bluuebunny/crossref_metadata_2025 huggingface dataset:
Determining Factors for Independent Walking in Patients Undergoing Cardiovascular Surgery: Differences between Coronary Artery Bypass Grafting, Heart Valve Surgery, and Aortic Surgery
Authors: Sakamoto Yui , Morimoto Yosuke , Hanada Masatoshi , Yano Yudai , Sawai Terumitsu , Miura Takashi , Eishi Kiyoyuki , Kozu Ryo
Published: November 2021

Physical deconditioning often occurs during the acute phase after cardiovascular surgery, and unassisted walking is required to achieve independence, to manage cardiac diseases, and to prevent recurrences. This study aims to investigate the characteristics of independent walking after cardiovascular surgery. We conducted a retrospective cohort study in patients who underwent cardiovascular surgeries (total of 567 patients): 153 in the coronary artery bypass grafting (CABG) group, 312 in the heart valve surgery group, and 102 in the aortic surgery group. We evaluated the effect of each surgery group on the cardiac rehabilitation (CR) progression. The factors associated with independent walking were age, renal diseases, intensive care unit (ICU) length of stay, and post-operative respiratory complications in the CABG group. In the heart valve surgery group, the factors were New York Heart Association functional classification, renal and respiratory diseases, ICU length of stay, duration of mechanical ventilatory support, and post-operative cardiovascular and respiratory complications. In the aortic surgery group, these were ICU length of stay and acute kidney injury. The CR progression in patients who underwent aortic surgery was significantly longer than those who underwent CABG and heart valve surgery (p < 0.001). New intervention strategies are needed for patients with prolonged ICU stays.
How Acculturation Influences Attitudes about Advance Care Planning and End-of-Life Care among Chinese Living in Taiwan, Hong Kong, Singapore, and Australia
Authors: Chiang Fu-Ming , Wang Ying-Wei , Hsieh Jyh-Gang
Published: November 2021

Background: Understanding attitudes towards life and death issues in different cultures is critical in end-of-life care and the uptake of advance care planning (ACP) in different countries. However, existing research suffers from a lack of cross-cultural comparisons among countries. By conducting this comparative study, we hope to achieve a clear understanding of the linkages and differences among healthcare cultures in different Chinese societies, which may serve as a reference for promoting ACP by considering cultural differences. Methods: Our researchers recruited Chinese adults who could communicate in Mandarin and lived in metropolitan areas in Taiwan, Hong Kong, Singapore, and Australia. Focus group interviews were conducted, and the interview contents were recorded and subjected to thematic analysis. Results: Between June and July 2017, 14 focus groups with 111 participants were conducted in four regions. With traditional Chinese attitudes towards death as a taboo, many participants felt it would be challenging to discuss ACP with elderly family members. Most participants also desire to avoid suffering for the self and family members. Although the four regions’ participants shared a similar Chinese cultural context, significant regional differences were found in the occasions at which participants would engage in end-of-life discussions and select settings for end-of-life care. By contrast, participants from Singapore and Australia exhibited more open attitudes. Most participants from Taiwan and Hong Kong showed a preference for end-of-life care at a hospital. Conclusions: The developmental experiences of ACP in Western countries, which place a strong emphasis on individual autonomy, cannot be directly applied to family-centric Asian ones. Healthcare professionals in Asian societies should make continuous efforts to communicate patient status to patients and their family members to ensure family involvement in decision-making processes.
The Role of CDK4 in the Pathogenesis of Pancreatic Cancer
Authors: Jiggens Emily , Mortoglou Maria , Grant Guy H. , Uysal-Onganer Pinar
Published: November 2021

Pancreatic cancer (PC) continues to have the lowest overall survival and the lack of effective early diagnosis. Cyclin-dependent kinase 4 (CDK4) plays a fundamental role in the orderly progression of the cell cycle, binding to cyclin D to promote the progression through the G1/2 transition. The inhibition of CDK4/6 has therefore gained substantial interest in the hope of new and effective therapeutics in multiple cancers, such as advanced metastatic breast cancer. While the use of these agents is encouraging, their potential is yet to be fully explored. In this study we used the GLOBOCAN database to understand the most recent epidemiology of PC, Human Protein Atlas and KEGG to highlight the role, prevalence, and significance on patient survival of CDK4 in PC. We found that CDK4 cannot be used as prognostic in PC and no significant differences were observed between CDK4 expression and the patient’s clinical status, though larger studies, especially concerning CDK4 protein expressions, are required for a more thorough understanding. The use of CDK4/6 inhibitors in PC is still in clinical trials. However, due to only modest improvements observed in the use of single-agent therapies, efforts have focused on combinatorial approaches.
Out of the Closet, Not Yet Out of the House: Gay Men’s Experiences of Homonegativity and Internalized Homonegativity
Authors: Thepsourinthone Jack , Dune Tinashe , Liamputtong Pranee , Arora Amit
Published: November 2021

This paper explores how Australian gay men experience gender and sexuality in relation to heteronormative gender norms, specifically masculinity. A sample of 32 gay men 22–72 years of age participated in an online interview, using a videoconferencing software, on masculinity and homosexuality. Thematic analyses revealed that gay men experience gender and sexuality-related strain across all levels of their socioecological environment through social regulation, homophobic discrimination/harassment, and anti-effeminacy prejudice. The gay men expressed feelings of self-loathing, shame, internalized homonegativity, and isolation as a result. In examining interactions at each level of the socioecological environment, future research and practice may gain understanding in the social phenomena and how to ameliorate such strain.
State of the Art in Hepatic Dysfunction in Pregnancy
Authors: Varlas Valentin Nicolae , Bohîlțea Roxana , Gheorghe Gina , Bostan Georgiana , Angelescu Gabriela Anca , Penes Ovidiu Nicolae , Bors Roxana Georgiana , Cloțea Eliza , Bacalbasa Nicolae , Diaconu Camelia Cristina
Published: November 2021

Hepatic dysfunction in pregnant women is always challenging for the obstetrician, as the spectrum of hepatic abnormalities can be very large and have various implications, both for mother and fetus. There is a diagnostic and therapeutic polymorphism of hepatic dysfunction in pregnancy and insufficient knowledge related to the etiopathogenesis and epidemiology of this disease. The clinical forms of hepatic dysfunction encountered in pregnancy can vary from liver diseases related to pregnancy (e.g., HELLP syndrome, intrahepatic cholestasis, hyperemesis gravidarum, or acute fatty liver of pregnancy) to de novo ones occurring in pregnancy, and pre-existing liver disease (cholelithiasis, Budd–Chiari syndrome, and cirrhosis). We performed a systematic literature search over 10 years. The review protocol assumed a search of two databases (PubMed®/MEDLINE and Web of Science Core Collection). The strategy regarding the management of these diseases involves multidisciplinary teams composed of different specialists (obstetricians, gastroenterologists and anesthetists) from specialized tertiary centers. Despite the improving prognosis of pregnant women with liver diseases, the risk of maternal–fetal complications remains very high. Therefore, it is necessary to ensure careful monitoring by a multidisciplinary team and to inform the patients of the potential risks.
Hazardous Effect of Low-Dose Aspirin in Patients with Predialysis Advanced Chronic Kidney Disease Assessed by Machine Learning Method Feature Selection
Authors: Tsai Ming-Hsien , Liou Hung-Hsiang , Huang Yen-Chun , Lee Tian-Shyug , Chen Mingchih , Fang Yu-Wei
Published: November 2021

Background: Low-dose aspirin (100 mg) is widely used in preventing cardiovascular disease in chronic kidney disease (CKD) because its benefits outweighs the harm, however, its effect on clinical outcomes in patients with predialysis advanced CKD is still unclear. This study aimed to assess the effect of aspirin use on clinical outcomes in such group. Methods: Patients were selected from a nationwide diabetes database from January 2009 to June 2017, and divided into two groups, a case group with aspirin use (n = 3021) and a control group without aspirin use (n = 9063), by propensity score matching with a 1:3 ratio. The Cox regression model was used to estimate the hazard ratio (HR). Moreover, machine learning method feature selection was used to assess the importance of parameters in the clinical outcomes. Results: In a mean follow-up of 1.54 years, aspirin use was associated with higher risk for entering dialysis (HR, 1.15 [95%CI, 1.10–1.21]) and death before entering dialysis (1.46 [1.25–1.71]), which were also supported by feature selection. The renal effect of aspirin use was consistent across patient subgroups. Nonusers and aspirin users did not show a significant difference, except for gastrointestinal bleeding (1.05 [0.96–1.15]), intracranial hemorrhage events (1.23 [0.98–1.55]), or ischemic stroke (1.15 [0.98–1.55]). Conclusions: Patients with predialysis advanced CKD and anemia who received aspirin exhibited higher risk of entering dialysis and death before entering dialysis by 15% and 46%, respectively.
Effects of a School-Based Intervention for Preventing Substance Use among Adolescents at Risk of Academic Failure: A Pilot Study of the Reasoning and Rehabilitation V2 Program
Authors: Alarcó-Rosales Raquel , Sánchez-SanSegundo Miriam , Ferrer-Cascales Rosario , Albaladejo-Blazquez Natalia , Lordan Oriol , Zaragoza-Martí Ana
Published: November 2021

Tobacco, alcohol and cannabis use are important health problems that contribute greatly to causes of death in worldwide. Early onset of substance use increases rapidly during adolescence and it has been associated with a wide range of adverse events. Because substance use is associated with dramatic consequences, delaying the initiation of substance use among adolescents remains a major public priority. This study examined the effectiveness of a school-based intervention program based on the application of the Reasoning and Rehabilitation V2 (R&R2) program for preventing substance use among adolescents at risk of academic failure. A sample of 142 participants (aged 13–17 years old) who were studying alternative education provision in Spain were randomly allocated to two conditions (68 experimental group, 74 control group). A pre-test survey assessing past and current substance use was conducted prior the implementation of the program, while a post-test survey was conducted about 12 months after the pre-test. The results showed a significant effect of the R&R program in the reduction of cigarette smoking, episodes of drunkenness, alcohol consumption and cannabis use. However, for daily smoking and episodes of drunkenness such benefits showed a reduction over time. These findings offer additional evidence of the effectiveness of the Reasoning and Rehabilitation V2 program in Spanish adolescent students who are exposed to substance use and suggest areas of future research.
Current Practice of Stress Ulcer Prophylaxis in Surgical Departments in Mecklenburg Western Pomerania, Germany
Authors: Rauch Julia , Franze Marco , Patrzyk Maciej , Heidecke Claus-Dieter , Schulze Tobias
Published: November 2021

Background: Despite the growing concern over its potentially severe side effects and considerable economic burden, stress ulcer prophylaxis (SUP) is still frequently prescribed to patients in medical non-intensive care units. Recent data indicate that the situation is similar in surgical departments. Currently, data on the concepts within and regulation of routine SUP practice in surgical departments are sparse. The present study was designed to examine the current practice of SUP in Mecklenburg West Pomerania, Germany, and to identify possible reasons for the dissociation of medical literature and clinical practice. Methods: A questionnaire-based survey was conducted to elucidate current SUP practices in surgical departments of acute care hospitals in Mecklenburg Western Pomerania, Germany. Results: In most surgical departments (68%), a standard operating procedure (SOP) for SUP had not been developed. In departments with an existing SOP, 47.6% of responding medical staff members (MSM) with prescribing authority did not know of its existence. Of the MSMs aware of the existence of an SUP-SOP, only 42.9% indicated that they were familiar with its content. Critical re-evaluation of SUP indications upon transfer from the intensive care unit (ICU) to the general hospital ward (GHW) and before hospital discharge was performed frequently or systematically by only about half of the responding MSMs. Discussion: In the face of continued massive over-prescription of SUP in the perioperative routine, the development of easy-to-use local guidelines and their strict implementation in the clinical routine, as well as intensified medial education on this subject, may be effective tools to reduce acid-suppressive medication (ASM) associated side effects and economic burden.
Study on the Types of Elderly Intelligent Health Management Technology and the Influencing Factors of Its Adoption
Authors: Chen Zhu , Qi Huiying , Wang Luman
Published: November 2021

[Background]: In recent years, aging has become a global social problem. Intelligent health management technology (IHMT) provides solutions for the elderly to deal with various health risks. However, the elderly are facing many difficulties in using IHMT. Studying the application types of IHMT and the influencing factors of the elderly’s acceptance of it will help to improve the use behavior of the elderly. [Methods]: This paper summarizes the application types of IHMT, identifies the influencing factors of the elderly’s adaption of IHMT, and makes a systematic comment on the influencing factors. [Results]: We divide the different functions of IHMT for the elderly into four types: self-monitoring, medical care, remote monitoring, and health education. The influencing factors are divided into three types: individual, social, and technology. [Conclusions]: This study finds that IHMT’s application covers all aspects of the health services of the elderly. Among these applications, self-monitoring is the most used. We divided the influencing factors of the elderly’s acceptance of IHMT into three categories and nine subcategories, having 25 variables.
Factors Associated with SARS-CoV-2 Infection Risk among Healthcare Workers of an Italian University Hospital
Authors: Modenese Alberto , Casolari Loretta , Rossi Giorgia , Della Vecchia Elena , Glieca Francesca , D’Elia Cristiana , Garavini Denise , Righi Elena , Mariani Stefania , Venturelli Luca , Vivoli Daniela , Gobba Fabriziomaria
Published: November 2021

We report the results of a study on the cumulative incidence of SARS-CoV-2 infections in about 6000 workers of the University Hospital of Modena, Northern Italy, in the period March 2020–January 2021, and the relations with some individual and occupational factors. Overall, in healthcare workers (HCW) the cumulative incidence of COVID-19 during the period was 13.8%. Results confirm the role of overweight and obesity as significant risk factors for SARS-CoV-2 infection. Chronic respiratory diseases, including asthma, also proved to be significantly associated with the infection rate. Considering occupational factors, the COVID-19 risk was about threefold (OR: 2.7; 95% CI 1.7–4.5) greater in nurses and nurse aides than in non-HCW, and about double (OR: 1.9; 95% CI 1.2–3.2) in physicians. Interestingly, an association was also observed between infection risk and nightshifts at work (OR: 1.8; 95% CI 1.4–2.3), significantly related to the total number of shifts in the whole eleven-month period. Even if the vaccination campaign has now greatly modified the scenario of SARS-CoV-2 infections among HCW, the results of this study can be useful for further development of health and policy strategies to mitigate the occupational risk related to the new variants of coronavirus, and therefore the evolution of the pandemic.
Effect of the Soil and Ripening Stage in Capsicum chinense var. Jaguar on the Content of Carotenoids and Vitamins
Authors: Oney Montalvo Julio Enrique , de Silva Madrigal Adriana Cristina , Ramírez Sucre Manuel Octavio , Rodríguez-Buenfil Ingrid Mayanin
Published: November 2021

The purpose of this work was to investigate the effect of the ripening stage and type of soil on the concentration of carotenoids and vitamins in Habanero pepper (Capsicum chinense Jacq.). Pepper plants were grown in two soils named according to the Mayan classification as: K’ankab lu’um (red soil) and Box lu’um (black soil). The results of two harvests at 320 and 334 PTD (post-transplant day) showed that the ripening stage exhibited a significant effect (p < 0.05) on the concentration of carotenoids and vitamins, while the effect of the soil type was negligible. The concentration of carotenoids decreases as the ripening process of the fruit takes place, with the highest concentration of lutein (49.47 ± 0.34 mg/100 g of dry mass), β-carotene (99.92 ± 0.69 mg/100 g of dry mass) and β-cryptoxanthin (20.93 ± 0.04 mg/100 g of dry mass) in the unripe peppers. The concentration of vitamins increases as the ripening process develops, with the highest concentration of Vitamin E (9.69 ± 0.02 mg/100 g of dry mass) and Vitamin C (119.44 ± 4.72 mg/100 g of dry mass) in the ripe peppers. This knowledge could be used to select the best ripening stage to harvest Habanero peppers according to the use of the pepper and to the needs of producers/company.
An Update on the Function, Biosynthesis and Regulation of Floral Volatile Terpenoids
Authors: Qiao Zhenglin , Hu Huizhen , Shi Senbao , Yuan Xuemei , Yan Bo , Chen Longqing
Published: November 2021

Floral volatile terpenoids (FVTs) belong to a group of volatile organic compounds (VOC) that play important roles in attracting pollinators, defending against pathogens and parasites and serving as signals associated with biotic and abiotic stress responses. Although research on FVTs has been increasing, a systematic generalization is lacking. Among flowering plants used mainly for ornamental purposes, a systematic study on the production of FVTs in flowers with characteristic aromas is still limited. This paper reviews the biological functions and biosynthesis of FVTs, which may contribute a foundational aspect for future research. We highlight regulatory mechanisms that control the production of FVTs in ornamental flowers and the intersection of biosynthetic pathways that produce flower fragrance and color. Additionally, we summarize the opportunities and challenges facing FVT research in the whole genome and -omics eras and the possible research directions that will provide a foundation for further innovation and utilization of flowering ornamental plants and their germplasm resources.
Crowd-Sourced City Images: Decoding Multidimensional Interaction between Imagery Elements with Volunteered Photos
Authors: Shen Yao , Xu Yiyi , Liu Lefeng
Published: November 2021

The built environment reshapes various scenes that can be perceived, experienced, and interpreted, which are known as city images. City images emerge as the complex composite of various imagery elements. Previous studies demonstrated the coincide between the city images produced by experts with prior knowledge and that are extracted from the high-frequency photo contents generated by citizens. The realistic city images hidden behind the volunteered geo-tagged photos, however, are more complex than assumed. The dominating elements are only one side of the city image; more importantly, the interactions between elements are also crucial for understanding how city images are structured in people’s minds. This paper focuses on the composition of city image–the various interactions between imagery elements and areas of a city. These interactions are identified as four aspects: co-presence, hierarchy, heterogeneity, and differentiation, which are quantified and visualized respectively as correlation network, dendrogram, spatial clusters, and scattergrams in a framework using scene recognition with volunteered and georeferenced photos. The outputs are interdependent elements, typologies of elements, imagery areas, and preferences for groups, which are essential for urban design processes. In the application in Central Beijing, the significant interdependency between two elements is complex and is not necessarily an interaction between the elements with higher frequency only. The main typologies and the principal imagery elements are different from what were prefixed in the image recognition model. The detected imagery areas with adaptive thresholds suggest the spatially varying spill over effects of named areas and their typologies can be well annotated by the detected principal imagery elements. The aggregation of the data from different social media platforms is proven as a necessity of calibrating the unbiased scope of the city image. Any specific data can hardly capture the whole sample. The differentiation across the local and non-local is found to be related to their preference and activity space. The results provide more comprehensive insights on the complex composition of city images and its effects on placemaking.
The Effect of Vanadium Inhalation on the Tumor Progression of Urethane-Induced Lung Adenomas in a Mice Model
Authors: López-Valdez Nelly , Rojas-Lemus Marcela , Fortoul Teresa I.
Published: November 2021

Lung cancer has the highest death rates. Aerosol drug delivery has been used for other lung diseases. The use of inhaled vanadium (V) as an option for lung cancer treatment is explored. Four groups of mice were studied: (1) Saline inhalation alone, (2) Single intraperitoneal (i.p.) dose of urethane, (3) V nebulization twice a week (Wk) for 8 Wk, and (4) A single dose of urethane and V nebulization for 8 Wk. Mice were sacrificed at the end of the experiment. Number and size of tumors, PCNA (proliferating cell nuclear antigen) and TUNEL (terminal deoxynucleotidyl tranferase dUTP nick-end labeling) immunohistochemistry were evaluated and compared within groups. Results: The size and number of tumors decreased in mice exposed to V-urethane and the TUNEL increased in this group; differences in the PCNA were not observed. Conclusions: Aerosol V delivery increased apoptosis and possibly the growth arrest of the tumors with no respiratory clinical changes in the mice.
Pyridinesilver Tetraoxometallate Complexes: Overview of the Synthesis, Structure, and Properties of Pyridine Complexed AgXO4 (X = Cl, Mn, Re) Compounds
Authors: Franguelli Fernanda Paiva , Béres Kende Attila , Kótai Laszló
Published: November 2021

We reviewed the synthesis, structure, and properties of pyridine complexes of AgXO4 (X = Cl, Mn, and Re) compounds with various compositions ([AgPy2] XO4, [AgPy2XO4]·0.5Py, [AgPy4] XO4, and 4 [AgPy2XO4] [AgPy4] XO4). We also clarified the controversial information about the existence and composition of pyridine complexes of silver permanganate, used widely as mild and selective oxidants in organic chemistry. We discussed in detail the available structural and spectroscopic (IR, Raman, and UV) data and thermal behavior, including the existence and consequence of quasi-intramolecular reactions between the reducing ligand and anions containing oxygen.
A Yeast RNA-Interference Pesticide Targeting the Irx Gene Functions as a Broad-Based Mosquito Larvicide and Adulticide
Authors: Mysore Keshava , Sun Longhua , Hapairai Limb K. , Wang Chien-Wei , Igiede Jessica , Roethele Joseph B. , Scheel Nicholas D. , Scheel Max P. , Li Ping , Wei Na , Severson David W. , Duman-Scheel Molly
Published: November 2021

Concerns for widespread insecticide resistance and the unintended impacts of insecticides on nontarget organisms have generated a pressing need for mosquito control innovations. A yeast RNAi-based insecticide that targets a conserved site in mosquito Irx family genes, but which has not yet been identified in the genomes of nontarget organisms, was developed and characterized. Saccharomyces cerevisiae constructed to express short hairpin RNA (shRNA) matching the target site induced significant Aedes aegypti larval death in both lab trials and outdoor semi-field evaluations. The yeast also induced high levels of mortality in adult females, which readily consumed yeast incorporated into an attractive targeted sugar bait (ATSB) during simulated field trials. A conserved requirement for Irx function as a regulator of proneural gene expression was observed in the mosquito brain, suggesting a possible mode of action. The larvicidal and adulticidal properties of the yeast were also verified in Aedes albopictus, Anopheles gambiae, and Culexquinquefasciatus mosquitoes, but the yeast larvicide was not toxic to other nontarget arthropods. These results indicate that further development and evaluation of this technology as an ecofriendly control intervention is warranted, and that ATSBs, an emerging mosquito control paradigm, could potentially be enriched through the use of yeast-based RNAi technology.
Effect of Early and Delayed Commencement of Paricalcitol in Combination with Enalapril on the Progression of Experimental Polycystic Kidney Disease
Authors: Sagar Priyanka S. , Saravanabavan Sayanthooran , Munt Alexandra , Wong Annette T. Y. , Rangan Gopala K.
Published: November 2021

Vitamin D secosteroids are intranuclear regulators of cellular growth and suppress the renin-angiotensin system. The aim of this study was to test the hypothesis that the vitamin D receptor agonist, paricalcitol (PC), either alone or with enalapril (E) (an angiotensin-converting enzyme inhibitor), reduces the progression of polycystic kidney disease. Preventative treatment of Lewis polycystic kidney (LPK) and Lewis control rats with PC (0.2 μg/kg i.p. 5 days/week) or vehicle from postnatal weeks 3 to 10 did not alter kidney enlargement. To evaluate the efficacy in established disease, LPK rats received either PC (0.8 μg/kg i.p; 3 days/week), vehicle, E (50 mg/L in water) or the combination of PC + E from weeks 10 to 20. In established disease, PC also did not alter the progression of kidney enlargement, kidney cyst growth or decline in renal function in LPK rats. Moreover, the higher dose of PC was associated with increased serum calcium and weight loss. However, in established disease, the combination of PC + E reduced systolic blood pressure and heart-body weight ratio compared to vehicle and E alone (p < 0.05). In conclusion, the combination of PC + E attenuated cardiovascular disease but caused hypercalcaemia and did not alter kidney cyst growth in LPK rats.
Thyroid Disfunction in Critically Ill COVID-19 Patients. Relationship with In-Hospital Mortality
Authors: Ballesteros Vizoso María Antonieta , Castilla Albert Figueras , Barceló Antonia , Raurich Joan Maria , Argente del Castillo Paula , Morell-García Daniel , Velasco Julio , Pérez-Bárcena Jon , Llompart-Pou Juan Antonio
Published: November 2021

The incidence of thyroid disfunction has not been analyzed in critically ill COVID-19 patients. Our objective was to analyze the relationship of the thyroid profile and in-hospital mortality in critically ill COVID-19 patients. This was a prospective single-center study involving critically ill COVID-19 patients admitted to the ICU of a tertiary University Hospital. Thyroid hormones were measured through drawing blood samples from a central venous catheter at ICU admission and on the fifth day. A multiple logistic regression analysis was performed to analyze the variables associated with mortality. The ability of the different thyroid hormones to predict in-hospital mortality was evaluated by calculating the receiver operating characteristics (ROCs) and the area under the curve (AUC). A total of 78 patients were included in the study at ICU admission; 72 had their thyroid profile measured at day 5. In-hospital mortality reached 29.5%. Multiple logistic regression analysis showed that variables associated with mortality were age and prior beta-blocker therapy at ICU admission and age fT4 at day 5. The AUC for in-hospital mortality predictions of fT4 at day 5 was 0.69. Thyroid responses are commonly observed in critically ill COVID-19 patients. fT4 at day 5 after ICU admission was associated with mortality.
One-Year Outcome of Glycoprotein IIb/IIIa Inhibitor Therapy in Patients with Myocardial Infarction-Related Cardiogenic Shock
Authors: Myrda Krzysztof , Gąsior Mariusz , Dudek Dariusz , Nawrotek Bartłomiej , Niedziela Jacek , Wojakowski Wojciech , Gierlotka Marek , Grygier Marek , Stępińska Janina , Witkowski Adam , Lesiak Maciej , Legutko Jacek
Published: November 2021

Background: We aimed to evaluate the effect of intravenous glycoprotein IIb/IIIa receptor inhibitors (GPIs) on in-hospital survival and mortality during and at the 1-year follow-up in patients undergoing percutaneous coronary intervention (PCI) for myocardial infarction (MI) complicated by cardiogenic shock (CS), who were included in the Polish Registry of Acute Coronary Syndromes (PL-ACS). Methods: From 2003 to 2019, 466,566 MI patients were included in the PL-ACS registry. A total of 10,193 patients with CS received PCI on admission. Among them, GPIs were used in 3934 patients. Results: The patients treated with GPIs were younger, had lower systolic blood pressure on admission, required inotropes and intra-aortic balloon pump (IABP) support more frequently, and showed a lower efficacy of coronary angioplasty. In both groups, the same rates of in-hospital adverse events were observed. A lower mortality rate was reported in the group treated with GPIs 12 months after admission (54.9% vs. 57.9%, p = 0.002). Therapy with GPI was an independent factor reducing the risk of mortality in the 12-month follow-up. Conclusions: The addition of GPIs to the standard pharmacotherapy combined with PCI in patients with MI and CS on admission reduced the risk of death in the 12-month follow-up period without increasing in-hospital adverse event rates.
Current Status of Cardiac Rehabilitation in the Regional Cardiocerebrovascular Centers in Korea
Authors: Kim Chul , Sung Jidong , Han Jae-Young , Jee Sungju , Lee Jang Woo , Lee Jong Hwa , Kim Won-Seok , Bang Heui Je , Baek Sora , Joa Kyung-Lim , Kim Ae Ryoung , Lee So Young , Kim Jihee , Kim Chung Reen , Kwon Oh Pum
Published: November 2021

Regional Cardiocerebrovascular Centers (RCCs)—a Korean government initiative—seek to reduce medical gaps across regions, and their cardiac rehabilitation (CR) programs are expected to model post-acute care for the Korean CR program. Accordingly, this study aimed to evaluate the current status of CR programs in the RCCs. We distributed surveys on the CR condition, activity, and barriers to 12 RCCs in different provinces. The results revealed significant gaps in the annual number of acute myocardial infarction admissions, and CR candidates, capacity, and density across the 12 RCCs. The CR capacity (50–500) and density (0.42–7.36) indicated particularly large gaps. Twelve RCCs had the necessary facilities, equipment and personnel for CR assessments and management, with high CR referral (97%) and patient education (78%) rates. However, the inpatient CR exercise training (56%) participation rate was inadequate, with much lower enrollment (47%) and adherence (17%) rates to the outpatient CR program and large differences across centers. Therefore, this study’s results will provide the evidence required to establish special national health strategies to overcome the CR barriers of patient, doctor/hospital, and policy factors for activating Korean CR programs.
Temporal Relationship between Atrial Fibrillation and Heart Failure Development Analysis from a Nationwide Database
Authors: Cottin Yves , Maalem Ben Messaoud Brahim , Monin Antoine , Guilleminot Pierre , Bisson Arnaud , Eicher Jean-Christophe , Bodin Alexandre , Herbert Julien , Juillière Yves , Zeller Marianne , Fauchier Laurent
Published: November 2021

Background Atrial fibrillation (AF) and heart failure (HF) often co-exist and are closely intertwined, each condition worsening the other. The temporal relationships between these two disorders have not yet been fully explored. We aimed to address the outcomes of patients hospitalized with HF and AF based on the chronology of the onset of the two disorders. Methods From the administrative database for the whole French population, we identified 1,349,638 patients diagnosed with both AF and HF between 2010 and 2018; 956,086 of these AF patients developed HF first (prevalent HF), and 393,552 developed HF after AF (incident HF). The outcome analysis (all-cause death, cardiovascular (CV) death, ischemic stroke or hospitalization for HF) was performed with follow-up starting at the time of last event between AF or HF in the whole cohort and in 427,848 propensity score-matched patients. Results During follow-up (mean follow-up 1.6 ± 1.9 year), matched patients with prevalent HF had a higher risk of all-cause death (21.6 vs. 19.3%/year, hazard ratio (HR) 1.10, 95% CI 1.08–1.11), CV death (7.7 vs. 6.5%/year, HR 1.14, 95% CI 1.12–1.16) as well as re-hospitalization for HF (19.4 vs. 13.2%/year, HR 1.44, 95% CI 1.41–1.46) than those with incident HF. The risk for ischemic stroke was lower in prevalent HF than in incident HF (1.2 vs. 2.4%/year, HR 0.50, 95% CI 0.48–0.52). Conclusions We identified two distinct clinical entities: patients in whom HF preceded AF (prevalent HF) had higher mortality and higher risk of re-hospitalization for HF.
Patient-Reported Outcome Measures in Endometriosis
Authors: Nicolas-Boluda Alba , Oppenheimer Anne , Bouaziz Jerome , Fauconnier Arnaud
Published: November 2021

Patient Reported Outcome Measures (PROM) evoke measurements that allow capturing patients’ perspectives on their condition. In endometriosis care, physicians’ understanding of the effect of the disease and the treatment on patients is often poor. The use of PROMs in endometriosis clinical practice can facilitate patient-provider communication and the implementation of patient-centered care, improve patients’ quality of life, as well as provide a tool for patients’ self-management of the disease. Today, PROMs are extensively used in research and clinical trials, however they are barely used in clinical practice. The development of digital tools facilitating capturing PROMs can contribute to their use by physicians in routine endometriosis care. However, all PROMs are not adapted to be used in routine care in the context of endometriosis. The objective of this study was to present a catalogue of available PROMs for routine endometriosis care and evaluate them according to selected criteria. To do so, we explored the different PROMs currently in the literature. Consequently, 48 PROM were identified as tools used to evaluate various dimensions of the impact of endometriosis on patients. The selected PROMs were evaluated for their potential to be used as a standard in clinical practice in endometriosis. The selected catalogue of PROMs is the starting point for the integration of digital tools to capture PROMs and the development of patient-centered dashboards to be used by patients and clinicians in endometriosis care and self-management to improve care processes, patient satisfaction, quality of life, and outcomes.
Association of Serum High-Density Lipoprotein Cholesterol with High Blood Pressures at Checkup: Results of Kanagawa Investigation of Total Checkup Data from the National Database-9 (KITCHEN-9)
Authors: Nakajima Kei , Igata Manami , Higuchi Ryoko , Tanaka Kotone , Mizusawa Kaori , Nakamura Teiji
Published: November 2021

Background: although high-density lipoprotein has cardioprotective effects, the association between serum high-density lipoprotein cholesterol (HDL-C) and hypertension is poorly understood. Therefore, we investigated whether high and low concentrations of HDL-C are associated with high blood pressure (HBP) using a large healthcare dataset. Methods: in a community-based cross-sectional study of 1,493,152 Japanese people (830,669 men and 662,483 women) aged 40–74 years who underwent a health checkup, blood pressures automatically measured at healthcare center were investigated in nine HDL-C groups (20–110 mg/dL or over). Results: crude U-shaped relationship were observed between the nine HDL-C and blood pressures in both men and women. Logistic regression analysis showed left-to-right inverted J-shaped relationships between HDL-C and odds ratios for HBP (≥140/90 mmHg and/or pharmacotherapy), with lower limits of 90–99 mg/dL in both sexes, which were unchanged after adjusting for confounding factors. However, further adjustment for body mass index and serum triglyceride concentration revealed positive linear associations between HDL-C and HBP, although blunt U-shaped associations remained in nonalcohol drinkers. Conclusion: both low and extremely high HDL-C concentrations are associated with HBP. The former association might be dependent on excess fat mass concomitant with low HDL-C, whereas the latter association may be largely dependent on frequent alcohol consumption.
Abscopal Effects in Metastatic Cancer: Is a Predictive Approach Possible to Improve Individual Outcomes?
Authors: Link Barbara , Torres Crigna Adriana , Hölzel Michael , Giordano Frank A. , Golubnitschaja Olga
Published: November 2021

Patients with metastatic cancers often require radiotherapy (RT) as a palliative therapy for cancer pain. RT can, however, also induce systemic antitumor effects outside of the irradiated field (abscopal effects) in various cancer entities. The occurrence of the abscopal effect is associated with a specific immunological activation in response to RT-induced cell death, which is mainly seen under concomitant immune checkpoint blockade. Even if the number of reported apscopal effects has increased since the introduction of immune checkpoint inhibition, its occurrence is still considered rare and unpredictable. The cases reported so far may nevertheless allow for identifying first biomarkers and clinical patterns. We here review biomarkers that may be helpful to predict the occurrence of abscopal effects and hence to optimize therapy for patients with metastatic cancers.
Cardiac Arrest Survival Postresuscitation In-Hospital (CASPRI) Score Predicts Neurological Favorable Survival in Emergency Department Cardiac Arrest
Authors: Tsai Jeffrey Che-Hung , Ma Jen-Wen , Liu Shih-Chia , Lin Tzu-Chieh , Hu Sung-Yuan
Published: November 2021

Background: This study was conducted to identify the predictive factors for survival and favorable neurological outcome in patients with emergency department cardiac arrest (EDCA). Methods: ED patients who suffered from in-hospital cardiac arrest (IHCA) from July 2014 to June 2019 were enrolled. The electronic medical records were retrieved and data were extracted according to the IHCA Utstein-style guidelines. Results: The cardiac arrest survival post-resuscitation in-hospital (CASPRI) score was associated with survival, and the CASPRI scores were lower in the survival group. Three components of the CASPRI score were associated with favorable neurological survival, and the CASPRI scores were lower in the favorable neurological survival group of patients who were successfully resuscitated. The independent predictors of survival were presence of hypotension/shock, metabolic illnesses, short resuscitation time, receiving coronary angiography, and TTM. Receiving coronary angiography and low CASPRI score independently predicted favorable neurological survival in resuscitated patients. The performance of a low CASPRI score for predicting favorable neurological survival was fair, with an AUROCC of 0.77. Conclusions: The CASPRI score can be used to predict survival and neurological status of patients with EDCA. Post-cardiac arrest care may be beneficial for IHCA, especially in patients with EDCA.
Food-Related Brain Activation Measured by fMRI in Adults with Prader–Willi Syndrome
Authors: Nieuwpoort Ingrid Caroline van , Slagboom Tessa N. A. , Jakobsdóttir Sigridur , Deijen Jan Berend , Veltman Dick J. , Curfs Leopold M. G. , Drent Madeleine L.
Published: November 2021

(1) Background: Prader–Willi syndrome (PWS) is characterized by hyperphagia, resulting in morbid obesity if not controlled. The primary aim of this study was to investigate whether PWS patients show altered activation of brain areas involved in hunger. As a secondary objective, we assessed whether there is an association between these brain areas and several endocrine and metabolic factors in the fasting state. (2) Methods: 12 PWS adults and 14 healthy controls (siblings) performed a food-related experimental task after an overnight fast while brain activation in regions of interest was measured by functional MRI. (3) Results: In controls, significantly more activation was found in the left insula (p = 0.004) and the bilateral fusiform gyrus (p = 0.003 and 0.013) when the individuals were watching food as compared to non-food pictures, which was absent in PWS patients. Moreover, in PWS adults watching food versus non-food pictures a significant negative correlation for glucose and right amygdala activation (p_fwe = 0.007) as well as a positive correlation for leptin and right anterior hippocampus/amygdala activation (p_fwe = 0.028) was demonstrated. No significant associations for the other hormonal and metabolic factors were found. (4) Conclusions: PWS individuals show aberrant food-related brain activation in the fasting state. Leptin is associated with activation within the neural motivation/reward circuitry, while the opposite is true for glucose.
Severe Hypoalbuminemia at Admission Is Strongly Associated with Worse Prognosis in Older Adults with SARS-CoV-2 Infection
Authors: Arnau-Barrés Isabel , Pascual-Dapena Ana , López-Montesinos Inmaculada , Gómez-Zorrilla Silvia , Sorlí Luisa , Herrero Marta , Nogués Xavier , Navarro-Valls Claudia , Ibarra Beatriz , Canchucaja Lizzeth , da Costa Venancio Elizabeth , Blasco-Hernando Fabiola , Cruz Juany , Vázquez Olga , Miralles Ramón , García-Giralt Natalia , Güerri-Fernández Robert
Published: November 2021

Serum albumin levels have been associated with prognosis in several conditions among older adults. The aim of this study is to assess the prognostic value in mortality of serum albumin in older adults with SARS-CoV-2 infection. Methods. Cohort observational study with consecutive older-adults (≥65 years old), with confirmed SARS-CoV-2 infection admitted to a university hospital between March–May 2020. A logistic regression model was fitted to assess the impact of albumin levels on in-hospital mortality adjusted by potential confounders. Results. Among a total of 840 patients admitted to the hospital, 405 (48%) were older adults with a total of 92 deaths (23%) among them. Those who died were older, had more comorbidities, higher inflammation status and lower levels of serum albumin at admission [3.10 g/dL (0.51) vs. 3.45 g/dL (0.45); p < 0.01. Serum albumin levels at admission were negatively correlated with inflammatory markers such as C-Reactive protein (Pearson Coeff −0.4634; p < 0.001) or IL-6 (Pearson’s Coeff −0.244; p = 0.006) at admission but also to other clinical outcomes such time to clinical stability (Pearson’s Coeff −0.259; p < 0.001). Severe hypoalbuminemia associated with increased risk of mortality was defined as ≤3 g/dL at admission according to the AUC/ROC analysis (0.72 95% CI 0.63–0.81) In a multivariate logistic regression model adjusting by age, inflammation, comorbidities and severity at admission severe hypoalbuminemia was a strong predictor of in-hospital mortality (OR 2.18 95% CI 1.03–4.62; p = 0.039). Conclusion. Severe hypoalbuminemia with ≤3 g/dL is an independent risk factor for mortality among older adults with SARS-CoV-2 infection. There is a consistent correlation between albumin levels and inflammatory biomarkers. Further studies are needed to determine whether the supplementation of albumin as coadjuvant treatment will have a positive impact on the prognosis of this infection.
Advances on Dye-Sensitized Solar Cells (DSSCs) Nanostructures and Natural Colorants: A Review
Authors: Castillo-Robles José A. , Rocha-Rangel Enrique , Ramírez-de-León José A. , Caballero-Rico Frida C. , Armendáriz-Mireles Eddie N.
Published: November 2021

Human beings are attempting to take advantage of renewable natural resources by using solar cells. These devices take the sun’s radiation and convert it into electrical energy. The issue with traditional silicon-based solar cells is their manufacturing costs and environmental problems. For this reason, alternatives have been developed within the solar cell field. One of these alternatives is the dye-sensitized solar cell (DSSC), also known as Grätzel solar cells. DSSCs are a type of solar cell that mimics photosynthesis. They have a photoanode, which is formed by a semiconductor film sensitized with a dye. Some of their advantages include low-cost manufacturing, eco-friendly materials use, and suitability for most environments. This review discusses four important aspects, with two related to the dye, which can be natural or synthetic. Herein, only natural dyes and their extraction methods were selected. On the other hand, this paper discusses the nanostructures used for DSSCs, the TiO2 nanostructure being the most reported; it recently reached an efficiency level of 10.3%. Finally, a review on the novelties in DSSCs technology is presented, where it is observed that the use of Catrin protein (cow brain) shows 1.45% of efficiency, which is significantly lower if compared to Ag nanoparticles doped with graphene that report 9.9% efficiency.
X-ray Imaging Investigation on the Gilding Technique of an Ancient Egyptian Taweret Wooden Statuette
Authors: Vigorelli Luisa , Re Alessandro , Guidorzi Laura , Cavaleri Tiziana , Buscaglia Paola , Nervo Marco , Facchetti Federica , Borla Matilde , Grassini Sabrina , Lo Giudice Alessandro
Published: November 2021

Diagnostic physical methods are increasingly applied to Cultural Heritage both for scientific investigations and conservation purposes. In particular, the X-ray imaging techniques of computed tomography (CT) and digital radiography (DR) are non-destructive investigation methods to study an object, being able to give information on its inner structure. In this paper, we present the results of the X-ray imaging study on an ancient Egyptian statuette (Late Period 722–30 BCE) belonging to the collection of Museo Egizio in Torino and representing an Egyptian goddess called Taweret, carved on wood and gilded with some colored details. Since few specific studies have been focused on materials and techniques used in Ancient Egypt for gilding, a detailed investigation was started in order to verify the technical features of the decoration in this sculpture. Specifically, DR and CT analyses have been performed at the Centro Conservazione e Restauro “La Venaria Reale” (CCR), with a new high resolution flat-panel detector, that allowed us to perform tomographic analysis reaching a final resolution better than the one achievable with the previous apparatus operating in the CCR.