bluuebunny/crossref_metadata_2025 huggingface dataset:
Phased Fractional Low-Order Moment-Based Doppler Shift Estimation in the Presence of Interference Signals and Impulsive Noise
Authors: Ni Bo , Wang Mengjia , Zhang Jiacheng , Zhang Ying , Liu Tao
Published: January 2025

Doppler shift estimation continues to be a critical challenge of utmost significance in both theoretical research and practical engineering applications. Many innovators have crafted solutions specific to this issue, with notable contributions across various signals and scenarios. Given that cyclostationary signals are prevalent in both artificial and natural phenomena, we propose a novel framework based on the phased fractional lower-order moment (PFLOM) for estimating Doppler shift in mixed cyclostationary signals. During the estimation process, a more realistic impulse noise model is examined in contrast to the ideal Gaussian noise typically assumed in conventional methods. This approach is meticulously derived through a series of detailed steps in line with cyclostationary signal processing and PFLOM principles. Furthermore, an extensive simulation has been conducted to validate the efficacy and robustness of our proposed method. It is anticipated that the concept and method presented here could be applied more broadly due to its solid theoretical underpinnings.
An Overview of Sargassum Seaweed as Natural Anticancer Therapy
Authors: Muñoz-Losada Kelly Johanna , Gallego-Villada Manuela , Puertas-Mejía Miguel Angel
Published: January 2025

Algae have great therapeutic value and have attracted a great deal of attention due to the abundance of bioactive compounds they contain, which may be the key to fighting diseases of various origins, such as skin cancer, breast cancer, or osteosarcoma. In this regard, global trends indicate that cancer is likely to become the leading cause of death and the main obstacle to increased life expectancy in the 21st century, which is related to multiple factors, including the various effects of climate change, which will continue to cause afflictions to human health. Then, excess exposure to ultraviolet radiation (UVR) causes damage to DNA, proteins, enzymes, and various cellular structures and leads to the development of cancer, premature aging of the skin (wrinkles, dryness, dilation of blood vessels, and loss of collagen and elastin), or alterations of the immune system. In addition, multidrug resistance (MDR) is characterized by the overexpression of efflux pumps, such as P-glycoprotein or P-gp, that expel chemotherapeutic drugs out of the cancer cell being the main obstacle to their efficacy. Some molecules inhibit efflux pumps when co-administered with antineoplastic agents, such as glycolipids. Mycosporin-like amino acids and glycolipids isolated from Sargassum have shown an important role as potential anticancer agents. The results show that glycolipids and mycosporin-like amino acids present in brown algae of the genus Sargassum exhibit cytotoxic effects on different types of cancer, such as breast cancer, leukemia, and osteosarcoma, which is a key criterion to be considered as a natural anti-cancer strategy; but, more in-depth in vitro studies are needed to represent them at the in vivo level, as well as their validation in preclinical assays.
Cybersecuity Analysis of a Telemedicine Platform
Authors: Nobili Martina , Raguseo Domenico , Setola Roberto
Published: January 2025

Background: The global shift toward telemedicine, accelerated by the COVID-19 pandemic, has revolutionized healthcare delivery by enabling remote consultations and treatments. However, this rapid adoption has also introduced critical cybersecurity vulnerabilities, particularly in safeguarding sensitive medical data and ensuring the secure operation of telemedicine platforms. If not properly addressed, these vulnerabilities can compromise patient safety and the integrity of healthcare systems. As a result, implementing robust cybersecurity measures in telemedicine platforms is essential. Methods: The framework developed in this study allows for the assessment of a telemedicine platform’s cybersecurity posture and provides concrete recommendations for improvement. In this context, the Security Framework for Telemedicine Platforms, developed as part of the study, serves as a valuable tool for evaluating platform security, identifying vulnerabilities, and pinpointing areas for enhancement. Conclusions: This framework empowers organizations to effectively strengthen their cybersecurity strategies, as demonstrated by a case study.
A Cross-Sectional Multivariable Analysis of the Quality of Hemodialysis Patients’ Life in Lahore City, Pakistan
Authors: Islam Ghosia , Shah Gulzar H. , Saeed Nadia , Jones Jeffery A. , Karibayeva Indira
Published: January 2025

Background/Objectives: Chronic kidney disease (CKD) is a severe health problem with dire consequences for the quality of life of millions of individuals and their families around the globe. This quantitative study analyzes the factors associated with hemodialysis patients’ quality of life (QoL) in Lahore City, Pakistan. Methods: Primary data from a sample of 384 patients were collected through regular visits to the hospital. We employed proportional odds models (POMs) and structural equation models to identify factors associated with the QoL. Results: The results revealed significant associations between various factors and patients’ quality of life. While gender showed no association with quality of life, younger age, single marital status, higher education, higher family income, and employment status were associated with a better QoL. Clinical variables such as the absence of diabetes and hypertension and specific laboratory parameters were protective against deteriorating QoL. Physical symptoms like muscle soreness, cramps, and shortness of breath significantly impacted QoL. Social and environmental factors adversely affected patient well-being, including family distress and financial issues. Psychological variables such as anxiety, depression, and fear of death also influenced QoL. Conclusions: The findings underscore the importance of holistic, patient-centered care approaches in renal failure management, highlighting the need for tailored interventions to address the diverse needs of dialysis patients and enhance their QoL. Further longitudinal research is recommended to validate these findings and guide the development of targeted interventions for improving patient well-being in hemodialysis settings.
Physical Exercise Interventions Using Virtual Reality in Children and Adolescents with Cerebral Palsy: Systematic Review
Authors: Velasco Aguado Javier , Espada Mário C. , Muñoz-Jiménez Jesús , Ferreira Cátia C. , Gámez-Calvo Luisa
Published: January 2025

Background/Objectives: Cerebral palsy (CP) is a neurological disorder that affects movement and posture. Physical activity (PA) is safe and crucial for healthy development; however, this population faces barriers that hinder its implementation. Virtual reality (VR) is an emerging and promising technology that promotes PA in young people with CP. This work aims to compile and analyze the current scientific literature on physical exercise (PE) programs using VR in children and adolescents with CP through a PRISMA systematic review. Methods: A systematic review was conducted and reported based on the PRISMA (Preferred Reporting Items for Systematic Review and Meta-analyses) statement. The search was conducted through the Web of Science, PubMed, and Scopus databases on 1st September 2024. Studies based on PA interventions using VR in children and adolescents with CP were selected. Results: A total of 24 experimental research articles were selected for this review. The studies included comprise a total sample of 616 participants between 4 and 18 years old. The studies involved a diverse range of interventions, from brief sessions to intensive training. The results consistently demonstrated improvements in motor control, muscle strength, aerobic capacity, and overall participation in daily activities. Conclusions: The results highlight that the use of VR for PE programs has numerous benefits such as increased enjoyment, facilitation of motor learning, and acquisition of functional skills. PE through VR in children and adolescents with CP represents a promising tool; more scientific and practical evidence is needed to confirm its long-term effectiveness.
Tobacco Use and Second-Hand Smoke Exposure Among Athletes; Assessment by Urine Cotinine Level and Exhaled Carbon Monoxide: A Cross-Sectional Study
Authors: Asar Erdogan , Bulut Yunus Emre , Dindar Badem Nermin , Orscelik Aydan , Sahin Cagri Emin , Buyukluoglu Gokhan , Kucuk Ismail , Kocahan Tugba , Erguder Toker
Published: January 2025

Background and Objectives: Tobacco use and exposure to tobacco products remain a major public health challenge, even among athletes. This study aimed to evaluate tobacco use and second-hand smoke exposure in athletes through urinary cotinine levels and exhaled air carbon monoxide (CO) measurements. Materials and Methods: This cross-sectional study included licensed athletes who visited the sports medicine outpatient clinic of a tertiary hospital. Participants completed an electronic questionnaire on smoking habits and second-hand smoke exposure. Urine samples were analysed for cotinine levels, while CO levels were measured in exhaled breath. Results: A total of 421 athletes participated (57.8% male, median age: 18 years). Tobacco use was reported by 29.9% (n = 126) of participants. Median urinary cotinine levels were 22.9 ng/mL among daily tobacco users and 17.4 ng/mL among athletes exposed daily to second-hand smoke, with a statistically significant difference between exposure levels (p < 0.05). The optimal cut-off value for detecting second-hand smoke exposure was identified as 12.5 ng/mL. Median exhaled air CO levels were 5 ppm in daily tobacco users. Conclusions: This study demonstrates that tobacco use prevalence among athletes mirrors Türkiye’s national rates. Despite legal measures to curb tobacco use, direct use and second-hand smoke exposure remain pressing issues among athletes.
The Prevalence of Peripheral Erythrophagocytosis in Pediatric Immune-Mediated Hemolytic Anemia
Authors: Lee Anselm Chi-wai
Published: January 2025

Background: Peripheral erythrophagocytosis appears to be a unique sign of acquired immune-mediated hemolytic anemia. It is said to be rare but its prevalence among patients with autoimmune hemolytic anemia has not been studied. Methods: In this retrospective study from July 2014 to June 2024, the clinical and laboratory features, treatment and outcomes of children diagnosed with autoimmune hemolytic anemia were described. The prevalence of peripheral erythrophagocytosis was compared to a group of children with hereditary spherocytosis at the time of first diagnosis seen in the same period. Results: Twelve consecutive children with autoimmune hemolytic anemia were included. There were four female patients. The mean age was 6.7 (range 0.8 to 16.6) years. The mean hemoglobin was 6.0 (range 2.5 to 8.1) g/dL. Seven patients were positive by a direct antiglobulin test, three were positive with cold agglutinins and two were positive on both tests. In seven cases, an acute infection appeared to be the precipitating factor. Mycoplasma pneumoniae infection was documented in three and suspected in another two cases. Peripheral erythrophagocytosis was present in five cases (42%) but was not found at diagnosis in any of the 16 cases of hereditary spherocytosis (p = 0.0081). Six children had pre-existing diseases, including two with hereditary hemolytic anemia. Conclusions: Peripheral erythrophagocytosis is a relatively common and characteristic finding in pediatric autoimmune hemolytic anemia and should be actively looked for in the evaluation of acute hemolysis, including in children with pre-existing hereditary hemolytic disorders.
Taphonomy as a Methodological Approach for the Study of Dog Domestication: Application to the Prehistoric Site of Peña Moñuz (Guadalajara, Spain)
Authors: Claver Idoia , Estaca-Gómez Verónica , Linares-Matás Gonzalo , Arenas-Esteban Jesús , Yravedra José
Published: January 2025

The study of early dog domestication has been the focus of considerable scholarly interest in recent years, prompting extensive research aimed at pinpointing the precise temporal and geographic origins of this process. However, a consensus among studies remains elusive, with various research efforts proposing differing timelines and locations for domestication. To address the questions related to the domestication process, researchers have employed a wide range of methodologies, including genetic, biomolecular, morphometric, paleontological, biometric, and isotopic analyses, as well as dental wear analysis to reconstruct paleodiets. Each of these approaches requires access to fossil canid specimens, given that they work directly with the skeletal remains of dogs or wolves. Alternatively, some methods can yield insights into the domestication process without necessitating the physical remains of these canids. Taphonomy, for instance, enables the study of bone surfaces for tooth marks, which may serve as indirect indicators of carnivore activity, potentially attributable to dogs or wolves. This study applies a high-resolution taphonomic analysis to bones modified by carnivores at the prehistoric site of Peña Moñuz. Our aim is to identify the specific carnivores responsible for the observed bone modifications. The findings demonstrate the efficacy of this technique in identifying the agents of bite marks, suggesting that taphonomy may complement the paleogenetic, paleontological, and isotopic methodologies traditionally used to explore the origins of dog domestication
Elderhood and Healthy Aging from an Indigenous Perspective
Authors: Huang Yu-Chi Kalesekes , Braun Kathryn L.
Published: January 2025

Researchers have outlined the components of healthy aging, and a 2022 scoping review by Quigley et al. examined healthy aging from Indigenous perspectives. Quigley’s review reinforced the notion that Indigenous health, and thus healthy aging, is a holistic concept. However, no review has specifically addressed Elderhood from an Indigenous perspective. This scoping review aimed to fill that gap by analyzing studies from Quigley’s review and sourcing additional literature on Indigenous Elderhood. Eligible articles identified participants as Indigenous and described Elderhood within the culture. From the 20 included publications, six themes were identified, suggesting that Elderhood was a term limited to adults who were respected for their wisdom, were active in the community, cared for others, passed down Indigenous knowledge, and promoted a vision of the future that built on tradition. Age was not a criterion, as older people who are not seen as respected contributors do not earn the title of Elder. The findings suggest that achieving Elderhood is key to healthy aging for Indigenous adults, regardless of one’s physical health status. Programs and policies offered in Indigenous communities should recognize this distinction. Further research should explore ways to support successful Elderhood, as defined here, as a component of healthy aging in Indigenous communities.
Paternal Depression and Anxiety During the COVID-19 Pandemic
Authors: Cameron Emily E. , Joyce Kayla M. , Hatherly Kathryn , Roos Leslie E.
Published: January 2025

The COVID-19 pandemic significantly impacted the lives of families worldwide. Findings suggest a substantial impact of the COVID-19 pandemic on maternal mental health. Yet, much less is known about the impact of COVID-19 on paternal mental health. This study describes depression and anxiety and risk and protective factors among fathers of young children largely residing in Canada during the COVID-19 pandemic. Fathers (N = 70) of children 0 to 8 years old self-reported depression (EPDS, CESD, CESD-R) and anxiety (PASS, GAD-7) symptoms, while mothers (N = 236) provided reports of paternal depressive symptoms using the EPDS-P. Fathers evidenced clinically significant depression (37.1%) and anxiety (22.9%). Linear regression models with significant bivariate correlates indicated that depressive symptoms were associated with a mental health history and experiencing recent stressful events in the past month, while anxiety symptoms were related to mental health history over and above other correlates. Mother-reported paternal depression was prevalent (61.9%) and associated with lower mother-reported marital quality and higher maternal depressive symptoms. Of the fathers reporting clinically significant mental health concerns, less than one-third reported accessing mental health services. Paternal depression and anxiety symptoms were elevated during the pandemic, when compared to pre-pandemic comparisons. The risk and protective factors for paternal depression and anxiety included mental health history, recent stressful events, maternal marital quality, and maternal depressive symptoms. Longitudinal studies evaluating the persistent impact of the COVID-19 pandemic on paternal mental health are needed to inform continued efforts to repair the pandemic’s impact on family wellbeing.
Analysis of the Climate Impact on Occupational Health and Safety Using Heat Stress Indexes
Authors: Ferrari Guilherme Neto , dos Santos Guilherme Custódio , Ossani Paulo Cesar , Leal Gislaine Camila Lapasini , Galdamez Edwin Vladimir Cardoza
Published: January 2025

Workers may be exposed to conditions that put their physical and mental integrity at risk, from workplace settings to climate characteristics. Heat stress is a harmful health condition caused by exceeding the human body’s tolerance limits, leading to illness and increasing the chance of work accidents. Heat stress indexes, such as the Humidex and the Heat Index (HI), are used to measure these impacts. These indexes are significant as they provide a quantitative measure of the heat stress experienced by workers, taking into account both environmental and individual factors. Objective: This study aims to compare multiple heat stress indexes, relating them to historical Brazilian occupational accident data. Methods: We selected eight indexes and applied multiple correspondence analysis to each one, a statistical method that generates graphs to visualize the association between variables in a database. Results: The analysis and comparison of the graphs indicated that seven of the eight indexes presented similar behavior. It was also possible to relate ranges of index values with specific characteristics of the accidents. Conclusions: The technique allowed us to analyze the relationship between climate and work accidents and showed that the choice of the heat stress index does not significantly alter the results for most indexes studied.
How Has the Renminbi’s Role in Non-USD Currency Markets Evolved After COVID-19? An Analysis Based on Spillover Effects
Authors: Lu Changrong , Yu Fandi , Li Jiaxiang , Zheng Guanghong , Liu Lian
Published: January 2025

Global uncertainty and the COVID-19 pandemic have significantly impacted the integration of emerging economies into global financial markets. Post-pandemic, the Federal Reserve’s interest rate hikes have drawn investor attention to relatively independent and stable currencies. This study investigates the sustained independence of the Renminbi by analyzing the spillover effects between the Renminbi and other major currencies in the context of the pandemic and USD interest rate hikes. By employing high-frequency data and cross-validating the results with low-frequency data transformed through Synchro Squeezing Wavelet Transform, we aimed to enhance the robustness of our findings. This analysis provides valuable insights for investors, highlighting the stability advantages of the Renminbi in the context of de-dollarization and global currency diversification.
Decoding the Contribution of IAPP Amyloid Aggregation to Beta Cell Dysfunction: A Systematic Review and Epistemic Meta-Analysis of Type 1 Diabetes
Authors: Moya-Gudiño Valeria , Altamirano-Bustamante Nelly F. , Revilla-Monsalve Cristina , Altamirano-Bustamante Myriam M.
Published: January 2025

Diabetes Mellitus Type 1 (DM1) is an autoimmune disease characterized by the destruction of beta cells in the pancreas. Although amyloid formation has been well-studied in Diabetes Mellitus Type 2 (DM2), its role in DM1 remains unclear. Understanding how islet amyloid polypeptide (IAPP) contributes to beta cell dysfunction and death in DM1 could provide critical insights into disease mechanisms and pave the way for novel diagnostic and therapeutic strategies. A systematic review and epistemic meta-analysis was conducted using a modified PICO framework, focusing on studies related to DM1 and the IAPP aggregation process. Searches in PubMed, BIREME, and Web of Science yielded 37 relevant articles, which were analyzed and individually evaluated based on specific quality criteria. Studies that experimentally identified the formation of IAPP oligomers in DM1 were selected, along with relevant review articles. Experimental studies from human and animal models detected the presence of IAPP oligomers in DM1 patients, as well as in nonobese diabetic (NOD) and homozygous mice. Techniques like Western Blot (WB), Transmission Electron Microscopy (TEM) and Congo red staining detected various oligomers sizes, with smaller ones showing higher cytotoxicity. IAPP oligomers have been detected in the pancreatic islets of DM1 patients, contributing to beta cell damage and disease progression.
Mechanism of Transcription Factor ChbZIP1 Enhanced Alkaline Stress Tolerance in Chlamydomonas reinhardtii
Authors: Wang Ao , Wang Rui , Miao Xiaoling
Published: January 2025

Alkaline environments such as alkaline lands, lakes, and industrial wastewater are not conducive to the growth of plants and microorganisms due to high pH and salinity. ChbZIP1 is a bZIP family transcription factor isolated from an alkaliphilic microalgae (Chlorella sp. BLD). Previous studies have demonstrated its ability to enhance alkaline tolerance in Arabidopsis thaliana. However, the potential of ChbZIP1 to confer similar alkaline tolerance in other microalgae remains unclear, and the specific mechanisms are not fully understood. The analysis of cellular physiological and biochemical indicators revealed that the ChbZIP1 transformants exhibited enhanced photosynthetic activity, increased lipid accumulation, and reduced fatty acid unsaturation. Genes associated with cellular reactive oxygen species (ROS) detoxification were found to be upregulated, and a corresponding increase in antioxidant enzyme activity was detected. In addition, the relative abundance of intracellular ROS and malondialdehyde (MDA) was significantly lower in the transformants. In summary, our research indicates that ChbZIP1 enhances the tolerance of Chlamydomonas reinhardtii to alkaline environments through several mechanisms, including the repair of damaged photosynthesis, increased lipid accumulation, improved fatty acid unsaturation, and enhanced antioxidant enzyme activity. This study aims to contribute to a more comprehensive understanding of the mechanisms underlying alkalinity tolerance in microalgae and offers new insights and theoretical foundations for the utilization of microalgae in alkaline environments.
Precise Crop Pest Detection Based on Co-Ordinate-Attention-Based Feature Pyramid Module
Authors: Kang Chenrui , Jiao Lin , Liu Kang , Liu Zhigui , Wang Rujing
Published: January 2025

Insect pests strongly affect crop growth and value globally. Fast and precise pest detection and counting are crucial measures in the management and mitigation of pest infestations. In this area, deep learning technologies have come to represent the method with the most potential. However, for small-sized crop pests, recent deep-learning-based detection attempts have not accomplished accurate recognition and detection due to the challenges posed by feature extraction and positive and negative sample selection. Therefore, to overcome these limitations, we first designed a co-ordinate-attention-based feature pyramid network, termed CAFPN, to extract the salient visual features that distinguish small insects from each other. Subsequently, in the network training stage, a dynamic sample selection strategy using positive and negative weight functions, which considers both high classification scores and precise localization, was introduced. Finally, several experiments were conducted on our constructed large-scale crop pest datasets, the AgriPest 21 dataset and the IP102 dateset, achieving accuracy scores of 77.2% and 29.8% for mAP (mean average precision), demonstrating promising detection results when compared to other detectors.
“It’s Enough to Make Someone… Lose Their Mind”: Exploring the Mental Impact of Racial Capitalism Across the Black American Life Course
Authors: Brown Jocelyn L.
Published: January 2025

This study introduces racial capitalism, the theory that racism and capitalistic exploitation are inextricably linked, into psychology and gerontology by exploring its mental impact across different age groups of Black Americans. Using Constructivist Grounded Theory (CGT), 27 participants from diverse age groups and socioeconomic statuses were interviewed via theoretical and purposive sampling. In-depth interviews were conducted to examine their lived experiences of racial capitalism and its evolving mental health impact. Data collection continued until thematic saturation was reached, and analysis followed an iterative coding process to identify emergent themes. The analysis revealed three themes: Individual-level racism impacts older adults’ mental well-being; middle-aged adults are learning from older adults’ poor mental health awareness; and younger adults are mentally struggling under the weight of capitalistic exploitation. Older adults primarily focused on individual-level racism earlier in life, maintaining a generally positive outlook. Middle-aged adults reflected on limited mental health awareness passed down from older cohorts and the strain of limited generational wealth transfer. Younger participants expressed heightened mental distress due to contemporary systemic racism and exploitation. These findings informed the development of Cumulative Racial Capitalism Theory (CRCT), a framework theorizing how racism and capitalism continually evolve, cumulatively impacting Black Americans’ mental health.
Longitudinal Outcomes of Patients with Aortic Stenosis Stratified by Sex: An Asian Perspective
Authors: Ong Joy Y. S. , Leow Aloysius S. T. , Ng Chun Yi , Loh Poay Huan , Quek Swee Chye , Kong William K. F. , Yeo Tiong Cheng , Sia Ching Hui , Poh Kian Keong
Published: January 2025

Background: Severe aortic stenosis (AS) stratified by sex has been increasingly studied in the European population. Sex-specific outcomes in Asian patients with AS remain poorly defined. Hence, we aimed to study the clinical characteristics and impact of sex in moderate-to-severe AS, undergoing both invasive and conservative interventions in an Asian cohort over 10 years. Methods: Consecutive data with echocardiographic diagnoses of AS were stratified according to gender in a tertiary academic center between 2011 and 2021. Demographics, comorbidities, and clinical outcomes were compared. Results: Seven hundred and three (703) patients were included (56%, n = 397 were female). Calcific AS was the dominant etiology in both genders. Females had higher incidences of anemia (p < 0.001) and chronic kidney disease (p = 0.026); although, females had lower incidences of cardiovascular complications of coronary artery disease (CAD) (p = 0.002) and prior acute myocardial infarction (AMI) (p = 0.015). Echocardiographically, females had a smaller left ventricular outflow tract diameter (LVOTd) (p < 0.001), LV mass (p < 0.001), and left ventricle end diastolic volume (LVEDV) (p < 0.001). Conversely, the left atrial (LA) area (p < 0.001) and volume index (LAVI) (p < 0.001) were larger in females. Females had higher average E/e’ (p = 0.010) ratios compared to males. The mean follow-up duration between genders was 4.1 ± 3.3 years. Upon univariate analysis, a greater proportion of female AS patients encountered cardiovascular (CV) hospitalization during follow-up (female: 27.5%, n = 109 vs. male: 18.3%, n = 56; p = 0.005) compared to male patients, but there were no significant differences for the outcomes of heart failure (p = 0.612), stroke (p = 0.664), and all-cause mortality (p = 0.827). Fewer females underwent aortic valve (AV) intervention compared to males (21.2% vs. 27.8%, p = 0.042), albeit with a longer duration to AV intervention (3.6 years ± 2.4 vs. 2.6 years ± 2.3, p = 0.016). In the severe AS cohort, female sex remained an independent predictor for subsequent heart failure (aHR 2.89, 95% CI 1.01–8.29, p = 0.048) and CV hospitalization (aHR 20.0, 95% CI 1.19–335, p = 0.037) after adjustments for age, ethnicity, body mass index (BMI), comorbidities, left ventricular ejection fraction (LVEF), and AV intervention. Conclusions: There was no difference in heart failure, stroke, and all-cause mortality outcomes between male and female Asian patients with moderate-to-severe AS. However, there were more cardiovascular hospitalizations, with fewer and longer duration to AV intervention in females compared to males in our cohort.
Long-Term Oro-Dental Effects of Chemotherapy in a Pediatric Patient: A Case Study and a Proposed Oral Care Protocol
Authors: Puwanun Sasima , Kriangkrai Rungarun
Published: January 2025

Background: Chemotherapy (CMT) in children can disrupt dental development and calcification, causing long-term dental issues, but good dental care and habits can help improve quality of life. This case report examines permanent dental disturbances in a 7-year, 4-month-old girl undergoing CMT, explores the histology of microdontia, and outlines an oral treatment plan for CMT management. Methods: Clinical examination revealed microdontia and a groove crossing the cervical area (chronological hypoplasia), which were assessed using panoramic radiographs and histological analysis. The patient was monitored for five years, and microdontia was extracted for orthodontic reasons. A tailored treatment plan was implemented to maintain oral health during CMT. Results: Clinical and radiographic findings indicated tooth agenesis, rudimentary form, chronological hypoplasia, and microdontia. Histological analysis showed reduced odontoblast counts, abnormal dentinal tubules, thinner pre-dentin, and interglobular dentin (hypocalcification) surrounded by globular dentin (normal calcification). CMT-related microdontia caused inflammation with dilated blood vessels in the pulp. A high fever during CMT led to a groove in the enamel of all teeth, presenting as chronological hypoplasia. No new dental caries was observed over the follow-up. Conclusions: This report highlights long-term dental disturbances from CMT in permanent dentition and associated histopathological changes. It proposes an oral care protocol for managing these issues. Maintaining oral hygiene and preventing caries during the five-year follow-up reduced CMT side effects and improved the quality of the patient’s life.
Combined Multilayered Amniotic Membrane Graft and Fibrin Glue as a Surgical Management of Limbal Dermoid Cyst
Authors: Poddi Maria , Romano Vito , Borgia Alfredo , Porcaro Floriana , Cagini Carlo , Messina Marco
Published: January 2025

Background/Objectives: To report the cosmetic, clinical, and visual outcomes of a combined surgical approach for treating a corneal/limbal dermoid using excision and a three-layered amniotic membrane graft with fibrin glue. Methods: An 18-year-old female presented with impaired vision and ocular discomfort caused by a prominent dome-shaped limbal congenital dermoid on the inferotemporal cornea, resulting in a significant aesthetic concern. A full assessment, including refraction, best-corrected visual acuity (BCVA), corneal topography, aberrometry and anterior segment OCT (AS-OCT) was conducted to plan the surgical approach. The dermoid was excised under peribulbar anaesthesia using manual lamellar dissection, followed by the application of 0.02% Mitomycin C and a multilayered amniotic membrane graft with fibrin glue. A bandage contact lens was applied and removed after three weeks, with postoperative treatment including topical antibiotics and steroids. Follow-ups were conducted on day 1, at 1 week, 3 weeks, 2 months, 6 months, 1 year, and 2 years. Results: Histopathological examination confirmed the mesoblastic nature of the lesion. Significant improvements in BCVA and ocular symptoms were observed. Corneal topography showed ocular surface regularization with reduction of high order aberrations and point spread function. AS-OCT showed complete integration of the amniotic membrane, with full epithelial coverage of the defect. The healing process was uneventful and the ocular surface remained stable throughout the entire follow-up, without complications or recurrence. Conclusions: This approach of dermoid excision, multilayered amniotic membrane and fibrin glue restored vision effectively, with notable improvements in ocular surface and cosmetic outcomes, without recurrence over two years.
The Cell-Specific Effects of JAK1 Inhibitors in Ulcerative Colitis
Authors: Veltkamp Suzanne H. C. , Voorneveld Philip W.
Published: January 2025

JAK1 inhibitors have become an important addition to the therapeutic options for ulcerative colitis (UC), targeting key inflammatory pathways mediated by cytokines such as the IL-6 family, interferons, IL-2 family, IL-10 family, and G-CSF. However, not all patients respond equally, and chronic inflammation persists in a subset of individuals. The variability in treatment response may reflect the heterogeneity of UC. Immune cells, epithelial cells, and stromal cells may have distinct contributions to disease pathogenesis. While JAK inhibitors were originally designed to target immune cells, their impact on non-immune cell types, such as epithelial and stromal cells, remains poorly understood. Investigating the mechanisms through which JAK1 inhibitors affect these diverse cellular populations and identifying the factors underlying differential responses is crucial to optimizing outcomes. This review explores the roles of immune, epithelial, and stromal cells in response to JAK1 inhibition and discusses potential strategies to improve treatment precision, such as predicting responders and identifying complementary therapeutic targets.
The Role of Impella in Cardiogenic Shock Complicated by an Acute Myocardial Infarction: A Meta-Analysis
Authors: Sassani Kiarash , Waechter Christian , Syntila Styliani , Kreutz Julian , Markus Birgit , Patsalis Nikolaos , Di Vece Davide , Schieffer Bernhard , Templin Christian , Chatzis Georgios
Published: January 2025

Background: Emerging evidence suggests the role of mechanical circulatory support (MCS) devices in the therapy of refractory cardiogenic shock (CS). However, largerandomized trials addressing the role of Impella in the therapy of infarct-associated CS are sparse. As such, evidence coming from comprehensive retrospective studies or meta-analyses is of major importance in order to clarify the role of the Impella device in this setting. Methods: Only clinical trials involving patients receiving Impella 2.5 and Impella CP for treatment of CS caused in terms of acute coronary syndrome (ACS) were included in this meta-analysis. The primary endpoint was 30-day mortality, with major bleeding and ischemic vascular complications serving as secondary endpoints. Results: A total of 18 observational retrospective studies (2617 patients with CS and Impella implantation) were included in this analysis. The mean age of the total participants was 64.7 ± 2.93 years. A mean mortality incidence of 45% was found between all included participants. The ischemia rate was in total 8.5 ± 4.4%, and the incidence of bleeding was 13.9 ± 5.6%. Conclusions: The 30-day mortality rate for patients with ACS-associated CS treated with Impella remains high. The high complication rates underline the importance of Impella use in only a very well-selected population of patients.
Advancing Insights into Pediatric Macular Diseases: A Comprehensive Review
Authors: Ambrosio Lucia , Perepelkina Tatiana , Elhusseiny Abdelrahman M. , Fulton Anne B. , Gonzalez Monroy Jose Efren
Published: January 2025

Pediatric macular disorders are a diverse group of inherited retinal diseases characterized by central vision loss due to dysfunction and degeneration of the macula, the region of the retina responsible for high-acuity vision. Common disorders in this category include Stargardt disease, Best vitelliform macular dystrophy, and X-linked retinoschisis. These conditions often manifest during childhood or adolescence, with symptoms such as progressive central vision loss, photophobia, and difficulty with fine visual tasks. Underlying mechanisms involve genetic mutations that disrupt photoreceptor and retinal pigment epithelium function, accumulating toxic byproducts, impaired ion channel activity, or structural degeneration. Advances in imaging modalities like optical coherence tomography and fundus autofluorescence have improved diagnostic accuracy and disease monitoring. Emerging therapies are transforming the treatment landscape. Gene therapy and genome editing hold promise for addressing the genetic basis of these disorders, while stem cell-based approaches and pharmacological interventions aim to restore retinal function and mitigate damage. Personalized medicine, driven by genomic sequencing, offers the potential for tailored interventions. Despite current challenges, ongoing research into molecular mechanisms, advanced imaging, and innovative therapies provides hope for improving outcomes and quality of life in children with macular disorders.
A Technique to Augment Arthroscopic Bankart Repair With or Without a Metal Block: A Comparison
Authors: Vedrenne Paul , Moussa Mohamad K. , Picard Kévin , Bauer Thomas , Hardy Alexandre
Published: January 2025

Introduction: Arthroscopic Bankart repair (ABR) is associated with an increased failure rate over time. The Recenter implant, a metal block, is designed to reinforce capsulolabral repair. The aim of this study was to evaluate whether the addition of the Recenter implant to ABR reduces the rate of recurrence in patients with glenohumeral anterior instability. Materials and Methods: This was a retrospective, multicentric case–control study focusing on patients surgically treated for anterior shoulder instability from February 2012 to November 2019. This study compared patients undergoing ABR augmented with the “Recenter” implant (augmented ABR group) against those receiving traditional ABR. Primary outcomes measured included recurrence rates. Secondary outcome measures included functional scores (Walch–Duplay and the subjective shoulder test [SST], the auto Rowe score, satisfaction, pain, and the presence or absence of subjective subluxation and apprehension), return to sports, the range of motion, as well as other complications. Results: Thirty-two patients with augmented ABR were compared to forty-eight patients in the traditional ABR group, with mean follow-up periods of 5.2 ± 1.3 years and 6.1 ± 1.5 years, respectively. Three patients (9.4%) experienced recurrence in the “Recenter” group, versus eight (16.7%) in the other group (p > 0.05). The Walch–Duplay score was 70.2 ± 8.2 in the “Recenter” group and 64.2 ± 8 in the control group (p > 0.05). The SST score out of 100 was, respectively, 84.6 ± 6 and 81.5 ± 5.5 (p = 0.05). There were no early complications in the implant group. No statistically significant differences were observed between the two groups for the other outcomes. Conclusions: ABR safely restores shoulder stability in selected patients with subcritical glenoid bone deficiency. However, the addition of the Recenter metal implant did not improve outcomes compared to traditional Bankart repair and introduced presumed significant surgical time, technical challenges, and additional costs.
A Real-Life Study in Sequential Therapy for Severe Menopausal Osteoporosis
Authors: Sima Oana-Claudia , Costachescu Mihai , Stanciu Mihaela , Nistor Claudiu , Carsote Mara , Tanasescu Denisa , Popa Florina Ligia , Valea Ana
Published: January 2025

Background: Teriparatide (TPT) acts against severe primary (postmenopausal) osteoporosis (MOP), and it requires continuation with another anti-resorptive drug to conserve or enhance the effects on fracture risk reduction. Objective: To analyse the sequential pharmacotherapy in MOP who were treated upon a 24-month daily 20 µg TPT protocol (24-mo-TPT) followed by another 12 months of anti-resorptive drugs (12-mo-AR) amid real-life settings. Hypotheses: 1. TPT candidates had a more severe fracture risk profile versus those who did not fulfil the TPT criteria according to the national protocol of TPT initiation; 2. Patients treated with TPT improved their DXA profile after 24 mo; 3. After 1 year of therapy since the last TPT injection, the improved bone profile and fracture risk at the end of the TPT protocol were conserved; 4. The mineral metabolism assays and fracture risk status were similar at TPT initiation between those who finished the 24 mo protocol and those who prematurely stopped it. Methods: This was a longitudinal, retrospective, multicentre study in MOP. The entire cohort (group A) included the TPT group (B) versus the non-TPT group (non-B). Group B included subjects who finished 24-mo-TPT (group P) and early droppers (ED), and then both continued 12-mo-AR. Results: Group B (40.5%) from cohort A (N = 79) vs. non-B had lower T-scores, increased age and years since menopause. A similar profile of demographic features, BTM, and prevalent fractures (73%, respectively, 57%) was found in group P (72%) vs. ED (21.8%). Group P: osteocalcin was statistically significantly higher at 12 mo (+308.39%), respectively, at 24 mo (+171.65%) vs. baseline (p < 0.001 for each), while at 12-mo-AR became similar to baseline (p = 0.615). The cumulative probability of transient hypercalcemia-free follow-up of protocol had the highest value of 0.97 at 6 mo. An incidental fracture (1/32) was confirmed under 24-mo-TPT. BMD had a mean percent increase at the lumbar spine of +8.21% (p < 0.001), of +12.22% (p < 0.001), respectively, of +11.39% (p < 0.001). The pharmacologic sequence for 12-mo-AR included bisphosphonates (24.24% were oral BP) or denosumab (13%). BTM showed a suppression at 12-mo-AR (p < 0.05), while all BMD/T-scores were stationary. No incidental fracture was registered during 12-mo-AR. Conclusions: All research hypotheses were confirmed. This study in high-risk MOP highlighted an effective sequential pharmacotherapy in reducing the fracture risk as pinpointed by BMD/T-score measurements and analysing the incidental fractures profile.
Assessing the Impact of the Prone Position on Acute Kidney Injury
Authors: Ezra Eden , Hazan Itai , Braiman Dana , Gaufberg Rachel , Taylor Jonathan , Alyagon Adva , Babievb Amit Shira , Fuchs Lior
Published: January 2025

Background: Prone positioning is a standard intervention in managing patients with severe acute respiratory distress syndrome (ARDS) and is known to improve oxygenation. However, its effects on other organs, particularly the kidneys, are less well understood. This study aimed to assess the association between prone positioning and the development of acute kidney injury (AKI), specifically in overweight and obese patients. Methods: A retrospective pre–post study was conducted on a cohort of 60 critically ill ARDS patients who were placed in the prone position during hospitalization. The development of AKI was assessed using the Acute Kidney Injury Network (AKIN) criteria, with AKI measured by both creatinine levels (AKINCr) and urine output (AKINUO). Patients were divided into two groups based on body mass index (BMI): overweight/obese (BMI ≥ 25) and non-obese (BMI < 25). Data were collected before and after prone positioning. Results: In overweight/obese patients (n = 39, 57 cases), both the median AKINCr and AKINUO scores increased significantly following prone positioning (from 0 to 1, median p < 0.01, and from 0 to 2, median p < 0.01, respectively). No statistically significant changes in AKIN scores were observed in non-obese patients nor were significant differences found in either group after repositioning to supine. Conclusions: Prone positioning is associated with an increased risk of acute kidney injury in overweight and obese ARDS patients. This may be due to the kidneys’ susceptibility to intra-abdominal hypertension in these patients. Further research is needed to explore optimal proning strategies for overweight and obese populations.
Reliability of Tracheal Temperature as a Measurement of Core Body Temperature During Cardiac Surgery Using Cardiopulmonary Bypass
Authors: Kang Hyun-Uk , Lee Sou-Hyun , Chin Ji-Hyun , Choi In-Cheol , Kim Kyungmi
Published: January 2025

Background: To compare tracheal temperature (TET) with nasopharyngeal temperature (TNP) in patients undergoing cardiac surgery using cardiopulmonary bypass (CPB). Methods: TET was measured using a thermistor in the cuff of an endotracheal tube and TNP was monitored using an esophageal stethoscope. Depending on the management of the CPB strategy, the operation was divided into four periods (pre-CPB, cooling, rewarming, and post-CPB). A Bland–Altman analysis was carried out to compare TET with TNP in each period. The concordance correlation coefficient for repeated measures analysis and various time lags was used to validate the time lag maximizing the concordance correlation coefficient between the two methods. Results: A total of 7191 pairs of temperature recordings acquired from 24 patients were included in the analysis. During steady normothermia, 81.7% (95% confidence interval [CI], 79.8–83.5%) of the pairs had a difference within ±0.5 °C, with a mean bias of −0.28 °C and limits of agreement (LOA) of −0.74 °C to 0.18 °C. The LOA during the cooling and rewarming phase of CPB were −1.13 °C to 0.51 °C and −0.91 °C to 1.29 °C, respectively. The mean bias and LOA throughout the entire operation were −0.10 °C and −0.98 °C to 0.77 °C, respectively. Throughout the entire operation, −2 min of time lag on TET maximized the concordance correlation coefficient (0.94 [95% CI, 0.92–0.96] to 0.95 [95% CI, 0.93–0.96]), indicating an earlier response of TET than TNP. Conclusions: TET could be an alternative to TNP during cardiac surgery using CPB.