bluuebunny/crossref_metadata_2025 huggingface dataset:
Effectiveness of Social Media-Based Interventions for the Promotion of Physical Activity: Scoping Review
Authors: Günther Liane , Schleberger Sarah , Pischke Claudia R.
Published: December 2021

A global target of the World Health Organization (WHO) is to reduce physical inactivity among all adults and adolescents by approximately fifteen percent by 2030. Social media could have an impact in this effort because of its enormous reach, potentially addressing underserved populations in need for physical activity (PA) interventions. This scoping review provides a broad overview of social media-based interventions and systematically maps the evidence regarding their effectiveness for PA promotion and other health outcomes. Scopus and Medline were searched using the terms “physical activity” and “social media” and the names of key social media platforms. Following the PRISMA guidelines for scoping reviews, abstracts and full texts were screened for eligibility. In total, 12,321 publications were identified and 53 met the inclusion criteria. The use of Facebook was most prevalent in PA interventions, followed by study-specific platforms. More than one third of the studies revealed positive effects regarding the promotion of PA. Additionally, social media-based interventions positively affected other physical dimensions of health (e.g., weight or blood pressure). Results pertaining to feasibility were heterogeneous. Social media seems to be a promising tool for increasing PA at the population level. Future studies should take the abundance of platforms into account and select social media platforms consciously.
Home Working and Physical Activity during SARS-CoV-2 Pandemic: A Longitudinal Cohort Study
Authors: Rapisarda Venerando , Loreto Carla , De Angelis Laura , Simoncelli Giuditta , Lombardo Claudia , Resina Riccardo , Mucci Nicola , Matarazzo Agata , Vimercati Luigi , Ledda Caterina
Published: December 2021

Background: Due to the SARS-CoV-2 pandemic, human lifestyles and occupational settings have changed in the workplace. This survey explores associations of home working employment and related physical activity (PA–MET min/week). Methods: A longitudinal cohort study was conducted between March 2020 and March 2021. A standardized method for assessing PA and sedentary time, the Italian version of the International Physical Activity Questionnaire-Short Form (IPAQ-SF), was used through the Microsoft Forms® platform for self-administering the questionnaire. Baseline data were collected, and four follow-ups were performed; a full calendar year was observed. Results: In total, 310 home workers were recruited in this investigation. The average body mass index (BMI- kg/m2) was 21.4 ± 4.2 at baseline. The value increased at the first follow-up and fluctuated in the other recalls. The t-test of MET values of the four activities (Total PA, Vigorous-intensity activity, Moderate-intensity activity, Walking) show similar results; the total PA, at baseline 275.7 ± 138.6, decreased statistically significantly at the first (198.5 ± 84.6), third (174.9 ± 98.4), and fourth (188.7 ± 78.5) follow-ups, while it increased statistically significantly at the second follow-up (307.1 ± 106.1) compared to the baseline. Sedentary time was constant until the second follow-up, while it increased statistically significantly at the 3rd and 4th follow-up. Conclusion: workers involved reduced and reorganized their PA during this pandemic year. Each business company should intervene to improve the PA levels of workers and reduce sedentary behavior in the workplace.
Gender-Specific Differences in Self-Care, Treatment-Related Symptoms, and Quality of Life in Hemodialysis Patients
Authors: Lerma Claudia , Lima-Zapata Larissa I. , Amaya-Aguilar Jorge A. , Leonardo-Cruz Itzel , Lazo-Sánchez Monica , Bermúdez Luis A. , Pérez-Grovas Héctor , Lerma Abel , Cadena-Estrada Julio César
Published: December 2021

Gender and sex differences affect women with kidney failure (KF) negatively at all stages of the disease. This study assessed gender differences in self-care, hemodialysis symptoms, and quality of life in a sample of 102 adult KF patients treated with hemodialysis, from two clinical centers in Mexico. Self-care agency, quality of life, and the symptoms related to hemodialysis were evaluated through questionnaires, and sociodemographic and laboratory variables were obtained from the clinical records. Compared to male patients, female patients reported similar self-care, lower quality of life subscales (symptoms, physical functioning, pain, and overall health), and higher prevalence and intensity of hemodialysis symptoms. There were gender differences regarding the correlation between self-care and quality of life, symptoms intensity, and symptoms prevalence. In conclusion, women with KF treated with hemodialysis perceived a higher impact of hemodialysis and reported a lower quality of life than men. Despite having a similar self-care agency, the self-care correlations with quality of life and hemodialysis symptoms appeared different between men and women treated with chronic hemodialysis. Such differences may be important in future nursing interventions to improve self-care and quality of life among KF patients.
Breastmilk as a Multisensory Intervention for Relieving Pain during Newborn Screening Procedures: A Randomized Control Trial
Authors: Lan Hsiang-Yun , Yang Luke , Lin Chiao-Hsuan , Hsieh Kao-Hsian , Chang Yue-Cune , Yin Ti
Published: December 2021

The study aim was to explore the effects of multisensory breastmilk interventions on short-term pain of infants during newborn screening. This is a randomized controlled trial. A total of 120 newborns were recruited and assigned by randomization to one of three treatment conditions: Condition 1 = routine care (gentle touch + verbal comfort); Condition 2 = breastmilk odor + routine care; or Condition 3 = breastmilk odor + taste + routine care. Pain was scored with the Neonatal Infant Pain Scale (NIPS). Data were collected from video recordings at 1 min intervals over the 11 phases of heel sticks: phase 1, 5 min before heel stick without stimuli (baseline); phase 2 to phase 6 (during heel stick); and phase 7 to phase 11 (recovery). Generalized estimating equations compared differences in pain scores for newborns over phases among the three conditions. Compared with the routine care, provision of the odor and taste of breastmilk reduce NIPS scores during heel sticks (B = −4.36, SE = 0.45, p < 0.001 [phase6]), and during recovery (B = −3.29, SE = 0.42, p < 0.001 [phase7]). Our findings provide new data, which supports the use of multisensory interventions that include breastmilk odor and taste in combination with gentle touch and verbal comfort to relieve pain in infants undergoing newborn screening.
Association between Nightlife Goers’ Likelihood of an Alcohol Use Disorder and Their Preferred Bar’s Closing Time: A Cross-Sectional Observational Study in Perth, Australia
Authors: Gilmore William , Symons Martyn , Liang Wenbin , Graham Kathryn , Kypri Kypros , Miller Peter , Chikritzhs Tanya
Published: December 2021

Introduction and aims: Associations between longer-term alcohol-related conditions and licensed outlet trading hours are not well understood. We investigated the association between nightlife-goers’ likelihood of an alcohol use disorder (AUD) and their preference for bars with special permits to remain open ‘late’ (i.e., spent more time there compared to any other venue) until 2 a.m. or 3 a.m. (Friday; Saturday) or midnight (Sunday) compared to bars with ‘standard’ closing times of midnight (Friday; Saturday) or 10 p.m. (Sunday). Design and methods: A cross-sectional observational study was conducted in four major nightlife areas of Perth, Australia, in 2015–2016. We conducted weekend street intercept surveys outside bars between 8 p.m. and 3 a.m. and screened participants who reported alcohol use prior to the survey and spent more time in a bar than any other venue type (n = 667) regarding their past year drinking pattern using AUDIT-C (n = 459). We used gender-specific logistic regression models to estimate associations between AUDIT-C categories (1–4, low risk; 5–7, hazardous; 8–12, active AUD) and preference for bars with different closing times (late vs. standard). Results: A large proportion of participants were hazardous drinkers or had active AUD (83% males; 65% females), and over half preferred a late to a standard closing bar. We found evidence of a positive association between preference for late closing bars and hazardous drinking females (OR = 3.48; 95% CI 1.47–8.23; p = 0.01), but not for females with active AUD, male hazardous drinkers, nor males with active AUD. Discussion and conclusions: Our study adds new evidence on associations between likelihood of AUD among nightlife-goers and trading hours. With increasing international relaxation of trading hours, evidence that late closing bars may be preferred by hazardous drinking females will be of concern to policymakers wanting to curb alcohol-related harms in the community.
Alcohol Consumption during the COVID-19 Lockdown Period: Predictors of At-Risk Drinking at Different AUDIT-C Cut-Off Thresholds
Authors: Foster John H. , Martin Colin R. , Davis Josh P.
Published: December 2021

During the COVID-19 pandemic, alcohol consumption was largely confined to drinking in the home. There has been little research examining variables associated with risk in home drinking. The study employed an online survey of (n = 1128) individuals who had been recruited for their face recognition skills (n = 838, 70.9% females, mean age 45.05 (12.3 SD)). The main dependent variables were three different AUDIT-C cut-off scores for at-risk drinking: (a) 5 for both genders as recommended by Public Health England, (b) 7 for females and 8 for males (cut-off for students and young people) and (c) 8 for both genders (individuals seeking online help for their drinking). Among the independent variables were gender and age, motivations for home drinking using the Home Drinking Assessment Scale (HDAS), purchasing patterns, context of drinking and health and wellbeing. The predictors following hierarchical logistic regressions were for (a) purchasing alcohol online or at a supermarket and emotional HDAS scores, (b) purchasing alcohol online or at a supermarket and for parties, drinking alone and with other members of the household and emotional and practical reason HDAS scores, (c) as for b with the addition that men were more likely to be at-risk drinkers. At-risk drinking in the pandemic was explained by motivational reasons, purchasing patterns and situational factors.
Mindfulness Meditation Improves Musical Aesthetic Emotion Processing in Young Adults
Authors: Liu Xiaolin , Shi Huijuan , Liu Yong , Yuan Hong , Zheng Maoping
Published: December 2021

This study explored the behavioral and neural correlates of mindfulness meditation improvement in musical aesthetic emotion processing (MAEP) in young adults, using the revised across-modal priming paradigm. Sixty-two participants were selected from 652 college students who assessed their mindfulness traits using the Mindful Attention Awareness Scale (MAAS). According to the 27% ratio of the high and low total scores, participants were divided into two subgroups: high trait group (n = 31) and low trait group (n = 31). Participants underwent facial recognition and emotional arousal tasks while listening to music, and simultaneously recorded event-related potentials (ERPs). The N400, P3, and late positive component (LPC) were investigated. The behavioral results showed that mindfulness meditation improved executive control abilities in emotional face processing and effectively regulated the emotional arousal of repeated listening to familiar music among young adults. These improvements were associated with positive changes in key neural signatures of facial recognition (smaller P3 and larger LPC effects) and emotional arousal (smaller N400 and larger LPC effects). Our results show that P3, N400, and LPC are important neural markers for the improvement of executive control and regulating emotional arousal in musical aesthetic emotion processing, providing new evidence for exploring attention training and emotional processing. We revised the affecting priming paradigm and E-prime 3.0 procedure to fulfill the simultaneous measurement of music listening and experimental tasks and provide a new experimental paradigm to simultaneously detect the behavioral and neural correlates of mindfulness-based musical aesthetic processing.
Concept Evolution and Multi-Dimensional Measurement Comparison of Urban Energy Performance from the Perspective of System Correlation: Empirical Analysis of 142 Prefecture Level Cities in China
Authors: Wang Lei , Li Wei , Li Guomin , Zhang Guozhen
Published: December 2021

In order to clarify the evolution characteristics and direction of urban energy performance concepts, reveal the research dimensions, determine the performance results and differences, and clarify the reference benchmark, this study depicts the main systems involved in the process of urban energy utilization, demonstrates their relevance guided by the system view, and proposes the measurement indicators in the economic, environmental, and well-being dimensions. The measurement model of each dimension is constructed using the corresponding models of Data Envelopment Analysis. Taking 142 prefecture level cities in China as examples, the energy performance in different dimensions is measured and compared. The energy performance levels are close in the economic and environmental dimensions. However, the results of the well-being dimension are different from these first two dimensions, and the performance levels among cities differ more. In the economic, environmental, and well-being dimension, 22, 28 and 16 cities have reached the effective frontier, respectively, and the performance benchmark cities of 15, 15 and 5 provinces are non-provincial capital cities, respectively. Based on the above analysis, the “chain” framework evolution direction of concept and measurement is proposed, and this study provides benchmarks and policy suggestions to improve energy performance.
Temporal–Spatial Evolution and Influencing Factors of Coordinated Development of the Population, Resources, Economy and Environment (PREE) System: Evidence from 31 Provinces in China
Authors: Cao Junjie , Zhang Yao , Wei Taoyuan , Sun Hui
Published: December 2021

Facing the increasingly severe friction among the domains of population, resources, economy and environment (PREE) in a system, theoretical guidance for the sustainable development of a PREE system can be obtained by exploring the coordinated development of a PREE system during its temporal–spatial evolution process. Based on the PREE data of 31 provinces in China from 2010 to 2019, this study uses a spatial measurement method to analyze the temporal and spatial evolution characteristics of the PREE systems of China’s provinces. The results show that the overall coordination level of China’s provincial PREE systems fluctuated but improved from moderate imbalance to moderate coordination. However, the differences in the regional coordination level first decreased and then increased. The distribution characteristics of the system coordination level changed from “high in the east and low in the west” to “high in the west and low in the east”, resulting in the “inversion” phenomenon of the system coordination level. The spatial correlation of the coordination level of the PREE system among provinces and cities gradually increased. The coordination level of the PREE system in the eastern, central and western regions was noticeably different, accompanied by different degrees of polarization and showing different dynamic evolution trends. In the analysis of influencing factors, it was found that seven factors, such as per capita GDP, the proportion of environmental pollution control investment to GDP and per capita energy production, promoted the coordinated development of China’s PREE system to varying degrees. The coordinated and stable development of China’s PREE system should be adjusted and optimized from the perspectives of different regions, scales and systems.
Noise Generation and Acoustic Impact of Free Surface Hydropower Machines: Focus on Water Wheels and Emerging Challenges
Authors: Quaranta Emanuele , Müller Gerald
Published: December 2021

The noise generated by free surface hydropower machines, e.g., water wheels, has led to complaints and to restrictions in their operation in urban areas. This problem generally occurs when water wheels are not well designed and are installed without expertise. Despite the relevance of the problem, and the growing interest in the use of water wheels at existing low head barriers, the acoustic impact of water wheels has not yet been properly addressed by the scientific community. Therefore, in this manuscript, the importance of the problem and the related scientific challenges are discussed, supported by case studies and theoretical considerations. A literature review on the topic is carried out, although little information is available in the scientific domain. The aim of this work is to increase the awareness on this problem, in order to stimulate future research and to suggest useful guidelines for future water wheel projects, thereby increasing the water wheel potential and reducing noise disturbance for people.
Automatic Extraction of Indoor Spatial Information from Floor Plan Image: A Patch-Based Deep Learning Methodology Application on Large-Scale Complex Buildings
Authors: Kim Hyunjung , Kim Seongyong , Yu Kiyun
Published: December 2021

Automatic floor plan analysis has gained increased attention in recent research. However, numerous studies related to this area are mainly experiments conducted with a simplified floor plan dataset with low resolution and a small housing scale due to the suitability for a data-driven model. For practical use, it is necessary to focus more on large-scale complex buildings to utilize indoor structures, such as reconstructing multi-use buildings for indoor navigation. This study aimed to build a framework using CNN (Convolution Neural Networks) for analyzing a floor plan with various scales of complex buildings. By dividing a floor plan into a set of normalized patches, the framework enables the proposed CNN model to process varied scale or high-resolution inputs, which is a barrier for existing methods. The model detected building objects per patch and assembled them into one result by multiplying the corresponding translation matrix. Finally, the detected building objects were vectorized, considering their compatibility in 3D modeling. As a result, our framework exhibited similar performance in detection rate (87.77%) and recognition accuracy (85.53%) to that of existing studies, despite the complexity of the data used. Through our study, the practical aspects of automatic floor plan analysis can be expanded.
Bombyx mori Nucleopolyhedrovirus (BmNPV) Induces G2/M Arrest to Promote Viral Multiplication by Depleting BmCDK1
Authors: Xiao Qin , Dong Zhan-Qi , Zhu Yan , Zhang Qian , Yang Xiu , Xiao Miao , Chen Peng , Lu Cheng , Pan Min-Hui
Published: December 2021

Understanding virus–host interaction is very important for delineating the mechanism involved in viral replication and host resistance. Baculovirus, an insect virus, can cause S or G2/M phase arrest in insect cells. However, the roles and mechanism of Baculovirus-mediated S or G2/M phase arrest are not fully understood. Our results, obtained using flow cytometry (FCM), tubulin-labeling, BrdU-labeling, and CellTiter 96® AQueous One Solution Cell Proliferation Assay (MTS), showed that Bombyx mori nucleopolyhedrovirus (BmNPV) induced G2/M phase arrest and inhibited cellular DNA replication as well as cell proliferation in BmN-SWU1 cells. We found that BmNPV induced G2/M arrest to support its replication and proliferation by reducing the expression of BmCDK1 and BmCyclin B. Co-immunoprecipitation assays confirmed that BmNPV IAP1 interacted with BmCDK1. BmNPV iap1 was involved in the process of BmNPV-induced G2/M arrest by reducing the content of BmCDK1. Taken together, our results improve the understanding of the virus–host interaction network, and provide a potential target gene that connects apoptosis and the cell cycle.
Ovary Structure and Oogenesis of Trypophloeus klimeschi (Coleoptera: Curculionidae: Scolytinae)
Authors: Gao Jing , Wang Jiaxing , Chen Hui
Published: December 2021

The female reproductive system, ovary structure and ultrastructure of Trypophloeus klimeschi (Coleoptera: Curculionidae: Scolytinae) were investigated using light microscopy, scanning electron microscopy, and transmission electron microscopy. Its female reproductive system is comprised of two ovaries (each ovary has two ovarioles), lateral oviducts, common oviduct, spermathecal sac, spermathecal pump, two accessory glands and bursa copulatrix. Well-developed endoplasmic reticulum can be clearly seen in the secretory cells of spermathecal sac. This species has telotrophic meroistic ovarioles that are comprised of terminal filament, tropharium, vitellarium and pedicel. The terminal filaments are simple; each is comprised of cellular peritoneal sheath. The presence of several clusters of nurse cells in the tropharium is indicative that its ovarioles conform to the transition stage. This indicates that there are at least two different types (transition stage and secondary stage) of ovarioles in Curculionidae.
Short-Term Outcomes of Switching to Ranibizumab in Polypoidal Choroidal Vasculopathy Resistant to Aflibercept Therapy
Authors: Jeon Young-Joon , Kim Jae-Hui , Kim Jong-Woo , Kim Chul-Gu
Published: December 2021

Background: To evaluate the short-term outcomes of switching to ranibizumab in aflibercept-resistant polypoidal choroidal vasculopathy (PCV). Methods: This retrospective study included 18 eyes diagnosed with aflibercept-resistant PCV. All patients were treated with two to four consecutive ranibizumab injections at 4–5-week intervals. The best-corrected visual acuity (BCVA), and central retinal thickness (CRT) values before and after switching to ranibizumab were compared. The proportion of eyes showing ≥100 µm decrease in retinal thickness and/or complete resolution of fluid after switching was identified. Results: The mean number of aflibercept injections before switching was 5.7 ± 3.3. After switching, a mean of 2.8 ± 0.6 consecutive ranibizumab injections was performed. The mean logarithm of minimal angle of resolution (logMAR) BCVA was 0.41 ± 0.26 (Snellen equivalents = 20/51) before switching, and 0.40 ± 0.30 (20/50) after switching (p = 0.574). The mean CRT was 422.2 ± 152.4 µm before switching, and 400.7 ± 182.0 µm after switching (p = 0.236). A decrease in CRT of ≥100 µm, and/or complete resolution of fluid was noted in three eyes (16.7%). Conclusions: Switching to ranibizumab in aflibercept-resistant polypoidal choroidal vasculopathy was not effective in most patients, suggesting the need for further investigation to seek more effective treatment options for this condition.
Trajectories of Adherence to Biologic Disease-Modifying Anti-Rheumatic Drugs in Tuscan Administrative Databases: The Pathfinder Study
Authors: Convertino Irma , Giometto Sabrina , Gini Rosa , Cazzato Massimiliano , Fornili Marco , Valdiserra Giulia , Cappello Emiliano , Ferraro Sara , Bartolini Claudia , Paoletti Olga , Tillati Silvia , Baglietto Laura , Turchetti Giuseppe , Trieste Leopoldo , Lorenzoni Valentina , Blandizzi Corrado , Mosca Marta , Tuccori Marco , Lucenteforte Ersilia
Published: December 2021

Scanty information on clustering longitudinal real-world data is available in the medical literature about the adherence implementation phase in rheumatoid arthritis (RA). To identify and characterize trajectories by analyzing the implementation phase of adherence to biologic Disease-Modifying Anti-Rheumatic Drugs (DMARDs), we conducted a retrospective cohort drug-utilization study using Tuscan administrative databases. RA patients were identified by a validated algorithm, including the first biologic DMARD supply from 2010 to 2015, RA specialist visit in the year before or after the first supply date and RA diagnosis in the five years before or in the year after the first supply date. We observed users for three years or until death, neoplasia, or pregnancy. We evaluated adherence quarterly through the Medication Possession Ratio. Firstly, we identified adherence trajectories and described the baseline characteristics; then, we focused on the trajectory most populated to distinguish the related sub-trajectories. We identified 952 first ever-biologic DMARD users in RA (712 females, mean age 52.7 years old, standard deviation 18.8). The biologic DMARD mostly supplied was etanercept (387 users) followed by adalimumab (233). Among 935 users with at least 3 adherence values, we identified 49 fully-adherent users, 829 continuous users, and 57 early-discontinuing users. Significant differences were observed among the index drugs. After focusing on the continuous users, three sub-trajectories were identified: continuous-steady users (556), continuous-alternate users (207), and continuous-declining users (66). No relevant differences emerged at the baseline. The majority of first ever-biologic DMARD users showed a continuous adherence behavior in RA. The role of adherence potential predictors and the association with effectiveness and safety outcomes should be explored by further studies.
Metabolic Syndrome Severity Score, Comparable to Serum Creatinine, Could Predict the Occurrence of End-Stage Kidney Disease in Patients with Antineutrophil Cytoplasmic Antibody-Associated Vasculitis
Authors: Park Pil Gyu , Pyo Jung Yoon , Ahn Sung Soo , Song Jason Jungsik , Park Yong-Beom , Huh Ji Hye , Lee Sang-Won
Published: December 2021

This study investigated whether the metabolic syndrome (MetS) severity (MSSS) at diagnosis could predict poor outcomes during follow-up in antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) patients with MetS. The equation for the MSSS at diagnosis used in this study was developed and validated in Korean adults aged 20–59 years. The medical records of 261 patients with AAV were retrospectively reviewed, and finally, 36 AAV patients with MetS aged 20–59 years fulfilling the inclusion criteria were included in this study. All-cause mortality, relapse, end-stage kidney disease (ESKD), cerebrovascular accident, and cardiovascular disease were assessed as the poor outcomes of AAV. Their median age was 51.2 years and 36.1% were male. The MSSS was significantly correlated with age and serum albumin but not AAV-specific indices. Among the five poor outcomes, only ESKD showed a relatively significant area under the curve (area 0.696) in receiver operating characteristic curve analysis. In the multivariable Cox hazards model analysis, both serum creatinine (HR 3.033) and MSSS (HR = 2.221) were significantly associated with ESKD occurrence. When the cut-off of the MSSS for ESKD was set at 1.72, ESKD occurred more frequently in patients with MSSS ≥ 1.72 than in those with MSSS < 1.72 (75.0% versus 14.3%, p = 0.002). Furthermore, patients with MSSS ≥ 1.72 exhibited a significantly lower cumulative ESKD-free survival rate than those with MSSS < 1.72 (p = 0.001). MSSS at the time of AAV diagnosis independently predicted the occurrence of ESKD during follow-up in patients with AAV and MetS.
CSA-AKI: Incidence, Epidemiology, Clinical Outcomes, and Economic Impact
Authors: Schurle Alan , Koyner Jay L.
Published: December 2021

Cardiac surgery-associated acute kidney injury (CSA-AKI) is a common complication following cardiac surgery and reflects a complex biological combination of patient pathology, perioperative stress, and medical management. Current diagnostic criteria, though increasingly standardized, are predicated on loss of renal function (as measured by functional biomarkers of the kidney). The addition of new diagnostic injury biomarkers to clinical practice has shown promise in identifying patients at risk of renal injury earlier in their course. The accurate and timely identification of a high-risk population may allow for bundled interventions to prevent the development of CSA-AKI, but further validation of these interventions is necessary. Once the diagnosis of CSA-AKI is established, evidence-based treatment is limited to supportive care. The cost of CSA-AKI is difficult to accurately estimate, given the diverse ways in which it impacts patient outcomes, from ICU length of stay to post-hospital rehabilitation to progression to CKD and ESRD. However, with the global rise in cardiac surgery volume, these costs are large and growing.
Treatment of Peripheral Arterial Occlusive Disease around the Globe: Malta
Authors: Dimech Anthony Pio , Galea Samuel Anthony , Cassar Kevin , Grima Matthew Joe
Published: December 2021

Introduction: Malta is a small island in the middle of the Mediterranean with a population of 514,564 inhabitants and is served by one public tertiary hospital, Mater Dei Hospital. The Vascular unit was set up in 2007. The aim of this review is to analyse the work related to peripheral arterial occlusive disease (PAOD) in Malta with an in-depth focus on amputations and revascularisation procedures since the introduction of the Vascular unit. Method: Various sources of data have been interrogated to address this subject. Population and prevalence data on obesity and type II diabetes mellitus from 2003 to 2019 was obtained from the National Statistics Office, the World Health Organization, and the International Diabetes Federation, respectively. The Maltese Vascular Register (MaltaVasc), and in-hospital reports from 2003 to 2019 was used to obtain data on revascularisation procedures, major amputations and minor amputation rates in Malta. Results: Malta has one of the highest rates of obesity in Europe. In 2015, the prevalence rate was 30.6%. Similarly, data from the International Diabetes Federation Atlas showed that the prevalence rate of T2DM among adults was 14% in 2017. There was a mean of 33 open/hybrid procedures per 100,000 population (28–38, 95% confidence interval) between 2005 and 2009 and a mean of 57 endovascular procedures per 100,000 population (46–68, 95% confidence interval) during the same time-period. From 2009 to 2019, there was a mean of 16 major amputations and 78 minor amputations per 100,000 population. Conclusion: A significant reduction in major amputation rates with an increase in minor amputation rates and revascularisation rates has been noted since the establishment of the vascular unit in Malta. During this period, there has been an increase in prevalence in obesity and T2DM together with an aging population.
Special Issue: “Skin Disease and Comorbidities”
Authors: Yamanaka Keiichi
Published: December 2021

The skin is one of the largest immune organs that involve innate and acquired immune systems, and is able to respond to internal and exogenous stimuli, producing a large amount of inflammatory cytokines, resulting in systemic inflammation [...]
Spectral Photon-Counting CT Technology in Chest Imaging
Authors: Si-Mohamed Salim Aymeric , Miailhes Jade , Rodesch Pierre-Antoine , Boccalini Sara , Lacombe Hugo , Leitman Valérie , Cottin Vincent , Boussel Loic , Douek Philippe
Published: December 2021

The X-ray imaging field is currently undergoing a period of rapid technological innovation in diagnostic imaging equipment. An important recent development is the advent of new X-ray detectors, i.e., photon-counting detectors (PCD), which have been introduced in recent clinical prototype systems, called PCD computed tomography (PCD-CT) or photon-counting CT (PCCT) or spectral photon-counting CT (SPCCT) systems. PCD allows a pixel up to 200 microns pixels at iso-center, which is much smaller than that can be obtained with conventional energy integrating detectors (EID). PCDs have also a higher dose efficiency than EID mainly because of electronic noise suppression. In addition, the energy-resolving capabilities of these detectors allow generating spectral basis imaging, such as the mono-energetic images or the water/iodine material images as well as the K-edge imaging of a contrast agent based on atoms of high atomic number. In recent years, studies have therefore been conducted to determine the potential of PCD-CT as an alternative to conventional CT for chest imaging.
Developing Pulmonary Rehabilitation for COVID-19: Are We Linked with the Present Literature? A Lexical and Geographical Evaluation Study Based on the Graph Theory
Authors: Fusco Augusto , Padua Luca , Coraci Daniele , Loreti Claudia , Castelli Letizia , Costantino Cosimo , Frizziero Antonio , Serafini Elisabetta , Biscotti Lorenzo , Bernabei Roberto , Giovannini Silvia
Published: December 2021

The Coronavirus Disease 2019 (COVID-19) pandemic is a severe ongoing global emergency. Despite high rates of asymptomatic patients, in many cases, the infection causes a rapid decline in pulmonary function due to an acute respiratory distress-like syndrome, leading to multi-organ failure and death. To date, recommendations about rehabilitation on COVID-19 are based on clinical data derived from other similar lung diseases. Rehabilitation literature lacks a standard taxonomy, limiting a proper evaluation of the most effective treatments for patients after COVID-19 infection. In this study, we assessed the clinical and rehabilitative associations and the geographical area involved in interstitial lung diseases (ILD) and in COVID-19, by a mathematical analysis based on graph theory. We performed a quantitative analysis of the literature in terms of lexical analysis and on how words are connected to each other. Despite a large difference in timeframe (throughout the last 23 years for ILD and in the last 1.5 years for COVID-19), the numbers of papers included in this study were similar. Our results show a clear discrepancy between rehabilitation proposed for COVID-19 and ILD. In ILD, the term “rehabilitation” and other related words such as “exercise” and “program” resulted in lower values of centrality and higher values of eccentricity, meaning relatively less importance of the training during the process of care in rehabilitation of patients with ILD. Conversely, “rehabilitation” was one of the most cited terms in COVID-19 literature, strongly associated with terms such as “exercise”, “physical”, and “program”, entailing a multidimensional approach of the rehabilitation for these patients. This could also be due to the widespread studies conducted on rehabilitation on COVID-19, with Chinese and Italian researchers more involved. The assessment of the terms used for the description of the rehabilitation may help to program shared rehabilitation knowledge and avoid literature misunderstandings.
Sex Differences in Salmonellosis Incidence Rates—An Eight-Country National Data-Pooled Analysis
Authors: Peer Victoria , Schwartz Naama , Green Manfred S.
Published: December 2021

Background: There are few studies on sex differences in the incidence rates (IR) for salmonellosis over several countries by age and time period. The purpose of this study was to explore the extent and consistency of the sex and age-specific differences. Methods: We analyzed national data from eight countries between 1994 and 2016. We computed country-specific male to female incidence rate ratios (IRRs) for each age group and pooled the data using meta-analytic methods. Variations of the IRRs by age, country and time period were evaluated using meta-regression. Results: The pooled male to female incidence RRs for ages 0–1, 1–4, 5–9 and 10–14, were 1.04 (1.02–1.06), 1.02 (1.01–1.03), 1.07 (1.05–1.08) and 1.28 (1.23–1.33), respectively. For the ages 15–44 and 45–64, the incidence rates were significantly higher in females. Meta-regression analyses indicate that age groups contributed most of the variation in the male to female IRRs. Conclusions: We suggest that genetic and hormonal factors and interactions between hormones and gut microbiota could contribute to the sex differences observed in young children. These findings should provide clues about the mechanisms of the infection, and should be useful in targeting treatments and development of vaccines. Highlights: (1) This manuscript provides consistent estimates of the excess salmonellosis incidence rates in male children up to age 15, which suggests an impact of sex hormones or genetic differences. (2) Our findings should promote the further investigations on sex-related determinants of infectious diseases.
Comparison of Conservative Treatment of Cervical Intraepithelial Lesions with Imiquimod with Standard Excisional Technique Using LLETZ: A Randomized Controlled Trial
Authors: Cokan Andrej , Pakiž Maja , Serdinšek Tamara , Dovnik Andraž , Kodrič Tatjana , Repše Fokter Alenka , Kavalar Rajko , But Igor
Published: December 2021

(1) Background: There are limited data on the success of conservative treatment of high-grade cervical squamous intraepithelial lesions (HSIL) with imiquimod directly compared to standard of treatment with LLETZ. (2) Methods: Patients aged 18–40 with histological HSIL (with high-grade cervical intraepithelial neoplasia, CIN2p16+ and CIN3), were randomly assigned to treatment with imiquimod or LLETZ. The primary outcome was defined as the absence of HSIL after either treatment modality. The secondary outcomes were the occurrence of side effects. (3) Results: 52 patients were allocated in each group and were similar regarding baseline characteristics. In the imiquimod group, 82.7% of patients completed treatment, which was successful in 51.9%. All patients in the LLETZ group completed treatment, which was successful in 92.3% (p < 0.001). In the subgroup of CIN2p16+ patients, treatment with imiquimod was not inferior to LLETZ (73.9% vs. 84.2%, p = 0.477). During and after treatment, no cases of progression to cancer were observed. Side effects and severe side effects (local and systemic) were more prevalent in the imiquimod than in the LLETZ group (88.5% vs. 44.2% (p-value < 0.001) and 51.9% vs. 13.5% (p-value < 0.001), respectively). (4) Conclusion: Generally, in patients with HSIL, LLETZ remains the gold standard of treatment. However, in a subgroup analysis of patients with CIN2p16+, the success rate was comparable between the two treatment modalities. Due to the prevalence of side effects, the treatment compliance with imiquimod use may, however, present a clinically important issue.
Trends in Frailty and Use of Evidence-Based Pharmacotherapy for Heart Failure in Australian Hospitalised Patients: An Observational Study
Authors: Sharma Yogesh , Horwood Chris , Hakendorf Paul , Thompson Campbell
Published: December 2021

Frailty increases morbidity and mortality in heart failure (HF) patients. Current risk-adjustment models do not include frailty-status and the relationship between frailty and pharmacotherapy is unclear. This study explored trends in frailty over time and its relationship with prescription of heart failure specific pharmacotherapy in hospitalised HF patients. We used the Hospital Frailty Risk Score (HFRS) to determine frailty status of patients ≥18 years admitted between 2015–2019 at two tertiary hospitals in Australia. Patients with an HFRS ≥ 5 were classified as frail. In the 3706 patients with a mean (SD) age of 76.1 (14.4) years, 876 (23.6%) were classified as frail. HFRS was weakly correlated with age (r = 0.16) and Charlson-index (r = 0.35) (both p values < 0.001). Whilst frailty was more common in older HF patients (28.9% of patients ≥80 years), 15.1% of patients ≤65 years of age were also found to be frail. The proportion of frail patients increased from 19.4% in 2015 to 29.2% in 2019 despite no significant change in age during this period. The proportion of patients who received heart failure specific pharmacotherapy decreased from 86.7% in 2015 to 82.9% in 2019 (p value = 0.03) and frail patients were significantly less likely to be prescribed HF specific pharmacotherapy than non-frail patients (77.4% vs. 85.9%, p < 0.001).
Hypogonadism in Women with Prader-Willi Syndrome—Clinical Recommendations Based on a Dutch Cohort Study, Review of the Literature and an International Expert Panel Discussion
Authors: Pellikaan Karlijn , Ben Brahim Yassine , Rosenberg Anna G. W. , Davidse Kirsten , Poitou Christine , Coupaye Muriel , Goldstone Anthony P. , Høybye Charlotte , Markovic Tania P. , Grugni Graziano , Crinò Antonino , Caixàs Assumpta , Eldar-Geva Talia , Hirsch Harry J. , Gross-Tsur Varda , Butler Merlin G. , Miller Jennifer L. , van der Kuy Paul-Hugo M. , van den Berg Sjoerd A. A. , Visser Jenny A. , van der Lely Aart J. , de Graaff Laura C. G.
Published: December 2021

Prader-Willi syndrome (PWS) is a rare neuroendocrine genetic syndrome. Characteristics of PWS include hyperphagia, hypotonia, and intellectual disability. Pituitary hormone deficiencies, caused by hypothalamic dysfunction, are common and hypogonadism is the most prevalent. Untreated hypogonadism can cause osteoporosis, which is already an important issue in PWS. Therefore, timely detection and treatment of hypogonadism is crucial. To increase understanding and prevent undertreatment, we (1) performed a cohort study in the Dutch PWS population, (2) thoroughly reviewed the literature on female hypogonadism in PWS and (3) provide clinical recommendations on behalf of an international expert panel. For the cohort study, we retrospectively collected results of a systematic health screening in 64 female adults with PWS, which included a medical questionnaire, medical file search, medical interview, physical examination and biochemical measurements. Our data show that hypogonadism is frequent in females with PWS (94%), but is often undiagnosed and untreated. This could be related to unfamiliarity with the syndrome, fear of behavioral changes, hygienic concerns, or drug interactions. To prevent underdiagnosis and undertreatment, we provide practical recommendations for the screening and treatment of hypogonadism in females with PWS.
Percutaneous Image-Guided Ablation of Lung Tumors
Authors: Alzubaidi Sadeer J. , Liou Harris , Saini Gia , Segaran Nicole , Scott Kriegshauser J. , Naidu Sailendra G. , Patel Indravadan J. , Oklu Rahmi
Published: December 2021

Tumors of the lung, including primary cancer and metastases, are notoriously common and difficult to treat. Although surgical resection of lung lesions is often indicated, many conditions disqualify patients from being surgical candidates. Percutaneous image-guided lung ablation is a relatively new set of techniques that offers a promising treatment option for a variety of lung tumors. Although there have been no clinical trials to definitively compare its efficacy to those of traditional treatments, lung ablation is widely practiced and generally accepted to be safe and effective. Especially encouraging results have recently emerged for cryoablation, one of the newer ablative techniques. This article reviews the indications, techniques, contraindications, and complications of percutaneous image-guided ablation of lung tumors with special attention to cryoablation and its recent developments in protocol optimization.
Laparoscopic Isthmocele Repair: Efficacy and Benefits before and after Subsequent Cesarean Section
Authors: Karampelas Stavros , Salem Wehbe Georges , de Landsheere Laurent , Badr Dominique A. , Tebache Linda , Nisolle Michelle
Published: December 2021

Objective: To evaluate the effect of laparoscopic isthmocele repair on isthmocele-related symptoms and/or fertility-related problems. The residual myometrial thickness before and after subsequent cesarean section was also evaluated. Design: Retrospective, case series. Setting: Public university hospital. Population: Women with isthmocele (residual myometrium < 5 mm) complaining of abnormal uterine bleeding, chronic pelvic pain or secondary infertility not otherwise specified. Methods: Women’s complaints and the residual myometrium were assessed pre-operatively and at three to six months post-operatively. In patients who conceived after surgery, the latter was measured at least six months after delivery by cesarean section. Main Outcome Measures: Resolution of the main symptom three to six months after surgery and persistence of laparoscopic repair benefits after subsequent cesarean section were considered as primary outcome measures. Results: Overall, 31 women underwent laparoscopic isthmocele repair. The success rates of the surgery as improvement of abnormal uterine bleeding, chronic pelvic pain and secondary infertility were 71.4% (10 of 14), 83.3% (10 of 12) and 83.3% (10 of 12), respectively. Mean residual myometrial thickness increased significantly from 1.77 mm pre-operatively to 6.67 mm, three to six months post-operatively. Mean myometrial thickness in patients who underwent subsequent cesarean section (N = 7) was 4.49 mm. In this sub-group, there was no significant difference between the mean myometrial thickness measured after the laparoscopic isthmocele repair and that measured after the subsequent cesarean section. None of these patients reported recurrence of their symptoms after delivery. Conclusion: Our findings suggest that the laparoscopic isthmocele excision and repair is an appropriate approach for the treatment of isthmocele-related symptoms when done by skilled laparoscopic surgeons. The benefit of this new surgical approach seems to persist even after a subsequent cesarean section. Further investigations and prospective studies are required to confirm this finding.
Multi-Frequency Image Completion via a Biologically-Inspired Sub-Riemannian Model with Frequency and Phase
Authors: Baspinar Emre
Published: December 2021

We present a novel cortically-inspired image completion algorithm. It uses five-dimensional sub-Riemannian cortical geometry, modeling the orientation, spatial frequency and phase-selective behavior of the cells in the visual cortex. The algorithm extracts the orientation, frequency and phase information existing in a given two-dimensional corrupted input image via a Gabor transform and represents those values in terms of cortical cell output responses in the model geometry. Then, it performs completion via a diffusion concentrated in a neighborhood along the neural connections within the model geometry. The diffusion models the activity propagation integrating orientation, frequency and phase features along the neural connections. Finally, the algorithm transforms the diffused and completed output responses back to the two-dimensional image plane.
Study on an Analytical Solution to the Mechanical Response of Soil Cut by a Bionic Force Enhancement Grouser
Authors: Chen Yanli , Zhu Wei , Qi Wengang , Ma Wenbo
Published: December 2021

With the depletion of land mineral resources, people have turned their attention to the sea. As an important part of deep-sea mining systems, the technical research and development of ore collectors has always been a difficult problem in many countries. According to the characteristic that buffalo hoof is suitable for walking on soft soil, a kind of bionic grouser for a deep-sea mining vehicle is designed in this paper. Through the optimization of Rankine’s passive earth pressure theory, the formula for calculating the tractive force of the grouser is obtained. The accuracy of the analytical solution is verified by finite element simulation, and the force enhancement mechanism of the bionic grouser is revealed. The results show that the design of the bionic grouser has a significant effect on the improvement of tractive force, and the tractive force of the No. 1 bionic grouser is 17.52% higher than that of the straight grouser. On this basis, the geometric parameters of the bionic grouser profile are optimized. The results show that when L is 0 mm and R is 183 mm, the force enhancement effect reaches the maximum of 27%, which provides a design basis for optimizing the grouser and improving the mining efficiency of the collector.