bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of a Targeted Ambulance Treatment Quality Improvement Programme on Outcomes from Out-of-Hospital Cardiac Arrest: A Metropolitan Citywide Intervention Study
Authors: Dong Xuejie , Wang Liang , Xu Hanbing , Ye Yingfang , Zhou Zhenxiang , Zhang Lin
Published: December 2022

The performance of ambulance crew affects the quality of pre-hospital treatment, which is vital to the survival for out-of-hospital cardiac arrest (OHCA) patients, yet remains suboptimal in China. In this retrospective analysis study, we aimed to examine the effect of a citywide quality improvement programme on provision of prehospital advanced life support (ALS) by emergency medical service (EMS) system. EMS-treated adult OHCA patients after the implementation of the programme (1 January 2021 to 30 June 2022) were compared with historical controls (1 June 2019 to 31 August 2020) in Suzhou. Multivariable logistic regression analysis and propensity score matching procedures were applied to compare the outcomes between two periods for total OHCA cases and subgroup of cases treated by fixed or non-fixed ambulance crews. A total of 1465 patients (pre-period/post-period: 610/855) were included. In the 1:1 matched analysis of 591 cases for each period, significant improvement (p < 0.05) was observed for the proportion of intravenous (IV) access (23.4% vs. 68.2%), advanced airway management (49.2% vs. 57.0%), and return of spontaneous circulation (ROSC) at handover (5.4% vs. 9.0%). The fixed ambulance crews performed better than non-fixed group in IV access and advanced airway management for both periods. There were significant increases in IV access (AOR 12.66, 95%CI 9.02–18.10, p < 0.001), advanced airway management (AOR 1.67, 95% CI 1.30–2.16, p < 0.001) and ROSC at handover (AOR 2.37, 95%CI 1.38–4.23, p = 0.002) after intervention in unfixed group, while no significant improvement was observed in fixed group except for IV access (AOR 7.65, 95%CI 9.02–18.10, p < 0.001). In conclusion, the quality improvement program was positively associated with the provision of prehospital ALS interventions and prehospital ROSC following OHCA. The fixed ambulance crews performed better in critical care provision and prehospital outcome, yet increased protocol adherence and targeted training could fill the underperformance of non-fixed crews efficaciously.
Vertebral Fractures in Acromegaly: A Systematic Review
Authors: Sorohan Madalina Cristina , Poiana Catalina
Published: December 2022

Introduction: Acromegaly is characterized by a very particular alteration of bone microarchitecture, leading to increased vertebral fragility. However, due to inconsistent and insufficient evidence, no guidelines are available for the evaluation of this osteopathy. Methods: We performed a literature review of studies published between 1968 and January 2022 on the PubMed and SCOPUS databases using the terms “acromegaly” and “vertebral fractures”. Twenty-four studies were found eligible for inclusion, published between June 2005 and November 2021. Included studies evaluated acromegaly patients, who were assessed for the presence of vertebral fractures. We excluded case reports, reviews, meta-analyses, letters to the editor, articles not written in English, and research performed on the same set of patients without significant differences in study design. Risk of bias was avoided by following the ROBIS risk of bias recommendations. We executed rigorous data collection, and the results are depicted as a narrative overview, but also, as statistical synthesis. Limitations of the evidence presented in the study include study heterogeneity, small sample sizes, and a small number of prospective studies with short follow-up. Findings: Data regarding vertebral fractures (VFs) in acromegaly and their influencing factors are variable. Twenty-four studies were included, nine out of which had a prospective design. The smallest group of acromegaly patients had 18 subjects and the largest included 248 patients. Prevalence ranges between 6.5% and 87.1%, although most studies agree that it is significantly higher than in controls. VFs also have a higher incidence (between 5.6% and 42%) and are more frequently multiple (between 46.15% and 71%). Evidence shows that disease activity and active disease duration are influencing factors for the prevalence and incidence of VFs. Nonetheless, hypogonadism does not seem to influence the frequency of VFs. While reports are conflicting regarding the use of bone mineral density in acromegaly, evidence seems to be slightly in favor of it not being associated with VFs. However, trabecular bone score is significantly lower in fractured patients, although no prospective studies are available. Interpretation: Vertebral fractures evaluation should be performed with regularity in all acromegalic patients, especially in the presence of active disease. Disease activity is an important determinant of vertebral fracture incidence and prevalence, although hypogonadism is less so. To clarify the predictive value of both BMD and TBS for vertebral fractures, additional, larger, prospective studies are necessary.
Factors Influencing Driving following DBS Surgery in Parkinson’s Disease: A Single UK Centre Experience and Review of the Literature
Authors: Furlanetti Luciano , Baig Mirza Asfand , Raslan Ahmed , Velicu Maria Alexandra , Burford Charlotte , Akhbari Melika , German Elaine , Saha Romi , Samuel Michael , Ashkan Keyoumars
Published: December 2022

Parkinson’s disease (PD) is a complex neurodegenerative disorder, leading to impairment of various neurological faculties, including motor, planning, cognitivity, and executive functions. Motor- and non-motor symptoms of the disease may intensify a patient’s restrictions to performing usual tasks of daily living, including driving. Deep Brain Stimulation (DBS) associated with optimized clinical treatment has been shown to improve quality of life, motor, and non-motor symptoms in PD. In most countries, there are no specific guidelines concerning minimum safety requirements and the timing of return to driving following DBS, leaving to the medical staff of individual DBS centres the responsibility to draw recommendations individually regarding patients’ ability to drive after surgery. The aim of this study was to evaluate factors that might influence the ability to drive following DBS in the management of PD. A total of 125 patients were included. Clinical, epidemiological, neuropsychological, and surgical factors were evaluated. The mean follow-up time was 129.9 months. DBS improved motor and non-motor symptoms of PD. However, in general, patients were 2.8-fold less likely to drive in the postoperative period than prior to surgery. Among the PD characteristics, patients with the akinetic subtype presented a higher risk to lose their driving licence postoperatively. Furthermore, the presence of an abnormal postoperative neuropsychological evaluation was also associated with driving restriction following surgery. Our data indicate that restriction to drive following surgery seems to be multifactorial rather than a direct consequence of DBS itself. Our study sheds light on the urgent need for a standardised multidisciplinary postoperative evaluation to assess patients’ ability to drive following DBS.
Diabetic Kidney Disease versus Primary Glomerular Disease: A Propensity Score-Matched Analysis of Association between Ambulatory Blood-Pressure Monitoring and Target-Organ Damage
Authors: Yu Tiantian , Song Shicong , Chen Xiaoqiu , Lou Tanqi , Zhang Jun , Peng Hui , Li Man , Wang Cheng
Published: December 2022

Diabetic kidney disease (DKD) and primary glomerular disease (PGD) are the main causes of chronic kidney disease (CKD) and end-stage renal disease (ESRD). This study was conducted to compare the characteristics of ambulatory blood-pressure monitoring (ABPM) and its relationship with target-organ damage (TOD) in patients with DKD and PGD matched by propensity score. The assessment of TOD included macroalbuminuria, left ventricular hypertrophy (LVH) and macrovascular disease. Propensity-score weighting (PSW) was used in stratified analysis. Results: Patients with DKD had a higher prevalence of abnormal blood-pressure patterns such as reversed dipper pattern, nocturnal hypertension, and sustained hypertension and had a higher prevalence of TOD than did patients with PGD. Logistic regression indicated that patients with DKD were more related to TOD than to PGD. The stratified analysis indicated that DKD patients with white-coat hypertension, masked hypertension and sustained hypertension had closer relationships with TOD compared with PGD patients. Conclusion: Patients with type 2 diabetic kidney disease had more abnormal blood-pressure patterns and were more closely related to target organ damage than were patients with primary glomerular disease.
Evinacumab, an ANGPTL3 Inhibitor, in the Treatment of Dyslipidemia
Authors: Sosnowska Bożena , Adach Weronika , Surma Stanisław , Rosenson Robert S. , Banach Maciej
Published: December 2022

Familial hypercholesterolemia (FH) is an inherited disorder. The level of low-density lipoprotein cholesterol (LDL-C) in patients with homozygous FH can be twice as high as that in patients with heterozygous FH. The inhibition of ANGPTL3 shows an important therapeutic approach in reducing LDL-C and triglycerides (TG) levels and, thus, is a potentially effective strategy in the treatment of FH. Evinacumab is a monoclonal antibody inhibiting circulating ANGPTL3, available under the trade name Evkeeza® for the treatment of homozygous FH. It was reported that evinacumab is effective and safe in patients with homozygous and heterozygous FH, as well as resistant hypercholesterolemia and hypertriglyceridemia. This paper summarizes existing knowledge on the role of ANGPTL3, 4, and 8 proteins in lipoprotein metabolism, the findings from clinical trials with evinacumab, a fully human ANGPTL3 mAb, and the place for this new agent in lipid-lowering therapy.
To Inject or to Reject? The Body Image Perception among Aesthetic Dermatology Patients
Authors: Yurtsever Ida , Matusiak Łukasz , Szepietowski Jacek Cezary
Published: December 2022

Background: Nowadays, aesthetic dermatology treatment has become not only physical beautification but also it can have positive effects on patients’ mental health. Body dysmorphic disorder can be the reason for treatment dissatisfaction. In the general population, the prevalence of BDD is 1.9% and it is more common among cosmetic patients. The aim of this study was to conduct the most comprehensive evaluation of body image and BDD among aesthetic patients. Methods: We recruited a group of 412 individuals, who were asked to complete 6 different on-line questionnaires concerning self-image, i.e., COPS, AAI, FAS, BAS-2, BSQ-16, and RSES. Results: The prevalence of BDD ranged from 7.28% to 11.17%, depending on the screening tool that was used. Our research revealed that BDD susceptibility, body image, body appreciation, and self-esteem were strongly interrelated (p < 0.001). A higher BMI was a risk factor for BDD, body dissatisfaction, and depreciation. The financial status markedly influenced all of the features. A history of psychiatric treatment influenced the risk of BDD, body satisfaction, body appreciation, and self-esteem. A history of cosmetic procedures and treatment satisfaction had no impact on the obtained results. Conclusions: Improving recognition of body dissatisfaction among aesthetic patients is very important. The psychometric assessment of patients before cosmetic treatment could be of help in choosing the appropriate approach.
Recent Clinical and Preclinical Advances in External Stimuli-Responsive Therapies for Head and Neck Squamous Cell Carcinoma
Authors: Jiang Zheng , Yang Xin , Ainiwaer Mailudan , Chen Fei , Liu Jun
Published: December 2022

Head and neck squamous cell carcinoma (HNSCC) has long been one of the most prevalent cancers worldwide; even though treatments such as surgery, chemotherapy, radiotherapy and immunotherapy have been proven to benefit the patients and prolong their survival time, the overall five-year survival rate is still below 50%. Hence, the development of new therapies for better patient management is an urgent need. External stimuli-responsive therapies are emerging therapies with promising antitumor effects; therapies such as photodynamic (PDT) and photothermal therapies (PTT) have been tested clinically in late-stage HNSCC patients and have achieved promising outcomes, while the clinical translation of sonodynamic therapy (SDT), radiodynamic therapy (RDT), microwave dynamic/thermodynamic therapy, and magnetothermal/magnetodynamic therapy (MDT/MTT) still lag behind. In terms of preclinical studies, PDT and PTT are also the most extensively studied therapies. The designing of nanoparticles and combinatorial therapies of PDT and PTT can be referenced in designing other stimuli-responsive therapies in order to achieve better antitumor effects as well as less toxicity. In this review, we consolidate the advancements and limitations of various external stimuli-responsive therapies, as well as critically discuss the prospects of this type of therapies in HNSCC treatments.
Does Hysteroscopic Dissection of Partial Uterine Septum Represent a Risk Factor for Placental Abnormalities in Subsequent Pregnancy Compared with Controls Undergoing Other Hysteroscopic Surgery? Results from a Large Case–Control Analysis
Authors: Hajšek Pia , Riemma Gaetano , Korošec Sara , Laganà Antonio Simone , Chiantera Vito , Mikuš Mislav , Ban Frangež Helena
Published: December 2022

Background: Hysteroscopic septum dissection (HSD) is thought to improve fertility and pregnancy outcomes. However, the available literature suggests that uterine surgery can cause placental abnormalities in subsequent pregnancies. Methods: A case–control study was performed at the University Medical Center of Ljubljana, Department of Human Reproduction, from 1 January 2016 to 31 December 2018. The primary outcome was the association between HSD and the occurrence of placental abnormalities. We included women who underwent HSD due to infertility. Age-matched women who underwent hysteroscopic surgery for other issues were considered as controls. In addition, we divided the groups according to conception method. Only singleton pregnancies and first delivery were considered. Results: A total of 1286 women (746 who underwent HSD and 540 controls) were included in the analysis. HSD had no influence on placental abnormalities since the ratio was comparable regardless of the method of conception (113/746 vs. 69/540; p = 0.515). Infertile women who conceived naturally after HSD had a normal placentation rate comparable to women who did not undergo HSD (380/427 vs. 280/312; p = 0.2104). The rate of placental abnormalities in women who achieved pregnancy with IVF/ICSI procedures following HSD was comparable to that of women who did not undergo HSD (52/319 vs. 33/228; p = 0.5478). Placenta previa occurred significantly more often in infertile women without HSD after IVF/ICSI compared to natural conception (2/312 vs. 7/228; p = 0.0401). Conclusions: HSD was not associated with higher rate of placental abnormalities in the first singleton pregnancy compared with other hysteroscopic procedures. A higher rate of placenta previa in pregnancies following IVF/ICSI procedures, which was shown by our research, is corroborated by previous research findings.
Towards an Established Intraoperative Oncological Favorable Tool: Results of Fluorescein-Guided Resection from a Monocentric, Prospective Series of 93 Primary Glioblastoma Patients
Authors: Falco Jacopo , Rubiu Emanuele , Broggi Morgan , Farinotti Mariangela , Vetrano Ignazio , Schiariti Marco , Anghileri Elena , Eoli Marica , Pollo Bianca , Moscatelli Marco , Restelli Francesco , Mazzapicchi Elio , La Corte Emanuele , Bonomo Giulio , Gemma Marco , Broggi Giovanni , Ferroli Paolo , Acerbi Francesco
Published: December 2022

It is commonly reported that maximizing surgical resection of contrast-enhancing regions in patients with glioblastoma improves overall survival. Efforts to achieve an improved rate of resection have included several tools: among those, the recent widespread of fluorophores. Sodium fluorescein is an unspecific, vascular dye which tends to accumulate in areas with an altered blood–brain barrier. In this retrospective analysis of patients prospectively enrolled in the FLUOCERTUM study, we aimed to assess the role of fluorescein-guided surgery on surgical radicality, survival, and morbidity. A retrospective review based on 93 consecutively and prospectively enrolled IDH wild-type glioblastoma patients (2016–2022) was performed; fluorescence characteristics, rate of resection, clinical outcome, and survival were analyzed. No side effect related to fluorescein occurred; all of the tumors presented a strong yellow-green enhancement and fluorescein was judged fundamental in distinguishing tumors from viable tissue in all cases. Gross total resection was achieved in 77 cases out of 93 patients (82.8%). After a mean follow-up time of 17.4 months (3–78 months), the median progression-free survival was 12 months, with a PFS-6 and PFS-12 of 94.2% and 50%, respectively, whereas median overall survival was estimated to be 16 months; survival at 6, 12, and 24 months was 91.8%, 72.3%, and 30.1%, respectively. Based on these results, we can assert that the fluorescein-guided technique is a safe and valuable method for patients harboring a newly diagnosed, untreated glioblastoma.
Prediction of Subsequent Contralateral Patellar Dislocation after First-Time Dislocation Based on Patellofemoral Morphologies
Authors: Chen Jiaxing , Li Qiaochu , Liu Sizhu , Fan Lin , Yin Baoshan , Yang Xinyu , Wang Linbang , Xu Zijie , Zhang Jian , Quan Zhengxue , Zhou Aiguo
Published: December 2022

The subsequent dislocation of a contralateral patellofemoral joint sometimes occurs after a first-time lateral patellar dislocation (LPD). However, the anatomic risk factors for subsequent contralateral LPD remain elusive. This study included 17 patients with contralateral LPD and 34 unilateral patellar dislocators. The anatomic parameters of the contralateral patellofemoral joints were measured using CT images and radiographs that were obtained at the time of the first dislocation. The Wilcoxon rank-sum test was performed, and a binary regression model was established to identify the risk factors. The receiver operating characteristic curves and the area under the curve (AUC) were analyzed. The tibial tubercle-Roman arch (TT-RA) distance was significantly different between patients with and without contralateral LPD (24.1 vs. 19.5 mm, p < 0.001). The hip–knee–ankle (HKA) angle, patellar tilt, congruence angle, and patellar displacement were greater in the study group than in the control group (p < 0.05). The TT-RA distance revealed an OR of 1.35 (95% CI (1.26–1.44]), p < 0.001) and an AUC of 0.727 for predicting contralateral LPD. The HKA angle revealed an OR of 1.74 (95% CI (1.51–2.00), p < 0.001) and an AUC of 0.797. The Patellar tilt, congruence angle, and patellar displacement had AUC values of 0.703, 0.725, and 0.817 for predicting contralateral LPD, respectively. In conclusion, the contralateral patellofemoral anatomic parameters were significantly different between patients with and without subsequent contralateral LPD. Increased TT-RA distance and excessive valgus deformity were risk factors and could serve as predictors for contralateral LPD. At first-time dislocation, the abnormal position of the patella relative to the trochlea may also be an important cause of subsequent LPD.
Deep Learning with a Dataset Created Using Kanno Saitama Macro, a Self-Made Automatic Foveal Avascular Zone Extraction Program
Authors: Kanno Junji , Shoji Takuhei , Ishii Hirokazu , Ibuki Hisashi , Yoshikawa Yuji , Sasaki Takanori , Shinoda Kei
Published: December 2022

The extraction of the foveal avascular zone (FAZ) from optical coherence tomography angiography (OCTA) images has been used in many studies in recent years due to its association with various ophthalmic diseases. In this study, we investigated the utility of a dataset for deep learning created using Kanno Saitama Macro (KSM), a program that automatically extracts the FAZ using swept-source OCTA. The test data included 40 eyes of 20 healthy volunteers. For training and validation, we used 257 eyes from 257 patients. The FAZ of the retinal surface image was extracted using KSM, and a dataset for FAZ extraction was created. Based on that dataset, we conducted a training test using a typical U-Net. Two examiners manually extracted the FAZ of the test data, and the results were used as gold standards to compare the Jaccard coefficients between examiners, and between each examiner and the U-Net. The Jaccard coefficient was 0.931 between examiner 1 and examiner 2, 0.951 between examiner 1 and the U-Net, and 0.933 between examiner 2 and the U-Net. The Jaccard coefficients were significantly better between examiner 1 and the U-Net than between examiner 1 and examiner 2 (p < 0.001). These data indicated that the dataset generated by KSM was as good as, if not better than, the agreement between examiners using the manual method. KSM may contribute to reducing the burden of annotation in deep learning.
The Risk of BPPV, Meniere’s Disease, and Vestibular Neuronitis in Patients with Gout: A Longitudinal Follow-Up Study Using a National Health Screening Cohort
Authors: Choi Hyo Geun , Kim So Young , Chung Juyong
Published: December 2022

This study evaluated the impact of pre-existing gout on the occurrence of benign paroxysmal positional vertigo (BPPV), Meniere’s disease, and vestibular neuronitis, with the goal of identifying novel associations of gout with other comorbid diseases. The 2002–2019 Korean National Health Insurance Service Health Screening Cohort data were retrospectively analyzed. 23,827 patients with gout were matched to 95,268 controls without gout for age, sex, income, region of residence, and index date. The occurrence of BPPV, Meniere’s disease, and vestibular neuronitis was evaluated in both groups. The hazard ratios (HRs) of gout for BPPV, Meniere’s disease, and vestibular neuronitis were calculated using a stratified Cox proportional hazard model. Participants with gout demonstrated a 1.13-fold higher risk of BPPV (95% CI, 1.06–1.21, p < 0.001) and a 1.15-fold higher risk of Meniere’s disease (95% CI, 1.15–1.37, p < 0.001) than the matched control group. However, the HR for vestibular neuronitis was not significantly higher in the gout group (adjusted HR = 1.06, 95% CI, 0.93–1.21, p = 0.391). A previous history of gout was related to a higher risk of BPPV and Meniere’s disease. Additional studies are necessary to elucidate the mechanism underlying the relationship between gout and comorbid diseases such as BPPV and Meniere’s disease.
Mid- and Long-Term Atrio-Ventricular Functional Changes in Children after Recovery from COVID-19
Authors: Sabatino Jolanda , Di Chiara Costanza , Di Candia Angela , Sirico Domenico , Donà Daniele , Fumanelli Jennifer , Basso Alessia , Pogacnik Pietro , Cuppini Elena , Romano Letizia Rosa , Castaldi Biagio , Reffo Elena , Cerutti Alessia , Biffanti Roberta , Cozzani Sandra , Giaquinto Carlo , Di Salvo Giovanni
Published: December 2022

Background: Although most children may experience mild to moderate symptoms and do not require hospitalization, there are little data on cardiac involvement in COVID-19. However, cardiac involvement is accurately demonstrated in children with MISC. The objective of this study was to evaluate cardiac mechanics in previously healthy children who recovered from severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection in a long-term follow-up by means of two-dimensional speckle-tracking echocardiography (STE). Methods: We analyzed a cohort of 157 paediatric patients, mean age 7.7 ± 4.5 years (age range 0.3–18 years), who had a laboratory-confirmed diagnosis of SARS-CoV-2 infection and were asymptomatic or mildly symptomatic for COVID-19. Patients underwent a standard transthoracic echocardiogram and STE at an average time of 148 ± 68 days after diagnosis and were divided in three follow-up groups (<180 days, 180–240 days, >240 days). Patients were compared with 107 (41 females—38%) age- and BSA-comparable healthy controls (CTRL). Results: Left ventricular (LV) global longitudinal strain (post-COVID-19: −20.5 ± 2.9%; CTRL: −21.8 ± 1.7%; p < 0.001) was significantly reduced in cases compared with CTRLs. No significant differences were seen among the three follow-up groups (p = NS). Moreover, regional longitudinal strain was significantly reduced in LV apical-wall segments of children with disease onset during the second wave of the COVID-19 pandemic compared to the first wave (second wave: −20.2 ± 2.6%; first wave: −21.2 ± 3.4%; p = 0.048). Finally, peak left atrial systolic strain was within the normal range in the post-COVID-19 group with no significant differences compared to CTRLs. Conclusions: Our study demonstrated for the first time the persistence of LV myocardial deformation abnormalities in previously healthy children with an asymptomatic or mildly symptomatic (WHO stages 0 or 1) COVID-19 course after an average follow-up of 148 ± 68 days. A more significant involvement was found in children affected during the second wave. These findings imply that subclinical LV dysfunction may also be a typical characteristic of COVID-19 infection in children and are concerning given the predictive value of LV longitudinal strain in the general population.
Comparison of Visual and Aberrometric Outcomes in Suture-Free Scleral Fixation: Three-Piece Lenses versus Carlevale Lenses
Authors: Franco Fabrizio , Serino Federica , Vicini Giulio , Nicolosi Cristina , Giansanti Fabrizio
Published: December 2022

Purpose: To compare the refractive results between sutureless scleral fixation intraocular lens (IOLs) (Carlevale, Soleko) and suture-free scleral fixation three-piece IOLs (Sensar AR40, Johnson & Johnson) for secondary implantation in patients with IOL dislocation or aphakia. Methods: This is a monocentric retrospective study on 28 patients (28 eyes) with sutureless scleral fixation Carlevale IOL and 25 patients (25 eyes) with suture-free scleral fixation three-piece IOL. Best-corrected visual acuity (BCVA) evaluation, refractive measures and IOL tilt evaluation with anterior segment optical coherence tomography were conducted at one, three, six and twelve months after surgery. Point Spread Function (PSF) was measured using a total ocular aberrometer. Results: BCVA in both groups improved since the postoperative visit at 1 month and reached a stable value at 3 months At month 12, mean BCVA was 0.23 logMAR in group one and 0.32 logMAR in group two. Mean IOL tilt angle at 12 months was 2.76° ± 1.87 in group one and 2.51° ± 1.80 in group two. PSF at 12 months was 0.18 ± 0.09 in group one and 0.15 ± 0.05 in group two. There were no statistically significant differences (p > 0.05) for all comparisons. The post-operative complications were similar within the two groups. Conclusions: Our results show that secondary IOL implantation has similar visual and surgical outcomes when a sutureless Carlevale lens scleral fixation and a suture-free scleral fixation three-piece IOL are used.
Open Globe Injury (OGI) with a Presence of an Intraocular Foreign Body (IOFB)—Epidemiology, Management, and Risk Factors in Long Term Follow-Up
Authors: Jabłoński Michał , Winiarczyk Mateusz , Biela Katarzyna , Bieliński Paweł , Jasielska Monika , Batalia Joanna , Mackiewicz Jerzy
Published: December 2022

The purpose of the study was to evaluate visual outcomes and consider management strategies in the eyes with an intraocular foreign body (IOFB). In a single-center, retrospective case-control study, 36 eyes of 36 patients who suffered from open globe injury (OGI) with IOFB were admitted to the Department of Vitreoretinal Surgery of Medical University of Lublin, Poland from January 2015 to December 2020. Most frequent primary procedure was the pars plana vitrectomy (PPV) with IOFB removal (n = 28). Retinal detachment (RD) developed in nine eyes soon after injury or as a further complication. Recurrent retinal detachment occurred in eight of these nine cases. Final VA 0.1 or better was observed in 21 eyes (58%). Fifteen patients had BCVA of less than 0.1. One eye was not included in the final VA assessment due to the short follow-up period. In 25 out of 28 patients who underwent any kind of pars plana vitrectomy (ppV) a BCVA of <0.4 was observed. The prognosis after an IOFB injury is uncertain due to multiple factors in a peri- and postoperative period. Factors predisposing to poor visual outcomes are: IOFB localization in the posterior segment, retinal detachment, vitreous hemorrhage and prolonged silicone oil tamponade.
Differential Diagnosis of Hyperferritinemia in Critically Ill Patients
Authors: Schuster Friederike S. , Nyvlt Peter , Heeren Patrick , Spies Claudia , Adam Moritz F. , Schenk Thomas , Brunkhorst Frank M. , Janka Gritta , La Rosée Paul , Lachmann Cornelia , Lachmann Gunnar
Published: December 2022

Background: Elevated serum ferritin is a common condition in critically ill patients. It is well known that hyperferritinemia constitutes a good biomarker for hemophagocytic lymphohistiocytosis (HLH) in critically ill patients. However, further differential diagnoses of hyperferritinemia in adult critically ill patients remain poorly investigated. We sought to systematically investigate hyperferritinemia in adult critically ill patients without HLH. Methods: In this secondary analysis of a retrospective observational study, patients ≥18 years admitted to at least one adult intensive care unit at Charité–Universitätsmedizin Berlin between January 2006 and August 2018, and with hyperferritinemia of ≥500 μg/L were included. Patients with HLH were excluded. All patients were categorized into non-sepsis, sepsis, and septic shock. They were also classified into 17 disease groups, based on their ICD-10 codes, and pre-existing immunosuppression was determined. Uni- and multivariable linear regression analyses were performed in all patients. Results: A total of 2583 patients were analyzed. Multivariable linear regression analysis revealed positive associations of maximum SOFA score, sepsis or septic shock, liver disease (except hepatitis), and hematological malignancy with maximum ferritin. T/NK cell lymphoma, acute myeloblastic leukemia, Kaposi’s sarcoma, acute or subacute liver failure, and hepatic veno-occlusive disease were positively associated with maximum ferritin in post-hoc multivariable linear regression analysis. Conclusions: Sepsis or septic shock, liver disease (except hepatitis) and hematological malignancy are important differential diagnoses in hyperferritinemic adult critically ill patients without HLH. Together with HLH, they complete the quartet of important differential diagnoses of hyperferritinemia in adult critically ill patients. As these conditions are also related to HLH, it is important to apply HLH-2004 criteria for exclusion of HLH in hyperferritinemic patients. Hyperferritinemic critically ill patients without HLH require quick investigation of differential diagnoses.
Detection and Prevention of Medication Errors by the Network of Sentinel Pharmacies in a Southern European Region
Authors: Jambrina Anna M. , Santomà Àlex , Rocher Andrea , Rams Neus , Cereza Glòria , Rius Pilar , Gironès Montserrat , Pareja Clara , Franch Àngels , Rabanal Manel
Published: December 2022

A medication error (ME) is a drug-related problem that has been recognized as a common and serious threat to patient safety. The aim of this study was to detect and analyze ME reports occurring throughout the therapeutic process through the community’s pharmacies in order to improve the efficacy and safety of medications and contribute to the prevention of future MEs. This was a three-year descriptive, observational, and prospective study to detect and analyze the different MEs reported by the Catalan sentinel pharmacies network (Catalan SePhaNet). In total, 1394 notifications of MEs were reported (an incidence rate of 737.34 cases/100,000 inhabitants). MEs were detected more frequently in primary care centers. Most of the MEs reported were caused by an incorrect, incomplete, illegible, or verbal medical prescription (41.3%). Of the global notifications detected, 71.9% did not reach the patient (categories A and B). The drugs most frequently implicated in the reported ME cases were beta-lactam antibiotics. In 6.0% of the cases, the ME caused injury to the patient (categories E and F). In 72.0% of the global notifications, a pharmacist’s intervention avoided the ME. The importance of a community pharmacy and the role of a pharmacist were demonstrated in aspects related to patient and drug safety.
Nomogram Model for Predicting the Prognosis of High-Grade Glioma in Adults Receiving Standard Treatment: A Retrospective Cohort Study
Authors: Du Peng , Yang Xionggang , Shen Li , Chen Jiawei , Liu Xiao , Wu Xuefan , Cao Aihong , Geng Daoying
Published: December 2022

Objectives: To identify the critical factors associated with the progression-free survival (PFS) and overall survival (OS) of high-grade glioma (HGG) in adults who have received standard treatment and establish a novel graphical nomogram and an online dynamic nomogram. Patients and Methods: This is a retrospective study of adult HGG patients receiving standard treatment (surgery, postoperative radiotherapy, and temozolomide (TMZ) chemotherapy) at Huashan Hospital, Fudan University between January 2017 and December 2019. We used uni- and multi-variable COX models to identify the significant prognostic factors for PFS and OS. Based on the significant predictors, graphical and online nomograms were established. Results: A total of 246 patients were enrolled in the study based on the inclusion criteria. The average PFS and OS were 22.99 ± 11.43 and 30.51 ± 13.73 months, respectively. According to the multi-variable COX model, age, extent of resection (EOR), and IDH mutation were associated with PFS and OS, while edema index (EI) was relevant to PFS. In addition, patients with IDH and TERT promoter co-mutations had longer PFSs and OSs, and no apparent survival benefit was found in the long-cycle TMZ adjuvant chemotherapy compared with the standard Stupp protocol. Based on these critical factors, a graphical nomogram and online nomogram were developed for predicting PFS and OS, respectively. The calibration curve showed favorable consistency between the predicted and actual survival rates. C-index and time-dependent AUC showed good discrimination abilities. Conclusions: We identified the significant predictors for the PFS and OS of HGG adults receiving standard treatment and established user-friendly nomogram models to assist neurosurgeons in optimizing clinical management and treatment strategies.
Krüppel-like Factor 6 Suppresses the Progression of Pancreatic Cancer by Upregulating Activating Transcription Factor 3
Authors: Xiong Qunli , Zhang Zhiwei , Yang Yang , Xu Yongfeng , Zhou Ying , Zhang Su , Liu Jinlu , Zheng Ying , Zhu Qing
Published: December 2022

Background: As a member of the Krüppel-like factor (KLFs) family, Krüppel-like factor 6 (KLF6) plays a critical role in regulating key cellular functions. Presently, scholars have proved the important role of KLF6 in the tumorigenesis of certain cancers through a large number of experiments. However, gaps still remain in our knowledge of the role of KLF6 in pancreatic cancer (PAAD). Therefore, this paper mainly investigates the role of KLF6 in the progression of pancreatic cancer. Methods: The expression pattern of KLF6 in pancreatic cancer was explored in pancreatic cancer tissues and cell lines. Then, we investigated the prognostic value of KLF6 in pancreatic cancer by immunohistochemical assays. Next, Cell Counting Kit-8 (CCK8) and clone information assays were employed to explore the proliferation of PAAD affected by KLF6. The metastasis and epithelial-mesenchymal transition (EMT) abilities affected by KLF6 were identified through transwell invasion as well as migration assays and western blots. Finally, the TRRUST tool was used to analyze the potential targeted genes of KLF6. The results were verified by Quantificational Real-time Polymerase Chain Reaction (qRT-PCR), western blot and rescue assays. Results: KLF6 expresses lowly in pancreatic cancer compared to corresponding normal tissues and relates to poor survival times. Overexpression of KLF6 inhibits the proliferation, metastasis, and EMT progression in pancreatic cancer cells. Further studies suggest that KLF6 could upregulate ATF3 in PAAD. Conclusions: Our results suggest that KLF6 can be a useful factor in predicting the prognosis of PAAD patients and that it inhibits the progression of pancreatic cancer by upregulating activating transcription factor 3 (ATF3).
Investigation on Magnetization, Magnetocalory, Magnetoresistance, and Electric Properties of Ni-Mn Based Heusler Alloy
Authors: Nambiar S. Sandeep , B. R. N. Murthy , B. M. Karthik , Sharma Sathyashankara , Prasanna A. A.
Published: December 2022

The magnetic and electrical characteristics of Ni-Mn quinary Heusler alloys are studied in the current work. The results concern the materials’ magnetic and electrical behavior. The physical property measurement system (PPMS) and superconducting quantum interference device (SQUID) were used at various magnetization levels to determine the results. The addition of Fe helps to form the alloy into a smart memory alloy with magnetocrystalline anisotropy, twin border mobility, and varied magnetic and martensite transition temperature characteristics. Character changes in the superparamagnetic (SPM) and paramagnetic (PM) alloys occur between 26 and 34 °C. The curves are supported by the alloy’s martensitic transition temperature change. A large refrigeration capacity is identified in the alloy. These properties are an indication of the alloys’ application prospects. Entropy change helps to detect the inverse magnetocaloric effect in the alloy, whereas adiabatic temperature change helps identify the origin and validity of reverse magnetic properties. The transition temperature changes occur when austenite’s sigma is larger than that of martensite, and as the magnetic field increases, the temperature declines. Isothermal magnetization curves, a large (MR)/B value at low and high magnetic fields, and temperatures near the transformation point suggest that small-crystal Heusler alloys have tremendous promise for low and high magnetic field magnetoresistance applications.
Stuck on the Last: The Last-Presented Benefit as an Index of Attentional Refreshing in Adolescents
Authors: Valentini Beatrice , Vergauwe Evie
Published: December 2022

Working memory is a limited-capacity system responsible for maintaining information that is known to dramatically develop throughout childhood and adolescence. Different maintenance mechanisms are proposed to support working memory development, among which is attentional refreshing. Attentional refreshing is assumed to improve the accessibility of working-memory representations by cycling attention from one mental representation to the other, serially. It has been suggested that the efficiency of refreshing increases between the ages of 7 and 14 years old, thereby supporting working memory development. Yet, there is not much research about refreshing in adolescence. Here, we investigate the occurrence of refreshing in 15-year-olds by using a recently-developed index, i.e., the last-presented benefit. Adolescents had to remember a list of four letters and judge whether a subsequent probe letter was present or not in the list. Reaction times to the probe were used to assess the spontaneous occurrence of refreshing. We found that, unlike young adults, 15-year-olds showed consistent speeded responses to probes matching the last-presented memory item, indicating that, in this task, adolescents did not refocus their attention away from the last memory item to initiate refreshing. Implications for working memory functioning and development are discussed.
Correction: Diez-Caballero et al. Environmental Compatibility of the Parc Tramuntana Offshore Wind Project in Relation to Marine Ecosystems. J. Mar. Sci. Eng. 2022, 10, 898
Authors: Diez-Caballero Koldo , Troiteiro Silvia , García-Alba Javier , Vidal Juan Ramón , González Marta , Ametller Sergi , Juan Raquel
Published: December 2022

The authors of this article would like to include a clarification of the original publication [...]
Waveform Design Using Coprime Frequency-Modulated Pulse Trains for Reverberation Suppression of Active Sonar
Authors: Cui Xiaobin , Chi Cheng , Li Shuqiu , Li Zigao , Li Yu , Huang Haining
Published: December 2022

Over the last two decades, low-frequency active sonar has become an attractive tool for underwater target detection. The reverberation to signal ratio (RSR) of transmitted waveforms is an important factor affecting the detection capability of low-frequency active sonar. Therefore, reasonable waveform design for reverberation suppression of active sonar is an important topic. Pulse trains of linear frequency-modulated (PTFM) waveforms have been proposed and manifested their good performance in suppressing reverberation. The number of sub-pulses is positively related to the reverberation to signal ratio; the lower the number of sub-pulses, the lower the reverberation to signal ratio. However, to avoid ambiguity in a Doppler measurement, the PTFM waveforms have a requirement for the number of sub-pulses to be satisfied, which prevents its reverberation suppression performance from being further improved. In this paper, we propose a coprime pulse train of linear frequency-modulated (CPTFM) waveform, which reduces the number of sub-pulses to some extent. Therefore, the ability of reverberation suppression of the CPTFM waveform can be improved. The RSR was chosen as the metric to evaluate the waveform’s ability to suppress reverberation, and the theoretical formula for the RSR of the CPTFM waveform was derived in zone A and B. With the overlap of zones A and B brought about by the decrease in the number of sub-pulses, the average RSR of zones A and B is used in this paper to evaluate the reverberation suppression ability of the waveform. The simulation experiment shows that the proposed CPTFM waveform decreases the average RSR by 7 dB and 20 dB in comparison to the reference PTFM waveform and continuous waveform (CW), which is consistent with the theoretical results by the derived formulas.
Integrated Design of the Vacuum and Safety Barrier between the Lithium and Test Systems of IFMIF-DONES
Authors: Zsákai András , Dézsi Tamás , Korossy-Khayll András , Katona Imre , Varga Viktor , Kósa Endre , Oravecz Dénes Zoltán , Becerril Santiago , Meléndez Carlos , Castellanos Jesus , Micciché Gioacchino , Ibarra Angel
Published: December 2022

The international fusion materials irradiation facility-DEMO-oriented neutron source (IFMIF-DONES) is a facility that is designed under the framework of the EU fusion roadmap. It is going to be an essential irradiation facility for testing and qualifying candidate materials under severe irradiation conditions of a neutron field having an energy spectrum like the one present in a fusion power reactor. The material specimens are irradiated in a containment structure named the test cell (TC), which is part of the test systems (TS). The TC also houses a part of the other major system (lithium system, LS), which provides the liquid lithium for the reaction through a piping system. At a point, the lithium piping needs to exit the TS, but the primary safety boundary must be continuous around these penetrations. Therefore, a special barrier, called the test systems–lithium systems interface cell (TLIC), has been developed around the piping system to provide a safety-approved and remotely maintainable vacuum boundary envelope. In this paper, the integrated design development of the TLIC is described, consisting of the design development according to the RCC-MRx code, the remote-handling (RH) needs, and the procedures and safety-related special needs of the design.
Relationships between Sclerostin, Leptin and Metabolic Parameters in Non-Dialysis Chronic Kidney Disease Males
Authors: Romejko Katarzyna , Rymarz Aleksandra , Szamotulska Katarzyna , Bartoszewicz Zbigniew , Niemczyk Stanisław
Published: December 2022

Sclerostin is an inhibitor of the Wnt-beta-catenin pathway. The relationship between sclerostin and adipose tissue or between sclerostin and nutritional status has been the subject of research interest in the last decade. Sclerostin concentrations are elevated in patients with chronic kidney disease (CKD). Leptin is an adipocytokine which inhibits food intake by stimulating the satiety center in the hypothalamus. Leptin concentrations rise with the reduction of eGFR (glomerular filtration rate). The aim of this study was to investigate the possible association between sclerostin and leptin, between sclerostin and selected poor prognostic factors of CKD progression, and between sclerostin and nutritional parameters in non-dialysis CKD male patients. 101 men with non-dialysis CKD stage 3–5 were included in the study. Bioimpedance spectroscopy (BIS) was used to measure body composition. Blood samples were drawn to measure the serum concentrations of sclerostin, leptin, creatinine, hemoglobin (Hgb), parathormone (PTH), inflammatory markers, and markers of nutritional status. We also measured homeostatic model assessment of insulin resistance (HOMA-IR) as well as blood pressure. We observed a significant, positive relationship between sclerostin and age, leptin, and glycated hemoglobin (HgbA1c) concentrations. A significant, negative association was observed between sclerostin and eGFR. Sclerostin is associated with leptin in non-dialysis CKD male patients. Sclerostin is also related to metabolic disturbances such as hyperglycemia in this population.
Machine Learning-Based Automated Detection and Quantification of Geographic Atrophy and Hypertransmission Defects Using Spectral Domain Optical Coherence Tomography
Authors: Kalra Gagan , Cetin Hasan , Whitney Jon , Yordi Sari , Cakir Yavuz , McConville Conor , Whitmore Victoria , Bonnay Michelle , Lunasco Leina , Sassine Antoine , Borisiak Kevin , Cohen Daniel , Reese Jamie , Srivastava Sunil K. , Ehlers Justis. P.
Published: December 2022

The current study describes the development and assessment of innovative, machine learning (ML)-based approaches for automated detection and pixel-accurate measurements of regions with geographic atrophy (GA) in late-stage age-related macular degeneration (AMD) using optical coherence tomography systems. 900 OCT volumes, 100266 B-scans, and en face OCT images from 341 non-exudative AMD patients with or without GA were included in this study from both Cirrus (Zeiss) and Spectralis (Heidelberg) OCT systems. B-scan and en face level ground truth GA masks were created on OCT B-scan where the segmented ellipsoid zone (EZ) line, retinal pigment epithelium (RPE) line, and bruchs membrane (BM) line overlapped. Two deep learning-based approaches, B-scan level and en face level, were trained. The OCT B-scan model had detection accuracy of 91% and GA area measurement accuracy of 94%. The en face OCT model had detection accuracy of 82% and GA area measurement accuracy of 96% with primary target of hypertransmission on en face OCT. Accuracy was good for both devices tested (92–97%). Automated lesion size stratification for CAM cRORA definition of 250um minimum lesion size was feasible. High-performance models for automatic detection and segmentation of GA area were achieved using OCT systems and deep learning. The automatic measurements showed high correlation with the ground truth. The en face model excelled at identification of hypertransmission defects. The models performance generalized well across device types tested. Future development will include integration of both models to enhance feature detection across GA lesions as well as isolating hypertransmission defects without GA for pre-GA biomarker extraction.