bluuebunny/crossref_metadata_2025 huggingface dataset:
Nicotine Exposure in the U.S. Population: Total Urinary Nicotine Biomarkers in NHANES 2015–2016
Authors: Mazumder Shrila , Shia Winnie , Bendik Patrick B. , Achilihu Honest , Sosnoff Connie S. , Alexander Joseph R. , Luo Zuzheng , Zhu Wanzhe , Pine Brittany N. , Feng June , Blount Benjamin C. , Wang Lanqing
Published: March 2022

We characterize nicotine exposure in the U.S. population by measuring urinary nicotine and its major (cotinine, trans-3′-hydroxycotinine) and minor (nicotine 1′-oxide, cotinine N-oxide, and 1-(3-pyridyl)-1-butanol-4-carboxylic acid, nornicotine) metabolites in participants from the 2015–2016 National Health and Nutrition Examination Survey. This is one of the first U.S. population-based urinary nicotine biomarker reports using the derived total nicotine equivalents (i.e., TNEs) to characterize exposure. Serum cotinine data is used to stratify tobacco non-users with no detectable serum cotinine (−sCOT), non-users with detectable serum cotinine (+sCOT), and individuals who use tobacco (users). The molar concentration sum of cotinine and trans-3′-hydroxycotinine was calculated to derive the TNE2 for non-users. Additionally, for users, the molar concentration sum of nicotine and TNE2 was calculated to derive the TNE3, and the molar concentration sum of the minor metabolites and TNE3 was calculated to derive the TNE7. Sample-weighted summary statistics are reported. We also generated multiple linear regression models to analyze the association between biomarker concentrations and tobacco use status, after adjusting for select demographic factors. We found TNE7 is positively correlated with TNE3 and TNE2 (r = 0.99 and 0.98, respectively), and TNE3 is positively correlated with TNE2 (r = 0.98). The mean TNE2 concentration was elevated for the +sCOT compared with the −sCOT group (0.0143 [0.0120, 0.0172] µmol/g creatinine and 0.00188 [0.00172, 0.00205] µmol/g creatinine, respectively), and highest among users (33.5 [29.6, 37.9] µmol/g creatinine). Non-daily tobacco use was associated with 50% lower TNE7 concentrations (p < 0.0001) compared with daily use. In this report, we show tobacco use frequency and passive exposure to nicotine are important sources of nicotine exposure. Furthermore, this report provides more information on non-users than a serum biomarker report, which underscores the value of urinary nicotine biomarkers in extending the range of trace-level exposures that can be characterized.
Use of Radon and CO2 for the Identification and Analysis of Short-Term Fluctuations in the Ventilation of the Polychrome Room Inside the Altamira Cave
Authors: Sainz Carlos , Fábrega Julia , Rábago Daniel , Celaya Santiago , Fernandez Alicia , Fuente Ismael , Fernandez Enrique , Quindos Jorge , Arteche Jose Luis , Quindos Luis
Published: March 2022

A study is presented on rapid episodes of air exchange in the Polychrome Room of the Altamira Cave (Cantabria, Spain) using continuous monitoring of radon and CO2 tracer gases, as well as environmental parameters such as internal and external air temperature. For this, criteria have been developed to carry out an inventory of these types of events during the 2015–2020 period. Most of the degassing-recharging events occur over several hours or days, especially during spring and autumn. This means that the room can be significantly ventilated during these short periods of time, posing an exchange of energy and matter with potential impact in the preservation of the rock art present inside. In addition, the hypothesis that temperature gradients between the internal and external atmosphere is one of the main factors that induces degassing has been tested. To this end, correlation analysis has been carried out between the different magnitudes involved in this study, such as radon and CO2 concentrations, and air temperature gradients. A total of 37 degassing-recharging events have been analyzed for the 5 year studied period. The distribution of the duration of the events have been described, as well as that of the correlations between the degassing and recharge stages of each event, showing significant values of r coefficients for the correlation with temperature gradients between the internal and external atmosphere.
Physical Activity Patterns among Individuals with Prediabetes or Type 2 Diabetes across Two Years—A Longitudinal Latent Class Analysis
Authors: Rossen Jenny , Hagströmer Maria , Larsson Kristina , Johansson Unn-Britt , von Rosen Philip
Published: March 2022

Background: This study aimed to identify distinct profiles of physical activity (PA) patterns among individuals with prediabetes or type 2 diabetes participating in a two-year PA trial and to investigate predictors of the profiles. Methods: Data (n = 168, collected 2013–2020) from the cohort of a randomized trial aimed at increasing PA in individuals with prediabetes and type 2 diabetes were used. PA and sedentary behaviours were assessed by waist-worn ActiGraph GT1M accelerometers at baseline and at 6, 12, 18 and 24 months. Fifteen PA and sedentary variables were entered into a latent class mixed model for multivariate longitudinal outcomes. Multinominal regression analysis modelled profile membership based on baseline activity level, age, gender, BMI, disease status and group randomisation. Results: Two profiles of PA patterns were identified: “Increased activity” (n = 37, 22%) included participants increasing time in PA and decreasing sedentary time. “No change in activity” (n = 131, 78%) included participants with no or minor changes. “Increased activity” were younger (p = 0.003) and more active at baseline (p = 0.011), compared to “No change in activity”. No other predictor was associated with profile membership. Conclusions: A majority of participants maintained PA and sedentary patterns over two years despite being part of a PA intervention. Individuals improving PA patterns were younger and more active at baseline.
Influence of Carbon Sources on Biomass and Biomolecule Accumulation in Picochlorum sp. Cultured under the Mixotrophic Condition
Authors: Goswami Rahul Kumar , Mehariya Sanjeet , Karthikeyan Obulisamy Parthiba , Verma Pradeep
Published: March 2022

The major downfalls of the microalgal biorefinery are low volume of high value product accumulation, low biomass productivity and high cultivation costs. Here, we aimed to improve the biomass productivity of the industrially relevant Picochlorum sp. BDUG 100241 strain. The growth of Picochlorum sp. BDUG 100241 was investigated under different cultivations conditions, including photoautotrophic (with light), mixotrophic (1% glucose, with light) and heterotrophic (1% glucose, without light). Among them, Picochlorum sp. BDUG100241 showed the highest growth in the mixotrophic condition. Under different (1%) carbon sources’ supplementation, including glucose, sodium acetate, glycerol, citric acid and methanol, Picochlorum sp. BDUG100241 growth was tested. Among them, sodium acetate was found to be most suitable carbon source for Picochlorum sp. BDUG 100241 growth, biomass (1.67 ± 0.18 g/L) and biomolecule productivity. From the different concentrations of sodium acetate (0, 2.5, 5.0, 7.5 and 10 g/L) tested, the maximum biomass production of 2.40 ± 0.20 g/L with the biomass productivity of 95 ± 5.00 mg/L/d was measured from 7.5 g/L in sodium acetate. The highest total lipid (53.50 ± 1.70%) and total carotenoids (0.75 ± 0.01 µg/mL) contents were observed at the concentration of 7.5 g/L and 5.0 g/L of sodium acetate as a carbon source, respectively. In conclusion, the mixotrophic growth condition containing 7.5 g/L of sodium acetate showed the maximum biomass yield and biomolecule accumulation compared to other organic carbon sources.
Digital Health Literacy and Information-Seeking Behavior among University College Students during the COVID-19 Pandemic: A Cross-Sectional Study from Denmark
Authors: Bak Carsten K. , Krammer Jeanne Ø. , Dadaczynski Kevin , Orkan Okan , von Seelen Jesper , Prinds Christina , Søbjerg Lene M. , Klakk Heidi
Published: March 2022

The COVID-19 pandemic and the concomitant infodemic have emphasized the importance of digital health literacy (DHL) to global public health research and practice. The aim of this study was to examine information-seeking behavior, the ability to find, understand and deal with health information among university college students in Denmark and/in addition we wanted to examine the impact of their close social network on students’ ability to find and understand health information. This research was carried out as part of the COVID-HL university student survey by using a uniform questionnaire consisting of elaborated scales. Data were collected from a cross-sectional survey conducted at University College South during 4 weeks in April and May 2020. To capture DHL, four subscales of the DHL instrument were adapted to the pandemic context. A total of 59.9% of the students have sufficient DHL—most students find it rather easy to find information and are satisfied with the information they find on the internet. However, some (28.1%) students find it difficult to judge the quality and reliability of the information. Students with a sufficient level of DHL are more likely to seek information through search engines and websites of official institutions, while students with a limited level of DHL more often use social media for health information. Students with sufficient DHL more often share health information and less often ask for support in their network
The OrBiD (Oral Health, Bite Force and Dementia) Pilot Study: A Study Protocol for New Approaches to Masticatory Muscle Training and Efficient Recruitment for Longitudinal Studies in People with Dementia
Authors: Jockusch Julia , Wiedemeier Daniel , Nitschke Ina
Published: March 2022

Research with people with dementia is a great challenge in terms of recruitment, study participation and adherence to interventions resulting in less research activity and higher financial, organizational and personnel efforts. As dementia progresses, there is a deterioration in general and oral health and chewing function. Oral treatment options often focus on healthy patients. Interventions for people with dementia are needed. The aims of the paper were to describe the study protocol of the OrBiD (Oral Health, Bite Force and Dementia) pilot study as well as the description of two new methodological approaches. These are (A) an efficient recruitment process of people with dementia, simultaneous double study participation and (B) a novel approach to train the masticatory muscles by using physiotherapy. A novel methodology for the recruitment process (A) and, in particular, for the assignment of subjects to the experimental and control groups was developed and successfully tested. Additionally, a physiotherapy program (B) to train strength and coordination of the masticatory muscles was newly developed with the challenge to ensure that this training could also be carried out with people with cognitive impairments and dementia, if necessary, in cooperation with their relatives or caregivers. This was also successfully implemented. Recommendations for a feasibility assessment of a study involving people with dementia were made considering the organizational effort, the required personnel, structural and financial resources, the required number of subjects and the type of study design. When planning crossed studies, it must be ensured that the content, the interventions or their possible results of the study arms do not influence each other. The overall aim of this paper is to demonstrate the sustainable and efficient feasibility of studies with people with dementia.
Work–Family Interaction, Self-Perceived Mental Health and Burnout in Specialized Physicians of Huelva (Spain): A Study Conducted during the SARS-CoV-2 Pandemic
Authors: Gago-Valiente Francisco-Javier , Moreno-Sánchez Emilia , Santiago-Sánchez Alba , Gómez-Asencio David , Merino-Godoy María-de-los-Ángeles , Castillo-Viera Estefanía , Costa Emília Isabel , Segura-Camacho Adrián , Saenz-de-la-Torre Luis-Carlos , Mendoza-Sierra María-Isabel
Published: March 2022

Background: The medical staff who work in specialized healthcare are among the professionals with a greater risk of presenting negative indicators of mental health. These professionals are exposed to numerous sources of stress that can have a negative influence on their personal life. Currently, SARS-CoV-2 poses an additional and relevant source of stress. The aim of this study was to identify the interactions between the work and family environments, as well as to analyze self-perceived mental health and burnout in physicians who, during the COVID-19 pandemic, carried out their jobs in public health in Huelva (Spain), also considering a series of sociodemographic variables. Methods: This is a descriptive, cross-sectional study. Information from 128 participants was collected using the SWING, MBI-HSS and GHQ-12 questionnaires, along with sociodemographic data and possible situations of contact with SARS-CoV-2. The data were analyzed, and correlations were established. Results: Most of the sample obtained a positive interaction result of work over family. Those who had been in contact with SARS-CoV-2 represented higher percentages of a positive result in GHQ-12, negative work–family interaction, burnout, emotional exhaustion and depersonalization. In general, the men showed a worse mental health state than women. Conclusions: The medical staff of Huelva who had been in contact with situations of SARS-CoV-2 in their work environment presented worse indicators of mental health and greater negative interaction of work over family than those who had not been in contact with these situations.
Developmental Disorder Probability Scores at 6–18 Years Old in Relation to In-Utero/Peripartum Antiretroviral Drug Exposure among Ugandan Children
Authors: Awadu Jorem Emmillian , Sikorskii Alla , Zalwango Sarah , Coventry Audrey , Giordani Bruno , Ezeamama Amara E.
Published: March 2022

(1) We examined the hypothesis that in utero/peripartum antiretroviral (IPA) exposure may affect the likelihood of developmental disorders—i.e., attention deficit and hyperactivity disorder (ADHD), autism spectrum disorder (ASD), and functional impairment (FI). (2) Children and their primary caregivers were enrolled and followed for 12 months. The sample included 250 children perinatally HIV-infected (CPHIV), 250 children HIV-exposed and uninfected (CHEU) of women living with HIV, and 250 children HIV unexposed and uninfected (CHUU) at 6–18 years of age. CHEU’s IPA exposure -type was established via medical records and categorized as no IPA, single-dose nevirapine with/without zidovudine (SdNVP ± AZT), SdNVP + AZT + Lamivudine (3TC), or combination ART (cART). Developmental disorders were assessed at months 0, 6, and 12 per caregiver response to standardized questions from the third edition of Behavioral Assessment System for Children. Multivariable repeated measures linear regression models estimated standardized mean differences (SMDs) with 95% confidence intervals (95% CI) according to the IPA exposure type relative to CHUU with adjustment for the dyad’s sociodemographic and psychosocial factors. (3) Relative to the CHUU, outcomes were similar for CPHIV/CHEU with cART, SdNVP ± AZT, and no anti-retroviral drug exposure in the peripartum period. For CHEU relative to CHUU, SdNVP + AZT + 3TC exposure was associated with lower resiliency (SMD = −0.26, 95% CI: −0.49, −0.51), and elevated scores on ADHD (SMD = 0.41, 95% CI: 0.12, 0.70), ASD (SMD = 0.40, 95% CI: 0.19, 0.61), and EBD (SMD = 0.32, 95% CI: 0.08, 0.56) probability and functional impairment (SMD = 0.39, 95% CI: 0.18, 0.61) index scores. With the exception of ADHD, the adverse association between SdNVP + AZT + 3TC and outcomes were replicated for CPHIV vs. CHUU. (4) The results provided reassuring evidence that cART exposure in the peripartum period is unlikely to be adversely associated with developmental disorder probability scores in late childhood and adolescent years. However, the peripartum SdNVP + AZT + 3TC exposure associated elevation in developmental disorder probability and functional limitation at 6–18 years of life is a concern.
Handgrip Strength-Related Factors in a Colombian Hypertensive Population: A Cross-Sectional Study
Authors: Rivas-Campo Yulieth , Muñoz-Laverde Elsa Patricia , Aibar-Almazán Agustín , Jiménez-García José Daniel , Martínez-Amat Antonio , García-Garro Patricia Alexandra , Muñoz-Perete Juan Miguel , Garcia-Sillero Manuel , Castellote-Caballero Yolanda
Published: March 2022

(1) Background: This study determined the factors associated with manual grip strength in people with high blood pressure (HBP); (2) Methods: 219 subjects participated in this cross-sectional study, which evaluated muscle strength (manual dynamometer), sociodemographic factors, clinical characteristics, level of physical activity (International Physical Activity Questionnaire-IPAQ score), and depression (Zung’s Depression Self-Rating Scale); (3) Results: The bivariate analysis found that handgrip strength in people with HPB was associated with sex (p = 0.000), age (p = 0.000), ethnicity (p = 0.019), smoking habits (p = 0.037), alcohol consumption (p = 0.004), diastolic blood pressure (p = 0.012), weight (p = 0.000), height (p = 0.000), measurement of waist circumference (p = 0.002), depression (p = 0.041), and IPAQ score (p = 0.000). Regardless of being male or female, handgrip strength was associated with age (p = 0.009), IPAQ (p = 0.000), weight (p = 0.038), height (p = 0.000), DPB units (p = 0.043), and depression (p = 0.020). The multivariate generalized linear gamma regression model showed that the coefficient with the greatest weight, regardless of sex, was age (p = 0.043), level of physical activity (24% more at high level than at low level, p = 0.031), and depression (moderate/severe depression level) associated with lower handgrip strength (p = 0.025); (4) Conclusions: Handgrip strength showed an association with level of physical activity, age, and level of depression in a middle-aged population with HBP.
Residents’ Support for Tourism Amidst the COVID-19 Era: An Application of Social Amplification of Risk Framework and Knowledge, Attitudes, and Practices Theory
Authors: Shen Ke , Yang Jian
Published: March 2022

Given that the concept of risk perception stems primarily from consumer behaviour, tourism research has tended to address the issue from tourists’ perspective, resulting in a lack of consideration of destination residents’ risk perception and its impact on their attitudes and subsequent behaviour. Based on the social amplification of risk framework (SARF) and the knowledge, attitudes, and practices (KAP) theory, this study constructed a theoretical model to deepen the understanding of destination residents’ support for tourism. Results indicate that residents’ social media use, knowledge of COVID-19 and attitudes to tourism and tourists are all positively related to their support for tourism. Furthermore, residents’ risk perception is negatively associated with their attitudes to tourism, attitudes to tourists and support for tourism. However, the relationship between residents’ social media use and risk perception was not confirmed. Theoretical and managerial implications were discussed.
Evaluation of the Pathogenic-Mixed Biofilm Formation of Pseudomonas aeruginosa/Staphylococcus aureus and Treatment with Limonene on Three Different Materials by a Dynamic Model
Authors: Gambino Edvige , Maione Angela , Guida Marco , Albarano Luisa , Carraturo Federica , Galdiero Emilia , Di Onofrio Valeria
Published: March 2022

Background: Biofilms have been found growing on implantable medical devices. This can lead to persistent clinical infections. The highly antibiotic-resistant property of biofilms necessitates the search for both potent antimicrobial agents and novel antibiofilm strategies. Natural product-based anti-biofilm agents were found to be as efficient as chemically synthesized counterparts with fewer side effects. In the present study, the effects of limonene as an antibiofilm agent were evaluated on Pseudomonas aeruginosa and Staphylococcus aureus biofilm formed on different surfaces using the CDC model system in continuous flow. The flgK gene and the pilA gene expression in P. aeruginosa, and the icaA gene and eno gene in S. aureus, which could be considered as efficient resistance markers, were studied. Methods: Mono- and dual-species biofilms were grown on polycarbonate, polypropylene, and stainless-steel coupons in a CDC biofilm reactor (Biosurface Technologies, Bozeman, MT, USA). To evaluate the ability of limonene to inhibit and eradicate biofilm, a sub-MIC concentration (10 mL/L) was tested. The gene expression of P. aeruginosa and S. aureus was detected by SYBR Green quantitative Real-Time PCR assay (Meridiana Bioline, Brisbane, Australia). Results: The limonene added during the formation of biofilms at sub-MIC concentrations works very well in inhibiting biofilms on all three materials, reducing their growth by about 2 logs. Of the same order of magnitude is the ability of limonene to eradicate both mono- and polymicrobial mature biofilms on all three materials. Greater efficacy was observed in the polymicrobial biofilm on steel coupons. The expression of some genes related to the virulence of the two microorganisms was differently detected in mono- and polymicrobial biofilm. Conclusions: These data showed that the limonene treatment expressed different levels of biofilm-forming genes, especially when both types of strains alone and together grew on different surfaces. Our findings showed that limonene treatment is also very efficient when biofilm has been grown under shear stress causing significant and irreversible damage to the biofilm structure. The effectiveness of the sanitation procedures can be optimized by applying antimicrobial combinations with natural compounds (e.g., limonene).
Molecular Insights on New Psychoactive Substances (NPSs)
Authors: Busardò Francesco , Pichini Simona
Published: March 2022

Currently, more than 1000 molecules have been classified as New Psychoactive Substances (NPSs), and it is reported that, every year, this number increases with new classes of compounds and/or newer generations of NPS families [...]
Recent Progress on the Salt Tolerance Mechanisms and Application of Tamarisk
Authors: Duan Qixin , Zhu Zhihui , Wang Baoshan , Chen Min
Published: March 2022

Salinized soil is a major environmental stress affecting plant growth and development. Excessive salt in the soil inhibits the growth of most plants and even threatens their survival. Halophytes are plants that can grow and develop normally on saline-alkali soil due to salt tolerance mechanisms that emerged during evolution. For this reason, halophytes are used as pioneer plants for improving and utilizing saline land. Tamarisk, a family of woody halophytes, is highly salt tolerant and has high economic value. Understanding the mechanisms of salt tolerance in tamarisk and identifying the key genes involved are important for improving saline land and increasing the salt tolerance of crops. Here, we review recent advances in our understanding of the salt tolerance mechanisms of tamarisk and the economic and medicinal value of this halophyte.
Impact of the Height of Buildings on the Maintainability of Natural Stone Claddings
Authors: Ferreira Cláudia , Silva Ana , de Brito Jorge
Published: March 2022

The buildings’ surroundings’ environmental exposure conditions (e.g., orientation, location, altitude, distance from the sea, temperature, precipitation, presence of damp, exposure to prevailing winds, among others) have a considerable influence on the performance and durability of their envelope. Furthermore, the intensity of these conditions can vary significantly with the height of the building and, consequently, influence the degradation of different parts of the same building in different ways. In a tall building, the upper part is more prone to higher solar radiation levels, temperature variations, and exposure to wind–rain action. On the other hand, external elements at the bottom are more susceptible to high levels of pollution, especially in city centres. In this sense, the main purpose of this study was to analyse the degradation processes in buildings with different heights and understand whether the processes and maintenance requirements are statistically different. A sample of 203 natural stone claddings (NSC), located in Portugal, was used as case study. The sample was collected based on the diagnosis of the degradation condition of these claddings through in situ visual inspections. To predict the degradation process of NSC over time, a stochastic service life prediction model, based on Petri nets (PN), was implemented. This model allows evaluating the performance of NSC by encompassing the uncertainty of the future performance of the claddings. The results obtained through the degradation and maintenance models were compared with real case studies to highlight the real impact of buildings’ height subjected to environmental exposure conditions on the maintainability of NSC.
Patients Hospitalized for Ischemic Stroke and Intracerebral Hemorrhage in France: Time Trends (2008–2019), In-Hospital Outcomes, Age and Sex Differences
Authors: Olié Valérie , Grave Clémence , Tuppin Philippe , Duloquin Gauthier , Béjot Yannick , Gabet Amélie
Published: March 2022

Background: Rates of patients hospitalized for stroke increased among people aged under 65 years in France, as has been found in other countries. Methods: To analyze time trends in the rates of patients hospitalized for ischemic stroke (IS) and intracerebral hemorrhage (ICH) in France between 2008 and 2019 and determine related short-term outcomes mainly, we selected all patients hospitalized for stroke using the French national hospital database. Results: The average annual percentage change in the rates of patients hospitalized for IS increased significantly in men and women aged 50–64 years (+2.0%) and in men aged 18–34 years (+1.5%) and 35–44 years (+2.2%). A decrease in the average annual percentage change was observed for IS among people aged over 75 years and among those over 50 years for ICH. After adjustment on confounding factors, women were less likely to die in hospital. Case fatality rates decreased overtime in all age groups for both sexes, with a more pronounced decrease for IS than ICH. Conclusions: The increasing trend of IS among adults under 65 years is ongoing, highlighting the urgent need for stroke prevention programs in that age. For the first time, we recorded a decrease in the rates of patients hospitalized for ICH among the population over 50 years.
State-of-the-Art Review on Immersive Virtual Reality Interventions for Colonoscopy-Induced Anxiety and Pain
Authors: Găină Marcel-Alexandru , Szalontay Andreea Silvana , Ștefănescu Gabriela , Bălan Gheorghe Gh , Ghiciuc Cristina Mihaela , Boloș Alexandra , Găină Alexandra-Maria , Ștefănescu Cristinel
Published: March 2022

Background: Colonoscopy related fear impairs the current gold standard screening of colorectal cancer. Compared to other minimally invasive procedures for cancer screening, colonoscopy-induced anxiety exceeds the procedure through bowel preparation. Immersive virtual reality’s (iVR) role in alleviating the complex stress–pain relationship encountered during medical procedures is directly proportional to the rising affordability of state-of-the-art Head-Mounted-Displays (HMDs). Objective: to assess the effect of iVR on patients’ colonoscopy-induced anxiety and pain. Materials and methods: A systematic search was conducted in PubMed, Cochrane Central Register of Controlled Trials, Web of Science, Embase and Scopus databases up to January 2022. Clinical trials evaluating anxiety as an outcome were included without language restriction. Results: Four clinical trials were included: three on the patients’ intraprocedural anxiety and one on patient education. Intraprocedural iVR interventions for colonoscopy-induced anxiety and pain revealed a similar effect as conventional sedation, while a statistically significant reduction was reported for non-sedated patients. iVR patient education improved the quality of bowel preparation and reduced patient anxiety before colonoscopy. Conclusions: The current research highlights the need to use high-end HMDs and appropriate interactive iVR software content for colonoscopy-induced anxiety. Methodological frameworks regarding the eligibility of participants, double-blinding and randomization of iVR studies can facilitate the development of iVR implementation for anxiety and pain management.
Patient Visits and Prescribing Patterns Associated with Rosacea in Korea: A Real-World Retrospective Study Based on Electronic Medical Records
Authors: Woo Yu Ri , Ju Hyun Jeong , Bae Jung Min , Cho Minah , Cho Sang Hyun , Kim Hei Sung
Published: March 2022

Rosacea is a common and chronic inflammatory skin disorder. The visiting trends and prescribing patterns involving Korean patients with rosacea have not been thoroughly examined. To examine the visiting trends of patients with rosacea, and to analyze the prescription patterns of Korean dermatologists managing such patients, a retrospective cross-sectional study on dermatology outpatients who visited the seven affiliated hospitals of The Catholic University of Korea between 2007 and 2018 was performed. A total of 56,651 visits were made by rosacea patients. The mean annual number of hospital visits made by rosacea patients over a 6-year period increased from 2456 in 2007–2012 to 6985 in 2013–2018. Hospital visits were most prevalent in female patients aged 40 to 59 years. There was no statistically significant difference in patient visitation between the seasons. As for prescriptions, systemic antibiotics were most commonly prescribed, followed by antihistamines, non-steroidal anti-inflammatory drugs, and retinoids. Among the topical agents, metronidazole was the most prescribed agent during 2007–2012, whereas calcineurin inhibitors were favored most during 2013–2018. Dermatology outpatient visits by individuals with rosacea have increased in Korea over time. The real-world prescription trend presented here may help dermatologists facilitate better treatment strategies and provide appropriate guidance to patients with rosacea.
Influence of Sexual Dimorphism, Aging, and Differential Cell Capture Efficiency of Blood Separation Systems on the Quality of Platelet-Rich Plasma
Authors: Trevissón Bibiana , Becerro-de-Bengoa-Vallejo Ricardo , Sevillano David , González Natalia , Losa-Iglesias Marta Elena , López-López Daniel , Alou Luis
Published: March 2022

Few studies have checked the impact of the hormonal/immunological dimorphism of patients on the cellular composition of platelet-rich plasma products (PRP). Whole blood (WB) from 26 volunteers was concentrated using a device previously characterized. Platelet and white blood cell (WBC) counts in WB and PRP were compared between genders, and after the population was split into pre (≤50 years)- and post (>50 years)-menopausal ages. In WB, platelet–total WBC densities were comparable in men and women. The phagocytic cell composition differed (p ≤ 0.04). After dividing by ages, phagocytic cell discrepancies were linked to women > 50 years (p ≤ 0.05), and differences emerged in lymphocyte counts (lower in >50 years groups, within and between genders, p ≤ 0.05). In PRP, densities were significantly higher, but the PRP/WB ratios varied according to blood cell (lower for phagocytic cells) and between subjects (more favorable at a lower density of a particular blood cell in WB). This “system compensatory efficiency” reduced/reverted PRP differences in the leukocyte composition between genders/age–sex groups in WB. In PRP, neutrophils were higher in younger men than older women (p < 0.05). WB lymphocyte differences between age–sex groups persisted. Age is a more determining factor than sex in the preparation of PRP. Post-menopause, sexual dimorphism strongly influences the composition of leukocytes, also conditioned by the capture efficiency of the system.
Decreased Need for Correction Boluses with Universal Utilisation of Dual-Wave Boluses in Children with Type 1 Diabetes
Authors: Lukka Mari , Tillmann Vallo , Peet Aleksandr
Published: March 2022

Insulin pumps offer standard (SB), square and dual-wave boluses (DWB). Few recommendations exist on how to use these dosing options. Several studies suggest that the DWB is more effective for high-fat or high-carbohydrate meals. Our objective was to test whether time in range (TIR) improves in children with type 1 diabetes (T1D) using the universal utilization of the dual-wave boluses for all evening meals regardless of the composition of the meal. This was a 28-day long prospective randomized open-label single-center crossover study. Twenty-eight children with T1DM using a Medtronic 640G pump and continuous glucose monitoring system were randomly assigned to receive either DWB or SB for all meals starting from 6:00 p.m. based solely on the food carbohydrate count. DWB was set for 50/50% with the second part extended over 2 h. After two weeks patients switched into the alternative treatment arm. TIR (3.9–10 mmol/L), time below range (TBR) (<3.9 mmol/L) and time above range (TAR) (>10 mmol/L) and sensor glucose values were measured and compared between the groups. Twenty-four children aged 7–14 years completed the study according to the study protocol. There were no statistically significant differences in mean TIR (60.9% vs. 58.8%; p = 0.3), TBR (1.6% vs. 1.7%; p = 0.7) or TAR (37.5 vs. 39%; p = 0.5) between DWB and SB groups, respectively. Subjects in the DWB treatment arm administered significantly less correction boluses between 6 p.m. and 6 a.m. compared to those in the SB group (1.2 ± 0.8 vs. 1.7 ± 0.8, respectively; p < 0.01). DWB for evening meals in which insulin is calculated solely on the food carbohydrate content did not improve TIR compared to standard bolus in children with T1D. However, DWB enabled to use significantly less correction boluses to achieve euglycemia by the morning compared to the SB.
Different Methods to Improve the Monitoring of Noninvasive Respiratory Support of Patients with Severe Pneumonia/ARDS Due to COVID-19: An Update
Authors: Pelosi Paolo , Tonelli Roberto , Torregiani Chiara , Baratella Elisa , Confalonieri Marco , Battaglini Denise , Marchioni Alessandro , Confalonieri Paola , Clini Enrico , Salton Francesco , Ruaro Barbara
Published: March 2022

The latest guidelines for the hospital care of patients affected by coronavirus disease 2019 (COVID-19)-related acute respiratory failure have moved towards the widely accepted use of noninvasive respiratory support (NIRS) as opposed to early intubation at the pandemic onset. The establishment of severe COVID-19 pneumonia goes through different pathophysiological phases that partially resemble typical acute respiratory distress syndrome (ARDS) and have been categorized into different clinical–radiological phenotypes. These can variably benefit on the application of external positive end-expiratory pressure (PEEP) during noninvasive mechanical ventilation, mainly due to variable levels of lung recruitment ability and lung compliance during different phases of the disease. A growing body of evidence suggests that intense respiratory effort producing excessive negative pleural pressure swings (Ppl) plays a critical role in the onset and progression of lung and diaphragm damage in patients treated with noninvasive respiratory support. Routine respiratory monitoring is mandatory to avoid the nasty continuation of NIRS in patients who are at higher risk for respiratory deterioration and could benefit from early initiation of invasive mechanical ventilation instead. Here we propose different monitoring methods both in the clinical and experimental settings adapted for this purpose, although further research is required to allow their extensive application in clinical practice. We reviewed the needs and available tools for clinical–physiological monitoring that aims at optimizing the ventilatory management of patients affected by acute respiratory distress syndrome due to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection.
Clinical Characteristics and Multimodal Imaging Findings of Central Serous Chorioretinopathy in Women versus Men
Authors: Bousquet Elodie , Torres-Villaros Héloïse , Provost Julien , Elalouf Martine , Gigon Anthony , Mantel Irmela , Timsit Aurélie , Behar-Cohen Francine
Published: March 2022

(1) The aim of this study was to compare the clinical characteristics and multimodal imaging findings of central serous chorioretinopathy (CSCR) between women and men. (2) Women and men with CSCR were compared in terms of their age and risk factors, the clinical form of their disease, multimodal imaging findings and the presence of macular neovascularization (MNV) on optical coherence tomography (OCT)-angiography. (3) Results: The data of 75 women and 75 men were compared. The women were significantly older than the men (52.2 years versus 45.7 years; p < 0.001). Corticosteroid intake was more frequent in the women (56% versus 40%; p = 0.05). The women had a single foveal subretinal detachment more often than the men (73.3% versus 46.9%; p < 0.001) and they often had fewer gravitational tracks (16.3% versus 29.6%; p = 0.03). On mid-phase indocyanine green angiography, hyperfluorescent plaques were detected less often in the women than in the men (48% versus 72.2%, p = 0.001). MNV was detected on OCT-angiography in 35.9% of the women and in 13.3% of the men (p = 0.004). (4) In the women, CSCR occurs at an older age, is more often unifocal foveolar, and is associated with a higher rate of MNV. The reasons for these gender-related differences remain to be determined.
Adherence to Medication in Older Adults with Type 2 Diabetes Living in Lubuskie Voivodeship in Poland: Association with Frailty Syndrome
Authors: Bonikowska Iwona , Szwamel Katarzyna , Uchmanowicz Izabella
Published: March 2022

Purpose: Diabetic patients aged 65 years or older are more likely to be frail than non-diabetic older adults. Adherence to therapeutic recommendations in the elderly suffering from diabetes and co-existent frailty syndrome may prevent complications such as micro- or macroangiopathy, as well as significantly affect prevention and reversibility of frailty. The study aimed at assessing the impact of frailty syndrome (FS) on the level of adherence to medication in elderly patients with type 2 diabetes (DM2). Patients and Methods: The research was carried out among 175 DM2 patients (87; 49.71% women and 88; 50.29% men) whose average age amounted to 70.25 ± 6.7. Standardized research instruments included Tilburg frailty indicator (TFI) to assess FS and adherence in chronic disease scale questionnaire (ACDS) to measure adherence to medications. Results: The group of 101 (57.71%) patients displayed medium, 39 (22.29%)—low, and 35 (20.00%)—high adherence. As many as 140 of them (80.00%) were diagnosed with frailty syndrome. The median of the average result of TFI was significantly higher in the low adherence group (p ˂ 0.001) (Mdn = 9, Q1–Q3; 7–10 pt.) than in the medium (Mdn = 6, Q1–Q3; 5–9 pt.) or high adherence (Mdn = 6.00, Q1–Q3; 4.5–8 pt.) ones. The independent predictors of the chance to be qualified to the non-adherence group included three indicators: TFI (OR 1.558, 95% CI 1.245–1.95), male gender (OR 2.954, 95% CI 1.044–8.353), and the number of all medications taken daily (each extra pill decreased the chance of being qualified to the non-adherence group by 15.3% (95% CI 0.728–0.954). Conclusion: Frailty syndrome in elderly DM2 patients influenced medical adherence in this group. The low adhesion group had higher overall TFI scores and separately higher scores in the physical and psychological domains compared to the medium and high adhesion groups.
An Evaluation of 7279 Sports Injuries from a Level 1 Trauma Center with a Focus on Gender Differences
Authors: Bernstorff Maria Alexandra , Schlombs Johanna , Schumann Norman , Rosteius Thomas , Somberg Ole , Wenzel Maximilian , Schildhauer Thomas Armin , Königshausen Matthias
Published: March 2022

Purpose: Hardly any other topic is as current as the gender-conscious medical treatment of every individual. Similarly, in sports, there are crucial differences that should be considered in order to treat everyone appropriately, with the aim to prevent injuries according to their needs. The objective of this study is to show that the differences between biological males and females are so significant that they require both specific injury prevention and therapy programs. Methods: This study is a retrospective analysis of letters from a department of orthopedics and trauma surgery between the years 2000 and 2015. Results: The analysis of 20,567 inpatient and outpatient letters of a level 1 trauma center in Germany revealed that 5455 patients suffered 7279 injuries; 1475 of the patients were female and suffered 2035 injuries, and 3890 patients were male and suffered 5244 injuries. Conclusion: The results show the differences between males and females with regard to sport-specific injuries, pointing out the sex differences in the sport-specific area in relation to the body region.
Molecular Hallmarks of Ischemia with Non-Obstructive Coronary Arteries: The “INOCA versus Obstructive CCS” Challenge
Authors: Bonanni Alice , d’Aiello Alessia , Pedicino Daniela , Di Sario Marianna , Vinci Ramona , Ponzo Myriana , Ciampi Pellegrino , Lo Curto Denise , Conte Cristina , Cribari Francesco , Canonico Francesco , Russo Giulio , Montone Rocco Antonio , Trani Carlo , Severino Anna , Crea Filippo , Liuzzo Giovanna
Published: March 2022

Up to 4 million patients with signs of myocardial ischemia have no obstructive coronary artery disease (CAD). The absence of precise guidelines for diagnosis and treatment in non-obstructive CAD encourages the scientific community to fill the gap knowledge, to provide non-invasive and less expensive diagnostic tools. The aim of our study was to explore the biological profile of Ischemia with Non-Obstructive Coronary Arteries (INOCA) patients with microvascular dysfunction compared to patients presenting with obstructive chronic coronary syndrome (ObCCS) in order to find specific hallmarks of each clinical condition. We performed a gene expression array from peripheral blood mononuclear cells (PBMCs) isolated from INOCA (n = 18) and ObCCS (n = 20) patients. Our results showed a significantly reduced gene expression of molecules involved in cell adhesion, signaling, vascular motion, and inflammation in INOCA as compared to the ObCCS group. In detail, we found lower expression of Platelet and Endothelial Cell Adhesion Molecule 1 (CD31, p < 0.0001), Intercellular Adhesion Molecule-1 (ICAM1, p = 0.0004), Tumor Necrosis Factor (TNF p = 0.0003), Transferrin Receptor (TFRC, p = 0.002), and Vascular Endothelial Growth Factor A (VEGFA, p = 0.0006) in the INOCA group compared with ObCCS. Meanwhile, we observed an increased expression of Hyaluronidase (HYAL2, p < 0.0001) in INOCA patients in comparison to ObCCS. The distinct expression of molecular biomarkers might allow an early and non-invasive differential diagnosis between ObCCS and INOCA, improving clinical management and treatment options, in the era of personalized medicine.
Sense of Coherence and Health-Related Quality of Life in Patients with Multiple Sclerosis: The Role of Physical and Neurological Disability
Authors: Dymecka Joanna , Gerymski Rafał , Tataruch Rafał , Bidzan Mariola
Published: March 2022

Multiple sclerosis is a progressive demyelinating disease of the central nervous system that can lead to permanent disability and significantly impact the quality of life. The present study explores the relationship between neurological disability and disease symptoms, quality of life, and the level of sense of coherence, which is an important resource for coping with the disease. EDSS, GNDS, SOC-29, and MSIS-29 were used in the presented study. The study group consisted of 137 people diagnosed with multiple sclerosis. The study showed the correlation between most of the analyzed variables. Mood disability and fatigue were significant predictors of the sense of coherence and explained 34% of its variance. Physical disability and fatigue served as significant predictors of the physical aspect of quality of life, explaining 49% of its variance. Fatigue and sense of coherence were significant predictors of the psychological aspect of quality of life, explaining 47% of the variance. In studies on a group of people with multiple sclerosis, it is worth considering, in addition to the level of disability, also invisible symptoms, such as fatigue or mood disability, which are important for the quality of life and the level of resources. As this study suggests, a sense of coherence is a resource essential for the quality of life of people with disabilities.
Chronic Heart Failure: Diagnosis and Management beyond LVEF Classification
Authors: Triposkiadis Filippos , Starling Randall C.
Published: March 2022

The classification, phenotyping, and management of heart failure (HF) has been based on the left ventricular (LV) ejection fraction (LVEF) [...]
COVID-19 Patients Presenting with Post-Intubation Upper Airway Complications: A Parallel Epidemic?
Authors: Stratakos Grigoris , Anagnostopoulos Nektarios , Alsaggaf Rajaa , Koukaki Evangelia , Bakiri Katerina , Emmanouil Philip , Zisis Charalampos , Vachlas Konstantinos , Vourlakou Christina , Koutsoukou Antonia
Published: March 2022

During the current pandemic, we witnessed a rise of post-intubation tracheal stenosis (PITS) in patients intubated due to COVID-19. We prospectively analyzed data from patients referred to our institution during the last 18 months for severe symptomatic post-intubation upper airway complications. Interdisciplinary bronchoscopic and/or surgical management was offered. Twenty-three patients with PITS and/or tracheoesophageal fistulae were included. They had undergone 31.85 (±22.7) days of ICU hospitalization and 17.35 (±7.4) days of intubation. Tracheal stenoses were mostly complex, located in the subglottic or mid-tracheal area. A total of 83% of patients had fracture and distortion of the tracheal wall. Fifteen patients were initially treated with rigid bronchoscopic modalities and/or stent placement and eight patients with tracheal resection-anastomosis. Post-treatment relapse in two of the bronchoscopically treated patients required surgery, while two of the surgically treated patients required rigid bronchoscopy and stent placement. Transient, non-life-threatening post-treatment complications developed in 60% of patients and were all managed successfully. The histopathology of the resected tracheal specimens didn’t reveal specific alterations in comparison to pre-COVID-era PITS cases. Prolonged intubation, pronation maneuvers, oversized tubes or cuffs, and patient- or disease-specific factors may be pathogenically implicated. An increase of post-COVID PITS is anticipated. Careful prevention, early detection and effective management of these iatrogenic complications are warranted.