bluuebunny/crossref_metadata_2025 huggingface dataset:
Research, Reading, and Publication Habits of Nurses and Nursing Students Applied to Impact Journals: International Multicentre Study
Authors: Sánchez-Gómez María Begoña , Duarte-Clíments Gonzalo , Gómez-Salgado Juan , González-Pacheco María Elena , de Castro-Peraza María Elisa , Novo-Muñoz María Mercedes , Rodríguez-Gómez José Ángel , Martínez-Riera José Ramón , Pessoa-Moreira Rafaella , Martins Maria do Rosario , Echevarría-Pérez Paloma , Bonilla-Calero Ana Isabel
Published: March 2023

Publishing in JCR and SJR journals has become crucial for curricular development. Results from nursing investigations “compete” for publication in journals which are not specific to the field of care, affecting the academic development of these investigators. This phenomenon may lead to an ongoing adverse effect on nursing researchers and academics engaged in research in nursing care. The aim of this study was to evaluate habits regarding scientific literature consulting, the transfer of published material, and the citation of nursing investigations. A cross-sectional descriptive study by means of questionnaires was carried out, focusing on both Spanish and Portuguese nurses. The findings of the study reveal the following reasons for reading the scientific literature: that the language was understood; for learning and applying what was learnt; that the journal was of open access; for elaborating protocols and work procedures; and that the journal was indexed in scientific databases and in nursing databases. The reasons for reading, using, and publishing in journals were related to knowledge of the language and the associated usefulness of learning and applying knowledge. Creating a specific index of research publications in nursing will have a positive effect on the scientific production of caring methodologies.
The Incidence and Severity of Myopia in the Population of Medical Students and Its Dependence on Various Demographic Factors and Vision Hygiene Habits
Authors: Oszczędłowski Paweł , Raczkiewicz Przemysław , Więsyk Piotr , Brzuszkiewicz Kinga , Rapa Maria , Matysik-Woźniak Anna , Zieliński Grzegorz , Onyszkiewicz Maksymilian , Rękas Krzysztof Marek , Makosz Inga , Latalska Małgorzata , Czarnek-Chudzik Aleksandra , Korulczyk Jan , Rejdak Robert
Published: March 2023

(1) Background: Myopia is one of the leading causes of visual impairment. Visual work and usage of electronic devices are known risk factors of myopia. Many education systems were forced to apply online and hybrid teaching methods, to reduce the number of new cases of COVID-19. Medical students are a population well-known for intense visual work in the form of learning; (2) Methods: Visual acuity and refractive error were measured in the population of medical students. Participants also filled out the survey that included their population characteristic and their habits related to the hygiene of vision; (3) Results: We found a correlation between the age of the first diagnosis of myopia and current values of refractive error. The majority of participants believe that the COVID-19 pandemic had an impact on the health of their vision. Among methods of studying, usage of the computer screen was less preferred by myopic students; (4) Conclusions: In the population of medical school students in Eastern Poland, visual acuity was lower than 1.0 in 232 (52.97%) in the right eye and 234 (53.42%) in the left eye. Early recognition of refractive error has influenced its current values. Among methods of studying, usage of the computer screen was less preferred by myopic students. More population-based studies should focus on the impact of the COVID-19 pandemic on the health of vision.
Novel Approach for Glycemic Management Incorporating Vibration Stimulation of Skeletal Muscle in Obesity
Authors: Kim Mijin , Zhang Hanlin , Kim Taeho , Mori Yutaro , Okura Tomohiro , Tanaka Kiyoji , Isobe Tomonori , Sakae Takeji , Oh Sechang
Published: March 2023

Because obesity is associated with impaired glucose tolerance and type 2 diabetes (T2D), it is important to manage the blood glucose level at an early stage. Nevertheless, people with obesity have significantly lower resistance to muscle fatigue after exercise and exercise adherence. Therefore, we developed a novel “Relaxing-Vibration Training (RVT)” consisting of 25 postures using vibration stimulation of skeletal muscle and determined the feasibility of RVT for glycemic management. Thirty-one participants with obesity were enrolled in a controlled trial (CT) and experimental trial (ET) based on a 75 g oral glucose tolerance test (OGTT). During the CT, participants were required to rest in a quiet room. During the ET, the RVT program (50 Hz, 4 mm), consisting of 25 postures of relaxation and stretching on the vibratory platform, was performed for 40 min. Subsequently, the participants rested as in the CT. Subjective fatigue and muscle stiffness measurements and blood collection were conducted before and after RVT. In both the CT and ET, interstitial fluid (ISF) glucose concentrations were measured every 15 min for 2 h. The incremental area under the curve value of real-time ISF glucose during an OGTT was significantly lower in the ET than in the CT (ET: 7476.5 ± 2974.9, CT: 8078.5 ± 3077.7, effect size r = 0.4). Additionally, the levels of metabolic glucose regulators associated with myokines, muscle stiffness, and subjective fatigue significantly improved after RVT. This novel RVT suggests that it is effective in glycemic management with great potential to improve impaired glucose tolerance and T2D with obesity in the future.
Do Weight Changes Affect the Association between Smoking Cessation and the Risk of Stroke Subtypes in Korean Males?
Authors: Moon Seulji , Yang Yeun Soo , Kimm Heejin , Jung Keum Ji , Lee Ji Young , Jee Sun Ha , Lee Sunmi , Kim So Young , Nam Chung Mo
Published: March 2023

(1) Background: We investigated whether weight changes affect the association between smoking cessation and stroke risk; (2) Methods: Overall, 719,040 males were categorized into eight groups according to smoking status (sustained smokers, non-smokers, long-term quitters (quit > 4 years), and recent quitters (quit < 4 years)) and post-cessation weight change (−5 kg, −5.0 to 0.1 kg, maintainers, 0.1–5.0 kg, and >5.0 kg). The hazard ratios (HR) and 95% confidence intervals (CI) for incident total, ischemic, and hemorrhagic strokes, including subarachnoid and intracerebral hemorrhage, were calculated using Cox proportional hazard models; (3) Results: We detected 38,730 strokes (median follow-up, 25.7 years), including 30,609 ischemic and 9055 hemorrhagic strokes. For recent quitters with a >5.0 kg or 0.1–5.0 kg weight increase, maintainers, or those who lost 0.1–5 kg, the multivariable HR for total stroke was 0.73 (95% CI, 0.67–0.79), 0.78 (95% CI, 0.74–0.82), 0.77 (95% CI, 0.69–0.85), 0.84 (95% CI, 0.77–0.90), and 1.06 (95% CI, 0.92–1.23), respectively, compared with that of sustained smokers; (4) Conclusions: Comparable patterns were obtained for stroke subtypes. Thus, we strongly recommend quitting smoking, as weight gain after quitting smoking does not alter the stroke-related benefits.
Impact of Unexpected In-House Major COVID-19 Outbreaks on Depressive Symptoms among Healthcare Workers: A Retrospective Multi-Institutional Study
Authors: Sato Hideki , Maeda Masaharu , Takebayashi Yui , Setou Noriko , Shimada Jiro , Kanari Yumiko
Published: March 2023

The coronavirus disease 2019 (COVID-19) has significantly affected the mental health of healthcare workers (HCWs). The authors have provided psychosocial support to HCWs working in typical hospitals and nursing homes in Fukushima Prefecture, Japan, where major COVID-19 outbreaks have occurred since December 2020. This study retrospectively examines depressive symptoms before psychosocial interventions among HCWs working at typical hospitals and nursing homes experiencing in-house major COVID-19 outbreaks. We have offered psychosocial support in eight hospitals and nursing homes, obtaining data on the mental health status of 558 HCWs using the Patient Health Questionnaire-9. The study’s results indicate that 29.4% of HCWs have exhibited moderate or higher depressive symptoms, and 10.2% had suicidal ideation. Multiple logistic regression analysis showed that being a nurse was associated with higher depressive symptoms and suicidal ideation compared to other HCWs. In addition, multiple logistic regression analysis of Polymerase Chain Reaction-positive HCWs showed that being a nurse and the number of COVID-19-related symptoms was associated with high depressive symptoms. These results suggest that HCWs in typical hospitals and nursing homes experiencing major COVID-19 outbreaks are more likely to exhibit severe depressive symptoms, which may worsen if infected with COVID-19. This study’s findings expand the current understanding of HCWs’ depressive symptoms and the importance of psychosocial support during unexpected major outbreaks in healthcare facilities.
Mental Health of Prostate Cancer Patients: Content Review on YouTubeTM
Authors: Muzii Benedetta , Di Bello Francesco , Carraturo Fabio , Di Perna Tiziana , Califano Gianluigi , Morra Simone , Mangiapia Francesco , Scandurra Cristiano , Giuliani Luigi , Celentano Giuseppe , La Rocca Roberto , Creta Massimiliano , Longo Nicola , Maldonato Nelson Mauro , Collà Ruvolo Claudia
Published: March 2023

The aim of this study is to evaluate YouTube™ content in terms of the quality of information available about prostate cancer (PCa) in relation to incidence, symptomatology, and potential treatments for patients’ mental health. We searched on YouTube™ for terms related to mental health combined with those relating to prostate cancer. Tools for audio–visual-content PEMAT A/V, Global Quality Score, and DISCERN score were applied for the assessment of videos’ quality. A total of 67 videos were eligible. Most of the analyzed YouTube™ videos were created by physicians (52.2%) in contrast to other author categories (48.8%). According to the PEMAT A/V, the median score for Understandability was 72.7% and the overall median score for Actionability was 66.7%; the median DISCERN score was 47, which correspond to a fair quality. Only videos focusing on the topic “Psychological Effects and PCa treatment” were significantly more accurate. The General Quality Score revealed that the majority of YouTube™ videos were rated as “generally poor” (21, 31.3%) or “poor” (12, 17.9%). The results suggest that the content of YouTube™ videos is neither exhaustive nor reliable in the current state, illustrating a general underestimation of the mental health of prostate cancer patients. A multidisciplinary agreement to establish quality standards and improve communication about mental health care is needed.
Enhancing Equitable Access to Rare Disease Diagnosis and Treatment around the World: A Review of Evidence, Policies, and Challenges
Authors: Adachi Takeya , El-Hattab Ayman W. , Jain Ritu , Nogales Crespo Katya A. , Quirland Lazo Camila I. , Scarpa Maurizio , Summar Marshall , Wattanasirichaigoon Duangrurdee
Published: March 2023

This document provides a comprehensive summary of evidence on the current situation of rare diseases (RDs) globally and regionally, including conditions, practices, policies, and regulations, as well as the challenges and barriers faced by RD patients, their families, and caregivers. The document builds on a review of academic literature and policies and a process of validation and feedback by a group of seven experts from across the globe. Panelists were selected based on their academic merit, expertise, and knowledge regarding the RD environment. The document is divided into five main sections: (1) methodology and objective; (2) background and context; (3) overview of the current situation and key challenges related to RDs covering six dimensions: burden of disease, patient journey, social impact, disease management, RD-related policies, and research and development; (4) recommendations; and (5) conclusions. The recommendations are derived from the discussion undertaken by the experts on the findings of this review and provide a set of actionable solutions to the challenges and barriers to improving access to RD diagnosis and treatment around the world. The recommendations can support critical decision-making, guiding efforts by a broad range of RDs stakeholders, including governments, international organizations, manufacturers, researchers, and patient advocacy groups.
The Role of Shame, Stigma, and Family Communication Patterns in the Decision to Disclose STIs to Parents in Order to Seek Support
Authors: Scheinfeld Emily
Published: March 2023

Emerging adulthood is identified as a time of personal growth wherein emerging adults engage in sexual exploration and risky behaviors, potentially resulting in the contraction of a sexually transmitted infection (STI). Due to the continued reliance on parents for support during this developmental period, emerging adults (EAs) may need to disclose their STI status to their parents. This study applies the health disclosure decision-making model (DD-MM) to extend our understanding of EA disclosures of sensitive health information such as STIs to parents. Data were collected from 204 college students. The results of mediational analyses provided some support for the mediating effects of family communication patterns on the relationship between relational quality and illness assessment (i.e., stigma) and willingness to disclose in a given scenario. The theoretical and practical implications of this are discussed.
Impact of COVID-19 on the Research Career Advancement of Health Equity Scholars from Diverse Backgrounds
Authors: Báez Adriana , Idris Muhammed Y. , Lawson Kimberly , Mubasher Mohamed , Strekalova Yulia , Green Keith , Pemu Priscilla , Stiles Jonathan K. , Salazar Martiza , Quarshie Alexander , Caplan Lee S. , Alema-Mensah Ernest , Pearson Thomas , Faupel-Badger Jessica , Engler Jeffrey A. , Ofili Elizabeth O.
Published: March 2023

The COVID-19 pandemic has significantly taxed scientific research and seems to have exacerbated existing inequities within the research field, particularly for early-stage investigators (ESIs). This study examines the effects of the COVID-19 pandemic on traditionally underrepresented ESIs enrolled in an NIH-supported study evaluating the effectiveness of developmental networks, grant writing coaching, and mentoring on research career advancement. The survey consisted of 24 closed-ended (quantitative) and 4 open-ended questions (qualitative) linked to a participant’s ability to meet grant submission deadlines, research and professional development disruptions, stress level, career transition level, self-efficacy and management of scholarly tasks, and familial responsibilities. Results from 32 respondents (53%) suggest that COVID-19 adversely impacted the continuity of research (81%) and grant submissions (63%). On average, grant submissions were delayed by 6.69 months (i.e., greater than one grant cycle). We also conducted additional analyses characterizing nonresponse and found that there were no significant predictors of nonresponse, indicating a limited threat to the validity of our findings. The disruption caused by COVID-19 to the careers of ESIs from underrepresented groups in the biomedical workforce has been profound in the short term. The long-term consequences to the future success of these groups are unknown but is a worthwhile area of research and potential innovation.
Collagen VI in the Musculoskeletal System
Authors: Di Martino Alberto , Cescon Matilde , D’Agostino Claudio , Schilardi Francesco , Sabatelli Patrizia , Merlini Luciano , Faldini Cesare
Published: March 2023

Collagen VI exerts several functions in the tissues in which it is expressed, including mechanical roles, cytoprotective functions with the inhibition of apoptosis and oxidative damage, and the promotion of tumor growth and progression by the regulation of cell differentiation and autophagic mechanisms. Mutations in the genes encoding collagen VI main chains, COL6A1, COL6A2 and COL6A3, are responsible for a spectrum of congenital muscular disorders, namely Ullrich congenital muscular dystrophy (UCMD), Bethlem myopathy (BM) and myosclerosis myopathy (MM), which show a variable combination of muscle wasting and weakness, joint contractures, distal laxity, and respiratory compromise. No effective therapeutic strategy is available so far for these diseases; moreover, the effects of collagen VI mutations on other tissues is poorly investigated. The aim of this review is to outline the role of collagen VI in the musculoskeletal system and to give an update about the tissue-specific functions revealed by studies on animal models and from patients’ derived samples in order to fill the knowledge gap between scientists and the clinicians who daily manage patients affected by collagen VI-related myopathies.
In Silico Binding of 2-Aminocyclobutanones to SARS-CoV-2 Nsp13 Helicase and Demonstration of Antiviral Activity
Authors: Mohammad Thahani S. Habeeb , Gupta Yash , Reidl Cory T. , Nicolaescu Vlad , Gula Haley , Durvasula Ravi , Kempaiah Prakasha , Becker Daniel P.
Published: March 2023

The landscape of viral strains and lineages of SARS-CoV-2 keeps changing and is currently dominated by Delta and Omicron variants. Members of the latest Omicron variants, including BA.1, are showing a high level of immune evasion, and Omicron has become a prominent variant circulating globally. In our search for versatile medicinal chemistry scaffolds, we prepared a library of substituted ɑ-aminocyclobutanones from an ɑ-aminocyclobutanone synthon (11). We performed an in silico screen of this actual chemical library as well as other virtual 2-aminocyclobutanone analogs against seven SARS-CoV-2 nonstructural proteins to identify potential drug leads against SARS-CoV-2, and more broadly against coronavirus antiviral targets. Several of these analogs were initially identified as in silico hits against SARS-CoV-2 nonstructural protein 13 (Nsp13) helicase through molecular docking and dynamics simulations. Antiviral activity of the original hits as well as ɑ-aminocyclobutanone analogs that were predicted to bind more tightly to SARS-CoV-2 Nsp13 helicase are reported. We now report cyclobutanone derivatives that exhibit anti-SARS-CoV-2 activity. Furthermore, the Nsp13 helicase enzyme has been the target of relatively few target-based drug discovery efforts, in part due to a very late release of a high-resolution structure accompanied by a limited understanding of its protein biochemistry. In general, antiviral agents initially efficacious against wild-type SARS-CoV-2 strains have lower activities against variants due to heavy viral loads and greater turnover rates, but the inhibitors we are reporting have higher activities against the later variants than the wild-type (10–20X). We speculate this could be due to Nsp13 helicase being a critical bottleneck in faster replication rates of the new variants, so targeting this enzyme affects these variants to an even greater extent. This work calls attention to cyclobutanones as a useful medicinal chemistry scaffold, and the need for additional focus on the discovery of Nsp13 helicase inhibitors to combat the aggressive and immune-evading variants of concern (VOCs).
Senescent Secretome of Blind Mole Rat Spalax Inhibits Malignant Behavior of Human Breast Cancer Cells Triggering Bystander Senescence and Targeting Inflammatory Response
Authors: Odeh Amani , Eddini Hossam , Shawasha Lujain , Chaban Anastasia , Avivi Aaron , Shams Imad , Manov Irena
Published: March 2023

Subterranean blind mole rat, Spalax, has developed strategies to withstand cancer by maintaining genome stability and suppressing the inflammatory response. Spalax cells undergo senescence without the acquisition of senescence-associated secretory phenotype (SASP) in its canonical form, namely, it lacks the main inflammatory mediators. Since senescence can propagate through paracrine factors, we hypothesize that conditioned medium (CM) from senescent Spalax fibroblasts can transmit the senescent phenotype to cancer cells without inducing an inflammatory response, thereby suppressing malignant behavior. To address this issue, we investigated the effect of CMs of Spalax senescent fibroblasts on the proliferation, migration, and secretory profile in MDA-MB-231 and MCF-7 human breast cancer cells. The results suggest that Spalax CM induced senescence in cancer cells, as evidenced by increased senescence-associated beta-galactosidase (SA-β-Gal) activity, growth suppression and overexpression of senescence-related p53/p21 genes. Contemporaneously, Spalax CM suppressed the secretion of the main inflammatory factors in cancer cells and decreased their migration. In contrast, human CM, while causing a slight increase in SA-β-Gal activity in MDA-MB-231 cells, did not decrease proliferation, inflammatory response, and cancer cell migration. Dysregulation of IL-1α under the influence of Spalax CM, especially the decrease in the level of membrane-bound IL1-α, plays an important role in suppressing inflammatory secretion in cancer cells, which in turn leads to inhibition of cancer cell migration. Overcoming of SASP in tumor cells in response to paracrine factors of senescent microenvironment or anti-cancer drugs represents a promising senotherapeutic strategy in cancer treatment.
The Chemokine Receptor CCR1 Mediates Microglia Stimulated Glioma Invasion
Authors: Zeren Nazende , Afzal Zobia , Morgan Sara , Marshall Gregory , Uppiliappan Maithrayee , Merritt James , Coniglio Salvatore J.
Published: March 2023

Glioblastoma multiforme (GBM) is the most aggressive form of adult brain tumor which is highly resistant to conventional treatment and therapy. Glioma cells are highly motile resulting in infiltrative tumors with poorly defined borders. Another hallmark of GBM is a high degree of tumor macrophage/microglia infiltration. The level of these tumor-associated macrophages/microglia (TAMs) correlates with higher malignancy and poorer prognosis. We previously demonstrated that inhibition of TAM infiltration into glioma tumors with the CSF-1R antagonist pexidartinib (PLX3397) can inhibit glioma cell invasion in-vitro and in-vivo. In this study, we demonstrate an important role for the chemokine receptor CCR1 in mediating microglia/TAM stimulated glioma invasion. Using two structurally distinct CCR1 antagonists, including a novel inhibitor “MG-1-5”, we were able to block microglial activated GL261 glioma cell invasion in a dose dependent manner. Interestingly, treatment of a murine microglia cell line with glioma conditioned media resulted in a strong induction of CCR1 gene and protein expression. This induction was attenuated by inhibition of CSF-1R. In addition, glioma conditioned media treatment of microglia resulted in a rapid upregulation of gene expression of several CCR1 ligands including CCL3, CCL5, CCL6 and CCL9. These data support the existence of tumor stimulated autocrine loop within TAMs which ultimately mediates tumor cell invasion.
TADF and X-ray Radioluminescence of New Cu(I) Halide Complexes: Different Halide Effects on These Processes
Authors: Artem'ev Alexander V. , Baranov Andrey Yu. , Berezin Alexey S. , Stass Dmitry V. , Hettstedt Christina , Kuzmina Ul’yana A. , Karaghiosoff Konstantin , Bagryanskaya Irina Yu.
Published: March 2023

A series of complexes [Cu2X2(Pic3PO)2] (X = Cl, Br, I) based on tris(pyridin-2-ylmethyl)phosphine oxide (Pic3PO) has been synthesized. At 298 K, these compounds exhibit thermally activated delayed fluorescence (TADF) of 1(M+X)LCT type with λmax varying from 485 to 545 nm, and quantum efficiency up to 54%. In the TADF process, the halide effect appears as the emission intensification and bathochromic shift of λmax in the following order X = I < Br < Cl. Upon X-ray irradiation, the title compounds emit radioluminescence, the emission bands of which have the same shape as those at TADF, thereby meaning a similar radiative excited state. By contrast to TADF, the halide effect in the radioluminescence is reversed: its intensity grows in the order X = Cl < Br < I, since heavier atoms absorb X-rays more efficiently. These findings essentially contribute to our knowledge about the halide effect in the photo- and radioluminescent Cu(I) halide emitters.
Are We Missing the Bus? A Case Study on Flexibility Options for Charging Infrastructure at the Amsterdam Central Station
Authors: Pennings Rogier , Wiegmans Bart , Spit Tejo
Published: March 2023

Is it possible for flexible applications of infrastructure to help cope with the demand for space? In this paper we tried to answer how different forms of flexibility can impact the societal costs of infrastructure development on passenger transport hubs. For this explorative research option, the value is used to determine these impacts. It is applied to charging infrastructure for electric buses at the Amsterdam Central Station. It shows the challenge in setting up a collective approach towards attaining the optimal societal impact, due to limited knowledge on the potential of flexibility, the complexity in setting up a win-win for each stakeholder based on their different interests and the lacking ownership of the overall collective impact that can be made. The remaining question is, will there be a way out?
Physical Properties of Substrates as a Driver for Hermetia illucens (L.) (Diptera: Stratiomyidae) Larvae Growth
Authors: Yakti Wael , Müller Marcus , Klost Martina , Mewis Inga , Dannehl Dennis , Ulrichs Christian
Published: March 2023

The growth and nutritional profile of the black soldier fly larvae (BSFL) is usually investigated and compared when the larvae feed on substrates that differ in the chemical composition as well as physical properties. This study compares BSFL growth on substrates that differ primarily in physical properties. This was achieved by using various fibres in the substrates. In the first experiment, two substrates with 20% or 14% chicken feed were mixed with three fibres (cellulose, lignocellulose, or straw). In the second experiment, the growth of BSFL was compared with a 17% chicken feed substrate that additionally contained straw with different particle sizes. We show that the substrate texture properties values did not influence the BSFL growth, but the bulk density of the fibre component did. The substrate mixed with cellulose led to higher larvae growth over time in comparison to substrates with higher bulk density fibres. BSFL grown on the substrate mixed with cellulose reached their maximum weight in 6 days instead of 7. Neither the fibres nor the nutrient level changed the crude protein content of BSFL and the values ranged between 33.5% and 38.3%, but an interaction between the fibre and nutrient level was observed. The size of straw particles in the substrates influenced the BSFL growth and led to a 26.78% difference in Ca concentration, a 12.04% difference in Mg concentration, and a 35.34% difference in P concentration. Our findings indicate that the BSFL-rearing substrates can be optimised by changing the fibre component or its particle size. This can improve the survival rate, reduce the cultivation time needed to reach the maximum weight, and alter the chemical composition of BSFL.
Brain Hypothermia Therapy and Targeted Temperature Management for Acute Encephalopathy in Children: Status and Prospects
Authors: Imataka George , Fujita Yuji , Kikuchi Jin , Wake Koji , Ono Kazuyuki , Yoshihara Shigemi
Published: March 2023

In adult intensive care, brain hypothermia therapy (BHT) was reported to be effective in neuroprotection after resuscitation and cardiac arrest. By contrast, in neonatal intensive care, the pathophysiology of brain damage caused by hypoxic–ischemic encephalopathy (HIE) is attributed to circulatory disturbances resulting from ischemia/reperfusion, for which neonatal brain cryotherapy is used. The International Liaison Committee on Resuscitation, 2010, recommends cerebral cryotherapy for HIE associated with severe neonatal pseudoparenchyma death. The usefulness of BHT for neuroprotection in infants and children, especially in pediatric acute encephalopathy, is expected. Theoretically, BHT could be useful in basic medical science and animal experiments. However, there are limitations in clinical planning for treating pediatric acute encephalopathy. No international collaborative study has been conducted, and no clinical evidence exists for neuroprotection using BHT. In this review, we will discuss the pathogenesis of neuronal damage in hypoxic and hypoperfused brains; the history of BHT, its effects, and mechanisms of action; the success of BHT; cooling and monitoring methods of BHT; adverse reactions to BHT; literature on BHT. We will review the latest literature on targeted temperature management, which is used for maintaining and controlling body temperature in adults in intensive care. Finally, we will discuss the development of BHT and targeted temperature management as treatments for pediatric acute encephalopathy.
Reverse Total Shoulder Arthroplasty for Proximal Humeral Fractures and Sequalae Compared to Non-Fracture Indications: A Matched Cohort Analysis of Outcome and Complications
Authors: Paszicsnyek Alexander , Kriechling Philipp , Razaeian Sam , Ernstbrunner Lukas , Wieser Karl , Borbas Paul
Published: March 2023

Background: With the increase in utility and popularity of the reverse total shoulder arthroplasty (RTSA) within the last decades, indications for RTSA have expanded. As well as the established indications such as cuff tear arthropathy and massive irreparable rotator cuff tears, RTSA for complex proximal humeral fractures in elderly patients has been proven to be a reliable treatment option. Methods: A prospectively enrolled RTSA database of 1457 RTSAs implanted between September 2005 and November 2020 was reviewed. Patients treated with RTSA for a complex proximal humerus fracture and fracture sequalae (F-RTSA) were 1:1 matched with a group of patients who were treated electively with RTSA for indications other than a fracture (E-RTSA). Matching criteria included sex, age, length of follow-up and body mass index. Evaluation after a minimum of 2 years follow-up included evaluation of the absolute and relative Constant–Murley score (aCS; rCS), subjective shoulder value (SSV), range of motion (ROM) assessment and complications. Results: Each of the matched cohorts comprised 134 patients with a mean follow-up of 58 ± 41 months for the fracture group and 58 ± 36 months for the elective group. The mean age for both groups was 69 ± 11 years in the F-RTSA and 70 ± 9 years for the E-RTSA group. There were no significant differences in clinical outcome measures including aCS, rCS and SSV (p > 0.05). There was a significant difference in mean active external rotation with 20° ± 18° in the F-RTSA group compared with 25° ± 19° in the E-RTSA group (p = 0.017). The complication rate was not significantly different, with 41 complications in 36 shoulders in the F-RTSA and 40 complications in 32 shoulders in the E-RTSA group (p = 0.73). The main complication for the F-RTSA group was dislocation of the greater tuberosity (6%), whereas acromial fractures (9%) were the leading complication in the E-RTSA group. There was also no significant difference in revision rate comparing F-RTSA with E-RTSA (10% vs. 14%; p = 0.25). Conclusions: RTSA for complex proximal humeral fractures and its sequalae leads to a comparable clinical outcome as that for patients treated electively with RTSA for indications other than fracture. There was, however, a significant difference in active external rotation, with inferior rotation in patients undergoing RTSA for fracture. This valuable information can help in requesting informed consent of patients with proximal humeral fractures.
Menopause Is Associated with Obstructive Sleep Apnea in a Population-Based Sample from Mecklenburg–Western Pomerania, Germany
Authors: Krüger Markus , Obst Anne , Ittermann Till , Bernhardt Olaf , Ivanovska Tatyana , Zygmunt Marek , Ewert Ralf , Fietze Ingo , Penzel Thomas , Biffar Reiner , Daboul Amro
Published: March 2023

Objective: Menopause is associated with multiple health risks. In several studies, a higher incidence or a higher risk for obstructive sleep apnea (OSA) in post-menopausal than pre-menopausal women is reported. This study was designed to verify such a connection between menopause and OSA in a population-based sample. Methods: For a subsample (N = 1209) of the Study of Health in Pomerania (N = 4420), complete polysomnography data was available. Of these, 559 females completed a structured interview about their menstrual cycle. Splines and ordinal regression analysis were used to analyze the resulting data. Results: In the ordinal regression analysis, a significant association between the apnea–hypopnea index (AHI) and menopause indicated that post-menopausal women had a substantially higher risk of OSA. In accordance with previous studies, risk indicators such as body mass index (BMI), age, and the influence of hysterectomies or total oophorectomies were included in the model. Conclusions: Our results clearly confirmed the assumed connection between menopause and OSA. This is important because OSA is most often associated with male patients, and it warrants further research into the underlying mechanisms.
Acupuncture in Patients with Diabetic Peripheral Neuropathy-Related Complaints: A Randomized Controlled Clinical Trial
Authors: Dietzel Joanna , Habermann Isabel V. , Hörder Sebastian , Hahn Katrin , Meyer-Hamme Gesa , Ortiz Miriam , Hua Kevin , Stöckigt Barbara , Bolster Marie , Grabowska Weronika , Roll Stephanie , Binting Sylvia , Willich Stefan N. , Schröder Sven , Brinkhaus Benno
Published: March 2023

Background: Diabetic polyneuropathy (DPN) is a common complication of diabetes, which presents with a loss of sensorimotor function or pain. This study assessed the effectiveness and safety of acupuncture as a treatment for DPN-related complaints. Methods: In this randomized controlled trial, patients with type II diabetes and symptoms of neuropathy in the lower limbs were included. A total of 12 acupuncture treatments were administered over 8 weeks. The waitlist control group received the same acupuncture treatment starting at week 16 (after baseline). Results: A total of 62 patients were randomized (acupuncture group n = 31; control group n = 31). The primary outcome was overall complaints, and it was reduced with a significant difference of 24.7 on a VAS (CI 95% 14.8;34.7, p < 0.001) between both groups in favor of acupuncture. Reductions were recorded for the secondary outcomes VAS pain, neuropathic pain symptom inventory (NPSI), emotional dimensions of pain, SF-12, and diabetic peripheral neuropathic pain impact (DPNPI) after the intervention and at the follow-ups in the acupuncture group. Adverse reactions were minor and transient. Conclusions: Acupuncture leads to a significant and lasting reduction in DPN-related complaints when compared to routine care and is well tolerated, with minor side effects.
Variability of Visual Recovery with Time in Epiretinal Membrane Surgery: A Predictive Analysis Based on Retinal Layer OCT Thickness Changes
Authors: Romano Mary , Catania Fiammetta , Vallejo-Garcia Josè Luis , Sorrentino Tania , Crincoli Emanuele , Vinciguerra Paolo
Published: March 2023

Purpose: To correlate postoperative optical coherence tomography (OCT) thickness changes of each retinal layer with different patterns of visual recovery after idiopathic epiretinal membrane (ERM) surgery in a cohort of patients showing no known risk factors for poor visual recovery at preoperative imaging. Methods: Best corrected visual acuity (BCVA) and OCT images were acquired preoperatively and 1 month, 3 months and 6 months postoperatively. Patients were divided into four groups according to postoperative BCVA improvement: improvement < 15 ETDRS letters (GROUP 1), immediate improvement of BCVA without further improvements at later follow-ups (GROUP 2), immediate improvement of BCVA with further improvements at later follow-ups (GROUP 3) and delayed improvement of BCVA (GROUP 4). Results: Eighty-five patients were included. GROUP1 was the only one characterized by retinal nerve fiber layer (RNFL) thickness increase and ganglion cell layer/central macular thickness (GCL/CMT) ratio decrease at 1 month and outer nuclear layer (ONL) thickness decrease at 3 and 6 months. GROUP 2 was the only one showing a decrease in GCL/inner plexiform layer (GCL/IPL) ratio at 1 month. GROUP 3 and 4 showed higher preoperative RNFL thickness compared to the other, and GROUP 4 manifested a late increase in RNFL thickness at 6 months. Conclusions: Different patterns of VA recovery are associated with specific layer thickness changes. If further confirmed, this would help detect those cases characterized by poor or delayed visual recovery despite the absence of other known imaging risk factors.
Clinical and Radiographic Outcomes of Inversed Restricted Kinematic Alignment Total Knee Arthroplasty by Asia Specific (Huang’s) Phenotypes, a Prospective Pilot Study
Authors: Hsieh Shang-Lin , Lin Tsung-Li , Hung Chih-Hung , Fong Yi-Chin , Chen Hsien-Te , Tsai Chun-Hao
Published: March 2023

Inverse restricted kinematic alignment (irKA) was modified from restricted kinematic alignment for total knee arthroplasty (TKA). This prospective single-center study aimed to evaluate the outcomes of irKA-TKA on all knee subtypes classified by Asia specific (Huang’s) phenotypes. A total of 96 knees that underwent irKA-TKA at one hospital between January 2018 and June 2020 were included, with 15 knees classified in Type 1, nine in Type 2, 15 in Type 3, 47 in Type 4, and 10 in Type 5 by Huang’s phenotypes. Outcomes were knee alignment measures and patient-reported satisfaction evaluated by the Western Ontario and McMaster Universities Arthritis Index (WOMAC) and traditional Chinese version of the Forgotten Joint Score-12 (FJS-12). Follow-up was one year. Type 4 knee was most significantly corrected in all angles by irKA-TKA, followed by Type 2 and 3 knees. Type 5 and 1 knee were only significantly corrected in some angles. The correlation between FJS-12 and WOMAC was good at 6 months (Pearson correlation coefficient (r) = 0.74) and moderate at 6 weeks, 3 months, and 12 months during follow-up (r = 0.37~0.47). FJS-12 and WOMAC displayed comparable hip–knee–ankle angle cut-off value (4.71° vs. 6.20°), sensitivity (70.49% vs. 67.19%), specificity (84.00% vs. 85.71%), and Youden index (54.49% vs. 52.90%) in prediction of good prognosis. In conclusion, irKA-TKA corrects knee alignment in all knee types with increasing satisfaction for one-year follow-up. Knees with presurgical varus deformity are most recommended for irKA-TKA. Both presurgical scores of the traditional Chinese version of FJS-12 and WOMAC predict the prognosis of irKA-TKA.
Microscopic Inspection of the Adhesive Interface of Composite Onlays after Cementation on Low Loading: An In Vitro Study
Authors: Magalhães Tiago , Fidalgo-Pereira Rita , Torres Orlanda , Carvalho Óscar , Silva Filipe S. , Henriques Bruno , Özcan Mutlu , Souza Júlio C. M.
Published: March 2023

Purpose: This study aimed to assess the layer thickness and microstructure of traditional resin-matrix cements and flowable resin-matrix composites at dentin and enamel to composite onlay interfaces after cementation on low loading magnitude. Materials and Methods: Twenty teeth were prepared and conditioned with an adhesive system for restoration with resin-matrix composite onlays manufactured by CAD-CAM. On cementation, tooth-to-onlay assemblies were distributed into four groups, including two traditional resin-matrix cements (groups M and B), one flowable resin-matrix composite (group G), and one thermally induced flowable composite (group V). After the cementation procedure, assemblies were cross-sectioned for inspection by optical microscopy at different magnification up to ×1000. Results: The layer thickness of resin-matrix cementation showed the highest mean values at around 405 µm for a traditional resin-matrix cement (group B). The thermally induced flowable resin-matrix composites showed the lowest layer thickness values. The resin-matrix layer thickness revealed statistical differences between traditional resin cement (groups M and B) and flowable resin-matrix composites (groups V and G) (p < 0.05). However, the groups of flowable resin-matrix composites did not reveal statistical differences (p < 0.05). The thickness of the adhesive system layer at around 7 µm and 12 µm was lower at the interfaces with flowable resin-matrix composites when compared to the adhesive layer at resin-matrix cements, which ranged from 12 µm up to 40 µm. Conclusions: The flowable resin-matrix composites showed adequate flowing even though the loading on cementation was performed at low magnitude. Nevertheless, significant variation in thickness of the cementation layer was noticed for flowable resin-matrix composites and traditional resin-matrix cements that can occur in chair-side procedures due to the clinical sensitivity and differences in rheological properties of the materials.
Feature Extraction and Classification of Simulated Monostatic Acoustic Echoes from Spherical Targets of Various Materials Using Convolutional Neural Networks
Authors: Kubicek Bernice , Sen Gupta Ananya , Kirsteins Ivars
Published: March 2023

Active sonar target classification remains an ongoing area of research due to the unique challenges associated with the problem (unknown target parameters, dynamic oceanic environment, different scattering mechanisms, etc.). Many feature extraction and classification techniques have been proposed, but there remains a need to relate and explain the classifier results in the physical domain. This work examines convolutional neural networks trained on simulated data with a known ground truth projected onto two time-frequency representations (spectrograms and scalograms). The classifiers were trained to discriminate the target material type, geometry, and internal fluid filling, while the hyperparameters were tuned to the classification task using Bayesian optimization. The trained networks were examined using an explainable artificial intelligence technique, gradient-weighted class activation mapping, to uncover the informative features used in discrimination. This analysis resulted in visual representations that allowed the CNN choices to be related to the physical domain. It was found that the scalogram representation provided a negligible classification accuracy increase compared with the spectrograms. Networks trained to discriminate between target geometries resulted in the highest accuracy, and the networks trained to discriminate the internal fluid of the target resulted in the lowest accuracy.
Non-Hydrostatic Modelling of Coastal Flooding in Port Environments
Authors: Suzuki Tomohiro , Altomare Corrado , Willems Marc , Dan Sebastian
Published: March 2023

Understanding key flooding processes such as wave overtopping and overflow (i.e., water flows over a structure when the crest level of the structure is lower than the water level in front) is crucial for coastal management and coastal safety assessment. In port and harbour environments, waves are not only perpendicular to the coastal structure but also very oblique, with wavefronts almost perpendicular to the main infrastructures in the harbour docks. Propagation and wave–structure interaction of such perpendicular and (very) oblique waves need to be appropriately modelled to estimate wave overtopping properly. Overflow can also be critical for estimating flooding behind any coastal defence. In this study, such oblique and parallel waves (i.e., main wave direction is parallel to the structures) are modelled in a non-hydrostatic wave model and validated with physical model tests in the literature. On top, overflow is also modelled and validated using an existing empirical formula. The model gives convincing behaviours on the wave overtopping and overflow.
Successful Multimodal Therapy with Intracerebral Liposomal Amphotericin B and Systemic High-Dose Isavuconazole in Proven Disseminated Aspergillosis
Authors: Feys Simon , Dedeurwaerdere Franceska , Lagrou Katrien , Van Lerbeirghe Jeroen , Deeren Dries
Published: March 2023

We report the case of a 32-year-old man receiving chemotherapeutics for an acute B-lymphoblastic leukemia who developed proven cerebral and pulmonary aspergillosis with Aspergillus flavus. Because of progressive fungal disease with neurological deterioration despite adequate systemic antifungal therapy and surgical debridement, intracerebral administration of liposomal amphotericin B was initiated at 5 mg twice weekly. This led to improvement of the cerebral infection. Surgical debridement of a pleural Aspergillus empyema was necessary, and pleural trough level of isavuconazole was found to be subtherapeutic despite adequate blood trough levels, which led us to increase the dose of isavuconazole. We conclude that intralesional amphotericin B might be beneficial at 5 mg twice weekly in cerebral aspergillosis if systemic antifungals and surgical debridement fail. In Aspergillus empyema, measurement of pleural isavuconazole trough levels should be considered.
In Search of Clinical Markers: Indicators of Exposure in Dampness and Mold Hypersensitivity Syndrome (DMHS)
Authors: Vaali Kirsi , Ekumi Kingsley Mokube , Andersson Maria A. , Mannerström Marika , Heinonen Tuula
Published: March 2023

Potential markers were sought to diagnose mold hypersensitivity. Indoor air condensed water and human macrophage THP-1 test were applied to evaluate the buildings. Basophil activation tests (BAT) were conducted and mold-specific immunoglobulins (IgE, IgG, IgA, and IgD) were measured in study subjects’ serum and feces. Exposed subjects reported markedly more symptoms from occupational air than controls. Basophils from exposed subjects died/lost activity at 225 times lower concentrations of toxic extracts from the target building than recommended in the common BAT protocol. Fecal IgG and IgD levels against Acrostalagmus luteoalbus and Aspergillus versicolor produced receiver operating curves (ROC) of 0.928 and 0.916, respectively, when plotted against the inflammation marker MRP8/14. Assaying serum immunoglobulin concentrations against the toxic Chaetomium globosum (MTAV35) from another building, a test control, did not differentiate study individuals. However, if liver metabolism produced the same core molecule from other Chaetomium globosum strains, this would explain the increased response in fecal immunoglobulins in the exposed. The altered immunoglobulin values in the samples of exposed when compared to controls revealed the route of mold exposure. The toxicity of indoor air condensed water samples, BAT and serology confirmed the severity of symptoms in the target building’s employees, supporting earlier findings of toxicity in this building.
A Gender-Based Point of View in Pediatric Neurology
Authors: Diana Pierluigi , Esposito Susanna
Published: March 2023

While the significance of gender has only recently been recognized, gender assigned at birth has long been understood to have a significant influence on a number of illnesses. Due to the paucity of data in this regard in pediatrics, the purpose of this narrative review is to frame the most recent knowledge about the role of gender assigned at birth in the neurological development and neuropsychiatric disorders among young people. Literature analysis showed that gender disparities exist in neurologic and neuropsychiatric disorders among the pediatric population and supported the fact that new guidelines should take this into account. However, there is an urgent need for specific studies focused on gender role among children and adolescents in order to better understand how this can relate to diagnosis, development and treatment of different neurologic and neuropsychiatric diseases. Moreover, further efforts should be directed to identify unique risks linked to gender disorders and gender dysphoria as well as taking into account a gender point of view when approaching a pediatric patient.