bluuebunny/crossref_metadata_2025 huggingface dataset:
Preparation and Characterization of Silymarin Gel: A Novel Topical Mucoadhesive Formulation for Potential Applicability in Oral Pathologies
Authors: Venugopal Divyambika Catakapatri , Senthilnathan Reshma Devi , Maanvizhi Saba , Madhavan Yasasve , Sankarapandian Sathasivasubramanian , Ramshankar Vijayalakshmi , Kalachaveedu Mangathayaru
Published: February 2023

Silybum marianum has been used for centuries by herbalists and physicians to treat different forms of liver diseases. It contains flavonoid, which has antioxidant, anti-inflammatory, antifibrotic and anticancer properties. The objective of this research was to develop a silymarin-based mucoadhesive gel for prolonged release in oral mucosa and to evaluate the same by using in vitro drug release kinetic models and ex vivo methods for drug permeation using chicken buccal mucosa. The mucoadhesive gel was formulated in different trials by varying the concentration of silymarin and polymer. Out of 10 formulation trials, the F10 optimized trial was characterized for in vitro physicochemical parameters such as pH, homogeneity, viscosity, stability, drug content, in vitro drug release, in vitro antioxidant assay and ex vivo permeation study. Trial 10 was chosen as the best trial formulation among the other trials and was marked as an optimal trial. The physicochemical properties observed were pH to be 6.4 ± 0.01, the gel free of lumps, spreadability of 23.75 ± 0.03 and drug content of 32.77 ± 0.20 mg/g. It had no physiological changes such as color shift or fluid exudate segregation after 6 months of storage at room temperature. In vitro drug release established the presence of a non-fickian mechanism and demonstrated dose-dependent antioxidant activity. Ex vivo findings indicated 21.97 ± 0.18% release, proving that the gel can permeate through the oral mucosal membrane. Our future research will concentrate on expanding the therapeutic scope by developing the formulation trial F10 to a nanoformulation and conducting clinical trials for its potential use in various oral diseases.
Collapsing Response of a Nonlinear Shear-Beam Building Model Excited by a Strong-Motion Pulse at Its Base
Authors: Abbasgholiha Hamid , Gičev Vlado , Trifunac Mihailo D. , Jalali Reza S. , Todorovska Maria I.
Published: February 2023

We present a simple nonlinear model of a shear-beam building that experiences large nonlinear deformations and collapse when excited by large pulses of strong earthquake ground motion. In this paper, we introduce the model and show that its properties can be selected to be consistent with the damage observed in a seven-story hotel in San Fernando Valley of the Los Angeles metropolitan area during the 1994 Northridge earthquake. We also show an example of excitation that leads to the collapse of the model. We illustrate the response only for a sequence of horizontal pulses. We will describe the response of the same model to horizontal, vertical, and rocking motions at its base, as well as for more general excitation by strong earthquake ground motion, in future papers.
Preoperative Risk Factors Associated with Increased Incidence of Postoperative Delirium: Systematic Review of Qualified Clinical Studies
Authors: Karageorgos Vlasios , Mevorach Lior , Silvetti Melissa , Bilotta Federico
Published: February 2023

Postoperative delirium (POD) is an acute alteration of mental state, characterized by reduced awareness and attention, occurring up to five postoperative days after recovery from anesthesia. Several original studies and reviews have identified possible perioperative POD risk factors; however, there is no comprehensive review of the preoperative risk factors in patients diagnosed with POD using only validated diagnostic scales. The aim of this systematic review was to report the preoperative risk factors associated with an increased incidence of POD in patients undergoing non-cardiac and non-brain surgery. The reviewed studies included original research papers that used at least one validated diagnostic scale to identify POD occurrence for more than 24 h. A total of 6475 references were retrieved from the database search, with only 260 of them being suitable for further review. Out of the 260 reviewed studies, only 165 that used a validated POD scale reported one or more preoperative risk factors. Forty-one risk factors were identified, with various levels of statistical significance. The extracted risk factors could serve as a preoperative POD risk assessment workup. Future studies dedicated to the further evaluation of the specific preoperative risk factors’ contributions to POD could help with the development of a weighted screening tool.
Preparation for Childbirth: Coping with the Fear of Childbirth
Authors: Sánchez-García Juan Carlos , Cortés-Martín Jonathan , Rodríguez-Blanque Raquel
Published: February 2023

Pregnancy is a vital event in a woman’s life that involves not only important physical changes, but also psychological changes [...]
Allelic Discrimination of Vitamin D Receptor Polymorphisms and Risk of Type 2 Diabetes Mellitus: A Case-Controlled Study
Authors: Mohammed Amal Ahmed , El-Matty Dina M. Abo , Abdel-Azeem Rola , Raafat Khaled , Hussein Mona A. , El-Ansary Amira R. , Hafez Wael , Hassan Hatem Ahmed , Nassar Nourelhuda Ahmed , Selim Nora Mahmoud , Ghaith Doaa , Kholy Amal A. El , Abd El Salam Soha M. , Anouti Fatme Al , Wahba Alaa S.
Published: February 2023

(1) Background: Type 2 diabetes mellitus (T2DM) is one of the rapidly growing healthcare problems, and several vitamin D receptor (VDR) polymorphisms seem to modulate the risk of T2DM. Our research was designed to investigate the allelic discrimination of VDR polymorphisms and T2DM occurrence risk. (2) Methods: This case-control research included 156 patients with T2DM and 145 healthy control subjects. Most of the study population were males 56.6% vs. 62.8% in the case and control groups, respectively. Genotyping for VDR single nucleotide polymorphisms (SNPs), rs228570 (Fok1), rs7975232 (Apa1), and rs1544410 (Bsm1) was compared between both groups. (3) Results: There was a negative link between vitamin D levels and insulin sensitivity. A significant difference was noted in the allelic discrimination of VDR polymorphism rs228570 and rs1544410 between the study groups (p < 0.001). No difference was observed in the allelic discrimination of VDR polymorphism rs7975232 between the groups (p = 0.063). Moreover, T2DM patients had significantly higher levels of fasting blood sugar (FBS), glycated hemoglobin HbA1c, 2-h post-prandial blood sugar (PP), serum glutamic oxaloacetic transaminase (SGOT), serum glutamic-pyruvic transaminase (SGPT), total cholesterol, and triglycerides (p < 0.001), while High-Density Lipoprotein (HDL) Cholesterol (HDL-C) was significantly decreased (p = 0.006). (4) Conclusions: VDR polymorphisms had a positive association with T2DM risk among the Egyptian population. Further large-scale research using deep sequencing of samples is strongly urged to investigate different vitamin D gene variants and interactions, as well as the influence of vitamin D on T2DM.
A COVID Dilemma: How to Manage Pregnancies in Case of Severe Respiratory Failure?
Authors: Di Lorenzo Pierpaolo , Casella Claudia , Marisei Mariagrazia , Sarno Laura , Aquino Carmen Imma , Osuna Eduardo , Guida Maurizio , Niola Massimo
Published: February 2023

To date, the impact of the COVID-19 pandemic on the world’s health, economics and politics is still heavy, and efforts to mitigate virus transmission have caused remarkable disruption. From the early onset of the pandemic, generated by SARS-CoV-2 spread, the scientific community was aware of its impact on vulnerable individuals, including pregnant women. The purpose of this paper is to highlight scientific pitfalls and ethical dilemmas emerging from management of severe respiratory distress in pregnant women in order to add evidence to this topic through an ethical debate. In the here-presented paper, three cases of severe respiratory syndrome are analyzed. No specific therapeutic protocol was available to guide physicians in a cost–benefit balance, and unequivocal conduct was not a priori suggested from scientific evidence. However, vaccines’ advent, viral variants lurking on the horizon and other possible pandemic challenges make it necessary to maximize the experience gained through these difficult years. Antenatal management of pregnancies complicated by COVID-19 infection with severe respiratory failure is still heterogeneous and ethical concerns must be pointed out.
Movement, Play, and Games—An Essay about Youth Sports and Its Benefits for Human Development
Authors: Nery Miguel , Sequeira Isabel , Neto Carlos , Rosado António
Published: February 2023

The acknowledgment of the qualities and features of the world is made through the body, movement, and imagination. During their development, children learn new skills, complexify their thoughts, and become more autonomous. The progressive increase in motor repertoire in children reflects a more unified and solid self. Nowadays, there is a generalized restriction of the movement of children. It starts at home when parents establish rigid and/or phobic attachments with their children; it can be also observed at school which is more and more based on rigid learning rhythms and obsessive ideas about students’ performance, and finally in urban areas where free and outdoor play has considerably decreased during recent decades. The current lifestyles in Western societies resulted in a decrease in play among children. The culture influences the dominant types of psychopathology and, during childhood, mental suffering is often expressed with the increase (turmoil) or decrease (inhibition) of the body movement. Sports are underpinned by movement and play; they are a powerful tool in health promotion and an excellent way to assign meaning to movement. This work is an essay about the importance of play and youth sports in child development.
Geographic and Specialty-Specific Disparities in Physicians’ Legal Compliance: A National-Scale Assessment of Romanian Medical Practice
Authors: Nanu Codrut Andrei , Plaiasu Maria Cristina , Edu Antoine
Published: February 2023

Background: Physicians must respect their patients’ rights to informed consent, privacy, access to medical records, non-discrimination, treatment by a qualified doctor, and a second medical opinion. Compliance with patients’ rights is mandatory, and legal breaches are considered medical malpractice under Romanian law. This is the first study to assess physicians’ practices nationally and create a geographical map of legal compliance. Results: We examined survey responses of 2978 physicians, including 1587 general practitioners and 1391 attending physicians from high-risk specialties. According to the findings, 46.67% of physicians’ practices adhered to the law. Physicians’ practices were homogenous across the country’s regions. General practitioners were significantly more legally compliant than attending physicians were. Additionally, 94.02% of the physicians acknowledged malpractice anxiety, whereas only 17.67% had been accused of malpractice. Conclusions: Our findings emphasize the need for further research and to voice issues about Romanian physicians’ low level of legal compliance. This study provides a starting point for future studies to evaluate the benefits of interventional strategies in this field. Healthcare facilities should provide physicians with easily available resources when they are unsure about their legal obligations, and establish an observer organization that can detect unlawful conduct. Interventions should concentrate on education programs and expert guidance.
Hydrographic Drone Non-Invasive Underwater Investigations: New Archaeological Discoveries in Valle Fossa di Porto (Comacchio—FE, Italy)
Authors: Bucci Giovanna
Published: February 2023

During forensic archaeological research conducted in 2021 in the Comacchio Lagoon (FE), we detected new data concerning the ancient local hydrography to the west of Argine Agosta, an ancient bank, in Valle Fossa di Porto. A systematic campaign of geophysical surveys for heritage and archaeology was conducted with a hydrographic drone equipped with a single-beam bathymetric sensor echo sounder, sub-bottom profiler, and side-scan sonar. In combination with the indirect non-invasive investigations, systematic surveys of the walkable areas were also completed. These remote-sensing studies have relocated the River Vatrenus palaeo-watercourse, while visual census have brought to light a system of wooden palisades with floors made of wood associated with some scattered finds belonging to the material culture dating back to the Mediaeval and Renaissance periods. A preview of the results of this case study is presented here, contributing to the reconstruction of the ancient landscape and waterscape area of the Valle Fossa di Porto.
Activity of Essential Oils and Plant Extracts as Biofungicides for Suppression of Soil-Borne Fungi Associated with Root Rot and Wilt of Marigold (Calendula officinalis L.)
Authors: Ahmed Hamada F. A. , Seleiman Mahmoud F. , Mohamed Ibrahim A. A. , Taha Ragab S. , Wasonga Daniel O. , Battaglia Martin L.
Published: February 2023

Essential oils (EOs) and Plant extracts (PEs) are gaining attention as eco-friendly alternatives to synthetic fungicides for the management of soil-borne fungi related to root rot and the wilt of marigolds. Here, EOs of Cinnamomum zeylanicum (cinnamon), Mentha piperita (peppermint), Syzygium aromaticum (clove), Thymus vulgaris (thyme), PEs of Cymbopogon citratus (lemongrass), Lantana camara (lantana), Ocimum basilicum (basil), and Zingiber officinales (ginger) were first evaluated in vitro for their inhibitory activity against the mycelium growth of the root rot and wilt fungi of marigold: Rhizoctonia solani, Sclerotinia sclerotiorum, Fusarium oxysporum, and F. solani, and in vivo for their activity in reducing disease progression. The results show that all EOs had a strong inhibitory activity on the mycelium growth of pathogens. Maximum inhibition of mycelium growth was achieved at a concentration of 1 mL/Lof S. aromaticum, C. zeylanicum, and M. piperita. The inhibition values were 100, 80.9, and 72.4% for F. solani, 100, 81.1, and 70% for S. sclerotiorum, 90.2, 79.4, and 69.1% for F. oxysporum, and 85.4, 78.2, and 68.7% for R. solani, respectively. Regarding plant extracts, the highest inhibition of mycelium growth was attained at a concentration of 20% of Z. officinales, C. citratus, and L. camara. The inhibition values were 77.4, 69.1, and 60.6% for F. solani, 76.5, 67.2, and 58% for S. sclerotiorum, 73.5, 68.2, and 56.3% for F. oxysporum, and 72, 64.8, and 55.2% for R. solani, respectively. In pot experiments, the application of EOs and PEs showed high efficiency in suppressing root rot and wilt of marigold at all concentrations used, especially at 3 mL/L for seed soaking (along with 1.5 mL/L for foliar spraying) for S. aromaticum, C. zeylanicum, and M. piperita EOs, and (40% for seed soaking along with 20% for foliar spraying) for Z. officinales, C. citratus, and L. camara PEs. All the treatments applied in the field greatly reduced the diseases in both seasons, especially S. aromaticum EO, C. zeylanicum EO, Z. officinales PE, and carbendazim treatments. This was accompanied by a significant improvement in morphological, yield, and phytochemical parameters of marigold as well as a significant increase in the activity of defense-related antioxidant enzymes. Overall, essential oils and plant extracts can be used effectively to control root rot and wilt in marigold as sustainable and eco-friendly botanical biofungicides.
Circadian and Seasonal Pattern of Arrhythmic Events in Arrhythmogenic Cardiomyopathy Patients
Authors: Castelletti Silvia , Orini Michele , Vischer Annina S. , McKenna William J. , Lambiase Pier D. , Pantazis Antonios , Crotti Lia
Published: February 2023

Arrhythmogenic right ventricular cardiomyopathy (ARVC) is an inherited cardiac disease associated with an increased risk of life-threatening arrhythmias. The aim of the present study was to evaluate the association of ventricular arrhythmias (VA) with circadian and seasonal variation in ARVC. One hundred two ARVC patients with an implantable cardioverter defibrillator (ICD) were enrolled in the study. Arrhythmic events included (a) any initial ventricular tachycardia (VT) or fibrillation (VF) prompting ICD implantation, (b) any VT or non-sustained VT (NSVT) recorded by the ICD, and (c) appropriate ICD shocks/therapy. Differences in the annual incidence of events across seasons (winter, spring, summer, autumn) and period of the day (night, morning, afternoon, evening) were assessed both for all cardiac events and major arrhythmic events. In total, 67 events prior to implantation and 263 ICD events were recorded. These included 135 major (58 ICD therapies, 57 self-terminating VT, 20 sustained VT) and 148 minor (NSVT) events. A significant increase in the frequency of events was observed in the afternoon versus in the nights and mornings (p = 0.016). The lowest number of events was registered in the summer, with a peak in the winter (p < 0.001). Results were also confirmed when excluding NSVT. Arrhythmic events in ARVC follow a seasonal variation and a circadian rhythm. They are more prevalent in the late afternoon, the most active period of the day, and in the winter, supporting the role of physical activity and inflammation as triggers of events.
Water Environment Characteristics and Water Quality Assessment of Water Source of Diversion System of Project from Hanjiang to Weihe River
Authors: Wu Wei , Chen Hang , Xu Sheng , Liu Ting , Wang Hao , Li Gaoqing , Wang Jiawei
Published: February 2023

The water source of the water diversion project from the Hanjiang River to the Weihe River is one of the most important drinking water sources in China. Its water quality is related to the water safety of the long-distance water diversion system from the Hanjiang to Weihe Rivers. In order to explore the spatiotemporal change trend of the water environment characteristics of the water source area and analyze the key factors that have a greater impact on it, this study collected 9 types of water environment physical and chemical parameters from 10 water quality monitoring sections from 2017 to 2019; the water environment characteristics of the water source area of the water diversion system from the Hanjiang River to the Weihe River were analyzed and evaluated by using the variance analysis method, the hierarchical cluster analysis method and the water quality identification index evaluation method. The results were as follows. (1) There was spatiotemporal heterogeneity in a number of physical and chemical parameters in the water body of the water source. In terms of time, the concentrations of CODMn, COD, BOD5 and F− were higher in the flood season (July–October) than in the non-flood season (November–June). The concentrations of DO, TP and TN in the non-flood season were higher than those in the flood season. Spatially, the concentration of physical and chemical parameters of the water body in the Huangjinxia Reservoir area was higher than that in the Sanhekou Reservoir area. (2) The water quality of the water source area was good. The comprehensive water quality reached the Class II water quality standard of surface water environmental quality. Time showed that the comprehensive water quality in the non-flood season was better than that in the flood season. Spatially, the overall water quality of the tributaries was better than that of the mainstream. TN is a key indicator that affects water quality. (3) The spatial and temporal differences in water quality in water source areas are mainly affected by factors such as rainfall, temperature and human activities. This study can provide a scientific and data basis for related research on maintaining and improving the quality of the ecological environment of the water source areas of the Hanjiang to Weihe River Water Diversion System.
Association between Problematic Use of Smartphones and Mental Health in the Middle East and North Africa (MENA) Region: A Systematic Review
Authors: Bouazza Samira , Abbouyi Samira , El Kinany Soukaina , El Rhazi Karima , Zarrouq Btissame
Published: February 2023

Smartphones have become essential components of daily life, and research into the harmful effects of problematic smartphone use (PSU) on mental health is expanding in the Middle East and North Africa (MENA) region. This issue has yet to be synthesized and critically evaluated. To find quantitative observational studies on the relationship between PSU and mental health in the MENA region, we developed a search equation and adapted it for four databases. The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines were followed during the selection process. This review included 32 cross-sectional studies and one cohort study. The available language was English. All identified studies published until 8 October 2021, were considered. A modified Newcastle-Ottawa scale was used to assess the quality of the included studies. The studies enrolled 21,487 people and had low-to-moderate methodological quality. The prevalence of PSU ranged from 4.3 to 97.8 percent. The time factor, type of application used on the smartphone, and sociodemographic characteristics were the determinants of PSU. Depression, anxiety, and stress were strongly correlated with PSU. Epidemiological longitudinal studies that respect the quality of evidence are needed in all MENA countries to better plan and implement preventive measures against PSU.
Portuguese Version of the HLS-EU-Q6 and HLS-EU-Q16 Questionnaire: Psychometric Properties
Authors: Pedro Ana Rita , Raposo Beatriz , Luís Luís , Amaral Odete , Escoval Ana , Simões Dias Sara
Published: February 2023

Health literacy refers to the competencies of individuals and the general population to navigate all the areas of health care, making health decisions. Health professionals need a set of skills and information to adapt to people’s health literacy. To succeed, it is crucial to determine the health literacy level of a population, in this case, the Portuguese. This study aims to measure the psychometric properties of the Portuguese version of HLS-EU-Q16 and HLS-EU-Q6 from the long form of HLS-EU-Q47, already validated for Portugal. To analyse these results, a comparison was made with the HLS-EU-PT index. Spearman correlation analysis was performed between the single items and scale scores. Cronbach’s alphas for all the indexes were calculated. For the statistical analysis, SPSS (version 28.0) was used. Cronbach’s alpha coefficient for HLS-EU-PT-Q16 internal consistency was 0.89 overall, and for HLS-EU-PT-Q6 was 0.78 overall. Indexes were not normally distributed, and the Spearman correlation was computed. The correlation between G HL47 and G HL16 indexes was ρ = 0.95 (p < 0.001), and between G HL6 and HLS-EU-PT-Q6 was perfect. The HLS-EU-PT-Q16 and HLS-EU-PT-Q6 are concise and present adequate psychometric properties to measure the HL level of the Portuguese population. However, more similarities are found between the 47-item and the 16-item forms.
The Role of Conspiracy Theories, Perceived Risk, and Trust in Science on COVID-19 Vaccination Decisiveness: Evidence from Cyprus
Authors: Mousoulidou Marilena , Christodoulou Andri , Siakalli Michailina , Argyrides Marios
Published: February 2023

COVID-19 reminded us of the importance of vaccinating for successfully overcoming health-related crises. Yet, vaccine hesitancy is still present. This study examined the impacts of conspiracy theories, perceived risk, and trust in science on COVID-19 vaccination decisiveness. The study was conducted at the end of the third wave of the pandemic, in July 2021, in Cyprus. Data were collected via an online self-administered anonymous survey using convenience and snowball sampling methods. Participants were 363 adults who completed a set of questionnaires that examined their believability in ten vaccine-related conspiracy theories, their perceived dangerousness of COVID-19, and their level of trust in science and scientists. The results suggest that (a) participants with a high conspiracy theory belief are less likely to be vaccinated, (b) participants who perceive COVID-19 as a dangerous disease are more likely to be vaccinated, and (c) participants with high trust in science are more likely to be vaccinated. The implications of the findings are discussed and can be used by public health officials in their campaigns.
The Value of Recreational Physical Activity in Aotearoa New Zealand: A Scoping Review of Evidence and Implications for Social Value Measurement
Authors: Griffiths Kerry , Davies Larissa , Savage Catherine , Shelling Madeline , Dalziel Paul , Christy Elizabeth , Thorby Rebecca
Published: February 2023

Internationally, there is rising interest in measuring the value of sport and physical activity to society. A critical step in valuing the sector is first establishing the relationship between engagement in sport and physical activity and the societal outcomes that ensue. This paper summarises the findings of a literature review carried out as part of a larger study on the Social Return on Investment (SROI) of recreational physical activity in Aotearoa New Zealand. The review aimed to synthesise existing evidence on the relationship between recreational physical activity and wellbeing outcomes for all New Zealanders, including tangata whenua (Māori, who are Aotearoa New Zealand’s Indigenous population). The methodology took the format of a scoping review and included a series of searches for academic and grey literature, including literature concerning Māori that might have been overlooked in a traditional academic search. The findings are grouped into five outcome areas: physical health; subjective wellbeing; individual development; personal behaviour; and social and community development. The review found some compelling evidence which shows examples of the links between sport and physical activity and outcomes in each of these areas for specific population sub-groups. In particular, for Māori, the findings demonstrate a strong impact on social and community development through building social capital and enhancing cultural identity. However, in all outcome areas, there is mixed quality evidence, a small amount of evidence on which to base definitive conclusions, and limited evidence relating to the monetary value of outcomes. The review concludes that there is a need for further research to strengthen the evidence base for social impact measurement, particularly around the impact of sport and physical activity for indigenous populations.
Distribution, Source Apportionment and Risk Assessment of Phthalate Esters in the Overlying Water of Baiyang Lake, China
Authors: Liu Chang , Fu Liguo , Du Hui , Sun Yaxue , Wu Yihong , Li Cheng , Tong Jikun , Liang Shuxuan
Published: February 2023

As a kind of endocrine disruptor compounds, the presence of phthalate esters (PAEs) has become a global concern. In this study, the pollution levels and spatial distribution of sixteen PAEs were investigated. Their potential sources and eco-environmental health risk were discussed in Baiyang Lake and its upstream rivers during different periods. PAEs were detected in all of samples, ranging from 1215 to 3014 ng·L−1 in October 2020 and 1384 to 3399 ng·L−1 in May 2021. Dibutyl phthalate (DBP) and di-isobutyl phthalate (DIBP) were the predominant monomers, with a detection rate of 100% and the highest concentrations in the overlying water. Restricted by multiple factors, the spatial distribution difference between Baiyang Lake and its upstream rivers in October was more significant than in May. The source apportionment revealed that agricultural cultivation and disorderly use and disposal of plastic products were the primary factors for the contamination. The human health risk assessment indicated that eight PAE congeners did not pose significant carcinogenic and non-carcinogenic harms to males, females and children. However, the ecological risks of DBP, DIBP and di (2-ethylhexyl) phthalate to algae, crustaceans and fish species were moderate or high-risk levels. This study provides an appropriate dataset for the assessment of the pollution of PEs to the water ecosystem affected by anthropogenic activities.
Understanding Fear after an Anterior Cruciate Ligament Injury: A Qualitative Thematic Analysis Using the Common-Sense Model
Authors: Little Cameron , Lavender Andrew P. , Starcevich Cobie , Mesagno Christopher , Mitchell Tim , Whiteley Rodney , Bakhshayesh Hanieh , Beales Darren
Published: February 2023

Fear is a significant factor affecting successful return to sport following an anterior cruciate ligament (ACL) injury. However, there is a lack of understanding of the emotional drivers of fear and how fear beliefs are formed. This study qualitatively explored the contextual and emotional underpinnings of fear and how these beliefs were formed, with reference to the Common-Sense Model of Self-Regulation. Face-to-face online interviews were conducted with ACL-injured participants (n = 18, 72% female) with a mean age of 28 years (range 18–50 years). Participants were either 1 year post ACL reconstruction surgery (n = 16) or at least 1 year post injury without surgery (n = 2) and scored above average on a modified Tampa Scale of Kinesiophobia. Four participants were playing state-level sport or higher. Five themes emerged describing factors contributing to fear: ‘External messages’, ‘Difficulty of the ACL rehabilitation journey’, ‘Threat to identity and independence’, ‘Socioeconomic factors’, and ‘Ongoing psychological barriers’. A sixth theme, ‘Positive coping strategies’, provided insight into influences that could reduce fear and resolve negative behaviors. This study identified a broad range of contextual biopsychosocial factors which contribute to fear, supporting the notion that ACL injuries should not be treated through a purely physical lens. Furthermore, aligning the themes to the common-sense model provided a conceptual framework conveying the inter-related, emergent nature of the identified themes. The framework provides clinicians with a means to understanding fear after an ACL injury. This could guide assessment and patient education.
Bone Health Status in Individuals with Amyotrophic Lateral Sclerosis: A Cross-Sectional Study on the Role of the Trabecular Bone Score and Its Implications in Neurorehabilitation
Authors: Morini Elisabetta , Portaro Simona , Leonetti Danilo , De Cola Maria Cristina , De Luca Rosaria , Bonanno Mirjam , Quartarone Angelo , Calabrò Rocco Salvatore
Published: February 2023

Background and Objectives: Osteoporosis is a metabolic skeletal disease resulting in low bone mass with increased bone fragility and susceptibility to fractures. May lead to rapid loss of bone mineral density (BMD) due to physical inactivity and reduced muscle contractions. Generally, the diagnosis of osteoporosis is made using dual X-ray absorptiometry (DXA), by measuring BMD and the trabecular bone score (TBS), which can be useful for detecting bone fragility and susceptibility to fractures. Therefore, the aim of this study was to investigate, using BMD and TBS, the bone health status in a sample of amyotrophic lateral sclerosis (ALS) inpatients attending neurorehabilitation. Materials and Methods: Thirty-nine patients were included in the study and underwent electrocardiogram and blood tests, including calcium and parathyroid hormone, as well as vitamin D dosage, and DXA. Results: We found that the TBS of patients with osteoporosis was lower than that of those ALS patients with osteopenia or normal bone status, both in the lumbar spine and femoral neck, although no statistical significance was reached. In addition, Spearman’s correlation coefficient indicated a moderate correlation between TBS and lumbar spine BMD (r = −0.34) and a mild correlation between TBS and femoral neck BMD (r = −0.28). Conclusions: This study confirmed the hypothesis that ALS patients may exhibit deteriorated bone health with lower bone density and focused on the possible role of the TBS in the multidisciplinary approach to ALS.
The Effects of Resistance Exercise on the Cardiorespiratory Tissue of Rats with Parkinson’s Disease
Authors: Moreira Graziele Mayra Santos , Damázio Laila Cristina Moreira , Silva Silvana Venâncio da , Silveira Augusto Targino , Mesquita Isabella Giordano , Silva Luana Aparecida de Sousa , Pereira Luan Alves , Costa Ana Clara Silva , Santos Ismael Augusto Lima , Campos Maria Eduarda Paiva , Vaz Luna Sara Campos , Cardoso Zenaide Alves , Gomes José Victor Ribeiro Silva , Júnior Paulo Henrique Almeida Campos , Ide Liliam Midori
Published: February 2023

Parkinson’s Disease (PD) affects the cardiorespiratory system, causing an increase in the left ventricular mass in the heart and respiratory muscle weakness in relation to healthy individuals. The objective of this study was to investigate the effects of progressive resistive physical exercise on the vertical ladder on the histomorphometry of cardiac tissue and respiratory muscles in rats with PD. Seventy male Wistar rats, aged 40 days old, were divided into Parkinson’s (PD) and Sham (SH) groups; they were also subdivided into groups that performed progressive resistive physical exercise on the vertical ladder Before Surgery (ExBS), After Surgery (ExAS), and Before and After Surgery (ExBAS). The physical training was carried out before and/or after PD induction. Exercise was performed five times a week for 25 min/day for four or eight weeks. PD induction was conducted via electrolytic stimulation of the Substantia nigra of the animals’ brains, adopting the following stereotaxic table coordinates: −4.9; lateral medium equal to 1.7, and dorsoventral equal to 8.1. For the morphometric analysis of the heart, the following variables were calculated: relative weight and diameter and thickness of the left ventricle. The diaphragm and the myocardial, intercostal, and abdominal muscles were stained with Hematoxylin and Eosin (HE). The histomorphometric analysis was performed using the ImageJ software to assess the cross-sectional area of muscles and the number of muscle fibers. Progressive resistance exercise promoted the hypertrophy of respiratory muscles and the left ventricle in animals with PD.
A Perceptual Structure of Soundscapes in Urban Public Spaces Using Semantic Coding Based on the Grounded Theory
Authors: Cao Jingwen , Kang Jian
Published: February 2023

The definition of ‘soundscape’ emphasises the perceptual construct of sounds; thus, the mechanism of sound perceptions becomes vital for soundscape evaluations. Using a qualitative approach, this study explored the aspects and processes of sound perceptions and built a perceptual soundscape structure from the insight of sociology. The interview was conducted between January and March 2018, in four urban public spaces. Data reached saturation after 23 participants were interviewed based on the grounded theory approach. Four perceptual aspects of sounds were identified from the semantic coding analysis: sound classification, sound features, psychological reactions, and soundscape preferences. These aspects form a three-level process of perceiving soundscapes: sound classifications, sound appraisals (including sound features and psychological reactions), and finally, judgment (soundscape preferences). Overall, four aspects categorised into three levels of perception make up the soundscape structure. Soundscape preferences are at the most profound level of perception and are informed by the previous three aspects. Soundscape preferences are expressed through descriptive words and narrative ‘image’. The ‘image’ reflects people participating in different activities according to their social background. Social relationships influence soundscape preferences through people’s sound requirements for various activities. The perceptual structure of soundscapes may provide guidance for future soundscape research and soundscape questionnaire design.
Metabolic and Inflammatory Response in Post-Traumatic Stress Disorder (PTSD): A Systematic Review on Peripheral Neuroimmune Biomarkers
Authors: Dell’Oste Valerio , Fantasia Sara , Gravina Davide , Palego Lionella , Betti Laura , Dell’Osso Liliana , Giannaccini Gino , Carmassi Claudia
Published: February 2023

Several heterogeneous pathophysiology pathways have been hypothesized for being involved in the onset and course of Post-Traumatic Stress Disorder (PTSD). This systematic review aims to summarize the current evidence on the role of inflammation and immunological dysregulations in PTSD, investigating possible peripheral biomarkers linked to the neuroimmune response to stress. A total of 44 studies on the dysregulated inflammatory and metabolic response in subjects with PTSD with respect to controls were included. Eligibility criteria included full-text publications in the English language, human adult samples, studies involving both subjects with a clinical diagnosis of PTSD and a healthy control group. The research was focused on specific blood neuroimmune biomarkers, namely IL-1β, TNF-α, IL-6 and INF-γ, as well as on the potential harmful role of reduced antioxidant activity (involving catalase, superoxide dismutase and glutathione peroxidase). The possible role of the inflammatory-altered tryptophan metabolism was also explored. The results showed conflicting data on the role of pro-inflammatory cytokines in individuals with PTSD, and a lack of study regarding the other mediators investigated. The present research suggests the need for further studies in human samples to clarify the role of inflammation in the pathogenesis of PTSD, to define potential peripheral biomarkers.
Knowledge, Attitude, and Practice towards COVID-19 among Patients Attending Phuentsholing Hospital, Bhutan: A Cross-Sectional Study
Authors: Gyeltshen Kinley , Phuntsho Sangay , Wangdi Kinley
Published: February 2023

Bhutan is one of the few countries in the world to take unprecedented steps to control the spread of COVID-19 in the country. This study aimed to investigate knowledge, attitude, and practice (KAP) and their associated covariates among patients attending Phuentsholing Hospital, Bhutan. Therefore, a cross-sectional study was conducted among patients attending Phuentsholing Hospital in Bhutan between March 17 and April 9, 2021, using an interview-administered questionnaire. The multivariable logistic regression was used to identify statistically significant covariates of good KAP. Further, the association between levels of KAP scores was assessed using Pearson’s correlation coefficient. Of the 441 participants, 54.6% (241) were female. Knowledge, attitude, and practice score were reported by 55.3%, 51.8%, and 83.7% of participants, respectively. Higher education, secondary education, monastic education, and non-formal education were 9 [adjusted odds ratio (AOR) = 9.23; 95% confidence interval (CI) 3.438, 24.797], 3.5 (AOR = 3.5; 95% CI 1.425, 8.619), and 4 (AOR = 3.8; 95% CI 1.199, 12.141) times more likely to report good knowledge than illiterates. A positive attitude was associated with higher (AOR = 2.97; 95% CI 1.154, 7.66) and secondary (AOR = 3.53; 95% CI 1.454, 8.55) education compared to illiteracy. The good practice was associated with higher (AOR = 12.31; 95% CI 2.952, 51.318) and secondary (AOR = 11.5; 95% CI 3.439, 38.476) education compared to illiteracy. Participants in the age groups 26–35 years (AOR = 0.11; 95% CI 0.026, 0.484) and >45 years (AOR = 0.12; 95% CI 0.026, 0.588) were less likely to exhibit good practice compared to those aged 18–25 years. Those working in the private or business sectors were 9 (AOR = 8.81; 95% CI 1.165, 41.455) times more likely to have good practice compared to civil servants. There was a weak but positive correlation between knowledge-attitude (r = 0.228), knowledge-practice (r = 0.220), and attitude-practice scores (r = 0.338). The need for health education on COVID-19 to increase knowledge and attitude is highly recommended, and should be focused on the less educated and other vulnerable groups such as farmers and students, as well as those older than 25 years.
Clinical Outcomes of Monolithic Zirconia Crowns on Posterior Natural Abutments Performed by Final Year Dental Medicine Students: A Prospective Study with a 5-Year Follow-Up
Authors: Barile Giuseppe , Capodiferro Saverio , Muci Giovannino , Carnevale Antonio , Albanese Giovanni , Rapone Biagio , Corsalini Massimo
Published: February 2023

The conventional metal–ceramic is still considered the gold standard in fixed prosthetics especially in terms of longevity. Among alternative materials used, Monolithic Zirconia has shown the capability to reconcile excellent biomechanical properties with acceptable aesthetic performance and to overcome several inconveniences related to veneer restorations. This study aims to clinically evaluate Monolithic Zirconia prosthetic crowns on natural abutments in the posterior sectors, performed by final-year dental medicine students (undoubtedly with less experience in the management of such material) by the standardized California Dental Association score system evaluation, to better understand the viability of Monolithic Zirconia. This prospective study was carried out at the Dental School of the University of Bari “Aldo Moro”, Italy. Prosthetic rehabilitation included single crowns or a short pontic prosthesis with maximum one intermediate. Final-year dental students performed tooth reduction under the supervision of three expert tutors. The California Dental Association systematics (based on color, surface, anatomical shape, and marginal integrity) were adopted to evaluate the prosthetic maintenance status over time. Annual follow-up visits were re-evaluated by the same parameters each year. Univariate logistic regression analysis was performed to evaluate outcomes and the Kaplan–Meier plot to report survival. The sample consists of 40 crowns performed on 31 patients, 15 males (48.4%) and 16 females (51.6%) with an average age of 59.3 years. The clinical cases subjected to experimental study were found to be “Excellent” (1a/2a/3a/4a) in 34 cases (85%), “Acceptable” in 4 cases (10%), and “To be re-done” in 2 cases (failures) (5%). Our conclusive data support the predictability of Monolithic Zirconia restorations on natural posterior abutments at a long-term follow-up of five years, even when performed by less-experienced clinicians.
Information Disclosure Impacts Intention to Consume Man-Made Meat: Evidence from Urban Residents’ Intention to Man-Made Meat in China
Authors: Chen Yong , Liu Li , Li Chao , Huang Yangfei , Luo Qiaojie
Published: February 2023

Meat substitutes such as man-made meat are emerging to promote low-carbon healthy consumption, mitigate climate change, and assist healthy economic development; however, most consumers seem reluctant to make the transition. While profound social change may be required to make significant progress in this area, limited efforts have been made to understand the psychological processes that may hinder or facilitate this transition. To clearly identify the factors influencing the public’s intention to consume man-made meat and their influencing paths, this study analyzes the mechanism by which man-made meat information disclosure affects the public’s intention to consume these products based on the social cognitive theory of “awareness-situation-behavior” and using structural equation modeling, with residents of seven Chinese cities as examples (647 respondents). The results of this study yielded three main findings. First, low-carbon awareness, personal social responsibility awareness, and man-made meat risk perception significantly influence the public’s intention to consume man-made meat, with risk perception having the greatest influence (−0.434). Second, low-carbon awareness and man-made meat risk perception have a significant interaction effect on the public’s intention to consume man-made meat (−0.694). Third, man-made meat information disclosure has the most significant moderating effect on the relationship between low-carbon awareness and the public’s intention to consume man-made meat, as well as a moderating effect on the relationship between man-made meat risk perception and the public’s intention to consume man-made meat.
Uptake of COVID-19 Vaccination and Its Associated Factors among College Students in China: A Nationwide Cross-Sectional Study
Authors: Xu Xuelian , Bian Junye , Guo Zhihui , Li Xinyi , Zhang Weijie , Wang Bingyi , Sun Yinghui , Meng Xiaojun , Zou Huachun
Published: February 2023

Our study aims to assess the uptake of COVID-19 vaccination and its associated factors among Chinese college students. A web-based cross-sectional study was conducted from 18 May to 17 June 2022. A total of 3916 participants were included. The coverage of the first dose, complete vaccination and booster vaccination among college students was 99.49%, 81.96% and 79.25%, respectively. College students with an older age (AOR: 0.72, 95% CI: 0.57–0.90), non-medical major (0.47, 0.37–0.61) and studying in north-east China (0.35, 0.22–0.58) were less likely to complete vaccination. Individuals who were female (1.62, 1.35–1.94) and received a recombinant subunit vaccine (8.05, 5.21–12.45) were more likely to complete vaccination. Non-medical students (0.56, 0.43–0.73) and students studying in north-east China (0.28, 0.16–0.49) were less likely to receive a booster dose, while female students (1.51, 1.23–1.85) had a higher likelihood. The main reason for being unvaccinated was “contraindication” (75.00%), and the main reason for not receiving a booster dose was “being too busy to attend to it” (61.37%). This study demonstrated a high adherence to the COVID-19 vaccination policy among Chinese college students. Targeted strategies should be applied to remove barriers to COVID-19 vaccination among college students.