bluuebunny/crossref_metadata_2025 huggingface dataset:
Longitudinal Internal Validity of the Quality of Life after Brain Injury: Response Shift and Responsiveness
Authors: Zeldovich Marina , Hahm Stefanie , Mueller Isabelle , Krenz Ugne , Bockhop Fabian , von Steinbuechel Nicole ,   the CENTER-TBI Participants and Investigators
Published: May 2023

The Quality of Life after Brain Injury (QoLIBRI) questionnaire was developed and validated to assess disease-specific health-related quality of life (HRQoL) in individuals after TBI. The present study aims to determine its longitudinal validity by assessing its responsiveness and response shift from 3 to 6 months post-injury. Analyses were based on data from the European longitudinal observational cohort Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury study. A total of 1659 individuals recovering from TBI were included in the analyses. Response shift was assessed using longitudinal measurement invariance testing within the confirmatory factor analyses framework. Responsiveness was analyzed using linear regression models that compared changes in functional recovery as measured by the Glasgow Outcome Scale–Extended (GOSE) with changes in the QoLIBRI scales from 3 to 6 months post-injury. Longitudinal tests of measurement invariance and analyses of discrepancies in practical significance indicated the absence of response shift. Changes in functional recovery status from three to six months were significantly associated with the responsiveness of the QoLIBRI scales over the same time period. The QoLIBRI can be used in longitudinal studies and is responsive to changes in an individual’s functional recovery during the first 6 months after TBI.
Serum Pancreatic Stone Protein Reference Values in Healthy Pregnant Women: A Prospective Cohort Study
Authors: Vonzun Ladina , Brun Romana , Gadient-Limani Nora , Schneider Marcel André , Reding Theresia , Graf Rolf , Limani Perparim , Ochsenbein-Kölble Nicole
Published: May 2023

Background: In non-pregnant populations, pancreatic stone protein (PSP) has been reported to have a higher diagnostic performance for identifying severe inflammatory and infectious disease than other established biomarkers. Objective: To generate reference values for serum PSP in pregnancy and compare them to the values of the general healthy population. Design: A prospective cohort study. Setting: A single center. Population: Healthy women with singleton and multiple pregnancies. Methods: This is a prospective single-center cohort study. Between 2013 and 2021, samples of 5 mL peripheral blood were drawn from 440 healthy pregnant women. Therein, 393 cases were singletons and 47 were multiple pregnancies. Serum PSP levels were measured by specific enzyme-linked immunosorbent assay. The main outcome measures were serum PSP level (ng/mL) reference values in healthy pregnant women. Results: The mean PSP reference values in women with singleton pregnancies were 7.9 ± 2.6 ng/mL (95% CI; 2.69–13.03 ng/mL). The PSP values in women with multiple pregnancies (9.17 ± 3.06 ng/mL (95% CI; 3.05–15.28 ng/mL)) were significantly higher (p = 0.001). The PSP values in the first trimester (6.94 ± 2.53 ng/mL) were lower compared to the second (7.42 ± 2.21 ng/mL) and third trimesters (8.33 ± 2.68 ng/mL, p = 0.0001). Subgroup analyses in singletons revealed no correlations between PSP values, maternal characteristics, and pre-existing medical conditions. Conclusion: The PSP values in healthy pregnant women (4–12 ng/mL) were in the range of the reference values of the general healthy population (8–16 ng/mL). This insight blazes a trail for further clinical studies on the use of PSP as a potential novel biomarker for the early detection of pregnancy-related diseases such as chorioamnionitis.
Pathways between Risk/Protective Factors and Maternal Postnatal Depressive Symptoms: The ELFE Cohort
Authors: Bales Mélanie , Pambrun Elodie , Maguet Charlotte , van der Waerden Judith , Glangeaud-Freudenthal Nine , Charles Marie-Aline , Bois Corinne , Melchior Maria , Milgrom Jeannette , Falissard Bruno , Verdoux Hélène , Sutter-Dallay Anne-Laure
Published: May 2023

Objective: The risk factors for postnatal depressive symptoms (PNDS) are numerous, but little is known about the protective factors or the interactions between different exposures. The present study explored the pathways between maternal, infant and parenthood vulnerabilities or risk/protective factors and PNDS at 2 months postpartum (PP) in a large sample of women from the general population. Methods: We used data from the French ELFE cohort, a nationally representative cohort of children followed-up from birth. The available information about vulnerabilities or risk/protective factors for PNDS was collected during the maternity ward stay (mother or medical records) and at 2 months PP (mother by phone). PNDS were evaluated with the Edinburgh Postnatal Depression Scale (EPDS) at 2 months. A measurement model was built based on the psychosocial model for PNDS of Milgrom and colleagues using exploratory factor analysis. The Structural Equation Model was used to investigate the pathways between vulnerability, risk/protective factors and PNDS at 2 months PP. Results: In the study sample (n = 11,583), a lack of a partner’s perceived antenatal emotional support, consultation with a mental health specialist before pregnancy, family financial difficulties, prenatal psychological distress and a difficult pregnancy experience were directly associated with the severity of maternal PNDS at 2 months PP, as well as lack of perceived postnatal support. Family financial difficulties and consultation with a mental health specialist before pregnancy were also indirectly associated with the intensity of PNDS through a lack of perceived antenatal emotional support, a difficult pregnancy experience, prenatal psychological distress and a lack of perceived postnatal support. Regarding infant and parenthood characteristics, infant self-regulation difficulties, maternal difficulty in understanding infant crying and infant hospitalisation were directly associated with PNDS severity at 2 months PP, while maternal difficulty in understanding an infant’s cries was also indirectly associated with infant self-regulation difficulties. Conclusions: Perinatal professional support should begin antenatally and target the couple’s prenatal functioning, with particular attention to women presenting a history of psychiatric disorders, especially those of low socioeconomic status. After delivery, addressing infant and parenthood characteristics is also recommended.
Tooth Migration in a Female Patient with Hyperdontia: 11-Year Follow-Up Case Report
Authors: Bogdanowicz Agnieszka , Szwarczyńska Kaja , Zaleska Sonia Barbara , Kulczyk Tomasz , Biedziak Barbara
Published: May 2023

We described an 11-year follow-up of a patient with a non-syndrome multiple supernumerary teeth who had one extra tooth in the maxilla and four additional premolars in the mandible. Together with an additional distal migration of the second lower right premolar to the ramus of the mandible that also occurred, it comprises a unique combination of conditions that were not previously presented in the literature. We showed the significance of routine X-rays in cases of hyperdontia since the additional teeth may develop later than expected and the patient may not experience any symptoms.
Cardiometabolic Effects of Cabergoline and Combined Oral Contraceptive Pills in Young Women with Hyperprolactinemia: A Pilot Study
Authors: Krysiak Robert , Kowalcze Karolina , Okopień Bogusław
Published: May 2023

Although dopaminergic agents are the drugs of choice in treatment of prolactin excess, women who cannot be treated with these agents are recommended to receive estrogen preparations. The aim of this study was to compare cardiometabolic effects of both treatment options. The study population included three groups of young women. Subjects with mild-to-moderate hyperprolactinemia received either low-dose cabergoline or oral combined contraceptives (ethinyl estradiol plus desogestrel), while normoprolactinemic women were drug-naive. Plasma prolactin, glucose homeostasis markers, lipids, circulating levels of uric acid, high-sensitivity C-reactive protein (hsCRP), fibrinogen and homocysteine, and the urinary albumin-to-creatinine ratio (UACR) were assessed at entry and six months later. Hyperprolactinemic women differed from normoprolactinemic ones in glucose homeostasis markers, high-density lipoprotein (HDL)-cholesterol, triglycerides, uric acid, hsCRP, fibrinogen, homocysteine and UACR. Cabergoline decreased total and monomeric prolactin levels, which was accompanied by normalization of glucose, insulin sensitivity, glycated hemoglobin, HDL-cholesterol, triglycerides, uric acid, hsCRP, fibrinogen, homocysteine and UACR. Despite a neutral effect on prolactin levels, combined contraceptives worsened insulin sensitivity and increased triglycerides, hsCRP, fibrinogen and UACR. At follow-up, cabergoline-treated women were characterized by a better cardiometabolic profile than women receiving ethinyl estradiol plus desogestrel. Our findings suggest that only cabergoline reduces cardiometabolic risk in young women with hyperprolactinemia.
Exploring the Potential of Artificial Intelligence in Pediatric Echocardiography—Preliminary Results from the First Pediatric Study Using AI Software Developed for Adults
Authors: Vasile Corina Maria , Bouteiller Xavier Paul , Avesani Martina , Velly Camille , Chan Camille , Jalal Zakaria , Thambo Jean-Benoit , Iriart Xavier
Published: May 2023

(1) Background: Transthoracic echocardiography is the first-line non-invasive investigation for assessing pediatric patients’ cardiac anatomy, physiology, and hemodynamics, based on its accessibility and portability, but complete anatomic and hemodynamic assessment is time-consuming. (2) Aim: This study aimed to determine whether an automated software developed for adults could be effectively used for the analysis of pediatric echocardiography studies without prior training. (3) Materials and Methods: The study was conducted at the University Hospital of Bordeaux between August and September 2022 and included 45 patients with normal or near normal heart architecture who underwent a 2D TTE. We performed Spearman correlation and Bland-Altman analysis. (4) Results: The mean age of our patients at the time of evaluation was 8.2 years ± 5.7, and the main reason for referral to our service was the presence of a heart murmur. Bland-Altman analysis showed good agreement between AI and the senior physician for two parameters (aortic annulus and E wave) regardless of the age of the children included in the study. A good agreement between AI and physicians was also achieved for two other features (STJ and EF) but only for patients older than 9 years. For other features, either a good agreement was found between physicians but not with the AI, or a poor agreement was established. In the first case, maybe proper training of the AI could improve the measurement, but in the latter case, for now, it seems unrealistic to expect to reach a satisfactory accuracy. (5) Conclusion: Based on this preliminary study on a small cohort group of pediatric patients, the AI soft originally developed for the adult population, had provided promising results in the evaluation of aortic annulus, STJ, and E wave.
Excessive Gestational Weight Gain and Pregnancy Outcomes
Authors: Goławski Ksawery , Giermaziak Wojciech , Ciebiera Michał , Wojtyła Cezary
Published: May 2023

Adequate weight gain during pregnancy is one of the factors for its proper course. Excessive weight gain during this period of a woman’s life is associated with adverse pregnancy outcomes. In this study, we determine the impact of excessive gestational weight gain on pregnancy outcomes. The study is based on the results of a Polish national survey performed between 2011 and 2017 on a group of 10,319 women and 6930 children. Excessive weight gain during pregnancy was associated with higher birthweight and higher prevalence and risk of birthweight over 4500 g (OR 6.92; 95% CI 3.10–15.42), cesarean section/assisted delivery (OR 2.71; 95% CI 1.63–4.49), pregnancy induced hypertension (OR 5.85; 95% CI 3.24–10.57), hospitalization during pregnancy (OR 1.85; 95% CI 1.12–3.04), and the Apgar score in the first minute of neonate’s life in the range of 0–7 (OR 2.65; 95% CI 1.36–5.2). We did not observe the significant difference in premature rupture of membranes and labor inductions. Our study indicates that excessive gestational weight gain is associated with higher risk for adverse pregnancy outcomes.
Towards Genetic Dissection of Skeletal Class III Malocclusion: A Review of Genetic Variations Underlying the Phenotype in Humans and Future Directions
Authors: Zohud Osayd , Lone Iqbal M. , Midlej Kareem , Obaida Awadi , Masarwa Samir , Schröder Agnes , Küchler Erika C. , Nashef Aysar , Kassem Firas , Reiser Vadim , Chaushu Gavriel , Mott Richard , Krohn Sebastian , Kirschneck Christian , Proff Peter , Watted Nezar , Iraqi Fuad A.
Published: May 2023

Introduction: Skeletal abnormalities and malocclusions have varied features that impact populations globally, impairing aesthetics and lowering life quality. The prevalence of the Skeletal Class III disease is the lowest among all angle malocclusions, with varied prevalence across nations. Environmental, genetic, and societal factors play a role in its numerous etiologies. In this study, we conducted a thorough search across the published data relating to quantitative trait loci (QTL) and the genes associated with Class III progression in humans, discussed these findings and their limitations, and proposed future directions and strategies for studying this phenotype. Methods: An inclusive search of published papers in the PubMed and Google Scholar search engines using the following terms: 1. Human skeletal Class III; 2. Genetics of Human skeletal Class III; 3. QTL mapping and gene associated with human skeletal Class III; 4. enriched skeletal Class-III-malocclusion-associated pathways. Results: Our search has found 53 genes linked with skeletal Class III malocclusion reported in humans, genes associated with epigenetics and phenomena, and the top 20 enriched pathways associated with skeletal Class III malocclusion. Conclusions: The human investigations yielded some contentious conclusions. We conducted a genome-wide association study (GWAS), an epigenetics-wide association study (EWAS), RNA-seq analysis, integrating GWAS and expression quantitative trait loci (eQTL), micro- and small-RNA, and long non-coding RNA analysis in tissues connected to skeletal Class III malocclusion phenotype in tissues connected with the skeletal phenotype. Finally, we invite regional, national, and international orthodontists and surgeons to join this effort by contributing human samples with skeletal Class III malocclusion following the accepted Helsinki ethical protocol to challenge these phenomena jointly.
Augmentation-Mastopexy: Analysis of 95 Consecutive Patients and Critical Appraisal of the Procedure
Authors: Zucal Isabel , Tremp Mathias , Duscher Dominik , Wenny Raphael , Zaussinger Maximilian , Kutz Alexander , Pagani Andrea , Huemer Georg M.
Published: May 2023

Single-stage mastopexy-augmentation has been demonstrated to be a safe procedure. However, revisions may still be necessary. We evaluate 95 consecutive patients undergoing mastopexy-augmentation and introduce a new surgical technique for the procedure: the modified dual plane technique. In this retrospective study, 95 patients (mean age 34 ± 11 years) underwent mastopexy-augmentation between 2009 and 2019. The procedures were classified as subglandular, dual plane, or modified dual plane technique. The outcome measures included major and minor complications. A total of 19 patients underwent a subglandular procedure, 32 patients a dual plane procedure, and 44 patients a modified dual plane procedure. We observed a high overall complication rate in the subglandular group (n = 12, 63%), dual plane group (n = 15, 47%), and modified dual plane group (n = 10, 23%). Complications leading to implant loss/change occurred in seven patients in the subglandular group (37%), six patients in the dual plane group (19%), and no patient in the modified dual plane group. While we observed a high complication rate in patients undergoing mastopexy-augmentations, the modified dual plane technique was associated with a lower complication rate.
Does Forward Head Posture Influence Somatosensory Evoked Potentials and Somatosensory Processing in Asymptomatic Young Adults?
Authors: Moustafa Ibrahim M. , Diab Aliaa Attiah Mohamed , Harrison Deed E.
Published: May 2023

The current investigation used somatosensory evoked potentials (SEPs) to assess differences in sensorimotor integration and somatosensory processing variables between asymptomatic individuals with and without forward head posture (FHP). We assessed different neural regions of the somatosensory pathway, including the amplitudes of the peripheral N9, spinal N13, brainstem P14, peak-to-peak amplitudes of parietal N20 and P27, and frontal N30 potentials. Central conduction time (N13–N20) was measured as the difference in peak latencies of N13 and N20. We measured these variables in 60 participants with FHP defined as a craniovertebral angle (CVA) < 50° and 60 control participants matched for age, gender, and body mass index (BMI) with normal FHP defined as CVA > 55°. Differences in variable measures were examined using the parametric t-test. Pearson’s correlation was used to evaluate the relationship between the CVA and sensorimotor integration and SEP measurements. A generalized linear model (GLM) was used to compare the SEP measures between groups, with adjustment for educational level, marital status, BMI, and working hours per week. There were statistically significant differences between the FHP group and control group for all sensorimotor integration and SEP processing variables, including the amplitudes of spinal N13 (p < 0.005), brainstem P14 (p < 0.005), peak-to-peak amplitudes of parietal N20 and P27 (p < 0.005), frontal N30 potentials (p < 0.005), and the conduction time N13–N20 (p = 0.004). The CVA significantly correlated with all measured neurophysiological variables indicating that as FHP increased, sensorimotor integration and SEP processing became less efficient. FHP group correlations were: N9 (r = −0.44, p < 0.001); N13 (r = −0.67, p < 0.001); P14 (r = −0.58, p < 0.001); N20 (r = −0.49, p = 0.001); P27 (r = −0.58, p < 0.001); N30 potentials (r = −0.64, p < 0.001); and N13–N20 (r = −0.61, p < 0.001). GLM identified that increased working hours adversely affected the SEP measures (p < 0.005), while each 1° increase in the CVA was associated with improved SEP amplitudes and more efficient central conduction time (N13–N20; p < 0.005). Less efficient sensorimotor integration and SEP processing may be related to previous scientific reports of altered sensorimotor control and athletic skill measures in populations with FHP. Future investigations should seek to replicate our findings in different spine disorders and symptomatic populations in an effort to understand how improving forward head posture might benefit functional outcomes of patient care.
Lipoprotein(a) As a Risk Factor in a Cohort of Hospitalised Cardiovascular Patients: A Retrospective Clinical Routine Data Analysis
Authors: Šuran David , Završnik Tadej , Kokol Peter , Kokol Marko , Sinkovič Andreja , Naji Franjo , Završnik Jernej , Blažun Vošner Helena , Kanič Vojko
Published: May 2023

Introduction: Lipoprotein(a) (Lp(a)) is a well-recognised risk factor for ischemic heart disease (IHD) and calcific aortic valve stenosis (AVS). Methods: A retrospective observational study of Lp(a) levels (mg/dL) in patients hospitalised for cardiovascular diseases (CVD) in our clinical routine was performed. The Lp(a)-associated risk of hospitalisation for IHD, AVS, and concomitant IHD/AVS versus other non-ischemic CVDs (oCVD group) was assessed by means of logistic regression. Results: In total of 11,767 adult patients, the association with Lp(a) was strongest in the IHD/AVS group (eβ = 1.010, p < 0.001), followed by the IHD (eβ = 1.008, p < 0.001) and AVS group (eβ = 1.004, p < 0.001). With increasing Lp(a) levels, the risk of IHD hospitalisation was higher compared with oCVD in women across all ages and in men aged ≤75 years. The risk of AVS hospitalisation was higher only in women aged ≤75 years (eβ = 1.010 in age < 60 years, eβ = 1.005 in age 60–75 years, p < 0.05). Conclusions: The Lp(a)-associated risk was highest for concomitant IHD/AVS hospitalisations. The differential impact of sex and age was most pronounced in the AVS group with an increased risk only in women aged ≤75 years.
A Treatment Approach for Carotid Blowout Syndrome and Soft Tissue Reconstruction after Radiotherapy in Patients with Oral Cancer: A Report of 2 Cases
Authors: Moest Tobias , Kesting Marco Rainer , Rohde Maximilian , Lang Werner , Meyer Alexander , Weber Manuel , Lutz Rainer
Published: May 2023

Background: This retrospective case series study aims to demonstrate a salvage technique for the treatment of carotid blow-out syndrome (CBS) in irradiated head and neck cancer patients with a vessel-depleted neck. Methods: Between October 2017 and October 2021, two patients (N = 2) with CBS were treated at our institution in a multidisciplinary approach together with the Department of Vascular Surgery. Patients were characterized based on diagnoses, treatment procedures, and the subsequent postoperative course. Results: Surgical emergency intervention was performed in both cases. The transition zone from the common carotid artery (CCA) to the internal carotid artery (ICA) was resected and reconstructed with a xenogic (case 1) or autogenic (case 2) interposition (end-to-end anastomosis). To allow reconstruction of the vascular defect, an additional autologous vein graft was anastomosed to the interposition graft in an end-to-side technique, allowing arterial anastomosis for a free microvascular flap without re-clamping of the ICA. Because of the intraoperative ICA reconstruction, none of the patients suffered a neurological deficit. Conclusions: The techniques presented in the form of two case reports allow for acute bleeding control, cerebral perfusion, and the creation of a vascular anastomosis option in the vessel-depleted neck.
An Immersive Virtual Kitchen Training System for People with Multiple Sclerosis: A Development and Validation Study
Authors: Pau Massimiliano , Cocco Eleonora , Arippa Federico , Casu Giulia , Porta Micaela , Menascu Shay , Achiron Anat , Kalron Alon
Published: May 2023

Rehabilitation via virtual reality (VR) training tools allows repetitive, intensive, and task-specific practice in a controlled and safe environment. Our goal was to develop and validate a novel immersive VR system based on the practice of real-life activities in a kitchen environment in people with multiple sclerosis (pwMS) with upper-limb dysfunction. The novel immersive VR kitchen application includes several tasks, i.e., tidying up the kitchen, preparing a hamburger and soup meal, and dish washing. Following the development phase, the system was tested for an 8-week intervention period on a small sample of pwMS suffering from upper-limb dysfunction. The Suitability Evaluation Questionnaire for VR systems served as the primary outcome. The scores for enjoyment, sense of comfort with the system, feelings of success and control, realism, easy-to-understand instructions, assists in rehabilitation therapy, were between 4.0 and 4.6, indicating a high satisfaction. The scores for eye discomfort, dizziness, nausea, and disorientation during practice were between 2.8 and 1.3, indicating a low-to-moderate interference of the system. The virtual kitchen training system is feasible and safe for upper-limb training in pwMS and paves the way for future RCTs to examine the benefits of the system compared with standard care, thus improving the functionality of the upper limbs in pwMS.
Association of aPTT-Guided Anticoagulation Monitoring with Thromboembolic Events in Patients Receiving V-A ECMO Support: A Systematic Review and Meta-Analysis
Authors: Rajsic Sasa , Breitkopf Robert , Treml Benedikt , Jadzic Dragana , Oberleitner Christoph , Oezpeker Ulvi Cenk , Innerhofer Nicole , Bukumiric Zoran
Published: May 2023

Background: The initiation of extracorporeal membrane oxygenation (ECMO) is associated with complex inflammatory and coagulatory processes, raising the need for systemic anticoagulation. The balance of anticoagulatory and procoagulant factors is essential, as therapeutic anticoagulation confers a further risk of potentially life-threatening bleeding. Therefore, our study aims to systematize and analyze the most recent evidence regarding anticoagulation monitoring and the thromboembolic events in patients receiving veno-arterial ECMO support. Methods: Using the PRISMA guidelines, we systematically searched the Scopus and PubMed databases up to October 2022. A weighted effects model was employed for the meta-analytic portion of the study. Results: Six studies comprising 1728 patients were included in the final analysis. Unfractionated heparin was used for anticoagulation, with an activated partial thromboplastin time (aPTT) monitoring goal set between 45 and 80 s. The majority of studies aimed to investigate the incidence of adverse events and potential risk factors for thromboembolic and bleeding events. None of the authors found any association of aPTT levels with the occurrence of thromboembolic events. Finally, the most frequent adverse events were hemorrhage (pooled 43%, 95% CI 28.4; 59.5) and any kind of thrombosis (pooled 36%, 95% CI 21.7; 53.7), and more than one-half of patients did not survive to discharge (pooled 54%). Conclusions: Despite the tremendous development of critical care, aPTT-guided systemic anticoagulation is still the standard monitoring tool. We did not find any association of aPTT levels with thrombosis. Further evidence and new trials should clarify the true incidence of thromboembolic events, along with the best anticoagulation and monitoring strategy in veno-arterial ECMO patients.
The Role of Angiogenesis Targeted Therapies in Metastatic Advanced Gastric Cancer: A Narrative Review
Authors: Nakayama Izuma , Takahari Daisuke
Published: May 2023

Since bevacizumab was first approved by the U.S. Food and Drug Administration as an anti-angiogenic therapy in 2004, angiogenesis-targeted therapy has been developed for various types of solid tumors. To date, ramucirumab and apatinib are clinically available as treatments for metastatic advanced gastric cancer (AGC). Ramucirumab demonstrated prolonged survival as second-line therapy of metastatic AGC in the RAINBOW and REGARD trials. However, neither ramucirumab extended survival in treatment-naïve patients with AGC in the RAINFALL or RAINSTORM trials nor bevacizumab in the AVAGAST and AVATAR trials. Apatinib demonstrated superior efficacy over the best supportive care in a Chinese phase III trial but not in an international phase III (ANGEL) trial. Currently, combination therapy of ramucirumab with irinotecan or FTD/TPI is being evaluated in the third-line setting, assessing the efficacy of continuous angiogenesis inhibition from second- to third-line therapy. Recently, the role of angiogenesis inhibition via immunomodulators is attractive to clinicians. Emerging results of several early-phase clinical trials indicated the promising antitumor activity of angiogenesis inhibition in combination with immune therapy. This review offers an overview of the history of clinical trials focused on anti-angiogenic for patients with AGC and presents future perspectives in this area.
Evaluation of a New Animal Tissue-Free Bleeding Model for Training of Endoscopic Hemostasis
Authors: Wichmann Dörte , Grether Sarah , Fundel Jana , Schweizer Ulrich , Wedi Edris , Walter Benjamin , Königsrainer Alfred , Duckworth-Mothes Benedikt
Published: May 2023

Background: For endoscopists, knowledge of the available hemotherapeutic devices and materials as well as competence in using them is a life-saving expertise in the treatment of patients with acute gastrointestinal bleeding. These competences can be acquired in training on live animals, animal organs, or simulators. We present an animal tissue-free training model of the upper gastrointestinal tract for bleeding therapy. Methods: An artificial, animal tissue-free mucosa and submucosa with the opportunity of injection and clipping therapy were created first. Patches with this artificial mucosa and submucosa were placed into silicone and latex organs with human-like anatomy. Esophageal bleeding situations were imitated as variceal bleeding and bleeding of a reflux esophagitis in latex organs. Finally, a modular training model with human anatomy and replaceable bleeding sources was created. Evaluation of the novel model for gastroscopic training was performed in a multicentric setting with endoscopic beginners and experts. Results: Evaluation was carried out by 38 physicians with different levels of education in endoscopy. Evaluation of the model was made with grades from one (excellent) to six (bad): suitability for endoscopic training was 1.4, relevance of the endoscopic training was 1.6, and grading for haptic and optic impression of the model was 1.7. Conclusions: The creation of a gastroscopic model for the training of hemostatic techniques without animal tissues was possible and multiple endoscopic bleeding skills could be trained in it. Evaluation showed good results for this new training option, which could be used in every endoscopic unit or other places without hygienic doubts.
Audiovestibular Manifestations in Patients with Primary Raynaud’s Phenomenon and Raynaud’s Phenomenon Secondary to Systemic Sclerosis
Authors: Amor-Dorado Juan Carlos , Martín-Sanz Eduardo , Franco-Gutiérrez Virginia , Urruticoechea-Arana Ana , García-Arumí Ana M. , Racines-Álava Erwin , Alemán-López Oscar , Simeón-Aznar Carmen P. , González-Gay Miguel Á.
Published: May 2023

Objectives: To address the prevalence of audiovestibular disorders in patients with primary Raynaud’s Phenomenon (RP). A series of patients with primary RP and secondary RP in the context of systemic sclerosis (SSc) were compared with healthy controls. Methods: A prospective multicenter observational cross-sectional study was conducted in several Otolaryngology and Rheumatology Divisions of tertiary referral hospitals, recruiting 57 patients with RP and 57 age- and gender-matched controls. Twenty patients were classified as primary RP when unrelated to any other conditions and 37 patients who met the 2013 ACR/EULAR classification criteria for SSc were classified as having secondary RP associated with SSc. Audiometric and vestibular testing (vHIT), clinical sensory integration and balance testing (CTSIB), and Computerized Dynamic Posturography (CDP) were performed. Results: As significant differences were found in the age of the two study groups, primary and secondary RP, no comparisons were made between both groups of RP but only with their control groups. No sensorineural hearing loss (SNHL) was recorded in any of our patients with primary RP and no differences were found in the voice audiometry tests with respect to controls. Four of 37 (10.8%) secondary RP patients presented SNHL. Those with SNHL were 7.03 times more likely to have a secondary RP than controls (p < 0.001). The audiometric curve revealed high-frequency hearing loss in 4 patients with RP secondary to SSc, and statistically significant differences were achieved when RP secondary was compared to controls in vHIT gain, caloric test, CTSIB, and CDP. Conclusions: Unlike patients with RP secondary to SSc, patients with primary RP do not show audiovestibular abnormalities. Regarding audiovestibular manifestations, primary RP can be considered a different condition than secondary RP.
Long-Term Efficacy and Safety of Risankizumab for Moderate to Severe Psoriasis: A 2-Year Real-Life Retrospective Study
Authors: Megna Matteo , Ruggiero Angelo , Battista Teresa , Marano Laura , Cacciapuoti Sara , Potestio Luca
Published: May 2023

Risankizumab is a humanized IgG monoclonal antibody inhibitor of IL23 and has been recently approved by the EMA and the FDA for the treatment of moderate to severe plaque psoriasis in adults who are candidates for systemic therapy. Its efficacy and safety have been reported by clinical trials and real-life studies. However, even if long-term data from trials have already been reported (up to 172 weeks), data on long-term real-life experiences are still limited. The aim of our study was to investigate the long-term (2 years) efficacy and safety of risankizumab for psoriasis management in a real-life setting. A monocentric retrospective study was performed, enrolling 168 patients affected by moderate to severe psoriasis who were undergoing treatment with risankizumab. Psoriasis severity and safety outcomes were evaluated at each follow-up visit (week 16, week 28, week 52, week 88, week 104). A statistically significant reduction of psoriasis severity scores was reported from week 16 and was maintained up to week 104. Moreover, interesting results in terms of safety have been collected, without any serious adverse events registered. Our long-term real-life monocentric retrospective study confirmed the efficacy and safety of risankizumab up to 104 weeks of treatment. However, further studies are required to confirm our results and to increase available data to establish the best evidence-based biologic selection algorithm.
Invasive Fungal Infections after Liver Transplantation
Authors: Senoner Thomas , Breitkopf Robert , Treml Benedikt , Rajsic Sasa
Published: May 2023

Invasive fungal infections represent a major challenge in patients who underwent organ transplantation. Overall, the most common fungal infections in these patients are candidiasis, followed by aspergillosis and cryptococcosis, except in lung transplant recipients, where aspergillosis is most common. Several risk factors have been identified, which increase the likelihood of an invasive fungal infection developing after transplantation. Liver transplant recipients constitute a high-risk category for invasive candidiasis and aspergillosis, and therefore targeted prophylaxis is favored in this patient population. Furthermore, a timely implemented therapy is crucial for achieving optimal outcomes in transplanted patients. In this article, we describe the epidemiology, risk factors, prophylaxis, and treatment strategies of the most common fungal infections in organ transplantation, with a focus on liver transplantation.
Effects of a Single Session of Systemic Vibratory Therapy on Flexibility, Perception of Exertion and Handgrip Strength in Chronic Obstructive Pulmonary Disease Individuals: A Quasi-Experimental Clinical Trial
Authors: Guedes-Aguiar Eliane de Oliveira , Taiar Redha , Paineiras-Domingos Laisa Liane , Monteiro-Oliveira Bruno Bessa , da Cunha de Sá-Caputo Danúbia , Bernardo-Filho Mario
Published: May 2023

Background: Whole-body vibration exercises (WBVE), that are generated in systemic vibratory therapy (SVT), may benefit individuals with chronic obstructive pulmonary disease (COPD). This study evaluated acute effects of SVT on the flexibility, on the perception of exertion to perform the anterior trunk flexion (ATF), and on the handgrip strength (HG). Methods: Thirty-eight individuals, separated into two groups, performed a single session of SVT (five bouts, 25 Hz, 2.5 of amplitude) on a side-alternating vibrating platform (SAVP), in two postures: sitting (Sitting group-SitG, n = 21) or standing (Stand group-StandG, n = 17). In both positions, the feet were on the base of the SAVP. The HG and the AFT were performed before and after the session, and the perception of effort (RPE) was measured during the ATF. Results: The ATF in the SitG (p ≤ 0.05) and in the StandG (p ≤ 0.05) was significantly improved, but in the comparison between both groups, no significant reduction was found (p = 0.14). The RPE was not influenced by the session. A significant increase of the HG in StandG post session (33.49 ± 10.30 kgf) p = 0.03 was found, but not in the SitG (p = 0.12) or between the two groups (p = 0.55). Conclusions: SVT, in a single acute session, would be capable of promoting some functional benefits for the COPD individuals without altering the perception of exertion to perform the ATF. Trial Registration: 49219115.3.0000.5259, RBR-72dqtm.
Serious Bacterial Infections in Preterm Infants: Should Their Age Be “Corrected”?
Authors: Hadhud Mohamad , Gross Itai , Hurvitz Noa , Ohana Sarna Cahan Lea , Ergaz Zivanit , Weiser Giora , Ofek Shlomai Noa , Eventov Friedman Smadar , Hashavya Saar
Published: May 2023

Adjusting the chronological age of preterm infants according to their gestational age is a widely accepted practice in the field of neurodevelopment. It has been suggested for the assessment of preterm infants with suspected infection, but has been poorly validated. Correcting for chronological age is especially critical in infants with a chronological age above 3 months, but a corrected age below 3 months due to the differences in assessment protocols. This study assessed the difference in incidence of serious bacterial infection (SBI) according to chronological and corrected age in preterm infants. A retrospective analysis of pediatric emergency department (PED) presentations was conducted for all 448 preterm infants born in between January 2010 and August 2019. Of the 448 preterm infants, 204 (46%) presented at one of 3 PEDs in Jerusalem, Israel, during their first year of life. Overall, 141 (31.4%) presented with fever and were included in the study. The infants were divided into 3 age groups: 1—corrected age >3 months; 2—chronological age >3 months, but corrected age <3 months; 3—chronological and corrected age <3 months. SBI was diagnosed in 2.6%, 16.7%, and 33.3% of the infants in groups 1, 2 and 3, respectively; (p < 0.01, p = 0.17, p < 0.001). The incidence of SBI in the control group of 300 term infants <3 months presenting to the PED due to fever was 15.3%. Preterm infants with a corrected age <3 months are at increased risk for SBI, similarly to term infants <3 months of age. Age correction should thus be considered for preterm infants presenting with fever.
Whole-Organ Pancreas and Islets Transplantations in UK: An Overview and Future Directions
Authors: Martin David , Alberti Piero , Demartines Nicolas , Phillips Melanie , Casey John , Sutherland Andrew
Published: May 2023

Whole-organ pancreas and islets transplantations are two therapeutic options to treat type 1 diabetic patients resistant to optimised medical treatment in whom severe complications develop. Selection of the best option for β-cell replacement depends on several factors such as kidney function, patient comorbidities, and treatment goals. For a patient with end-stage kidney disease, the treatment of choice is often a simultaneous transplant of the pancreas and kidney (SPK). However, it remains a major surgical procedure in patients with multiple comorbidities and therefore it is important to select those who will benefit from it. Additionally, in view of the organ shortage, new strategies to improve outcomes and reduce immune reactions have been developed, including dynamic organ perfusion technologies, pancreas bioengineering, and stem cell therapies. The purpose of this article is to review the indications, surgical techniques, outcomes, and future directions of whole-organ pancreas and islets transplantations.
Effect of Phosphorus and Chlorine Containing Plasticizers on the Physicochemical and Mechanical Properties of Epoxy Composites
Authors: Bekeshev Amirbek , Mostovoy Anton , Shcherbakov Andrey , Zhumabekova Arai , Serikbayeva Gulbanu , Vikulova Maria , Svitkina Victoria
Published: May 2023

The possibility of using tris(2-chloroethyl) phosphate, tris(1-chloro-2-propyl) phosphate and tris(4-methylphenyl) phosphate as effective plasticizers for epoxy polymers has been studied. As a result of the research the optimum content of plasticizers (40 parts by mass) has been determined, which has the best effect on the strength and fire safety properties of epoxy composites. Modification of the epoxy polymer with presented plasticizers influences carbonization process increasing char yield and reducing the amount of volatile thermolysis products released into the gas phase, thus improving fire safety parameters of epoxy composites, reducing mass loss on ignition in air from 78 to 2–9% and increasing limiting oxygen index (LOI) values from 19 to 25–31% by volume, giving good fire protective properties to epoxy composites (UL-94 rating—V-0/V-1). The thermo-protective properties and the structure of the char formed by polymer combustion have been studied and the correlation between the thermo-protective properties of the char and the combustibility of the composite has been determined. Furthermore, the behaviour of the modified composite during high rate pyrolysis has been analyzed.
Big-Volume SliceGAN for Improving a Synthetic 3D Microstructure Image of Additive-Manufactured TYPE 316L Steel
Authors: Sugiura Keiya , Ogawa Toshio , Adachi Yoshitaka , Sun Fei , Suzuki Asuka , Yamanaka Akinori , Nakada Nobuo , Ishimoto Takuya , Nakano Takayoshi , Koizumi Yuichiro
Published: May 2023

A modified SliceGAN architecture was proposed to generate a high-quality synthetic three-dimensional (3D) microstructure image of TYPE 316L material manufactured through additive methods. The quality of the resulting 3D image was evaluated using an auto-correlation function, and it was discovered that maintaining a high resolution while doubling the training image size was crucial in creating a more realistic synthetic 3D image. To meet this requirement, modified 3D image generator and critic architecture was developed within the SliceGAN framework.
Quantifiable Measures of Abdominal Wall Motion for Quality Assessment of Cine-MRI Slices in Detection of Abdominal Adhesions
Authors: van den Beukel Bastiaan A. W. , de Wilde Bram , Joosten Frank , van Goor Harry , Venderink Wulphert , Huisman Henkjan J. , ten Broek Richard P. G.
Published: May 2023

Abdominal adhesions present a diagnostic challenge, and classic imaging modalities can miss their presence. Cine-MRI, which records visceral sliding during patient-controlled breathing, has proven useful in detecting and mapping adhesions. However, patient movements can affect the accuracy of these images, despite there being no standardized algorithm for defining sufficiently high-quality images. This study aims to develop a biomarker for patient movements and determine which patient-related factors influence movement during cine-MRI. Included patients underwent cine-MRI to detect adhesions for chronic abdominal complaints, data were collected from electronic patient files and radiologic reports. Ninety slices of cine-MRI were assessed for quality, using a five-point scale to quantify amplitude, frequency, and slope, from which an image-processing algorithm was developed. The biomarkers closely correlated with qualitative assessments, with an amplitude of 6.5 mm used to distinguish between sufficient and insufficient-quality slices. In multivariable analysis, the amplitude of movement was influenced by age, sex, length, and the presence of a stoma. Unfortunately, no factor was changeable. Strategies for mitigating their impact may be challenging. This study highlights the utility of the developed biomarker in evaluating image quality and providing useful feedback for clinicians. Future studies could improve diagnostic quality by implementing automated quality criteria during cine-MRI.
Does Thinking in Opposites in Order to Think Differently Improve Creativity?
Authors: Bianchi Ivana , Branchini Erika
Published: May 2023

In this paper, we focus on the link between thinking in opposites and creativity. Thinking in opposites requires an intuitive, productive strategy, which may enhance creativity. Given the importance of creativity for the well-being of individuals and society, finding new ways to enhance it represents a valuable goal in both professional and personal contexts. We discuss the body of evidence that exists concerning the importance of the first representation of the structure of a problem to be solved, which determines the baseline representation and sets limits on the area within which a problem solver will explore. We then review a variety of interventions described in the literature on creativity and insight problem solving that were designed to overcome fixedness and encourage people to move away from stereotypical solutions. Special attention is paid to the research carried out in the context of problem solving, which provides evidence that prompting people to “think in opposites” is beneficial. We suggest that an extended investigation of the effects of this strategy in various types of tasks related to creativity is an interesting line of research to follow. We discuss the rationale supporting this claim and identify specific questions, both theoretical and methodological, for future research to address.
Adding Metal Ions to the Bacillus mojavensis D50 Promotes Biofilm Formation and Improves Ability of Biocontrol
Authors: Zheng Lining , Gu Xuehu , Sun Liangpeng , Dong Meiqi , Gao Ao , Han Zhe , Pan Hongyu , Zhang Hao
Published: May 2023

Bacillus mojavensis D50, a biocontrol strain, is used to prevent and treat the fungal plant pathogen Botrytis cinerea. Bacillus mojavensis D50’s biofilms can affect its colonization; thus, the effects of different metal ions and culture conditions on biofilm formation were determined in this study. The results of medium optimization showed that Ca2+ had the best ability to promote biofilm formation. The optimal medium composition for the formation of biofilms contained tryptone (10 g/L), CaCl2 (5.14 g/L), and yeast extract (5.0 g/L), and the optimal fermentation conditions included pH 7, a temperature of 31.4 °C, and a culture time of 51.8 h. We found that the antifungal activity and abilities to form biofilms and colonize roots were improved after optimization. In addition, the levels of expression of the genes luxS, SinR, FlhA, and tasA were up-regulated by 37.56-, 2.87-, 12.46-, and 6.22-fold, respectively. The soil enzymatic activities which related biocontrol-related enzymes were the highest when the soil was treated by strain D50 after optimization. In vivo biocontrol assays indicated that the biocontrol effect of strain D50 after optimization was improved.
Evaluation of Five Non-Culture-Based Methods for the Diagnosis of Meningeal Sporotrichosis
Authors: Almeida-Silva Fernando , Almeida Marcos de Abreu , Rabello Vanessa Brito de Souza , Zancopé-Oliveira Rosely Maria , Baeza Lilian Cristiane , Lamas Cristiane da Cruz , Lima Marco Antonio , de Macedo Priscila Marques , Gutierrez-Galhardo Maria Clara , Almeida-Paes Rodrigo , Freitas Dayvison Francis Saraiva
Published: May 2023

Sporotrichosis is the main subcutaneous mycosis worldwide. Several complications, including meningeal forms, can be observed in immunocompromised individuals. The sporotrichosis diagnosis is time-consuming due to the culture’s limitations. The low fungal burden in cerebrospinal fluid (CSF) samples is another important drawback in the diagnosis of meningeal sporotrichosis. Molecular and immunological tests can improve the detection of Sporothrix spp. in clinical specimens. Therefore, the following five non-culture-based methods were evaluated for the detection of Sporothrix spp. in 30 CSF samples: (i) species-specific polymerase chain reaction (PCR); (ii) nested PCR; (iii) quantitative PCR; (iv) enzyme-linked immunosorbent assay (ELISA) for IgG detection; and (v) ELISA for IgM detection. The species-specific PCR was unsuccessful in the diagnosis of the meningeal sporotrichosis. The other four methods presented substantial levels of sensitivity (78.6% to 92.9%) and specificity (75% to 100%) for the indirect detection of Sporothrix spp. Both DNA-based methods presented similar accuracy (84.6%). Both ELISA methods were concomitantly positive only for patients with sporotrichosis and clinical signs of meningitis. We suggest that these methods should be implemented in clinical practice to detect Sporothrix spp. in CSF early, which may optimize treatment, augment the chances of a cure, and improve the prognosis of affected individuals.