bluuebunny/crossref_metadata_2025 huggingface dataset:
Analysis of Salivary Levels of IL-1β, IL17A, OPG and RANK-L in Periodontitis Using the 2017 Classification of Periodontal Diseases—An Exploratory Observational Study
Authors: Relvas Marta , Silvestre Ricardo , Gonçalves Maria , Cabral Cristina , Mendes-Frias Ana , Monteiro Luís , Viana da Costa Alexandra
Published: January 2023

Periodontitis is a chronic disease with a high overall prevalence. It involves a complex interplay between the immune-inflammatory pathways and biofilm changes, leading to periodontal attachment loss. The aims of this study were (i) to assess whether the salivary IL-1β, IL-17A, RANK-L and OPG levels have the potential to discriminate between the mild and severe periodontitis conditions; and (ii) to enable diagnostic/prognostic actions to differentiate between distinct levels of the disease. The analysis of the clinical parameters and the evaluation of the salivary immunomediators levels by means of a multiplex flow assay revealed a statistically significantly higher level of IL-1β in the periodontitis III/IV patients, as well as a higher level of RANK-L in the periodontitis III/IV and I/II patients, when compared to the healthy controls. Furthermore, the grade C periodontitis patients presented a significantly higher level of RANK-L compared to the grade B and grade A patients. In the grade C patients, IL-1β had a positive correlation with the PPD and CAL indices and RANK_L had a positive correlation with CAL. The evidence emerging from this study associates the salivary IL-1β and RANK-L levels with an advanced stage of periodontitis, stage III/IV, and with grade C, suggesting the possible cooperative action of both in the inflammatory and bone loss events. In addition to IL-1β, RANK-L could be considered a combined diagnostic biomarker for periodontitis.
Parents Rate Problematic Video Streaming in Adolescents: Conceptualization and External Assessment of a New Clinical Phenomenon Based on the ICD-11 Criteria of Gaming Disorder
Authors: Paschke Kerstin , Napp Ann-Kathrin , Thomasius Rainer
Published: January 2023

In recent years, video streaming (VS) increased substantially. Adolescents are at significant risk of presenting problematic VS patterns associated with a spectrum of mental-health difficulties. Because VS platforms rely on similar mechanisms as digital games, the ICD-11 criteria for Gaming Disorder (GD) have been successfully implemented to measure Streaming Disorder (StrD) in adolescents. For proper diagnoses, external rating scales are urgently required in addition to self-reports. The Streaming Disorder Scale for Parents (STREDIS-P) was created and validated in a representative sample of n = 891 adolescent-parent dyads. Mental health problems were assessed with standardized instruments. Confirmatory factor analysis was conducted to examine the underlying factor structure. Cutoff scores were determined using ROC analysis. Accordance between parental and adolescents’ self-ratings was calculated. Consistent with the results of previous validation studies for screening instruments assessing similar phenomena based on ICD-11-GD criteria, two factors, cognitive-behavioral symptoms and negative consequences, were confirmed. STREDIS-P demonstrated good to excellent internal consistency, criterion validity, and discriminatory power. Accordance with adolescents’ self-ratings was moderate. STREDIS-P is the first screening tool for assessing StrD in adolescents by parental ratings. It is highly relevant for conceptualizing a new phenomenon in clinical routine and academic research.
A Comparative Analysis of Bi-Portal Endoscopic Spine Surgery and Unilateral Laminotomy for Bilateral Decompression in Multilevel Lumbar Stenosis Patients
Authors: Eun Dong-Chan , Lee Yong-Ho , Park Jin-Oh , Suk Kyung-Soo , Kim Hak-Sun , Moon Seong-Hwan , Park Si-Young , Lee Byung-Ho , Park Sang-Jun , Kwon Ji-Won , Park Sub-Ri
Published: January 2023

The clinical and radiological results before and after surgery were compared and analyzed for patients with multilevel lumbar stenosis who underwent bi-portal endoscopic spine surgery (BESS) and microscopic unilateral laminotomy for bilateral decompression (ULBD). We retrospectively identified 47 and 49 patients who underwent BESS and microscopic ULBD, respectively, who were diagnosed with multi-level lumbar stenosis. Clinical outcomes were evaluated using the visual analog scale score for both back and leg pain, and medication (pregabalin) use and Oswestry Disability Index (ODI) scores for overall treatment outcomes were used pre-operatively and at the final follow-up. Radiological outcomes were evaluated as the percentage of dura expansion volume, and percentage preservation of both facets and both lateral recess angles. The follow-up period of patients was about 17.04 months in the BESS group and about 16.90 months in the microscopic ULBD group. The back and leg visual analog scale (VAS) scores and average pregabalin use decreased more significantly in the BESS group than in the microscopic ULBD group (each p-value 0.0443, <0.001, 0.0378). All radiological outcomes were significantly higher in the BESS group than in the ULBD group. The change in ODI in two-level spinal stenosis showed a significantly higher value in the BESS group compared to the microscopic ULBD group (p-value 0.0335). Multilevel decompression with the BESS technique in multiple spinal stenosis is an adequate technique as it shows better clinical and radiological results than microscopic ULBD during a short-term follow-up period.
High Incidence of Obstetric Anal Sphincter Injuries among Immigrant Women of Asian Ethnicity
Authors: Baruch Yoav , Gold Ronen , Eisenberg Hagit , Amir Hadar , Reicher Lee , Yogev Yariv , Groutz Asnat
Published: January 2023

(1) Background: Obstetric anal sphincter injuries (OASI) may complicate vaginal deliveries. The aim of the present study was to explore the incidence and clinical characteristics of OASI among Asian women living in a Western country compared to local Caucasian women. (2) Methods: A retrospective cohort study of 380 women diagnosed with OASI, following singleton vaginal deliveries, during a 10-year period (January 2011 to December 2020). Exclusion criteria: age < 18 years, stillbirth, and breech presentation. Demographic, clinical, and obstetrical data were obtained, and a comparison between Asian and Caucasian women was performed. (3) Results: There were 35 cases of OASI among 997 women of Asian ethnicity compared to 345 cases of OASI among 86,250 Caucasian women (3.5% vs. 0.4%, respectively, p < 0.001). Asian women endured a significantly higher rate of fourth-degree OASI (17.1%) even though they bore smaller newborns (3318 g vs. 3501 g, p = 0.004), and birth weights rarely exceeded 3800 g (2.8% vs. 25.8%, p < 0.001). Asian ethnicity was also associated with a significantly higher risk for blood transfusion following OASI and a lower tendency for postpartum follow up. (4) Conclusions: Immigrant women of Asian ethnicity had a nine-fold higher rate of OASI, much higher than previously reported. Furthermore, Asian women had higher rates of fourth-degree OASI.
Being Underweight Is Associated with Increased Risk of Sudden Cardiac Death in People with Diabetes Mellitus
Authors: Kim Yun Gi , Han Kyung-Do , Roh Seung-Young , Jeong Joo Hee , Choi Yun Young , Min Kyongjin , Shim Jaemin , Choi Jong-Il , Kim Young-Hoon
Published: January 2023

Background: Diabetes mellitus (DM) can cause various atherosclerotic cardiovascular disease including sudden cardiac death (SCD). The impact of being underweight on the risk of SCD in people with DM remains to be revealed. We aimed to evaluate the risk of SCD according to body-mass index (BMI; kg/m2) level in DM population. Methods: We used a nationwide healthcare insurance database to conduct this study. We identified people with DM among those who underwent nationwide health screening during 2009 to 2012. Medical follow-up data was available until December 2018. Results: A total of 2,602,577 people with DM with a 17,851,797 person*year follow-up were analyzed. The underweight group (BMI < 18.5) showed 2.4-fold increased risk of SCD during follow-up (adjusted-hazard ratio [HR] = 2.40; 95% confidence interval [CI] = 2.26–2.56; p < 0.001). When normal-BMI group (18.5 ≤ BMI < 23) was set as a reference, underweight group (adjusted-HR = 2.01; 95% CI = 1.88–2.14) showed even higher risk of SCD compared with the obesity group (BMI ≥ 30; adjusted-HR = 0.89; 95% CI = 0.84–0.94). When BMI was stratified by one unit, BMI and SCD risk showed a U-curve association with the highest risk observed at low BMI levels. The lowest risk was observed in 27 ≤ BMI < 28 group. The association between being underweight and increased SCD risk in DM people was maintained throughout various subgroups. Conclusions: Being underweight is significantly associated with an increased risk of SCD in the DM population. A steep rise in the risk of SCD was observed as the BMI level decreased below 23. The lowest risk of SCD was observed in 27 ≤ BMI < 28 group.
Global, Regional, and National Incidence and Disability-Adjusted Life-Years for Urolithiasis in 195 Countries and Territories, 1990–2019: Results from the Global Burden of Disease Study 2019
Authors: Li Juan , Zhao Yue , Xiong Zhuang , Yang Guoqiang
Published: January 2023

Purpose: Urolithiasis is highly prevalent worldwide. The aim of this study was to report the results of the Global Burden of Disease 2019 study on urolithiasis burden estimates grouped by gender, regions, countries or territories, and sociodemographic index (SDI) from 1990 to 2019 globally. Methods: We reported detailed estimates and temporal trends of the burden estimates of urolithiasis from 1990 to 2019 in 195 countries and territories and further evaluated the relationship between these estimates and SDI, a composite indicator of income per person, years of education, and fertility as a measurement of country/region socio-economic level. Urolithiasis incidence and disability-adjusted life years by gender, regions, countries or territories, and SDI were reported. The percentage change and estimated annual percentage change of these burden estimates were calculated to quantify temporal trends. Results: From 1990 to 2019, the age-standardized incidence rate (ASIR) and disability-adjusted life years (DALYs) of urolithiasis decreased globally by 0.459% and 1.898% per year, respectively. Such a trend of ASIR was prominently due to the decline in the middle, high-middle, and high SDI countries, including Eastern Asia, high-income Eastern Europe, and high-income North America. During this period, these estimates increased in low and low-middle SDI countries, particularly in South Asia, Andean Latin America, and Western Europe. A decline in DALYs was observed in all SDI countries. An approximate positive linear association existed between the burden estimate’s decreased APC and SDI level, except at the high SDI level. Both males and females showed the same trend. Conclusions: This study provides comprehensive knowledge of the burden estimate of urolithiasis. Although the burden estimates of urolithiasis showed a global decrease during the past 29 years, this progress has yet to be universal; the increasing trends were observed in countries with low and low-middle SDI countries. Research in these countries is needed and helps with the appropriate allocation of health resources for prevention, screening, and treatment strategies.
Pleural Effusion in COVID-19 Pneumonia: Clinical and Prognostic Implications—An Observational, Retrospective Study
Authors: Cappelli Sara , Casto Elisabetta , Lomi Marta , Pagano Alessandra , Gabbrielli Luciano , Pancani Roberta , Aquilini Ferruccio , Gemignani Giulia , Carrozzi Laura , Celi Alessandro
Published: January 2023

Background: COVID-19 presents with a wide spectrum of clinical and radiological manifestations, including pleural effusion. The prevalence and prognostic impact of pleural effusion are still not entirely clear. Patients and methods: This is a retrospective, single-center study including a population of consecutive patients admitted to the University Hospital of Cisanello (Pisa) from March 2020 to January 2021 with a positive SARS-CoV-2 nasopharyngeal swab and SARS-CoV-2-related pneumonia. The patients were divided into two populations based on the presence (n = 150) or absence (n = 515) of pleural effusion on chest CT scan, excluding patients with pre-existing pleural effusion. We collected laboratory data (hemoglobin, leukocytes, platelets, C-reactive protein, procalcitonin), worst PaO2/FiO2 ratio as an index of respiratory gas exchange impairment, the extent of interstitial involvement related to SARS-CoV-2 pneumonia and data on intensity of care, length of stay and outcome (discharge or death). Results: The prevalence of pleural effusion was 23%. Patients with pleural effusion showed worse gas exchange (p < 0.001), longer average hospital stay (p < 0.001), need for more health care resources (p < 0.001) and higher mortality (p < 0.001) compared to patients without pleural effusion. By multivariate analysis, pleural effusion was found to be an independent negative prognostic factor compared with other variables such as increased C-reactive protein, greater extent of pneumonia and older age. Pleural effusion was present at the first CT scan in most patients (68%). Conclusions: Pleural effusion associated with SARS-CoV-2 pneumonia is a relatively frequent finding that is confirmed to be a negative prognostic factor. Identifying early prognostic factors in an endemic-prone disease such as COVID-19 is necessary to optimize its clinical management. Further clinical studies aimed at better characterizing pleural effusion in these patients will be appropriate in order to clarify its pathogenetic role.
Quality of Life in COVID-Related ARDS Patients One Year after Intensive Care Discharge (Odissea Study): A Multicenter Observational Study
Authors: Deana Cristian , Vetrugno Luigi , Cortegiani Andrea , Mongodi Silvia , Salve Giulia , Mangiagalli Matteo , Boscolo Annalisa , Pettenuzzo Tommaso , Miori Sara , Sanna Andrea , Lassola Sergio , Magnoni Sandra , Ferrari Elena , Biagioni Emanuela , Bassi Flavio , Castaldo Nadia , Fantin Alberto , Longhini Federico , Corradi Francesco , Forfori Francesco , Cammarota Gianmaria , De Robertis Edoardo , Buonsenso Danilo , Spadaro Savino , Grieco Domenico Luca , Martino Maria De , Isola Miriam , Mojoli Francesco , Girardis Massimo , Giarratano Antonino , Bignami Elena Giovanna , Navalesi Paolo , Cecconi Maurizio , Maggiore Salvatore Maurizio ,   on behalf of the Italian Odissea Group
Published: January 2023

Background: Investigating the health-related quality of life (HRQoL) after intensive care unit (ICU) discharge is necessary to identify possible modifiable risk factors. The primary aim of this study was to investigate the HRQoL in COVID-19 critically ill patients one year after ICU discharge. Methods: In this multicenter prospective observational study, COVID-19 patients admitted to nine ICUs from 1 March 2020 to 28 February 2021 in Italy were enrolled. One year after ICU discharge, patients were required to fill in short-form health survey 36 (SF-36) and impact of event-revised (IES-R) questionnaire. A multivariate linear or logistic regression analysis to search for factors associated with a lower HRQoL and post-traumatic stress disorded (PTSD) were carried out, respectively. Results: Among 1003 patients screened, 343 (median age 63 years [57–70]) were enrolled. Mechanical ventilation lasted for a median of 10 days [2–20]. Physical functioning (PF 85 [60–95]), physical role (PR 75 [0–100]), emotional role (RE 100 [33–100]), bodily pain (BP 77.5 [45–100]), social functioning (SF 75 [50–100]), general health (GH 55 [35–72]), vitality (VT 55 [40–70]), mental health (MH 68 [52–84]) and health change (HC 50 [25–75]) describe the SF-36 items. A median physical component summary (PCS) and mental component summary (MCS) scores were 45.9 (36.5–53.5) and 51.7 (48.8–54.3), respectively, considering 50 as the normal value of the healthy general population. In all, 109 patients (31.8%) tested positive for post-traumatic stress disorder, also reporting a significantly worse HRQoL in all SF-36 domains. The female gender, history of cardiovascular disease, liver disease and length of hospital stay negatively affected the HRQoL. Weight at follow-up was a risk factor for PTSD (OR 1.02, p = 0.03). Conclusions: The HRQoL in COVID-19 ARDS (C-ARDS) patients was reduced regarding the PCS, while the median MCS value was slightly above normal. Some risk factors for a lower HRQoL have been identified, the presence of PTSD is one of them. Further research is warranted to better identify the possible factors affecting the HRQoL in C-ARDS.
The sFlt-1/PlGF Ratio in Pregnant Patients Affected by COVID-19
Authors: Kosinska-Kaczynska Katarzyna , Malicka Ewa , Szymusik Iwona , Dera Norbert , Pruc Michal , Feduniw Stepan , Rafique Zubaid , Szarpak Lukasz
Published: January 2023

COVID-19 in pregnant women increases the risk of adverse pregnancy outcomes, including preeclampsia. This meta-analysis aimed to examine the effect of SARS-CoV-2 infection on sFlt-1/PIGF ratio during pregnancy. The study was designed as a systematic review and meta-analysis. PubMed, Web of Science, Embase and Cochrane Library were searched for relevant studies reporting the sFlt-1/PlGF ratio in pregnant women with COVID-19. Results were compared using meta-analysis by the Mantel–Haenszel method. A total of 7 studies were included in the analysis. sFlt-1/PlGF ratios between COVID-19 positive vs. negative women were 45.8 ± 50.3 vs. 37.4 ± 22.5, respectively (SMD = 1.76; 95% CI: 0.43 to 3.09; p = 0.01). sFlt-1/PlGF ratios between asymptomatic vs. symptomatic patients were 49.3 ± 35.7 vs. 37.1 ± 25.6 (SMD = 0.30; 95% CI: −0.35 to 0.95; p = 0.36). sFlt-1/PlGF ratio in non-severe group was 30.7 ± 56.5, compared to 64.7 ± 53.5 for severe patients (SMD = −1.88; 95% CI: −3.77 to 0.01; p = 0.05). sFlt-1/PlGF ratios in COVID-19 patients, with and without hypertensive disease of pregnancy, were 187.0 ± 121.8 vs. 21.6 ± 8.6, respectively (SMD = 2.46; 95% CI: 0.99 to 3.93; p = 0.001). Conclusions: Patients with COVID-19, as compared to patients without COVID-19, were characterized by higher sFlt-1/PlGF ratio. Moreover, severe COVID-19 and SARS-CoV-2 infection in hypertensive pregnant women was related to significantly higher sFlt-1/PlGF ratio.
Aesthetic Results, Functional Outcome and Radiographic Analysis in THA by Direct Anterior, Bikini and Postero-Lateral Approach: Is It Worth the Hassle?
Authors: Di Martino Alberto , Brunello Matteo , Rossomando Valentino , Pederiva Davide , Schilardi Francesco , Stefanini Niccolò , Geraci Giuseppe , Faldini Cesare
Published: January 2023

Total hip arthroplasty (THA) can be performed by several approaches such as direct anterior (DAA), direct lateral (DL) and postero-lateral (PL). Our study was conducted to compare among different approaches, such as DAA, bikini (BK) and PL, the aesthetic impact of the scar, differences in the position of prosthetic components and differences in functional rehabilitation outcomes. Materials and methods: Population, composed by 240 patients, was collected among patients treated for primary total hip arthroplasty (THA) from 1 January 2017 to 31 December 2021 and divided by surgical approach. Of these, 160 female patients were included in the current analysis, leaving 58 DAA, 52 BK patients and 50 PL patients. Demographic and clinical parameters were retrospectively collected: age, BMI, time of surgery, length of stay, Harris Hip Score (HHS) before and after surgery at 6 months and patient, intra/post-surgical complications and Patient and Observer Scar Assessment Scale (POSAS). Results and Discussion: Our results showed a better aesthetical result in BK group compared to DAA group and faster rehabilitation with the DAA compared to PL. Optimal cup positioning was reached both in PL approach and DAA approach. DAA showed no increase in complications compared to PL approach and offered a faster recovery. Bikini approach is an alternative to the standard DAA approach and can be proposed for patients where a better aesthetic result is desired in addition to better functional recover.
Thrombotic Events Develop in 1 Out of 5 Patients Receiving ECMO Support: An 11-Year Referral Centre Experience
Authors: Rajsic Sasa , Breitkopf Robert , Rugg Christopher , Bukumiric Zoran , Reitbauer Jakob , Treml Benedikt
Published: January 2023

Background: The use of extracorporeal membrane oxygenation (ECMO) for critically ill patients is growing rapidly given recent developments in technology. However, adverse events are frequently reported that have potentially devastating impacts on patient outcomes. The information on predictors and risk factors for thrombotic events, especially that focusing on the comparison of veno-arterial and veno-venous ECMO configurations, are still inconsistent and sparse; therefore, we aimed to close this gap. Methods: We performed a retrospective analysis of all patients on extracorporeal life support admitted to the intensive care units of a tertiary university center in Europe. Results: From 645 patients, 417 who received extracorporeal life support due to cardiogenic shock (290, 70%), respiratory failure (116, 28%) or hypothermia (11, 3%) were included. In total, 22% (92) of the patients experienced thrombotic events with a similar incidence in both ECMO configurations. Anticoagulation consisted of unfractionated heparin (296, 71%) and argatroban (70, 17%). Univariate Cox analyses identified hemoconcentration and increased maximal clot firmness (thromboelastometry) as risk factors for thrombosis. Moreover, the patients experiencing thrombosis had longer ECMO duration and intensive care stays. Conclusions: ECMO is a specialized life-support modality with a high risk of complications. A longer ECMO duration is associated with thrombosis occurrence in patients receiving ECMO support. Following hemorrhage, thromboembolic complications are common adverse events. However, in contrast to major bleeding, no impact on mortality was observed. The question arises if a protocol with less anticoagulation may have a role to play in the future.
Performance of the New ABC and MAP(ASH) Scores in the Prediction of Relevant Outcomes in Upper Gastrointestinal Bleeding
Authors: Jimenez-Rosales Rita , Lopez-Tobaruela Jose Maria , Lopez-Vico Manuel , Ortega-Suazo Eva Julissa , Martinez-Cara Juan Gabriel , Redondo-Cerezo Eduardo
Published: January 2023

Background & Aims: Several risk scores have been proposed for risk-stratification of patients with upper gastrointestinal bleeding. ABC score was found more accurate predicting mortality than AIMS65. MAP(ASH) is a simple, pre-endoscopy score with a great ability to predict intervention and mortality. The aim of this study was to compare ABC and MAP(ASH) discriminative ability for the prediction of mortality and intervention in UGIB. As a secondary aim we compared both scores with Glasgow-Blatchford score and AIMS65. Methods: Our study included patients admitted to the emergency room of Virgen de las Nieves University Hospital with UGIB (2017–2020). Information regarding clinical, biochemical tests and procedures was collected. Main outcomes were in-hospital mortality and a composite endpoint for intervention. Results: MAP(ASH) and ABC had similar AUROCs for mortality (0.79 vs. 0.80). For intervention, MAP(ASH) (AUROC = 0.75) and ABC (AUROC = 0.72) were also similar. Regarding rebleeding, AUROCs of MAP(ASH) and ABC were 0.67 and 0.61 respectively. No statistically differences were found in these outcomes. With a low threshold for MAP(ASH) ≤ 2, ABC and MAP(ASH) classified a similar proportion of patients as being at low risk of death (42% vs. 45.2%), with virtually no mortality under these thresholds. Conclusions: MAP(ASH) and ABC were similar for the prediction of relevant outcomes for UGIB, such as intervention, rebleeding and in-hospital mortality, with an accurate selection of low-risk patients. MAP(ASH) has the advantage of being easier to calculate even without the aid of electronic tools.
Podocyte Infolding Glomerulopathy: A Case Series Report and Literature Review
Authors: Feng Yunlin , Wang Wei , Zou Yurong , Chen Tingyu , Wang Wei , Li Guisen , Wang Amanda Y. , Zhang Ping
Published: January 2023

Background: Podocyte infolding glomerulopathy (PIG) is a peculiar and very rare manifestation in renal pathology. Its underlying pathogenesis mechanism and clinical characteristics remain unclear due to sparse reports. Objective: To further elucidate the clinical profile of PIG by carefully reporting our four cases and a comprehensive review of cases in the literature. Methods: This study retrospectively reviewed four cases of PIG from 2010 to 2022 in our centre. Clinical and pathological profiles were reported. PIG cases in the literature were searched in the MEDLINE database and analysed together with our cases. Results: Four cases of PIG identified from our centre and 40 cases from the current literature were reported. The pooled analysis of these 44 cases indicated 79.5% (35/44) were females, 93.2% (41/44) were East Asians, and 63.6% (28/44) were reported in Japan. The average age was 42.0 ± 12.5 years old. The average amount of proteinuria at the time of renal biopsy was 3.06 ± 3.2 g/day. The most reported comorbidities were connective tissue diseases, mainly systemic lupus erythematosus, and 20.5% (9/44) of the cases did not have any contaminant disease. Most of the cases (81.8%, 36/44) had been treated with immunosuppressants, of which a combination of corticosteroids and one other type of immunosuppressant was most commonly reported. In addition, 45.4% (20/44) and 34.1% (15/44) of the cases had achieved complete response and partial response, respectively, after treatment. Whole exosome sequencing indicated mutations in the INF2 gene. Conclusions: PIG is a rare condition and seen in relatively younger populations, often associated with connective tissue diseases clinically and one or two other glomerulopathies histologically. The outcomes following immunosuppressive treatment are relatively good. Mutations in INF2 might be involved in the development of PIG; however, the implications of these results need to be investigated.
Comparison of Flexible Ureteroscope Performance between Reusable and Single-Use Models
Authors: Bragaru Marius , Multescu Razvan , Geavlete Petrisor , Popescu Razvan , Geavlete Bogdan
Published: January 2023

Background: Single-use flexible ureteroscopes for urinary retention have been developed in recent years as an alternative to reusable ureteroscopes in order to eliminate the risk of cross-infections and to solve the primary limitations of traditional reusable flexible ureteroscopes for urinary retention. Methods: In this study, we evaluated and contrasted three of the most recent types of flexible ureteroscopes, including two digital reusable versions (Olympus URF-V and Olympus URF-V2) and one single-use model (Pusen Medi-calUscope UE3022), in both ex vivo and in vivo scenarios. The influence of a variety of instruments on the flow of irrigation and its deflection was investigated ex vivo. In the in vivo investigation, a total of 40 patients were treated with retrograde fURS utilizing URF-V, 20 patients were treated with URF-V2, and 20 patients were treated with single-use fURS. The visibility and maneuverability of each fURS were evaluated by the same urologist during the procedures, and the results were compared. Results: Intraoperatively, we compared the image quality of reusable (URF-V and URF-V2) and single-use fURS USCOPE UE3022 cameras and found that there was no statistically significant difference between the two types of camera. The score for maneuverability was the same (4.2) regardless of whether we used the UscopeUE3022 or the URF-V2, but it was significantly lower (3.8, p = 0.03) when we utilized the URF-V. Irrigation was about the same when utilizing reused scopes, whereas employing a single-use scope was more than fifty percent more effective. Conclusions: The findings of our research indicate that reusable and single-use fURs have visibility and maneuverability characteristics that are at least comparable to one another. The possibilities of the single-use type in terms of irrigation flow and deflection are superior.
The Effect of Polishing, Glazing, and Aging on Optical Characteristics of Multi-Layered Dental Zirconia with Different Degrees of Translucency
Authors: Toma Flavia Roxana , Porojan Sorin Daniel , Vasiliu Roxana Diana , Porojan Liliana
Published: January 2023

(1) Background: Considering that the appearance of a dental material is an important factor that contributes to the success of prosthetic restorations. The purpose of this study is to investigate the optical properties and color changes among the layers of three commercial zirconias, to compare the aspect of the polished and glazed surfaces before and after aging and to evaluate the effects of hydrothermal degradation on their aesthetics. (2) Methods: Forty-eight plate-shaped samples were sectioned from presintered blocks of each multilayer translucent zirconia with different Yttrium content: Ceramill Zolid fx ML (5 mol%) = CeZ, STML (4 mol%) = STM, IPS e.maxZirCAD CEREC/in Lab MT Multi (4 mol% + 5 mol%) = IPZ. The samples were sintered according to the recommendation of each manufacturer, and half (24) of them were polished and the other half (24) glazed on one of the surfaces. Each type was equally divided into one control and one aging group, and, for each material, this resulted in four groups (n = 12): polished-control, polished-autoclaved glazed-control, and glazed-autoclaved. The artificial aging was carried out with an autoclave and distilled water at 134 °C, 0.2 MPa for 1 h, and for optical parameters (TP, CR, OP) and color change (ΔE*) measurements on a black and white background in a CIE L*a*b* color system, a spectrophotometer was used. The specimens were evaluated in incisal, cervical, and medium areas on polished and glazed samples before and after the aging stage. Statistical analysis was achieved with a two-way ANOVA test, the unpaired t-test, and the paired t-test. (3) Results: Before and after aging, the mean TP values for polished samples were higher than the glazed ones. After aging, the mean TP values increased for all groups (except polished CeZ), and significant differences were reported for polished STM, IPZ. After LTD, the opalescence registered an increase for almost all groups (except polished CeZ, polished and glazed IPZ—medium area), and significant differences were reported for almost all groups (except STM—incisal, IPZ—cervical, medium areas). The levels of color change were between extremely slight to perceivable. (4) Conclusions: Optical properties of the selected multilayer zirconia were influenced by polishing and glazing as surface treatment and affected by artificial aging (CeZ the least); perceivable color changes for polished STM, IPZ were detected.
Anthocyanin/Honey-Incorporated Alginate Hydrogel as a Bio-Based pH-Responsive/Antibacterial/Antioxidant Wound Dressing
Authors: Lotfinia Faezeh , Norouzi Mohammad-Reza , Ghasemi-Mobarakeh Laleh , Naeimirad Mohammadreza
Published: January 2023

Infection is a major problem that increases the normal pH of the wound bed and interferes with wound healing. Natural biomaterials can serve as a suitable environment to acquire a great practical effect on the healing process. In this context, anthocyanin-rich red cabbage (Brassica oleracea var. capitata F. rubra) extract and honey-loaded alginate hydrogel was fabricated using calcium chloride as a crosslinking agent. The pH sensitivity of anthocyanins can be used as an indicator to monitor possible infection of the wound, while honey would promote the healing process by its intrinsic properties. The mechanical properties of the hydrogel film samples showed that honey acts as a plasticizer and that increasing the incorporation from 200% to 400% enhances the tensile strength from 3.22 to 6.15 MPa and elongation at break from 0.69% to 4.75%. Moreover, a water absorption and retention study showed that the hydrogel film is able to absorb about 250% water after 50 min and retain 40% of its absorbed water after 12 h. The disk diffusion test showed favorable antibacterial activity of the honey-loaded hydrogel against both Gram-positive and Gram-negative Staphylococcus aureus and Escherichia coli, respectively. In addition, the incorporation of honey significantly improved the mechanical properties of the hydrogel. 2,2-diphenyl-1-picrylhydrazyl (DPPH) assay proved the antioxidant activity of the honey and anthocyanin-containing hydrogel samples with more than 95% DPPH scavenging efficiency after 3 h. The pH-dependent property of the samples was investigated and recorded by observing the color change at different pH values of 4, 7, and 9 using different buffers. The result revealed a promising color change from red at pH = 4 to blue at pH = 7 and purple at pH = 9. An in vitro cell culture study of the samples using L929 mouse fibroblast cells showed excellent biocompatibility with significant increase in cell proliferation. Overall, this study provides a promising start and an antibacterial/antioxidant hydrogel with great potential to meet wound-dressing requirements.
Mechanisms of Advective and Tidal Oscillatory Salt Transport in the Hypertidal Estuary: Yeomha Channel in Gyeonggi Bay
Authors: Lee Hye Min , Kim Jong Wook , Woo Seung-Buhm
Published: January 2023

Many estuaries have been damaged by such material movements as marine debris, suspended sediment, and pollutants. Understanding the estuarine circulation system is necessary to solve such problems. Salt transport analysis provides an insight into hydrodynamic processes about material circulation in the estuary. In this study, to understand the mechanisms of salt transport, a three-dimensional hydrodynamic model was applied in the hypertidal estuary system—Yeomha Channel in Gyeonggi Bay. The simulation period of the model was a total of 245 days (20 January to 20 September 2020), including the dry and wet seasons. The model results for the temporal variation in tide, current velocity, and salinity were validated by comparing them with the observed in-situ data. The total salt transport (FS) was calculated in three cross sections of the Yeomha Channel and was decomposed into three components (QfS0: advective salt transport; FE: steady shear dispersion; FT: tidal oscillatory salt transport). During the dry season with strong tidal forces, the total salt transport patterns were mainly dominated by QfS0. During the wet season with high river discharge, the total salt transport patterns were determined by the balance between QfS0, FE, and FT. The long-term tidal constituents (MSf and Mm) were the main mechanisms causing QfS0 with the spring–neap variation during the dry season. The tidal trapping effect, caused by a phase difference of less than 90° between tidal current and salinity, generated landward FT in the dry and wet seasons. In addition, the high river discharge during the wet season decreased the phase difference between tidal current and salinity to less than 70°, resulting in a much stronger landward FT. This study suggests that the long-term tidal constituents and tidal trapping effect are unique characteristics that contribute to material circulation in the hypertidal estuary.
Recognition of Unsafe Onboard Mooring and Unmooring Operation Behavior Based on Improved YOLO-v4 Algorithm
Authors: Zhao Changjiu , Zhang Wenjun , Chen Changyuan , Yang Xue , Yue Jingwen , Han Bing
Published: January 2023

In the maritime industry, unsafe behaviors exhibited by crew members are a significant factor contributing to shipping and occupational accidents. Among these behaviors, unsafe operation of mooring lines is particularly prone to causing severe accidents. Video-based monitoring has been demonstrated as an effective means of detecting these unsafe behaviors in real time and providing early warning to crew members. To this end, this paper presents a dataset comprising videos of unsafe mooring line operations by crew members on the M.V. YuKun. Additionally, we propose an unsafe behavior recognition model based on the improved You Only Look Once (YOLO)-v4 network. Experimental results indicate that the proposed model, when compared to other models such as the original YOLO-v4 and YOLO-v3, demonstrates a significant improvement in recognition speed by approximately 35% while maintaining accuracy. Additionally, it also results in a reduction in computation burden. Furthermore, the proposed model was successfully applied to an actual ship test, which further verifies its effectiveness in recognizing unsafe mooring operation behaviors. Results of the actual ship test highlight that the proposed model’s recognition accuracy is on par with that of the original YOLO-v4 network but shows an improvement in processing speed by 50% and a reduction in processing complexity by about 96%. Hence, this work demonstrates that the proposed dataset and improved YOLO-v4 network can effectively detect unsafe mooring operation behaviors and potentially enhance the safety of marine operations.
Gender Medicine in Clinical Radiology Practice
Authors: Giacobbe Giuliana , Granata Vincenza , Trovato Piero , Fusco Roberta , Simonetti Igino , De Muzio Federica , Cutolo Carmen , Palumbo Pierpaolo , Borgheresi Alessandra , Flammia Federica , Cozzi Diletta , Gabelloni Michela , Grassi Francesca , Miele Vittorio , Barile Antonio , Giovagnoni Andrea , Gandolfo Nicoletta
Published: January 2023

Gender Medicine is rapidly emerging as a branch of medicine that studies how many diseases common to men and women differ in terms of prevention, clinical manifestations, diagnostic-therapeutic approach, prognosis, and psychological and social impact. Nowadays, the presentation and identification of many pathological conditions pose unique diagnostic challenges. However, women have always been paradoxically underestimated in epidemiological studies, drug trials, as well as clinical trials, so many clinical conditions affecting the female population are often underestimated and/or delayed and may result in inadequate clinical management. Knowing and valuing these differences in healthcare, thus taking into account individual variability, will make it possible to ensure that each individual receives the best care through the personalization of therapies, the guarantee of diagnostic-therapeutic pathways declined according to gender, as well as through the promotion of gender-specific prevention initiatives. This article aims to assess potential gender differences in clinical-radiological practice extracted from the literature and their impact on health and healthcare. Indeed, in this context, radiomics and radiogenomics are rapidly emerging as new frontiers of imaging in precision medicine. The development of clinical practice support tools supported by artificial intelligence allows through quantitative analysis to characterize tissues noninvasively with the ultimate goal of extracting directly from images indications of disease aggressiveness, prognosis, and therapeutic response. The integration of quantitative data with gene expression and patient clinical data, with the help of structured reporting as well, will in the near future give rise to decision support models for clinical practice that will hopefully improve diagnostic accuracy and prognostic power as well as ensure a more advanced level of precision medicine.
Axillary Treatment Management in Breast Cancer during COVID-19 Pandemic (Association between ACOSOG Z0011 Criteria and OSNA Test)
Authors: Anedda Giacomo , Cappellacci Federico , Canu Gian Luigi , Farris Stefania , Calò Pietro Giorgio , Dessena Massimo , Medas Fabio
Published: January 2023

The outbreak of the SARS-COVID-2 pandemic (COVID-19) had a significant effect on the organisation of healthcare systems. Surgical units saw a significant reduction in the volume of surgical procedures performed, with lengthening waiting lists as a consequence. We assessed the surgical activity in relation to breast cancer that took place at the University Hospital of Cagliari, Italy, from February 2018 to March 2022. Two phases were identified based on the epidemiological circumstances: Phase 1—February 2018 to February 2020; Phase 2—March 2020 to March 2022. The surgery performed in the two phases was then compared. All the patients in our sample underwent a breast surgical procedure involving a lymph node biopsy using OSNA associated with the ACOSOG Z0011 criteria. In the study period overall at our facility, there were 4214 procedures, 417 of which involved breast surgery. In Phase 2, 91 procedures were performed using the OSNA method and ACOSOG Z0011 criteria, enabling the intraoperative staging of axillary nodes. Axillary treatment in breast cancer using this approach resulted in a significant reduction in the number of reoperations for the radicalisation of metastatic sentinel lymph nodes.
High Concentration Hydrogen Mitigates Sepsis-Induced Acute Lung Injury in Mice by Alleviating Mitochondrial Fission and Dysfunction
Authors: Zhao Nan , Sun Ruiqiang , Cui Yan , Song Yu , Ma Wanjie , Li Yingning , Liang Jing , Wang Guolin , Yu Yonghao , Han Jiange , Xie Keliang
Published: January 2023

Background: Multiple organ failure (MOF) is the main cause of early death in septic shock. Lungs are among the organs that are affected in MOF, resulting in acute lung injury. A large number of inflammatory factors and stress injury in sepsis can lead to alterations in mitochondrial dynamics. Numerous studies have confirmed that hydrogen can alleviate sepsis in the animal model. The purpose of this experiment was to explore the therapeutic effect of high concentration (67%) hydrogen on acute lung injury in septic mice and its mechanism. Methods: The moderate and severe septic models were prepared by cecal ligation and puncture. Hydrogen with different concentrations was inhaled for one hour at 1 h and 6 h after the corresponding surgery. The arterial blood gas of mice during hydrogen inhalation was monitored in real time, and the 7-day survival rate of mice with sepsis was recorded. The pathological changes of lung tissues and functions of livers and kidneys were measured. The changes of oxidation products, antioxidant enzymes and pro-inflammatory cytokines in lungs and serums were detected. Mitochondrial function was measured. Results: The inhalation of 2% or 67% hydrogen improves the 7-day survival rate and reduces acute lung injury as well as liver and kidney injury in sepsis. The therapeutic effect of 67% hydrogen inhalation on sepsis was related to increasing antioxidant enzyme activity, reducing oxidation products and pro-inflammatory cytokines in lungs and serums. Compared with the Sham group, mitochondrial dysfunction was alleviated in hydrogen groups. Conclusions: Hydrogen inhalation by high or low concentration can both significantly improve sepsis; however, a high concentration demonstrates a better protective effect. High concentration hydrogen inhalation can significantly improve the mitochondrial dynamic balance and reduce the lung injury in septic mice.
Combining Preoperative Clinical and Imaging Characteristics to Predict MVI in Hepatitis B Virus-Related Combined Hepatocellular Carcinoma and Cholangiocarcinoma
Authors: Huang Si-Si , Zuo Meng-Xuan , Xie Chuan-Miao
Published: January 2023

Background: Combined hepatocellular carcinoma and cholangiocarcinoma (cHCC-CCA) is a rare form of primary liver malignancy. Microvascular invasion (MVI) indicates poor postsurgical prognosis in cHCC-CCA. The objective of this study was to investigate preoperative predictors of MVI in hepatitis B virus (HBV) -related cHCC-CCA patients. Methods: A total of 69 HBV-infected patients with pathologically confirmed cHCC-CCA who underwent hepatectomy were included. Univariate and multivariate analyses were conducted to determine independent risk factors that were then incorporated into the predictive model associated with MVI. Receiver operating characteristic analysis was used to assess the predictive performance of the new model. Results: For the multivariate analysis, γ-glutamyl transpeptidase (OR, 3.69; p = 0.034), multiple nodules (OR, 4.41; p = 0.042) and peritumoral enhancement (OR, 6.16; p = 0.004) were independently associated with MVI. Active replication of HBV indicated by positive HBeAg showed no differences between MVI-positive and MVI-negative patients. The prediction score using the independent predictors achieved an area under the curve of 0.813 (95% CI 0.717–0.908). A significantly lower recurrence-free survival was observed in the high-risk group with a score of ≥1 (p < 0.001). Conclusion: γ-glutamyl transpeptidase, peritumoral enhancement and multiple nodules were independent preoperative predictors of MVI in HBV-related cHCC-CCA patients. The established prediction score demonstrated satisfactory performance in predicting MVI pre-operatively and may facilitate prognostic stratification.
Exploring Accessibility and Its Impact in the Mountain City: A Typical Case Study of Nyingchi City, Tibet Autonomous Region, China
Authors: Gong Qianqian , Li Jiaming , Wu Lingzhi , Zhu Miner , Luo Maoyu , Sun Jingyi , Fu Wenqing , Ma Renfeng , Liang Xianjun
Published: January 2023

The accessibility of mountain tourist attractions is a prerequisite to enhancing the attractiveness of tourist attractions and driving the well-being of local residential areas, which increases people’s prosperity and the sustainable development of tourist attractions, and achieves the UN’s Sustainable Development Goals (SDGs). This paper focuses on the accessibility of typical mountainous areas in the Qinghai–Tibet Plateau, and uses the cost distance and OD distance methods under the guidance of core-edge theory to explore the changes of accessibility of traffic nodes, tourist attractions, and residents with the future enrichment of the traffic road network. The results show that: (1) The change in accessibility will highlight the location advantages of some tourist attractions, which can be prioritized in the context of similar tourist attractions; (2) Regional accessibility improvements require a combination of traffic modes to maximize impact; (3) Residents of different multi-core circles could choose various industrial development patterns based on the accessibility of tourist attractions and residential areas; (4) Group development according to the spatial location and accessibility of tourist attractions can facilitate the virtuous drive among tourist attractions, which achieves the goal of integrated tourism.