bluuebunny/crossref_metadata_2025 huggingface dataset:
Exploring the Use of Washington Group Questions to Identify People with Clinical Impairments Who Need Services including Assistive Products: Results from Five Population-Based Surveys
Authors: Boggs Dorothy , Kuper Hannah , Mactaggart Islay , Bright Tess , Murthy GVS , Hydara Abba , McCormick Ian , Tamblay Natalia , Alvarez Matias L. , Atijosan-Ayodele Oluwarantimi , Yonso Hisem , Foster Allen , Polack Sarah
Published: April 2022

This study analyses the use of the self-reported Washington Group (WG) question sets as a first stage screening to identify people with clinical impairments, service and assistive product (AP) referral needs using different cut-off levels in four functional domains (vision, hearing, mobility and cognition). Secondary data analysis was undertaken using population-based survey data from five countries, including one national survey (The Gambia) and four regional/district surveys (Cameroon, Chile, India and Turkey). In total 19,951 participants were sampled (range 538–9188 in individual studies). The WG question sets on functioning were completed for all participants alongside clinical impairment assessments/questionnaires. Using the WG “some/worse difficulty” cut-off identified people with mild/worse impairments with variable sensitivity (44–79%) and specificity (73–92%) in three of the domains. At least 64% and 60% of people with mild/worse impairments who required referral for surgical/medical and rehabilitation/AP services, respectively, self-reported “some/worse difficulty”, and much fewer reported “a lot/worse difficulty.” For moderate/worse impairment, both screening cut-offs improved identification of service/AP need, but a smaller proportion of people with need were identified. In conclusion, WG questions could be used as a first-stage screening option to identify people with impairment and referral needs, but only with moderate sensitivity and specificity.
How Symbols and Social Interaction Influence the Experienced Utility of Sustainable Lifestyle Guiding Policies: Evidence from Eastern China
Authors: Cheng Xiu , Long Ruyin , Wu Fan
Published: April 2022

As the key to mitigating climate change, a sustainable lifestyle has become a focus of environment policy. Past studies have largely neglected the symbols of sustainable lifestyle guiding policies and failed to capture its effect on the experienced utility of sustainable lifestyle guiding policies (EUSLGP). To address this drawback, symbolic value was incorporated into a model consisting of social interaction and the EUSLGP. With data collected from 3257 respondents in Eastern China, ordinary least squares were applied to examine hypotheses and two-stage least squares based on the instrumental variable to verify the results. Results show that symbolic value combines self-expression value, relationship consolidation value, group identification value, and status-showing value, and is positively associated with EUSLGP. Social interaction plays a moderating role in the association between symbolic value and EUSLGP. Moreover, significant regional differences are discovered in the identified relationships. Consequently, policy suggestions, covering symbolic value, social interaction, and regional conditions, are proposed to enhance the EUSLGP for other countries and regions.
Genotoxic Effects of Lead and Their Impact on the Expression of DNA Repair Genes
Authors: Hemmaphan Sirirak , Bordeerat Narisa K.
Published: April 2022

Exposure to lead (Pb) continues to be a significant worldwide problem. Pb is a highly poisonous heavy metal affecting several organ systems in the body. Although Pb has been shown to be genotoxic to experimental animals and humans, the underlying mechanisms are still not understood. An indirect mechanism related to the inhibition of DNA repair systems by Pb has been suggested. Heavy metals can interfere with the activities of several proteins and gene expressions. Recent studies gathered in this review article demonstrated an altered expression of DNA repair genes due to Pb toxicity. However, their findings are conflicting. Furthermore, the interaction of Pb and epigenetic mechanisms regulating gene expression may have a crucial role in the inhibition of DNA repair systems. Therefore, additional studies are needed to evaluate these findings and to obtain a complete picture of the genotoxic properties of Pb and the underlying mechanisms that may have a crucial role in carcinogenesis.
Microbial Contamination and Survival Rate on Different Types of Banknotes
Authors: Cozorici Derniza , Măciucă Roxana-Alexandra , Stancu Costel , Tihăuan Bianca-Maria , Uță Robert Bogdan , Codrea Cosmin Iulian , Matache Răzvan , Pop Cristian-Emilian , Wolff Robert , Fendrihan Sergiu
Published: April 2022

In the COVID-19 pandemic context, numerous concerns have been raised regarding the hygienic status of certain objects we interact with on a daily basis, and especially cash money and their potential to harbor and transmit pathogenic bacteria. Therefore, in the present study, we analyzed different currency bills represented by British pounds (5 £, 10 £ and 20 £), Romanian lei (1 leu, 5 lei and 10 lei), U.S. dollars (1 $, 5 $ and 10 $) and Euros (5 €, 10 € and 20 €) in order to evaluate the bacterial survival rate and bacterial adherence. We used five reference microorganisms by American Type Culture Collection (ATCC, Manassas, VA, USA): Staphylococcus aureus ATCC 6538, Escherichia coli ATCC 8739, Enterococcus sp. ATCC 19952, Salmonella enterica subsp. enterica serovar Typhi ATCC 6539, and Listeria monocytogenes ATCC 7644. Microorganisms were selected in accordance with the criteria of prevalence, pathogenicity, opportunism, and incidence. However, Maldi-TOF analysis from samples taken from the banknotes revealed only a few of the common pathogens that are traditionally thought to be found on banknotes. Some of the most important factors for the survival of pathogenic agents on surfaces are the presence of organic matter, temperature and humidity. Our data showed that Salmonella enterica survived 72 h on every banknote tested, while L. monocytogenes tended to improve persistence in humid conditions. Survival rate is also influenced by the substrate composition, being lower for polymer-based banknotes especially for Salmonella enterica, Listeria monocytogenes and Enterococcus sp. The adherence of bacterial strains was lower for polymer-based banknotes British pounds and Romanian Leu, in contrast to the cotton-based U.S dollars and Euro banknotes. The risk of bacterial contamination from the banknote bills is high as indicated by both a strong survival capacity and low adherence of tested bacteria with differences between the two types of materials used for the tested banknotes.
Differences in Characteristics between Older Adults Meeting Criteria for Sarcopenia and Possible Sarcopenia: From Research to Primary Care
Authors: Shin Hyung Eun , Kim Miji , Won Chang Won
Published: April 2022

Identification of possible sarcopenia, which is a simple assessment of sarcopenia, has been proposed for the earlier detection of sarcopenia in primary care settings; however, there are no studies comparing the differences in characteristics of older adults with possible sarcopenia or sarcopenia. This study aimed to compare the characteristics of “possible sarcopenia” in real-world primary care and “sarcopenia” in research settings. A total of 2129 older adults were enrolled from the Korean Frailty and Aging Cohort Study. Possible sarcopenia and sarcopenia were defined using Asian Working Group for Sarcopenia 2019; the possible sarcopenia for real-world primary care was defined by a combination of case findings using low calf circumference or the SARC-F questionnaire and 5-times chair stand test, without considering the measurement of handgrip strength. The prevalence of possible sarcopenia was higher in women than in men; however, that of sarcopenia was higher in men than in women (all, p < 0.001). Older men and women with possible sarcopenia had a lower education level, longer time taken for the Timed Up and Go test, more severe mobility limitation, lower scores on the EuroQol-5 dimension and 12-item short-form survey for physical health, and more cognitive dysfunction than those with sarcopenia did (all, p < 0.05). In conclusion, the participants with possible sarcopenia differed from those with sarcopenia in some characteristics. Identifying differences in characteristics may be helpful to screening and earlier diagnosis of sarcopenia in real-world primary care, as well as in research, which can lay the foundations for personalized lifestyle intervention in diet and exercise.
Drug-Related Problems and Polypharmacy in Nursing Home Residents: A Cross-Sectional Study
Authors: Díez Raquel , Cadenas Raquel , Susperregui Julen , Sahagún Ana M. , Fernández Nélida , García Juan J. , Sierra Matilde , López Cristina
Published: April 2022

At present, 19.2% of the Spanish population is aged 65 or older. Polypharmacy is a frequent condition among the elderly, especially in those living in nursing homes, which is associated with adverse outcomes, such as adverse drug events or drug-drug interactions. This study aimed to assess the pattern of polypharmacy in a nursing home in Leon, one of Spain’s most ageing regions, and its relationship with different drug-related problems. A descriptive, observational, and cross-sectional study design was used; 222 residents were involved in this study. Data on drug use were collected from medical charts. Information was screened with the software CheckTheMeds, BOT PLUS and Drug-Reax. Residents were on a median of 7 medicines. Polypharmacy and inappropriate medications were present in 78.8% and 96.8% of residents, respectively. Drug-related problems were present in almost all the populations evaluated. Drug-drug interactions were very common in participants (81.1%), being severe/moderate in 24.7%. A high prevalence of polypharmacy and drug-related problems in the nursing home population assessed has been observed. A significantly higher risk of suffering drug-drug interactions was revealed for increasing polypharmacy and anticholinergic risk. A regular evaluation of drug prescribing in nursing home residents is necessary to minimize drug-related problems risk.
Home-Based Physical Activity as a Healthy Aging Booster before and during COVID-19 Outbreak
Authors: De Maio Marianna , Bratta Cecilia , Iannaccone Alice , Castellani Loriana , Foster Carl , Cortis Cristina , Fusco Andrea
Published: April 2022

The role of physical activity in improving overall aspects of health regardless of age is well documented. Due to the coronavirus disease 2019 outbreak, preventive measures to limit airborne infection have been introduced, with people, especially older adults, advised to stay at home, thus increasing sedentary lifestyle and the risk of chronic diseases. As one of the few possible ways to stay active is home-based training, this review aims to provide evidence on alternative and feasible home-based activity programs as a tool to improve the fitness level in older adults, especially when preventive measures are needed to ensure isolation and limit interpersonal contacts. During quarantine, older adults, especially those with chronic diseases, are recommended to regularly exercise. Combined balance and muscle-strengthening training has proven to be particularly useful in limiting falls and mobility limitations. In addition, the use of virtual reality systems seems to be a potential strategy in remaining physically active, reducing physical inactivity time and significantly increasing the compliance of the older adults with physical activity programs. In conclusion, home-based programs induce improvements in physical functions in general and quality of life in older people with or without co-morbidities, and it can be considered in the future as one of the feasible and economic ways to increase physical well-being. This may be of unique importance in the setting of coronavirus disease 2019 enforced limitations in out-of-home activity.
Natural History of the Hymenoptera Venom Sensitivity Reactions in Adults: Study Design
Authors: Perčič Simona , Bojanić Lidija , Košnik Mitja , Kukec Andreja
Published: April 2022

Background: Allergic reactions to Hymenoptera stings can have varying levels of severity, according to the Müller grading system. Methods: By an epidemiological concept, this is a retrospective cohort study. The observed cohort was represented by patients referred to the University Clinic Golnik due to Hymenoptera allergic reaction in the period from 1997 to 2015. From the immunological database of the University Clinic Golnik, we obtained laboratory data (sIgE, skin tests and basophil activation test). The clinical characteristics of patients were obtained from BIRPIS. With the help of a questionnaire, which was sent to each patient in the period from May 2019 to April 2021, we obtained epidemiological data. For the assessment of the association between the severity of allergic reaction for the observed outcome, the severity of the first allergic reaction after Hymenoptera sting was used. Other variables were grouped according to risk factors. Discussion: We will identify the risk factors that could play an important role in a severe systemic reaction: the aetiology of the Hymenoptera sting, sex, age, history and severity of previous systemic reactions, being re-stung in an interval of two months, the frequency of re-stings, atopy, genetic predisposition, preventive medication use, other medication use, beekeeping or living next to beehives and why immunotherapy was not taken. Laboratory data will also be analysed to determine if there is any association with laboratory tests and the severity of the allergic reactions after Hymenoptera stings. Conclusions: Several new approaches are introduced in the study design. The most important is that the protocol covers epidemiological data gained from the questionnaire, as well as clinical data gained from the Immunological database and BIRPIS database. We expect to obtain significant results that will explain the risk factors for the natural history of Hymenoptera sting allergic reactions and will help allergologists, as well as general doctors, when facing those patients allergic to Hymenoptera venom without immunotherapy.
Excretion of Ni, Pb, Cu, As, and Hg in Sweat under Two Sweating Conditions
Authors: Kuan Wen-Hui , Chen Yi-Lang , Liu Chao-Lin
Published: April 2022

Physiologists have long regarded sweating as an effective and safe means of detoxification, and heavy metals are excreted through sweat to reduce the levels of such metals in the body. However, the body can sweat through many means. To elucidate the difference in the excretion of heavy metals among sweating methods, 12 healthy young university students were recruited as participants (6 men and 6 women). Sweat samples were collected from the participants while they were either running on a treadmill or sitting in a sauna cabinet. After they experienced continuous sweating for 20 min, a minimum of 7 mL of sweat was collected from each participant, and the concentrations of nickel (Ni), lead (Pb), copper (Cu), arsenic (As), and mercury (Hg) were analyzed. The results demonstrated that the sweating method affected the excretion of heavy metals in sweat, with the concentrations of Ni, Pb, Cu, and As being significantly higher during dynamic exercise than during sitting in the sauna (all p < 0.05). However, the concentrations of Hg were unaffected by the sweating method. This study suggests that the removal of heavy metals from the body through dynamic exercise may be more effective than removal through static exposure to a hot environment.
The Effect of Neighborhood Deprivation on Mortality in Newly Diagnosed Diabetes Patients: A Countrywide Population-Based Korean Retrospective Cohort Study, 2002–2013
Authors: Cho Kyoung-Hee , Kim Juyeong , Choi Young , Kim Tae-Hyun
Published: April 2022

Background: Neighborhood environmental factors along with individual factors are beginning to make a mark as factors which influence individual health outcomes. The goal of this study is to look at the combined impact of individual and neighborhood socioeconomic status on all-cause mortality in diabetic patients who have just been diagnosed. Methods: The Korean National Health Insurance (2002–2013) was employed in this cohort research, which used a stratified random sample. During the years 2003–2006, a total of 15,882 individuals who were newly diagnosed with diabetes and using oral disease-controlling medication were included in the study. Individual income and neighborhood deprivation index were used to examine the combined effect on all-cause mortality. The frailty model was performed using Cox’s proportional hazard regression. Results: During the study period, 28.3 percent (n = 4493) of the 15,882 eligible individuals died. In a Cox regression analysis after adjusting for all covariates, with advantaged and disadvantaged neighborhoods classified according to individual household income, the adjusted HR for patients living in a disadvantaged area was higher compared to patients living in an advantaged area in patients with middle income, compared to the reference group (a high income within an advantaged neighborhood) (HR, 1.22; 95% CI, 1.09–1.35; HR, 1.13; 95% CI, 1.02–1.25, respectively). The adjusted HR for patients with low income who lived in a disadvantaged location was greater than for patients who lived in an advantaged area (HR, 1.34; 95% CI, 1.18–1.53 vs. HR, 1.28; 95% CI, 1.14–1.49). Conclusions: Individual SES has a greater impact on all-cause mortality among diabetic patients when they live in a low-income neighborhood.
Factors Determining the Functional State of Cardiac Surgery Patients with Complicated Postoperative Period
Authors: Sumin Alexey N. , Oleinik Pavel A. , Bezdenezhnykh Andrey V. , Bezdenezhnykh Natalia A.
Published: April 2022

The purpose of this work was to study the factors determining the functional state of cardiac surgery patients with a complicated postoperative period upon discharge from the hospital. This observational study included 60 patients who underwent cardiac surgery with a complicated postoperative course and with a prolonged intensive care unit stay of more than 72 h. We assessed handgrip and lower-extremity muscle strength and the six-minute walk test (6MWT) distance 3 days after the surgery and at discharge from the hospital. Some patients (53%) additionally underwent a course of neuromuscular electrostimulation (NMES). Two groups of patients were formed: first (6MWT distance at discharge of more than 300 m) and second groups (6MWT distance of 300 m or less). The patients of the second group had less lower-extremity muscle strength and handgrip strength on the third postoperative day, a longer aortic clamping time and a longer stay in the intensive care unit. Independent predictors of decreased exercise tolerance at discharge were body mass index, foot extensor strength and baseline 6MWT distance in the general group, duration of cardiopulmonary bypass in the NMES group and in the general group, and age in the NMES group. Thus, the muscle status on the third postoperative day was one of the independent factors associated with the 6MWT distance at discharge in the general group, but not in patients who received NMES. It is advisable to use these results in patients with complications after cardiac surgery with the use of NMES rehabilitation.
The Behavioral Factors That Influence Person-Centered Social Care: A Literature Review and Conceptual Framework
Authors: Tay Eugene , Vlaev Ivo , Massaro Sebastiano
Published: April 2022

The last decade has seen numerous policy reforms to emplace person-centered social care. Consequently, the public has been given more information, choice, and autonomy to decide how best they want to be cared for later in life. Despite this, adults generally fail to plan or prepare effectively for their future care needs. Understanding the behavioral antecedents of person-centered decision-making is thus critical for addressing key gaps in the provision of quality social care. To this end, we conducted a literature review of the psychological and health sciences with the aim of identifying the aspects that influence person-centered decision-making in social care. Using an established theoretical framework, we distilled nine behavioral factors―knowledge, competency, health, goal clarity, time discounting, familiarity, cognitive biases, cognitive overload, and emotion―associated with “Capability,” “Opportunity,” “Motivation,” and “Behavior” that explained person-centered decision-making in social care. These factors exist to different degrees and change as a person ages, gradually impacting their ability to obtain the care they want. We discuss the role of carers and the promise of shared decision-making and conclude by advocating a shift from personal autonomy to one that is shared with carers in the delivery of quality social care.
Healthcare Supply Chain Reliability: The Case of Medical Air Transport
Authors: Skowron-Grabowska Beata , Wincewicz-Bosy Marta , Dymyt Małgorzata , Sadowski Adam , Dymyt Tomasz , Wąsowska Katarzyna
Published: April 2022

The principal task of national healthcare systems is to provide health services that are safe, accessible, high-quality and people-oriented. To ensure the continuity of healthcare, support activities related to patient transfer and logistics are necessary. Effective implementation of transport processes is a factor affecting the possibility of medical intervention, in terms of both planned and life-saving care. The reliability of the healthcare supply chain is a key factor in patient health. In our research, we have used the method of a single case study of a public regional hospital in Poland providing comprehensive medical services. The aim of the research is to identify the factors that affect the reliability of the healthcare supply chain in relation to the interhospital air transport of patients. Our qualitative research using process mapping reveals what factors affect the reliability of interhospital medical air transport. The analysis of 100 interhospital medical air transport cases has allowed us to create a general procedure related to the movement of patients between the facilities of the healthcare system in Poland. Our research shows that the key factor of reliability is the coherent and integrated cooperation of institutions involved in transport processes.
Microfluidic-Based Cationic Cholesterol Lipid siRNA Delivery Nanosystem: Highly Efficient In Vitro Gene Silencing and the Intracellular Behavior
Authors: Zhu Zhaoyuan , Zhang Li , Sheng Ruilong , Chen Jian
Published: April 2022

Safe and efficient delivery of small interfering RNA (siRNA) is essential to gene therapy towards intervention of genetic diseases. Herein, we developed a novel cationic cholesterol lipid derivative (CEL) in which cholesterol hydrophobic skeleton was connected to L-lysine cationic headgroup via a hexanediol linker as the non-viral siRNA delivery carrier. Well-organized CEL/siRNA nanocomplexes (100–200 nm) were prepared by microfluidic-assisted assembly of CEL and siRNA at various N/P ratios. The CEL and CEL/siRNA nanocomplexes have lower cytotoxicity compared with bPEI25k. Delightfully, we disclosed that, in Hela–Luc and H1299–Luc cell lines, the micro-fluidic-based CEL/siRNA nanocomplexes exhibited high siRNA transfection efficiency under both serum-free condition (74–98%) and low-serum circumstances (80–87%), higher than that of lipofectamine 2000. These nanocomplexes also showed high cellular uptake through the caveolae/lipid-raft mediated endocytosis pathway, which may greatly contribute to transfection efficiency. Moreover, the time-dependent (0–12 h) dynamic intracellular imaging demonstrated the efficient delivery to cytoplasm after lysosomal co-localization. The results indicated that the microfluidic-based CEL/siRNA nanosystems possessed good stability, low cytotoxicity, high siRNA delivery efficiency, rapid cellular uptake and caveolae/lipid raft-dependent internalization. Additionally, this study provides a simple approach for preparing and applying a “helper lipid-free” cationic lipid siRNA delivery system as potential nanotherapeutics towards gene silencing treatment of (tumor) diseases.
Calibration Dependencies and Accuracy Assessment of a Silicone Rubber 3D Printer
Authors: Jaksa Laszlo , Pahr Dieter , Kronreif Gernot , Lorenz Andrea
Published: April 2022

Silicone rubbers are relatively new in additive manufacturing, with only a few commercial printing services and reports on custom-built printers available. Publications and standards on calibration and accuracy assessment are especially lacking. In this study, the printhead calibration process of a custom-built silicone printer is explained, and a set of test objects is proposed and evaluated. The printer in use is based on an open-source filament printer, capable of multi-material printing with silicone rubbers and thermoplastic polymers. Three different high-viscosity single-component liquid silicone rubbers and one polylactic acid thermoplastic filament were used as printing materials. First, the calibration process of the silicone printhead was conducted, and the dependency of the dosing accuracy on silicone viscosity, nozzle diameter and extrusion speed was evaluated. Second, various test specimens were proposed and printed to characterize the accuracy and geometric limitations of this printer. These test parts contained features such as thin walls, slender towers, small holes and slots, unsupported overhangs and bridges. It was concluded that silicone viscosity strongly affects geometric inaccuracies. Design recommendations were deducted from the results, advising for wall thicknesses above 1 mm, slenderness ratios below 2, bridging lengths below 2 mm and unsupported overhang angles below 30°.
The Effects of Intranasal, Inhaled and Systemic Glucocorticoids on Intraocular Pressure: A Literature Review
Authors: Wijnants Dries , Stalmans Ingeborg , Vandewalle Evelien
Published: April 2022

Topical glucocorticoids are a well-known risk factor of intraocular pressure (IOP) elevation in one third of the general population and in up to 90% of glaucomatous patients. Whether this steroid response is caused by intranasal, inhaled or systemic glucocorticoids, is less known. This study presents an overview of the current literature on the topic, thereby providing guidance on when ophthalmological follow-up is indicated. A literature study was performed in Medline, and 31 studies were included for analysis. Twelve out of fourteen studies discussing intranasal glucocorticoids show no significant association with an elevated IOP. Regarding inhaled glucocorticoids, only three out of twelve studies show a significant association. The observed increase was either small or was only observed in patients treated with high inhaled doses or in patients with a family history of glaucoma. An elevated IOP caused by systemic glucocorticoids is reported by four out of the five included studies, with one study reporting a clear dose–response relationship. This review concludes that a steroid response can be triggered in patients treated with systemic glucocorticoids. Inhaled glucocorticoids may cause a significant IOP elevation when administered in high doses or in patients with a family history of glaucoma. At present, there is no evidence for a clinically significant steroid response caused by intranasally administered glucocorticoids.
Impact of the COVID-19 Pandemic on In-Patient Treatment of Peripheral Artery Disease in Germany during the First Pandemic Wave
Authors: Scheurig-Muenkler Christian , Schwarz Florian , Kroencke Thomas J. , Decker Josua A.
Published: April 2022

Patients with peripheral artery disease (PAD) belong to a vulnerable population with relevant comorbidity. Appropriate care and timely treatment are imperative, but not readily assured in the current pandemic. What impact did the first wave have on in-hospital treatment in Germany? Nationwide healthcare remuneration data for inpatient care of the years 2019 and 2020 were used to compare demographic baseline data including the assessment of comorbidity (van Walraven score), as well as the encoded treatments. A direct comparison was made between the first wave of infections in 2020 and the reference period in 2019. The number of inpatient admissions decreased by 10.9%, with a relative increase in hospitalizations due to PAD Fontaine IV (+13.6%). Baseline demographics and comorbidity showed no relevant differences. The proportion of emergency admissions increased from 23.4% to 28.3% during the first wave to the reference period in 2019, and in-hospital mortality increased by 21.9% from 2.5% to 3.1%. Minor and major amputations increased by 24.5% and 18.5%. Endovascular and combined surgical/endovascular treatment strategies increased for all stages. Already in the first, comparatively mild wave of the pandemic, significantly fewer patients with predominantly higher-grade PAD stages were treated as inpatients. Consecutively, in-hospital mortality and amputation rates increased.
Safety and Efficacy of the New Combination Iron Chelation Regimens in Patients with Transfusion-Dependent Thalassemia and Severe Iron Overload
Authors: Origa Raffaella , Cinus Monia , Pilia Maria Paola , Gianesin Barbara , Zappu Antonietta , Orecchia Valeria , Clemente Maria Grazia , Pitturru Carla , Denotti Anna Rita , Corongiu Francesco , Piras Simona , Barella Susanna
Published: April 2022

The aim of this study is the evaluation of the safety and the efficacy of long-term combination therapy deferasirox plus desferrioxamine and deferasirox plus deferiprone in a large group of transfusion-dependent thalassemia patients with high values of serum ferritin and/or magnetic resonance, indicative of severe liver and cardiac iron accumulation. Sixteen adults with transfusion-dependent thalassemia were treated simultaneously with deferasirox plus desferrioxamine, while another 42 patients (seven children) were treated with deferasirox plus deferiprone. The hepatic and cardiac iron overload was assessed prior to treatment and then annually with magnetic resonance imaging, and the serum ferritin was measured monthly. Adverse events were checked at each transfusion visit. The safety of both the combinations was consistent with established monotherapies. Both treatments were able to decrease the serum ferritin and liver iron concentration over time, depending on the level of compliance with therapy. Cardiac iron measured as R2* did not significantly change in patients treated with deferasirox plus desferrioxamine. Most patients with MRI indicative of myocardial siderosis at the beginning of treatment reached normal values of cardiac iron at the last determination if treated with deferasirox plus desferrioxamine. The greatest limitation of these therapies was low patient adherence to the two drugs, which is not surprising considering that the need for an intensive chelation is generally linked to previous issues of compliance.
Marginal Bone Maintenance and Different Prosthetic Emergence Angles: A 3-Year Retrospective Study
Authors: Lops Diego , Romeo Eugenio , Stocchero Michele , Palazzolo Antonino , Manfredi Barbara , Sbricoli Luca
Published: April 2022

The aim of the present retrospective study was to assess marginal bone changes around implants restored with different prosthetic emergence profile angles. Patients were treated with implants supporting fixed dentures and were followed for 3 years. Marginal bone levels (MBL) measured at the prosthesis installation (t0) and at the 3-year follow-up visit (t1) were considered. The MBL change from t0 to t1 was investigated. Two groups were considered: Group 1 for restorations with an angle between implant axis and prosthetic emergence profile >30°, and Group 2 for those with an angle ≤30°, respectively. Moreover, peri-implant soft tissue parameters, such as the modified bleeding index (MBI) and plaque index (PI) were assessed. Seventy-four patients were included in the analysis and a total of 312 implants were examined. The mean EA in groups 1 and 2 was 45 ± 4 and 22 ± 7 degrees, respectively. The mean marginal bone level change (MBL change) of 0.06 ± 0.09 mm and 0.06 ± 0.10 mm were, respectively, in groups 1 and 2. The difference in the MBL change between the two groups was not statistically significant (p = 0.969). The MBL change does not seem to be influenced by the emergence angle for implants with a stable internal conical connection and platform-switching of the abutment diameter.
A Japanese Dose of Prasugrel versus a Standard Dose of Clopidogrel in Patients with Acute Myocardial Infarction from the K-ACTIVE Registry
Authors: Mori Hiroyoshi , Mizukami Takuya , Maeda Atsuo , Fukui Kazuki , Akashi Yoshihiro , Ako Junya , Ikari Yuji , Ebina Toshiaki , Tamura Kouichi , Namiki Atsuo , Michishita Ichiro , Kimura Kazuo , Suzuki Hiroshi
Published: April 2022

Background: Dual antiplatelet therapy (DAPT) with aspirin plus P2Y12 inhibitor is used as a standard therapy for patients with acute myocardial infarction (AMI) treated with drug-eluting stents (DESs). In Japan, clopidogrel was the major P2Y12 inhibitor used for a decade until the new P2Y12 inhibitor, prasugrel, was introduced. Based on clinical studies considering Japanese features, the set dose for prasugrel was reduced to 20 mg as a loading dose (LD) and 3.75 mg as a maintenance dose (MD); these values are 60 and 10 mg, respectively, globally. Despite this dose discrepancy, little real-world clinical data regarding its efficacy and safety exist. Methods: From the K-ACTIVE registry, based on the DAPT regimen, patients were divided into a prasugrel group and a clopidogrel group. The ischemic event was a composite of cardiovascular death, non-fatal MI, and non-fatal stroke. The bleeding event was type 3 or 5 bleeding based on the Bleeding Academic Research Consortium (BARC) criteria. Results: Substantially more patients were prescribed prasugrel (n = 2786) than clopidogrel (n = 890). Clopidogrel tended to be selected over prasugrel in older patients with numerous comorbidities. Before adjustments were made, the cumulative incidence of ischemic events at 1 year was significantly greater in the clopidogrel group than in the prasugrel group (p = 0.007), while the cumulative incidence of bleeding events at 1 year was comparable between the groups (p = 0.131). After adjustments were made for the age, sex, body weight, creatine level, type of AMI, history of MI, approach site, oral anticoagulation therapy, presence of multivessel disease, Killip classification, and presence of intra-aortic balloon pumping, both ischemic and bleeding events became comparable between the groups. Conclusion: A Japanese dose of prasugrel was commonly used in AMI patients in the real-world database. Both the prasugrel and clopidogrel groups showed comparable rates of 1 year ischemic and bleeding events.
Fungal Infections in Critically Ill COVID-19 Patients: Inevitabile Malum
Authors: Rovina Nikoletta , Koukaki Evangelia , Romanou Vasiliki , Ampelioti Sevasti , Loverdos Konstantinos , Chantziara Vasiliki , Koutsoukou Antonia , Dimopoulos George
Published: April 2022

Patients with severe COVID-19 belong to a population at high risk of invasive fungal infections (IFIs), with a reported incidence of IFIs in critically ill COVID-19 patients ranging between 5% and 26.7%. Common factors in these patients, such as multiple organ failure, immunomodulating/immunocompromising treatments, the longer time on mechanical ventilation, renal replacement therapy or extracorporeal membrane oxygenation, make them vulnerable candidates for fungal infections. In addition to that, SARS-CoV2 itself is associated with significant dysfunction in the patient’s immune system involving both innate and acquired immunity, with reduction in both CD4+ T and CD8+ T lymphocyte counts and cytokine storm. The emerging question is whether SARS-CoV-2 inherently predisposes critically ill patients to fungal infections or the immunosuppressive therapy constitutes the igniting factor for invasive mycoses. To approach the dilemma, one must consider the unique pathogenicity of SARS-CoV-2 with the deranged immune response it provokes, review the well-known effects of immunosuppressants and finally refer to current literature to probe possible causal relationships, synergistic effects or independent risk factors. In this review, we aimed to identify the prevalence, risk factors and mortality associated with IFIs in mechanically ventilated patients with COVID-19.
Novel Mode of Near-Infrared Spectroscopy as a Continuous Cerebral Physiological Monitoring Device during Cardiopulmonary Resuscitation: Four Case Reports
Authors: Matsuyama Tasuku , Yasutake Yuki , Inaba Daichi , Yoshihara Hideaki , Bando Keisuke , Matsui Toshihisa , Nagama Masaki , Kano Hitoshi
Published: April 2022

Background: NIRO-Pulse is a novel mode of near-infrared spectroscopy that can be used to visually evaluate cerebral perfusion during cardiopulmonary resuscitation (CPR), providing real-time feedback as to the quality of the CPR. The aim of this report was to describe the several representative cases of NIRO-Pulse for physiological monitoring during CPR. Methods: We present several cases from out-of-hospital cardiac arrest (OHCA) patients for whom NIRO-Pulse was attached to the forehead after hospital arrival. Patients were subjected to continuous brain monitoring during CPR using NIRO-Pulse, which allows for the visualisation of ΔHb (Hb pulsation). NIRO-Pulse is capable of simultaneously measuring and displaying cerebral tissue oxygen saturation (SctO2) and Hb pulsation, providing real-time feedback during CPR in the form of physiological indicators, and assessing changes in SctO2 throughout the CPR procedure by post-mortem analysis. Results: We observed several representative cases that provided the following insights: (1) SctO2 increased after a change in the quality of chest compression, (2) SctO2 decreased during the ventilation phase of synchronised CPR, (3) SctO2 decreased during the interruption of chest compressions for the preparation of defibrillation, and (4) SctO2 gradually and continuously increased after return of spontaneous circulation. Conclusion: Displaying Hb pulsation in conjunction with SctO2 during CPR may be helpful for evaluating the quality of and patient responsiveness to CPR. Further studies investigating the association between the use of NIRO-Pulse during CPR and subsequent outcomes should be conducted.
Dislocation Arthropathy of the Shoulder
Authors: Coifman Ismael , Brunner Ulrich H. , Scheibel Markus
Published: April 2022

Glenohumeral osteoarthrosis (OA) may develop after primary, recurrent shoulder dislocation or instability surgery. The incidence is reported from 12 to 62%, depending on different risk factors. The risk of severe OA of the shoulder following dislocation is 10 to 20 times greater than the average population. Risk factors include the patient’s age at the first episode of instability or instability surgery, bony lesions, and rotator cuff tears. For mild stages of OA, arthroscopic removal of intraarticular material, arthroscopic debridement, or arthroscopic arthrolysis of an internal rotation contracture might be sufficient. For severe stages, mobilization of the internal rotation contracture and arthroplasty is indicated. With an intact rotator cuff and without a bone graft, results for anatomical shoulder arthroplasty are comparable to those following primary OA. With a bone graft at the glenoidal side, the risk for implant loosening is ten times greater. For the functional outcome, the quality of the rotator cuff is more predictive than the type of the previous surgery or the preoperative external rotation contracture. Reverse shoulder arthroplasty could be justified due to the higher rate of complications and revisions of non-constrained anatomic shoulder arthroplasties reported. Satisfactory clinical and radiological results have been published with mid to long term data now available.
Substrates of the MAPK Slt2: Shaping Yeast Cell Integrity
Authors: González-Rubio Gema , Sastre-Vergara Lucía , Molina María , Martín Humberto , Fernández-Acero Teresa
Published: April 2022

The cell wall integrity (CWI) MAPK pathway of budding yeast Saccharomyces cerevisiae is specialized in responding to cell wall damage, but ongoing research shows that it participates in many other stressful conditions, suggesting that it has functional diversity. The output of this pathway is mainly driven by the activity of the MAPK Slt2, which regulates important processes for yeast physiology such as fine-tuning of signaling through the CWI and other pathways, transcriptional activation in response to cell wall damage, cell cycle, or determination of the fate of some organelles. To this end, Slt2 precisely phosphorylates protein substrates, modulating their activity, stability, protein interaction, and subcellular localization. Here, after recapitulating the methods that have been employed in the discovery of proteins phosphorylated by Slt2, we review the bona fide substrates of this MAPK and the growing set of candidates still to be confirmed. In the context of the complexity of MAPK signaling regulation, we discuss how Slt2 determines yeast cell integrity through phosphorylation of these substrates. Increasing data from large-scale analyses and the available methodological approaches pave the road to early identification of new Slt2 substrates and functions.
Off-Season Agriculture Encroachment in the Uplands of Northern Pakistan: Need for Sustainable Land Management
Authors: Khurshid Muhammad , Nafees Mohammad , Khan Abdullah , Yin He , Ullah Wahid , Rashid Wajid , Han Heesup , Lashari Akhtar Hussain
Published: April 2022

Agriculture encroachment over alpine pastoral land is posing serious threats to the sustainable use of natural resources and agro-pastoral systems in the upland environment. This study aimed to understand the scenario of agriculture encroachment within a sustainable land management context in Northern Pakistan’s uplands (Buhrawai). Both quantitative and qualitative methodological approaches were used for the primary data collection on the pattern of cropland expansion, cropland productivity, agrochemical inputs, and perceived socio-ecological system. The results showed that off-season agriculture has emerged as a cash-earning livelihood activity, largely adopted by decade-old and influential tenant communities in the study areas. During the last few decades, this off-season agriculture regularly expanded from lower- to higher-elevation (2980–3800 m) areas, and extensively encroached on accessible pastoral areas in the bottomlands. Cultivation of the two major vegetable crops, i.e., peas and potatoes, occurred on a total of 417.4 ha of pastoral land, where pea cultivation predominantly occurred on 367.2 ha and potato cultivation on 50.2 ha of pastoral land. We found that repeated cultivation of the same crops, without crop rotation and land management practices, significantly reduced land productivity with time; the crop productivity was recorded to be the highest in the virgin cultivated land (pea: 1.8 tons/ha and potato: 14.8 tons/ha) and the lowest in the old-cultivated land (pea: 0.6 tons/ha and potato: 8.2 tons/ha). As a result of this trend, farmers are abandoning unproductive agricultural land and subsequently starting cultivation in other marginal areas, even cultivating crops on steeper slopes beyond the permissible level (16°). These findings revealed that farmers have extensively used key pastoral areas for cultivation, and they have deprived landless pastoralists of their traditional grazing land in the uplands. Furthermore, this agriculture encroachment imposed serious pressure on the pastoralists’ livelihoods and the upland ecosystem on which they rely. Therefore, policies and regulations that promote sustainable land management are much needed to ensure socio-economic equity and ecological integrity in the uplands of Northern Pakistan.
The Effect of Pelletized Lime Kiln Dust Combined with Biomass Combustion Ash on Soil Properties and Plant Yield in a Three-Year Field Study
Authors: Drapanauskaitė Donata , Bunevičienė Kristina , Repšienė Regina , Karčauskienė Danutė , Mažeika Romas , Baltrusaitis Jonas
Published: April 2022

Extensive application of mineral fertilizers resulted in high soil acidity, which is one of the major problems for crop production and soil degradation. Industrial solid waste, such as lime kiln dust and wood ash, can be used as alternative liming materials to benefit sustainable agricultural development. In this work, pelletized lime kiln dust with and without wood ash was utilized as liming material and the results of the three-year field study were compared with conventional mineral-based liming materials. It was determined that pelletized lime kiln dust satisfies the requirements posed by the recent European Union regulations to qualify as liming materials. The application of 2000 kg/ha Ca equivalent pelletized lime kiln dust increased soil pHKCl by ~0.55 pH units. Moreover, pelletized lime kiln dust significantly increased spring wheat grain yields ranging from 33.6% to 40.4%, depending on the pellet size. The usage of these liming materials not only increased crop yield but also decreased heavy metal concentration in soil. Due to high alkalinity, carbonate content, easy handling, and the transportation of pelletized lime kiln dust with and without wood ash, the materials have the potential to be used in agriculture as liming materials to reduce soil acidification and increase crop productivity or be used as soil amendments.
Half-Century of Forest Change in a Neotropical Peri-Urban Landscape: Drivers and Trends
Authors: Von Thaden Juan , Binnqüist-Cervantes Gilberto , Pérez-Maqueo Octavio , Lithgow Debora
Published: April 2022

Neotropical forested landscapes have become agricultural areas and human settlements, causing forest fragmentation, land degradation, and habitat loss. Nonetheless, complex tree cover loss and recovery processes may occur even while urban areas expand. Biophysical, social, political, and economic drivers influence forest loss or recovery over time. This study analyzes land-use change dynamics in urban and peri-urban landscapes in the western sector of Xalapa City between 1966–2018 and identifies the primary drivers that have played a significant role in deforestation and forest recovery processes. The main finding denotes the city’s expansion between 1966 and 2018, initially covering 8% of the study area and increasing to 27%. However, between 1966 and 2018, 15% of forest cover was lost in net terms, a finding ascribed to forest recovery in some abandoned areas. Social and biophysical variables significantly influenced deforestation and forest recovery trends, and few variables were singular to one process. The deceleration of forest loss and accomplishing tree cover recovery are possible in some urban settings. In this context, green urban and peri-urban landscapes become strategic to achieve more sustainable cities. Among other benefits, green areas provide landscape connectivity, temperature regulation, air quality improvement, noise dampening, and recreational areas.