bluuebunny/crossref_metadata_2025 huggingface dataset:
Left Atrial Appendage Closure for Atrial Fibrillation in the Elderly >75 Years Old: A Meta-Analysis of Observational Studies
Authors: Han Shaojie , Jia Ruikun , Zhao Shenyu , Chan Juan , Bai Yixuan , Cui Kaijun
Published: December 2022

Background: Left atrial appendage closure (LAAC) is an established therapy for patients with atrial fibrillation (AF); however, there is a limited understanding of LAAC in elderly patients (≥75 years old). We conducted a meta-analysis to investigate the procedural complications and long-term outcomes after LAAC in the elderly versus the non-elderly. Methods: We screened PubMed, EMBASE, Cochrane Library, and Web of Science. Procedural endpoints of interest included successful implantation LAAC rates, in-hospital mortality, major bleeding events, pericardial effusion/tamponade, stroke, and vascular access complications related to LAAC. Long-term outcomes included all-cause mortality, major bleeding events, and stroke/transient ischemic attack (TIA) during follow-up. Results: Finally, 12 studies were included in the analysis; these included a total of 25,094 people in the elderly group and 36,035 people in the non-elderly group. The successful implantation LAAC rates did not differ between the groups, while the elderly patients experienced more periprocedural mortality (OR 2.62; 95% CI 1.79–3.83, p < 0.01; I2 = 0%), pericardial effusion/tamponade (OR 1.39; 95% CI: 1.06–1.82, p < 0.01; I2 = 0%), major bleeding events (OR 1.32; 95% CI 1.17–1.48, p < 0.01; I2 = 0%), and vascular access complications (OR 1.34; 95% CI 1.16–1.55, p < 0.01; I2 = 0%) than the non-elderly patients. The long-term stroke/TIA rates did not differ between the elderly and the non-elderly at least one year after follow-up. Conclusions: Even though successful implantation LAAC rates are similar, elderly patients have a significantly higher incidence of periprocedural mortality, major bleeding events, vascular access complications, and pericardial effusion/tamponade after LAAC than non-elderly patients. The stroke/TIA rates did not differ between both groups after at least one-year follow-up.
The Community Collaboration Model for School Improvement: A Scoping Review
Authors: Anderson-Butcher Dawn , Bates Samantha , Lawson Hal A. , Childs Tasha M. , Iachini Aidyn L.
Published: December 2022

Schools worldwide are developing innovative models in response to, and in anticipation of, societal changes. Aiming to address non-academic barriers to learning, while capitalizing on out-of-school time, some school and community leaders have prioritized family and community partnerships, especially in the United States (U.S.). The Community Collaboration Model (CCM) is one such U.S. partnership-oriented model of expanded school improvement. In contrast to some partnership-oriented models, the CCM prioritizes improvements in classrooms and communities, aiming to support students, assist teachers, and improve relationships beyond the typical school day. This scoping review examines 14 peer-reviewed articles which describe CCM-centered innovations and documented outcomes. Barriers and facilitators associated with CCM adoption and implementation in diverse U.S. school and community settings also are explored. CCM’s contributions to important student and school outcomes (e.g., increased access to mental health services, improved school climate, decreased discipline referrals) are documented in this scoping review. Some researchers have also described implementation-related facilitators (e.g., partnerships with universities) and barriers (e.g., initial resistance by educators) that influence the utility of the model in practice. Drawing on prior research, the authors discuss findings and implications for future research, educational policy, and practice.
Can Mathematical Modelling Be Taught and Learned in Primary Mathematics Classrooms: A Systematic Review of Empirical Studies
Authors: Wei Yicheng , Zhang Qiaoping , Guo Jing
Published: December 2022

STEM education has been promoted in schools worldwide to cultivate students’ 21st-century skills. Mathematical modelling is a valuable method for developing STEM education. However, in this respect, more attention is given to secondary level or above compared with kindergarten or primary level. Teaching mathematics at the primary level is closely related to authentic problems, which is a crucial characteristic of mathematical modelling activities. After screening 239 publications from various databases, we reviewed 10 empirical studies on mathematical modelling at the primary level. In this systematic review, we analysed the following three aspects: (1) the use of professional development intervention methods/strategies to enhance the intervention effects and the competencies of primary teachers to utilize mathematical modelling; (2) the effects of mathematical modelling on primary students and methods of improving their mathematical modelling skills; and (3) methods used to assess the modelling skills of primary school teachers and students. The results indicate that professional development interventions can enhance the teaching quality of mathematical modelling. The components of the interventions should include an introduction to the pedagogy of mathematical modelling, clarifying the role of the teacher and the student in mathematical modelling activities. Through mathematical modelling, students can generate mathematical ideas, explore mathematical theorems independently, develop critical thinking, and improve their metacognitive and communicative skills. The competency of mathematical modelling is often determined using formative assessments of teachers and students. Because limitations still exist in conducting primary-level modelling activities, schools should utilise more standardised assessment methods, provide universal teacher training, and grant more opportunities for primary school students to participate in mathematical modelling activities. The lack of research on cross-cultural contexts should draw the attention of future research.
Visibility of Scientific Production and Digital Identity of Researchers through Digital Technologies
Authors: Andrea Basantes-Andrade , Miguel Naranjo-Toro , Frank Guerra-Reyes , Ramiro Carrascal , Andrés Benavides-Piedra
Published: December 2022

The research process does not end with the publication of the results; on the contrary, it has to continue even further, when results are disseminated and scientific disclosure on the Web begins. The purpose of this article is to promote visibility of the scientific production and digital identity of the faculty and researchers at the Universidad Técnica del Norte (Ibarra-Ecuador). By implementing a quantitative documentary, descriptive, and quasi-experimental comparative approach, it was possible to determine the importance of scientific visibility, the most suitable digital platforms for this task (ORCID, Google Scholar, Academia, ResearchGate, ResearcherID (WoS), Author ID (Scopus), Sciprofiles, Mendeley, Facebook, Twitter, LinkedIn and Impactstory), and the level of knowledge that professors have of these platforms. With the results, a pilot training-course was planned and implemented for researchers and university professors of the Faculty of Education Science and Technology, with the purpose of registering their author profiles and incorporating their scientific production onto the platforms with the greatest impact and visibility. The results from the two stages (pre-test and post-test) of the pilot course show a significant difference regarding the creation and management of the research profiles; therefore, this strategy puts forward an alternative way to make research and digital/identity visible in the academic, scientific and social community.
Atmospheric Ducting Interference on DAB, DAB+ Radio in Eastern Mediterranean
Authors: Constantinides Antonios , Najat Saam , Haralambous Haris
Published: December 2022

A serious problem affecting the local radio industry in Cyprus is radio interference from the Middle East. This problem is especially acute on the highway along the coast during the summer months because interference degrades the sound quality in vehicle receivers due to chirping noise, hissing, fading and distortion. During the last decade the issue was explored by monitoring the field strength intensity of unwanted signals with respect to atmospheric conditions that excacerbate interference. According to the research outcomes presented in this paper, severe interference occurs due to “Tropospheric Ducting”, i.e., radio energy becomes trapped between two boundaries in the lower layers of Earth’s atmosphere. Thereby, this phenomenon acts as a waveguide that favors radio waves to propagate beyond the horizon with very strong field strength intensity where under certain atmospheric conditions exceeding the expected free space theoretical value. Because the commercial Band FM is already oversaturated for years, it was considered important to expand this research to explore the impact of interference on the new digital DAB, DAB+ radio, that will soon be launched in Cyprus, as it is discussed below.
An Efficient Hidden Markov Model with Periodic Recurrent Neural Network Observer for Music Beat Tracking
Authors: Song Guangxiao , Wang Zhijie
Published: December 2022

In music information retrieval (MIR), beat tracking is one of the most fundamental tasks. To obtain this critical component from rhythmic music signals, a previous beat tracking system of hidden Markov model (HMM) with a recurrent neural network (RNN) observer was developed. Although the frequency of music beat is quite stable, existing HMM based methods do not take this feature into account. Accordingly, most of hidden states in these HMM-based methods are redundant, which is a disadvantage for time efficiency. In this paper, we proposed an efficient HMM using hidden states by exploiting the frequency contents of the neural network’s observation with Fourier transform, which extremely reduces the computational complexity. Observers that previous works used, such as bi-directional recurrent neural network (Bi-RNN) and temporal convolutional network (TCN), cannot perceive the frequency of music beat. To obtain more reliable frequencies from music, a periodic recurrent neural network (PRNN) based on attention mechanism is proposed as well, which is used as the observer in HMM. Experimental results on open source music datasets, such as GTZAN, Hainsworth, SMC, and Ballroom, show that our efficient HMM with PRNN is competitive to the state-of-the-art methods and has lower computational cost.
A Portable and Low-Cost Triboelectric Nanogenerator for Wheelchair Table Tennis Monitoring
Authors: Zhu Xiaorui , Zhang Mengqi , Wang Xiaodong , Jia Changjun , Zhang Yingqiu
Published: December 2022

With progress in fifth-generation techniques, more advanced techniques are available for disabled people. Disability table tennis has also benefited from the new technology. In this paper, a portable and low-cost triboelectric nanogenerator for wheelchair table tennis monitoring systems is proposed. It was applied for wheelchair table tennis athletes’ monitoring. The portable and low-cost triboelectric nanogenerator consists of Kapton, polyurethane triboelectric films, and a foam supporting layer. The materials have flexible and low-cost characteristics. Therefore, the device has no influence on exercise performance. Due to triboelectric and electrostatic induction, the portable and low-cost triboelectric nanogenerator can convert biomechanical signals into electric signals. The electric signal is used as a sensing signal and is transformed in a computer by an Analog-to-Digital acquisition module. The coach acquires motion information in real time from a terminal device regarding force, exercise amplitude, and stability of the athlete. Meanwhile, the electric signal provides also sustainable energy for the microelectronic device. It can light 20 LEDs easily and power a calculator and a watch. This portable and low-cost self-powered triboelectric nanogenerator offers a new approach to the field of motion monitoring for disabled people.
Research on Quantitative Calculation Method of Accident Scope of Gathering and Transportation Station
Authors: Chen Lin , Tong Hang , Liu Zheng , Zhang Zhi , Mou Pengfei
Published: December 2022

In order to ensure the security and stability of oilfield gathering and transportation stations and to improve the risk assessment method, this paper proposes an evaluation method that can fully and quantitatively calculate the impact range of process equipment and pipelines in the event of fire and explosion accidents based on API 581-2016 Quantitative Risk Assessment Technology. It mainly analyzes and calculates the leakage type, leakage rate and total leakage amount, combined with the occurrence probability of various failure situations, the casualty area and the fact that equipment damage could be finally determined. In addition, PHAST Software is used to verify this method. The average deviation of the calculation results is very small, which shows that the method is completely feasible and accurate. In order to further correct the error, specific correction methods and formulas are also proposed. This theoretical calculation method greatly improves the quantitative evaluation method of oil field gathering and transportation stations, and lays a solid foundation for the quantitative calculation of failure consequences in the future.
Major Causes of Variation of External Appearance, Chemical Composition, Texture, and Color Traits of 37 Categories of Cheeses
Authors: Bittante Giovanni , Amalfitano Nicolò , Cipolat-Gotet Claudio , Lombardi Angiolella , Stocco Giorgia , Tagliapietra Franco
Published: December 2022

Cheeses are produced by many different procedures, giving rise to many types differing in ripening time, size, shape, chemical composition, color, texture, and sensory properties. As the first step in a large project, our aim was to characterize and quantify the major sources of variation in cheese characteristics by sampling 1050 different cheeses manufactured by over 100 producers and grouped into 37 categories (16 with protected designation of origin, 4 traditional cheese categories, 3 pasta filata cheese categories, 5 flavored cheese categories, 2 goat milk categories, and 7 other categories ranging from very fresh to very hard cheeses). We obtained 17 traits from each cheese (shape, height, diameter, weight, moisture, fat, protein, water soluble nitrogen, ash, pH, 5 color traits, firmness, and adhesiveness). The main groups of cheese categories were characterized and are discussed in terms of the effects of the prevalent area of origin/feeding system, species of lactating females, main cheese-making technologies, and additives used. The results will allow us to proceed with the further steps, which will address the interrelationships among the different traits characterizing cheeses, detailed analyses of the nutrients affecting human health and sensorial fingerprinting.
Combined Heat and Mass Transfer Associated with Kinetics Models for Analyzing Convective Stepwise Drying of Carrot Cubes
Authors: Chupawa Prarin , Suksamran Wanwisa , Jaisut Donludee , Ronsse Frederik , Duangkhamchan Wasan
Published: December 2022

Stepwise drying is an effective technique that promotes energy saving without additional capital cost. The stepwise drying mode was investigated for energy consumption and dried product qualities using a coupled heat and mass transfer model associated with kinetics equations of volume shrinkage and degradation of β-carotene in carrot cubes. Simulations were performed using a finite element method with extension of a chemical species transport. Validation experiments were carried out under constant drying modes at 60 °C, 70 °C and 80 °C using a lab-scale convective hot air dryer. The verified models were subsequently employed to investigate the effects of two step-up drying modes (60 to 70 °C and 60 to −80 °C). The optimal drying condition was determined using the synthetic evaluation index (SI) with criteria of high specific moisture evaporation rate (SMER), low shrinkage ratio and β-carotene degradation. Simulated results showed comparable agreement with experimental data of moisture content, shrinkage ratio and β-carotene ratio. Step-up drying of 60 to 70 °C gave the highest SMER of 0.50 × 10−3 kg of water evaporated per kWh, while the operation at constant temperature of 80 °C gave the lowest value of 0.19 × 10−3 kg of water evaporated per kWh. Model-predicted results showed less shrinkage of carrot cubes, but higher degradation of β-carotene under step-up drying compared to single-stage drying under temperature of 60 °C. Based on the highest SI value (0.36), carrot cubes were optimally dried under step-up mode of 60 to 70 °C.
Construction of an MLR-QSAR Model Based on Dietary Flavonoids and Screening of Natural α-Glucosidase Inhibitors
Authors: Yang Ting , Yang Zichen , Pan Fei , Jia Yijia , Cai Shengbao , Zhao Liang , Zhao Lei , Wang Ou , Wang Chengtao
Published: December 2022

Postprandial hyperglycemia can be reduced by inhibiting α-glucosidase activity. Common α-glucosidase inhibitors such as acarbose may have various side effects. Therefore, it is important to find natural products that are non-toxic and have high α-glucosidase-inhibitory activity. In the present study, a comprehensive computational analysis of 27 dietary flavonoid compounds with α-glucosidase-inhibitory activity was performed. These included flavonoids, flavanones, isoflavonoids, dihydrochalcone, flavan-3-ols, and anthocyanins. Firstly, molecular fingerprint similarity clustering analysis was performed on the target molecules. Secondly, multiple linear regression quantitative structure–activity relationship (MLR-QSAR) models of dietary flavonoids (2D descriptors and 3D descriptors optimized), with R2 of 0.927 and 0.934, respectively, were constructed using genetic algorithms. Finally, the MolNatSim tool based on the COCONUT database was used to match the similarity of each flavonoid in this study, and to sequentially perform molecular enrichment, similarity screening, and QSAR prediction. After screening, five kinds of natural product molecule (2-(3,5-dihydroxyphenyl)-5,7-dihydroxy-4H-chromen-4-one, norartocarpetin, 2-(2,5-dihydroxyphenyl)-5,7-dihydroxy-4H-chromen-4-one, 2-(3,4-dihydroxyphenyl)-5-hydroxy-4H-chromen-4-one, and morelosin) were finally obtained. Their IC50pre values were 8.977, 31.949, 78.566, 87.87, and 94.136 µM, respectively. Pharmacokinetic predictions evaluated the properties of the new natural products, such as bioavailability and toxicity. Molecular docking analysis revealed the interaction of candidate novel natural flavonoid compounds with the amino acid residues of α-glucosidase. Molecular dynamics (MD) simulations and molecular mechanics/generalized Born surface area (MMGBSA) further validated the stability of these novel natural compounds bound to α-glucosidase. The present findings may provide new directions in the search for novel natural α-glucosidase inhibitors.
Flour on Gluten-Free Muffins from Different Edible Cassava Varieties in Thailand
Authors: Sangpueak Rungthip , Saengchan Chanon , Laemchiab Kansinee , Kiddeejing Dusadee , Siriwong Supatcharee , Thumanu Kanjana , Hoang Nguyen Huy , Phansak Piyaporn , Buensanteai Kumrai
Published: December 2022

In Thailand new edible cassava varieties have been developed to be used in the food industry. The aim of this research was to analyze the difference between flour from three cassava varieties and to evaluate the suitability and quality of flour for gluten-free muffins. The physico-chemical properties of flour from three varieties were studied. The results showed the moisture content of flour was between 10.65 ± 0.01 and 10.85 ± 0.45%. Total protein content was highly significant with a difference of 1.97 ± 0.00%, 2.15 ± 0.01%, and 2.18 ± 0.01%, respectively. Moreover, ash and fat in each flour were highly significant. Amylose content was 19.93 ± 0.47%, and the viscosity was 6286.00 ± 1.52 mPa.s. The color of flour values of L* a* b* value was not statistically different in each variety of flour. Fourier transform infrared spectroscopy (FTIR) analysis was used for the biochemical change in flour. The PCA and cluster analysis results revealed that cassava flour from Pirun 6 was different from Pirun 2 and Pirun 4. After that, the test using selected cassava flour from Pirun 6 to test the physical properties and sensory attributes of gluten-free muffins compared with wheat flour found that gluten-free muffins were overall better than basic muffins.
The Association of Variants within Types V and XI Collagen Genes with Knee Joint Laxity Measurements
Authors: Beckley Samantha , Dey Roopam , Stinton Shaun , van der Merwe Willem , Branch Thomas , September Alison V. , Posthumus Mike , Collins Malcolm
Published: December 2022

Joint laxity is a multifactorial phenotype with a heritable component. Mutations or common polymorphisms within the α1(V) (COL5A1), α1(XI) (COL11A1) and α2(XI) (COL11A2) collagen genes have been reported or proposed to associate with joint hypermobility, range of motion and/or genu recurvatum. The aim of this study was to investigate whether polymorphisms within these collagen-encoding genes are associated with measurements of knee joint laxity and computed ligament length changes within the non-dominant leg. One hundred and six healthy participants were assessed for genu recurvatum (knee hyperextension), anterior-posterior tibial translation, external-internal tibial rotation and ligament length changes during knee rotation of their non-dominant leg. Participants were genotyped for COL5A1 rs12722 (T/C), COL11A1 rs3753841 (C/T), COL11A1 rs1676486 (T/C) and COL11A2 rs1799907 (A/T). The genotype-genotype combination of any two or more of the four COL5A1 rs12722 CC, COL11A1 rs3753841 CC, COL11A1 rs1676486 TT and COL11A2 rs1799907 AA genotypes was associated with decreased active and passive knee hyperextension. These genotype-genotype combinations, including sex (male), increased age and decreased body mass collectively, also contributed to decreased passive knee hyperextension. These findings suggest that COL5A1, COL11A1 and COL11A2 gene-gene interactions are associated with knee hyperextension measurements of the non-dominant leg of healthy individuals.
Potential Cytoprotective and Regulatory Effects of Ergothioneine on Gene Expression of Proteins Involved in Erythroid Adaptation Mechanisms and Redox Pathways in K562 Cells
Authors: Bernardo Victoria Simões , Torres Flaviene Felix , de Paula Carla Peres , da Silva João Pedro Maia de Oliveira , de Almeida Eduardo Alves , da Cunha Anderson Ferreira , da Silva Danilo Grünig Humberto
Published: December 2022

This study aimed to establish the importance of ergothioneine (ERT) in the erythroid adaptation mechanisms by appraising the expression levels of redox-related genes associated with the PI3K/AKT/FoxO3 and Nrf2-ARE pathways using K562 cells induced to erythroid differentiation and H2O2-oxidative stress. Cell viability and gene expression were evaluated. Two concentrations of ERT were assessed, 1 nM (C1) and 100 µM (C2), with and without stress induction (100 µM H2O2). Assessments were made in three periods of the cellular differentiation process (D0, D2, and D4). The C1 treatment promoted the induction of FOXO3 (D0 and 2), PSMB5, and 6 expressions (D4); C1 + H2O2 treatment showed the highest levels of NRF2 transcripts, KEAP1 (D0), YWHAQ (D2 and 4), PSMB5 (D2) and PSMB6 (D4); and C2 + H2O2 (D2) an increase in FOXO3 and MST1 expression, with a decrease of YWHAQ and NRF2 was observed. in C2 + H2O2 (D2) an increase in FOXO3 and MST1, with a decrease in YWHAQ and NRF2 was observed All ERT treatments increased gamma-globin expression. Statistical multivariate analyzes highlighted that the Nrf2-ARE pathway presented a greater contribution in the production of PRDX1, SOD1, CAT, and PSBM5 mRNAs, whereas the PI3K/AKT/FoxO3 pathway was associated with the PRDX2 and TRX transcripts. In conclusion, ERT presented a cytoprotective action through Nrf2 and FoxO3, with the latter seeming to contribute to erythroid proliferation/differentiation.
Identification and Characterization of Short-Term Motor Patterns in Rest Tremor of Individuals with Parkinson’s Disease
Authors: Rabelo Amanda , Folador João Paulo , Cabral Ariana Moura , Lima Viviane , Arantes Ana Paula , Sande Luciane , Vieira Marcus Fraga , Almeida Rodrigo Maximiano Antunes de , Andrade Adriano de Oliveira
Published: December 2022

(1) Background: The dynamics of hand tremors involve nonrandom and short-term motor patterns (STMPs). This study aimed to (i) identify STMPs in Parkinson’s disease (PD) and physiological resting tremor and (ii) characterize STMPs by amplitude, persistence, and regularity. (2) Methods: This study included healthy (N = 12, 60.1 ± 5.9 years old) and PD (N = 14, 65 ± 11.54 years old) participants. The signals were collected using a triaxial gyroscope on the dorsal side of the hand during a resting condition. Data were preprocessed and seven features were extracted from each 1 s window with 50% overlap. The STMPs were identified using the clustering technique k-means applied to the data in the two-dimensional space given by t-Distributed Stochastic Neighbor Embedding (t-SNE). The frequency, transition probability, and duration of the STMPs for each group were assessed. All STMP features were averaged across groups. (3) Results: Three STMPs were identified in tremor signals (p < 0.05). STMP 1 was prevalent in the healthy control (HC) subjects, STMP 2 in both groups, and STMP3 in PD. Only the coefficient of variation and complexity differed significantly between groups. (4) Conclusion: These results can help professionals characterize and evaluate tremor severity and treatment efficacy.
Lifestyle Changes among Mexican People during the COVID-19 Lockdown in 2020: A Cross-Sectional Study
Authors: Hernández-Nava Rocio Guadalupe , de la Luz Sánchez-Mundo María , García-Barrientos Raquel , Espinosa-Solis Vicente , Villalobos-Aguayo Patricia , Salmerón-Muñiz Nancy Natividad , Anaya-Tacuba José Daniel
Published: December 2022

The COVID-19 pandemic generated a new challenge of our time with different scenarios. For this reason, this work aimed to identify changes in the diet and lifestyle of Mexicans during the COVID-19 lockdown. This study was based on a Google online survey, which contained questions about eating habits, physical activity, and sleep behavior before and during the COVID-19 lockdown. It was conducted from 2 June to 4 July 2020 and included 1004 participants (698 women and 306 men 18 years old and above). The subjects reported the increased frequency of consumption of meat, vegetables, fruits, eggs, legumes, fast food, and alcoholic drinks during the lockdown. Furthermore, subjects reported sleeping more hours than usual and negative changes in sleep quality (insomnia, nightmares, and leg pain or cramps). There was a reduction in practicing 30 min of intense physical activity during the week. On the other hand, there was an increase in the number of hours spent in front of the screen. Participants over 36 years of age performed less physical activity during the COVID-19 lockdown. These results indicated that it is vital to develop national strategies to promote healthy lifestyle habits in the population during pandemic lockdown measures.
Correction: Alijanzadeh et al. Measurement Invariance and Differential Item Functioning of the Health Literacy Instrument for Adults (HELIA): A Large-Scale Cross-Sectional Study in Iran. Healthcare 2022, 10, 2064
Authors: Alijanzadeh Mehran , Lin Chung-Ying , Yahaghi Rafat , Rahmani Jalal , Yazdi Nahid , Jafari Elahe , Alijani Hashem , Zamani Narges , Fotuhi Razie , Taherkhani Elham , Buchali Zeinab , Jafari Robabe , Mahmoudi Narges , Poorzolfaghar Leila , Ahmadizade Safie , Shahbazkhania Azam , Alimoradi Zainab , Pakpour Amir H.
Published: December 2022

There were some errors in the original publication in the Abstract and Results sections [...]
Barriers and Facilitating Factors of Adherence to Antidepressant Treatments: An Exploratory Qualitative Study with Patients and Psychiatrists
Authors: González de León Beatriz , Abt-Sacks Analía , Acosta Artiles Francisco Javier , del Pino-Sedeño Tasmania , Ramos-García Vanesa , Rodríguez Álvarez Cristobalina , Bejarano-Quisoboni Daniel , Trujillo-Martín María M.
Published: December 2022

This study examines the experiences and expectations of patients with depressive disorders regarding the disease and different antidepressants, as well as examining the barriers and facilitating factors that could affect their adherence to medications. An exploratory qualitative study was carried out. The study involved two focus groups made up of patients and caregivers and six semi-structured interviews with psychiatrists. In both cases, the participants were selected by intentional theoretical sampling, seeking maximum significance variation of social types. Prejudice about the side effects of medication was relevant. The importance of patients being well informed about the disease/treatments was noteworthy. The stigmatization of antidepressants by patients was identified as a barrier to medication adherence. The involvement of family members and the motivation of patients to be actively involved in the process to recover from the disease were identified as facilitating factors. The work carried out suggests the need for patients to have rigorous information about the disease/treatment to reduce the possible prejudices generated by beliefs. Maintaining greater contact and monitoring of patients/caregivers to help therapeutic adherence in patients with depressive disorders was also identified as being of great importance.
Knowledge, Attitudes, and Practices of the Population in Jazan Region, Saudi Arabia Regarding Dengue Fever and Its Prevention Measures: A Community-Based Cross-Sectional Study
Authors: Ahmed Anas Elyas , Almarhabi Mohammed A. , Shami Mohammed O. , Alhazemi Alhassan Ali , Alsharif Hassan M. , Abu Hayyah Ali Essa , Alhazmi Wessam Ahmed , Alfaifi Mohammed A. , Abdali Abdulaziz Q. , Alshihri Mohammed S. , Alhazmi Ali H. , Qasem Halimah A. , Alhazmi Mazen Ahmed , Abdelwahab Siddig Ibrahim
Published: December 2022

In previous studies, there was an apparent lack of health education about dengue fever (DF) among the Saudi population. Therefore, we conducted this study to assess the knowledge, attitude, and practices (KAP) about dengue fever among the Jazan region population, which is one of the most prevalent diseases in the region in Saudi Arabia (KSA). This was a cross-sectional and community-based study. The adult population was divided into governorates according to the regions that were close to each other, and then a convenient stratum was selected from each region. Next, random sampling was applied. Data were collected using a self-administered questionnaire. Exclusion criteria were young people (<18 years old) and health workers. Data analysis was performed using descriptive statistics, the Pearson’s correlation coefficient, and multiple linear regression. Of the 392 participants in this cross-sectional study, 59.18% were male, 76.28% were aged 18–35 years, 72.96% had a university degree, and 63% had a monthly income of less than SAR 5000 (USD1 = 3.76). The scores (mean ± SD) for KAP regarding DF among the responders were 22.77 ± 7.9, 22.68 ± 7.24, and 25.62 ± 9.4, respectively. KAP constructs were positively correlated according to the Pearson’s coefficient. In multiple linear regression analysis, males were favorably and substantially linked with attitude score (β = 2.76, p = 0.001) and negatively associated with practice score (β = −2.45, p = 0.023). No-degree participants scored lower on knowledge (β = −2.78, p = 0.003). There is potential for more research in Saudi Arabia to increase the generalizability to reduce the impact of dengue epidemics.
Lessons in a Green School Environment and in the Classroom: Effects on Students’ Cognitive Functioning and Affect
Authors: Mason Lucia , Manzione Lucia , Ronconi Angelica , Pazzaglia Francesca
Published: December 2022

The positive impact of short-term exposure to nature during a green recess in a school day is documented in the literature. In this study we investigated cognitive, academic, and affective effects of a single contact with nature during a regular school lesson in the greenness, compared to an usual classroom lesson, on young students in second and third grades (N = 65). In a within-subjects design, for the cognitive effects we examined children’s (a) selective and sustained attention and (b) math calculation performance in common school tasks. For affective effects we considered (c) their positive and negative mood and (d) the perception of environmental restorativeness. Findings revealed that after a single lesson taught in the green school garden, children had greater selective attention and math calculation performance in two tasks than after a similar lesson in the classroom environment. Moreover, children with higher self-reported emotional difficulties showed greater selective attention and reported a statistically significant increase in positive affect and a tendency to a significant decrease in negative affect after the lesson in the greenness than in the classroom. Students also perceived the green space as more restorative than the classroom environment. Results are discussed against theories on the benefits of exposure to natural environments, highlighting the theoretical and practical significance of the study.
Second Victim Support at the Core of Severe Adverse Event Investigation
Authors: Cobos-Vargas Angel , Pérez-Pérez Pastora , Núñez-Núñez María , Casado-Fernández Eloísa , Bueno-Cavanillas Aurora
Published: December 2022

There is limited evidence and a lack of standard operating procedures to address the impact of serious adverse events (SAE) on healthcare workers. We aimed to share two years’ experience of a second victim support intervention integrated into the SAE management program conducted in a 500-bed University Hospital in Granada, Spain. The intervention strategy, based on the “forYOU” model, was structured into three levels of support according to the degree of affliction and the emotional needs of the professionals. A semi-structured survey of all workers involved in an SAE was used to identify potential second victims. Between 2020 and 2021, the SAE operating procedure was activated 23 times. All healthcare workers involved in an SAE (n = 135) received second-level support. The majority were physicians (51.2%), followed by nurses (26.7%). Only 58 (43.0%) received first-level emotional support and 47 (34.8%) met “second victim” criteria. Seven workers (14.9%) required third-level support. A progressive increase in the notification rates was observed. Acceptance of the procedure by professionals and managers was high. This novel approach improved the number of workers reached by the trained staff; promoted the visibility of actions taken during SAE management and helped foster patient safety culture in our setting.
Characteristics of Air Pollutants Emission and Its Impacts on Public Health of Chengdu, Western China
Authors: Wang Ju , Li Juan , Li Xinlong , Fang Chunsheng
Published: December 2022

Pollution caused by PM2.5 and O3 are common environmental problems which can easily affect human health. Chengdu is a major central city in Western China, and there is little research on the regional emissions and health effects of air pollution in Chengdu. According to the Multi-resolution Emissions Inventory of the Chinese Model, 2017 (MEIC v1.3), this study compiled the air pollutant emission inventory of Chengdu. The results show that the pollutant emission of Chengdu is generally higher in winter than in summer. The southeast area of Chengdu is the key area where emissions of residential and industrial sectors are dominant. Through air quality simulation with a Weather Research and Forecasting model, coupled with the Community Multiscale Air Quality (WRF-CMAQ), the health effects of PM2.5 and O3 in winter and summer in Chengdu of 2017 were investigated. The primary pollutant in winter is PM2.5 and O3 in summer. PM2.5 pollution accounted for 351 deaths in January and July 2017, and O3 pollution accounted for 328 deaths in the same period. There were 276 deaths in rural areas and 413 in urban areas. In January and July 2017, the health economic loss caused by PM2.5 accounted for 0.0974% of the gross regional product (GDP) of Chengdu in 2017, and the health economic loss caused by O3 accounted for 0.0910%.
Challenges for Management of Dilated Cardiomyopathy during COVID-19 Pandemic—A Telemedicine Application
Authors: Iliuta Luminita , Andronesi Andreea Gabriella , Panaitescu Eugenia , Rac-Albu Madalina Elena , Scafa-Udriște Alexandru , Moldovan Horațiu
Published: December 2022

Background and Objectives: The 2019 coronavirus pandemic (COVID-19) represented a significant challenge for the medical community. The first aim of this study was to examine the COVID-19 impact on the follow-up of patients with dilated cardiomyopathy (DCM) and to establish the advantages of multiparametric home monitoring. Also, we tried to establish the main prognostic predictors at 2-years follow-up and the value of LV diastolic filling pattern (LVDFP) in increasing mortality and morbidity. Materials and Methods: We conducted a prospective study of 142 patients with DCM assessed by in-patient visit in the pre-pandemic period and hybrid (face-to-face, online consultation and telemedicine home monitoring with a dedicated application) during the pandemic period. The statistical analysis compared the strategy used in the pre-pandemic with management during the pandemic, in terms of clinical assessment, hospitalizations/emergency room visits due to HF exacerbation and total mortality. Results: We did not observe significant changes in blood pressure (BP), heart rate (FC), weight and symptoms or an increased rate of adverse drug events between the two periods. We successfully titrated HF medications with close monitoring of HF decompensations, which were similar in number, but were mostly managed at home during the pandemic. There was also no statistically significant difference in emergency room visits due to severe decompensated HF. Mortality in the first and second year of follow-up was between 12.0 and 13%, similar in the pre-pandemic and pandemic periods, but significantly higher in patients with restrictive LVDFP. Clinical improvement or stability after 2 years was more frequent in patients with nonrestrictive LVDFP. The main prognostic predictors at 1 and 2-years follow-up were: the restrictive LVDFP, significantly dilated LV, comorbidities (DM, COPD), older age, associated severe mitral regurgitation and pulmonary hypertension. Conclusions: The pandemic restrictions determined a marked decrease of the healthcare use, but no significant change in the clinical status of DCM patients under multiparametric home monitoring. At 2-years follow-up, the presence of the restrictive LVDFP was associated with an increased risk of death and with a worse clinical status in DCM patients.
Electrocautery, Harmonic, and Thunderbeat Instruments in Parotid Surgery: A Retrospective Comparative Study
Authors: Vaira Luigi Angelo , Rizzo Davide , Murrocu Claudia , Zullo Caterina Francesca , Dessy Margherita , Mureddu Luca , Ligas Enrica , Salzano Giovanni , Biglio Andrea , Mayo-Yáñez Miguel , Lechien Jerome R. , Piombino Pasquale , Bussu Francesco , De Riu Giacomo
Published: December 2022

The aim of this retrospective study has been to compare the surgical outcomes of patients undergoing superficial parotidectomy with three different instruments: bipolar electrocautery, ultrasound, and mixed energy instruments. The clinical records of 102 patients who had undergone superficial parotidectomy for benign tumors between January 2016 and April 2022 were considered. Based on the tool used during the surgery, the patients were divided into three study groups: classic electrocautery hemostasis group (CH group), ultrasonic instrument group (HA group), and combined energy instrument group (TB group). The duration of surgery, the total post-operative drainage volume, and the intra-operative blood loss were significantly higher in the CH group compared to the HA and the TB group, while the differences were not significant between the latter two groups. Facial nerve weakness was detected in 45.9% of the CH group, 12.5% of the HA group, and 21.2% of the TB group. The rate of facial nerve dysfunction in the CH group was significantly higher than in the HA group (0.011). In the patients who experienced post-operative facial nerve dysfunction, the recovery time was significantly shorter in the HA group compared to the CH and the TB group. The HA and TB groups have demonstrated comparable and significantly better surgical outcomes than bipolar electrocautery. Ultrasound instruments have been shown to cause, in comparison with the other techniques, a lower rate of temporary facial nerve dysfunction and, if this is present, lead to a faster spontaneous recovery time.
Single-Stage Revision Reverse Shoulder Arthroplasty: Preoperative Planning, Surgical Technique, and Mixed Reality Execution
Authors: Italia Kristine , Launay Marine , Gilliland Luke , Nielsen James , Pareyon Roberto , Hollman Freek , Salhi Asma , Maharaj Jashint , Jomaa Mohammad , Cutbush Kenneth , Gupta Ashish
Published: December 2022

Revision shoulder arthroplasty is increasing with the number of primary shoulder replacements rising globally. Complex primary and revisions of shoulder arthroplasties pose specific challenges for the surgeon, which must be addressed preoperatively and intraoperatively. This article aimed to present strategies for the management of revision of shoulder arthroplasties through a single-stage approach. Preoperatively, patient factors, such as age, comorbidities, and bone quality, should be considered. The use of planning software can aid in accurately evaluating implants in situ and predict bony anatomy that will remain after explantation during the revision surgery. The planning from such software can then be executed with the help of mixed reality technology to allow accurate implant placement. Single-stage revision is performed in two steps (debridement as first step, implantation and reconstruction as the second step), guided by the following principles: adequate debridement while preserving key soft tissue attachments (i.e., rotator cuff, pectoralis major, latissimus dorsi, deltoid), restoration of glenoid joint line using bone grafting, restoration of humeral length, reconstruction and/or reattachment of soft tissues, and strict compliance with the postoperative antibiotic regimen. Preliminary results of single-stage revision shoulder arthroplasty show improvement in patient outcomes (mean 1 year), successful treatment of infection for those diagnosed with periprosthetic joint infection, and improved cost–benefit parameters for the healthcare system.
Ultrasound-Guided Needle Aspiration vs. Surgical Incision of Parotid Abscesses
Authors: Strassen Ulrich , Grimler Christophe , Hofauer Benedikt
Published: December 2022

Objective: Standard treatment of parotideal abscesses consists of surgical drainage. This often has to be carried out in general anesthesia and carries the risk of iatrogenic injury of the facial nerve. Ultrasound-guided needle aspiration is an alternative therapy. Up until now a lack of systematic data concerning this subject exists. The study at hand aims to answer the question whether needle aspiration is a viable alternative for surgical drainage. Methods: All patients who had been treated surgically (n = 39) or via ultrasound-guided needle aspiration (n = 18) at our clinic were included into this monocentric retrospective analysis. Results: There was no statistically significant difference (p = 0.142) regarding the mean abscess volume in both groups (5.7 vs. 10.1 mL). Therapy of the abscesses on average required 1.88 (1–5) ultrasound-guided needle aspirations or 1.10 (1–4) surgical interventions. There was a trend to a shorter inpatient treatment period (5.88 vs. 7.33 days) after ultrasound-guided needle aspiration. This trend did not reach statistical significance (p = 0.301). Facial nerve alterations did not occur in any of the patients. Postoperative bleeding did never occur after needle aspirations but in 2% of the patients after surgical abscess revision. Conclusion: Ultrasound-guided needle aspiration is safe and effective in the treatment of parotid abscesses.
Multiple Cutaneous Manifestations in ANCA-Positive Eosinophilic Granulomatosis with Polyangiitis before and after Biologic Therapy: Clinical and Histopathologic Characterization of a Paradigmatic Case
Authors: Carnicelli Giorgia , Sernicola Alvise , Gomes Vito , Cundari Giulia , Trasarti Stefania , Priori Roberta , Grieco Teresa
Published: December 2022

Eosinophilic granulomatosis with polyangiitis (EGPA) is a rare immune-mediated vasculitis associated with anti-neutrophil cytoplasmic antibodies (ANCAs). Having systemic and possibly severe involvement, a prompt recognition of its clinical features is crucial to achieve favorable patient outcomes. Although cutaneous manifestations represent key elements, these still remain poorly characterized. We report a case of ANCA-positive EGPA presenting with palpable purpura, livedo reticularis, and pemphigoid-like lesions that was successfully treated with glucocorticoid therapy and rituximab. This report portrays the evolution of cutaneous lesions in ANCA-positive EGPA and demonstrates how dermatologic signs may represent indicators of active disease, allowing for timely diagnosis and for the monitoring of disease activity during treatment.
Myocardial Injury Is Associated with the Incidence of Major Adverse Cardiac Events in Patients with Severe Trauma
Authors: Stroda Alexandra , Jaekel Carina , M’Pembele René , Guenther Alexander , Tenge Theresa , Thielmann Carl Maximilian , Thelen Simon , Schiffner Erik , Bieler Dan , Bernhard Michael , Huhn Ragnar , Lurati Buse Giovanna , Roth Sebastian
Published: December 2022

Background: Severe trauma potentially results in end-organ damage such as myocardial injury. Data suggest that myocardial injury is associated with increased mortality in this cohort, but the association with the incidence of in-hospital major adverse cardiac events (MACE) remains undetermined. Methods: Retrospective cohort study including adult patients with severe trauma treated at the University Hospital Duesseldorf between January 2016 and December 2019. The main exposure was myocardial injury at presentation. Endpoints were in-hospital incidence of MACE and incidence of acute kidney injury (AKI) within 72 h. Discrimination of hsTnT for MACE and AKI was examined by the receiver operating characteristic curve (ROC) and the area under the curve (AUC). We conducted multivariate logistic regression analysis. Results: We included 353 patients in our final analysis (72.5% male (256/353), age: 55 ± 21 years). The AUC for hsTnT and MACE was 0.68 [95% confidence interval (CI): 0.59–0.78]. The AUC for hsTnT and AKI was 0.64 [95% (CI): 0.55–0.72]. The adjusted odds ratio (OR) for myocardial injury and MACE was 2.97 [95% (CI): 1.31–6.72], and it was 2.14 [95% (CI): 1.03–4.46] for myocardial injury and AKI. Conclusion: Myocardial injury at presentation in patients with severe trauma is independently associated with the incidence of in-hospital MACE and AKI.