bluuebunny/crossref_metadata_2025 huggingface dataset:
Analysis of Wildfire Susceptibility by Weight of Evidence, Using Geomorphological and Environmental Factors in the Marche Region, Central Italy
Authors: Gentilucci Matteo , Barbieri Maurizio , Younes Hamed , Rihab Hadji , Pambianchi Gilberto
Published: April 2024

Fires are a growing problem even in temperate climate areas, such as those in Central Italy, due to climate change leading to longer and longer periods of drought. Thus, knowing the fire susceptibility of an area is crucial for good planning and taking appropriate countermeasures. In this context, it was decided to use only causal factors of a geomorphological and environmental nature in order to obtain a fire susceptibility analysis that can also be applied to climatically under-sampled areas. Vector data of fires in Central Italy from 2005 to 2023 were collected, and the correct areal extent was calculated for each. At the same time, six factors were selected that could have an influence on fire development, such as ecological units, topographic wetness index (TWI), geology, slope, exposure, and altitude. The model was obtained by means of the weight of evidence statistical method, which takes into account past data by reinterpreting them in a future-oriented way on the basis of the identified factors and classes. The model was validated with a test sample and shows an area under the curve (AUC) value of 0.72 with a reliability that can be described as good considering the total absence of climatic factors that are known to play a major role in fire development. Furthermore, the identified causal factors were divided into classes, and these were carefully weighted in order to define their relative influence in the study area. Particularly Ecological Units with characteristic and well-defined contrast (C) values, which could lead to a more complete definition of forests that tend to increase fire susceptibility and those that tend to decrease it, allowing the latter to be exploited as a hazard mitigation agent.
Geotechnical Characterisation of Flysch-Derived Colluvial Soils from a Pre-Alpine Slope Affected by Recurrent Landslides
Authors: Del Fabbro Marco , Paronuzzi Paolo , Bolla Alberto
Published: April 2024

Heterogeneous rock masses that include rhythmic alternations of marl, shale, marly limestone, sandstone, siltstone, and argillite, such as Flysch, are particularly prone to generating colluvial deposits on gentle slopes, which are often subject to failures triggered by heavy rainfall. Flysch-derived colluvial soils are made up of highly heterogeneous sediments ranging from clayey loam to rock fragments, and they have been studied more rarely than homogeneous soils. In this work, we present a geotechnical and hydraulic characterisation performed both in situ and in the laboratory on flysch-derived colluvial soils that were involved in a channelised landslide in the pre-alpine area of the Friuli Venezia Giulia region (NE Italy). The investigated soils were characterised by the average values of the grain size composition of about 25% gravel, 20% sand, 30% silt, and 25% clay. The loamy matrix presented low-to-medium values of the liquid and plastic limits, as well as of the plasticity index (LL = 40%, PL = 23%, and PI = 17%, respectively). The values of the peak friction angle for natural intact samples were 33° < ϕ’p < 38°, whereas the residual friction angle fell to 23–24° at great depths and high vertical stresses, for a prevailing silty–clayey matrix. Variable head permeability tests were performed both in situ and in the laboratory, showing that the values of the vertical and horizontal permeability were very close and in the range 1 × 10−4–1 × 10−6 m/s. The soil permeability measured in the field was generally higher than the hydraulic conductivity calculated on laboratory samples. The proposed geotechnical and hydrological characterisation of flysch-derived colluvial soils can be of fundamental importance before the use of more thorough analyses/models aimed at forecasting the possible occurrence of slope failures and evaluating the related landslide hazard. The reported geotechnical and hydraulic parameters of flysch-derived colluvial materials can represent a useful reference for rainfall infiltration modelling and slope stability analyses of colluvial covers that are subject to intense and/or prolonged precipitation. However, when facing engineering problems involving colluvial soils, particularly those coming from flysch rock masses, the intrinsic variability in their grain size composition, consistency, and plasticity characteristics is a key feature and attention should be paid to the proper assumption of the corresponding geotechnical and hydraulic parameters.
Patient-Perceived Quality Assessment in Orthopedics and Traumatology Departments during COVID-19 Pandemic
Authors: Bancsik Karoly , Ilea Codrin Dan Nicolae , Daina Mădălina Diana , Bancsik Raluca , Șuteu Corina Lacramioara , Bîrsan Simona Daciana , Manole Felicia , Daina Lucia Georgeta
Published: April 2024

The COVID-19 pandemic has led to significant disruptions in various healthcare systems. In Romania, the elective procedures in the orthopedic and traumatology specialty were one of the most affected. The study aims to investigate the influence of the COVID-19 pandemic on patient perceptions of quality in these departments. Standardized assessment tools were used, which consist of satisfaction questionnaires addressed to patients in order to assess the quality of health services in orthopedics and traumatology departments. Thus, a retrospective study was conducted using satisfaction questionnaires addressed to patients admitted to the orthopedics and traumatology departments of the County Clinical Emergency Hospital Bihor between January 2019 and December 2022. Eight reports, based on 746 questionnaires conducted during the studied period, were evaluated. To gauge patient satisfaction, Likert scales featuring five response options were used. A total of 627 questionnaires were valid, the exclusion criteria being incomplete questionnaires (the patients did not respond on all questions, n = 119). Four domains were analyzed: demographic data, hotel conditions, quality of medical care, and overall satisfaction. Demographic data highlight that patients exhibited an equitable distribution across residences, with 50.2% hailing from urban locales, while 53.5% (n = 333) were female. Regarding the overall impression, in 2020, there was a decline in the top rating of 5 compared to 2019, dropping to just 45.10% from 53.45%. Scores of 4 increased to 41.83%, while scores of 3 stayed under 8.5%. Scores of 2 and 1 were negligible. In 2021 and 2022, we can observe a sustained increase in the number of patients who awarded 5 points for overall impression and a decrease in the number of patients who awarded 4 points compared to previous years. The maximum difference between 2020 and 2021 and the period before and after this period was 27.24% (p-value < 0.001). The results indicate that while overall impressions of the hospital remained positive throughout the studied period, there were notable fluctuations in satisfaction levels during the pandemic. Patient satisfaction with attending physicians dipped in 2020 from 86.70% to 77.78% but recovered by 2022. The same trend can be observed with nurses and caregivers, as well as hotel services, during this period. These findings underscore the importance of addressing patient concerns and improving the quality of care delivery, particularly during times of crisis.
Factors Influencing Occupational Health and Safety among Nursing Students in Their Clinical Placements: A Cross-Sectional Study
Authors: Alsharari Abdullah Suwailem , Kerari Ali
Published: April 2024

Occupational health and safety aims to promote and maintain optimal physical, mental, and social health for workers in their occupations. Within Saudi Arabia, adequate information must be gathered to address the various factors influencing occupational health and safety among nursing students to minimize occupational health hazards and ensure a safe clinical environment. This cross-sectional study was conducted in Riyadh, Saudi Arabia, between April and September 2023, involving 150 nursing students. Data collection included questions to gather sociodemographic information, and contained an instrument assessing the participants’ knowledge of occupational health and safety and evaluation of risk control in clinical environments. Blood and other bodily fluids, workplace violence, needle-stick injuries, and injuries caused by sharp instrument tools were identified as the most prevalent occupational risks among the participants. Most nursing students were aware of occupational health and safety, with a high level of compliance with occupational health and safety measures and personal protective equipment use. We also identified a statistically significant correlation between occupational health and safety knowledge and risk control evaluation among nursing students. To ensure a safe and beneficial clinical training area, student nurses must complete extensive occupational health and safety courses before moving to clinical areas to reduce potential hazards that may affect their lives.
Impact of Wood-Boring Larvae of Xylotrechus arvicola (Coleoptera: Cerambycidae) on Mechanical Properties of Vitis vinifera Plants
Authors: Ramírez-Lozano Daniela , Antolín-Rodríguez Andrea , Carro-Huerga Guzmán , Zanfaño Laura , Casquero Pedro A. , Guerra Marcos , Juan-Valdés Andrés , Rodríguez-González Álvaro
Published: April 2024

Xylotrechus arvicola represents a significant insect pest impacting Vitis vinifera within the principal wine-producing territories of the Iberian Peninsula. The larvae of this species bore into grapevine wood, resulting in significant structural and biomechanical deterioration to the plant. Compressive and flexural tests were conducted to assess the mechanical properties of wood affected by X. arvicola. Compressive and flexural strength exhibited a decline with the escalation of the Total Damaged Surface Area (TDSA) of the samples, ranging from 0.31% to 0.73% in trunks and from 0.04 to 0.76% in branches, irrespective of the wood moisture content (fresh and dry). The most significant reduction in resistance occurred in affected dry trunks and branches. Notably, the deflection at break for dry samples was lower compared to fresh samples (65.00 and 97.85 mm, respectively). Moreover, the deflection at break for affected fresh samples (164.37 mm) significantly surpassed that of unaffected fresh samples (72.58 mm) and affected dry samples (37.50 mm). It is noteworthy that a higher percentage of TDSA coincided with diminished wood resistance. The percentage of fungal growth symptoms observed in affected wood samples was 66.66% for dry trunks, 75.00% for fresh branches, and 60.00% for dry branches. The damage inflicted by larvae facilitated the spread of grapevine diseases via emergence of holes created by insects upon exiting the wood and through the larval galleries connected to them. This damage also altered the mechanical properties of grapevine plants, with fresh branches exhibiting the most pronounced effects.
Rotational Strip Bean and Celery Intercropping Alters the Microbial Community to Improve Crop Yield and Soil Nutrients
Authors: Li Shuang , Yuan Tao , Ibrahim Musawar , Wu Fengzhi
Published: April 2024

Rotational strip intercropping involves the strategic combination of stubble intercropping and the rotational placement of intercropped strips, which can improve crop yield. Here, we evaluated the effects of rotational strip bean (Phaseolus vulgaris L.) and celery (Apium graveolens L.) intercropping with bed ratios of 1:1 and 2:2 on crop yield, soil microbial community and nutrition. The 1:1 ratio of rotational strip bean and celery intercropping had a higher yield than the 2:2 ratio. The 1:1 rotational strip intercropping markedly improved the nitrate nitrogen and available phosphorus contents of the beans, and the nitrate nitrogen and available potassium contents of the celery. The 2:2 rotational strip intercropping reduced the bacterial α diversity of the beans, and the 1:1 and 2:2 rotational strip intercropping enhanced the fungal α diversity of both the beans and the celery. Both planting patterns also altered the microbial communities found on the bean and celery plants. Microorganisms enriched in the rhizosphere of the bean and celery plants significantly increased the soil nutrient content and yield in the 1:1 rotational strip intercropping, and included the genera Achromobacter, Luteibacter, Stenotrophomonas, Fusarium, Flavobacterium and Preussia in the bean rhizosphere, and Alternaria, Arthrographis and Pluteus, Sphingopyxis and Clostridium_sensu_stricto_1 in the celery rhizosphere.
The Synergistic Effect of Lemongrass Essential Oil and Flometoquin, Flonicamid, and Sulfoxaflor on Bemisia tabaci (Genn.) (Hemiptera: Aleyrodidae): Insights into Toxicity, Biochemical Impact, and Molecular Docking
Authors: Moustafa Moataz A. M. , Ahmed Fatma S. , Alfuhaid Nawal Abdulaziz , El-Said Nourhan A. , Ibrahim El-Desoky S. , Awad Mona
Published: April 2024

The whitefly, Bemisia tabaci (Genn.), is one of the most dangerous polyphagous pests in the world. Eco-friendly compounds and new chemical insecticides have gained recognition for whitefly control. In this study, the toxicity and biochemical impact of flometoquin, flonicamid, and sulfoxaflor, alone or combined with lemongrass essential oil (EO), against B. tabaci was studied. In addition, a molecular docking study was conducted to assess the binding affinity of the tested compounds to AchE. Based on the LC values, the descending order of the toxicity of the tested compounds to B. tabaci adults was as follows: sulfoxaflor > flonicamid > flometoquin > lemongrass EO. The binary mixtures of each of the tested compounds with lemongrass EO exhibited synergism in all combinations, with observed mortalities ranging from 15.09 to 22.94% higher than expected for an additive effect. Sulfoxaflor and flonicamid, alone or in combination with lemongrass EO, significantly inhibited AchE activity while only flonicamid demonstrated a significant impact on α-esterase, and none of the tested compounds affected cytochrome P450 or GST. However, the specific activity of P450 was significantly inhibited by the lemongrass/sulfoxaflor mixture while α-esterase activity was significantly inhibited by the lemongrass/flometoquin mixture. Moreover, the lemongrass EO and all the tested insecticides exhibited significant binding affinity to AchE with energy scores ranging from −4.69 to −7.06 kcal/mol. The current findings provide a foundation for utilizing combinations of essential oils and insecticides in the integrated pest management (IPM) of B. tabaci.
Mechanical Support in High-Risk Pulmonary Embolism: Review Article
Authors: Kadri Amer N. , Alrawashdeh Razan , Soufi Mohamad K. , Elder Adam J. , Elder Zachary , Mohamad Tamam , Gnall Eric , Elder Mahir
Published: April 2024

Acute pulmonary embolism (PE) may manifest with mild nonspecific symptoms or progress to a more severe hemodynamic collapse and sudden cardiac arrest. A substantial thrombotic burden can precipitate sudden right ventricular strain and failure. Traditionally, systemic thrombolytics have been employed in such scenarios; however, patients often present with contraindications, or these interventions may prove ineffective. Outcomes for this medically complex patient population are unfavorable, necessitating a compelling argument for advanced therapeutic modalities or alternative approaches. Moreover, patients frequently experience complications beyond hemodynamic instability, such as profound hypoxia and multiorgan failure, necessitating assertive early interventions to avert catastrophic consequences. The existing data on the utilization of mechanical circulatory support (MCS) devices are not exhaustive. Various options for percutaneous MCS devices exist, each possessing distinct advantages and disadvantages. There is an imminent imperative to develop a tailored approach for this high-risk patient cohort to enhance their overall outcomes.
A Comparison of Sensorimotor Integration and Motor Fitness Components between Collegiate Athletes with and without Long COVID: A Cross-Sectional Study with Pair-Matched Controls
Authors: Moustafa Ibrahim M. , Ahbouch Amal , Kader Raheesa P. , Shousha Tamer Mohamed , Alrahoomi Abdulla
Published: April 2024

Background: Long COVID presents a concern for collegiate athletes, potentially impacting sensorimotor processing and motor fitness. This study aimed to assess these effects. Methods: This cross-sectional study involved 60 athletes diagnosed with Long COVID and 60 controls. Sensorimotor processing and integration were evaluated using neurophysiological variables (N13, P14, N20, P27, and N30), while motor fitness was assessed through balance, agility, and vertical jump testing. T-tests compared groups, and Pearson’s correlations explored relationships. Results: Significant differences (p < 0.001) were observed in neurophysiological variables and motor fitness between Long COVID and control groups. Fatigue correlated positively (p < 0.001) with neurophysiological variables in Long COVID cases but not with motor fitness (p = 0.08, p = 0.07, p = 0.09). Conclusions: Collegiate athletes with Long COVID exhibit abnormal sensorimotor processing, integration, and diminished motor fitness compared to uninfected peers. The fatigue severity of Long COVID correlates with neurophysiological changes, suggesting a link between sensorimotor deficits and fatigue. Targeted interventions for sensorimotor deficits and fatigue management are crucial for athletes recovering from Long COVID. This study underscores the importance of addressing these issues to optimize the recovery and performance of collegiate athletes affected by Long COVID.
Effects of Etching Time and Ethanol Wet Bonding on Bond Strength and Metalloproteinase Activity in Radicular Dentin
Authors: Comba Allegra , Baldi Andrea , Pucci Riccardo , Rolando Chiara , Alovisi Mario , Pasqualini Damiano , Scotti Nicola
Published: April 2024

(1) Background: The objective of this in vitro study was to evaluate the impact of different etching times and ethanol pre-treatments on the immediate bond strength of a hydrophilic multi-mode universal adhesive (Clearfil Universal Bond Quick, Kuraray, UBQ) and on the consequent gelatinolytic activity of metalloproteinases (MMPs) on radicular dentin. (2) Methods: Sixty single-root teeth were selected and divided into four groups according to the adhesive protocol applied for fiber post cementation: (G1) 15 s H3PO4 application + UBQ; (G2) 30 s H3PO4 application + UBQ; (G3) 15 s H3PO4 application + ethanol pre-treatment + UBQ; (G4) 30 s H3PO4 + ethanol pre-treatment + UBQ. After adhesive procedures, fiber posts were luted into the post space with a dual-curing cement (DC Core, Kuraray) and light-cured for 40 s. To perform the push-out test and nanoleakage analyses for both coronal end apical areas, 1 mm slices were prepared, following a 24 h storage period in artificial saliva. Additionally, an in situ zymographic assay was conducted to explore endogenous MMP activity within the radicular layer. Results were statistically analyzed with ANOVA and Tukey post hoc tests. Statistical significance was set at p < 0.05. (3) Result: ANOVA revealed a statistically significant difference in push-out bond strength related to the pre-treatment variable but did not highlight any significance of etching time. Specimens pre-treated with ethanol wet bond application showed higher bond strength (p < 0.01). In situ zymography quantification analyses revealed that all tested groups, independently of etching time end ethanol pre-treatment, activated MMP gelatinolytic activity. A significant increase in MMP activity was detected for the 30 s etching time. However, ETOH pre-treatment significantly reduced MMP activity within the adhesive interface (p < 0.01). (4) Conclusions: The tested adhesive showed similar results regardless of the etching time protocol. The gelatinolytic activity of MMPs was observed in all the groups. Further investigations and extended follow-ups are required to validate the results of the present study in vivo.
Nanosurgical and Bioengineering Treatment of Human Anterior Cruciate Ligament Tears with Ultrasound-Guided Injection of Modified Platelet-Rich Plasma Using Human Cell Memory Based on Clinical, Ultrasound, MRI, and Nanoscope Analyses: A Double-Blind Randomized Trial
Authors: Wasilczyk Cezary
Published: April 2024

Background: Anterior cruciate ligament (ACL) tears account for 40% to 50% of all ligamentous knee injuries. Most patients with ACL ruptures undergo surgical treatment. There is currently no objective, well-documented, repeatable, and standardized nonsurgical method for ACL tear treatment. This study aimed to investigate ACL outcomes in patients who underwent a novel nanosurgery and bioengineering treatment (NSBT) for an ACL tear. Methods: This was a double-blind randomized trial including 44 patients with a history of traumatic knee injury and a confirmed ACL tear. The final sample comprised 40 patients who met all the eligibility criteria. The patients were divided into two groups: the treatment group (n = 30) and the control group (n = 10). The treatment group underwent nanosurgery with an ultrasound-guided injection of modified platelet-rich plasma (PRP) using human cell memory (RP-hCM). The control group was treated with an ultrasound-guided PRP injection into the joint capsule. At baseline and post-treatment, all patients underwent both ultrasonography and magnetic resonance imaging (MRI), and the following clinical variables were assessed: the WOMAC score, the Lysholm knee score, the visual analog scale score, and knee instability. In most patients, the clinical outcome was verified using nanoscopy. Results: The median WOMAC, VAS, and LKS scores, as well as knee instability, improved significantly 12 weeks after the procedure in the treatment group (p < 0.001). We found a significantly larger improvement in the assessed parameters in the treatment group compared to the control group (p < 0.001). In the treatment group, all the patients had good and very good clinical outcomes, while 90% of the patients had a normal ACL signal in a follow-up MRI scan. In the control group, a physical examination revealed no changes in knee stability after treatment. Conclusions: This study showed that there is a significant difference in patient experience and the duration of recovery for patients with ACL tears treated with NSBT. The novel nonsurgical method was shown to be repeatable, objective, well documented, standardized, and highly effective.
Sex Differences in Youth with Chronic Tic Disorder and Tourette Syndrome: Evaluation of Tic Severity, Psychological Profiles, and Quality of Life
Authors: Gagnon Méliza , Singer Ilana , Morand-Beaulieu Simon , O’Connor Kieron P. , Gauthier Bruno , Woods Douglas W. , Blanchet Pierre , Lavoie Marc E. , Leclerc Julie B.
Published: April 2024

Background: Tourette syndrome (TS) and Chronic Tic Disorder (CT) are neurodevelopmental conditions involving motor and/or phonic tics. Youth with tics may encounter feelings of isolation, diminished self-esteem and quality of life, and academic difficulties. A growing body of scientific literature suggests sex differences in youth with tics, but findings have been mixed so far. Because symptom severity peaks around puberty, understanding sex differences in tic manifestations and associated symptoms during this critical period is essential. Therefore, we aimed to assess sex differences related to tic symptoms, action planning styles, quality of life, and externalizing/internalizing symptoms in youth with tics. Methods: Our sample consisted of 66 youths with tics (19 girls) aged 7–14 (mean = 10 years). Youths were assessed with clinical interviews, as well as self- and parent-reported inventories evaluating tic symptoms, psychological profiles, and quality of life. Results: While no differences in tic symptoms were found, girls exhibited lower functional inflexibility, reduced overall functional planning effectiveness, and higher impairment in the psychological well-being subscale than boys. Additionally, girls had reduced general life satisfaction and social self-esteem. Boys reported more explosive outbursts, higher levels of hyperactivity, and more difficulties with self-concept. Conclusions: Our analyses suggested differences in several manifestations associated with tics. This introduces new perspectives that refine our understanding of sex differences. A better understanding of sex differences in tic disorders may eventually improve outcomes for all individuals living with these conditions.
Exploring Quality of Life and Mortality in Pertrochanteric Fragility Hip Fractures in Northern Greece: A Single Tertiary Center Study
Authors: Konstantinou Panagiotis , Kostretzis Lazaros , Fragkiadakis Georgios , Touchtidou Panagiota , Mavrovouniotis Argyrios , Davitis Vasileios , Ditsiou Athina Zacharoula , Gigis Ioannis , Nikolaides Anastasios P. , Niakas Dimitris , Papadopoulos Pericles , Ditsios Konstantinos
Published: April 2024

Background: Fragility-related pertrochanteric fractures have become a significant public health concern, with a rising incidence attributed to the expanding elderly demographic. Assessing patient-reported health-related quality of life (HRQoL), mortality, and factors correlated with them serves as a crucial metric in evaluating the effectiveness of hip fracture surgery. Methods: In a single-center retrospective study, 259 patients underwent surgical treatment with a cephalomedullary nail, with a mean follow-up of 21.7 months. Health-related quality of life (HRQoL) was assessed using SF-12 (12-item Short Form) and EQ-5D (EuroQoL-5 Dimensions) questionnaires. Mobility status was measured by the Crude Mobility Index (CMI). Surveys were administered during hospitalization and six months postoperatively. Statistical analysis involved descriptive statistics, non-parametric controls (Kendall, Mann-Whitney, and Wilcoxon), and Spearman correlation and logistic regression analysis, which were conducted using IBM SPSS version 28. Results: A statistically significant decrease was observed in the mean EQ-5D and SF-12 scores at 6 months post-op compared to the pre-fracture status. The ASA (American Society of Anaesthesiologists) score showed a significant correlation with the decrease in HRQoL measured by the SF-12 questionnaire. The 30-day post-operative mortality rate was 9.3%, increasing to 32.4% at 1 year. Notably, the 30-day mortality significantly rose during the pandemic era (5.0% vs. 12.0%; p = 0.003). Conclusions: Pertrochanteric hip fractures cause a lasting decline in quality of life. Annual mortality is high, and further investigations are needed to formulate policies that prevent hip fractures and reduce mortality rates.
The Effect of Cell Culture Passage on the Efficacy of Mesenchymal Stromal Cells as a Cell Therapy Treatment
Authors: Carmona-Luque MDolores , Ballesteros-Ribelles Antonio , Millán-López Alejandro , Blanco Alfonso , Nogueras Sonia , Herrera Concha
Published: April 2024

Background/Objective: Mesenchymal Stromal Cells (MSCs) have been considered a promising treatment for several diseases, such as cardiac injuries. Many studies have analyzed their functional properties; however, few studies have characterized MSCs through successive culture passages. The main objective of this work was to analyze the phenotype and functionality of MSCs isolated from two different sources in five culture passages to determine if the culture passage might influence the efficacy of MSCs as a cell therapy treatment. Methods: Bone Marrow (BM)-MSCs were harvested from the femur of Wistar rats (n = 17) and Adipose Tissue(AT)-MSCs were isolated from inguinal fat (n = 17). MSCs were cultured for five culture passages, and the immunophenotype was analyzed by flow cytometry, the functionality was characterized by adipogenic, osteogenic, and chondrogenic differentiation assays, and cytokine secretion capacity was determined through the quantification of the Vascular Endothelial Growth-Factor, Fibroblast Growth-Factor2, and Transforming Growth-Factorβ1 in the cell supernatant. The ultrastructure of MSCs was analyzed by transmission electron microscopy. Results: BM-MSCs exhibited typical phenotypes in culture passages two, four, and five, and their differentiation capacity showed an irregular profile throughout the five culture passages analyzed. AT-MSCs showed a normal phenotype and differentiation capacity in all the culture passages. BM- and AT-MSCs did not modify their secretion ability or ultrastructural morphology. Conclusions: Throughout the culture passages, BM-MSCs, but not AT-MSCs, exhibited changes in their functional and phenotypic characteristic that might affect their efficacy as a cell therapy treatment. Therefore, the culture passage selected should be considered for the application of MSCs as a cell therapy treatment.
The Dysregulation of the Monocyte–Dendritic Cell Interplay Is Associated with In-Hospital Mortality in COVID-19 Pneumonia
Authors: Galati Domenico , Mallardo Domenico , Nicastro Carmine , Zanotta Serena , Capitelli Ludovica , Lombardi Carmen , Baino Bianca , Cavalcanti Ernesta , Sale Silvia , Labonia Francesco , Boenzi Rita , Atripaldi Luigi , Ascierto Paolo Antonio , Bocchino Marialuisa
Published: April 2024

Background: The monocyte–phagocyte system (MPS), including monocytes/macrophages and dendritic cells (DCs), plays a key role in anti-viral immunity. We aimed to analyze the prognostic value of the MPS components on in-hospital mortality in a cohort of 58 patients (M/F; mean age ± SD years) with COVID-19 pneumonia and 22 age- and sex-matched healthy controls. Methods: We measured frequencies and absolute numbers of peripheral blood CD169+ monocytes, conventional CD1c+ and CD141+ (namely cDC2 and cDC1), and plasmacytoid CD303+ DCs by means of multi-parametric flow cytometry. A gene profile analysis of 770 immune-inflammatory-related human genes and 20 SARS-CoV-2 genes was also performed. Results: Median frequencies and absolute counts of CD169-expressing monocytes were significantly higher in COVID-19 patients than in controls (p 0.04 and p 0.01, respectively). Conversely, percentages and absolute numbers of all DC subsets were markedly depleted in patients (p < 0.0001). COVID-19 cases with absolute counts of CD169+ monocytes above the median value of 114.68/μL had significantly higher in-hospital mortality (HR 4.96; 95% CI: 1.42–17.27; p = 0.02). Interleukin (IL)-6 concentrations were significantly increased in COVID-19 patients (p < 0.0001 vs. controls), and negatively correlated with the absolute counts of circulating CD1c+ cDC2 (r = −0.29, p = 0.034) and CD303+ pDC (r = −0.29, p = 0.036) subsets. Viral genes were upregulated in patients with worse outcomes along with inflammatory mediators such as interleukin (IL)-1 beta, tumor necrosis-α (TNF-α) and the anticoagulant protein (PROS1). Conversely, surviving patients had upregulated genes related to inflammatory and anti-viral-related pathways along with the T cell membrane molecule CD4. Conclusions: Our results suggest that the dysregulated interplay between the different components of the MPS along with the imbalance between viral gene expression and host anti-viral immunity negatively impacts COVID-19 outcomes. Although the clinical scenario of COVID-19 has changed over time, a deepening of its pathogenesis remains a priority in clinical and experimental research.
Human Papillomavirus-Associated Giant Clear Cell Acanthoma and Squamous Cell Carcinoma: A Rare Case Report and Literature Review
Authors: Cuomo Roberto , Rozen Warren M. , Pentangelo Paola , Ceccaroni Alessandra , Alfano Carmine , Seth Ishith
Published: April 2024

Clear cell acanthoma (CCA) and squamous cell carcinoma (SCC) represent distinct entities within dermatological oncology, each posing unique diagnostic and therapeutic challenges. CCA is a rare, benign epidermal growth, often not associated with human papillomavirus (HPV) infection, whereas SCC, a more aggressive form of skin cancer, has been linked to both ultraviolet (UV) exposure and HPV. Understanding the co-occurrence of these conditions in a single patient can enhance diagnostic accuracy and therapeutic outcomes. We report a 64-year-old male who underwent an operation for a verruciform lesion in the right groin, which was diagnosed as HPV-positive CCA alongside keratinised SCC. A literature search across January 2024 revealed limited evidence directly linking HPV to CCA, suggesting a need for further investigation. The speculative association between HPV and CCA warrants deeper exploration, especially considering the potential for HPV to contribute to lesion development through indirect mechanisms. The coexistence of CCA and SCC in an elderly patient presents a unique clinical scenario. This emphasises the need for vigilant diagnosis and tailored treatment strategies, highlighting the gap in understanding the pathogenesis of CCA, particularly its potential association with HPV. Further research is crucial for elucidating the complex interactions governing these conditions and for developing targeted interventions.
Periconceptional Counselling in Women with Autoimmune Inflammatory Rheumatic Diseases
Authors: Rosta Klara , Binder Julia , Kuczwara Valerie , Horvath Mira , Heinzl Florian , Hörhager Christina , Mayrhofer Daniel , Mandl Peter , Fritsch-Stork Ruth , Ott Johannes , Mazzucato-Puchner Antonia
Published: April 2024

Systemic autoimmune rheumatic diseases (SARDs) in pregnancy represent a complex challenge for both patients and healthcare providers. Timely preparation for pregnancy enables adequate disease control, thereby reducing the risk of disease flare and pregnancy complications. Interdisciplinary care starting from the pre-pregnancy period throughout pregnancy and during breastfeeding ensures better fetal and maternal outcomes. This review provides a comprehensive guide to pre-pregnancy counselling in SARDs, an overview of medication management strategies tailored to pregnancy, disease activity and pregnancy monitoring in patients, and the promotion of shared decision making between healthcare providers and patients. Guidelines from international organizations were selected to provide a basis for this review and guidance through the quintessential discussion points of care.
Correlation of Non-Invasive Transthoracic Doppler Echocardiography with Invasive Doppler Wire-Derived Coronary Flow Reserve and Their Impact on Infarct Size in Patients with ST-Segment Elevation Myocardial Infarction Treated with Primary Percutaneous Coronary Intervention
Authors: Milasinovic Dejan , Tesic Milorad , Nedeljkovic Arsenovic Olga , Maksimovic Ruzica , Sobic Saranovic Dragana , Jelic Dario , Zivkovic Milorad , Dedovic Vladimir , Juricic Stefan , Mehmedbegovic Zlatko , Petrovic Olga , Trifunovic Zamaklar Danijela , Djordjevic Dikic Ana , Giga Vojislav , Boskovic Nikola , Klaric Marija , Zaharijev Stefan , Travica Lazar , Dukic Djordje , Mladenovic Djordje , Asanin Milika , Stankovic Goran
Published: April 2024

Background: Coronary microvascular dysfunction is associated with adverse prognosis after ST-segment elevation myocardial infarction (STEMI). We aimed to compare the invasive, Doppler wire-based coronary flow reserve (CFR) with the non-invasive transthoracic Doppler echocardiography (TTDE)-derived CFR, and their ability to predict infarct size. Methods: We included 36 patients with invasive Doppler wire assessment on days 3–7 after STEMI treated with primary percutaneous coronary intervention (PCI), of which TTDE-derived CFR was measured in 47 vessels (29 patients) within 6 h of the invasive Doppler. Infarct size was assessed by cardiac magnetic resonance at a median of 8 months. Results: The correlation between invasive and non-invasive CFR was modest in the overall cohort (rho 0.400, p = 0.005). It improved when only measurements in the LAD artery were considered (rho 0.554, p = 0.002), with no significant correlation in the RCA artery (rho −0.190, p = 0.435). Both invasive (AUC 0.888) and non-invasive (AUC 0.868) CFR, measured in the recanalized culprit artery, showed a good ability to predict infarct sizes ≥18% of the left ventricular mass, with the optimal cut off values of 1.85 and 1.80, respectively. Conclusions: In patients with STEMI, TTDE- and Doppler wire-derived CFR exhibit significant correlation, when measured in the LAD artery, and both have a similarly strong association with the final infarct size.
Pathological Fractures in Aneurysmal Bone Cysts: A Systematic Review
Authors: Costa Doriana Di , Gabrielli Elena , Cerrone Mariagrazia , Di Gialleonardo Emidio , Maccauro Giulio , Vitiello Raffaele
Published: April 2024

Background: Aneurysmal bone cysts (ABCs) are osteolytic, non-malignant, vascular lesions of the bone. Pathological fractures can be a manifestation of the ABCs, which occur in about 8% of ABCs. Different treatments have been described in the literature, but, nowadays, an optimal management of the pathological fractures in patients with ABCs is still a matter of debate and there are no standard guidelines for treatment nor any shared indication about the best surgical intervention. The aim of our study is to review the current literature available on this matter exploring and confronting different surgical treatments for pathological fractures in ABC in order to clarify the surgical approach to these patients. Methods: A systematic review of the literature indexed in PubMed, MEDLINE, and Cochrane Library databases was carried out. The Preferred Reporting Items for Systematically Reviews and Meta-Analyses (PRISMA) were followed. Results: A total of 37 articles were relevant and were finally included in the study. In total, we reached a population of 140 patients. Of the 140 patients included in the review, 124 patients (88.6%) underwent curettage surgery, 15 patients (10.7%) underwent en bloc resection surgery. A total of 47% of patients (70) underwent synthesis surgery with a plate, screw, nail, or external fixator. Adjuvant treatments were used in 8.6% of patients (12). Complications involved 20.7% of the patients (29). Conclusions: In conclusion, the treatment of pathological fractures in aneurysmal bone cysts requires careful patient assessment, considering factors such as age, the presence of open growth plates, the location of the lesion, and the surgeon’s expertise.
Non-Invasive Tools in Perioperative Stroke Risk Assessment for Asymptomatic Carotid Artery Stenosis with a Focus on the Circle of Willis
Authors: Lengyel Balázs , Magyar-Stang Rita , Pál Hanga , Debreczeni Róbert , Sándor Ágnes Dóra , Székely Andrea , Gyürki Dániel , Csippa Benjamin , István Lilla , Kovács Illés , Sótonyi Péter , Mihály Zsuzsanna
Published: April 2024

This review aims to explore advancements in perioperative ischemic stroke risk estimation for asymptomatic patients with significant carotid artery stenosis, focusing on Circle of Willis (CoW) morphology based on the CTA or MR diagnostic imaging in the current preoperative diagnostic algorithm. Functional transcranial Doppler (fTCD), near-infrared spectroscopy (NIRS), and optical coherence tomography angiography (OCTA) are discussed in the context of evaluating cerebrovascular reserve capacity and collateral vascular systems, particularly the CoW. These non-invasive diagnostic tools provide additional valuable insights into the cerebral perfusion status. They support biomedical modeling as the gold standard for the prediction of the potential impact of carotid artery stenosis on the hemodynamic changes of cerebral perfusion. Intraoperative risk assessment strategies, including selective shunting, are explored with a focus on CoW variations and their implications for perioperative ischemic stroke and cognitive function decline. By synthesizing these insights, this review underscores the potential of non-invasive diagnostic methods to support clinical decision making and improve asymptomatic patient outcomes by reducing the risk of perioperative ischemic neurological events and preventing further cognitive decline.
Propensity Score-Matched Analysis of Perioperative Outcomes of Supine versus Prone Percutaneous Nephrolithotomy
Authors: Babaoff Roi , Creiderman Gherman , Darawsha Abd Elhalim , Ehrlich Yaron , Somani Bhaskar , Lifshitz David A.
Published: April 2024

Objective: To compare the perioperative outcomes of supine and prone percutaneous nephrolithotomy (PCNL). Methods: A retrospective search of a tertiary medical center database yielded 517 patients who underwent supine (n = 91) or prone (n = 426) PCNL between September 2015 and July 2020. Data on demographics, baseline clinical parameters, and stone burden were included as predictors in a logistic regression model, generating a set of propensity scores. Seventy patients after supine PCNL were propensity score-matched 1:1 with patients after prone PCNL and compared for operative time, perioperative complications, system complexity, and stone-free rate. Results: We found that the operative time was significantly shorter in the supine PCNL group than in the prone PCNL group (85.5 ± 25.2 min vs. 96.4 ± 25.8 min, respectively; p = 0.012). The majority of both groups had low-grade (I–II) complexity systems (85.6% and 88.6%, respectively), with no significant difference among all grade groups (p = 0.749). There were no significant differences between the supine and prone PCNL groups in terms of the overall perioperative complication rate (8.6% vs. 4.3%, respectively; p = 0.301) or stone-free rate (74.3 vs. 65.7%, respectively; p = 0.356), while the rate of blood transfusion was significantly higher in the supine group (p = 0.023). Conclusions: In our study, we used propensity score matching to compare patients who underwent PCNL in the supine or prone position, adjusting for selection bias. Supine PCNL was associated with a shorter operative time but a higher blood transfusion rate, with no differences in the overall complication and stone-free rates.
Retrograde Intrarenal Surgery for Lithiasis Using Suctioning Devices: A Shift in Paradigm?
Authors: Geavlete Petrisor , Multescu Razvan , Mares Cristian , Buzescu Bogdan , Iordache Valentin , Geavlete Bogdan
Published: April 2024

New suction endoscopes, ureteral access sheaths (UAS) and catheters aim to improve the efficacy of flexible ureteroscopy and optimize its safety. Suction UAS with non-flexible tips have shown promising results, especially in maintaining low intrarenal pressure, but also in removing small debris and reducing the “snow globe” effect. In addition, suctioning UAS with a flexible tip offers the advantage of being able to be navigated through the pyelocaliceal system to where the laser lithotripsy is performed. It can also remove small stone fragments when the flexible ureteroscope is retracted, using the Venturi effect. Direct in-scope suction (DISS) involves aspirating dust and small stone debris through the working channel of a flexible ureteroscope, thus regulating intrarenal pressure and improving visibility. Steerable aspiration catheters are other devices designed to increase stone clearance of the pyelocaliceal system. They are inserted under fluoroscopic guidance into every calyx after retraction of the flexible ureteroscope, alternating irrigation and aspiration to remove dust and small gravels. Combining flexible-tip suction UAS and the DISS technique may offer some advantages worth evaluating. The advantage of using these instruments to achieve a low intrarenal pressure was demonstrated. The true practical impact on the long-term stone-free status is a matter requiring further studies.
TaKeTiNa Music Therapy for Outpatient Treatment of Depression: Study Protocol for a Randomized Clinical Trial
Authors: Behzad Ali , Feldmann-Schulz Christoph , Lenz Bernd , Clarkson Lucy , Ludwig Celine , Luttenberger Katharina , Völkl Simon , Kornhuber Johannes , Mühle Christiane , von Zimmermann Claudia
Published: April 2024

Background/Objectives: Depression is a prevalent and debilitating illness that significantly affects psychological and physical well-being. Apart from conventional therapies such as psychotherapy and medication, individuals with depression often lack opportunities for activities that are generally perceived as enjoyable, such as music, meditation, and arts, which have demonstrated therapeutic effectiveness. TaKeTiNa music therapy has been employed as a therapeutic intervention for more than two decades. However, there is a notable absence of well-designed clinical trials investigating its antidepressant effects, a gap we aim to address in our current study. Furthermore, shifts in the progression of depression may manifest both psychologically, by influencing emotional states, and physiologically, by leading to alterations in lipid and sphingolipid metabolism, cortisol levels, and immune system function. Our study seeks to analyze the impact of TaKeTiNa music therapy on both levels. Methods: This is a prospective monocentric randomized waitlist-controlled clinical trial. It investigates the influence of TaKeTiNa music therapy on patients with major depression in an outpatient setting. Therefore, interested persons are randomly assigned to two groups, an intervention group or a control group, after completing a screening procedure. The intervention group starts with an eight-week TaKeTiNa music therapy intervention. The waiting group receives the same therapy program after completing the follow-up period. Blood and saliva sampling as well as responses to questionnaires are obtained at specific time points. Discussion: Our study investigates the effects of TaKeTiNa music therapy, a non-pharmacological antidepressant treatment option, on depressive symptoms. We also address functional and causal immunological changes; hormonal changes, such as changes in cortisol levels; and metabolic changes, such as changes in serum lipids and sphingolipids, during the course of depression. We expect that this study will provide evidence to expand the range of treatment options available for depression.
Patients with Type 2 Diabetes, Higher Blood Pressure, and Infrequent Fundus Examinations Have a Higher Risk of Sight-Threatening Retinopathy
Authors: Tomić Martina , Vrabec Romano , Ljubić Spomenka , Prkačin Ingrid , Bulum Tomislav
Published: April 2024

Background: Diabetic retinopathy (DR) is the most common cause of preventable blindness among working-age adults. This study aimed to evaluate the impact of the regularity of fundus examinations and risk factor control in patients with type 2 diabetes (T2DM) on the prevalence and severity of DR. Methods: One hundred and fifty-six T2DM patients were included in this cross-sectional study. Results: In this sample, the prevalence of DR was 46.2%. Patients with no DR mainly did not examine the fundus regularly, while most patients with mild/moderate nonproliferative DR (NPDR) underwent a fundus examination regularly. In 39.7% of patients, this was the first fundus examination due to diabetes, and 67% of them had sight-threatening DR (STDR). Diabetes duration (p = 0.007), poor glycemic control (HbA1c) (p = 0.006), higher systolic blood pressure (SBP) (p < 0.001), and diastolic blood pressure (DBP) (p = 0.002) were the main predictors of DR. However, the impact of SBP (AOR 1.07, p = 0.003) and DBP (AOR 1.13, p = 0.005) on DR development remained significant even after adjustment for diabetes duration and HbA1c. The DR prevalence was higher in patients with higher blood pressure (≥130/80 mmHg) than in those with target blood pressure (<130/80 mmHg) (p = 0.043). None of the patients with target blood pressure had STDR. The peaks in SBP and DBP were observed in T2DM with DR and the first fundus examination due to diabetes. Conclusions: In this T2DM sample, DR prevalence was very high and strongly related to blood pressure and a lack of regular fundus examinations. These results indicate the necessity of establishing systematic DR screening in routine diabetes care and targeting blood pressure levels according to T2DM guidelines.