bluuebunny/crossref_metadata_2025 huggingface dataset:
The Potential of Parapanteles hyposidrae and Protapanteles immunis (Hymenoptera: Braconidae) as Biocontrol Agents for the Tea Grey Geometrid Ectropis grisescens (Lepidoptera)
Authors: Wang Zi-Qi , Zhou Xiao-Gui , Xiao Qiang , Tang Pu , Chen Xue-Xin
Published: October 2022

The tea grey geometrid Ectropis grisescens has long been a significant insect pest of tea plants in China. Two parasitoids, Parapanteles hyposidrae and Protapanteles immunis (Hymenoptera: Braconidae: Microgastrinae), are the most important parasitoids in the larval stage of E. grisescens. Yet, the potential of these two parasitoids for controlling the tea grey geometrid is not known. Here, we studied the parasitism performance of these two parasitoid species on different host densities under different temperatures as well as the interference effect of parasitoid density. The results showed that both parasitoid species, Pa. hyposidrae and Pr. immunis, exhibited a Type II functional response towards the tea grey geometrid E. grisescens at four tested temperatures. With increasing the density of E. grisescens larvae, the number of parasitized larvae increased until a maximum was reached. The highest number of hosts parasitized by Pa. hyposidrae or Pr. immunis reached 14.5 or 14.75 hosts d−1 at 22 °C, respectively. The estimated values of instantaneous searching efficiency (a) and handling time (h) for Pa. hyposidrae or Pr. immunis were 1.420 or 3.621 and 0.04 or 0.053 at 22 °C, respectively. Pr. immunis performed better than Pa. hyposidrae under higher temperatures. The parasitism rate by a single female parasitoid decreased with increasing parasitoid density at different temperatures, resulting in a reduction of searching efficiency. The findings of this study showed that Pr.immunis could be a better effective biocontrol agent than Pa. hyposidrae against the tea grey geometrid.
Minimally Invasive Surgical Repair of a Partial Atrioventricular Canal Defect in a 20-Year-Old Patient—A Case Report and Review of Literature
Authors: Moldovan Horațiu , Bulescu Cristian , Cacoveanu Mihai , Voica Cristian , Safta Sabina , Goicea Mihai , Dobra Irina , Antoniac Iulian , Gheorghiță Daniela , Zaharia Ondin
Published: October 2022

The association of an ostium primum-type defect with a cleft anterior mitral valve is known in the medical literature as the partial form of an atrioventricular canal. We present a case report about a 20-year-old woman with minimal symptomatology that discovered her pathology on routine echocardiography. Today, surgical operation remains the gold standard in such pathologies, especially mandatory when there is important valvular regurgitation and left-to-right shunt. Currently living in the era of fast and good cosmetic outcomes, minimally invasive and endovascular approaches should be developed and more often practiced. This scientific presentation is the first step in showing our department steps in performing minimally invasive surgeries as a routine.
Prosthetic Valve Function after Aortic Valve Replacement for Severe Aortic Stenosis by Transcatheter Procedure versus Surgery
Authors: Saito Shunsuke , Sairenchi Toshimi , Hirota Shotaro , Niitsuma Ken , Yokoyama Shohei , Kanno Yasuyuki , Kanazawa Yuta , Tezuka Masahiro , Takei Yusuke , Tsuchiya Go , Konishi Taisuke , Shibasaki Ikuko , Ogata Koji , Monta Osamu , Tsutsumi Yasushi , Fukuda Hirotsugu
Published: October 2022

Background This study compared the clinical outcomes of transcatheter (TAVR) and surgical (SAVR) aortic valve replacements, focusing on postoperative valvular performance assessed by echocardiography. Method and Results A total of 425 patients who underwent TAVR (230 patients) or SAVR (195 patients) were included. Postoperative effective orifice area index (EOAI) was higher in the TAVR group (1.27 ± 0.35 cm2/m2) than in the SAVR group (1.06 ± 0.27 cm2/m2, p < 0.001), and patient–prosthesis mismatch (PPM) was more frequent in the SAVR group (22.6%) than in the TAVR group (8.7%, p < 0.001). Mild or greater paravalvular leakage (PVL) was more frequent in the TAVR group (21.3%) than in the SAVR group (0%, p < 0.001). Moreover, there was no difference in freedom from all-cause death, stroke, or rehospitalization between the groups. Patients with moderate or greater PPM (EOAI < 0.85 cm2/m2) had lower freedom from composite events than those without this PPM criterion (p = 0.008). Patients with mild or greater PVL also had lower freedom from composite events than those without this PVL criterion (p = 0.017). Conclusions Postoperative valvular performance of TAVR was superior to that of SAVR in terms of EOAI. This merit was counterbalanced by the significantly lower rates of PVL in patients who underwent SAVR. The overall clinical outcomes were similar between the study groups.
Role of Fibrinolysis in the Management of Patients with COVID-19 and Thromboembolic Complications: A Review
Authors: Zając Patrycja , Kaziród-Wolski Karol , Oleś Izabela , Sielski Janusz , Siudak Zbigniew
Published: October 2022

An impaired fibrinolytic process has been demonstrated in patients infected with SARS-CoV-2, including those in severe or critical condition. Disruption of fibrinolysis leads to fibrin deposition, which exacerbates inflammation and fibrosis and damages the pulmonary surfactant. Numerous authors point out the different course of coagulopathy in patients with COVID-19. It is reported that they may have a state of secondary hyperfibrinolysis, which may explain, at least in part, the increased incidence of venous thromboembolism, even among those patients already receiving appropriate anticoagulant treatment. This raises the question of whether current guidelines for the prevention and treatment of embolic–thrombotic complications, among patients with severe COVID-19, are sufficient. Some studies show evidence of clinical improvement in patients who have received fibrinolytic therapy, beyond the current indications for its implementation. However, when considering the inclusion of systemic fibrinolytic therapy, the benefits of such treatment should always be weighed over the risk of adverse effects. Thromboelastography and rotational thromboelastometry can be helpful in making such decisions. The purpose of this study was to review the current knowledge regarding fibrinolysis and its role in the treatment of patients with severe COVID-19, including those with thromboembolic complications.
At Mean 30-Year Follow-Up, Cervical Spine Disease Is Common and Associated with Thoracic Hypokyphosis after Pediatric Treatment of Adolescent Idiopathic Scoliosis
Authors: Young Ernest , Regan Christina , Currier Bradford L. , Yaszemski Michael J. , Larson A. Noelle
Published: October 2022

Patients with adolescent idiopathic scoliosis (AIS) often have reduced sagittal thoracic kyphosis (hypokyphosis) and cervical lordosis causing an uneven distribution of physiologic load. However, the long-term consequences of hypokyphosis in AIS patients have not been previously documented. To evaluate whether uneven load distribution leads to future complications in patients with AIS, we conducted a retrospective chart review and subsequently surveyed 180 patients treated for idiopathic scoliosis between 1975 and 1992. These patients all had a minimum follow-up time of 20 years since their treatment. We observed a ten-fold increase in the incidence of anterior cervical discectomy and fusion (ACDF) compared to reported rates in the non-pathologic population. Out of the 180 patients, 33 patients met the criteria and returned for follow-up radiographs. This population demonstrated a statistically significant increased rate of cervical osteoarthritis and disc degeneration. Overall, our study suggests that hypokyphosis in patients with AIS presents with increased rates of cervical spine degeneration and dysfunction, suggesting that these patients may require additional follow-up and treatment.
Circulating Tumor Cells and Breast Cancer Metastasis: From Enumeration to Somatic Mutational Profile
Authors: Zhu Chengjun , Xu Jing , Sun Jinyu , Cui Shiyun , Sun Yue , Yu Tao , Wang Cenzhu , Wang Tianyao , Wu Yufeng , Ju Feng , Yao Jiafeng , Liu Kai , Zhang Wenwen , Guan Xiaoxiang
Published: October 2022

Aims: This study investigates the association between circulating tumor cells (CTCs) and breast cancer metastasis. Methods: A retrospective study was conducted using patients with histologically confirmed breast cancer recruited from the First Affiliated Hospital of Nanjing Medical University during the period of August 2017–October 2020. We used adjusted logistic regression, the random forest algorithm, and sensitivity analysis to study the association between CTC enumeration and tumor metastasis. Further, we performed next-generation sequencing (NGS) on the CTCs obtained from two patients with breast cancer brain metastasis. Results: A total of 41 out of 116 enrolled patients were identified with tumor metastasis. CTC enumeration was significantly higher in patients with liver metastasis than in those without liver metastasis. Patients with CTCs ≥ 5 exhibited a higher risk of tumor metastasis than those with CTCs < 5 in the adjusted model (odds ratios (OR) = 6.25, 95% confidence interval (CI) = 2.63–15.58). The random forest model identified CTC enumeration as a significant metastasis-related variable with the highest mean decrease accuracy and mean decrease Gini score. No significant association was found between CTCs and visceral metastasis with an OR of 1.29 (95% CI = 0.98–2.05, p = 0.232). Upon further investigating organ-specific metastasis, we found that patients with high CTC levels were more likely to develop liver metastasis (OR = 4.87, 95% CI = 1.34–20.17, p = 0.021). The NGS study of CTCs identified a total of 120 indel mutations (e.g., CNGB1, NTSR1, ZG16). The enriched biological processes were mechanoreceptor differentiation and macrophage activation involved in the immune response. The enriched KEGG pathways included focal adhesion, the PI3K-Akt signaling pathway, and microRNAs involved in cancer. Conclusions: Our study revealed that CTCs ≥ 5 are a risk factor for tumor metastasis in breast cancer patients. In addition, we reported that CTCs ≥ 5 might be associated with a higher risk of liver metastasis in patients with metastatic breast cancer. We have provided the mutational profiles of CTCs based on next-generation sequencing.
Persistent Atrial Fibrillation in Elderly Patients: Limited Efficacy of Pulmonary Vein Isolation
Authors: Boehmer Andreas A. , Rothe Moritz , Zezyk Celine , Soether Christina M. , Dobre Bianca C. , Kaess Bernhard M. , Ehrlich Joachim R.
Published: October 2022

(1) Background: Cryoballoon pulmonary vein isolation (cryoPVI) is established for symptomatic paroxysmal atrial fibrillation (AF) treatment, but its value in persistent AF is less clear. In particular, limited data are available on its efficacy in elderly patients (≥75 years) with persistent AF. Age is an important modifier of AF progression and represents a risk-factor for AF recurrence. (2) Methods: Prospective, single-center observational study to evaluate the impact of age on efficacy and safety of cryoPVI in elderly patients. Primary efficacy endpoint was symptomatic AF recurrence after 90-day blanking period. Primary safety endpoints were death from any cause, procedure-associated complications or stroke/transient ischemic attack. Median follow-up was 17 months (range 3–24). (3) Results: We included 268 patients with persistent AF (94 ≥ 75 years of age). Multivariate Cox regression analysis identified age as the only independent factor influencing AF recurrence in the overall cohort (p = 0.006). To minimize confounding bias in efficacy and safety analysis of cryoPVI, we matched younger and elderly patients with respect to baseline characteristics. At 24 months, primary efficacy endpoint occurred in 13/69 patients <75 years and 31/69 patients ≥75 years of age (24 months Kaplan–Meier event-rate estimates, HR 0.34; 95% CI, 0.19 to 0.62; log-rank p = 0.0004). No differences were observed in the occurrence of safety end points. (4) Conclusions: Elderly (≥75 years) patients with persistent AF undergoing cryoPVI had an approximately threefold higher risk of symptomatic AF recurrence than matched younger patients. Accordingly, other treatment modalities may be evaluated in this population.
Is Less Always More? A Prospective Two-Centre Study Addressing Clinical Outcomes in Leadless versus Transvenous Single-Chamber Pacemaker Recipients
Authors: Bertelli Michele , Toniolo Sebastiano , Ziacchi Matteo , Gasperetti Alessio , Schiavone Marco , Arosio Roberto , Capobianco Claudio , Mitacchione Gianfranco , Statuto Giovanni , Angeletti Andrea , Martignani Cristian , Diemberger Igor , Forleo Giovanni Battista , Biffi Mauro
Published: October 2022

(1) Background: Leadless (LL) stimulation is perceived to lower surgical, vascular, and lead-related complications compared to transvenous (TV) pacemakers, yet controlled studies are lacking and real-life experience is non-conclusive. (2) Aim: To prospectively analyse survival and complication rates in leadless versus transvenous VVIR pacemakers. (3) Methods: Prospective analysis of mortality and complications in 344 consecutive VVIR TV and LL pacemaker recipients between June 2015 and May 2021. Indications for VVIR pacing were “slow” AF, atrio-ventricular block in AF or in sinus rhythm in bedridden cognitively impaired patients. LL indication was based on individualised clinical judgement. (4) Results: 72 patients received LL and 272 TV VVIR pacemakers. LL pacemaker indications included ongoing/expected chronic haemodialysis, superior venous access issues, active lifestyle with low pacing percentage expected, frailty causing high bleeding/infectious risk, previous valvular endocarditis, or device infection requiring extraction. No significant difference in the overall acute and long-term complication rate was observed between LL and TV cohorts, with greater mortality occurring in TV due to selection of older patients. (5) Conclusions: Given the low complication rate and life expectancy in this contemporary VVIR cohort, extending LL indications to all VVIR candidates is unlikely to provide clear-cut benefits. Considering the higher costs of LL technology, careful patient selection is mandatory for LL PMs to become advantageous, i.e., in the presence of vascular access issues, high bleeding/infectious risk, and long life expectancy, rendering lead-related issues and repeated surgery relevant in the long-term perspective.
Risk Factors for Postoperative Osteomyelitis among Patients after Bone Fracture: A Matched Case–Control Study
Authors: Slyamova Gulnur , Gusmanov Arnur , Batpenov Arman , Kaliev Nurlan , Viderman Dmitriy
Published: October 2022

The healthcare burden of osteomyelitis is increasing. Postoperative and posttraumatic osteomyelitis account for 80% of all cases of osteomyelitis. The aim of this study was to find risk factors for postoperative osteomyelitis in Kazakhstan. We included 245 patients admitted to the National Scientific Center of Traumatology and Orthopedics from 2018 to 2020. Cases were matched with controls in a 1:4 ratio. Exact matching was performed by gender, ICD-10, and ICD-9 codes. The main variables included socio-demographics, diagnosis at admission, characteristics of fractures, comorbidities, complications, hospitalization milestones, and osteomyelitis characteristics. Descriptive analyses, along with bivariate analysis and multivariate conditional logistic regression, were performed. Open fracture (adjOR = 6.25; 95%CI 1.64–23.79), the presence of complications of initial fracture (adjOR = 3.46, 95%CI 1.13–10.56), comminuted fracture form (adjOR = 1.87; 95%CI 0.73–4.75), a positive history of diabetes or blood glucose >7 g/L (adjOR = 4.25; 95%CI 1.26–14.3), incision or wound length of more than 10 cm (adjOR = 6.53; 95%CI 1.1–38.6), additional implanted medical item (adjOR = 1.23; 95% CI 1.1–1.47), and unemployment or being retired (adjOR = 4.21; 95%CI 1.74–10.18) were found to be significant predictors of postoperative osteomyelitis. Almost all our findings are concordant with previous studies, except for the type of fracture. Different authors report conflicting results on the latter potential risk factor. Therefore, prospective studies on this issue are required.
Clinical Characteristics and Current Practice of Endovascular Revascularization in Aorto-Iliac, Femoropopliteal and Infra-Popliteal Lower Extremity Artery Disease—Insights from the RECCORD Registry
Authors: Stella Jacqueline , Stausberg Jürgen , Lichtenberg Michael , Hoffmann Ulrich , Malyar Nasser M.
Published: October 2022

Background: Endovascular revascularization (EVR) is a pillar of therapeutic management in patients with symptomatic lower extremity artery disease (LEAD). Due to lack of scientific evidence, the approach of EVR type and the devices used at the different anatomic vascular segments of the lower limbs vary substantially between operators and centers. We analyzed data from the RECcording COurses of vasculaR Diseases (RECCORD) registry to assess the current real-world EVR treatment patterns in relation to anatomic vascular segments in symptomatic LEAD patients in Germany. Patients and Methods: RECCORD is an ongoing, prospective, multicenter, all-comers and entirely web-based registry platform. Baseline demographic and periprocedural data of patients undergoing EVR for symptomatic LEAD were assessed and performed EVRs were grouped according to the intervened anatomic vascular segment. We analyzed four EVR groups comprising either the aorto-iliac, femoropopliteal, or infrapopliteal segments (all these EVRs with or without a further intervention in another anatomic segment) or the infrapopliteal segment alone. Results: A total of 2210 EVR segments (in 1639 patients) were analyzed. Of those 616 (27.9%) were aorto-iliacal, 1346 (60.9%) femoropopliteal, 248 (11.2%) infrapopliteal and 104 (4.7%) only infrapopliteal segments. Aorto-iliac EVR was associated with younger age, smoking, claudication and simple lesions, while the distal infrapopliteal EVRs were related to advanced age, diabetes, multiple comorbidities, limb threatening ischemia and complex lesions. The use of different EVR devices at the aorto-iliac, femoropopliteal, infrapopliteal and only infrapopliteal segments were: only ballon-angioplasty: 8.3%, 12.9%, 58.1% and 63.5%; stenting: 82.3%, 45.3%, 16.9% and 12.5%; drug-coated balloon: 11.2%, 55.0%, 19.4% and 19.2%. Conclusion: The RECCORD registry data demonstrate that in LEAD clinical and lesion characteristics are related to anatomic vascular segments. Despite the clear relationship between vascular segments and the current use of device types, prospective, segment-specific clinical studies are warranted to establish a consistent, evidence-based path for EVR in LEAD.
Clinical Factors and the Outcome of Treatment with Methotrexate in Rheumatoid Arthritis: Role of Rheumatoid Factor, Erosive Disease and High Level of Erythrocyte Sedimentation Rate
Authors: Majorczyk Edyta , Mazurek-Mochol Małgorzata , Pawlik Andrzej , Kuśnierczyk Piotr
Published: October 2022

To identify the clinical factors predicting the outcome of treatment with methotrexate in rheumatoid arthritis, we examined 312 patients (253 females, 59 males) with rheumatoid arthritis diagnosed according to the criteria of the American College of Rheumatology. All patients included in this analysis began treatment with a regimen of oral MTX 7.5 mg weekly, with the dosage increasing to 15 mg weekly after 4 weeks, in combination with folic acid (1 mg daily). Good responders were defined as patients who had a DAS28 of ≤2.4 at 6 months (patients with remission of disease symptoms). Poor responders were defined as patients who had a DAS28 of >2.4. In this study, we analyzed the association between clinical parameters such as sex of patients, age of patients, age at disease onset, disease duration, rheumatoid factor, anti-CCP antibodies, ESR values, presence of joints erosions, presence of extra-articular manifestations and the response to MTX in RA patients. Multivariate logistic regression analysis showed four independent factors significantly associated with good response to MTX treatment: older age at disease onset, low ESR, no erosive disease and negative RF. The results of our study suggest that a younger age at disease onset, the presence of RF, erosive disease, as well as a high level of ESR are associated with worse response to MTX therapy.
Transgender Males as Potential Donors for Uterus Transplantation: A Survey
Authors: Carbonnel Marie , Karpel Léa , Corruble Ninon , Legendri Sophie , Pencole Lucile , Cordier Bernard , Racowsky Catherine , Ayoubi Jean-Marc
Published: October 2022

Uterus transplantation is a new treatment for patients with absolute uterine infertility that is conducted in order to enable them to carry their own pregnancy. One of the limitations for its development is donor availability. Some transgender males undergo a hysterectomy in the gender-affirming surgery process, and might be interested in donating their uterus for transplantation. In this manuscript, we report the results of a survey designed to determine the attitudes of such individuals regarding donation of their uterus for this purpose. Over 32 years (January 1989–January 2021), 348 biological women underwent hysterectomy at our hospital as part of gender-affirming surgery. The survey was sent to 212 of the 348 prospective participants (for 136, we lacked postal or email addresses). Among the 212 surveys sent, we obtained responses from 94 individuals (44%): 83 (88.3%) stated they would agree to donate, of whom 44 would do so for altruism, 23 for the usefulness of the gesture and 16 out of understanding of the desire to have a child; 63 (75.5%) wanted to know the recipient and 45 (54.2%) wanted to know the result of the donation. According to this survey, a high proportion of transgender males surveyed would be interested in donating their uterus for uterus transplantation.
Left Ventricular Mass with Delayed Enhancement as a Predictor of Major Events in Patients with Myocarditis with Preserved Ejection Fraction
Authors: Ghionzoli Nicolò , Gismondi Annalaura , Mandoli Giulia Elena , Spera Lucia , Di Florio Alex , D’Ascenzi Flavio , Cameli Matteo , Cavigli Luna , Sciaccaluga Carlotta , Carbone Salvatore Francesco , Aquaro Giovanni Donato , Valente Serafina , Focardi Marta
Published: October 2022

Background: Cardiac Magnetic Resonance (CMR) has a key role in subjects presenting with acute myocarditis, independent from left ventricular ejection fraction; it is widely used as a non-invasive imaging test for both diagnostic and prognostic purposes. However, poor data is available about the CMR-derived prognostic parameters of acute myocarditis with preserved ejection fraction (AMpEF). The aim of this study was to investigate the role of CMR in predicting outcomes in patients followed up for AMpEF, using a composite endpoint of all-cause mortality and hospitalization for heart failure (HF). Methods: We retrospectively enrolled 61 patients with diagnosed AMpEF. All patients underwent biohumoral, echocardiographic and CMR evaluation in the acute phase. Myocarditis was confirmed by Lake–Louis criteria assessed on CMR images. Mean follow-up was 4.8 ± 0.6 years during which a composite endpoint of all-cause mortality and hospitalization for HF was investigated. Results: The population was fairly homogeneous regarding baseline clinical features. In particular, no significant differences in age and main cardiovascular risk factors were found between patients with and without events at follow-up. Seven patients met the endpoint. They had significantly higher levels of circulating neutrophils in the acute phase (76 ± 7% vs. 61 ± 11%, p = 0.014) and a higher amount of left ventricular mass with delayed enhancement (DE-LVM, 18 (14–29.5) vs. 12 (8–16) g, p = 0.028). At Cox univariate analysis, DE-LVM was the only significant predictor of endpoint, regardless of the site of inflammation. Conclusions: DE-LVM can predict the composite endpoint of all-cause mortality and hospitalization for HF in a population of patients with AMpEF, representing a new added tool for prognostic stratification.
Evaluation of Fecal Calprotectin, Serum C-Reactive Protein, Erythrocyte Sedimentation Rate, Seromucoid and Procalcitonin in the Diagnostics and Monitoring of Crohn’s Disease in Children
Authors: Akutko Katarzyna , Iwańczak Barbara
Published: October 2022

Background: The development of diagnostic and monitoring algorithms for Crohn’s disease based on non-invasive methods is of particular importance in children and is the subject of many studies. Objectives: Evaluate the usefulness of fecal calprotectin, serum C-reactive protein, erythrocyte sedimentation rate, seromucoid and procalcitonin in the differential diagnosis of non-inflammatory gastrointestinal tract diseases and Crohn’s disease in children and their usefulness in determining the phenotype of Crohn’s disease. Material and methods: Forty-seven children with non-inflammatory gastrointestinal tract diseases and fifty-four with Crohn’s disease were enrolled. Clinical and endoscopic activity was evaluated based on the Pediatric Crohn’s Disease Activity Index (PCDAI) and the Simple Endoscopic Score for Crohn’s Disease (SES-CD). Results: Fecal calprotectin, C-reactive protein, erythrocyte sedimentation rate and seromucoid were significantly higher in children with Crohn’s disease than in controls (p < 0.001). Fecal calprotectin correlated with clinical and endoscopic activity according to the Pediatric Crohn’s Disease Activity Index (r = 0.338; p = 0.012) and the Simple Endoscopic Score for Crohn’s Disease (r = 0.428; p = 0.001). Non-invasive biomarkers did not correlate with the location and clinical manifestation of Crohn’s disease. Conclusions: Fecal calprotectin, C-reactive protein, erythrocyte sedimentation rate and seromucoid are useful in the differentiation of Crohn’s disease from non-inflammatory gastrointestinal tract diseases in children and in monitoring the clinical course of Crohn’s disease, but not in evaluating activity and phenotype of the disease.
The Role of Genetically Modified Human Feeder Cells in Maintaining the Integrity of Primary Cultured Human Deciduous Dental Pulp Cells
Authors: Ibano Natsumi , Inada Emi , Otake Shinji , Kiyokawa Yuki , Sakata Kensuke , Sato Masahiro , Kubota Naoko , Noguchi Hirofumi , Iwase Yoko , Murakami Tomoya , Sawami Tadashi , Kakihara Yoshito , Maeda Takeyasu , Terunuma Miho , Terao Yutaka , Saitoh Issei
Published: October 2022

Tissue-specific stem cells exist in tissues and organs, such as skin and bone marrow. However, their pluripotency is limited compared to embryonic stem cells. Culturing primary cells on plastic tissue culture dishes can result in the loss of multipotency, because of the inability of tissue-specific stem cells to survive in feeder-less dishes. Recent findings suggest that culturing primary cells in medium containing feeder cells, particularly genetically modified feeder cells expressing growth factors, may be beneficial for their survival and proliferation. Therefore, the aim of this study was to elucidate the role of genetically modified human feeder cells expressing growth factors in maintaining the integrity of primary cultured human deciduous dental pulp cells. Feeder cells expressing leukemia inhibitory factor, bone morphogenetic protein 4, and basic fibroblast growth factor were successfully engineered, as evidenced by PCR. Co-culturing with mitomycin-C-treated feeder cells enhanced the proliferation of newly isolated human deciduous dental pulp cells, promoted their differentiation into adipocytes and neurons, and maintained their stemness properties. Our findings suggest that genetically modified human feeder cells may be used to maintain the integrity of primary cultured human deciduous dental pulp cells.
Novel Candidate Genes for Non-Syndromic Tooth Agenesis Identified Using Targeted Next-Generation Sequencing
Authors: Biedziak Barbara , Firlej Ewa , Dąbrowska Justyna , Bogdanowicz Agnieszka , Zadurska Małgorzata , Mostowska Adrianna
Published: October 2022

Non-syndromic tooth agenesis (ns-TA) is one of the most common dental anomalies characterized by the congenital absence of at least one permanent tooth (excluding third molars). Regarding the essential role of genetic factors in ns-TA aetiology, the present study aimed to identify novel pathogenic variants underlying hypodontia and oligodontia. In a group of 65 ns-TA patients and 127 healthy individuals from the genetically homogenous Polish population, the coding sequences of 423 candidate genes were screened using targeted next-generation sequencing. Pathogenic and likely pathogenic variants were identified in 37 (56.92%) patients, including eight nucleotide alternations of genes not previously implicated in ns-TA (CHD7, CREBBP, EVC, LEF1, ROR2, TBX22 and TP63). However, since only single variants were detected, future research is required to confirm and fully understand their role in the aetiology of ns-TA. Additionally, our results support the importance of already known ns-TA candidate genes (AXIN2, EDA, EDAR, IRF6, LAMA3, LRP6, MSX1, PAX9 and WNT10A) and provide additional evidence that ns-TA might be an oligogenic condition involving the cumulative effect of rare variants in two or more distinct genes.
Usefulness of Adding Maspin Staining to p53 Staining for EUS-FNA Specimens of Pancreatic Ductal Adenocarcinoma
Authors: Fukushi Koh , Yamamiya Akira , Tominaga Keiichi , Abe Yoko , Hoshi Koki , Nagashima Kazunori , Kashima Ken , Kunogi Yasuhito , Sakuma Fumi , Yamagishi Hidetsugu , Ishida Kazuyuki , Haruyama Yasuo , Irisawa Atsushi
Published: October 2022

Background: Endoscopic ultrasound-guided puncture aspiration biopsy (EUS-FNA) of pancreatic ductal adenocarcinoma (PDAC) is highly diagnostic, but it is difficult to distinguish from benign disease. Our objective was to determine the usefulness of maspin staining, in addition to conventional p53 staining, in the diagnosis of PDAC by EUS-FNA. Methods: Of the patients who underwent EUS-FNA and were diagnosed with PDAC, we retrospectively identified 90 cases in which both maspin and p53 staining were performed. In addition, we identified 28 cases of benign pancreatic disease diagnosed using EUS-FNA and these were selected as a control group. For analysis of EUS-FNA specimens, Cohen’s Kappa (κ) coefficient and the prevalence and bias adjusted Kappa statistic (PABAK) were applied to assess the significance of sensitivity and specificity, comparing p53, maspin, p53+maspin. Results: The sensitivity and specificity of p53 staining were 48.9% and 100%. The κ coefficient was 0.31 (95%CI 0.18–0.44) (p < 0.01) and the PABAK coefficient was 0.22 (95%CI 0.03–0.40). The results for maspin staining were 88.9% and 92.9%. The κ coefficient was 0.72 (95%CI 0.54–0.90) (p < 0.01) and the PABAK coefficient was 0.78 (95%CI 0.64–0.88). The results for the combination of maspin and p53 staining were 94.4% and 92.2%. The κ coefficient was 0.82 (95%CI 0.64–1.00) (p < 0.01) and the PABAK coefficient was 0.86 (95%CI 0.74–0.94). Conclusion: Adding maspin staining to p53 staining showed high sensitivity and specificity. Our results demonstrated the usefulness of their combined use that might contribute to the improvement of tissue diagnostic performance of PDAC by EUS-FNA.
Risk Factors of Proximal Junctional Kyphosis in Adolescent Idiopathic Scoliosis—The Spinous Processes and Proximal Rod Contouring
Authors: Boeckenfoerde Kathrin , Schulze Boevingloh Albert , Gosheger Georg , Bockholt Sebastian , Lampe Lukas Peter , Lange Tobias
Published: October 2022

Proximal junctional kyphosis (PJK), as one of the most discussed problems after corrective surgery in adolescent idiopathic scoliosis (AIS), is still not fully clarified and seems to be multifactorial. Biomechanical and a few clinical studies have shown the influence of destruction of posterior ligaments by resection of spinous processes and some parameters concerning rod contouring as risk factors for PJK. To verify these results, 192 patients with AIS and corrective surgery via a posterior approach between 2009 and 2017 were included. Radiographic parameters were analyzed preoperatively (preOP), postoperatively (postOP), and with a mean follow up (FU) of 27 months. The participants were divided into two groups (PJK group and non-PJK group). The incidence of PJK was 15.6%. Contrary to the results of biomechanical studies, we could not find any significant influence of the spinous process resection. However, the PJK group had significantly larger preOP T4–T12 kyphosis (31.1° ± 13.93° vs. 23.3° ± 14.93°, p = 0.016). Furthermore, the PJK group showed a significantly larger rod contour angle (RCA) (8.0° ± 4.44° vs. 5.9° ± 3.28°, p = 0.003) and mismatch of postOP proximal junctional angle (PJA) and RCA (3.5° ± 5.72° vs. 0.9° ± 4.86°, p = 0.010) compared to the non-PJK group. An increase in the mismatch of postOP PJA and RCA (OR = 1.14, p = 0.008) and a high RCA are risk factors for PJK and need to be focused on by surgeons.
The Scientific Evolution of Periacetabular Osteotomy: A Global Review
Authors: Ahmad Sufian S. , Haertlé Marco , Konrads Christian , Derksen Alexander , Windhagen Henning , Wirries Nils
Published: October 2022

It is well-known that hip disorders are frequently of bony origin related to an underlying pathomorphology. A fundamental understanding of morphology and biomechanics is therefore of essential importance for a targeted approach in defining treatment plans. Treatment is frequently based on altering bony morphology, for which a set of effective techniques have been proposed. Periacetabular osteotomy (PAO) allows for reorientation of the acetabulum and powerful correction of acetabular coverage. The revolutionary aspect of PAO compared to prior osteotomies lies in maintenance of the integrity of the posterior column. This allows for a substantial increase in primary stability, a larger bony surface for healing, and simple reorientation of the acetabular fragment that is free of posterior ligamentous restraints. The results for dysplasia are very promising. Indications have been refined by studies revealing that the presence of degenerative changes and age > 40 years at the time of surgery represent prognostic factors of poorer outcome. Indications have also been broadened to include acetabular retroversion (with posterolateral dysplasia) and borderline hip dysplasia. A glimpse at the future would reflect major advances related to individual planning, surgical training, and precise surgical conduction. In the era of digitalization, augmented reality may assist in performing bony cuts and act as an aid for some of the blind ischial and retro-acetabular cuts. Innovations in perioperative management will enhance recovery after the procedure and allow for early recovery programs with optimized protocols of pain management. Considering that the success of PAO in the young is comparable to the success of hip arthroplasty in the old, PAO should be considered one of the pillars of modern orthopedic surgery.
Improvement of Body Weight and Nutritional Status in Gastric Cancer Patients Enhances the Benefit of Nivolumab Therapy
Authors: Ikoma Tatsuki , Matsumoto Toshihiko , Kurioka Yusuke , Takatani Masahiro , Nagai Hiroki , Matsumoto Yusuke , Satake Hironaga , Yasui Hisateru
Published: October 2022

Nivolumab improves overall survival (OS) in patients with advanced gastric cancer (AGC) refractory to at least two previous chemotherapy regimens. We investigated whether changes in body weight and nutrition from first-line chemotherapy to nivolumab affected its efficacy. The correlation between weight change and nutritional status up to the start of nivolumab treatment and OS and progression-free survival (PFS) after starting nivolumab treatment was determined. Nutritional status was examined using the C-reactive protein/albumin ratio (CAR). A loss in body weight (LBW) from the onset of the first treatment of <4.5% led to OS prolongation and improved PFS outcomes. The median OS values in the LBW < 4.5% and ≥4.5% groups were 11.4 and 3.6 months, respectively. Similarly, changes in CAR from first-line chemotherapy (ΔCAR) affected OS; the ΔCAR < 0.01 group had a better prognosis than the ΔCAR ≥ 0.01 group. The median OS values in the ΔCAR < 0.01 and ≥0.01 groups were 9.4 and 4.5 months, respectively. The median OS in the group with LBW < 4.5% and ΔCAR < 0.01 was 12.9 months. LBW and deterioration of nutritional status following first-line chemotherapy are poor prognostic factors in AGC patients who received nivolumab as third- or later-line therapy. Early intervention to maintain body weight and nutritional status may improve the efficacy of immune checkpoint inhibitors.
Accurate and Reliable Assessment of Heart Rate in Real-Life Clinical Settings Using an Imaging Photoplethysmography
Authors: Allado Edem , Poussel Mathias , Moussu Anthony , Hily Oriane , Temperelli Margaux , Cherifi Asma , Saunier Veronique , Bernard Yohann , Albuisson Eliane , Chenuel Bruno
Published: October 2022

Remote photoplethysmography imaging (rPPGc) is a new method measuring essential parameters, such as heart rate (HR), which uses a video camera during teleconsultation. Our work aimed to evaluate the accuracy of such remote measurements compared with existing contact point measurement methods in real-life clinical settings. The prospective hospital-based study recruited 1045 patients who required a pulmonary function test. For each patient, measurements of HR using a standard electrocardiogram acquisition system (gold standard) were carried out concomitantly with the measurements made by the rPPGc system (Caducy v1.0.0) taken within a 60 s timeframe. Age, gender, and skin phototype were collected. We performed an intraclass coefficient correlation (ICC) and Bland–Altman plotting to determine the accuracy and precision of the rPPGc algorithm readings. We achieved measurement of HR using the two methods in 963 patients. The ICC measured at a 60 s timeframe, and when we compared the rPPGc with the gold standard, it had a 95% confidence interval (CI95) value of 0.886 [0.871:0.899]. In all, 94.6% (n = 911) patients showed promising results with a CI95 in Bland–Altman plotting. Fifty-two measurements were discordant, and further analysis established the method’s accuracy at 96.2%. Our results described a good accuracy and correlation between the rPPGc system and the gold standard, thus paving the way for more precise care via telemedicine.
Core Lab Adjudication of the ACURATE neo2 Hemodynamic Performance Using Computed-Tomography-Corrected Left Ventricular Outflow Tract Area
Authors: Elkoumy Ahmed , Rück Andreas , Kim Won-Keun , Abdel-Wahab Mohamed , Abdelshafy Mahmoud , De Backer Ole , Elzomor Hesham , Hengstenberg Christian , Mohamed Sameh K. , Saleh Nawzad , Arsang-Jang Shahram , Bjursten Henrik , Simpkin Andrew , Meduri Christopher U. , Soliman Osama
Published: October 2022

(1) Background: Hemodynamic assessment of prosthetic heart valves using conventional 2D transthoracic Echocardiography-Doppler (2D-TTE) has limitations. Of those, left ventricular outflow tract (LVOT) area measurement is one of the major limitations of the continuity equation, which assumes a circular LVOT. (2) Methods: This study comprised 258 patients with severe aortic stenosis (AS), who were treated with the ACURATE neo2. The LVOT area and its dependent Doppler-derived parameters, including effective orifice area (EOA) and stroke volume (SV), in addition to their indexed values, were calculated from post-TAVI 2D-TTE. In addition, the 3D-LVOT area from pre-procedural MDCT scans was obtained and used to calculate corrected Doppler-derived parameters. The incidence rates of prosthesis patient mismatch (PPM) were compared between the 2D-TTE and MDCT-based methods (3) Results: The main results show that the 2D-TTE measured LVOT is significantly smaller than 3D-MDCT (350.4 ± 62.04 mm2 vs. 405.22 ± 81.32 mm2) (95% Credible interval (CrI) of differences: −55.15, −36.09), which resulted in smaller EOA (2.25 ± 0.59 vs. 2.58 ± 0.63 cm2) (Beta = −0.642 (95%CrI of differences: −0.85, −0.43), and lower SV (73.88 ± 21.41 vs. 84.47 ± 22.66 mL), (Beta = −7.29 (95% CrI: −14.45, −0.14)), respectively. PPM incidence appears more frequent with 2D-TTE- than 3D-MDCT-corrected measurements (based on the EOAi) 8.52% vs. 2.32%, respectively. In addition, significant differences regarding the EOA among the three valve sizes (S, M and L) were seen only with the MDCT, but not on 2D-TTE. (4) Conclusions: The corrected continuity equation by combining the 3D-LVOT area from MDCT with the TTE Doppler parameters might provide a more accurate assessment of hemodynamic parameters and PPM diagnosis in patients treated with TAVI. The ACURATE neo2 THV has a large EOA and low incidence of PPM using the 3D-corrected LVOT area than on 2D-TTE. These findings need further confirmation on long-term follow-up and in other studies.
BMI Modifies Increased Mortality Risk of Post-PCI STEMI Patients with AKI
Authors: Schvartz Reut , Lupu Lior , Frydman Shir , Banai Shmuel , Shacham Yacov , Gal-Oz Amir
Published: October 2022

Mortality from acute ST elevation myocardial infarction (STEMI) was significantly reduced with the introduction of percutaneous catheterization intervention (PCI) but remains high in patients who develop acute kidney injury (AKI). Previous studies found overweight to be protective from mortality in patients suffering from STEMI and AKI separately but not as they occur concurrently. This study aimed to establish the relationship between AKI and mortality in STEMI patients after PCI and whether body mass index (BMI) has a protective impact. Between January 2008 and June 2016, two thousand one hundred and forty-one patients with STEMI underwent PCI and were admitted to the Tel Aviv Medical Center Cardiac Intensive Care Unit. Their demographic, laboratory, and clinical data were collected and analyzed. We compared all-cause mortality in patients who developed AKI after PCI for STEMI and those who did not. In total, 178 patients (10%) developed AKI and had higher mortality (p < 0.001). Logistic regression analysis was performed to determine the relationship between AKI, BMI, and mortality. AKI was significantly associated with both 30-day and overall mortality, while BMI had a significant protective effect. Survival analysis found a significant difference in 30-day and overall survival between patients with and without AKI with a significant protective effect of BMI on survival at 30 days. AKI presents a major risk for mortality and poor survival after PCI for STEMI, yet a beneficial effect of increased BMI modifies it.
Summary: 2021 International Consultation on Incontinence Evidence-Based Surgical Pathway for Pelvic Organ Prolapse
Authors: de Tayrac Renaud , Antosh Danielle D. , Baessler Kaven , Cheon Cecilia , Deffieux Xavier , Gutman Robert , Lee Joseph , Nager Charles , Schizas Alexis , Sung Vivian , Maher Christopher
Published: October 2022

(1) Background: There is wide variation in the reported prevalence rates for pelvic organ prolapse (POP). There is also wide variation in the rate at which surgical interventions for pelvic organ prolapse are performed, as well as the type of interventions undertaken. As part of the International Consultation on Incontinence (ICI), our committee was tasked to produce evidence-based pathways for the surgical management of POP, any associated stress urinary incontinence (SUI), and bowel dysfunction. (2) Methods: To enable us to generate such evidence, we undertook a thorough search for the POP surgery-related, English-language scientific literature published up to April 2021. (3) Results: The committee evaluated the literature and made recommendations based on the Oxford grading system. (4) Conclusions: This review serves to provide a summary of the 2021 ICI surgical management of an evidence-based prolapse pathway and outline the evidence used to inform this guidance.
FRP Stay-in-Place Formworks for High Performance of Concrete Slabs
Authors: Goyal Reema , Majhi Subhra , Mukherjee Abhijit , Goyal Shweta
Published: October 2022

Stay-in-Place (SiP) formworks obviate the transportation, placement, removal and storage requirements of conventional formworks. Fibre Reinforced Polymer SiPs (FRP-SiP) have additional advantages, such as corrosion resistance, high specific strength and durability. This paper discusses an experimental instigation consisting of two sets of slabs having varying span-to-depth ratios cast on an FRP-SiP. Control specimens with conventional steel bar reinforcements were also cast. Several treatments for improving interfacial bonds at the interface between concrete and FRP-SiP have been investigated. Cyclic flexural tests were performed to evaluate their structural performance. Load-displacement relationship and load capacity are presented. Failure envelopes and energy absorption capacity were evaluated. It was found that the load capacity of FRP-SiP was around 107% greater than the conventional steel rebar specimens. Bond treatment on the FRP-SiP specimens increased the load capacity by around 215% over the untreated specimens. The load-deflection behaviour and the failure modes of the FRP-SiP specimens were distinctly different from those of the conventional specimens. The flexure and shear provisions in American Concrete Institute Standards (ACI 440) were found to be conservative in comparison to the present results. This study demonstrates that FRP-SiPs improve both the structural performance and construction efficiency of concrete slabs, however, new standards would be necessary to be able to utilize their improved capacity.
A New Strategy for Somatotype Assessment Using Bioimpedance Analysis: Stratification According to Sex
Authors: Bertuccioli Alexander , Sisti Davide , Amatori Stefano , Perroni Fabrizio , Rocchi Marco , Benelli Piero , Trecroci Athos , Di Pierro Francesco , Bongiovanni Tindaro , Cannataro Roberto
Published: October 2022

Body composition assessment is a relevant element in the biomedical field, in research and daily practice in the medical and nutritional fields, and in the management of athletes. This paper aimed to operate in an Italian sample investigating the possibility of predicting the somatotype from bioimpedance analysis and comparing the predicted results with those obtained from anthropometric measurements. This observational study was conducted with retrospective data collected from 2827 subjects. The somatotype of each subject was calculated both with the Heath–Carter method and by a multiple regression model based on bioimpedance and anthropometric parameters. Somatotypes (endomorph, mesomorph, and ectomorph) were predicted with a high goodness of fit (R2 adjusted > 0.80). Two different somatocharts were obtained from anthropometric measures and bioimpedance parameters and subsequentially compared. Bland–Altman plots showed acceptable accuracy. This study could be a first step in developing a new approach that allows the detection of a subject’s somatotype via bioimpedance analysis, stratified according to sex, with a time-saving and more standardized procedure. It would allow, for example, during the COVID-19 pandemic, to minimize operator–patient contact in having measurements.