bluuebunny/crossref_metadata_2025 huggingface dataset:
Influence of Sex and Age on Irisin Levels in Pediatric Type 1 Diabetes: A Pilot Study
Authors: Averbuch Shay , Gaiduk Oxana , Yackobovitch-Gavan Michal , Laurian Irina , Dorfman Anna , Shefer Gabi , Brener Avivit , Lebenthal Yael
Published: January 2025

Background: Irisin is a myokine involved in the browning of adipocytes, the regulation of body composition and the enhancement of glycemic control. Additionally, irisin has been suggested to play a role in signaling mechanisms associated with the onset of puberty. In this study, we aimed to explore the interaction between muscle and adipose indices, urine irisin levels and glycemic control. Methods: This cross-sectional pilot study enrolled 76 consecutive pediatric patients (mean age 11.7 ± 3.8 years) diagnosed with type 1 diabetes (mean disease duration 2.1 ± 1.6 years). Body composition was assessed by bioelectrical impedance analysis (MFR z-score and skeletal muscle mass index). Urine irisin levels and glycemic control parameters (HbA1c, insulin dose-adjusted A1c [IDAA1c]) were evaluated. One linear regression model, stratified by sex, analyzed the sex-specific impact of puberty and age on irisin levels. A second linear regression model explored the associations of selected variables with irisin levels. Results: The first linear regression model revealed that irisin levels rise with age in prepubertal boys and decline with increased age among pubertal boys. The second linear regression analysis revealed no significant associations between irisin levels and metabolic parameters after adjusting for covariates. In contrast to boys, there were no significant interactions found in girls. Conclusions: Our novel findings revealed sex and age differences in the irisin levels of children and adolescents with type 1 diabetes. The dynamics underlying the role of irisin during pubertal development in the pediatric population with diabetes warrant further exploration.
Uterine Penetrating Wounds in Pregnant Women—Review and Case Study
Authors: Dolińska-Kaczmarek Klaudia , Burchardt Bartosz , Aurast Zuzanna , Ambrosius Franciszek , Szubert Sebastian , Rzepczyk Szymon , Świderski Paweł , Żaba Czesław
Published: January 2025

Introduction: Uterine penetrating wounds in pregnant women are rare. Usually, they are caused by traffic accidents, but sometimes they are an effect of violence, accidental injuries, or deliberate self-harm. Case Report: We present a case of a stab wound to the uterus in a 25-year-old woman in the 37th week of pregnancy, which was the result of a knife attack. Emergency splenectomy and cesarean section were performed less than an hour after the attack. The child required resuscitation and long-term intensive therapy. Both the woman and the newborn survived; however, the newborn’s condition remained poor. The child died a few months later, according to community-acquired pneumonia. Discussion: Cases of wounds penetrating the uterus have been described for many years around the world. They are often the result of violence, most often from the partner. Statistically, pregnant women are more likely to be victims of violence. Sometimes, the wounds penetrating the uterus are accidental and arise, for example, as a result of a fall. A rare but not isolated case is self-mutilation to terminate a pregnancy. Women often inflict such injuries on themselves using sharp tools, sometimes firearms. There are also cases of another person helping to terminate a pregnancy in this way. Conclusions: Violence against women, including pregnant women, remains a significant social problem in all regions of the world and poses a challenge to uniformed services, medical professions, and social services. Regardless of the mechanism of injury, in the event of an imminent threat to the life of the mother and fetus, it is crucial to make quick decisions aimed at saving lives.
Serum Galectin-3 and IL-6 as Inflammatory Markers in Bipolar Disorder: Insights from Manic and Euthymic Episodes
Authors: Ozkaya Alev Lazoglu , Gürbüzer Nilifer , Tozoğlu Elif Özcan , Akyildirim Sumeyya , Mercantepe Filiz
Published: January 2025

Objectives: This study aimed to assess serum Galectin-3 (Gal-3) and IL-6 levels, along with other inflammatory markers, in type-1 bipolar disorder (BD) patients and explore their relationship with clinical features, metabolic parameters, and symptom severity. Background: The study included 38 manic, 35 euthymic BD patients, and 40 healthy controls. Sociodemographic data, such as age, gender, alcohol and smoking habits, and body mass index (BMI), were recorded. Methods: The Young Mania Rating Scale (YMRS) and Hamilton Depression Rating Scale (HAM-D) were administered to patients. Biochemical measurements included Gal-3, IL-6, CRP, neutrophil, lymphocyte, platelet counts, and inflammatory indices like NLR, PLR, SII, and SIRI. Results: Gal-3 levels significantly differed among the groups (F = 52.251, p < 0.001), with the highest levels in euthymic patients. IL-6 levels were elevated in both manic and euthymic patients compared to controls (F = 7.379, p = 0.001). Manic patients had significantly higher levels of neutrophils, monocytes, CRP, NLR, PLR, SII, and SIRI. A positive correlation was found between Gal-3 levels, the total number of episodes, and YMRS scores in manic patients. In euthymic patients, Gal-3 levels correlated positively with disease duration and episode count. Conclusions: Elevated Gal-3 levels, particularly in the euthymic phase, may serve as a biomarker for BD and indicate ongoing inflammation. These findings suggest Gal-3 could help identify BD and differentiate the euthymic phase.
Return to Work After Subcutaneous Transposition of the Extensor Indicis Proprius to Repair Inveterate Ruptures of Extensor Pollicis Longus
Authors: Tamburrino Gabriele , Rovere Giuseppe , Marcovici Lucian Lior , Migliorini Filippo , Fulchignoni Camillo , Fidanza Andrea
Published: January 2025

Background/Objectives: An Extensor Pollicis Longus (EPL) subcutaneous rupture is a substantial complication in post-traumatic or degenerative wrist and tendinous lesions. The diagnosis is essentially dictated by a clinical evaluation; in fact, it is characterized by the inability to extend the thumb interphalangeal joint and to retropose the thumb while the hand is resting on a surface. The tendinous transposition using the Extensor Indicis Proprius (EIP) as a donor tendon is a well-known surgical technique performed to restore functional activity to the thumb, and it is preferred for the closer cerebellar network with the thumb itself. However, there is a dearth of clinical results and scientific evidence in the literature. The aim of this study is to evaluate the return-to-work eligibility after an inveterate EPL subcutaneous rupture repaired with a transposition of the EIP. Methods: Patients who reported a subcutaneous rupture of the EPL due to rheumatic diseases or who had undergone previous hand or wrist surgery were excluded; however, all patients tested positive for traumatic wrist hypertension. The surgical technique involves three small incisions to achieve tenorrhaphy of the EIP at the distal head of the EPL. Dynamic tests are carried out intraoperatively to verify the tightness and sufficient rigidity of the suture. The objective evaluation involves the range of motion, pinch strength, and power extension of the thumb and the index finger. Patient-reported outcome measures for pain and patient satisfaction include the Numeric Pain Rating Scale and the Disabilities of the Arm, Shoulder, and Hand questionnaire. Results: A total of 12 patients were eligible (7 W, 5 M, mean age 56.3 years) and were followed for at least one year. There were no surgery-related complications. After the cast was removed 3 weeks after surgery, patients could extend their thumbs, put them back, and use their index fingers. An immediate improvement in objective and subjective assessments was reported. At 10 weeks, nine patients (75%) returned to full work with no pain and without the aid of rehabilitation; two patients (17%) returned to full work with no symptoms 2 weeks later; and only one patient (8%) with a neurological disease required physical therapy, achieving pain control and restoration of full mobility approximately six months after surgery. Conclusions: This surgical technique seems to address satisfactory results in terms of skill recovery and rapid return to work. A tailored rehabilitation program should be implemented for selected patients with neurological conditions that may prolong the adaptation process of the transposed tendon, the coordination, and the independent function of the thumb and index finger.
Visual Performance and Satisfaction of Extended Depth of Focus Contact Lenses in Presbyopic Subjects
Authors: Kamiya Kazutaka , Tokuda Shota , Kaida Tomoko , Higashi Shizuka , Hashiguchi Midori , Kanaya Eriko , Miyata Kazunori
Published: January 2025

Background/Objectives: The objective was to assess visual performance and the overall satisfaction of extended-depth-of-focus (EDOF) contact lenses (CLs) in a presbyopic population. Methods: We prospectively investigated visual acuity at all distances (0.3, 0.4, 0.5, 0.7, 1, and 5 m), higher-order aberrations (HOAs), contrast sensitivity function, and overall satisfaction score, before and during EDOF CL wear in 42 eyes of 21 presbyopic subjects (1 man and 20 women). Results: Binocular visual acuity at 0.3, 0.5, 0.7, 1, 2, 3, and 5 m when wearing EDOF CLs was 0.01 ± 0.14, −0.08 ± 0.02, −0.08 ± 0.02, −0.08 ± 0.00, −0.08 ± 0.00, −0.08 ± 0.02, and −0.07 ± 0.02, respectively. We found a significant improvement at near to intermediate distances (0.3, and 0.5 m), but no significant change at intermediate to far distances (0.7, 1, 2, 3, and 5 m) between before and during CL wear. The area under the log contrast sensitivity function was not significantly changed under photopic nor mesopic conditions (p = 0.099, and p = 0.689). Ocular third-order aberrations, fourth-order aberrations, or total HOAs for a 4 mm pupil significantly increased. The overall satisfaction score significantly improved by wearing EDOF CLs. Conclusions: EDOF CLs significantly improved visual acuity at near to intermediate distances, while maintaining far vision, and the effect of contrast sensitivity was minimal, suggesting the viability of presbyopic correction in such candidates.
Reply to Riva et al. Comment on “Gaspari et al. Blood Purification in Hepatic Dysfunction after Liver Transplant or Extensive Hepatectomy: Far from the Best-Case Scenarios. J. Clin. Med. 2024, 13, 2853”
Authors: Gaspari Rita , Aceto Paola , Spinazzola Giorgia , Piervincenzi Edoardo , Chioffi Maurizio , Giuliante Felice , Antonelli Massimo , Avolio Alfonso Wolfango
Published: January 2025

We sincerely appreciate the authors’ comments [...]
Eyelid Contact Dermatitis: 25-Year Single-Center Retrospective Study
Authors: Rubegni Giovanni , Padula Tommaso , Calabrese Laura , D’Onghia Martina , Tognetti Linda , Cinotti Elisa , Lazzeri Laura , Ermini Gabriele , Cartocci Alessandra , Tosi Gian Marco
Published: January 2025

Background/Objectives: Eyelid dermatitis is an inflammatory disease affecting the palpebral skin characterized by itching, edema, and scaling of the periorbital area. This entity can be a manifestation of various underlying dermatological diseases, but allergic contact dermatitis (ACD) is the predominant etiology of eyelid dermatitis among patients, being diagnosed in 43.4% of cases. The thin and highly permeable nature of eyelid skin increases its susceptibility to allergens, making it a distinct clinical entity. This study aimed to identify the primary haptens associated with eyelid ACD and compare these findings with the allergens implicated in non-eyelid ACD over a 25-year period in a large cohort of patients. Methods: We conducted a monocentric, retrospective study on a dataset of 7955 patients patch-tested for ACD at the Outpatient Allergy Dermatology Clinic of the Azienda Ospedaliera Universitaria Senese (AOUS) from 1997 to 2021. Eyelid ACD cases were identified based on clinical features and positive patch test results. Data on demographics, occupation, and personal history of atopy were collected. The statistical analyses assessed the associations between allergens and eyelid ACD. The trends in the sensitization rates for the most prevalent allergens were also evaluated. Results: Eyelid ACD was identified in 4.6% of the study population, predominantly affecting women (88.6%). Patients with eyelid ACD were more likely to exhibit single-hapten positivity (54.6%) and an atopic phenotype (52.3%) compared to non-eyelid ACD cases. Nickel sulfate (54%), cobalt chloride (13.4%), and thimerosal (12.6%) were the most common allergens associated with eyelid ACD. While thimerosal sensitization decreased significantly following its removal from topical products, nickel sensitization increased, likely due to exposure from electronic devices and hand–eye contact. Conclusions: The haptens identified in eyelid ACD largely overlap with those found in other body regions, including metals, fragrances, and preservatives. However, the unique characteristics of eyelid skin and hand–eye contact patterns play a significant role in sensitization. This study highlights the need for further investigation into the pathophysiology of eyelid allergic contact dermatitis, with particular emphasis on elucidating the mechanisms of hapten sensitization. Such insights could contribute to the development of effective strategies aimed at reducing allergen exposure.
Use of Anthropometric Data for the Prediction of Four-Strand Hamstring Graft Size in White Caucasian Population
Authors: Bouras Theodoros , Lianou Ioanna , Filippopoulos Andreas , Lakoumentas John , Ntourantonis Dimitrios
Published: January 2025

Background/Objectives: The purpose of this study was to preoperatively estimate the four-strand hamstring graft size in a White Caucasian population, using anthropometric data. Methods: This was a prospective study of a consecutive series of fifty patients with anterior cruciate ligament (ACL) rupture, who were scheduled for reconstruction using hamstring autografts; however, one of them was ultimately not enrolled according to the exclusion criteria (49 patients in total). Preoperatively, age, sex, weight, body mass index (BMI), length, and diameter of the contralateral thigh, length of the harvested gracilis/semitendinosus tendons, and length and thickness of the four-stranded graft were recorded. Graft diameter and length were dependent variables, measured via a graft sizer and a ruler, respectively. Quantitative variables were described with mean ± SD (correlated in a pairwise manner with Pearson’s r correlation). Qualitative variables were described with an absolute count (relative % percent) per categorical level, and their dependency on any quantitative (dependent) variable was assessed via Student’s t-test. Results: The mean lengths of the gracilis and semitendinosus were 25.6 ± 3.2 cm and 28.4 ± 3.3 cm, respectively, and they were positively correlated with the length of the four-strand hamstring graft along with the patients’ height and thigh length. Conclusions: The use of anthropometric data can assist in the prediction of the hamstring autograft size, aiding the selection of an appropriate graft type. The four-strand hamstring graft length was related to the gracilis, semitendinosus, and thigh length. The patients’ height was related to the graft length and diameter.
Safety and Effectiveness of Colonic Stenting for Ileocecal Valve Obstruction and Usefulness of Two-Step Strategy: Single-Center Retrospective Study
Authors: Fujisawa Gota , Ishibashi Rei , Yoshida Shuntaro , Kondo Ryo , Hata Masahiro , Oya Yukiko , Odawara Nariaki , Nakada Ayako , Komine Yumiko , Hakuta Ryunosuke , Takahara Naminatsu , Suzuki Nobumi , Nakai Yousuke , Isayama Hiroyuki , Fujishiro Mitsuhiro
Published: January 2025

Background: Endoscopic self-expandable metallic stent (SEMS) placement is a widely accepted treatment for malignant left-sided colorectal obstruction (LSO) because of its lower invasiveness and quicker symptomatic relief compared to surgery. However, SEMS placement for ileocecal valve obstruction (ICVO) has not been established due to its technical difficulties. Methods: This single-center retrospective study compared the clinical outcomes of patients who underwent SEMS placement for ICVO (ICVO group, n = 13) and LSO (LSO group, n = 146). Particularly in cases with severe small-intestine dilation, we applied a “Two-Step Strategy”, which involved long intestinal tube insertion followed by SEMS placement to ensure safety and overcome technical challenges. Results: Patients in the ICVO group were significantly more likely to undergo SEMS placement with the Two-Step Strategy compared to those in the LSO group (76.9% vs. 6.9%, p < 0.001). Both groups achieved similarly high technical and clinical success rates (100% vs. 98.6%, p = 1.000; 92.3% vs. 88.4%, p = 1.000), and the incidence of adverse events also showed no significant difference between the groups (7.7% vs. 13.0%; p = 1.000). Furthermore, the median time to recurrent colorectal obstruction and survival time after SEMS placement did not differ between patients with palliative stenting for ICVO and LSO (not reached vs. 430 days, p = 0.586; 119 days vs. 200 days, p = 0.303). Conclusions: SEMS placement for malignant ICVO is as safe and effective as it is for malignant LSO, and the Two-Step Strategy might be useful in ICVO cases.
The Correlation Between Meibomian Gland Dysfunction and Aniridia-Associated Keratopathy: A Prospective Analysis
Authors: Wowra Bogumił , Łach-Wojnarowicz Olga , Wysocka-Kosmulska Marzena , Dobrowolski Dariusz , Wylęgała Edward
Published: January 2025

Background/Objectives: Aniridia is a rare congenital disorder characterized by structural and functional abnormalities in ocular development due to PAX6 haploinsufficiency, leading to complications such as aniridia-associated keratopathy (AAK). Meibomian gland dysfunction (MGD), a prevalent yet underexplored condition in aniridia, exacerbates tear film instability and chronic ocular surface inflammation, contributing to AAK progression. This study investigates the relationship between MGD severity and AAK in individuals with aniridia. Methods: This prospective randomized study included 113 participants (53 with aniridia and 60 controls). Comprehensive ophthalmic evaluations, including noninvasive meibography, were performed. The MGD severity was assessed using a standardized meiboscore scale, while the AAK severity was classified according to established clinical grading criteria. Statistical analyses, including Spearman’s correlation and chi-squared tests, were used to evaluate the relationships among MGD, AAK, and visual acuity. Results: MGD was significantly more prevalent and severe in the aniridia group compared to controls (p < 0.00001). A strong positive correlation was observed between MGD severity and AAK grade (r = 0.72, p < 0.00001), with both conditions associated with reduced best-corrected visual acuity (BCVA; r = −0.80 and −0.86, respectively, p < 0.0001). Age was positively correlated with MGD (r = 0.47, p = 0.0004) and AAK (r = 0.34, p = 0.0123), with gender-specific trends observed in females. Conclusions: MGD significantly contributes to AAK progression and visual impairment in aniridia. Meibography offers valuable insights into MGD severity, supporting early diagnosis and targeted interventions. Addressing MGD through tailored therapies could mitigate AAK progression and improve visual outcomes in this challenging condition.
Evolution of Coagulation and Platelet Activation Markers After Transcatheter Edge-to-Edge Mitral Valve Repair
Authors: Hadjadj Sandra , Beaudoin Jonathan , Beaupré Frédéric , Gravel Caroline , Marsit Ons , Pouliot Sylvain , Arsenault Benoit J. , Pibarot Philippe , Farjat-Pasos Julio , Nuche-Berenguer Jorge , M-Labbé Benoît , O’Connor Kim , Bernier Mathieu , Salaun Erwan , Rodés-Cabau Josep , Paradis Jean-Michel
Published: January 2025

Background/Objectives: The recommendations for antithrombotic therapy after transcatheter edge-to-edge mitral valve repair (TEER) are empirical, and the benefit of antiplatelet (APT) or anticoagulation therapy (ACT) remains undetermined. The study sought to investigate the degree and the timing of coagulation and platelet marker activation after TEER. Methods: This was a prospective study including 46 patients undergoing TEER. The markers of coagulation activation, namely prothrombin fragment 1 + 2 (F1 + 2) and thrombin-antithrombin III (TAT), and the markers of platelet activation, namely soluble P-Selectin and soluble CD-40 ligand (sCD40L), were measured at baseline, 24 h, 1 month, and 1 year after TEER. Results: At discharge, 20 (43%) patients received APT (single: 16, dual: 4), 24 (52%) received ACT, and 2 (4%) had both single APT and ACT. Levels of F1 + 2 and TAT significantly increased at 24 h post TEER (both p < 0.001), rapidly returning to baseline levels at 1 month. However, levels of F1 + 2 and TAT remained higher at 1 month in patients without ACT compared to patients with ACT (respectively, 303.1 vs. 148.1 pmol/L; p < 0.001 and 4.6 vs. 3.0 µg/L; p = 0.020), with a similar trend at 1 year. Levels of soluble P-selectin and sCD40L remained stable at all times after TEER (respectively, p = 0.071 and p = 0.056), regardless of the APT. Conclusions: TEER is associated with an acute activation of the coagulation system, with no increase in platelet activation markers. Hence, the use of dual APT is questionable in this population. Our results raise the hypothesis that the optimal antithrombotic therapy after TEER could be short-term ACT over APT. Further larger studies are warranted.
Antiplatelet Therapy in Low-Platelet-Count Patients After Percutaneous Coronary Intervention for Acute Coronary Syndromes
Authors: Paciullo Francesco , Gresele Paolo
Published: January 2025

The risk of cardiovascular events increases considerably after an acute coronary syndrome (ACS), particularly in the first few months. Dual antiplatelet therapy represents the mainstay of secondary prevention during this period, but is associated with a not-negligible risk of bleeding which, among other factors, is influenced by the platelet count. Thrombocytopenic patients may experience an ACS, and several patients with ACSs develop thrombocytopenia during hospitalization: the management of antithrombotic therapy in this setting represents a challenge. Here, we review the available evidence on the use of antithrombotic therapy in patients with low platelet counts after an ACS.
Impact of Right Heart Failure on Outcomes of Transcatheter Aortic Valve Implantation: Insights from the National Inpatient Sample
Authors: Kansakar Sajog , Qureshi Waqas T. , Sharma Nava Raj , Shrestha Dhan Bahadur , Shtembari Jurgen , Shetty Vijay , Moskovits Norbert , Dahal Khagendra , Mattumpuram Jishanth , Katz Daniel H.
Published: January 2025

Background: There are limited data on the impact of right heart failure (RHF) on patients undergoing transcatheter aortic valve implantation (TAVI). We investigated the mortality, in-hospital complications, length of stay, and total hospitalization charges for TAVI admissions, with and without RHF. Methods: We analyzed the National Inpatient Sample data from 2018 to 2022. The International Classification of Diseases–Tenth Revision (ICD-10) codes were used to define the patient cohorts. Propensity score weighting was used to balance patient demographic, hospital-level, and comorbidity data. Results: From 2018 to 2022, there were 383,860 TAVI admissions, among which 1915 (0.50%) had the presence of RHF. Compared to patients without RHF, mortality was higher in patients with RHF (7.57% vs. 1.11%, p < 0.01). Similarly, acute kidney injury (37.10% vs. 8.56%, p < 0.01), respiratory failure (12.79% vs. 1.91%, p < 0.01), and use of mechanical circulatory support (11.48% vs. 0.83%, p < 0.01) was higher in the cohort with RHF. Median length of stay (7 days vs. 2 days, p < 0.01) and hospitalization charges ($257,239 vs. $180,501, p < 0.01) were higher in patients with RHF. Conclusions: In conclusion, we report that RHF is associated with increased mortality risk, complications, and resource utilization in patients undergoing TAVI. Right ventricular function should be a part of the evaluation for TAVI, given significantly elevated risks associated with its presence.
Home Enzyme Replacement Therapy in Gaucher Disease: A Review
Authors: Kieć-Wilk Beata , Guijt Paul , Dan Michaela , Abdelwahab Magy , Revel-Vilk Shoshana , Serratrice Christine
Published: January 2025

Since the early 1990s, Gaucher Disease has been a pioneering condition for home-based enzyme replacement therapy (ERT), marking a significant shift in patient care. Since then, many countries have adopted this approach. However, home ERT is not possible in all countries. Objectives: The aim of this article is to explore the implementation of home ERT for Gaucher disease, focusing on patient expectations, safety, compliance, economic benefits, and practical considerations. Methods: The PRISMA reporting protocol was followed, focusing on articles about home ERT for Gaucher Disease. Results: Twenty articles were analyzed in the review, revealing promising outcomes. Home ERT has consistently been shown to be safe, to improve patients’ quality of life, to reduce the utilization of hospital resources, and to pose no compliance issues. Conclusions: We believe it is essential to expand the availability of home ERT for Gaucher Disease to all countries where ERT is accessible. Based on the literature review, we present the conditions that must be met before starting home ERT programs.
Minimally Invasive Bipolar Technique for Scoliosis in Rett Syndrome—Results and Complications in a Series of 22 Cases
Authors: Del Sal Alice , Haumont Edouard , Pigeolet Manon , Gaume Mathilde , Riouallon Guillaume , Bahi Buisson Nadia , Linglart Agnes , Desguerre Isabelle , Pannier Stephanie , Miladi Lotfi
Published: January 2025

Background: This is a retrospective study. The aim of this study is to report the results of bipolar minimally invasive fusionless surgery for scoliosis in Rett syndrome with a minimum follow-up of 2 years. Conservative treatment is often not effective in Rett syndrome scoliosis. Posterior spinal fusion (PSF) has a high rate of complications; early surgery using traditional growing rods (TGRs) controls the deformity while preserving spinal and thoracic growth before arthrodesis. The need for surgical rod lengthening still has a high rate of complications and costs. Methods: We recorded the clinical and radiological outcomes of 22 consecutive patients with Rett scoliosis who underwent bipolar fusionless surgery with a mean follow-up of 56 months (24–99). We performed a bilateral construct with rods (with or without a self-sliding device) anchored proximally with four hook claws distally to the pelvis by ilio-sacral (IS) screws through a minimally invasive approach. Results: The Cobb angle was reduced from 74.4° initially to 28.9° postoperatively and to 25.7° at the last follow-up, which corresponds to a 65% correction of the initial deformity. The gain was maintained at the last follow-up. None of the patients required spinal fusion at skeletal maturity (55% of our patients reached skeletal maturity). There was a gain in body weight (27.97 kg at preoperative time and 33.04 kg at postoperative time). The surgical complication rate was 32%. Conclusions: We recorded the stable correction of deformities and weight gain over time using the bipolar minimally invasive fusionless technique with a reduced rate of complication compared to arthrodesis. The arthrodesis was not necessary at skeletal maturity, thanks to the delayed natural ankylosis of a fixed spine.
Use of FGF-23 and sαKlotho for Risk Stratification in Patients with Acute Heart Failure
Authors: Płonka Joanna , Olejnik Agnieszka , Klus Anna , Gawrylak-Dryja Ewa , Wężyk Natalia , Rzepiela Lidia , Dąbrowska Klaudia , Nalewajko Krzysztof , Porażko Tomasz , Bil-Lula Iwona , Gierlotka Marek
Published: January 2025

Background/Objectives: Soluble αKlotho (sαKlotho) and fibroblast growth factor 23 (FGF-23) are increased in acute heart failure (AHF). This study aimed to assess changes in serum sαKlotho and FGF-23 concentrations during an episode of AHF as well as the usefulness of both biomarkers for predicting long-term prognosis. Methods: The study included 104 consecutive patients hospitalized in t he intensive cardiac care unit due to AHF (mean age, 65.8 ± 14.6 years; mean ejection fraction, 31.4% ± 14). New-onset AHF was reported in 43.3% of the population. Blood samples were measured at entry and on discharge from hospital. The main clinical outcomes assessed in this study were all-cause mortality or rehospitalization due to HF during a 3-year follow-up. Results: At admission sαKlotho, FGF-23, and NT-pro BNP levels, compared with discharge, were significantly higher at p < 0.001, p < 0.001, and p < 0.001 respectively. The 3-year Kaplan–Meier analysis, based on tertiles, revealed, for sαKlotho levels from Tertile 1 on admission and at discharge, a 2-fold higher rate of all-cause mortality or rehospitalization for HF compared with Tertile 3 (p = 0.006 and p = 0.028, respectively). One-third of patients showed an increase in FGF-23 and sαKlotho levels during hospitalization. Patients with the highest percentage increase in the levels of both biomarkers had an elevated risk of all-cause morality or hospitalization for HF (hazard ratio, 2.75; confidence interval, 1.19–6.35; p = 0.02). Conclusions: sαKlotho and FGF-23 levels are elevated during an episode of AHF. Low sαKlotho levels are associated with an increased risk of all-cause mortality or rehospitalization for HF. Increases in sαKlotho and FGF-23 values during hospitalization identify patients with poor prognosis.
Clinical Features and Prospective Outcomes of Thin-Filament Hypertrophic Cardiomyopathy: Intrinsic Data and Comparative Insights from Other Cohorts
Authors: Chumakova Olga S. , Baklanova Tatiana N. , Zateyshchikov Dmitry A.
Published: January 2025

Background/Objectives: Hypertrophic cardiomyopathy (HCM) is the most common genetic heart disease. The most frequently mutated genes encode proteins of the thick filament of the sarcomere, while mutations in thin-filament genes are rare findings in HCM cohorts. Recent studies have revealed distinct mechanisms of disease development linked to thin-filament mutations, highlighting the need for further investigation into this rare subgroup. Methods: A total of 82 adult patients with sarcomere-positive HCM were enrolled. Baseline characteristics and nearly five years of follow-up data from 15 patients with thin-filament mutations were analyzed and compared with those from 67 patients with thick-filament mutations and findings from other studies. Results: Compared to thick-filament HCM patients, individuals with thin-filament mutations exhibited significantly lower maximum left ventricular wall thickness, as measured by both echocardiography (p = 0.024) and cardiac magnetic resonance (p = 0.006), showed more rapid progression to advanced heart failure (HR = 5.6, p = 0.018), and less often underwent septal reduction therapy (p = 0.025). None of the thin-filament HCM patients experienced malignant arrhythmic events. Conclusions: In adults, thin-filament HCM is associated with a ‘thinner’ phenotype and a more rapid progression to advanced heart failure compared to thick-filament HCM. Data on a higher risk of malignant arrhythmias in thin-filament HCM remain controversial between studies and rather depend on the age of onset and genotype in each particular family.
Culprit-Lesion Drug-Coated-Balloon Percutaneous Coronary Intervention in Patients Presenting with ST-Elevation Myocardial Infarction (STEMI)
Authors: Sanz-Sánchez Jorge , Teira Calderón Andrea , Neves David , Cortés Villar Carlos , Lukic Antonela , Rumiz González Eva , Sánchez-Elvira Guillermo , Patricio Lino , Díez-Gil José Luis , García-García Héctor M. , Martínez Dolz Luis , San Román J. Alberto , Amat Santos Ignacio
Published: January 2025

Background/Objectives: Drug-eluting stents (DESs) remain the standard of treatment for patients with ST-elevation myocardial infarction (STEMI). However, complications such as stent thrombosis and in-stent restenosis still pose significant risks. Drug-coated balloons (DCBs) have emerged as a promising alternative, but data for this clinical scenario are still scarce. The objective was to evaluate the safety and efficacy of DCB culprit-lesion primary percutaneous coronary intervention (pPCI) in patients presenting with STEMI and to evaluate its impact on the microcirculatory territory. Methods: An observational retrospective study was conducted across six European centers. Results: In total, 118 patients were included. Of these, 82.2% were male, with a median age of 67 years (IQR 36–92); 28% patients presented with stent thrombosis and most of them (94%) underwent paclitaxel-DCB-pPCI. The median follow-up was 23.2 months (IQR 6.7–77.3). Target lesion failure (TLF) rates were low (3.4%), with no differences between patients presenting with native coronary vessel and stent thrombosis (4.7% vs. 0%; p = 0.205). Overall mortality rates at follow-up were 7%, with only 1.8% attributed to cardiac causes. A target lesion revascularization (TLR) rate of 1.8% was observed, with no target vessel myocardial infarction reported. A subgroup of patients (42; 35.6%) underwent an adenosine-free angiographic microvascular resistance (AMR) analysis. The median AMR was 4.7 (3.9–5.5) and was greater in the stent thrombosis group than in the native coronary group (5.1 vs. 4.6; p = 0.038) with no clinical differences between patients based on the AMR. Conclusions: DCB-pPCI has emerged as an alternative potential treatment for patients presenting with STEMI, with few long-term adverse cardiac events. Despite the encouraging outcomes, these findings underscore the need for a large randomized clinical trial powered by a relevant clinical outcome in order to elucidate the role of DCB-PCI in patients presenting with STEMI.
Adolescent Obesity and Charlson Comorbidity Index in Young Adults
Authors: Treister-Goltzman Yulia , Menashe Idan , Nemet Dan
Published: January 2025

Background: There is insufficient evidence regarding the independent risk of childhood/adolescent obesity for morbidity and mortality in adulthood. The objective of the present study was to evaluate the association of weight categories during adolescence with high-risk diseases determined by the Charlson Comorbidity Index in young adulthood. We also analyzed the association of weight categories with cumulative mortality at the age of 30. Methods: A retrospective cohort study, based on the central computerized database of a major health service organization, was conducted. The study population consisted of 80,853 adolescents. The study period was from 1 January 2007 to 31 December 2022 and was divided into the exposure period from 1 January 2007 to 31 December 2011 (ages 17–19) and the follow-up period from 1 January 2007 to 31 December 2022 (from the date of the defining BMI measurement up to the age of 30 years). Results: The five diseases with the highest cumulative incidence were chronic pulmonary disease (8.2%), mild liver disease (3.7%), cerebrovascular disease (2.8%), diabetes without end-organ damage (2.0%), and peptic disease (1.6%). When adjusted for socio-demographic variables and adult BMI, the relative risks with 95% confidence intervals for the increase in the Charlson Comorbidity Index were 1.11 (1.05–1.17), 1.17 (1.11–1.24), and 1.22 (1.09–1.35) for the “overweight”, “obesity”, and “class 2 obesity” categories, respectively, while the mortality for these categories were 1.60 (1.11–2.27), 1.71 (1.12–2.57), and 3.18 (1.48–6.35), respectively. Conclusions: Adolescent obesity is an independent risk factor for high-risk diseases and mortality in young adulthood. Interventions aimed at reducing the rate of adolescent overweight and obesity should be implemented as early as possible.
Efficacy of Serum BDNF for the Evaluation of Depressive Neurological Symptoms in Patients with Refractory Ulcerative Colitis
Authors: Moriya Kei , Nagamatsu Shinsaku , Nishio Yuya , Komeda Yusuke , Kikukawa Shoma , Matsuura Kyohei , Matsuo Hideki , Uejima Masakazu , Kitagawa Takamichi , Nakamura Fumihiko
Published: January 2025

Background/Aims: Numerous patients with ulcerative colitis (UC) become mentally unstable after experiencing a long-standing, physically painful life, and their long-term prognosis is poorer than that of those who are mentally stable. The current study aimed to evaluate serum biomarkers for predicting mental instability, which is challenging to objectively quantify. Methods: In total, 29 refractory UC patients newly treated with filgotinib underwent measurements of blood parameters associated with depression and a quantitative assessment of quality of life using the Inflammatory Bowel Disease Questionnaire (IBDQ) before and after treatment initiation with a 12-week interval. The data collected were examined in relation to each other. Results: The induction of remission treatment with filgotinib resulted in a clinical response rate of 89.7% and a clinical remission rate of 86.2%, with all eight extraintestinal manifestations resolved. No adverse events were observed. The serum zinc, high-density lipoprotein cholesterol, mature brain-derived neurotrophic factor (BDNF) concentrations, and the IBDQ psychiatric subscores increased significantly after treatment (p < 0.05). Among these parameters, the mature-BDNF concentration and the IBDQ psychiatric subscore had the strongest positive correlation (R = 0.29, p = 0.08). Based on the logistic regression analysis, the mature-BDNF concentration (cutoff value: 20.5 ng/mL) had a sensitivity of 68.2%, specificity of 64.7%, and area under the curve of 0.67 for predicting psychiatric remission (subscore > 42.5) (p = 0.04). Conclusions: While it is not easy to objectively predict the degree of psychiatric instability in patients with refractory UC, serum mature-BDNF levels can be a useful biomarker.
Revision of Entrophosporales, with Three Genera and an Identification Key for All Species Currently Attributed to This Order
Authors: Silva Gladstone Alves da , Sieverding Ewald , Assis Daniele Magna Azevedo de , Goto Bruno Tomio , Corazon-Guivin Mike Anderson , Oehl Fritz
Published: January 2025

The objective of the present study was to revise the recently described order Entrophosporales of the Glomeromycetes. The single family Entrophosporaceae had been divided into three genera, Entrophospora, Claroideoglomus and Albahypha, due to molecular phylogenetic or morphological analyses, but recently these three genera were combined within the type genus of the family, Entrophospora. Our new studies now suggest once more three genera, but Entrophospora and Claroideoglomus were not separated again. In the present study, we resurrected Albahypha with A. drummondii and A. furrazolae comb. nov. and established Alborhynchus gen. nov. with A. walkeri comb. nov. Morphologically, all glomoid morphs of the three genera have hyaline to white subtending hyphae with one spore wall continuous with the subtending hyphal wall. However, the genera can easily be differentiated from each other and from other glomoid species of the Glomeromycetes by the combination of the characteristics of the subtending hyphae, the staining reaction of the spore wall layers in Melzer’s reagent and phylogeny. In conclusion, the three AMF genera, currently recognized in the Entrophosporales, can unequivocally be identified by molecular phylogeny or by morphological characteristics of their spores and their subtending hyphae. An identification key distinguishes all AMF species currently attributed to Entrophosporales.
Species Identification and Orthologous Allergen Prediction and Expression in the Genus Aspergillus
Authors: Zuleta Maria C. , Gómez Oscar M. , Misas Elizabeth , Torres Susana , Rúa-Giraldo Álvaro L. , McEwen Juan G. , Garcia Ana M. , Borges Clayton L. , Hernández Orville , López Angela M.
Published: January 2025

The genus Aspergillus comprises a diverse group of fungi that can cause a range of health issues, including systemic infections and allergic reactions. In this regard, A. fumigatus has been recognized as the most prevalent allergen-producing species. This genus taxonomic classification has been subject to frequent updates, which has generated considerable difficulties for its classification when traditional identification methodologies are employed. To demonstrate the feasibility of this approach, we sequenced the whole genomes of 81 Aspergillus isolates and evaluated a WGS-based pipeline for precise species identification. This pipeline employed two methodologies: (i) BLASTn web using four barcode genes and (ii) species tree inference by OrthoFinder. Furthermore, we conducted a prediction of allergenic capacity based on a homology analysis across all the isolated species and confirmed by RT-qPCR the expression of three orthologous allergens (Asp f 1, Asp f 3 and Asp f 22) in fifteen different Aspergillus species. The species-level identification rate with the barcoding and the species tree were calculated at 64.2% and 100%, respectively. The results demonstrated that A. fumigatus, A. flavus and A. niger were the most prevalent species. The species A. hortae, A. uvarum, A. spinulosporus, A. sydowii, A. westerdijkiae, A. amoenus and A. rhizopodus identified in this study represent the inaugural report of their presence in our region. The results of the homology analysis indicated the presence of orthologous allergens in a wide range of non-fumigatus species. This study presents a novel approach based on WGS that enables the classification of new species within the genus Aspergillus and reports the genomic sequences of a great diversity of species isolated in our geographic area that had never been reported before. Additionally, this approach enables the prediction of allergens in species other than A. fumigatus and demonstrates their genetic expression, thereby contributing to the understanding of the allergenic potential of different species within this fungal genus.
Additionality in Theoretical von Thünenian Models of Deforestation and Conservation Payments
Authors: West Thales A. P. , Caviglia-Harris Jill L. , Fearnside Philip Martin
Published: January 2025

Simple theoretical von Thünenian models of deforestation and agricultural expansion have been extensively studied in the literature but have not yet been adapted to reflect contemporary conservation paradigms, such as the emergence of REDD+ (Reducing Emissions from Deforestation and Forest Degradation) initiatives, related payments for forest conservation, and payments for ecosystem services (PES) more broadly. We revisit Angelsen’s 1999 seminal adaptation of the 1826 von Thünenian model of deforestation and agricultural expansion and propose a “toy model” to incorporate the potential revenues from conservation payments and build on the concept of additionality in the payments for environmental services literature. As theorized, our extended model illustrates how such payments are more effective when they approach the profit margins of geographically peripherical crops that replace the forest. Moreover, it illustrates how conservation payments influence the agricultural frontier while quantifying the avoided deforestation area.
The Mechanical Properties, Corrosion Resistance, and Biocompatibility of a Novel Ternary Ti-xNb-5Ta Alloy for Biomedical Applications
Authors: Wu Haochen , Jiang Tao , Kong Linghui , Chen Xiaohong , Liu Ping
Published: January 2025

In recent years, advancements in dental implants have posed new challenges for the use of traditional orthopedic materials. This study prepared novel Ti-xNb-5Ta alloys via arc-melting and comprehensively evaluated the effects of Nb content on microstructure, mechanical properties, elastic modulus, electrochemical behavior, and in vitro performance. Interestingly, alloys with different Nb contents exhibited distinct properties. The results indicated that the 10 and 13 wt.% Nb alloys surpassed the TA4G surgical implant standard in strength while offering a lower elastic modulus and greater elongation. Electrochemical experiments showed that the corrosion resistance of the alloys improved with increasing Nb content. Furthermore, CCK-8 assay results, ALP semi-quantitative analysis, and RT-PCR demonstrated that Ti-xNb-5Ta alloys enhanced the early osteogenic differentiation of human bone marrow stromal cells (hBMSCs). This work not only reveals the potential of Ti-xNb-5Ta alloys as biomedical materials but also offers insights for developing novel biomaterials.
Impact of Virtual Clinics on Diabetes Distress and HbA1c Levels Among Patients with Diabetes Mellitus in Saudi Arabia
Authors: Almarzooq Mohammed A. , Almarzoug Hussain A. , Alhassan Mohammed Jassim , Alrashed Mukhtar Ibrahim , Alnajjar Jawad S. , Albejais Noor Abdullah , Albahrani Suha , Alibrahim Ibrahim A. , Almaqhawi Abdullah
Published: January 2025

Background and Objectives: Diabetes mellitus is a prevalent chronic disease caused by inadequate insulin secretion or ineffective insulin response, leading to complications such as retinopathy, nephropathy, heart attacks, and strokes. Recently, “diabetes distress (DD)” has emerged as a concept, highlighting the significant emotional burden of managing diabetes, which can impact disease outcomes. Thus, this study evaluates the impact of virtual clinics on diabetes distress and glycemic measures in individuals with diabetes mellitus. Materials and Methods: A cross-sectional study was conducted between May and August 2024 at the Endocrine and Diabetes Center in Alahsa, Saudi Arabia, targeting persons aged 18 and older with diabetes who had engaged in-person clinics, virtual clinics, or both between 2019 and 2024. Data were collected through structured phone interviews, supplemented by laboratory results from clinical records. The survey included demographic details, diabetes information, and the Diabetes Distress Scale. Statistical analyses, including descriptive statistics, were performed to explore the relationships between diabetes distress, clinic visit type, and glycemic control, with Mann–Whitney and Chi-Squared tests used to compare variables between two groups. Results: Of the 108 participants, 55.6% were male, with a mean age of 38.5 years. Type 2 diabetes was reported in 51.9% of individuals, while 48.1% had type 1. High emotional burden (44.4%) and regimen-related distress (28.7%) were prevalent, particularly among individuals with suboptimal glycemic control. While virtual visits were not significantly correlated with lower distress levels, individuals with suboptimal glycemic control exhibited significantly higher diabetes distress across various domains, including emotional and regimen-related distress (p < 0.05). Laboratory analysis showed a median HbA1c of 8.2%, with poor control associated with greater distress. Conclusions: Diabetic individuals with suboptimal glycemic control report higher diabetes distress levels, underscoring the need for integrated psychological support in DM care. Although virtual clinic visits did not significantly reduce distress, they provide a feasible option for individual follow-up.