bluuebunny/crossref_metadata_2025 huggingface dataset:
Uncontrolled Hypertension, Treatment, and Predictors among Hypertensive Out-Patients Attending Primary Health Facilities in Johannesburg, South Africa
Authors: Makukule Amaziah , Modjadji Perpetua , Thovhogi Ntevhe , Mokgalaboni Kabelo , Kengne Andre Pascal
Published: October 2023

Hypertension is a poorly controlled risk factor for cardiovascular disease in South Africa, particularly among patients receiving care in the public sector who are mostly from low socioeconomic backgrounds. This cross-sectional study investigated uncontrolled hypertension, treatment, and predictors among hypertensive out-patients attending primary health care facilities in Johannesburg, South Africa. The WHO STEPwise approach to the surveillance of non-communicable diseases was used to collect data, including sociodemographic and lifestyle factors, health status, and measurements for anthropometry and blood pressure along with self-reported adherence to treatment, estimated through the general medication adherence scale. Uncontrolled hypertension was defined as systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg in diagnosed patients receiving anti-hypertensive treatment. Overweight and obesity were defined as a body mass index ≥25 and ≥30 kg/m2, respectively. Logistic regression models were used to assess the predictors of uncontrolled hypertension. Four hundred (n = 400) hypertensive out-patients (mean age: 50 ± 8 years) participated in this study, with most living in poor sociodemographic environments. The prevalence rate of uncontrolled hypertension was 57%. Obesity (62% vs. 42%, p ≤ 0.0001), salt consumption (90% vs. 55%, p ≤ 0.0001), alcohol intake (42% vs. 19%, p ≤ 0.0001), a smoking habit (23% vs. 4%, p ≤ 0.0001), alternative medicine use (51% vs. 40%, p = 0.043), and comorbidities (64% vs. 36%, p ≤ 0.0001) were higher in the uncontrolled group than the controlled group, whereas the prevalence of physical activity (38% vs. 15%, p ≤ 0.0001) was high in the controlled group vs. the uncontrolled. Overall, 85% of the patients moderately adhered to treatment, only 2% exhibited high adherence, and 13% demonstrated low adherence; over half of the patients received tri-therapy treatment. The predictors of uncontrolled hypertension are a number of prescribed antihypertensive therapies [adjusted odds ration = 2.39; 95% confidence interval: 1.48–3.87], treatment adherence [0.46; 0.21–0.97], salt consumption [28.35; 7.87–102.04], physical activity [0.22; 0.13–0.37], current alcohol use [2.10; 1.22–3.61], and current cigarette smoking [4.79; 1.88–12.18]. The high prevalence of uncontrolled hypertension in this study suggests a need to optimize prescriptions, adherence to BP-lowering medications, and lifestyle modifications. The management of comorbidities such as diabetes could offer considerable benefits in controlling blood pressure.
Orofacial Migraine and Other Idiopathic Non-Dental Facial Pain Syndromes: A Clinical Survey of a Social Orofacial Patient Group
Authors: Reina Federica , Salemi Giuseppe , Capizzi Mariarita , Lo Cascio Salvatore , Marino Antonio , Santangelo Giuseppe , Santangelo Andrea , Mineri Mirko , Brighina Filippo , Raieli Vincenzo , Costa Carmelo Attilio
Published: October 2023

Background: Orofacial pain syndromes (OFPs) are a heterogeneous group of syndromes mainly characterized by painful attacks localized in facial and oral structures. According to the International Classification of Orofacial Pain (ICOP), the last three groups (non-dental facial pain, NDFP) are cranial neuralgias, facial pain syndromes resembling primary headache syndromes, and idiopathic orofacial pain. These are often clinical challenges because the symptoms may be similar or common among different disorders. The diagnostic efforts often induce a complex diagnostic algorithm and lead to several imaging studies or specialized tests, which are not always necessary. The aim of this study was to describe the encountered difficulties by these patients during the diagnostic–therapeutic course. Methods: This study was based on the responses to a survey questionnaire, administered to an Italian Facebook Orofacial Patient Group, searching for pain characteristics and diagnostic–therapeutic care courses. The questionnaire was filled out by patients affected by orofacial pain, who were 18 years and older, using a free online tool available on tablets, smartphones, and computers. Results: The sample was composed of 320 subjects (244F/76M), subdivided by age range (18–35 ys: 17.2%; 36–55 ys: 55.0%; >55 ys 27.8%). Most of the patients were affected by OFP for more than 3 years The sample presented one OFP diagnosis in 60% of cases, more than one in 36.2% of cases, and 3.8% not classified. Trigeminal neuralgia is more represented, followed by cluster headaches and migraines. About 70% had no pain remission, showing persisting background pain (VAS median = 7); autonomic cranial signs during a pain attack ranged between 45 and 65%. About 70% of the subjects consulted at least two different specialists. Almost all received drug treatment, about 25% received four to nine drug treatments, 40% remained unsatisfied, and almost 50% received no pharmacological treatment, together with drug therapy. Conclusion: To the authors’ knowledge, this is the first study on an OFP population not selected by a third-level specialized center. The authors believe this represents a realistic perspective of what orofacial pain subjects suffer during their diagnostic–therapeutic course and the medical approach often results in unsatisfactory outcomes.
Evaluating Rural Health Disparities in Colombia: Identifying Barriers and Strategies to Advancing Refugee Health
Authors: Diaz John , Taboada Isabel , Abreu Adriana , Vargas Lara , Polanco Ysabel , Zorrilla Alex , Beatty Norman
Published: October 2023

Health disparities within rural communities, notably those affecting migrant and refugee populations, are well-documented. Refugees often grapple with high disease burdens and mortality rates due to limited access to primary healthcare and their vulnerable socio-economic and political situations. This issue is particularly acute in the rural areas around Medellin, Colombia, where the refugee influx exacerbates the existing public health challenges. Studies highlight a substantial gap between community needs and public health policies, resulting in inadequate healthcare access. Our study, utilizing the Delphi technique, aimed to identify common barriers and strategies to enhance rural healthcare for refugees. Through consensus-building with community leaders, we identified six primary barriers to healthcare access and five barriers to healthcare quality. Community leaders endorsed five strategies to address the access barriers and eight strategies to improve healthcare quality. This research provides valuable insights for optimizing resource allocation and designing effective support programs for these vulnerable populations.
A Review of Patient Experiences and Provider Education to Improve Transgender Health Inequities in the USA
Authors: Tanenbaum Gabriel J. , Holden LaTasha R.
Published: October 2023

Transgender individuals are an underserved, vulnerable population. They face many inequities including barriers in both accessing and receiving adequate healthcare. These inequities are proposed here to be rooted in a lack of education about transgender people and their experiences. We begin by exploring the existing transgender healthcare research carried out in the USA, examining client experiences, provider education and attitudes, and the barriers transgender people face to obtaining proper healthcare. Secondly, we look at the previous research on educational interventions implemented with medical students and practitioners in the USA to enhance knowledge about transgender people, and increase sensitivity and awareness, while also increasing the level of comfort in working with these clients. The limitations in these fields of study are discussed in order to understand how to better serve transgender clients in the USA. We will do this through a narrative review to determine evidence-based best practices for educational intervention, uncovering gaps in the literature and highlighting where to focus in future work for researchers and practitioners.
The Intersection of Health Literacy and Public Health: A Machine Learning-Enhanced Bibliometric Investigation
Authors: Tabak Benjamin , Froner Matheus , Corrêa Rafael , Silva Thiago
Published: October 2023

In recent decades, health literacy has garnered increasing attention alongside a variety of public health topics. This study aims to explore trends in this area through a bibliometric analysis. A Random Forest Model was utilized to identify keywords and other metadata that predict average citations in the field. To supplement this machine learning analysis, we have also implemented a bibliometric review of the corpus. Our findings reveal significant positive coefficients for the keywords “COVID-19” and “Male”, underscoring the influence of the pandemic and potential gender-related factors in the literature. On the other hand, the keyword “Female” showed a negative coefficient, hinting at possible disparities that warrant further investigation. Additionally, evolving themes such as COVID-19, mental health, and social media were discovered. A significant change was observed in the main publishing journals, while the major contributing authors remained the same. The results hint at the influence of the COVID-19 pandemic and a significant association between gender-related keywords on citation likelihood, as well as changing publication strategies, despite the fact that the main researchers remain those who have been studying health literacy since its creation.
Effects of a Participation in a Structured Writing Retreat on Doctoral Mental Health: An Experimental and Comprehensive Study
Authors: Vincent Cynthia , Tremblay-Wragg Émilie , Plante Isabelle
Published: October 2023

Challenges faced by doctoral researchers led to a concerning “doctoral mental health crisis” within academia. Recognizing the pressing need to address mental health concerns, notably among doctoral students, the Quebec Ministry of Higher Education introduced the Higher Education Student Mental Health Action Plan 2021–2026. One potentially relevant intervention approach is the implementation of tailored structured writing retreats for graduate students. Aiming to measure and explain the effects of participating to a three-day writing retreat on doctoral mental health, this study followed an explanatory sequential mixed method, including an experimental design. One hundred doctoral researchers were randomly assigned to either the experimental group (n = 50) or the waitlist control trial group (n = 50). Both groups answered a questionnaire comprising validated scales and open-ended questions at different timepoints, separated by a two-week gap. Results reveal that writing retreats reduced doctoral researchers’ psychological distress and improved their psychological, emotional, and social wellbeing. Among the multiple writing retreat aspects evaluated, only productivity experienced, as well as socialization/networking opportunities, acted as predictors for all doctoral mental health measures. Qualitative findings further supported the importance of perceived productivity and socialization/networking in promoting doctoral mental health. Recommendations are provided for fostering a supportive research work environment for doctoral researchers.
Effects of 12 Weeks of Family and Individual Multi-Disciplinary Intervention in Overweight and Obese Adolescents under Cardiometabolic Risk Parameters: A Clinical Trial
Authors: de Souza Marques Déborah , dos Santos Moraes Lilian , de Souza Marques Marilene , Ryal Joed , Santos Isabella , De Paula Silva Lalucci Marielle , Mota Jorge , Valdés-Badilla Pablo , Westphal Nardo Greice , Magnani Branco Braulio
Published: October 2023

Adolescence is a complex period of human development in which young people are susceptible to unhealthy behaviors, such as physical inactivity and an unbalanced diet. This study aimed to analyze the effects of 12 weeks of multi-disciplinary family and individual intervention on cardiometabolic risk parameters in overweight and obese adolescents and compare sub-groups, considering possible differences between sexes (males vs. females vs. intervention approach). Forty-three adolescents (13.73 ± 2.46 years old) of both sexes were divided into two groups: family group (FG) (n = 21; 14.24 ± 2.61 years old) and individual group (IG) (n = 22; 13.23 ± 2.27 years old). The following parameters were evaluated: anthropometry (body weight, height, waist circumference (WC), hip circumference (HC), abdominal circumference (AC), calculation of body mass index (BMI), and waist–hip ratio (WHR)), body composition (fat mass (FM), lean mass (LM), fat-free mass (FFM), skeletal muscle mass (SMM), body fat percentage (BF), and visceral fat), biochemical measures (fasting glucose, triglycerides (TG), total cholesterol (TC), low-density lipoproteins (LDL-c), and high-density lipoproteins (HDL-c)), and the measurement of systolic and diastolic blood pressure (SBP and DBP) before and after the interventions. The multi-disciplinary interventions occurred for 12 weeks (three days a week lasting 1 h and 30 min, in which 30 min were dedicated to theoretical interventions (nutrition: nutritional education and psychology: psychoeducation) and 1 h to physical exercises. A time effect was observed for LM, FFM, SMM, FM, and HDL-c, with higher values after intervention and a significant decrease for FM, BF, visceral fat, fasting glucose, TG, TC, LDL-c, and DBP (p < 0.05). However, no group, sub-group, or interaction effects were observed when comparing FG, IG, or sexes (p > 0.05). The responses of the present study show that both multi-disciplinary approaches (family and individual) promoted improvement in the body composition indicators, biochemical markers, and DBP of overweight and obese adolescents independently of the intervention group. Given this finding, health professionals, families, and adolescents could choose the type of intervention based on their preferences.
Cranial Neural Crest Specific Deletion of Alpl (TNAP) via P0-Cre Causes Abnormal Chondrocyte Maturation and Deficient Cranial Base Growth
Authors: Ohkura Naoto , Nam Hwa Kyung , Liu Fei , Hatch Nan
Published: October 2023

Bone growth plate abnormalities and skull shape defects are seen in hypophosphatasia, a heritable disorder in humans that occurs due to the deficiency of tissue nonspecific alkaline phosphatase (TNAP, Alpl) enzyme activity. The abnormal development of the cranial base growth plates (synchondroses) and abnormal skull shapes have also been demonstrated in global Alpl−/− mice. To distinguish local vs. systemic effects of TNAP on skull development, we utilized P0-Cre to knockout Alpl only in cranial neural crest-derived tissues using Alpl flox mice. Here, we show that Alpl deficiency using P0-Cre in cranial neural crest leads to skull shape defects and the deficient growth of the intersphenoid synchondrosis (ISS). ISS chondrocyte abnormalities included increased proliferation in resting and proliferative zones with decreased apoptosis in hypertrophic zones. ColX expression was increased, which is indicative of premature differentiation in the absence of Alpl. Sox9 expression was increased in both the resting and prehypertrophic zones of mutant mice. The expression of Parathyroid hormone related protein (PTHrP) and Indian hedgehog homolog (IHH) were also increased. Finally, cranial base organ culture revealed that inorganic phosphate (Pi) and pyrophosphate (PPi) have specific effects on cell signaling and phenotype changes in the ISS. Together, these results demonstrate that the TNAP expression downstream of Alpl in growth plate chondrocytes is essential for normal development, and that the mechanism likely involves Sox9, PTHrP, IHH and PPi.
Berberine-Encapsulated Poly(lactic-co-glycolic acid)–Hydroxyapatite (PLGA/HA) Microspheres Synergistically Promote Bone Regeneration with DOPA-IGF-1 via the IGF-1R/PI3K/AKT/mTOR Pathway
Authors: Chen Li , Tian Meng , Yang Jing , Wu Zhenxu
Published: October 2023

Polymer microspheres have recently shown outstanding potential for bone tissue engineering due to their large specific surface area, good porosity, injectable property, good biocompatibility, and biodegradability. Their good load-release function and surface modifiability make them useful as a carrier of drugs or growth factors for the repair of bone defects in irregularly injured or complex microenvironments, such as skull defects. In this study, berberine (BBR)-encapsulated poly(lactic-co-glycolic acid) (PLGA)/hydroxyapatite (HA) microspheres were fabricated using electrified liquid jets and a phase-separation technique, followed by modification with the 3,4-hydroxyphenalyalanine-containing recombinant insulin-like growth–factor-1 (DOPA-IGF-1). Both the BBR and the IGF-1 exhibited sustained release from the IGF-1@PLGA/HA-BBR microspheres, and the composite microspheres exhibited good biocompatibility. The results of the alkaline phosphatase (ALP) activity assays showed that the BBR and IGF-1 in the composite microspheres synergistically promoted the osteogenic differentiation of MC3T3-E1 cells. Furthermore, it was confirmed that immobilized IGF-1 enhances the mRNA expression of an osteogenic-related extracellular matrix and that BBR accelerates the mRNA expression of IGF-1-mediated osteogenic differentiation and cell mineralization. Further cellular studies demonstrate that IGF-1 could further synergistically activate the IGF-1R/PI3K/AKT/mTOR pathway using BBR, thereby enhancing IGF-1-mediated osteogenesis. Rat calvarial defect repair experiments show that IGF-1@PLGA/HA-BBR microspheres can effectively promote the complete bony connection required to cover the defect site and enhance bone defect repair. These findings suggest that IGF-1@PLGA/HA-BBR composite microspheres show a great potential for bone regeneration.
Homozygous C677T Methylenetetrahydrofolate Reductase (MTHFR) Polymorphism as a Risk Factor for Endometriosis: A Retrospective Case–Control Study
Authors: Delli Carpini Giovanni , Giannella Luca , Di Giuseppe Jacopo , Montik Nina , Montanari Michele , Fichera Mariasole , Crescenzi Daniele , Marzocchini Carolina , Meccariello Maria Liberata , Di Biase Donato , Vignini Arianna , Ciavattini Andrea
Published: October 2023

This study was conducted to evaluate the role of methylenetetrahydrofolate reductase (MTHFR) C677T homozygous polymorphism as a risk factor for endometriosis. A retrospective case–control study was conducted from January 2020 to December 2022 on all patients attending the gynecological outpatient clinic of our institution who had performed an MTHFR polymorphisms test. Patients with endometriosis were considered cases, while those without endometriosis were considered controls. The presence of an MTHFR C677T homozygous polymorphism was defined as exposure. Risk factors for endometriosis were considered confounders in a binomial logistic regression, with endometriosis diagnosis as the dependent variable. Among the 409 included patients, 106 (25.9%) cases and 303 (74.1%) controls were identified. A higher rate of MTHFR C677T homozygous polymorphism was found in patients with endometriosis (24.5% vs. 15.8%, p = 0.0453), with an adOR of 1.889 (95% CI 1.076–3.318, p = 0.0269) at the binomial logistic regression. A history of no previous pregnancy was associated with an endometriosis diagnosis (adOR 2.191, 95% CI 1.295–3.708, p = 0.0035). An MTHFR C677T homozygous polymorphism could be considered a risk factor for endometriosis. Epigenetic modifications may be the most important mechanism explaining the observed association through the processes of altered DNA methylation and reduced activity of antioxidant systems.
Surrogate Modeling of the Aeroacoustics of an NM80 Wind Turbine
Authors: De Girolamo Filippo , Tieghi Lorenzo , Delibra Giovanni , Barnabei Valerio Francesco , Corsini Alessandro
Published: October 2023

Wind turbines play a major role in the European Green Deal for clean energy transition. Noise is a critical aspect among open technological issues, as it determines the possibility of onshore installations near inhabited places and the possible detrimental effects on wildlife when offshore. This paper assesses the accuracy of different approaches to predicting the sound pressure level (SPL) of a wind turbine. The 2.75 MW Neg Micon NM80 horizontal axis wind turbine (HWAT) was simulated in OpenFOAM, modeling the turbine with the actuator line method (ALM) implemented in the turbinesFoam library. Two different inflow conditions were considered: a stationary inflow with a typical atmospheric boundary layer profile and a time-dependent inflow derived from a precursor channel with fully turbulent conditions. The surrogate model for noise prediction used for this work is based on the synthetic/surrogate acoustics models (SAMs) of Amiet and Brooks-Pope-Marcolini (BPM). This approach allows for blade motion modeling and the prediction of the SPL of the URANS postprocessing results. The SPL spectrum obtained was then compared to the results from the other aeroacoustic solvers of IEA Task 39 participants, showing the best performance in the fully turbulent case. The results demonstrate that coupling between the ALM and surrogate acoustics provides more accurate results than the blade element momentum (BEM) approach.
Computing the Sound–Sense Harmony: A Case Study of William Shakespeare’s Sonnets and Francis Webb’s Most Popular Poems
Authors: Delmonte Rodolfo
Published: October 2023

Poetic devices implicitly work towards inducing the reader to associate intended and expressed meaning to the sounds of the poem. In turn, sounds may be organized a priori into categories and assigned presumed meaning as suggested by traditional literary studies. To compute the degree of harmony and disharmony, I have automatically extracted the sound grids of all the sonnets by William Shakespeare and have combined them with the themes expressed by their contents. In a first experiment, sounds have been associated with lexically and semantically based sentiment analysis, obtaining an 80% of agreement. In a second experiment, sentiment analysis has been substituted by Appraisal Theory, thus obtaining a more fine-grained interpretation that combines dis-harmony with irony. The computation for Francis Webb is based on his most popular 100 poems and combines automatic semantically and lexically based sentiment analysis with sound grids. The results produce visual maps that clearly separate poems into three clusters: negative harmony, positive harmony and disharmony, where the latter instantiates the need by the poet to encompass the opposites in a desperate attempt to reconcile them. Shakespeare and Webb have been chosen to prove the applicability of the method proposed in general contexts of poetry, exhibiting the widest possible gap at all linguistic and poetic levels.
A Conceptual Design of an AI-Enabled Decision Support System for Analysing Donor Behaviour in Nonprofit Organisations
Authors: Alsolbi Idrees , Agarwal Renu , Unhelkar Bhuvan , Al-Jabri Tareq , Samarawickrama Mahendra , Tafavogh Siamak , Prasad Mukesh
Published: October 2023

Analysing and understanding donor behaviour in nonprofit organisations (NPOs) is challenging due to the lack of human and technical resources. Machine learning (ML) techniques can analyse and understand donor behaviour at a certain level; however, it remains to be seen how to build and design an artificial-intelligence-enabled decision-support system (AI-enabled DSS) to analyse donor behaviour. Thus, this paper proposes an AI-enabled DSS conceptual design to analyse donor behaviour in NPOs. A conceptual design is created following a design science research approach to evaluate an AI-enabled DSS’s initial DPs and features to analyse donor behaviour in NPOs. The evaluation process of the conceptual design applied formative assessment by conducting interviews with stakeholders from NPOs. The interviews were conducted using the Appreciative Inquiry framework to facilitate the process of interviews. The evaluation of the conceptual design results led to the recommendation for efficiency, effectiveness, flexibility, and usability in the requirements of the AI-enabled DSS. This research contributes to the design knowledge base of AI-enabled DSSs for analysing donor behaviour in NPOs. Future research will combine theoretical components to introduce a practical AI-enabled DSS for analysing donor behaviour in NPOs. This research is limited to such an analysis of donors who donate money or volunteer time for NPOs.
Growth Performance, Diet Digestibility, and Chemical Composition of Mealworm (Tenebrio molitor L.) Fed Agricultural By-Products
Authors: Montalbán Ana , Martínez-Miró Silvia , Schiavone Achille , Madrid Josefa , Hernández Fuensanta
Published: October 2023

Humanity’s growing demand for animal protein exceeds the capacity of traditional protein sources to support growing livestock production. Insects offer promising partial substitutes, converting low-nutritional quality materials into high-value biomass. Hence, the bioconversion ability of Tenebrio molitor larvae was assessed by using three types of agricultural by-products (broccoli by-product, tigernut pulp, and grape pomace) at different inclusion levels (0%, 25%, 50%, and 100%) in a carbohydrate-based diet. Ten diets were formulated to assess their impact on the growth, diet digestibility, and nutritional composition of the larvae. For each treatment, eight replicates were employed: five for the growth-performance-digestibility trial and three for the complementary test of uric acid determination. The growth was influenced by the type of diet administered. The broccoli by-product resulted in higher larvae weight and a better feed conversion ratio. However, diets based solely on a single by-product (100%) compromised the productivity and diet digestibility. The larvae changed their nutritional composition depending on the rearing substrate, although the amino acid profile remained consistent. In conclusion, the studied by-products have the potential for use in T. molitor rearing as part of the diet but not as the exclusive ingredients, indicating promising opportunities for using agricultural by-products in T. molitor rearing and production.
Diapause Induction, Color Changes, and Supercooling Point of Diapause Larvae of Tetrastichus septentrionalis Yang (Hymenoptera: Eulophidae)
Authors: Li Zhixin , Shi Junrui , Yang Liyuan , Cheng Yiran , Liu Xudan , Sun Shouhui
Published: October 2023

The chalcid wasp Tetrastichus septentrionalis Yang (Hymenoptera: Eulophidae) is one of the dominant pupal parasitoids of Hyphantria cunea (Drury) (Lepidoptera: Erebidae). In this study, the photoperiod’s effect on diapause induction in T. septentrionalis using the alternative host Tenebrio molitor was measured, revealing that T. septentrionalis is of the long-day type. The critical photoperiods for diapause induction in T. septentrionalis were estimated to be between photoperiods of 13:11 and 14:10 (L:D) h at 18 °C, and between photoperiods of 12:12 and 13:11 (L:D) h at 21 °C and 24 °C. We also found that T. septentrionalis diapausing larvae were grey-brown, while normally developed (non-diapausing) individuals were light yellow. The diapause-sensitive insect state was the larval stage, and the short light exposure treatment had a significant cumulative effect on diapause induction. The least squares method was used to calculate a lower developmental threshold of 13.34 ± 0.50 °C and an effective cumulative temperature of 184.46 ± 11.46 d·°C for post-diapause development. The average supercooling point of diapausing mature larvae was significantly lower than that of non-diapausing ones. Our research on T. septentrionalis provides a reference for the biological control of H. cunea and other leaf-eating pests.
Exploring a Potential Avenue for Beekeeping in Ireland: Safeguarding Locally Adapted Honeybees for Breeding Varroa-Resistant Lines
Authors: Smith Stephen , Moro Arrigo , McCormack Grace P.
Published: October 2023

Beekeeping in Ireland has been strongly impacted by the parasitic mite Varroa destructor, whose introduction caused alarming honeybee colony losses. If unmitigated, these losses could lead to the disappearance of the native honeybee subspecies, Apis mellifera mellifera, with severe consequences for local biodiversity. Although beekeepers play a pivotal role in mitigating this crisis, beekeeping in Ireland is less intensive compared to other European regions, lacking significant infrastructure or support. These circumstances offer a unique opportunity for the development of national programmes that promote sustainable beekeeping practices for varroa control. Notably, local accounts highlight an increasing number of beekeepers successfully managing colonies in the absence of treatments, indicating a potential avenue for developing varroa-resistant stocks through selection of local colonies. Through a survey, we explored beekeeper’s opinions and attitudes towards future national projects focused on the development of sustainable beekeeping practices and selection for varroa resistance. The findings confirm the hobbyist nature of Irish beekeepers and their preference for the native honey bee. Some beekeepers were reported to be effectively controlling varroa without treatment, yielding comparable survivals to those using treatments. The majority expressed preference towards a varroa-resistant line if it were of native origin; a few were open to importing non-Irish lines. Overall, a strong willingness to participate in a national breeding programme was expressed. These findings highlight a prime opportunity for Ireland to establish a community-driven strategy based on sustainable beekeeping practices for safeguarding native honeybees and local biodiversity.
Relationship between Dry Eye Disease and Dyslipidemia: A Systematic Review
Authors: Wang Tzu-Hao , Tsai Yuan-Jen , Wang Yuan-Hung , Wu Chien-Liang , Lin I-Chan
Published: October 2023

Background: Dyslipidemia has been suggested to be associated with the occurrence of dry eye disease (DED). However, whether dyslipidemia is responsible for the development of DED remains unclear. In this systematic review, we explored the relationship between DED and dyslipidemia by using quantitative data. Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we conducted a comprehensive literature search in several databases, including PubMed, Embase, Cochrane Library, Web of Science, and Google Scholar, and obtained six relevant studies. Results: Our findings indicated that the majority of the selected studies reported a statistically significant association between dyslipidemia and DED, particularly in women. However, our quantitative analysis revealed that only two studies reported statistically significant differences in total cholesterol and high-density lipoprotein cholesterol values. Conclusion: No statistically significant differences exist in the majority of lipid profile parameters between individuals with and without DED, but there is a statistically significant association between dyslipidemia and DED.
Differences in Prevalence of Transfusion Protocols between Critically Ill Neurologic and Non-Neurologic Patient Populations
Authors: Oliveira Thiago M. , Billington Michael E. , Seethala Raghu R. , Hou Peter C. , Askari Reza , Aisiku Imoigele P.
Published: October 2023

This study describes the prevalence of blood transfusion protocols in ICUs caring for neurologically vs. non-neurologically injured patients across a sample of US ICUs. This prospective, observational multi-center cohort study is a subgroup analysis of the USCIITG—CIOS, comprising 69 ICUs across the US (25 medical, 24 surgical, 20 mixed ICUs). Sixty-four ICUs were in teaching hospitals. A total of 6179 patients were enrolled, with 1266 (20.4%) having central nervous system (CNS) primary diagnoses. We evaluated whether CNS versus non-CNS diagnosis was associated with care in ICUs with restrictive transfusion protocols (RTPs) or massive transfusion protocols (MTPs) and whether CNS versus non-CNS diagnosis was associated with receiving blood products or colloids during the initial 24 h of care. Protocol utilization in CNS vs. non-CNS patients was as follows: RTPs—36.9% vs. 42.9% (p < 0.001); MTPs—48.3% vs. 47.4% (p = 0.57). Blood product transfusions in the first 24 h of ICU care (comparing CNS vs. non-CNS patients) were as follows: packed red blood cells—4.3% vs. 14.6% (p < 0.001); fresh frozen plasma—2.9% vs. 5.1% (p < 0.001); colloid blood products—3.2% vs. 9.2% (p < 0.001). In this cohort, we found differences in ICU utilization of RTPs, but not MTPs, when comparing where critically ill patients with neurologic versus non-neurologic primary diagnoses received ICU care.
Cerebrolysin in Patients with Subarachnoid Hemorrhage: A Systematic Review and Meta-Analysis
Authors: Kojder Klaudyna , Jarosz Konrad , Bosiacki Mateusz , Andrzejewska Agata , Zacha Sławomir , Solek-Pastuszka Joanna , Jurczak Anna
Published: October 2023

Subarachnoid Hemorrhage (SAH) is one of the acute neurological conditions that is associated with high mortality and recovery failure rates. In recent years, due to the development of endovascular and classical techniques, the mortality rate after SAH has decreased. Currently, more research is focused on understanding the molecular mechanisms underlying SAH. Methods of treatment are investigated in order to obtain the best treatment result, not only survival. One of the drugs used in stroke, including SAH, is Cerebrolysin. It is a mixture of neuropeptides that has similar properties to neurotrophic factors. Its positive impact on strokes has been analyzed; however, there are no meta-analyses concerning only the subpopulation of patients diagnosed with SAH in the current literature. Therefore, we conducted a meta-analysis of available clinical trials to evaluate the effect of Cerebrolysin on the treatment outcome. The data suggest a positive effect of Cerebrolysin on the mortality of SAH patients. However, further randomized clinical trials with larger groups of patients are needed to draw final conclusions.
Association between Acute Respiratory Distress Syndrome Due to COVID-19 and Long-Term Sleep and Circadian Sleep–Wake Disorders
Authors: Henríquez-Beltrán Mario , Benítez Iván , Belmonte Thalía , Jorquera Jorge , Jorquera-Diaz Jorge , Cigarroa Igor , Burgos Matías , Sanhueza Rocio , Jeria Claudia , Fernandez-Bussy Isabel , Nova-Lamperti Estefania , Barbé Ferrán , Targa Adriano , Labarca Gonzalo
Published: October 2023

Current studies agree on the impact of sleep and circadian rest–activity rhythm alterations in acute respiratory distress syndrome (ARDS) survivors. However, research on the duration of this impact is scarce. In this study, we evaluate the impact of ARDS on the sleep and circadian rest–activity rhythm of COVID-19 survivors twelve months after hospital discharge. This is a prospective study including COVID-19 survivors with and without ARDS during hospitalization. Data was collected four and twelve months after hospital discharge. The interventions included one-week wrist actigraphy and a home sleep apnea test (HSAT), and evaluations were conducted according to the Pittsburgh sleep quality index (PSQI), Epworth sleepiness scale (ESS), and insomnia severity index (ISI). Fifty-two patients were evaluated (ARDS = 31 and non-ARDS = 21); they had a median age of 49.0 [39.0;57.2] years and 53.8% were male. After twelve months, 91.3% presented poor sleep quality, 58.7% presented insomnia, 50% presented daytime somnolence, and 37% presented comorbid insomnia and obstructive sleep apnea (COMISA). No significant improvement was observed in relation to sleep or the circadian rest–activity rhythm between four and twelve months. A tendency of poor sleep quality, insomnia, daytime somnolence, and COMISA was observed. Finally, there was no significant impact on the circadian rest–activity rhythm between four and twelve months or between the groups.
Thromboembolic and Bleeding Events in Transthyretin Amyloidosis and Coagulation System Abnormalities: A Review
Authors: Napolitano Angela , De Michieli Laura , Sinigiani Giulio , Berno Tamara , Cipriani Alberto , Spiezia Luca
Published: October 2023

Transthyretin amyloidosis (ATTR) is a group of diseases caused by the deposition of insoluble fibrils derived from misfolded transthyretin, which compromises the structure and function of various organs, including the heart. Thromboembolic events and increased bleeding risk are among the most important complications of ATTR, though the underlying mechanisms are not yet fully understood. Transthyretin plays a complex role in the coagulation cascade, contributing to the activation and regulation of the coagulation and fibrinolytic systems. The prevalence of atrial fibrillation, cardiac mechanical dysfunction, and atrial myopathy in patients with ATTR may contribute to thrombosis, though such events may also occur in patients with a normal sinus rhythm and rarely in properly anticoagulated patients. Haemorrhagic events are modest and mainly linked to perivascular amyloid deposits with consequent capillary fragility and coagulation anomalies, such as labile international-normalised ratio during anticoagulant therapy. Therefore, it is paramount to carefully stratify the thrombotic and haemorrhagic risks, especially when initiating anticoagulant therapy. Our review aims to ascertain the prevalence of thromboembolic and haemorrhagic events in ATTR and identify potential risk factors and predictors and their impact on antithrombotic therapy.
Current and Emerging Endovascular and Neurocritical Care Management Strategies in Large-Core Ischemic Stroke
Authors: Migdady Ibrahim , Johnson-Black Phoebe H. , Leslie-Mazwi Thabele , Malhotra Rishi
Published: October 2023

The volume of infarcted tissue in patients with ischemic stroke is consistently associated with increased morbidity and mortality. Initial studies of endovascular thrombectomy for large-vessel occlusion excluded patients with established large-core infarcts, even when large volumes of salvageable brain tissue were present, due to the high risk of hemorrhagic transformation and reperfusion injury. However, recent retrospective and prospective studies have shown improved outcomes with endovascular thrombectomy, and several clinical trials were recently published to evaluate the efficacy of endovascular management of patients presenting with large-core infarcts. With or without thrombectomy, patients with large-core infarcts remain at high risk of in-hospital complications such as hemorrhagic transformation, malignant cerebral edema, seizures, and others. Expert neurocritical care management is necessary to optimize blood pressure control, mitigate secondary brain injury, manage cerebral edema and elevated intracranial pressure, and implement various neuroprotective measures. Herein, we present an overview of the current and emerging evidence pertaining to endovascular treatment for large-core infarcts, recent advances in neurocritical care strategies, and their impact on optimizing patient outcomes.
Direct Stenting versus Conventional Stenting in Patients with ST-Segment Elevation Myocardial Infarction—A COMPARE CRUSH Sub-Study
Authors: Vogel Rosanne F. , Delewi Ronak , Wilschut Jeroen M. , Lemmert Miguel E. , Diletti Roberto , van Vliet Ria , van der Waarden Nancy W. P. L. , Nuis Rutger-Jan , Paradies Valeria , Alexopoulos Dimitrios , Zijlstra Felix , Montalescot Gilles , Angiolillo Dominick J. , Krucoff Mitchell W. , Van Mieghem Nicolas M. , Smits Pieter C. , Vlachojannis Georgios J.
Published: October 2023

Background: Direct stenting (DS) compared with conventional stenting (CS) after balloon predilatation may reduce distal embolization during percutaneous coronary intervention (PCI), thereby improving tissue reperfusion. In contrast, DS may increase the risk of stent underexpansion and target lesion failure. Methods: In this sub-study of the randomized COMPARE CRUSH trial (NCT03296540), we reviewed the efficacy of DS versus CS in a cohort of contemporary, pretreated ST-segment elevation myocardial infarction (STEMI) patients undergoing primary PCI. We compared DS versus CS, assessing (1) stent diameter in the culprit lesion, (2) thrombolysis in myocardial infarction (TIMI) flow in the infarct-related artery post-PCI and complete ST-segment resolution (STR) one-hour post-PCI, and (3) target lesion failure at one year. For proportional variables, propensity score weighting was applied to account for potential treatment selection bias. Results: This prespecified sub-study included 446 patients, of whom 189 (42%) were treated with DS. Stent diameters were comparable between groups (3.2 ± 0.5 vs. 3.2 ± 0.5 mm, p = 0.17). Post-PCI TIMI 3 flow and complete STR post-PCI rates were similar between groups (DS 93% vs. CS 90%, adjusted OR 1.16 [95% CI, 0.56–2.39], p = 0.69, and DS 72% vs. CS 58%, adjusted OR 1.29 [95% CI 0.77–2.16], p = 0.34, respectively). Moreover, target lesion failure rates at one year were comparable (DS 2% vs. 1%, adjusted OR 2.93 [95% CI 0.52–16.49], p = 0.22). Conclusion: In this contemporary pretreated STEMI cohort, we found no difference in early myocardial reperfusion outcomes between DS and CS. Moreover, DS seemed comparable to CS in terms of stent diameter and one-year vessel patency.
Syringomyelia Is Associated with a Reduction in Spinal Canal Compliance, Venous Outflow Dilatation and Glymphatic Fluid Obstruction
Authors: Bateman Grant Alexander , Bateman Alexander Robert
Published: October 2023

The cause of the cystic dilatation of the cord found in syringomyelia has been a source of conjecture for a considerable time. Recent studies have shown that there is a reduction in craniospinal compliance in both childhood hydrocephalus and multiple sclerosis which leads to venous outflow dilatation. Both diseases are associated with glymphatic outflow obstruction. Venous dilatation will narrow the perivenous glymphatic outflow pathway and lead to an increase in glymphatic outflow resistance. Syringomyelia has been shown to be associated with reduced spinal canal compliance. This paper discusses the possibility that venous dilatation and obstructed glymphatic outflow within the cord may be behind the cystic dilatation found within syringomyelia.
Exploring Deep Cervical Compartments in Head and Neck Surgical Oncology through Augmented Reality Vision: A Proof of Concept
Authors: Tel Alessandro , Zeppieri Marco , Robiony Massimo , Sembronio Salvatore , Vinayahalingam Shankeeth , Pontoriero Antonio , Pergolizzi Stefano , Angileri Filippo Flavio , Spadea Leopoldo , Ius Tamara
Published: October 2023

Background: Virtual surgical planning allows surgeons to meticulously define surgical procedures by creating a digital replica of patients’ anatomy. This enables precise preoperative assessment, facilitating the selection of optimal surgical approaches and the customization of treatment plans. In neck surgery, virtual planning has been significantly underreported compared to craniofacial surgery, due to a multitude of factors, including the predominance of soft tissues, the unavailability of intraoperative navigation and the complexity of segmenting such areas. Augmented reality represents the most innovative approach to translate virtual planning for real patients, as it merges the digital world with the surgical field in real time. Surgeons can access patient-specific data directly within their field of view, through dedicated visors. In head and neck surgical oncology, augmented reality systems overlay critical anatomical information onto the surgeon’s visual field. This aids in locating and preserving vital structures, such as nerves and blood vessels, during complex procedures. In this paper, the authors examine a series of patients undergoing complex neck surgical oncology procedures with prior virtual surgical planning analysis. For each patient, the surgical plan was imported in Hololens headset to allow for intraoperative augmented reality visualization. The authors discuss the results of this preliminary investigation, tracing the conceptual framework for an increasing AR implementation in complex head and neck surgical oncology procedures.
Determination of Tympanostomy Tube Types for Otitis Media with Effusion in Patients with Cleft Palate: Comparison between Paparella Type 1 and Type 2 Tubes
Authors: Ha Jungho , Gu Ga Young , Yeou Se Hyun , Kim Hantai , Choo Oak-Sung , Jang Jeong Hun , Park Hun Yi , Choung Yun-Hoon
Published: October 2023

This study examined the effects of different types of tympanostomy tubes in pediatric patients undergoing cleft palate (CP) surgery in order to provide guidance for the proper insertion of tympanostomy tubes in the management of otitis media with effusion (OME). A total of 101 ears with middle ear effusion in 51 patients with CP were included in this study. Patients underwent palatoplasty and tympanostomy tube surgery at the same time. The type of tube inserted (Paparella type 1 or 2), the severity of CP, and types of palatoplasty surgeries were investigated. All patients were followed up for at least 6 months, and recurrence rates, complications, and reinsertion surgery were evaluated. The rate of OME recurrence after spontaneous tube extrusion was significantly higher in the type 1 group than in the type 2 group (44.3% vs. 19.4%, respectively, p = 0.016). Persistent eardrum perforation was more common in the type 2 group than in the type 1 group (41.9% vs. 12.9%, respectively, p = 0.001). The tube reinsertion rate was higher in the type 1 group than in the type 2 group (22.9% vs. 3.2%, respectively, p = 0.015). The tube reinsertion rate decreased to 8.6% in cases of palatoplasty with Sommerlad’s technique, even with type 1 tube insertion, which was not significantly different from the reinsertion rate in the type 2 group (3.7%, p = 0.439). The Paparella type 1 tube would be a better choice in cases of palatoplasty performed using Sommerlad’s technique, particularly considering the higher rate of persistent eardrum perforation after extrusion associated with the Paparella type 2 tube. Alternatively, a larger size type 2 tube may be considered in other surgeries to decrease the frequency of recurrence and tube reinsertion.
Advances in Therapies to Treat Neonatal Hypoxic-Ischemic Encephalopathy
Authors: Ranjan Amaresh K. , Gulati Anil
Published: October 2023

Neonatal hypoxic-ischemic encephalopathy (HIE) is a condition that results in brain damage in newborns due to insufficient blood and oxygen supply during or after birth. HIE is a major cause of neurological disability and mortality in newborns, with over one million neonatal deaths occurring annually worldwide. The severity of brain injury and the outcome of HIE depend on several factors, including the cause of oxygen deprivation, brain maturity, regional blood flow, and maternal health conditions. HIE is classified into mild, moderate, and severe categories based on the extent of brain damage and resulting neurological issues. The pathophysiology of HIE involves different phases, including the primary phase, latent phase, secondary phase, and tertiary phase. The primary and secondary phases are characterized by episodes of energy and cell metabolism failures, increased cytotoxicity and apoptosis, and activated microglia and inflammation in the brain. A tertiary phase occurs if the brain injury persists, characterized by reduced neural plasticity and neuronal loss. Understanding the cellular and molecular aspects of the different phases of HIE is crucial for developing new interventions and therapeutics. This review aims to discuss the pathophysiology of HIE, therapeutic hypothermia (TH), the only approved therapy for HIE, ongoing developments of adjuvants for TH, and potential future drugs for HIE.