bluuebunny/crossref_metadata_2025 huggingface dataset:
Synergistic Effect of Repolarization of M2 to M1 Macrophages Induced by Iron Oxide Nanoparticles Combined with Lactate Oxidase
Authors: Liao Zi-Xian , Ou Da-Liang , Hsieh Ming-Jung , Hsieh Chia-Chen
Published: December 2021

Metabolic reprogramming of tumors with the accompanying reprogramming of glucose metabolism and production of lactate accumulation is required for the subsequent development of tumors. Recent evidence has indicated that tumor-secreted lactate can promote an oncolytic immune microenvironment within the tumor. Furthermore, tumor-secreted lactate directly induces polarization of tumor-supportive M2 macrophages. However, oxidized tumor-secreted lactate in the tumor microenvironment can be exploited. Iron oxide nanoparticles have shown promising anticancer potential by activating tumor-suppressing macrophages. Furthermore, lactate oxidase (LOX) generally oxidizes tumor-secreted lactate and subsequently converts to pyruvate. Particularly, the ratio of M2 macrophages to M1 macrophages corresponds with tumor growth. In this study, we present iron oxide nanoparticles with carboxylic acid combined with LOX that enhance antitumor efficacy as a synergistic effect on the repolarization of tumor-supportive M2 macrophages to tumor-suppressive M1 macrophages in a tumor microenvironment. After M2 macrophages treated with iron oxide nanoparticles were combined with LOX, the ratio of M1 macrophages was significantly greater than iron oxide nanoparticles alone or with LOX alone. It is concluded that the inhibition of cancer cell proliferation by ratio of M1 macrophages was observed. This study suggests that the iron oxide nanoparticles combined with LOX could be potentially used for potentiating immune checkpoint inhibitor therapies for cancer treatment.
The HLA-G Immune Checkpoint Plays a Pivotal Role in the Regulation of Immune Response in Autoimmune Diseases
Authors: Zaborek-Łyczba Monika , Łyczba Jakub , Mertowska Paulina , Mertowski Sebastian , Hymos Anna , Podgajna Martyna , Niedźwiedzka-Rystwej Paulina , Grywalska Ewelina
Published: December 2021

The human G-leukocyte antigen (HLA-G) molecule is a non-classical major histocompatibility complex (MHC) class I molecule. The pertinence of HLA-G has been investigated in numerous studies which have sought to elucidate the relevance of HLA-G in pathologic conditions, such as autoimmune diseases, cancers, and hematologic malignancies. One of the main goals of the current research on HLA-G is to use this molecule in clinical practice, either in diagnostics or as a therapeutic target. Since HLA-G antigens are currently considered as immunomodulatory molecules that are involved in reducing inflammatory and immune responses, in this review, we decided to focus on this group of antigens as potential determinants of progression in autoimmune diseases. This article highlights what we consider as recent pivotal findings on the immunomodulatory function of HLA-G, not only to establish the role of HLA-G in the human body, but also to explain how these proteins mediate the immune response.
Adipose Lipolysis Regulates Cardiac Glucose Uptake and Function in Mice under Cold Stress
Authors: Choi Youngshim , Shin Hyunsu , Tang Ziwei , Yeh Yute , Ma Yinyan , Kadegowda Anil K. G. , Wang Huan , Jiang Long , Arya Rakesh K. , Chen Ling , Xue Bingzhong , Shi Hang , Gavrilova Oksana , Yu Liqing
Published: December 2021

The heart primarily uses fatty acids as energy substrates. Adipose lipolysis is a major source of fatty acids, particularly under stress conditions. In this study, we showed that mice with selective inactivation of the lipolytic coactivator comparative gene identification-58 (CGI-58) in adipose tissue (FAT-KO mice), relative to their littermate controls, had lower circulating FA levels in the fed and fasted states due to impaired adipose lipolysis. They preferentially utilized carbohydrates as energy fuels and were more insulin sensitive and glucose tolerant. Under cold stress, FAT-KO versus control mice had >10-fold increases in glucose uptake in the hearts but no increases in other tissues examined. Plasma concentrations of atrial natriuretic peptide and cardiac mRNAs for atrial and brain-type natriuretic peptides, two sensitive markers of cardiac remodeling, were also elevated. After one week of cold exposure, FAT-KO mice showed reduced cardiac expression of several mitochondrial oxidative phosphorylation proteins. After one month of cold exposure, hearts of these animals showed depressed functions, reduced SERCA2 protein, and increased proteins for MHC-β, collagen I proteins, Glut1, Glut4 and phospho-AMPK. Thus, CGI-58-dependent adipose lipolysis critically regulates cardiac metabolism and function, especially during cold adaptation. The adipose-heart axis may be targeted for the management of cardiac dysfunction.
Submergence Gene Sub1A Transfer into Drought-Tolerant japonica Rice DT3 Using Marker-Assisted Selection
Authors: Wu Yong-Pei , Wang Shu-Mei , Chang Yu-Chi , Ho Chi , Hsu Yu-Chia
Published: December 2021

Flash flooding is a major environmental stressor affecting rice production worldwide. DT3 is a drought-tolerant, recurrent parent with a good yield, edible quality, and agronomic traits akin to those of an elite Taiwanese variety, Taiken9 (TK9). Progenies carrying Sub1A can enhance submergence stress tolerance and can be selected using the marker-assisted backcross (MAB) breeding method. For foreground selection, Sub1A and SubAB1 were utilized as markers on the BC2F1, BC3F1, and BC3F2 generations to select the submergence-tolerant gene, Sub1A. Background selection was performed in the Sub1A-BC3F2 genotypes, and the percentages of recurrent parent recovery within individuals ranged from 84.7–99.55%. BC3F3 genotypes (N = 100) were evaluated for agronomic traits, yield, and eating quality. Four of the eleven BC3F4 lines showed good yield, yield component, grain, and eating quality. Four BC3F4 lines, SU39, SU40, SU89, and SU92, exhibited desirable agronomic traits, including grain quality and palatability, consistent with those of DT3. These genotypes displayed a high survival rate between 92 and 96%, much better compared with DT3 with 64%, and demonstrated better drought tolerance compared to IR64 and IR96321-345-240. This study provides an efficient and precise MAB strategy for developing climate-resilient rice varieties with good grain quality for flood-prone regions.
Organic Control Strategies for Use in IPM of Invertebrate Pests in Apple and Pear Orchards
Authors: Shaw Bethan , Nagy Csaba , Fountain Michelle T.
Published: December 2021

Growers of organic tree fruit face challenges in controlling some pests more easily suppressed by broad-spectrum insecticides in conventionally managed orchards. In recent decades, there has been a move towards organically growing varieties normally reliant on synthetic chemical pesticides (e.g., Gala), often to meet retailer/consumer demands. This inevitably makes crop protection in organic orchards more challenging, as modern varieties can be less tolerant to pests. In addition, there have been substantial reductions in plant protection product (PPP) approvals, resulting in fewer chemical options available for integrated pest management (IPM)-maintained orchards. Conversely, the organic management of fruit tree pests involves many practices that could be successfully implemented in conventionally grown crops, but which are currently not. These practices could also be more widely used in IPM-maintained orchards, alleviating the reliance on broad-spectrum PPP. In this review, we evaluate organic practices, with a focus on those that could be incorporated into conventional apple and pear production. The topics cover cultural control, biological control, physical and pest modifications. While the pests discussed mainly affect European species, many of the methods could be used to target other global pests for more environmentally sustainable practices.
Transcriptome Analysis Reveals the Gene Expression Changes in the Silkworm (Bombyx mori) in Response to Hydrogen Sulfide Exposure
Authors: Zhang Rui , Cao Yu-Yao , Du Juan , Thakur Kiran , Tang Shun-Ming , Hu Fei , Wei Zhao-Jun
Published: December 2021

Hydrogen sulfide (H2S) has been recognized for its beneficial influence on physiological alterations. The development (body weight) and economic characteristics (cocoon weight, cocoon shell ratio, and cocoon shell weight) of silkworms were increased after continuous 7.5 µM H2S treatment. In the present study, gene expression changes in the fat body of silkworms at the 5th instar larvae in response to the H2S were investigated through comparative transcriptome analysis. Moreover, the expression pattern of significant differentially expressed genes (DEGs) at the 5th instar larvae was confirmed by quantitative real-time PCR (qRT-PCR) after H2S exposure. A total of 1200 (DEGs) was identified, of which 977 DEGs were up-regulated and 223 DEGs were down-regulated. Most of the DEGs were involved in the transport pathway, cellular community, carbohydrate metabolism, and immune-associated signal transduction. The up regulated genes under H2S exposure were involved in endocytosis, glycolysis/gluconeogenesis, the citrate cycle (TCA cycle), and the synthesis of fibroin, while genes related to inflammation were down-regulated, indicating that H2S could promote energy metabolism, the transport pathway, silk synthesis, and inhibit inflammation in the silkworm. In addition, the expression levels of these genes were increased or decreased in a time-dependent manner during the 5th instar larvae. These results provided insight into the effects of H2S on silkworms at the transcriptional level and a substantial foundation for understanding H2S function.
Recent Developments of Computational Methods for pKa Prediction Based on Electronic Structure Theory with Solvation Models
Authors: Fujiki Ryo , Matsui Toru , Shigeta Yasuteru , Nakano Haruyuki , Yoshida Norio
Published: December 2021

The protonation/deprotonation reaction is one of the most fundamental processes in solutions and biological systems. Compounds with dissociative functional groups change their charge states by protonation/deprotonation. This change not only significantly alters the physical properties of a compound itself, but also has a profound effect on the surrounding molecules. In this paper, we review our recent developments of the methods for predicting the Ka, the equilibrium constant for protonation reactions or acid dissociation reactions. The pKa, which is a logarithm of Ka, is proportional to the reaction Gibbs energy of the protonation reaction, and the reaction free energy can be determined by electronic structure calculations with solvation models. The charge of the compound changes before and after protonation; therefore, the solvent effect plays an important role in determining the reaction Gibbs energy. Here, we review two solvation models: the continuum model, and the integral equation theory of molecular liquids. Furthermore, the reaction Gibbs energy calculations for the protonation reactions require special attention to the handling of dissociated protons. An efficient method for handling the free energy of dissociated protons will also be reviewed.
Oral Mucositis Association with Periodontal Status: A Retrospective Analysis of 496 Patients Undergoing Hematopoietic Stem Cell Transplantation
Authors: Radochová Vladimíra , Šembera Martin , Slezák Radovan , Heneberk Ondřej , Radocha Jakub
Published: December 2021

Background: Hematopoietic stem cell transplantation (HSCT) can induce serious oral complications, including oral mucositis (OM). The presence of periodontal inflammation before HSCT is believed to be associated with OM. The aim of our study was to determine the prevalence and severity of OM in patients undergoing HSCT and its relation to periodontal status. Patients and methods: This is a retrospective study of patients who underwent HSCT and a detailed dental examination between 2007 and 2015. The dental and periodontal status of all patients was evaluated by clinical and radiographic examination prior to HSCT. Oral health was assessed with the gingival index, the the community periodontal index, presence of plaque-related gingivitis, and marginal periodontitis. During the HSCT period, patients were examined daily for the presence of OM, which was graded according to World Health Organization (WHO) classification if present. The patients were assigned to the groups according to type of transplantation: autologous HSCT, myeloablative allogeneic HSCT, and non-myeloablative allogeneic HSCT. Results: A total of 496 patients were included in the study. OM was present in 314 of 496 patients (63.3%): 184/251 (73.3%) in the autologous group, 100/151 (66.2%) in the myeloablative allogeneic group, and 30/94 (31.9%) in the nonmyeloablative allogeneic group. Significantly more patients suffered from OM in the autologous and myeloablative groups versus the nonmyeloablative conditioning group (p < 0.001). The presence of periodontal inflammation did not significantly differ among the groups. There was only a borderline trend for the higher prevalence of OM in the non-myeloablative allogeneic nonmyeloablative group when periodontal inflammation was present (0.073939). Conclusions: Oral mucositis prevalence and severity after stem cell transplantation is not widely affected by the oral hygiene and periodontal disease presence before HSCT. We confirmed the wide-known connection of the conditioning regimen intensity to the prevalence of OM.
The Relationship between Initial Tacrolimus Metabolism Rate and Recipients Body Composition in Kidney Transplantation
Authors: Kolonko Aureliusz , Pokora Patrycja , Słabiak-Błaż Natalia , Czerwieńska Beata , Karkoszka Henryk , Kuczera Piotr , Piecha Grzegorz , Więcek Andrzej
Published: December 2021

There are several premises that the body composition of kidney transplant recipients may play a role in tacrolimus metabolism early after transplantation. The present study aimed at analyzing the relationship between the body composition parameters assessed by bioimpedance analysis (BIA) and initial tacrolimus metabolism. Immediately prior to transplantation, BIA using InBody 770 device was performed in 122 subjects. Tacrolimus concentration-to-dose (C/D) ratio was calculated based on the first blood trough level measurement. There was no difference in phase angle, visceral fat area, lean body mass index (LBMI) and the proportion of lean mass as a percentage of total body mass between the subgroups of slow and fast metabolizers. However, subjects with LBMI ≥ median value of 18.7 kg/m2, despite similar initial tacrolimus dose per kg of body weight, were characterized by a significantly lower tacrolimus C/D ratio (median 1.39 vs. 1.67, respectively; p < 0.05) in comparison with the subgroup of lower LBMI. Multivariate regression analysis confirmed that age (rpartial = 0.322; p < 0.001) and LBMI (rpartial = −0.254; p < 0.01) independently influenced the tacrolimus C/D ratio. A LBMI assessed by BIA may influence the tacrolimus metabolism in the early post-transplant period and can be a useful in the optimization of initial tacrolimus dosing.
Immunohistochemical Expression of Wnt-4 Protein in Clear Cell Renal Carcinoma
Authors: Pavlovic Oliver , Hudolin Tvrtko , Miskulin Ivan , Bulimbasic Stela , Coric Marijana , Perkovic Josip , Zekulic Toni
Published: December 2021

Wingless binding integration site proteins (Wnt) have an important role in normal kidney development and in various kidney diseases. They are required for complete epithelial differentiation and normal nephron formation. Changes in these proteins could also have important role in carcinogenesis. This study included 185 patients with clear cell renal carcinoma (ccRCC) in whom immunohistochemical expression of Wnt-4 protein in healthy and tumorous tissue after surgery was investigated. There was higher expression of Wnt-4 in healthy than in tumor tissue. No difference between Fuhrman’s grade and Wnt-4 expression was found. A poor negative correlation between tumor size and Wnt-4 expression was found. Patients with suspected metastatic diseases had higher Wnt-4 expression. There was no difference in survival rates between Wnt-4 negative and positive groups. In our study we have shown that high Wnt-4 expression in healthy tissue decreases in low-grade tumors but then increases in high-grade tumors, suggesting that tumor progression requires Wnt-4 activation or reactivation.
Radiographs and MRI of the Cervical Spine in Juvenile Idiopathic Arthritis: A Cross-Sectional Retrospective Study
Authors: Kotecki Mateusz , Gietka Piotr , Posadzy Magdalena , Sudoł-Szopińska Iwona
Published: December 2021

Background: Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease among children. In some patients, cervical spine arthritis remains a serious and chronic manifestation of JIA. The aim of this study was to assess the frequency of cervical spine lesions on radiographs and MRI in JIA patients with clinical signs of cervical spine involvement and to verify if with the addition of MRI, the use of radiographs could be abandoned. Methods: This retrospective study evaluated consecutive 34 children (25 girls; aged 6–18 years, median 15.5 years) with JIA and with clinical involvement of cervical spine. In each patient, both radiographs and MRI of the cervical spine were performed. Imaging findings were correlated with clinical and laboratory data. Results: The cervical spine was affected in 35% of patients. The most frequent lesions were subaxial subluxations (SAS; 24%), apophyseal joint ankylosis (9%), and C1/C2 joint lesions (9%). Anterior atlanto-axial subluxation (AAS) was diagnosed only by radiography, and most of the SAS were seen on radiography, whereas only a few on MRI. Reversely, C1/C2 soft tissue involvement were seen on MRI only. Cervical spine involvement was associated with raised ESR (p = 0.012) and CRP (p = 0.014). Conclusions: The cervical spine lesions are still frequent complication of JIA affecting up to 35% of JIA patients. Most of them develop serious complications, such as AAS and ankylosis. Despite advantages of MRI in terms of the imaging of the atlanto-axial region radiography shows superiority in diagnosis of AAS and SAS.
Long COVID a New Derivative in the Chaos of SARS-CoV-2 Infection: The Emergent Pandemic?
Authors: Fernández-Lázaro Diego , Sánchez-Serrano Nerea , Mielgo-Ayuso Juan , García-Hernández Juan Luis , González-Bernal Jerónimo J. , Seco-Calvo Jesús
Published: December 2021

Coronavirus disease 2019 (COVID-19) is a multisystem illness caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), which can manifest with a multitude of symptoms in the setting of end-organ damage, though it is predominantly respiratory. However, various symptoms may remain after acute SARS-CoV-2 infection, and this condition is referred to as “Long COVID” (LC). Patients with LC may develop multi-organ symptom complex that remains 4–12 weeks after the acute phase of illness, with symptoms intermittently persisting over time. The main symptoms are fatigue, post-exertional malaise, cognitive dysfunction, and limitation of functional capacity. Pediatric patients developed the main symptoms of LC like those described in adults, although there may be variable presentations of LC in children. The underlying mechanisms of LC are not clearly known, although they may involve pathophysiological changes generated by virus persistence, immunological alterations secondary to virus–host interaction, tissue damage of inflammatory origin and hyperactivation of coagulation. Risk factors for developing LC would be female sex, more than five early symptoms, early dyspnea, previous psychiatric disorders, and alterations in immunological, inflammatory and coagulation parameters. There is currently no specific treatment for LC, but it could include pharmacological treatments to treat symptoms, supplements to restore nutritional, metabolic, and gut flora balance, and functional treatments for the most disabling symptoms. In summary, this study aims to show the scientific community the current knowledge of LC.
Measuring and Predicting Maturity to Parenthood: What Has Personality Got to Do with It?
Authors: Łada-Maśko Ariadna Beata , Kaźmierczak Maria
Published: December 2021

Maturity to parenthood is essential for taking on parental roles but remains an understudied issue. Still, close relations between maturity and personality dimensions are commonly emphasized. Thus, conducting research on maturity in context of personality seems a valuable research direction. The present research consists of two studies, focusing on the development and validation of Maturity to Parenthood Scale (MPS), in relation to personality, emotional regulation, coping with challenges, and intimate relationship satisfaction. In both studies, childless adults aged 20–35 years took part: (1) 718 participants (Mage = 25.49; SD = 2.89; 479 women), (2) 150 participants (Mage = 23.69; SD = 3.15; 104 women). All the participants had been in an intimate relationship for at least six months at the time of the study, the majority declared their willingness to have children in the future, had higher education, and were professionally active. The results showed that MPS is a reliable, valid measure comprising the following three subscales: valence, behavioral, and cognitive–emotional maturity to parenthood. The findings also confirmed the importance of broad- and narrow-band individual differences and contextual factors for maturity. MPS may be used in psychoeducation, supporting the transition to biological or adoptive/foster parenthood, as well as in medical and psychological care.
Alpha Smooth Muscle Actin (αSMA) Immunohistochemistry Use in the Differentiation of Pancreatic Cancer from Chronic Pancreatitis
Authors: Winter Katarzyna , Dzieniecka Monika , Strzelczyk Janusz , Wągrowska-Danilewicz Małgorzata , Danilewicz Marian , Małecka-Wojciesko Ewa
Published: December 2021

Aim: Fibrosis is observed both in pancreatic cancer (PDAC) and chronic pancreatitis (CP). The main cells involved in fibrosis are pancreatic stellate cells (PSCs), which activate alpha smooth muscle actin (αSMA), which is considered to be the best-known fibrosis marker. The aim of the study was to evaluate the expression of the αSMA in patients with PDAC and CP as the possible differentiation marker. Methods: We enrolled 114 patients undergoing pancreatic resection: 83 with PDAC and 31 with CP. Normal fragments of resected specimen from 21 patients represented the control tissue. The immunoexpressions of αSMA were detected in tissue specimens with immunohistochemistry (Abcam antibodies, GB). Results: Mean cytoplasmatic expression of αSMA protein in PDAC stromal cells was significantly higher compared to CP: 2.42 ± 0.37 vs 1.95 ± 0.45 (p < 0.01) and control group 0.61 ± 0.45 (p < 0.01). Strong immunoexpression of the αSMA protein was found in the vast majority (80.7%) of patients with PDAC, in about half (58%) of patients with CP, and not at all in healthy tissue. The expression of αSMA of different intensity was found in all patients with PDAC and CP, while in healthy tissue was minimal or absent. In PDAC patients, αSMA expression was significantly higher in tumors of diameter higher than 3 cm compared to smaller ones (p = 0.017). Conclusions: Presented findings confirm the significant role of fibrosis in both PDAC and CP; however, they do not confirm the role of αSMA as a marker of differentiation.
Physician-Led Thoracic Trauma Management in a Specialist Emergency Care Centre
Authors: Bates-Powell Jonathan , Basterfield David , Jackson Karl , Aujayeb Avinash
Published: December 2021

Introduction: Falls cause 75% of trauma in patients above 65 years of age, and thoracic trauma is the second commonest injury; rib fractures are the most common thoracic injury. These patients have up to 12% mortality, with 31% developing pneumonias. There is wide variation in care. Northumbria Healthcare has a team of respiratory consultants, physiotherapists, specialist nurses and anesthetists for thoracic-trauma management on a respiratory support unit. Methods: With Caldicott approval, basic demographics and clinical outcomes of patients admitted with thoracic trauma between 20 August–21 April were analyzed. A descriptive statistical methodology was applied. Results: A total of 119 patients were identified with a mean age of 71.1 years (range 23–97). Of the 119 patients, 53 were male, 66 females. The main mechanism of injury was falls from standing (65) and falls down stairs/bed or in the bath (18). Length of stay was 7.3 days (range 1–54). In total, 85 patients had more than one co-morbidity, 26 had a full trauma assessment and 75 had pan CTs. The mean number of rib fractures was 3.6 and 31 (26%) patients had a pneumothorax and/or haemothorax. A total of 18 chest drains were inserted (all small bore) and one needle aspiration was performed. No cardiothoracic input was required. Isolated chest trauma was present only in 45 patients. All patients had a pain team review, 22 erector spinae catheters were inserted with 2 paravertebral blocks. Overall, 82 patients did not require oxygen, 1 required CPAP and 1 HFNC. 7 needed intensive care transfer. Furthermore, 20 (17%) developed pneumonias and 16 (14%) deaths occurred within 30 days—all were in those with falls from standing. There was no correlation between number of fractured ribs, length of stay and mortality. Conclusions: High level care for thoracic trauma can be performed by a physician led team. Overall, 42% pneumothoraces/haemothoraces were observed. Further large scale randomised trials are warranted for definitive outcomes.
Portal Vein Pulsatility as a Dynamic Marker of Venous Congestion Following Cardiac Surgery: An Interventional Study Using Positive End-Expiratory Pressure
Authors: Huette Pierre , Guinot Pierre-Grégoire , Haye Guillaume , Moussa Mouhamed Djahoum , Beyls Christophe , Guilbart Mathieu , Martineau Lucie , Dupont Hervé , Mahjoub Yazine , Abou-Arab Osama
Published: December 2021

We aimed to assess variations in the portal vein pulsatility index (PI) during mechanical ventilation following cardiac surgery. Method. After ethical approval, we conducted a prospective monocentric study at Amiens University Hospital. Patients under mechanical ventilation following cardiac surgery were enrolled. Doppler evaluation of the portal vein (PV) was performed by transthoracic echography. The maximum velocity (VMAX) and minimum velocity (VMIN) of the PV were measured in pulsed Doppler mode. The PI was calculated using the following formula (VMAX − VMIN)/(VMax). A positive end-expiratory pressure (PEEP) incremental trial was performed from 0 to 15 cmH2O, with increments of 5 cmH2O. The PI (%) was assessed at baseline and PEEP 5, 10, and 15 cmH2O. Echocardiographic and hemodynamic parameters were recorded. Results. In total, 144 patients were screened from February 2018 to March 2019 and 29 were enrolled. Central venous pressure significantly increased for each PEEP increment. Stroke volumes were significantly lower after PEEP incrementation, with 52 mL (50–55) at PEEP 0 cmH2O and 30 mL (25–45) at PEEP 15 cmH2O, (p < 0.0001). The PI significantly increased with PEEP incrementation, from 9% (5–15) at PEEP 0 cmH2O to 15% (5–22) at PEEP 5 cmH2O, 34% (23–44) at PEEP 10 cmH2O, and 45% (25–49) at PEEP 15 cmH2O (p < 0.001). Conclusion. In the present study, PI appears to be a dynamic marker of the interaction between mechanical ventilation and right heart pressure after cardiac surgery. The PI could be a useful noninvasive tool to monitor venous congestion associated with mechanical ventilation.
Early Diagnosis and Real-Time Monitoring of Regional Lung Function Changes to Prevent Chronic Obstructive Pulmonary Disease Progression to Severe Emphysema
Authors: Jung Tony , Vij Neeraj
Published: December 2021

First- and second-hand exposure to smoke or air pollutants is the primary cause of chronic obstructive pulmonary disease (COPD) pathogenesis, where genetic and age-related factors predispose the subject to the initiation and progression of obstructive lung disease. Briefly, airway inflammation, specifically bronchitis, initiates the lung disease, leading to difficulty in breathing (dyspnea) and coughing as initial symptoms, followed by air trapping and inhibition of the flow of air into the lungs due to damage to the alveoli (emphysema). In addition, mucus obstruction and impaired lung clearance mechanisms lead to recurring acute exacerbations causing progressive decline in lung function, eventually requiring lung transplant and other lifesaving interventions to prevent mortality. It is noteworthy that COPD is much more common in the population than currently diagnosed, as only 16 million adult Americans were reported to be diagnosed with COPD as of 2018, although an additional 14 million American adults were estimated to be suffering from COPD but undiagnosed by the current standard of care (SOC) diagnostic, namely the spirometry-based pulmonary function test (PFT). Thus, the main issue driving the adverse disease outcome and significant mortality for COPD is lack of timely diagnosis in the early stages of the disease. The current treatment regime for COPD emphysema is most effective when implemented early, on COPD onset, where alleviating symptoms and exacerbations with timely intervention(s) can prevent steep lung function decline(s) and disease progression to severe emphysema. Therefore, the key to efficiently combatting COPD relies on early detection. Thus, it is important to detect early regional pulmonary function and structural changes to monitor modest disease progression for implementing timely interventions and effectively eliminating emphysema progression. Currently, COPD diagnosis involves using techniques such as COPD screening questionnaires, PFT, arterial blood gas analysis, and/or lung imaging, but these modalities are limited in their capability for early diagnosis and real-time disease monitoring of regional lung function changes. Hence, promising emerging techniques, such as X-ray phase contrast, photoacoustic tomography, ultrasound computed tomography, electrical impedance tomography, the forced oscillation technique, and the impulse oscillometry system powered by robust artificial intelligence and machine learning analysis capability are emerging as novel solutions for early detection and real time monitoring of COPD progression for timely intervention. We discuss here the scope, risks, and limitations of current SOC and emerging COPD diagnostics, with perspective on novel diagnostics providing real time regional lung function monitoring, and predicting exacerbation and/or disease onset for prognosis-based timely intervention(s) to limit COPD–emphysema progression.
Comparison between Dexamethasone and Methylprednisolone Therapy in Patients with COVID-19 Pneumonia Admitted to Non-Intensive Medical Units
Authors: Buso Roberta , Cinetto Francesco , Dell’Edera Alessandro , Veneran Nicola , Facchini Cesarina , Biscaro Valeria , Schiavon Stefania , Vian Elisa , Grossi Ugo , Zanus Giacomo , Giobbia Mario , Scarpa Riccardo , Agostini Carlo , Rattazzi Marcello , Felice Carla
Published: December 2021

(1) Background: Data on different steroid compounds for the treatment of hospitalized COVID-19 (coronavirus disease 2019) patients are still limited. The aim of this study was to compare COVID-19 patients admitted to non-intensive units and treated with methylprednisolone or dexamethasone. (2) Methods: This was a single-center retrospective study that included consecutive patients with COVID-19 hospitalized in medical wards during the second wave of the pandemic. Thirty-day mortality and the need for intensive or semi-intensive care were the main clinical outcomes analyzed in patients receiving methylprednisolone (60 mg/day) compared with dexamethasone (6 mg/day). Secondary outcomes included complication rates, length of hospital stay, and time to viral clearance. (3) Results: Two-hundred-forty-six patients were included in the analysis, 110 treated with dexamethasone and 136 with methylprednisolone. No statistically significant differences were found between the two groups of patients regarding 30-day mortality (OR 1.35, CI95% 0.71–2.56, p = 0.351) and the need for intensive or semi-intensive care (OR 1.94, CI95% 0.81–4.66, p = 0.136). The complication rates, length of hospital stay, and time to viral clearance did not significantly differ between the two groups. (4) Conclusions: In patients hospitalized for COVID-19 in non-intensive units, the choice of different steroid compounds, such as dexamethasone or methylprednisolone, did not affect the main clinical outcomes.
Effect of the Renin-Angiotensin-Aldosterone System Reactivity on Endothelial Function and Modulative Role of Valsartan in Male Subjects with Essential Hypertension
Authors: Jasiczek Jakub , Trocha Małgorzata , Derkacz Arkadiusz , Szahidewicz-Krupska Ewa , Doroszko Adrian
Published: December 2021

Background: The aim of the study was to evaluate the relationship between renin-angiotensin-aldosterone (RAA) system activity and reactivity, and the endothelial function profile in normotensive subjects (N), and in essential hypertensives (H), followed by analysis of the modulatory role of an angiotensin receptor blocker (ARB): valsartan, administered in the management of hypertension. Methods: A total of 101 male subjects were enrolled to the study: 31H and 70N. The nitric-oxide (NO) bioavailability (l-Arginine, asymmetric dimethylarginine (ADMA)), symmetric dimethylarginine (SDMA), endothelial vasodilative function (flow mediated dilation (FMD)), oxidative-stress markers (malonyldialdehyde (MDA), thiol index (GSH/GSSG), nitrotyrozine (N-Tyr)), and pro-inflammatory/angiogenic parameters (sICAM-1, sVCAM-1, PAI-1, sE-selectin, PAI-1, thromboxane -B2) were assessed at baseline, then after intravenous -l-arginine administration, which was repeated after the 4-day acetylsalicylic acid (ASA) administration (75 mg/24 h). In hypertensives, this whole protocol was repeated following 2 weeks of valsartan therapy. Results: No effect of valsartan and ASA on the flow-mediated vasodilation (FMD) and the NO bioavailability in hypertensives was observed. Administration of valsartan increased plasma renin activity (PRA), but without a decrease in the aldosterone levels. ASA treatment minimized the pre-existing differences between the groups, and increased the PRA in the N-subgroup with the highest ARR values. The blood concentrations of proinflammatory sICAM-1, sE-selectin, sVCAM-1, and PAI-1 were higher, whereas the anti-inflammatory 6-keto-PGF1 alpha level was lower in hypertensive subjects. The levels of angiogenic VEGF did not differ between groups. Conclusions: Our study does not confirm the modulative effect of valsartan on endothelial function. Normotensive men showed an increase in FMD after l-arginine administration, possibly indicating baseline impairment of the NO synthesis.
SARS-CoV-2 Infection in Patients on Dialysis: Incidence and Outcomes in the Lazio Region, Italy
Authors: Marino Claudia , Angelici Laura , Pistolesi Valentina , Morabito Santo , Di Napoli Anteo , Calandrini Enrico , Cascini Silvia , Bargagli Anna Maria , Petrosillo Nicola , Agabiti Nera , Davoli Marina ,   on behalf of the Regional Registry Dialysis and Transplant Lazio Region
Published: December 2021

Patients with end-stage kidney disease represent a frail population and might be at higher risk of SARS-CoV-2 infection. The Lazio Regional Dialysis and Transplant Registry collected information on dialysis patients with a positive swab. The study investigated incidence of SARS-CoV-2 infection, mortality and their potential associated factors in patients undergoing maintenance hemodialysis (MHD) in the Lazio region. Method: The occurrence of infection was assessed among MHD patients included in the RRDTL from 1 March to 30 November 2020. The adjusted cumulative incidence of infection and mortality risk within 30 days of infection onset were estimated. Logistic and Cox regression models were applied to identify factors associated with infection and mortality, respectively. Results: The MHD cohort counted 4942 patients; 256 (5.2%) had COVID-19. The adjusted cumulative incidence was 5.1%. Factors associated with infection included: being born abroad, educational level, cystic renal disease/familial nephropathy, vascular disease and being treated in a dialysis center located in Local Health Authority (LHA) Rome 2. Among infected patients, 59 (23.0%) died within 30 days; the adjusted mortality risk was 21.0%. Factors associated with 30-day mortality included: age, malnutrition and fever at the time of swab. Conclusions: Factors associated with infection seem to reflect socioeconomic conditions. Factors associated with mortality, in addition to age, are related to clinical characteristics and symptoms at the time of swab.
FPGA Implementation of Mutual Authentication Protocol for Medication Security System
Authors: Lin Wei-Chen , Huang Po-Kai , Pan Chung-Long , Huang Yu-Jung
Published: December 2021

Medication safety administration is a complicated process involving the information of patients, drugs, and data storage. The sensitive data transmitted through wireless sensor networks (WSNs) from Internet of things (IoT) over an insecure channel is vulnerable to several threats and needs proper attention to be secured from adversaries. Taking medication safety into consideration, this paper presents a secure authentication protocol for wireless medical sensor networks. The XOR scheme-based algorithm is applied to achieve the purposes of data confidentiality. The proposed architecture is realized as hardware in a field-programmable gate array (FPGA) device which acts as a secure edge computing device. The performance of the proposed protocol is evaluated and simulated via Verilog hardware description language. The functionality of the proposed protocol is verified using the Altera Quartus II software tool and implemented in the Altera Cyclone II DE2-70 FPGA development module. Furthermore, the output signals from the FPGA are measured in the 16702A logic analyzer system to demonstrate real-time functional verification.
Detecting Process Anomalies in the GMAW Process by Acoustic Sensing with a Convolutional Neural Network (CNN) for Classification
Authors: Rohe Maximilian , Stoll Benedict Niklas , Hildebrand Jörg , Reimann Jan , Bergmann Jean Pierre
Published: December 2021

Today, the quality of welded seams is often examined off-line with either destructive or non-destructive testing. These test procedures are time-consuming and therefore costly. This is especially true if the welds are not welded accurately due to process anomalies. In manual welding, experienced welders are able to detect process anomalies by listening to the sound of the welding process. In this paper, an approach to transfer the “hearing” of an experienced welder into an automated testing process is presented. An acoustic measuring device for recording audible sound is installed for this purpose on a fully automated welding fixture. The processing of the sound information by means of machine learning methods enables in-line process control. Existing research results until now show that the arc is the main sound source. However, both the outflow of the shielding gas and the wire feed emit sound information. Other investigations describe welding irregularities by evaluating and assessing existing sound recordings. Descriptive analysis was performed to find a connection between certain sound patterns and welding irregularities. Recent contributions have used machine learning to identify the degree of welding penetration. The basic assumption of the presented investigations is that process anomalies are the cause of welding irregularities. The focus was on detecting deviating shielding gas flow rates based on audio recordings, processed by a convolutional neural network (CNN). After adjusting the hyperparameters of the CNN it was capable of distinguishing between different flow rates of shielding gas.
Integrated Porosity Classification and Quantification Scheme for Enhanced Carbonate Reservoir Quality: Implications from the Miocene Malaysian Carbonates
Authors: Janjuhah Hammad , Kontakiotis George , Wahid Abdul , Khan Dost , Zarkogiannis Stergios , Antonarakou Assimina
Published: December 2021

The pore system in carbonates is complicated because of the associated biological and chemical activity. Secondary porosity, on the other hand, is the result of chemical reactions that occur during diagenetic processes. A thorough understanding of the carbonate pore system is essential to hydrocarbon prospecting. Porosity classification schemes are currently limited to accurately forecast the petrophysical parameters of different reservoirs with various origins and depositional environments. Although rock classification offers a way to describe lithofacies, it has no impact on the application of the poro-perm correlation. An outstanding example of pore complexity (both in terms of type and origin) may be found in the Central Luconia carbonate system (Malaysia), which has been altered by diagenetic processes. Using transmitted light microscopy, 32 high-resolution pictures were collected of each thin segment for quantitative examination. An FESEM picture and a petrographic study of thin sections were used to quantify the grains, matrix, cement, and macroporosity (pore types). Microporosity was determined by subtracting macroporosity from total porosity using a point-counting technique. Moldic porosity (macroporosity) was shown to be the predominant type of porosity in thin sections, whereas microporosity seems to account for 40 to 50% of the overall porosity. Carbonates from the Miocene have been shown to possess a substantial quantity of microporosity, making hydrocarbon estimate and production much more difficult. It might lead to a higher level of uncertainty in the estimation of hydrocarbon reserves if ignored. Existing porosity classifications cannot be used to better understand the poro-perm correlation because of the wide range of geological characteristics. However, by considering pore types and pore structures, which may be separated into macro- and microporosity, the classification can be enhanced. Microporosity identification and classification investigations have become a key problem in limestone reservoirs across the globe.
HESS in a Wind Turbine Generator: Assessment of Electric Performances at Point of Common Coupling with the Grid
Authors: Barelli Linda , Pelosi Dario , Ciupageanu Dana Alexandra , Ottaviano Panfilo Andrea , Longo Michela , Zaninelli Dario
Published: December 2021

Among Renewable Energy Sources (RES), wind energy is emerging as one of the largest installed renewable-power-generating capacities. The technological maturity of wind turbines, together with the large marine wind resource, is currently boosting the development of offshore wind turbines, which can reduce the visual and noise impacts and produce more power due to higher wind speeds. Nevertheless, the increasing penetration of wind energy, as well as other renewable sources, is still a great concern due to their fluctuating and intermittent behavior. Therefore, in order to cover the mismatch between power generation and load demand, the stochastic nature of renewables has to be mitigated. Among proposed solutions, the integration of energy storage systems in wind power plants is one of the most effective. In this paper, a Hybrid Energy Storage System (HESS) is integrated into an offshore wind turbine generator with the aim of demonstrating the benefits in terms of fluctuation reduction of the active power and voltage waveform frequency, specifically at the Point of Common Coupling (PCC). A MATLAB®/SimPowerSystems model composed of an offshore wind turbine interfaced with the grid through a full-scale back-to-back converter and a flywheel-battery-based HESS connected to the converter DC-link has been developed and compared with the case of storage absence. Simulations were carried out in reference to the wind turbine’s stress conditions and were selected—according to our previous work—in terms of the wind power step. Specifically, the main outcomes of this paper show that HESS integration allows for a reduction in the active power variation, when the wind power step is applied, to about 3% and 4.8%, respectively, for the simulated scenarios, in relation to more than 30% and 42% obtained for the no-storage case. Furthermore, HESS is able to reduce the transient time of the frequency of the three-phase voltage waveform at the PCC by more than 89% for both the investigated cases. Hence, this research demonstrates how HESS, coupled with renewable power plants, can strongly enhance grid safety and stability issues in order to meet the stringent requirements relating to the massive RES penetration expected in the coming years.
Reconstructing Maritime Incidents and Accidents Using Causal Models for Safety Improvement: Based on a Case Study
Authors: Gucma Lucjan , Androjna Andrej , Łazuga Kinga , Vidmar Peter , Perkovič Marko
Published: December 2021

No advance in navigation has yet to prevent the occurrence of accidents (incidents are always implied when we discuss accidents) at sea. At the same time, advances in accident models are possible, and may provide the basis for investigations and analyses to help prevent future adverse events and improve the safety of marine transport systems. In such complex socio-technical systems models that treat accidents as the result of a chain or sequence of events are used most commonly. Such models are well suited to damage caused by failure of physical components in relatively simple systems. Although these often include methods for modeling human error, they do not cover broader aspects related to the management of the organization using the means of transport itself (shipowners) nor errors that may occur in the design phase. In particular, they do not cover changes in the systems over time. The paper presents accident investigation approaches and uses a modified causal model to analyze an incident that occurred in January 2019 on the city ferry in Świnoujście. The results of the analysis were used to provide guidelines for increasing safety at the crossing and to evaluate the accident analysis model used. Additionally, incidentally, through the study of this case we uncovered a problem in communication among stakeholders that unnecessarily complicates the models for the models for the improvement of safety.
Scale Model Experiment on Local Scour around Submarine Pipelines under Bidirectional Tidal Currents
Authors: Zhang Zhiyong , Guo Yakun , Yang Yuanping , Shi Bing , Wu Xiuguang
Published: December 2021

In nearshore regions, bidirectional tidal flow is the main hydrodynamic factor, which induces local scour around submarine pipelines. So far, most studies on scour around submarine pipelines only consider the action of unidirectional, steady currents and little attention has been paid to the situation of bidirectional tidal currents. To deeply understand scour characteristics and produce a more accurate prediction method in bidirectional tidal currents for engineering application, a series of laboratory scale experiments were conducted in a bidirectional current flume. The experiments were carried out at a length scale of 1:20 and the tidal currents were scaled with field measurements from Cezhen pipeline in Hangzhou Bay, China. The experimental results showed that under bidirectional tidal currents, the scour depth increased significantly during the first half of the tidal cycle and it only increased slightly when the flow of the tidal velocity was near maximum flood or ebb in the following tidal cycle. Compared with scour under a unidirectional steady current, the scour profile under a bidirectional tidal current was more symmetrical, and the scour depth in a bidirectional tidal current was on average 80% of that under a unidirectional, steady current based on maximum peak velocity. Based on previous research and the present experimental data, a more accurate fitted equation to predict the tidally induced live-bed scour depth around submarine pipelines was proposed and has been verified using field data from the Cezhen pipeline.