bluuebunny/crossref_metadata_2025 huggingface dataset:
Factors Associated with Surgical Smoke Self-Protection Behavior of Operating Room Nurses
Authors: Yu Ching-Lan , Hsieh Suh-Ing , Lin Li-Hung , Chi Shu-Fen , Huang Tzu-Hsin , Yeh Shu-Ling , Wang Chi
Published: May 2022

Surgical smoke has been proven to be harmful and carcinogenic to humans as well as increasing the risk of acquiring infectious diseases. The operating room nurses’ willingness to use protective equipment against surgical smoke was low. The factors associated with personal protective behavior in the operating room against surgical smoke were sparsely explored. The purpose of this study is to determine factors associated with surgical smoke self-protection behavior of the operating room nurses. This was a descriptive correlational study using a convenience sample from a medical center in northern Taiwan. The self-designed questionnaires included personal characteristics and perceived attributes. The data were analyzed by descriptive and linear regression. Attendance at in-service education with regard to surgical smoke, the attitude to surgical smoke, and surgical smoke self-protection barriers were significant factors found in multivariate linear regression after controlling the covariates. The overall model was significant and accounted for 14.2% of variances. In summary, attending in-service education, attitude and barriers in executing self-protective behaviors were significant factors. It is important to promote operating room nurses’ health through providing correct surgical smoke knowledge, self-protection strategies to improve attitudes toward surgical smoke, improving the hospital’s environment by adding surgical smoke evacuation equipment, and standardizing the operating procedures.
Patterns and Associations of Physical Activity, Screen Time, Sleep, and Dietary Habits among Saudi Females Participating in Fitness Centers
Authors: AlMarzooqi Mezna A. , Albawardi Nada M. , Altamimi Abeer A. , Altalhi Arwa S. , Al-Hazzaa Hazzaa M.
Published: May 2022

This study was designed to investigate the level and associations of physical activity, sedentary behavior, sleep, and dietary habits among Saudi women attending fitness centers in Riyadh. A descriptive cross-sectional study was carried out from 12 fitness centers in Riyadh, Saudi Arabia. A total of 460 participants answered a two-part survey self-administered questionnaire, which included information about the demographic characteristics and lifestyle. The analysis found significant differences between the two groups in terms of age, weight, BMI, and combined prevalence of being overweight and obese. Compared with less active females, high active females showed significantly more favorable dietary habits (p < 0.05). Significantly higher values were observed for the total physical activity energy expenditure in METs-min/week (p = 0.028). Moreover, females with high screen time (>3 h per day) were younger, less active, slept longer, and had higher intakes of fast foods and chocolates/candy intake (p = 0.001). Overall, the participants were highly active, exceeding the recommended physical activity needed to enhance health. The analysis also showed sufficient sleep duration (>7 h/night) was significantly associated with the diet and nutrition of the participants. Health education programs are needed to reduce the risks of sedentary behavior, sleep problems, and dietary habits.
A Machine Learning Based Discharge Prediction of Cardiovascular Diseases Patients in Intensive Care Units
Authors: Karboub Kaouter , Tabaa Mohamed
Published: May 2022

This paper targets a major challenge of how to effectively allocate medical resources in intensive care units (ICUs). We trained multiple regression models using the Medical Information Mart for Intensive Care III (MIMIC III) database recorded in the period between 2001 and 2012. The training and validation dataset included pneumonia, sepsis, congestive heart failure, hypotension, chest pain, coronary artery disease, fever, respiratory failure, acute coronary syndrome, shortness of breath, seizure and transient ischemic attack, and aortic stenosis patients’ recorded data. Then we tested the models on the unseen data of patients diagnosed with coronary artery disease, congestive heart failure or acute coronary syndrome. We included the admission characteristics, clinical prescriptions, physiological measurements, and discharge characteristics of those patients. We assessed the models’ performance using mean residuals and running times as metrics. We ran multiple experiments to study the data partition’s impact on the learning phase. The total running time of our best-evaluated model is 123,450.9 mS. The best model gives an average accuracy of 98%, highlighting the location of discharge, initial diagnosis, location of admission, drug therapy, length of stay and internal transfers as the most influencing patterns to decide a patient’s readiness for discharge.
Deep Learning for Infant Cry Recognition
Authors: Liang Yun-Chia , Wijaya Iven , Yang Ming-Tao , Cuevas Juarez Josue Rodolfo , Chang Hou-Tai
Published: May 2022

Recognizing why an infant cries is challenging as babies cannot communicate verbally with others to express their wishes or needs. This leads to difficulties for parents in identifying the needs and the health of their infants. This study used deep learning (DL) algorithms such as the convolutional neural network (CNN) and long short-term memory (LSTM) to recognize infants’ necessities such as hunger/thirst, need for a diaper change, emotional needs (e.g., need for touch/holding), and pain caused by medical treatment (e.g., injection). The classical artificial neural network (ANN) was also used for comparison. The inputs of ANN, CNN, and LSTM were the features extracted from 1607 10 s audio recordings of infants using mel-frequency cepstral coefficients (MFCC). Results showed that CNN and LSTM both provided decent performance, around 95% in accuracy, precision, and recall, in differentiating healthy and sick infants. For recognizing infants’ specific needs, CNN reached up to 60% accuracy, outperforming LSTM and ANN in almost all measures. These results could be applied as indicators for future applications to help parents understand their infant’s condition and needs.
Habit—Does It Matter? Bringing Habit and Emotion into the Development of Consumer’s Food Waste Reduction Behavior with the Lens of the Theory of Interpersonal Behavior
Authors: Mumtaz Sumia , Chu Amanda M. Y. , Attiq Saman , Shah Hassan Jalil , Wong Wing-Keung
Published: May 2022

The immense food waste, generated by restaurants is not only a serious burden for the foodservice business but also a cause of anguish for the emerging nations in which eating out is becoming increasingly trendy. Consumers’ food wastes account for a significant portion of restaurant food waste, indicating the need for a change in consumers’ behavior to minimize food waste. To examine this problem, our study sought to identify the elements that influence restaurant consumers’ behaviors on food waste reduction, reuse, and recycling. The influence of anticipated positive emotions, awareness of consequences, environmental knowledge, and social norms on waste reduction intentions were examined by using a quantitative technique in the investigation. Furthermore, the influence of habits, waste reduction intentions, and facilitating conditions on food waste reduction, reuse, and recycling behaviors have also been investigated. The study collected 1063 responses and employed the PLS-SEM approach to verify the hypotheses. The results suggested that anticipated positive emotions, awareness of consequences, environmental knowledge, and social norms all have substantial impacts on waste reduction intentions. In addition, habits, waste reduction intentions, and facilitating conditions have noteworthy influences on consumers’ behaviors towards food waste reduction, reuse, and recycling in restaurants. Understanding these elements could help in correcting customers’ waste behaviors in restaurants. The findings in this study are useful for managers, policymakers, and researchers who want to solve the problems of food waste. The implications, limits, and suggestions for further studies have also been discussed in our study.
Letting the World See through Your Eyes: Using Photovoice to Explore the Role of Technology in Physical Activity for Adolescents Living with Type 1 Diabetes
Authors: Morrow Diane , Kirk Alison , Muirhead Fiona , Lennon Marilyn
Published: May 2022

This paper qualitatively explores how technologies and physical activity are experienced by adolescents with type 1 diabetes. Type 1 diabetes is a life-threatening autoimmune condition, which is highly prevalent in young children. Physical activity is underutilised as part of treatment goals due to multifactorial challenges and lack of education in both the family setting and across society as a whole. Using photovoice methodology, 29 participants (parents and adolescents), individually or as dyads, shared and described in reflective journal format examples of technology and physical activity in their lives. In total, 120 personal photographs with accompanying narratives were provided. The data were thematically coded by the researcher and then collaboratively with participants. Four key themes (and 12 subthemes) were generated including: (i) benefits of technology; (ii) complexity and difficulty; (iii) emotional impact; (iv) reliance and risk. Findings demonstrate that current technology does not address the complex needs of adolescents with type 1 diabetes to enable participation in physical activity without life risk. We conclude from our findings that future technologies for supporting engagement in physical activity as part of diabetes management need to be: more interoperable, personalised and integrated better with ongoing education and support.
Indoor Air Purification and Residents’ Self-Rated Health: Evidence from the China Health and Nutrition Survey
Authors: Li Lei , Zheng Yilin , Ma Shaojun
Published: May 2022

Indoor air pollution is injurious to human health, even worse than outdoor air pollution. However, there is a lack of empirical evidence using large samples in developing countries regarding whether indoor air purification can improve human health by reducing indoor air pollutants. Using the data from the China Health and Nutrition Survey in 2015, this study analyzes the relationship between indoor air purification and residents’ self-rated health. We apply the generalized ordered logit model and find that indoor air purification has a significantly positive effect on residents’ self-rated health. This positive effect is limited to improving the probability of residents’ health level being rated “good”, and there is no significant movement between the two levels of “bad” and “fair”. The results also show that, as an important source of indoor air pollutants, solid fuels used in cooking significantly reduced residents’ self-rated health level. Additional results show the heterogeneity of the relationship between indoor air purification and resident health among groups with different characteristics. This study provides empirical evidence for further optimizing the indoor air environment.
General Labor Well-Being in Latin American Dentists during the COVID-19 Pandemic
Authors: Evaristo-Chiyong Teresa , Mattos-Vela Manuel Antonio , Agudelo-Suárez Andrés A. , Armas-Vega Ana del Carmen , Cuevas-González Juan Carlos , Díaz-Reissner Clarisse Virginia , López Torres Ana Cristina , Martínez-Delgado Cecilia María , Paz-Betanco Manuel Amed , Pérez-Flores María Antonieta , Piovesan-Suárez Sylvia , Pistochini Adriana , Romero-Uzcátegui Yajaira
Published: May 2022

This study aimed to determine the general labor well-being of Latin American dentists according to sociodemographic characteristics during the COVID-19 pandemic. A cross-sectional study was conducted in a final sample of 2214 participants from 11 countries. A validated online questionnaire on general work well-being was used (data collection period from 1 June to 10 July 2021), containing two dimensions: psychosocial well-being and collateral effects. The sociodemographic characteristics of the dentists and their perception of the economic impact of the pandemic were also recorded. A multivariate linear regression analysis was performed (hierarchical regression model) to evaluate the joint effect of the explanatory variables on labor well-being and the changes in the variance between each model. A score of psychosocial well-being of 233.6 + 40.2 and collateral effects of 45 + 20.1 was found. Psychosocial well-being was associated with sex, country of origin, academic training achieved, type of dental activity, and perceived impact during the pandemic (p < 0.05). Somatization was frequently manifested through back pain (88.2%) and muscular tensions (87.2%). Women, those who worked 41 or more hours and had between 1 to 15 years of professional experience presented a greater collateral effect (p < 0.001). The impact of the COVID-19 pandemic a year and a half after it began on the labor well-being of Latin American dentists was evidenced with important interactions with social characteristics.
Accounting for Sampling Weights in the Analysis of Spatial Distributions of Disease Using Health Survey Data, with an Application to Mapping Child Health in Malawi and Mozambique
Authors: Cassy Sheyla , Manda Samuel , Marques Filipe , Martins Maria
Published: May 2022

Most analyses of spatial patterns of disease risk using health survey data fail to adequately account for the complex survey designs. Particularly, the survey sampling weights are often ignored in the analyses. Thus, the estimated spatial distribution of disease risk could be biased and may lead to erroneous policy decisions. This paper aimed to present recent statistical advances in disease-mapping methods that incorporate survey sampling in the estimation of the spatial distribution of disease risk. The methods were then applied to the estimation of the geographical distribution of child malnutrition in Malawi, and child fever and diarrhoea in Mozambique. The estimation of the spatial distributions of the child disease risk was done by Bayesian methods. Accounting for sampling weights resulted in smaller standard errors for the estimated spatial disease risk, which increased the confidence in the conclusions from the findings. The estimated geographical distributions of the child disease risk were similar between the methods. However, the fits of the models to the data, as measured by the deviance information criteria (DIC), were different.
The Impact of Robotic Therapy on the Self-Perception of Upper Limb Function in Cervical Spinal Cord Injury: A Pilot Randomized Controlled Trial
Authors: Lozano-Berrio V. , Alcobendas-Maestro M. , Polonio-López B. , Gil-Agudo A. , de la Peña-González A. , de los Reyes-Guzmán A.
Published: May 2022

Background: The aim of the present study was to evaluate the impact of robotic therapy in patients with cervical spinal cord injury (SCI), measured on the basis of the patients’ self-perception of limited upper limb function and level of independence in activities of daily living. Methods: Twenty-six patients with cervical SCI completed the treatment after being randomly assigned to the intervention or control group. The training consisted of 40 experimental sessions 1 h in duration, ideally occurring 5 days/week for 8 weeks. In addition to the conventional daily therapy (30 min), the control group received another 30 min of conventional therapy, whereas the intervention group received 30 min of robotic therapy. Patients were evaluated by means of the Capabilities of Upper Extremity Questionnaire (CUE) and Spinal Cord Independence Measure (SCIM) clinical scales. Results: The improvement in the feeding item of SCIM was significantly higher in the intervention group than in the control group after the treatment (2.00 (0.91) vs. 1.18 (0.89), p = 0.03). The correlation between the CUE and SCIM scales was higher at the ending than at baseline for both groups. Conclusions: Although both groups improved, the clinical relevance related to the changes observed for both assessments was slightly higher in the intervention group than in the control group.
The Effect of Physical Exercise on Fundamental Movement Skills and Physical Fitness among Preschool Children: Study Protocol for a Cluster-Randomized Controlled Trial
Authors: Wang Guangxu , Zi Yahua , Li Bo , Su Shan , Sun Lei , Wang Fei , Ren Chener , Liu Yang
Published: May 2022

Background: Evidence shows that physical exercise promotes preschoolers’ fundamental movement skills (FMSs) and physical fitness (PF). However, studies that assess the effectiveness of different types of physical exercise interventions to improve FMSs and PF in preschool children remain scarce. To explore and compare the effectiveness of different physical exercise on FMSs and PF, interventions comprising ball games (BGs), rhythm activities (RAs), basic movements (BMs), and a combination of all related activities (multiple activities, MAs) will be conducted among preschoolers. Methods: A single-blind, five-arm, cluster-randomized trial will be conducted in kindergarten in Shanghai, China. In total, 300 healthy preschoolers, aged 4 to 5 years, will be randomized to four intervention groups (BG, RA, BM, or MA) and one control group (unorganized physical activities). Four intervention groups will receive three 30-min lessons weekly for 16 weeks. At the baseline, the end of the 16-week intervention, and the 6-month follow-up after the end of the intervention, the primary outcomes (FMSs and PF) and physical activity (PA), and sociodemographic and anthropometric data will be assessed. Discussion: This study will provide vital information regarding the effect of different physical exercise interventions on preschool children’s FMSs and PF, PA, and the potential interactions between these domains. The most effective intervention strategy can be generalized to kindergarten and other preschool educational institutions in practice to promote preschoolers’ development of FMSs and PF. Conclusions: This study protocol aims to provide a method to solve the problem of “how to arrange physical exercise and which kind of physical exercise program can promote FMS and PF better in preschool children”.
Responses Presented by Adult Patients with COVID-19, Based on the Formulated Nursing Diagnoses: A Scoping Review
Authors: Cortinhal Vanessa , Pereira António , Correia Sofia , Deodato Sérgio
Published: May 2022

(1) Background: this review aims to identify the human responses exhibited by adult patients with COVID-19, by listing the corresponding nursing diagnoses. Nursing diagnosis it’s a clinical analysis of human responses to a person, family, or community. Therefore, it is possible to state that nursing diagnoses represent human responses. (2) Methods: a scoping review was conducted following recommendations provided by the Joanna Briggs Institute (JBI) and the research was carried out between December 2020 and 15 January, 2021, via CINAHL Complete, Complementary Index, MEDLINE, Science Direct, Academic Search Complete, Science Citation Index, Directory of Open Access Journals, Scopus, Social Sciences Citation Index, Business Source Complete, eBook Index (by B-on), and the Cochrane Database of Systematic Reviews (by Cochrane Library). (3) Results: with respect to studies using the NANDA-I taxonomy, the findings have shown that “impaired gas exchange” was the most highlighted nursing diagnosis. ICNP taxonomy, the relevant nursing diagnosis is “cough present”. (4) Conclusions: concurrently, as suggested by the human responses documented in this review, throughout the pandemic, the requirements for adequate care provision have been constantly updated, to improve the quality of life of those patients, as much as possible.
Impact of Gingivitis on Circulating Neutrophil Reactivity and Gingival Crevicular Fluid Inflammatory Proteins
Authors: Roberts Helen M. , Yonel Zehra , Kantarci Alpdogan , Grant Melissa M. , Chapple Iain L. C.
Published: May 2022

Gingivitis is an extremely common oral inflammatory condition and can be induced in humans using an acute 21-day experimental gingivitis model. Neutrophils are known to be highly prevalent in the gingival crevice during gingival inflammation; however, the effect of gingivitis and the associated biofilm on peripheral blood neutrophils (PBN) is not well characterised. Thus, the aim of this study was to examine the impact of inflammation induced by experimental gingivitis and its resolution upon the function of PBN. Fifteen systemically healthy volunteers undertook a split-mouth 21-day experimental gingivitis study followed by a resolution phase of 14 days. PBN function, including reactive oxygen species (ROS) production, neutrophil extracellular trap (NET) release, directional chemotactic accuracy and expression of host mediators in gingival crevicular fluid (GCF), were measured at baseline (day 0), on day 21 and on day 35. NET formation and ROS production were significantly elevated at day 21. Chemotactic speed was also elevated in response to bacterial peptide fMLP at day 21. At day 35, ROS production in response to an Fcgamma stimulant, opsonised Staphylococcus aureus, remained elevated. The data presented suggest a lasting biological impact of the experimental gingivitis on PBN function even after clinical symptoms have abated.
The Health Cost of Organizational Citizenship Behavior: Does Health-Promoting Leadership Matter?
Authors: Fu Bo , Peng Jian , Wang Tao
Published: May 2022

Previous research has mainly focused on the positive effects of organizational citizenship behavior (OCB). This study questions the positive impact of OCB, arguing that there is a health cost of OCB. Based on the conservation of resource theory, this study expects that OCB triggers citizenship fatigue, which, in turn, negatively affects employees’ health and results in health complaints. This study also seeks to find a moderator (health-promoting leadership) that could mitigate the negative effects of citizenship fatigue (caused by engaging in OCB) on health complaints. To test our predictions, we collected three-wave data from 207 leader–subordinate dyads. The results of regression analyses show that OCB is positively related to employees’ health complaints, which is mediated by citizenship fatigue. Health-promoting leadership weakens the positive relationship between citizenship fatigue and health complaints, thus negatively moderating the indirect relationship between OCB and health complaints via citizenship fatigue. This study provides theoretical and practical implications for future research directions.
Non-Normality as a Predictor of Participation in Bullying: Valuation in Victims and Aggressors
Authors: Carretero Bermejo Raúl , Nolasco Hernández Alberto , Gracia Sánchez Laura
Published: May 2022

Bullying is related to several variables, including diversity and variables that place the victim outside of normality. However, it is not easy to find a single meaning of normality. The present study has two main objectives: to find out whether victims are evaluated as non-normal and to find out whether aggressors are evaluated as non-normal. A cross-sectional, correlational, and quantitative study was designed, focusing on a representative sample of secondary school students from the Community of Madrid. The sample consisted of 2076 participants and was constructed using a stratified, proportional, and random sampling technique. To gather this information, a questionnaire was constructed. It includes a first section where sociodemographic and normality information is collected, and a second section made up of the Defensor del pueblo-UNICEF Bullying Questionnaire. The reliability and consistency of the questionnaire are acceptable (Cronbach’s alpha 0.91). For the comparison of means between groups, a Student’s t-test was applied, and the correlation between variables was calculated by applying the bivariate correlation test. Results show that victims are evaluated as non-normal while aggressors are perceived as normal. This implies that the risk of being involved in bullying situations as a victim can be predicted.
The Prospective Co-Parenting Relationship Scale (PCRS) for Sexual Minority and Heterosexual People: Preliminary Validation
Authors: Leal Daniela , Gato Jorge , Coimbra Susana , Tasker Fiona , Tornello Samantha
Published: May 2022

The coparenting relationship begins with a process of planning and negotiation about having children. Available psychological instruments have not been adapted to sexual minority people, which compromises their ecological validity. This mixed method study aimed to adapt and validate a prospective version of the Co-Parenting Relationship Scale in a Portuguese sample of sexual minority and heterosexual adults who did not have children and who were in a dyadic relationship. In study 1, cognitive interviews were used to gather participants’ reflections about the original items and the role played by the family of origin and anticipated stigma in coparenting (n = 6). In study 2, using a sample of individuals from 18 to 45 years old, two Exploratory Factor Analyses (EFA) were conducted separately for sexual minority (n = 167) and heterosexual persons (n = 198), and a Confirmatory Factor Analysis (CFA) was conducted for heterosexual persons (n = 176). Results showed underscored the importance of families of origin independent of sexual orientation. Different factorial structures for sexual minority and heterosexual persons were observed. Among sexual minority persons, the role of stigma was also highlighted. Implications for practice and research are discussed.
The Role of Physical Activity Status in the Relationship between Obesity and Carotid Intima-Media Thickness (CIMT) in Urban South African Teachers: The SABPA Study
Authors: Veldsman Tamrin , Swanepoel Mariette , Monyeki Makama Andries , Brits Johanna Susanna , Malan Leoné
Published: May 2022

Globally, the prevalence of physical inactivity and obesity are on the rise, which may increase carotid intima-media thickness (CIMT) as a marker of subclinical atherosclerosis. This study assessed the association between physical activity (PA), obesity, and CIMT. A cross-sectional study design was used, including a sub-sample (n = 216) of teachers who participated in the Sympathetic Activity and Ambulatory Blood Pressure in Africans (SAPBA) study. Measurements included the following: physical activity status (measured with ActiHeart devices over 7 consecutive days), body mass index (BMI), waist circumference (WC), waist-to-height ratio (WtHR), CIMT (measured by SonoSite Micromax ultrasound), blood pressure (BP), fasting C-reactive protein (CRP), and cholesterol and glucose levels. Data were analysed using the Statistical Package for Social Science. One-third of the teachers were physically inactive (33%) and had low-grade inflammation CRP ≥ 3 mg/L (41%). Males were more sedentary and had higher BP and CIMT (p < 0.05). Independent of age and sex, WC or central obesity was 2.63 times more likely (p = 0.02) to contribute to atherosclerosis, especially in females (OR: 4.23, p = 0.04). PA levels were insignificantly and negatively (β −0.034; 0.888; 0.240) related to subclinical atherosclerosis. The cardiovascular disease risk profiles and limited PA status may have curbed the beneficial impact of PA on the obesity and atherosclerosis.
Leachate Pretreatment before Pipe Transportation: Reduction of Leachate Clogging Potential and Upgrading of Landfill Gas
Authors: Xie Mingde , Guo Xi , Liu Dan
Published: May 2022

Leachate and landfill gas are the main contaminants produced by modern sanitary landfills. The leachate easily leads to clogging in the leachate transportation pipe, and the landfill gas can be used as renewable energy after the removal of CO2. The study aims to investigate the removal of the major scale forming ion of Ca2+ in leachate using raw landfill gas before pipe transportation. The research demonstrated that, under the given experimental conditions, the removal rate of Ca2+ in the leachate was positively correlated with the pH value of the leachate, and negatively correlated with the intake flow rate of the landfill gas; the highest removal rate of Ca2+ was achieved when the intake flow rate and volume were 0.05 L/min and 2.0 L, respectively, and the highest removal rate of Ca2+ from the leachate was about 90%. The maximum removal rate of CO2 from landfill gas could reach 95%, and the CO2 content of the post-reaction gas was as low as 1.74% (volume percentage). The scanning electron microscope (SEM) and X-ray diffraction (XRD) analysis showed that the precipitate was spherical and mainly contained inorganic substances such as CaCO3, MgCO3, Ca(OH)2, Mg(OH)2, and SiO2. The study showed that, before the leachate was piped, the Ca2+ could be removed using the raw landfill gas, thereby reducing the potential for the formation of precipitation clogging in the pipeline. This study also provides new ideas for upgrading landfill gas to achieve a renewable-energy utilization plan, and reduces greenhouse gas emissions by reducing CO2 emissions from landfills.
Clinical Training during the COVID-19 Pandemic: Experiences of Nursing Students and Implications for Education
Authors: Dziurka Magdalena , Machul Michał , Ozdoba Patrycja , Obuchowska Anna , Kotowski Michał , Grzegorczyk Aleksandra , Pydyś Aleksandra , Dobrowolska Beata
Published: May 2022

The COVID-19 pandemic has caused difficulties in the organization of clinical classes for nursing students. It is therefore important to explore students’ experiences related to participation in clinical classes during the pandemic and to draw conclusions that will allow for the introduction of innovations enabling the development of the required professional competencies as part of training during current and future pandemic restrictions. In this study, we aimed to explore the experiences of nursing students related to clinical education during the COVID-19 pandemic and to identify practical implications for this education in the future. A qualitative study was performed based on individual interviews among Polish nursing students (n = 20). The study is reported using the COREQ checklist. Content analysis was applied, and five main categories were identified, including ‘the key role of clinical mentor’, ‘theory-practice gap’, ‘ambivalent emotions and ethical challenges’, ‘to be part of the team’, and ‘strengthened professional identity’. The results of our research indicate that higher education institutions should implement clear strategies to support students, both in terms of psychological support and compensation of professional skills, the development of which might be limited during the pandemic. Modern technologies, including medical simulations, virtual reality, artificial intelligence, and telemedicine should be used in the practical teaching of nursing students to educate them on how to cope with difficult, new situations, build decision-making skills, and solve problems.
Exploring the User Interaction Network in an Anxiety Disorder Online Community: An Exponential Random Graph Model with Topical and Emotional Effects
Authors: Liu Jingfang , Liu Yafei
Published: May 2022

The increasing number of people with anxiety disorders presents challenges when gathering health information. Users in anxiety disorder online communities (ADOCs) share and obtain a variety of health information, such as treatment experience, drug efficacy, and emotional support. This interaction alleviates the difficulties involved in obtaining health information. Users engage in community interaction via posts, comments, and replies, which promotes the development of an online community as well as the wellbeing of community users, and research concerning the formation mechanism of the user interaction network in ADOCs could be beneficial to users. Taking the Anxiety Disorder Post Bar as the research object, this study constructed an ADOC user interaction network based on users’ posts, comments, and personal information data. With the help of exponential random graph models (ERGMs), we studied the effects of the network structure, user attributes, topics, and emotional intensity on user interaction networks. We found that there was significant reciprocity in the user interaction network in ADOCs. In terms of user attributes, gender homogeneity had no impact on the formation of the user interaction network. Experienced users in the community had obvious advantages, and experienced users could obtain replies more easily from other members. In terms of topics, pathology popularization showed obvious homogeneity, and symptoms of generalized anxiety disorder showed obvious heterogeneity. In terms of emotional intensity, users with polarized emotions were more likely to receive replies from users with positive emotions. The probability of interaction between two users with negative emotions was small, and users with opposite emotional polarity tended to interact, especially when the interaction was initiated by users with positive emotions.
Influence of Social Adversity on Perceived Health Status and Depressive Symptoms among Portuguese Older People
Authors: Sampaio Joana , Henriques Ana , Ramos Elisabete , Dias Isabel , Lopes Alexandra , Fraga Sílvia
Published: May 2022

This study aims to investigate how exposure to poverty, food insecurity, and abuse at older ages relates to health outcomes. A questionnaire collecting data on sociodemographic and economic characteristics, health status, depressive symptoms, food insecurity, and abuse was administered to a sample of 677 older adults. Logistic regression was used to quantify the association of poverty, food insecurity, and abuse with perceived health status and depressive symptoms. If the older person only reported experiences of abuse, it was more likely to report the presence of depressive symptoms, even after adjustment for covariates. If it was only reported the experience of food insecurity, it was more likely to report a worse health status. Older people exposed to at least two factors of vulnerability were significantly more likely to report (very) poor perceived health status (OR: 7.11, 95% CI: 2.77–18.25) and the presence of relevant depressive symptoms (OR: 4.34; 95% CI: 2.04–9.22). Thus, the combined effect of vulnerabilities was significantly associated with worse health among older people. Public health policies to mitigate these adverse exposures should be developed to promote health and well-being in this population.
Molecular Mechanisms of Hemostasis, Thrombosis and Thrombo-Inflammation
Authors: Kuijpers Marijke J. E. , Heemskerk Johan W. M. , Jurk Kerstin
Published: May 2022

In the present decade, we are seeing a rapid increase in available genetics and multiomics information on blood and vascular components of the human and mammalian circulation, involved in haemostasis, athero- and venous thrombosis, and thrombo-inflammation [...]
The Role of IgG Fc Region N-Glycosylation in the Pathomechanism of Rheumatoid Arthritis
Authors: Gyebrovszki Balázs , Ács András , Szabó Dániel , Auer Felícia , Novozánszki Soma , Rojkovich Bernadette , Magyar Anna , Hudecz Ferenc , Vékey Károly , Drahos László , Sármay Gabriella
Published: May 2022

Anti-citrullinated protein antibodies (ACPAs) are involved in the pathogenesis of rheumatoid arthritis. N-glycosylation pattern of ACPA-IgG and healthy IgG Fc differs. The aim of this study is to determine the relative sialylation and galactosylation level of ACPAs and control IgG to assess their capability of inducing TNFα production, and furthermore, to analyze the correlations between the composition of Fc glycans and inflammatory markers in RA. We isolated IgG from sera of healthy volunteers and RA patients, and purified ACPAs on a citrulline-peptide column. Immunocomplexes (IC) were formed by adding an F(ab)2 fragment of anti-human IgG. U937 cells were used to monitor the binding of IC to FcγR and to trigger TNFα release determined by ELISA. To analyze glycan profiles, control IgG and ACPA-IgG were digested with trypsin and the glycosylation patterns of glycopeptides were analyzed by determining site-specific N-glycosylation using nano-UHPLC-MS/MS. We found that both sialylation and galactosylation levels of ACPA-IgG negatively correlate with inflammation-related parameters such as CRP, ESR, and RF. Functional assays show that dimerized ACPA-IgG significantly enhances TNFα release in an FcγRI-dependent manner, whereas healthy IgG does not. TNFα production inversely correlates with the relative intensities of the G0 glycoform, which lacks galactose and terminal sialic acid moieties.
Editorial to Special Issue “Theme Issue Honoring Prof. Dr. Ludger Wessjohann’s 60th Birthday: Natural Products in Modern Drug Discovery”
Authors: Hussain Hidayat
Published: May 2022

Nature continuously produces biologically useful molecules and provides mankind with life-saving drugs or therapies [...]
Implication of microRNAs in Carcinogenesis with Emphasis on Hematological Malignancies and Clinical Translation
Authors: Gaál Zsuzsanna
Published: May 2022

MicroRNAs (miRNAs) are evolutionarily conserved small non-coding RNAs, that are involved in the multistep process of carcinogenesis, contributing to all established hallmarks of cancer. In this review, implications of miRNAs in hematological malignancies and their clinical utilization fields are discussed. As components of the complex regulatory network of gene expression, influenced by the tissue microenvironment and epigenetic modifiers, miRNAs are “micromanagers” of all physiological processes including the regulation of hematopoiesis and metabolic pathways. Dysregulated miRNA expression levels contribute to both the initiation and progression of acute leukemias, the metabolic reprogramming of malignantly transformed hematopoietic precursors, and to the development of chemoresistance. Since they are highly stable and can be easily quantified in body fluids and tissue specimens, miRNAs are promising biomarkers for the early detection of hematological malignancies. Besides novel opportunities for differential diagnosis, miRNAs can contribute to advanced chemoresistance prediction and prognostic stratification of acute leukemias. Synthetic oligonucleotides and delivery vehicles aim the therapeutic modulation of miRNA expression levels. However, major challenges such as efficient delivery to specific locations, differences of miRNA expression patterns between pediatric and adult hematological malignancies, and potential side effects of miRNA-based therapies should be considered.
Optical Fluorescence Imaging of Native Proteins Using a Fluorescent Probe with a Cell-Membrane-Permeable Carboxyl Group
Authors: Kim Jung Min , Kang Young-Mi
Published: May 2022

Although various methods for selective protein tagging have been established, their ap plications are limited by the low fluorescent tagging efficiency of specific terminal regions of the native proteins of interest (NPIs). In this study, the highly sensitive fluorescence imaging of single NPIs was demonstrated using a eukaryotic translation mechanism involving a free carboxyl group of a cell-permeable fluorescent dye. In living cells, the carboxyl group of cell-permeable fluorescent dyes reacted with the lysine residues of acceptor peptides (AP or AVI-Tag). Genetically encoded recognition demonstrated that the efficiency of fluorescence labeling was nearly 100%. Nickel-nitrilotriacetic acid (Ni-NTA) beads bound efficiently to a single NPI for detection in a cell without purification. Our labeling approach satisfied the necessary conditions for measuring fluorescently labeled NPI using universal carboxyl fluorescent dyes. This approach is expected to be useful for resolving complex biological/ecological issues and robust single-molecule analyses of dynamic processes, in addition to applications in ultra-sensitive NPIs detection using nanotechnology.
Genotoxicological Characterization of (±)cis-4,4′-DMAR and (±)trans-4,4′-DMAR and Their Association
Authors: Lenzi Monia , Gasperini Sofia , Cocchi Veronica , Tirri Micaela , Marti Matteo , Hrelia Patrizia
Published: May 2022

The novel psychoactive substance (NPS) 4-Methyl-5-(4-methylphenyl)-4,5-dihydroxazol-2-amine (4,4′-DMAR) shows psychostimulant activity. Data on the acute toxicity of 4,4′-DMAR are becoming increasingly available, yet the long-term effects are still almost unknown. In particular, no data on genotoxicity are available. Therefore, the aim of the present study was to evaluate its genotoxic potential using the “In Vitro Mammalian Cell Micronucleus Test” (MNvit) on (±)cis-4,4′-DMAR and (±)trans-4,4′-DMAR and their associations. The analyses were conducted in vitro on human TK6 cells. To select suitable concentrations for MNvit, we preliminarily evaluated cytotoxicity and apoptosis. All endpoints were analysed by flow cytometry. The results reveal the two racemates’ opposite behaviours: (±)cis-4,4′-DMAR shows a statistically significant increase in micronuclei (MNi) frequency that (±)trans-4,4′-DMAR is completely incapable of. This contrast confirms the well-known possibility of observing opposite biological effects of the cis- and trans- isomers of a compound, and it highlights the importance of testing single NPSs that show even small differences in structure or conformation. The genotoxic capacity demonstrated stresses an additional alarming toxicological concern related to this NPS. Moreover, the co-treatments indicate that consuming both racemates will magnify the genotoxic effect, an aspect to consider given the unpredictability of illicit drug composition.
Analysis of Huntington’s Disease Modifiers Using the Hyperbolic Mapping of the Protein Interaction Network
Authors: Vagiona Aimilia-Christina , Mier Pablo , Petrakis Spyros , Andrade-Navarro Miguel A.
Published: May 2022

Huntington’s disease (HD) is caused by the production of a mutant huntingtin (HTT) with an abnormally long poly-glutamine (polyQ) tract, forming aggregates and inclusions in neurons. Previous work by us and others has shown that an increase or decrease in polyQ-triggered aggregates can be passive simply due to the interaction of proteins with the aggregates. To search for proteins with active (functional) effects, which might be more effective in finding therapies and mechanisms of HD, we selected among the proteins that interact with HTT a total of 49 pairs of proteins that, while being paralogous to each other (and thus expected to have similar passive interaction with HTT), are located in different regions of the protein interaction network (suggesting participation in different pathways or complexes). Three of these 49 pairs contained members with opposite effects on HD, according to the literature. The negative members of the three pairs, MID1, IKBKG, and IKBKB, interact with PPP2CA and TUBB, which are known negative factors in HD, as well as with HSP90AA1 and RPS3. The positive members of the three pairs interact with HSPA9. Our results provide potential HD modifiers of functional relevance and reveal the dynamic aspect of paralog evolution within the interaction network.
Characterisation of Extracellular Vesicles from Equine Mesenchymal Stem Cells
Authors: Soukup Robert , Gerner Iris , Gültekin Sinan , Baik Hayeon , Oesterreicher Johannes , Grillari Johannes , Jenner Florien
Published: May 2022

Extracellular vesicles (EVs) are nanosized lipid bilayer-encapsulated particles secreted by virtually all cell types. EVs play an essential role in cellular crosstalk in health and disease. The cellular origin of EVs determines their composition and potential therapeutic effect. Mesenchymal stem/stromal cell (MSC)-derived EVs have shown a comparable therapeutic potential to their donor cells, making them a promising tool for regenerative medicine. The therapeutic application of EVs circumvents some safety concerns associated with the transplantation of viable, replicating cells and facilitates the quality-controlled production as a ready-to-go, off-the-shelf biological therapy. Recently, the International Society for Extracellular Vesicles (ISEV) suggested a set of minimal biochemical, biophysical and functional standards to define extracellular vesicles and their functions to improve standardisation in EV research. However, nonstandardised EV isolation methods and the limited availability of cross-reacting markers for most animal species restrict the application of these standards in the veterinary field and, therefore, the species comparability and standardisation of animal experiments. In this study, EVs were isolated from equine bone-marrow-derived MSCs using two different isolation methods, stepwise ultracentrifugation and size exclusion chromatography, and minimal experimental requirements for equine EVs were established and validated. Equine EVs were characterised using a nanotracking analysis, fluorescence-triggered flow cytometry, Western blot and transelectron microscopy. Based on the ISEV standards, minimal criteria for defining equine EVs are suggested as a baseline to allow the comparison of EV preparations obtained by different laboratories.
Fluctuations in Corneal Endothelial LAP2 Expression Levels Correlate with Passage Dependent Declines in Their Cell Proliferative Activity
Authors: Maurizi Eleonora , Merra Alessia , Schiroli Davide , Ghezzi Benedetta , Macaluso Claudio , Pellegrini Graziella
Published: May 2022

The corneal endothelium is the inner corneal mono-layered epithelium, fundamental for preserving corneal hydration and transparency. However, molecular mechanisms that regulate corneal endothelial cells (CEnCs), in particular regarding their proliferative capacity, have been only partially elucidated. CEnCs are quiescent in vivo and they easily undergo endothelial to mesenchymal transition (EnMT) in vitro. This study aims to analyze CEnCs behavior and expression in vitro, either in sub-confluent growing (S) or confluent (C) CEnCs cultures. Primary rabbit and human CEnCs were cultured and used for RT-PCR, immunofluorescence or western blot analysis. These methods allowed identifying a novel molecular marker, LAP2, that is upregulated in S while downregulated in C human or rabbit CEnCs. Those results were observed for several subsequent passages in culture and this, together with the correlation between ki67 and LAP2 expression, suggested LAP2 as a novel possible indicator for culture ageing. Finally, treatment with FGF and TGFβ in rCEnCs highlighted how LAP2 can vary as the cells regulate their proliferative state. In conclusion, we have identified a novel marker for CEnCs, LAP2, that regulates its expression depending on the cells sub/confluent state and that correlates with CEnCs proliferation.
Experiences of Families Caring for Children with Newborn Screening-Related Conditions: Implications for the Expansion of Genomics in Population-Based Neonatal Public Health Programs
Authors: Bush Lynn , Davidson Hannah , Gelles Shani , Lea Dawn , Koehly Laura
Published: May 2022

With the expansion of newborn screening conditions globally and the increased use of genomic technologies for early detection, there is a need for ethically nuanced policies to guide the future integration of ever-more comprehensive genomics into population-based newborn screening programs. In the current paper, we consider the lived experiences of 169 family caregivers caring for 77 children with NBS-related conditions to identify lessons learned that can inform policy and practice related to population-based newborn screening using genomic technologies. Based on caregiver narratives obtained through in-depth interviews, we identify themes characterizing these families’ diagnostic odyssey continuum, which fall within two domains: (1) medical management implications of a child diagnosed with an NBS-related condition and (2) psychological implications of a child diagnosed with an NBS-related condition. For Domain 1, family caregivers’ experiences point to the need for educational resources for both health care professionals that serve children with NBS-related conditions and their families; empowerment programs for family caregivers; training for providers in patient-centered communication; and access to multi-disciplinary specialists. For Domain 2, caregivers’ experiences suggest a need for access to continuous, long-term counseling resources; patient navigator resources; and peer support programs. These lessons learned can inform policy recommendations for the benefit of the child, the family, the healthcare system, and society.