bluuebunny/crossref_metadata_2025 huggingface dataset:
Performance of the Toddler and Infant (TANDI) Health-Related Quality of Life Instrument in 3–4-Year-Old Children
Authors: Verstraete Janine , Lloyd Andrew J. , Jelsma Jennifer
Published: October 2021

The Toddler and Infant (TANDI) dimensions of Health-Related Quality of Life assess ‘age appropriate’ behaviour and measurement could be extended to older children. A sample of 203 children 3–4 years of age was recruited, and their caregivers completed the TANDI, Pediatric Quality of Life Inventory (PedsQL) and EQ-5D-Y Proxy. Spearman and Pearson’s correlation coefficients, and Kruskal–Wallis H-test were used to explore the feasibility, known-group validity, discriminate validity and concurrent validity of the TANDI. Children with a health condition (n = 142) had a lower ceiling effect (p = 0.010) and more unique health profiles (p < 0.001) than the healthy group (n = 61). The TANDI discriminated between those with and without a health condition. In children with a health condition, the TANDI discriminated between clinician rated severity of the health condition. The TANDI had moderate to strong correlations with similar PedsQL and EQ-5D-Y items and scores. The TANDI is valid for children aged 3–4 years and is recommended for children with a health condition, whereas the PedsQL may be better for healthy children. The TANDI is recommended for studies with young children whereas the EQ-5D-Y Proxy is recommended for a sample including older children or for longitudinal studies with preschoolers. Further work on the TANDI is recommended to establish test-retest reliability and responsiveness.
Parental Internalizing Psychopathology and PTSD in Offspring after the 2012 Earthquake in Italy
Authors: Forresi Barbara , Caputi Marcella , Scaini Simona , Caffo Ernesto , Aggazzotti Gabriella , Righi Elena
Published: October 2021

Post-traumatic stress disorder (PTSD) is common in youths after earthquakes, with parental psychopathology among the most significant predictors. This study investigated the contribution and the interactional effects of parental internalizing psychopathology, the severity of exposure to the earthquake, and past traumatic events to predict PTSD in offspring, also testing the reverse pattern. Two years after the 2012 earthquake in Italy, 843 children and adolescents (9–15 years) living in two differently affected areas were administered a questionnaire on traumatic exposure and the UCLA PTSD Reaction Index. Anxiety, depression, and somatization were assessed in 1162 parents through the SCL-90-R. General linear model showed that, for offspring in the high-impact area, predictors of PTSD were earthquake exposure, past trauma, and parental internalizing symptoms, taken individually. An interaction between earthquake exposure and parental depression or anxiety (not somatization) was also found. In the low-impact area, youth PTSD was only predicted by earthquake exposure. The reverse pattern was significant, with parental psychopathology explained by offspring PTSD. Overall, findings support the association between parental and offspring psychopathology after natural disasters, emphasizing the importance of environmental factors in this relationship. Although further research is needed, these results should be carefully considered when developing mental health interventions.
Socioeconomic Factors and Quality of Life Perceived by Parents and Children with Complex Chronic Conditions in Spain
Authors: Pérez-Ardanaz Bibiana , Peláez-Cantero María José , Morales-Asencio José Miguel , Vellido-González Concepción , Gómez-González Alberto , León-Campos Álvaro , Gutiérrez-Rodríguez Laura
Published: October 2021

Health-related quality of life of children with complex chronic conditions could be affected by sociodemographic factors. Most studies focus exclusively on the parents’ perceptions of quality of life. This study aimed to determine the health-related quality of life of these children, according to their parents and the children themselves. A cross-sectional study was developed on children aged over five years with complex chronic conditions. Health-related quality of life, educational attainment, and social status were evaluated. A total of 101 children were included with a mean age of 10.48 years, and 35.6% were female. The most frequent disease was oncological (28.7%). Children perceived a better health-related quality of life, compared to their parents’ assessment: median difference −8.4 (95%CI: −9.2 to −3.8). Moreover, differences were observed by socioeconomic factors. Parents and children with complex chronic conditions perceive differently the health-related quality of life. Social determinants associate with an uneven perceived quality of life.
Exploring the Relation between Atopic Diseases and Lifestyle Patterns among Adolescents Living in Greece: Evidence from the Greek Global Asthma Network (GAN) Cross-Sectional Study
Authors: Antonogeorgos George , Priftis Kostas N. , Panagiotakos Demosthenes B. , Ellwood Philippa , García-Marcos Luis , Liakou Evangelia , Koutsokera Alexandra , Drakontaeidis Pavlos , Moriki Dafni , Thanasia Marina , Mandrapylia Maria , Douros Konstantinos
Published: October 2021

Introduction: Diet and physical activity might be associated with the risk of allergic diseases in childhood. However, evidence in literature is sparse and diverse. We aim to examine the associations between four healthy dietary consumption pattern drinks, plus the adherence to a physically active lifestyle with atopic diseases (asthma, allergic rhinitis and eczema) in adolescence and their relative importance. Methods: A total of 1934 adolescents (921 boys, 47.5%) and their parents completed a validated questionnaire assessing atopic diseases’ symptoms prevalence in the past 12 months, as well as nutritional and physical activity information. Four healthy dietary and one physical active lifestyle patterns were identified and logistic regression was applied to assess their relation with allergic diseases. Results: A high weekly consumption of fruits, vegetables and pulses and low consumption of unhealthy foods was negatively associated with all atopic symptoms while adherence to a physical active lifestyle was inversely associated with asthma and allergic rhinitis symptoms and dairy products with asthma and eczema symptoms in the past 12 months after adjustment for several confounders (all p < 0.05). Fruits, vegetables and pulses consumption per week emerged as the most important lifestyle pattern negatively associated for all atopic diseases, after the adjustment for all the remaining lifestyle patterns and confounders (all p < 0.05) Conclusions: Our findings suggest that a high fruit, vegetable and pulse intake should be the first lifestyle intervention every clinician and public health care worker evolving in the management of atopic adolescents should encourage and promote.
Diagnosis and Treatment for Pediatric Supracondylar Humerus Fractures with Brachial Artery Injuries
Authors: Vu Tu Ngoc , Phung Son Hong Duy , Vo Long Hoang , Nguyen Uoc Huu
Published: October 2021

(1) Background: This study aims to describe the clinical and paraclinical characteristics of and the diagnostic approach to brachial artery injuries in pediatric supracondylar humerus fractures, as well as to evaluate intraoperative vascular anatomical lesions and early postoperative results. (2) Methods: A retrospective, hospital-based analysis of medical records at Viet Duc University Hospital (Vietnam), using a sample of children under 16 years who met the diagnostic criteria for supracondylar humerus fractures with brachial artery injuries between January 2016 and December 2020, was performed. A total of 50 patients were included in the analysis. (3) Results: Out of 50 pediatric patients, 36 patients were male (72%) and the mean age was 5.85 years (range, 1.5–14 years). Before treatment, there were 46 patients with severely displaced fractures which were classified as Gartland type III (92%). Following casting, the percentage of those with severely displaced fractures was reduced significantly to 12%, while there were no patients with Gartland type III fractures after percutaneous pinning. Doppler sonography failed to assess vascular lesions at the fracture site before and after casting in most patients. Two-thirds of surgical cases had only vasospasm, without physical damage to the vessel wall or intravascular thrombosis. Preoperative Doppler spectrum analysis was not consistent with the severity of intraoperative brachial artery injury. Out of 24 patients with vasospasm, we performed vascular blockade using papaverin in 11 cases and intraoperative balloon angioplasty of the brachial artery using the Fogarty catheter in 13 cases. Brachial artery graft was performed with 12 patients who had anatomical damage to the vascular wall. A complication of embolism occurred in one patient immediately after surgery, and two patients had superficial infections. One month following surgery, 2 out of 36 patients had a temporary loss of sensation in the area of incision. (4) Conclusions: Most pediatric patients did not present with symptoms of critical limb ischemia similar to those associated with lower extremity vascular injuries. The diagnosis and treatment of pediatric supracondylar humerus fractures with vascular injury is difficult and time-consuming, especially in cases of transverse fractures.
Amblyopia and Routine Eye Exam in Children: Parent’s Perspective
Authors: Alatawi Alhanouf , Alali Naif , Alamrani Abrar , Hashem Faris , Alhemaidi Seham , Alreshidi Shaker , Albalawi Hani
Published: October 2021

Amblyopia is a reduced best-corrected visual acuity of one or both eyes that cannot be attributed to a structural abnormality; it is a functional reduction in the vision of an eye caused by disuse during a critical period of visual development. It is considered the leading cause of visual defects in children. With early diagnosis and treatment, children with amblyopia can significantly improve their vision. However, if it is neglected and not treated during childhood, unfortunately, it permanently decreases vision. Therefore, prevention, detection, and treatment largely depend on parents. This article explores parents’ perspectives on amblyopia and routine examination of their children’s eyes. A cross-sectional study used an electronic questionnaire consisting of five main sections to assess the level of awareness of amblyopia among parents. As a result, a total of 325 participants were included in our analysis. 209 (64.3%) were mothers, and 116 (35/7%) were fathers. The age groups were 35–50 years of age (61.5%), 20–34 years (23.4%), and older than 50 years (15%). Participants with a history of amblyopia numbered 23 (7.1%), and 39 had an amblyopic child (12%). A good awareness level of amblyopia among parents was found in only 10 (3%) participants, a fair awareness level in 202 (62%), and 113 (35%) participants were classified as having a poor awareness level of amblyopia. Only 13.8% of the parents took their children for yearly routine eye exams, while the majority (72%) took their children only if they had a complaint, and 14.2% took them for eye checkups only before school entry. In conclusion, parents’ awareness of amblyopia in Tabuk City, KSA, was low. In addition, a limited proportion of parents reported consistently taking their children for routine eye exams. Therefore, raising awareness should be considered in public education regarding the disease.
FLII and MLL1 Cooperatively Regulate Aryl Hydrocarbon Receptor-Mediated Transcription in ARPE-19 Cells
Authors: Jeong Kwang Won
Published: October 2021

Aryl hydrocarbon receptors (AHRs), a class of ligand-dependent nuclear receptors that regulate cellular responses by inducing the expression of various target genes in response to external signals, are implicated in maintaining retinal tissue homeostasis. Previous studies have shown that the regulation of AHR-induced gene expression requires transcriptional co-regulators. However, it is not yet clear how chromatin remodelers, histone methyltransferases and coactivators interact during AHR-mediated gene expression in human retinal cells. In this study, we reveal that the histone methyltransferase MLL1 and the coactivator FLII are involved in AHR-mediated gene expression in retinal pigment epithelial cells. 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) significantly increased the expression of CYP1A1, CYP1B1 and AHRR in ARPE-19 cells, whereas FLII or MLL1 depletion significantly reduced the expression of these genes induced by TCDD. Mechanistically, FLII binds to AHR in a ligand-dependent manner in ARPE-19 cells. In particular, the binding of FLII to MLL1 occurs through the GelB domain of FLII. In addition, MLL1 binds to AHR in a ligand-independent manner. FLII is involved in the recruitment of the BRG1 chromatin remodeler and MLL1 histone methyltransferase to the AHR-regulated CYP1A1 gene region in ARPE-19 cells and consequently, plays an important role in RNA polymerase II binding and transcriptional activity by modulating chromatin accessibility. Our results identify the functions and mechanisms of action of FLII and MLL1 in AHR-induced gene expression in human retinal pigment epithelial cells.
Water Sensitive Cities: An Integrated Approach to Enhance Urban Flood Resilience in Parma (Northern Italy)
Authors: Dada Arianna , Urich Christian , Berteni Francesca , Pezzagno Michèle , Piro Patrizia , Grossi Giovanna
Published: October 2021

Climate change is globally causing more intense meteorological phenomena. Our cities experience increased rainfall intensity, more intense heat waves, and prolonged droughts providing economic, social, health and environmental challenges. Combined with population growth and rapid urbanization, the increasing impact of climate change will make our cities more and more vulnerable, especially to urban flooding. In order to adapt our urban water systems to these challenges, the adoption of newly emerging water management strategies is required. The complexity and scale of this challenge calls for the integration of knowledge from different disciplines and collaborative approaches. The water sensitive cities principles provide guidance for developing new techniques, strategies, policies, and tools to improve the livability, sustainability, and resilience of cities. In this study, the DAnCE4Water modeling approach promoting the development of water sensitive cities was applied to Parma, an Italian town that has faced serious water issues in the last few years. The city, indeed, had to face the consequences of flooding several times, caused by the inadequacy of both the network of open channels and the sewerage network due to the urban expansion and climate change of the last 30 years. Through the model, the efficiency of decentralized technologies, such as green roofs and porous pavement, and their integration with the existing centralized combined sewer system was assessed under a range of urban development scenarios. The obtained results show that the adoption of an integrated approach, including soft engineering hydraulic strategies, consisting in the use of natural and sustainable solutions, can increase resilience to urban flooding. Further, the study shows that there is a critical need for strategic investment in solutions that will deliver long-term sustainable outcomes.
Measurement of Stress Optic Coefficient for Thermal Barrier Coating Based on Terahertz Time-Domain Spectrum
Authors: Wang Zong , Zhang Yanheng , Lu Ning , Wang Zhiyong , Qiu Wei
Published: October 2021

The residual stress introduced inside the thermal barrier coating (TBC) top coating during manufacturing and service processes is one of the main causes of thermal barrier failure. Therefore, a nondestructive and accurate measurement of the residual stress in top coating is essential for the evaluation of TBC life. The terahertz time-domain spectroscopy (THz-TDS) technique, which is based on the calibration or measurement of the stress optical coefficients of the measured materials, is applicable to the measuring of internal stress of nonmetal materials. In this work, to characterize the internal stress in TBC, the stress optic coefficient of the TBC top coating was measured by reflection-type THz-TDS. First, the mechanics model for the internal stress measurement in a TBC top coating was derived based on the photoelastic theory. Then, the THz time-domain spectra of TBC specimens under different loadings were measured in situ by a reflection-type THz-TDS system. Finally, the unimodal fitting, multimodal fitting and barycenter methods were used to carry out the data processing of the THz time-domain spectral-characteristic peaks. By comparing the processed results, the results using the barycenter method were regarded as the calibrated stress optical coefficient of the TBC due to the method’s sufficient accuracy and stability.
Electrophoretic Mobility and Electric Conductivity of Salt-Free Suspensions of Charged Soft Particles
Authors: Lin Wei C. , Keh Huan J.
Published: October 2021

A unit cell model is employed to analyze the electrophoresis and electric conduction in a concentrated suspension of spherical charged soft particles (each is a hard core coated with a porous polyelectrolyte layer) in a salt-free medium. The linearized Poisson–Boltzmann equation applicable to a unit cell is solved for the equilibrium electrostatic potential distribution in the liquid solution containing the counterions only surrounding a soft particle. The counterionic continuity equation and modified Stokes/Brinkman equations are solved for the ionic electrochemical potential energy and fluid velocity distributions, respectively. Closed-form formulas for the electrophoretic mobility of the soft particles and effective electric conductivity of the suspension are derived, and the effect of particle interactions on these transport characteristics is interesting and significant. Same as the case in a suspension containing added electrolytes under the Debye–Hückel approximation, the scaled electrophoretic mobility in a salt-free suspension is an increasing function of the fixed charge density of the soft particles and decreases with increases in the core-to-particle radius ratio, ratio of the particle radius to the permeation length in the porous layer, and particle volume fraction, keeping the other parameters unchanged. The normalized effective electric conductivity of the salt-free suspension also increases with an increase in the fixed charge density and with a decrease in the core-to-particle radius ratio, but is not a monotonic function of the particle volume fraction.
A Language for Modeling and Optimizing Experimental Biological Protocols
Authors: Cardelli Luca , Kwiatkowska Marta , Laurenti Luca
Published: October 2021

Automation is becoming ubiquitous in all laboratory activities, moving towards precisely defined and codified laboratory protocols. However, the integration between laboratory protocols and mathematical models is still lacking. Models describe physical processes, while protocols define the steps carried out during an experiment: neither cover the domain of the other, although they both attempt to characterize the same phenomena. We should ideally start from an integrated description of both the model and the steps carried out to test it, to concurrently analyze uncertainties in model parameters, equipment tolerances, and data collection. To this end, we present a language to model and optimize experimental biochemical protocols that facilitates such an integrated description, and that can be combined with experimental data. We provide probabilistic semantics for our language in terms of Gaussian processes (GPs) based on the linear noise approximation (LNA) that formally characterizes the uncertainties in the data collection, the underlying model, and the protocol operations. In a set of case studies, we illustrate how the resulting framework allows for automated analysis and optimization of experimental protocols, including Gibson assembly protocols.
Estimation of Daily Reproduction Numbers during the COVID-19 Outbreak
Authors: Demongeot Jacques , Oshinubi Kayode , Rachdi Mustapha , Seligmann Hervé , Thuderoz Florence , Waku Jules
Published: October 2021

(1) Background: The estimation of daily reproduction numbers throughout the contagiousness period is rarely considered, and only their sum R0 is calculated to quantify the contagiousness level of an infectious disease. (2) Methods: We provide the equation of the discrete dynamics of the epidemic’s growth and obtain an estimation of the daily reproduction numbers by using a deconvolution technique on a series of new COVID-19 cases. (3) Results: We provide both simulation results and estimations for several countries and waves of the COVID-19 outbreak. (4) Discussion: We discuss the role of noise on the stability of the epidemic’s dynamics. (5) Conclusions: We consider the possibility of improving the estimation of the distribution of daily reproduction numbers during the contagiousness period by taking into account the heterogeneity due to several host age classes.
Ready Teacher One: Virtual and Augmented Reality Online Professional Development for K-12 School Teachers
Authors: Mystakidis Stylianos , Fragkaki Maria , Filippousis Giorgos
Published: October 2021

Augmented reality (AR) and virtual reality (VR) are two technologies with the potential to enhance learning quality by activating episodic student memory. In this manuscript we outline the pedagogical benefits of AR and VR as well as the rationale, design, development, and pilot evaluation results from an in-service teacher online professional development program (OPD) on AR and VR linked with research activities. More specifically, we examined the “Augmented and Virtual Reality in Teaching and Learning” OPD course aimed at K-12 educators in a European country combining pedagogically informed methods such as inquiry-based learning and digital storytelling. Findings from a mixed-method research using questionnaires and focus groups indicate that AR- and VR-based pedagogical scenarios can be integrated effectively into everyday school teaching practice. The study also outlines implications and limitations that policy makers, education leaders, and educators need to consider for efficient institution-wide deployment of AR and VR technologies.
Shape Memory Properties and Microstructure of New Iron-Based FeNiCoAlTiNb Shape Memory Alloys
Authors: Tseng Li-Wei , Chen Chih-Hsuan , Chen Wei-Cheng , Cheng Yu , Lu Nian-Hu
Published: October 2021

The shape memory properties and microstructure of Fe41Ni28Co17Al11.5(Ti+Nb)2.5 (at.%) cold-rolled alloys were studied at the first time using the values reported in constant stress thermal cycling experiments in a three-point bending test. Thermo-magnetization curves of 97% cold-rolled and solution-treated sample aged at 600 °C for 24, 48 and 72 h showed evidence of the martensitic transformation, and the transformation temperatures increased their values from 24 to 72 h. The alloy cold-rolled to 97% and then solution-treated at 1277 °C for 1 h showed that most grains were aligned near <100> in the rolling direction in the recrystallization texture. The intensity of texture was 13.54, and an average grain size was around 400 μm. The sample aged at 600 °C for 48 h showed fully recoverable strain up to 1.6% at 200 MPa stress level in the three-point bending test. However, the experimental recoverable strain values were lower than the theoretical values, possibly due to the small volume fraction of low angle grain boundary, the formation of brittle grain boundary precipitates, and a grain boundary constraint lower than the expected intensity of texture in the samples.
Characterization, X-ray Absorption Spectroscopic Analysis and Photocatalytic Activity of Co/Zn Co-Doped TiO2 Nanoparticles Synthesized by One-Step Sonochemical Process
Authors: Mekprasart Wanichaya , Pavasupree Sorapong , Jayasankar C. , Ravuri Balaji , Wattanawikkam Chakkaphan , Pecharapa Wisanu
Published: October 2021

A novel one-step preparation of sonochemical method was applied to synthesize Co/Zn co-doped TiO2 nanoparticles using a sonicator of 750 W, 20 kHz for 30 min at room temperature. The formation of the anatase TiO2 phase for all as-prepared samples was observed from XRD results with a crystalline size in nanoscale. The use of ultrasound allowed for the successful doping of both Co and Zn into the TiO2 lattice, which was confirmed by Synchrotron light including X-ray near edge structure (XANES) and Extended X-ray absorption fine structure (EXAFS) spectroscopy. Ti K-edge, Co K-edge, and Zn K-edge XANES spectra exhibited the dominating +4, +2, and +2 valence state of Ti, Co, and Zn in as-prepared samples, respectively. A detailed XANES and EXAFS data analysis give strong evidence that the Co/Zn dopants partially replace the Ti atom of the TiO2 host. The Co/Zn co-doping extends the light absorption of the host to the visible region and restricts the e+/h+ recombination. The photocatalytic activity of samples was tested for degradation of Rhodamine B dye solution under visible light irradiation. The as-synthesized of the co-doped catalyst was presented as highly efficient, with 2.5 and 5 times dye degradation compared with single-doped and bare TiO2.
Oxidative Thermal Conversion of Hydrothermal Derived Precursors toward the Mixed-Metal Cobaltite Spinel Oxides (ZnCo2O4 and NiCo2O4): In-Situ Investigation by Synchrotron-Radiation XRD and XAS Techniques
Authors: Deeloed Wanchai , Hanlumyuang Yuranan , Limphirat Wanwisa , Suramitr Songwut , Chansaenpak Kantapat , Kanjanaboos Pongsakorn , Wannapaiboon Suttipong , Wattanathana Worawat
Published: October 2021

In-situ investigations of structural transitions during the thermal-oxidative event of mixed-metal spinel oxide precursors, the so-called nickel- (NCO) and zinc-containing (ZCO) cobaltite spinel precursors, were investigated to understand the formations of the derived NiCo2O4 and ZnCo2O4 spinel oxides, respectively. In-situ XRD investigation revealed that emerged temperatures for spinel oxide phase were between 325 and 400 °C, depending on the cationic substituent. It indicated that the emerged temperature correlated with the absolute octahedral site preference energy (OSPE) of those cations that participated in the development of the spinel framework. Moreover, the incorporated nickel and zinc in the precursors was beneficial for inhibiting the occurrence of the undesired CoO phase. Time-resolved X-ray absorption spectroscopic (TRXAS) data suggested the local structure rearrangement of nickel and zinc throughout the calcination process, which differed from the behavior of single-metal cobalt system. The essential information reported herein provides a benefit to control the cationic distribution within spinel materials, leading to the tunable physical and chemical properties.
Impediment of Iron Corrosion by N,N′-Bis[2-hydroxynaphthylidene]amino]oxamide in 3.5% NaCl Solution
Authors: Sherif El-Sayed M. , Ahmed Ayman H. , Abdo Hany S. , DefAllah Monerah N.
Published: October 2021

Hydrazone [N,N′-bis[2-hydroxynaphthylidene]amino]oxamide] derived from the condensation of ethanedihydrazide with 2-hydroxynaphthalene-1-carbaldehyde was synthesized and assessed on the basis of elemental analysis (CHN) and spectral (IR, mass, 13C/1H NMR and UV-Vis) measurements. The influence of N,N-bis([2-hydroxynaphthylidene]amino)oxamide (HAO) in terms of the inhibition of iron corrosion in concentrated sodium chloride solution (3.5 wt.% NaCl) after various exposure periods was assessed. Numerous electrochemical and spectroscopic assessment techniques were performed. Cyclic potentiodynamic polarization experiments indicated that the presence of HAO and its increased concentration decreased the corrosion of iron in NaCl solution by decreasing the corrosion values, anodic and cathodic currents, and corrosion rate. The electrochemical impedance spectroscopy results showed that HAO molecules greatly increased the corrosion resistance. The chronoamperometric experiments performed at −475 mV (Ag/AgCl) revealed that the HAO molecules decreased the absolute currents and reduced the probability of the occurrence of pitting corrosion. The effect of HAO on the inhibition of iron corrosion was also confirmed through scanning electron microscopy micrographs and energy-dispersive X-ray profile analyses, which proved that the surface of the iron sample exposed to chloride solution alone was pitted, while the presence of HAO molecules reduced the severity of the pitting corrosion. The results confirmed that the presence of HAO molecules inhibits the corrosion of iron and this impact increased when the exposure time was increased to 48 h.
Effectiveness and Safety of First-Line Pembrolizumab in Older Adults with PD-L1 Positive Non-Small Cell Lung Cancer: A Retrospective Cohort Study of the Alberta Immunotherapy Database
Authors: Grosjean Heidi A. I. , Dolter Samantha , Meyers Daniel E. , Ding Philip Q. , Stukalin Igor , Goutam Siddhartha , Kong Shiying , Chu Quincy , Heng Daniel Y. C. , Bebb D. Gwyn , Morris Don G. , Cheung Winson Y. , Pabani Aliyah
Published: October 2021

The emergence of immunotherapy revolutionized the treatment of non-small-cell-lung cancer (NSCLC), with multiple landmark clinical trials establishing the efficacy of these agents. However, many patients who receive immunotherapy in clinical practice would be considered clinical trial ineligible. One such population that is often under-represented in clinical trials is older adults. In the current study, we evaluated clinical and safety outcomes in this population. Overall, older adults (>70 years of age) and younger adults had comparable clinical outcomes with an equivalent objective response rate (ORR), time to treatment failure (TTF), and median overall survival (p = 0.67, p = 0.98, and p = 0.91, respectively). Furthermore, the safety outcomes were equivalent between the cohorts with similar rates of immune-related adverse events (irAEs), irAE-related hospitalizations, and all-cause hospitalization (p = 0.99, p = 0.63, and p = 0.74, respectively). While older age was not found to impact overall survival, multivariant analysis revealed that a poor Eastern Cooperative Oncology Group (ECOG) status, low body-mass-index (BMI), and poor/intermediate lung immune prognostic index (LIPI) were all associated with worse survival. In conclusion, age does not impact the efficacy or safety of pembrolizumab in NSCLC, and therefore advanced age should not be a deterrent for treating these patients with pembrolizumab. Physicians and care providers can thus focus on other factors that may influence therapeutic outcomes.
The Natural Capital Value of the Seagrass Posidonia oceanica in the North-Western Mediterranean
Authors: Rigo Ilaria , Paoli Chiara , Dapueto Giulia , Pergent-Martini Christine , Pergent Gerard , Oprandi Alice , Montefalcone Monica , Bianchi Carlo Nike , Morri Carla , Vassallo Paolo
Published: October 2021

Posidonia oceanica is an endemic Mediterranean seagrass used as a ‘biological quality element’ in monitoring programmes of the EU Water Framework Directive, providing information about coastal ecosystems status. The regression of P. oceanica meadows caused a growing interest among policy makers to assess the value of seagrasses and to increase their protection. An evaluation of P. oceanica meadows located in the Ligurian-Provençal basin (NW Mediterranean) through a biophysical approach is here developed. Six meadows located in Liguria (Italy) and Corsica (France) were investigated by applying the emergy analysis to assess the natural capital (NC) stocked by leaves and rhizomes components. Results highlighted the importance of carrying out an analysis of the variations in the NC value in both components: rhizomes defined the growth stage and the capacity to store NC over time; leaves provided information on the variability due to disturbances in the water column. Emergy analysis allows defining the NC, in terms of resources needed to maintain the meadows and to provide services to coastal communities. This research is inserted into the effort of incorporating the NC evaluation into marine planning and decision making to achieve nature conservation goals, while ensuring the sustainable exploitation of marine resources.
Before and after Endovascular Aortic Repair in the Same Patients with Aortic Dissection: A Cohort Study of Four-Dimensional Phase-Contrast Magnetic Resonance Imaging
Authors: Chen Chien-Wei , Fang Yueh-Fu , Tseng Yuan-Hsi , Wong Min Yi , Lin Yu-Hui , Hsu Yin-Chen , Lin Bor-Shyh , Huang Yao-Kuang
Published: October 2021

(1) Background: We used four-dimensional phase-contrast magnetic resonance imaging (4D PC-MRI) to evaluate the impact of an endovascular aortic repair (TEVAR) on aortic dissection. (2) Methods: A total of 10 patients received 4D PC-MRI on a 1.5-T MR both before and after TEVAR. (3) Results: The aortas were repaired with either a GORE TAG Stent (Gore Medical; n = 7) or Zenith Dissection Endovascular Stent (Cook Medical; n = 3). TEVAR increased the forward flow volume of the true lumen (TL) (at the abdominal aorta, p = 0.047). TEVAR also reduced the regurgitant fraction in the TL at the descending aorta but increased it in the false lumen (FL). After TEVAR, the stroke distance increased in the TL (at descending and abdominal aorta, p = 0.018 and 0.015), indicating more effective blood transport per heartbeat. Post-stenting quantitative flow revealed that the reductions in stroke volume, backward flow volume, and absolute stroke volume were greater when covered stents were used than when bare stents were used in the FL of the descending aorta. Bare stents had a higher backward flow volume than covered stents did. (4) Conclusions: TEVAR increased the stroke volume in the TL and increased the regurgitant fraction in the FL in patients with aortic dissection.
Do We Really Need Hazard Prevention at the Expense of Safeguarding Death Dignity in COVID-19?
Authors: Pomara Cristoforo , Sessa Francesco , Galante Domenico , Pace Lorenzo , Fasanella Antonio , Di Nunno Nunzio , Esposito Massimiliano , Salerno Monica
Published: October 2021

To date, little is known regarding the transmission risks of SARS-CoV-2 infection for subjects involved in handling, transporting, and examining deceased persons with known or suspected COVID-19 positivity at the time of death. This experimental study aims to define if and/or how long SARS-CoV-2 persists with replication capacity in the tissues of individuals who died with/from COVID-19, thereby generating infectious hazards. Sixteen patients who died with/from COVID-19 who underwent autopsy between April 2020 and April 2021 were included in this study. Based on PMI, all samples were subdivided into two groups: ‘short PMI’ group (eight subjects who were autopsied between 12 to 72 h after death); ‘long PMI’ (eight subjects who were autopsied between 24 to 78 days after death). All patients tested positive for RT-PCR at nasopharyngeal swab both before death and on samples collected during post-mortem investigation. Moreover, a lung specimen was collected and frozen at −80 °C in order to perform viral culture. The result was defined based on the cytopathic effect (subjective reading) combined with the positivity of the RT-PCR test (objective reading) in the supernatant. Only in one sample (PMI 12 h), virus vitality was demonstrated. This study, supported by a literature review, suggests that the risk of cadaveric infection in cases of a person who died from/with COVID-19 is extremely low in the first hours after death, becoming null after 12 h after death, confirming the World Health Organization (WHO) assumed in March 2020 and suggesting that the corpse of a subject who died from/with COVID-19 should be generally considered not infectious.
A Survival Guide for the Rapid Transition to a Fully Digital Workflow: The “Caltagirone Example”
Authors: Fraggetta Filippo , Caputo Alessandro , Guglielmino Rosa , Pellegrino Maria Giovanna , Runza Giampaolo , L'Imperio Vincenzo
Published: October 2021

Digital pathology for the routine assessment of cases for primary diagnosis has been implemented by few laboratories worldwide. The Gravina Hospital in Caltagirone (Sicily, Italy), which collects cases from 7 different hospitals distributed in the Catania area, converted the entire workflow to digital starting from 2019. Before the transition, the Caltagirone pathology laboratory was characterized by a non-tracked workflow, based on paper requests, hand-written blocks and slides, as well as manual assembling and delivering of the cases and glass slides to the pathologists. Moreover, the arrangement of the spaces and offices in the department was illogical and under-productive for the linearity of the workflow. For these reasons, an adequate 2D barcode system for tracking purposes, the redistribution of the spaces inside the laboratory and the implementation of the whole-slide imaging (WSI) technology based on a laboratory information system (LIS)-centric approach were adopted as a needed prerequisite to switch to a digital workflow. The adoption of a dedicated connection for transfer of clinical and administrative data between different software and interfaces using an internationally recognised standard (Health Level 7, HL7) in the pathology department further facilitated the transition, helping in the integration of the LIS with WSI scanners. As per previous reports, the components and devices chosen for the pathologists’ workstations did not significantly impact on the WSI-based reporting phase in primary histological diagnosis. An analysis of all the steps of this transition has been made retrospectively to provide a useful “handy” guide to lead the digital transition of “analog”, non-tracked pathology laboratories following the experience of the Caltagirone pathology department. Following the step-by-step instructions, the implementation of a paperless routine with more standardized and safe processes, the possibility to manage the priority of the cases and to implement artificial intelligence (AI) tools are no more an utopia for every “analog” pathology department.
Reactive Hyperemia-Triggered Wrist Pulse Analysis for Early Monitoring of Young Men with High Atherosclerotic Risk
Authors: Chen Jian-Jung , Wu Hsien-Tsai , Haryadi Bagus
Published: October 2021

The high prevalence of cardiovascular disease in young adults has raised significant concern regarding the early identification of risk factors to allow for timely intervention. This study aimed to identify young males at risk of atherosclerosis using a noninvasive instrument and an initial application percussion entropy analysis of the wrist pressure pulse (WPP). In total, 49 young males aged 18 to 28, without any known history of vascular disease, were recruited. Blood samples were obtained whereby a TC/HDL cutoff value of 4 was used to divide the young men into low-risk (Group 1, TC/HDL < 4, N = 32) and high-risk (Group 2, TC/HDL ≥ 4, N = 17) groups regarding atherosclerosis. The reactive hyperemia-triggered WPPs were measured using a modified air-pressure-sensing system (MAPSS). The dilation index (DI) of the endothelial function and percussion entropy index (PEI) of the heart rate variability (HRV) assessments, calculated using pragmatic signal-processing techniques, were compared between the two groups. The nonparametric Mann–Whitney U test showed that the DI and PEI of the two groups showed statistical differences (both p < 0.05). Not only could the MAPSS assess endothelial function and HRV in young males, but the results also showed that waist circumference and PEI may serve as indicators for the early identification of young males at risk of atherosclerosis.
A Multivariate Model to Predict Chronic Heart Failure after Acute ST-Segment Elevation Myocardial Infarction: Preliminary Study
Authors: Oleynikov Valentin Elievich , Averyanova Elena Vladimirovna , Oreshkina Anastasia Aleksandrovna , Burko Nadezhda Valerievna , Barmenkova Yulia Andreevna , Golubeva Alena Vladimirovna , Galimskaya Vera Aleksandrovna
Published: October 2021

A multivariate model for predicting the risk of decompensated chronic heart failure (CHF) within 48 weeks after ST-segment elevation myocardial infarction (STEMI) has been developed and tested. Methods. The study included 173 patients with acute STEMI aged 51.4 (95% confidence interval (CI): 42–61) years. Two-dimensional (2D) speckle-tracking echocardiography (STE) has been performed on the 7th–9th days, and at the 12th, 24th, and 48th weeks after the index event with the analysis of volumetric parameters and values for global longitudinal strain (GLS), global circumferential strain (GCS), and global radial strain (GRS). A 24-h ECG monitoring (24 h ECG) of the electrocardiogram (ECG) to assess heart rate turbulence (HRT) has been performed on the 7th–9th days of STEMI. The study involved two stages of implementation. At the first stage, a multivariate model to assess the risk of CHF progression within 48 weeks after STEMI has been built on the basis of examination and follow-up data for 113 patients (group M). At the second stage, the performance of the model has been assessed based on a 48-week follow-up of 60 patients (group T). Results. A multivariate regression model for CHF progression in STEMI patients has been created based on the results of the first stage. It included the following parameters: HRT, left ventricular (LV) end-systolic dimension (ESD), and GLS. The contribution of each factor for the relative risk (RR) of decompensated CHF has been found: 3.92 (95% CI: 1.66–9.25) (p = 0.0018) for HRT; 1.04 (95% CI: 1.015–1.07) (p = 0.0027) for ESD; 0.9 (95% CI: 0.815–0.98) (p = 0.028) for GLS. The diagnostic efficiency of the proposed model has been evaluated at the second stage. It appeared to have a high specificity of 83.3%, a sensitivity of 95.8%, and a diagnostic accuracy of 93.3%. Conclusion. The developed model for predicting CHF progression within 48 weeks after STEMI has a high diagnostic efficiency and can be used in early stages of myocardial infarction to stratify the risk of patients.
Patient Heterogeneity in Acute Myeloid Leukemia: Leukemic Cell Communication by Release of Soluble Mediators and Its Effects on Mesenchymal Stem Cells
Authors: Aasebø Elise , Brenner Annette K. , Hernandez-Valladares Maria , Birkeland Even , Mjaavatten Olav , Reikvam Håkon , Selheim Frode , Berven Frode S. , Bruserud Øystein
Published: October 2021

Acute myeloid leukemia (AML) is an aggressive bone marrow malignancy, and non-leukemic stromal cells (including mesenchymal stem cells, MSCs) are involved in leukemogenesis and show AML-supporting effects. We investigated how constitutive extracellular mediator release by primary human AML cells alters proteomic profiles of normal bone marrow MSCs. An average of 6814 proteins (range 6493−6918 proteins) were quantified for 41 MSC cultures supplemented with AML-cell conditioned medium, whereas an average of 6715 proteins (range 6703−6722) were quantified for untreated control MSCs. The AML effect on global MSC proteomic profiles varied between patients. Hierarchical clustering analysis identified 10 patients (5/10 secondary AML) showing more extensive AML-effects on the MSC proteome, whereas the other 31 patients clustered together with the untreated control MSCs and showed less extensive AML-induced effects. These two patient subsets differed especially with regard to MSC levels of extracellular matrix and mitochondrial/metabolic regulatory proteins. Less than 10% of MSC proteins were significantly altered by the exposure to AML-conditioned media; 301 proteins could only be quantified after exposure to conditioned medium and 201 additional proteins were significantly altered compared with the levels in control samples (153 increased, 48 decreased). The AML-modulated MSC proteins formed several interacting networks mainly reflecting intracellular organellar structure/trafficking but also extracellular matrix/cytokine signaling, and a single small network reflecting altered DNA replication. Our results suggest that targeting of intracellular trafficking and/or intercellular communication is a possible therapeutic strategy in AML.
Nonrestorative Management of Dental Caries
Authors: Yu Ollie Yiru , Lam Walter Yu-Hang , Wong Amy Wai-Yee , Duangthip Duangporn , Chu Chun-Hung
Published: October 2021

The World Dental Federation (FDI) policy statement in 2016 advocated evidence-based caries-control measures for managing dental caries. The caries management philosophy has shifted from the traditional surgical manners to minimal intervention dentistry. Minimal intervention dentistry aims to extend the longevity of natural teeth. It places the nonrestorative approaches as a priority. The nonrestorative approaches for caries management aim to tackle the etiological factors of dental caries. Caries can be prevented or reversed by restricting the sugar intake and its frequency in the diet, improving oral hygiene practices, and using fluoride toothpaste. This article aims to present strategies for the nonrestorative management of dental caries, which are divided into four components to address the different etiological factors of dental caries. The first component is controlling dental plaque. Strategies for plaque control include oral hygiene instruction, motivational interviewing, mechanical plaque control, and chemical plaque control. The second component for nonrestorative management is reducing the risk of caries by identifying caries risk factors and protective factors, assessing personal caries risk, and customizing a treatment plan. Evidence-based measures for caries prevention include using fluoride, and dental sealants should be provided. The third component includes topical treatment to remineralise early carious lesions. The last component is long-term follow-up. Appropriate strategy adoption for the nonrestorative management of dental caries prolongs the life span of the teeth and sustains the good oral health of patients.
A Reliable Surgical Procedure for Sinus Floor Augmentation with Antral Pseudocysts
Authors: Nosaka Yasuhiro , Nosaka Hitomi , Nakajima Yasushi , Tanioka Tadasuke , Botticelli Daniele , Baba Shunsuke
Published: October 2021

An antral pseudocyst (AP) is a common well-defined ‘dome-shaped’ faintly radiopaque lesion of the maxillary sinus, and usually does not require treatment in asymptomatic patients. However, when sinus floor augmentation is required to increase bone volume for implant installation, the elevation of the sinus mucosa might drive the AP against the ostium. This might cause its obstruction and, as possible consequence, sinusitis. The purpose of this study was to investigate the clinical and tomographic conditions of APs to identify a predictable cyst removal that might allow a safety sinus floor augmentation. A total of 52 maxillary sinuses in 46 patients (mean age 55.1 years) presenting AP were examined by cone beam computed tomographies (CBCTs). A two-stage approach was applied. At the first surgery, the cystic lesions were further inspected by an endoscope through the antrostomy, and histopathological diagnosis of the removed tissues was carried out. After the confirmation of decrease of the swelling of sinus membrane by CBCT, the sinus floor augmentation was performed, at least four months after cyst removal. The color and transparency of the 86 cystic lesions were classified into 4 types. The whitish transparent cysts were 34 (39.5%), the yellowish transparent cysts were 18 (20.9%), the dark purple transparent cysts were 8 (9.3%) and the milky-white opaque cysts were 26 (30.2%). The contents of the 60 (69.8%) transparent cysts were serous fluid, but those of milky-white cysts were composed of viscous or elastic soft tissues, and the aspiration of the contents was unsuccessful. The analysis of the preoperative CBCT did not provide certainty on the contents of the cystic lesions. All cystic lesions were diagnosed as AP, and an infection was identified in one AP, presenting marked infiltration of the inflammatory cells. Considering the difficulties of performing a correct diagnosis of the AP content by a CBCT analysis, the risk of failure of the surgery that creates severe afflictions to the patients, and the necessity of a histological evaluation of the cyst, a two-stage surgery appeared to be the most reliable procedure.