bluuebunny/crossref_metadata_2025 huggingface dataset:
Wound Healing Potential of Herbal Hydrogel Formulations of Cedrus brevifolia Extracts in Mice
Authors: Lyggitsou Georgia , Barda Christina , Anagnostou Maria , Douros Andreas , Statha Dimitra , Karampasi Christina , Papantonaki Anastasia Ioanna , Svoliantopoulos Ioannis , Sfiniadakis Ioannis , Vitsos Andreas , Skaltsa Helen , Rallis Michail Ch.
Published: November 2024

Wound healing stands as a paramount therapeutic pursuit, imposing significant challenges on healthcare, particularly for vulnerable populations. Cedrus brevifolia, a species endemic to Cyprus, thrives in the Tripylos region, commonly known as Cedar Valley, within the Paphos forest. Despite its endemism, this species exhibits negligible genetic divergence from its Mediterranean related species. This study aims to investigate the potential of C. brevifolia resin and bark extracts in promoting wound healing in a mouse model. Previous in vitro investigations have elucidated the antioxidant and anti-inflammatory potential of extracts and isolates derived from the title plant, warranting further exploration in an in vivo setting. This experimental design employed 40 male SKH-hr2 black and brown mice aged 2–4 months. Wounds measuring 1 cm2 were meticulously induced in the anesthetized mice and the potential healing effect of the herbal hydrogel formulations was evaluated. The healing potential of the C. brevifolia extracts was rigorously assessed through the daily application of gel formulations containing resin concentrations of 5% and 10% w/w, alongside sapwood and heartwood extracts at concentrations of 0.5% and 1% w/w. The evaluation of the treatments encompassed a multifaceted approach, incorporating clinical observations, skin biophysical parameter assessments utilizing an Antera 3D camera, and FT-IR spectroscopy, in addition to histopathological examination. The chemical compositions were also investigated through NMR and bio-guided isolation. The most prominent herbal hydrogel preparation proved to be the 10% resin, followed by the sapwood at 1%. The chemical analysis unveiled abietic acid, manool, and lariciresinol derivatives that potentially contributed to the observed results. Bridging the gap between in vitro observations and in vivo outcomes attempts to shed light on the potential therapeutic benefits of C. brevifolia hydrogels in wound care.
In the Shadow of a Parent’s Genocidal Crimes in Rwanda: The Impact of Ambiguous Loss on the Everyday Life of Children of (Ex-)Prisoners
Authors: Rutayisire Theoneste , Richters Annemiek
Published: November 2024

In Rwanda, following the 1994 Genocide against the Tutsi, many people were found guilty of genocide crimes and imprisoned. Their children ended up in a situation of ambiguous loss during and after a parent’s imprisonment. The article presents the multidimensional impact of this loss on the everyday lives of these children and their families according to key themes as they emerged from an ethnographic study in which 21 children and their family members participated. Themes include changed family dynamics and family stress, economic deprivation, incomprehension of a parent’s criminal past, the social stigma of being a child of a génocidaire, and strategies used to make the loss bearable. The uniqueness of the ambiguous loss as experienced by children of perpetrators of genocide in Rwanda compared to those of perpetrators of the Holocaust or other mass crimes relates to an amalgam of factors specific for the context of post-genocide Rwanda; major ones being the severity of genocidal crimes and gacaca courts Rwanda chose as its main form of transitional justice. The case study illustrates how using the prism of intergenerational relations helps to understand some of the transformative and enduring effects of a crisis that deeply affects a society.
Dementia and Video Games: Systematic and Bibliographic Review
Authors: Eckert Martin , Ostermann Thomas , Ehlers Jan P. , Hohenberg Gregor
Published: November 2024

Background/Objectives: This systematic and bibliographic review examines publications in the field of dementia and video game research from 2004 to 2023. The main objective is to assess developments and trends in video game technology for dementia care and detection. Methods: The PubMed database was the primary source for publications. PRISMA guidelines were applied to structure this review. Ten variables were defined, investigated, and split into three main categories: bibliographic, medical, and technical. Results: The results were synthesized using a quantitative approach to reduce bias through interpretation. Of 209 initial results, 77 publications have been included in the investigation. More studies focus on rehabilitation over assessment and detection of dementia. Clinical trials are typically conducted with limited participants. The most populated trials rarely enrol over 300 subjects. On average, around 38 subjects were enrolled in the trials. These studies are commonly supervised by a trainer or technology specialist, suggesting a technology gap in familiarity in the trial demographic. Conclusions: Most interventions assessed were custom-designed applications with a specific outcome, focusing on physical activity and cognitive exercises. As the first of its kind, this publication focuses on the technical aspects of applied technologies and development methods. Using video games to treat and detect patients with cognitive impairments like dementia can benefit healthcare professionals, caretakers, and patients.
An Umbrella Review of the Association Between Periodontal Disease and Diabetes Mellitus
Authors: Arbildo-Vega Heber Isac , Cruzado-Oliva Fredy Hugo , Infantes-Ruíz Edward Demer , Coronel-Zubiate Franz Tito , Becerra-Atoche Eric Giancarlo , Terrones-Campos Wilfredo , Herrera-Plasencia Paul Martín , Seminario-Trelles Oscar Alex , Ortega-Gallegos Roberto Enrique
Published: November 2024

Aim: To determine the clinical association between periodontal disease and diabetes mellitus through an umbrella review. Materials and Methods: A search for publications up to August 2023 was conducted using the following electronic databases: PubMed, Cochrane Database, Scopus, SciELO, Google Scholar, and OpenGrey. We included systematic reviews (SRs) with or without meta-analysis evaluating primary studies that investigated the association between periodontal disease and diabetes mellitus, and there were no time or language restrictions. Literature or narrative reviews, rapid reviews, intervention studies, observational studies, preclinical and basic research, abstracts, comments, case reports, protocols, personal opinions, letters, and posters were excluded. The AMSTAR-2 tool was used to determine the methodological quality of the included studies. Results: The preliminary search yielded a total of 577 articles, of which only 17 remained after discarding those that did not meet the selection criteria. Following their analysis, an association between periodontal disease and diabetes mellitus (type 1 and type 2 diabetes mellitus and gestational diabetes mellitus) was found. Conclusions: The findings and conclusions of this umbrella review indicate with high confidence that periodontal disease is associated with the onset of type 1 and type 2 diabetes mellitus and gestational diabetes.
Multilevel Mechanisms of Cancer Drug Resistance
Authors: Roszkowska Malgorzata
Published: November 2024

Cancer drug resistance represents one of the most significant challenges in oncology and manifests through multiple interconnected molecular and cellular mechanisms. Objective: To provide a comprehensive analysis of multilevel processes driving treatment resistance by integrating recent advances in understanding genetic, epigenetic, and microenvironmental factors. This is a systematic review of the recent literature focusing on the mechanisms of cancer drug resistance, including genomic studies, clinical trials, and experimental research. Key findings include the following: (1) Up to 63% of somatic mutations can be heterogeneous within individual tumors, contributing to resistance development; (2) cancer stem cells demonstrate enhanced DNA repair capacity and altered metabolic profiles; (3) the tumor microenvironment, including cancer-associated fibroblasts and immune cell populations, plays a crucial role in promoting resistance; and (4) selective pressure from radiotherapy drives the emergence of radioresistant phenotypes through multiple adaptive mechanisms. Understanding the complex interplay between various resistance mechanisms is essential for developing effective treatment strategies. Future therapeutic approaches should focus on combination strategies that target multiple resistance pathways simultaneously, guided by specific biomarkers.
Morphology and Applications of Self-Assembled Peptide Nucleic Acids
Authors: D’Andrea Luca Domenico , Romanelli Alessandra
Published: November 2024

Obtaining new materials by exploiting the self-assembly of biomolecules is a very challenging field. In recent years, short peptides and nucleic acids have been used as scaffolds to produce supramolecular structures for different applications in the biomedical and technological fields. In this review, we will focus on the self-assembly of peptide nucleic acids (PNAs), their conjugates with peptides, or other molecules. We will describe the physical properties of the assembled systems and, where described, the application they were designed for.
Participation of Semaphorin Family and Plexins in the Clinical Course of Patients with Inflammatory Bowel Disease
Authors: Fonseca-Camarillo Gabriela , Furuzawa-Carballeda Janette , Aguilar-León Diana , Martínez-Benítez Braulio , Barreto-Zúñiga Rafael , Yamamoto-Furusho Jesús K.
Published: November 2024

Semaphorins are an immunoregulatory protein family. Plexins bind semaphorins (SEMAs) and can form receptor complexes that give them chemotactic capacity. The role and expression profile of semaphorins and plexins in inflammatory bowel disease (IBD) is currently unknown. Aim: Characterize the semaphorins and plexins gene and protein expression in intestinal tissue from IBD patients and correlate them with the clinical phenotype. Material and Methods: This comparative and cross-sectional study enrolled 54 diagnosed IBD patients and 20 controls. Gene and protein expression of semaphorins and plexins were determined by RT-PCR and IHQ for the co-localization with neutrophils (myeloperoxidase, MPO) or CD123 plasmacytoid dendritic cells in intestinal tissue from IBD patients. Results: Colonic mucosa from active and remission ulcerative colitis (UC) had a significantly lower SEMA4D and PLXNA1, but higher PLXNB1 gene expression than the control group. The only significant difference between active UC and remission was observed in the higher gene expression of SEMA6D in remission. It was associated with histological remission (p = 0.01, OR = 15, 95% CI: 1.39–16.1). The low expression of PLXNA1 was associated with mild intermittent activity with two relapses per year (p = 0.003, OR = 0.05, CI = 0.006–0.51). Higher SEMA4D+ positive cells were detected in the submucosa, while PLXNC1+/MPO+ in the mucosal and submucosa of active UC patients compared with controls. Conclusions: The increased expression of the semaphorin and plexin family in IBD patients suggests their immunoregulatory function and is associated with remission and clinical phenotype in patients with UC.
Benchmarking for a New Railway Accident Classification Methodology and Its Database: A Case Study in Mexico, the United States, Canada, and the European Union
Authors: Sandoval-Valencia Tania Elizabeth , Téllez-Anguiano Adriana del Carmen , Ruiz-Robles Dante , Alanis-Fuerte Ivon , Vázquez-Esquivel Alexis Vaed , Jáuregui-Correa Juan C.
Published: November 2024

Rail accidents have decreased in recent years, although not significantly if measured by train accidents recorded in the last six years. Therefore, it is essential to identify weaknesses in the implementation of security and prevention systems. This research aims to study the trend and classification of railway accidents, as well as analyze public databases. Using the business management method of benchmarking, descriptive statistics, and a novel approach to the Ishikawa diagram, this study demonstrates best practices and strategies to reduce accidents. Unlike previous studies, this research specifically examines public databases and provides a framework for developing the standardization of railway accident causes and recommendations. The main conclusion is that the proposed classification of railway accident causes, and its associated database, ensures that agencies, researchers, and the government have accessible, easily linkable, and usable data references to enhance their analysis and support the continued reduction of accidents.
SoK: The Impact of Educational Data Mining on Organisational Administration
Authors: Almaghrabi Hamad , Soh Ben , Li Alice , Alsolbi Idrees
Published: November 2024

Educational Data Mining (EDM) applies advanced data mining techniques to analyse data from educational settings, traditionally aimed at improving student performance. However, EDM’s potential extends to enhancing administrative functions in educational organisations. This systematisation of knowledge (SoK) explores the use of EDM in organisational administration, examining peer-reviewed and non-peer-reviewed studies to provide a comprehensive understanding of its impact. This review highlights how EDM can revolutionise decision-making processes, supporting data-driven strategies that enhance administrative efficiency. It outlines key data mining techniques used in tasks like resource allocation, staff evaluation, and institutional planning. Challenges related to EDM implementation, such as data privacy, system integration, and the need for specialised skills, are also discussed. While EDM offers benefits like increased efficiency and informed decision-making, this review notes potential risks, including over-reliance on data and misinterpretation. The role of EDM in developing robust administrative frameworks that align with organisational goals is also explored. This study provides a critical overview of the existing literature and identifies areas for future research, offering insights to optimise educational administration through effective EDM use and highlighting its growing significance in shaping the future of educational organisations.
Reproductive and Flight Characteristics of Lymantria xylina (Lepidoptera: Erebidae) in Fuzhou, China
Authors: Zhang Jifeng , Wang Baode , Wang Liqiang , Zuo Cheng , Li Junnan , Cui Yonghong , Wen Xuanye , Cowan David , Wu Songqing , Liu Mengxia , Wang Rong , Zhang Feiping
Published: November 2024

The biological characteristics of Lymantria xylina Swinhoe (Lepidoptera: Erebidae), a moth that threatens coastal forests in Fuzhou, China, are closely linked to its spread risk. To characterize these traits, we primarily investigated emergence, reproductive, and flight behaviors. Our findings show that females typically emerge, mate, and copulate during specific times of day. The peak hours of emergence, courtship, and copulation are 13:00–14:00, 19:00–21:00, and around 0:00, respectively. The starting time of oviposition was concentrated before dawn and during the daytime. They preferentially lay eggs on columnar objects, including artificial ones. On average, females laid 361 eggs, lived for 4.5 days, and weighed 0.74 g. Non-ovipositing females were observed to fly for short distances, especially during the evening. Field observations suggest that these females can potentially travel up to 184.5 m in total and 34.5 m continuously. While this indicates a theoretical risk of long-distance dispersal, our findings suggest that the overall risk is limited. These results contribute to our understanding of the biology and dispersal potential of L. xylina.
V-ATPase C Acts as a Receptor for Bacillus thuringiensis Cry2Ab and Enhances Cry2Ab Toxicity to Helicoverpa armigera
Authors: Li Pin , Zhao Yuge , Zhang Ningbo , Yao Xue , Li Xianchun , Du Mengfang , Wei Jizhen , An Shiheng
Published: November 2024

Cry2Ab is a significant alternative Bacillus thuringiensis (Bt) protein utilized for managing insect resistance to Cry1 toxins and broadening the insecticidal spectrum of crops containing two or more Bt genes. Unfortunately, the identified receptors fail to fully elucidate the mechanism of action underlying Cry2Ab. Previous studies have demonstrated the involvement of vacuolar H+-ATPase subunits A, B, and E (V-ATPase A, B, and E) in Bt insecticidal activities. The present study aims to investigate the contribution of V-ATPase C to the toxicities of Cry2Ab against Helicoverpa armigera. The feeding of Cry2Ab in H. armigera larvae resulted in a significant decrease in the expression of V-ATPase C. Further investigations confirmed the interaction between V-ATPase C and activated Cry2Ab protein according to Ligand blot and homologous and heterologous competition assays. Expressing endogenous HaV-ATPase C in Sf9 cells resulted in an increase in Cry2Ab cytotoxicity, while the knockdown of V-ATPase C by double-stranded RNAs (dsRNA) in midgut cells decreased Cry2Ab cytotoxicity. Importantly, a higher toxicity of the mixture containing Cry2Ab and V-ATPase C against insects was also observed. These findings demonstrate that V-ATPase C acts as a binding receptor for Cry2Ab and is involved in its toxicity to H. armigera. Furthermore, the synergy between V-ATPase C protein and Cry2Ab protoxins provides a potential strategy for enhancing Cry2Ab toxicity or managing insect resistance.
Toxicity of Flonicamid to Diaphorina citri (Hemiptera: Liviidae) and Its Identification and Expression of Kir Channel Genes
Authors: Zhu Jiangyue , Wang Xinjing , Mo Yunfei , Wu Beibei , Yi Tuyong , Yang Zhongxia
Published: November 2024

Flonicamid is a selective insecticide effective against piercing–sucking insects. Although its molecular target has been identified in other species, the specific effects and detailed mechanism of action in Diaphorina citri Kuwayama remain poorly understood. In this study, we determined that the LC50 of flonicamid for D. citri adults was 16.6 mg AI L−1 after 4 days of exposure. To explore the relevant mechanisms, the treatments with acetone and with 20 mg AI L−1 flonicamid for 96 h were collected as samples for RNA-Seq. The analysis of the transcriptomes revealed 345 differentially expressed genes (DEGs) in D. citri adults subjected to different treatments. Among these DEGs, we focused on the inward-rectifying potassium (Kir) channel genes, which have been extensively studied as potential targets of flonicamid. Three Kir subunit genes (Dckir1, Dckir2, Dckir3) in D. citri were successfully cloned and identified. Furthermore, the expression profiles of these DcKirs were investigated using RT-qPCR and showed that their expression significantly increased after D. citri eclosion to adulthood, particularly for DcKir3. The DcKirs were predominantly expressed in gut tissues, with DcKir1 and DcKir2 exhibiting high expression levels in the hindgut and midgut, respectively, while DcKir3 showing high expression in the midgut and Malpighian tubules. This study provides insights into the potential roles of Kir subunits in D. citri and enhances our understanding of the physiological effects of flonicamid in this pest.
Predicted Spatial Patterns of Suitable Habitats for Troides aeacus Under Different Climate Scenarios
Authors: Liu Biyu , Deng Xinqi , Liu Zhiqian , Wei Xinju , Zhang Honghua , Xu Danping , Zhuo Zhihang
Published: November 2024

Troides aeacus is the largest butterfly in China and is highly valued for its ornamental beauty. Due to T. aeacus being classified as a national second-class protected species in China, studying its spatial distribution is crucial for developing effective conservation measures. In this study, a total of 490 distribution points were obtained, and the potential distribution areas of the golden-sheathed T. aeacus were analyzed by using the maximum entropy model (MaxEnt) based on three different greenhouse gas emission scenarios, namely, SSP1-2.6, SSP2-4.5, and SSP5-8.5, in combination with nine important environmental variables. The results indicate that temperature and precipitation are the primary environmental factors influencing the suitable habitat of T. aeacus, with key variables including the minimum temperature of the coldest month (bio6), temperature annual range (bio7), mean temperature of the warmest quarter (bio10), annual precipitation (bio12), precipitation of the coldest quarter (bio19), and slope. The height distribution of T. aeacus in my country is in the area south of the Huaihe River in the Qinling Mountains, with a total area of 270.96 × 104 km2, accounting for 28.23% of the total area of China. According to future climate change conditions, as climate warming progresses, both low- and high-suitability areas show an expansion trend in most scenarios, particularly under the SSP5-8.5 scenario, where highly suitable areas increase significantly while moderately suitable areas gradually shrink. To address future climate change, conservation strategies should focus on protecting highly suitable areas and strengthening the management of marginal habitats to enhance the adaptability and survival chances of T. aeacus.
Microorganism Diversity Found in Blatta orientalis L. (Blattodea: Blattidae) Cuticle and Gut Collected in Urban Environments
Authors: Schapheer Constanza , González Luciano Matías , Villagra Cristian
Published: November 2024

Pest cockroaches share urban habitats with us; their prevalence in urban areas prompts concerns regarding their effect on human health, as synanthropic cockroaches often host pathogenic microorganisms. Nonetheless, microbial associates in these insects can also be related to their biology, contributing to their physiological homeostasis and reproductive success. In this article, we present in detail, for the first time, the bacterial community associated with the oriental cockroach Blatta orientalis, one of the world’s five most prominent pest cockroaches. We report the composition of the communities of bacteria found over the exoskeleton and inside the gut of this global pest. We collected B. orientalis in Santiago, Chile’s capital city, and the urban nucleus in this country. We conducted DNA extractions and metabarcoding analysis. We found diverse bacterial lineages, including mutualist symbiotic strains, and microorganisms considered pathogenic to humans. We also analyzed the metabolic functions of the bacterial communities identified and discussed the role of B. orientalis as a reservoir and vector of pathogens in urban areas. We discuss to what extent the diversity of functions of the microbial community associated with cockroaches may contribute to emergent properties enabling these insects to inhabit human-modified habitats.
Functional Measures in Non-COPD Chronic Respiratory Diseases: A Systematic Review
Authors: Zamboti Camile Ludovico , Pimpão Heloise Angélico , Bertin Larissa Dragonetti , Krinski Gabriela Garcia , Garcia Tathielle , dos Santos Filho Sandro Laerth Souza , Cavalheri Vinicius , Pitta Fabio , Camillo Carlos Augusto
Published: November 2024

Background/Objectives: The extensive range of instruments designed for evaluating functional performance (FP) in chronic respiratory diseases (CRD) other than chronic obstructive pulmonary disease (COPD) presents a challenge in selecting the most appropriate one. Therefore, this systematic review aimed to summarise FP instruments, their measurement properties, their minimum clinically important differences, and their associations with CRD course-related events or prognosis in non-COPD CRD. Methods: Studies employing patient-reported or performance-based instruments to assess FP in non-COPD CRD were systematically identified in the PubMed, PEDro, Embase, and Cochrane Library databases. COPD-exclusive studies or those solely reporting exercise capacity tests were excluded. Examination focused on measurement properties and associations with CRD course-related events or prognosis. The risk of bias was evaluated using the COSMIN, Downs and Black, and PEDro checklists based on the study design. Results: A total of 216 studies across seven CRD categories [asthma, bronchiectasis, cystic fibrosis, interstitial lung disease (ILD), pulmonary arterial hypertension (PAH), pre-/post-lung-transplantation] from various study types were included. Thirty-three instruments were identified, with the SF-36 questionnaire’s physical function domain being the most commonly used patient-reported tool. The 1 min sit-to-stand test was the most extensively studied performance-based measure, with its measurement properties frequently reported in non-COPD CRD studies. Associations with events were infrequently documented, primarily in ILD and PAH studies related to mortality. Conclusions: Despite the prevalent use of FP instruments, limited information exists concerning their measurement properties and clinical implications. This review furnishes a concise summary of available evidence, aiding informed clinical decisions when selecting FP tools for non-COPD CRD.
Sleep Problems and Quality of Life in Children with Epilepsy Without Neurodevelopmental Disorders
Authors: Yazaki Kotaro , Sakuma Satoru , Shirokihara Yuuto , Inutsuka Kayo , Imamura Takuji , Mihara Takenao , Tachibana Naoko , Kondo Kyoko , Fukushima Wakaba , Hamazaki Takashi
Published: November 2024

Background/Objectives: Sleep problems affect the quality of life (QoL) and treatment prognosis of children with epilepsy (CWE). We analyzed sleep problems and QoL in CWE but without neurodevelopmental disorders, which affect sleep and QoL. We also examined discrepancies between child self-reports and parent proxy reports in QoL assessments. Methods: Thirty-two CWE in grades 2–6 (aged 7–12 years) in regular classes who attended Osaka Metropolitan University Hospital and PL General Hospital between January 2022 and August 2023 were compared with 21 children who had attended the hospitals for acute non-neurological disorders and had recovered (control group). Children with neurodevelopmental disorders, those unable to answer questionnaires, and those taking sleeping pills were excluded. Children in both groups completed the Kinder Lebensqualität Fragebogen (KINDL-R); their parents completed the KINDL-R and Japanese Sleep Questionnaire for Elementary Schoolers (JSQ-ES). Results: There were no significant differences in mean (±SD) JSQ-ES total scores between the epilepsy and control groups (71.6 ± 21.4 vs. 63.2 ± 15.2, respectively; p = 0.16). In the epilepsy group, there were no significant differences in total or subscale KINDL-R scores between children with (JSQ-ES ≥ 80) and without (JSQ-ES < 80) sleep problems. Correlation coefficients between child self-reports and parent proxy reports for KINDL-R total scores were 0.171 (p = 0.348) and 0.656 (p = 0.001) for the epilepsy and control groups, respectively. There was a significant difference between the total scores of children’s self-reports and parents’ proxy reports in the control (p = 0.008) group, but not in the epilepsy group (p = 0.837). Conclusions: Sleep problems may not have significant impacts on the QoL of CWE without neurodevelopmental disorders. Parents of CWE do not always correctly assess their children’s QoL, so it is important to ask both children and their parents to obtain a comprehensive picture of their QoL.
Risk Factors for Developmental Dysplasia of the Hip: A Critical Analysis About an Unclear Relationship
Authors: Dib Tamir , Nanni Matteo , Sanzarello Ilaria , Salvatori Giada , Marletta Daniela Alessia , Zampogna Biagio , Leonetti Danilo
Published: November 2024

Objective: To evaluate the relationship between prenatal risk factors and developmental dysplasia of the hip using the Graf grade, and to identify the determinants of a higher Graf grade. Materials and Methods: A retrospective analysis of data from 112 newborns with DDH was conducted. The participants were selected on the basis of a DDH diagnosis using sonography. A total of 181 hips of patients with DDH were considered in our study group (Graf types IIa to IV), and the normal hips of those affected unilaterally were excluded from the analyses (43 participants were affected unilaterally). The risk factors considered included female sex, breech presentation, firstborn status, familiarity, association with other orthopedic abnormalities, and uterine packing, which includes factors such as twin pregnancy, macrosomia, and oligohydramnios. Binary logistic regression was used to analyze the relationship between these variables and the Graf type of DDH at presentation, which was defined using two groups: Graf types IIc–IV, which include unstable or decentered hips, and Graf types IIa and IIb, which encompass stable and centered hips. Results: The analyses revealed a significant protective role of the presence of other lower limb congenital malformations such as clubfoot, which was more closely associated with a stable form of DDH (OR = 0.26, p = 0.017), a significant association between the presence of mechanical risk factors in females with an unstable form of DDH (OR = 5.00, p = 0.042), a borderline significant protective role of breech presentation in females, which was more closely associated with a stable form of DDH (OR = 0.25, p = 0.054), and a borderline significant association between the presence of mechanical risk factors and an unstable form of DDH (OR = 4.28, p = 0.054). Conclusions: Prenatal risk factors may have a complex effect on the Graf grade in DDH. The protective effects of some factors in contrast with the increased risk associated with other factors suggest a possible relationship, with some prenatal risk factors affecting the severity of DDH. These findings may have implications for the early identification and management of DDH.
A Six-Year Examination of the Influence of Surgical Technique and Intraoperative Intraglandular Clostridium Botulinum Toxin Application in Salivary Gland Tumor Operations
Authors: Johnson Felix , Burian Nora-Maria , Santer Matthias , Strasser Verena , Steinbichler Teresa , Hofauer Benedikt , Stenzl Anna , Klarer Johanna , Lochbaum Robin , Lei Haochen , Cao Hongyuan , Hillebrand Gabriel , Bolooki Amir
Published: November 2024

Introduction: Salivary gland tumor operations are associated with complications including facial nerve dysfunction (FND) and salivary fistula. The objective of this study was to investigate the effect of extracapsular dissection (ECD) and the application of Clostridium botulinum toxin (CBT) in contrast to partial and lateral parotidectomy on complications. Methods: All salivary gland tumor operations performed within the last 6 years were retrospectively examined. Data were collected from electronic patient files from our otorhinolaryngology clinic. Total parotidectomies and submandibulectomies were not included in the analysis of CBT application. Results: In total, 418 cases were examined, including 84 (20%) malignant tumors. In total, 18 patients underwent ECD, 93 partial parotidectomy, 199 lateral parotidectomy, 76 total parotidectomy, and 32 submandibulectomy. The most common complication was transient FND (49%; n = 205; data available for 415 patients), which was measured at four days. Additional complications included salivary fistula (n = 56), infection (n = 49), bleeding or hematoma (n = 21). Preoperative facial nerve paralysis (p < 0.0001), pain (p < 0.0001), and a history of squamous cell skin carcinoma (SCC) (p < 0.001) were predictive of malignancy. The application of CBT did not reduce the risk of salivary fistula (p-value: 0.0182) and was associated with a higher combined complication rate (p-value: 0.0199). ECD was not associated with a lower likelihood for FND (p = 0.350). Conclusions: Preoperative pain, facial paralysis, or a history of SCC are predictors of malignancy. Use of CBT was not associated with a reduced risk of salivary fistula, but rather a higher complication rate.
Impulsivity in ADHD and Borderline Personality Disorder: A Systematic Review of Gray and White Matter Variations
Authors: Franczak Łukasz , Podwalski Piotr , Wysocki Patryk , Dawidowski Bartosz , Jędrzejewski Adam , Jabłoński Marcin , Samochowiec Jerzy
Published: November 2024

Introduction: Impulsivity is one of the overlapping symptoms common to borderline personality disorder (BPD) and attention deficit hyperactivity disorder (ADHD), but the neurobiological basis of these disorders remains uncertain. This systematic review aims to identify abnormalities in the gray and white matter associated with impulsivity in BPD and ADHD. Methods: We conducted a systematic search of the PubMed, Embase, and SCOPUS databases, adhering to PRISMA guidelines. Studies that investigated gray and white matter alterations in BPD or ADHD populations and their relationship with impulsivity were included. We reviewed information from 23 studies involving 992 participants, which included findings from structural MRI and DTI. Results: The review identified various nonhomogeneous changes associated with impulsivity in BPD and ADHD. BPD was mainly associated with abnormalities in the prefrontal cortex (PFC) and limbic areas, which correlated negatively with impulsivity. In contrast, impulsivity associated with ADHD was associated with structural changes in the caudate nucleus and frontal–striatal pathways. Despite the overlapping symptoms of impulsivity, the neurobiological mechanisms appeared to differ between the two disorders. Conclusions: These findings emphasize the distinct neurostructural correlates of impulsivity in BPD and ADHD. While both disorders show impulsivity as one of their main symptoms, the fundamental brain structures associated with this trait are different. BPD is primarily associated with abnormalities in the prefrontal cortex and limbic system, whereas the alterations seen in ADHD tend to focus on the caudate nucleus and frontostriatal pathways. Further research is needed to clarify these differences and their implications for treatment.
Validation of EuroSCORE II, ACEF Score, CHA2DS2-VASc, and CHA2DS2-VA in Patients Undergoing Left Main Coronary Artery Angioplasty: Analysis from All-Comers BIA-LM Registry
Authors: Dąbrowski Emil Julian , Kralisz Paweł , Nowak Konrad , Gugała Kamil , Prokopczuk Przemysław , Mężyński Grzegorz , Święczkowski Michał , Dobrzycki Sławomir , Kożuch Marcin
Published: November 2024

Background: Simple surgical and clinical risk scores are useful in mortality prediction. Aims: The study’s aim was to validate three scores in real-world registry of percutaneous coronary intervention (PCI) for the left main coronary artery (LMCA). Methods: All data were obtained from the BIA-LM Registry. Discrimination and calibration of EuroSCORE II, ACEF, CHA2DS2-VASc, and CHA2DS2-VA were assessed with receiver operating characteristic (ROC) curves analysis and Hosmer–Lemeshow (HL) test. Results: The final cohort included 851 patients, median age was 71, and 156 patients had history of previous coronary artery bypass grafting (CABG). Median EuroSCORE II, ACEF, CHA2DS2-VASc, and CHA2DS2-VA were 3.1% (IQR 5.4%), 1.56 (IQR 0.9), 4 (IQR 2), and 4 (IQR 2), respectively. In the short- (30 days) and long-term (mean 4.1 years), there were 27 and 318 deaths. In short-term, EuroSCORE II showed the best discrimination in the overall population and subgroup with unprotected LMCA [area under the curve (AUC) 0.804, 95% CI 0.717–0.890 and AUC 0.826, 95% CI 0.737–0.913, respectively, p < 0.001 for comparisons with other models), with the best cut-off value at 7.1%. In long-term observation, EuroSCORE II and ACEF showed good predictive value (overall population: AUC 0.716, 95% CI 0.680–0.750 and AUC 0.725, 95% CI 0.690–760, respectively). In short- and long-term observation, EuroSCORE II and ACEF showed poor calibration (HL test p < 0.05) as compared to CHA2DS2-VASc (HL test p = 0.40 and 0.18). Conclusions: EuroSCORE II showed good mortality prediction in short-term observation; however, its predicted risk should be interpreted with caution due to poor calibration. ACEF and EuroSCORE II may be useful in long-term mortality prediction.
Depression in Cardiac Patients Is a Major Cardiovascular Event Risk Factor: A 12-Month Observational Study
Authors: Podolec Jakub , Kleczyński Paweł , Piechocki Marcin , Okarski Michał , Lizończyk Katarzyna , Szkodoń Kornelia , Silczuk Andrzej , Przewłocki Tadeusz , Legutko Jacek , Kabłak-Ziembicka Anna
Published: November 2024

Background: Depression is a known factor in poor cardiovascular outcomes but is often underassessed in cardiac units. This study evaluates the impact of depression on cardiovascular outcomes in patients undergoing cardiac interventions. Methods: The study included 133 patients who underwent uncomplicated procedures for degenerative aortic valve stenosis (n = 40), acute coronary syndrome (n = 29), or chronic coronary artery disease (n = 64). Depression was assessed using the Beck Depression Inventory (BDI) and Hamilton Depression Rating Scale (HAM-D). The primary endpoint was a major adverse cardiac and cerebrovascular event (MACCE). Patients were followed up for 12 months. Cox proportional hazards analysis was used to identify MACCE risk factors. Results: Depression was more frequently screened by HAM-D than BDI (42.9% vs. 30.8%, p < 0.001). During follow-up, 26 (19.5%) MACCEs occurred. In univariate analysis, risk factors included BDI score ≥ 11, HAM-D score ≥ 8, diabetes on insulin, anticoagulant use, atrial fibrillation, and serum creatinine level ≥ 130 µmol/L. Depression in the BDI increased the risk of the MACCE 3.6-fold (95%CI: 1.64–8.0, p = 0.001), whereas in the HAM-D, it increased the risk 4.9-fold (95%CI: 1.97–12.24, p < 0.001). Multivariate analysis showed HAM-D score ≥ 8 as the strongest predictor of MACCE (HR: 3.08, 95%CI: 1.18–8.08). Conclusions: Depression is a common finding in cardiovascular patients, and it is a strong risk factor for one-year cardiovascular mortality and adverse event risk. Therefore, we believe that common guidelines should be elaborated between relevant psychiatry and cardiology scientific societies.
Hepatic Sinusoidal Obstruction Syndrome/Veno-Occlusive Disease (SOS/VOD) Primary Prophylaxis in Patients Undergoing Hematopoietic Stem Cell Transplantation: A Network Meta-Analysis of Randomized Controlled Trials
Authors: Sousa-Pimenta Mário , Martins Ângelo , Estevinho Letícia M. , Pinho Vaz Carlos , Leite Luís , Mariz José
Published: November 2024

Introduction: Hepatic sinusoidal obstruction syndrome/veno-occlusive disease (SOS/VOD) is a major complication following hematopoietic stem cell transplantation, resulting from immune and chemical toxicity in the sinusoidal endothelium and hepatocellular damage. In the most severe cases, multiorgan dysfunction occurs, so it is essential to promptly identify patients at greater risk of SOS/VOD and to adopt prophylactic strategies. Objectives: This study aims to systematize the impact of different approaches as primary prophylaxes against SOS/VOD in patients undergoing hematopoietic stem cell transplantation (HSCT). Methods: A systematic review and meta-analysis of randomized clinical trials evaluating different strategies for primary prophylaxis of SOS/VOD was carried out in pairwise fashion and with a consistent network structure. The odds ratio (OR) and corresponding confidence intervals were calculated using the random-effects model. Heterogeneity was assessed by the I2 method and the efficacy of each approach was estimated by SUCRA (surface under the cumulative ranking curve). Results: Considering all patients undergoing HSCT, ursodeoxycholic acid (UDCA) [OR = 0.38, 95%CI 0.14–1.06, SUCRA = 0.720] was associated with a lower incidence of VOD while defibrotide reached a modest reduction in its incidence [OR = 0.64, 95%CI 0.23–1.67; SUCRA = 0.486]. Considering the subgroup of patients undergoing hematopoietic progenitors allotransplantation, defibrotide scored higher [OR = 0.51, 95%CI 0.09–2.85, SUCRA = 0.650] by comparison with UDCA [OR = 0.53, 95%CI 0.14–1.96, SUCRA = 0.639]. Conclusions: This is the first meta-analysis comparing primary prophylaxes against SOS/VOD. UDCA yielded more promising results when considering all patients undergoing hematopoietic stem cell transplantation, yet, in a subgroup analysis of the ones exposed to allogeneic grafts, it becomes not significantly overrun by defibrotide.
Family’s Caregiving Status and Post-Stroke Functional Recovery During Subacute Period from Discharge to Home: A Retrospective Study
Authors: So Jungmin , Park Moon-Ho
Published: November 2024

Background/Objectives: Family members, often informal caregivers, play a crucial role in providing home care for stroke survivors. The period following discharge to home after receiving acute stroke management in a hospital includes the subacute phase of stroke and remains critical to the recovery of stroke patients. This study evaluated the association between family caregiving and post-stroke functional recovery after discharge to home. Methods: Data from 402 patients with stroke were obtained from the Korea University Ansan Hospital Stroke Center from January 2019 to May 2022. The family’s caregiving status was evaluated for family burden and supportable environment in the home. This study’s outcome of interest was the modified Rankin Scale (mRS) at discharge to home and three months after stroke onset. The repeated mRS scores were analyzed using the Linear Mixed Model. Results: Median days from discharge to 3 months after stroke onset was 81.0 days. The median score of mRS at discharge was 2.0, and the score at three months after stroke onset was 2.0. The distribution of mRS score 0–2 was 60.9% at discharge and 72.1% at three months after stroke onset. In Linear Mixed Models after adjustments with covariables, the family’s caregiving status was positively associated with repeated mRS scores (β = 0.17; 95% confidence interval = 0.11, 0.23; p < 0.001). Conclusions: These findings suggest that family caregiving to patients with stroke might be associated with post-stroke functional recovery within the period from discharge to home until three months after stroke onset.
Two Handheld Retinograph Devices Evaluated by Ophthalmologists and an Artificial Intelligence Algorithm
Authors: Romero-Aroca Pedro , Fontoba-Poveda Benilde , Garcia-Curto Eugeni , Valls Aida , Cristiano Julián , Llagostera-Serra Monica , Morente-Lorenzo Cristian , Mendez-Marín Isabel , Baget-Bernaldiz Marc
Published: November 2024

Background/Objectives: Telemedicine in diabetic retinopathy (RD) screening is effective but does not reach the entire diabetes population. The use of portable cameras and artificial intelligence (AI) can help in screening diabetes. Methods: We evaluated the ability of two handheld cameras, one based on a smartphone and the other on a smartscope, to obtain images for comparison with OCT. Evaluation was carried out in two stages: the first by two retina specialists and the second using an artificial intelligence algorithm that we developed. Results: The retina specialists reported that the smartphone images required mydriasis in all cases, compared to 73.05% of the smartscope images and 71.11% of the OCT images. Images were ungradable in 27.98% of the retinographs with the smartphone and in 7.98% with the smartscope. The detection of any DR using the AI algorithm showed that the smartphone obtained lower recall values (0.89) and F1 scores (0.89) than the smartscope, with 0.99. Low results were also obtained using the smartphone to detect mild DR (146 retinographs), compared to using the smartscope (218 retinographs). Conclusions: we consider that the use of handheld devices together with AI algorithms for reading retinographs can be useful for DR screening, although the ease of image acquisition through small pupils with these devices needs to be improved.
The Association Between Glycemic Variability and Mortality in Critically Ill Patients: A Multicenter Prospective Observational Study
Authors: Emgin Ömer , Yavuz Mehmet , Şahin Adem , Güneş Murat , Eser Mustafa , Yavuz Tunzala , Kökalan Damla , Ergün Bişar , Rollas Kazım , Çakırgöz Mensure Yılmaz
Published: November 2024

Background: Glycemic variability (GV) is a prevalent and significant condition observed in critically ill patients. This study aimed to investigate the relationship between early glycemic variability parameters and 28-day mortality in critically ill patients. Methods: A multicenter, prospective, and observational study was performed at five tertiary intensive care units (ICUs) in Turkey. All patients who had more than six blood glucose level (BGL) measures per 24 h were included. The parameters of GV including the SD, MGL, MGD (the difference between the maximal and minimal glucose level), and the CV (the percentage of SD to the MGL) in the first 24 h were recorded. Results: A total of 578 eligible patients were enrolled in the study, of whom 43.6% were women. The mean age of the patients was 68.09 ± 16.62 years. Overall mortality was 31.5% (n = 182). The glycemic parameters of the CV, SD, and MGD were significantly higher in the non-survivor group than in the survivor group (p = 0.040, 0.006, and 0.002, respectively). The multivariate logistic regression analysis revealed that the CV (OR 1.023; 95% CI 1.004–1.042; p = 0.017) was an independent factor that increased mortality. Spearman’s rho correlation analysis revealed a strong (r:0.871) and statistically significant correlation (p < 0.001) between the CV and MGD. Conclusions: The CV calculated within the first 24 h of ICU admission is independently associated with 28-day mortality. The MGD is correlated with the CV and is maybe a practical tool to predict increased risk of mortality at the bedside. However, further studies are needed to establish the independent association of the MGD with mortality.
Impact of Duodenal Papilla Morphology on the Success of Transpancreatic Precut Sphincterotomy
Authors: Chen Yi-Peng , Liao Yi-Jun , Peng Yen-Chun , Tung Chun-Fang , Tsai Hsin-Ju , Yang Sheng-Shun , Chen Chia-Chang
Published: November 2024

Background: This study aimed to evaluate whether the morphology of the duodenal major papilla is linked to transpancreatic precut sphincterotomy (TPS) failure. Methods: We conducted a retrospective review of patients who underwent endoscopic retrograde cholangiopancreatography (ERCP) at our institution. The inclusion criteria involved patients with a naïve major duodenal papilla who required TPS due to difficult biliary cannulation. Papilla morphology was classified using Haraldsson’s system, as follows: regular (Type 1), small (Type 2), protruding or pendulous (Type 3), and creased or ridged (Type 4). The analysis focused on identifying risk factors for TPS failure and related complications. Results: A total of 103 cases were analyzed, with an overall TPS success rate of 85.44%. There were no significant differences in age, gender, ERCP indications, or the prevalence of juxtapupillary diverticula across the four papilla types. The TPS failure rates by papilla type were Type 1 (10.53%), Type 2 (0%), Type 3 (16.67%), and Type 4 (28%). Type 4 papilla had a significantly higher failure rate compared to Type 1 and Type 2 in the univariate analysis (p = 0.028), but this was not statistically significant in the multivariate analysis (p = 0.052). Age emerged as an independent risk factor for TPS failure. Conclusions: Duodenal papilla morphology may influence the success rate of TPS, with advanced age being a key risk factor for failure. Identifying high-risk factors such as Type 4 papilla and older age can help endoscopists adjust their techniques early, potentially improving outcomes and minimizing complications.