bluuebunny/crossref_metadata_2025 huggingface dataset:
Correlation between Physical Activity and Psychological Distress in Patients Receiving Hemodialysis with Comorbidities: A Cross-Sectional Study
Authors: Wu Yu-Hui , Hsu Yu-Juei , Tzeng Wen-Chii
Published: March 2022

Comorbidities cause psychological distress to patients on hemodialysis and cause their physical function to deteriorate. This study aims to examine whether physical patterns are associated with anxiety, depression and fatigue among patients with and without comorbidities who are on hemodialysis. To this end, a cross-sectional survey was administered to 120 patients on hemodialysis. Data were collected using the International Physical Activity Questionnaire—Short Form, Beck Depression Inventory—Second Edition, Beck Anxiety Inventory, and Brief Fatigue Inventory—Taiwan Version. An independent sample t test and generalized linear model analyses were conducted. The results revealed that patients with comorbidities exhibited more severe levels of depression (p < 0.001), anxiety (p < 0.001), and fatigue (p = 0.010) than patients without comorbidities. Additionally, patients on hemodialysis with a high physical activity level (≥600 metabolic equivalent of task per min/week) exhibited less depression (B = −4.03; p < 0.001; 95% confidence interval [CI] = −6.04, −2.03) and anxiety (B = −2.64; p = 0.002; 95% CI = −4.27, −1.00) severity than those with a low physical activity level; those who engaged in weekly physical activities exhibited less fatigue severity (B = −1.17; p = 0.001; 95% CI = −1.84, −0.49) and fatigue interference (B = −0.61; p = 0.015; 95% CI = −1.10, −0.12). For patients on hemodialysis, having comorbidities was correlated with more severe levels of depression, anxiety, and fatigue. Weekly moderate-intensity physical activities were revealed to be correlated with less severity levels of depression, anxiety, and fatigue. The study findings aid the development of interventions for promoting physical activity among patients on hemodialysis to prevent the exacerbation of complications caused by comorbidities and psychological distress.
Chronic Vulvovaginal Pain in Patients of Color: Benefits of Partner Supportiveness in Relation to Sexual Dissatisfaction and Distress
Authors: Bennett-Brown Margaret , Adams Olivia R. , Campbell Jessica T. , Moscovici Zoe , Gesselman Amanda N.
Published: March 2022

Within the social support literature, individuals who experience chronic pain have shown many positive outcomes and benefits when receiving the appropriate level of emotional support. In the current study, individuals who experience chronic vulvovaginal pain (CVVP) were asked about their partner’s supportiveness, other sources of emotional support, and their satisfaction and stress surrounding sexual activity. The participants (n = 333) also identified as people of color, with a majority identifying as African American or Black (n = 227). The participants indicated that their partners were overall supportive of their diagnoses and found other emotional support sources through medical professionals, vulvar/vaginal pain-specific medical information websites, and family or friends. After conducting linear regressions, results showed the partner supportiveness was associated with less distress and less dissatisfaction surrounding sexual activity. Future research is suggested to further examine social support’s role for minority patients who experience chronic vulvovaginal pain.
A Citizen Science Approach to Identifying Indoor Environmental Barriers to Optimal Health for under 5s Experiencing Homelessness in Temporary Accommodation
Authors: Rosenthal Diana Margot , Ucci Marcella , Heys Michelle , Schoenthaler Antoinette , Lakhanpaul Monica , Hayward Andrew , Lewis Celine
Published: March 2022

The first five years of life are critical for optimal growth, health, and cognitive development. Adverse childhood experiences, including experiencing homelessness, can be a risk factor for multiple health issues and developmental challenges. There is a dearth of data collected with and by families with children under age five living in temporary accommodation due to experiencing homelessness (U5TA) describing indoor environmental barriers that prevent U5TA from achieving and maintaining optimal health. The aim of this study was to address this current gap using a citizen science approach. Fifteen participants, who were mothers of U5TA living in a deprived area of London, and the lead researcher collected data in late 2019/early 2020 using: (I) a housing survey conducted via a mobile app; (II) house visits; and (III) collaborative meetings. Data were analyzed using thematic analysis. Key themes included: overcrowding/shared facilities, dampness/mold growth, poor/inadequate kitchen/toilet facilities, infestations/vermin, structural problems/disrepair, unsafe electrics, excessively cold temperatures, and unsafe surfaces that risk causing trips/falls, with all participants experiencing multiple concurrent indoor environmental barriers. The citizen science approach was successfully used to collect meaningful data demonstrating the need for child-centered housing policies meeting the needs of current and future generations of families living in TA.
Strengthening Emotional Development and Emotion Regulation in Childhood—As a Key Task in Early Childhood Education
Authors: Thümmler Ramona , Engel Eva-Maria , Bartz Janieta
Published: March 2022

The following article deals with emotional development and the development of emotion regulation skills in children during early childhood education, focusing primarily on the importance of the early childhood teacher. Emotion regulation is important for success and wellbeing in further life. It is developed in interaction with parents as attachment figures. Teachers can also be important persons for the child in the context of bonding. This leads to the question of how early childhood teachers can support children learning to regulate their emotions. We analyze with the content analysis, four programs for promoting social and emotional skills that are currently used in Germany. The main question is if the programs include elements that increase teachers’ skills in supporting the children in regulating their emotions. The categories to analyze the programs are derived from theories of teacher-child interaction. In addition to programs for promoting emotional and social development, we will discuss aspects of shaping interaction as essential elements in promoting emotion regulation. The conclusion outlines some key implications for educational practice and the importance of developing professional behavior for qualitative teacher-child interactions.
Occupational Difficulties of Disaster-Affected Local Government Employees in the Long-Term Recovery Phase after the Fukushima Nuclear Accident: A Cross-Sectional Study Using Modeling Analysis
Authors: Kashiwazaki Yuya , Matsunaga Hitomi , Orita Makiko , Taira Yasuyuki , Oishi Keiko , Takamura Noboru
Published: March 2022

Local government officials play a central role in post-disaster community reconstruction. However, few studies have reported on the actual difficulties during a complex disaster involving a nuclear accident. A self-rated questionnaire survey was administered to a total of 583 public employees in four municipalities around the Fukushima Daiichi Nuclear Power Station. The relationship between universal occupational factors and radiation disaster-specific factors on job satisfaction and intention to leave the job due to radiation anxiety was evaluated using structural equation modeling. The results showed that interpersonal problems (β = −0.246) and service years (β = −0.127) were related to job satisfaction, whereas radiation-specific factors were not related to job satisfaction, and only to the intention to leave work due to radiation anxiety. A sense of coherence was associated with job satisfaction (β = 0.373) and intention to leave work due to radiation anxiety (β = −0.182), and it served as a moderator of the universal occupational factors and the radiation disaster-specific factors. Therefore, it is suggested that outcomes could be improved through increased stress coping capacity by providing support for relationships and radiation risk communication to public employees during the disaster recovery period.
The Threshold Effect of Urban Levels on Environmental Collaborative Governance: An Empirical Analysis from Chinese Cities
Authors: Fan Jie , Shen Zhuo , Wang Zhengwen
Published: March 2022

Taking 286 cities above the prefecture level in China as the research object and the research period from 2003 to 2019, through the two-way fixed effect model, this paper empirically analyzes the impact of the city level on environmental collaborative governance. The threshold regression model is used to reveal the nonlinear relationship between urban levels and environmental collaborative governance and to analyze the phase characteristics of different urban levels for environmental collaborative governance. The results show that: (1) The city level has a significant role in promoting collaborative environmental governance. (2) The regression results of the three major sections show that the urban level promotion in the eastern region has the strongest promoting effect on the coordinated environmental governance, and the western region is the weakest. (3) The impact of the city level on collaborative environmental governance is nonlinear. When the city scale reaches a certain critical point, its impact on the collaborative environmental governance tends to intensify.
Design to Assist Better Youthhood for Adolescents with Lower-Limb Disability through Virtual Reality Sports
Authors: Zhang Xiaochen , Hui Lanxin , Li Muge , Huang Jiajing , Chen Chengyuan , Yang Yunping , Song Fuchuan , Hu Fei , Luh Ding-Bang
Published: March 2022

Background: Youths with lower limb dysfunction display low levels of sports participation, which limits their growth and self-development, both physically and mentally. Recently, VR technology has proven its profound value in the psychological evaluation and treatment, rehabilitation, and immersive training of people in need. We have proposed, designed, and developed a VR rock-climbing game for youths with lower-limb dysfunction that allows them to engage in enjoyable and purposeful in-game tasks that simultaneously bring about intensive real-world exercise. Methods: Pilot studies were conducted on college students whose lower limbs were fixed to chairs. Heart rate monitoring, a flow questionnaire, interviews, and observation were conducted for each participant to evaluate the impact of the VR rock-climbing game. The collected data were trimmed on the basis of Cronbach’s alpha and corrected item–total correlation (CITC) to guarantee the data’s reliability. Results: The average value of each flow experience dimension was greater than 4 (0.76 < SD < 0.91). According to the flow-based analysis and the whole-process feeling distribution (WPFD), the evaluated study brought about the participants’ happiness and a sense of mastery and achievement. Conclusions: By bringing about a deep and enjoyable immersion in VR, it remarkably promotes the participants’ intention to participate in exercises.
A Robustness Study for the Extraction of Watertight Volumetric Models from Boundary Representation Data
Authors: Jahn Markus Wilhelm , Bradley Patrick Erik
Published: March 2022

Geometrically induced topology plays a major role in applications such as simulations, navigation, spatial or spatio-temporal analysis and many more. This article computes geometrically induced topology useful for such applications and extends previous results by presenting the unpublished used algorithms to find inner disjoint (d+1)-dimensional simplicial complexes from a set of intersecting d-dimensional simplicial complexes which partly shape their B-Reps (Boundary Representations). CityGML has been chosen as the input data format for evaluation purposes. In this case, the input data consist of planar segment complexes whose triangulated polygons serve as the set of input triangle complexes for the computation of the tetrahedral model. The creation of the volumetric model and the computation of its geometrically induced topology is partly parallelized by decomposing the input data into smaller pices. A robustness analysis of the implementations is given by varying the angular precision and the positional precision of the epsilon heuristic inaccuracy model. The results are analysed spatially and topologically, summarised and presented. It turns out that one can extract most, but not all, volumes and that the numerical issues of computational geometry produce failures as well as a variety of outcomes.
Role of the Ubiquitin System in Stress Granule Metabolism
Authors: Tolay Nazife , Buchberger Alexander
Published: March 2022

Eukaryotic cells react to various stress conditions with the rapid formation of membrane-less organelles called stress granules (SGs). SGs form by multivalent interactions between RNAs and RNA-binding proteins and are believed to protect stalled translation initiation complexes from stress-induced degradation. SGs contain hundreds of different mRNAs and proteins, and their assembly and disassembly are tightly controlled by post-translational modifications. The ubiquitin system, which mediates the covalent modification of target proteins with the small protein ubiquitin (‘ubiquitylation’), has been implicated in different aspects of SG metabolism, but specific functions in SG turnover have only recently emerged. Here, we summarize the evidence for the presence of ubiquitylated proteins at SGs, review the functions of different components of the ubiquitin system in SG formation and clearance, and discuss the link between perturbed SG clearance and the pathogenesis of neurodegenerative disorders. We conclude that the ubiquitin system plays an important, medically relevant role in SG biology.
Identification and In Silico Characterization of a Novel COLGALT2 Gene Variant in a Child with Mucosal Rectal Prolapse
Authors: Sadakierska-Chudy Anna , Szymanowski Paweł , Lebioda Arleta , Płoski Rafał
Published: March 2022

Rectal prolapse is influenced by many factors including connective tissue dysfunction. Currently, there is no data about genetic contribution in the etiology of this disorder. In this study, we performed trio whole-exome sequencing in an 11-year-old girl with mucosal rectal prolapse and her parents and sibling. Genetic testing revealed a novel heterozygous missense variant c.1406G>T; p.G469V in exon 11 of the COLGALT2 gene encoding the GLT25 D2 enzyme. Sanger sequencing confirmed this variant only in the patient while the mother, father and sister showed a wild-type sequence. The pathogenicity of the novel variant was predicted using 10 different in silico tools that classified it as pathogenic. Further, in silico prediction, according to Phyre2, Project HOPE, I-Mutant3.0 and MutPred2 showed that the missense variant can decrease protein stability and cause alterations in the physical properties of amino acids resulting in structural and functional changes of the GLT25D2 protein. In conclusion, the present study identifies a previously unknown missense mutation in the COLGALT2 gene that encodes the enzyme involved in collagen glycosylation. The clinical features observed in the patient and the results of in silico analysis suggest that the new genetic variant can be pathogenic.
Prediction of Rainfall in Australia Using Machine Learning
Authors: Sarasa-Cabezuelo Antonio
Published: March 2022

Meteorological phenomena is an area in which a large amount of data is generated and where it is more difficult to make predictions about events that will occur due to the high number of variables on which they depend. In general, for this, probabilistic models are used that offer predictions with a margin of error, so that in many cases they are not very good. Due to the aforementioned conditions, the use of machine learning algorithms can serve to improve predictions. This article describes an exploratory study of the use of machine learning to make predictions about the phenomenon of rain. To do this, a set of data was taken as an example that describes the measurements gathered on rainfall in the main cities of Australia in the last 10 years, and some of the main machine learning algorithms were applied (knn, decision tree, random forest, and neural networks). The results show that the best model is based on neural networks.
Social Media Bullying in the Workplace and Its Impact on Work Engagement: A Case of Psychological Well-Being
Authors: Anwar Aizza , Kee Daisy Mui Hung , Ijaz Muhammad Fazal
Published: March 2022

The hotel industry has transformed the social and official interaction and communication landscape due to information technology. This has created a new venue for bullying, known as cyberbullying. This study aims to examine the impact of workplace cyberbullying on the work engagement of hotel employees while examining the mediating role of psychological well-being and work meaningfulness using the job demand resource model and conservation of resource theory. The data (n = 470) were collected from 4-star and 5-star hotel employees in Pakistan. The results reported that psychological well-being mediates the relationship between workplace cyberbullying and work engagement. Moreover, work meaningfulness also mediates the relationship between psychological well-being and work engagement. Findings suggest that the hotel industry of Pakistan should acknowledge the presence of cyberbullying and design policies and procedures to maintain a healthy work environment for employees’ psychological well-being and ensure that hotel employees find their work meaningful.
A LiDAR–Camera Fusion 3D Object Detection Algorithm
Authors: Liu Leyuan , He Jian , Ren Keyan , Xiao Zhonghua , Hou Yibin
Published: March 2022

3D object detection with LiDAR and camera fusion has always been a challenge for autonomous driving. This work proposes a deep neural network (namely FuDNN) for LiDAR–camera fusion 3D object detection. Firstly, a 2D backbone is designed to extract features from camera images. Secondly, an attention-based fusion sub-network is designed to fuse the features extracted by the 2D backbone and the features extracted from 3D LiDAR point clouds by PointNet++. Besides, the FuDNN, which uses the RPN and the refinement work of PointRCNN to obtain 3D box predictions, was tested on the public KITTI dataset. Experiments on the KITTI validation set show that the proposed FuDNN achieves AP values of 92.48, 82.90, and 80.51 at easy, moderate, and hard difficulty levels for car detection. The proposed FuDNN improves the performance of LiDAR–camera fusion 3D object detection in the car category of the public KITTI dataset.
Ozone Efficiency on Two Coleopteran Insect Pests and Its Effect on Quality and Germination of Barley
Authors: Dong Xue , Agarwal Manjree , Xiao Yu , Ren Yonglin , Maker Garth , Yu Xiangyang
Published: March 2022

Ozone (O3) is a potential fumigant to control pests in stored grain since it can safely and rapidly auto-decompose without leaving residues. In this study, the efficacy of O3 on all life stages of Rhyzopertha dominica (Fabricius) and Tribolium castaneum (Herbst) in barley and the physiological effects on barley and its quality were investigated. Complete control of all life stages of pests was obtained at 700 ppm for 1440 min of ozone exposure without negatively impacting the contents of soluble protein, moisture content, seed colour, hardness, and the weight of thousand barley seeds. The eggs and pupae of these two insects were the more tolerant stages than their larvae and adults. Prolonged exposure times (40 to 1440 min) and mortality assessment intervals (1, 2, and 7 days) increased O3 efficacy due to the reaction characteristics and delayed toxicity. Aging barley seeds appeared to be more sensitive to prolonged ozone duration than new seeds. A total of 20 and 40 min could promote germination rate, and longer O3 exposure (1440 min) was unfavourable for germination and seedling growth. Thus, it is imperative to select an optimal O3 exposure time to transfer ozone into quality contributors of final products and achieve the desired functional outcomes.
Optimal Landmark for Chest Compressions during Cardiopulmonary Resuscitation Derived from a Chest Computed Tomography in Arms-Down Position
Authors: Usawasuraiin Pimpan , Wittayachamnankul Borwon , Chenthanakij Boriboon , Euathrongchit Juntima , Phinyo Phichayut , Tangsuwanaruk Theerapon
Published: March 2022

Compressions at the left ventricle increase rate of return of spontaneous circulation. This study aimed to identify the landmark of the point of maximal left ventricular diameter on the sternum (LVmax) by using chest computed tomography (CCT) in the arms-down position, which was similar to an actual cardiac arrest patient. A retrospective study was conducted between September 2014 and November 2020. We included adult patients who underwent CCT in an arms-down position and measured the rescuer’s hand. We measured the distance from the sternal notch to LVmax (DLVmax), to the lower half of sternum (DLH), and to the point of maximal force of hand, which placed the lowest palmar margin of the rescuer’s reference hand at the xiphisternal junction. Thirty-nine patients were included. The LVmax was located below the lower half of the sternum; DLVmax and DLH were 12.6 and 10.0 cm, respectively (p < 0.001). Distance from the sternal notch to the point of maximal force of the left hand, with the ulnar border located at the xiphisternal junction, was close to DLVmax; 11.3 and 12.6 cm, respectively (p = 0.076). In conclusion, LVmax was located below the lower half of the sternum, which is recommended by current guidelines.
Future Perspectives in Oxidative Stress in Trisomy 13 and 18 Evaluation
Authors: Buczyńska Angelika , Sidorkiewicz Iwona , Hameed Ahsan , Krętowski Adam Jacek , Zbucka-Krętowska Monika
Published: March 2022

Autosomal aneuploidies are the most frequently occurring congenital abnormalities and are related to many metabolic disorders, hormonal dysfunctions, neurotransmitter abnormalities, and intellectual disabilities. Trisomies are generated by an error of chromosomal segregation during cell division. Accumulating evidence has shown that deregulated gene expression resulting from the triplication of chromosomes 13 and 18 is associated with many disturbed cellular processes. Moreover, a disturbed oxidative stress status may be implicated in the occurrence of fetal malformations. Therefore, a literature review was undertaken to provide novel insights into the evaluation of trisomy 13 (T13) and 18 (T18) pathogeneses, with a particular concern on the oxidative stress. Corresponding to the limited literature data focused on factors leading to T13 and T18 phenotype occurrence, the importance of oxidative stress evaluation in T13 and T18 could enable the determination of subsequent disturbed metabolic pathways, highlighting the related role of mitochondrial dysfunction or epigenetics. This review illustrates up-to-date T13 and T18 research and discusses the strengths, limitations, and possible directions for future studies. The progressive unification of trisomy-related research protocols might provide potential medical targets in the future along with the implementation of the foundation of modern prenatal medicine.
An Exploratory Study of Itolizumab on the Preservation of Beta Cell Function in Adults with Recent-Onset Type 1 Diabetes
Authors: Cabrera-Rode Eduardo , Cubas-Dueñas Ileana , Rodríguez-Acosta Janet , García-García Yudith , Torres-López Yelena , Prieto-Noa Claudia , Vázquez-Izada Bárbara M. , Ruíz-Reinoso Maité , Echevarría-Valdés Ragmila , Álvarez-Álvarez Aimee , Domínguez-Alonso Emma , Conesa-González Ana Ibis , González-Calero Teresa , Robles-Torres Erick , Turcios-Tristá Silvia Elena , Senra-Estévez Elizabeth , Hernández-Casaña Patricia , Sarmiento Luis
Published: March 2022

We conducted a phase I-IIa, randomized, monocentric, double-blind, placebo-controlled clinical trial to evaluate the safety and impact of the combination treatment of Itolizumab and insulin on preserving beta cell function in adults with recent-onset type 1 diabetes. Twelve patients were randomly assigned to three treatment groups, each receiving a different Itolizumab dose (0.4/0.8/1.6 mg/kg body weight, respectively) and a placebo group. All patients received concomitant intensive multiple-dose insulin therapy. Endogenous insulin secretion was assessed by the measurement of C-peptide during the mixed-meal tolerance test. No serious adverse events were reported. No changes in the total daily insulin doses, glycated hemoglobin levels, and stimulated C-peptide were observed between the Itolizumab and placebo groups at 52 weeks. A significant decrease in stimulated C-peptide was observed during the follow-up period (p = 0.012). One subject treated with 1.6 mg of Itolizumab showed a marked increase in the levels of stimulated C-peptide three years after completion of the trial. Taken together, this is the first study to demonstrate that combination treatment with Itolizumab and insulin is safe in humans and does not affect the residual function of beta cells up to 52 weeks. The findings from our study show preliminary evidence that high doses of Itolizumab could potentially arrest the loss of beta cell function in the long term. Further studies with a longer follow-up and larger numbers of patients are envisaged to assess the effect with high dose Itolizumab.
A Simple Prognostic Score for Critical COVID-19 Derived from Patients without Comorbidities Performs Well in Unselected Patients
Authors: Georgakopoulou Vasiliki E. , Vlachogiannis Nikolaos I. , Basoulis Dimitrios , Eliadi Irene , Georgiopoulos Georgios , Karamanakos Georgios , Makrodimitri Sotiria , Samara Stamatia , Triantafyllou Maria , Voutsinas Pantazis M. , Ntziora Fotinie , Psichogiou Mina , Samarkos Michael , Sfikakis Petros P. , Sipsas Nikolaos V.
Published: March 2022

We aimed to search for laboratory predictors of critical COVID-19 in consecutive adults admitted in an academic center between 16 September 2020–20 December 2021. Patients were uniformly treated with low-molecular-weight heparin, and dexamethasone plus remdesivir when SpO2 < 94%. Among consecutive unvaccinated patients without underlying medical conditions (n = 241, 49 year-old median, 71% males), 22 (9.1%) developed critical disease and 2 died (0.8%). White-blood-cell counts, neutrophils, neutrophil-to-lymphocyte ratio, CRP, fibrinogen, ferritin, LDH and γ-GT at admission were each univariably associated with critical disease. ROC-defined cutoffs revealed that CRP > 61.8 mg/L, fibrinogen > 616.5 mg/dL and LDH > 380.5 U/L were each associated with critical disease development, independently of age, sex and days from symptom-onset. A score combining higher-than-cutoff CRP (0/2), LDH (0/1) and fibrinogen (0/1) predicted critical disease (AUC: 0.873, 95% CI: 0.820–0.926). This score performed well in an unselected patient cohort (n = 1228, 100% unvaccinated) predominantly infected by the alpha variant (AUC: 0.718, 95% CI: 0.683–0.753), as well as in a mixed cohort (n = 527, 65% unvaccinated) predominantly infected by the delta variant (AUC: 0.708, 95% CI: 0.656–0.760). Therefore, we propose that a combination of standard biomarkers of acute inflammatory response, cell death and hypercoagulability reflects the severity of COVID-19 per se independently of comorbidities, age and sex, being of value for risk stratification in unselected patients.
Urinary Tract Infections in Hospitalized COVID-19 Patients, What’s Up, Doc?
Authors: Díaz Pollán Beatriz , Guedez López Gladys Virginia , García Clemente Paloma María , Jiménez González María , García Bujalance Silvia , Gómez-Gil Mirá María Rosa
Published: March 2022

The SARS-CoV-2 pandemic might have increased the risks of healthcare-associated infections (HAIs); however, several studies of HAI such as urinary tract infections (UTIs) and catheter-associated urinary tract infections (CAUTIs) have shown contradictory results. The aim of this study is to assess the clinical features of UTIs and bacterial isolates from urine samples of hospitalized COVID-19 patients. We conducted a retrospective observational study including 87 COVID-19 patients with UTIs admitted to our centre. Bacterial UTIs presented were 87: 9 (10.3%) community-acquired UTIs (coinfection group) and 78 (89.6%) hospital-acquired UTIs (superinfection group). In the coinfection group, the most frequent type was non-CAUTI with 5 (55.5%) patients; however, the most frequent UTI in the superinfection group was CAUTI, with 53 (67.9%) patients. The median number of days of hospitalization in coinfected patients was lower than superinfection patients: 13 (IQR 11, 23) vs. 34 days (IQR 23, 47) p < 0.006. All UTI patients admitted to ICU, 38 (43.7%), belonged to the superinfection group. The mortality rate was 26.4% (23/87), 22/23 in the superinfection group. The most common microorganisms were E. coli 27 (28.4%), E. faecalis 25 (26.3%) and E. faecium 20 (21.1%). There was an increased incidence of E. faecalis and E. faecium in UTIs as well as hospital-acquired UTIs. This can be related to urethral catheterization during hospitalization, UCI admissions and the number of days of hospitalization.
Performance of Computed Tomography Angiography (CTA) for the Diagnosis of Hypo-Attenuated Leaflet Thickening (HALT)
Authors: Hein Manuel , Breitbart Philipp , Minners Jan , Blanke Philipp , Schoechlin Simon , Schlett Christopher , Krauss Tobias , Soschynski Martin , Neumann Franz-Josef , Ruile Philipp
Published: March 2022

(1) Background: Early hypo-attenuated leaflet thickening (HALT) is diagnosed by computed tomography angiography (CTA) in approximately 15% of patients undergoing transcatheter aortic valve replacement (TAVR). We sought to investigate the diagnostic performance of CTA for the diagnosis of HALT, focusing on timing data assessment within the cardiac cycle. (2) Methods: The study enrolled 50 patients with and 50 without HALT with available post-TAVR-CTA. The primary objective was to compare the diagnostic performance of CTA readings at specific intervals and time points during the cardiac cycle (entire systole, entire diastole, end-systole, and mid-diastole) versus gold standard (consensus reading by two observers based on multiphase full cardiac cycle data sets). (3) Results: 100 CTAs were independently analysed by two observers blinded to clinical characteristics of the study population and the results from the gold standard reading. Sensitivity and specificity for the diagnosis of HALT were 84%/94% in systole, 87%/92% in diastole, 78%/95% at end-systole, and 80%/94% at mid-diastole. End-systole had the highest positive predictive value (0.88) and positive likelihood ratio (36). Cohen’s kappa for interobserver reliability was 0.715 in systole, 0.578 in diastole, 0.650 at end-systole, and 0.517 at mid-diastole. (4) Conclusion: Limiting CTA reading to distinct intervals or time points during the cardiac cycle has good specificity but lowers sensitivity. For a reliable diagnosis of HALT, data sets from a multiphase CTA covering the entire cardiac cycle should be analysed. A double reader approach would be desirable in further studies investigating HALT.
Retinal Manifestations in Patients with COVID-19: A Prospective Cohort Study
Authors: Riotto Eleonora , Mégevand Vladimir , Mégevand Alexis , Marti Christophe , Pugin Jerome , Stangos Alexandros N. , Marconi Archinto Leonardo , Sunaric Mégevand Gordana
Published: March 2022

The recent outbreak of the Coronavirus SARS-CoV-2 has been declared a worldwide pandemic. Within various multi-organ involvement, several ocular manifestations have been described, such as conjunctivitis and retinopathy. The prevalence and severity of retinal lesions and their relation to the severity of the systemic disease are unknown. We performed a prospective, observational study on 172 consecutively hospitalized patients with acute confirmed COVID-19 infection. All patients underwent screening widefield fundus photography at the time of hospital admission. Despite no ocular or vision-related symptoms, we found cotton wool spots (CWS) and/or hemorrhages in 19/172 patients (11%). Diabetes history, overweight, and elevated C-reactive protein were more frequently observed among patients with retinal abnormalities, while a history of systemic hypertension was more frequently observed among patients without retinal findings. At a 3-month follow-up visit, CWS had subsided in all patients.
Macular Pigment and Open-Angle Glaucoma in the Elderly: The Montrachet Population-Based Study
Authors: Arnould Louis , Seydou Alassane , Binquet Christine , Gabrielle Pierre-Henry , Chamard Chloé , Bretillon Lionel , Bron Alain M. , Acar Niyazi , Creuzot-Garcher Catherine
Published: March 2022

(1) Background: To compare macular pigment optical density (MPOD) and its spatial distribution between eyes with primary open-angle glaucoma (POAG) and control eyes in an elderly population. (2) Methods: The Montrachet study (Maculopathy Optic Nerve and nutrition neurovAsCular and HEarT) is a population-based study including participants aged 75 years and over. All participants had a slit lamp examination, fundus photographs, and a questionnaire about their medical past history and smoking status. Optic disc spectral domain optical coherence tomography was also performed. All glaucoma-suspected patients were convocated to have a new full examination. We only retained one eye with POAG for analysis in the glaucoma group and one eye without optic neuropathy in the control participants group. MPOD measurements were performed with the two-wavelength autofluorescence method (488 and 514 nm). (3) Results: Overall, 601 eyes had MPOD measurements among 1153 participants. Among the 601 eyes, 48 had POAG. The mean age for the glaucoma and control participants was 84.01 ± 4.22 years and 81.94 ± 3.61 years, respectively (p < 0.001). In the multivariable analysis, we could not find any association between POAG and MPOD at 0.5° (p = 0.336). We found no significant difference regarding MP spatial distribution between the two groups (p = 0.408). (4) Conclusion: In this elderly population-based study, eyes with POAG and control eyes without optic neuropathy did not differ in terms of MPOD and MP spatial distribution.
Effect of Percutaneous Electric Stimulation with High-Frequency Alternating Currents on the Sensory-Motor System of Healthy Volunteers: A Double-Blind Randomized Controlled Study
Authors: Álvarez David Martín-Caro , Serrano-Muñoz Diego , Fernández-Pérez Juan José , Gómez-Soriano Julio , Avendaño-Coy Juan
Published: March 2022

Former studies investigated the application of high-frequency alternating currents (HFAC) in humans for blocking the peripheral nervous system. The present trial aims to assess the effect of HFAC on the motor response, somatosensory thresholds, and peripheral nerve conduction when applied percutaneously using frequencies of 10 kHz and 20 kHz in healthy volunteers. A parallel, placebo-controlled, double-blind, randomized clinical trial was conducted. Ultrasound-guided HFAC at 10 kHz and 20 kHz and sham stimulation were delivered to the median nerve of 60 healthy volunteers for 20 min. The main assessed variables were the maximum isometric flexion strength (MFFS) of the index finger, myotonometry, pressure pain threshold (PPT), mechanical detection threshold (MDT), and sensory nerve action potential (SNAP). A decrease in the MFFS is observed immediately postintervention compared to baseline, both in the 10 kHz group (−8.5%; 95% CI −14.9 to −2.1) and the 20 kHz group (−12.0%; 95% CI −18.3 to −5.6). The between-group comparison of changes in MFFS show a greater reduction of −10.8% (95% CI −19.8 to −1.8) immediately postintervention in the 20 kHz compared to the sham stimulation group. The percutaneous stimulation applying 20 kHz HFAC to the median nerve produces a reversible postintervention reduction in strength with no adverse effects.
ADAMTS13, VWF, and Endotoxin Are Interrelated and Associated with the Severity of Liver Cirrhosis via Hypercoagulability
Authors: Takaya Hiroaki , Namisaki Tadashi , Asada Shohei , Iwai Satoshi , Kubo Takahiro , Suzuki Junya , Enomoto Masahide , Tsuji Yuki , Fujinaga Yukihisa , Nishimura Norihisa , Sawada Yasuhiko , Kaji Kosuke , Kawaratani Hideto , Moriya Kei , Akahane Takemi , Matsumoto Masanori , Yoshiji Hitoshi
Published: March 2022

ADAMTS13 specifically cleaves the multimeric von Willebrand factor (VWF), and an imbalance between ADAMTS13 activity (ADAMTS13:AC) and VWF antigen (VWF:Ag) levels is associated with the severity of liver cirrhosis (LC). However, the reason for this imbalance in patients with LC is unknown. This study investigated the relationship among ADAMTS13:AC, VWF:Ag, and endotoxin (Et) levels in patients with LC. ADAMTS13:AC and VWF:Ag levels were determined using ELISA, whereas Et levels were estimated using a chromogenic substrate assay. The levels of ADAMTS13 inhibitor (ADAMTS13:INH) were evaluated by measuring the extent that heat-inactivated patient’s plasma reduces the ADAMTS13:AC of the control. The status (degraded, normal, or unusually large [UL]) of the VWF multimer (VWFM) was determined through vertical agarose gel electrophoresis. ADAMTS13:AC, VWF:Ag, and Et levels decreased, increased, and increased, respectively, with the severity of LC. Patients with cirrhosis with high Et levels had lower and higher ADAMTS13:AC and VWF:Ag levels, respectively, than those with low Et levels. Patients with cirrhosis with detectable ADAMTS13:INH had higher Et levels than those with undetectable ADAMTS13:INH. Patients whose VWFM was either normal or UL had higher Et levels than those with degraded VWFM. In conclusion, ADAMTS13, VWF, and Et may be interrelated and associated with the severity of LC via hypercoagulability.
CRP Serum Levels Are Associated with High Cardiometabolic Risk and Clinical Disease Activity in Systemic Lupus Erythematosus Patients
Authors: Pesqueda-Cendejas Karen , Parra-Rojas Isela , Mora-García Paulina E. , Montoya-Buelna Margarita , Ruiz-Ballesteros Adolfo I. , Meza-Meza Mónica R. , Campos-López Bertha , Rivera-Escoto Melissa , Vizmanos-Lamotte Barbara , Cerpa-Cruz Sergio , de la Cruz-Mosso Ulises
Published: March 2022

Systemic lupus erythematosus (SLE) patients have a higher frequency of cardiovascular risk factors such as high C-reactive protein (CRP) levels than the general population. CRP is considered a cardiovascular disease marker that could be related to SLE clinical disease activity. This study aimed to assess the association between CRP with cardiometabolic risk and clinical disease activity in SLE patients. A comparative cross-sectional study was conducted in 176 female SLE patients and 175 control subjects (CS) with median ages of 38 and 33 years, respectively; SLE patients were classified by the 1997 SLE-ACR criteria, and the clinical disease activity by the Mexican-SLEDAI (Mex-SLEDAI). CRP and lipid profile (triglycerides, cholesterol, HDL-C, and LDL-C) were quantified by turbidimetry and colorimetric-enzymatic assays, respectively. SLE patients had higher CRP levels than CS (SLE: 5 mg/L vs. CS = 1.1 mg/L; p < 0.001). In SLE patients, CRP levels ≥ 3 mg/L were associated with a higher risk of cardiometabolic risk status assessed by LAP index (OR = 3.01; IC: 1.04–8.7; p = 0.04), triglycerides/HDL-C index (OR = 5.2; IC: 2.1–12.8; p < 0.001), Kannel index (OR = 3.1; IC: 1.1–8.1; p = 0.03), Castelli index (OR = 6.6; IC: 2.5–17.8; p < 0.001), and high clinical disease activity (OR = 2.5: IC: 1.03–6.2; p = 0.04; and β coefficient = 5.8; IC: 2.5–9.4; R2 = 0.15; p = 0.001). In conclusion, high CRP levels were associated with high cardiometabolic risk and clinical disease activity in SLE patients.
Ethical Dilemmas with Regard to Elderly Patients with Hip Fracture: The Problem of Nonagenarians and Centenarians
Authors: Herrera-Pérez Mario , González-Martín David , Sanz Emilio J. , Pais-Brito José L.
Published: March 2022

Hip fracture is the most feared complication of osteoporosis, producing up to 30% mortality at the first year. With the aging of society, it is increasingly common to deal with ethical dilemmas that involve decision making in the elderly patient with a hip fracture. The objectives of the present work are to describe the main bioethical dilemmas in this group of patients and their relationship with surgical delay. We conducted a retrospective descriptive study that studied an elderly population admitted to a University Hospital with a diagnosis of hip fracture. In total, 415 patients were analyzed. The majority received surgical treatment, a correct application of the principles of justice, non-maleficence and beneficence is verified, but a possible violation of the principle of autonomy is confirmed. Based on the results of this study, the elderly population may somehow lose their principle of autonomy when they enter a hospital due to a hip fracture. On the other hand, the so-called ageism due to ignorance can influence the surgical delay and therefore the mortality of these patients.
Predictive Markers for Immune Checkpoint Inhibitors in Non-Small Cell Lung Cancer
Authors: Ushio Ryota , Murakami Shuji , Saito Haruhiro
Published: March 2022

Immune checkpoint inhibitors (ICIs) have dramatically improved the outcomes of non-small cell lung cancer patients and have increased the possibility of long-term survival. However, few patients benefit from ICIs, and no predictive biomarkers other than tumor programmed cell death ligand 1 (PD-L1) expression have been established. Hence, the identification of biomarkers is an urgent issue. This review outlines the current understanding of predictive markers for the efficacy of ICIs, including PD-L1, tumor mutation burden, DNA mismatch repair deficiency, microsatellite instability, CD8+ tumor-infiltrating lymphocytes, human leukocyte antigen class I, tumor/specific genotype, and blood biomarkers such as peripheral T-cell phenotype, neutrophil-to-lymphocyte ratio, interferon-gamma, and interleukin-8. A tremendous number of biomarkers are in development, but individual biomarkers are insufficient. Tissue biomarkers have issues in reproducibility and accuracy because of intratumoral heterogeneity and biopsy invasiveness. Furthermore, blood biomarkers have difficulty in reflecting the tumor microenvironment and therefore tend to be less predictive for the efficacy of ICIs than tissue samples. In addition to individual biomarkers, the development of composite markers, including novel technologies such as machine learning and high-throughput analysis, may make it easier to comprehensively analyze multiple biomarkers.
Involvement of Proinflammatory Arachidonic Acid (ARA) Derivatives in Crohn’s Disease (CD) and Ulcerative Colitis (UC)
Authors: Kikut Justyna , Mokrzycka Małgorzata , Drozd Arleta , Grzybowska-Chlebowczyk Urszula , Ziętek Maciej , Szczuko Małgorzata
Published: March 2022

Recently, an increase in the incidence of inflammatory bowel disease (IBD) has been observed, especially among children and adolescents. Currently, few studies focus on the differentiation of inflammation in IBD subunits, i.e., Crohn’s Disease (CD) and Ulcerative Colitis (UC). The aim of this study was to compare the concentrations of proinflammatory mediators of arachidonic acid (ARA) and linoleic acid (LA) in patients with CD (n = 34) and UC (n = 30), in order to identify differences in inflammation in both diseases and within the same entity, according to disease activity. Sixty-four adolescents with a mean age of 13.76 ± 2.69 and 14.15 ± 3.31, for CD and UC, respectively, were enrolled in the study. Biochemical analysis of ARA and LA derivatives was performed using a liquid chromatography. A trend was observed in the concentration of 15S-HETE (hydroxyeicosatetraenoic acids) in CD relative to UC. The active phase of both diseases showed a higher 15S-HETE concentration in active CD relative to active UC. Comparing patients with CD with active and inactive disease showed a trend of increased levels of thromboxane B2, leukotriene B4 and 9S-HODE (hydroxyoctadecadienoic acid) in the active versus the inactive disease. We also observed statistically significantly higher levels of 12S-HETE in inactive CD relative to active CD. In the UC group, on the other hand, statistically significantly higher levels of prostaglandin E2 and 16RS-HETE were observed in active UC relative to inactive UC. Moreover, significantly higher concentrations of LTX A4 5S, 6R were observed in inactive UC relative to the active phase. In conclusion, the present study indicated the activity of the 15-LOX pathway in CD. Further studies involving lipid mediators in patients with IBD may contribute to the development of new therapies for the treatment of IBD. The identification of differences in the course of inflammation may help to target therapy in CD and UC, and perhaps allow the introduction of an additional diagnostic marker between the two main IBD subtypes.
Unsupervised Machine Learning Techniques for Detecting PLC Process Control Anomalies
Authors: Aboah Boateng Emmanuel , Bruce J. W.
Published: March 2022

The security of programmable logic controllers (PLCs) that control industrial systems is becoming increasingly critical due to the ubiquity of the Internet of Things technologies and increasingly nefarious cyber-attack activity. Conventional techniques for safeguarding PLCs are difficult due to their unique architectures. This work proposes a one-class support vector machine, one-class neural network interconnected in a feed-forward manner, and isolation forest approaches for verifying PLC process integrity by monitoring PLC memory addresses. A comprehensive experiment is conducted using an open-source PLC subjected to multiple attack scenarios. A new histogram-based approach is introduced to visualize anomaly detection algorithm performance and prediction confidence. Comparative performance analyses of the proposed algorithms using decision scores and prediction confidence are presented. Results show that isolation forest outperforms one-class neural network, one-class support vector machine, and previous work, in terms of accuracy, precision, recall, and F1-score on seven attack scenarios considered. Statistical hypotheses tests involving analysis of variance and Tukey’s range test were used to validate the presented results.
Phase Retardation Analysis in a Rotated Plane-Parallel Plate for Phase-Shifting Digital Holography
Authors: Shevkunov Igor , Petrov Nikolay V.
Published: March 2022

In this paper, we detail a phase-shift implementation in a rotated plane-parallel plate (PPP). Considering the phase-shifting digital holography application, we provide a more precise phase-shift estimation based on PPP thickness, rotation, and mutual inclination of reference and object wavefronts. We show that phase retardation uncertainty implemented by the rotated PPP in a simple configuration is less than the uncertainty of a traditionally used piezoelectric translator. Physical experiments on a phase test target verify the high quality of phase reconstruction.