bluuebunny/crossref_metadata_2025 huggingface dataset:
Polymorphism rs7079 in miR-31/-584 Binding Site in Angiotensinogen Gene Associates with Earlier Onset of Coronary Artery Disease in Central European Population
Authors: Novák Jan , Maceková Soňa , Héžová Renata , Máchal Jan , Zlámal Filip , Hlinomaz Ota , Rezek Michal , Souček Miroslav , Vašků Anna , Slabý Ondřej , Bienertová-Vašků Julie
Published: October 2022

Angiotensinogen (AGT) represents a key component of the renin–angiotensin–aldosterone system (RAAS). Polymorphisms in the 3′ untranslated region (3′UTR) of the AGT gene may alter miRNA binding and cause disbalance in the RAAS. Within this study, we evaluated the possible association of AGT +11525C/A (rs7079) with the clinical characteristics of patients with coronary artery diseases (CAD). Selective coronarography was performed in 652 consecutive CAD patients. Clinical characteristics of the patients, together with peripheral blood samples for DNA isolation, were collected. The genotyping of rs7079 polymorphism was performed with TaqMan® SNP Genotyping Assays. We observed that patients with the CC genotype were referred for coronarography at a younger age compared to those with the AA+CA genotypes (CC vs. AA+CA: 59.1 ± 9.64 vs. 60.91 ± 9.5 (years), p = 0.045). Moreover, according to the logistic regression model, patients with the CC genotype presented more often with restenosis than those with the CA genotype (p = 0.0081). In conclusion, CC homozygotes for rs7079 present with CAD symptoms at a younger age compared with those with the AA+CA genotype, and they are more prone to present with restenosis compared with heterozygotes.
Genome Mining Reveals High Biosynthetic Potential of Biocontrol Agent Bacillus velezensis B.BV10
Authors: Bertê Rosiana , Teixeira Gustavo Manoel , de Oliveira João Paulo , Nicoletto Maria Luiza Abreu , da Silva Daniel Vieira , de Godoy Guilherme Gonçalves , Sanches Danilo Sipoli , de Resende Juliano Tadeu Vilela , Pereira Ulisses de Padua , Nunes da Rocha Ulisses , de Oliveira Admilton Gonçalves
Published: October 2022

The present study demonstrates the biocontrol potential of a plant growth-promoting bacterial strain using three different approaches: (i) an in vitro evaluation of antagonistic activity against important phytopathogenic fungi; (ii) an evaluation under greenhouse conditions with strawberry plants to assess the control of gray mold; and (iii) an in silico whole genome sequence mining to assign genetic features such as gene clusters or isolated genes to the strain activity. The in vitro assay showed that the B.BV10 strain presented antagonistic activity, inhibiting the mycelial growth in all the phytopathogenic fungi evaluated. The application of the Bacillus velezensis strain B.BV10 under greenhouse conditions reduced the presence of Botrytis cinerea and increased the mean fruit biomass. The genome of B.BV10 was estimated at 3,917,533 bp, with a GC content of 46.6% and 4088 coding DNA sequences, and was identified as B. velezensis. Biosynthetic gene clusters related to the synthesis of the molecules with antifungal activity were found in its genome. Genes related to the regulation/formation of biofilms, motility, and the important properties for the rhizospheric colonization were also found in the genome. The current study offers a comprehensive understanding of the genomic architecture and control activity of phytopathogenic fungi by the B. velezensis strain B.BV10 that may substantiate the industrialization of this strain in the future.
Comparing the Accuracy of sUAS Navigation, Image Co-Registration and CNN-Based Damage Detection between Traditional and Repeat Station Imaging
Authors: Loerch Andrew C. , Stow Douglas A. , Coulter Lloyd L. , Nara Atsushi , Frew James
Published: October 2022

The application of ultra-high spatial resolution imagery from small unpiloted aerial systems (sUAS) can provide valuable information about the status of built infrastructure following natural disasters. This study employs three methods for improving the value of sUAS imagery: (1) repeating the positioning of image stations over time using a bi-temporal imaging approach called repeat station imaging (RSI) (compared here against traditional (non-RSI) imaging), (2) co-registration of bi-temporal image pairs, and (3) damage detection using Mask R-CNN, a convolutional neural network (CNN) algorithm applied to co-registered image pairs. Infrastructure features included roads, buildings, and bridges, with simulated cracks representing damage. The accuracies of platform navigation and camera station positioning, image co-registration, and resultant Mask R-CNN damage detection were assessed for image pairs, derived with RSI and non-RSI acquisition. In all cases, the RSI approach yielded the highest accuracies, with repeated sUAS navigation accuracy within 0.16 m mean absolute error (MAE) horizontally and vertically, image co-registration accuracy of 2.2 pixels MAE, and damage detection accuracy of 83.7% mean intersection over union.
Provenance, Age, and Tectonic Settings of Rock Complexes (Transangarian Yenisey Ridge, East Siberia): Geochemical and Geochronological Evidence
Authors: Likhanov Igor I.
Published: October 2022

The tectonic evolution of the Siberian Cratonic margins offers important clues for global paleogeographic reconstructions, particularly with regard to the complex geological history of Central Asia and Precambrian supercontinents Columbia/Nuna and Rodinia and its subsequent breakup with the opening of the Paleo-Asian Ocean. Here, we present an overview of geochemical, petrological, and geochronological data from a suite of various rocks to clarify the age, tectonic settings, and nature of their protolith, with an emphasis on understanding the tectonic history of the Yenisey Ridge fold-and-thrust belt at the western margin of the Siberian Craton. These pre-Grenville, Grenville, and post-Grenville episodes of regional crustal evolution are correlated with the synchronous successions and similar style of rocks along the Arctic margin of Nuna-Columbia and Rodinia and support the possible spatial proximity of Siberia and North Atlantic cratons (Laurentia and Baltica) over a long period ~1.4–0.55 Ga.
Finite Element Simulations of Fluids Leakage through the Faulted Reservoir
Authors: Islam Mohammad Nurul
Published: October 2022

Carbon dioxide (CO2) capture and storage (CCS) in geological formation as a supercritical fluid is a viable option to reduce anthropogenic greenhouse gas emissions. Due to the density difference between CO2 and formation fluid, CO2 shows a buoyant tendency. Thereby, if CO2 migrates towards the fault in a compromised faulted reservoir, it may escape the storage reservoir. Therefore, it is essential to predict fluids leakage through the faulted reservoir into the aquifer, associated pressure development, and fluids properties over time to assess associated risk and quantification of leakage. We present finite element simulations of miscible fluids flow through the faulted reservoir to elucidate this behavior. There are very few attempts to model multicomponent fluids non-isothermal model during phase change including the Equation of State (EoS) which we addressed by coupling the mass balance equation of fluids, the fractional mass transport, and the energy balance equation. To obtain fluids mixture thermo-physical properties, we used the Peng-Robinson EoS. For validation of the coupled formulation, we compared the simulation results with Ketzin Pilot project field monitoring data, which shows good agreement. A faulted reservoir comprised of five layers is used to investigate fluids leakage through a compromised reservoir. These layers are a CO2 storage reservoir, overlain by alternating caprocks and aquifers. We also considered three different CO2 injection rates to study the injection rate effect to assess the pressure buildup during injection process. We present the thermal effect by comparing the isothermal and the non-isothermal conditions. For the latter case, we assumed three different thermal gradients. Additionally, to assess the fault aperture effect, we studied three different apertures. We observed that developed pressure and fluids properties have effects on injection rates, temperature gradient, and fault aperture. Additionally, such responses in the near-field and the far-field from the injection well are critical to assess the risk, which we discussed in this paper.
Management of Anti-Hepatitis C Virus-Antibody-Positive Patients in Non-Hepatology Departments in an Acute Care, General Hospital in Japan
Authors: Kawabata Hideaki , Nakase Kojiro , Yamamoto Tetsuya , Satake Hiroaki , Yamaguchi Katsutoshi , Okazaki Yuji , Miyata Masatoshi , Motoi Shigehiro
Published: October 2022

In Japanese hospitals, patients undergoing invasive procedures or surgery are screened for anti-HCV antibodies; however, the majority of possible HCV careers are not referred to hepatologists. In addition to the conventional alert email system, a hepatologist extracted monthly lists of anti-HCV-antibody-positive patients who had been tested two months previously and checked medical records to determine whether the doctors who ordered the tests had properly dealt with the positive results. If the doctors had not yet properly followed up, the hepatologist would send emails to both the doctor and a medical clerk to inform them to conduct an HCV-RNA test and to refer HCV-RNA-positive patients to hepatologists. In total, 130 patients managed in the pre-intervention period and 151 patients managed in the post-intervention period were included in this study. The number of anti-HCV-positive patients whose results were not properly handled showed a significant decrease after the introduction of the double alert system (p = 0.034). Among patients undergoing screening anti-HCV antibody testing, a significant number of patients with probable chronic HCV hepatitis were overlooked by the email alert system and their results were not properly handled. The double alert system was useful for reducing the number of positive anti-HCV antibody patients whose results were not properly handled.
Seasonal Mass, Performance under Grazing, and Animal Preference for Irrigated Winter Cereal Forages under Continuous Stocking in a Semiarid, Subtropical Region
Authors: Lauriault Leonard M. , Marsalis Mark A. , Cox Shad H. , Duff Glenn C.
Published: October 2022

Winter annual cereal forages perform well in semiarid, subtropical regions forming, a significant component of livestock operations for autumn through spring stocker cattle (Bos taurus) backgrounding in either grazeout or graze-grain systems; however, little information is available about their relative seasonal productivity and animal preference. Seasonal growth and regrowth under grazing and grazing preference of oat (Avena sativa), rye (Secale cereale), triticale (×Triticosecale rimpaui Wittm.), and wheat (Triticum aestivum) were compared over two years at New Mexico State University’s Rex E. Kirksey Agricultural Science Center at Tucumcari. Seasonlong (Nov–Apr) average forage dry matter yield was rye > oat > wheat > triticale (5.03, 4.44, 3.58, and 2.79 Mg ha−1, respectively; p < 0.0001). Rye also had greater average monthly growth than the other cereals, among which there was no difference (1.58, 1.05, 0.96, and 0.85 Mg ha−1 mo−1 for rye, oat, wheat, and triticale, respectively; p < 0.0331). Growth of ungrazed cereals was reduced in mid-winter and regrowth of grazed forage did not equal removal by growing cattle. When given a preference and allowed to deplete available forage, growing cattle preferred oat followed by rye, then wheat and triticale. Regrowth of grazed forage did not differ among cereals.
Authenticity and Atwood’s ‘Scientific Turn’
Authors: Chilton Myles
Published: October 2022

Margaret Atwood’s science/speculative dystopian MaddAddam trilogy—Oryx and Crake (2003), The Year of the Flood (2009), and MaddAddam (2013)—opens up questions about how genre-mixing indexes and probes interrelated notions of authenticity. This focus is prompted by the simple question of why Atwood, having established worldwide renown for realist novels of socio-historical authenticity, switched to blending realism with science/speculative fiction. Through analyzing how the trilogy departs from realism, while never truly embracing SF, the paper argues that while the realist novel may offer the strongest representations of authentic psychological states, larger questions of epistemic authority and the state of our world demand a literature that authenticates knowledge. The MaddAddam trilogy challenges the notion that realism’s social, existential and moral concerns are more authentic when supported with a scientific explanatory logic. Authenticity is thus found in a negotiation between Truth and whether to trust in the locations (social and geographical, literary and literal) of knowledge.
“Freedom and Dignity Are Worth More than Life”: The Dramatic Suicide of an Anti-Vax Man
Authors: Sablone Sara , Spagnolo Lorenzo , Macorano Enrica , Ciavarella Mauro Claudio , Pascale Natascha , Strisciullo Giuseppe , Introna Francesco , Di Fazio Aldo
Published: October 2022

Since the beginning of the COVID-19 public health emergency, we have witnessed an increase in psychiatric problems and pathologies, such as depression, anxiety, isolation, posttraumatic stress disorder, substance abuse, and burnout. The world’s collective sentiment finally turned toward optimism after authorization was granted for the COVID-19 vaccines’ emergency use by the FDA in December 2020. With the increase in vaccine coverage in Western countries, case counts and deaths gradually plummeted while activity restrictions were progressively lifted. At the same time, however, a new COVID-19-related public health issue has arisen, as a substantial number of eligible individuals refused vaccination. Behaviors assumed by the so-called anti-vax people in manifesting their own opposition towards COVID-19 vaccination are various, and sometimes assume the forms of dramatic gestures with symbolic value, such as suicide. Here, we present the case of a healthy, convinced anti-vax, 58-year-old man, who allowed himself to be run over by a moving train in the presence of eyewitnesses, bringing with him a demonstrative note of his reasons. The present article aims to raise awareness against the social and psychological impact of COVID-19 vaccination refusal and to point out the need of a specific support net to avoid the spread of psychological impairment, social isolation and suicidal behaviors among the “anti-vax community”.
Effect of Method of Removing Caries-Affected Dentin on the Bond Strength of Composite Resin to Root Canal Dentin
Authors: Otake Shiho , Oishi Shinya , Ozaki Taisuke , Ikeda Masaomi , Komada Wataru
Published: October 2022

The adhesion of composite resin to caries-affected dentin differs from the adhesion of resin to sound dentin. We evaluated the bond strengths of dual-cure resin composites applied to caries-affected root canal dentin under various clinical conditions and using several caries removal indicators. In the dye stain 1 group, caries were removed to a pale pink stain level using a caries detector. In the dye stain 2 group, caries were removed to a stain-free level using a caries detector. In the probing group, caries were removed to the level of hardness based on probing with a sharp explorer. Additionally, a sound dentin group was used as a control. We compared the resin composite microtensile bond strengths and failure mode distribution among the groups. The bond strengths (MPa) of the probing (64.6 ± 11.9) and the sound dentin (68.7 ± 11.1) groups were significantly higher than those of the dye stain 1 (46.9 ± 7.9) and 2 (47.5 ± 8.4) groups (p < 0.05). The removal of caries-affected dentin using a dentin-hardness-based technique showed higher tensile strength than that using a dye stain technique involving removal to any color level. Thus, the caries removal technique used on root canal dentin affects the bond strength of the resin composite.
Real-World Outcomes of Systemic Therapy in Japanese Patients with Cancer (Tokushukai REAl-World Data Project: TREAD): Study Protocol for a Nationwide Cohort Study
Authors: Shimoyama Rai , Imamura Yoshinori , Uryu Kiyoaki , Mase Takahiro , Fujimura Yoshiaki , Hayashi Maki , Ohtaki Megu , Ohtani Keiko , Shinozaki Nobuaki , Minami Hironobu
Published: October 2022

Cohort studies using large-scale databases have become increasingly important in recent years. The Tokushukai Medical Group is a leading medical group in Japan that includes 71 general hospitals nationwide from Hokkaido to Okinawa, with a total of 18,000 beds, and a unified electronic medical record system. This retrospective cohort study aims to evaluate the real-world outcomes of systemic therapy for Japanese patients with cancer using this merit of scale. All adult patients with cancer who received systemic therapy using a centrally registered chemotherapy protocol system at 46 hospitals from April 2010 to March 2020 will be identified (~48,850 patients). Key exclusion criteria include active double cancer and inadequate data extraction. Data will be obtained through electronic medical records, diagnosis procedure combination data, medical prescription data, and the national cancer registration system that includes sociodemographic variables, diagnostic and laboratory tests, concomitant drug prescriptions, cost, and overall survival. Kaplan–Meier estimates will be calculated for time-to-event analyses. Stratified/conventional Cox proportional hazards regression analyses will be conducted to examine the relationships between overall survival and related factors. Our findings provide important insights for future research directions, policy initiatives, medical guidelines, and clinical decision-making.
Unmet Care Needs and Uncertainty in Patients Newly Diagnosed with Breast Cancer
Authors: Chen Li-Wei , Chou Hsu-Huan , Wang Shih-Yung , Shih Whei-Mei
Published: October 2022

Breast cancer is the most common cancer in women in the world. Statistics revealed the number of breast cancer patients less than 40 years of age increased over time. Clinical studies found there is a trend of yearly illness happening in younger patients, whose needs related to the illness are different from older patients. The purpose of this study was to explore the uncertainty and needs of patients in different age groups who were newly diagnosed with breast cancer. A descriptive cross-sectional survey study was adopted to recruit 128 patients. The Mishel’s Uncertainty in Illness Scale (MUIS, Chinese version) and the Cancer Needs Questionnaire (short-form, CNQ-SF) were used to collect data. The results revealed that a patient’s age and religion negatively correlated with illness uncertainty. A patient’s age, educational level, work or not, and children’s age correlated with needs for care. Age, illness uncertainty, and educational level were important predictors of the needs of care, with an explanatory power of 29.0%. In Conclusion, patients ≤40 years of age had greater illness uncertainty and needs for care than those who were >40 years of age. For younger patients newly diagnosed with cancer, medical professionals should take the initiative to provide detailed and complete information on breast cancer treatment plans, prognosis, and home self-care, which helps clarify the possible future treatments and results and further enables patients to acquire self-care skills and knowledge.
Deep Learning Chest CT for Clinically Precise Prediction of Sepsis-Induced Acute Respiratory Distress Syndrome: A Protocol for an Observational Ambispective Cohort Study
Authors: Li Han , Gu Yang , Liu Xun , Yi Xiaoling , Li Ziying , Yu Yunfang , Yu Tao , Li Li
Published: October 2022

Background: Sepsis commonly causes acute respiratory distress syndrome (ARDS), and ARDS contributes to poor prognosis in sepsis patients. Early prediction of ARDS for sepsis patients remains a clinical challenge. This study aims to develop and validate chest computed tomography (CT) radiomic-based signatures for early prediction of ARDS and assessment of individual severity in sepsis patients. Methods: In this ambispective observational cohort study, a deep learning model, a sepsis-induced acute respiratory distress syndrome (SI-ARDS) prediction neural network, will be developed to extract radiomics features of chest CT from sepsis patients. The datasets will be collected from these retrospective and prospective cohorts, including 400 patients diagnosed with sepsis-3 definition during a period from 1 May 2015 to 30 May 2022. 160 patients of the retrospective cohort will be selected as a discovering group to reconstruct the model and 40 patients of the retrospective cohort will be selected as a testing group for internal validation. Additionally, 200 patients of the prospective cohort from two hospitals will be selected as a validating group for external validation. Data pertaining to chest CT, clinical information, immune-associated inflammatory indicators and follow-up will be collected. The primary outcome is to develop and validate the model, predicting in-hospital incidence of SI-ARDS. Finally, model performance will be evaluated using the area under the curve (AUC) of receiver operating characteristic (ROC), sensitivity and specificity, using internal and external validations. Discussion: Present studies reveal that early identification and classification of the SI-ARDS is essential to improve prognosis and disease management. Chest CT has been sought as a useful diagnostic tool to identify ARDS. However, when characteristic imaging findings were clearly presented, delays in diagnosis and treatment were impossible to avoid. In this ambispective cohort study, we hope to develop a novel model incorporating radiomic signatures and clinical signatures to provide an easy-to-use and individualized prediction of SI-ARDS occurrence and severe degree in patients at early stage.
Is There a Relationship between Hyperventilation Syndrome and History of Acute SARS-CoV-2 Infection? A Cross-Sectional Study
Authors: Allado Edem , Poussel Mathias , Hamroun Aghiles , Moussu Anthony , Kneizeh Ghias , Hily Oriane , Temperelli Margaux , Corradi Christophe , Koch Alexandre , Albuisson Eliane , Chenuel Bruno
Published: October 2022

Following COVID-19 infection, many patients suffer from long-lasting symptoms that may greatly impair their quality of life. Persisting dyspnea and other functional respiratory complaints can evoke hyperventilation syndrome (HVS) as a putative contributor to long-COVID presentation in COVID-19 survivors. We aimed to assess the possible relationship between HVS and previous acute COVID-19 infection. We designed a cross-sectional, single-center study, including all patients consecutively referred to our Lung Function and Exercise Testing Department between January and June 2021. Participants completed a systematic Nijmegen Questionnaire, a modified Medical Research Council dyspnea scale assessment, a post-COVID screening questionnaire, and performed a standardized lung function test. The population was divided according to HVS diagnosis, defined as a Nijmegen score of > 23/64. The occurrence of previous COVID-19 infection was compared according to the Nijmegen score after adjustment for potential confounders by multivariate logistic regression. In total, 2846 patients were included: 1472 men (51.7%) with a mean age of 56 (±16.6) years. A total of 455 patients (16%) declared a previous SARS-CoV-2 infection, and 590 patients presented a positive score (>23/64) in the Nijmegen Questionnaire (20.7%). Compared with COVID-19-free patients, there was an increased occurrence of HVS+ in cases of COVID-19 infection that did not require hospitalization (aOR = 1.93 [1.17–3.18]). The results of this large-scale, cross-sectional study suggest an association between HVS diagnosis and a history of COVID-19 disease in patients who were not hospitalized.
Heterogeneity in Response to MCT and Psychoeducation: A Feasibility Study Using Latent Class Mixed Models in First-Episode Psychosis
Authors: Ferrer-Quintero Marta , Fernández Daniel , López-Carrilero Raquel , Díaz-Cutraro Luciana , Verdaguer-Rodríguez Marina , García-Mieres Helena , Huerta-Ramos Elena , Gómez-Benito Juana , Peláez Trini , Birulés Irene , Barajas Ana , Pousa Esther , Barrigón Marisa , Gutiérrez-Zotes Alfonso , Grasa Eva , Ruiz-Delgado Isabel , Lorente-Rovira Esther , Cid Jordi ,   on behalf of the Spanish Metacognition Study Group, Ochoa Susana
Published: October 2022

Metacognitive training (MCT) is an effective treatment for psychosis. Longitudinal trajectories of treatment response are unknown but could point to strategies to maximize treatment efficacy during the first episodes. This work aims to explore the possible benefit of using latent class mixed models (LCMMs) to understand how treatment response differs between metacognitive training and psychoeducation. We conducted LCMMs in 28 patients that received MCT and 34 patients that received psychoeducation. We found that MCT is effective in improving cognitive insight in all patients but that these effects wane at follow-up. In contrast, psychoeducation does not improve cognitive insight, and may increase self-certainty in a group of patients. These results suggest that LCMMs are valuable tools that can aid in treatment prescription and in predicting response to specific treatments.
Viral Response among Early Treated HIV Perinatally Infected Infants: Description of a Cohort in Southern Mozambique
Authors: Lain Maria Grazia , Vaz Paula , Sanna Marco , Ismael Nalia , Chicumbe Sérgio , Simione Teresa Beatriz , Cantarutti Anna , Porcu Gloria , Rinaldi Stefano , de Armas Lesley , Dinh Vinh , Pallikkuth Suresh , Pahwa Rajendra , Palma Paolo , Cotugno Nicola , Pahwa Savita
Published: October 2022

Early initiation of antiretroviral therapy and adherence to achieve viral load suppression (VLS) are crucial for reducing morbidity and mortality of perinatally HIV-infected infants. In this descriptive cohort study of 39 HIV perinatally infected infants, who started treatment at one month of life in Mozambique, we aimed to describe the viral response over 2 years of follow up. VLS ≤ 400 copies/mL, sustained VLS and viral rebound were described using a Kaplan–Meier estimator. Antiretroviral drug transmitted resistance was assessed for a sub-group of non-VLS infants. In total, 61% of infants reached VLS, and 50% had a rebound. Cumulative probability of VLS was 36%, 51%, and 69% at 6, 12 and 24 months of treatment, respectively. The median duration of VLS was 7.4 months (IQR 12.6) and the cumulative probability of rebound at 6 months was 30%. Two infants had resistance biomarkers to drugs included in their treatment regimen. Our findings point to a low rate of VLS and high rate of viral rebound. More frequent viral response monitoring is advisable to identify infants with rebound and offer timely adherence support. It is urgent to tailor the psychosocial support model of care to this specific age group and offer differentiated service delivery to mother–baby pairs.
The Relationship between Psychological Disability and Religious Practice and Coping Strategies in Caregivers of Children with Traumatic Brain Injury in Pakistani Population
Authors: Ayesha  , Ahmad Saboor , Saba Shazadi , Kashif Muhammad , Khan Danish Ali , Haque Absarul , Naseer Muhammad Imran , Abuzenadah Adel M , Hashem Anwar M. , Rehman Shafiq Ur
Published: October 2022

Background: Traumatic brain injury (TBI) is a serious issue and a leading cause of death and disability worldwide. Caregivers of TBI patients experience psychological distress and a variety of social and financial issues. The present study aims to investigate the caregiver’s burden and the factors that influence this burden. Furthermore, the present study will find out the association of religious practice, religious coping relations and psychological distress among caregivers of children affected with TBI. Methods: A cross-sectional survey was conducted on 302 caregivers of children with TBI using Duke University Religion Index (DURL) for religious practice. General Health Questionaire-12 (GHQ-12) was used for anxiety and depression and Brief Religious Coping Scale (RCOPE) was used for coping strategies. The caregivers were conveniently chosen from different regions of Khyber Pakhtunkhwa province and data was collected from different tertiary care hospitals in Peshawar. Results: Forty-nine (49) % of caregivers score ≥ 3 on GHQ suffer from psychological distress with a Mean of 20.957 ± 4.175). Positive coping methods were mostly used by caregivers than negative coping have a low level of distress with a Mean Positive Coping (P-COPE ) of 6.93 ± 0.41, Mean of Negative Coping (N-COPE) 0.486 ± 1.023. In religious practice, caregivers mostly participate in Organized Reliogious Activities (ORA) or some Non-Organized Reliogious Activities (NORA) with a Mean ORA of 4.20 ± 1.27, and NORA Mean of 4.17 ± 1.37 used by the caregivers. Coping methods were related to Caregiver psychological distress (GHQ-12 and P-COPE co-relation scores are (ρ −0.022, p b 0.05); GHQ-12 scores and N-COPE (ρ + 0.221=, p b 0.001). There is a negative correlation between GHQ 12 and PCOPE, while GHQ12 is positively correlated with NCOPE. Conclusion: According to this study, there is a significant association between religious coping methods, religious practice, and psychological distress among caregivers of children with traumatic brain injury.
The Implementation of a Geriatrics Co-Management Model of Care Reduces Hospital Length of Stay
Authors: Leite Homero Teixeira , Manhães Alex C. , Antunes Luisa A. , Chan Tevy , Hajj-Boutros Guy , Morais José A.
Published: October 2022

(1) Background: Older adults comprise a large proportion of hospitalized patients. Many are frail and require complex care. Geriatrics has developed models of care specific to this inpatient population. Our objective was to demonstrate the effect of a geriatric co-management team on clinical administrative indicators of care in Clinical Teaching Units (CTUs) that have adopted the Age-friendly Hospital (AFH) principles in Brazilian hospitals. (2) Methods: Following 3 months of implementation of the AFH principles in CTUs, two periods of the same 6 months of two consecutive years were compared. (3) Results: The total number of participants in the study was 641 and 743 in 2015 and 2016, respectively. Average length of patient-stay (length of stay: 8.7 ± 2.7 vs. 5.4 ± 1.7 days) and number of monthly complaints (44.2 ± 6.5 vs. 13.5 ± 2.2) were significantly lower with the co-management model. Number of homecare service referrals/month was also significantly higher (2.5 ± 1 vs. 38.3 ± 6.3). The 30-day readmission rates and total hospital costs per patient remained unchanged. (4) Conclusion: The presence of a geriatric co-management team in CTUs is of added benefit to increase the efficiency of the AFH for vulnerable older inpatients with reduced LOS and increased referrals to homecare services without increasing hospital costs.
National Survey on Silver Diamine Fluoride (SDF) Awareness, Knowledge, Attitude, and Use among General Dental Practitioners in the Kingdom of Saudi Arabia—An Exploratory Survey
Authors: Robaian Ali , Mirza Mubashir Baig , Alayad Abdullah , Almutairi Malak , Alotaibi Ashjan , Alroqi Alanoud
Published: October 2022

Silver diamine fluoride (SDF) has been accepted as an appropriate alternative for caries management. However, knowledge and utilization of SDF among dentists vary considerably. The authors in the present study aimed to assess the awareness, knowledge, attitudes, and use of SDF among general dentists (GD) in Saudi Arabia and to correlate the differences based on the different regions and experience levels of the dentists. In this regard, a cross-sectional web-based questionnaire was conducted, and a response was received from 311 GDs from different parts of the country. Information regarding demographic data, knowledge, attitudes, use, and barriers to SDF in dentists’ professional lives were elicited. The mean age of the participants (55.3%) was between 25–35 years. Most (92.45%) of the dentists were aware of the material and (61%) agreed that SDF could arrest carious lesions. More than half of the dentists agreed/strongly agreed that SDF was a good treatment alternative for restorations in children with behavioral issues (63.1%), medically fragile patients (53.7%), patients with severe anxiety (64.5%), patients who underwent radiation or chemotherapy (47.3%), and patients needing general anesthesia for dental treatment (74%). Comparative evaluation using ANOVA revealed regional differences based on knowledge, attitudes, and use. Tukey HSD further highlighted that the practitioners in the western region are more knowledgeable regarding its benefits and utilize it more frequently in their practice compared to other regions. On the other hand, the experience level of the GDs did not have any impact on their knowledge, attitudes, and use of SDF.
Experiences and Perceived Barriers of Asylum Seekers and People with Refugee Backgrounds in Accessing Healthcare Services in Romania
Authors: Dumitrache Liliana , Nae Mariana , Mareci Alina , Tudoricu Anca , Cioclu Alexandra , Velicu Alexandra
Published: October 2022

Traditionally a country of emigration, Romania recently experienced an increased migration influx, although it is more a country of transit than a destination for refugees and irregular migrants. Refugees often face difficulties when trying to meet their needs and access essential services. This study aims to explore the experiences and barriers of asylum seekers and people with refugee backgrounds in accessing healthcare services in Romania. It is an exploratory study with a qualitative research design, which uses an inductive and deductive approach, with thematic analysis being applied in order to grasp the difficulties and barriers that asylum seekers and people with refugee backgrounds experience in accessing essential social services. The research was based on seven in-depth interviews with representatives of significant national or international non-governmental organisations assisting refugees and asylum seekers in Romania and 129 semi-structured interviews with different categories of people with refugee backgrounds from Southwest Asia, Eastern Africa and Ukraine. One of the most salient themes we identified relates to accessing the healthcare system. Participants talked about what information they needed to access medical services, where they looked for this information, and what barriers they faced in the process. Cultural, linguistic, structural, and financial barriers were perceived as the most significant. Improved public awareness, a better understanding of asylum issues, and stronger community support are essential to addressing inequalities experienced by this vulnerable population.
AI-Supported Comprehensive Detection and Quantification of Biomarkers of Subclinical Widespread Diseases at Chest CT for Preventive Medicine
Authors: Palm Viktoria , Norajitra Tobias , von Stackelberg Oyunbileg , Heussel Claus P. , Skornitzke Stephan , Weinheimer Oliver , Kopytova Taisiya , Klein Andre , Almeida Silvia D. , Baumgartner Michael , Bounias Dimitrios , Scherer Jonas , Kades Klaus , Gao Hanno , Jäger Paul , Nolden Marco , Tong Elizabeth , Eckl Kira , Nattenmüller Johanna , Nonnenmacher Tobias , Naas Omar , Reuter Julia , Bischoff Arved , Kroschke Jonas , Rengier Fabian , Schlamp Kai , Debic Manuel , Kauczor Hans-Ulrich , Maier-Hein Klaus , Wielpütz Mark O.
Published: October 2022

Automated image analysis plays an increasing role in radiology in detecting and quantifying image features outside of the perception of human eyes. Common AI-based approaches address a single medical problem, although patients often present with multiple interacting, frequently subclinical medical conditions. A holistic imaging diagnostics tool based on artificial intelligence (AI) has the potential of providing an overview of multi-system comorbidities within a single workflow. An interdisciplinary, multicentric team of medical experts and computer scientists designed a pipeline, comprising AI-based tools for the automated detection, quantification and characterization of the most common pulmonary, metabolic, cardiovascular and musculoskeletal comorbidities in chest computed tomography (CT). To provide a comprehensive evaluation of each patient, a multidimensional workflow was established with algorithms operating synchronously on a decentralized Joined Imaging Platform (JIP). The results of each patient are transferred to a dedicated database and summarized as a structured report with reference to available reference values and annotated sample images of detected pathologies. Hence, this tool allows for the comprehensive, large-scale analysis of imaging-biomarkers of comorbidities in chest CT, first in science and then in clinical routine. Moreover, this tool accommodates the quantitative analysis and classification of each pathology, providing integral diagnostic and prognostic value, and subsequently leading to improved preventive patient care and further possibilities for future studies.
Impact of the Implementation of Laboratory Information System (WWDISA) on Timely Provision of HIV-1 Viral Load Results in a Rural Area, Inhambane, Mozambique
Authors: Anapakala Elda Muianga , Chongo Patrina , Barca Isis da , Dimas Tomás , Sitoe Nadia , Sebastião Ruben , Chongola Francelino , Pinto Isabel , Loquiha Osvaldo , Kidane Solon , Jani Ilesh , Viegas Sofia
Published: October 2022

WWDISA is an optional module of the DISA Laboratory Information system (LIS) that offers a web portal that allows access to test results over the internet for patient clinical management. This study aims to assess the applicability of using the WWDISA web application, and the lessons learned from its implementation in six health facilities in Mabote district, Inhambane province. Data from 2463 and 665 samples for HIV-viral load (HIVVL) tests, extracted from paper-based and WWDISA systems, respectively, were included, from January to December 2020. Data were simultaneously collected on a quarterly basis from both systems to allow comparison. The WWDISA turnaround time (TAT) from sample collection to results becoming available was found to be 10 (IQR: 8–12) days and significantly lower than the health unit manual logbook (p value < 0.001). Regarding the system efficiency, it was found that among 1978 search results, only 642 (32.5%) were found, and the main challenges according to the users were lack of connectivity (77%) and the website going down (62%). The WWDISA module has been shown to be effective in reducing the TAT, although a stable internet connection and accurate data entry are essential to make the system functional.
Registered Nurses’ Views and Experiences of Delivering Care in War and Conflict Areas: A Systematic Review
Authors: Sadhaan Abdullah , Brown Michael , McLaughlin Derek
Published: October 2022

Background: Several studies have been undertaken regarding civilian and military nurses’ training, deployment, and experiences during missions in war and conflict areas. However, no review study regarding the experiences of nurses in serving in war and conflict areas has been published. Aim: This review aims to identify the views, experiences, and support needs of Registered Nurses when caring for patients in war and conflict areas. Method: Four electronic databases—MEDLINE, CINAHL, PsycINFO, and general BC PubMed—were searched in this systematic review. Study screening and selection, data extraction, quality appraisal, and narrative synthesis were conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 checklist. Results: Twenty-five studies were included in the final review. The findings were categorised based on four main themes: Challenges in nursing practice, Meaning of experience, Scope of practice, and Nursing support pre- and post-conflict. Conclusions: Registered Nurses play a critical role in prehospital care and have a significant impact on the survival of wounded military personnel and civilians and on their mortality. Registered Nurses play important roles in military deployment, with barriers to their successful implementation experienced due to a lack of information at the decision-making level, and the need for psychological supports and role-appropriate medical readiness training. Implications: Registered Nurses who are military-ready need to be effective in war and conflict areas. Using the experiences of military or civilian Registered Nurses to assess the pre-deployment preparation needs of these nurses will be beneficial to the effectiveness of the nursing workforce. There are elements that demand more attention during the pre-deployment preparation phase of nurses required to serve in war and conflict areas.
Exploring Addictive Online Behaviors in Patients with Narcolepsy Type 1
Authors: Varallo Giorgia , Musetti Alessandro , D’Anselmo Anita , Gori Alessio , Giusti Emanuele Maria , Pizza Fabio , Castelnuovo Gianluca , Plazzi Giuseppe , Franceschini Christian
Published: October 2022

Background: Narcolepsy type 1 (NT1) is a rare neurological sleep disorder caused by the loss of neurons that produce hypocretin—a peptide that plays a crucial role in addictive behaviors. We aimed to compare, for the first time, levels of problematic online gaming, problematic social media use, and compulsive Internet use between NT1 patients and healthy controls (HC), and to evaluate the association between anxiety, depression, and emotion dysregulation with addictive online behaviors in NT1 patients. Methods: A total of 43 patients with NT1 and 86 sex- and age-matched HC participated in an online cross-sectional survey. Results: NT1 patients did not differ from HC in terms of problematic social media use and compulsive Internet use but displayed higher levels of problematic online gaming compared to HC. Higher levels of emotion dysregulation were significantly associated with higher levels of problematic social media use and compulsive Internet use, while none of the tested factors were associated with problematic online gaming. Conclusion: NT1 patients and HC had similar levels of problematic social media use and compulsive Internet use, but NT1 patients showed higher levels of problematic online gaming. Emotion dysregulation might be an intervention target for reducing compulsive Internet use and problematic social media use.
Somatic, Emotional and Behavioral Symptomatology in Children during COVID-19 Pandemic: The Role of Children’s and Parents’ Alexithymia
Authors: Renzi Alessia , Conte Giulia , Tambelli Renata
Published: October 2022

The COVID-19 pandemic has deeply affected the psychophysical wellbeing of children worldwide. Alexithymia, a personality trait involving difficulties in identifying and expressing feelings represents a vulnerability factor for stress-related disorders. Under pandemic stress exposure, we aimed to investigate the role of parents’ and children’s alexithymia in the psychophysical symptomatology shown by children and to evaluate possible differences according to age, gender and history of COVID-19 infections. The perception of parents and children about the impact of the pandemic on children’s emotional, social and physiological wellbeing was also explored. Sixty-five familial triads were surveyed in the period from March to May 2022: children (n = 33 males; mean age = 9.53, sd = 1.55), mothers (mean age = 44.12; sd = 6.10) and fathers (mean age = 47.10; sd = 7.8). Both parental and children’s alexithymia scores were significantly associated with somatic and externalizing symptomatology in children. Self-reported anger and externally oriented thinking scores were higher in younger children (age 8–9.9 years) than in older ones (10–12 years). Girls scored higher than boys in somatic complaints, as reported by parents. No difference emerged between children affected/not affected by COVID-19. Notably, children reported a greater negative impact of the pandemic on their emotional and psychosocial well-being than their parents. The findings emphasize the role of alexithymia in the occurrence of psychophysical symptoms in children during the COVID-19 pandemic. The reduced parental awareness of the emotional burden imposed by the pandemic on children indicates the need to better consider how epidemics affect children’s mental health and to develop adequate preventive strategies to support them in these exceptional times.
Comparative Analysis of Quality of Life of Patients with Dermatological Problems: Teledermatology Versus Face-to-Face Dermatology
Authors: Lopez-Liria Remedios , Lopez-Villegas Antonio , Valverde-Martinez Maria Angeles , Perez-Heredia Mercedes , Vega-Ramirez Francisco Antonio , Peiro Salvador , Leal-Costa Cesar
Published: October 2022

The health-related quality of life (HRQoL) of the patients cared for with teledermatology (TD) services was analyzed as compared with face-to-face dermatology (F-F/D) at the hospital. This study was a controlled, non-blinded, intra-level, and multicenter randomized clinical trial, with a 6-month follow-up. A total of 450 patients were randomly assigned to two different groups. The Spanish version of the generic EuroQol-5-dimensions-5-Levels (EQ-5D-5L) questionnaire and the specific Skindex-29 questionnaire were used at 0 and 6 months. The number of primary care visits (2.24 TD; 1.68 F-F/D) and number of hospital visits (0.01 TD; 1.48 F-F/D) were statistically significant. It was observed that from month 0 onwards, the users included in the F-F/D group self-perceived a lower HRQoL than the users included in the TD group (Skindex-29 total: p ≤ 0.00; EQ-5D-5L VAS = p ≤ 0.00; EQ-5D-5L utilities = p ≤ 0.00). At the end of the study, the patients included in the F-F/D group still obtained lower scores in their perception of HRQoL, as compared to those included in the other type of follow-up (Skindex-29 total: p ≤ 0.00; EQ-5D-5L VAS = p ≤ 0.00; EQ-5D-5L utilities = p ≤ 0.00). TD was an effective diagnosis and follow-up tool. At the end of the study period, the HRQoL of the patients in both groups was significantly higher as compared to their baseline levels. Additionally, both the general and specific HRQoL perceived by the TD patients was higher than the F-F/D group from the start of the study.
Comprehensive Assessment of the Universal Healthcare System in Dentistry Japan: A Retrospective Observational Study
Authors: Ni Shy Chwen , Thomas Carlos , Yonezawa Yu , Hojo Yasushi , Nakamura Takehiko , Kobayashi Kenichiro , Sato Hiroki , Da Silva John D. , Kobayashi Takuya , Ishikawa-Nagai Shigemi
Published: October 2022

Japan’s universal healthcare insurance is facing economic challenges due to the advanced aging society, however, objective data of dental expenditure has never been introduced. This study aimed to identify the associated factors with dental expenditures using government-provided digitized insurance claims data and calculated the spending in the context of dental cost per person (DCPP). Seven associated factors analyzed were age, demographic, geographic, socioeconomic, regional wealth, the impact of the 8020-national campaign implementation (keep 20 teeth at age 80), and the effect of the home-visit dentistry for the elders. The average DCPP was high in older populations (75+) in all prefectures. The prefectures with the highest and lowest DCPP were significant compared to other states and retained their respective places in the cost hierarchy over the four years. The prefectures with more citizens participating in government assistance programs (GAP) had greater DCPPs. Dental costs were significantly related to geographic regions, age, per capita income, government assistance program prevalence, office complete denture frequency, and home visit care per patient. With a growing aging population, dental care costs will continue to increase, burdening its fiscal future. Associated factors identified should be considered to control the contentious increase of healthcare cost.