bluuebunny/crossref_metadata_2025 huggingface dataset:
Is Static Alignment a Good Predictor of Dynamic Alignment after Total Knee Arthroplasty?
Authors: Gu Cheng , Mao Yurong , Dong Haiyan , Cui Yu , Fu Ming
Published: February 2022

Background: Total knee arthroplasty (TKA) is the only effective treatment of end-stage knee osteoarthritis (OA). Lower limb neutral alignment has been a criterion to predict prosthesis life; however, there has been recent controversy over this. Some researchers believe that lower limb static alignment does not significantly affect prosthesis life and some researchers have found that dynamic mechanical alignment may affect prosthesis life, which needs to be further studied. Methods: Eighty-seven patients with knee OA were evaluated by a three-dimensional (3D) gait analysis system before TKA and six months after TKA, dynamic mechanical alignment and basic gait parameters were then calculated. Based on the static alignment of the lower limb on the postoperative X-radiographs, they were divided into a neutral alignment group (58 cases), varus alignment group (20 cases), and valgus alignment group (9 cases). Simple linear regression was used to assess the correlation between static and dynamic alignment. One-way analysis of variance (ANOVA) was used to compare the differences in gait parameters between and within groups. Results: Eighty-seven patients were followed up for an average of six months after the operation. There was no significant difference in all gait parameters among the three groups after TKA. There was no correlation found between static alignment and dynamic alignment/knee adduction moment (KAM) after TKA, although patients showed a significant linear correlation before operation. There was a significant linear correlation between dynamic alignment and KAM before and after the operation. Conclusions: Static alignment has no significant effect on postoperative gait function. Static alignment is no longer an effective predictor of the dynamic alignment or KAM six months after TKA, although they are correlated before TKA. The dynamic alignment allows for better prediction of KAM, which may be a risk factor for the life of the prosthesis.
Value of Adding Bioelectrical Impedance Analysis to Anthropometric Indices in the Diagnosis of Metabolic Syndrome in 10–16 Years Old Schoolgirls
Authors: Muhanna Rawan G. , Aljuraiban Ghadeer S. , Almadani Najwa K. , Alquraishi Mohammed , El-Sharkawy Mohamed S. , Abulmeaty Mahmoud M. A.
Published: February 2022

The use of bioelectrical impedance analysis (BIA) in clinical settings is common. However, the value of BIA-based parameters in diagnosing metabolic syndrome (MetS) in children is under-investigated. Herein, we aimed to study the usefulness of BIA-indices in the diagnoses of MetS in 6–10-year-old girls. Therefore, a diagnostic accuracy case-control study was conducted, which included 75 girls aged 10–16 years, divided into three age-matched groups (normal, None-MetS, and MetS). Anthropometric indices, BIA parameters (including fat-free mass (FFM), body fat percent (BFP), and total body water (TBW)), blood pressure (BP), and blood samples were collected. Our main findings show that for girls in None-MetS and MetS groups, the waist circumference (WC) correlated positively with waist-hip ratio and mid-arm circumference (r = 0.58, 0.47, respectively), but not with BFP based on skinfold thickness (SFT), or mid-arm muscle area. WC was positively correlated with FFM and TBW, while high-density lipoprotein was inversely correlated with FFM. However, fasting blood glucose, triglycerides and BP showed no association with anthropometric measurements and BIA components. WC was the best indicator of MetS (AUC = 0.88, cut-off = 81.5 cm), followed by BMI (AUC = 0.84, cut-off = 26.9 kg/m2), while BFP based on SFT was the least sensitive (62.5%). In conclusion, apart from the FM index, anthropometric parameters such as WC are more valuable in diagnosing MetS in young adolescent girls.
Extracellular Vesicles and Their Role in Patients with Multiple Myeloma
Authors:   Hematology Reports Editorial Office
Published: February 2022

B cell lymphoproliferative diseases, including Multiple Myeloma [...]
Essays in Archaeology and Archaeometry and the Hellenic Contribution to Egyptology
Authors: Lazaridis Nikolaos , Abdel-Kareem Omar , Tsokas Grigorios
Published: February 2022

The contemporary trend of research projects and works are presented on selective issues of archaeometry, archaeology and Egyptology. The current status in research in the area of SE Mediterranean on cultural heritage and archaeological/historical reflections alone and/or coupled with archaeological sciences of eleven papers are placed within an updated frame. The results concern a variety of selected topics critically presented. The topics touch on the cultural astronomy, the ancient textiles and masonries and the physico-chemical and biological investigations, the socio-political issues of Egyptian Ramesside era, revisiting the inscription of an Egyptian statuette, and the valuable information extracted from rock graffiti in north Kharga, Egypt.
Pedra Branca off Singapore: A Historical Cartographic Analysis of a Post-Colonial Territorially Disputed Island
Authors: Ong Brenda , Perono Cacciafoco Francesco
Published: February 2022

At the eastern entrance of the Singapore Strait lies Pedra Branca, an island of granite rock situated in hazardous waters. Its unexceptional presence belies a rich cartographical history and infamous reputation for leading ships to grief since antiquity. Pedra Branca was first pushed into the spotlight when the British constructed the Horsburgh Lighthouse in 1851. It later caught international attention when a heated territorial dispute for the island between Singapore and Malaysia arose, lasting from 1979–2018, with the International Court of Justice (ICJ) eventually granting rights to Singapore. The ensuing legal battle led to renewed interest in the geography and post-19th century history of the island. The most recent breakthrough, however, provides a glimpse into an even earlier history of Pedra Branca—and by extension, Singapore—as shipwrecked remains dating from the 14th century were uncovered in the surrounding waters. Historical research on the ancient history of Pedra Branca has been mostly neglected by scholars over the years; thus, this paper aims to shed some light on this enigmatic history of the island and at the same time establish its history and significance by utilizing pre-British-colonization historical cartographical data from as early as the 15th century.
First Isolation and Identification of Neopestalotiopsis clavispora Causing Postharvest Rot of Rosa sterilis and Its Control with Methyl Jasmonate and Calcium Chloride
Authors: Shi Tingfeng , Pan Tingtiao , Guo Meiting
Published: February 2022

Postharvest rot is a major issue in fruit. However, the cause of postharvest rot on R. sterilis fruit has not been clarified, and there are few studies on the disease control. In this study, the fungus causing postharvest rot is isolated from the symptomatic R. sterilis fruit, and identified by morphological characteristic, pathogenicity test and molecular identification. Moreover, the effects of methyl jasmonate (MeJA) or calcium chloride (CaCl2) alone and their combination on disease resistance to fruit rot were assessed by the determination of defense-related enzyme activity and other indicators. N. clavispora was identified as the main fungus causing the postharvest rot of R. sterilis fruit. The infected fruits were treated with MeJA and CaCl2, and these partially controlled the disease, were additive in effectiveness when used together, increased retention of vitamin C content and fruit firmness, and both enhanced and improved the retention of PAL, POD and PPO activities. The treatment of 500 μL/L MeJA and 3% CaCl2 resulted in the high inhibition of the disease. To our knowledge, this is the first report of N. clavispora causing R. sterilis fruit rot, and the combined treatment is a promising method for controlling postharvest rot on R. sterilis fruit.
Exogenous Melatonin Improves Cold Tolerance of Strawberry (Fragaria × ananassa Duch.) through Modulation of DREB/CBF-COR Pathway and Antioxidant Defense System
Authors: Hayat Faisal , Sun Zixun , Ni Zhaojun , Iqbal Shahid , Xu Wuyi , Gao Zhihong , Qiao Yushan , Tufail Muhammad Aammar , Jahan Mohammad Shah , Khan Ummara , Wan Chunyan , Gu Xianbin
Published: February 2022

The strawberry (Fragaria × ananassa Duch.) is an important fruit crop cultivated worldwide for its unique taste and nutritional properties. One of the major risks associated with strawberry production is cold damage. Recently, melatonin has emerged as a multifunctional signaling molecule that influences plant growth and development and reduces adverse consequences of cold stress. The present study was conducted to investigate the defensive role of melatonin and its potential interrelation with abscisic acid (ABA) in strawberry plants under cold stress. The results demonstrate that melatonin application conferred improved cold tolerance on strawberry seedlings by reducing malondialdehyde and hydrogen peroxide contents under cold stress. Conversely, pretreatment of strawberry plants with 100 μM melatonin increased soluble sugar contents and different antioxidant enzyme activities (ascorbate peroxidase, catalase, and peroxidase) and non-enzymatic antioxidant (ascorbate and glutathione) activities under cold stress. Furthermore, exogenous melatonin treatment stimulated the expression of the DREB/CBF—COR pathways’ downstream genes. Interestingly, ABA treatment did not change the expression of the DREB/CBF—COR pathway. These findings imply that the DREB/CBF-COR pathway confers cold tolerance on strawberry seedlings through exogenous melatonin application. Taken together, our results reveal that melatonin (100 μM) pretreatment protects strawberry plants from the damages induced by cold stress through enhanced antioxidant defense potential and modulating the DREB/CBF—COR pathway.
Environmental Toxicants and Preterm Birth: A Bibliometric Analysis of Research Trends and Output
Authors: Vidal Manuel S. , Menon Ramkumar , Yu Gracia Fe B. , Amosco Melissa D.
Published: February 2022

Preterm birth remains a problem globally, as multiple factors contribute to its etiology and pathogenesis. One such factor is the exposure to environmental toxicants, in which recent literature has described contributory roles in disease progression. This study aims to show research trends and collaborations in papers related to environmental toxicants and preterm birth through a bibliometric analysis to determine hot spots for research as well as to identify already established themes that can point to policy making and development. Using the Scopus database, we were able to identify 956 original research articles from 72 countries between 1955 and 2021; bibliographic information was exported, analyzed, and visualized using Bibliometrix and VOSviewer. There was an annual growth of research and reporting in this area, which significantly increased within the last two decades. The top countries that have published on this topic include the USA (n = 343), China (n = 103), and Australia (n = 43), with strong international collaboration in reports from China. Top journals for publication include Environmental Research (n = 53), Environmental Health Perspectives (n = 47), and Environment International (n = 46). Previous literature focused on establishing toxicants that are significantly associated with preterm birth, with current research focusing on molecular mechanisms of environmental toxicants. Overall, our bibliometric analysis gives a scoping view of the existing research landscape in terms of environmental health and preterm birth.
Challenges Experienced by Italian Nursing Home Staff in End-of-Life Conversations with Family Caregivers during COVID-19 Pandemic: A Qualitative Descriptive Study
Authors: Gonella Silvia , Di Giulio Paola , Antal Alexandra , Cornally Nicola , Martin Peter , Campagna Sara , Dimonte Valerio
Published: February 2022

End-of-life conversations are among the most challenging of all communication scenarios and on the agenda of several healthcare settings, including nursing homes (NHs). They may be also difficult for experienced healthcare professionals (HCPs). This study explores the difficulties experienced by Italian NH staff in end-of-life conversations with family caregivers (FCs) during COVID-19 pandemic to uncover their educational needs. A qualitative descriptive study based on inductive thematic analysis was performed. Twenty-one HCPs across six Italian NHs were interviewed. Four themes described their experiences of end-of-life conversations: (1) communicating with FCs over the overall disease trajectory; (2) managing challenging emotions and situations; (3) establishing a partnership between HCPs and FCs; (4) addressing HCPs’ communication skills needs. HCPs had to face multiple challenging situations that varied across the care period as well as complex emotions such as anxiety, guilt, uncertainty, fear, anger, or suffering, which required tailored answers. COVID-19 pandemic increased FCs’ aggressive behaviors, their distrust, and uncertainty due to visitation restrictions. HCPs had to overcome this by developing a set of strategies, including adoption of an active-listening approach, supportive communication, and explicit acknowledgement of FCs’ emotions. Since communication needs were mostly practical in nature, HCPs valued practical communication training.
Post-Migration Stressors and Health-Related Quality of Life in Refugees from Syria Resettled in Sweden
Authors: Sengoelge Mathilde , Nissen Alexander , Solberg Øivind
Published: February 2022

The link between post-migration stressors and mental ill health is well documented in refugees resettled in high-income host countries, but the consequences of these stressors on refugees’ health-related quality of life (HRQoL) are less known. This study examined the association between post-migration stressors and HRQoL among Syrian adult refugees resettled in Sweden using a preference-based value set obtained from the general Swedish population. A total of 1215 Syrian adults, ages 18–64 years, granted residency in Sweden, responded to a postal questionnaire in 2016 regarding various aspects of their resettlement. The European Quality of Life Five Dimensions Five Level (EQ–5D–5L) questionnaire was used to assess HRQoL through an EQ–5D–5L index score (range; 0=dead to 1=full health). The index score was preference weighted using a Swedish population value set. Predictors were four self-reported post-migration stressors related to daily living in the host country: financial strain, social strain, competency strain and perceived discrimination divided into low, medium and high levels of experienced stress. Multivariable linear regression models were employed to assess the association between post-migration stressors and HRQoL index score, adjusting for potentially traumatic events in the pre- and peri-migration phase as well as sociodemographic confounders/covariates (sex, age, education, civil status, immigration year). The Syrian refugees had a mean EQ–5D–5L index score of 0.863 (SD = 0.145). There was strong evidence of a negative dose-response association in both unadjusted and adjusted models between HRQoL and the post-migration stressors financial strain and social strain—i.e., there was a stepwise, and statistically significant, decrease in HRQoL when going from low to medium to high strain. Competency strain and discrimination were only associated with lower HRQoL when experienced at high levels in fully adjusted models. High exposure to potentially traumatic experiences before or during flight was also associated with lower HRQoL. Syrian refugees resettled in Sweden reported a lower HRQoL than the general Swedish population and lower than age-matched Swedish adults. The present study results point to the possible adverse effects of post-migration stressors on HRQoL.
Analysis of Infection Transmission Routes through Exhaled Breath and Cough Particle Dispersion in a General Hospital
Authors: Jung Minji , Chung Woong June , Sung Minki , Jo Seongmin , Hong Jinkwan
Published: February 2022

Identifying infection transmission routes in hospitals may prevent the spread of respiratory viruses and mass infections. Most previous related research focused on the air movement of passive tracers, which typically represent breathing. In this study, particle evaporation and dispersions with various particle sizes were applied to evaluate particle movement because of breathing and coughing using computational fluid dynamics (CFD) simulations. Pyeongtaek St. Mary Hospital, where a Middle East respiratory syndrome (MERS) index patient infected several patients on the same floor, was used for a case study. We compared the dispersion characteristics of various particle sizes and validated results by comparing infection rates in different ward. Results indicated that droplets spread across the corridor and dispersed to wards that were more than 17 m apart from the index patient by natural ventilation. Droplets from exhaled breath under steady-state simulation showed a wider range of dispersion than cough droplets under transient simulation, but cough droplet dispersion was more consistent with the actual infection rate in each ward. Cough droplets sized under 75 µm evaporated to 26% of the initial size and started to disperse into the corridor within one minute; in nine minutes, droplets dispersed throughout every ward. This study may increase awareness on the dispersion characteristics of infectious particles.
The 17-Item Computer Vision Symptom Scale Questionnaire (CVSS17): Translation, Validation and Reliability of the Italian Version
Authors: Rossi Gemma Caterina Maria , Bettio Federica , González-Pérez Mariano , Briola Aba , Pasinetti Gemma Ludovica Maria , Scudeller Luigia
Published: February 2022

Background. To validate the 17-item Computer Vision Symptom Scale questionnaire (CVSS17) in Italian. Methods. Cross-sectional validation study on video terminal (VDT) users and a reference sample of subjects not working at a VDT (control group), cognitively able to respond to a health status interview. The Italian self-administered version of the CVSS17 questionnaire was administered to all participants. The reliability and validity of the Italian translation of the CVSS17 were tested using standard statistical methods for questionnaire validation. The Rasch analysis was performed as well. Results. A total of 216 subjects were enrolled. Concerning the reliability, the Cronbach’s alpha coefficient was 0.925 (from 0.917 to 0.924), and the test–retest stability was 0.91 (<0.001). Concerning the validity, the control group had significantly better scores, and there were good correlations between responses to the CVSS17 and analogous domains of the GSS. Conclusion. The Italian version of the CVSS17 has shown psychometric properties comparable to those of the Spanish version, having good validity, discriminatory power, internal consistency and reliability. The questionnaire is a specific measure of vision-related quality of life in Italian-speaking VDT workers and can be used both in clinical practice and for research purposes.
Strengths and Weaknesses of the Pharmacovigilance Systems in Three Arab Countries: A Mixed-Methods Study Using the WHO Pharmacovigilance Indicators
Authors: Garashi Hamza , Steinke Douglas , Schafheutle Ellen
Published: February 2022

Using the WHO pharmacovigilance (PV) indicators as a framework, this study aimed to explore the structures, processes, and outcomes of three Arab countries’ (Jordan, Oman, and Kuwait) PV systems to inform recommendations for countries with nascent PV systems. A mixed-methods design involving document review, semi-structured interviews, and a questionnaire was employed. Fifty-six key informants from the three countries’ national PV centres (NPVCs) and pharmaceutical industry were interviewed. The questionnaire collecting quantitative measures was only completed by Oman and Kuwait’s NPVCs. Using the framework, system strengths were attributed to the presence of “core” structural indicators, including a dedicated and officially recognised NPVC, PV legislation, and a national PV advisory committee, as well as “complementary” structural indicators, e.g., a computerised case-report management system. Contrastingly, weaknesses were attributed to the absence of these indicators plus other “core” structural indicators, namely, regular financial provision and adequate staff. Other weaknesses were attributed to low performance in “core” process and outcome indicators including reporting rates, reporter awareness, and signal detection. Greater governmental prioritisation through the provision of legislative enforcements, resources, and expertise as part of a well-structured system is required. More regional coordination efforts are needed to allow for sharing of expertise in order to bolster nascent systems.
Sunburns and Sun Protection Behaviors among Male Hispanic Outdoor Day Laborers
Authors: Niu Zhaomeng , Riley Mary , Stapleton Jerod , Ochsner Michele , Hernandez Germania , Kimmel Louis , Giovenco Daniel , Hudson Shawna , O’Malley Denalee , Lozada Carolina , Pabellón Marién , Heckman Carolyn , Coups Elliot
Published: February 2022

Individuals who work outside are at increased risk for skin cancer due to excessive exposure to ultraviolet (UV) radiation. Little is known about UV exposures and sun safety practices of outdoor day laborers, who are disproportionately Hispanic. This study identified the correlates of sunburn and sun protection behaviors in a sample of male, Hispanic day laborers (n = 175). More than half of the participants (54.9%) experienced one or more sunburns when working during the past summer, and 62.9% reported having one or more symptoms of heat illness. The frequency of engaging in sun protection behaviors was suboptimal, including sunglasses use (M = 2.68, SD = 1.71), staying in the shade (M = 2.30, SD = 0.94), wearing sunscreen (M = 2.10, SD = 1.39), and wearing a wide-brimmed hat (M = 1.75, SD = 1.32), based on a 5-point scale (1 = never; 5 = always). Lower education level, higher levels of skin sensitivity to the sun, any symptom of heat illness, fewer barriers to wearing a wide-brimmed hat, and not wearing a wide-brimmed hat were associated with a greater number of sunburns. Factors associated with each sun protection behavior varied. Implications and directions for future research are discussed.
Metal(loid)s Spatial Distribution, Accumulation, and Potential Health Risk Assessment in Soil-Wheat Systems near a Pb/Zn Smelter in Henan Province, Central China
Authors: Yang Ling , Ren Qiang , Ge Shiji , Jiao Zhiqiang , Zhan Wenhao , Hou Runxiao , Ruan Xinling , Pan Yanfang , Wang Yangyang
Published: February 2022

To understand the influence of Pb/Zn smelter on surrounding environment, 110 soil and 62 wheat grain samples (62 paired samples) were collected nearby a Pb/Zn smelter in Jiaozuo City, Henan Province, China. The content and spatial distribution of metal(loid)s in the soil-wheat system, and the potential health risk via consumption of wheat grains were determined. Results showed that the average content of Pb, Cd, As, Cu, Zn, and Ni in soil were 129.16, 4.28, 17.95, 20.43, 79.36, and 9.42 mg/kg, respectively. The content of Cd in almost all soil samples (99.1%) exceeded the national limitation of China (0.6 mg/kg). Spatial distribution analysis indicated that atmospheric deposition might be the main pollution source of Pb, Cd, As, and Zn in soil. In addition, the average content of Pb, Cd, As, Cu, Zn, and Ni in wheat grain were 0.62, 0.35, 0.10, 3.7, 35.77, and 0.15 mg/kg, respectively, with the average Pb and Cd content exceeding the national limitation of China. The average bioaccumulation factor of these metal(loid)s followed the following order: Zn (0.507) > Cu (0.239) > Cd (0.134) > Ni (0.024) > Pb (0.007) > As (0.006). Health risk assessment indicated that the average noncarcinogenic risk of children (6.78) was much higher than that of adults (2.83), and the carcinogenic risk of almost all wheat grain is higher than the acceptable range, with an average value of 2.43 × 10−2. These results indicated that humans who regularly consume these wheat grains might have a serious risk of noncarcinogenic and carcinogenic diseases.
An Observational Cross-Sectional Study on Cancer Awareness and Beliefs about Carcinogens among Saudi Women
Authors: Akkour Khalid , Alsuwaidan Shahad , Almoqren Mohammed , Alsaleh Futoon , Alghuson Lolowah
Published: February 2022

Public knowledge about the risk factors of cancer is essential to ensure an effective prevention program. This study aims to explore the knowledge of the general Saudi population about cancer and carcinogens and to determine the misconceptions about carcinogens to help create appropriate evidence-based prevention awareness programs. A questionnaire of 63 questions related to biographic data, source of knowledge, risk factors, and the burden of cancer was distributed online. The internet was the most sought source for cancer-related information (75.2%). The inclusion of cancer-related subjects in the educational curriculum was believed to be the best way to educate children about cancer (48.4%). Knowledge about cancer risk factors was good overall for 10 out of the 27 risk factors assessed in the study, with cigarette smoking being the most well-known risk factor (91.5%), followed by hookah smoking (85.6%), and nuclear waste exposure (80%). However, only 16.3% of participants were aware of the risk associated with Oral Contraceptive Pills (OCPs), and less than half of the participants knew the risk associated with poor physical activity. About 45% (44.9%) believed that envy and spiritual causes are associated with cancer. Most of the study participants (70%) considered cancer to be a significant health issue in Saudi, mainly due to the increasing incidence rate (44%). Conclusion: This study showed a good level of awareness regarding cancer risk factors and environmental carcinogens, which could serve as a roadmap for future awareness programs and studies targeted at the knowledge of other risk factors for cancer.
Adolescer in Time of COVID-19′s Pandemic: Rationale and Construction Process of a Digital Intervention to Promote Adolescents’ Positive Development
Authors: Freire Teresa , Santana Gabriela , Vieira Alexandra , Barbosa Bruna
Published: February 2022

The coronavirus pandemic has severely impacted children’s and adolescents’ lives due to policies and regulations implemented to slow the virus from spreading, which led to a loss of routine, structure, academic support, and social contacts. Literature also reports a lack of outdoor activity, inappropriate diet, and disruption of sleeping habits as affecting children’s and adolescents’ lifestyles and well-being. Remarkably, these consequent psychological, behavioral, and emotional changes can compromise their self-esteem, sense of self-efficacy, and self-concept, affecting their immune systems. These maladaptive coping strategies and associated effects may emerge as a failure to access some of the sources of support that might help them cope. Facing this crisis, we aimed at promoting well-being, growth, and the positive development of Portuguese adolescents through an intervention focused on positive coping strategies. We developed “Adolescer in time of COVID-19—A good practices Guide for adolescents in social distancing” as a digital document to be quickly disseminated online, answering the emergent needs of Portuguese youth between 13 and 18 years old during the COVID-19 pandemic. In this article, we present the rationale and process of construction of this intervention while living within a quarantine period, considering the restrictive measures adopted at the time.
Mental Resilience, Mood, and Quality of Life in Young Adults with Self-Reported Impaired Wound Healing
Authors: Balikji Jessica , Hoogbergen Maarten M. , Garssen Johan , Verster Joris C.
Published: February 2022

The purpose of this study was to evaluate the impact of self-reported impaired wound healing on quality of life, wellbeing, and mood. It was hypothesized that individuals with impaired wound healing report significantly poorer mood compared to healthy controls. An online survey was conducted among 2173 Dutch young adults (18–30 years old) to investigate mood, neuroticism, and mental resilience. Participants were allocated to a healthy control group (N = 1728) or impaired wound healing groups comprising a wound infection group (WI, N = 76), a slow-healing wounds group (SHW, N = 272), and a group that experienced both WI and SHW (the COMBI group, N = 97). The Kruskal–Wallis test was used to compare outcomes the groups. Compared to the healthy control group, the SHW and COMBI groups, but not the WI group, reported significantly poorer mood, increased neuroticism, reduced mental resilience, and reduced quality of life. An analysis evaluating sex differences found that negative effects on stress, mental resilience, and neuroticism were significantly more pronounced among women than among men. In conclusion, self-reported impaired wound healing is associated with poorer mood and reduced quality of life. To improve future wound care, these findings advocate for an interdisciplinary approach taking into account mood effects accompanying having impaired wound healing.
Retrospective Analysis of the Pharmaco-Utilization of VEGF Inhibitors and Health Care Costs among Patients with Wet Age-Related Macular Degeneration and Other Ocular Diseases in Italy
Authors: Perrone Valentina , Dovizio Melania , Veronesi Chiara , Citraro Rita , De Francesco Adele , Dell’Orco Stefania , Di Manno Gianluca , Paciello Arrigo , Resta Anna Maria , Quarta Fabrizio , Ferrante Nicola , Ritrovato Daniela , Degli Esposti Luca
Published: February 2022

This Italian retrospective study aimed to analyze the pharmaco-utilization of anti-VEGF drugs and health care costs among patients with wet age-related macular degeneration (wAMD) or other ocular diseases. A retrospective analysis was performed on administrative databases of Italian entities covering approximately six million individuals. Across January 2010–December 2017, patients aged ≥50 years with a prescription of intravitreal anti-VEGFs were included as “wAMD” patients [by wAMD hospitalization or intravitreal injections] or as “other ocular diseases” patients [by hospitalization for other ocular disorders or intravitreal injections, with concomitant diabetes diagnosis or dexamethasone treatment]. The date of first matching of inclusion criteria was index-date. wAMD-cohort. Overall, 3879 patients were included; at index-date, 82.2% were treated with Ranibizumab, 15.8% with Aflibercept, and 2% with Pegaptanib. During the follow-up, the mean/annual anti-VEGF prescription [3.6 (first-year)–0.8 (third-year)] and the total expenditure [5799.84 € (first-year)–3212.84 € (third-year)] decreased. Other ocular diseases-cohort. Overall, 2646 patients were enclosed; 85.9% were treated with Ranibizumab, 13.5% with Aflibercept, and 0.6% with Pegaptanib. During the follow-up, the mean/annual anti-VEGF prescription [3.3 (first-year)–0.5 (third-year)] and the total cost [7196.83 € (first-year)–5162.68 € (third-year)] decreased. This observational study highlighted a decline in anti-VEGF prescriptions over time in both cohorts, suggesting a trend of under-treatment that could worsen the patients’ clinical outcomes and increase health care resource consumption.
Dissemination of Early Intervention Program for Preschool Children on the Autism Spectrum into Community Settings: An Evaluation
Authors: Masi Anne , Azim Syeda Ishra , Khan Feroza , Karlov Lisa , Eapen Valsamma
Published: February 2022

We aimed to address a policy-relevant research area with high priority, namely disseminating early intervention for children on the autism spectrum into mainstream community settings. The study cohort comprised 47 children with a diagnosis of Autism Spectrum Disorder (ASD) receiving the Early Start Denver Model (ESDM) intervention: 23 children attending an Autism Specific Early Learning and Care Centre (ASELCC) and 24 children attending a mainstream preschool setting. Group comparisons revealed that the overall response to intervention was in the majority of cases not significantly different between settings. One difference was found in that children in the mainstream preschool setting showed a significant reduction in externalising behaviours compared to the children attending the autism-specific preschool. Intervention duration was found to influence outcomes with a one-month increase in duration found to improve expressive language skills. While the results need to be interpreted with caution due to the small sample size, these findings suggest that early intervention can be successfully delivered in both autism-specific and mainstream settings. However, those families needing additional parent support may be better served by a specialised service.
A Structural Model of Quality of Life in Patients after Colorectal Cancer Surgery
Authors: Yeom Jeong Won , Suh Yeon Ok
Published: February 2022

Background: This study was conducted to determine a hypothetical model for the factors affecting the quality of life of postoperative colorectal cancer patients. Methods: We collected data from 209 patients that was analyzed using SPSS 22.0 and AMOS 25. Results: Predictive variables of the hypothesis model included an exogenous variable, social support, as well as endogenous variables self-efficacy, symptoms, health promotion behavior, and quality of life. Testing of the correction model showed that significant paths directly affecting quality of life of patients after colorectal cancer surgery included health promotion behavior, symptoms, and self-efficacy and also showed an explanation power of 58.7%. Social support was found to have a significant impact on the quality of life indirectly through self-efficiency. Conclusions: To improve the quality of life of colorectal cancer patients, it is necessary to develop a nursing intervention program that strengthens patients’ health promotion behaviors to alleviate their symptoms and improve their social support and self-efficacy.
Street Clinics and the Healthcare of Vulnerable Homeless Communities in Brazil: A Qualitative Study
Authors: Bombonatti Giulia Romano , Saidel Maria Giovana Borges , Rocha Fernanda Mota , Santos Débora de Souza
Published: February 2022

(1) Background: homeless people are characterized by serious social vulnerability and difficulty in accessing health services worldwide. In Brazil, this population is supported by the Street Clinic teams who are challenged to establish intersectoral networks to expand access and promote unique and humanized care from the perspective of harm reduction. The study aimed to analyze the practices of professionals working at the Street Clinic in a city in the interior of São Paulo, Brazil, to tackle the vulnerabilities of the homeless population and expand access to the health care network. (2) Methods: a qualitative study was conducted with a social approach in which we interviewed eight workers from the Street Clinic. Data were analyzed using the thematic content analysis tool. (3) Results: three nuclei of meaning were built: stigma and prejudice as the main barriers to accessing services, harm reduction as a humanized care practice and valuing autonomy, and Street Clinic as a gateway to the health system and main interlocutor with other services. (4) Conclusions: the articulation with network services is marked by contradictory relationships, of conflict and trust, signaling the need for greater investment in educational qualifications and working conditions for professionals at all levels of care to expand access to health care.
Exploring Perceived and Objective Measures of the Neighborhood Environment and Associations with Physical Activity among Adults: A Review and a Meta-Analytic Structural Equation Model
Authors: Menardo Elisa , De Dominicis Stefano , Pasini Margherita
Published: February 2022

There is an urgent need to understand factors that promote physical activities (PA) because it is one of the modifiable risk factors for global mortality. None of the previous reviews considered both perceived and objective characteristics of the same environment. The first aim was to review the literature on studies investigating the relationship between PA behavior of adults and perceived and objective physical environment measures. The second aim was to verify the potential mediational role of the perceived measure in the relationship between the objective measure of the environment and PA using meta-analytic SEM. Only 15 studies reported a relationship between PA and both environmental measures. One of the most studied characteristics of the physical environment is the accessibility to recreational/PA facilities. Both objective and subjective measures of accessibility to PA facilities are associated with PA. Meta-SEM results suggest a significant effect of the objective accessibility to facilities on PA behavior (β = 0.15) and on the perceived measure (β = 0.10), but the indirect effect was not significant. No significant effect was found for the perceived measure on PA, suggesting that individuals’ level of awareness about their environments may have played a role. This prompts a need to create awareness campaigns.
Advanced Glycation End Products: A Sweet Flavor That Embitters Cardiovascular Disease
Authors: Pinto Raphael S. , Minanni Carlos A. , de Araújo Lira Aécio Lopes , Passarelli Marisa
Published: February 2022

Epidemiological studies demonstrate the role of early and intensive glycemic control in the prevention of micro and macrovascular disease in both type 1 and type 2 diabetes mellitus (DM). Hyperglycemia elicits several pathways related to the etiopathogenesis of cardiovascular disease (CVD), including the generation of advanced glycation end products (AGEs). In this review, we revisit the role played by AGEs in CVD based in clinical trials and experimental evidence. Mechanistic aspects concerning the recognition of AGEs by the advanced glycosylation end product-specific receptor (AGER) and its counterpart, the dolichyl-diphosphooligosaccharide-protein glycosyltransferase (DDOST) and soluble AGER are discussed. A special focus is offered to the AGE-elicited pathways that promote cholesterol accumulation in the arterial wall by enhanced oxidative stress, inflammation, endoplasmic reticulum stress and impairment in the reverse cholesterol transport (RCT).
Overexpression of miR-375 and L-type Amino Acid Transporter 1 in Pheochromocytoma and Their Molecular and Functional Implications
Authors: Manso Jacopo , Bertazza Loris , Barollo Susi , Mondin Alberto , Censi Simona , Carducci Sofia , Ferrara Alfonso Massimiliano , Boschin Isabella Merante , Zovato Stefania , Schiavi Francesca , Gregianin Michele , Pennelli Gianmaria , Iacobone Maurizio , Mian Caterina
Published: February 2022

Pheochromocytoma (Pheo) is a tumor derived from chromaffin cells. It can be studied using 18F-dihydroxyphenylalanine (DOPA)—positron emission tomography (PET) due to its overexpression of L-type amino acid transporters (LAT1 and LAT2). The oncogenic pathways involved are still poorly understood. This study examined the relationship between 18F-DOPA-PET uptake and LAT1 expression, and we explored the role of miR-375 and putative target genes. A consecutive series of 58 Pheo patients were retrospectively analyzed, performing 18F-DOPA-PET in 32/58 patients. Real-time quantitative PCR was used to assess the expression of LAT1, LAT2, phenylethanolamine N-methyltransferase (PNMT), miR-375, and the major components of the Hippo and Wingless/Integrated pathways. Principal germline mutations associated with hereditary Pheo were also studied. Pheo tissues had significantly higher LAT1, LAT2, and PNMT mRNA levels than normal adrenal tissues. MiR-375 was strongly overexpressed. Yes-associated protein 1 and tankyrase 1 were upregulated, while beta-catenin, axin2, monocarboxylate transporter 8, and Frizzled 8 were downregulated. A positive relationship was found between 18F-DOPA-PET SUV mean and LAT1 gene expression and for 24 h-urinary norepinephrine and LAT1. This is the first experimental evidence of 18F-DOPA uptake correlating with LAT1 overexpression. We also demonstrated miR-375 overexpression and downregulated (Wnt) signaling and identified the Hippo pathway as a new potentially oncogenic feature of Pheo.
Dynamics of Endothelial Engagement and Filopodia Formation in Complex 3D Microscaffolds
Authors: Ucla Pierre , Ju Xingming , Demircioglu Melisa , Baiz Sarah , Muller Laurent , Germain Stéphane , Monnot Catherine , Semetey Vincent , Coscoy Sylvie
Published: February 2022

The understanding of endothelium–extracellular matrix interactions during the initiation of new blood vessels is of great medical importance; however, the mechanobiological principles governing endothelial protrusive behaviours in 3D microtopographies remain imperfectly understood. In blood capillaries submitted to angiogenic factors (such as vascular endothelial growth factor, VEGF), endothelial cells can transiently transdifferentiate in filopodia-rich cells, named tip cells, from which angiogenesis processes are locally initiated. This protrusive state based on filopodia dynamics contrasts with the lamellipodia-based endothelial cell migration on 2D substrates. Using two-photon polymerization, we generated 3D microstructures triggering endothelial phenotypes evocative of tip cell behaviour. Hexagonal lattices on pillars (“open”), but not “closed” hexagonal lattices, induced engagement from the endothelial monolayer with the generation of numerous filopodia. The development of image analysis tools for filopodia tracking allowed to probe the influence of the microtopography (pore size, regular vs. elongated structures, role of the pillars) on orientations, engagement and filopodia dynamics, and to identify MLCK (myosin light-chain kinase) as a key player for filopodia-based protrusive mode. Importantly, these events occurred independently of VEGF treatment, suggesting that the observed phenotype was induced through microtopography. These microstructures are proposed as a model research tool for understanding endothelial cell behaviour in 3D fibrillary networks.
Molecular Mechanisms and Physiological Changes behind Benign Tracheal and Subglottic Stenosis in Adults
Authors: Marchioni Alessandro , Tonelli Roberto , Andreani Alessandro , Cappiello Gaia Francesca , Fermi Matteo , Trentacosti Fabiana , Castaniere Ivana , Fantini Riccardo , Tabbì Luca , Andrisani Dario , Gozzi Filippo , Bruzzi Giulia , Manicardi Linda , Moretti Antonio , Baroncini Serena , Samarelli Anna Valeria , Pinelli Massimo , De Santis Giorgio , Stefani Alessandro , Marchioni Daniele , Mattioli Francesco , Clini Enrico
Published: February 2022

Laryngotracheal stenosis (LTS) is a complex and heterogeneous disease whose pathogenesis remains unclear. LTS is considered to be the result of aberrant wound-healing process that leads to fibrotic scarring, originating from different aetiology. Although iatrogenic aetiology is the main cause of subglottic or tracheal stenosis, also autoimmune and infectious diseases may be involved in causing LTS. Furthermore, fibrotic obstruction in the anatomic region under the glottis can also be diagnosed without apparent aetiology after a comprehensive workup; in this case, the pathological process is called idiopathic subglottic stenosis (iSGS). So far, the laryngotracheal scar resulting from airway injury due to different diseases was considered as inert tissue requiring surgical removal to restore airway patency. However, this assumption has recently been revised by regarding the tracheal scarring process as a fibroinflammatory event due to immunological alteration, similar to other fibrotic diseases. Recent acquisitions suggest that different factors, such as growth factors, cytokines, altered fibroblast function and genetic susceptibility, can all interact in a complex way leading to aberrant and fibrotic wound healing after an insult that acts as a trigger. However, also physiological derangement due to LTS could play a role in promoting dysregulated response to laryngo-tracheal mucosal injury, through biomechanical stress and mechanotransduction activation. The aim of this narrative review is to present the state-of-the-art knowledge regarding molecular mechanisms, as well as mechanical and physio-pathological features behind LTS.
A Connecting Link between Hyaluronan Synthase 3-Mediated Hyaluronan Production and Epidermal Function
Authors: Ota Yukiko , Yoshida Hiroyuki , Endo Yoko , Sayo Tetsuya , Takahashi Yoshito
Published: February 2022

Hyaluronan (HA), an essential component of the extracellular matrix of the skin, is synthesized by HA synthases (HAS1-3). To date, epidermal HA has been considered a major player in regulating cell proliferation and differentiation. However, a previous study reported that depletion of epidermal HA by Streptomyces hyaluronidase (St-HAase) has no influence on epidermal structure and function. In the present study, to further explore roles of epidermal HA, we examined effects of siRNA-mediated knockdown of HAS3, as well as conventional HA-depletion methods using St-HAase and 4-methylumbelliferone (4MU), on epidermal turnover and architecture in reconstructed skin or epidermal equivalents. Consistent with previous findings, HA depletion by St-HAase did not have a substantial influence on the epidermal architecture and turnover in skin equivalents. 4MU treatment resulted in reduced keratinocyte proliferation and epidermal thinning but did not seem to substantially decrease the abundance of extracellular HA. In contrast, siRNA-mediated knockdown of HAS3 in epidermal equivalents resulted in a significant reduction in epidermal HA content and thickness, accompanied by decreased keratinocyte proliferation and differentiation. These results suggest that HAS3-mediated HA production, rather than extracellularly deposited HA, may play a role in keratinocyte proliferation and differentiation, at least in the developing epidermis in reconstructed epidermal equivalents.
HF Formation through Dissociative Electron Attachment—A Combined Experimental and Theoretical Study on Pentafluorothiophenol and 2-Fluorothiophenol
Authors: Cipriani Maicol , Ingólfsson Oddur
Published: February 2022

In chemoradiation therapy, dissociative electron attachment (DEA) may play an important role with respect to the efficiency of the radiosensitizers used. The rational tailoring of such radiosensitizers to be more susceptive to DEA may thus offer a path to increase their efficiency. Potentially, this may be achieved by tailoring rearrangement reactions into the DEA process such that these may proceed at low incident electron energies, where DEA is most effective. Favorably altering the orbital structure of the respective molecules through substitution is another path that may be taken to promote dissociation up on electron capture. Here we present a combined experimental and theoretical study on DEA in relation to pentafluorothiophenol (PFTP) and 2-fluorothiophenol (2-FTP). We investigate the thermochemistry and dynamics of neutral HF formation through DEA as means to lower the threshold for dissociation up on electron capture to these compounds, and we explore the influence of perfluorination on their orbital structure. Fragment ion yield curves are presented, and the thermochemical thresholds for the respective DEA processes are computed as well as the minimum energy paths for HF formation up on electron capture and the underlying orbital structure of the respective molecular anions. We show that perfluorination of the aromatic ring in these compounds plays an important role in enabling HF formation by further lowering the threshold for this process and through favorable influence on the orbital structure, such that DEA is promoted. We argue that this approach may offer a path for tailoring new and efficient radiosensitizers.