bluuebunny/crossref_metadata_2025 huggingface dataset:
Prehospital triage tools across the world: a scoping review of the published literature
Authors: Bhaumik Smitha , Hannun Merhej , Dymond Chelsea , DeSanto Kristen , Barrett Whitney , Wallis Lee A. , Mould-Millman Nee-Kofi
Published: April 2022

Background

Accurate triage of the undifferentiated patient is a critical task in prehospital emergency care. However, there is a paucity of literature synthesizing currently available prehospital triage tools. This scoping review aims to identify published tools used for prehospital triage globally and describe their performance characteristics.

Methods

A comprehensive search was performed of primary literature in English-language journals from 2009 to 2019. Papers included focused on emergency medical services (EMS) triage of single patients. Two blinded reviewers and a third adjudicator performed independent title and abstract screening and subsequent full-text reviews.

Results

Of 1521 unique articles, 55 (3.6%) were included in the final synthesis. The majority of prehospital triage tools focused on stroke (n = 19; 35%), trauma (19; 35%), and general undifferentiated patients (15; 27%). All studies were performed in high income countries, with the majority in North America (23, 42%) and Europe (22, 40%). 4 (7%) articles focused on the pediatric population. General triage tools aggregate prehospital vital signs, mental status assessments, history, exam, and anticipated resource need, to categorize patients by level of acuity. Studies assessed the tools’ ability to accurately predict emergency department triage assignment, hospitalization and short-term mortality. Stroke triage tools promote rapid identification of patients with acute large vessel occlusion ischemic stroke to trigger timely transport to diagnostically- and therapeutically-capable hospitals. Studies evaluated tools’ diagnostic performance, impact on tissue plasminogen activator administration rates, and correlation with in-hospital stroke scales. Trauma triage tools identify patients that require immediate transport to trauma centers with emergency surgery capability. Studies evaluated tools’ prediction of trauma center need, under-triage and over-triage rates for major trauma, and survival to discharge.

Conclusions

The published literature on prehospital triage tools predominantly derive from high-income health systems and mostly focus on adult stroke and trauma populations. Most studies sought to further simplify existing triage tools without sacrificing triage accuracy, or assessed the predictive capability of the triage tool. There was no clear ‘gold-standard’ singular prehospital triage tool for acute undifferentiated patients.

Trial registration

Not applicable.
The efficacy of Narrative Exposure Therapy for Children (KIDNET) as a treatment for traumatized young refugees versus treatment as usual: update to the study protocol for the multi-center randomized controlled trial YOURTREAT
Authors: Wittmann Jasmin , Groß Melissa , Catani Claudia , Schmidt Telja , Neldner Sina , Wilker Sarah , May Theodor , Ertl Verena , Rosner Rita , Zindler Areej , Odenwald Michael , Neuner Frank
Published: April 2022

Background

The trial YOURTREAT aims to compare the pragmatic, short-term psychotherapy Narrative Exposure Therapy for Children (KIDNET) with treatment as usual (TAU) for the treatment of young refugees in Germany. This update outlines changes made to the study protocol in response to the current COVID-19 pandemic with the aim of allowing the continuation of the clinical trial while ensuring the safety of the staff and the participants, maintaining methodological quality, and ensuring compliance with legal regulations.

Methods

The major amendments to the original study protocol include (1) the possibility of using telehealth technology for the conduction of diagnostic and therapy sessions, (2) a reduction of the diagnostic set, and (3) an increased flexibility in the time frame of the study protocol.

Discussion

The adaptations to the study protocol made it feasible to continue with the trial YOURTREAT during the COVID-19 pandemic. Although the diagnostic set had to be shortened, the primary outcomes and the main secondary outcomes remain unimpaired by the amendment. Therefore, we expect the trial to provide evidence regarding effective treatment options for young refugees in Germany, a population that has received little scientific attention so far and has only very limited access to mental health care in the German health care system. In light of the current pandemic, which globally increases the risk of mental problems, the situation for young refugees is likely to aggravate further. Thus, the clinical and social relevance of the present trial YOURTREAT is even more important in these particular times.

Trial registration

German Clinical Trials Register (Deutsches Register Klinischer Studien; DRKS) DRKS00017222. Registered on May 15, 2019
Clinical trial management: a profession in crisis?
Authors: Mitchell E. J. , Goodman K. , Wakefield N. , Cochran C. , Cockayne S. , Connolly S. , Desai R. , Hartley S. , Lawton S. A. , Oatey K. , Rhodes S. , Savage J. S. , Taylor J. , Youssouf N. F. J. ,   on behalf of the UK Trial Managers’ Network, Mitchell Eleanor , Goodman Kirsteen , Wakefield Natalie , Cochran Claire , Cockayne Sarah , Connolly Simon , Desai Riti , Fletcher Lucy , Hartley Suzanne , Lawton Sarah , Lee Ryonfa , Oatey Katherine , Rhodes Shelley , Savage Joshua , Taylor Jodi , Youssouf Nabila
Published: April 2022

Clinical trial managers play a vital role in the design and conduct of clinical trials in the UK. There is a current recruitment and retention crisis for this specialist role due to a complex set of factors, most likely to have come to a head due to the COVID-19 pandemic. Academic clinical trial units and departments are struggling to recruit trial managers to vacant positions, and multiple influences are affecting the retention of this highly skilled workforce. Without tackling this issue, we face major challenges in the delivery on the Department of Health and Social Care’s Future of UK Clinical Research Delivery implementation plan. This article, led by a leading network of and for UK Trial Managers, presents some of the issues and ways in which national stakeholders may be able to address this.
NFκB inhibition to lift the mechano-competence of mesenchymal stromal cell-derived neocartilage toward articular chondrocyte levels
Authors: Lückgen Janine , Raqué Elisabeth , Reiner Tobias , Diederichs Solvig , Richter Wiltrud
Published: April 2022

Background

Fully functional regeneration of skeletal defects by multipotent progenitor cells requires that differentiating cells gain the specific mechano-competence needed in the target tissue. Using cartilage neogenesis as an example, we asked whether proper phenotypic differentiation of mesenchymal stromal cells (MSC) into chondrocytes in vitro will install the adequate biological mechano-competence of native articular chondrocytes (AC).

Methods

The mechano-competence of human MSC- and AC-derived neocartilage was compared during differentiation for up to 35 days. The neocartilage layer was subjected to physiologic dynamic loading in a custom-designed bioreactor and assayed for mechano-sensitive gene and pathway activation, extracellular matrix (ECM) synthesis by radiolabel incorporation, nitric oxide (NO) and prostaglandin E2(PGE2) production. Input from different pathways was tested by application of agonists or antagonists.

Results

MSC and AC formed neocartilage of similar proteoglycan content with a hardness close to native tissue. Mechano-stimulation on day 21 and 35 induced a similar upregulation of mechano-response genes, ERK phosphorylation, NO production and PGE2release in both groups, indicating an overall similar transduction of external mechanical signals. However, while AC maintained or enhanced proteoglycan synthesis after loading dependent on tissue maturity, ECM synthesis was always significantly disturbed by loading in MSC-derived neocartilage. This was accompanied by significantly higherCOX2andBMP2background expression, > 100-fold higher PGE2production and a weaker SOX9 stimulation in response to loading in MSC-derived neocartilage. Anabolic BMP-pathway activity was not rate limiting for ECM synthesis after loading in both groups. However, NFκB activation mimicked the negative loading effects and enhanced PGE2production while inhibition of catabolic NFκB signaling rescued the load-induced negative effects on ECM synthesis in MSC-derived neocartilage.

Conclusions

MSC-derived chondrocytes showed a higher vulnerability to be disturbed by loading despite proper differentiation and did not acquire an AC-like mechano-competence to cope with the mechanical stress of a physiologic loading protocol. Managing catabolic NFκB influences was one important adaptation to install a mechano-resistance closer to AC-derived neocartilage. This new knowledge asks for a more functional adaptation of MSC chondrogenesis, novel pharmacologic co-treatment strategies for MSC-based clinical cartilage repair strategies and may aid a more rational design of physical rehabilitation therapy after AC- versus MSC-based surgical cartilage intervention.
Dppa3 facilitates self-renewal of embryonic stem cells by stabilization of pluripotent factors
Authors: Zhao Shuang , Zhang Chuanyu , Xu Jia , Liu Siying , Yu Lu , Chen Shang , Wen Hang , Li Zongjin , Liu Na
Published: April 2022

Background

Developmental pluripotency-associated 3 (Dppa3, also called Stella or PGC7) is a principal maternal protein specially expressed in pre-implantation embryos, embryonic stem cells (ES cells) and primordial germ cells (PGCs). It plays critical role in the regulating of DNA methylation in zygotes and oocytes. However, the effect of Dppa3 in ES cells on the stability of proteins is still unclear.

Methods

In this study, we first identified the potential interacting proteins with Dppa3 using immunoprecipitation-mass spectrometry (IP-MS). After GO analysis, we further constructed Dppa3-silenced ES cells and ES cell lines overexpressing with different lengths of Dppa3 to explore the mechanisms of Dppa3 on protein stability.

Results

IP-MS results showed that Dppa3 interacted with quite a few subunits of 26S proteasome. Full length of Dppa3 stabilized Uhrf1 and Nanog by inhibiting its degradation. Silencing Dppa3 promoted degradation of Nanog protein.

Conclusions

Our results indicated that Dppa3 safeguard the stability of Uhrf1 and Nanog by inhibiting proteasome-associated degradation in ES cells. These findings shed light on new function of Dppa3 in maintaining stability of proteins and provides a valuable resource for understanding the roles of Dppa3 in embryonic stem cells.
Sex differences following percutaneous coronary intervention or coronary artery bypass surgery for acute myocardial infarction
Authors: Lin Donna Shu-Han , Lin Yu-Sheng , Lee Jen-Kuang , Kao Hsien-Li
Published: April 2022

Background

Women have been underrepresented in the literature; the effects of female sex on outcomes in patients with acute myocardial infarction (AMI) remain unclear.

Objectives

This study compares the real-world outcomes of women and men with AMI who have undergone revascularization via percutaneous coronary intervention (PCI) or coronary artery bypass graft surgery (CABG).

Methods

This is a retrospective cohort study utilizing data from the Taiwan National Health Insurance database. We identified patients who were admitted for AMI and who underwent coronary revascularization during the index admission period between January 1, 2001, and December 31, 2013. Patients were then categorized based on the treatment received into PCI and CABG groups. In-hospital and long-term outcomes were compared between women and men in each group. Interaction tests were then performed to determine whether the differences between sexes were modified by the mode of revascularization. Analyses were repeated after propensity score matching between women and men in each group to minimize possible confounders. We also conducted subgroup analyses, stratifying by the presence of diabetes mellitus, congestive heart failure, and chronic kidney disease.

Results

We enrolled 67,534 patients who met the inclusion criteria in the analysis; 60,207 patients had undergone PCI (13,514 female and 46,693 male), while 7327 patients had received CABG (1762 female and 5565 male). Prior to matching, enrolled female patients were older on average, with more comorbidities. In-hospital and long-term outcomes were worse in women, particularly in the PCI group. After matching, the incidence of hospitalization for heart failure (HHF) was higher in women (10.4% vs 8.0%, OR 1.32, 95% CI 1.22–1.43), with fewer repeat revascularizations (28.1% vs 32.4%, OR 0.84, 95% CI 0.81–0.88). Both observations were more pronounced in the PCI group (HHF: P for interaction = 0.0496; repeat revascularization: P for interaction = 0.021).

Conclusions

Women presenting with AMI exhibited worse in-hospital and long-term outcomes than men, especially among women who received PCI as the initial mode of revascularization. Women who underwent PCI were more likely to be admitted for heart failure during follow-up. Possible socioeconomic inequalities or a distinct pathobiology of cardiac ischemia between sexes may underlie these results; thus, further investigation is needed.
Placement of LC-II and trans-sacral screws using a robotic arm in a simulated bone model in the supine position – a feasibility study
Authors: Carlson Jon B. , Zou Jiyao , Hartley Brandi
Published: April 2022

Purpose

The use of a robotic arm has been well-described in the literature for the placement of pedicle screws in spine surgery as well as implants for sacroiliac joint fusion. There are no reports describing the use of a robotic arm to place screws in osseous fixation pathways (OFPs) employed in the treatment of pelvic ring and acetabular fractures outside of a single center in China. Using a Sawbones model, the authors describe a technique for using a robotic arm widely available in Europe and the Americas for placement of 6.5 mm cannulated screws into two OFPs commonly used in the treatment of pelvic and acetabular fractures.

Methods

Using the Mazor X Stealth Edition (MSXE) robot from Medtronic, the authors were able to place a pin into the pelvis onto which the robot was docked. The authors were then able to designate the area of interest using navigated instruments, and in combination with the MSXE “scan and plan” marker, obtain cross-sectional imaging using the O-Arm and successfully register the MSXE robot. We then used the provided software to plan trajectories for the lateral compression type 2 (LC-II) screw pathway as well as a pathway for a trans-ilio-trans-sacral screw. We describe in detail the steps for setup, planning and placement of 6.5 mm cannulated screws using the MSXE robotic arm into these two OFPs.

Results

Visual inspection and plain x-rays demonstrated successful placement of the screws into the two planned OFPs. No breach of cortical bone was seen on either visual inspection of the model or demonstrated on post-procedure x-rays.

Conclusion

It is possible to use the Mazor X Stealth Edition robot to place screws into the LC-II and trans-ilio-transsacral screw pathways in a Sawbones model. This is only a feasibility study, and should in no way be taken to suggest that clinical application of this technique should be attempted.
Deep learning-based point-spread function deconvolution for migration image deblurring
Authors: Liu Cewen , Sun Mengyao , Dai Nanxun , Wu Wei , Wei Yanwen , Guo Mingjie , Fu Haohuan
Published: April 2022

High-resolution seismic imaging is crucial for deriving an accurate geologic section and ensuring successful petroleum exploration. However, traditional high-resolution imaging methods, such as least-squares reverse time migration (LSRTM) and migration deconvolution, usually involve high computational costs for approximating the inverse Hessian matrix with limited improvements in resolution. To obtain high-resolution migration images and reduce computing costs, we present a deep learning-based point-spread function (PSF) deconvolution method. We decompose the large Hessian matrix into small dispersed PSFs and design a convolutional neural network (CNN) to automatically predict the deconvolution operator of every single PSF. The deconvolution operator eliminates the PSF effect and balances the insufficient illumination of the acquisition geometry. To obtain an efficient CNN model for predicting deconvolution operators, we trained 2500 pairs of PSFs and their corresponding deconvolution operators collected from part of a model using the regular PSF deconvolution method. After training the network, we could predict all deconvolution operators in a few seconds for the following processing of migration images. The results on synthetic and field-data applications indicate that our method could provide a deblurred migration image comparable to that of the LSRTM approaches with significantly reduced computational and memory costs.
Πολιτική φιλοσοφία και ελληνική ταυτότητα στο έργο του Κ. Τσάτσου
Authors: Τσορμπάρη Χριστίνα
Published: April 2022

Ο Κ. Τσάτσος πέρα από σημαντικός διανοητής, είχε επίδραση ευρύτερα στην πολιτισμική και πολιτική ζωή της χώρας. Η έως τώρα έρευνα δεν έχει καλύψει όλο το εύρος του έργου του και της προσφοράς του, εστιάζοντας κυρίως στην πολιτική του φιλοσοφία ως προϋπόθεση της πολιτικής του δράσης. Άλλες πτυχές του έργου του, όπως η αισθητική του, παρότι είναι κομβικές για την ορθή κατανόηση του έργου του, δεν έχουν μελετηθεί επαρκώς. Η αισθητική του Τσάτσου είναι όρος της ελληνικότητας, η οποία αποτελούσε μέριμνα του Τσάτσου. Όσον αφορά το πρώτο μέρος της διατριβής, δηλαδή την πολιτική φιλοσοφία του, είναι η πλέον προβεβλημένη, λόγω της κύριας ενασχόλησης του με την φιλοσοφία του Δικαίου, της οποίας την έδρα κατείχε στο Πανεπιστήμιο Αθηνών. Οι πνευματικοί του ορίζοντες όμως ήταν πολύ ευρύτεροι περιλαμβάνοντας και θέματα νεοελληνικής ταυτότητας με επίκεντρο τον όρο της ελληνικότητας, και πως θα ήθελε να τη δει εκφρασμένη στην ελληνική ποίηση. Η αγάπη του για την ποίηση έδωσε την αφορμή για έναν διάλογο πολύ υψηλού επιπέδου με τον Σεφέρη, στον οποίο ενεπλάκη και ο Ελύτης. Ο όρος της ελληνικότητας που συζητήθηκε και στον περίφημο διάλογο, ταυτίστηκε με τη λεγόμενη γενιά του ’30, στην οποία ανήκει και ο Τσάτσος. Μάλιστα υπάρχει η αίσθηση ότι είναι δική της επινόηση. Αυτό δεν είναι σωστό, ως όρος υπήρχε, αλλά το περιεχόμενο που του δόθηκε από την εν λόγω γενιά, δεν έχει ξεπεραστεί έως σήμερα.
Μελέτη των εμπλεκομένων οργάνων σε πειραματικό μοντέλο επίμυος ισχαιμίας - επαναιμάτωσης ήπατος με ενδοφλέβια χορήγηση σιλιμπινίνης
Authors: Κολλάρας Βασίλειος
Published: April 2022

Σκοπός: Μελέτη της προστατευτικής επίδρασης της σιλιμπινίνης στο νεφρικό και πνευμονικό παρέγχυμα κατά τη διάρκεια της ηπατικής ισχαιμίας-επανιμάτωσης. Υλικά και μέθοδοι: 63 επίμυες τύπου Wistar χωρίστηκαν σε τρεις ομάδες: α)Sham (ομάδα εικονικής παρέμβασης) β) ομάδα ελέγχου (C)(45 λεπτά ισχαιμίας και επαναιμάτωση) γ) ομάδα σιλιμπινίνης(Si) (45 λεπτά ισχαιμίας και χορήγηση σιλιμπινίνης πριν την επαναιμάτωση) Για τη μελέτη της έκφρασης των MMP2, MMP3, MMP9 και TIMP2 στο νεφρικό και πνευμονικό παρέγχυμα, χρησιμοποιήθηκε ανοσοϊστοχημεία και αλυσιδωτή αντίδραση πολυμεράσης με αντίστροφη μεταγραφάση σε πραγματικό χρόνο (qRT-PCR). Αποτελέσματα: Συγκρίνοντας την ομάδα Sham με τις ομάδες ελέγχου διαπιστώθηκε ότι η ηπατική βλάβη από ισχαιμία επαναιμάτωση αύξησε την έκφραση τόσο των νεφρικών όσο και των πνευμονικών MMP2,MMP3,MMP9 και TIMP2, με σημείο εκκίνησης της αύξησης αυτής τα 180 λεπτά (p<0.001). Η σύγκριση ανάμεσα στις ομάδες ελέγχου και σιλιμπινίνης ανέδειξε στατιστικά σημαντική μείωση στα επίπεδα έκφρασης των MMP2,MMP3,MMP9 και TIMP2 στο νεφρικό και πνευμονικό παρέγχυμα. Το χρονικό σημείο έναρξης της μείωσης αυτής ήταν τα 120 λεπτά μετά την επαναιμάτωση, τόσο για τις νεφρικές όσο και για τις πνευμονικές παραμέτρους, ενώ στα 240 λεπτά η διαφορά ήταν στατιστικά σημαντική (p<0,001) για το νεφρό. Στα 180 λεπτά μετά την επαναιμάτωση, η σιλιμπινίνη ανέδειξε κορύφωση της προστατευτικής της επίδρασης στο πνευμονικό παρέγχυμα (p<0.001). Συμπέρασμα: Η ηπατική βλάβη από ισχαιμία-επαναιμάτωση προκαλεί απομακρυσμένη βλάβη στο νεφρό και στον πνεύμονα, ενώ η ενδοφλέβια χορήγηση σιλιμπινίνης προσφέρει στατιστικά σημαντική προστατευτική δράση τόσο στο νεφρικό όσο και στο πνευμονικό παρέγχυμα.
Μελέτη μηχανισμών ψυχολογικής προσαρμογής σε ασθενείς κατά την οξεία και χρόνια φάση εμφράγματος μυοκαρδίου
Authors: Χαριζοπούλου Μαρία
Published: April 2022

Η ψυχολογική προσαρμογή έπειτα από ένα επεισόδιο εμφράγματος του μυοκαρδίου, είναι ένας βοηθητικός μηχανισμός για τους ασθενείς στη διαδικασία διαχείρισης της νέας πραγματικότητας μετά μια ανάλογη απειλητική για τη ζωή συνθήκη. Είναι περιορισμένες οι βιβλιογραφικές αναφορές σχετικά με την αλληλεπίδραση των μηχανισμών ψυχολογικής προσαρμογής και του προφίλ των ασθενών. Η παρούσα έρευνα μελετά τις συσχετίσεις μεταξύ των προαναφερθέντων μηχανισμών (αποδόσεις αιτίου, στρατηγικές διαχείρισης, μετατραυματική ωρίμανση) και της συναισθηματικής διάθεσης των ασθενών έπειτα από έμφραγμα του μυοκαρδίου. Διακόσιοι άνδρες ασθενείς με έμφραγμα του μυοκαρδίου, συμμετείχαν στην έρευνα, μέσω συνέντευξης, έπειτα από το καρδιολογικό επεισόδιο. Δημογραφικά και ιατρικά στοιχεία καταγράφθηκαν από τους φακέλους των ασθενών μετά από συγκατάθεση των ίδιων των ασθενών. Μια λίστα αποδόσεων αιτίου με 24 στοιχεία, και τα ερωτηματολόγια: COPE, PTGI, POMS και Ryff Well-Being Scale χρησιμοποιήθηκαν κατά την αξιολόγηση του ψυχολογικού προφίλ. Το κάπνισμα και το στρες ήταν οι κύριες αποδόσεις αιτίου που δήλωσαν οι ασθενείς και στις δυο χρονικές φάσεις. Στην οξεία φάση, το κάπνισμα, ως απόδοση αιτίου, βρέθηκε να σχετίζεται με την ενεργή διαχείριση, την αυτομομφή και την εκτίμηση ζωής. Στη χρόνια φάση, το κάπνισμα, ως αιτία, συνδέθηκε με την αυτομομφή και την ατομική αντοχή. Από την άλλη μεριά, το στρες ως αιτία, βρέθηκε να σχετίζεται με την εκτόνωση συναισθημάτων και τις στρατηγικές δέσμευσης στην οξεία και χρόνια φάση αντίστοιχα. Επιπρόσθετα, οι στρατηγικές δέσμευσης συνδέθηκαν θετικά με τις περισσότερες υποκλίμακες της μετατραυματικής ωρίμανσης. Το στρες ως αιτία, οι στρατηγικές δέσμευσης και η μετατραυματική ωρίμανση αλληλοεπέδρασαν θετικά με την ψυχική ευεξία. Αναφορικά με τα προφίλ των ασθενών, οι στρατηγικές δέσμευσης, η αυτομομφή, η ψυχική αντοχή και η εκτίμηση ζωής, δηλώθηκαν από τους συμμετέχοντες που απέδωσαν την αιτία στο κάπνισμα ή το στρες. Η πνευματικότητα, η σχέση με τους άλλους και η πνευματική αλλαγή, δηλώθηκαν κυρίως από τους πάσχοντες που απέδωσαν την αιτία σε κλινικές αιτίες. Η παρούσα έρευνα αξιολόγησε τις συσχετίσεις ανάμεσα στους μηχανισμούς ψυχολογικής προσαρμογής σε ασθενείς με έμφραγμα του μυοκαρδίου. Η σημαντικότητα των κλινικών δεδομένων της μελέτης χρειάζεται να διερευνηθούν περαιτέρω σε μελλοντικές έρευνες.
Molecular mediators involved in skin healing: a narrative review
Authors: dos Santos Leite Camila , César Pires Oscar , Henrique Avi Pedro , Luiza M. Soto Maria , Ribeiro Martins Ariane , Rocha Thalita
Published: April 2022

Background: The expression of biological mediators, such as growth factors and cytokines, after skin damage, and their balance, is important to guarantee proliferation, differentiation and migration of cells and extracellular matrix, as well as to the homeostasis during tissue remodeling. The present review means to clarify their functions over inflammation, proliferation and remodeling stages of skin regeneration.

Methods: Reviews, experimental studies and clinical trials included in this paper were search on PubMed database using the following terms: platelet-derived growth factor, interleukin 1, tumor necrosis factor alpha, keratinocyte growth factor, transforming growth factor beta, endothelial vascular growth factor, matrix metalloproteinase 9, tissue metalloproteinase inhibitor 1, interferon gamma, transcription nuclear factor kappa B, skin inflammation, skin cell proliferation, skin extracellular matrix and skin regeneration.

Results and Discussion: Several studies on the signaling mechanism of these mediators in normal and impaired healing have already been developed and have shown promising results. Currently, some of these mediators are already direct focuses of potential clinical therapies that address the treatment of acute and chronic skin wounds. These mediators, basically synthetized by platelets, macrophages, vascular endothelial cells, fibroblasts and keratinocytes, act on epidermis and dermis proliferation, hypertrophy and cell migration, resulting in formation of granulation tissue, reepithelization and extracellular matrix remodeling and angiogenesis. A better understanding of the action of these mediators can provide greater knowledge not only of their roles in the natural healing process but also in the presence of disorders that affect skin repair.

Conclusion: Future studies aimed to understand the mechanism of action of these mediators in the different types of cells involved in wound healing may lead to the discovery of new therapeutics to optimize the treatment of skin pathologies.
Edición de textos desde el documento al monumento: Nuevos textos, nueva historia
Authors: González Gómez Jimena , Romera Manzanares Ana María
Published: April 2022

Constituye en la actualidad una constante, dentro de los estudios diacrónicos del español, la búsqueda y localización de nuevos testimonios manuscritos, su edición y posterior estudio para poder ampliar la nómina de fuentes documentales, tradicionalmente asociada a los textos literarios, sobre las que acometer la investigación histórica de la lengua escrita. Desde una perspectiva plural y abarcadora, los trabajos recogidos en este volumen nos permiten examinar, de la mano de especialistas, aspectos relacionados con la edición de testimonios manuscritos de diferente caracterización (textual, cronológica y dialectal), con la localización de nuevos documentos custodiados en archivos hasta ahora no suficientemente explorados o con la presentación de los nuevos corpus lingüísticos disponibles.
Play Like the Pros? Solving the Game of Darts as a Dynamic Zero-Sum Game
Authors: Haugh Martin B. , Wang Chun
Published: April 2022

The game of darts has enjoyed great growth over the past decade with the perception of darts moving from that of a pub game to a game that is regularly scheduled on prime-time television in many countries such as the United Kingdom, Germany, the Netherlands, and Australia, among others. It involves strategic interactions between two players, but to date, the literature has ignored these interactions. In this paper, we formulate and solve the game of darts as a dynamic zero-sum game (ZSG), and to the best of our knowledge, we are the first to do so. We also estimate individual skill models using a novel data set based on darts matches that were played by the top 16 professional players in the world during the 2019 season. Using the fitted skill models and our ZSG problem formulation, we quantify the importance of playing strategically—that is, taking into account the score and strategy of one’s opponent—when computing an optimal strategy. For top professionals, we find that playing strategically results in an increase in win probability of just 0.2%–0.6% over a single leg but as much as 2.2% over a best-of-31-legs match.

Summary of Contribution: Dynamic zero-sum games (ZSGs) are of considerable interest, as they arise in many applications including sports, the management of communication networks, interdiction games, and heads-up poker—an important topic in modern artificial intelligence. In this study we consider the game of darts, which is growing increasingly popular around the world today. We formulate the game of darts as a ZSG and solve it iteratively by formulating each player’s best-response problem as a stochastic shortest-path (SSP) problem. We then solve these SSPs using standard dynamic programming methods. In solving the ZSG, we are able to accurately quantify the importance of top professionals playing strategically.
UMA INTRODUÇÃO AO LATIM BOTÂNICO POR MEIO DE UM TEXTO DE GUILHERME PISO
Authors: Florêncio Francisco De Assis
Published: April 2022

O presente artigo tem por objetivo apresentar uma introdução ao Latim Botânico (LB), a partir da análise de um trecho da Historia Naturalis Brasiliae (HNB). O trecho citado tem por título De Vmbu Arbore Illiusque Facultatibus, cujo autor é Willem Piso, ilustre médico alemão que veio ao Brasil na companhia do conde Maurício de Nassau e sua comitiva. Poderíamos ter escolhido qualquer texto de autoria de Piso presente na HNB, já que todos serviriam de exemplo para o LB, mas escolhemos o supracitado pelo fato de ele abordar uma árvore de vital importância para o povo nordestino: o umbuzeiro. O texto será apresentado em sua língua original, o latim, mas não o latim clássico, e sim uma variante dele, que se caracteriza por uma linguagem técnica, voltada principalmente para descrever e classificar animais e plantas, vindo a se tornar, no século XVIII, a língua da Botânica, principalmente na nomenclatura.  Do ponto de vista teórico, fundamentamo-nos principalmente na obra Botanical Latin, de William T. Stear, sem nos olvidarmos, porém, de outras fontes. A título de cotejo, baseamo-nos especialmente em duas obras, que, provavelmente, foram consultadas por Piso: Tratados da terra e gente do Brasil, de Fernão Cardim e Notícia do Brasil: Tratado descritivo do Brasil em 1587, de Gabriel Soares de Sousa.
The journey of policies during the COVID-19 pandemic in Indonesia: a need of evidence-informed policy
Authors: Taher Akmal
Published: April 2022

[No abstract available]
Citation index analysis: a key or a trap?
Authors: Rizal Ardy Hariandy Hamid Agus
Published: April 2022

[No abstract available]
Internet addiction and its association with depression, anxiety, and stress symptoms among allied health students in Malaysia
Authors: Jaafar Nor Subhi , Idris Idayu Badilla , Ahmad Norfazilah , Hod Rozita , Baddiri Baidi , Hod Rafidah
Published: April 2022

BACKGROUND Internet addiction (IA) is prone to be experienced by students and has become a major health concern. However, data on IA among allied health students are limited. This study aimed to describe the prevalence of IA and the association between mental health problems and IA among allied health students in Malaysia. METHODS A cross-sectional study was conducted from July to December 2021 in three government-funded allied health training institutes in Malaysia. A total of 265 allied health students undertaking a diploma in nursing, medical assistant training, physiotherapy, occupational therapy, and diagnostic imaging were recruited using stratified random sampling. The Malay version of the IA test was used to measure IA, while depression, anxiety and stress scale-21 items were used to assess their mental health problems. A general linear model was used to analyze the association between IA scores and mental health problems. RESULTS The prevalence of IA among allied health students was more than 80%, with 16.2% and 2.3% of them reporting moderate and severe IA, respectively. Higher depression (p<0.001), anxiety (p<0.001), and stress scores (p = 0.002) were associated with higher IA scores. CONCLUSIONS There were significant associations between mental health problems and IA scores among allied health students. Future studies with rigorous scientific methods are necessary to explore mental health effects on IA. Early intervention is also needed to prevent mental health problems among allied health students to overcome the problem of IA.
Neuroeducacion y aprendizaje de la lectura: Del laboratorio al salón de clase
Authors: Restrepo Gérardo , Calvachi-Galvis Liliana
Published: April 2022

El aprendizaje de la literacidad constituye un logro primordial para el aprendizaje del niño, el desarrollo de su personalidad y su inclusión en la cultura y la sociedad. Los niños y niñas aprenden a leer, para luego leer para aprender. Sin embargo, se estima que el 63% de los alumnos de 4 grado tienen competencias en lectura muy por debajo del nivel deseado y el 80% de ellos vienen de estratos socioeconómicos bajos. Las dificultades en el aprendizaje de la lectura pueden llevar a una baja autoestima, desesperanza y depresión en niños y adolescentes. El resultado es que los niños con dificultades del aprendizaje tienen menos probabilidades de completar la secundaria y de continuar estudios superiores, y en la adolescencia y la edad adulta tienen más riesgo de verse involucrados en conductas criminales. El 92% de los adultos que presentan dificultades del aprendizaje tienen ingresos mensuales muy bajos y el 67% ganan un salario mínimo o menos. La Neuroeducación es una disciplina académica joven donde convergen las neurociencias, la psicología cognitiva y la educación. Su objetivo es elucidar las estructuras y las funciones cerebrales asociadas con la educación. Este articulo revisa los resultados neurocientificos relacionados con el aprendizaje de la lectura, y discute su potencialidad de aplicación en la educación. La obtención de imágenes cerebrales ha permitido estudiar los correlatos neurales de las funciones cognitivas en general, y de la lectura en particular, y esta información orienta el aprendizaje y la enseñanza en un contexto educativo formal. Los resultados recientes de las investigaciones en neurociencias muestran que algunos marcadores neurales, como la conectividad del Fascículo Arqueado, son muy útiles y eficaces en la predicción de las trayectorias de desarrollo y aprendizaje de niños y niñas, y en sus respuestas a la enseñanza. Los resultados de las investigaciones revisadas en este artículo sugieren que la Neuroeducación puede dar más que intuiciones y proponer soluciones prácticas, basadas en resultados empíricos. Para ello, la Neuroeducación debe continuar construyendo colaboraciones, conceptuales y metodológicas entre disciplinas, que permitan disminuir la brecha existente entre la investigación, la formación de los educadores y la práctica profesional.
Diode-pumped 1-µm Nd:YVO4 and Nd:YLF lasers with active thermal lensing compensation and manipulated beam quality
Authors: Lin Shou-Tai , Chen Cheng-Po
Published: April 2022

Thermally induced optical adaptive lens in a solid-state laser can be used to compensate for the thermal lens and improve the beam quality. Herein, we present an active compensation method for thermal lensing in 1 µm diode-pumped solid-state Nd:YVO4 and Nd:YLF lasers. The compensation scheme comprised thermally inducing the defocusing effect of π polarization in Nd:YLF; the defocusing strength was controlled using a diode pump power. By varying the absorbed ∼790 nm diode power of Nd:YLF (0 to 7.8 W), the beam quality, M2, of Nd:YVO4 was manipulated from 2.4 to ∼1.1 and the power fluctuation was measured to be less than 0.5%.
Effect of a single dose of 8 mg moxidectin or 150 μg/kg ivermectin on O. volvulus skin microfilariae in a randomized trial: Differences between areas in the Democratic Republic of the Congo, Liberia and Ghana and impact of intensity of infection
Authors: Bakajika Didier , Kanza Eric M. , Opoku Nicholas O. , Howard Hayford M. , Mambandu Germain L. , Nyathirombo Amos , Nigo Maurice M. , Kennedy Kambale Kasonia , Masembe Safari L. , Mumbere Mupenzi , Kataliko Kambale , Bolay Kpehe M. , Attah Simon K. , Olipoh George , Asare Sampson , Vaillant Michel , Halleux Christine M. , Kuesel Annette C.
Published: April 2022

Background

Our study in CDTI-naïve areas in Nord Kivu and Ituri (Democratic Republic of the Congo, DRC), Lofa County (Liberia) and Nkwanta district (Ghana) showed that a single 8 mg moxidectin dose reduced skin microfilariae density (microfilariae/mg skin, SmfD) better and for longer than a single 150μg/kg ivermectin dose. We now analysed efficacy by study area and pre-treatment SmfD (intensity of infection, IoI).

Methodology/Principal findings

Four and three IoI categories were defined for across-study and by-study area analyses, respectively. We used a general linear model to analyse SmfD 1, 6, 12 and 18 months post-treatment, a logistic model to determine the odds of undetectable SmfD from month 1 to month 6 (UD1-6), month 12 (UD1-12) and month 18 (UD1-18), and descriptive statistics to quantitate inter-interindividual response differences. Twelve months post-treatment, treatment differences (difference in adjusted geometric mean SmfD after moxidectin and ivermectin in percentage of the adjusted geometric mean SmfD after ivermectin treatment) were 92.9%, 90.1%, 86.8% and 84.5% in Nord Kivu, Ituri, Lofa and Nkwanta, and 74.1%, 84.2%, 90.0% and 95.4% for participants with SmfD 10–20, ≥20-<50, ≥50-<80, ≥80, respectively. Ivermectin’s efficacy was lower in Ituri and Nkwanta than Nord Kivu and Lofa (p≤0.002) and moxidectin’s efficacy lower in Nkwanta than Nord Kivu, Ituri and Lofa (p<0.006). Odds ratios for UD1-6, UD1-12 or UD1-18 after moxidectin versus ivermectin treatment exceeded 7.0. Suboptimal response (SmfD 12 months post-treatment >40% of pre-treatment SmfD) occurred in 0%, 0.3%, 1.6% and 3.9% of moxidectin and 12.1%, 23.7%, 10.8% and 28.0% of ivermectin treated participants in Nord Kivu, Ituri, Lofa and Nkwanta, respectively.

Conclusions/Significance

The benefit of moxidectin vs ivermectin treatment increased with pre-treatment IoI. The possibility that parasite populations in different areas have different drug susceptibility without prior ivermectin selection pressure needs to be considered and further investigated.

Clinical Trial Registration

Registered on 14 November 2008 in Clinicaltrials.gov (ID: NCT00790998).
Rates, perceptions and predictors of depression, anxiety and Post Traumatic Stress Disorder (PTSD)-like symptoms about Covid-19 in adolescents
Authors: Stewart Tracy M. , Fry Debi , McAra Lesley , Hamilton Sarah , King Albert , Laurie Margaret , McCluskey Gillean
Published: April 2022

Increasing evidence has shown that the Covid-19 outbreak, and subsequent school closures and exam cancellations that followed, has impacted adolescent mental health. The current cross-sectional study examined rates of depression, anxiety and Post Traumatic Stress Disorder (PTSD)-like symptoms about Covid-19 in adolescents and whether current or past mental health support, additional support in school, keyworker status, poorer household relationships since the outbreak of Covid-19 or reduced physical activity were associated with elevated levels of depression, anxiety or PTSD-like symptoms. Lastly, it examined perceived changes in mental health due to the Covid-19 pandemic, school closures and the cancellation of exams. A total of 899 adolescents (14–18 years) took part in the ’in isolation instead of in school’ (INISS) project. Findings indicated that older adolescents, females, those who currently or previously received mental health support or additional support in school and adolescents who reported poorer relationships at home since Covid-19 were more likely to meet clinical threshold levels for their mental health. Adolescents highlighted worsening of their mental health due to Covid-19 and school closures with mixed positive and negative impact of exam cancellations. Adolescents experiencing clinical threshold levels of depression and anxiety uniquely reported worsening of their mental health since the Covid-19 pandemic, school closures and exam cancellations. Understanding the rates, perceptions and factors associated with increases in depression, anxiety and PTSD-like symptoms in adolescents during the Covid-19 pandemic will inform national policy in supporting adolescent mental health and recovery from the Covid-19 pandemic.
Healthcare contacts with self-harm during COVID-19: An e-cohort whole-population-based study using individual-level linked routine electronic health records in Wales, UK, 2016—March 2021
Authors: DelPozo-Banos M. , Lee S. C. , Friedmann Y. , Akbari A. , Torabi F. , Lloyd K. , Lyons R. A. , John A.
Published: April 2022

Introduction

Reduced rates of help seeking by those who self-harmed during the COVID-19 pandemic have been reported.

Objectives

To understand changes in healthcare service contacts for self-harm during the COVID-19 pandemic across primary, emergency and secondary care.

Methods

This retrospective cohort study used routine electronic healthcare data for Wales, United Kingdom, from 2016 to March 14, 2021. Population-based data from primary care, emergency departments and hospital admissions were linked at individual-level. All Welsh residents aged ≥10 years over the study period were included in the study. Primary, emergency and secondary care contacts with self-harm at any time between 2016 and March 14, 2021 were identified. Outcomes were counts, incidence, prevalence and proportion of self-harm contacts relative to all contacts in each and all settings, as well as the proportion of people contacting one or more settings with self-harm. Weekly trends were modelled using generalised estimated equations, with differences between 2020 (to March 2021) and comparison years 2016–2018 (to March 2017–2019) quantified using difference in differences, from which mean rate of odds ratios (μROR) across years was reported.

Results

The study included 3,552,210 individuals over the study period. Self-harm contacts reduced across services in March and December 2020 compared to previous years. Primary care contacts with self-harm reduced disproportionately compared to non-self-harm contacts (μROR = 0.7, p<0.05), while their proportion increased in emergency departments during April 2020 (μROR = 1.3, p<0.05 in 2/3 comparison years) and hospital admissions during April-May 2020 (μROR = 1.2, p<0.05 in 2/3 comparison years). Despite this, those who self-harmed in April 2020 were more likely to be seen in primary care than other settings compared to previous years (μROR = 1.2, p<0.05). A lower proportion of those with self-harm contacts in emergency departments were subsequently admitted to hospital in December 2020 compared to previous years (μROR = 0.5, p<0.05).

Conclusions

These findings suggest that those who self-harmed during the COVID-19 pandemic may have been less likely to seek help, and those who did so faced more stringent criteria for admission. Communications encouraging those who self-harm to seek help during pandemics may be beneficial. However, this needs to be supported by maintained provision of mental health services.
Dimerization of the pulmonary surfactant protein C in a membrane environment
Authors: Korolainen Hanna , Lolicato Fabio , Enkavi Giray , Pérez-Gil Jesús , Kulig Waldemar , Vattulainen Ilpo
Published: April 2022

Surfactant protein C (SP-C) has several functions in pulmonary surfactant. These include the transfer of lipids between different membrane structures, a role in surfactant recycling and homeostasis, and involvement in modulation of the innate defense system. Despite these important functions, the structures of functional SP-C complexes have remained unclear. SP-C is known to exist as a primarily α-helical structure with an apparently unstructured N-terminal region, yet there is recent evidence that the functions of SP-C could be associated with the formation of SP-C dimers and higher oligomers. In this work, we used molecular dynamics simulations, two-dimensional umbrella sampling, and well-tempered metadynamics to study the details of SP-C dimerization. The results suggest that SP-C dimerizes in pulmonary surfactant membranes, forming dimers of different topologies. The simulations identified a dimerization motif region V21xxxVxxxGxxxM33 that is much larger than the putative A30xxxG34 motif that is commonly assumed to control the dimerization of some α-helical transmembrane domains. The results provide a stronger basis for elucidating how SP-C functions in concert with other surfactant proteins.
Magnitude, pattern and correlates of multimorbidity among patients attending chronic outpatient medical care in Bahir Dar, northwest Ethiopia: The application of latent class analysis model
Authors: Eyowas Fantu Abebe , Schneider Marguerite , Alemu Shitaye , Pati Sanghamitra , Getahun Fentie Ambaw
Published: April 2022

Objective

This study aimed to investigate the magnitude, pattern and associated factors of multimorbidity in Bahir Dar, northwest Ethiopia.

Methods

A multi-centered facility-based study was conducted among 1440 participants aged 40+ years attending chronic outpatient medical care. Two complementary methods (interview and review of medical records) were employed to collect data on socio-demographic, behavioral and disease related characteristics. The data were analyzed by STATA V.16 and R Software V.4.1.0. We fitted logistic regression and latent class analyses (LCA) models to identify the factors associated with multimorbidity and determine patterns of disease clustering, respectively. Statistical significance was considered at P-value <0.05.

Results

The magnitude of individual chronic conditions ranged from 1.4% (cancer) to 37.9% (hypertension), and multimorbidity was identified in 54.8% (95% CI = 52.2%-57.4%) of the sample. The likelihood of having multimorbidity was higher among participants aged 45–54 years (AOR: 1.6, 95%CI = 1.1, 2.2), 55–64 years (AOR: 2.6, 95%CI = 1.9, 3.6) and 65+ years (AOR: 2.6, 95%CI = 1.9, 3.6) compared to those aged 40–44 years. The odds of multimorbidity was also higher among individuals classified as overweight (AOR: 1.6, 95%CI = 1.2, 2.1) or obese (AOR: 1.9, 95%CI = 1.3, 3.0) than the normal weight category. Four patterns of multimorbidity were identified; the cardiovascular category being the largest class (50.2%) followed by the cardio-mental, (32.6%), metabolic (11.5%) and respiratory (5.7%) groups. Advanced age, being overweight and obesity predicted latent class membership, adjusting for relevant confounding factors.

Conclusions

The magnitude of multimorbidity in this study was high, and the most prevalent conditions shaped the patterns of multimorbidity. Advanced age, being overweight and obesity were the factors correlated with multimorbidity. Further research is required to better understand the burden of multimorbidity and related factors in the population, and to determine the impact of multimorbidity on individuals’ well-being and functioning.