian , von Rüden Christian
Published: July 2023

Background: Severe thoracic trauma can lead to pulmonary restriction, loss of lung volume, and difficulty with ventilation. In recent years, there has been increasing evidence of better clinical outcomes following surgical stabilization of clavicle fractures in the setting of this combination of injuries. The aim of this study was to evaluate surgical versus non-surgical treatment of clavicle fractures in severe thoracic trauma in terms of clinical and radiological outcomes in order to make a generalized treatment recommendation based on the results of a large patient cohort. Patients and Methods: This retrospective study included 181 patients (42 women, 139 men) from a European level I trauma centre with a median of 49.3 years in between 2005 and 2021. In 116 cases, the clavicle fracture was stabilized with locking plate or hook plate fixation (group 1), and in 65 cases, it was treated non-surgically (group 2). Long-term functional outcomes at least one year postoperatively using the disabilities of the arm, shoulder and hand (DASH) questionnaire and the Nottingham Clavicle Score (NCS) as well as radiological outcomes were collected in addition to parameters such as hospital days, intensive care days, and complication rates. Results: The Injury Severity Score (ISS) was 17.8 ± 9.8 in group 1 and 19.9 ± 14.4 in group 2 (mean ± SEM; p = 0.93), the time in hospital was 21.5 ± 27.2 days in group 1 versus 16 ± 29.3 days in group 2 (p = 0.04). Forty-seven patients in group 1 and eleven patients in the group 2 were treated in the ICU. Regarding the duration of ventilation (group 1: 9.1 ± 8.9 days, group 2: 8.1 ± 7.7 days; p = 0.64), the functional outcome (DASH group 1: 11 ± 18 points, group 2: 13.7 ± 18. 4 points, p = 0.51; NCS group 1: 17.9 ± 8.1 points, group 2: 19.4 ± 10.3 points, p = 0.79) and the radiological results, no significant differences were found between the treatment groups. With an overall similar complication rate, pneumonia was found in 2% of patients in group 1 and in 14% of patients in group 2 (p = 0.001). Discussion: This study could demonstrate that surgical locking plate fixation of clavicle fractures in combination with CWI significantly reducing the development of posttraumatic pneumonia in a large patient collection and, therefore, can be recommended as standard therapeutic approach for severe thoracic trauma.
ESEM-EDX Mineralization and Morphological Analysis of Human Retrieved Maxillary Sinus Bone Graft Biopsies before Loading
Authors: Imai Hideki , Prati Carlo , Zamparini Fausto , Iezzi Giovanna , Botticelli Daniele , Gandolfi Maria Giovanna , Baba Shunsuke
Published: July 2023

This study aimed to analyze the morphology of bone graft granules, the presence of granule demineralization, and bone morphology in retrieved human maxillary sinus bone graft biopsies. Healthy patients underwent sinus bone augmentation using lateral access. Two different dimensions of the antrostomy were performed, a 4 mm or 8 mm height. After 6 months, all sites received one implant using a flap technique, crestal positioning, and submerged healing. Implant biopsies were retrieved after 3 months and were histologically processed. The ESEM analysis was performed on the entire portion of the peri-implant bone (up to 750 µm from the implant thread). Three different regions of interest (ROIs) were selected: the coronal, middle, and apical portions of the implant. In these areas, EDX was performed, and calcium (Ca), phosphate (P), nitrogen (N), and their atomic ratios (Ca/P, Ca/N, and P/N) were calculated. Different bone tissue electron-dense areas were detected through grayscale intensity quantification of ESEM images with different organic (N) or inorganic (Ca,P) compositions. A total of 16 biopsies from 16 healthy patients were analyzed. Bone graft granules were mostly detected in the apical ROI. New bone tissue bridges were detected in the apical and middle ROI. These structures, with lower Ca/N and P/N ratios, were connected and enveloped the bone graft granules. Cortical ROI revealed the most mineralized bone tissue. Conclusions: After 9 months, bone graft resorption was only partially completed and new bone tissue appeared less mineralized in the middle and apical ROI than in the coronal ROI.