bluuebunny/crossref_metadata_2025 huggingface dataset:
Academic Advising in Civil Engineering: Design and Evaluation of a Hybrid Model
Authors: Keenahan Jennifer , Casero Miguel , Cotterill Sarah , O’Loughlin Fiachra , O’Sullivan John , Donohue Shane , McCrum Daniel , Gonzalez Arturo , Carroll Páraic , Purcell Patrick
Published: May 2022

A project to formalise and expand Academic Advising has been implemented at the UCD Civil Engineering School. The goals of this project were twofold: on the one hand, it aimed at training faculty members in Academic Advising roles and providing them with the necessary resources. On the other hand, the project sought to expand student interaction, in particular by engaging students informally in order to build a rapport between them and the academic advisors that we expect will bring long term benefits. The resulting model combines elements of both the prescriptive, e.g., formal training, informative talks on key topics, and developmental approaches, e.g., coffee mornings for students and faculty members. The evaluation of the project was carried out through questionnaires and focus groups. It highlighted very positive feedback from the students, who find these new lines of communication with the academic staff to be useful and productive.
Designing an Intelligent Virtual Educational System to Improve the Efficiency of Primary Education in Developing Countries
Authors: Alonso-Secades Vidal , López-Rivero Alfonso-José , Martín-Merino-Acera Manuel , Ruiz-García Manuel-José , Arranz-García Olga
Published: May 2022

Incorporating technology into virtual education encourages educational institutions to demand a migration from the current learning management system towards an intelligent virtual educational system, seeking greater benefit by exploiting the data generated by students in their day-to-day activities. Therefore, the design of these intelligent systems must be performed from a new perspective, which will take advantage of the new analytical functions provided by technologies such as artificial intelligence, big data, educational data mining techniques, and web analytics. This paper focuses on primary education in developing countries, showing the design of an intelligent virtual educational system to improve the efficiency of primary education through recommendations based on reliable data. The intelligent system is formed of four subsystems: data warehousing, analytical data processing, monitoring process and recommender system for educational agents. To illustrate this, the paper contains two dashboards that analyze, respectively, the digital resources usage time and an aggregate profile of teachers’ digital skills, in order to infer new activities that improve efficiency. These intelligent virtual educational systems focus the teaching–learning process on new forms of interaction on an educational future oriented to personalized teaching for the students, and new evaluation and teaching processes for each professor.
Integration and Deployment of Cloud-Based Assistance System in Pharaon Large Scale Pilots—Experiences and Lessons Learned
Authors: Grguric Andrej , Mosmondor Miran , Huljenic Darko
Published: May 2022

The EU project Pharaon aims to support older European adults by integrating digital services, tools, interoperable open platforms, and devices. One of the objectives is to validate the integrated solutions in large-scale pilots. The integration of mature solutions and existing systems is one of the preconditions for the successful realization of the different aims of the pilots. One such solution is an intelligent, privacy-aware home-care assistance system, SmartHabits. After briefly introducing the Pharaon and SmartHabits, the authors propose different Pharaon models in the Ambient/Active Assisted Living (AAL) domain, namely the Pharaon conceptual model, Pharaon reference logical architecture view, AAL ecosystem model, meta AAL ecosystem model, and Pharaon ecosystem and governance models. Building on the proposed models, the authors provide details of the holistic integration and deployment process of the SmartHabits system into the Pharaon ecosystem. Both technical and supporting integration challenges and activities are discussed. Technical activities, including syntactic and semantic integration and securing the transfer of the Pharaon sensitive data, are among the priorities. Supporting activities include achieving legal and regulatory compliance, device procurement, and use-case co-designing in COVID-19 conditions.
Gene-Based Methods for Estimating the Degree of the Skewness of X Chromosome Inactivation
Authors: Li Meng-Kai , Yuan Yu-Xin , Zhu Bin , Wang Kai-Wen , Fung Wing Kam , Zhou Ji-Yuan
Published: May 2022

Skewed X chromosome inactivation (XCI-S) has been reported to be associated with some X-linked diseases, and currently several methods have been proposed to estimate the degree of the XCI-S (denoted as γ) for a single locus. However, no method has been available to estimate γ for genes. Therefore, in this paper, we first propose the point estimate and the penalized point estimate of γ for genes, and then derive its confidence intervals based on the Fieller’s and penalized Fieller’s methods, respectively. Further, we consider the constraint condition of γ∈[0, 2] and propose the Bayesian methods to obtain the point estimates and the credible intervals of γ, where a truncated normal prior and a uniform prior are respectively used (denoted as GBN and GBU). The simulation results show that the Bayesian methods can avoid the extreme point estimates (0 or 2), the empty sets, the noninformative intervals ([0, 2]) and the discontinuous intervals to occur. GBN performs best in both the point estimation and the interval estimation. Finally, we apply the proposed methods to the Minnesota Center for Twin and Family Research data for their practical use. In summary, in practical applications, we recommend using GBN to estimate γ of genes.
Treatment of Pelvic Organ Prolapse by the Downregulation of the Expression of Mitofusin 2 in Uterosacral Ligament Tissue via Mesenchymal Stem Cells
Authors: Wang Xiaoqing , He Ruiju , Nian Songwen , Xiao Bingbing , Wang Yu , Zhang Lei , Wang Xiaoxiao , Guo Ruilin , Lu Ye
Published: May 2022

Background: The relationship between pelvic organ prolapse (POP), an aging-related disease, and the senescence-related protein mitofusin 2 (Mfn2) has rarely been studied. The aim of the present study was to explore the therapeutic effects of the downregulation of Mfn2 expression by stem cells on POP through animal experiments. Methods: First, a rat POP model was constructed by ovariectomy and traction. The rats in the non-pelvic organ prolapse (NPOP) and POP groups were divided into four groups for negative controls (N1–N4, N1: NPOP-normal saline; N2: NPOP-untransfected stem cells; N3: NPOP-short hairpin negative control (NPOP-sh-NC); N4: NPOP-short hairpin-Mfn2 (NPOP-sh-Mfn2)), and four groups for prolapse (P1–P4, P1: POP-normal saline; P2: POP-untransfected stem cells; P3: POP-sh-NC; P4: POP-sh-Mfn2), respectively. Stem cells were then cultured and isolated. The expression of Mfn2 was inhibited by lentivirus transfection, and the stem cells were injected into the uterosacral ligament of the rats in each group. The expression levels of Mfn2 and procollagen 1A1/1A2/3A1 in the uterosacral ligaments of the rats were observed at 0, 7, 14, and 21 days after injection. Results: Compared to the rats in the NPOP group, the POP rats had significant prolapse. The Mfn2 expression in the uterosacral ligaments of the POP rats was significantly increased (p < 0.05, all), and the expression of procollagen 1A1/1A2/3A1 was significantly decreased (p < 0.001, all). The POP rat model maintained the same trend after 21 days (without stem cell injection). At day 14, compared to the rats in the N1 group, the Mfn2 expression in the uterosacral ligament of the rats in the N4 group was significantly decreased (p < 0.05, all), and the expression of procollagens was significantly increased (p < 0.05, all). Similarly, compared to the rats in the P1 group, the Mfn2 expression in the uterosacral ligament of the rats in the P4 group was significantly decreased (p < 0.05, all), and the expression of procollagens was significantly increased (p < 0.05, all). Similarly, on day 21, the Mfn2 mRNA and protein expression in the uterosacral ligament of the POP and NPOP rats was significantly decreased (p < 0.05, all), and the expression of procollagens was significantly increased (p < 0.05, all) in the rats in the sh-Mfn2 group (N4, P4) compared to the rats in the saline group (N1, P1). Conclusions: The downregulation of Mfn2 expression by stem cells decreased the expression of Mfn2 and increased the expression of procollagen1A1/1A2/3A1 in the uterosacral ligament of the POP rats; this effect was significant 14–21 days after the injection. Thus, Mfn2 may be a new target for POP control.
Reducing the Risk of Healthcare Associated Infections from Legionella and Other Waterborne Pathogens Using a Water Management for Construction (WMC) Infection Control Risk Assessment (ICRA) Tool
Authors: Scanlon Molly M. , Gordon James L. , Tonozzi Angela A. , Griffin Stephanie C.
Published: May 2022

Construction activities in healthcare settings potentially expose building occupants to waterborne pathogens including Legionella and have been associated with morbidity and mortality. A Water Management for Construction—Infection Control Risk Assessment (WMC-ICRA) tool was developed addressing gaps in building water management programs. This enables healthcare organizations to meet the requirements of ANSI/ASHRAE Standard 188 referenced in numerous guidelines and regulations. A WMC-ICRA was modeled after the ICRA required for prevention and control of airborne pathogens to reduce the risk of healthcare associated infections. The tool allows users to evaluate risk from waterborne pathogen exposure by analyzing construction activities by project category and building occupant risk group. The users then select an appropriate level of risk mitigation measures. Technical aspects (e.g., water age/stagnation, flushing, filtration, disinfection, validation testing), are presented to assist with implementation. An exemplar WMC-ICRA tool is presented as ready for implementation by infection prevention and allied professionals, addressing current gaps in water management, morbidity/mortality risk, and regulatory compliance. To reduce exposure to waterborne pathogens in healthcare settings and improve regulatory compliance, organizations should examine the WMC-ICRA tool, customize it for organization-specific needs, while formulating an organizational policy to implement during all construction activities.
Children’s Involvement in Different Sport Types Differentiates Their Motor Competence but Not Their Executive Functions
Authors: Spanou Martha , Stavrou Nektarios , Dania Aspasia , Venetsanou Fotini
Published: May 2022

Sports provide a context where important aspects of children’s health, such as motor skills and cognitive functions, can be enhanced. However, it is unknown which type of sport may be better for the development of motor competence (MC) and executive functions (EFs). This study investigated potential differences in MC and EFs in boys and girls, being involved in different types of sports (team, individual open skill, individual closed skill). A total of 115 children (49 boys), 8–12 years old (10.30 ± 1.19 years), participated in the study. Their MC was assessed with the Bruininks–Oseretsky Test of Motor Proficiency-2 Short Form, whereas for EFs, the Attention Network Test, the digits backwards test, and the how many–what number test were utilized. Significant MC differences among participants in different types of sports were revealed, favoring those from closed-skill sports; nevertheless, their EFs were at similar levels. Furthermore, no significant gender MC and EFs differences were detected. It seems that children’s participation in specific types of sports differentiates their motor skills but not their EFs, whereas boys and girls, when provided with the same opportunities, present similar levels of MC and EFs.
A Cross-Sectional Study on Self-Perceived Health and Physical Activity Level in the Spanish Population
Authors: Denche-Zamorano Ángel , Mendoza-Muñoz María , Carlos-Vivas Jorge , Muñoz-Bermejo Laura , Rojo-Ramos Jorge , Pastor-Cisneros Raquel , Giakoni-Ramírez Frano , Godoy-Cumillaf Andrés , Barrios-Fernandez Sabina
Published: May 2022

One-third of the Spanish population over 15 years of age did not achieve a reasonable amount of physical activity (PA) before the COVID-19 pandemic. We aim to analyse the associations between the PA level (PAL) and self-perceived health (SPH) in the Spanish population aged 15–69 years during the pre-pandemic period. A cross-sectional study was conducted using the Spanish National Health Survey 2017 (ENSE 2017) data, with 17,777 participants. We carried out a descriptive analysis, analysed intergroup differences with non-parametric statistical tests, and calculated the Odds Ratio (OR) and Relative Risk (RR) of having a negative SPH according to PAL. In addition, correlations between PAL and SPH were studied, finding associations between them (p < 0.001). Thus, performing moderate and intense PA was related to better SPH than just walking or inactive. Weak and moderate correlations were found between PAL and SPH (p < 0.001). We also found high ORs and RRs of negative SPH as PAL decreased. Moderate and intense PA were related to positive SPH, while the risk of negative perception in inactive people was higher.
Physical Persistency across Game Quarters and during Consecutive Games in Elite Junior Basketball Players
Authors: Portes Rubén , Navarro Barragán Rafael Manuel , Calleja-González Julio , Gómez-Ruano Miguel Ángel , Jiménez Sáiz Sergio Lorenzo
Published: May 2022

Given the intermittent nature of basketball and the different demands that occur during playing time that are specific to every level of competition, the ratio of accelerations/decelerations and the intensity level across quarters were evaluated in female elite junior basketball players (n = 48; age: 16.8 ± 0.7 years; height: 1.76 ± 0.07 cm; body mass: 67.2 ± 6.2 kg). The following variables were analyzed to determine physical persistency across game quarters:(a) total distance covered (m), (b) high-intensity running (HIR) (14–21 km·h−1) distance covered (m), (c) sprint (21–30 km·h−1) distance covered (m), (d) total accelerations (n), (e) total decelerations (n), (f) relative accelerations (n·min−1), (g) relative decelerations (n·min−1), (h) ratio of acceleration/deceleration (A/D), (i) total jumps (j) relative jumps (n·min−1) (k) player load (AU). using the WIMU PRO® system. Higher but shorter acceleration intensity occurred during the last quarters due to the tight results of the matches. The results suggest that high-intensity efforts such as sprints and HIR seem to increase the A/D ratio (guard and forward positions). Therefore, specific conditioning, as well as eccentric strength training, could be included by practitioners in training programs to improve the performance of these positions during competition, especially as a prior preparation to a game-congested event. Centers seem to have a more variable performance through quarters than do other positions, perhaps highlighting the need for specific conditioning strategies.
Stimulating Employability and Job Crafting Behaviour of Physicians: A Randomized Controlled Trial
Authors: van Leeuwen Evelien , Knies Eva , van Rensen Elizabeth , Taris Toon
Published: May 2022

The demanding work context of physicians challenges their employability (i.e., their ability and willingness to continue to work). This requires them to proactively manage their working life and employability, for instance, through job crafting behaviour. This randomized controlled intervention study aimed to examine the effects of a personalized feedback report on physicians’ employability and job crafting behaviour. A total of 165 physicians from two hospitals in a large Dutch city were randomly assigned to a waitlist control or intervention group in May 2019. Physicians in the intervention group received access to a personalized feedback report with their employability scores, suggestions to improve these and to engage in job crafting. Participants completed a pre-test and eight weeks later a post-test. RM MANOVAs and RM ANOVAs showed that the intervention enhanced participants’ perceptions of their mental (F (1,130) = 4.57, p < 0.05) and physical (F (1,135) = 16.05, p < 0.001) ability to continue working. There was no effect on their willingness to continue to work. Furthermore, while job crafting behaviour significantly increased over time, the personalized feedback report did not account for this change. This low-investment intervention is relevant for organizations to stimulate employees’ proactivity and create positive perceptions of their ability to continue to work. Moreover, this study contributes to the literature by examining a novel approach of a job crafting intervention that does not require many resources to implement.
The Impact of COVID-19 Pandemic on Outpatient Visits for All-Cause and Chronic Diseases in Korea: A Nationwide Population-Based Study
Authors: Sim Boram , Nam Eun Woo
Published: May 2022

This study explores the impact of the coronavirus disease 2019 (COVID-19) pandemic on outpatient visits for all-cause and chronic diseases in 2020. We extracted the data of patients who visited medical institutions over the past five years (2016–2020) from nationwide claims data and measured the number of monthly outpatient visits. A negative binomial regression model was fitted to monthly outpatient visits from 2016 to 2019 to estimate the numbers of 2020. The number of all-cause outpatient visits in 2020 was 12% lower than expected. However, this change was relatively stable in outpatient visits for chronic diseases, which was 2% lower than expected. Deficits in all-cause outpatient visits were observed in all months except January; however, deficits in outpatient visits for chronic diseases have rebounded since April 2020. The levels of change in healthcare utilization were observed differently among disease groups, which indicates that the impacts of the pandemic were disproportionate. This study calls for a policy response to emerging and reemerging infectious diseases, as the findings confirm that a health crisis, such as the COVID-19 pandemic, could disrupt the healthcare system. Assessing the mid-to long-term impacts of COVID-19 on healthcare utilization and health consequences will require further research.
Satisfaction of Clinical Teachers on Standardized Residency Training Program (SRTP) in China: A Cross-Sectional Survey
Authors: Chen Boyan , Jin Xiaoyuan , Zhou Jie , Chen Ying , Wang Hongmei
Published: May 2022

Background: The Standardized Residency Training Program (SRTP) is a significant initiative to deepen health systems and medical education in developing countries like China. Despite the promotion of the SRTP nationwide and its implementation with various improvements, Chinese continuous medical education is still in its infancy. Compared with the residents, little is known about clinical teachers under the SRTP in China. However, clinical teachers effectively determine the training quality as critical disseminators of knowledge, skills, and values in medical practice. Thus, the study aims to analyze critical factors affecting their cognitive job satisfaction and provide continuous improvements for SRTP. Methods: From 1 December 2018 to 31 May 2019, we conducted a self-designed questionnaire with 13 SRTPs (including both training bases and professional bases) in Shaoxing city to evaluate clinical teachers’ satisfaction. Altogether, 574 clinical teachers responded to the survey expressing generally high overall satisfaction. We adopted a Chi-square test and Fisher’s Exact Test to evaluate the single impact factors affecting the satisfaction of clinical teachers. The multiple factors analysis applied the logistic regression model. Results: The male clinical teachers had significant differences in satisfaction with the teaching content (OR: 0.675, [95% CI: 0.477~0.953]), conflicts between study and work (OR: 0.542, [95%CI: 0.371~0.791]), the attention of leaders (OR: 0.403, [95%CI: 0.252~0.645]), and the subsidies of teachers (OR: 0.527, [95%CI: 0.347~0.805]). Compared with internal medicine, clinical teachers from surgery (OR: 2.396, [95%CI: 1.365–4.206]) and other departments (OR: 2.409, [95%CI: 1.406–4.129]) were more satisfied when they considered that residents have high motivation to attend training. In addition, compared with the attending physicians, the deputy chief physicians (OR: 0.493, [95%CI: 0.310–0.783]) and the chief physicians (OR: 0.683, [95%CI: 0.471–0.991]) disagreed more regarding the residents’ wage being good enough. Conclusion: Clinical teachers widely recognize the SRTP. However, teachers’ satisfaction varied due to different genders, working departments, and professional titles. The study also discussed possible reasons and strategy implications behind these findings, which combined unique Chinese society characteristics. Further, we believe the analysis and interpretations remind us of the applications of residency training methods from other Western countries, which should also consider the unique socio-cultural challenges.
Strain Characterisation for Measuring Bioefficacy of ITNs Treated with Two Active Ingredients (Dual-AI ITNs): Developing a Robust Protocol by Building Consensus
Authors: Lees Rosemary , Armistead Jennifer , Azizi Salum , Constant Edi , Fornadel Christen , Gimnig John , Hemingway Janet , Impoinvil Daniel , Irish Seth , Kisinza William , Lissenden Natalie , Mawejje Henry , Messenger Louisa , Moore Sarah , Ngufor Corine , Oxborough Richard , Protopopoff Natacha , Ranson Hilary , Small Graham , Wagman Joseph , Weetman David , Zohdy Sarah , Spiers Angus
Published: May 2022

Durability monitoring of insecticide-treated nets (ITNs) containing a pyrethroid in combination with a second active ingredient (AI) must be adapted so that the insecticidal bioefficacy of each AI can be monitored independently. An effective way to do this is to measure rapid knock down of a pyrethroid-susceptible strain of mosquitoes to assess the bioefficacy of the pyrethroid component and to use a pyrethroid-resistant strain to measure the bioefficacy of the second ingredient. To allow robust comparison of results across tests within and between test facilities, and over time, protocols for bioefficacy testing must include either characterisation of the resistant strain, standardisation of the mosquitoes used for bioassays, or a combination of the two. Through a series of virtual meetings, key stakeholders and practitioners explored different approaches to achieving these goals. Via an iterative process we decided on the preferred approach and produced a protocol consisting of characterising mosquitoes used for bioefficacy testing before and after a round of bioassays, for example at each time point in a durability monitoring study. We present the final protocol and justify our approach to establishing a standard methodology for durability monitoring of ITNs containing pyrethroid and a second AI.
MicroRNA Profile of Human Small Intestinal Tumors Compared to Colorectal Tumors
Authors: Nakagawa Yoshihito , Akao Yukihiro , Yamashita Hiromi , Tahara Tomomitsu , Funasaka Kohei , Nagasaka Mitsuo , Kuzuya Teiji , Miyahara Ryoji , Hashimoto Senju , Shibata Tomoyuki , Hirooka Yoshiki
Published: May 2022

Small intestinal tumors (adenoma and adenocarcinoma, SIT) are rare, and their microRNA (miRNA) expression profiles have not been established. Previously, we reported a relationship between miRNA expression profiles and the development, growth, morphology, and anticancer drug resistance of colorectal tumors. Here, we demonstrate that the miRNA expression profile of SIT is significantly different from those of tumors of the colon. We compared the onco-related miRNA expression profiles of SIT and colorectal tumors and found them to be different from each other. The expressions of miR-143 and miR-145 were frequently downregulated in SIT and colorectal tumors but not in sessile serrated adenoma/polyp tumors. The profiles of SIT and colorectal carcinomas of miR-7, miR-21, and miR-34a were considerably different. Upregulation of miR-31 expression was not found in any SIT cases. Our data suggested that miR-143 and miR-145 might act as anti-oncomirs common to adenocarcinoma of the small intestine, similar to those of colorectal adenoma and other cancers. However, the expression profiles of the other miRNAs of SIT were significantly different from those of colorectal tumors. These findings contribute useful insights into the tumor development and diagnosis of SIT.
Prevalence and Methods for Assessment of Oropharyngeal Dysphagia in Older Adults: A Systematic Review and Meta-Analysis
Authors: Doan Thanh-Nhan , Ho Wen-Chao , Wang Liang-Hui , Chang Fei-Chun , Nhu Nguyen Thanh , Chou Li-Wei
Published: May 2022

Background: This systematic review and meta-analysis aimed to estimate the pooled prevalence of dysphagia in older adults, subgrouping by recruitment settings and varying dysphagia assessment methods. Methods: Five major databases were systematically searched through January 2022. A random-effects model for meta-analysis was conducted to obtain the pooled prevalence. Results: Prevalence of dysphagia in the community-dwelling elderly screened by water swallow test was 12.14% (95% CI: 6.48% to 19.25%, I2 = 0%), which was significantly lower than the combined prevalence of 30.52% (95% CI: 21.75% to 40.07%, I2 = 68%) assessed by Standardized Swallowing Assessment (SSA) and volume-viscosity swallow test (V−VST). The dysphagia prevalence among elderly nursing home residents evaluated by SSA was 58.69% (95% CI: 47.71% to 69.25%, I2 = 0%) and by the Gugging Swallowing Screen test (GUSS) test was 53.60% (95% CI: 41.20% to 65.79%, I2 = 0%). The prevalence of dysphagia in hospitalized older adults screened by the 10-item Eating Assessment Tool was 24.10% (95% CI: 16.64% to 32.44%, I2 = 0%), which was significantly lower than those assessed by V-VST or GUSS tests of 47.18% (95% CI: 38.30% to 56.14%, I2 = 0%). Conclusions: Dysphagia is prevalent in the elderly, affecting approximately one in three community-dwelling elderly, almost half of the geriatric patients, and even more than half of elderly nursing home residents. The use of non-validated screening tools to report dysphagia underestimates its actual prevalence.
Port Placement Strategies for Robotic Pulmonary Lobectomy: A Narrative Review
Authors: Parini Sara , Massera Fabio , Papalia Esther , Baietto Guido , Bora Giulia , Rena Ottavio
Published: May 2022

Background: Despite the use of robotics becoming increasingly popular among thoracic surgeons worldwide, there remains debate over the best robotic approach for lung resections. In this paper, we delineated the main port placement strategies and discussed their advantages and disadvantages. Methods: A PubMed literature review was performed using key phrases such as “robotic lobectomy technique”, “RATS lobectomy”, and “port placement robotic lobectomy”. After the final review, 22 articles were included as references, of which 10 described common robotic port mapping techniques. Results: Several port strategies for robot-assisted pulmonary lobectomies have been proposed and described in the literature, each showing its own limitations and advantages. Conclusions: New robotic surgeons may choose their port strategy according to personal preference and previous surgical experience, especially regarding open or VATS resections. Robust data comparing different port placements in robotic surgery are lacking. Further research should be directed toward comparisons of clinical outcomes with different robotic approaches.
Periodontitis and Other Risk Factors Related to Myocardial Infarction and Its Follow-Up
Authors: Seoane Tania , Bullon Beatriz , Fernandez-Riejos Patricia , Garcia-Rubira Juan Carlos , Garcia-Gonzalez Nestor , Villar-Calle Pablo , Quiles Jose Luis , Battino Maurizio , Bullon Pedro
Published: May 2022

The main issue in the prevention of myocardial infarction (MI) is to reduce risk factors. Periodontal disease is related to cardiovascular disease and both share risk factors. The purpose of this study is to investigate whether periodontitis can be considered a risk factor for MI and common risk factors in a case–control study and in a prospective follow-up study in patients with MI. The test group (MIG) was made up of 144 males who had MI in the previous 48 h. The control group (CG) was composed of 138 males without MI. Both groups were subdivided according to the presence or absence of stage III and IV of periodontitis. General data; Mediterranean diet and physical activity screening; periodontal data; and biochemical, microbiological and cardiological parameters were recorded. ANOVA, Mann–Whitney U and Kruskal–Wallis statistical tests and binary logistic regression analysis were applied. No differences in anthropometric variables were observed between the four groups. The average weekly exercise hours have a higher value in CG without periodontitis. The number of leukocytes was higher in MIG, the number of monocytes was higher in CG and the number of teeth was lower in MIG with periodontitis. Adherence to the Mediterranean diet was higher in CG. Porphyromonas gingivalis and Tannerella forsythia were higher in CG with periodontitis and in MIG with and without periodontitis. At follow-up, the left ventricular ejection fraction (LVEF) data were better in the non-periodontitis group: 15 patients had Mayor Cardiovascular Adverse Events (MACE), 13 of them had periodontitis and 2 did not show periodontitis. Periodontitis, exercise, diet and smoking are risk factors related to MI. MACE presented in the ‘MI follow-up’ shows periodontitis, weight, exercise hours and dyslipidemia as risk factors. LVEF follow-up values are preserved in patients without periodontitis. Our data suggest that periodontitis can be considered a risk factor for MI and MACE in the studied population.
The Relationship between Cognitive Functions and Psychopathological Symptoms in First Episode Psychosis and Chronic Schizophrenia
Authors: Rek-Owodziń Katarzyna , Tyburski Ernest , Plichta Piotr , Waszczuk Katarzyna , Bielecki Maksymilian , Wietrzyński Krzysztof , Podwalski Piotr , Rudkowski Krzysztof , Michalczyk Anna , Grąźlewski Tomasz , Sagan Leszek , Kucharska-Mazur Jolanta , Samochowiec Jerzy , Mak Monika
Published: May 2022

Impairments in cognitive functions are one of the main features of schizophrenia. A variety of factors can influence the extent of cognitive deficits. In our study, we examined the severity of cognitive deficits at different stages of the disease and the relationship between psychopathological symptoms and cognitive functions. We recruited 32 patients with first-episode psychosis (FEP), 70 with chronic schizophrenia (CS), and 39 healthy controls (HC). Psychopathological symptoms were evaluated with the Positive and Negative Syndrome Scale (PANSS) and cognitive functions were measured with the MATRICS Cognitive Consensus Battery (MCCB). Cognitive deficits were present in both FEP and CS participants. CS individuals had lower overall scores and poorer working memory; however, clinical variables appeared to play a significant role in these scores. In FEP, disorganization correlated negatively with verbal and visual learning and memory, social cognition, and overall score; negative symptoms negatively correlated with social cognition. In CS participants, disorganization correlated negatively with speed of processing, reasoning, problem solving, and overall score; negative symptoms were negatively correlated with speed of processing, visual learning, memory, and overall score; positive symptoms were negatively correlated with reasoning and problem solving. Our findings indicate that psychopathological symptoms have a significant impact on cognitive functions in FEP and CS patients.
The Predictive Role of NLR and PLR in Outcome and Patency of Lower Limb Revascularization in Patients with Femoropopliteal Disease
Authors: Russu Eliza , Mureșan Adrian Vasile , Arbănași Emil Marian , Kaller Réka , Hosu Ioan , Voidăzan Septimiu , Arbănași Eliza Mihaela , Coșarcă Cătălin Mircea
Published: May 2022

Background: Peripheral arterial disease (PAD) changes the arterial structure and function, and is the most common manifestation of the atherosclerotic process, except for the coronary and cerebral arterial systems. Inflammation is well known to have a role in the progression of atherosclerosis and, by extension, in PAD. Among the recently studied markers in the literature, we list the neutrophil–lymphocyte ratio (NLR) and platelet–lymphocyte ratio (PLR). This study aims to analyze the preoperative role of NLR and PLR in the medium-term outcome of patients surgically revascularized for femoropopliteal disease. Methods: A retrospective study included patients admitted to the Vascular Surgery Clinic of the County Emergency Clinical Hospital of Târgu-Mureș, Romania, between January 2017 and December 2019, diagnosed with femoropopliteal disease and having presented an indication for surgical revascularization. The patients included in the study were classified according to the 12 months primary patency in two groups: “patency” and “nonpatency”. Results: Depending on the Rutherford classification (RC), there was a higher incidence of stages II and III in the patency group and a higher incidence of stage V in the nonpatency group. Depending on the optimal cut-off value according to ROC for the 12 months primary patency, obtained from Youden’s index (3.95 for NLR (82.6% sensitivity and 89.9% specificity), and 142.13 for PLR (79.1% sensitivity and 82.6% specificity)), in all high-NLR and high-PLR groups, there was a higher incidence of all adverse outcomes. Moreover, a multivariate analysis showed that a high baseline value for NLR and PLR was an independent predictor of all outcomes for all recruited patients. Furthermore, for all hospitalized patients, RC 5 was an independent predictor of poor prognosis. Conclusions: Our findings establish that a high value of preoperative NLR and PLR determined at hospital admission is strongly predictive of primary patency failure (12 months after revascularization). Additionally, elevated ratio values are an independent predictor for a higher amputation rate and death for all patients enrolled in the study, except for mortality in RC 2, and both amputation and mortality in RC 5.
How to Improve Healthcare for Patients with Multimorbidity and Polypharmacy in Primary Care: A Pragmatic Cluster-Randomized Clinical Trial of the MULTIPAP Intervention
Authors: del Cura-González Isabel , López-Rodríguez Juan A. , Leiva-Fernández Francisca , Gimeno-Miguel Antonio , Poblador-Plou Beatriz , López-Verde Fernando , Lozano-Hernández Cristina , Pico-Soler Victoria , Bujalance-Zafra Mª Josefa , Gimeno-Feliu Luis A. , Aza-Pascual-Salcedo Mercedes , Rogero-Blanco Marisa , González-Rubio Francisca , García-de-Blas Francisca , Polentinos-Castro Elena , Sanz-Cuesta Teresa , Castillo-Jimena Marcos , Alonso-García Marcos , Calderón-Larrañaga Amaia , Valderas José M. , Marengoni Alessandra , Muth Christiane , Prados-Torres Juan Daniel , Prados-Torres Alexandra ,   Multi-PAP Group
Published: May 2022

(1) Purpose: To investigate a complex MULTIPAP intervention that implements the Ariadne principles in a primary care population of young-elderly patients with multimorbidity and polypharmacy and to evaluate its effectiveness for improving the appropriateness of prescriptions. (2) Methods: A pragmatic cluster-randomized clinical trial was conducted involving 38 family practices in Spain. Patients aged 65–74 years with multimorbidity and polypharmacy were recruited. Family physicians (FPs) were randomly allocated to continue usual care or to provide the MULTIPAP intervention based on the Ariadne principles with two components: FP training (eMULTIPAP) and FP patient interviews. The primary outcome was the appropriateness of prescribing, measured as the between-group difference in the mean Medication Appropriateness Index (MAI) score change from the baseline to the 6-month follow-up. The secondary outcomes were quality of life (EQ-5D-5 L), patient perceptions of shared decision making (collaboRATE), use of health services, treatment adherence, and incidence of drug adverse events (all at 1 year), using multi-level regression models, with FP as a random effect. (3) Results: We recruited 117 FPs and 593 of their patients. In the intention-to-treat analysis, the between-group difference for the mean MAI score change after a 6-month follow-up was −2.42 (95% CI from −4.27 to −0.59) and, between baseline and a 12-month follow-up was −3.40 (95% CI from −5.45 to −1.34). There were no significant differences in any other secondary outcomes. (4) Conclusions: The MULTIPAP intervention improved medication appropriateness sustainably over the follow-up time. The small magnitude of the effect, however, advises caution in the interpretation of the results given the paucity of evidence for the clinical benefit of the observed change in the MAI. Trial registration: Clinicaltrials.gov NCT02866799.
Investigating the Stability of Six Phenolic TMZ Ester Analogues, Incubated in the Presence of Porcine Liver Esterase and Monitored by HPLC
Authors: Shervington Leroy A. , Ingham Oliver
Published: May 2022

Previous published data from our group showed the encouraging in vitro activities of six phenolic temozolomide (TMZ) ester analogues (ES8–ES12 and ES14) with up to a five-fold increase in potency compared to TMZ against glioblastoma multiform cell lines and TMZ-resistant O6-methylguanine-DNA methyl transferase (MGMT)-positive primary cells. This study investigated the stabilities of the six phenolic TMZ ester analogues in the presence of porcine liver esterase (PLE) as a hydrolytic enzyme, using high-performance liquid chromatography (HPLC), monitored by a diode-array detector (DAD). Determining the rates of hydrolysis of the esters provided a useful insight into the feasibility of progressing them to the next phase of drug development. Fifty percent of TMZ esters consisting of para nitro, chloro, phenyl and tolyl groups (ES9, ES10, ES12 and ES14) were hydrolysed within the first 4.2 min of PLE exposure, while the TMZ esters consisting of para methoxy and nitrile groups (ES8 and ES11) demonstrated increased stability, with 50% hydrolysis achieved in 7.3 and 13.7 min, respectively. In conclusion, the survival of these phenolic TMZ esters on route to the target site of a brain tumor would be a challenge, mainly due to the undesirable rapid rate of hydrolysis. These findings therefore pose a question regarding the effectiveness of these esters in an in vivo setting.
N-Rich Doped Anatase TiO2 with Smart Defect Engineering as Efficient Photocatalysts for Acetaldehyde Degradation
Authors: Wei Mingzhuo , Li Zhijun , Chen Peijiao , Sun Lei , Kang Shilin , Dou Tianwei , Qu Yang , Jing Liqiang
Published: May 2022

Nitrogen (N) doping is an effective strategy for improving the solar-driven photocatalytic performance of anatase TiO2, but controllable methods for nitrogen-rich doping and associated defect engineering are highly desired. In this work, N-rich doped anatase TiO2 nanoparticles (4.2 at%) were successfully prepared via high-temperature nitridation based on thermally stable H3PO4-modified TiO2. Subsequently, the associated deep-energy-level defects such as oxygen vacancies and Ti3+ were successfully healed by smart photo-Fenton oxidation treatment. Under visible-light irradiation, the healed N-doped TiO2 exhibited a ~2-times higher activity of gas-phase acetaldehyde degradation than the non-treated one and even better than standard P25 TiO2 under UV-visible-light irradiation. The exceptional performance is attributed to the extended spectral response range from N-rich doping, the enhanced charge separation from hole capturing by N-doped species, and the healed defect levels with the proper thermodynamic ability for facilitating O2 reduction, depending on the results of ∙O2− radicals and defect measurement by electron spin resonance, X-ray photoelectron spectroscopy, atmosphere-controlled surface photovoltage spectra, etc. This work provides an easy and efficient strategy for the preparation of high-performance solar-driven TiO2 photocatalysts.
Dietary Iron and the Elite Dancer
Authors: Attwell Caitlin , Dugan Cory , McKay Alannah K. A. , Nicholas Joanna , Hopper Luke , Peeling Peter
Published: May 2022

Dancers are an athlete population at high risk of developing iron deficiency (ID). The aesthetic nature of the discipline means dancers potentially utilise dietary restriction to meet physique goals. In combination with high training demands, this means dancers are susceptible to problems related to low energy availability (LEA), which impacts nutrient intake. In the presence of LEA, ID is common because of a reduced mineral content within the low energy diet. Left untreated, ID becomes an issue that results in fatigue, reduced aerobic work capacity, and ultimately, iron deficient anaemia (IDA). Such progression can be detrimental to a dancer’s capacity given the physically demanding nature of training, rehearsal, and performances. Previous literature has focused on the manifestation and treatment of ID primarily in the context of endurance athletes; however, a dance-specific context addressing the interplay between dance training and performance, LEA and ID is essential for practitioners working in this space. By consolidating findings from identified studies of dancers and other relevant athlete groups, this review explores causal factors of ID and potential treatment strategies for dancers to optimise absorption from an oral iron supplementation regime to adequately support health and performance.
Novel Soy Peptide CBP: Stimulation of Osteoblast Differentiation via TβRI-p38-MAPK-Depending RUNX2 Activation
Authors: Wang Kuaitian , Kong Xiao , Du Mengdi , Yu Wei , Wang Zhenhua , Xu Bo , Yang Jianrong , Xu Jingru , Liu Zhili , Cheng Yongqiang , Gan Jing
Published: May 2022

DEDEQIPSHPPR, the calcium-binding peptide (CBP) identified in soy yogurt, was proven to be a potential cofactor in osteoporosis prevention in our previous study, but the mechanism was unknown. In this study, the activity of alkaline phosphatase (ALP) and osteocalcin (OCN), the regulation of RUNX2, and the expression of TβRI were investigated to elucidate the underlying mechanism. The results show that CBP upregulated ALP activity and OCN concentration and increased the expression of RUNX2 and the activation of the MAPK signaling pathway. Similarly, the expression of osteogenesis-related genes in osteoblasts also increased upon CBP treatment. Moreover, the CBP-induced enhancement of ALP activity and phosphorylation levels in the p38 pathway was inhibited by treatment with a p38 inhibitor (SB203538) and TβRI inhibitor (SB431542), respectively, suggesting that p38 and TβRI were involved in the osteogenic action. Based on the signaling pathways, the intracellular calcium concentration was significantly elevated by CBP, which was correlated with the increased behavioral functions and the relative fluorescence intensity of the bone mass. These findings suggest that CBP stimulates osteoblast differentiation and bone mineralization through the activation of RUNX2 via mechanisms related to the TβRI-p38-MAPK signaling pathways, further highlighting CBP’s important potential for treating osteoporosis.
Treatment of Vitamin D Deficiency with Calcifediol: Efficacy and Safety Profile and Predictability of Efficacy
Authors: Pérez-Castrillon Jose-Luis , Usategui-Martín Ricardo , Pludowski Pawel
Published: May 2022

Calcifediol (25-OH-vitamin D3) is the prohormone of the vitamin D endocrine system. It is used to prevent and treat vitamin D deficiency. Calcifediol, as well as cholecalciferol (vitamin D3), is efficient and safe in the general population, although calcifediol has certain advantages over cholecalciferol, such as its rapid onset of action and greater potency. This review analyzed studies comparing the efficacy and safety of both calcifediol and cholecalciferol drugs in the short and long term (>6 months). Calcifediol was found to be more efficacious, with no increase in toxicity. We also assessed the predictability of both molecules. A 25OHD increase depends on the dose and frequency of calcifediol administration. In contrast, after cholecalciferol administration, 25OHD increase depends on more factors than dose and frequency of administration, also phenotypic aspects (such as obesity and malabsorption), and genotypic factors impacts in this increase.
Spectrum of Atazanavir-Selected Protease Inhibitor-Resistance Mutations
Authors: Rhee Soo-Yon , Boehm Michael , Tarasova Olga , Di Teodoro Giulia , Abecasis Ana B. , Sönnerborg Anders , Bailey Alexander J. , Kireev Dmitry , Zazzi Maurizio ,   the EuResist Network Study Group, Shafer Robert W.
Published: May 2022

Ritonavir-boosted atazanavir is an option for second-line therapy in low- and middle-income countries (LMICs). We analyzed publicly available HIV-1 protease sequences from previously PI-naïve patients with virological failure (VF) following treatment with atazanavir. Overall, 1497 patient sequences were identified, including 740 reported in 27 published studies and 757 from datasets assembled for this analysis. A total of 63% of patients received boosted atazanavir. A total of 38% had non-subtype B viruses. A total of 264 (18%) sequences had a PI drug-resistance mutation (DRM) defined as having a Stanford HIV Drug Resistance Database mutation penalty score. Among sequences with a DRM, nine major DRMs had a prevalence >5%: I50L (34%), M46I (33%), V82A (22%), L90M (19%), I54V (16%), N88S (10%), M46L (8%), V32I (6%), and I84V (6%). Common accessory DRMs were L33F (21%), Q58E (16%), K20T (14%), G73S (12%), L10F (10%), F53L (10%), K43T (9%), and L24I (6%). A novel nonpolymorphic mutation, L89T occurred in 8.4% of non-subtype B, but in only 0.4% of subtype B sequences. The 264 sequences included 3 (1.1%) interpreted as causing high-level, 14 (5.3%) as causing intermediate, and 27 (10.2%) as causing low-level darunavir resistance. Atazanavir selects for nine major and eight accessory DRMs, and one novel nonpolymorphic mutation occurring primarily in non-B sequences. Atazanavir-selected mutations confer low-levels of darunavir cross resistance. Clinical studies, however, are required to determine the optimal boosted PI to use for second-line and potentially later line therapy in LMICs.
Non-Cellular Layers of the Respiratory Tract: Protection against Pathogens and Target for Drug Delivery
Authors: Fröhlich Eleonore
Published: May 2022

Epithelial barriers separate the human body from the environment to maintain homeostasis. Compared to the skin and gastrointestinal tract, the respiratory barrier is the thinnest and least protective. The properties of the epithelial cells (height, number of layers, intercellular junctions) and non-cellular layers, mucus in the conducting airways and surfactant in the respiratory parts determine the permeability of the barrier. The review focuses on the non-cellular layers and describes the architecture of the mucus and surfactant followed by interaction with gases and pathogens. While the penetration of gases into the respiratory tract is mainly determined by their hydrophobicity, pathogens use different mechanisms to invade the respiratory tract. Often, the combination of mucus adhesion and subsequent permeation of the mucus mesh is used. Similar mechanisms are also employed to improve drug delivery across the respiratory barrier. Depending on the payload and target region, various mucus-targeting delivery systems have been developed. It appears that the mucus-targeting strategy has to be selected according to the planned application.