bluuebunny/crossref_metadata_2025 huggingface dataset:
Temporal Changes of Metabolic Indicators and Quality of Life by a Two-Day Patient Education Program for Metabolic Syndrome Patients
Authors: Jeon Jeong Suk , Lee Sang Yeoup , Ahn Soon Cheol , Kim Yun Jin , Lee Jeong Gyu , Yi Yu Hyeon
Published: March 2022

Metabolic syndrome (MetS) is a disease with a high prevalence that threatens the health of modern people. Patient education is essential to control MetS. This prospective study aimed to evaluate 6-month changes in health indicators following a two-day education program for patients with MetS aged 45 or older. Education about MetS, lifestyle modification, nutrition, and physical activity was provided. At 3 and 6 months after the program, participants visited for follow-up. Twenty-two patients completed the 6-month study. Waist circumference was reduced, and life quality and depression index improved in 3 and 6 months compared to pre-education. Blood pressure decreased, and anxiety index improved at three months. Nutritional knowledge was well maintained for 3 and 6 months. High-density lipoprotein-cholesterol levels increased at six months. Three out of twenty-two patients did not satisfy MetS criteria at the end of the study due to improved indicators. A two-day multidisciplinary education program positively affected health indicators in MetS patients. Participation in the program also help with life satisfaction and positive emotional condition. However, some indicators improved in 3 months, but the effect disappeared 6 months after the program.
Effect of Growth Mindset on Mental Health Two Years Later: The Role of Smartphone Use
Authors: Lai Xiaoxiong , Nie Chang , Huang Shunsen , Li Yajun , Xin Tao , Zhang Cai , Wang Yun
Published: March 2022

The negative association between the growth mindset and mental health problems suggests that prevention and intervention programs to improve mental health by targeting mindset may have potential clinical value. However, research on the longitudinal effect of mindset on adolescent mental health and its underlying mechanisms is lacking. Using a three-wave longitudinal design, we obtained data from a diverse sample of Chinese adolescents (n = 2543). Longitudinal multiple mediation models were constructed to examine the effects of the growth mindset on levels of anxiety and depression two years later. In addition, the mediating effects of smartphone use for entertainment and problematic smartphone use (PSU) were examined. After controlling for various covariates and the autoregressive effects of mental health problems, the growth mindset had significant negative effects on anxiety (β = −0.053, p = 0.004) and depression (β = −0.074, p < 0.001). Smartphone use had a significant mediating role in the effect of mindset on anxiety (β = −0.016, p < 0.001) and depression (β = −0.016, p < 0.001). The growth mindset has long-lasting positive effects on adolescent mental health. Smartphone use for entertainment and PSU mediate the effect of mindset on adolescent mental health.
Psychological Distress, Burnout, and Academic Performance in First Year College Students
Authors: March-Amengual Jaume-Miquel , Cambra Badii Irene , Casas-Baroy Joan-Carles , Altarriba Cristina , Comella Company Anna , Pujol-Farriols Ramon , Baños Josep-Eladi , Galbany-Estragués Paola , Comella Cayuela Agustí
Published: March 2022

Background: The first years of university can be very challenging for students. Previous research has focused on the study of the prevalence of burnout and of psychological distress in medical students. The aim of this study was to investigate the prevalence of psychological symptoms and burnout reported by first-year students, the relationship between these variables and their academic performance, and the differences between health and non-health sciences students. Methods: An observational study with a cross-sectional design was performed. Students of health sciences (medicine, nursing, physiotherapy, psychology), and non-health sciences (biology, social sciences, business management, and engineering) undergraduate programs completed the Brief Symptom Inventory (BSI-18) and the Maslach Burnout Inventory-Student Survey (MBI-SS). Students’ grades for the first semester were collected. Results: A sample of 506 students participated. Prevalence of psychological distress was 27.1% and burnout was 7.3%. Academic performance was unaffected in relation to either psychological distress or burnout. Non-health sciences students showed a greater risk of depression. Conclusions: This study provides evidence of the high prevalence of psychological distress in the first year of college. Even when burnout prevalence was low, the results suggest the need to introduce prevention programs to improve the psychological wellbeing of these students.
Clustering of Small Territories Based on Axes of Inequality
Authors: Perafita Xavier , Saez Marc
Published: March 2022

Background: In the present paper, we conduct a study before creating an e-cohort for the design of the sample. This e-cohort had to enable the effective representation of the province of Girona to facilitate its study according to the axes of inequality. Methods: The territory under study is divided by municipalities, considering these different axes. The study consists of a comparison of 14 clustering algorithms, together with 3 data sets of municipal information to detect the grouping that was the most consistent. Prior to carrying out the clustering, a variable selection process was performed to discard those that were not useful. The comparison was carried out following two axes: results and graphical representation. Results: The intra-cluster results were also analyzed to observe the coherence of the grouping. Finally, we study the probability of belonging to a cluster, such as the one containing the county capital. Conclusions: This clustering can be the basis for working with a sample that is significant and representative of the territory.
‘Shall We Send a Panda?’ A Practical Guide to Engaging Schools in Research: Learning from Large-Scale Mental Health Intervention Trials
Authors: March Anna , Ashworth Emma , Mason Carla , Santos Joao , Mansfield Rosie , Stapley Emily , Deighton Jessica , Humphrey Neil , Tait Nick , Hayes Daniel
Published: March 2022

The substantial time that children and young people spend in schools makes them important sites to trial and embed prevention and early intervention programmes. However, schools are complex settings, and it can be difficult to maintain school engagement in research trials; many projects experience high levels of attrition. This commentary presents learning from two large-scale, mixed-methods mental health intervention trials in English schools. The paper explores the barriers and challenges to engaging schools in promotion or early intervention research and offers detailed recommendations for other researchers.
Perception of Occupational and Environmental Risks and Hazards among Mineworkers: A Psychometric Paradigm Approach
Authors: Alrawad Mahmaod , Lutfi Abdalwali , Alyatama Sundus , Elshaer Ibrahim A. , Almaiah Mohammed Amin
Published: March 2022

This study aims to assess workers’ perception of occupational and environmental risks and hazards using the psychometric paradigm. For this purpose, data were collected using survey questionnaires from 360 mineworkers recruited from mineral and sand mines. Respondents were asked to evaluate eight occupational and environmental risks and hazards on nine commonly used risk characteristics. The principal component analysis revealed that two components, “Dreaded” and “Unknown”, explained 73% percent of the total variance in workers’ risk perception. The results also showed that the risk of developing an occupational disease was perceived as the most dreaded and unknown type of risk, while landslide, occupational noise, and vibration exposure were the least familiar to the respondents. A practical implication of this research is that the results may offer an insight into the employees’ perceptions of the hazards and risks associated with their working environment. This could help risk management develop and implement effective risk management and communications strategies.
The Impact of Aquatic Exercise Programs on the Intima-Media thickness of the Carotid Arteries, Hemodynamic Parameters, Lipid Profile and Chemokines of Community-Dwelling Older Persons: A Randomized Controlled Trial
Authors: Farinha Carlos , Santos Hélder , Serrano João , Oliveiros Bárbara , Silva Fernanda M. , Cascante-Rusenhack Márcio , Teixeira Ana Maria , Ferreira José Pedro
Published: March 2022

Scientific evidence has shown that physical exercise is an effective way of improving several cardiovascular disease markers. However, few studies have tested its effectiveness when performed in aquatic environments. The purpose of this study was to test the impact of different aquatic exercise programs on the intima-media thickness of carotid arteries (IMT) and hemodynamic and biochemical markers of cardiovascular diseases in community-dwelling older persons. A total of 102 participants were randomly allocated into four groups: an aerobic exercise group (AerG) (n = 25, 71.44 ± 4.84 years); an aerobic interval group (IntG) (n = 28, 72.64 ± 5.22 years); a combined group (ComG) (n = 29, 71.90 ± 5.67 years); and a control group (CG) (n = 20, 73.60 ± 5.25 years). The AerG, IntG, and ComG participants took part in three different aquatic exercise programs for 28 weeks. The CG participants maintained their usual routines. All participants were evaluated for IMT, blood pressure, lipid profile, and MCP-1 and MIP-1α chemokines, pre- and post-intervention. Significant differences were found in the AerG for diastolic diameter (DD), in the IntG for peak systolic velocity (PSV), and in the ComG for DD and end-diastolic velocity (EDV). Regarding blood pressure, significant differences were found in AerG for systolic blood pressure (SBP) and diastolic blood pressure (DBP); in IntG for DBP; and in ComG for SBP, DBP, and heart rate (HR). Significant differences were found in the AerG and IntG for glucose (GLU). Lower plasma levels of monocyte chemoattractant protein-1 (MCP-1) and macrophage inflammatory protein (MIP-1α) were found in the AerG and in the ComG for MCP-1 after the intervention. Aquatic physical exercise appears to improve cardiovascular health, regardless of the type of the program adopted. Aerobic programs (combined and continuous aerobic exercises) seemed to have a more beneficial effect in reducing important cardiovascular risk markers.
Public Policy Measures to Increase Anti-SARS-CoV-2 Vaccination Rate in Russia
Authors: Boguslavsky Dmitry V. , Sharova Natalia P. , Sharov Konstantin S.
Published: March 2022

The total vaccination rate remains relatively low in Russia as of March 2022 (around 55%, with around 20% in some regions). In the paper, we study the reasons for it. We communicate the results of our survey aimed at detecting reasons for the relatively low anti-SARS-CoV-2 vaccination rate in Russia (47.1% as of mid-January 2022) and suggest potential measures to increase the level of confidence in the Russian vaccination campaign. A total of 14,310 users exhibited interest to participate in the research (16.84% of the total number of invitations sent in the Russian social network VKontakte). After the sample set repair, only 5822 (40.68% of those who agreed to participate) responses were suitable for the research, and they composed the final set. The age range of the respondents was 16–51 years old (y.o.) with a mean of 29.1 ± 10.6 y.o. The proportion of the female gender in responses was 44.23%. A total of 2454 persons (42.15%) expressed their hesitant, cautious, or negative attitude towards vaccine uptake. Of the 2454 persons with cautious attitude towards vaccination, only 928 (37.82%) were concerned about the quality of the Russian vaccines. A total of 1323 individuals (53.91%) supported one or more conspiracy beliefs. A total of 5064 (86.98% of the whole set) showed cautious or negative attitude towards the planned introduction of a nationwide system of vaccination certification/verification based on QR codes. The main social factors that hinder the Russian vaccination campaign are: vexation over the lack of desire of officials to receive feedback from the general population regarding vaccination, wide support for conspiracy beliefs, and controversy over the QR code-based digital system. To elevate the vaccination rate in Russia, the following steps may be taken: social encouragement of those who support vaccination, increase in transparency of the vaccination campaign, acceptance of both digital and paper vaccination certificates, increase in participation of society in vaccination-related discussions, public disclosure of vaccine composition, and avoidance of excessive digitalization of data in the vaccination campaign.
Factors Associated with Polyp Detection Rate in European Colonoscopy Practice: Findings of The European Colonoscopy Quality Investigation (ECQI) Group
Authors: Spada Cristiano , Koulaouzidis Anastasios , Hassan Cesare , Amaro Pedro , Agrawal Anurag , Brink Lene , Fischbach Wolfgang , Hünger Matthias , Jover Rodrigo , Kinnunen Urpo , Ono Akiko , Patai Árpád , Pecere Silvia , Petruzziello Lucio , Riemann Jürgen Ferdinand , Staines Harry , Stringer Ann L. , Toth Ervin , Antonelli Giulio , Fuccio Lorenzo ,   on behalf of the ECQI Group
Published: March 2022

Background: The European Colonoscopy Quality Investigation (ECQI) Group aims to raise awareness for improvement in colonoscopy standards across Europe. We analysed data collected on a sample of procedures conducted across Europe to evaluate the achievement of the polyp detection rate (PDR) target. We also investigated factors associated with PDR, in the hope of establishing areas that could lead to a quality improvement. Methods: 6445 form completions from 12 countries between 2 June 2016 and 30 April 2018 were considered for this analysis. We performed an exploratory analysis looking at PDR according to European Society of Gastrointestinal Endoscopy (ESGE) definition. Stepwise multivariable logistic regression analysis was conducted to determine the most influential associated factors after adjusting for the other pre-specified variables. Results: In our sample there were 3365 screening and diagnostic procedures performed in those over 50 years. The PDR was 40.5%, which is comparable with the ESGE minimum standard of 40%. The variables found to be associated with PDR were in descending order: use of high-definition equipment, body mass index (BMI), patient gender, age group, and the reason for the procedure. Use of HD equipment was associated with a significant increase in the reporting of flat lesions (14.3% vs. 5.7%, p < 0.0001) and protruded lesions (34.7% vs. 25.4%, p < 0.0001). Conclusions: On average, the sample of European practice captured by the ECQI survey meets the minimum PDR standard set by the ESGE. Our findings support the ESGE recommendation for routine use of HD colonoscopy.
Geospatial Information Technologies for Mobile Collaborative Geological Mapping: The Italian CARG Project Case Study
Authors: Gencarelli Christian Natale , Voltolina Debora , Hammouti Mohammed , Zazzeri Marco , Sterlacchini Simone
Published: March 2022

A collaborative open-source IT infrastructure is designed and implemented to optimize the process of geological field data collection, integration, validation, and sharing. Firstly, field data collection is carried out by multiple users using free and open-source GIS-based tools for mobile devices according to a predefined database structure; then, data integration is automatically performed in a central server, where the collected geological information is stored and validated; finally, data are shared over the Internet, providing users with up-to-date information. The IT infrastructure is currently being employed to accomplish surveys for the realization of the “Brescia” geological map within the New Geological Map of Italy, scale 1:50,000 (CARG Project). Users are only required to run the field data collection application on their mobile devices, add different geometric features to predefined thematic layers and fill in the dialogue forms with the required information to store the new structured and georeferenced data in the central database. The major advantage of the proposed IT infrastructure consists of guaranteeing the operational continuity between field surveys and the finalization of geological or geothematic maps leveraging field data collection tools that are operational both online and offline to ensure the overall system resilience.
Spatial-Temporal Diffusion Convolutional Network: A Novel Framework for Taxi Demand Forecasting
Authors: Luo Aling , Shangguan Boyi , Yang Can , Gao Fan , Fang Zhe , Yu Dayu
Published: March 2022

Taxi demand forecasting plays an important role in ride-hailing services. Accurate taxi demand forecasting can assist taxi companies in pre-allocating taxis, improving vehicle utilization, reducing waiting time, and alleviating traffic congestion. It is a challenging task due to the highly non-linear and complicated spatial-temporal patterns of the taxi data. Most of the existing taxi demand forecasting methods lack the ability to capture the dynamic spatial-temporal dependencies among regions. They either fail to consider the limitations of Graph Neural Networks or do not efficiently capture the long-term temporal dependencies. In this paper, we propose a Spatial-Temporal Diffusion Convolutional Network (ST-DCN) for taxi demand forecasting. The dynamic spatial dependencies are efficiently captured through a two-phase graph diffusion convolutional network where the attention mechanism is introduced. Moreover, a novel temporal convolution module is designed to learn various ranges of temporal dependencies, including recent, daily, and weekly periods. Inside the module, convolution layers are stacked to handle very long sequences. Experimental results on two large-scale real-world taxi datasets from New York City (NYC) and Chengdu demonstrate that our method significantly outperforms seven state-of-the-art baseline methods.
SmartEle: Smart Electricity Dashboard for Detecting Consumption Patterns: A Case Study at a University Campus
Authors: Jing Changfeng , Guo Shasha , Zhang Hongyang , Lv Xinxin , Wang Dongliang
Published: March 2022

To achieve Sustainable Development Goal 7 (SDG7), it is essential to detect the spatiotemporal patterns of electricity consumption, particularly the spatiotemporal heterogeneity of consumers. This is also crucial for rational energy planning and management. However, studies investigating heterogeneous users are lacking. Moreover, existing works focuses on mathematic models to identify and predict electricity consumption. Additionally, owing to the complex non-linear interrelationships, interactive visualizations are more effective in detecting patterns. Therefore, by combining geospatial dashboard knowledge and interactive visualization technology, a Smart Electricity dashboard (SmartEle) was designed and developed to interactively visualize big electrical data and interrelated factors. A university campus as the study area. The SmartEle system addressed three challenges. First, it permitted user group-oriented monitoring of electricity consumption patterns, which has seldom been considered in existing studies. Second, a visualization-driven data mining model was proposed, and an interactive visualization dashboard was designed to facilitate the perception of electricity usage patterns at different granularities and from different perspectives. Finally, to deal with the non-linear features of electricity consumption, the ATT-LSTM machine learning model to support multivariate collaborative predicting was proposed to improve the accuracy of short-term electricity consumption predictions. The results demonstrated that the SmartEle system is usable for electricity planning and management.
DEK48 Is Required for RNA Editing at Multiple Mitochondrial Sites and Seed Development in Maize
Authors: Yang Dalin , Cao Shi-Kai , Yang Huanhuan , Liu Rui , Sun Feng , Wang Le , Wang Miaodi , Tan Bao-Cai
Published: March 2022

In flowering plants, C-to-U RNA editing can be critical to normal functions of mitochondrion-encoded proteins. Mitochondrial C-to-U RNA editing is facilitated by many factors from diverse protein families, of which the pentatricopeptide repeat (PPR) proteins play an important role. Owing to their large number and frequent embryo lethality in mutants, functions of many PPRs remain unknown. In this study, we characterized a mitochondrion-localized DYW-type PPR protein, DEK48, functioning in the C-to-U RNA editing at multiple mitochondrial transcripts in maize. Null mutation of Dek48 severely arrests embryo and endosperm development, causing a defective kernel (dek) phenotype, named dek48. DEK48 loss of function abolishes the C-to-U editing at nad3-185, -215, and nad4-376, -977 sites and decreases the editing at 11 other sites, resulting in the alteration of the corresponding amino acids. Consequently, the absence of editing caused reduced assembly and activity of complex I in dek48. Interestingly, we identified a point mutation in dek48-3 causing a deletion of the Tryptophan (W) residue in the DYW motif that abolishes the editing function. In sum, this study reveals the function of DEK48 in the C-to-U editing in mitochondrial transcripts and seed development in maize, and it demonstrates a critical role of the W residue in the DYW triplet motif of DEK48 for the C-to-U editing function in vivo.
Cell Type-Specific Induction of Inflammation-Associated Genes in Crohn’s Disease and Colorectal Cancer
Authors: Saul Dominik , Leite Barros Luísa , Wixom Alexander Q. , Gellhaus Benjamin , Gibbons Hunter R. , Faubion William A. , Kosinsky Robyn Laura
Published: March 2022

Based on the rapid increase in incidence of inflammatory bowel disease (IBD), the identification of susceptibility genes and cell populations contributing to this condition is essential. Previous studies suggested multiple genes associated with the susceptibility of IBD; however, due to the analysis of whole-tissue samples, the contribution of individual cell populations remains widely unresolved. Single-cell RNA sequencing (scRNA-seq) provides the opportunity to identify underlying cellular populations. We determined the enrichment of Crohn’s disease (CD)-induced genes in a publicly available Crohn’s disease scRNA-seq dataset and detected the strongest induction of these genes in innate lymphoid cells (ILC1), highly activated T cells and dendritic cells, pericytes and activated fibroblasts, as well as epithelial cells. Notably, these genes were highly enriched in IBD-associated neoplasia, as well as sporadic colorectal cancer (CRC). Indeed, the same six cell populations displayed an upregulation of CD-induced genes in a CRC scRNA-seq dataset. Finally, after integrating and harmonizing the CD and CRC scRNA-seq data, we demonstrated that these six cell types display a gradual increase in gene expression levels from a healthy state to an inflammatory and tumorous state. Together, we identified cell populations that specifically upregulate CD-induced genes in CD and CRC patients and could, therefore, contribute to inflammation-associated tumor development.
Somatostatin Primes Endothelial Cells for Agonist-Induced Hyperpermeability and Angiogenesis In Vitro
Authors: Aslam Muhammad , Idrees Hafiza , Ferdinandy Peter , Helyes Zsuzsanna , Hamm Christian , Schulz Rainer
Published: March 2022

Somatostatin is an inhibitory peptide, which regulates the release of several hormones, and affects neurotransmission and cell proliferation via its five Gi protein-coupled receptors (SST1-5). Although its endocrine regulatory and anti-tumour effects have been thoroughly studied, little is known about its effect on the vascular system. The aim of the present study was to analyse the effects and potential mechanisms of somatostatin on endothelial barrier function. Cultured human umbilical vein endothelial cells (HUVECs) express mainly SST1 and SST5 receptors. Somatostatin did not affect the basal HUVEC permeability, but primed HUVEC monolayers for thrombin-induced hyperpermeability. Western blot data demonstrated that somatostatin activated the phosphoinositide 3-kinases (PI3K)/protein kinase B (Akt) and p42/44 mitogen-activated protein kinase (MAPK) pathways by phosphorylation. The HUVEC barrier destabilizing effects were abrogated by pre-treating HUVECs with mitogen-activated protein kinase kinase/extracellular signal regulated kinase (MEK/ERK), but not the Akt inhibitor. Moreover, somatostatin pre-treatment amplified vascular endothelial growth factor (VEGF)-induced angiogenesis (3D spheroid formation) in HUVECs. In conclusion, the data demonstrate that HUVECs under quiescence conditions express SST1 and SST5 receptors. Moreover, somatostatin primes HUVECs for thrombin-induced hyperpermeability mainly via the activation of MEK/ERK signalling and promotes HUVEC proliferation and angiogenesis in vitro.
Controlled Hydrolysis of Odorants Schiff Bases in Low-Molecular-Weight Gels
Authors: Nicastro Gloria , Black Louise Mary , Ravarino Paolo , d’Agostino Simone , Faccio Davide , Tomasini Claudia , Giuri Demetra
Published: March 2022

Imines or Schiff bases (SB) are formed by the condensation of an aldehyde or a ketone with a primary amine, with the removal of a water molecule. Schiff bases are central molecules in several biological processes for their ability to form and cleave by small variation of the medium. We report here the controlled hydrolysis of four SBs that may be applied in the fragrance industry, as they are profragrances all containing odorant molecules: methyl anthranilate as primary amine, and four aldehydes (cyclamal, helional, hydroxycitronellal and triplal) that are very volatile odorants. The SB stability was assessed over time by HPLC-MS in neutral or acidic conditions, both in solution and when trapped in low molecular weight gels. Our results demonstrate that it is possible to control the hydrolysis of the Schiff bases in the gel environment, thus tuning the quantity of aldehyde released and the persistency of the fragrance.
SGLT-2 Inhibitors in NAFLD: Expanding Their Role beyond Diabetes and Cardioprotection
Authors: Androutsakos Theodoros , Nasiri-Ansari Narjes , Bakasis Athanasios-Dimitrios , Kyrou Ioannis , Efstathopoulos Efstathios , Randeva Harpal S. , Kassi Eva
Published: March 2022

Non-alcoholic fatty liver disease (NAFLD) is an ‘umbrella’ term, comprising a spectrum ranging from benign, liver steatosis to non-alcoholic steatohepatitis, liver fibrosis and eventually cirrhosis and hepatocellular carcinoma. NAFLD has evolved as a major health problem in recent years. Discovering ways to prevent or delay the progression of NAFLD has become a global focus. Lifestyle modifications remain the cornerstone of NAFLD treatment, even though various pharmaceutical interventions are currently under clinical trial. Among them, sodium-glucose co-transporter type-2 inhibitors (SGLT-2i) are emerging as promising agents. Processes regulated by SGLT-2i, such as endoplasmic reticulum (ER) and oxidative stress, low-grade inflammation, autophagy and apoptosis are all implicated in NAFLD pathogenesis. In this review, we summarize the current understanding of the NAFLD pathophysiology, and specifically focus on the potential impact of SGLT-2i in NAFLD development and progression, providing current evidence from in vitro, animal and human studies. Given this evidence, further mechanistic studies would advance our understanding of the exact mechanisms underlying the pathogenesis of NAFLD and the potential beneficial actions of SGLT-2i in the context of NAFLD treatment.
Online Customer Reviews and Satisfaction with an Upscale Hotel: A Case Study of Atlantis, The Palm in Dubai
Authors: Wei Shengnan , Kim Hak-Seon
Published: March 2022

The main purpose of this study is to explore the insights of customers’ reviews from the upscale hotel Atlantis, The Palm in the Dubai area. The data was collected from the SCTM 3.0 (smart crawling and text mining) platform developed by the Wellness & Tourism Big Data Institute at Kyungsung University. A total of 2051 online reviews were collected from the period from 29 October 2018 to 29 October 2021. The following steps were conducted by RStudio and UCINET 6.0 to analyze the collected data and to visualize the results. The results showed the top 50 keywords customers used in the reviews, such as ‘great’, ‘amazing’, or ‘service’. Exploratory factor analysis (EFA) and linear regression analysis were applied for an in-depth understanding of customer satisfaction. The analysis results demonstrated that the ‘value’ and ‘dining’ factors had a negative influence on overall customer satisfaction. These findings could provide managerial and marketing insights for upscale hotel managers when formulating and implementing strategies and tactics to improve customer satisfaction.
Effect of Intravenous Alteplase on Functional Outcome and Secondary Injury Volumes in Stroke Patients with Complete Endovascular Recanalization
Authors: Broocks Gabriel , Meyer Lukas , Ruppert Celine , Haupt Wolfgang , Faizy Tobias D. , Van Horn Noel , Bechstein Matthias , Kniep Helge , Elsayed Sarah , Kemmling Andre , Barow Ewgenia , Fiehler Jens , Hanning Uta
Published: March 2022

Intravenous thrombolytic therapy with alteplase (IVT) is a standard of care in ischemic stroke, while recent trials investigating direct endovascular thrombectomy (EVT) approaches showed conflicting results. Yet, the effect of IVT on secondary injury volumes in patients with complete recanalization has not been analyzed. We hypothesized that IVT is associated with worse functional outcome and aggravated secondary injury volumes when administered to patients who subsequently attained complete reperfusion after EVT. Anterior circulation ischemic stroke patients with complete reperfusion after thrombectomy defined as thrombolysis in cerebral infarctions (TICI) scale 3 after thrombectomy admitted between January 2013–January 2021 were analyzed. Primary endpoints were the proportion of patients with functional independence defined as modified Rankin Scale (mRS) score 0–2 at day 90, and secondary injury volumes: Edema volume in follow-up imaging measured using quantitative net water uptake (NWU), and the rate of symptomatic intracerebral hemorrhage (sICH). A total of 219 patients were included and 128 (58%) patients received bridging IVT before thrombectomy. The proportion of patients with functional independence was 28% for patients with bridging IVT, and 34% for patients with direct thrombectomy (p = 0.35). The rate of sICH was significantly higher after bridging IVT (20% versus 7.7%, p = 0.01). Multivariable logistic and linear regression analysis confirmed the independent association of bridging IVT with sICH (aOR: 2.78, 95% CI: 1.02–7.56, p = 0.046), and edema volume (aOR: 8.70, 95% CI: 2.57–14.85, p = 0.006). Bridging IVT was associated with increased edema volume and risk for sICH as secondary injury volumes. The results of this study encourage direct EVT approaches, particularly in patients with higher likelihood of successful EVT.
Long-Term Efficacy and Safety of Rifaximin in Japanese Patients with Hepatic Encephalopathy: A Multicenter Retrospective Study
Authors: Kawaratani Hideto , Kondo Yasuteru , Tatsumi Ryoji , Kawabe Naoto , Tanabe Norikazu , Sakamaki Akira , Okumoto Kazuo , Uchida Yoshihito , Endo Kei , Kawaguchi Takumi , Oikawa Tsunekazu , Ishizu Yoji , Hige Shuhei , Takami Taro , Terai Shuji , Ueno Yoshiyuki , Mochida Satoshi , Takikawa Yasuhiro , Torimura Takuji , Matsuura Tomokazu , Ishigami Masatoshi , Koike Kazuhiko , Yoshiji Hitoshi
Published: March 2022

Background: Rifaximin is commonly used for hepatic encephalopathy (HE). However, the effects of long-term treatment for Japanese people are limited. Therefore, this study aimed to investigate the effects and safety of long-term treatment with rifaximin on HE. Methods: A total of 215 patients with cirrhosis administered with rifaximin developed overt or covert HE, which was diagnosed by an attending physician for >12 months. Laboratory data were extracted at pretreatment and 3, 6, and 12 months after rifaximin administration. The long-term effect of rifaximin was evaluated, and the incidence of overt HE during 12 months and adverse events was extracted. Results: Ammonia levels were significantly improved after 3 months of rifaximin administration and were continued until 12 months. There were no serious adverse events after rifaximin administration. The number of overt HE incidents was 9, 14, and 27 patients within 3, 6, and 12 months, respectively. Liver enzymes, renal function, and electrolytes did not change after rifaximin administration. Prothrombin activity is a significant risk factor for the occurrence of overt HE. The serum albumin, prothrombin activity, and albumin–bilirubin (ALBI) scores were statistically improved after 3 and 6 months of rifaximin administration. Moreover, the same results were obtained in patients with Child–Pugh C. Conclusions: The long-term rifaximin treatment was effective and safe for patients with HE, including Child–Pugh C.
Gender-Specific Coagulation Profiles of Peripheral and Portal Blood May Help to Differentiate Malignant from Benign Pancreatic Tumour—Pilot Study
Authors: Szmiel Aneta , Majos Alicja , Ciesielski Wojciech , Kumor Anna , Strzelczyk Janusz , Szwedziak Krzysztof , Hogendorf Piotr , Durczyński Adam
Published: March 2022

Objective: Pancreatic adenocarcinoma (PDAC) and mass forming chronic pancreatitis (CP) can be easily misdiagnosed due to their resemblances in clinical, radiological, and biochemical criteria. In our previous study, we reported a very high concentration of D-Dimers in portal blood in patients with pancreatic cancer which may help to differentiate malignant from benign pancreatic tumours. In this study, we aim to describe other portal and peripheral coagulation profiles of PDAC in comparison to CP patients, as well to test the hypothesis; thus, it is possible to distinguish pancreatic malignancy and benign tumour based on these parameters. Methods: We included retrospectively 115 patients with the absence of venous thromboembolism (VTE), qualified to surgical treatment due to pancreatic tumours, both PDAC and CP. Patients underwent surgery in General and Transplant Surgery Unit of Medical University of Lodz between December 2011 and February 2014. Patients with distant metastases diagnosed before or during the surgery were excluded. The coagulation profile, which includes fibrinogen, activated partial thromboplastin time (aPTT), prothrombin time (PT), and thrombin time (TT), was determined in blood samples from the portal and peripheral vein taken intraoperatively. Results: The fibrinogen level was higher and the aPTT index shortened in the peripheral and portal blood of the PDAC group, which reflects the well-known link between PDAC and general hypercoagulability. Furthermore, these effects are sex-specific. The mean age in the CP group was lower than in the PDAC group (54.63 ± 12.37 vs. 63.77 ± 3.23, p < 0.001) and correlated with the fibrinogen distribution in male patients with CP (portal r = 0.34; p = 0.07; peripheral r = 0.39; p = 0.04). We calculated sex-specific logistic regression models (male: peripheral aPTT and age, AUC: 0.795, female: portal fibrinogen and age, AUC: 0.805), both maintaining the good discrimination properties after V-fold cross validation (0.759, 0.742). Conclusions: Our study shows that the differences between coagulation profiles in PDAC and CP patients not only seems to be a reflection of gender-specific biological features, but also helps to discriminate between them. The main goal of the study was to explore the biology of pancreatic cancer and lay a solid base for further investigations of PDAC biomarkers. This paper is the first to describe the detailed coagulation profile in portal blood in patients with pancreatic solid tumors. At present, the clinical application of our results is not clear; however, we hope that it may improve our understanding of this complex disease.
Effect of rLH Supplementation during Controlled Ovarian Stimulation for IVF: Evidence from a Retrospective Analysis of 1470 Poor/Suboptimal/Normal Responders Receiving Either rFSH plus rLH or rFSH Alone
Authors: Canosa Stefano , Carosso Andrea Roberto , Mercaldo Noemi , Ruffa Alessandro , Evangelista Francesca , Bongioanni Francesca , Benedetto Chiara , Revelli Alberto , Gennarelli Gianluca
Published: March 2022

We retrospectively studied a real-life population of 1470 women undergoing IVF, with poor/suboptimal/normal ovarian responsiveness to controlled ovarian stimulation (COS), comparing the cumulative live birth rate (cLBR) when COS was performed using rFSH alone or rFSH + rLH in a 2:1 ratio. Overall, we observed significantly higher cLBR in the rFSH alone group than in the rFSH + rLH group (29.3% vs. 22.2%, p < 0.01). However, considering only suboptimal/poor responders (n = 309), we observed comparable cLBR (15.6% vs. 15.2%, p = 0.95) despite the fact that patients receiving rFSH + rLH had significantly higher ages and worse ovarian reserve markers. The equivalent effectiveness of rFSH + rLH and rFSH alone was further confirmed after stratification according to the number of oocytes retrieved: despite basal characteristics were still in favor of rFSH alone group, the cLBR always resulted comparable. Even subdividing patients according to the POSEIDON classification, irrespective of differences in the baseline clinical characteristics in favor of FSH alone group, the cLBR resulted comparable in all subgroups. Despite the retrospective, real-life analysis, our data suggest that rLH supplementation in COS may represent a reasonable option for patients with predictable or unexpected poor/suboptimal ovarian responsiveness to FSH, those matching the Bologna criteria for poor responsiveness, and those included in the POSEIDON classification.
Features of Nodules in Explants of Children Undergoing Liver Transplantation for Biliary Atresia
Authors: Calinescu Ana M. , Rougemont Anne-Laure , Anooshiravani Mehrak , Rock Nathalie M. , McLin Valerie A. , Wildhaber Barbara E.
Published: March 2022

(1) Background: In patients with biliary atresia (BA) liver nodules can be identified either by pre-transplant imaging or on the explant. This study aimed to (i) analyze the histopathology of liver nodules, and (ii) to correlate histopathology with pretransplant radiological features. (2) Methods: Retrospective analysis of liver nodules in explants of BA patients transplanted in our center (2000–2021). Correlations with pretransplant radiological characteristics, patient age at liver transplantation (LT), time from Kasai hepatoportoenterostomy (KPE) to LT, age at KPE and draining KPE. (3) Results: Of the 63 BA-patients included in the analysis, 27/63 (43%) had nodules on explants. A majority were benign macroregenerative nodules. Premalignant (low-grade and high-grade dysplastic) and malignant (hepatocellular carcinoma) nodules were identified in 6/63 and 2/63 patients, respectively. On pretransplant imaging, only 13/63 (21%) patients had liver nodules, none meeting radiological criteria for malignancy. The occurrence of liver nodules correlated with patient age at LT (p < 0.001), time KPE-LT (p < 0.001) and draining KPE (p = 0.006). (4) Conclusion: In BA patients, pretransplant imaging did not correlate with the presence of liver nodules in explants. Liver nodules were frequent in explanted livers, whereby 25% of explants harboured malignant/pre-malignant nodules, emphasizing the need for careful surveillance in BA children whose clinical course may require LT.
The Role of Skin Immune System in Acne
Authors: Firlej Ewelina , Kowalska Wioleta , Szymaszek Karolina , Roliński Jacek , Bartosińska Joanna
Published: March 2022

Acne vulgaris is a skin disease that often occurs in adolescence and in young adulthood. The main pathogenic factors are hyperkeratinization, obstruction of sebaceous glands, stimulation of sebaceous gland secretion by androgens, and bacterial colonization of sebaceous units by Cutibacterium acnes, which promotes inflammation. Little is known about the role of skin immune cells in the development of acne lesions. The aim of the study was to try to understand the role of skin immune cells in the course of acne. Recent studies have shown that there are at least four major pathways by which Cutibacterium acnes interacts with the innate immune system to induce inflammation: through TLRs, activating inflammasomes, inducing the production of matrix metalloproteinases (MMPs), and stimulating antimicrobial peptide (AMP) activity. Cells of adaptive immune response, mainly Th1 and Th17 lymphocytes, also play an important role in the pathogenesis of acne. It is worth emphasizing that understanding the role of the skin’s immune cells in the pathogenesis of acne may, in the future, contribute to the application of modern therapeutic strategies that would avoid addiction to antibiotics, which would alleviate the spectrum of resistance that is now evident and a current threat.
Neurological Presentation of Giant Pituitary Tumour Apoplexy: Case Report and Literature Review of a Rare but Life-Threatening Condition
Authors: Puglisi Valentina , Morini Elisabetta , Biasini Fiammetta , Vinciguerra Luisa , Lanza Giuseppe , Bramanti Placido
Published: March 2022

Background: Giant pituitary adenomas are benign intracranial tumours with a diameter ≥4 cm. Even if hormonally non-functional, they may still cause local extension, leading to symptoms that include mostly gland dysfunction, mass effects, and, much less frequently, apoplexy due to haemorrhage or infarction. Neurological presentation of giant pituitary tumour apoplexy is even more rare and has not been systematically reviewed. Case Presentation: An 81-year-old woman was admitted to the Emergency Department because of acute onset headache, bilateral visual deficit, and altered consciousness. Computed tomography showed a giant mass lesion (>5.5 cm diameter) expanding upward to the suprasellar cistern, optic chiasm, and third ventricle, over-running the sphenoid sinus, and with lateral invasion of the cavernous sinus. Laboratory investigations revealed central adrenal and hypothyroidism insufficiency, while magnetic resonance imaging confirmed a voluminous suprasellar tumour (~6 cm diameter), with signs of pituitary tumour apoplexy. Neurological manifestations and gland-related deficits improved after hormonal replacement therapy with a high dose of intravenous hydrocortisone, followed by oral hydrocortisone and levo-thyroxine. The patient declined surgical treatment and follow-up visit. Conclusions: Giant pituitary tumour apoplexy is a rare but potentially life-threatening condition. Prompt diagnosis and multidisciplinary management may allow a remarkable clinical improvement, as seen in this case.
Risk Factors, Clinical and Endoscopic Features, and Clinical Outcomes in Patients with Cytomegalovirus Esophagitis
Authors: Yeh Pai-Jui , Wu Ren-Chin , Chen Chien-Ming , Chiu Cheng-Tang , Lai Ming-Wei , Chen Chien-Chang , Kuo Chia-Jung , Hsu Jun-Te , Su Ming-Yao , Le Puo-Hsien
Published: March 2022

Cytomegalovirus (CMV) esophagitis is the second most common CMV disease of the gastrointestinal tract. This study aims to comprehensively analyze risk factors, clinical characteristics, endoscopic features, outcomes, and prognostic factors of CMV esophagitis. We retrospectively collected data of patients who underwent esophageal CMV immunohistochemistry (IHC) staining between January 2003 and April 2021 from the pathology database at the Chang Gung Memorial Hospital. Patients were divided into the CMV and non-CMV groups according to the IHC staining results. We enrolled 148 patients (44 CMV and 104 non-CMV patients). The risk factors for CMV esophagitis were male sex, immunocompromised status, and critical illness. The major clinical presentations of CMV esophagitis included epigastric pain (40.9%), fever (36.4%), odynophagia (31.8%), dysphagia (29.5%), and gastrointestinal bleeding (29.5%). Multiple diffuse variable esophageal ulcers were the most common endoscopic feature. The CMV group had a significantly higher in-hospital mortality rate (18.2% vs. 0%; p < 0.001), higher overall mortality rate (52.3% vs. 14.4%; p < 0.001), and longer admission duration (median, 24 days (interquartile range (IQR), 11–47 days) vs. 14 days (IQR, 7–24 days); p = 0.015) than the non-CMV group. Acute kidney injury (odds ratio (OR), 174.15; 95% confidence interval (CI), 1.27–23,836.21; p = 0.040) and intensive care unit admission (OR, 26.53; 95% CI 1.06–665.08; p = 0.046) were predictors of in-hospital mortality. In conclusion, the mortality rate of patients with CMV esophagitis was high. Physicians should be aware of the clinical and endoscopic characteristics of CMV esophagitis in high-risk patients for early diagnosis and treatment.
Quality of Life in Patients with End-Stage Renal Disease Undergoing Hemodialysis
Authors: Dembowska Elżbieta , Jaroń Aleksandra , Gabrysz-Trybek Ewa , Bladowska Joanna , Gacek Szymon , Trybek Grzegorz
Published: March 2022

End-stage renal disease and hemodialysis therapy cause a number of changes, not only somatic but also psychosocial, including the patient’s perception and assessment of their quality of life. The literature describes predispositions to pathologies in the oral mucosa, craniofacial bones, teeth, and surrounding tissues in hemodialysis patients. This study aimed to determine the quality of life of hemodialysis patients in comparison with healthy subjects. The study group consisted of 200 subjects: the HD group (hemodialysis patients, n = 100) and the K group (control group, n = 100). General health and oral status were assessed using the following indices: plaque index, gingival index, probing depth, and clinical adhesion level. The WHOQOL-BREF survey was performed to determine both groups’ overall quality of life. The results showed lower values of assessed quality-of-life parameters in hemodialysis patients compared to the control group, especially in the somatic sphere. General diseases such as oral mycosis, osteoporosis, rheumatoid arthritis, and coronary-artery disease negatively impact the perceived quality of life. There are numerous indications for comprehensive psychological care of hemodialysis patients due to their poor psychosocial status.
Hypothermia Therapy for Traumatic Spinal Cord Injury: An Updated Review
Authors: Ransom Seth C. , Brown Nolan J. , Pennington Zachary A. , Lakomkin Nikita , Mikula Anthony L. , Bydon Mohamad , Elder Benjamin D.
Published: March 2022

Although hypothermia has shown to protect against ischemic and traumatic neuronal death, its potential role in neurologic recovery following traumatic spinal cord injury (TSCI) remains incompletely understood. Herein, we systematically review the safety and efficacy of hypothermia therapy for TSCI. The English medical literature was reviewed using PRISMA guidelines to identify preclinical and clinical studies examining the safety and efficacy of hypothermia following TSCI. Fifty-seven articles met full-text review criteria, of which twenty-eight were included. The main outcomes of interest were neurological recovery and postoperative complications. Among the 24 preclinical studies, both systemic and local hypothermia significantly improved neurologic recovery. In aggregate, the 4 clinical studies enrolled 60 patients for treatment, with 35 receiving systemic hypothermia and 25 local hypothermia. The most frequent complications were respiratory in nature. No patients suffered neurologic deterioration because of hypothermia treatment. Rates of American Spinal Injury Association (AIS) grade conversion after systemic hypothermia (35.5%) were higher when compared to multiple SCI database control studies (26.1%). However, no statistical conclusions could be drawn regarding the efficacy of hypothermia in humans. These limited clinical trials show promise and suggest therapeutic hypothermia to be safe in TSCI patients, though its effect on neurological recovery remains unclear. The preclinical literature supports the efficacy of hypothermia after TSCI. Further clinical trials are warranted to conclusively determine the effects of hypothermia on neurological recovery as well as the ideal means of administration necessary for achieving efficacy in TSCI.