bluuebunny/crossref_metadata_2025 huggingface dataset:
Magnetic Resonance Left Ventricle Mass-Index/Fibrosis: Long-Term Predictors for Ventricular Arrhythmia in Hypertrophic Cardiomyopathy—A Retrospective Registry
Authors: Khan Habib Rehman , Rodwell Philip , Taha Ahmed Hasan , Goha Ahmed , Ahmed Mobeen , Thain Andrew Peter , Somarakis Konstantinos , Al-Atta Ayman , Erhayiem Bara , Uddin Akhlaque , Mathew Thomas
Published: March 2023

Objective: We aimed to study the long-term association of LV mass index (LVMI) and myocardial fibrosis with ventricular arrhythmia (VA) in a population of patients with confirmed hypertrophic cardiomyopathy (HCM) using cardiac magnetic resonance imaging (CMR). Methods: We retrospectively analyzed the data in consecutive HCM patients confirmed on CMR referred to an HCM clinic between January 2008 and October 2018. Patients were followed up yearly following diagnosis. Baseline demographics, risk factors and clinical outcomes from cardiac monitoring and an implanted cardioverter defibrillator (ICD) were analyzed for association of LVMI and LV late gadolinium enhancement (LVLGE) with VA. Patients were then allocated to one of two groups according to the presence of VA (Group A) or absence of VA (Group B) during the follow-up period. The transthoracic echocardiogram (TTE) and CMR parameters were compared between the two groups. Results: A total of 247 patients with confirmed HCM (age 56.2 ± 16.6, male = 71%) were studied over the follow-up period of 7 ± 3.3 years (95% CI = 6.6–7.4 years). LVMI derived from CMR was higher in Group A (91.1 ± 28.1 g/m2 vs. 78.8 ± 28.3 g/m2, p = 0.003) when compared to Group B. LVLGE was higher in Group A (7.3 ± 6.3% vs. 4.7 ± 4.3%, p = 0.001) when compared to Group B. Multivariable Cox regression analysis showed LVMI (hazard ratio (HR) = 1.02, 95% CI = 1.001–1.03, p = 0.03) and LVLGE (HR = 1.04, 95% CI = 1.001–1.08, p = 0.04) to be independent predictors for VA. Receiver operative curves showed higher LVMI and LVLGE with a cut-off of 85 g/m2 and 6%, respectively, to be associated with VA. Conclusions: LVMI and LVLGE are strongly associated with VA over long-term follow-up. LVMI requires more thorough studies to consider it as a risk stratification tool in patients with HCM.
Morphological and Functional Remodeling of the Ischemic Heart Correlates with Homocysteine Levels
Authors: Cziraki Attila , Nemeth Zoltan , Szabados Sandor , Nagy Tamas , Szántó Márk , Nyakas Csaba , Koller Akos
Published: March 2023

Background: Homocysteine (Hcy) is involved in various methylation processes, and its plasma level is increased in cardiac ischemia. Thus, we hypothesized that levels of homocysteine correlate with the morphological and functional remodeling of ischemic hearts. Thus, we aimed to measure the Hcy levels in the plasma and pericardial fluid (PF) and correlate them with morphological and functional changes in the ischemic hearts of humans. Methods: Concentration of total homocysteine (tHcy) and cardiac troponin-I (cTn-I) of plasma and PF were measured in patients undergoing coronary artery bypass graft (CABG) surgery (n = 14). Left-ventricular (LV) end-diastolic diameter (LVED), LV end-systolic diameter (LVES), right atrial, left atrial (LA) area, thickness of interventricular septum (IVS) and posterior wall, LV ejection fraction (LVEF), and right ventricular outflow tract end-diastolic area (RVOT EDA) of CABG and non-cardiac patients (NCP; n = 10) were determined by echocardiography, and LV mass was calculated (cLVM). Results: Positive correlations were found between Hcy levels of plasma and PF, tHcy levels and LVED, LVES and LA, and an inverse correlation was found between tHcy levels and LVEF. cLVM, IVS, and RVOT EDA were higher in CABG with elevated tHcy (>12 µM/L) compared to NCP. In addition, we found a higher cTn-I level in the PF compared to the plasma of CABG patients (0.08 ± 0.02 vs. 0.01 ± 0.003 ng/mL, p < 0.001), which was ~10 fold higher than the normal level. Conclusions: We propose that homocysteine is an important cardiac biomarker and may have an important role in the development of cardiac remodeling and dysfunction in chronic myocardial ischemia in humans.
The Influence of Male Ejaculatory Abstinence Time on Pregnancy Rate, Live Birth Rate and DNA Fragmentation: A Systematic Review
Authors: Sørensen Freja , Melsen Linda Magnusson , Fedder Jens , Soltanizadeh Sinor
Published: March 2023

Variation in ejaculatory abstinence time and its influence on semen quality and clinical reproductive outcomes is a growing concern among clinicians and researchers. The WHO (World Health Organization) recommends 2–7 days of abstinence time prior to semen collection for diagnostic purposes; however, the evidence that such an abstinence period leads to better pregnancy outcomes remains unclear. The aim of this systematic review is to evaluate short and long ejaculatory abstinence time in association with pregnancy rate, live birth rate and DNA fragmentation, in order to make a recommendation on an ideal timeframe for ejaculatory abstinence. This review is conducted according to the PRISMA guidelines and registered in PROSPERO (CRD42022379039). The electronic databases PubMed, Embase and Cochrane were searched for eligible studies. The Scottish Intercollegiate Guidelines Network was used for the assessment of the risk of bias across the included studies. Twenty-four studies were included in this systematic review. The included studies confirm that a shorter abstinence time is associated with improved pregnancy rates and live birth rates following assisted reproductive technology compared with longer ejaculatory abstinence times at different cut-off points. Similarly, a lower DNA fragmentation index was reported in semen analyses collected from short abstinence times compared with long abstinence times. However, due to the heterogeneity of the included studies, it is not possible to extract an ideal time of ejaculatory abstinence, but all outcomes improved with shorter ejaculatory abstinence times. This systematic review confirms that short ejaculatory abstinence times, less than those recommended by the WHO for diagnostic purposes, are associated with higher pregnancy and live birth rates and improved DNA fragmentation, when compared to long ejaculatory abstinence times.
The Bone Biomarker of Quantitative Chemical Shift Imaging in Patients with Type 1 Gaucher Disease Receiving Low-Dose Long-Term Enzyme Replacement Therapy
Authors: Zimran Ari , Szer Jeff , Becker-Cohen Michal , Jens Sjoerd , Cozma Claudia , Revel-Vilk Shoshana
Published: March 2023

Quantitative chemical shift imaging (QCSI) is the most sensitive imaging biomarker to assess bone marrow involvement in Gaucher disease. Widespread QCSI use is limited by test availability. Anecdotal reports describe two patients demonstrating significant improvement in fat fraction (FF) assessed by QCSI following a switch from imiglucerase to taliglucerase alfa. This analysis evaluated bone marrow involvement in adults with Type 1 Gaucher disease receiving low-dose enzyme replacement therapy (ERT) with imiglucerase and/or velaglucerase alfa. We report baseline data for 30 patients meeting eligibility criteria. Median (range) duration and dose of ERT were 18 (5–26) years and 30 (30–60) U/kg/month, respectively. Low FF scores (<0.30) were observed for seven patients (23%; 95% confidence interval, 10–42%) and were more common in females (n = 6) versus males (n = 1; p < 0.025); one female was menopausal. These baseline data demonstrate that prolonged low-dose ERT with imiglucerase or velaglucerase alfa led to an adequate bone response, assessed by QCSI, in the majority of patients. A minority of such patients with suboptimal bone response require therapeutic change. The next phase of the study will address the effect of switching to taliglucerase alfa on bone status for patients with less than optimal QCSI scores (<0.30).
Review of Possible Therapies in Treatment of Novichoks Poisoning and HAZMAT/CBRNE Approaches: State of the Art
Authors: Noga Maciej , Michalska Agata , Jurowski Kamil
Published: March 2023

Novichoks-organophosphorus compounds belong to the nerve agents group, constituting the fourth generation of chemical warfare agents. The tremendous toxicity of Novichoks is assumed to be several times greater than that of VX, whereas no published experimental research supports this. They were surreptitiously created during the Cold War by the Soviet Union. Novichok’s toxic action mechanism consists of the inhibition of acetylcholinesterase activity. The review includes data on treating poisoning caused by OPs which could be used as guidelines for the therapy in case of Novichok exposure and HAZMAT/CBRNE approaches. Novichoks pose a severe threat due to their toxicity; however, there is insufficient information about the identity of A-series nerve agents. Filling in the missing data gaps will accelerate progress in improving protection against Novichoks and developing optimal therapy for treating poisoning casualties. Furthermore, introducing solutions to protect medical personnel in contact with a hazardous substance increases the chances of saving casualties of HAZMAT/CBRNE incidents.
Safety and Efficacy of Different Anticoagulant Doses for Patients with COVID-19 in the ICU: A Systematic Review and Meta-Analysis
Authors: Rachina Svetlana , Belkova Yuliya , Shchendrygina Anastasia , Suvorov Aleksandr , Bourgeois Denis , Karuk Marina , Sitnikova Violetta , Dyatlov Nikita
Published: March 2023

Critically ill COVID-19 patients have a high incidence of thromboembolic events, which significantly influence the risk of mortality. Anticoagulant therapy is generally recommended to these patients but the optimal dosing regimens require further investigations. The objective of this systematic review and meta-analysis was to assess the efficacy and safety of prophylactic, intermediate and therapeutic dose anticoagulation in COVID-19 patients admitted to the ICU. A systematic search for original prospective observational studies and clinical trials was performed in online databases from 2020 to 2022. A total of 13 studies (3239 patients) were included. The type of anticoagulant dosing showed no significant influence on short-term mortality (p = 0.84), deep vein thrombosis (p = 0.66), arterial thrombosis (p = 0.44), major bleeding (p = 0.35) and minor bleeding incidence (p = 0.46). An anticoagulation regimen significantly influenced pulmonary embolism occurrence (16% for prophylactic dose vs. 4% for therapeutic dose, p = 0.02), but the number of studies in the analysis was relatively low. In conclusion, the results of this meta-analysis suggest that critically ill COVID-19 patients admitted in the ICU have no benefit from therapeutic doses of anticoagulants and that all three thromboprophylaxis regimes have a comparable effect on short term mortality and venous thromboembolism incidence but for pulmonary embolism, for which the results were inconclusive.
Correction: Yamamoto et al. Trends in Open vs. Endoscopic Carpal Tunnel Release: A Comprehensive Survey in Japan. J. Clin. Med. 2022, 11, 4966
Authors: Yamamoto Michiro , Curley James , Hirata Hitoshi
Published: March 2023

In the original publication [...]
Multimorbidity of Allergic Conditions in Urban Citizens of Southern China: A Real-World Cross-Sectional Study
Authors: Li Ya-Ting , Hou Ming-Hui , Lu Ya-Xin , Chen Pei-Ran , Dai Zhen-Yuan , Yang Li-Fen , Zhang Ping-Ping , Xiong Guo-Wei , Liu Zi-Feng , Zhou Qi-Lin , Su Jing , Cheng Yun , Zhou Yu-Qi , Tao Jin , Huang Xue-Kun , Dai Min , Zhang Kun , Zhou Min , Yang Qin-Tai , Feng Pei-Ying , Chen Zhuang-Gui
Published: March 2023

Background: Extensive knowledge of allergic multimorbidities is required to improve the management of allergic diseases with the industrialization of China. However, the demography and allergen distribution patterns of allergic multimorbidities in China remain unclear, despite the increasing prevalence of allergies. Methods: This was a real-world, cross-sectional study of 1273 outpatients diagnosed with one or more allergic diseases in Guangzhou, the most populated city of southern China, with leading industrial and commercial centers, between April 2021 and March 2022. Seven allergic diseases (allergic rhinitis (AR), asthma (AS)/cough variant asthma (CVA), atopic dermatitis (AD)/eczema, food allergy (FA), allergic conjunctivitis (AC), drug allergy (DA), and anaphylaxis) were assessed. Positive rates of sensitization to different allergens were measured using an allergen detection system of the UniCAP (Pharmacia Diagnostics, Sweden) instrument platform to compare the groups of allergic multimorbidities against a single entity. Results: There were 659 (51.8%) males and 614 (48.2%) females aged from 4 months to 74 years included in the analysis. The study participants who were diagnosed with allergic diseases had an average of 1.6 diagnoses. Overall, 46.5% (592 of 1273) of the patients had more than one allergic condition, and allergic rhinitis was the most common type of multimorbidity. Women were more likely to suffer from an allergic disease alone, whereas allergic multimorbidities were more likely to be diagnosed in men (p = 0.005). In addition, allergic multimorbidities were common in all age groups, with an incidence ranging from 37.1% to 57.4%, in which children and adolescents were more frequently diagnosed with allergic multimorbidities than adults (18–60 years old) (all p < 0.05). Allergic multimorbidity was observed throughout the year. A difference in the positive rate of allergens sensitization and total immunoglobulin E (tIgE) levels between different allergic multimorbidities was observed. Conclusions: Allergic multimorbidities were very commonly found in nearly half of all patients with allergies. The proportion of allergic multimorbidities varied with the type of disease, sex, age, and allergen distribution pattern. These findings may help clinicians to develop “One health” strategies for the clinical management of allergic diseases.
Posterior Preventive Foraminotomy before Laminectomy Combined with Pedicle Screw Fixation May Decrease the Incidence of C5 Palsy in Complex Cervical Spine Surgery in Patients with Severe Myeloradiculopathy
Authors: Lee Yong-Ho , Abdou Mahmoud , Kwon Ji-Won , Suk Kyung-Soo , Moon Seong-Hwan , Won You-Gun , Lee Tae-Jin , Lee Byung-Ho
Published: March 2023

C5 palsy is a frequent sequela of cervical decompression surgeries for cervical myeloradiculopathy. Although many researchers have suggested various risk factors, such as cord shifting and the correction of lordotic angles, the tethering of the C5 root beneath the narrow foramen is an independent risk factor for C5 palsy. In this study, we tried to investigate different techniques for foramen decompression with posterior cervical fusion and assess the incidence of C5 palsy with each technique depending on the order of foraminal decompression. A combined 540° approach with LMS and uncovertebrectomy was used in group 1. Group 2 combined a 540° approach with pedicle screws and posterior foraminotomy, while posterior approach only with pedicle screws and foraminotomy was used in group 3. For groups 2 and 3, prophylactic posterior foraminotomy was performed before laminectomy. Motor manual testing to assess C5 palsy, the Neck Disability Index (NDI) and the Japanese Orthopedic Association (JOA) scores were determined before and after surgery. Simple radiographs, MRI and CT scans, were obtained to assess radiologic parameters preoperatively and postoperatively. A total of 362 patients were enrolled in this study: 208 in group 1, 72 in group 2, and 82 in group 3. The mean age was 63.2, 65.5, and 66.6 years in groups 1, 2, and 3, respectively. The median for fused levels was 4 for the three groups. There was no significant difference between groups regarding the number of fused levels. Weight, height, comorbidities, and diagnosis were not significantly different between groups. Preoperative JOA scores were similar between groups (p = 0.256), whereas the preoperative NDI score was significantly higher in group 3 than in group 2 (p = 0.040). Mean JOA score at 12-month follow-up was 15.5 ± 1.89, 16.1 ± 1.48, and 16.1 ± 1.48 for groups 1, 2, and 3, respectively; it was higher in group 3 compared with group 1 (p = 0.008) and in group 2 compared with group 1 (p = 0.024). NDI score at 12 months was 13, 12, and 13 in groups 1, 2, and 3, respectively; it was significantly better in group 3 than in group 1 (p = 0.040), but there were no other significant differences between groups. The incidence of C5 palsy was significantly lower in posterior foraminotomy groups with pedicle screws (groups 2 and 3) than in LMS with uncovertebrectomy (group 1) (p < 0.001). Thus, preventive expansive foraminotomy before decompressive laminectomy is able to significantly decrease the root tethering by stenotic lesion, and subsequently, decrease the incidence of C5 palsy associated with posterior only or combined posterior and anterior cervical fusion surgeries. Additionally, such expansive foraminotomy might be appropriate with pedicle screw insertion based on biomechanical considerations.
Predicting Gross Motor Function in Children and Adolescents with Cerebral Palsy Applying Artificial Intelligence Using Data on Assistive Devices
Authors: von Elling-Tammen Lisa , Stark Christina , Wloka Kim Ramona , Alberg Evelyn , Schoenau Eckhard , Duran Ibrahim
Published: March 2023

Data obtained from routine clinical care find increasing use in a scientific context. Many routine databases, e.g., from health insurance providers, include records of medical devices and therapies, but not on motor function, such as the frequently used Gross Motor Function Measure-66 (GMFM-66) score for children and adolescents with cerebral palsy (CP). However, motor function is the most common outcome of therapeutic efforts. In order to increase the usability of available records, the aim of this study was to predict the GMFM-66 score from the medical devices used by a patient with CP. For this purpose, we developed the Medical Device Score Calculator (MDSC) based on the analysis of a population of 1581 children and adolescents with CP. Several machine learning algorithms were compared for predicting the GMFM-66 score. The random forest algorithm proved to be the most accurate with a concordance correlation coefficient (Lin) of 0.75 (0.71; 0.78) with a mean absolute error of 7.74 (7.15; 8.33) and a root mean square error of 10.1 (9.51; 10.8). Our findings suggest that the MDSC is appropriate for estimating the GMFM-66 score in sufficiently large patient groups for scientific purposes, such as comparison or efficacy of different therapies. The MDSC is not suitable for the individual assessment of a child or adolescent with CP.
Vascular Responses following Light Therapy: A Pilot Study with Healthy Volunteers
Authors: Saloň Adam , Steuber Bianca , Neshev Ruslan , Schmid-Zalaudek Karin , De Boever Patrick , Bergmann Eva , Picha Rainer , Fredriksen Per Morten , Nkeh-Chungag Benedicta Ngwechi , Goswami Nandu
Published: March 2023

(1) Background: Studies have reported the effectiveness of light therapy in various medical conditions. Our pilot study aimed to assess the effect of Maharishi light therapy (MLT) on physiological parameters, such as the heart rate (HR), HR variability (HRV), blood pressure (BP), BP variability (BPV), and the retinal microvasculature of healthy participants; (2) Methodology: Thirty (14 males and 16 females) healthy, non-smoking participants between 23 and 71 years old (46 ± 18 years) were included in this randomized crossover study. Each participant was tested with a placebo (using LED light) and gem lights, 24 h apart. Hemodynamic parameters were recorded during the session, and 24 h heart rate and BP levels were assessed via mobile devices. Retinal vascular responses were captured with fundus images and the subsequent analysis of retinal vessel widths. A linear model, using repeated measures ANOVA, was used to compare the responses across the sexes and to assess the effect of the MLT; (3) Results: Changes in the central retinal artery equivalent (CRAE) (p < 0.001) and central retinal vein equivalent (CRVE) (p = 0.002) parameters were observed. CRAE and CRVE decreased under MLT and increased under the placebo condition from before to after. However, the baseline values of the participants already differed significantly before the application of any therapy, and the variation in the retinal vessel diameters was already large in the baseline measurements. This suggests that the observed effect results may only reflect naturally occurring fluctuations in the microcirculation and not the effect of MLT. Furthermore, no significant effects were observed in any other investigated parameters; (4) Conclusion: Our study with healthy participants finds significant changes in retinal parameters, but the biological variation in the baseline measurements was large to begin with. This suggests that the observed effect results only reflect naturally occurring fluctuations in the microcirculation and not the effect of MLT. However, in the future, larger studies in which MLT is applied for longer periods and/or in patients with different diseases could discover the physiological impacts of this type of therapy.
Adropin Predicts Chronic Kidney Disease in Type 2 Diabetes Mellitus Patients with Chronic Heart Failure
Authors: Berezina Tetiana A. , Obradovic Zeljko , Boxhammer Elke , Berezin Alexander A. , Lichtenauer Michael , Berezin Alexander E.
Published: March 2023

Adropin is a multifunctional secreted protein, which is involved in the metabolic modulation of the heart-brain-kidney axis in heart failure (HF). The aim of the study was to detect the plausible predictive value of serum levels of adropin for chronic kidney disease (CKD) grades 1–3 in type 2 diabetes mellitus (T2DM) patients with chronic HF. We enrolled 417 T2DM individuals with chronic HF and subdivided them into two groups depending on the presence of CKD. The control group was composed of 25 healthy individuals and 30 T2DM patients without HF and CKD. All eligible patients underwent an ultrasound examination. Adropin was detected by ELISA in blood samples at the study baseline. We found that adropin levels in T2DM patients without HF and CKD were significantly lower than in healthy volunteers, but they were higher than in T2DM patients with known HF. The optimal cut-off point for adropin levels was 2.3 ng/mL (area under the curve [AUC] = 0.86; 95% CI = 0.78–0.95; sensitivity = 81.3%, specificity = 77.4%). The multivariate logistic regression adjusted for albuminuria/proteinuria showed that serum levels of adropin <2.30 ng/mL (OR = 1.55; p = 0.001) independently predicted CKD. Conclusions: Low levels of adropin in T2DM patients with chronic CH seem to be an independent predictor of CKD at stages 1–3.
The Role of Rehabilitation in Arterial Function Properties of Convalescent COVID-19 Patients
Authors: Gounaridi Maria Ioanna , Vontetsianos Angelos , Oikonomou Evangelos , Theofilis Panagiotis , Chynkiamis Nikolaos , Lampsas Stamatios , Anastasiou Artemis , Papamikroulis Georgios Angelos , Katsianos Efstratios , Kalogeras Konstantinos , Pesiridis Theodoros , Tsatsaragkou Aikaterini , Vavuranakis Manolis , Koulouris Nikolaos , Siasos Gerasimos
Published: March 2023

Coronavirus disease (COVID-19) is a respiratory disease, although arterial function involvement has been documented. We assess the impact of a post-acute COVID-19 rehabilitation program on endothelium-dependent vasodilation and arterial wall properties. We enrolled 60 convalescent patients from COVID-19 and one-month post-acute disease, who were randomized at a 1:1 ratio in a 3-month cardiopulmonary rehabilitation program (study group) or not (control group). Endothelium-dependent vasodilation was evaluated by flow-mediated dilation (FMD), and arterial wall properties were evaluated by carotid–femoral pulse wave velocity (cf-PWV) and augmentation index (AIx) at 1 month and at 4 months post-acute disease. FMD was significantly improved in both the study (6.2 ± 1.8% vs. 8.6 ± 2.4%, p < 0.001) and control groups (5.9 ± 2.2% vs. 6.6 ± 1.8%, p = 0.009), but the improvement was significantly higher in the study group (rehabilitation) (p < 0.001). PWV was improved in the study group (8.2 ± 1.3 m/s vs. 6.6 ± 1.0 m/s, p < 0.001) but not in the control group (8.9 ± 1.8 m/s vs. 8.8 ± 1.9 m/s, p = 0.74). Similarly, AIx was improved in the study group (25.9 ± 9.8% vs. 21.1 ± 9.3%, p < 0.001) but not in the control group (27.6 ± 9.2% vs. 26.2 ± 9.8 m/s, p = 0.15). Convalescent COVID-19 subjects of the study group (rehabilitation) with increased serum levels of circulating IL-6 had a greater reduction in FMD. Conclusively, a 3-month cardiopulmonary post-acute COVID-19 rehabilitation program improves recovery of endothelium-dependent vasodilation and arteriosclerosis.
Insights on the Association between Thyroid Diseases and Colorectal Cancer
Authors: Gagliardi Federica , Baldini Enke , Lori Eleonora , Cardarelli Silvia , Pironi Daniele , Lauro Augusto , Tripodi Domenico , Palumbo Piergaspare , D’Armiento Eleonora , Cavallaro Giuseppe , Polistena Andrea , D’Orazi Valerio , Sibio Simone , Fallahi Poupak , Antonelli Alessandro , D’Andrea Vito , Ulisse Salvatore , Sorrenti Salvatore
Published: March 2023

Benign and malignant thyroid diseases (TDs) have been associated with the occurrence of extrathyroidal malignancies (EMs), including colorectal cancers (CRCs). Such associations have generated a major interest, as their characterization may provide useful clues regarding diseases’ etiology and/or progression, with the possible identification of shared congenital and environmental elements. On the other hand, elucidation of the underlying molecular mechanism(s) could lead to an improved and tailored clinical management of these patients and stimulate an increased surveillance of TD patients at higher threat of developing EMs. Here, we will examine the epidemiological, clinical, and molecular findings connecting TD and CRC, with the aim to identify possible molecular mechanism(s) responsible for such diseases’ relationship.
Study of Modifications Induced by Continued Direct Oral Anticoagulant Therapy during Atrial Fibrillation Ablation Procedures on Standard Hemostasis Parameters
Authors: Muller Marie , Godet Julien , Delabranche Xavier , Sattler Laurent , Millard David , Marzak Halim , Mertes Paul Michel , Steib Annick , Grunebaum Lelia , Jesel Laurence , Tacquard Charles Ambroise
Published: March 2023

Background: Unfractionated heparin (UFH) is used as an anticoagulant during the atrial fibrillation (AF) ablation procedure to prevent the occurrence of thromboembolic events. Guidelines recommend an activated clotting time (ACT) greater than 300 s (s) based on studies of patients treated with vitamin K antagonist (VKA) for their AF. However, direct oral anticoagulants (DOACs) have supplanted VKAs in AF and are now used as first-line therapy. It is recommended not to interrupt them during the procedure, which could interfere with the ACT measures. Objective: To assess the real-life relationship between ACT, DOAC concentrations, and UFH anti-Xa activity in patients treated by uninterrupted DOAC therapy. Methods: We conducted a single-center retrospective study. We analyzed consecutive patients with AF who underwent catheter ablation under DOAC therapy. Results: In total, 40 patients were included, including 15 (37.5%), 20 (50.0%), and 5 (12.5%) on rivaroxaban, apixaban, and dabigatran, respectively. Baseline ACT was significantly lower in the apixaban group. ACT was linearly correlated with the residual concentration of apixaban and dabigatran but not with rivaroxaban. After UFH injection, ACT was linearly correlated with the anti-Xa activity, regardless of DOAC. Patients in the apixaban group received a higher total dose of UFH during the procedure to achieve a target ACT > 300 s, which resulted in significantly higher anti-Xa activity during the procedure. Conclusion: Our results raise the question of optimal management of intra-procedural heparin therapy and highlight the limitations of the ACT test, particularly in patients on apixaban.
Albumin–Globulin Score Combined with Skeletal Muscle Index as a Novel Prognostic Marker for Hepatocellular Carcinoma Patients Undergoing Liver Transplantation
Authors: Huang Yang , Wang Ning , Xu Liangliang , Wu Youwei , Li Hui , Jiang Li , Xu Mingqing
Published: March 2023

Background: Sarcopenia was recently identified as a poor prognostic factor in patients with malignant tumors. The present study investigated the effect of the preoperative albumin–globulin score (AGS), skeletal muscle index (SMI), and combination of AGS and SMI (CAS) on short- and long-term survival outcomes following deceased donor liver transplantation (DDLT) for hepatocellular carcinoma (HCC) and aimed to identify prognostic factors. Methods: A total of 221 consecutive patients who underwent DDLT for HCC were enrolled in this retrospective study between January 2015 and December 2019. The skeletal muscle cross-sectional area was measured by CT (computed tomography). Clinical cutoffs of albumin (ALB), globulin (GLB), and sarcopenia were defined by receiver operating curve (ROC). The effects of the AGS, SMI, and CAS grade on the preoperative characteristics and long-term outcomes of the included patients were analyzed. Results: Patients who had low AGS and high SMI were associated with better overall survival (OS) and recurrence-free survival (RFS), shorter intensive care unit (ICU) stay, and fewer postoperative complications (grade ≥ 3, Clavien–Dindo classification). Stratified by CAS grade, 46 (20.8%) patients in grade 1 were associated with the best postoperative prognosis, whereas 79 (35.7%) patients in grade 3 were linked to the worst OS and RFS. The CAS grade showed promising accuracy in predicting the OS and RFS of HCC patients [areas under the curve (AUCs) were 0.710 and 0.700, respectively]. Male recipient, Child–Pugh C, model for end-stage liver disease (MELD) score > 20, and elevated CAS grade were identified as independent risk factors for OS and RFS of HCC patients after DDLT. Conclusion: CAS grade, a novel prognostic index combining preoperative AGS and SMI, was closely related to postoperative short-term and long-term outcomes for HCC patients who underwent DDLT. Graft allocation and clinical decision making may be referred to CAS grade evaluation.
Malnutrition and Insulin Resistance May Interact with Metabolic Syndrome in Prevalent Hemodialysis Patients
Authors: Kobayashi Shuzo , Mochida Yasuhiro , Ishioka Kunihiro , Oka Machiko , Maesato Kyoko , Moriya Hidekazu , Hidaka Sumi , Ohtake Takayasu
Published: March 2023

Background: We sought to determine the prevalence of metabolic syndrome (Mets) and whether 100 cm2 of visceral fatty area (VFA) measured by computed tomography (CT) validates the criteria of waist circumference (WC) in hemodialysis (HD) patients. Methods: The study comprised 141 HD patients. Mets was defined according to the criteria of Adult Treatment Panel III (ATP III) and the modified criteria of National Cholesterol Education Program (NCEP) that defines abdominal obesity as a WC of >=85 cm in men and >=90 cm in women. Results: The prevalence of Mets was 31.9% in men and 13.6% in women. However, the prevalence of patients with a body mass index over 25 in all HD patients was only 11.2%. The visceral fatty area (VFA) measured by CT showed a strong positive correlation with WC. The patients with Mets, comparing with those without Mets, have significantly shorter duration of HD, higher high-sensitive C-reactive protein, and higher Homeostatic Model Assessment for Insulin Resistance (HOMA-IR). In the patients with Mets, there was a significant negative correlation between HOMA-IR and serum albumin levels. Multivariate logistic regression analysis showed that HOMA-IR and short duration of HD were chosen as independent risk factors for Mets. Conclusions: Mets is more prevalent in HD patients. In Japanese HD patients, 100 cm2 of VFA corresponded to a WC of 85 cm in men and 90 cm in women, thus confirming the validity of the modified criteria. HOMA-IR and serum albumin were significantly correlated in HD patients with Mets.
Recent Advances in Endometrial Cancer Management
Authors: Di Donato Violante , Giannini Andrea , Bogani Giorgio
Published: March 2023

In recent years, growing attempts have been carried out to improve the quality of care in the setting of gynecologic oncology, and, in particular, in endometrial cancer management [...]
A Five Glutamine-Associated Signature Predicts Prognosis of Prostate Cancer and Links Glutamine Metabolism with Tumor Microenvironment
Authors: Wang Hai , Chen Yuxiao , Zhao Wei , Liu Haolin , Tu Hongtao , Xia Zhongyou , Wang Rui , Tang Jinze , Zhu Chuang , Li Rui , Liu Xiaodong , Gu Peng
Published: March 2023

Glutamine has been recognized as an important amino acid that provide a variety of intermediate products to fuel biosynthesis. Glutamine metabolism participates in the progression of the tumor via various mechanisms. However, glutamine-metabolism-associated signatures and its significance in prostate cancer are still unclear. In this current study, we identified five genes associated with glutamine metabolism by univariate and Lasso regression analysis and constructed a model to predict the biochemical recurrence free survival (BCRFS) of PCa. Further validation of the prognostic risk model demonstrated a good efficacy in predicting the BCRFS in PCa patients. Interestingly, based on the CIBERSORTx, ssGSEA and ESTIMATE algorithms predictions, we noticed a distinct immune cell infiltration and immune pathway pattern in the prediction of the two risk groups stratified by the risk model. Drug sensitivity prediction revealed that patients in the high-risk group were more suitable for chemotherapy. Last but not least, glutamine deprivation significantly inhibited cell growth in GLUL or ASNS knock down prostate cancer cell lines. Therefore, we proposed a novel prognostic model by using glutamine metabolism genes for PCa patients and identified potential mechanism of PCa progression through glutamine-related tumor microenvironment remodeling.
The Biology of Stress Intolerance in Patients with Chronic Pain—State of the Art and Future Directions
Authors: Wyns Arne , Hendrix Jolien , Lahousse Astrid , De Bruyne Elke , Nijs Jo , Godderis Lode , Polli Andrea
Published: March 2023

Stress has been consistently linked to negative impacts on physical and mental health. More specifically, patients with chronic pain experience stress intolerance, which is an exacerbation or occurrence of symptoms in response to any type of stress. The pathophysiological mechanisms underlying this phenomenon remain unsolved. In this state-of-the-art paper, we summarised the role of the autonomic nervous system (ANS) and hypothalamus-pituitary-adrenal (HPA) axis, the two major stress response systems in stress intolerance. We provided insights into such mechanisms based on evidence from clinical studies in both patients with chronic pain, showing dysregulated stress systems, and healthy controls supported by preclinical studies, highlighting the link between these systems and symptoms of stress intolerance. Furthermore, we explored the possible regulating role for (epi)genetic mechanisms influencing the ANS and HPA axis. The link between stress and chronic pain has become an important area of research as it has the potential to inform the development of interventions to improve the quality of life for individuals living with chronic pain. As stress has become a prevalent concern in modern society, understanding the connection between stress, HPA axis, ANS, and chronic health conditions such as chronic pain is crucial to improve public health and well-being.
Impact of Sociodemographic, Premorbid, and Injury-Related Factors on Patient-Reported Outcome Trajectories after Traumatic Brain Injury (TBI)
Authors: von Steinbuechel Nicole , Hahm Stefanie , Muehlan Holger , Arango-Lasprilla Juan Carlos , Bockhop Fabian , Covic Amra , Schmidt Silke , Steyerberg Ewout W. , Maas Andrew I. R. , Menon David , Andelic Nada , Zeldovich Marina ,   The CENTER-TBI Participants and Investigators
Published: March 2023

Traumatic brain injury (TBI) remains one of the leading causes of death and disability worldwide. To better understand its impact on various outcome domains, this study pursues the following: (1) longitudinal outcome assessments at three, six, and twelve months post-injury; (2) an evaluation of sociodemographic, premorbid, and injury-related factors, and functional recovery contributing to worsening or improving outcomes after TBI. Using patient-reported outcome measures, recuperation trends after TBI were identified by applying Multivariate Latent Class Mixed Models (MLCMM). Instruments were grouped into TBI-specific and generic health-related quality of life (HRQoL; QOLIBRI-OS, SF-12v2), and psychological and post-concussion symptoms (GAD-7, PHQ-9, PCL-5, RPQ). Multinomial logistic regressions were carried out to identify contributing factors. For both outcome sets, the four-class solution provided the best match between goodness of fit indices and meaningful clinical interpretability. Both models revealed similar trajectory classes: stable good health status (HRQoL: n = 1944; symptoms: n = 1963), persistent health impairments (HRQoL: n = 442; symptoms: n = 179), improving health status (HRQoL: n = 83; symptoms: n = 243), and deteriorating health status (HRQoL: n = 86; symptoms: n = 170). Compared to individuals with stable good health status, the other groups were more likely to have a lower functional recovery status at three months after TBI (i.e., the GOSE), psychological problems, and a lower educational attainment. Outcome trajectories after TBI show clearly distinguishable patterns which are reproducible across different measures. Individuals characterized by persistent health impairments and deterioration require special attention and long-term clinical monitoring and therapy.
Realizing Both Antibacterial Activity and Cytocompatibility in Silicocarnotite Bioceramic via Germanium Incorporation
Authors: Ji Yingqi , Yang Shun , Sun Jian , Ning Congqin
Published: March 2023

The treatment of infective or potentially infectious bone defects is a critical problem in the orthopedic clinic. Since bacterial activity and cytocompatibility are always contrary factors, it is hard to have them both in one material. The development of bioactive materials with a good bacterial character and without sacrificing biocompatibility and osteogenic activity, is an interesting and valuable research topic. In the present work, the antimicrobial characteristic of germanium, GeO2 was used to enhance the antibacterial properties of silicocarnotite (Ca5(PO4)2SiO4, CPS). In addition, its cytocompatibility was also investigated. The results demonstrated that Ge–CPS can effectively inhibit the proliferation of both Escherichia coli (E. coli) and Staphylococcus aureus (S. aureus), and it showed no cytotoxicity to rat bone marrow-derived mesenchymal stem cells (rBMSCs). In addition, as the bioceramic degraded, a sustainable release of germanium could be achieved, ensuring long-term antibacterial activity. The results indicated that Ge–CPS has excellent antibacterial activity compared with pure CPS, while no obvious cytotoxicity was observed, which could make it a promising candidate for the bone repair of infected bone defects.
Fluorescence In Situ Hybridization (FISH) for the Characterization and Monitoring of Primary Cultures from Human Tumors
Authors: Román-Lladó Ruth , Aguado Cristina , Jordana-Ariza Núria , Roca-Arias Jaume , Rodríguez Sonia , Aldeguer Erika , Garzón-Ibañez Mónica , García-Peláez Beatriz , Vives-Usano Marta , Giménez-Capitán Ana , Aguilar Andrés , Martinez-Bueno Alejandro , Cao María Gonzalez , García-Casabal Florencia , Viteri Santiago , Mayo de las Casas Clara , Rosell Rafael , Molina-Vila Miguel Angel
Published: March 2023

Genetic and drug sensitivity assays on primary cultures are not only of basic but also of translational interest and could eventually aid oncologists in the selection of treatments. However, cancer cells need to be identified and differentiated from the non-tumor cells always present in primary cultures. Also, successive passages can change the proportions of these two subpopulations. In this study, we propose fluorescence in situ hybridization (FISH) analysis on cell smears to determine the presence of tumor cells in primary cultures obtained from patients carrying translocations or copy number gains. FISH proved to be an easy, fast, economic, and reliable method of characterizing cell populations, which could be used repeatedly at different passages to monitor variations and to confirm the maintenance of translocations and copy number gains throughout the culture process.
Computational Fluid Mechanics Methods and Applications in Marine Engineering
Authors: Du Peng , Ouahsine Abdellatif , Hu Haibao , Chen Xiaopeng
Published: March 2023

Ocean flows and their interactions with marine structures, vehicles, etc [...]
Time Variation Trend of Wave Power Density in the South China Sea
Authors: Li Hongyu , Gao Qingshan , Yang Shaobo , Ma Weizhuang , Zhen Dongsong , Zhang Yu
Published: March 2023

Based on the third-generation wave model WAVEWATCH-III (WW3), this paper analyzes the changing trend of wave power density (WPD) in the South China Sea, which can provide necessary references for the development and utilization of wave energy resources in the future. In this study, multi-platform cross-calibrated (CCMP) wind data was used to drive WW3 to calculate the WPD of the South China Sea. The Mann-Kendall (MK) algorithm can be used to determine the mutation of WPD, and the accuracy of the CCMP wind was verified. Next, the time distribution of WPD is analyzed for the whole sea area and dominant sea area of the South China Sea, and on this basis, the dominant sea area for the development of wave energy resources in the South China Sea was studied. The results are as follows: (1) Extreme weather has a significant impact on the change of WPD in the South China Sea, and this change is likely due to the effect of extreme weather on sea temperature. (2) Dongsha Islands has the highest annual WPD value and has the greatest impact on the overall trend change of the South China Sea. (3) Integrated wave energy exploitability and safety and technology perspectives, the waters around Taiwan Strait are more suitable as the primary site for energy conversion.
Development of a Cascade Intelligent System for Path Planning of the Group of Marine Robotic Complexes
Authors: Nikushchenko Dmitry , Maevskiy Andrey , Kozhemyakin Igor , Ryzhov Vladimir , Bondar Alexander , Goreliy Artem , Pechaiko Ivan , Nikitina Ekaterina
Published: March 2023

Artificial Intelligence (hereinafter referred to as AI) systems have recently found great application and use in various industries, such as data processing, data analysis, and the operation control of marine robotic complexes, etc. In view of the ever-increasing degree of complexity of the missions assigned to marine robotic systems, it is becoming obvious that the AI technologies should be used as combined systems which can provide control of marine robotic complexes (hereinafter referred to as MRCs), their navigation in sea, logic formation of MRC behaviour in uncertain environments, path planning, and processing optimization of the received MRC payload data. All the areas mentioned above are within the field of MRC development, and currently do not have a general solution. This article discusses the development process of an intelligent system for path planning of a group of marine robotic complexes. The architecture of the intelligent system is based on a cascade approach, which includes the consistent use of functional modules designed as various “organs of perception” of the system. A detailed description of the development of each module and mathematical modelling of the presented algorithms are provided in this paper, and the main results of the conducted full-scale experiments are demonstrated.
Influence of Algal Organic Matter on Algal Removal Efficiency by Flocculation of Modified Clay
Authors: Wang Mingyong , Zhang Bowen , Cao Xihua , Li Fang , Song Xiuxian , Yu Zhiming
Published: March 2023

Modified clay (MC) technology is the most effective method to control harmful algal blooms (HABs) and has been widely testified in many countries in recent decades. Although dissolved algal organic matter (dAOM) has been found to be abundant in HAB-affected waters, little is known about its effect on MC flocculation. Prorocentrum donghaiense was chosen as the model organism in this study. The flocculation of MC with different concentrations of dAOM was observed by particle image velocimeter, and the removal efficiency of MC to microalgae was determined using a fluorometer. The results showed that a small amount of dAOM resulted in faster flocculation, larger flocs, higher floc strength and better floc regeneration capacity, and the removal efficiency of microalgae by MC could reach about 80%. However, large amounts of dAOM produced during the occurrence of HABs could inhibit the flocculation of MC, and the removal efficiency of microalgae was only about 35%. Furthermore, with the increase of dAOM, the zeta potential of MC particles decreases from 1.56 mV to −18.9 mV, and the repulsive force between the particles also increases. The examination of 18-angle laser light scattering gel permeation chromatography and specific ultraviolet absorption (SUVA254) revealed that some hydrophobic organic macromolecules preferred to attach to MC and increase MC flocculation at a tiny amount of dAOM, while a higher concentration of dAOM would inhibits flocculation by reducing surface activity and intergranular repulsion. According to the findings of this study, the dosage of MC must be increased in order to obtain the best algal removal efficiency with MC.
Maximizing Green Hydrogen Production from Water Electrocatalysis: Modeling and Optimization
Authors: Rezk Hegazy , Olabi A. G. , Abdelkareem Mohammad Ali , Alahmer Ali , Sayed Enas Taha
Published: March 2023

The use of green hydrogen as a fuel source for marine applications has the potential to significantly reduce the carbon footprint of the industry. The development of a sustainable and cost-effective method for producing green hydrogen has gained a lot of attention. Water electrolysis is the best and most environmentally friendly method for producing green hydrogen-based renewable energy. Therefore, identifying the ideal operating parameters of the water electrolysis process is critical to hydrogen production. Three controlling factors must be appropriately identified to boost hydrogen generation, namely electrolysis time (min), electric voltage (V), and catalyst amount (μg). The proposed methodology contains the following two phases: modeling and optimization. Initially, a robust model of the water electrolysis process in terms of controlling factors was established using an adaptive neuro-fuzzy inference system (ANFIS) based on the experimental dataset. After that, a modern pelican optimization algorithm (POA) was employed to identify the ideal parameters of electrolysis duration, electric voltage, and catalyst amount to enhance hydrogen production. Compared to the measured datasets and response surface methodology (RSM), the integration of ANFIS and POA improved the generated hydrogen by around 1.3% and 1.7%, respectively. Overall, this study highlights the potential of ANFIS modeling and optimal parameter identification in optimizing the performance of solar-powered water electrocatalysis systems for green hydrogen production in marine applications. This research could pave the way for the more widespread adoption of this technology in the marine industry, which would help to reduce the industry’s carbon footprint and promote sustainability.