The 2023 MDPI Annual Report has
been released!
 
9 pages, 374 KiB  
Article
Effect of Fluid Intake on Acute Changes in Plasma Volume: A Randomized Controlled Crossover Pilot Trial
by Janis Schierbauer, Sabrina Sanfilippo, Auguste Grothoff, Ulrich Fehr, Nadine Wachsmuth, Thomas Voit, Paul Zimmermann and Othmar Moser
Metabolites 2024, 14(5), 263; https://doi.org/10.3390/metabo14050263 - 06 May 2024
Abstract
Plasma volume (PV) undergoes constant and dynamic changes, leading to a large intra-day variability in healthy individuals. Hydration is known to induce PV changes; however, the response to the intake of osmotically different fluids is still not fully understood. In a randomized controlled [...] Read more.
Plasma volume (PV) undergoes constant and dynamic changes, leading to a large intra-day variability in healthy individuals. Hydration is known to induce PV changes; however, the response to the intake of osmotically different fluids is still not fully understood. In a randomized controlled crossover trial, 18 healthy individuals (10 females) orally received an individual amount of an isotonic sodium-chloride (ISO), Ringer (RIN), or glucose (GLU) solution. Hemoglobin mass (Hbmass) was determined with the optimized carbon monoxide re-breathing method. Fluid-induced changes in PV were subsequently calculated based on capillary hemoglobin concentration ([Hb]) and hematocrit (Hct) before and then every 10 minutes until 120 min (t0–120) after the fluid intake and compared to a control trial arm (CON), where no fluid was administered. Within GLU and CON trial arms, no statistically significant differences from baseline until t120 were found (p > 0.05). In the ISO trial arm, PV was significantly increased at t70 (+138 mL, p = 0.01), t80 (+191 mL, p < 0.01), and t110 (+182 mL, p = 0.01) when compared to t0. Moreover, PV in the ISO trial arm was significantly higher at t70 (p = 0.02), t110 (p = 0.04), and t120 (p = 0.01) when compared to the same time points in the CON trial arm. Within the RIN trial arm, PV was significantly higher between t70 and t90 (+183 mL, p = 0.01) and between t110 (+194 mL, p = 0.03) and t120 (+186 mL, p < 0.01) when compared to t0. These results demonstrated that fluids with a higher content of osmotically active particles lead to acute hemodilution, which is associated with a decrease in [Hb] and Hct. These findings underpin the importance of the hydration state on PV and especially on PV constituent levels in healthy individuals. Full article
14 pages, 1438 KiB  
Article
Metabolome in Tibialis and Soleus Muscles in Wild-Type and Pin1 Knockout Mice through High-Resolution Magic Angle Spinning 1H Nuclear Magnetic Resonance Spectroscopy
by Valeria Righi, Martina Grosso, Renata Battini, Takafumi Uchida, Anna Gambini, Susanna Molinari and Adele Mucci
Metabolites 2024, 14(5), 262; https://doi.org/10.3390/metabo14050262 - 06 May 2024
Abstract
Skeletal muscles are heterogenous tissues composed of different myofiber types that can be classified as slow oxidative, fast oxidative, and fast glycolytic which are distinguished on the basis of their contractile and metabolic properties. Improving oxidative metabolism in skeletal muscles can prevent metabolic [...] Read more.
Skeletal muscles are heterogenous tissues composed of different myofiber types that can be classified as slow oxidative, fast oxidative, and fast glycolytic which are distinguished on the basis of their contractile and metabolic properties. Improving oxidative metabolism in skeletal muscles can prevent metabolic diseases and plays a protective role against muscle wasting in a number of neuromuscular diseases. Therefore, achieving a detailed understanding of the factors that regulate myofiber metabolic properties might provide new therapeutic opportunities for these diseases. Here, we investigated whether peptidyl-prolyl cis-trans isomerase NIMA-interacting 1 (PIN1) is involved in the control of myofiber metabolic behaviors. Indeed, PIN1 controls glucose and lipid metabolism in a number of tissues, and it is also abundant in adult skeletal muscles; however, its role in the control of energy homeostasis in this tissue is still to be defined. To start clarifying this topic, we compared the metabolome of the tibialis anterior muscle (mainly glycolytic) and soleus muscle (oxidative) in wild-type and Pin1 knockout mice with High-Resolution Magic Angle Spinning (HR-MAS) NMR on intact tissues. Our analysis reveals a clear demarcation between the metabolomes in the two types of muscles and allows us to decode a signature able to discriminate the glycolytic versus oxidative muscle phenotype. We also detected some changes in Pin1-depleted muscles that suggest a role for PIN1 in regulating the metabolic phenotype of skeletal muscles. Full article
Show Figures

Graphical abstract

12 pages, 5987 KiB  
Article
Detection of In Vivo-Like Cells by a Biosensor Chip Based on Metamaterials in Terahertz Regime
by Lulu Han, Yuchen Wang, Kanglong Chen, Hengyu Gao, Kexin Xia, Qinggang Ge, Jun Yang, Wei Shi and Cunjun Ruan
Biosensors 2024, 14(5), 230; https://doi.org/10.3390/bios14050230 - 06 May 2024
Abstract
Early diagnosis of diseases, especially cancer, is critical for effective treatment. The unique properties of terahertz technology have attracted attention in this field. However, current terahertz bio-detection methods face challenges due to differences between the test environment and the actual in vivo conditions. [...] Read more.
Early diagnosis of diseases, especially cancer, is critical for effective treatment. The unique properties of terahertz technology have attracted attention in this field. However, current terahertz bio-detection methods face challenges due to differences between the test environment and the actual in vivo conditions. In this study, a novel method is proposed for detecting in vivo-like cells using a biosensor chip composed of metamaterials and a cavity. The cavity has a thickness of ~50 μm. The structure can protect cells from damage and provides a liquid environment like an in vivo state. Through simulation analysis, the metamaterials sensor exhibits a theoretical sensitivity of 0.287 THz/RIU (Refractive Index Unit) with a 50 μm thick analyte. The detection method is experimentally validated using the apoptosis of glioma cells and various cell types. The biosensor investigates the apoptosis of glioma cells under the impact of temozolomide, and the trend of the results was consistent with the Cell Counting Kit-8 method. Furthermore, at a concentration of ~5200 cells/cm2, the experimental results demonstrate that the sensor can distinguish between neurons and glioma cells with a resonance frequency difference of approximately 30 GHz. This research has significant potential for detecting glioma cells and offers an alternative approach to in vivo-like cell detection. Full article
Show Figures

Figure 1

15 pages, 1967 KiB  
Article
Assessing the Preservation of Lumbar Lordotic Curvature in Everyday Sitting Conditions Assessed with an Inertial Measurement System
by Ju Chan Kim, Jeong-Gil Kim, Beom Suk Kim, Cheol Ki Kim, Minseok Choi, Joonnyong Lee and Sun Gun Chung
J. Clin. Med. 2024, 13(9), 2728; https://doi.org/10.3390/jcm13092728 - 06 May 2024
Abstract
Lumbar lordotic curvature (LLC), closely associated with low back pain (LBP) when decreased, is infrequently assessed in clinical settings due to the spatiotemporal limitations of radiographic methods. To overcome these constraints, this study used an inertial measurement system to compare the magnitude and [...] Read more.
Lumbar lordotic curvature (LLC), closely associated with low back pain (LBP) when decreased, is infrequently assessed in clinical settings due to the spatiotemporal limitations of radiographic methods. To overcome these constraints, this study used an inertial measurement system to compare the magnitude and maintenance of LLC across various sitting conditions, categorized into three aspects: verbal instructions, chair type, and desk task types. Methods: Twenty-nine healthy participants were instructed to sit for 3 min with two wireless sensors placed on the 12th thoracic vertebra and the 2nd sacral vertebra. The lumbar lordotic angle (LLA) was measured using relative angles for the mediolateral axis and comparisons were made within each sitting category. Results: The maintenance of LLA (LLAdev) was significantly smaller when participants were instructed to sit upright (−3.7 ± 3.9°) compared to that of their habitual sitting posture (−1.2 ± 2.4°) (p = 0.001), while the magnitude of LLA (LLAavg) was significantly larger with an upright sitting posture (p = 0.001). LLAdev was significantly larger when using an office chair (−0.4 ± 1.1°) than when using a stool (−3.2 ± 7.1°) (p = 0.033), and LLAavg was also significantly larger with the office chair (p < 0.001). Among the desk tasks, LLAavg was largest during keyboard tasks (p < 0.001), followed by mouse and writing tasks; LLAdev showed a similar trend without statistical significance (keyboard, −1.2 ± 3.0°; mouse, −1.8 ± 2.2°; writing, −2.9 ± 3.1°) (p = 0.067). Conclusions: Our findings suggest that strategies including the use of an office chair and preference for computer work may help preserve LLC, whereas in the case of cueing, repetition may be necessary. Full article
(This article belongs to the Section Clinical Rehabilitation)
10 pages, 716 KiB  
Article
Understanding Patterns of Adherence to Antifibrotic Treatment in Idiopathic Pulmonary Fibrosis: Insights from an Italian Prospective Cohort Study
by Marica Iommi, Francesca Gonnelli, Martina Bonifazi, Andrea Faragalli, Federico Mei, Marco Pompili, Flavia Carle and Rosaria Gesuita
J. Clin. Med. 2024, 13(9), 2727; https://doi.org/10.3390/jcm13092727 - 06 May 2024
Abstract
Pirfenidone and Nintedanib have significantly improved the prognosis of patients with idiopathic pulmonary fibrosis (IPF), reducing mortality risk and exacerbations. This study aimed to analyze antifibrotic treatment utilization and its association with clinical outcomes (i.e., acute exacerbation or death) during 2014–2021 in newly [...] Read more.
Pirfenidone and Nintedanib have significantly improved the prognosis of patients with idiopathic pulmonary fibrosis (IPF), reducing mortality risk and exacerbations. This study aimed to analyze antifibrotic treatment utilization and its association with clinical outcomes (i.e., acute exacerbation or death) during 2014–2021 in newly diagnosed IPF patients, using Healthcare Utilization Databases of the Marche Region, Italy. Methods: The first 12-month adherence to antifibrotic was estimated using the Proportion of Days Covered (PDC), defining adherence as PDC ≥ 75%. State Sequence Analysis over the initial 52 weeks of treatment was used to identify adherence patterns. The role of adherence patterns on acute exacerbations/death, adjusted by demographic, clinical features, and monthly adherence after the 52-week period (time-dependent variable), was assessed with Cox regression. Results: Among 667 new IPF cases, 296 received antifibrotic prescriptions, with 62.8% being adherent in the first year. Three antifibrotic utilization patterns emerged—high adherence (37.2%), medium adherence (42.5%), and low adherence (20.3%)—with median PDCs of 95.3%, 79.5%, and 18.6%, respectively. These patterns did not directly influence three-year mortality/exacerbation probability, but sustained adherence reduced risk over time. Conclusions: Good adherence was observed in in this population-based study, emphasizing the importance of continuous antifibrotics therapy over time to mitigate adverse outcomes. Full article
(This article belongs to the Special Issue Pulmonary Fibrosis: Therapeutic and Management Strategies)
10 pages, 485 KiB  
Article
Secondary Microsurgical Reconstruction of the Cervical Esophagus: Safer Flaps and Practical Tips in a Challenging Situation
by Vittorio Ramella, Andrea Ferrari, Federico Cesare Novati, Zoran Marij Arnež, Grace Marchi, Agostino Rodda, Stefano Bottosso and Giovanni Papa
J. Clin. Med. 2024, 13(9), 2726; https://doi.org/10.3390/jcm13092726 - 06 May 2024
Abstract
Cervical esophageal reconstruction is vital to improve the quality of life in cancer surgery patients. Microsurgery is crucial in providing vascularized tissue for defect repair, particularly in secondary cases with a higher risk of failure due to larger defects and damage from previous [...] Read more.
Cervical esophageal reconstruction is vital to improve the quality of life in cancer surgery patients. Microsurgery is crucial in providing vascularized tissue for defect repair, particularly in secondary cases with a higher risk of failure due to larger defects and damage from previous surgery and radiotherapy. The purpose of this study was to describe the clinical characteristics of a series of patients who underwent secondary repair of esophageal defects and provide practical information for the management and treatment of such cases based on the authors’ experience and the literature review. Methods: We retrospectively reviewed the electronic medical records of the Plastic Surgery Clinic at the University of Trieste to identify cases of patients who underwent secondary esophageal microsurgical reconstructions following oncological surgery. Patient demographics, the etiology of esophageal defects, previous surgical history, and preoperative assessments were collected from medical records. Surgical techniques utilized for reconstruction, such as pedicled flaps or free tissue transfers, were documented along with intraoperative information. Postoperative outcomes, including complications, graft viability, and functional outcomes, were evaluated during follow-up. Results: We treated 13 cases of secondary esophageal reconstructions between 2011 and 2022. Most commonly, Antero-Lateral Thigh (ALT) flaps were used in 10 cases, while 2 cases employed a radial forearm flap (RFF), and 1 case employed a chimeric parascapular flap. No flap failures occurred during a median 50-month follow-up. One ALT flap patient experienced postop stricture but maintained swallowing ability. A single tracheoesophageal fistula occurred in an RFF patient with a history of radiotherapy and complete lymph node dissection. Conclusions: Cervical esophageal reconstruction significantly impacts patients’ quality of life by restoring oral feeding and phonation. When local flaps fall short, microsurgical reconstruction with intestinal flaps is valuable but is burdened by limitations. For challenging secondary cases, ALT or RFF flaps emerge as safer options due to their robust pedicles, yielding low complication rates and positive functional outcomes. Full article
(This article belongs to the Special Issue New Advances in Oral and Facial Surgery)
32 pages, 5737 KiB  
Article
Neural Adaptation at Stimulus Onset and Speed of Neural Processing as Critical Contributors to Speech Comprehension Independent of Hearing Threshold or Age
by Jakob Schirmer, Stephan Wolpert, Konrad Dapper, Moritz Rühle, Jakob Wertz, Marjoleen Wouters, Therese Eldh, Katharina Bader, Wibke Singer, Etienne Gaudrain, Deniz Başkent, Sarah Verhulst, Christoph Braun, Lukas Rüttiger, Matthias H. J. Munk, Ernst Dalhoff and Marlies Knipper
J. Clin. Med. 2024, 13(9), 2725; https://doi.org/10.3390/jcm13092725 - 06 May 2024
Abstract
It is assumed that speech comprehension deficits in background noise are caused by age-related or acquired hearing loss. Methods: We examined young, middle-aged, and older individuals with and without hearing threshold loss using pure-tone (PT) audiometry, short-pulsed distortion-product otoacoustic emissions (pDPOAEs), auditory brainstem [...] Read more.
It is assumed that speech comprehension deficits in background noise are caused by age-related or acquired hearing loss. Methods: We examined young, middle-aged, and older individuals with and without hearing threshold loss using pure-tone (PT) audiometry, short-pulsed distortion-product otoacoustic emissions (pDPOAEs), auditory brainstem responses (ABRs), auditory steady-state responses (ASSRs), speech comprehension (OLSA), and syllable discrimination in quiet and noise. Results: A noticeable decline of hearing sensitivity in extended high-frequency regions and its influence on low-frequency-induced ABRs was striking. When testing for differences in OLSA thresholds normalized for PT thresholds (PTTs), marked differences in speech comprehension ability exist not only in noise, but also in quiet, and they exist throughout the whole age range investigated. Listeners with poor speech comprehension in quiet exhibited a relatively lower pDPOAE and, thus, cochlear amplifier performance independent of PTT, smaller and delayed ABRs, and lower performance in vowel-phoneme discrimination below phase-locking limits (/o/-/u/). When OLSA was tested in noise, listeners with poor speech comprehension independent of PTT had larger pDPOAEs and, thus, cochlear amplifier performance, larger ASSR amplitudes, and higher uncomfortable loudness levels, all linked with lower performance of vowel-phoneme discrimination above the phase-locking limit (/i/-/y/). Conslusions: This study indicates that listening in noise in humans has a sizable disadvantage in envelope coding when basilar-membrane compression is compromised. Clearly, and in contrast to previous assumptions, both good and poor speech comprehension can exist independently of differences in PTTs and age, a phenomenon that urgently requires improved techniques to diagnose sound processing at stimulus onset in the clinical routine. Full article
13 pages, 366 KiB  
Article
The Effect of Physical Activity and Repeated Whole-Body Cryotherapy on the Expression of Modulators of the Inflammatory Response in Mononuclear Blood Cells among Young Men
by Justyna Kusmierczyk, Magdalena Wiecek, Gabriela Wojciak, Mateusz Mardyła, Grzegorz Kreiner, Zbigniew Szygula and Jadwiga Szymura
J. Clin. Med. 2024, 13(9), 2724; https://doi.org/10.3390/jcm13092724 - 06 May 2024
Abstract
Background: Series of whole-body cryotherapy (WBC) among healthy and physically active individuals can potentially reduce inflammatory response, although exact mechanisms remain unclear. Methods: The impact of whole-body cryotherapy on inflammation modulators among 28 young males, categorized as non-training (NTR, N = 10), non-training [...] Read more.
Background: Series of whole-body cryotherapy (WBC) among healthy and physically active individuals can potentially reduce inflammatory response, although exact mechanisms remain unclear. Methods: The impact of whole-body cryotherapy on inflammation modulators among 28 young males, categorized as non-training (NTR, N = 10), non-training with WBC (NTR-WBC, N = 10), and training with WBC (TR-WBC, N = 8), is investigated in this study. Over a period of eight weeks, NTR-WBC and TR-WBC subjects underwent 24 WBC treatments (−130 °C for 3 min, three times a week), examining changes in mRNA expressions of IL-1A, IL-6, IL-10, IFN-G, SIRT1, SIRT3, SOD2, GSS, and ICAM-1. Results: The received data indicate an acute inflammatory response to initial WBC (increased IL-1A, IL-6, and SIRT), with a greater effect in NTR-WBC. Subsequent sessions showed enhanced expressions of antioxidative genes in both WBC groups, particularly non-trained, suggesting improved oxidative stress adaptation. A notable decrease in ICAM-1 mRNA post-24 WBC treatments in NTR-WBC signifies a potential systemic anti-inflammatory effect. Conclusions: The findings of the study suggest that the combination of regular physical activity with WBC administered three times per week can potentially modulate inflammatory and antioxidant responses. This modulation is evidenced by changes in the expression of genes related to these processes. Full article
(This article belongs to the Section Clinical Rehabilitation)
15 pages, 2584 KiB  
Article
Alcohol Consumption Is a Coping Mechanism for Male Patients with Severe Anxiety Disorders Treated with Antidepressants Monotherapy
by Mădălina Iuliana Mușat, Felicia Militaru, Ion Udriștoiu, Smaranda Ioana Mitran and Bogdan Cătălin
J. Clin. Med. 2024, 13(9), 2723; https://doi.org/10.3390/jcm13092723 - 06 May 2024
Abstract
Anxiety disorders are prevalent mental health conditions often accompanied by various comorbidities. The association between anxiety and liver disease, as well as fluctuations in blood sugar levels, highlights the importance of carefully evaluating patients with anxiety undergoing antidepressant therapy. The aim of this [...] Read more.
Anxiety disorders are prevalent mental health conditions often accompanied by various comorbidities. The association between anxiety and liver disease, as well as fluctuations in blood sugar levels, highlights the importance of carefully evaluating patients with anxiety undergoing antidepressant therapy. The aim of this study was to conduct a comparative assessment of liver function and blood glucose levels in patients diagnosed with anxiety disorders while considering potential gender-specific differences. Methods: An analysis was conducted over a 24-month period. This study included 88 patients diagnosed with anxiety disorders, with symptoms severe enough to require hospitalization, aged 18 or older, undergoing antidepressant monotherapy, without any additional pathologies. Liver enzymes (AST, ALT, GGT), AST/ALT ratio, and blood glucose levels were measured and compared. Results: While no significant differences were found between antidepressant classes, increased GGT levels were observed in men older than 40 years compared to women of the same age, suggesting that alcohol consumption may be a coping mechanism for anxiety. This gender difference was not observed among young patients. Conclusions: Early detection of alcohol consumption is essential in patients with anxiety disorders in order to prevent alcohol-related liver damage and to adjust the management of both conditions accordingly. Full article
(This article belongs to the Section Mental Health)
13 pages, 1486 KiB  
Article
Clinical Efficacy of Application-Linked Stretching Ball as Digital Therapeutics in Plantar Fasciitis
by Seok Chang Ryu, Dong-Oh Lee, Yoojin Park, Yujeong Shin, Dong Yeon Lee and Min Gyu Kyung
J. Clin. Med. 2024, 13(9), 2722; https://doi.org/10.3390/jcm13092722 - 06 May 2024
Abstract
Background/Objectives: This study aimed to evaluate the efficacy of application-linked stretching ball instruments that record the rolling time and force of patients compared with a traditional simple stretching ball. Methods: Fourteen participants with plantar fasciitis were divided into a simple massage [...] Read more.
Background/Objectives: This study aimed to evaluate the efficacy of application-linked stretching ball instruments that record the rolling time and force of patients compared with a traditional simple stretching ball. Methods: Fourteen participants with plantar fasciitis were divided into a simple massage ball group (group A, n = 8) and an application-linked massage ball group (group B, n = 6). The application-linked massage ball sends information regarding the massages, such as the frequency and force of the massage on the foot, to the application on the patient’s smartphone. All clinical outcomes were evaluated at the beginning of the study and 1-, 2-, and 3-month follow-up. The primary outcome measure was the Manchester–Oxford Foot Questionnaire (MOXFQ) score. Results: At the beginning of the study, the initial MOXFQ score was not significantly different between the two groups (p = 0.948). At each time point, the MOXFQ score of the whole population did not improve significantly compared to that of the initial state (p = 0.131). Generalized estimating equation modeling demonstrated that there was no significant difference in the improvement of the MOXFQ score between groups A and B during follow-up (p = 0.826). In addition, no group-by-time interactions were observed (p = 0.457). Conclusions: The efficacy of an application-linked massage ball for the treatment of plantar fasciitis was not as definite as that of a traditional simple stretching ball in patients whose symptoms persisted for at least six months. Future studies that include patients with acute plantar fasciitis are required. Full article
(This article belongs to the Special Issue Rehabilitation and Recovery from Orthopedic Trauma)
Show Figures

Figure 1

11 pages, 1118 KiB  
Article
Prospective Analysis of Squamous Cell Carcinoma Antigen-1 and -2 for Diagnosing Sinonasal Inverted Papilloma
by Hitoshi Hirakawa, Taro Ikegami, Masatomo Toyama, Yurika Ooshiro, Tomoyo Higa, Hidetoshi Kinjyo, Shunsuke Kondo, Norimoto Kise, Yukashi Yamashita and Mikio Suzuki
J. Clin. Med. 2024, 13(9), 2721; https://doi.org/10.3390/jcm13092721 - 06 May 2024
Abstract
Background: The goal of this research was to confirm whether preoperative serum squamous cell carcinoma antigen (SCCA)-1 and -2 levels are useful diagnostic markers for sinonasal inverted papilloma (IP) in a prospective study. Methods: Participants were 102 patients who underwent consecutive [...] Read more.
Background: The goal of this research was to confirm whether preoperative serum squamous cell carcinoma antigen (SCCA)-1 and -2 levels are useful diagnostic markers for sinonasal inverted papilloma (IP) in a prospective study. Methods: Participants were 102 patients who underwent consecutive endoscopic sinus surgery: 18 with IP, two with other types of papilloma, 77 with chronic rhinosinusitis, four with sinonasal cancer, and one with hemangioma. SCCA-1 and SCCA-2 were measured preoperatively by an automatic chemiluminescence immunoassay and an enzyme-linked immunosorbent assay, respectively. Results: SCCA-1 and SCCA-2 values were significantly correlated (r = 0.603, p < 0.001). Receiver operating characteristic analysis for differentiating papilloma (IP and other types of papilloma) from other diseases yielded an area under the curve of 0.860, with a Youden index of 1.75. Combined with SCCA-2 analysis, the detection system had a sensitivity and specificity of 0.65 and 0.98, respectively. While our study did not find a strong link between SCCA levels and skin or lung diseases, smoking status may influence SCCA levels in IP patients (p = 0.035). We recommend a cutoff value of 1.8 ng/mL for SCCA-1 in IP diagnosis. Conclusions: SCCA-1 and SCCA-2 when combined with imaging and pathology hold promise for enhancing the preoperative detection of IP, which would be a valuable contribution to clinical practice. Full article
(This article belongs to the Section Otolaryngology)
Show Figures

Figure 1

13 pages, 724 KiB  
Article
The Multidisciplinary Mobile Unit (MMU) Program Bringing Hospital Specialist Geriatric Competencies at Home: A Feasible Alternative to Admission in Older Patients with Urgent Complaints
by Antonio Nouvenne, Andrea Ticinesi, Carmine Siniscalchi, Martina Rendo, Nicoletta Cerundolo, Alberto Parise, Giampiero Castaldo, Giulia Chiussi, Richard Carrassi, Angela Guerra and Tiziana Meschi
J. Clin. Med. 2024, 13(9), 2720; https://doi.org/10.3390/jcm13092720 - 06 May 2024
Abstract
Background/Objectives: Older patients are subject to a high number of Emergency Department (ED) visits and hospitalizations. Innovative strategies to manage geriatric urgencies in the community are thus needed. Methods: In this prospective observational study, we examined the case mix of a [...] Read more.
Background/Objectives: Older patients are subject to a high number of Emergency Department (ED) visits and hospitalizations. Innovative strategies to manage geriatric urgencies in the community are thus needed. Methods: In this prospective observational study, we examined the case mix of a hospital-based domiciliary urgent care service tailored to older patients, called Multidisciplinary Mobile Unit (MMU), from January to September 2023. The service, activated by general practitioners or territorial specialists during workdays, provided domiciliary geriatric assessment, point-of-care diagnostics, including multi-site ultrasound and lab tests, and therapeutical measures, including intravenous treatment and insertion of invasive devices, with the goal of reaching on-site stabilization and avoiding ED referral. We collected data regarding multimorbidity, polypharmacy, and frailty according to the Clinical Frailty Scale (CFS), reasons for MMU activation, and diagnostic and therapeutical services provided. The assessed outcomes were immediate hospitalization after a visit, 30-day admission, and 30-day mortality. Results: Participants (n = 205, 102 M) were mostly aged (median age 83 years old), with multimorbidity and frailty (CFS median 6). The most frequent reasons for MMU activation were dyspnea (49%), cough (34%), and musculoskeletal pain (17%), while the commonest diagnostic test provided was thoracic ultrasound (81%). Only five patients (2.4%) were hospitalized immediately after MMU visit. The 30-day rate of hospitalization was 10.2%, with age, cancer, and abdominal pain as independent predictors on a stepwise binary logistic regression model. 30-day mortality was 4.9%. Conclusions: The MMU model is a feasible strategy to manage geriatric urgencies, especially involving the cardiorespiratory system, is associated with good outcomes and may prevent ED visits. Full article
(This article belongs to the Section Emergency Medicine)
Show Figures

Figure 1

12 pages, 1864 KiB  
Article
Role of Vascular Function in the Prognosis of Heart Failure Patients
by Shunsuke Kiuchi, Shinji Hisatake, Shintaro Dobashi, Yoshiki Murakami and Takanori Ikeda
J. Clin. Med. 2024, 13(9), 2719; https://doi.org/10.3390/jcm13092719 - 06 May 2024
Abstract
Background: Blood vessels have the Windkessel effect and are involved in blood circulation. The breakdown of this mechanism is also involved in the pathogenesis of heart failure (HF); however, the relationship between vascular dysfunction and HF prognosis is not fully understood. Methods: [...] Read more.
Background: Blood vessels have the Windkessel effect and are involved in blood circulation. The breakdown of this mechanism is also involved in the pathogenesis of heart failure (HF); however, the relationship between vascular dysfunction and HF prognosis is not fully understood. Methods: We evaluated 214 patients hospitalized for HF at our institution who underwent a cardio–ankle vascular index (CAVI), which evaluates vascular function, between January 2012 and July 2018. To investigate factors (including CAVI) associated with major adverse cardiac events (MACE) during 1 year after patients with HF were discharged, we evaluated clinical profiles, blood tests, chest X-P, 12-lead electrocardiography, and transthoracic echocardiographic findings. MACE was defined as cardiovascular death or readmission for HF. Results: The severity of HF between the MACE and non-MACE was not significantly different. Previous HF and chronic kidney disease were significantly more common in the MACE group. CAVI and % mean atrial pressure in the MACE group were statistically higher than those in the non-MACE group. The cardiac shadow as shown by chest X-P and left ventricular size in the MACE group were significantly bigger, and HF preserved ejection fraction (EF) (EF > 50%) was significantly more common in the MACE group. In multivariate analysis, CAVI was an independent predictive factor for the occurrence of MACE (model 1; hazard ratio (HR): 1.33, 95% confidence interval (CI): 1.05–1.68, p = 0.018; model 2; HR: 1.31, 95% CI: 1.07–1.60, p = 0.009). Conclusions: Because high CAVI is associated with poor prognosis of HF, these patients require more careful treatment. Full article
(This article belongs to the Special Issue New Insights into Arterial Stiffness)
Show Figures

Figure 1

15 pages, 2925 KiB  
Article
Creation and Validation of Patient-Derived Cancer Model Using Peritoneal and Pleural Effusion in Patients with Advanced Ovarian Cancer: An Early Experience
by Ruri Nishie, Tomohito Tanaka, Kensuke Hirosuna, Shunsuke Miyamoto, Hikaru Murakami, Hiromitsu Tsuchihashi, Akihiko Toji, Shoko Ueda, Natsuko Morita, Sousuke Hashida, Atsushi Daimon, Shinichi Terada, Hiroshi Maruoka, Hiromi Konishi, Yuhei Kogata, Kohei Taniguchi, Kazumasa Komura and Masahide Ohmichi
J. Clin. Med. 2024, 13(9), 2718; https://doi.org/10.3390/jcm13092718 - 06 May 2024
Abstract
Background: The application of personalized cancer treatment based on genetic information and surgical samples has begun in the field of cancer medicine. However, a biopsy may be painful for patients with advanced diseases that do not qualify for surgical resection. Patient-derived xenografts [...] Read more.
Background: The application of personalized cancer treatment based on genetic information and surgical samples has begun in the field of cancer medicine. However, a biopsy may be painful for patients with advanced diseases that do not qualify for surgical resection. Patient-derived xenografts (PDXs) are cancer models in which patient samples are transplanted into immunodeficient mice. PDXs are expected to be useful for personalized medicine. The aim of this study was to establish a PDX from body fluid (PDX-BF), such as peritoneal and pleural effusion samples, to provide personalized medicine without surgery. Methods: PDXs-BF were created from patients with ovarian cancer who had positive cytology findings based on peritoneal and pleural effusion samples. PDXs were also prepared from each primary tumor. The pathological findings based on immunohistochemistry were compared between the primary tumor, PDX, and PDX-BF. Further, genomic profiles and gene expression were evaluated using DNA and RNA sequencing to compare primary tumors, PDXs, and PDX-BF. Results: Among the 15 patients, PDX-BF was established for 8 patients (5 high-grade serous carcinoma, 1 carcinosarcoma, 1 low-grade serous carcinoma, and 1 clear cell carcinoma); the success rate was 53%. Histologically, PDXs-BF have features similar to those of primary tumors and PDXs. In particular, PDXs-BF had similar gene mutations and expression patterns to primary tumors and PDXs. Conclusions: PDX-BF reproduced primary tumors in terms of pathological features and genomic profiles, including gene mutation and expression. Thus, PDX-BF may be a potential alternative to surgical resection for patients with advanced disease. Full article
(This article belongs to the Section Oncology)
Show Figures

Figure 1

5 pages, 436 KiB  
Editorial
Cardiopulmonary Resuscitation: Clinical Updates and Perspectives
by Stephan Marsch and Timur Sellmann
J. Clin. Med. 2024, 13(9), 2717; https://doi.org/10.3390/jcm13092717 - 06 May 2024
Abstract
Cardiopulmonary resuscitation (CPR) stands as a cornerstone in emergency care, representing the crucial link between life and death for victims of cardiac arrest [...] Full article
(This article belongs to the Special Issue Cardiopulmonary Resuscitation: Clinical Updates and Perspectives)
Show Figures

Figure 1

12 pages, 4519 KiB  
Article
Endovascular Recanalization and Carotid Stenting: The New Approach to Restore Cerebral Perfusion during Aortic Dissection
by Maxim Agarkov, Kirill Kozlov, Ekaterina Senkina, Sergey Gornov, Natalia Linkova, Elena Kechaeva, Dmitrii Medvedev, Alexander Krasichkov, Anastasiia Dyatlova and Victoria Polyakova
J. Clin. Med. 2024, 13(9), 2716; https://doi.org/10.3390/jcm13092716 - 06 May 2024
Abstract
A type A aortic dissection (TAAD) is a dangerous condition requiring emergency surgery. Due to the similarity of the symptoms of cerebral malperfusion in TAAD and the signs of ischemic stroke, a differential diagnosis of these diseases is not always available. Patients with [...] Read more.
A type A aortic dissection (TAAD) is a dangerous condition requiring emergency surgery. Due to the similarity of the symptoms of cerebral malperfusion in TAAD and the signs of ischemic stroke, a differential diagnosis of these diseases is not always available. Patients with TAAD after cerebral malperfusion can have a neurological deficit. Thrombolysis is performed in this case. It can worsen the patient’s condition and increase the risk of mortality and disability. The aim of the study is to evaluate the new approach to restoring cerebral perfusion during aortic dissection. This approach includes endovascular recanalization and carotid stenting. Methods: Two clinical cases of TAAD complicated by cerebral malperfusion are described. The first patient is 73 years old and was admitted as planned to perform transcatheter aortic valve implantation (TAVI) for grade III aortic stenosis. The patient underwent transcatheter aortic valve implantation (TAVI) on the second day after admission. The second patient is 60 years old and was hospitalized by an ambulance with strong hypertension and ischemia. The surgical correction of aortic dissection was postponed until the neurological status assessment in both patients. Results: The surgery to correct the aorta dissection was deemed inappropriate. The carotid arteries have been reanalyzed, and cerebral perfusion has been restored in a short time in both patients. Conclusion: Acute bilateral internal carotid occlusion is a potentially fatal TAAD outcome. Emergency endovascular recanalization and carotid stenting may be considered one of the few ways to restore cerebral perfusion. Full article
Show Figures

Figure 1

10 pages, 2505 KiB  
Communication
Homocystein, Vitamin B12 and Folic Acid as Screening Biomarkers in Early Diagnosis and Gastric Cancer Monitoring
by Fernanda Farias de Alcântara, Carla de Castro Sant’Anna, Diego Di Felipe Ávila Alcântara, Amanda de Nazaré Cohen-Paes, Paulo Cardoso Soares, Paulo Pimentel de Assumpção, Margareth Maria Braun Guimarães Imbiriba and Rommel Mario Rodriguez Burbano
Med. Sci. 2024, 12(2), 24; https://doi.org/10.3390/medsci12020024 - 06 May 2024
Abstract
Gastric cancer has been demonstrating a reduction in the number of cases over the past decades, largely attributed to advancements in public health practices and increased accessibility to educational initiatives for the general population. Nevertheless, it persists as the third leading cause of [...] Read more.
Gastric cancer has been demonstrating a reduction in the number of cases over the past decades, largely attributed to advancements in public health practices and increased accessibility to educational initiatives for the general population. Nevertheless, it persists as the third leading cause of mortality globally among both men and women. These fatalities are typically associated with delayed disease detection. The current study assessed the levels of homocysteine, vitamin B12, and folic acid as a means of establishing a screening biomarker profile that could be integrated into routine testing protocols to facilitate swift diagnosis of the illness. A total of 207 control subjects and 207 individuals with gastric cancer were scrutinized, with biochemical measurements conducted using chemiluminescence for homocysteine, folic acid, and vitamin B12. The two groups were matched based on age, tumor location, subtype, tumor classification, presence of Epstein-Barr Virus infection (EBV), and Helicobacter pylori (H. pylori). Significant statistical variances were identified in the mean levels of the triad of substances among cancer patients when compared to the control group for all corresponding variables. In conclusion, our study indicated that analyzing the triad of homocysteine, vitamin B12, and folic acid holds diagnostic value for gastric cancer and could potentially serve as an effective screening marker for this type of cancer in the future. Full article
Show Figures

Figure 1

14 pages, 312 KiB  
Article
Energy Poverty and Health Expenditure: Empirical Evidence from Vietnam
by Hang Thu Nguyen-Phung and Hai Le
Soc. Sci. 2024, 13(5), 253; https://doi.org/10.3390/socsci13050253 - 06 May 2024
Abstract
Utilizing data from the 2016 Vietnam Household Living Standard Survey, we undertake an empirical investigation into the influence of energy poverty on the health expenditure of Vietnamese households. Employing a double-hurdle model, our empirical findings reveal a negative relationship between energy poverty and [...] Read more.
Utilizing data from the 2016 Vietnam Household Living Standard Survey, we undertake an empirical investigation into the influence of energy poverty on the health expenditure of Vietnamese households. Employing a double-hurdle model, our empirical findings reveal a negative relationship between energy poverty and health expenditure. Specifically, our results indicate that for each incremental unit increase in energy poverty, there is a substantial reduction of 42.5 percentage points in the overall health expenditure of the households. Furthermore, as energy poverty deepens, we observe declines of 24.6 percentage points and 45.5 percentage points in the expenses incurred for inpatient/outpatient care and self-treatment, respectively. To validate the robustness of our results, we conduct several sensitivity analyses, including propensity score matching, double/debiased machine learning. Across all these methods, our findings consistently underscore the significant and persistent adverse impact of energy poverty on the examined outcome variables. Additionally, to examine the underlying pathways, we conduct a structural equation modeling analysis and find that the relationship between energy poverty and health expenses is mediated by household hospitalization and expenditures on essential items, such as food and daily necessities. Full article
(This article belongs to the Section Social Economics)
21 pages, 315 KiB  
Article
“We Cannot Go There, They Cannot Come Here”: Dispersed Care, Asian Indian Immigrant Families and the COVID-19 Pandemic
by Rianka Roy, Bandana Purkayastha and Elizabeth Chacko
Soc. Sci. 2024, 13(5), 252; https://doi.org/10.3390/socsci13050252 - 06 May 2024
Abstract
The COVID-19 pandemic disrupted families and displaced individuals. For migrant workers, these disruptions and displacements exacerbated the state-imposed constraints on family formation. But how did high-skilled and high-wage immigrants, presumably immune from these challenges, provide care to and receive care from families during [...] Read more.
The COVID-19 pandemic disrupted families and displaced individuals. For migrant workers, these disruptions and displacements exacerbated the state-imposed constraints on family formation. But how did high-skilled and high-wage immigrants, presumably immune from these challenges, provide care to and receive care from families during the pandemic? Based on 33 in-depth interviews with high-skilled Asian Indian immigrants in the USA during the pandemic, we note disruptions in their care to and from families. These disruptions reveal a persistent pattern of dispersion in immigrant families which leads to what we call “dispersed care.” By “dispersed care” we identify the effects of various state-imposed immigration laws and policies, which force immigrants to divide and allocate care among multiple fragments of their families in home and host countries. Dispersed care affects immigrant workers’ professional output, forcing them to make difficult choices between their career and care commitments. To unsettle the assumed homogeneity of high-skilled “Asian Indians,” we choose participants at diverse intersections of their migration pathways—naturalized US citizens, permanent US residents, and temporary visa holders or nonimmigrants. While naturalized US citizens and permanent residents have better resources to maintain transnational family ties than nonimmigrants, all of them face the intersectional challenges of dispersed care. Full article
20 pages, 646 KiB  
Article
Exploring Motivators for Trust in the Dichotomy of Human—AI Trust Dynamics
by Michael Gerlich
Soc. Sci. 2024, 13(5), 251; https://doi.org/10.3390/socsci13050251 - 06 May 2024
Abstract
This study analyses the dimensions of trust in artificial intelligence (AI), focusing on why a significant portion of the UK population demonstrates a higher level of trust in AI compared to humans. Conducted through a mixed-methods approach, this study gathered 894 responses, with [...] Read more.
This study analyses the dimensions of trust in artificial intelligence (AI), focusing on why a significant portion of the UK population demonstrates a higher level of trust in AI compared to humans. Conducted through a mixed-methods approach, this study gathered 894 responses, with 451 meeting the criteria for analysis. It utilised a combination of a six-step Likert-scale survey and open-ended questions to explore the psychological, sociocultural, and technological facets of trust. The analysis was underpinned by structural equation modelling (SEM) and correlation techniques. The results unveil a strong predilection for trusting AI, mainly due to its perceived impartiality and accuracy, which participants likened to conventional computing systems. This preference starkly contrasts with the scepticism towards human reliability, which is influenced by the perception of inherent self-interest and dishonesty in humans, further exacerbated by a general distrust in media narratives. Additionally, this study highlights a significant correlation between distrust in AI and an unwavering confidence in human judgment, illustrating a dichotomy in trust orientations. This investigation illuminates the complex dynamics of trust in the era of digital technology, making a significant contribution to the ongoing discourse on AI’s societal integration and underscoring vital considerations for future AI development and policymaking. Full article
(This article belongs to the Section Contemporary Politics and Society)
Show Figures

Figure 1

13 pages, 2390 KiB  
Article
Anti-Leishmania major Properties of Nuphar lutea (Yellow Water Lily) Leaf Extracts and Purified 6,6′ Dihydroxythiobinupharidine (DTBN)
by Orit Shmuel, Aviv Rasti, Melodie Zaknoun, Nadav Astman, Avi Golan-Goldhirsh, Orly Sagi and Jacob Gopas
Pathogens 2024, 13(5), 384; https://doi.org/10.3390/pathogens13050384 - 06 May 2024
Abstract
Cutaneous leishmaniasis (CL) is a zoonotic disease, manifested as chronic ulcers, potentially leaving unattractive scars. There is no preventive vaccination or optimal medication against leishmaniasis. Chemotherapy generally depends upon a small group of compounds, each with its own efficacy, toxicity, and rate of [...] Read more.
Cutaneous leishmaniasis (CL) is a zoonotic disease, manifested as chronic ulcers, potentially leaving unattractive scars. There is no preventive vaccination or optimal medication against leishmaniasis. Chemotherapy generally depends upon a small group of compounds, each with its own efficacy, toxicity, and rate of drug resistance. To date, no standardized, simple, safe, and highly effective regimen for treating CL exists. Therefore, there is an urgent need to develop new optimal medication for this disease. Sesquiterpen thio-alkaloids constitute a group of plant secondary metabolites that bear great potential for medicinal uses. The nupharidines found in Nuphar lutea belong to this group of compounds. We have previously published that Nuphar lutea semi-purified extract containing major components of nupharidines has strong anti-leishmanial activity in vitro. Here, we present in vivo data on the therapeutic benefit of the extract against Leishmania major (L. major) in infected mice. We also expanded these observations by establishing the therapeutic effect of the extract-purified nupharidine 6,6′-dihydroxythiobinupharidine (DTBN) in vitro against promastigotes and intracellular amastigotes as well as in vivo in L. major-infected mice. The results suggest that this novel anti-parasitic small molecule has the potential to be further developed against Leishmania. Full article
(This article belongs to the Special Issue Leishmaniasis: Transmission, Pathogenesis and Treatment)
Show Figures

Figure 1

12 pages, 2297 KiB  
Article
Migration Activity of Spodoptera litura (Lepidoptera: Noctuidae) between China and the South-Southeast Asian Region
by Yifei Song, Xinzhu Cang, Wei He, Haowen Zhang and Kongming Wu
Insects 2024, 15(5), 335; https://doi.org/10.3390/insects15050335 - 06 May 2024
Abstract
The common cutworm, Spodoptera litura (F.), feeds on a wide variety of food and cash crops and is one of the most widespread and destructive agricultural pests worldwide. Migration is the biological basis of its regional population outbreaks but the seasonal movement of [...] Read more.
The common cutworm, Spodoptera litura (F.), feeds on a wide variety of food and cash crops and is one of the most widespread and destructive agricultural pests worldwide. Migration is the biological basis of its regional population outbreaks but the seasonal movement of this pest between east and south Asia regions remains unknown. In this study, searchlight traps were used to monitor the seasonal migration of S. litura from 2019 to 2023 in Ruili City (Yunnan, China), located along the insect migratory route between China and the south Asia region. The results showed that migratory activity could occur throughout the year, with the main periods found in spring (April–May) and autumn (October–December). The ovarian development and mating status of the trapped females indicated that most individuals were in the middle or late stages of migration and that Ruili City was located in the transit area of the long-distance migration of the pest. In the migration trajectory simulation, populations of S. litura moved from northeast India, Bangladesh, and northern Myanmar to southwestern China along the southern margin of the Himalayas in spring and returned to the south Asia region in autumn. Our findings clarify the seasonal migration patterns of S. litura in China and South Asia and facilitate the development of regional cross-border monitoring and management systems for this pest. Full article
(This article belongs to the Section Insect Pest and Vector Management)
Show Figures

Figure 1

9 pages, 657 KiB  
Article
Effects of RDL GABA Receptor Point Mutants on Susceptibility to Meta-Diamide and Isoxazoline Insecticides in Drosophila melanogaster
by Tianhao Zhou, Weiping Wu, Suhan Ma, Jie Chen, Jia Huang and Xiaomu Qiao
Insects 2024, 15(5), 334; https://doi.org/10.3390/insects15050334 - 06 May 2024
Abstract
Ionotropic γ-aminobutyric acid (GABA) receptors in insects, specifically those composed of the RDL (resistant to dieldrin) subunit, serve as important targets for commonly used synthetic insecticides. These insecticides belong to various chemical classes, such as phenylpyrazoles, cyclodienes, meta-diamides, and isoxazolines, with the latter [...] Read more.
Ionotropic γ-aminobutyric acid (GABA) receptors in insects, specifically those composed of the RDL (resistant to dieldrin) subunit, serve as important targets for commonly used synthetic insecticides. These insecticides belong to various chemical classes, such as phenylpyrazoles, cyclodienes, meta-diamides, and isoxazolines, with the latter two potentially binding to the transmembrane inter-subunit pocket. However, the specific amino acid residues that contribute to the high sensitivity of insect RDL receptors to these novel insecticides remain elusive. In this study, we investigated the susceptibility of seven distinct Drosophila melanogaster Rdl point mutants against four meta-diamide and isoxazoline insecticides: isocycloseram, fluxametamide, fluralaner, and broflanilide. Our findings indicate that, despite exhibiting increased sensitivity to fluralaner in vitro, the RdlI276C mutant showed resistance to isocycloseram and fluxametamide. Similarly, the double-points mutant RdlI276F+G279S also showed decreased sensitivity to the tested isoxazolines. On the other hand, the RdlG335M mutant displayed high levels of resistance to all tested insecticides. Molecular modeling and docking simulations further supported these findings, highlighting similar binding poses for these insecticides. In summary, our research provides robust in vivo evidence supporting the idea that the inter-subunit amino acids within transmembrane M1 and M3 domains form the binding site crucial for meta-diamide and isoxazoline insecticide interactions. This study highlights the complex interplay between mutations and insecticide susceptibility, paving the way for more targeted pest control strategies. Full article
(This article belongs to the Section Insect Molecular Biology and Genomics)
Show Figures

Figure 1

Open Access Journals

Browse by Indexing Browse by Subject Selected Journals
Back to TopTop