bluuebunny/crossref_metadata_2025 huggingface dataset:
The impact of empowerment theory-based health education on Alzheimer’s disease informal caregivers: a randomized controlled trial
Authors: Liu Xiaofeng , Wang Shurui , Wei Lirong , Liu Yun , Bian Jiping , Wang Shen , Du Xian
Published: August 2024

Background

There is a lack of evidence regarding the effectiveness of empowerment healthy education for caregivers of Alzheimer’s patients.

Objective

To explore the effectiveness of the intervention of health education guided by empowerment theory on dementia knowledge, caregiving readiness, positive caregiving emotions, anxiety, and depression in informal Alzheimer’s disease caregivers.

Design

A single-blinded, randomized controlled trial.

Setting

A teaching hospital in Tianjin, China.

Participants

Eighty caregivers of Alzheimer’s disease patients.

Methods

Participants were recruited from the hospital and randomly assigned to either experimental or control group. The experimental group underwent a 12-weeks, one-to-one intervention of six session lasting 45–60 min each. The control group received conventional health education. Outcome measures included dementia knowledge, caregiver readiness (primary outcomes), positive caregiving emotions, anxiety, and depression (secondary outcomes).

Results

After 12 weeks, the intervention group exhibited significantly higher levels of dementia knowledge, caregiver readiness, and positive caregiving emotions compared with the control group. Furthermore, levels of hospitalization-related anxiety and depression were lower in the intervention group. All study results of this study showed statistically significant differences (p < 0.05).

Discussion

Empowerment theory-based health education appears to be an effective intervention for improving caregiver and readiness to care for caregivers of Alzheimer’s disease individuals. The intervention may help reduce caregivers’ anxiety and depression levels.
Prevalence of dyslipidemia among teachers in China: a systematic review and meta-analysis
Authors: Wei Xiaoxue , Ouyang Feng , Liu Yang , Du Qingfeng
Published: August 2024

Objective

To systematically analyze the current situation with dyslipidemia among teachers in China, to provide guidance for lipid management and prevention of ASCVD.

Design

A systematic review and meta-analysis of the prevalence of dyslipidemia among teachers in China.

Methods

We searched via 9 databases for studies published between June 1, 1996, and July, 25, 2024. The article were evaluated by the Joanna Briggs Institute (JBI) Article Quality Assessment Tool (2016) in Australia. RevMan5.0 and R4.3.1 software were used for statistical analysis to calculate the OR and RR values and the 95% confidence intervals. This systematic review and meta-analysis were reported in line with the PRISMA guidelines.

Results

A total of 12 cross-sectional studies from 10 provinces (regions) were included, with the sample of 24,851, including 12,626 males and 12,198 females, the average age of about 40 (1,036 were aged ≤30, 5,872 were aged 30–40, 3,854 were aged 40–50, 4,607 were aged 50–60, and 3,425 were aged ≥60), including 9,114 people with dyslipidemia. The overall prevalence of dyslipidemia among teachers in China was 38% (p < 0.01, 95% CI (1.27–1.95)). The prevalence of hypertriglyceridemia was 21.6% (p < 0.01, 95% CI (1.05–1.50)), that of hypercholesterolemia was 13.3% (p < 0.05, 95% CI (0.98–1.34)), that of hyper-LDL-Cemia was 9.4% (p < 0.01, 95% CI (1.04–1.59)), and that of hypo-HDL-Cemia was 4.3% (p = 0.25, 95% CI (0.61–6.52)). The heterogeneity of dyslipidemia among teachers of the different sexes was I2 = 92% (p < 0.01). The overall prevalence of dyslipidemia, as well as that of high TC, high TG, and high LDL-C levels, was greater in female teachers than in male teachers (df = 10, 95% CI:1.35–1.52, p < 0.01). The heterogeneity of dyslipidemia among teachers of different ages was I2 = 74% (p < 0.01), and the risk was lower for aged <50 years than those aged ≥50 years (df = 7, 95% CI: 0.38–0.44, p = 0.04). The year, region, school type, and these factors showed no effect on the prevalence of dyslipidemia (p = 0.7353).

Conclusion

The prevalence of dyslipidemia in the teacher population in China is high and tends to increase with age. We should pay attention to the health management of the teachers, which can be done by appropriately adjusting the educational model settings, increasing the programs on physical activities, promoting the improvement of healthy lifestyles.

Systematic review registration

https://www.crd.york.ac.uk/prospero/, identifier [CRD42024567785].
Sex differences in mobility recovery after hip fracture: a time series analysis
Authors: Jansen Carl-Philipp , Engdal Monika , Peter Raphael S. , Helbostad Jorunn L. , Taraldsen Kristin , Vereijken Beatrix , Pfeiffer Klaus , Becker Clemens , Klenk Jochen
Published: August 2024

Introduction

Sex differences are commonly reported for hip fracture incidence rates and recovery. Current knowledge about mobility recovery after hip fracture involves clinical assessments of physical capacity or patient-reported outcomes. Information on mobility performance during daily life is missing but relevant to evaluate patients’ recovery. Hence, it remains unclear whether sex differences exist in the longitudinal progression of mobility performance in hip fracture patients. To investigate this, we pooled data from four studies in Germany and Norway.

Methods

In all studies, real-world mobility was assessed continuously over 1 to 7 days using a sensor fixed to the unaffected frontal thigh. All studies assessed mobility at different time points that were allocated to three distinct phases: Acute and post-acute phase (week 1–6), extended recovery (7–26), and long-term recovery (27–52). Sex-specific continuous trajectories of the median (50th percentile) as well as the 1st (25th percentile) and 3rd quartile (75th percentile) were estimated using quantile regression models with splines for daily walking and standing duration; number of sit-to-stand-to-walk transfers and walking bouts; mean walking bout duration; maximum number of steps per walking bout.

Results

There were 5,900 valid observation days from n = 717 participants (mean age = 83.4 years, SD 6.1). The majority was female (75.3%), with similar sex distribution across all studies. Demographics of both sexes were comparable, but a higher percentage of women was living alone (69.0% compared to 40.9% in men) and had experienced an indoor fall leading to the fracture (74.3% compared to 67.4% in men). There were clear sex differences in mobility recovery. Women improved their mobility faster than men, but men showed larger increases later in the year after surgery. At the end of the first year, both sexes reached comparable levels in almost all mobility parameters.

Conclusion

We identified varying aspects of mobility recovery between men and women, i.e., timely development of mobility recovery shows different patterns. Our findings support the consideration of sex differences in planning and implementing rehabilitation measures for hip fracture patients and highlight the need to provide adapted support at different time points. The underlying mechanisms of these sex differences need further investigation.
An automated syringe-based PoC RT-LAMP LFB platform for infectious disease detection from saliva
Authors: Naranbat Dulguunnaran , Murphy John , Tripathi Anubhav
Published: August 2024

Decentralized Point-of-Care (PoC) diagnostics hold momentous potential for rapid and accessible viral infection disease detection. Presented is a unique design application of an easy-to-use (plug-and-play) platform for viral detection. The platform leverages a simplified multiplex Reverse-Transcription Loop-mediated Isothermal Amplification (RT-LAMP) Lateral Flow Biosensor (LFB) assay with a lyophilized master mix, eliminating the need for RNA isolation or special reporting equipment. A user-friendly Saliva Measuring Tube (SMT) ensures accurate saliva volume self-collection, and a Syringe-based PoC (SPoC) platform automates sample treatment, reagent mixing, and temperature control using readily available components and consumables. The platform’s performance was evaluated by multiplexed detection of the SARS-CoV-2 N2 target gene and human ACTB gene from saliva samples. The SPoC platform achieved a detection limit of spiked 500 copies/mL for SARS-CoV-2 and consistent internal control readout. The presented PoC system offers a promising initial step for further development toward a decentralized solution for viral infection testing.
Transforming harmful representations, investigating violence and empowering care practises in masculinities
Authors: Moura Tatiana
Published: August 2024

Stemming from a critical perspective of feminist studies on masculinities, this article proposes to explore how dominant and hegemonic masculinities are being reimagined, renegotiated and reconstructed, by understanding new patterns of violence amongst boys, on the one hand; and how care, as the opposite of violence, and a concept in construction from a feminist perspective, can be adopted, put in practise and understood. From a feminist standpoint masculinities studies need to go through a renewed problematisation of the social constructions of masculinities in a space–time context that intersects the economic crisis, health crisis and, on the other hand, implementation of legislation and initiatives for gender equality and citizenship, and is marked by social challenges that are related to the increase of gender inequality, violence indicators and extremism but also the emergence of caring masculinities that need closer attention. This feminist approach to masculinities allows us to critically challenge hegemonic models of boyhood/manhood, specifically by developing a FEMINIST THEORY OF CARING MASCULINITIES. Through a critical understanding of the new patterns and ways in which patriarchal masculinities are perpetuated in society, and placing CARE as the centrepiece and pro-active practise that opposes violence sustained models of masculinities, feminist masculinities studies can challenge dominant forms of masculinity by taking action in diverse social contexts and emphasising empathy, emotional expression, and cooperative relationships.
Hybrid Particle Swarm Optimization-Jaya Algorithm for Team Formation
Authors: Shingade Sandip , Niyogi Rajdeep , Pichare Mayuri
Published: August 2024

Collaboration in a network is crucial for effective team formation. This paper addresses challenges in collaboration networks by identifying the skills required for effective team formation. The communication cost is low when agents with the same skills are connected. Our main objective is to minimize team communication costs by selecting agents with the required skills. However, finding an optimal team is a computationally hard problem. This study introduces a novel hybrid approach called I-PSO-Jaya (improved PSO-Jaya, which combines PSO (Particle Swarm Optimization) and the Jaya algorithm with the Modified Swap Operator to form efficient teams. A potential application scenario of the algorithm is to build a team of engineers for an IT project. The implementation results show that our approach gives an improvement of 73% in the Academia dataset and 92% in the ACM dataset compared to existing methods.
Preparation, Characterization, and Testing of Compost Tea Derived from Seaweed and Fish Residues
Authors: Moț Andrei , Pârvulescu Oana Cristina , Ion Violeta Alexandra , Moloșag Ailin , Dobrin Aurora , Bădulescu Liliana , Orbeci Cristina , Egri Diana , Dobre Tănase , Løes Anne-Kristin , Cabell Joshua , Salifoglou Athanasios , Matsia Sevasti , Letelier-Gordo Carlos Octavio , Răducanu Cristian , Mocanu Alexandra
Published: August 2024

Non-aerated compost tea (CT) was prepared from compost derived from rockweed (Ascophyllum nodosum) and fish (cod, common ling, haddock, saithe) residues that fermented in water. Electrical conductivity, pH, concentrations of dry matter, ash, C, macronutrients (N, P, K, Ca, and Mg), and micronutrients (Cu, Fe, Mn, Mo, and Zn) of CT prepared under different fermentation conditions were measured. The effects of process factors, i.e., water/compost mass ratio (4.2–9.8 g/g) and fermentation time (4.2–9.8 days = 100–236 h), on the physicochemical properties of CT were quantified using quadratic polynomial models. CT obtained at optimal levels of process factors (4.2 g/g and 5.6 days = 134 h) was tested for lettuce seed germination and seedling growth. Diluted CT (25% CT + 75% ultrapure water) improved seedling growth while achieving a high germination percentage (97%).
The Global Rise of ESBL-Producing Escherichia coli in the Livestock Sector: A Five-Year Overview
Authors: Mandujano-Hernández Antonio , Martínez-Vázquez Ana Verónica , Paz-González Alma D. , Herrera-Mayorga Verónica , Sánchez-Sánchez Mario , Lara-Ramírez Edgar E. , Vázquez Karina , de Jesús de Luna-Santillana Erick , Bocanegra-García Virgilio , Rivera Gildardo
Published: August 2024

β-lactam antibiotics are a key element in the treatment of bacterial infections. However, the excessive use of these antibiotics has contributed to the emergence of β-lactam-resistant enterobacteria, including Escherichia coli. One of the main challenges facing the public health sector is antibacterial resistance (ABR), mainly due to limited options in its pharmacological treatment. Currently, extended-spectrum β-lactamases (ESBLs) present an alarming situation, as there is an increase in morbidity and mortality rates, prolonged hospital stays, and increased costs for sanitary supplies, which involve not only humans but also the environment and animals, especially animals destined for food production. This review presents an analysis of the prevalence of ESBL-producing E. coli and its distribution in different animal sources throughout the world, providing an understanding of the association with resistance and virulence genes, as well as perceiving the population structure of E. coli.
Advanced Manufacturing Processes
Authors: Carvalho Gustavo H. S. F. L. , Leal Rui M. , Galvão Ivan
Published: August 2024

The advancement of engineering and the emergence of increasingly individualized and specific applications have heightened the need to develop advanced manufacturing processes capable of delivering all of the required characteristics [...]
D*-KDDPG: An Improved DDPG Path-Planning Algorithm Integrating Kinematic Analysis and the D* Algorithm
Authors: Liu Chunyang , Liu Weitao , Zhang Dingfa , Sui Xin , Huang Yan , Ma Xiqiang , Yang Xiaokang , Wang Xiao
Published: August 2024

To address the limitations of the Deep Deterministic Policy Gradient (DDPG) in robot path planning, we propose an improved DDPG method that integrates kinematic analysis and D* algorithm, termed D*-KDDPG. Firstly, the current work promotes the reward function of DDPG to account for the robot’s kinematic characteristics and environment perception ability. Secondly, informed by the global path information provided by the D* algorithm, DDPG successfully avoids getting trapped in local optima within complex environments. Finally, a comprehensive set of simulation experiments is carried out to investigate the effectiveness of D*-KDDPG within various environments. Simulation results indicate that D*-KDDPG completes strategy learning within only 26.7% of the training steps required by the original DDPG, retrieving enhanced navigation performance and promoting safety. D*-KDDPG outperforms D*-DWA with better obstacle avoidance performance in dynamic environments. Despite a 1.8% longer path, D*-KDDPG reduces navigation time by 16.2%, increases safety distance by 72.1%, and produces smoother paths.
Research on the Design of Multi-Rope Friction Hoisting System of Vertical Shaft Gravity Energy Storage System
Authors: Shi Qinpeng , Wang Dagang , Zeng Xiaochao , Guo Yinan , Wang Hao , Xu Ziyang , Deng Qiao , Zhong Hailang , Wang Bo , Li Chenchen
Published: August 2024

Renewable energy generation methods such as wind power and photovoltaic power have problems of randomness, intermittency, and volatility. Gravity energy storage technology can realize the stable and controllable conversion of gravity potential energy and electric energy by lifting and lowering heavy loads. The hoisting system is an important component of a gravity energy storage system, and its lifting capacity and speed seriously restrict its energy storage capacity, energy conversion efficiency, and operational safety and reliability. In this paper, a design method for a multi-rope friction hoisting system of a vertical shaft gravity energy storage system is proposed. The parameter design and calculation of the hoisting rope, balance rope, and friction wheel of the friction hoisting system under typical conditions were carried out. The static and dynamic anti-slip capabilities of the friction hoisting system under the typical condition were explored. The results show that the maximum acceleration and deceleration speed of the compacted strand wire rope scheme is the largest, and the lifting and lowering time is the shortest. The maximum acceleration and deceleration speed of the triangular strand wire rope scheme is the lowest, and the lifting and lowering time is the longest. The dynamic tension of the hoisting rope at the heavy-load end is positively correlated with the acceleration, and the maximum value occurs in the accelerated lifting stage and decelerated lowering stage of the heavy load. The static anti-slip safety factor between the hoisting rope and the friction lining and the specific pressure between the hoisting rope and the friction lining comply with the requirements of China’s Safety Regulations for Coal Mines. The dynamic anti-slip safety factor of the hoisting system under different rope selection schemes is greater than the minimum value of 1.25 stipulated in the Safety Regulations for Metal and Nonmetal Mines. The research results are of great significance for the safety, reliability, and stable and efficient energy storage of a gravity energy storage system.
Modeling the Stress–Strain State of a Filled Human Bladder
Authors: Barulina Marina , Timkina Tatyana , Ivanov Yaroslav , Masliakov Vladimir , Polidanov Maksim , Volkov Kirill
Published: August 2024

In this paper, the problems of modeling the human bladder and its stress–strain state under an external static influence are considered. A method for the identification of the anisotropic biomechanical characteristics of the bladder tissue is proposed. An FEM model was created, which takes into account the fact that the bladder is surrounded by fiber, affected by surrounding organs, and partially protected by pelvic bones. The model considers the presence of constant hydrostatic pressure on the walls of the bladder when it is full. It has been shown that the isotropic mechanical characteristics of biological tissue can be used for studying the deformed state of a filled bladder if a filled bladder of 300 mL is considered as the initial non-deformed stage. This was shown by the modeling and verification of the effect of the external static force on the bladder. Numerical experiments were conducted based on the constructed model. To validate the results obtained, a series of natural experiments on the effect of external pressure on the bladder under ultrasound control were conducted. In the future, there are plans to use the constructed model to study rupture deformations of the bladder under the influence of static and dynamic loads.
10 Years of Convergent Neck Implants: A Systematic Review of Clinical Outcomes, Initial Original Concepts, and Changes in Surgical and Prosthetic Protocols
Authors: Zamparini Fausto , Spinelli Andrea , Gandolfi Maria Giovanna , Prati Carlo
Published: August 2024

The study reviewed the state of the art of the clinical use of a convergent-neck-designed Prama implant. This implant was introduced approximately 10 years ago and was characterized by a specific and unique convergent neck with a microtextured surface (UTM surface) and Zirconium Titanium (ZirTi) implant body surface. The neck design was developed to adopt the biologically oriented preparation technique (BOPT). A critical analysis of the published clinical studies and an evaluation of the adopted clinical protocols were performed. A total of forty-six articles were eligible to be reviewed. Only sixteen clinical studies reported clinical outcomes on Prama implants, and nine of these were selected having the longest follow-up from different research groups. The clinical follow-up/duration of the studies ranged from 12 months to 6 years. The initially proposed protocols explored neck supracrestal–transmucosal placement and gained interest due to its minimally invasive concept and the ability to proceed without a pre-prosthesis second surgery. The following investigations dedicated attention to the subcrestal or equicrestal implant placement with the conventional flap approach. The clinical studies characterized by the transmucosal exposed neck approach reported high survival rates with a stable bone morphology and reduced bone loss during the follow-up. Further recent implementations included the introduction of different convergent neck heights that need to be evaluated. The use of intraoral scanner technologies and digital workflow resulted in a simpler methodology with control of the marginal crown morphology. The studies support the concept that the hard tissue parameters (such as marginal bone level, MBL) and soft tissue parameters (such as pink esthetic score, PES) were stable or improved during the follow-up. Definitive crowns, designed with low invasiveness for soft tissues, were possible thanks to the morphology of the neck. The clinical studies support the use of the Prama implant with the different neck positions, demonstrating hard tissue preservation and optimal esthetic results in the first years following insertion. However, the current body of evidence is not robust enough to draw definitive conclusions, especially in the long term, and further high-quality research (long-term randomized trials) is required to consolidate these early observations.
Principal Component Approach and Relationship between Nomination Scale for Identification of Football Talent and Physical Fitness in Young Soccer Players
Authors: Castro-Infantes Santiago , Soto Hermoso Víctor M. , Martín-Moya Ricardo , Manuel Clemente Filipe , Sarmento Hugo , Castillo-Rodríguez Alfonso , González-Fernández Francisco Tomás
Published: August 2024

The present study aimed to investigate the relationship between the physical capabilities of young soccer players and their performance in game-related variables as assessed through the Nomination Scale for Identifying Football Talent (NSIFT) questionnaire. A total of 80 young soccer players, with an average age of 10.70 ± 1.02 years, participated in the research. Each player underwent a comprehensive assessment session that included the 5-0-5 Change of Direction (COD) test, the Illinois Agility Test, and the Countermovement Jump (CMJ) test. These assessments were selected to evaluate critical physical attributes essential for soccer performance such as agility, explosive strength, and the ability to change direction rapidly. To analyze the data, Principal Component Analysis (PCA), a statistical technique that reduces the dimensionality of large datasets while retaining as much variance as possible, was employed. The PCA results indicated strong sample validity as confirmed by the Kaiser–Meyer–Olkin (KMO) measurement index, which assesses the adequacy of the sample size for factor analysis. The analysis revealed two principal components: development and disposition, which together accounted for 73% of the total variance in the data. The development component encompasses various physical attributes that contribute to a player’s growth and improvement, including strength, speed, and agility. Conversely, the disposition component reflects innate qualities and cognitive skills that predispose players to excel in soccer such as decision making and game awareness. This research highlights the importance of incorporating physical assessments into talent identification processes, providing objective measures that complement subjective evaluations. This study contributed to the literature on talent identification in soccer, emphasizing the need for a multidisciplinary approach to nurture young athletes effectively. Future research should continue to explore the interplay between physical and cognitive skills in soccer to enhance player development and success in competitive environments.
Structural Particularities, Prediction, and Synthesis Methods in High-Entropy Alloys
Authors: Caramarin Stefania , Badea Ioana-Cristina , Mosinoiu Laurentiu-Florin , Mitrica Dumitru , Serban Beatrice-Adriana , Vitan Nicoleta , Cursaru Laura-Madalina , Pogrebnjak Alexander
Published: August 2024

High-Entropy Alloys (HEAs) represent a transformative class of materials characterized by multiple principal elements and high configurational entropy. This review article provides an in-depth examination of their structural particularities, prediction methodologies, and synthesis techniques. HEAs exhibit unique structural stability due to high-entropy effects, severe lattice distortions, and slow diffusion processes. Predictive models, including thermodynamic and kinetic approaches, are essential for understanding phase stability. Various synthesis methods impact HEA properties, and advanced characterization techniques are crucial for their study. The article highlights current applications and future research directions, emphasizing the potential of HEAs in diverse technological fields.
EEG-Based Methods for Diagnosing Color Vision Deficiency: A Comprehensive Review
Authors: AlEssa Ghada N. , Alzahrani Saleh I.
Published: August 2024

Color vision deficiency (CVD) is one of the most common disorders related to visual impairment. Individuals with this condition are unable to differentiate between colors due to the absence or impairment of one or more color photoreceptors in their retinas. This disorder can be diagnosed through multiple approaches. This review paper provides a comprehensive summary of studies on applying Brain–Computer Interface (BCI) technology for diagnosing CVD. The main purpose of this review is to help researchers understand how BCI can be further developed and utilized for diagnosing CVD in the future.
Factors Affecting Cell Viability during the Enzymatic Dissociation of Human Endocrine Tumor Tissues
Authors: Shcherbakova Anastasia , Utkina Marina , Valyaeva Anna , Pachuashvili Nano , Bondarenko Ekaterina , Urusova Liliya , Popov Sergey , Mokrysheva Natalya
Published: August 2024

The enzymatic dissociation of human solid tissues is a critical process for disaggregating extracellular matrix and the isolation of individual cells for various applications, including the immortalizing primary cells, creating novel cell lines, and performing flow cytometry and its specialized type, FACS, as well as conducting scRNA-seq studies. Tissue dissociation procedures should yield intact, highly viable single cells that preserve morphology and cell surface markers. However, endocrine tissues, such as adrenal gland tumors, thyroid carcinomas, and pituitary neuroendocrine tumors, present unique challenges due to their complex tissue organization and morphological features. Our study conducted a morphological examination of these tissues, highlighting the intricate structures and secondary degenerative changes that complicate the dissociation process. We investigated the effects of various dissociation parameters, including the types of enzymes, incubation duration, and post-dissociation purification procedures, such as debris removal and nontarget blood cell lysis, on the viability of cells derived from different tumor types. The findings emphasize the importance of optimizing tissue digestion protocols to preserve cell viability and integrity, ensuring reliable outcomes for downstream analyses.
Correction: Esmaeilzadeh et al. RETRACTED: Identify Biomarkers and Design Effective Multi-Target Drugs in Ovarian Cancer: Hit Network-Target Sets Model Optimizing. Biology 2022, 11, 1851
Authors:   Biology Editorial Office
Published: August 2024

A correction has been made to the authorship list of this article [...]
A Novel Personalized Strategy for Hip Joint Flexion Assistance Based on Human Physiological State
Authors: Wu Beixian , Chen Chunjie , Wang Sheng , Chen Hui , Wang Zhuo , Liu Yao , He Tingwei , Zhang Jiale , Wu Xinyu
Published: August 2024

Soft exosuits have emerged as potent assistive tools for walking support and rehabilitation training. However, most existing soft exosuit systems rely on preset assistance modes, which may not accurately align with individual physiological states and movement requirements, leading to variable user experiences and efficacy. While existing human-in-the-loop (HIL) research predominantly focuses on optimizing metabolic cost and torque difference parameters, there is a notable absence of real-time monitoring methods that closely reflect the human body’s physiological state and strategies that dynamically indicate walking efficiency. Motivated by this, we developed a novel personalized power-assist system. This system optimizes the power-assist output of the hip joint by monitoring the user’s physiological and motion signals in real time, including heart rate (HR), blood oxygen saturation (SpO2), and inertial measurement unit (IMU) data, to assist hip flexion based on feedback. The findings from a metabolic expenditure trial demonstrate that the innovative soft exosuit, which is based on a Physiological State Monitoring Control (PSMC) system, achieves a reduction of 7.81% in metabolic expenditure during treadmill walking at a speed of 3.5 km/h compared to walking without the assistance of the exosuit. Additionally, during continuous exercise with varying intensities, the metabolic consumption level is reduced by 5.1%, 5.8%, and 8.2% at speeds of 2, 4, and 6 km per hour, respectively. These results support the design of a novel hip flexion-assisting soft exosuit, demonstrating that applying different assistance forces in consideration of different physiological states is a reasonable approach to reducing metabolic consumption.
Real-World Adherence to a Delirium Screening Test Administered by Nurses and Medical Staff during Routine Patient Care
Authors: Soboh Rashad , Rotfeld Meital , Gino-Moor Sharon , Jiries Nizar , Ginsberg Shira , Oliven Ron
Published: August 2024

Delirium is often the first symptom of incipient acute illness or complications and must therefore be detected promptly. Nevertheless, routine screening for delirium in acute care hospital wards is often inadequate. We recently implemented a simple, user-friendly delirium screening test (RMA) that can be administered during ward rounds and routine nursing care. The test was found to be non-inferior to 4AT in terms of sensitivity and specificity. However, the dominant factors to take into account when assessing the performance of a test added to the routine work of busy acute care hospital wards are ease of administration, real-life amenability and the ability of the staff to adhere to testing requirements. In this study, we evaluated the prevalence of daily RMA tests that were not administered as scheduled and the impact of these omissions on the overall real-world performance of RMA. Using point-in-time assessments of 4AT by an external rater, we found that complete RMA was administered in 88.8% of the days. Physicians omitted significantly more tests than nurses, but their results were more specific for delirium. Omissions reduced the sensitivity and specificity of RMA for delirium (compared to 4AT) from 90.7% to 81.7%, and from 99.2% to 87.8%, respectively. Ideally, the number of omitted RMA tests should be minimized. However, if over 85% of the daily quota of complete tests are administered, the sensitivity and specificity of RMA for diagnosing delirium as soon as it appears remain at acceptable levels.
Efficacy of a Virtual Reality Rehabilitation Protocol Based on Art Therapy in Patients with Stroke: A Single-Blind Randomized Controlled Trial
Authors: Tieri Gaetano , Iosa Marco , Fortini Antonio , Aghilarre Federica , Gentili Federico , Rubeca Cristiano , Mastropietro Tommaso , Antonucci Gabriella , De Giorgi Roberto
Published: August 2024

Background: Art therapy has a long history of applications in cognitive and motor rehabilitation. More recently, a growing body of scientific literature has highlighted the potential of virtual reality in neurorehabilitation, though it has focused more on the technology itself than on the principles adopted in digital scenarios. Methods: This study is a single-blind randomized controlled trial conducted on 40 patients with stroke, comparing conventional therapy (physical therapy for the upper and lower limbs, for posture and balance, cognitive therapy, occupational therapy, speech therapy, and specific therapy for swallowing, bowel, and bladder dysfunctions) to a protocol in which the upper limb physical therapy was substituted with art therapy administered by means of virtual reality exploiting the so-called Michelangelo effect. Results: After 12 sessions, patients in the virtual art therapy group showed a significantly greater improvement in independence in activities of daily living, as assessed by the Barthel Index (interaction of time and group: p = 0.001). Significant differences were also found in terms of upper limb muscle strength (Manual Muscle Test, p < 0.01) and reduction in spasticity (Ashworth scale, p = 0.007) in favor of the experimental group. In the virtual art therapy group, the effectiveness of the intervention was significantly correlated with patient participation (Pittsburgh Rehabilitation Participation Scale: R = 0.41), patient satisfaction (R = 0.60), and the perceived utility of the intervention by the therapist (R = 0.43). Conclusions: These findings support the efficacy of virtual art therapy leveraging the Michelangelo effect. Further studies should also focus on cognitive domains that could benefit from this type of approach.
Difficulties among Teachers’ Emotional Regulation: Analysis for the Development of Student Well-Being in Chilean Schools
Authors: Fuentes-Vilugrón Gerardo , Sandoval-Obando Eduardo , Caamaño-Navarrete Felipe , Arriagada-Hernández Carlos , Etchegaray-Pezo Paulo , Muñoz-Troncoso Flavio , Cuadrado-Gordillo Isabel , del Val Martín Pablo , Riquelme-Mella Enrique
Published: August 2024

Introduction. Emotional regulation, a process that involves detecting and evaluating physiological signals in response to stressful events, is a crucial aspect of preparing students for school and ensuring teachers’ effectiveness, stress management, and job satisfaction. Method. This research, which adopted a quantitative approach, used a non-experimental comparative and cross-sectional design with a non-probabilistic sample by convenience. The study involved the participation of n = 1321 teachers (n = 125 preschool education; n = 645 primary education; n = 417 secondary education; n = 134 higher education). Results. The results revealed significant differences in the total scores of emotional regulation difficulty between teachers at the higher education level and primary and secondary school teachers, with the latter group showing higher levels of difficulty. Discussion. The findings suggest that the impact of emotional regulation difficulties affects professional performance, highlighting the importance of interventions aimed at improving teachers’ self-efficacy, resilience, and emotion regulation to reduce emotional exhaustion. Conclusion. From a practical point of view, our findings underline the importance of integrating emotional regulation training into pre-service teacher education and continuous teacher professional development programs. This could improve relational dynamics between students and teachers, fostering an environment conducive to teaching and learning processes.
Test Procedures and Mechanical Properties of Three-Dimensional Printable Concrete Enclosing Different Mix Proportions: A Review and Bibliometric Analysis
Authors: Huseien Ghasan Fahim , Tan Shea Qin , Saleh Ali Taha , Lim Nor Hasanah Abdul Shukor , Ghoshal Sib K.
Published: August 2024

Three-dimensional printable concrete (3DPC) has become increasingly popular in the building and architecture industries due to its low cost and fast design. Currently, there is great interest in the mix design methods and mechanical properties of 3DPC, particularly in relation to yield stress analysis. The ability to extrude and build 3D-printed objects can be significantly affected by factors such as the rate of extrusion, nozzle size, and type of pumps used. It has been observed that a yield stress lower than 1.5 to 2.5 kPa is not sufficient to maintain the shape stability of concrete, while a yield stress above this range can limit the material’s extrudability. Furthermore, the strength properties of 3DPC are influenced by factors such as changes in yield stress and superplasticiser dosages. To meet the high mechanical strength and durability requirements of 3DPC in the construction industry, it is essential to analyse the material’s early-age mechanical properties. However, the development of standardised test methods for 3DPC is still deficient. To address this issue, a bibliometric analysis was conducted to comprehensively review the diverse test methods and mechanical characteristics of 3DPC with different mix proportions. To produce high-performance concrete from various additives and waste materials, it is critical to have a basic understanding of the hydration processes of 3DPC. Moreover, a detailed analysis of the environmental impact and energy efficiency of 3DPC is necessary for its widespread implementation. This review article will highlight the recent trends, upcoming challenges, and benefits of using 3DPC. It serves as a taxonomy to navigate the field of 3DPC towards sustainable development.
Valuation of Project Managers to Enhance Project Performance in Nigeria’s Construction Industry
Authors: Iroha Ebuka Valentine , Watanabe Tsunemi , Tsuchiya Satoshi
Published: August 2024

Construction project management is critical to the success of construction projects, with the performance of project managers (PMRs) playing a central role. Despite its importance, previous studies have highlighted the poor performance of construction organizations in Nigeria, such as project delays and cost overruns and the need for proper project management practices. However, the specific performance of PMRs in the Nigerian construction industry (NCI) has not been extensively studied. To address this issue, this study aims to identify the causes of underperformance among PMRs in the NCI by examining the tasks where PMRs underperform and the extent of this underperformance and its effect on motivational support from organizations. Data were collected through 206 questionnaires and 36 semi-structured interviews with organizations and project managers. Descriptive analysis was conducted to evaluate project management (PM) practices as well as the level of motivational support provided to PMRs. The analysis revealed that PMRs underperform in more than 60% of tasks but outperform in 20%. Underperformance refers to the tasks in which PMRs performed less than the expected contributions set by the organization, while outperformance describes tasks where PMRs exceeded the organization’s expectations. The analysis also revealed low motivational support of PMR. Correlation analysis was conducted to investigate whether motivational support influences PMR performance, and the results indicated a two-way causal relationship between underperformance and low motivational support. This study integrated a game theory model with regression analysis to show that (stay, support) is the dominant solution for project managers and organizations, provided the net contribution of support is positive. In this context, “stay” refers to PMRs continuing working with their current organization, while “support” refers to the motivational support provided by the organization to enhance the commitment and performance of the PMRs. However, current support levels may not be enough to cause PMRs to begin to outperform. In addition, regression analysis was conducted between the degree of underperformance and motivational factors, and we conducted a preliminary simulation by increasing these values of regression coefficients. The results indicated that while motivational support from organizations can improve PMRs performance, its effectiveness is limited. Factors such as corruption, political pressures, and organizational culture have a greater impact on performance. Addressing these factors may be more crucial for enhancing performance and project outcomes than focusing only on motivational support. Therefore, the Nigerian construction industry needs to implement institutional changes alongside motivational strategies to improve PMRs performance and project success.
New Insights into the Exosome-Induced Migration of Uveal Melanoma Cells and the Pre-Metastatic Niche Formation in the Liver
Authors: Ramos Raquel , Vinyals Antònia , Campos-Martin Rafael , Cabré Eduard , Bech Joan Josep , Vaquero Javier , Gonzalez-Sanchez Ester , Bertran Esther , Ferreres Josep Ramon , Lorenzo Daniel , De La Torre Carolina G. , Fabregat Isabel , Caminal Jose Maria , Fabra Àngels
Published: August 2024

UM is an aggressive intraocular tumor characterized by high plasticity and a propensity to metastasize in the liver. However, the underlying mechanisms governing liver tropism remain poorly understood. Given the emerging significance of exosomes, we sought to investigate the contribution of UM-derived exosomes to specific steps of the metastatic process. Firstly, we isolated exosomes from UM cells sharing a common genetic background and different metastatic properties. A comparison of protein cargo reveals an overrepresentation of proteins related to cytoskeleton remodeling and actin filament-based movement in exosomes derived from the parental cells that may favor the detachment of cells from the primary site. Secondly, we assessed the role of macrophages in reprogramming the HHSCs by exosomes. The activation of HHSCs triggered a pro-inflammatory and pro-fibrotic environment through cytokine production, upregulation of extracellular matrix molecules, and the activation of signaling pathways. Finally, we found that activated HHSCs promote increased adhesion and migration of UM cells. Our findings shed light on the pivotal role of exosomes in pre-metastatic niche construction in the liver.
Recurrence Rates and Patterns after Radical Resection of Lung Carcinoids
Authors: Askildsen Erika , Soldath Patrick , Langer Seppo W. , Andreassen Mikkel , Knigge Ulrich , Petersen René Horsleben
Published: August 2024

Atypical lung carcinoid (AC) is widely accepted to recur more often after radical resection than typical lung carcinoid (TC). However, their recurrence rates have never been compared in a multi-state competing risks model. We retrospectively reviewed files from patients with AC and TC who had been radically resected at our European Neuroendocrine Tumor Society Center of Excellence between 2009 and 2020. We estimated the recurrence rates between the AC and TC patients counting unrelated death as a competing event using Aalen–Johansen estimates and compared them using a multi-state Cox model. Finally, we analyzed all AC and TC recurrences as to resection type, pathological stage, resection margin, recurrence site, and time to recurrence. The study included 217 patients, of whom 194 had TC and 23 had AC. The median follow-up was 9.4 years. The AC patients experienced recurrence at a higher rate (hazard ratio [HR] 16.0, 95% confidence interval [CI] 5.3–47.9, p < 0.001). Correspondingly, the 5- and 10-year recurrence rates were 18% and 32% for AC and merely 1.0% and 2.4% for TC. In patients without nodal involvement, AC recurred at a considerably higher rate (HR 41.2, 95% CI 8.7–194.8, p < 0.001) than TC. In both AC and TC, most recurrences were distant and occurred in patients with a resection margin less than 2 cm. We conclude that AC recurs more often than TC, even in patients without nodal involvement at surgery, suggesting that all AC patients regardless of their pathological stage should undergo close follow-up care after surgery.
Pre-Operative Calcitonin and CEA Values May Predict the Extent of Metastases to the Lateral Neck Lymph Nodes in Patients with Medullary Thyroid Cancer
Authors: Prinzi Antonio , Frasca Francesco , Russo Marco , Pellegriti Gabriella , Piticchio Tommaso , Tumino Dario , Belfiore Antonino , Malandrino Pasqualino
Published: August 2024

Background: In medullary thyroid cancer (MTC), lymph node metastases are often present at diagnosis and the extent of surgery is usually based upon pre-operative calcitonin and CEA levels as well as ultrasound findings. The aim of this study was to evaluate the role of pre-operative calcitonin and CEA levels as predictive markers of the burden of lymph node metastases at diagnosis. Methods: we conducted a retrospective study analyzing 87 MTC patients. Results: The median levels of calcitonin and CEA were 88.4 pg/mL and 7.0 ng/mL, respectively, in patients with no lymph nodes metastases; 108.0 pg/mL and 9.6 ng/mL, respectively, in patients with metastases to 1–5 lymph nodes; 520.5 pg/mL and 43.2 ng/mL, respectively, in patients with metastases to >5 lymph nodes. There were no significant differences in pre-operative calcitonin and CEA values between N0 and N1a patients, whereas they were significantly higher in N1b patients. Pre-operative cut-off levels distinguishing N0/N1a from N1b patients were 90 pg/mL for calcitonin (sensitivity 100%, specificity 59.3%, AUC = 0.82) and 17 ng/mL for CEA (sensitivity 100%, specificity 75%, AUC = 0.89). Conclusions: in patients with MTC, pre-operative serum calcitonin and CEA levels may drive the decision-making process to better define the extent of surgery.
Prognostic Role of Clinicopathological Characteristics and Serum Markers in Metastatic Melanoma Patients Treated with BRAF and MEK Inhibitors
Authors: Janka Eszter Anna , Szabó Imre Lőrinc , Kollár Sándor , Toka-Farkas Tünde , Ványai Beatrix , Várvölgyi Tünde , Kapitány Anikó , Shabu Hibah , Szegedi Andrea , Emri Gabriella
Published: August 2024

Prognostic studies can provide important information about disease biology and improve the use of biomarkers to optimize treatment decisions. Methods: A total of 199 patients with advanced melanoma treated with BRAF + MEK inhibitors were included in our single-center retrospective study. We analyzed the risk of progression and death using multivariate Cox proportional hazard models. The predictive effect of prognostic factors on progression-free survival (PFS) was evaluated in ROC analysis. Results: We found that primary tumor localization, Clark level, pT category, baseline M stage and baseline serum S100B are independent and significant prognostic factors for PFS. The discriminative power of the combination of these factors was excellent for predicting 18 month PFS (AUC 0.822 [95% CI 0.727; 0.916], p < 0.001). Primary tumor localization on the extremities, Clark level V, baseline M1c stage or M1d stage, and elevated baseline serum S100B and LDH levels were independently and significantly associated with unfavorable overall survival (OS). Conclusion: Baseline M stage and serum S100B appear to be independent prognostic factors for both PFS and OS in melanoma patients treated with BRAF + MEK inhibitors. We newly identified significant and independent prognostic effects of primary tumor localization and Clark level on survival that warrant further investigation.