bluuebunny/crossref_metadata_2025 huggingface dataset:
A qualitative study of barriers and facilitators to pediatric early warning score (PEWS) implementation in a resource-limited setting
Authors: Reuland Carolyn , Shi Galen , Deatras Mark , Ang Mellinor , Evangelista Paula Pilar G. , Shilkofski Nicole
Published: March 2023

Objectives

Globally, pediatric hospitals have implemented Pediatric Early Warning Scores (PEWS) to standardize escalation of care and improve detection of clinical deterioration in pediatric patients. This study aims to utilize qualitative methodology to understand barriers and facilitators of PEWS implementation at Philippine Children's Medical Center (PCMC), a tertiary care hospital in Manila, Philippines.

Methods

Semi-structured interviews querying current processes for clinical monitoring, Pediatric Intensive Care Unit (PICU) transfer, and clinician attitudes towards PEWS implementation were audio recorded. In-person hospital observations served to triangulate interview findings. The Systems Engineering Initiative for Patient Safety (SEIPS) framework guided content coding of interviews to characterize work systems, processes, and outcomes related to patient monitoring and care escalation. Thematic coding was performed using Dedoose software. This model allowed identification of barriers and facilitators to PEWS implementation.

Results

Barriers within PCMC workflow included: limited bed capacity, delay in referral, patient overflow, limited monitoring equipment, and high patient to staff ratio. Facilitators of PEWS implementation included support for PEWS adaptation and existence of systems for vital sign monitoring. Observations by study personnel confirmed validity of themes.

Conclusion

Utilizing qualitative methodology to understand barriers and facilitators to PEWS in specific contexts can guide implementation at resource-limited hospitals.
Nanoconstructs for theranostic application in cancer: Challenges and strategies to enhance the delivery
Authors: Mishra Shivani , Bhatt Tanvi , Kumar Hitesh , Jain Rupshee , Shilpi Satish , Jain Vikas
Published: March 2023

Nanoconstructs are made up of nanoparticles and ligands, which can deliver the loaded cargo at the desired site of action. Various nanoparticulate platforms have been utilized for the preparation of nanoconstructs, which may serve both diagnostic as well as therapeutic purposes. Nanoconstructs are mostly used to overcome the limitations of cancer therapies, such as toxicity, nonspecific distribution of the drug, and uncontrolled release rate. The strategies employed during the design of nanoconstructs help improve the efficiency and specificity of loaded theranostic agents and make them a successful approach for cancer therapy. Nanoconstructs are designed with a sole purpose of targeting the requisite site, overcoming the barriers which hinders its right placement for desired benefit. Therefore, instead of classifying modes for delivery of nanoconstructs as actively or passively targeted systems, they are suitably classified as autonomous and nonautonomous types. At large, nanoconstructs offer numerous benefits, however they suffer from multiple challenges, too. Hence, to overcome such challenges computational modelling methods and artificial intelligence/machine learning processes are being explored. The current review provides an overview on attributes and applications offered by nanoconstructs as theranostic agent in cancer.
Study on machine learning of molar incisor hypomineralization in an endemic fluorosis region in central China
Authors: Zhang Yimeng , Wang Yu , Zhang Zhaoxin , Wang Yuqi , Jia Jie
Published: March 2023

Objectives: The aim of the present study was to develop a machine learning model to predict the risk of molar incisor hypomineralization (MIH) and to identify factors associated with MIH in an endemic fluorosis region in central China.

Methods: A cross-sectional study was conducted with 1,568 schoolchildren from selected regions. The clinical examination included an investigation of MIH based on the European Academy of Paediatric Dentistry (EAPD) criteria. In this study, supervised machine learning (e.g., logistic regression) and correlation analysis (e.g., Spearman correlation analysis) were used for classification and prediction.

Results: The overall prevalence of MIH was 13.7%. The nomograph showed that non-dental fluorosis (DF) had a considerable influence on the early occurrence of MIH and that this influence became weaker as DF severity increased. We examined the association between MIH and DF and found that DF had a protective correlation with MIH; the protective effect became stronger as DF severity increased. Furthermore, children with defective enamel were more likely to experience caries, and dental caries were positively correlated with MIH (OR = 1.843; 95% CI: 1.260–2.694). However, gender, oral hygiene, and exposure to poor-quality shallow underground water did not increase the likelihood of developing MIH.

Conclusions: DF should be considered a protective factor within the multifactorial etiology of MIH.
Genome-wide exploration of the GDSL-type esterase/lipase gene family in rapeseed reveals several BnGELP proteins active during early seedling development
Authors: Ding Yahui , Xing Liwen , Xu Jiamin , Jiang Teng , Tang Xiuhua , Wang Yaxuan , Huang Shuhua , Hao Wenfang , Zhou Xiaona , Zhang Yanfeng , Xie Chang Gen
Published: March 2023

The Gly-Asp-Ser-Leu (GDSL)-type esterase/lipase proteins (GELP) are one of the most important families of lipolytic enzymes and play prominent roles in seed germination and early seedling establishment through mobilizing the lipids stored in seeds. However, there are no comprehensive studies systematically investigating the GELP gene family in Brassica napus (BnGELP), and their biological significance to these physiological processes are far from understood. In the present study, a total of 240 BnGELP genes were identified in B. napus cultivar “Zhongshuang 11” (ZS11), which is nearly 2.3-fold more GELP genes than in Arabidopsis thaliana. The BnGELP genes clustered into 5 clades based on phylogenetic analysis. Ten BnGELPs were identified through zymogram analysis of esterase activity followed by mass spectrometry, among which five clustered into the clade 5. Gene and protein architecture, gene expression, and cis-element analyses of BnGELP genes in clade 5 suggested that they may play different roles in different tissues and in response to different abiotic stresses. BnGELP99 and BnGELP159 were slightly induced by cold, which may be attributed to two low-temperature responsive cis-acting regulatory elements present in their promoters. An increased activity of esterase isozymes by cold was also observed, which may reflect other cold inducible esterases/lipases in addition to the ten identified BnGELPs. This study provides a systemic view of the BnGELP gene family and offers a strategy for researchers to identify candidate esterase/lipase genes responsible for lipid mobilization during seed germination and early seedling establishment.
Emotion regulation as a mediator on the relationship between emotional awareness and depression in elementary school students
Authors: Wang Ruian , Li Haoyue , Sang Biao , Zhao Yuyang
Published: March 2023

As a cognitive skill, emotional awareness plays a fundamental role in emotional intelligence and significant effect on the development of individuals’ social adaptation. However, the role of emotional awareness in children’s social adaptation, especially emotional development, remains unclear, the current study sought to determine the significant influence of emotional awareness in children’s emotional development. By using cross-sectional and longitudinal study designs, the current study explored the relationship between emotional awareness and children’s depression, as well as the mediation effect of emotion regulation on this relationship. The sample comprised 166 Chinese elementary school students (89 girls and 77 boys) ranging from 8 to 12 years old. After adjusting for demographic variables (gender, grade, etc.), the results showed that children with high emotional awareness were less likely to adopt expressive suppression as an emotion regulation strategy and had lower depression levels currently and in the future. In contrast, children with low emotional awareness were more likely to use suppression strategies and showed higher depression levels. Thus, the results indicated that emotional awareness could predict children’s current and future depression status. Meanwhile, emotional regulation strategies are an important mediating variable explaining the relationship between emotional awareness and children’s depression. Implications and limitations were also discussed.
With a little help from my friends? Acculturation and mental health in Arabic-speaking refugee youth living with their families
Authors: Meyer Caroline , Alhaddad Lina , Stammel Nadine , Sixtus Frederick , Wesche Jenny Sarah , Kerschreiter Rudolf , Kanngiesser Patricia , Knaevelsrud Christine
Published: March 2023

Introduction

Refugee youth are often faced with the compounding challenges of heightened exposure to traumatic events and acculturating to a new country during a developmental period when their sense of self is still forming. This study investigated whether refugee youth’s acculturation orientation (separation, integration, marginalization, and assimilation) is associated with depressive and posttraumatic stress symptoms and aimed to identify additional indicators of acculturation that may contribute to mental health.

Methods

A total of 101 Arabic-speaking refugee youths (aged 14–20 years), who were living with their families and attending school in Germany, took part in the study. They answered questions concerning traumatic exposure and posttraumatic stress symptoms, depressive symptoms, and several indicators of acculturation, including cultural orientation, positive and negative intra- and intergroup contact, language skills and friendship networks. All participants were categorized into one of four acculturation orientations using median splits.

Results

Kruskal–Wallis rank sum tests revealed that acculturation orientation was not significantly associated with depressive symptoms [χ2 (3, 97) = 0.519, p = 0.915] or posttraumatic stress symptoms [χ2 (3, 97) = 0.263, p = 0.967]. Regression analysis revealed that German language skills were significantly associated with lower scores of depressive symptoms (p = 0.016) and number of friends in Germany was significantly associated with lower scores of depressive (p = 0.006) and posttraumatic stress symptoms (p = 0.002), respectively.

Discussion

Policies that provide refugee youth with access to language classes and social activities with peers do not only enable them to actively participate in a new society but may also have a positive effect on their mental health.
Blank canvas or under construction? Examining the pre-academy experiences of young developing professional team sports athletes
Authors: Papastaikoudis Foivos , Collins Rosie , Collins Dave
Published: March 2023

Introduction

Extensive research has been carried out on Talent Development (TD) environments and an increasing amount of work shows the development of psychological characteristics as an important formal part of the academy experience. Importantly, however, very little attention has been paid to what types of skills, if any, young players arrive with. In other words, there seems to be an assumption that young athletes arrive at the academy as a blank canvas.

Methods

As such, to investigate whether players' arrive with these psychological characteristics, we looked across a sample of young footballers' and rugby players' personal experiences (such as, family input, sporting background or personal challenges) prior joining the academy. Individual semi-structured interviews were conducted, and data were analysed via thematic analysis.

Results

Our findings suggested that young athletes acquired an aptitude from general experiences, whereby they had already started to develop and deploy specific skills (such as, reflective practice, mental skills or seeking social support) to navigate particular challenges, prior to arriving at the academy.

Conclusion

Implications include the need for coaches and psychologists to assess young athletes' skillsets and pre-academy experiences upon arrival and use this as a starting point for developing tailored and individualised pathways that would enable them maximise their potential.
Multisystem Inflammatory Syndrome in Adults (MIS-A) and SARS-CoV2: An Evolving Relationship
Authors: Worku Dominic
Published: March 2023

The SARS-CoV2 pandemic is the most significant global health emergency of the last century. While the pathophysiology of SARS-CoV2 is understood, the early and long-term outcomes of natural infection are increasingly being recognised. Multisystem inflammatory syndrome (MIS) represents a manifestation of the extreme immune dysfunction that SARS-CoV2 infection heralds and has been described in both children (MIS-C) and adults (MIS-A). Here, we discuss current knowledge of MIS-A and the vast questions that remain unanswered.
A Thermostable Lipase Isolated from Brevibacillus thermoruber Strain 7 Degrades Ɛ-Polycaprolactone
Authors: Atanasova Nikolina , Paunova-Krasteva Tsvetelina , Kambourova Margarita , Boyadzhieva Ivanka
Published: March 2023

The tremendous problem with plastic waste accumulation has determined an interest in biodegradation by effective degraders and their enzymes, such as thermophilic enzymes, which are characterized by high catalytic rates, thermostability, and optimum temperatures close to the melting points of some plastics. In the present work, we report on the ability of a thermophilic lipase, by Brevibacillus thermoruber strain 7, to degrade Ɛ-polycaprolactone (PCL), as well as the enzyme purification, the characterization of its physicochemical properties, the product degradation, and its disruptive effect on the PCL surface. The pure enzyme showed the highest reported optimum temperature at 55 °C and a pH of 7.5, while its half-life at 60 °C was more than five hours. Its substrate specificity referred the enzyme to the subgroup of lipases in the esterase group. A strong inhibitory effect was observed by detergents, inhibitors, and Fe3+ while Ca2+ enhanced its activity. The monomer Ɛ-caprolactone was a main product of the enzyme degradation. Similar elution profiles of the products received after treatment with ultra-concentrate and pure enzyme were observed. The significant changes in PCL appearance comprising the formation of shallower or deeper in-folds were observed after a week of incubation. The valuable enzyme properties of the lipase from Brevibacillus thermoruber strain 7, which caused a comparatively quick degradation of PCL, suggests further possible exploration of the enzyme for effective and environment-friendly degradation of PCL wastes in the area of thermal basins, or in thermophilic remediation processes.
Outcomes of Patients with Positive Interim Positron Emission Tomography (PET) Continuing ABVD in the Clinical Setting
Authors: Zheng Serena , Gupta Kanika , Goyal Piyush , Nakajima Reiko , Michaud Laure , Batlevi Connie Lee , Hamlin Paul A. , Horwitz Steven , Kumar Anita , Matasar Matthew J. , Moskowitz Alison J. , Moskowitz Craig H. , Noy Ariela , Palomba M. Lia , Straus David J. , Von Keudell Gottfried , Falchi Lorenzo , Yahalom Joachim , Zelenetz Andrew D. , Younes Anas , Salles Gilles , Schöder Heiko , Joffe Erel
Published: March 2023

Recent prospective clinical trial data suggest that patients with Hodgkin’s lymphoma who continue treatment with ABVD, despite failing to attain a complete metabolic response on interim PET (PET2+), may fare better than previously published. We describe the outcomes of PET2+ patients who continued ABVD and compare the performance of a quantitative measure based on the lesion-to-liver SUV ratio (LLS qPET2+) to that of the subjective Deauville criteria (dvPET2+). We analyzed all patients with newly diagnosed advanced-stage Hodgkin lymphoma treated with frontline ABVD at the Memorial Sloan Kettering Cancer Center between 2008 and 2017. Eligibility was set to correspond with the RATHL inclusion criteria. Images were reviewed by two nuclear medicine physicians and discordant cases were resolved with a third expert in consensus. qPET2+ was defined as LLS ≥ 1.3. We identified 227 patients of whom 25% (57) were qPET2+, but only 14% (31) were dvPET2+. Forty-eight patients (84%) continued ABVD with a 3-year PFS of 70% for qPET2+ and 64% for dvPET2+. In conclusion, interim PET interpretation in clinical practice may be associated with a higher rate of scans deemed positive. Irrespective of the criteria for PET2 positivity, a subset of patients may continue ABVD without a dismal outcome.
Prognostic Value of Combined Hematological/Biochemical Indexes and Tumor Clinicopathologic Features in Colorectal Cancer Patients—A Pilot Single Center Study
Authors: Cuk Vladica , Karamarkovic Aleksandar , Juloski Jovan , Arbutina Dragana , Radulovic Radosav , Milic Ljiljana , Kovacevic Bojan , De Luka Silvio , Grahovac Jelena
Published: March 2023

Colorectal cancer (CRC) is a significant public health problem. There is increasing evidence that the host’s immune response and nutritional status play a role in the development and progression of cancer. The aim of our study was to examine the prognostic value of clinical markers/indexes of inflammation, nutritional and pathohistological status in relation to overall survival and disease free-survival in CRC. The total number of CRC patients included in the study was 111 and they underwent laboratory analyses within a week before surgery. Detailed pathohistological analysis and laboratory parameters were part of the standard hospital pre-operative procedure. Medical data were collected from archived hospital data. Data on the exact date of death were obtained by inspecting the death registers for the territory of the Republic of Serbia. All parameters were analyzed in relation to the overall survival and survival period without disease relapse. The follow-up median was 42 (24−48) months. The patients with the III, IV and V degrees of the Clavien–Dindo classification had 2.609 (HR: 2.609; 95% CI: 1.437−4.737; p = 0.002) times higher risk of death. The modified Glasgow prognostic score (mGPS) 2 and higher lymph node ratio carried a 2.188 (HR: 2.188; 95% CI: 1.413−3.387; p < 0.001) and 6.862 (HR: 6.862; 95% CI: 1.635−28.808; p = 0.009) times higher risk of death in the postoperative period, respectively; the risk was 3.089 times higher (HR: 3.089; 95% CI: 1.447−6.593; p = 0.004) in patients with verified tumor deposits. The patients with tumor deposits had 1.888 (HR: 1.888; 95% CI: 1024−3481; p = 0.042) and 3.049 (HR: 3.049; 95% CI: 1.206−7.706; p = 0.018) times higher risk of disease recurrence, respectively. The emphasized peritumoral lymphocyte response reduced the risk of recurrence by 61% (HR: 0.391; 95% CI: 0.196−0.780; p = 0.005). Standard perioperative laboratory and pathohistological parameters, which do not present any additional cost for the health system, may provide information on the CRC patient outcome and lay the groundwork for a larger prospective examination.
Tumor Models and Drug Targeting In Vitro—Where Are We Today? Where Do We Go from Here?
Authors: Krüger Marcus , Kopp Sascha
Published: March 2023

Cancer is one of the leading causes of death worldwide [...]
Gastric Cancer with Peritoneal Metastases: Current Status and Prospects for Treatment
Authors: Manzanedo Israel , Pereira Fernando , Pérez-Viejo Estíbalitz , Serrano Ángel
Published: March 2023

Gastric cancer (GC) has a poor prognostic and only one in four patients will have survived by 5 years after diagnosis. These poor results are due to the fact that most patients are diagnosed in advanced stages; peritoneal metastases (PM) are especially frequent and are difficult to treat. Currently, PM are considered a terminal stage of GC with a poor survival rate and are treated with palliative systemic chemotherapy. Since the beginning of the century, the treatment of PM from different origins has evolved; cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) have become the treatment of choice for many malignant diseases that affect the peritoneum. CRS and HIPEC have also been used for patients with GC and PM, achieving survival results that have never been achieved when using systemic chemotherapy alone. The use of HIPEC can even prevent the development of peritoneal recurrences in patients with locally advanced GC as adjuvant therapy, can reduce the volume of peritoneal disease as neoadjuvant therapy, and can control symptoms in a palliative setting. The aim of this review is to collate the current scientific evidence regarding the treatment of PM of GC origin with surgery and intraperitoneal chemotherapy.
A Mathematical Model for Mollusc Shells Based on Parametric Surfaces and the Construction of Theoretical Morphospaces
Authors: Contreras-Figueroa Gabriela , Aragón José L.
Published: March 2023

In this study, we propose a mathematical model based on parametric surfaces for the shell morphology of the phylum Mollusca. Since David Raup’s pioneering works, many mathematical models have been proposed for different contexts to describe general shell morphology; however, there has been a gap in the practicality of models that allow the estimation of their parameter values in real specimens. Our model collects ideas from previous pioneering studies; it rests on the equation of the logarithmic spiral, uses a fixed coordinate system (coiling axis), and defines the position of the generating curve with a local moving system using the Frenet frame. However, it improves upon previous models by applying apex formation, rotations, and substantially different parameter definitions. Furthermore, the most conspicuous improvement is the development of a simple and standardized methodology to obtain the six theoretical parameters from shell images from different mollusc classes and to generate useful theoretical morphospaces. The model was applied to reproduce the shape of real mollusc-shell specimens from Gasteropoda, Cephaloda and Bivalvia, which represent important classes in geological time. We propose a specific methodology to obtain the parameters in four morphological groups: helicoidal, planispiral, conic, and valve-like shells, thereby demonstrating that the model offers an adequate representation of real shells. Finally, possible improvements to the model are discussed along with further work. Based on the above considerations, the capacity of the model to allow the construction of theoretical morphospaces, the methodology to estimate parameters and from the comparison between several existing models for shells, we believe that our model can contribute to future research on the development, diversity and evolutionary processes that generated the diversity in mollusc shells.
Growth of Populus × euramericana Plantlet under Different Light Durations
Authors: Liu Chenggong , Liu Ning , Ding Changjun , Liu Fenfen , Su Xiaohua , Huang Qinjun
Published: March 2023

Using full-spectrum LED lights, six light treatments of 11 h, 12 h, 13 h, 14 h, 15 h, and CK (greenhouse natural light) were designed to examine the response of Populus euramericana plantlets to light duration in the greenhouse. Every 15 days during the 150-day experiment, plantlet height (H), ground diameter (GD), number of nodes (NN), number of leaves (NL), and the relative chlorophyll content(SPAD) were measured. The response of plantlets to different light durations was demonstrated by establishing and screening growth models, and rhythm and relative chlorophyll content were statistically analyzed. The light duration had a significant effect on the H and GD of Populus euramericana, and their growth was positively correlated with light duration. The short full-spectrum LED lighting duration will affect the rhythm and prematurely halt the growth of H, but the GD will continue to expand. The Gomperz model has the best fitting effect for the growth of Populus euramericana plantlets under LED lighting, with all R2s values greater than 0.89. Long light duration has a greater growth potential, and the rapid growth lasts longer. The delay in the cessation of the increase in the NN was a result of the increased illumination time. Compared with natural light, LED light lessens the NL. Poplar plantlets will have a lower SPAD value if the light duration exceeds 14 h. In the process of growing plantlets in the greenhouse, both light quality and light duration should be considered. In actual production, a combination of natural and artificial light can improve efficiency.
Telomere Length Changes in Cancer: Insights on Carcinogenesis and Potential for Non-Invasive Diagnostic Strategies
Authors: Holesova Zuzana , Krasnicanova Lucia , Saade Rami , Pös Ondrej , Budis Jaroslav , Gazdarica Juraj , Repiska Vanda , Szemes Tomas
Published: March 2023

Telomere dynamics play a crucial role in the maintenance of chromosome integrity; changes in telomere length may thus contribute to the development of various diseases including cancer. Understanding the role of telomeric DNA in carcinogenesis and detecting the presence of cell-free telomeric DNA (cf-telDNA) in body fluids offer a potential biomarker for novel cancer screening and diagnostic strategies. Liquid biopsy is becoming increasingly popular due to its undeniable benefits over conventional invasive methods. However, the organization and function of cf-telDNA in the extracellular milieu are understudied. This paper provides a review based on 3,398,017 cancer patients, patients with other conditions, and control individuals with the aim to shed more light on the inconsistent nature of telomere lengthening/shortening in oncological contexts. To gain a better understanding of biological factors (e.g., telomerase activation, alternative lengthening of telomeres) affecting telomere homeostasis across different types of cancer, we summarize mechanisms responsible for telomere length maintenance. In conclusion, we compare tissue- and liquid biopsy-based approaches in cancer assessment and provide a brief outlook on the methodology used for telomere length evaluation, highlighting the advances of state-of-the-art approaches in the field.
First Known Report of mcr-Harboring Enterobacteriaceae in the Dominican Republic
Authors: Perdomo Angela , Webb Hattie E. , Bugarel Marie , Friedman Cindy R. , Francois Watkins Louise K. , Loneragan Guy H. , Calle Alexandra
Published: March 2023

Colistin is a last-resort antibiotic used to treat infections caused by multidrug-resistant Gram-negative bacteria. People with a history of travel to the Dominican Republic have become sick with pathogenic bacteria carrying the mobile colistin resistance gene, mcr-1, during and after traveling. This investigation aimed to identify mcr genes in Enterobacteriaceae isolated from food animal sources in the Dominican Republic. Three hundred and eleven samples were tested, from which 1354 bacterial isolates were obtained. Real-time PCR tests showed that 70.7% (220 out of 311) of the samples and 3.2% (44 out of 1354) of the isolates tested positive for the mcr gene. All RT-PCR presumptive mcr-positive isolates (n = 44) and a subset (n = 133) of RT-PCR presumptive mcr-negative isolates were subjected to whole-genome sequencing. WGS analysis showed that 39 isolates carried the mcr gene, with 37 confirmed as positive through RT-PCR and two as negative. Further, all of the mcr-positive genomes were identified as Escherichia coli and all contained a IncX4 plasmid replicon. Resistant determinants for other antibiotics important for human health were found in almost all isolates carrying mcr genes.
The Role of Leadership and Digital Transformation in Higher Education Students’ Work Engagement
Authors: Niță Valentin , Guțu Ioana
Published: March 2023

Teaching and learning processes should be subject to continuous change due to the constant evolution of social, educational and technological environments, which ultimately results in higher levels of student engagement. The current paper describes the technological changes faced by higher education institutions as a result of digital transformation challenges. Further, transformational and transactional leadership styles’ effectiveness is regarded within the context of higher education institutions’ digital enhancements. Over time, these factors have led to contextual shifts that have disengaged students from learning and thus self-development. The current research aimed to examine how higher education institutions should apply different leadership styles within digitally transformed contexts so as to increase students’ learning engagement and reduce the risk of failure in their future developments within (inter)national labor markets. Data gathering and analysis involved a qualitative approach: an online survey was distributed, resulting in 856 responses. Through structural equation modeling, the data revealed a valid higher education digital transformation assessment tool; the results also emphasize the increased role of transactional leadership, as opposed to the traditional transformational style, within a highly digitized higher education institutional framework. Consequently, the linear relationship of students’ work engagement with leadership proved to also be enhanced by quadratic effects. The current study stresses the importance of internal and external peers in higher education performance through high levels of student learning (work) engagement through leadership and a uniformly developed digitally transformed higher education environment.
A Survey of Cannabis Use among Patients with Inflammatory Bowel Disease (IBD)
Authors: Velez-Santiago Alondra , Alvarez-Torres Edwin , Martinez-Rodriguez Ricardo , Candal-Rivera Emmanuel , Muniz-Camacho Luis , Ramos-Burgos Luis , Torres Esther A.
Published: March 2023

Inflammatory bowel diseases (IBDs) are chronic conditions of unknown cause or cure. Treatment seeks to reduce symptoms and induce and maintain remission. Many patients have turned to alternatives, such as cannabis, to alleviate living with IBD. This study reports the demographics, prevalence, and perception on cannabis use of patients attending an IBD clinic. Patients agreed to participate and completed an anonymous survey during their visit or online. Descriptive analysis, Fisher’s exact test, and Wilcoxon-Mann-Whitney rank-sum test were used. One hundred and sixty-two adults (85 males, 77 with CD) completed the survey. Sixty (37%) reported use of cannabis, of which 38 (63%) used it to relieve their IBD. A value of 77% reported low to moderate knowledge about cannabis, and 15% reported little to no knowledge. Among cannabis users, 48% had discussed use with their physician, but 88% said they would feel comfortable discussing medical cannabis for IBD. Most saw improvement of their symptoms (85.7%). A considerable number of patients with IBD use medical cannabis for their disease, unknown to their physician. The study reinforces the importance that physicians understand the role of cannabis in the treatment of IBD in order to appropriately counsel patients.
Sedentary Behaviour and Telomere Length Shortening during Early Childhood: Evidence from the Multicentre Prospective INMA Cohort Study
Authors: Prieto-Botella Daniel , Martens Dries S. , Valera-Gran Desiree , Subiza-Pérez Mikel , Tardón Adonina , Lozano Manuel , Casas Maribel , Bustamante Mariona , Jimeno-Romero Alba , Fernández-Somoano Ana , Llop Sabrina , Vrijheid Martine , Nawrot Tim S. , Navarrete-Muñoz Eva-María
Published: March 2023

Sedentary behaviour (SB) may be related to telomere length (TL) attrition due to a possible pro-inflammatory effect. This study examined the association between parent-reported sedentary behaviour (SB) and leukocyte TL at the age of 4 and telomere tracking from 4 to 8 years. In the Spanish birth cohort Infancia y Medio Ambiente (INMA) project, we analysed data from children who attended follow-up visits at age 4 (n = 669) and 8 (n = 530). Multiple robust regression models were used to explore the associations between mean daily hours of SB (screen time, other sedentary activities, and total SB) at 4 years categorised into tertiles and TL at 4 years and difference in TL rank between age 4 and 8, respectively. At the age of 4, the results showed that children with the highest screen time (1.6–5.0 h/day) had a shorter TL of −3.9% (95% CI: −7.4, −0.4; p = 0.03) compared with children in the lowest tertile (0.0–1.0 h/day). Between 4 and 8 years, a higher screen time (highest tertile group vs. lowest tertile) was associated with a decrease in the LTL rank of −1.9% (95% CI: −3.8, −0.1; p = 0.03) from 4 to 8 years. Children exposed to a higher screen time at 4 years were more prone to have shorter TL at 4 and between 4 and 8 years of age. This study supports the potential negative effect of SB during childhood on cellular longevity.
The Association between Masticatory Muscles Activation and Foot Pressure Distribution in Older Female Adults: A Cross-Sectional Study
Authors: Messina Giuseppe , Amato Alessandra , Rizzo Federica , Dominguez Ligia Juliana , Iovane Angelo , Barbagallo Mario , Proia Patrizia
Published: March 2023

The association between craniofacial muscles and postural control is well-known because of numerous anatomical connections. However, there are a few conflicting studies that correlated the activity of the masticatory muscles with the distribution of body weight pressure on the feet, which can strongly influence balance. Therefore, the purpose of our study was to evaluate the association between the masseter and temporalis muscle activity and foot pressure distribution. Fifty-two women were recruited, and baropodometric and EMG analyses of the masseter and temporalis baseline activities were analyzed. An ipsilateral association was found between the right temporal muscle activity and the right rearfoot load (r = 0.29, p < 0.05) and right forefoot load (r = −0.29; p < 0.05), as well as the percentage of muscle activation of the right masseter muscles with the percentage of pressure on the right forefoot (r = 0.31, p < 0.05) and right rearfoot (r = −0.31, p < 0.05). While further studies are needed, an ipsilateral association was found between masticatory muscles and foot pressure distribution.
How Do COVID-19 Risk, Life-Safety Risk, Job Insecurity, and Work–Family Conflict Affect Miner Performance? Health-Anxiety and Job-Anxiety Perspectives
Authors: Zhang Wei , Gu Dongxiao , Xie Yuguang , Khakimova Aida , Zolotarev Oleg
Published: March 2023

The coronavirus pandemic (COVID-19) has created challenging working conditions in coal-production activities. In addition to the massive loss of resources for miners, it has had a devastating impact on these individuals’ mental health. Based on the conservation of resources (COR) theory and a resource-loss perspective, this study examined the impact of COVID-19 risk, life-safety risk, perceived job insecurity, and work–family conflict on miners’ job performance. Moreover, this study investigated the mediating role of job anxiety (JA) and health anxiety (HA). The study data were collected through online structured questionnaires disseminated to 629 employees working in a coal mine in China. The data analysis and hypothesis generation were conducted using the structural equation modeling (partial least squares) method. The results demonstrated that the perception of COVID-19 risk, life-safety risk, job insecurity, and work–family conflict negatively and significantly impacted miners’ job performance. In addition, JA and HA negatively mediated the relationships between the perception of COVID-19 risk, life-safety risk, perceived job insecurity, work–family conflict, and job performance. The findings of this study can give coal-mining companies and their staff useful insights into how to minimize the pandemic’s effects on their operations.
Speech Emotion Recognition Using Attention Model
Authors: Singh Jagjeet , Saheer Lakshmi Babu , Faust Oliver
Published: March 2023

Speech emotion recognition is an important research topic that can help to maintain and improve public health and contribute towards the ongoing progress of healthcare technology. There have been several advancements in the field of speech emotion recognition systems including the use of deep learning models and new acoustic and temporal features. This paper proposes a self-attention-based deep learning model that was created by combining a two-dimensional Convolutional Neural Network (CNN) and a long short-term memory (LSTM) network. This research builds on the existing literature to identify the best-performing features for this task with extensive experiments on different combinations of spectral and rhythmic information. Mel Frequency Cepstral Coefficients (MFCCs) emerged as the best performing features for this task. The experiments were performed on a customised dataset that was developed as a combination of RAVDESS, SAVEE, and TESS datasets. Eight states of emotions (happy, sad, angry, surprise, disgust, calm, fearful, and neutral) were detected. The proposed attention-based deep learning model achieved an average test accuracy rate of 90%, which is a substantial improvement over established models. Hence, this emotion detection model has the potential to improve automated mental health monitoring.
Trunk Control Measurement Scale (TCMS): Psychometric Properties of Cross-Cultural Adaptation and Validation of the Spanish Version
Authors: López-Ruiz Javier , Estrada-Barranco Cecilia , Martín-Gómez Carlos , Egea-Gámez Rosa M. , Valera-Calero Juan Antonio , Martín-Casas Patricia , López-de-Uralde-Villanueva Ibai
Published: March 2023

The aim of this study was to develop a Spanish Version of the Trunk Measurement Scale (TCMS-S) to analyze its validity and reliability and determine the Standard Error of Measurement (SEM) and Minimal Detectable Change (MDC) in children with Cerebral Palsy (CP). Participants were assessed twice 7–15 days apart with the TCMS-S and once with the Gross Motor Function Measurement-88 (GMFM-88), Pediatric Disability Inventory-Computer Adaptive Test (PEDI-CAT), Cerebral Palsy Quality of Life (CPQoL), and Gross Motor Classification System (GMFCS). Internal consistency was evaluated using Cronbach’s alpha, and the intraclass correlation (ICC) and kappa coefficients were used to investigate the agreement between the assessments. Finally, 96 participants with CP were included. The TCMS-S showed excellent internal consistency (Cronbach’s alpha = 0.95 [0.93 to 0.96]); was highly correlated with the GMFM-88 (rho = 0.816) and the “mobility” subscale of the PEDI-CAT (rho = 0.760); showed a moderate correlation with the “feeling about functioning” CPQoL subscale (rho = 0.576); and differentiated between the GMFCS levels. Excellent test–retest agreement was found for the total and subscale scores (ICC ≥ 0.94 [0.89 to 0.97). For the total TCMS-S score, an SEM of 1.86 and an MDC of 5.15 were found. The TCMS-S is a valid and reliable tool for assessing trunk control in children with CP.
Cardiovascular Risk Estimation Based on Country-of-Birth- and Country-of-Residence-Specific Scores among Migrants in the Netherlands: The HELIUS Study
Authors: Osei-Yeboah James , Moll van Charante Eric , Kengne Andre-Pascal , Owusu-Dabo Ellis , van den Born Bert-Jan , Galenkamp-van der Ploeg Henrike , Chilunga Felix , Boateng Daniel , Motazedi Ehsan , Agyemang Charles
Published: March 2023

Background: Regional and country-specific cardiovascular risk algorithms have been developed to improve CVD risk prediction. But it is unclear whether migrants’ country-of-residence or country-of-birth algorithms agree in stratifying the CVD risk of these populations. We evaluated the risk stratification by the different algorithms, by comparing migrant country-of-residence-specific scores to migrant country-of-birth-specific scores for ethnic minority populations in the Netherlands. Method: data from the HELIUS study was used in estimating the CVD risk scores for participants using five laboratory-based (Framingham, Globorisk, Pool Cohort Equation II, SCORE II, and WHO II) and three nonlaboratory-based (Framingham, Globorisk, and WHO II) risk scores with the risk chart for the Netherlands. For the Globorisk, WHO II, and SCORE II risk scores, we also computed the risk scores using risk charts specified for the migrant home country. Risk categorization was first done according to the specification of the risk algorithm and then simplified to low (green), moderate (yellow and orange), and high risk (red). Results: we observed differences in risk categorization for different risk algorithms ranging from 0% (Globorisk) to 13% (Framingham) for the high-risk category, as well as differences in the country-of-residence- and country-of-birth-specific scores. Agreement between different scores ranged from none to moderate. We observed a moderate agreement between the Netherlands-specific SCORE II and the country-of-birth SCORE II for the Turkish and a nonagreement for the Dutch Moroccan population. Conclusion: disparities exist in the use of the country-of-residence-specific, as compared to the country-of-birth, risk algorithms among ethnic minorities living in the Netherlands. Hence, there is a need for further validation of country-of-residence- and country-of-birth-adjusted scores to ascertain appropriateness and reliability.
Estimating Excess Mortality Due to Prostate, Breast, and Uterus Cancer during the COVID-19 Pandemic in Peru: A Time Series Analysis
Authors: Ramírez-Soto Max Carlos , Salazar-Peña Mariangel , Vargas-Herrera Javier
Published: March 2023

During the COVID-19 pandemic, most of the deaths in Peru were related to COVID-19; however, cancer deaths have also been exacerbated in the first months of the pandemic. Despite this, excess mortalities of prostate, breast, and uterus cancer are not available by age group and region from January to December 2020. Therefore, we estimated the excess deaths and excess death rates (per 100,000 habitants) due to prostate, breast, and uterus cancer in 25 Peruvian regions. We did a time series analysis. Prostate, breast, and uterus cancer death data for 25 Peruvian regions were retrieved during the COVID-19 pandemic in 2020, as well as data for up to 3 years prior (2017–2019) from the Sistema Informatico Nacional de Defunciones at the Ministry of Health of Peru. Deaths in 2020 were defined as observed deaths. The expected deaths (in 2020) were estimated using the average deaths over 3 preceding years (2017, 2018 and 2019). Excess mortality was calculated as the difference between observed mortality and expected mortality in 2020. We estimated that the number of excess deaths and the excess death rates due to prostate, breast, and uterus cancer were 610 deaths (55%; 12.8 deaths per 100,000 men), 443 deaths (43%; 6 deaths per 100,000 women), and 154 deaths (25%; 2 deaths per 100,000 women), respectively. Excess numbers of deaths and excess death rates due to prostate and breast cancer increased with age. These excess deaths were higher in men aged ≥ 80 years (596 deaths (64%) and 150 deaths per 100,000 men) and women aged 70–79 years (229 deaths (58%) and 15 deaths per 100,000 women), respectively. In summary, during the COVID-19 pandemic, there were excess prostate and breast cancer mortalities in 2020 in Peru, while excess uterus cancer mortalities were low. Age-stratified excess death rates for prostate cancer and breast cancer were higher in men ≥ 80 years and in women ≥ 70 years, respectively.
Music, Pleasure, and Meaning: The Hedonic and Eudaimonic Motivations for Music (HEMM) Scale
Authors: Powell Merrick , Olsen Kirk , Thompson William
Published: March 2023

Many people listen to music that conveys challenging emotions such as sadness and anger, despite the commonly assumed purpose of media being to elicit pleasure. We propose that eudaimonic motivation, the desire to engage with aesthetic experiences to be challenged and facilitate meaningful experiences, can explain why people listen to music containing such emotions. However, it is unknown whether music containing violent themes can facilitate such meaningful experiences. In this investigation, three studies were conducted to determine the implications of eudaimonic and hedonic (pleasure-seeking) motivations for fans of music with violent themes. In Study 1, we developed and tested a new scale and showed that fans exhibit high levels of both types of motivation. Study 2 further validated the new scale and provided evidence that the two types of motivations are associated with different affective outcomes. Study 3 revealed that fans of violently themed music exhibited higher levels of eudaimonic motivation and lower levels of hedonic motivation than fans of non-violently themed music. Taken together, the findings support the notion that fans of music with violent themes are driven to engage with this music to be challenged and to pursue meaning, as well as to experience pleasure. Implications for fans’ well-being and future applications of the new measure are discussed.
Electrochemotherapy as an Effective Alternative in the Treatment of Local Advanced Oral Squamous Cell Carcinoma: A Retrospective Analysis of Treated Cases
Authors: Barca Ida , Ferragina Francesco , Kallaverja Elvis , Arrotta Antonella , Cristofaro Maria
Published: March 2023

Advanced oral squamous cell carcinomas represent a major challenge for maxillofacial surgeons, oncologists and radiation therapists. They also account for a large share of healthcare costs. They respond little and/or poorly to conventional therapies (surgery, radiotherapy and chemotherapy). Electrochemotherapy is a new method used as a palliative treatment in patients with advanced cancer of the neck/head region who are not eligible for standard therapies. It combines the use of cytotoxic drugs with the physical principle of electroporation; it effectively controls the tumour locally and preserves organ function. To date, ECT has been little used for oral mucosal tumours, as this is difficult to access for electrodes. We report six cases of advanced oral squamous cell carcinoma treated with electrochemotherapy. This study aims to assess the debulking effect of cancer via ECT in patients with advanced oral squamous cell carcinoma. It also aims to assess the safety and tolerability of this treatment.
Challenges in the Management of Sarcopenia in the Primary Care Setting: A Scoping Review
Authors: Kandayah Thinakaran , Safian Nazarudin , Azhar Shah Shamsul , Abdul Manaf Mohd Rizal
Published: March 2023

Background: Sarcopenia is a disease associated with the loss of muscle mass, strength, and function. It affects the elderly in various ways, such as reduced mobility, compromising their daily activities, and even deteriorating metabolic health. Primary care serves as the first point of contact for patients and plays an important role in health promotion and disease prevention. Hence, this review is conducted to identify the challenges in the management of sarcopenia in the primary care setting. Method: In December 2022, a scoping review was conducted using PubMed, SCOPUS, Web of Science, and a manual search, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria. We used articles that have been written in English, and relevant articles were then screened, duplicates were removed, eligibility criteria were applied, and studies that met the criteria were reviewed. The keywords challenges, management, sarcopenia, and primary care were included. Result: The initial search generated 280 publications, and 11 articles were included after inclusion and exclusion criteria for this review. In this review, challenges in the management of sarcopenia in a primary care setting are reviewed based on the screening and diagnosis. Conclusions: With an increasing aging population, it is important to understand the challenges in the management of sarcopenia in a primary care setting. Identification of elderly at risk of sarcopenia, followed by referring the affected elderly for confirmation of the diagnosis, is essential to preventing the adverse health effects. The initiation of treatment that comprises resistance exercise training and nutrition should not be delayed, as they are salient in the management of sarcopenia.