bluuebunny/crossref_metadata_2025 huggingface dataset:
Healthcare Professionals’ Perceptions, Barriers, and Facilitators towards Adopting Computerised Clinical Decision Support Systems in Antimicrobial Stewardship in Jordanian Hospitals
Authors: Albahar Fares , Abu-Farha Rana K. , Alshogran Osama Y. , Alhamad Hamza , Curtis Chris E. , Marriott John F.
Published: March 2023

Understanding healthcare professionals’ perceptions towards a computerised decision support system (CDSS) may provide a platform for the determinants of the successful adoption and implementation of CDSS. This cross-sectional study examined healthcare professionals’ perceptions, barriers, and facilitators to adopting a CDSS for antibiotic prescribing in Jordanian hospitals. This study was conducted among healthcare professionals in Jordan’s two tertiary and teaching hospitals over four weeks (June–July 2021). Data were collected in a paper-based format from senior and junior prescribers and non-prescribers (n = 254) who agreed to complete a questionnaire. The majority (n = 184, 72.4%) were aware that electronic prescribing and electronic health record systems could be used specifically to facilitate antibiotic use and prescribing. The essential facilitator made CDSS available in a portable format (n = 224, 88.2%). While insufficient training to use CDSS was the most significant barrier (n = 175, 68.9%). The female providers showed significantly lower awareness (p = 0.006), and the nurses showed significantly higher awareness (p = 0.041) about using electronic prescribing and electronic health record systems. This study examined healthcare professionals’ perceptions of adopting CDSS in antimicrobial stewardship (AMS) and shed light on the perceived barriers and facilitators to adopting CDSS in AMS, reducing antibiotic resistance, and improving patient safety. Furthermore, results would provide a framework for other hospital settings concerned with implementing CDSS in AMS and inform policy decision-makers to react by implementing the CDSS system in Jordan and globally. Future studies should concentrate on establishing policies and guidelines and a framework to examine the adoption of the CDSS for AMS.
Marketing Channel Preferences of Cut Flower Producers: A Case Study of Turkey
Authors: Kenanoğlu Zerrin
Published: March 2023

This study aims to determine the preferred criteria of cut flower producers when choosing marketing channels, and the degrees of importance of these criteria. In this study, the levels of importance of the different marketing criteria used by cut flower producers and their marketplace preferences were analyzed using the analytic hierarchy process. The data used in this study were obtained from questionnaires completed by 82 cut flower producers in İzmir province. The most preferred marketing criterion for producers was payment guarantee, followed by ease of marketing and price. When producers’ marketplace preferences were ranked according to the different criteria, cooperatives ranked first, followed by wholesalers and exporters. The Tobit model was employed to reveal the socio-economic variables that affected the producers’ choices and the criteria considered in the analytic hierarchy process. It was established that cooperatives play an important role in marketing cut flowers and developing this sector in Turkey.
Support Vector Regression Models of Stormwater Quality for a Mixed Urban Land Use
Authors: Kshirsagar Mugdha P. , Khare Kanchan C.
Published: March 2023

The present study is an attempt to model the stormwater quality of a stream located in Pune, India. The city is split up into twenty-three basins (named A to W) by the Pune Municipal Corporation. The selected stream lies in the haphazardly expanded peri-urban G basin. The G basin has constructed stormwater drains which open up in this selected open stream. The runoff over the regions picks up the non-point source pollutants which are also added to the selected stream. The study becomes more complex as the stream is misused to dump trash materials, garbage and roadside litter, which adds to the stormwater pollution. Experimental investigations include eleven distinct locations on a naturally occurring stream in the G basin. Stormwater samples were collected for twenty-two storm events, for the monsoon season over four years from 2018–2021, during and after rainfall. The physicochemical characteristics were analyzed for twelve water quality parameters, including pH, Conductivity, Turbidity, Total solids (TS), Total Suspended Solids (TSS), Total Dissolved Solids (TDS), Bio-chemical Oxygen Demand (BOD5), Chemical Oxygen Demand (COD), Dissolved Oxygen (DO), Phosphate, Ammonia and Nitrate. The Water Quality Index (WQI) ranged from 46.9 to 153.9 and from 41.20 to 87.70 for samples collected during and immediately after the rainfall, respectively. Principal Component Analysis was used to extract the most significant stormwater quality parameters. To understand the non-linear complex relationship of rainfall characteristics with significant stormwater pollutant parameters, a Support Vector Regression (SVR) model with Radial Basis Kernel Function (RBF) was developed. The Support Vector Machine is a powerful supervised algorithm that works best on smaller datasets but on complex ones with the help of kernel tricks. The accuracy of the model was evaluated based on normalized root-mean-square error (NRMSE), coefficient of determination (R2) and the ratio of performance to the interquartile range (RPIQ). The SVR model depicted the best performance for parameter TS with NRMSE (0.17), R2 (0.82) and RPIQ (2.91). The unit increase or decrease in the coefficients of rainfall characteristics displays the weighted deviation in the values of pollutant parameters. Non-linear Support Vector Regression models confirmed that both antecedent dry days and rainfall are correlated with significant stormwater quality parameters. The conclusions drawn can provide effective information to decision-makers to employ an appropriate treatment train approach of varied source control measures (SCM) to be proposed to treat and mitigate runoff in an open stream. This holistic approach serves the stakeholder’s objectives to manage stormwater efficiently. The research can be further extended by selecting a multi-criteria decision-making tool to adopt the best SCM and its multiple potential combinations.
Barriers and Facilitators to Father’s Engagement in a Depression and Alcohol Use Intervention in Kenya: Father, Family, and Community Factors
Authors: Giusto Ali , Jaguga Florence , Pereira-Sanchez Victor , Rono Wilter , Triplett Noah , Rukh-E-Qamar Hani , Parker Mattea , Wainberg Milton L.
Published: March 2023

In Kenya, there is a treatment gap for depression and alcohol use that is especially large for fathers, which has consequences for families. While treatments exist, there are challenges to implementation. This study aimed to understand barriers and facilitators to implementing a treatment for fathers’ depression and alcohol use in Eldoret, Kenya. Guided by the Consolidated Framework for Implementation Research and the Integrated Sustainability Framework, we conducted 18 key informant interviews and 7 focus group discussions (31 total participants) with stakeholders in Eldoret (hospital leaders, policy makers, mental health providers, community leaders, fathers, lay providers, and patients previously engaged in treatment). Interviews were analyzed using the framework method; themes were matrixed by framework domains. Participants identified barriers and facilitators, and opportunities for implementation, in the following domains: innovation, outer setting, inner setting, individual, sustainability, and characteristics of systems. Barriers included a lack of resources, stigma, masculine norms, cost of services, and alcohol dependence. Facilitators included community buy-in, family support, providers with lived experience, government support, and relevant treatment content. Findings will inform implementation strategy development for an intervention for fathers with depression and alcohol use, and family problems with local relevance and scalable potential.
Values, Health and Well-Being of Young Europeans Not in Employment, Education or Training (NEET)
Authors: Hult Marja , Kaarakainen Minna , De Moortel Deborah
Published: March 2023

Youth unemployment is a problem that undermines young people’s health and well-being and is also a concern for their immediate communities and society. Human values predict health-related behaviour; however, this relation is very little studied and not examined earlier among NEET (not in employment, education or training) young people. This study aimed to explore the association between four higher-order human values (conservation, openness to change, self-enhancement, self-transcendence), self-rated health (SRH) and subjective well-being (SW) among NEET young men and women (n = 3842) across European regions. Pooled European Social Survey data from 2010–2018 were used. First, we run linear regression analysis stratified by European socio-cultural regions and gender. Then, multilevel analyses by gender with interactions were performed. The results show expected variation in value profiles across genders and regions and corresponding differences in SRH and SW. Significant associations between values and SRH and SW were found among both genders and across the regions; however, the results did not entirely confirm the expectations about the “healthiness” of specific values. More likely, prevailing values in societies, such as the social norm to work, might shape these associations. This study contributes to a deeper understanding of the factors affecting NEETs’ health and well-being.
Sleep Patterns during the COVID-19 Lockdown in Spain
Authors: Ruiz-Herrera Noelia , Díaz-Román Amparo , Guillén-Riquelme Alejandro , Quevedo-Blasco Raúl
Published: March 2023

Background: To mitigate the spread of the coronavirus disease (COVID-19) pandemic, governments around the world adopted exceptional lockdown measures. This led to the disruption of normal life routines, including sleep. The aim of this study was to analyze differences in sleep patterns and subjective variables of sleep quality before and during lockdown. Methods: A sample of 1673 Spanish adults (30% men; 82% of the total were between 21 and 50 years of age) was evaluated. The following sleep variables were evaluated: Sleep latency, sleep time, number and duration of awakenings, sleep satisfaction, daytime sleepiness, and the manifestation of symptoms related to sleep problems. Results: Although 45% of people changed their sleep schedules (resulting in 42% sleeping longer during lockdown), sleep quality (37.6% worse), daytime sleepiness (28% worse), number of awakenings (36.9% more), and duration of awakenings (45% longer) were markedly worse. Statistical analyses indicated significant differences in all the evaluated sleep variables before and during lockdown in both men and women. Women reported less sleep satisfaction, and more symptoms related to sleep problems than men. Conclusions: A deterioration in the sleep patterns of the Spanish population, especially women, because of the lockdown declared due to the COVID-19 pandemic.
Information Gathering about Pregnancy, Birth, and Puerperium—Good and Fake Information
Authors: Oyman Oezden , Fest Joy , Zimmermann Roland , Ochsenbein-Kölble Nicole , Vonzun Ladina
Published: March 2023

Recent research on the subject of information-gathering processes among pregnant women has revealed a shift towards online sources. Health professionals’ knowledge about sources of information has been shown to improve the understanding and counseling of patients. The objective of this study was to create an overview of all types of sources relevant to information gathering and to put their role and perception into perspective. Methods: A total of 249 women were included in this study and recruited over a period of one month at the University Hospital of Zurich (USZ). Exclusion criteria included cases of fetal demise and late abortions. The survey on information-gathering processes was divided into three stages: pregnancy, birth, and puerperium. The different sources of information were compared based on women’s characteristics. Results: The response rate was 78% (n = 197). The main findings include a significant difference in information gathering based on varying levels of education, with women at the lowest educational level using the Internet the least during pregnancy (p = 0.029). During puerperium, significant differences could be observed in the involvement of the gynecologist. Primipara women as well as women of lower educational levels contacted their gynecologist less in contrast to multipara women (p = 0.006) and women of higher educational levels (p = 0.011). Overall, health professionals were considered to be the most important source of information. Conclusions: This study demonstrates that parity and educational level influence the information-gathering process. As the most important source for information gathering, health professionals must use this advantage to better assist their patients in accessing reliable information.
Exploring the Relationships between Multilevel Built Environments and Commute Durations in Dual-Earner Households: Does Gender Matter?
Authors: Wang Xiaoquan , Wang Weifeng , Yin Chaoying
Published: March 2023

The links between built environments (BE) and commute durations have been extensively studied. However, relatively few studies have considered the effects of BEs at different spatial levels within a unified framework, or identified the gendered relationships between BEs and commute durations. Using survey data from 3209 household couples in 97 Chinese cities, this study investigates the effects of neighborhood- and city-level BEs on commute durations and the potential differences in these effects between the male and female members of the same household couple. A multi-group generalized multilevel structural equation model is applied to reveal the gendered relationships between neighborhood- and city-level BEs and commute durations. The findings suggest that the BE variables at two levels have significant effects on the commute duration. The mediating roles that the traffic congestion, car ownership, and commuting modes play in linking these BEs and commute durations are confirmed. Both levels of the BE variables are more influential factors for males’ commuting durations. These findings have policy implications for the design of gender-equal transportation systems.
Mood and Emotions among Inmates after COVID-19 Pandemic
Authors: Chimicz Dorota , Lewicka-Zelent Agnieszka , Lisiecka Alicja
Published: March 2023

Background: During imprisonment, inmates face many difficulties in adapting to life behind bars. The aim of the study was to find out (a) how challenging for inmates were the selected COVID-19 pandemic-related changes and stressors, (b) what moods and emotions are most commonly experienced by prisoners just after the difficult period of the COVID-19 pandemic, and (c) which of the selected factors determine the positive and negative mood of inmates. Methods: The research was conducted in July 2022 in six randomly selected Polish prisons. Prisoners (N = 250) were invited to participate. Comparative and regression analyses were carried out. Two scales measuring moods: the General Mood Scale and the Mood Scale (positive and negative), the Emotions Questionnaire by B. Wojciszke and W. Baryła, and a proprietary questionnaire were used. Results: Sanitary restrictions implemented in prisons resulted in a moderate experience of discomfort among prisoners, mainly in terms of not being able to have direct contact with family and friends, limitation in their personal freedoms to do their jobs, self-development, and deterioration of mental and physical health. A depressed mood predominated among the prisoners, making them feel unhappy, discouraged, tense, and uptight. They reported dominant feelings of alienation, distress, anxiety, and worry at the time of the survey. The mood of inmates was changing from more positive to more negative; on average, it was described as moderate. Based on the regression coefficients, the significant predictors of inmates’ positive mood were perceived happiness (for those who got sick with COVID-19 during their prison sentence) and joy, angst, and contentment (for the healthy ones). In the group of SARS-CoV-2-infected prisoners, unhappiness, age, concern, cheerfulness, and rage were found to be predictors of their negative mood. The feeling of joy appeared to be a significant predictor of negative mood for those inmates who had no personal experience with COVID-19. Conclusions: It is necessary to provide convicts with continuous psychological care and to monitor their mood. Such measures should be the foundation for restorative interventions.
Predictors of Anxiety in Romanian Generation Z Teenagers
Authors: Runcan Remus , Nadolu Delia , David Gheorghe
Published: March 2023

Adolescence is a very complex period of life, full of challenges, and explorations that young people have to face on the path to becoming adults. In adolescence, specific deviations from the everyday lifestyle, as well as emotional failures or imbalances, may also occur. When things tend to become more and more unclear, adolescents come to directly face some form of anxiety. The present study concerns the relationship of Romanian adolescents with their fathers from the perspective of anxiety issues. For this, an anonymous questionnaire was applied using a sample of availability of 558 teenagers and a complementary second questionnaire was intended for their fathers (N2 = 114 subjects). The questionnaire addressed to Generation Z Romanian adolescents included items regarding the self-assessment of one’s own behaviour and relationship with one’s father, as well as the Generalized Anxiety Disorder Scale-7 (GAD-7). The questionnaire addressed to the fathers included mirror questions regarding the relationship with their children. The main results showed that the relationship between adolescents and their fathers has an ambivalent impact on anxiety: if it is a strong relationship, the risk to develop anxiety decreases, while if it is a weak relationship, it increases the risk of anxiety.
Sugar-Sweetened Beverages Consumption in a Multi-Ethnic Population of Young Men and Association with Sociodemographic Characteristics and Obesity
Authors: AlTamimi Jozaa Z. , Alshwaiyat Naseem M. , Alkhalidy Hana , AlKehayez Nora M. , Alagal Reham I. , Alsaikan Reem A. , Alsemari Malak A. , BinMowyna Mona N. , AlFaris Nora A.
Published: March 2023

Sugar-sweetened beverages are frequently consumed among adults and are linked with the incidence of obesity. We aimed to determine rates of weekly and daily sugar-sweetened beverage intake in a multi-ethnic population of young men and their association with sociodemographic characteristics and obesity. This cross-sectional study included 3600 young men who lived in Riyadh, KSA. Participants’ sociodemographic characteristics and frequency of sugar-sweetened beverage consumption were gathered through personal interviews. The outcome variables in this study are based on the weekly and daily consumption of sugar-sweetened beverages. Weight and height were measured following standard protocols. The rates of weekly and daily sugar-sweetened beverage intake by participants were 93.6% and 40.8%, respectively. Nationality was a predictor of weekly and daily consumption of sugar-sweetened beverages. The highest rates of weekly (99.5%) and daily (63.9%) consumption were observed in subjects from the Philippines and Yemen, respectively, while Bangladeshi subjects had the lowest rates of weekly (76.9%) and daily (6.9%) consumption. Obesity was another predictor of sugar-sweetened beverage consumption. Obese participants had a significantly higher odds ratio of weekly sugar-sweetened beverage consumption than non-obese subjects (OR = 4.53, p = 0.037). In conclusion, sugar-sweetened beverage consumption was relatively high and our results support an association between the consumption of sugar-sweetened beverages and certain sociodemographic variables and obesity.
Self-Compassion and Well-Being during the COVID-19 Pandemic: A Study of Greek College Students
Authors: Karakasidou Eirini , Raftopoulou Georgia , Papadimitriou Anna , Stalikas Anastassios
Published: March 2023

The present study examined the relationship between self-compassion (SC) and emotional well-being in college students during the COVID-19 pandemic. The theoretical framework for the study was that SC, defined as an understanding and caring response to one’s suffering and limitations, may serve as a protective factor against negative mental health outcomes. A sample of college students (N = 101) completed self-report measures of SC, depression, anxiety, stress, life satisfaction and subjective happiness. Data were analysed using regression analysis to examine the prediction of emotional well-being variables by SC and moderation analysis to examine the moderating effect of SC on the relationships between emotional well-being variables. The study’s results confirmed the hypothesis that SC would predict emotional well-being. SC significantly predicted all variables examined, including depression, anxiety, stress, life satisfaction (LS) and subjective happiness (SH). However, SC did not moderate the relationships between these variables. Isolation significantly moderated the relationship between SH and depression among college students. These findings support the idea that SC may serve as a protective factor against negative mental health outcomes and suggest that interventions aimed at increasing SC may improve mental health and overall well-being in college students during the COVID-19 pandemic. Further research is needed to understand these relationships’ mechanisms and the factors that may influence them.
Adherence to the Mediterranean Diet Related to the Health Related and Well-Being Outcomes of European Mature Adults and Elderly, with an Additional Reference to Croatia
Authors: Maltarić Manuela , Ruščić Paula , Kolak Mirela , Bender Darija Vranešić , Kolarić Branko , Ćorić Tanja , Hoejskov Peter Sousa , Bošnir Jasna , Kljusurić Jasenka Gajdoš
Published: March 2023

With the increase in life expectancy, expectation of a longer healthy life is also increasing. Importance of consumption of certain foods is confirmed to have a strong effect on quality of life. One of the healthiest dietary patterns consistently associated with a range of beneficial health outcomes is the Mediterranean diet (MD). The aim of this study was to assess MD adherence in the population over 50 years of age, in Europe, with special reference to Croatia, and to assess regional differences and investigate the association with health-related indicators (disease incidence, body mass index (BMI), grip strength measure, control, autonomy, self-realization, and pleasure scale (CASP-12)). This research uses data from the SHARE project for the population over 50 years of age. The frequency of individual responses was analyzed (frequencies, cross tables, and appropriate tests of significance, depending on the data set), and logistic regression was used to connect adherence to the Mediterranean diet with health indicators. The results of the study indicate a positive correlation between adherence to the principles of the Mediterranean diet with CASP and self-perception of health, which the followers of the MD pattern predominantly rate as “very good” or “excellent” (37.05%) what is significantly different (p < 0.05) from individuals which do not follow the patterns of MD (21.55%). The regression models indicate significant changes in the measure of maximum grip strength also among MD followers (ORMEDIUM = 1.449; ORHIGH = 1.293). Data for EU countries are also classified by regions (Central and Eastern; Northern, Southern and Western Europe), additionally allocating Croatia, and the trends in meat, fish and egg consumption showed the greatest differences for Croatian participants (39.6% twice a week) versus participants from four European regions. Data for Croatia deviates from the European average also in terms of the proportion of overweight and obese persons in all observed age groups, of which the largest proportion is in the 50–64 age group (normal BMI: only 30.3%). This study extended the currently available literature covering 27 European countries, placing the findings in a wider geographical context. The Mediterranean diet has once again proven to be an important factor related to health-related behavior. The presented results are extremely important for public health services, indicating possible critical factors in preserving the health of the population over 50 years old.
Quality of Life in Patients with Pancreatic Cancer—A Literature Review
Authors: Cipora Elżbieta , Czerw Aleksandra , Partyka Olga , Pajewska Monika , Badowska-Kozakiewicz Anna , Fudalej Marta , Sygit Katarzyna , Kaczmarski Mateusz , Krzych-Fałta Edyta , Jurczak Anna , Karakiewicz-Krawczyk Katarzyna , Wieder-Huszla Sylwia , Banaś Tomasz , Bandurska Ewa , Ciećko Weronika , Kosior Dariusz Artur , Kułak Piotr , Deptała Andrzej
Published: March 2023

Pancreatic cancer is the malignant disease with the highest mortality rate, and it ranks third in the world after lung and colon cancer. Identified factors that increase the risk of developing pancreatic cancer include chronic pancreatitis, radiation therapy to the pancreatic area due to another cancer, diabetes mellitus, obesity, smoking, and age. The objective of this study was to present the current state of knowledge on the quality of life of patients diagnosed with pancreatic cancer, factors that determine QoL, and ways of coping with the disease. The low curability and low survival rates of pancreatic cancer significantly affect the quality of life of patients, often in the form of significant deterioration, especially in terms of mental changes, cognitive functions, and coping with the disease. Cognitive decline with comorbid depression is also typical for patients with this type of cancer. Research has shown that the health-related quality of life of patients with pancreatic cancer is low, so further research is needed to improve the situation in this area.
Filling in the Spaces: Compactifying Cities towards Accessibility and Active Transport
Authors: Monteiro João , Para Marvin , Sousa Nuno , Natividade-Jesus Eduardo , Ostorero Carlo , Coutinho-Rodrigues João
Published: March 2023

Compactification of cities, i.e., the opposite of urban sprawl, has been increasingly presented in the literature as a possible solution to reduce the carbon footprint and promote the sustainability of current urban environments. Compact environments have higher concentrations of interaction opportunities, smaller distances to them, and the potential for increased active mode shares, leading to less transport-related energy consumption and associated emissions. This article presents a GIS-based quantitative methodology to estimate on how much can be gained in that respect if vacant spaces within a city were urbanized, according to the municipal master plan, using four indicators: accessibility, active modal share, transport energy consumption, and a 15-minute city analysis. The methodology is applied to a case study, in which the city of Coimbra, Portugal, and a compact version of itself are compared. Results show the compact layout improves all indicators, with averages per inhabitant improving by 20% to 92%, depending on the scenario assumed for cycling, and is more equitable.
Spatial Pattern Evolution and Influencing Factors of Tourism Flow in the Chengdu–Chongqing Economic Circle in China
Authors: Chen Xuejun , Huang Yang , Chen Yuesheng
Published: March 2023

Based on Ctrip’s ‘tourism digital footprint’, the spatial pattern of tourism flows in the Chengdu–Chongqing Economic Circle from 2018 to 2021 is explored, social network analysis and spatial visualisation of tourism information data are conducted, and factors affecting the network structure of tourism flows are analysed using linear weighted regression methods. The results show that tourism flows in the Chengdu–Chongqing Economic Circle show a significant ‘dual core’ polarisation effect. At the end of 2019, as a turning point, the density value of the tourism flow network shows an irregular inverted ‘U’ distribution. Kuanzhai Alley, Hong Ya Dong and Chunxi Road have irreplaceable competitive advantages in the tourism flow network. The density of highways, the number of star-rated hotels and the regional GDP per capita are positively correlated with the effective size of the structural hole of the administrative unit. Finally, based on the research results, countermeasures are proposed to optimise the tourism development of the Chengdu–Chongqing Economic Circle.
Characterization and Functional Analysis of Toll Receptor Genes during Antibacterial Immunity in the Green Peach Aphid Myzus persicae (Sulzer)
Authors: He Li , Zhang Chao , Yang Hong , Ding Bo , Yang Han-Zhi , Zhang Sen-Wen
Published: March 2023

The insect Toll receptor is one of the key members of the Toll signaling pathway, which plays an indispensable role in insect resistance to pathogen infection. Herein, we cloned and characterized five Toll receptor genes from Myzus persicae (Sulzer), which were found to be highly expressed in the first-instar nymphs and adults (both wingless and winged) at different developmental stages. Expressions of MpToll genes were highest in the head, followed by the epidermis. High transcription levels were also found in embryos. Expressions of these genes showed different degrees of positive responses to infection by Escherichia coli and Staphylococcus aureus. The expression of MpToll6-1 and MpToll7 significantly increased after infection with E. coli, whereas the expression of MpToll, MpToll6, MpToll6-1, and MpTollo continuously increased after infection with S. aureus. RNA interference-mediated suppressed expression of these genes resulted in a significant increase in the mortality of M. persicae after infection with the two bacterial species compared with that in the control group. These results suggest that MpToll genes play vital roles in the defense response of M. persicae against bacteria.
Impact of Insulin-Treated Compared to Non-Insulin-Treated Diabetes Mellitus on Outcome of Percutaneous Coronary Intervention with Drug-Coated Balloons versus Drug-Eluting Stents in De Novo Coronary Artery Disease: The Randomized BASKET-SMALL 2 Trial
Authors: Seeger Julia , Wöhrle Jochen , Scheller Bruno , Farah Ahmed , Ohlow Marc-Alexander , Mangner Norman , Möbius-Winkler Sven , Weilenmann Daniel , Stachel Georg , Leibundgut Gregor , Rickenbacher Peter , Cattaneo Marco , Gilgen Nicole , Kaiser Christoph , Jeger Raban ,   on behalf of the BASKET-SMALL 2 Investigators
Published: March 2023

Background: We evaluated the outcome of PCI of de novo stenosis with drug-coated balloons (DCB) versus drug-eluting stents (DES) in patients with insulin-treated diabetes mellitus (ITDM) versus non-insulin-treated diabetes mellitus (NITDM). Methods: Patients were randomized in the BASKET-SMALL 2 trial to DCB or DES and followed over 3 years for MACE (cardiac death, non-fatal myocardial infarction [MI], and target vessel revascularization [TVR]). Outcome in the diabetic subgroup (n = 252) was analyzed with respect to ITDM or NITDM. Results: In NITDM patients (n = 157), rates of MACE (16.7% vs. 21.9%, hazard ratio [HR] 0.68, 95% confidence interval [CI] 0.29–1.58, p = 0.37), death, non-fatal MI, and TVR (8.4% vs. 14.5%, HR 0.30, 95% CI 0.09–1.03, p = 0.057) were similar between DCB and DES. In ITDM patients (n = 95), rates of MACE (DCB 23.4% vs. DES 22.7%, HR 1.12, 95% CI 0.46–2.74, p = 0.81), death, non-fatal MI, and TVR (10.1% vs. 15.7%, HR 0.64, 95% CI 0.18–2.27, p = 0.49) were similar between DCB and DES. TVR was significantly lower with DCB versus DES in all diabetic patients (HR 0.41, 95% CI 0.18–0.95, p = 0.038). Conclusions: DCB compared to DES for treatment of de novo coronary lesions in diabetic patients was associated with similar rates of MACE and numerically lower need for TVR both for ITDM and NITDM patients.
Clinical Features of Diabetes Mellitus on Rheumatoid Arthritis: Data from the Cardiovascular Obesity and Rheumatic DISease (CORDIS) Study Group
Authors: Cacciapaglia Fabio , Spinelli Francesca Romana , Bartoloni Elena , Bugatti Serena , Erre Gian Luca , Fornaro Marco , Manfredi Andreina , Piga Matteo , Sakellariou Garifallia , Viapiana Ombretta , Atzeni Fabiola , Gremese Elisa
Published: March 2023

Rheumatoid arthritis (RA) and diabetes mellitus (DM) are linked by underlying inflammation influencing their development and progression. Nevertheless, the profile of diabetic RA patients and the impact of DM on RA need to be elucidated. This cross-sectional study includes 1523 patients with RA and no episodes of cardiovascular events, followed up in 10 Italian University Rheumatologic Centers between 1 January and 31 December 2019 belonging to the “Cardiovascular Obesity and Rheumatic DISease (CORDIS)” Study Group of the Italian Society of Rheumatology. The demographic and clinical features of DM RA patients were compared to non-diabetic ones evaluating factors associated with increased risk of DM. Overall, 9.3% of the RA patients had DM, and DM type 2 was more common (90.2%). DM patients were significantly older (p < 0.001), more frequently male (p = 0.017), with a significantly higher BMI and mean weight (p < 0.001) compared to non-diabetic patients. DM patients were less likely to be on glucocorticoids (p < 0.001), with a trend towards a more frequent use of b/ts DMARDs (p = 0.08), and demonstrated higher HAQ (p = 0.001). In around 42% of patients (n = 114), DM diagnosis preceded that of RA. Treatment lines were identical in diabetic and non-diabetic RA patients. DM is a comorbidity that may influence RA management and outcome. The association between DM and RA supports the theory of systemic inflammation as a condition underlying the development of both diseases. DM may not have a substantial impact on bDMARDs resistance, although further investigation is required to clarify the implications of biological therapy resistance in RA patients.
Selected Serum Markers Associated with Pathogenesis and Clinical Course of Type 1 Diabetes in Pediatric Patients—The Effect of Disease Duration
Authors: Ochocińska Agnieszka , Wysocka-Mincewicz Marta , Świderska Jolanta , Cukrowska Bożena
Published: March 2023

Biochemical abnormalities in the course of type 1 diabetes (T1D) may cause the production/activation of various proteins and peptides influencing treatment and causing a risk of complications. The aim of this study was to assess concentrations of selected serum substances involved in the pathogenesis and course of T1D and to correlate their concentrations with the duration of T1D. The study included patients with T1D (n = 156) at the age of 3–17, who were divided according to the duration of the disease into those newly diagnosed (n = 30), diagnosed after 3–5 (n = 77), 6–7 (n = 25), and over 7 (n = 24) years from the onset of T1D, and age-matched healthy controls (n = 30). Concentrations of amylin (IAPP), proamylin (proIAPP), catestatin (CST), chromogranin A (ChgA), nerve growth factor (NFG), platelet-activating factor (PAF), uromodulin (UMOD), and intestinal fatty acid binding protein (I-FABP) were measured in sera using immunoenzymatic tests. There were significant differences in concentrations of all the substances except UMOD and NGF between T1D patients and healthy children. The duration of the disease affected concentrations of CST, ChgA, PAF, and NGF, i.e., proteins/peptides which could have an impact on the course of T1D and the development of complications. In long-term patients, a decrease in concentrations of CST and ChgA, and an increase in PAF concentrations were found. In the case of NGF, a decrease was observed after the initial high values, followed by an increase over 7 years after T1D diagnosis. Concluding, the results show that concentrations of selected serum indicators may change in the course of T1D. Further studies are needed to establish whether these indicators could be used in the context of predicting long-term complications.
Antihyperglycemic Potential of Spondias mangifera Fruits via Inhibition of 11β-HSD Type 1 Enzyme: In Silico and In Vivo Approach
Authors: Wahab Shadma , Khalid Mohammad , Alqarni Mohammed H. , Elagib Mohamed Fadul A. , Bahamdan Ghadah Khaled , Foudah Ahmed I. , Aljarba Tariq M. , Mohamed Mons S. , Mohamed Nazik Salih , Arif Muhammad
Published: March 2023

The 11 β- hydroxysteroid dehydrogenase 1 (11 β-HSD1) is hypothesized to play a role in the pathogenesis of type 2 diabetes and its related complications. Because high glucocorticoid levels are a risk factor for metabolic disorders, 11β-HSD1 might be a viable therapeutic target. In this investigation, docking experiments were performed on the main constituents of Spondias mangifera (SM) oleanolic acid, β-amyrin, and β-sitosterol to ascertain their affinity and binding interaction in the human 11β-hydroxysteroid dehydrogenase-1 enzyme’s active region. The results of in vitro 11β HSD1 inhibitory assay demonstrated that the extract of S. mangifera had a significant (p < 0.05) decrease in the 11-HSD1% inhibition (63.97%) in comparison to STZ (31.79%). Additionally, a non-insulin-dependent diabetic mice model was used to examine the sub-acute anti-hyperlipidemic and anti-diabetic effects of SM fruits. Results revealed that, in comparison to the diabetic control group, SM fruit extract (SMFE) extract at doses of 200 and 400 mg/kg body weight considerably (p < 0.05 and p < 0.01) lowered blood glucose levels at 21 and 28 days, as well as significantly decreased total cholesterol (TC) and triglycerides (TG) and enhanced the levels of high-density lipoprotein (HDL). After 120 and 180 s of receiving 200 and 400 mg/kg SMFE, respectively, disease control mice showed significantly poorer blood glucose tolerance (p < 0.05 and p < 0.01). SMFE extract 200 (p < 0.05), SMFE extract 400 (p < 0.01), and Glibenclamide at a dosage of 5 mg/kg body weight all resulted in statistically significant weight increase (p < 0.01) when compared to the diabetic control group after 28 days of treatment. According to in silico, in vitro, and in vivo validation, SMFE is a prospective medication with anti-diabetic and hypoglycemic effects.
Exploring the Bio-Functional Effect of Single Nucleotide Polymorphisms in the Promoter Region of the TNFSF4, CD28, and PDCD1 Genes
Authors: Chen Ding-Ping , Wen Ying-Hao , Wang Wei-Ting , Lin Wei-Tzu
Published: March 2023

In a prior study, we discovered that hematopoietic stem cell transplantation (HSCT) and/or autoimmune diseases, such as systemic lupus erythematosus, were associated with the rs1234314 C/G and rs45454293 C/T polymorphisms of TNFSF4, the rs5839828 C > del and rs36084323 C > T polymorphisms of PDCD1, and the rs28541784C/T, rs200353921A/T, rs3181096C/T, and rs3181098 G/A polymorphisms of CD28. However, the association does not imply causation. These single nucleotide polymorphisms (SNPs) are all located in the promoter region of these genes, so we used the dual-luminescence reporter assay to explore the effect of single nucleotide polymorphisms (SNPs) on transcriptional activity. For each promoter–reporter with a single SNP mutation, more than 10 independent experiments were carried out, and the difference in transcription activity was compared using one-way ANOVA and Tukey’s honestly significant difference test. The results showed that the G-allele of rs1234314 had 0.32 ± 0.09 times the average amount of relative light units (RLU) compared to the C-allele (p = 0.003), the T-allele of rs45454293 had 4.63 ± 0.92 times the average amount of RLU compared to the C-allele (p < 0.001), the del-allele of rs5839828 had 1.37 ± 0.24 times the average amount of RLU compared to the G-allele (p < 0.001), and the T-allele of rs36084323 had 0.68 ± 0.07 times the average amount of RLU compared to the C-allele (p < 0.001). The CD28 SNPs studied here did not affect transcriptional activity. In conclusion, the findings of this study could only confirm that the SNP had a bio-functional effect on gene expression levels. According to the findings, several SNPs in the same gene have bio-functions that affect transcriptional activity. However, some increase transcriptional activity while others decrease it. Consequently, we inferred that the final protein level should be the integration result of the co-regulation of all the SNPs with the effect on transcriptional activity.
A Comparison of 13C-Methacetin and 13C-Octanoate Breath Test for the Evaluation of Nonalcoholic Steatohepatitis
Authors: Fierbinteanu-Braticevici Carmen , Enciu Vlad-Teodor , Calin-Necula Ana-Maria , Papacocea Ioana Raluca , Moldoveanu Alexandru Constantin
Published: March 2023

Background: While non-alcoholic fatty liver disease (NAFLD) is a wide-spread liver disease, only some patients progress towards steatohepatitis and cirrhosis. Aim: We comparatively analyzed the methacetin breath test (MBT) for the microsomal function of the liver and the octanoate breath test (OBT) for mitochondrial activity, in detecting patients with steatohepatitis and estimating fibrosis. Methods: 81 patients with histologically proven NAFLD (SAF score) were evaluated. The parameters used for both breath tests were the dose/h and the cumulative dose recovery at multiple timepoints. The statistical association between histological diagnosis and breath test results used Independent Samples t Test. The accuracy for diagnosis was evaluated using area under the receiver operator characteristic (AUROC) and the sensitivity and specificity were assessed using the Youden J method. Results: Both MBT and OBT were able to differentiate patients with simple steatosis from NASH and to stratify patients with significant fibrosis and cirrhosis (p-values < 0.001 for most analyzed timepoints). The best parameter for NASH diagnosis was OBT dose at 30 min. In the case of significant fibrosis, the most accurate test was MBT cumulative dose at 30 min. Conclusions: Both MBR and OBT tests are potentially useful tools in assessing patients with NAFLD.
The Role of the Mycobiome in Women’s Health
Authors: Esposito Michelle Marie , Patsakos Savannah , Borruso Larisa
Published: March 2023

Although the human bacteriome and virome have gained a great deal of attention over the years, the human mycobiome has been far more neglected despite having significant value and implications in human health. In women, mycobiome profiles in breastmilk, vaginal regions, the gut, skin, and the oral cavity can provide insight into women’s health, diseases, and microbiome dysbiosis. Analyses of mycobiome composition under factors, such as health, age, diet, weight, and drug exposure (including antibiotic therapies), help to elucidate the various roles of women’s mycobiome in homeostasis, microbiome interactions (synergistic and antagonistic), and health. This review summarizes the most recent updates to mycobiome knowledge in these critical areas.
Ecosystem Protection through Myco-Remediation of Chromium and Arsenic
Authors: Kamal Neel , Parshad Jagdish , Saharan Baljeet Singh , Kayasth Monika , Mudgal Vishal , Duhan Joginder Singh , Mandal Balwan Singh , Sadh Pardeep Kumar
Published: March 2023

The current study emphasizes fungi as an important tool against heavy metals and how isolated fungal species can be used to create a successful strategy for the bioremediation of chromium and arsenic-contaminated sites/soils. Globally, heavy metal pollution is a serious issue. In the current investigation, contaminated sites were chosen, and samples could be taken from various localities of Hisar (29.1492° N, 75.7217° E) and Panipat (29.3909° N, 76.9635° E), India. A total of 19 fungal isolates were obtained from the collected samples through the enrichment culture technique using PDA media supplemented with Cr as chromic chloride hexahydrate (50 mg/L) and As as sodium arsenate (10 mg/L) and the potential of fungal isolates to be used for the removal of heavy metals was examined. The isolates were screened for minimum inhibitory concentrations (MIC) exhibiting tolerance capabilities, and the four best isolates C1, C3, A2, and A6 with the highest MICs (>5000 mg/L), were chosen for further investigations. To use the chosen isolates in the remediation of heavy metals (Cr and As), the culture conditions were optimized. The fungal isolates C1 and C3 estimated the highest removal of 58.60% and 57.00% at 50 mg/L chromium concentration, while the isolates A6 and A2 recorded the highest removal efficiency of 80% and 56% at 10 mg/L arsenic concentration under optimal conditions. Finally, the chosen fungal isolates C1 and A6 were molecularly identified as Aspergillus tamarii and Aspergillus ustus, respectively.
IgG4-Related Oesophageal Disease with Cytomegalovirus Infection: A Case Report
Authors: Zhang Bacui , Lai Yuexing , Xu Yongwei , Wang Jing , Xu Ping
Published: March 2023

Immunoglobulin G4-related disease (IgG4-RD) is a fibrous inflammatory process related to immunomodulation. The involvement of the pancreato-biliary tract, retroperitoneum/aorta, head and neck, and salivary glands are the most frequently observed disease phenotypes, differing in their epidemiological features, serological findings, and prognostic outcomes. IgG4-RD was combined with oesophageal ulcers, and the patients were infected with cytomegalovirus at the time of the examination. This constituted a huge challenge in the diagnosis and treatment of oesophageal ulcers. We report the case of a 53-year-old male who experienced nausea, vomiting, and anaemia recurrently for many years. According to his medical records, an upper gastrointestinal endoscopy revealed an oesophageal ulcer, and he had had numerous hospital visits for anaemia but with no definitive diagnosis, and he had responded poorly to therapy. However, with persistent symptoms, he came to our hospital and, according to the results of the upper gastrointestinal endoscopy, a serum IgG4 test, and histopathological and immunohistochemical staining, he was finally diagnosed with IgG4-related oesophageal disease combined with a cytomegalovirus infection. We hope that through this case, we can learn more about IgG4-RD and, at the same time, give clinicians a better understanding of IgG4-RD combined with oesophageal ulceration, a new understanding of cytomegalovirus infections, and improved clinical knowledge.
Impact of the First and Second Lockdown for COVID-19 Pandemic on Preterm Birth, Low Birth Weight, Stillbirth, Mode of Labor, and of Delivery in Lombardy, Italy
Authors: Esposito Giovanna , Rossi Marta , Favilli Alessandro , Franchi Matteo , Corrao Giovanni , Parazzini Fabio , La Vecchia Carlo
Published: March 2023

We investigated the effect of lockdown measures implemented in Lombardy on selected obstetric and perinatal outcomes. Births that occurred during the two lockdowns imposed (i.e., the first from 16 March to 2 June 2020 and the second from 3 November 2020 to 5 April 2021) and the comparison periods (i.e., the first from 16 March to 2 June 2018 and the second from 3 November 2018 to 5 April 2019) were identified using regional healthcare databases. The distribution of births according to the selected outcomes was computed and the Chi-square test was used for testing differences in the periods compared. During the two lockdowns, we observed a lower proportion of low birth weight, from 6.8% in the comparison period to 6.1% in the first lockdown (p = 0.019), and from 6.5% to 6.1% in the second one (p = 0.109). The proportion of preterm births decreased from 6.8% to 6.3% in the first lockdown (p = 0.097), and from 6.2% to 6.0% in the second one (p = 0.172). No differences in stillbirth rate emerged for both lockdowns. Induction of labor was more frequent during both lockdowns, from 28.6% to 32.7% in the first (p < 0.0001), and from 29.9% to 33.2% in the second one (p < 0.0001). Cesarean section was less frequent during the second lockdown.