bluuebunny/crossref_metadata_2025 huggingface dataset:
CMV Colitis: A Rare Complication of Azacitidine and Venetoclax Chemotherapy
Authors: Bankur Mustafa Nissar , Keeling Archie , Adil Shah Khoodoruth Mohamed , Avenoso Daniele
Published: June 2022

Herein, we present a case of cytomegalovirus (CMV) colitis that occurred after two cycles of azacitidine and venetoclax in a 64-year-old woman affected with acute myeloid leukaemia (AML) secondary to a previous diagnosis of a hypoplastic myelodysplastic syndrome (hypo-MDS). This patient never had detectable CMV viraemia, and there was no evidence of immune deficiency that could justify this opportunistic infection. Additionally, this is most likely the first report describing CMV colitis in a patient treated upfront with azacitidine and venetoclax.
The Meteoritic Origin of Morocco Iron Dagger Blades
Authors: Ibhi Abderrahmane , Ouknine Lahcen , Khiri Fouad , Ait Touchnt Ahmed , Nachit Hassan , De Pascale Olga , Senesi Giorgio S.
Published: June 2022

Up until now, a few artifacts made of meteoritic iron have been discovered worldwide, though none in Morocco. The number of these objects has rarely been verified, as museums generally do not allow artifacts to be tested, and they are often confused with common smelted objects of the Iron Age. In this work, portable X-ray fluorescence (pXRF) and scanning electron microscopy-energy dispersive X-ray spectroscopy (SEM-EDS) have been used to analyze three iron dagger blades recovered in two localities near Imilchil and Missour in Morocco. The composition of one blade (7.2 wt% Ni and 1.1 wt% Co) strongly supports its meteoritic origin, whereas it was not so for the other two ones. The results of this work provide the first case of the exploitation of meteoritic iron as a metal source in Morocco.
Mature and Older Adults’ Perception of Active Ageing and the Need for Supporting Services: Insights from a Qualitative Study
Authors: Barbaccia Valentina , Bravi Laura , Murmura Federica , Savelli Elisabetta , Viganò Elena
Published: June 2022

The improvement in life expectancy, economic conditions, and technological and medical progress have radically changed the demographic structure of many societies. Since many countries now have an ageing population, by adopting a life-course study perspective, this paper aims to explore the needs of older adults (over 60), and the currently adult population which will become older in the coming decades (50–60 years). In detail, the study investigates the lifestyles of the target populations by focusing on two main areas concerning health (healthy diet; attitudes towards physical activity) and socio-relational-housing and living conditions (social housing, senior co-housing in rural environments, etc.). A qualitative study was carried out based on 16 in-depth interviews developed over one month (February 2022). The conduct of the interviews was supported by the Italian Center for Sensory Analysis (CIAS). Emerging from the results, the concept of active ageing is perceived by mature and older adults in a positive and optimistic way. The sample considered want to re-engage in life, continuing to be active, useful, and maintaining their self-esteem, social life and independence. However, despite older people’s major concerns being preserve their physical abilities and social integration, this target group adopts behaviours focused more on current well-being rather than worrying too much about how this well-being will change as they age.
The Unique Role of Hope and Optimism in the Relationship between Environmental Quality and Life Satisfaction during COVID-19 Pandemic
Authors: Wider Walton , Taib Nasehah , Khadri Mohd , Yip Foon , Lajuma Surianti , Punniamoorthy Prasath
Published: June 2022

COVID-19 in Malaysia has significantly affected the higher education system of the country and increased the level of distress among university students. Empirical evidence proposed that environment quality is associated with university students’ life satisfaction during COVID-19. It was found that hope and optimism are linked with greater life satisfaction in general. Although past literature has reported the effects of hope and optimism on life satisfaction, there are limited studies examining the underlying mechanism among Malaysian private university students. Therefore, the current study offers the preliminary understanding of the intervening role of hope and optimism on the relationship between environmental quality and life satisfaction among private university students in Malaysia. A total of 133 private university students in Malaysia were recruited through homogenous convenience sampling. Partial least square structure equation modeling (SmartPLS) was used to analyze the mediation models. The results revealed that only hope mediated the relationship between environmental quality and life satisfaction, but not optimism. Hence, it is proposed that mental health providers should focus on providing hope-related interventions to university students in confronting COVID-19 challenges and ultimately improving life satisfaction.
Collaborative Learning: A Qualitative Study Exploring Factors Contributing to a Successful Tobacco Cessation Train-the-Trainer Program as a Community of Practice
Authors: Martinez Leal Isabel , Martinez Jayda , Britton Maggie , Chen Tzuan A. , Correa-Fernández Virmarie , Kyburz Bryce , Nitturi Vijay , Obasi Ezemenari M. , Drenner Kelli , Williams Teresa , Casey Kathleen , Carter Brian J. , Reitzel Lorraine R.
Published: June 2022

Individuals with behavioral health conditions account for 50% of annual smoking-related deaths, yet rarely receive tobacco dependence treatment within local mental health authorities (LMHAs). As lack of training and knowledge are key barriers to providing tobacco dependence treatment, Taking Texas Tobacco-Free (TTTF) developed an iterative, 4–6-months train-the-trainer program to embed expertise and delivery of sustained education on tobacco-free workplace policies and practices in participating centers. We explore the employee “champions’” train-the-trainer program experiences using a community of practice (CoP) model to identify key contributors to successful program implementation. Across 3 different LMHAs, we conducted semi-structured individual and group interviews online at 2 time points. We interviewed each champion twice (except for 1 champion who dropped out between measurements); pre-implementation (3 group interviews; N = 4 + 4 + 3 = 11 champions); post-implementation (7 individual interviews and 1 group interview; 7 + 3 = 10 champions). Therefore, 11 champions participated in pre- and post-implementation interviews from July 2020–May 2021. Guided by an iterative, thematic analysis and constant comparison process, we inductively coded and summarized data into themes. Five factors contributed to successful program implementation: value of peer support/feedback; building knowledge, champion confidence, and program ownership; informative curriculum, adaptable to targeted populations; staying abreast of current tobacco/nicotine research and products; and TTTF team responsiveness and practical coaching/assistance. Champions reported the TTTF train-the-trainer program was successful and identified attitudes and CoP processes that effectively built organizational capacity and expertise to sustainably address tobacco dependence. Study findings can guide other agencies in implementing sustainable tobacco-free training programs.
Spatial Pattern Analysis of Xinjiang Tourism Resources Based on Electronic Map Points of Interest
Authors: Chang Yao , Li Dongbing , Simayi Zibibula , Yang Shengtian , Abulimiti Maliyamuguli , Ren Yiwei
Published: June 2022

This study considers the Point of Interest data of tourism resources in Xinjiang and studies their spatial distribution by combining geospatial analysis methods, such as the average nearest neighbor index, standard deviation ellipse, kernel density analysis, and hotspot analysis, to explore their spatial distribution characteristics. Based on the analysis results, the following conclusions are made. Different categories of tourism resource sites have different spatial distributions, and all categories of tourism resources in Xinjiang are clustered in Urumqi city. The geological landscape resource sites are widely distributed and have a ring-shaped distribution in the desert area of southern Xinjiang. The biological landscape resources are distributed in a strip along the Tianshan Mountains. The water landscape resources are concentrated in the northern Xinjiang area. The site ruins are mostly distributed in the western region of Xinjiang. The distributions of the architectural landscape and entertainment and shopping resources are highly coupled with the distribution of cities. The distributions of the six categories of tourism resource points are in the northeast-southwest direction. The centripetal force and directional nature of the resource points of the water landscape are not obvious. The remaining five categories of resource points have their own characteristics. The distribution of resources in the site ruins is relatively even, and there are many hotspot areas in the geomantic and architectural landscapes, which are mainly concentrated in Bazhou and other places. The biological landscape has many cold-spot areas, distributed in areas such as Altai in northern Xinjiang and Hotan in southern Xinjiang. The remaining four categories have cold-spot and hotspot areas with different distributions. Tourism is an important thrust for economic development. The study of the distribution of tourism resources on the spatial distribution of tourism resources has clear guidance for later tourism development, can help the tourism industry optimize the layout of resources, and can promote tourism resources to achieve maximum benefits. The government can implement effective control and governance.
Socioeconomic Status and the Sense of Coherence among Japanese People Living with HIV
Authors: Togari Taisuke , Inoue Yoji , Oshima Gaku , Abe Sakurako , Hosokawa Rikuya , Takaku Yosuke
Published: June 2022

People living with HIV (PLWH) are forced to live with multiple and severe stressors. Focusing on sense of coherence (SOC), which is a concept of salutogenic and stress coping capacity, is useful in PLWH support. This study aimed to examine the association between SOC and socioeconomic status (SES) for Japanese PLWH. Methods: This study used data from the HIV Futures Japan national survey, which is an online survey with a cross-sectional design. This survey of PLWH in Japan was conducted from July 2013 to February 2014 and December 2016 to July 2017, resulting in 1422 valid responses. The mean age (SD) was 38.6 years (8.3). The 13-item SOC scale score was divided into two groups, based on Japanese standard score in a previous study, and logistic regression analysis was performed. Results: Education levels were indirectly associated with SOC through occupation. Compared to freelance-profession/self-employed, “unemployed job seekers” (OR [95%CI] = 2.16 [1.16, 4.04]) and “homemaker/recuperating/student” (2.09 [1.09, 4.02]) were directly related to poor SOC, regardless of income. Also, there is a clear SOC disparity in income (compared to “>8 million yen/year”, “<1 million yen/year” was 2.94 [1.46, 5.92], and “1–2.99 million yen/year” was 2.49 [1.33, 4.68]). Conclusion: It became clear that there is a relationship between SOC and SES. The results of this research provide important evidence for health promotion measures for PLWH.
Occupational Exposure Assessment of the Static Magnetic Field Generated by Nuclear Magnetic Resonance Spectroscopy: A Case Study
Authors: Hartwig Valentina , Sansotta Carlo , Morelli Maria Sole , Testagrossa Barbara , Acri Giuseppe
Published: June 2022

Magnetic resonance (MR) systems are used in academic research laboratories and industrial research fields, besides representing one of the most important imaging modalities in clinical radiology. This technology does not use ionizing radiation, but it cannot be considered without risks. These risks are associated with the working principle of the technique, which mainly involves static magnetic fields that continuously increase—namely, the radiofrequency (RF) field and spatial magnetic field gradient. To prevent electromagnetic hazards, the EU and ICNIRP have defined workers’ exposure limits. Several studies that assess health risks for workers and patients of diagnostic MR are reported in the literature, but data on workers’ risk evaluation using nuclear MR (NMR) spectroscopy are very poor. Therefore, the aim of this research is the risk assessment of an NMR environment, paying particular attention to workers with active implantable medical devices (AIMDs). Our perspective study consisted of the measurement of the static magnetic field around a 300 MHz (7 T) NMR research spectrometer and the computation of the electric field induced by the movements of an operator. None of the calculated exposure parameters exceeded the threshold limits imposed by legislation for protection against short-term effects of acute occupational exposure, but our results revealed that the level of exposure exceeded the action level threshold limit for workers with AIMD during the execution of tasks requiring the closest proximity to the spectrometer. Moreover, the strong dependence of the induced electric field results from the walking speed models is shown. This case study represents a snapshot of the NMR risk assessment with the specific goal to increase the interest in the safety of NMR environments.
Citizens’ Communication Needs and Attitudes to Risk in a Nuclear Accident Scenario: A Mixed Methods Study
Authors: Rasmussen Joel , Eriksson Mats , Martinsson Johan
Published: June 2022

The potential devastation that a nuclear accident can cause to public health and the surrounding environment demands robust emergency preparedness. This includes gaining a greater knowledge of citizens’ needs in situations involving radiation risk. The present study examines citizens’ attitudes to a remediation scenario and their information and communication needs, using focus group data (n = 39) and survey data (n = 2291) from Sweden. The focus groups uniquely showed that adults of all ages express health concerns regarding young children, and many also do so regarding domestic animals. Said protective sentiments stem from a worry that even low-dose radiation is a transboundary, lingering health risk. It leads to doubts about living in a decontaminated area, and high demands on fast, continuous communication that in key phases of decontamination affords dialogue. Additionally, the survey results show that less favorable attitudes to the remediation scenario—worry over risk, doubt about decontamination effectiveness, and preferences to move away from a remediation area—are associated with the need for in-person meetings and dialogue. Risk managers should thus prepare for the need for both in-person meetings and frequent information provision tasks, but also that in-person, citizen meetings are likely to feature an over-representation of critical voices, forming very challenging communication tasks.
A Retrospective Literature Review of Eating Disorder Research (1990–2021): Application of Bibliometrics and Topical Trends
Authors: Park Eunhye , Kim Woo-Hyuk
Published: June 2022

Despite the growing importance of eating disorders in society and academic literature, only a few bibliometric review studies using bibliometric analysis were available. Hence, this study aimed to explore and uncover hidden research topics and patterns in articles in terms of eating disorders over the last 30 years. In total, 4111 articles on eating disorders were analyzed using bibliometrics, network analyses, and structural topic modeling as the basis of mixed methods. In addition to general statistics about the journal, several key research topics, such as eating disorder (ED) treatment, ED symptoms, factors triggering ED, family related factors, eating behaviors, and social factors, were found based on topic correlations. This study found the key research variables that are frequently studied with EDs, such as AN, BN, BED, and ARFID. This study may help clinicians comprehend important risk factors associated with EDs. Moreover, the findings about key ED research topics and their association can be helpful for future studies to construct a comprehensive ED research framework. To our knowledge, this is the first study to use topic modeling in an academic journal on EDs and examine the diversity in ED research over 30 years of published research.
A Systematic Review and Bayesian Network Meta-Analysis Investigating the Effectiveness of Psychological Short-Term Interventions in Inpatient Palliative Care Settings
Authors: Schweighoffer Reka , Schumacher Andrea M. , Blaese Richard , Walter Silke , Eckstein Sandra
Published: June 2022

This paper reviews and summarises the evidence of short-term psychosocial interventions (up to 12 sessions delivered within less than eight weeks) on anxiety, depression, and emotional distress in palliative patients in inpatient settings. We screened publications from the following five databases, Embase, PubMed, PsycINFO, Web of Science, and CINAHL, from their inception to 10 September 2021. The eligible studies included controls receiving standard palliative care, actively treated controls, and wait-list controls. Nine studies met the eligibility criteria and reported the effects of five psychosocial interventions in a total of N = 543 patients. We followed PRISMA-guidelines for outcome reporting and the Cochrane Risk of Bias Assessment Tool for assessing study quality. This paper used the network meta-analysis to compare multiple treatments by providing greater statistical power and the cross-validation of observed treatment effects, using the R package BUGSnet. Compared to control groups, the following psychosocial interventions in inpatient settings showed to be superior: life review interventions were the best ranked treatment for improving anxiety and distress, while the top ranked treatment for reducing depression was outlook intervention. The short-term psychosocial interventions investigated in this meta-analysis, especially life review intervention, are feasible and can potentially improve anxiety, depression, and distress in palliative inpatients and should therefore be offered in inpatient settings.
Effects of a SMART Goal Setting and 12-Week Core Strength Training Intervention on Physical Fitness and Exercise Attitudes in Adolescents: A Randomized Controlled Trial
Authors: Lu Yijuan , Yu Kehong , Gan Xiaomei
Published: June 2022

This study aimed to analyze the impacts of a 12-week core strength training (CST) and goal-setting (GS) program on the core endurance, agility, sprinting, jumping, grip strength, and exercise attitude in a group of adolescents. This study followed a randomized parallel design in which 362 adolescents (age: 14.5 ± 1.07 years; body mass index: 19.82 ± 3.64) were allocated to a GS (n = 89), CST (n = 92), or GS + CST (n = 90) program or to a control group (n = 91). Participants were assessed two times (baseline and postintervention) for the following tests: (i) 50 m dash, (ii) grip strength, (iii) long jump, (iv) 1000 m running for boys and 800 m for girls, (v) core endurance, and (vi) exercise attitude. Significant differences (p < 0.05, η2p = 0.035−0.218) were found between the four groups of the six components of physical fitness and the three components of attitude toward exercise (target attitudes, behavioral habits, and sense of behavioral control). Between-group analysis revealed that the GS + CST had significant advantages (p < 0.05) over the CON in terms of the 50 m dash (Cohen’s d = 0.06), grip strength (Cohen’s d = 0.19_left, 0.31_right), 800/1000 m running (Cohen’s d = 0.41), core endurance (Cohen’s d = 0.95), and sense of behavioral control (Cohen’s d = 0.35). Between-group analysis also revealed that the CST had significant advantages over the CON in terms of grip strength (Cohen’s d = 0.27_left, 0.39_right), 50 m (Cohen’s d = 0.04), long jump (Cohen’s d = 0.21), 800/1000 m (Cohen’s d = 0.09), and core stability (Cohen’s d = 0.63), which were significantly different from CON (p < 0.05). GS differed from CON only on 50 m (Cohen’s d = 0.02) and core stability (Cohen’s d = 0.13) with a small effect (p < 0.05). We conclude that the combined intervention of GS and CST is more effective in promoting fitness in adolescents, i.e., GS + CST > CST and GS + CST > GS.
earlyMYCO: A Pilot Mother-Child Cohort Study to Assess Early-Life Exposure to Mycotoxins—Challenges and Lessons Learned
Authors: Martins Carla , Assunção Ricardo , Costa Ana , Serrano Débora , Visintin Lia , De Boevre Marthe , Lachat Carl , Vidal Arnau , De Saeger Sarah , Namorado Sónia , Vidigal Cristina , Almeida Elisabete , Alvito Paula , Nunes Carla
Published: June 2022

Early-life exposure occurs during gestation through transfer to the fetus and later, during lactation. Recent monitoring data revealed that the Portuguese population is exposed to mycotoxins, including young children. This study aimed to develop a pilot study to assess the early-life exposure to mycotoxins through a mother–child cohort, and to identify the associated challenges. Participants were recruited during pregnancy (1st trimester) and followed-up in three moments of observation: 2nd trimester of pregnancy (mother), and 1st and 6th month of the child’s life (mother and child), with the collection of biological samples and sociodemographic and food consumption data. The earlyMYCO pilot study enrolled 19 mother–child pairs. The analysis of biological samples from participants revealed the presence of 4 out of 15 and 5 out of 18 mycotoxins’ biomarkers of exposure in urine and breast milk samples, respectively. The main aspects identified as contributors for the successful development of the cohort were the multidisciplinary and dedicated team members in healthcare units, reduced burden of participation, and the availability of healthcare units for the implementation of the fieldwork. Challenges faced, lessons learned, and suggestions were discussed as a contribution for the development of further studies in this area.
Kinesiology Students’ Perception Regarding Exercise Oncology: A Cross-Sectional Study
Authors: Avancini Alice , Ferri Marini Carlo , Sperduti Isabella , Natalucci Valentina , Borsati Anita , Pilotto Sara , Cerulli Claudia , Barbieri Elena , Lucertini Francesco , Lanza Massimo , Parisi Attilio , Grazioli Elisa , Di Blasio Andrea
Published: June 2022

Delivering physical activity in cancer care requires knowledge, competence, and specific skills to adapt the exercise program to the patients’ specific needs. Kinesiology students could be one of the main stakeholders involved in the promotion of physical activity. This study aims to investigate the knowledge, perception, and competence about exercise in patients with oncological disease in a sample of students attending the Sports Science University. A total of 854 students (13% response rate) from four Italian universities completed the online survey between May and June 2021. About half of the study participants identified the correct amount of aerobic (44%) and strength (54%) activities proposed by the American College of Sports Medicine for patients with cancer. Almost all the students recognized the importance of physical activity in cancer prevention (96%), in the management of cancer before surgery (96%), during anticancer treatments (84%), and after therapies completion (98%). On the contrary, they reported a lack of university courses dedicated to cancer diseases, psychological implications, and prescription of physical activity in all types of cancer prevention. Overall, few students felt qualified in delivered counseling about physical activity and individual or group-based exercise programs in patients with cancer. Logistic regression revealed that the students attending the Master’s Degree in Preventive and Adapted Physical Activity were more likely to have knowledge and competence than other students. The present study suggests that kinesiology universities should increase the classes and internships about exercise oncology to train experts with specific skills who are able to adequately support patients in their lifestyle modification.
The Peer Effect on Dietary and Nutritional Cognition among Primary School Students
Authors: Gao Lei , Li Ruotong , Zhao Peiyan , Zhang Ying
Published: June 2022

This study uses data from a 2018 survey of 11,384 students in five Chinese provinces to investigate the peer effect on students’ dietary and nutritional cognition. Children’s eating habits have an important impact on their growth and health. Studies have shown that students’ dietary behavior is mainly affected by their dietary and nutritional cognition. Therefore, studying the influencing factors of elementary school students’ cognition of diet and nutrition has become an important research question. However, there are few discussions about the impact of peers’ dietary and nutritional cognition on students’ cognition of diet and nutrition. Consequently, this paper studied the peer effect on students’ cognition of diet and nutrition. The results indicated that peers had a significant impact on the students’ dietary and nutritional cognition. The endogeneity problem was solved using peers’ parents’ dietary and nutritional cognition scores and average educational level as instrumental variables. The impact of peer cognition on diet and nutrition was heterogeneous among different groups. The significance and degree of the peer effect differed based on peer relations, gender, age and school. The results indicated that in addition to family, school, teachers and other factors, peers were an important influencing factor.
Newborn Screening for Cystic Fibrosis: A Qualitative Study of Successes and Challenges from Universal Screening in the United States
Authors: Sontag Marci K. , Miller Joshua I. , McKasson Sarah , Gaviglio Amy , Martiniano Stacey L. , West Rhonda , Vazquez Marisol , Ren Clement L. , Farrell Philip M. , McColley Susanna A. , Kellar-Guenther Yvonne
Published: June 2022

Cystic fibrosis (CF) newborn screening (NBS) was universally adopted in 2009 in the United States. Variations in NBS practices between states may impact the timing of diagnosis and intervention. Quantitative metrics can provide insight into NBS programs (NBSP), but the nuances cannot be elucidated without additional feedback from programs. This study was designed to determine facilitators and barriers to timely diagnosis and intervention following NBS for CF. The median age at the first CF event for infants with CF within each state was used to define early and late states (n = 15 per group); multiple CF centers were invited in states with more than two CF centers. Thirty states were eligible, and 61 NBSP and CF centers were invited to participate in structured interviews to determine facilitators and barriers. Once saturation of themes was reached, no other interviews were conducted. Forty-five interviews were conducted (n = 16 early CF center, n = 12 late CF center, n = 11 early NBSP, and n = 6 late NBSP). Most interviewees reported good communication between CF centers and NBSP. Communication between primary care providers (PCPs) and families was identified as a challenge, leading to delays in referral and subsequent diagnosis. The misperception of low clinical risk in infants from racial and ethnic minority groups was a barrier to early diagnostic evaluation for all groups. NBSP and CF centers have strong relationships. Early diagnosis may be facilitated through more engagement with PCPs. Quality improvement initiatives should focus on continuing strong partnerships between CF centers and NBS programs, improving education, communication strategies, and partnerships with PCPs, and improving CF NBS timeliness and accuracy.
A Sustainable Decision Support System for Drinking Water Systems: Resiliency Improvement against Cyanide Contamination
Authors: Gheibi Mohammad , Eftekhari Mohammad , Akrami Mehran , Emrani Nima , Hajiaghaei-Keshteli Mostafa , Fathollahi-Fard Amir M. , Yazdani Maziar
Published: June 2022

Maintaining drinking water quality is considered important in building sustainable cities and societies. On the other hand, water insecurity is an obstacle to achieving sustainable development goals based on the issues of threatening human health and well-being and global peace. One of the dangers threatening water sources is cyanide contamination due to industrial wastewater leakage or sabotage. The present study investigates and provides potential strategies to remove cyanide contamination by chlorination. In this regard, the main novelty is to propose a sustainable decision support system for the dirking water system in a case study in Iran. First, three scenarios have been defined with low ([CN−] = 2.5 mg L−1), medium ([CN−] = 5 mg L−1), and high ([CN−] = 7.5 mg L−1) levels of contamination. Then, the optimal chlorine dosage has been suggested as 2.9 mg L−1, 4.7 mg L−1, and 6.1 mg L−1, respectively, for these three scenarios. In the next step, the residual cyanide was modelled with mathematical approaches, which revealed that the Gaussian distribution has the best performance accordingly. The main methodology was developing a hybrid approach based on the Gaussian model and the genetic algorithm. The outcomes of statistical evaluations illustrated that both injected chlorine and initial cyanide load have the greatest effects on residual cyanide ions. Finally, the proposed hybrid algorithm is characterized by the multilayer perceptron algorithm, which can forecast residual cyanide anion with a regression coefficient greater than 0.99 as a soft sensor. The output can demonstrate a strong positive relationship between residual cyanide- (RCN−) and injected chlorine. The main finding is that the proposed sustainable decision support system with our hybrid algorithm improves the resiliency levels of the considered drinking water system against cyanide treatments.
Spatial Variation of Acanthophlebia cruentata (Ephemeroptera), a Mayfly Endemic to Te Ika-a-Māui—North Island of Aotearoa, New Zealand
Authors: Trewick Steven A. , Henderson Ian M. , Pohe Stephen R. , Morgan-Richards Mary
Published: June 2022

The mayfly Acanthophlebia cruentata of Aotearoa, New Zealand, is widespread in Te Ika-a-Māui North Island streams, but has never been collected from South Island despite land connection during the last glacial maximum. Population structure of this mayfly might reflect re-colonisation after volcanic eruptions in North Island c1800 years ago, climate cycling or conceal older, cryptic diversity. We collected population samples from 33 locations to estimate levels of population genetic diversity and to document phenotypic variation. Relatively low intraspecific haplotype divergence was recorded among mitochondrial cytb sequences from 492 individuals, but these resolved three geographic-haplotype regions (north, west, east). We detected a signature of isolation by distance at low latitudes (north) but evidence of recent population growth in the west and east. We did not detect an effect of volcanic eruptions but infer range expansion into higher latitudes from a common ancestor during the last glacial period. As judged from wing length, both sexes of adult mayflies were larger at higher elevation and we found that haplotype region was also a significant predictor of Acanthophlebia cruentata size. This suggests that our mitochondrial marker is concordant with nuclear genetic differences that might be explained by founder effect during range expansion.
A Compact Avalanche-Transistor-Based Pulse Generator for Transcranial Infrared Light Stimulation (TILS) Experiments
Authors: Lopez Abraham , Strong Haley N. , McGlothen Kendra I. , Hines Dustin J. , Baker R. Jacob
Published: June 2022

A pulse generator using an avalanche transistor operating in current-mode second breakdown driving a 780 nm laser diode is reported. The laser diode is mounted on the skull of a mouse and used in transcranial infrared light stimulation (TILS) experiments. The output current pulse width is approximately 2 ns in an attempt to generate a true impulse-like optical pulse excitation for the TILS experiments.
Prognostic Factors for Mortality in Acute Mesenteric Ischemia
Authors: Otto Carlos Constantin , Czigany Zoltan , Heise Daniel , Bruners Philipp , Kotelis Drosos , Lang Sven Arke , Ulmer Tom Florian , Neumann Ulf Peter , Klink Christian , Bednarsch Jan
Published: June 2022

Postoperative mortality in patients undergoing surgical and/or interventional treatment for acute mesenteric ischemia (AMI) has remained an unsolved problem in recent decades. Here, we investigated clinical predictors of postoperative mortality in a large European cohort of patients undergoing treatment for AMI. In total, 179 patients who underwent surgical and/or interventional treatment for AMI between 2009 and 2021 at our institution were included in this analysis. Associations between postoperative mortality and various clinical variables were assessed using univariate and multivariable binary logistic regression analysis. Most of the patients were diagnosed with arterial ischemia (AI; n = 104), while venous ischemia (VI; n = 21) and non-occlusive mesenteric ischemia (NOMI; n = 54) were present in a subset of patients. Overall inhouse mortality was 55.9% (100/179). Multivariable analyses identified leukocytes (HR = 1.08; p = 0.008), lactate (HR = 1.25; p = 0.01), bilirubin (HR = 2.05; p = 0.045), creatinine (HR = 1.48; p = 0.039), etiology (AI, VI or NOMI; p = 0.038) and portomesenteric vein gas (PMVG; HR = 23.02; p = 0.012) as independent predictors of postoperative mortality. In a subanalysis excluding patients with fatal prognosis at the first surgical exploration (n = 24), leukocytes (HR = 1.09; p = 0.004), lactate (HR = 1.27; p = 0.003), etiology (AI, VI or NOMI; p = 0.006), PMVG (HR = 17.02; p = 0.018) and intraoperative FFP transfusion (HR = 4.4; p = 0.025) were determined as independent predictors of postoperative mortality. Further, the risk of fatal outcome changed disproportionally with increased preoperative lactate values. The clinical outcome of patients with AMI was determined using a combination of pre- and intraoperative clinical and radiological characteristics. Serum lactate appears to be of major clinical importance as the risk of fatal outcome increases significantly with higher lactate values.
Differentiation of Cerebral Dissecting Aneurysm from Hemorrhagic Saccular Aneurysm by Machine-Learning Based on Vessel Wall MRI: A Multicenter Study
Authors: Cao Xin , Zeng Yanwei , Wang Junying , Cao Yunxi , Wu Yifan , Xia Wei
Published: June 2022

The differential diagnosis of a cerebral dissecting aneurysm (DA) and a hemorrhagic saccular aneurysm (SA) often depends on the intraoperative findings; thus, improved non-invasive imaging diagnosis before surgery is essential to distinguish between these two aneurysms, in order to provide the correct formulation of surgical procedure. We aimed to build a radiomic model based on high-resolution vessel wall magnetic resonance imaging (VW-MRI) and a machine-learning algorithm. In total, 851 radiomic features from 146 cases were analyzed retrospectively, and the ElasticNet algorithm was used to establish the radiomic model in a training set of 77 cases. A clinico-radiological model using clinical features and MRI features was also built. Then an integrated model was built by combining the radiomic model and clinico-radiological model. The area under the ROC curve (AUC) was used to quantify the performance of models. The models were evaluated using leave-one-out cross-validation in a training set, and further validated in an external test set of 69 cases. The diagnostic performance of experienced radiologists was also assessed for comparison. Eight features were used to establish the radiomic model, and the radiomic model performs better (AUC = 0.831) than the clinico-radiological model (AUC = 0.717), integrated model (AUC = 0.813), and even experienced radiologists (AUC = 0.801). Therefore, a radiomic model based on VW-MRI can reliably be used to distinguish DA and hemorrhagic SA, and, thus, be widely applied in clinical practice.
Pre- and Post-Operative Relationship between Radiological Measures and Clinical Outcomes in Women with Hallux Valgus
Authors: Motta Luci M. , Manchado Ignacio , Blanco Gustavo , García-Flemate Felipe , González Jesús , Garcés Gerardo L.
Published: June 2022

The surgical correction of a hallux valgus (HV) deformity improves radiological parameters and clinical outcomes. However, it is not known how these improvements are related between themselves. In this retrospective study, 73 women were assessed preoperatively and 60 months after HV surgical correction. Several radiological parameters were measured: the hallux valgus angle (HVA), I–II intermetatarsal angle (IMA) and sesamoid position. The functional outcomes were assessed using the American Orthopaedic Foot and Ankle Society (AOFAS) Hallux Metatarsophalangeal-Interphalangeal (HMI) scale, and patient-reported outcomes (PROMs) were recorded with the Manchester–Oxford Foot Questionnaire (MOXFQ). A pre–post-surgery comparison of radiological and clinical values was performed, the correlation among them was studied and the differences pre–post-surgery in the radiological measurements compared with those for the clinical outcomes were studied. The results show that all the radiological parameters, functional outcomes and PROMs improved significantly from their pre-operative values to the follow-up values. Multivariate regression analysis showed a significant relationship (p < 0.001) between the differential pre–post-surgery AOFAS scoring only with two sesamoid position differential pre–post-surgery measures: position of medial sesamoid (PMS) and translation of the first metatarsal head (TMH). However, no significant association was observed between the pre–post-surgery radiological differences and the pre–post-surgery MOXFQ scoring.
Operability of a Resonance-Based Viscoelastic Haemostatic Analyzer in the High-Vibration Environment of Air Medical Transport
Authors: Zipperle Johannes , Ziegler Bernhard , Schöchl Herbert , Voelckel Wolfgang , Schlimp Christoph J. , Oberladstätter Daniel
Published: June 2022

Trauma and bleeding are associated with a high mortality, and most of these deaths occur early after injury. Viscoelastic haemostatic tests have gained increasing importance in goal-directed transfusion and bleeding management. A new generation of small-sized and thus portable ultrasound-based viscoelastic analysers have been introduced in clinical practice. We questioned whether a promising candidate can be used in emergency helicopters, with a focus on the susceptibility to vibration stress. We investigated whether the high vibration environment of an emergency helicopter would affect the operability of an ultrasound-based viscoelastic analyser and would yield reproducible results in flight and on the ground. We drew blood from 27 healthy volunteers and performed simultaneous analyses on two TEG 6s. Each measurement was performed in-flight on board an Airbus H135 emergency helicopter and was repeated on the ground, close to the flight area. Results from both measurements were compared, and the recorded tracings and numeric results were analysed for artifacts. Vibratometric measurements were performed throughout the flight in order to quantify changes in the magnitude and character of vibrations in different phases of helicopter operation. The high vibration environment was associated with the presence of artifacts in all recorded tracings. There were significant differences in citrated Kaolin + Heparinase measurements in-flight and on the ground. All other assays increased in variability but did not show significant differences between the two time points. We observed numerous artifacts in viscoelastic measurements that were performed in flight. Some parameters that were obtained from the same sample showed significant differences between in-flight and on-ground measurements. Performing resonance-based viscoelastic tests in helicopter medical service is prone to artifacts. However, a 10 min delay between initiation of measurement and take-off might produce more reliable results.
TMJ Position in Symmetric Dentofacial Deformity
Authors: Ravelo Victor , Olate Gabriela , de Moraes Marcio , Guevara Henry Garcia , Parra Marcelo , Olate Sergio
Published: June 2022

The aim of this research was to analyze the facial class, presence of malocclusion, and the mandibular plane and to relate this to the mandibular condyle position. A cross-sectional study in subjects under analysis for orthognathic surgery was done. The mandibular plane, the gonial angle, and the molar class were included to compare the coronal and sagittal position of the condyle and the joint space observed in the CBCT. The measurements were obtained by the same observer at an interval of two weeks. In addition, the Spearman test was performed to determine the correlation using a p value < 0.05 to observe any significant differences. Eighty-nine male and female subjects (18 to 58 years old, 24.6 ± 10.5) were included. In the coronal section, subjects with CIII had a greater mediolateral distance (MLD, p = 0.0001) and greater vertical distance (SID, p = 0.0001) than subjects with CII. In terms of the skeletal class and the mandibular plane, it was observed that subjects in the CII group had a greater mandibular angle (open angle) (p = 0.04) than the CII group and was related to the anterior position of the condyle. The most anterior condylar position was observed in the CII group (p = 0.03), whereas a posterior condylar position was significant in CIII subjects (p = 0.03). We can conclude that the sagittal position of the TMJ was related to the mandibular plane and the skeletal class showing a higher mandibular angle and most anterior position of the condyle in CII subjects and a lower mandibular angle and most posterior position of the condyle in CIII subjects. The implications for surgical treatment have to be considered.
Sepsis Management in Southeast Asia: A Review and Clinical Experience
Authors: Mehta Yatin , Paul Rajib , Rabbani Raihan , Acharya Subhash Prasad , Withanaarachchi Ushira Kapilani
Published: June 2022

Sepsis is a life-threatening condition that causes a global health burden associated with high mortality and morbidity. Often life-threatening, sepsis can be caused by bacteria, viruses, parasites or fungi. Sepsis management primarily focuses on source control and early broad-spectrum antibiotics, plus organ function support. Comprehensive changes in the way we manage sepsis patients include early identification, infective focus identification and immediate treatment with antimicrobial therapy, appropriate supportive care and hemodynamic optimization. Despite all efforts of clinical and experimental research over thirty years, the capacity to positively influence the outcome of the disease remains limited. This can be due to limited studies available on sepsis in developing countries, especially in Southeast Asia. This review summarizes the progress made in the diagnosis and time associated with sepsis, colistin resistance and chloramphenicol boon, antibiotic abuse, resource constraints and association of sepsis with COVID-19 in Southeast Asia. A personalized approach and innovative therapeutic alternatives such as CytoSorb® are highlighted as potential options for the treatment of patients with sepsis in Southeast Asia.
Point-of-Care Ultrasound (POCUS) as an Extension of the Physical Examination in Patients with Bacteremia or Candidemia
Authors: López Palmero Serafín , López Zúñiga Miguel Angel , Rodríguez Martínez Virginia , Reyes Parrilla Raul , Alguacil Muñoz Ana Maria , Sánchez-Yebra Romera Waldo , Martín Rico Patricia , Poquet Catalá Inmaculada , Jiménez Guardiola Carlos , Del Pozo Pérez Alfonso , Lobato Cano Ruben , Lazo Torres Ana Maria , López Martínez Gines , Díez García Luis Felipe , Parrón Carreño Tesifon
Published: June 2022

Background: In general, transthoracic echocardiography (TTE) is the first diagnostic test used for patients with bacteremia or candidemia and clinical signs of Infective Endocarditis (IE). Point-of-care ultrasound (POCUS) may be used in addition to physical examination for the detection of structural heart disease and valve abnormalities. Objective: To determine the diagnostic accuracy of POCUS for the detection of signs suggestive of IE, including vegetation, valvular regurgitation, structural heart disease, hepatomegaly, splenomegaly and septic embolisms, in patients with bacteremia or candidemia. Design: Observational, cross-sectional, multicenter study using convenience sampling. Setting: Six Spanish academic hospitals. Patients: Adult patients with bacteremia or candidemia between 1 February 2018 and 31 December 2020. Measurements: The reference test, to evaluate vegetation, valvular regurgitation and structural heart disease, was transesophageal echocardiography (TEE). For patients who did not undergo TEE, transthoracic echocardiography (TTE) was considered the reference test. POCUS was performed by internists, while conventional echocardiography procedures were performed by cardiologists. Results: In 258 patients, for the detection of valvular vegetation, POCUS had sensitivity, specificity, and positive and negative predictive values of 77%, 94%, 82% and 92%, respectively. For valvular regurgitation (more than mild), sensitivity was ≥76% and specificity ≥85%. Sensitivity values for the detection of hepatomegaly and splenomegaly were 92% and 92%, respectively, while those for specificity were 96% and 98%. Conclusion: POCUS could be a valuable tool, as a complement to physical examination, at the hospital bedside for patients with bacteremia or candidemia, helping to identify signs suggestive of IE.
Recent Advances in Pancreato-Biliary Endoscopic Intervention: How to Resolve Unmet Needs in Pancreato-Biliary Diseases Endoscopically
Authors: Isayama Hiroyuki , Ishii Shigeto , Tomishima Ko , Fujisawa Toshio
Published: June 2022

Various procedures are available for pancreato-biliary (PB) endoscopic interventions [...]
It Is All about Pressure
Authors: Brusini Paolo , Salvetat Maria Letizia , Zeppieri Marco
Published: June 2022

Glaucoma is an ocular disease caused by elevated intraocular pressure that leads to progressive optic neuropathy [...]
The Role of Humeral Neck-Shaft Angle in Reverse Total Shoulder Arthroplasty: 155° versus <155°—A Systematic Review
Authors: Longo Umile Giuseppe , Gulotta Lawrence V. , De Salvatore Sergio , Berton Alessandra , Piergentili Ilaria , Bandini Benedetta , Lalli Alberto , Denaro Vincenzo
Published: June 2022

The aim of this study was to have updated scrutiny of the influence of the humeral neck-shaft angle (HNSA) in patients who underwent reverse shoulder arthroplasty (RSA). A PRISMA-guided literature search was conducted from May to September 2021. Clinical outcome scores, functional parameters, and any complications were reviewed. Eleven papers were identified for inclusion in this systematic review. A total of 971 shoulders were evaluated at a minimum-follow up of 12 months, and a maximum of 120 months. The sample size for the “HNSA 155°” group is 449 patients, the “HNSA 145°” group involves 140 patients, and the “HSNA 135°” group comprises 291 patients. The HNSA represents an important variable in choosing the RSA implant design for patients with rotator cuff arthropathy. Positive outcomes are described for all the 155°, 145°, and 135° HSNA groups. Among the different implant designs, the 155° group show a better SST score, but also the highest rate of revisions and scapular notching; the 145° cohort achieve the best values in terms of active forward flexion, abduction, ASES score, and CMS, but also the highest rate of infections; while the 135° design obtains the best results in the external rotation with arm at side, but also the highest rate of fractures. High-quality studies are required to obtain valid results regarding the best prosthesis implant.