bluuebunny/crossref_metadata_2025 huggingface dataset:
Deep Sedation for Dental Care Management in Healthy and Special Health Care Needs Children: A Retrospective Study
Authors: Gómez-Ríos Inmaculada , Pérez-Silva Amparo , Serna-Muñoz Clara , Ibáñez-López Francisco Javier , Periago-Bayonas Paula M. , Ortiz-Ruiz Antonio J.
Published: February 2023

Background: Very young children, and those with disabilities and extensive oral pathology, who cannot be treated in the dental chair, require deep sedation or general anesthesia for dental treatment. Objective: The aim of this study is to describe and compare the oral health status in healthy and SHCN children and the treatments performed under deep sedation on an outpatient basis with a minimal intervention approach, and their impact on quality of life. Methods: A retrospective study between 2006 and 2018 was made. A total of 230 medical records of healthy and SHCN children were included. The data extracted were age, sex, systemic health status, reason for sedation, oral health status before sedation, treatments administered during sedation, and follow-up. The quality of life after deep sedation of 85 children was studied through parental questionnaires. Descriptive and inferential analyses were made. Results: Of the 230 children, 47.4% were healthy and 52.6% were SHCN. The median age was 7.10 ± 3.40 years (5.04 ± 2.42 in healthy children and 8.95 ± 3.09 in SHCN children). The main reason for sedation was poor handling in the dental chair (99.5%). The most frequent pathologies were caries (90.9%) and pulp pathology (67.8%). Healthy children had more teeth affected by decay and with pulp involvement. Patients aged < 6 years received more pulpectomies and pulpotomies. After treatment, parents stated that children were more rested and less irascible, ate better, increased in weight, and had improved dental aesthetics. Conclusions: Differences in treatments carried out did not depend on the general health status or the failure rate but on age, with more pulp treatments in healthy children who were younger, and more extractions near to the age of physiological turnover in children with SHCN who were older. Intervention under deep sedation with a minimally invasive treatments approach met the expectations of parents and guardians, as it improved the children’s quality of life.
Three-Dimensional Carbon Monolith Coated by Nano-TiO2 for Anode Enhancement in Microbial Fuel Cells
Authors: Zhao Fan , Chen Yini , Zhang Shiyang , Li Meng , Tang Xinhua
Published: February 2023

A three-dimensional (3D) anode is essential for high-performance microbial fuel cells (MFCs). In this study, 3D porous carbon monoliths from a wax gourd (WGCM) were obtained by freeze-drying and carbonization. Nano-TiO2 was further coated onto the surface of WGCM to obtain a nano-TiO2/WGCM anode. The WGCM anode enhanced the maximum power density of MFCs by 167.9% compared with the carbon felt anode, while nano-TiO2/WGCM anode additionally increased the value by 45.8% to achieve 1396.2 mW/m2. WGCM enhancement was due to the 3D porous structure, the good conductivity and the surface hydrophilicity, which enhanced electroactive biofilm formation and anodic electron transfer. In addition, nano-TiO2 modification enhanced the enrichment of Acinetobacter, an electricigen, by 31.0% on the anode to further improve the power production. The results demonstrated that the nano-TiO2/WGCM was an effective anode for power enhancement in MFCs.
Digitalisation Medical Records: Improving Efficiency and Reducing Burnout in Healthcare
Authors: Shaharul Nur Adibah , Ahmad Zamzuri Mohd ‘Ammar Ihsan , Ariffin Ahmad Azuhairi , Azman Ahmad Zaid Fattah , Mohd Ali Noor Khalili
Published: February 2023

(1) Background: electronic medical record (EMR) systems remain a significant priority for the improvement of healthcare services. However, their implementation may have resulted in a burden on healthcare workers (HCWs). This study aimed to determine the prevalence of burnout symptoms among HCWs who use EMRs at their workplace, as well as burnout-associated factors. (2) Methods: an analytical cross-sectional study was conducted at six public health clinics equipped with an electronic medical record system. The respondents were from a heterogeneity of job descriptions. Consent was obtained before enrolment into the study. A questionnaire was distributed through an online platform. Ethical approval was secured. (3) Results: a total of 161 respondents were included in the final analysis, accounting for a 90.0% response rate. The prevalence of burnout symptoms was 10.7% (n = 17). Three significant predictors were obtained in the final model: experiencing ineffective screen layouts and navigation systems, experiencing physical or verbal abuse by patients, and having a poor relationship with colleagues. (4) Conclusions: the prevalence of burnout symptoms among healthcare workers working with electronic medical record systems was low. Despite several limitations and barriers to implementation, a paradigm shift is needed to equip all health sectors with electronic medical record systems to improve healthcare service delivery. Continuous technical support and financial resources are important to ensure a smooth transition and integration.
Spatial Distribution, Contamination Assessment and Origin of Soil Heavy Metals in the Danjiangkou Reservoir, China
Authors: Dong Qiuyao , Song Chao , Yang Dongxue , Zhao Yuqing , Yan Mingjiang
Published: February 2023

Soil heavy metal contamination is crucial due to menacing food safety and mortal health. At present, with the fast advancement of urbanization and industrialization, heavy metals are increasingly released into the soil by anthropogenic activities, and the soil ecosystem contamination around the Danjiangkou Reservoir is directly associated with water quality security of the reservoir. In this paper, using 639 soil samples from the Danjiangkou Reservoir, Henan Province, China, we studied a variety of space distribution characteristics of heavy metals in soil. Geographic information system analysis (GIS), geo-accumulation index (Igeo), contamination factor (CF), principal component analysis (PCA) model, and positive matrix factorization (PMF) model were used together to recognize and quantify the distribution, contamination, and origin of heavy metals. We uncovered an exceptional variety of heavy metal concentrations among the tested soils: the mean arsenic (As), cadmium (Cd), cobalt (Co), chromium (Cr), manganese (Mn), nickel (Ni), zinc (Zn), lead (Pb) and mercury (Hg) concentrations (14.54, 0.21, 18.69, 81.69, 898.42, 39.37, 79.50, 28.11, 0.04 mg/kg, respectively, in the topsoil (0–20 cm depth)), all exceed their background values. The mean Igeo value and CF values of these trace elements are both in descending order: Cd > Co > Mn > Ni > Pb > Zn > Cr > As > Hg. Cd was the highest contributor to the assessment of heavy metal pollution, with an average Igeo value over three, indicating that the study area is modestly contaminated by Cd. The PCA analysis and PMF model revealed three potential sources, including natural sources (PC1) for Cr, Co, Mn and Ni; agricultural sources (PC2) for Cd, Zn and Hg; and industrial emissions and transportation sources (PC3) for Pb. This study displays a map of heavy metal contamination in the eastern area topsoil of the Danjiangkou Reservoir, showing the most severe pollutant is Cd, which poses a threat to the water quality security of Danjiangkou Reservoir and provides a significant source identification for future contamination control.
Prevalence and Determinants of Excessive Screen Viewing Time in Children Aged 3–15 Years and Its Effects on Physical Activity, Sleep, Eye Symptoms and Headache
Authors: Jain Shilpa , Shrivastava Shreya , Mathur Aditya , Pathak Deepali , Pathak Ashish
Published: February 2023

Screen viewing time is the total time spent by a child on any digital/electronic device. The objective of the present study was to determine the prevalence and predictors of excessive screen viewing time in children in Ujjain, India. This cross-sectional, community-based study was conducted through a house-to-house survey using the three-stage cluster sampling method in 36 urban wards and 36 villages of Ujjain District, India. Excessive screen viewing time was defined as screen viewing for >2 h/day. The prevalence of excessive screen viewing time was 18%. Risk factors identified using the multivariate logistic regression model were age (OR: 1.63, p < 0.001); mobile phone use before bedtime (OR: 3.35, p = 0.004); parents’ perception about the child’s habituation to screen time (OR: 8.46, p < 0.001); television in the bedroom (OR: 35.91, p < 0.001); morning mobile screen viewing time (OR: 6.40, p < 0.001); not reading books other than textbooks (OR: 6.45, p < 0.001); and lack of outdoor play for >2 h (OR: 5.17, p < 0.001). The presence of eye pain was a protective factor for excessive screen viewing time (OR: 0.13, p = 0.012). This study identified multiple modifiable risk factors for excessive screen viewing time.
The Emotion Regulation Questionnaire: Psychometric Properties and Prediction of Posttraumatic Consequences during the COVID-19 Pandemic in Chilean Adults
Authors: García Felipe E. , Vergara-Barra Pablo , Concha-Ponce Pablo , Andrades Mariela , Rincón Paulina , Valdivia-Devia Mauricio
Published: February 2023

The Emotion Regulation Questionnaire (ERQ) is widely used to assess the use of cognitive reappraisal and expressive suppression strategies to regulate negative emotions. The present study evaluates the psychometric properties, reliability and validity of a Chilean adaptation of the ERQ in a large sample of 1543 participants aged between 18 and 87 (38% male, 62% female). The results of the confirmatory factor analysis showed the expected two-factor structure and factorial invariance in relation to gender. Results also indicated adequate internal consistency, test–retest reliability, convergent and predictive validity in predicting posttraumatic stress symptoms and posttraumatic growth six months after the first measurement in a subsample of students exposed to the COVID-19 pandemic. The use of reappraisal was positively associated with general well-being, whereas the use of suppression was positively associated with depressive symptomatology. In terms of posttraumatic consequences, the use of reappraisal was negatively associated with posttraumatic symptomatology and positively associated with posttraumatic growth six months later; in turn, suppression was positively associated with posttraumatic symptomatology and negatively associated with posttraumatic growth six months later. This study demonstrates that the ERQ is a valid and reliable instrument to measure emotional regulation strategies in Chilean adults.
Design of a Computer Model for the Identification of Adolescent Swimmers at Risk of Low BMD
Authors: Marin-Puyalto Jorge , Gomez-Cabello Alba , Gomez-Bruton Alejandro , Matute-Llorente Angel , Castillo-Bernad Sergio , Lozano-Berges Gabriel , Gonzalez-Agüero Alejandro , Casajus Jose A. , Vicente-Rodriguez German
Published: February 2023

This paper aims to elaborate a decision tree for the early detection of adolescent swimmers at risk of presenting low bone mineral density (BMD), based on easily measurable fitness and performance variables. The BMD of 78 adolescent swimmers was determined using dual-energy X-ray absorptiometry (DXA) scans at the hip and subtotal body. The participants also underwent physical fitness (muscular strength, speed, and cardiovascular endurance) and swimming performance assessments. A gradient-boosting machine regression tree was built to predict the BMD of the swimmers and to further develop a simpler individual decision tree. The predicted BMD was strongly correlated with the actual BMD values obtained from the DXA (r = 0.960, p < 0.001; root mean squared error = 0.034 g/cm2). According to a simple decision tree (74% classification accuracy), swimmers with a body mass index (BMI) lower than 17 kg/m2 or a handgrip strength inferior to 43 kg with the sum of both arms could be at a higher risk of having a low BMD. Easily measurable fitness variables (BMI and handgrip strength) could be used for the early detection of adolescent swimmers who are at risk of suffering from low BMD.
Improving Intensive Care Unit Early Readmission Prediction Using Optimized and Explainable Machine Learning
Authors: González-Nóvoa José A. , Campanioni Silvia , Busto Laura , Fariña José , Rodríguez-Andina Juan J. , Vila Dolores , Íñiguez Andrés , Veiga César
Published: February 2023

It is of great interest to develop and introduce new techniques to automatically and efficiently analyze the enormous amount of data generated in today’s hospitals, using state-of-the-art artificial intelligence methods. Patients readmitted to the ICU in the same hospital stay have a higher risk of mortality, morbidity, longer length of stay, and increased cost. The methodology proposed to predict ICU readmission could improve the patients’ care. The objective of this work is to explore and evaluate the potential improvement of existing models for predicting early ICU patient readmission by using optimized artificial intelligence algorithms and explainability techniques. In this work, XGBoost is used as a predictor model, combined with Bayesian techniques to optimize it. The results obtained predicted early ICU readmission (AUROC of 0.92 ± 0.03) improves state-of-the-art consulted works (whose AUROC oscillate between 0.66 and 0.78). Moreover, we explain the internal functioning of the model by using Shapley Additive Explanation-based techniques, allowing us to understand the model internal performance and to obtain useful information, as patient-specific information, the thresholds from which a feature begins to be critical for a certain group of patients, and the feature importance ranking.
Suicide Risk, Alcohol Consumption and Attitudes towards Psychological Help-Seeking among Lithuanian General Population Men, Conscripts and Regular Active Duty Soldiers
Authors: Mazulyte-Rasytine Egle , Grigiene Dovile , Gailiene Danute
Published: February 2023

The aim of this study was to investigate the relationship between suicide risk, alcohol consumption, and attitudes towards professional psychological help among Lithuanian general population men, conscripts, and regular active duty (AD) soldiers. In total, 1195 Lithuanian adult males participated in the study: 445 men from the general population, 490 conscripts, and 260 regular AD soldiers from the Lithuanian Armed Forces. The study’s measures included: general suicide risk, alcohol consumption levels, frequency of using alcohol as a means to suppress difficult thoughts and feelings, and attitudes toward psychological help. Both military samples showed significantly lower suicide risk than men from the general population. Alcohol use as a means to suppress difficult thoughts and feelings was the most significant predictor of suicide risk and a significant mediator between alcohol consumption and suicide risk in all study groups. Another significant suicide risk predictor and mediator between alcohol consumption and suicide risk—i.e., the value of seeking psychological treatment—was found only in the conscript sample. Results of the current study suggest that there is an opportunity for intervention aimed at the attitudes toward seeking professional psychological help for conscripts. However, that might not be the case for regular AD soldiers, nor the general population of Lithuanian men.
Inequalities in Resource Distribution and Healthcare Service Utilization of Long-Term Care in China
Authors: Yang Changyong , Huang Jianyuan , Yu Jiahao
Published: February 2023

Background: Long-term care (LTC) services help the elderly maintain their functional ability and live with dignity. In China, the establishment of an equitable LTC system is a primary focus of the current public health reform. This paper assesses levels of equality in resources for and utilization of LTC services between urban and rural areas and economic regions in China. Methods: We use social services data from the China Civil Affairs Statistical Yearbooks. Gini coefficients against elderly population size are calculated for the number of institutions, beds, and workers, and the concentration index (CI) against per capita disposable income is calculated for the number of disabled residents per 1000 elderly people and the number of rehabilitation and nursing services per resident. Results: The Gini coefficients against the elderly population in urban areas indicate relatively good equality. In rural areas, the Gini coefficients have increased rapidly from relatively low values since 2015. The CI values in both urban and rural areas are positive, indicating that utilization is concentrated in the richer population. In rural areas, the CI values for rehabilitation and nursing have remained above 0.50 for the last three years, implying high levels of income-related inequality. The negative CI values for rehabilitation and nursing services in urban areas in the Central economic region and rural areas in the Western region imply a concentration of resource utilization toward poorer groups. The Eastern region shows relatively high internal inequality. Conclusion: Inequalities exist between urban and rural areas in the utilization of LTC services, despite similar numbers of institution and bed resources. Resource distribution and healthcare service utilization are more equal in urban areas, creating a low level of equilibrium. This urban-rural split is a source of risk for both formal and informal LTC. The Eastern region has the largest number of resources, the highest level of utilization, and the greatest internal variation. In the future, the Chinese government should enhance support for the utilization of services for the elderly with LTC needs.
Effects of Different Recovery Modalities on Delayed Onset Muscle Soreness, Recovery Perceptions, and Performance Following a Bout of High-Intensity Functional Training
Authors: De Oliveira Francine , Paz Gabriel Andrade , Corrêa Neto Victor Gonçalves , Alvarenga Renato , Marques Neto Silvio R. , Willardson Jeffrey M. , Miranda Humberto
Published: February 2023

The purpose of this study was to investigate the effects of the foam rolling technique and static stretching on perceptual and neuromuscular parameters following a bout of high-intensity functional training (HIFT), which consisted of 100 pull-ups, 100 push-ups, 100 sit-ups, and 100 air squats (Angie benchmark) in recreationally trained men (n = 39). Following baseline measurements (Feeling Scale, Visual Analogue Scale, Total Quality Recovery, Sit-and-Reach, Countermovement Jump, and Change-of-Direction t-test), the volunteers performed a single bout of HIFT. At the end of the session, participants were randomly assigned to one of three distinct groups: control (CONT), foam rolling (FR), or static stretching (SS). At the 24 h time-point, a second experimental session was conducted to obtain the post-test values. The level of significance was set at p < 0.05. Regarding power performance, none of the three groups reached pretest levels at 24 h point of the intervention. However, the CONT group still showed a greater magnitude of effect at the 24 h time-point (ES = 0.51, p ≥ 0.05). Flexibility presented the same recovery pattern as power performance (post × 24 h CONT = ES = 0.28, FR = ES = 0.21, SS = ES = 0.19). At 24 h, all groups presented an impaired performance in the COD t-test (CONT = ES = 0.24, FR = ES = 0.65, SS = ES = 0.56 p ≥ 0.05). The FR protocol resulted in superior recovery perceptions (pre × 24 h TQR = ES = 0.32 p ≥ 0.05). The results of the present study indicate that the use of FR and SS exercises may not be indicated when aiming to restore neuromuscular performance following a single bout of HIFT. The use of the FR technique during the cooldown phase of a HIFT session may be helpful in improving an individual’s perception of recovery.
Nutritional Status of Coronary Artery Disease Patients—Preliminary Results
Authors: Popiolek-Kalisz Joanna , Blaszczak Piotr
Published: February 2023

Introduction: Malnutrition is a condition that negatively impacts the clinical outcomes of numerous diseases. The aim of this study was to assess the nutritional status of coronary artery disease (CAD) patients and to investigate its relationship with the main clinical aspects of CAD. Material and methods: 50 CAD patients undergoing coronary angiography were enrolled in this study. The nutritional status assessment was based on Nutritional Risk Score 2002 (NRS 2002), body mass index (BMI), and bioelectrical impedance analysis (BIA) measurements. Results: The analysis showed a moderate inverse correlation between NRS 2002 and BIA phase angle measured at 50 kHz (R: −0.31; p = 0.03) and Z200/5 parameter (R: 0.34; p = 0.02). The analysis of CAD clinical parameters showed a significant correlation between NRS 2002 and Canadian Cardiovascular Society (CCS) class (R: 0.37; p = 0.01). Left ventricle ejection fraction (LVEF) was correlated with BMI (R: 0.38; p = 0.02), however further BIA revealed hydration changes as LVEF was correlated to intracellular (ICF) and extracellular fluid (ECF) proportion: positively with ICF (R: 0.38; p = 0.02) and negatively with ECF (R: −0.39; p = 0.02). Conclusions: NRS 2002 and BIA are valuable tools for nutritional status assessment in CAD patients. Malnutrition is related to the severity of CAD symptoms, particularly in women. Maintaining proper nutritional status can have a potentially important role in this group of patients.
Developing Psychological Resilience to the Impact of Drought
Authors: Abunyewah Matthew , Byrne Mitchell K. , Keane Carol A. , Bressington Daniel
Published: February 2023

Background: Drought is a slow-onset natural hazard with significant socioeconomic, environmental and psychological impacts. The extant literature has predominately focused on the physical and economic dimensions of resilience, which mainly address the socioeconomic and environmental consequences of drought. However, the mental health effects of chronic environmental adversity, such as prolonged drought, remain an under-researched area, and frameworks that build and strengthen the psychological aspect of the social resilience of communities are lacking. Methods: This feasibility study will employ a mixed-method design sub-divided into three phases. Phase 1 will utilise social network analysis (SNA) to identify leadership patterns and their intersections across communities. While phase 2 will use semi-structured interviews to ascertain the perceived roles of identified leaders in preparing for and recovering from drought impacts, the third phase will adopt the Delphi method to unpack existing perceptions of control, coherence and connectedness.
The Psychological Impact of the COVID-19 Pandemic on Alcohol Abuse and Drunkorexia Behaviors in Young Adults
Authors: Di Tata Daniele , Bianchi Dora , Pompili Sara , Laghi Fiorenzo
Published: February 2023

The COVID-19 outbreak negatively affected young adults’ psychological well-being, increasing their stress levels and symptoms of anxiety and depression, and potentially triggering health-risk behaviors. The present study was aimed at investigating the psychological impact of the COVID-19 pandemic on alcohol abuse and drunkorexia behaviors among young adults living in Italy. Participants were 370 emerging adults (63% women, 37% men; Mage = 21.00, SDage = 2.96, range: 18–30) who were recruited through an online survey between November 2021 and March 2022. Participants completed measures of alcohol abuse, drunkorexia behaviors, negative life experiences, and post-traumatic symptoms related to the COVID-19 outbreak. The results showed that the emotional impact and negative life experiences associated with the pandemic predicted both alcohol abuse and drunkorexia behaviors, albeit in different ways. Specifically, the number of negative life experiences during the pandemic and the tendency to avoid COVID-19–related negative thoughts positively predicted alcohol abuse; and the presence of intrusive thoughts associated with the pandemic significantly predicted the frequency of drunkorexia behaviors. Implications for research and clinical practice are discussed.
The Role of “Physiologically Based Pharmacokinetic Model (PBPK)” New Approach Methodology (NAM) in Pharmaceuticals and Environmental Chemical Risk Assessment
Authors: Deepika Deepika , Kumar Vikas
Published: February 2023

Physiologically Based Pharmacokinetic (PBPK) models are mechanistic tools generally employed in the pharmaceutical industry and environmental health risk assessment. These models are recognized by regulatory authorities for predicting organ concentration–time profiles, pharmacokinetics and daily intake dose of xenobiotics. The extension of PBPK models to capture sensitive populations such as pediatric, geriatric, pregnant females, fetus, etc., and diseased populations such as those with renal impairment, liver cirrhosis, etc., is a must. However, the current modelling practices and existing models are not mature enough to confidently predict the risk in these populations. A multidisciplinary collaboration between clinicians, experimental and modeler scientist is vital to improve the physiology and calculation of biochemical parameters for integrating knowledge and refining existing PBPK models. Specific PBPK covering compartments such as cerebrospinal fluid and the hippocampus are required to gain mechanistic understanding about xenobiotic disposition in these sub-parts. The PBPK model assists in building quantitative adverse outcome pathways (qAOPs) for several endpoints such as developmental neurotoxicity (DNT), hepatotoxicity and cardiotoxicity. Machine learning algorithms can predict physicochemical parameters required to develop in silico models where experimental data are unavailable. Integrating machine learning with PBPK carries the potential to revolutionize the field of drug discovery and development and environmental risk. Overall, this review tried to summarize the recent developments in the in-silico models, building of qAOPs and use of machine learning for improving existing models, along with a regulatory perspective. This review can act as a guide for toxicologists who wish to build their careers in kinetic modeling.
A Human-Centered Design Approach to Develop Oral Health Nursing Interventions in Patients with a Psychotic Disorder
Authors: Kuipers Sonja , Castelein Stynke , Kronenberg Linda , Veer Job van ’t , Boonstra Nynke
Published: February 2023

In mental health, oral health is often given little attention. Mental health nurses (MHNs) are professionally the appropriate target group to support maintaining and increasing oral health. We aimed to develop and validate personas that reflect the attitudes and needs of MHNs regarding oral health in patients with a psychotic disorder. We used a human-centered design with contextual interviews (n = 10) to address the key issues of the problems and needs of MHNs working with patients with a psychotic disorder. We analyzed the data thematically and reflected on insights into unique personas, which were then validated by conducting semi-structured interviews (n = 19) and member checking. Four personas were found based on attitudes and perspectives, barriers, needs, suggestions for interventions, and site conditions regarding practicing oral care in this patient group. Our findings were as follows: the attitudes and perspectives differed from not feeling any responsibility to a holistic obligation, including oral health; suggestions for interventions for MHNs ranged from interventions focusing on improving skills and knowledge to using practical tools; most MHNs recognized themselves within a persona that had a holistic obligation that included oral health; in addition, the MHNs indicated that they considered the issue of oral health in this patient group important, but, in practice, took little responsibility for that role. These findings suggest that a toolkit with interventions for MHNs that are tailored to the personas that emerged from our research should be developed by MHNs in co-creation with designers. The differences between the perceived role and MHNs’ practice in oral health highlighted the need for role clarification and professional leadership of MHNs regarding oral health, which should be considered when developing interventions.
Beyond Sentinel Lymph Node: Outcomes of Indocyanine Green-Guided Pelvic Lymphadenectomy in Endometrial and Cervical Cancer
Authors: Chiofalo Benito , Laganà Antonio Simone , Ghezzi Fabio , Certelli Camilla , Casarin Jvan , Bruno Valentina , Sperduti Isabella , Chiantera Vito , Peitsidis Panagiotis , Vizza Enrico
Published: February 2023

Background: The aim of our study was to compare the number of lymph nodes removed during indocyanine green (ICG)-guided laparoscopic/robotic pelvic lymphadenectomy with standard systematic lymphadenectomy in endometrial cancer (EC) and cervical cancer (CC). Methods: This is a multicenter retrospective comparative study (Clinical Trial ID: NCT04246580; updated on 31 January 2023). Women affected by EC and CC who underwent laparoscopic/robotic systematic pelvic lymphadenectomy, with (cases) or without (controls) the use of ICG tracer injection within the uterine cervix, were included in the study. Results: The two groups were homogeneous for age (p = 0.08), Body Mass Index, International Federation of Gynaecology and Obstetrics (FIGO) stages (p = 0.41 for EC; p = 0.17 for CC), median estimated blood loss (p = 0.76), median operative time (p = 0.59), and perioperative complications (p = 0.66). Nevertheless, the number of lymph nodes retrieved during surgery was significantly higher (p = 0.005) in the ICG group (n = 18) compared with controls (n = 16). Conclusions: The accurate and precise dissection achieved with the use of the ICG-guided procedure was associated with a higher number of lymph nodes removed in the case of systematic pelvic lymphadenectomy for EC and CC.
Incidental Pathologic Findings from Orthodontic Pretreatment Panoramic Radiographs
Authors: Hlongwa Phumzile , Moshaoa Mpule Annah Lerato , Musemwa Charity , Khammissa Razia Abdool Gafaar
Published: February 2023

Panoramic radiography is frequently performed for new patients, follow-ups and treatment in progress. This enables dental clinicians to detect pathology, view important structures, and assess developing teeth. The objective of the study was to determine prevalence of incidental pathologic findings (IPFs) from orthodontic pretreatment panoramic radiographs at a university dental hospital. A retrospective cross-sectional review was conducted of pretreatment panoramic radiographs, using data collection sheets with predefined criteria. Demographic data and abnormalities (impacted teeth, widening of periodontal ligament, pulp stones, rotated teeth, missing teeth, unerupted teeth, crowding, spacing, supernumerary teeth, and retained deciduous teeth) were reviewed. SPSS 28.0 was used to analyze data with statistical tests set at a 5% significance level. Results: One hundred panoramic radiographs were analyzed with an age range of 7 to 57 years. The prevalence of IPFs was 38%. A total of 47 IPFs were detected with altered tooth morphology predominantly (n = 17). Most IPFs occurred in males (55.3%), with 44.7% in females. A total of 49.2% were in the maxilla and 50.8% in the mandible. This difference was statistically significant (p < 0.0475). Other abnormalities were detected in 76% of panoramic radiographs; 33 with IPFs and 43 without. A total of 134 other abnormalities detected showed predominantly impacted teeth (n = 49). Most of these abnormalities were in females (n = 77). Conclusions: The prevalence of IPFs was 38%, predominated by altered tooth morphology, idiopathic osteosclerosis, and periapical inflammatory lesions. Detection of IPFs from panoramic radiographs underscored the importance for clinicians to examine them for comprehensive diagnosis and treatment planning, especially in orthodontics.
Modelling Well-Being with Mindfulness Intervention on Bottom- and Middle-40% Income Earners in Malaysia
Authors: Zaidi Fatin Zaida , Lai Ming-Ming , Jumaat Anisah , Lee Yvonne
Published: February 2023

This paper examines mindfulness as a costless cognitive asset in reducing stress and improving subjective well-being and psychological well-being among Malaysian bottom-forty-percent and middle-forty-percent income earners, known as B40 and M40, respectively. The participants recruited for this experimental study were divided into intervention and control groups and completed pre- and post-assessment questionnaires. The leveraging on digital technologies during pandemic times from May to June 2021 enabled participants in the intervention group (n = 95) to undergo four weekly online mindfulness intervention sessions through Google Meet and completed daily home mindfulness practices using the mobile application for mindfulness: the MindFi version 3.8.0 mobile app. Based on the Wilcoxon signed-rank test, the intervention group’s mindfulness and well-being levels increased significantly after four weeks. This outcome contrasted to those in the control group (n = 31), who exhibited lower mindfulness and well-being levels. The PLS-SEM structural model consists of mindfulness as an independent variable, subjective and psychological well-being as dependent variables, and perceived stress and financial desire discrepancies as the mediators. This model has a goodness-of-fit of 0.076, proving that it is a fit and strong model. There is a positive relationship between mindfulness and subjective well-being (β = 0.162, p-value < 0.01). This model supports the mediation effect of perceived stress between mindfulness and subjective well-being variables (β = 0.152, p-value < 0.05). The overall structural model implies that the effectiveness of mindfulness intervention training not only enhanced bottom- and middle-income earners’ well-being but also lowered the perceived stress level that, henceforth, brought the mind and body together in the present moment.
COVID-19 Vaccination: Comparison of Attitudes, Decision-Making Processes, and Communication among Vaccinated and Unvaccinated Black Americans
Authors: Cunningham-Erves Jennifer , George Whitney , Stewart Elizabeth C. , Footman Alison , Davis Jamaine , Sanderson Maureen , Smalls Meredith , Morris Phillip , Clarkson Kristin , Lee Omaran , Brandt Heather M.
Published: February 2023

Background: COVID-19 vaccination rates remain suboptimal among Black Americans who disproportionately experience higher hospitalization and death rates than White Americans. Methods: We conducted a multi-method (interviews and surveys) study among 30 Black Americans (n = 16 vaccinated, n = 14 unvaccinated) to explore factors related to vaccination hesitancy, decision-making processes, and communication related to uptake. Participants were recruited by using community-driven approaches, including partner collaborations. Thematic analysis was used to analyze qualitative data, and descriptive and bivariate analysis was used for quantitative data. Results: Of those unvaccinated, 79% (n = 11) stated they were delaying and 21% (n = 3) were declining vaccination indefinitely. When asked about the likelihood of vaccine initiation in 6 months and 12 months, 29% (n = 4) and 36% (n = 5), respectively, stated that they would receive the vaccine. The following themes emerged: (1) COVID-19 vaccination hesitancy exists on a continuum; (2) varied decision-making processes for COVID-19 vaccination; (3) motivators among vaccinated individuals; (4) barriers among unvaccinated individuals; (5) retrieving and navigating vaccine information within the COVID-19 infodemic; and (6) parent perspectives on child vaccination. Conclusions: Findings suggest that vaccinated and unvaccinated participants had similar and dissimilar perspectives in decision-making processes and vaccine concerns as shown in the Decision-making Processes for the COVID-19 vaccination (DePC) model. Based on these findings, future studies should further explore how factors influencing decision-making can lead to divergent outcomes for COVID-19 vaccination.
Long-Term Outcomes after Stroke in Patients with Atrial Fibrillation: A Single Center Study
Authors: Tracz Justyna , Gorczyca-Głowacka Iwona , Rosołowska Anita , Wożakowska-Kapłon Beata
Published: February 2023

Atrial fibrillation (AF) is known to be a significant risk factor for poor prognosis after stroke. In this study, we compared differences in long-term outcomes after ischemic stroke among patients with AF and sinus rhythm (SR). We identified patients admitted to the reference Neurology Center between 1 January 2013 and 30 April 2015, inclusive, with acute ischemic stroke. Of the 1959 surviving patients, 892 were enrolled and followed for five years or until death. We analyzed the risk of stroke recurrence and death between patients with AF and SR at 1, 3, and 5 years after stroke. The rates of death and stroke recurrence were estimated using Kaplan–Meier analysis and multivariate Cox regression. During follow-up, 17.8% of patients died and 14.6% had recurrent stroke. The mortality in the AF group increased relative to the SR group with subsequent years. The risk of death was statistically higher in the AF than SR group at 1 year after stroke (13.5 vs. 7%, p = 0.004). After adjusting for age, stroke severity, and comorbidities, there was also no significant effect of AF on mortality in the first year after stroke (OR = 1.59, p = 0.247). There were no significant differences between the groups in stroke recurrence during follow-up. The results of our study showed that post-stroke patients with AF have a more severe prognosis, although AF itself does not have an independent negative effect on long-term outcomes after stroke. Long-term survival after stroke in patients with AF was strongly associated with age, stroke severity, and heart failure. The impact of other factors on prognosis after stroke in patients with AF should be considered.
The Interplay among Empathy, Vicarious Trauma, and Burnout in Greek Mental Health Practitioners
Authors: Kounenou Kalliope , Kalamatianos Antonios , Nikoltsiou Panagiota , Kourmousi Ntina
Published: February 2023

Background. Mental health professionals are at risk of experiencing vicarious trauma and burnout as a consequence of the nature of their work. Studies and scholars so far have demonstrated that empathy interacts directly with burnout, and they imply an interaction with vicarious trauma. However, research has paid little attention to the interplay among vicarious trauma, empathy, and burnout in mental health professionals who practice psychotherapy. This study examines the interplay between mental health professionals’ (those practicing psychotherapy) vicarious trauma and empathy and investigates the ways they contribute to burnout. Methods. The sample consisted of 214 mental health professionals (32 males and 182 females), working in the public and private sectors. Specific instruments were administered online to the sample: (a) an improvised demographic questionnaire (age, gender, education, specialty, years of experience, years of supervision); (b) the Counselor Burnout Inventory, validated for the Greek population by Kounenou et al.; (c) the Vicarious Trauma Scale; and (d) the Jefferson Scale of Physician Empathy. Results. Correlation analysis showed that empathy and vicarious trauma were positively related to burnout. Moreover, multiple regression analysis revealed that supervision, empathy, and, to a greater degree, vicarious trauma have a significant impact on burnout. Conclusion. Unlike relative research on burnout, gender and work experience did not seem to play a significant role in the prediction of burnout in the present study. Several suggestions for future studies, as well as implications for mental health practitioners, are discussed.
Nexus between Macroeconomic Factors and Corporate Investment: Empirical Evidence from GCC Markets
Authors: Farooq Umar , Tabash Mosab I. , Hamouri Basem , Daniel Linda Nalini , Safi Samir K.
Published: February 2023

The current study aims to explore the role of various macroeconomic factors in determining corporate investment. Using firm-level data of six Gulf Cooperation Council (GCC) region countries for a 14 year period (2007–2020), the current study establishes the empirical analysis by employing the system generalized method of moments (GMM) technique. The empirical results reveal the negative impact of foreign direct investment whilst the positive impact of economic growth, financial development, and inflation rate on corporate investment decisions. Due to high market competition, foreign direct investment can hamper the growth of domestic industrial sectors. However, economic growth, financial development, and inflation rate positively drive the investment by enhancing the demand for industrial products, cheap financing, and price appreciation effect on production enrichment respectively. Based on results, it is suggested that corporate managers should consider the economic sensitivity of investment. The novelty of study can be listed, as the current analysis presents the dynamic role of various economic factors in determining the corporate investment decisions specifically in GCC region countries.
Memory Precursors and Short-Lived Effector T cell Subsets Have Different Sensitivities to TGFβ
Authors: O’Sullivan Jeremy A. , Kohlhapp Frederick J. , Zloza Andrew , Plaza-Rojas Lourdes , Burke Brianna , Dulin Nickolai O. , Guevara-Patiño José A.
Published: February 2023

After exposure to an antigen, CD8 T cells reach a decision point about their fate: to become either short-lived effector cells (SLECs) or memory progenitor effector cells (MPECs). SLECs are specialized in providing an immediate effector function but have a shorter lifespan and lower proliferative capacity compared to MPECs. Upon encountering the cognate antigen during an infection, CD8 T cells rapidly expand and then contract to a level that is maintained for the memory phase after the peak of the response. Studies have shown that the contraction phase is mediated by TGFβ and selectively targets SLECs, while sparing MPECs. The aim of this study is to investigate how the CD8 T cell precursor stage determines TGFβ sensitivity. Our results demonstrate that MPECs and SLECs have differential responses to TGFβ, with SLECs being more sensitive to TGFβ than MPECs. This difference in sensitivity is associated with the levels of TGFβRI and RGS3, and the SLEC-related transcriptional activator T-bet binding to the TGFβRI promoter may provide a molecular basis for increased TGFβ sensitivity in SLECs.
HSPs/STAT3 Interplay Sustains DDR and Promotes Cytokine Release by Primary Effusion Lymphoma Cells
Authors: Gonnella Roberta , Arena Andrea , Zarrella Roberta , Gilardini Montani Maria Saveria , Santarelli Roberta , Cirone Mara
Published: February 2023

Primary effusion lymphoma (PEL) is a rare and aggressive B-cell lymphoma, against which current therapies usually fail. In the present study, we show that targeting HSPs, such as HSP27, HSP70 and HSP90, could be an efficient strategy to reduce PEL cell survival, as it induces strong DNA damage, which correlated with an impairment of DDR. Moreover, as HSP27, HSP70 and HSP90 cross talk with STAT3, their inhibition results in STAT3 de-phosphorylation and. On the other hand, the inhibition of STAT3 may downregulate these HSPs. These findings suggest that targeting HSPs has important implications in cancer therapy, as it can reduce the release of cytokines by PEL cells, which, besides affecting their own survival, could negatively influence anti-cancer immune response.
Relationship among Low T3 Levels, Type 3 Deiodinase, Oxidative Stress, and Mortality in Sepsis and Septic Shock: Defining Patient Outcomes
Authors: Vidart Josi , Axelrud Luiza , Braun André Cardoso , Marschner Rafael Aguiar , Wajner Simone Magagnin
Published: February 2023

Low T3 syndrome occurs frequently in patients with sepsis. Type 3 deiodinase (DIO3) is present in immune cells, but there is no description of its presence in patients with sepsis. Here, we aimed to determine the prognostic impact of thyroid hormones levels (TH), measured on ICU admission, on mortality and evolution to chronic critical illness (CCI) and the presence of DIO3 in white cells. We used a prospective cohort study with a follow-up for 28 days or deceased. Low T3 levels at admission were present in 86.5% of the patients. DIO3 was induced by 55% of blood immune cells. The cutoff value of 60 pg/mL for T3 displayed a sensitivity of 81% and specificity of 64% for predicting death, with an odds ratio of 4.89. Lower T3 yielded an area under the receiver operating characteristic curve of 0.76 for mortality and 0.75 for evolution to CCI, thus displaying better performance than commonly used prognostic scores. The high expression of DIO3 in white cells provides a novel mechanism to explain the reduction in T3 levels in sepsis patients. Further, low T3 levels independently predict progression to CCI and mortality within 28 days for sepsis and septic shock patients.
Facile Synthesis of 2D/2D Ti2C3/ZnIn2S4 Heterostructure for Enhanced Photocatalytic Hydrogen Generation
Authors: Chen Yongjuan , Ge Yanfang , Wu Chunling , Tang Hua , Luo Xiu , He Jiao , Jiang Liang , Yan Zhiying , Wang Jiaqiang
Published: February 2023

ZnIn2S4, a novel two-dimensional visible light-responsive photocatalyst, has attracted much attention in the photocatalytic evolution of H2 under visible light irradiation due to its attractive intrinsic photoelectric properties and geometric configuration. However, ZnIn2S4 still has severe charge recombination, which results in moderate photocatalytic performance. Herein, we report the successful synthesis of 2D/2D ZnIn2S4/Ti3C2 nanocomposites by a facile one-step hydrothermal method. The efficiency of the nanocomposites in photocatalytic hydrogen evolution under visible light irradiation was also evaluated for different ratios of Ti3C2, and the optimal photocatalytic activity was achieved at 5% Ti3C2. Importantly, the activity was significantly higher than that of pure ZnIn2S4, ZnIn2S4/Pt, and ZnIn2S4/graphene. The enhanced photocatalytic activity is mainly due to the close interfacial contact between Ti3C2 and ZnIn2S4 nanosheets, which amplifies the transport of photogenerated electrons and enhances the separation of photogenerated carriers. This research describes a novel approach for the synthesis of 2D MXenes for photocatalytic hydrogen production and expands the utility of MXene composite materials in the fields of energy storage and conversion.
New Sources, Differentiation, and Therapeutic Uses of Mesenchymal Stem Cells 2.0
Authors: Jung Sung-Chul , Park Saeyoung
Published: February 2023

For the clinical application of mesenchymal stem cells (MSCs), the optimization of biological products (e [...]