bluuebunny/crossref_metadata_2025 huggingface dataset:
“Work Like a Chinese”: Aspirations, Patterns of Work, and Working Conditions of the Chinese Immigrant Community in Southern Spain
Authors: Badanta Bárbara , González-Cano Caballero María , Fernández-García Elena , de Diego-Cordero Rocío , Lucchetti Giancarlo , Fernández-Castillo Rafael-Jesús , Barrientos-Trigo Sergio
Published: September 2020

Expanding businesses was the main reason for the immigration of Chinese people in Spain, which consists the fifth largest nationality of immigrants in this country. Nevertheless, few studies have been carried out to understand the working conditions of this population. Using an ethnographic design, this study examined the work patterns and working conditions among Chinese immigrants living in southern Spain and how these factors affected their health. Observing participants, field notes, and semi-structured interviews with question script were conducted with 133 Chinese immigrants. Five main themes were defined: “Economic improvement as a migratory reason”, “Conception to Work”, “Labor Sector”, “Work conditions”, and “Occupational health”. Our results showed that Chinese immigrants worked in the provision of services, with long working hours and little rest. Although they had low rates of unemployment, the working conditions had an important impact on their dietary patterns and their family life. Ergonomic and psychosocial risks also explained high rates of musculoskeletal problems and stress. In conclusion, Chinese immigrants living in southern Spain work actively in the service sector of the economy, but with many work hours. These characteristics seem to impact their health at a physical, psychological, and social level.
Adolescent Enrollment in Psychosocial Care: Do Parents Make a Difference?
Authors: Paclikova Katerina , Dankulincova Veselska Zuzana , Madarasova Geckova Andrea , Dijk Jitse P. van , Reijneveld Sijmen A.
Published: September 2020

Care for adolescents with emotional and behavioral problems (EBP) is frequently unequally distributed. Parents may play a role in the access to this care. Therefore, the aim was to explore the association between parental characteristics and their adolescent’s enrollment in psychosocial care. We used data from the Care4Youth cohort study. Our sample consisted of 446 adolescents (mean age 13.22 years, 48% boys) and 382 parents (mean age 42.95 years, 14% males). EBP combined with enrollment created four groups: 1, no EBP/no care; 2, no EBP/care; 3, EBP/no care; 4, EBP/care. We assessed differences in parental characteristics among the groups. Group 2 had a significantly lower socioeconomic position (p < 0.01), more psychological distress (p < 0.001), poorer supervision (p < 0.001) and lower family social support (p < 0.05) than Group 1. Group 4 had a significantly lower socioeconomic position (p < 0.01) and poorer supervision (p < 0.001) than Group 1. Group 3 had significantly poorer supervision (p < 0.001) than Group 4. The poor supervision in Group 3 requires attention, as these adolescents receive no care. The quality of parental supervision should be addressed generally, e.g., by providing better parenting support and more parental training.
The Moderating Effect of Nursing Practice Environment on the Relationship between Clinical Nurses’ Sleep Quality and Wellness
Authors: Hong Kyung Jin , Lee Youngjin
Published: September 2020

This study examined the moderating effect of nursing practice environment on the relationship between clinical nurses’ sleep quality and wellness. The wellness of clinical nurses is a direct outcome of individual-level health behaviors and organizational environmental factors. This study was a cross-sectional analysis. Participants were clinical nurses recruited using convenience sampling. The Nurse Practice Environment Scale, Wellness Index, and Pittsburgh Sleep Quality Index, Korean version (PSQI-K) were used. Data collected from 1874 nurses were analyzed using descriptive statistics and hierarchical multiple regression analyses. A total of 95.3% of the participants were women, and the mean age was 28.8 years. Further, 42.4% of the participants had a nursing career of 5 years or longer. The mean score for nursing practice environment was 2.24 and the mean PSQI-K score was 9.39. Nurses with less than 1 year of experience reported lower wellness scores. The wellness scores decreased with poorer sleep quality, and a more positive evaluation of the nursing practice environment predicted higher levels of wellness. Nursing practice environment had a moderating effect on the negative association of nurses’ poor sleep quality with their wellness. Regarding management, individual strategies for nurses’ well-being and organizational improvement policies may improve the nursing work environment.
Multidimensional Geriatric Assessment with MAGIC Questionnaire and Quality of Life in Elderly Primary Care Patients
Authors: Dios-Quiroga Fátima , Soliño-Lourido Susana , Pallas-Queijo Carmen , González-Formoso Clara , Constenla-Castro Aurelia , Conde-Freire Soledad , Clavería Ana
Published: September 2020

The Manageable Geriatric Assessment (MAGIC) questionnaire, recently developed by a group of European family doctors for multidimensional geriatric assessment in primary care, has not yet been evaluated in clinical practice. The objectives of this study were to translate and adapt it to Spanish and to check the association between the limitations of older adults identified by this questionnaire and their perceived health status assessed by the five-level version of the EuroQol-5D (EQ-5D-5L). First, questionnaire translation, back translation and cognitive test were applied. Then, a cross-sectional observational study was performed in two Spanish health centers Galicia, Spain. Participants were 170 people aged over 75, recruited opportunistically by consecutive case sampling. Anonymous surveys were used to collect data. The MAGIC questionnaire, the EQ-5D-5L scale, age and sex were employed. The visual analog scale of EQ-5D-5L (EQ VAS) was used as the outcome variable. Descriptive and bivariate analyses by sex and outcome variable are presented. The linear regression analysis showed an association with quality of life for daily activities, recognizing people and stress incontinence. As this is associated with quality of life, the MAGIC questionnaire may be useful in primary care and a study to investigate the impact on health with a clinical trial would be worth considering.
Psychometric Properties of the Persian Pittsburgh Sleep Quality Index for Adolescents
Authors: Chehri Azita , Brand Serge , Goldaste Nastaran , Eskandari Sodabeh , Brühl Annette , Sadeghi Bahmani Dena , Khazaie Habibolah
Published: September 2020

Background: Both cross-sectional and longitudinal studies show that poor sleep is a health concern related to further psychological and physiological issues during adolescence. To assess subjective sleep quality and sleep patterns among adults, the Pittsburgh Sleep Quality Index (PSQI) is a well and internationally established tool. Here, we established the psychometric properties of the Persian version of the PSQI for adolescents. Method: A total of 1477 adolescents (mean age: 15.47 years; 53.2% females) took part in the study. They completed a booklet on sociodemographic information, the Persian version of the PSQI for adolescents, and the Adolescent Sleep Hygiene Scale (ASHS). We relied on classical test reliability approaches of exploratory and confirmatory factor analyses. Results: Classical exploratory factor analysis yielded the seven-factor solution, with concurrent confirmation and overlap with the dimensions of the ASHS, although correlation coefficients were small to medium. A further factor analysis yielded a four-factor solution, explaining 72% of the variance of the PSQI. Further, three out of these four factors predicted the ASHS overall score. Conclusions: The Persian version of the PSQI for adolescents showed satisfactory psychometric properties. It follows that the Persian PSQI is a suitable tool to assess sleep quality and sleep patterns among adolescents.
Trends of Alcohol Use, Dietary Behaviour, Interpersonal Violence, Mental Health, Oral and Hand Hygiene Behaviour among Adolescents in Lebanon: Cross-Sectional National School Surveys from 2005, 2011 and 2017
Authors: Pengpid Supa , Peltzer Karl
Published: September 2020

Health risk behaviours during adolescence can have long-term negative consequences. Little is known, however, about the recent health risk behaviour trends in adolescents in Lebanon. This investigation aimed to report the trends in the prevalence of various health risk behaviours, such as alcohol use, dietary behaviour, interpersonal violence, mental health, oral and hand hygiene, among adolescents in Lebanon. Cross-sectional nationally representative data were analysed from 13,109 adolescents (14 years median age) that participated in three waves (2005, 2011 and 2017) of the “Lebanon Global School-Based Student Health Survey (GSHS)”. Results indicate that significant improvements were found among both boys and girls in the decline in interpersonal violence (bulling victimization, being physically attack and involvement in physical fighting), poor washing of hands after using the toilet, and suicide planning, and among girls only loneliness, worry-induced sleep disturbance and suicidal ideation. Significant increases were found among both boys and girls in the prevalence of inadequate fruit consumption, and among boys only unintentional injury and not always washing hands before eating. In conclusion, several decreases but also increases in health risk behaviours were found over three assessment points during a period of 12 years calling for continued health enhancing activities in this adolescent population.
Tourism Destination Management Strategy for Young Children: Willingness to Pay for Child-Friendly Tourism Facilities and Services at a Heritage Site
Authors: Song Hwasung , Park Chanyul , Kim Miseong
Published: September 2020

The present study seeks to establish tourism destination management centered on young children for accessible tourism from a public perspective. Preferences for services and facilities for young children were identified using a choice experiment (CE). The present study was conducted at Hwaseong Fortress, a UNESCO World Heritage Site, located in Suwon City, which leads the clean restroom culture. Overall, 1870 experiments were conducted with 374 participants to estimate their willingness to pay for child-friendly tourism facilities and services. As a result, willingness to pay was found in the order of specialized courses for young children, rest areas, restrooms, and rides. In conclusion, the importance of health/hygiene and amenities has implications for tourism destination management for young children. This study contributes to a better understanding of families with young children by evaluating preferences for levels of services and facilities for young children.
Outcome and Subsequent Pregnancy after Fertility-Sparing Surgery of Early-Stage Cervical Cancers
Authors: Lee Chia-Yi , Chen Yu-Li , Chiang Ying-Cheng , Cheng Ching-Yu , Lai Yen-Ling , Tai Yi-Jou , Hsu Heng-Cheng , Hwa Hsiao-Lin , Cheng Wen-Fang
Published: September 2020

We aimed to investigate the outcomes and subsequent pregnancies of early-stage cervical cancer patients who received conservative fertility-sparing surgery. Women with early-stage cervical cancer who underwent conservative or fertility-sparing surgery in a tertiary medical center were reviewed from 2004 to 2017. Each patient’s clinicopathologic characteristics, adjuvant therapy, subsequent pregnancy, and outcome were recorded. There were 32 women recruited, including 12 stage IA1 patients and 20 stage IB1 patients. Twenty-two patients received conization/LEEP and the other 10 patients received radical trachelectomy. Two patients did not complete the definite treatment after fertility-sparing surgery. There were 11 women who had subsequent pregnancies and nine had at least one live birth. The live birth rate was 73.3% (11/15). We conclude that patients with early-stage cervical cancer who undergo fertility-sparing surgery can have a successful pregnancy and delivery. However, patients must receive a detailed consultation before surgery and undergo definitive treatment, if indicated, and regular postoperative surveillance.
Shaping Policy on Chronic Diseases through National Policy Dialogs in CHRODIS PLUS
Authors: Sienkiewicz Dorota , Maassen Alison , Imaz-Iglesia Iñaki , Poses-Ferrer Elisa , McAvoy Helen , Horgan Rita , Arriaga Miguel Telo de , Barnfield Andrew
Published: September 2020

Policy dialogs are deliberative dialogue that gather policy makers and relevant stakeholders from across disciplines to discuss a topic of mutual interest. They typically serve as a single element in a broader policymaking cycle, either informing the content of new policy or forming a component of policy evaluation and review. In the joint action CHRODIS PLUS, national policy dialogs were conducted in fourteen EU Member States. The aim of the dialogs was to identify new policies or changes to existing policies and legislation that are capable of tackling major risk factors for chronic disease, to strengthen health promotion and prevention programs and to ensure health systems are equipped to respond to priority issues within the chronic diseases field. In this paper, we present the CHRODIS PLUS policy dialog methodology, as well as results and lessons learnt from three national policy dialogs held in Ireland, Portugal and Spain. After discussion of the results, we conclude that the CHRODIS PLUS methodology is an effective mechanism to provoke deliberative discussion around chronic disease prevention and management in different countries. However, it is essential to ensure adequate human and financial resources—as well as political commitment—to accomplish objectives set out during the policy dialogs. We argue that priority-setting across sectors can improve the resilience of health systems and opportunities for investment in Health in All Policies (HiAP), both at European Union and Member State levels.
Sensory Processing, Functional Performance and Quality of Life in Unilateral Cerebral Palsy Children: A Cross-Sectional Study
Authors: Jovellar-Isiegas Patricia , Resa Collados Inés , Jaén-Carrillo Diego , Roche-Seruendo Luis Enrique , Cuesta García César
Published: September 2020

Background: The study of children with unilateral cerebral palsy (UCP) has traditionally focused on motor aspects. The extent to which sensory processing disorders can affect their functional performance and quality of life (QoL) is uncertain. This study aimed to explore the differences in sensory processing between UCP and typical development (TD) children and to analyze the relationship of sensory processing with functional performance and QoL. Methods: Fifty-three children aged from 6 to 15 years (TD = 24; UCP = 29) were recruited. The Child Sensory Profile 2, Pediatric Evaluation of Disability Inventory—Computer Adaptive Test and Kidscreen were used to evaluate sensory processing, functional performance and QoL. Results: UCP children showed sensory processing difficulties (avoidance: p = 0.02; registration: p = 0.00; body position: p = 0.00; oral: p = 0.02; social-emotional: p = 0.01), and scored lower in functional performance (daily activities: p = 0.00; mobility: p = 0.00; social/cognitive: p = 0.04) and in physical well-being (p = 0.00). The highest correlations in UCP group were found between proprioceptive processing and daily activities and mobility (r = −0.39); auditory, visual and tactile information and school environment (r = −0.63; r = −0.51; r = −0.46); behavioral and social-emotional responses and psychological well-being (r = −0.64; r = −0.49). Conclusions: UCP children have greater difficulty in sensory processing than TD children. Difficulties in proprioceptive processing contribute to poorer functional performance. Auditory, visual and tactile processing is associated with participation in the school environment and behavioral and social-emotional responses related to sensory processing are associated with the psychological well-being.
Pressure Stimuli Improve the Proliferation of Wharton’s Jelly-Derived Mesenchymal Stem Cells under Hypoxic Culture Conditions
Authors: Park Sang Eon , Kim Hyeongseop , Kwon Soojin , Choi Suk-joo , Oh Soo-young , Ryu Gyu Ha , Jeon Hong Bae , Chang Jong Wook
Published: September 2020

Mesenchymal stem cells (MSCs) are safe, and they have good therapeutic efficacy through their paracrine action. However, long-term culture to produce sufficient MSCs for clinical use can result in side-effects, such as an inevitable senescence and the reduction of the therapeutic efficacy of the MSCs. In order to overcome this, the primary culture conditions of the MSCs can be modified to simulate the stem cells’ niche environment, resulting in accelerated proliferation, the achievement of the target production yield at earlier passages, and the improvement of the therapeutic efficacy. We exposed Wharton’s jelly-derived MSCs (WJ-MSCs) to pressure stimuli during the primary culture step. In order to evaluate the proliferation, stemness, and therapeutic efficacy of WJ-MSCs, image, genetic, and Western blot analyses were carried out. Compared with standard incubation culture conditions, the cell proliferation was significantly improved when the WJ-MSCs were exposed to pressure stimuli. However, the therapeutic efficacy (the promotion of cell proliferation and anti-apoptotic effects) and the stemness of the WJ-MSCs was maintained, regardless of the culture conditions. Exposure to pressure stimuli is a simple and efficient way to improve WJ-MSC proliferation without causing changes in stemness and therapeutic efficacy. In this way, clinical-grade WJ-MSCs can be produced rapidly and used for therapeutic applications.
Patient-Derived Induced Pluripotent Stem Cell-Based Models in Parkinson’s Disease for Drug Identification
Authors: Kouroupi Georgia , Antoniou Nasia , Prodromidou Kanella , Taoufik Era , Matsas Rebecca
Published: September 2020

Parkinson’s disease (PD) is a common progressive neurodegenerative disorder characterized by loss of striatal-projecting dopaminergic neurons of the ventral forebrain, resulting in motor and cognitive deficits. Despite extensive efforts in understanding PD pathogenesis, no disease-modifying drugs exist. Recent advances in cell reprogramming technologies have facilitated the generation of patient-derived models for sporadic or familial PD and the identification of early, potentially triggering, pathological phenotypes while they provide amenable systems for drug discovery. Emerging developments highlight the enhanced potential of using more sophisticated cellular systems, including neuronal and glial co-cultures as well as three-dimensional systems that better simulate the human pathophysiology. In combination with high-throughput high-content screening technologies, these approaches open new perspectives for the identification of disease-modifying compounds. In this review, we discuss current advances and the challenges ahead in the use of patient-derived induced pluripotent stem cells for drug discovery in PD. We address new concepts implicating non-neuronal cells in disease pathogenesis and highlight the necessity for functional assays, such as calcium imaging and multi-electrode array recordings, to predict drug efficacy. Finally, we argue that artificial intelligence technologies will be pivotal for analysis of the large and complex data sets obtained, becoming game-changers in the process of drug discovery.
Potential Role of Lycopene in the Prevention of Postmenopausal Bone Loss: Evidence from Molecular to Clinical Studies
Authors: Walallawita Umani S. , Wolber Frances M. , Ziv-Gal Ayelet , Kruger Marlena C. , Heyes Julian A.
Published: September 2020

Osteoporosis is a metabolic bone disease characterized by reduced bone mineral density, which affects the quality of life of the aging population. Furthermore, disruption of bone microarchitecture and the alteration of non-collagenous protein in bones lead to higher fracture risk. This is most common in postmenopausal women. Certain medications are being used for the treatment of osteoporosis; however, these may be accompanied by undesirable side effects. Phytochemicals from fruits and vegetables are a source of micronutrients for the maintenance of bone health. Among them, lycopene has recently been shown to have a potential protective effect against bone loss. Lycopene is a lipid-soluble carotenoid that exists in both all-trans and cis-configurations in nature. Tomato and tomato products are rich sources of lycopene. Several human epidemiological studies, supplemented by in vivo and in vitro studies, have shown decreased bone loss following the consumption of lycopene/tomato. However, there are still limited studies that have evaluated the effect of lycopene on the prevention of bone loss in postmenopausal women. Therefore, the aim of this review is to summarize the relevant literature on the potential impact of lycopene on postmenopausal bone loss with molecular and clinical evidence, including an overview of bone biology and the pathophysiology of osteoporosis.
Physiologic and Metabolic Changes in Crepidiastrum denticulatum According to Different Energy Levels of UV-B Radiation
Authors: Park Song-Yi , Lee Mee-Youn , Lee Choong-Hwan , Oh Myung-Min
Published: September 2020

Ultraviolet B (UV-B) light, as a physical elicitor, can promote the secondary metabolites biosynthesis in plants. We investigated effects of different energy levels of UV-B radiation on growth and bioactive compounds of Crepidiastrum denticulatum. Three-week-old seedlings were grown in a plant factory for 5 weeks. Plants were subjected to different levels of UV-B (0, 0.1, 0.25, 0.5, 1.0, and 1.25 W m−2), 6 h a day for 6 days. All UV-B treatments had no negative effect on the shoot dry weight; however, relatively high energy treatments (1.0 and 1.25 W m−2) inhibited the shoot fresh weight. UV-B light of 0.1, 0.25, and 0.5 W m−2 did not affect total chlorophyll and H2O2 contents; however, they increased total carotenoid content. On 4 days, 0.25 W m−2 treatment increased antioxidant capacity, total hydroxycinnamic acids (HCAs) content, and several sesquiterpenes. Treatments with 1.0 and 1.25 W m−2 increased total carotenoid, total HCAs, and H2O2 contents, and destroyed chlorophyll pigments, reducing maximum quantum yield of photosystem II and causing visible damage to leaves. Partial least squares discrimination analysis (PLS-DA) showed that secondary metabolites were distinguishably changed according to energy levels of UV-B. The potential of 0.25 W m−2 UV-B for the efficient production of bioactive compounds without growth inhibition in C. denticulatum was identified.
Association of Human Leukocyte Antigens Class II Variants with Susceptibility to Hidradenitis Suppurativa in a Caucasian Spanish Population
Authors: Ocejo-Vinyals J. Gonzalo , Gonzalez-Gay Miguel A. , Fernández-Viña Marcelo A. , Cantos-Mansilla Juan , Vilanova Iosune , Blanco Ricardo , González-López Marcos A.
Published: September 2020

Hidradenitis suppurativa (HS) is a chronic inflammatory cutaneous disease of the hair follicle typically presenting recurrent, painful, and inflamed lesions on the inverse areas of the body. Although its pathogenesis remains unknown, the immune system appears to play a potential role. To date, two previous studies have not found any association between the Human Leukocyte Antigen system (HLA) and HS. In this study we analyzed the HLA-A, -B, -C; and DRB1, -DQA1, and –DQB1 allele distribution in 106 HS patients and 262 healthy controls from a Caucasian population in Cantabria (northern Spain). HLA-A*29 and B*50 were significantly more common in HS patients and A*30 and B*37 in controls, but these associations disappeared after statistical correction. DRB1*07, DQA1*02, and DQB1*02 were significantly more common in controls (p 0.026, p 0.0012, and p 0.0005, respectively) and the HLA allele DQB1*03:01 was significantly more common in HS patients (p 0.00007) after the Bonferroni correction. The DRB1*07~DQA1*02~DQB1*02 haplotype was significantly more common in controls (p < 0.0005). This is the first study showing an association between HLA-class II and HS. Our results suggest that HLA-II alleles (DRB1*07, DQA1*02, DQB1*02, and DQB1*03:01) and the DRB1*07~DQA1*02~DQB1*02 haplotype could influence resistance or susceptibility to HS.
Low Physical Activity in Patients with Complicated Type 2 Diabetes Mellitus Is Associated with Low Muscle Mass and Low Protein Intake
Authors: Hagedoorn Ilse J. M. , den Braber Niala , Oosterwijk Milou M. , Gant Christina M. , Navis Gerjan , Vollenbroek-Hutten Miriam M. R. , van Beijnum Bert-Jan F. , Bakker Stephan J. L. , Laverman Gozewijn D.
Published: September 2020

Objective: In order to promote physical activity (PA) in patients with complicated type 2 diabetes, a better understanding of daily movement is required. We (1) objectively assessed PA in patients with type 2 diabetes, and (2) studied the association between muscle mass, dietary protein intake, and PA. Methods: We performed cross-sectional analyses in all patients included in the Diabetes and Lifestyle Cohort Twente (DIALECT) between November 2016 and November 2018. Patients were divided into four groups: <5000, 5000–6999, 7000–9999, ≥ 10,000 steps/day. We studied the association between muscle mass (24 h urinary creatinine excretion rate, CER) and protein intake (by Maroni formula), and the main outcome variable PA (steps/day, Fitbit Flex device) using multivariate linear regression analyses. Results: In the 217 included patients, the median steps/day were 6118 (4115–8638). Of these patients, 48 patients (22%) took 7000–9999 steps/day, 37 patients (17%) took ≥ 10,000 steps/day, and 78 patients (36%) took <5000 steps/day. Patients with <5000 steps/day had, in comparison to patients who took ≥10,000 steps/day, a higher body mass index (BMI) (33 ± 6 vs. 30 ± 5 kg/m2, p = 0.009), lower CER (11.7 ± 4.8 vs. 14.8 ± 3.8 mmol/24 h, p = 0.001), and lower protein intake (0.84 ± 0.29 vs. 1.08 ± 0.22 g/kg/day, p < 0.001). Both creatinine excretion (β = 0.26, p < 0.001) and dietary protein intake (β = 0.31, p < 0.001) were strongly associated with PA, which remained unchanged after adjustment for potential confounders. Conclusions: Prevalent insufficient protein intake and low muscle mass co-exist in obese patients with low physical activity. Dedicated intervention studies are needed to study the role of sufficient protein intake and physical activity in increasing or maintaining muscle mass in patients with type 2 diabetes.
Paraneoplastic Neurological Syndromes: Study of Prevalence in a Province of the Lombardy Region, Italy
Authors: Lorusso Lorenzo , Precone Vincenza , Ferrari Daniela , Ngonga Gaelle K. , Russo Antonio Giampiero , Paolacci Stefano , Bertelli Matteo
Published: September 2020

Paraneoplastic neurological syndromes (PNSs) are a heterogeneous group of rare immune-mediated diseases associated with cancer. The aim of this study was to investigate the prevalence of PNSs in the province of Brescia. PNS prevalence was calculated using the Lombardy regional hospital admission records from 1998 to 2003. We used the website “Epidemiologic and Economic Atlas of Hospital Activities in Lombardy” and the “International Statistical Classification of Diseases and Related Health Problems”. In the province of Brescia, we found 54 cases of PNSs, 29 with subacute neuropathies, five with paraneoplastic cerebellar degeneration and 20 with encephalomyelitis. Peripheral nervous system diseases were the most frequent neurological disorders. In Lombardy, the number of PNS patients admitted was 322 (133 with encephalomyelitis, 21 with paraneoplastic cerebellar degeneration, 166 with polyneuropathies and two with optic degeneration). In Lombardy, the prevalence of PNSs was 25 in 100,000 hospital admissions and 5.92 in 100,000 for the Lombardy population. Our results show a discrete presence of PNS patients in the province of Brescia and in the Lombardy region as a whole.
Benefit of Ambulatory Management of Patients with Chronic Heart Failure by Protocolized Follow-Up Therapeutic Education and Remote Monitoring Solution: An Original Study in 159 Patients
Authors: Jenneve Anne , Lorenzo-Villalba Noel , Courdier Guy , Talha Samy , Séverac François , Zulfiqar Abrar-Ahmad , Arnold Patrick , Lang Philippe , Roul Gérald , Andrès Emmanuel
Published: September 2020

This study sought to determine whether the implementation of regular and structured follow-up of patients with chronic heart failure (CHF), combined with therapeutic education and remote monitoring solution, leads to better management. This was a single-center retrospective study conducted in a cohort of patients with proven CHF who were followed up in the Mulhouse region (France) between January 2016 and December 2017 by the Unité de Suivi des Patients Insuffisants Cardiaques (USICAR) unit. These patients received regular protocolized follow-up, a therapeutic education program, and several used a telemedicine platform for a two-year period. The primary endpoint was the number of days hospitalized for heart failure (HF) per patient per year. The main secondary endpoints included the number of days hospitalized for a heart condition other than HF and the number of hospital stays for HF per patient. These endpoints were collected during the year preceding enrollment, at one year of follow-up, and at two years of follow-up. The remote monitoring solution was evaluated on the same criterion. Overall, 159 patients with a mean age of 72.9 years were included in this study. They all had CHF, mainly NYHA Class I-II (88.7%), predominantly of ischemic origin (50.9%), and with altered left ventricular ejection fraction in 69.2% of cases. The mean number of days hospitalized for HF per patient per year was 8.33 (6.84–10.13) in the year preceding enrollment, 2.6 (1.51–4.47) at one year of follow-up, and 2.82 at two years of follow-up (1.30–6.11) (p < 0.01 for both comparisons). The mean number of days hospitalized for a heart condition other than HF was 1.73 (1.16–2.6), 1.81 (1.04–3.16), and 1.32 (0.57–3.08), respectively (p = ns). The percentage of hospitalization for HF for each patient was 69.5% (60.2–77.4), 16.2% (10–25.2), and 19.3% (11–31.8), respectively (p < 0.001 for both comparisons). In the group telemedicine, the mean number of days hospitalized for HF per patient per year was 8.33 during the year preceding enrollment, 2.3 during the first year of follow-up, and 1.7 during the second. This difference was significant (p < 0.001). The “number of days hospitalized for a heart condition other than HF” was significantly reduced in the group of patient’s beneficiating from the remote monitoring solution. This study demonstrates the value of a protocolized follow-up associated with a therapeutic optimization, therapeutic education program, and the use of a remote monitoring solution to improve the management of ambulatory patients with CHF, particularly of moderate severity.
Growth Differentiation Factor-15 as a Potent Predictor of Long-Term Mortality among Subjects with Osteoarthritis
Authors: Arnold Natalie , Rehm Martin , Büchele Gisela , Peter Raphael Simon , Brenner Rolf Erwin , Günther Klaus-Peter , Brenner Hermann , Koenig Wolfgang , Rothenbacher Dietrich
Published: September 2020

Background: Subjects with osteoarthritis (OA) are at increased risk for cardiovascular (CV) and all-cause mortality. Whether biomarkers improve outcome prediction in these patients remains to be elucidated. We investigated the association between growth differentiation factor 15 (GDF-15), a novel stress-responsive cytokine, and long-term all-cause mortality among OA patients. Methods: Within the Ulm Osteoarthritis Study, GDF-15 has been measured in the serum of 636 subjects, who underwent hip or knee arthroplasty between 1995 and 1996 (median age 65 years). Results: During a median follow-up of 19.7 years, a total of 402 deaths occurred. GDF-15 was inversely associated with walking distance. Compared to the bottom quartile (Q), subjects within the top quartile of GDF-15 demonstrated a 2.69-fold increased risk of dying (hazard ratio (HR) (95% confidence interval (CI)) 2.69 (1.82–3.96) adjusted for age, sex, BMI, smoking status, localization of OA, diabetes, maximum walking distance, total cholesterol, and cystatin C. Further adjustment for NT-proBNP, troponin I, and hs-C-reactive protein did not change the results appreciably (HR (95%CI) 1.56 (1.07–2.28); 1.75 (1.21–2.55); 2.32 (1.55–3.47) for Q2, Q3, and Q4 respectively, p for trend < 0.001). Conclusions: In subjects with OA, GDF-15 represents a potent predictor of decreased survival over >20 years, independently of conventional CV risk factors, renal, cardiac, and inflammatory biomarkers as well as walking disability, previously associated with increased mortality and lower extremity OA.
Measurements of Plasma-Free Metanephrines by Immunoassay Versus Urinary Metanephrines and Catecholamines by Liquid Chromatography with Amperometric Detection for the Diagnosis of Pheochromocytoma/Paraganglioma
Authors: Raber Wolfgang , Kotal Hans , Marculescu Rodrig , Scheuba Christian , Niederle Martin B. , Kautzky-Willer Alexandra , Krebs Michael
Published: September 2020

Studies conflict concerning the use of enzyme immunoassays (EIA) for plasma free metanephrines (P-MNs) vs. other methods for pheochromocytoma/paraganglioma (PPGL) diagnosis. We compared commercially available EIAs for P-MNs with high-pressure liquid chromatography (HPLC) for 24 h-urinary MNs (U-MNs) and -catecholamines (U-CATs). 943 (565 female, 378 male) patients (54 PPGL, 889 Non-PPGL) were studied. Simultaneous measurements of all parameters analyzed at the central lab of our university hospital was mandatory for inclusion. Sensitivity of P-MNs (94.4%) was similar to that of U-MNs (100%), and both were higher than of U-CATs (77.8%), specificity of P-MNs (100%) higher than of U-MNs (73.6%), and similar to U-CATs (99.8%). With the recently proposed downward adjusted ULN of P-MNs to correct for the reported negative bias of the EIAs sensitivity (98.1%) raised non-significantly, but specificity decreased significantly (94.8%). Areas under receiver-operating characteristic curves indicated comparable diagnostic performance of P-MNs (0.989) vs. U-MNs (0.995), both better than U-CATs (0.956). In summary, the EIAs to measure P-MNs performed similarly to U-MNs by HPLC, and both better than U-CATs by HPLC. The post-test probability of PPGL given a positive test result was best for P-MNs, and higher than for the other pairs of analytes. Downward corrections of ULN of P-MNs did not improve test performances.
Environment and Lifestyle: Their Influence on the Risk of RA
Authors: Salliot Carine , Nguyen Yann , Boutron-Ruault Marie-Christine , Seror Raphaèle
Published: September 2020

Background: Rheumatoid arthritis (RA) is a complex disease in which environmental agents are thought to interact with genetic factors that lead to triggering of autoimmunity. Methods: We reviewed environmental, hormonal, and dietary factors that have been suggested to be associated with the risk of RA. Results: Smoking is the most robust factor associated with the risk of RA, with a clear gene–environment interaction. Among other inhalants, silica may increase the risk of RA in men. There is less evidence for pesticides, pollution, and other occupational inhalants. Regarding female hormonal exposures, there is some epidemiological evidence, although not consistent in the literature, to suggest a link between hormonal factors and the risk of RA. Regarding dietary factors, available evidence is conflicting. A high consumption of coffee seems to be associated with an increased risk of RA, whereas a moderate consumption of alcohol is inversely associated with the risk of RA, and there is less evidence regarding other food groups. Dietary pattern analyses (Mediterranean diet, the inflammatory potential of the diet, or diet quality) suggested a potential benefit of dietary modifications for individuals at high risk of RA. Conclusion: To date, smoking and silica exposure have been reproducibly demonstrated to trigger the emergence of RA. However, many other environmental factors have been studied, mostly with a case-control design. Results were conflicting and studies rarely considered potential gene–environment interactions. There is a need for large scale prospective studies and studies in predisposed individuals to better understand and prevent the disease and its course.
Rehabilitation Strategies for Patients with Femoral Neck Fractures in Sarcopenia: A Narrative Review
Authors: Avola Marianna , Mangano Giulia Rita Agata , Testa Gianluca , Mangano Sebastiano , Vescio Andrea , Pavone Vito , Vecchio Michele
Published: September 2020

Sarcopenia is defined as a syndrome characterized by progressive and generalized loss of skeletal muscle mass and strength. It has been identified as one of the most common comorbidities associated with femoral neck fracture (FNF). The aim of this review was to evaluate the impact of physical therapy on FNF patients’ function and rehabilitation. The selected articles were randomized controlled trials (RCTs), published in the last 10 years. Seven full texts were eligible for this review: three examined the impact of conventional rehabilitation and nutritional supplementation, three evaluated the effects of rehabilitation protocols compared to new methods and a study explored the intervention with erythropoietin (EPO) in sarcopenic patients with FNF and its potential effects on postoperative rehabilitation. Physical activity and dietary supplementation are the basic tools of prevention and rehabilitation of sarcopenia in elderly patients after hip surgery. The most effective physical therapy seems to be exercise of progressive resistance. Occupational therapy should be included in sarcopenic patients for its importance in cognitive rehabilitation. Erythropoietin and bisphosphonates could represent medical therapy resources.
Untangling the Emotional Intelligence-Suicidal Ideation Connection: The Role of Cognitive Emotion Regulation Strategies in Adolescents
Authors: Quintana-Orts Cirenia , Mérida-López Sergio , Rey Lourdes , Neto Félix , Extremera Natalio
Published: September 2020

Though contemporary scientific literature addressing the links between emotional intelligence (EI) and suicidal ideation in adolescents is scarce, one of the potential proposed pathways through which EI may reduce the risk of suicidal ideation involves its relationship with the use of adaptive coping strategies. The aim of this research is to provide support for an empirical pathway that proposes that the effects of EI on suicide risk may follow an indirect pathway, involving maladaptive and adaptive cognitive emotion regulation strategies, using both cross-sectional and prospective design in two independent studies with Spanish adolescents. The sample of Study 1 consisted of 1824 students (52.4% female; mean age 14.55 years). In Study 2, 796 adolescents (54.4% female; mean age 13.76 years) filled out the measures twice, four months later. The results confirmed a positive association between EI and adaptive cognitive emotion regulation strategies and a negative link with suicidal ideation. As expected, the results showed that both cross-sectionally (Study 1) and prospectively (Study 2) EI predicted lower suicidal ideation. Bootstrap mediation analysis indicated that only adaptive cognitive emotion regulation strategies partially mediated the link between EI and suicidal ideation both cross-sectionally and prospectively. Together, those adolescents who showed higher EI were more likely to report more adaptive cognitive emotion regulation, which in turn predicted lower levels of suicidal ideation. Our findings suggest possible avenues for prevention and intervention efforts aimed at boosting emotional abilities and developing adaptive coping strategies among adolescents who are at elevated suicide risk.
Methodological Considerations for Neuroimaging in Deep Brain Stimulation of the Subthalamic Nucleus in Parkinson’s Disease Patients
Authors: Isaacs Bethany R. , Keuken Max C. , Alkemade Anneke , Temel Yasin , Bazin Pierre-Louis , Forstmann Birte U.
Published: September 2020

Deep brain stimulation (DBS) of the subthalamic nucleus is a neurosurgical intervention for Parkinson’s disease patients who no longer appropriately respond to drug treatments. A small fraction of patients will fail to respond to DBS, develop psychiatric and cognitive side-effects, or incur surgery-related complications such as infections and hemorrhagic events. In these cases, DBS may require recalibration, reimplantation, or removal. These negative responses to treatment can partly be attributed to suboptimal pre-operative planning procedures via direct targeting through low-field and low-resolution magnetic resonance imaging (MRI). One solution for increasing the success and efficacy of DBS is to optimize preoperative planning procedures via sophisticated neuroimaging techniques such as high-resolution MRI and higher field strengths to improve visualization of DBS targets and vasculature. We discuss targeting approaches, MRI acquisition, parameters, and post-acquisition analyses. Additionally, we highlight a number of approaches including the use of ultra-high field (UHF) MRI to overcome limitations of standard settings. There is a trade-off between spatial resolution, motion artifacts, and acquisition time, which could potentially be dissolved through the use of UHF-MRI. Image registration, correction, and post-processing techniques may require combined expertise of traditional radiologists, clinicians, and fundamental researchers. The optimization of pre-operative planning with MRI can therefore be best achieved through direct collaboration between researchers and clinicians.
Containment, Contact Tracing and Asymptomatic Transmission of Novel Coronavirus Disease (COVID-19): A Modelling Study
Authors: Kinoshita Ryo , Anzai Asami , Jung Sung-mok , Linton Natalie M. , Miyama Takeshi , Kobayashi Tetsuro , Hayashi Katsuma , Suzuki Ayako , Yang Yichi , Akhmetzhanov Andrei R. , Nishiura Hiroshi
Published: September 2020

When a novel infectious disease emerges, enhanced contact tracing and isolation are implemented to prevent a major epidemic, and indeed, they have been successful for the control of severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS), which have been greatly reduced without causing a global pandemic. Considering that asymptomatic and pre-symptomatic infections are substantial for the novel coronavirus disease (COVID-19), the feasibility of preventing the major epidemic has been questioned. Using a two-type branching process model, the present study assesses the feasibility of containing COVID-19 by computing the probability of a major epidemic. We show that if there is a substantial number of asymptomatic transmissions, cutting chains of transmission by means of contact tracing and case isolation would be very challenging without additional interventions, and in particular, untraced cases contribute to lowering the feasibility of containment. Even if isolation of symptomatic cases is conducted swiftly after symptom onset, only secondary transmissions after the symptom onset can be prevented.
The Long-Term Outcomes of Intensive Combined Therapy of Adult Patients with Localised Synovial Sarcoma
Authors: Kozak Katarzyna , Teterycz Paweł , Świtaj Tomasz , Koseła-Paterczyk Hanna , Falkowski Sławomir , Morysiński Tadeusz , Bartnik Ewa , Czarnecka Anna M. , Wągrodzki Michał , Ługowska Iwona , Rutkowski Piotr
Published: September 2020

Introduction: Synovial sarcoma (SaSy) is a high-grade, malignant soft tissue sarcoma (STS) accounting for 5–9% of STS. The aim of this study was to analyse outcomes of patients with localised SaSy treated in a single institution with a uniform neo- and adjuvant-combined therapy protocol. Methods: 171 patients with stage II/III SaSy were treated between 1997 and 2014. Chemotherapy consisted of 4 cycles of ifosfamide 12 g/m2 and two cycles of a doxorubicin-based regimen 75 mg/m2. With the exception of patients who underwent amputation, all patients received neoadjuvant radiotherapy. Results: Median age was 33 years (range 17–69). Tumours larger than 5 cm in size were found in 70% of patients. The 5-year overall survival (OS), local relapse-free survival (LRFS) and metastasis-free survival (MFS) rates were 75%, 80% and 60%, respectively. In multivariate Cox’s regression, age > 35 years, male sex, larger tumour size and histology other than monophasic were associated with worse OS. Conclusions: In adult patients with localised SaSy, long-term survival can be achieved in a significant proportion of cases with intensive combined therapy. The multivariate analysis identified age, sex, disease stage and histology subtype as independent prognostic factors of OS.
New Ultrasound Technologies for Ischemic Heart Disease Assessment and Monitoring in Cardiac Rehabilitation
Authors: D’Andrea Antonello , Sperlongano Simona , Pacileo Mario , Venturini Elio , Iannuzzo Gabriella , Gentile Marco , Sperlongano Rossella , Vitale Giuseppe , Maglione Marco , Cice Gennaro , Maria Sarullo Filippo , Di Lorenzo Anna , Vigorito Carlo , Giallauria Francesco , Picano Eugenio
Published: September 2020

Owing to its ease of application, noninvasive nature, and safety, echocardiography is an essential imaging modality to assess cardiac function in patients affected by ischemic heart disease (IHD). Over the past few decades, we have witnessed a continuous series of evolutions in the ultrasound field that have led to the introduction of innovative echocardiographic modalities which allowed to better understand the morphofunctional abnormalities occurring in cardiovascular diseases. This article offers an overview of some of the newest echocardiographic modalities and their promising application in IHD diagnosis, risk stratification, management, and monitoring after cardiac rehabilitation.
PCSK9 Levels Are Raised in Chronic HCV Patients with Hepatocellular Carcinoma
Authors: Fasolato Silvano , Pigozzo Sabrina , Pontisso Patrizia , Angeli Paolo , Ruscica Massimiliano , Savarino Edoardo , De Martin Sara , Lupo Maria Giovanna , Ferri Nicola
Published: September 2020

Background: Since emerging evidence suggests a protective role of proprotein convertase subtilisin/kexin type 9 (PCSK9) on hepatitis C virus (HCV) infection, the aim of the present study was to evaluate the correlation between PCSK9 and HCV infection in hepatocellular carcinoma (HCC) patients. Methods: In this retrospective study, PCSK9 levels were evaluated by ELISA, in plasma samples from control (n = 24) and 178 patients diagnosed for HCC, cirrhosis, or chronic hepatitis, either positive or negative for HCV. Results: HCV positive patients (HCV+) presented with higher PCSK9 levels compared to HCV negative individuals (HCV-), 325.2 ± 117.7 ng/mL and 256.7 ± 139.5 ng/mL, respectively. This difference was maintained in the presence of HCC, although this disease significantly reduced PCSK9 levels. By univariate analysis, a positive correlation between PCSK9 and HCV viral titer was found, being G2 genotype the most-potent inducer of PCSK9 among other genotypes. This induction was not associated with changes in total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C) and triglycerides (TG). A negative correlation was also found between PCSK9 levels and liver impairment, assessed by Model for End-Stage Liver Disease (MELD). Finally, a multivariate correlation analysis corrected for age, TC, LDL-C, and sex, demonstrated, in the whole cohort, a positive association between PCSK9 and HCV and a negative with HCC. Conclusions: taken together, our study reveals that HCV raised PCSK9 in both the presence and absence of HCC.