bluuebunny/crossref_metadata_2025 huggingface dataset:
Emerging Role of microRNA Dysregulation in Diagnosis and Prognosis of Extrahepatic Cholangiocarcinoma
Authors: Prinz Christian , Frese Robin , Grams Mashiba , Fehring Leonard
Published: August 2022

Extrahepatic cholangiocarcinomas, also called bile duct carcinomas, represent a special entity in gastrointestinal tumors, and histological specimens of the tumors are often difficult to obtain. A special feature of these tumors is the strong neovascularization, which can often be seen in the endoluminal endoscopic procedure called cholangioscopy, performed alone or in combination with laserscanning techniques. The additional analysis of microRNA expression profiles associated with inflammation and neovascularization in bile duct tumors or just the bile duct fluid of these patients could be of enormous additional importance. In particular, the dysregulation of microRNA in these cholangiocarcinomas (CCA) was previously reported to affect epigenetics (reported for miR-148, miR-152), inflammation (determined for miR-200, miR-125, and miR-605), and chemoresistance (miR-200b, 204) in patients with cholangiocarcinoma. More importantly, in the context of malignant neovascularization, well-defined microRNAs including miR-141, miR-181, miR-191, and miR-200b have been found to be dysregulated in cholangiocarcinoma and have been associated with an increased proliferation and vascularization in CCA. Thus, a panel of these microRNA molecules together with the clinical aspects of these tumors might facilitate tumor diagnosis and early treatment. To our knowledge, this is the first review that outlines the unique potential of combining macroscopic findings from cholangioscopy with microRNA expression.
Genome-Wide Analysis of the WOX Transcription Factor Genes in Dendrobium catenatum Lindl.
Authors: Li Hefan , Li Cheng , Wang Yuhua , Qin Xiangshi , Meng Lihua , Sun Xudong
Published: August 2022

The WUSCHEL-related homeobox (WOX) proteins are a class of transcription factors exclusive to plants. They can promote cell division or inhibit stem cell differentiation to regulate plant growth and development. However, the WOX transcription factor genes in the monocotyledon Dendrobium catenatum Lindl. remain relatively uncharacterized. Specifically, the effects of phytohormones on their expression levels are unclear. In this study, we identified and analyzed 10 candidate DcaWOX transcription factor genes in D. catenatum. The DcaWOX family was divided into the modern/WUS, intermediate, and ancient clades. The subcellular localization analysis detected DcaWOX-GFP fusion proteins in the tobacco epidermal leaf cell nucleus. In DcaWOX, members of the WUS clade with the WUS-box motif can significantly activate the expression of TPL in vivo, while members of the intermediate and ancient clades cannot. The expression of the DcaWOX genes varied among the examined tissues. Moreover, the DcaWOX expression patterns were differentially affected by the phytohormone treatments, with differences detected even between homologs of the same gene. Furthermore, the gene expression patterns were consistent with the predicted cis-acting elements in the promoters. The above results suggest that DcaWOX may have an important role in its growth and development and resistance to stress. The results of this comprehensive investigation of the DcaWOX gene family provide the basis for future studies on the roles of WOX genes in D. catenatum.
An Atypical Presentation of Upper Motor Neuron Predominant Juvenile Amyotrophic Lateral Sclerosis Associated with TARDBP Gene: A Case Report and Review of the Literature
Authors: Sánchez-Tejerina Daniel , Restrepo-Vera Juan Luis , Rovira-Moreno Eulalia , Codina-Sola Marta , Llauradó Arnau , Sotoca Javier , Salvado Maria , Raguer Núria , García-Arumí Elena , Juntas-Morales Raúl
Published: August 2022

Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease that can rarely affect young individuals. Juvenile ALS (JALS) is defined for individuals with an onset of the disease before the age of 25. The contribution of genetics to ALS pathology is a field of growing interest. One of the differences between adult-onset ALS and JALS is their genetic background, with a higher contribution of genetic causes in JALS. We report a patient with JALS and a pathogenic variant in the TARDBP gene (c.1035C > G; p.Asn345Lys), previously reported only in adult-onset ALS, and with an atypical phenotype of marked upper motor neuron predominance. In addition, the proband presented an additional variant in the NEK1 gene, c.2961C > G (p.Phe987Leu), which is classified as a variant of unknown significance. Segregation studies showed a paternal origin of the TARDBP variant, while the variant in NEK1 was inherited from the mother. We hypothesize that the NEK1 variant acts as a disease modifier and suggests the possibility of a functional interaction between both genes in our case. This hypothesis could explain the peculiarities of the phenotype, penetrance, and the age of onset. This report highlights the heterogeneity of the phenotypic presentation of ALS associated with diverse pathogenic genetic variants.
Selection of Suitable Reference Genes for Gene Expression Normalization Studies in Dendrobium huoshanense
Authors: Yi Shanyong , Lu Haibo , Tian Chuanjun , Xu Tao , Song Cheng , Wang Wei , Wei Peipei , Gu Fangli , Liu Dong , Cai Yongping , Han Bangxing
Published: August 2022

Dendrobium huoshanense is a kind of precious herb with important medicinal and edible value in China, which is widely used in traditional Chinese medicine for various diseases. Recent studies have paid close attention to the genetic expression of the biosynthetic pathway of the main active components (polysaccharides, alkaloids, and flavonoids), and real-time polymerase chain reaction (qPCR) is one of the most widely used methods for doing so. However, so far, no reference gene selections have been reported in D. huoshanense. In this study, 15 reference gene candidates (GAPDH, eIF, EF-1α, PP2A, UBCE, RPL5, TBP, APT1, MDH, PTBP3, PEPC, CYP71, NCBP2, TIP41, and F-box) were selected and evaluated for their expression stability in D. huoshanense under various experimental conditions, including in different tissues (root, stem, and leaf), abiotic stresses (oxidative, drought, cold, and UV), and hormone treatment (methyl jasmonate) using three statistical programs (geNorm, NormFinder, and BestKeeper). Then, the RefFinder program was employed to comprehensively validate the stability of the selected reference genes. Finally, the expression profiles of the CESA and GMPP genes were further analyzed, and these results indicated that TBP, NCBP2, and CYP71 were the top three most stable reference genes after comprehensive comparison, which could be used as stable reference genes for normalizing the genes expression in D. huoshanense. This study described here provides the first data regarding on reference gene selection in D. huoshanense, which will be extremely beneficial for future research on the gene expression normalization in D. huoshanense.
Evaluation of the Impact of the Peregrine Falcon (Falco peregrinus peregrinus) Reintroduction Process on Captive-Bred Population
Authors: Puchała Karol O. , Nowak-Życzyńska Zuzanna , Sielicki Sławomir , Olech Wanda
Published: August 2022

The main objective of this study was to determine the impact of increased demand for peregrine falcons via breeding (mainly Polish, Czech, German and Slovak) on the genetic structure of the birds. In the analysis, 374 specimens from six countries were sampled in 2008–2019 (omitting 2009), and all the birds analyzed were released into the wild as part of the Polish reintroduction program. The assessment of genetic variation was based on a well-known panel of 10 microsatellite markers described for the species. We calculated a fixation index for the samples from each year, and based on this, we determined the level of inbreeding. We also performed an analysis using the Bayesian cluster method, assuming that 1–19 hypothetical populations would define the division that best fit the samples. The most probable division was into two groups; in the first group, the samples from individuals delivered in 2013 were most often segregated; moreover, in this year, a jump in inbreeding, expressed by the fixation index, was observed.
The Rm1 and Rm2 Resistance Genes to Green Peach Aphid (Myzus persicae) Encode the Same TNL Proteins in Peach (Prunus persica L.)
Authors: Duval Henri , Heurtevin Laure , Dlalah Naïma , Callot Caroline , Lagnel Jacques
Published: August 2022

The green peach aphid (GPA), Myzus persicae, is an important pest of the peach crop. Three major dominant resistance genes have already been detected, Rm1 in the Weeping Flower Peach (WFP) clone, Rm2 in the Rubira clone, and Rm3 in the Fen Shouxing clone. In this study, after NGS resequencing of WFP and Rubira, we found that their genomic sequences in the Rm1 and Rm2 region were similar but very different from that of the susceptible reference peach Lovell. We constructed a BAC library for the GPA-resistant WFP and screened four BAC clones to sequence the target region. The new sequence was 61.7 Kb longer than Lovell and was annotated with four different TIR_NBS_LRR genes. Among them, the TNL1 gene was very overexpressed in WFP leaves 24 h after GPA infestation. This gene was also present and expressed in the Rubira clone and had the same sequence as the candidate Rm3 gene, supporting the hypothesis that the three genes share the same origin. In addition, we identified a second TNL, TNL2, located at 35.4 Kb from TNL1 and slightly overexpressed after GPA infestation. Kasp and size molecular markers were designed for use in marker-assisted selection and were validated in a peach segregating population.
Inherited Retinal Dystrophy in Southeastern United States: Characterization of South Carolina Patients and Comparative Literature Review
Authors: Griffith Joseph , Sioufi Kareem , Wilbanks Laurie , Magrath George N. , Say Emil A. T. , Lyons Michael J. , Wilkes Meg , Pai Gurpur Shashidhar , Peterseim Mae Millicent Winfrey
Published: August 2022

Inherited retinal dystrophies (IRDs) are a group of rare diseases involving more than 340 genes and a variety of clinical phenotypes that lead to significant visual impairment. The aim of this study is to evaluate the rates and genetic characteristics of IRDs in the southeastern region of the United States (US). A retrospective chart review was performed on 325 patients with a clinical diagnosis of retinal dystrophy. Data including presenting symptoms, visual acuity, retinal exam findings, imaging findings, and genetic test results were compiled and compared to national and international IRD cohorts. The known ethnic groups included White (64%), African American or Black (30%), Hispanic (3%), and Asian (2%). The most prevalent dystrophies identified clinically were non-syndromic retinitis pigmentosa (29.8%), Stargardt disease (8.3%), Usher syndrome (8.3%), cone-rod dystrophy (8.0%), cone dystrophy (4.9%), and Leber congenital amaurosis (4.3%). Of the 101 patients (31.1%) with genetic testing, 54 (53.5%) had causative genetic variants identified. The most common pathogenic genetic variants were USH2A (n = 11), ABCA4 (n = 8), CLN3 (n = 7), and CEP290 (n = 3). Our study provides initial information characterizing IRDs within the diverse population of the southeastern US, which differs from national and international genetic and diagnostic trends with a relatively high proportion of retinitis pigmentosa in our African American or Black population and a relatively high frequency of USH2A pathogenic variants.
Deterioration Processes on Prehistoric Rock Art Induced by Mining Activity (Arenaza Cave, N Spain)
Authors: Cañaveras Juan Carlos , Muñoz-Cervera María Concepción , Sánchez-Moral Sergio
Published: August 2022

Arenaza Cave is located in Vizcaya (N Spain) and contains important Palaeolithic rock art representations. This cave belongs to an active karstic system developed on Lower Cretaceous limestones, mainly consisting of micrites and biomicrites with abundant pyrite moulds. The paintings are made directly on the host rock or on thin stalagmitic calcite crusts. Cretaceous limestones in this area contain important iron ore deposits, which have been mined by subsurface and surface-mining methods since the beginning of the 20th century. Mining activities have induced significant changes in the karstic drainage pattern and in the endo and exokarstic morphologies of the Arenaza karstic system, directly affecting the state of conservation of the prehistoric paintings. Thus, in addition to natural process of deterioration, the enlargement of the limestone fissure system as a result of blasting-induced vibrations seems to be the responsible for changes in the rates of water-rock interactions and of the formation of botryoidal gypsum concretions on the rock surface. The final result is the activation and acceleration of detachment processes and the increase of irreversible deterioration processes in the cave.
Latest Pleistocene and Holocene Floodplain Evolution in Central Europe—Insights from the Upper Unstrut Catchment (NW-Thuringia/Germany)
Authors: Kirchner André , Karaschewski Jasmin , Schulte Philipp , Wunderlich Tina , Lauer Tobias
Published: August 2022

The upper Unstrut River is located in Germany at the modern Central European climate boundary of Cfb and Dfb climate. The river drains a loess landscape, which has experienced important environmental changes throughout the last 12,000 years. To evaluate the impacts of these changes on floodplain evolution, a multi-proxy research program, consisting of 2D electrical resistivity tomography profiling (ERT), vibracoring, and sedimentological investigations, 14C and OSL dating were applied. From base to top the investigations the following fluvial deposits were revealed: (1) gravels embedded in a fine-grained sediment matrix (interpreted as fluvial bedload deposits); (2) silty sediment with pedogenic features (interpreted as overbank floodplain deposits); (3) peat and tufa deposits (interpreted as wetland deposits) intercalated by pedogenetically influenced silty sediments (interpreted as overbank deposits); (4) humic silty sediment with some pedogenic features (interpreted as overbank floodplain deposits); and (5) silty sediments (interpreted as overbank deposits). Radiocarbon and luminescence dates yielded the following periods for sediment formation: (1) Younger Dryas to Preboreal period (around 11.6 cal ka BP); (2) Preboreal to early Atlantic period (approx. 11.6 to 7.0 cal ka BP); (3) early Atlantic to late Subboreal period (approx. 7.3 to 3.4 cal ka BP); (4) late Subboreal to early Subatlantic period (2.9 to 2.3 cal ka BP); and (5) late Subatlantic period (approx. 1.0 to 0.6 cal ka BP). The results suggest that floodplain development during the latest Pleistocene and early Holocene (approx. 11.6 to 7.0 cal ka BP) was considerably controlled by climatic conditions and short-term climate variabilities, which caused gravel deposition and overbank sedimentation. Afterwards floodplain conditions varied between rather stable (peat and tufa development, initial soil formation) and active periods (deposition of overbank fines). In this context, active periods with increased sediment input prevailed from approx. 5.1 to 3.4 cal ka BP, 2.9 to 2.3 cal ka, and 1.0 to 0.6 cal ka BP, temporally corresponding well with increased land-use phases of the past. In conclusion this study demonstrates that the investigated Unstrut catchment has reacted very sensitively to natural and human-induced changes during the latest Pleistocene and Holocene. Consequently, this high vulnerability to external changes should be considered in future river predictions or river management.
Topographical Impact on Snow Cover Distribution in the Trans-Himalayan Region of Ladakh, India
Authors: Passang Stanzin , Schmidt Susanne , Nüsser Marcus
Published: August 2022

This article presents the distribution of seasonal snow cover in the Trans-Himalayan region of Ladakh over the observation period of 2000–2019. Seasonal snow cover area and duration have been monitored and mapped based on the MODIS Normalised Difference Snow Index (NDSI). Using different MODIS cloud removal algorithms, monthly mean cloud-covered areas have been reduced to 3%. Pixel-wise approaches using Mann–Kendall (MK) and Sen’s slope trend tests allow to assess seasonal and annual trends of snow cover days (SCD) and snow cover area (SCA) across seven delineated subregions of Ladakh. Analyses include the impact of topographical parameters (elevation, slope, aspect). Overall, the mean annual SCA amounts to 42%, varying from 15% in August to 71% in February. However, large differences of SCA have been detected between and within subregions. The trend analysis of SCA shows a non-significant, slight increase for summer as well as for the entire year and a decrease for spring and winter seasons. The SCD trend analysis indicates more pixels with a significant increase than a decrease. In total, 12% of all pixels show an increasing trend in summer, 6% over the entire year, 3% in autumn, and 2% in spring and winter, whereas less than 2% of all pixels show a decreasing trend in all seasons. The results are important for regional irrigated agricultural production and freshwater supply in the context of climate change.
Quantification of Alpine Metamorphism in the Edolo Diabase, Central Southern Alps
Authors: Filippi Marco , Zanoni Davide , Rebay Gisella , Roda Manuel , Regorda Alessandro , Lardeaux Jean-Marc , Spalla Maria Iole
Published: August 2022

The Southern Alps are the retro-vergent belt of the European Alps that developed from Late Cretaceous subduction to Neogene times. The most prominent Alpine thrusts and folds, nowadays sealed off by the Adamello intrusion, were already developed before the continental collision and clasts derived from the eroded pre-collisional wedge can be found in the Cretaceous foredeep sequences. In contrast, the thermal state attained by the Southern Alps during the long-lasting Alpine evolution is still unknown. This contribution provides evidence for Alpine metamorphism in the northern part of the central Southern Alps. Metamorphic conditions are determined for the alkaline Edolo diabase dykes that emplaced in the exhumed Variscan basement rocks before being deformed during the Alpine convergence (D3). The Alpine foliation in the Edolo diabase dykes is marked by actinolite, biotite, chlorite, epidote, albite, and titanite and it developed under greenschist facies conditions at temperature of 350–420 °C and pressure ≤0.2 GPa. The T/depth ratio indicates a minimum of 50–60 °C/km that is compatible with thermal gradients characteristic of arc settings. Based on radiometric ages from the literature, these conditions were attained during the Alpine subduction.
Frailty and Associated Factors among the Elderly in Vietnam: A Cross-Sectional Study
Authors: Huynh Trung Quoc Hieu , Pham Thi Lan Anh , Vo Van Tam , Than Ha Ngoc The , Nguyen Tan Van
Published: August 2022

Background: Frailty syndrome is common among older people and can lead to various adverse consequences such as falls, cognitive decline, disability, dependent living, increased mortality, excessive drug use, and prolonged hospital stays. Objectives: This research determined the prevalence of frailty and associated factors among older adults in Vietnam. Methods: A cross-sectional study was conducted on 584 older adults across five Ho Chi Minh City wards from November 2020 to January 2021. Based on the modified Fried frailty scale, the participants were divided into three categories: robust, pre-frail, and frail. A chi-square test (or Fisher’s test) examined the relationship between frailty categories and other variables. Multivariable logistic regression used variates with a cut-off of p ≤ 0.05 in the univariate analysis. Results: The prevalence rates of frailty and pre-frailty were 19% and 64%, respectively. The most common frailty component was weak grip strength (63.9%), followed by slowness (36.1%), weight loss (21.6%), low physical activity (19.5%), and exhaustion (18.5%). In addition, the prevalence of frailty was significantly associated with age, BMI levels, living alone, and sarcopenia. Conclusion: The community’s prevalence of frailty among older adults is high. Frailty can lead to many adverse consequences for the elderly. As there were some modifiable factors associated with frailty, it should be assessed in older people through community-based healthcare programs for early diagnosis and management.
The Impact of Postoperative Complications on Survival after Simultaneous Resection of Colorectal Cancer and Liver Metastases
Authors: Alexandrescu Sorin Tiberiu , Zarnescu Narcis Octavian , Diaconescu Andrei Sebastian , Tomescu Dana , Droc Gabriela , Hrehoret Doina , Brasoveanu Vladislav , Popescu Irinel
Published: August 2022

Background: The aim of this study was to investigate the impact of postoperative complications on the long-term outcomes of patients who had undergone simultaneous resection (SR) of colorectal cancer and synchronous liver metastases (SCLMs). Methods: We conducted a single-institution survival cohort study in patients with SR, collecting clinical, pathological, and postoperative complication data. The impact of these variables on overall survival (OS) and disease-free survival (DFS) was compared by log rank test. Multivariate Cox regression analysis identified independent prognostic factors. Results: Out of 243 patients, 122 (50.2%) developed postoperative complications: 54 (22.2%) major complications (Clavien–Dindo grade III–V), 86 (35.3%) septic complications, 59 (24.2%) hepatic complications. Median comprehensive complication index (CCI) was 8.70. Twelve (4.9%) patients died postoperatively. The 3- and 5-year OS and DFS rates were 60.7%, 39.5% and 28%, 21.5%, respectively. Neither overall postoperative complications nor major and septic complications or CCI had a significant impact on OS or DFS. Multivariate analysis identified the N2 stage as an independent prognostic of poor OS, while N2 stage and four or more SCLMs were independent predictors for poor DFS. Conclusion: N2 stage and four or more SCLMs impacted OS and/or DFS, while CCI, presence, type, or grade of postoperative complications had no significant impact on long-term outcomes.
Pulmonary Parameters in Adolescents with Severe Thoracic Idiopathic Scoliosis: Comparison Girls versus Boys
Authors: Politarczyk Katarzyna , Popowicz-Mieloch Wiktoria , Kotwicki Tomasz
Published: August 2022

The study compared pulmonary parameters, registered at the preoperative examination, in adolescent boys versus girls, both with severe thoracic idiopathic scoliosis. Thirty consecutive boys and 30 consecutive girls with Lenke 1 or 3 type, in the age range 14–18 years, with a Cobb angle of >50° and Risser sign ≥ 3 were enrolled. Corrected body height was used to calculate pulmonary parameters according to the Global Lung Function (GLI 2012) reference values. Significantly higher values of the calculated predicted pulmonary parameters and the upper and lower limit of normal (ULN and LLN), as well as significantly higher absolute values of forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1), were observed in boys than girls; however, the registered FVC and FEV1, expressed as percentages of the predicted values, tended to be lower in boys. The FEV1 z-score difference between boys and girls may suggest a need for more intensive preoperative pulmonary rehabilitation in boys.
uNGAL Predictive Value for Serum Creatinine Decrease in Critically Ill Children
Authors: Gavrilovici Cristina , Duşa Cristian Petru , Mihai Cosmin Teodor , Spoială Elena-Lia , Stârcea Iuliana Magdalena , Iliescu-Halitchi Codruta Olimpiada , Zetu Irina Nicoleta , Ionescu Lavinia Bodescu-Amancei , Bogos Roxana Alexandra , Hanganu Elena , Boiculese Vasile Lucian
Published: August 2022

Acute kidney injury (AKI) occurs frequently in critically ill children, having an incidence of up to 26.9% and is associated with high morbidity and mortality in pediatric intensive care units (PICU). Currently, the decrease in the glomerular filtration rate is calculated using the serum creatinine levels. Nevertheless, there may be a 48 h delay between the renal injury and measurable increase in creatinine. Urinary neutrophil gelatinase-associated lipocalin (uNGAL) has been validated in relation to cardiopulmonary bypass in children, being able to detect AKI before the functional change proven by the rise in serum creatinine. Our aim was to study the utility of using uNGAL in the management of critical pediatric patients admitted to our hospital in a six month period, more specifically, its capacity to predict AKI development, alone and in the association with the renal angina index (RAI). Twenty-eight critically ill children aged from 1 day to 15 years have been included. We found that an increase in uNGAL in day 1 of admission in the PICU was significantly correlated with a decrease in creatinine clearance but not anymore in day 3. However, in our sample uNGAL did not show a significant predictability for AKI development nor the supplementary incorporation of RAI into the prediction model. Therefore, apart from cardiac surgery, the efficacy and utility or uNGAL in the management of critically ill children is still questionable. For the best prediction, we will need to incorporate not only the RAI or other PICU scores, but other biomarkers such as KIM-1, urinary cystatin, and IL 18 in larger samples.
Meeting the Need for a Discussion of Unmet Medical Need
Authors: Horgan Denis , Borisch Bettina , Eliasen Bogi , Kapitein Peter , Biankin Andrew V. , Gijssels Stefan , Zaiac Michael , Fandel Marie-Helene , Lal Jonathan A. , Kozaric Marta , Moss Barbara , De Maria Ruggero , Geanta Marius , Nowak Frédérique , Montserrat-Moliner Antoni , Riess Olaf
Published: August 2022

As Europe and the world continue to battle against COVID, the customary complacency of society over future threats is clearly on display. Just 30 months ago, such a massive disruption to global lives, livelihoods and quality of life seemed unimaginable. Some remedial European Union action is now emerging, and more is proposed, including in relation to tackling “unmet medical need” (UMN). This initiative—directing attention to the future of treating disease and contemplating incentives to stimulate research and development—is welcome in principle. But the current approach being considered by EU officials merits further discussion, because it may prove counter-productive, impeding rather than promoting innovation. This paper aims to feed into these ongoing policy discussions, and rather than presenting research in the classical sense, it discusses the key elements from a multistakeholder perspective. Its central concern is over the risk that the envisaged support will fail to generate valuable new treatments if the legislation is phrased in a rigidly linear manner that does not reflect the serpentine realities of the innovation process, or if the definition placed on unmet medical need is too restrictive. It cautions that such an approach presumes that “unmet need” can be precisely and comprehensively defined in advance on the basis of the past. It cautions that such an approach can reinforce the comfortable delusion that the future is totally predictable—the delusion that left the world as easy prey to COVID. Instead, the paper urges reflection on how the legislation that will shortly enter the pipeline can be phrased so as to allow for the flourishing of a culture capable of rapid adaptation to the unexpected.
Perspectives and Experiences of Cardiac Rehabilitation after Stroke—A Qualitative Study
Authors: Lennon Olive , Crystal Alexandra , Kwan Michelle , Tierney Caoimhe , Gallagher Anne , Murphy Sean
Published: August 2022

Cardiac rehabilitation (CR) after stroke has been proven to be a safe and feasible secondary prevention intervention. Limited qualitative data capture people’s experiences and perceptions of attending CR following stroke, but with none addressing translational aspects when CR is delivered as routine clinical care. Using a phenomenological, qualitative approach, four semi-structured focus groups were conducted with 15 individuals (60% male) who had completed CR during their stroke care pathway. Our inductive thematic analysis identified five themes. The first centred on recognising stroke as a cardiovascular disease and the applicability of CR post-stroke. The second addressed how peer understanding, camaraderie, and medical supervision created a safe and supportive environment. The third identified how the programme-built confidence supported longer-term healthy lifestyle choices in physical activity, diet, and smoking. The penultimate theme addressed the period from hospital discharge to attending CR as a time of uncertainty where many participants experienced cognitive difficulties, mood disturbances, and mental fatigue without adequate support. Lastly, participants identified unmet needs in their care pathway that included a lack of information about their referral to CR, the programme content, and accessing local supports ahead of CR. Ongoing and unmet needs both during and after CR related to self-management of secondary prevention medications, neurological issues, post-stroke fatigue, and the lack of structured support following CR completion.
Piperacillin–Tazobactam Plus Vancomycin-Associated Acute Kidney Injury in Adults: Can Teicoplanin or Other Antipseudomonal Beta-Lactams Be Remedies?
Authors: Aslan Abdullah Tarık , Akova Murat
Published: August 2022

Numerous observational studies and meta-analyses have suggested that combination therapy consisting of piperacillin–tazobactam (TZP) and vancomycin (VAN) augments acute kidney injury (AKI) risk when compared to viable alternatives, such as cefepime–vancomycin (FEP–VAN) and meropenem–VAN. However, the exact pathophysiological mechanisms of this phenomenon are still unclear. One major limitation of the existing studies is the utilization of serum creatinine to quantify AKI since serum creatinine is not a sufficiently sensitive and specific biomarker to truly define the causal relationship between TZP–VAN exposure and nephrotoxicity. Even so, some preventive measures can be taken to reduce the risk of AKI when TZP–VAN is preferred. These measures include limiting the administration of TZP–VAN to 72 h, choosing FEP–VAN in place of TZP–VAN in appropriate cases, monitoring the VAN area under the curve level rather than the VAN trough level, avoiding exposure to other nephrotoxic agents, and minimizing the prescription of TZP–VAN for patients with a high risk of AKI. More data are needed to comment on the beneficial impact of the extended-infusion regimen of TZP on nephrotoxicity. Additionally, TZP and teicoplanin can be reasonable alternatives to TZP–VAN for the purpose of lowering AKI risk. However, the data are scarce to advocate this practice convincingly.
Students’ Perception of Quality of Learning Experience (Structure, Process and Outcome): Discipline Versus Problem Based Medical Curriculum and the Mediation Role of Process Quality
Authors: Jarrar Mu’taman , Mohamed Radwa Bakr , Al-Bsheish Mohammad , Albaker Waleed , Alumran Arwa , Alomran Ammar K.
Published: August 2022

Problem-based learning (PBL) is now incorporated into the curricula of most medical schools around the world. In comparison to the traditional curriculum, less is known about the influence of the adoption and implementation of a problem-based curriculum on the perceived structures, processes, and outcomes of learning experiences reported by students. The purpose of this study was twofold: (1) to compare the quality of learning experience of students enrolled in traditional discipline-based and problem-based medical curricula and (2) to explore the mediation effect of the process quality between the relationship of the structural quality and students’ perception of learning experience outcomes. Through the distribution of an electronic survey, all 3rd and 4th year medical students enrolled in the discipline-based curriculum and the problem-based curriculum were invited to participate in the study. The students from both curricula completed the Student Experience Survey (SES), which was developed by the National Center for Academic Accreditation and Evaluation. Descriptive statistics, independent sample t-test and Hayes Macro regression analysis were used. Students enrolled in the problem-based curriculum had higher perceived support and sufficient advice with higher perceived quality of learning experiences compared with students enrolled in the traditional curriculum, however they reported less enjoyment of their university life. The structural factors (t = 19.83, p ≤ 0.001) and process factors (t = 9.21, p ≤ 0.001) were associated with an increase in students’ reported outcomes by 0.67 and 0.49, respectively. These findings explain the mechanism by which the structural factors, such as maintaining adequate facilities and support, may help in enhancing the process quality (e.g., learner-centered learning), which in turn can enhance learning experience outcomes.
Attitudes towards Antibiotic Prescription and Antimicrobial Resistance Awareness among Italian Dentists: What Are the Milestones?
Authors: D’Ambrosio Francesco , Di Spirito Federica , Amato Alessandra , Caggiano Mario , Lo Giudice Roberto , Martina Stefano
Published: August 2022

Antimicrobial resistance is a growing phenomenon, often associated with the improper prescription of antibiotics, prescribed by those who do not follow the guidelines for antibiotic stewardship. The aim of this study was to evaluate the current attitude towards antibiotic prescribing and antimicrobial resistance awareness among Italian dentists. An online questionnaire was distributed to Italian dentists from September to December 2021. The questionnaire was composed of three main sections. The first part was focused on demographic characteristics, the second part on prescription habits, and the third part on the dentists’ knowledge regarding the phenomenon of antimicrobial resistance. A chi-square test was used to find associations between different variables. The level of significance was set at p < 0.05. A total of 382 dentists completed the questionnaire. The main reasons for antibiotic prescribing were for abscesses (39.6%), extractions (24.5%), and pulpitis (14.1%). The majority of participants (85.3%) reported prescribing macrolides in the case of a penicillin allergy. Most dentists (98.9%) were aware of the antimicrobial resistance phenomenon, but only 7.4% of them consulted the guidelines for prescribing antibiotics. This study demonstrates that the same trend exists in Italy as in other countries in terms of the high prevalence of misuse and overuse of antibiotics, and that Italian dentists utilize a range of antibiotic management strategies.
Periodontal Healing after Lower Third Molars Extraction: A Clinical Evaluation of Different Flap Designs
Authors: Castagna Valentina , Pardo Alessia , Lanaro Luca , Signoriello Annarita , Albanese Massimo
Published: August 2022

Periodontal healing after third molars extraction seems to be influenced by the choice of different flap techniques. The purpose of the present study was to assess the clinical condition of adjacent first and second molar sites, after the extraction of lower third molars, performed through different flap designs. Eighty patients, aged between 14 and 30 years, were analyzed for periodontal parameters of VPI, PPD, and CAL, pre-operatively (T0), after 15 days (T1), after 1 month (T2), and after 2 months (T3) from extraction. Techniques performed were trapezoidal flap (TRAP), marginal flap (MARG), flap with papilla detachment (DETP), and flap with papilla decapitation (DEC). No significant differences were found between the four flaps at each observation time and considering the interval between T0 and T3, for VPI, PPD at first molar site, PPD at second molar site, and CAL at second molar site. Significant variations for CAL were registered, for each flap, between T0 and T3, in all cases for buccal site, in three cases for buccal-distal site. After 2 months of follow-up, no strong evidence can be assumed for or against the use of a particular flap design for the extraction of lower third molars.
First Isolation and Characterization of Serratia liquefaciens Associated with Rot Disease of Malus domestica (Apple) Fruit and Its Inhibition by Origanum vulgare (Oregano) Oil
Authors: Khalifa Ashraf
Published: August 2022

Microbial food spoilage has been a major source of concern because it widens the global food production-to-consumption gap. Thus, in the current study, we aimed to isolate, characterize and identify bacteria associated with spoiled apple fruit in Al-Ahsa city, Saudi Arabia. MDK33, a bacterial strain isolated from rotten apple fruit, was characterized at the phenotypic and genotypic levels. Furthermore, the antibacterial effect of oregano essential oil (OEO) against MDK33 was investigated. MDK33 formed circular colonies with entire margins, and the cells were Gram-negative rods with no endospores. Biochemical characterizations of MDK33, as revealed by the Biolog Gen III MicroPlate test system, indicated that the strain utilized 66 (~70%) of the 94 diverse metabolites and did not utilize 29 (~30%). MDK33 grew well on a variety of substrates, including pectin, gelatin, Tween 40 and dextrin, at pH 5 and 6; tolerated salts up to 4% NaCl; and was resistant to multiple antibiotics. Furthermore, based on the sequences of the 16S rRNA gene, MDK33 was identified as Serratia liquefaciens at a 99.73% identity level. Koch’s postulates were affirmed, confirming that S. liquefaciens MDK33 is the causative agent of apple rot disease in Al-Ahsa, Saudi Arabia. The minimum inhibitory concentration (MIC) of 0.23 mg/mL for oregano oil against S. liquefaciens MDK33 demonstrated remarkable antibacterial and antibiofilm activities. This is the first isolation of pathogenic S. liquefaciens as the causative agent of rot disease of apple fruit and its inhibition by oregano oil. Furthermore, the findings pave the way for oregano oil to be evaluated as a natural preservative to reduce post-harvest losses while maintaining high quality for sustainable food security in future studies.
Seed Germination and Seedling Growth of Yellow and Purple Passion Fruit Genotypes Cultivated in Ecuador
Authors: Viera William , Shinohara Takashi , Sanada Atsushi , Terada Naoki , Ron Lenin , Koshio Kaihei
Published: August 2022

Seed is a fundamental tool to carry out breeding processes and for the propagation of the crops; however, seed propagation generally has low and irregular germination. Passion fruit (Passiflora) species are economically important for Ecuador, which is the main exporter of passion fruit concentrate in Latin America. Ecuadorian farmers propagate new plants by seeds to establish new passion fruit orchards or to extend their cultivated area. The objective of this research was to determine the differences in germination and seedling development with the application of priming methods in five genotypes of passion fruit belonging to three different taxa that are of commercial use in Ecuador. The genotypes used were: INIAP 2009 and P10 (P. edulis f. flavicarpa), Gulupa (P. edulis f. edulis), and local germplasms POR1 (P. edulis f. flavicarpa) and PICH1 (P. maliformis). The priming methods were: water (control), hydrogen peroxide at 15%, potassium nitrate at 1%, PEG 6000 at −1.2 MPa, and gibberellic acid at 500 ppm. The results showed that there was a genotype-response depending on the priming method. Nevertheless, Polietilenoglicol (PEG 6000) could be considered as a promising method to encourage seed germination and promote seedling growth in the Passiflora species. More research regarding the use of this compound has to be carried out in order to determine in depth the physiological processes related to its functions to improve seed germination as well as production of vigorous seedlings.
Trauma Recovery Rubric: A Mixed-Method Analysis of Trauma Recovery Pathways in Four Countries
Authors: Koutra Kleio , Burns Courtney , Sinko Laura , Kita Sachiko , Bilgin Hülya , Arnault Denise Saint
Published: August 2022

Research is beginning to examine gender-based violence (GBV) survivors’ recovery, but little is known about diverse recovery trajectories or their relationships with other distress and recovery variables. This interdisciplinary, international multisite mixed-method study developed and used the TRR to identify and classify survivors’ trauma pathways. This study describes the phases of the initial development of the preliminary TRR (Phase 1), refines and calibrates the TRR (Phase 2), and then integrates the TRR into quantitative data from four countries (Phase 3). Seven recovery pathways with six domains emerged: normalizing, minimizing, consumed/trapped; shutdown or frozen, surviving, seeking and fighting for integration; finding integration/equanimity. Depression scores were related to most recovery domains, and TRR scores had large effect sizes. At the same time, PTSD was not statistically related to TRR scores, but TRR had a medium effect size. Our study found that the TRR can be implemented in diverse cultural settings and promises a reliable cross-cultural tool. The TRR is a survivor-centered, trauma-informed way to understand different survivorship pathways and how different pathways impact health outcomes. Overall, this rubric provides a foundation for future study on differences in survivor healing and the drivers of these differences. This tool can potentially improve survivor care delivery and our understanding of how to meet best the needs of the survivor populations we intend to serve.
New Advances on Wellness Therapies Using Integrated Health Focusing on Nature
Authors: Vermeesch Amber L. , Littzen-Brown Chloe , Lafrenz Andrew
Published: August 2022

The purpose of this Special Issue is to provide you, the reader, with an overview of new advancements in wellness therapies using integrative health focusing on nature [...]
Involvement, Perception, and Understanding as Determinants for Patient–Physician Relationship and Their Association with Adherence: A Questionnaire Survey among People Living with HIV and Antiretroviral Therapy in Austria
Authors: Beichler Helmut , Grabovac Igor , Leichsenring Birgit , Dorner Thomas Ernst
Published: August 2022

Background: The relationship between patients and healthcare professionals (physicians) is the cornerstone of successful long-term antiretroviral therapy for people living with human immunodeficiency virus (HIV). Purpose: This study aimed to investigate the connection between involvement, perception, and understanding as the basis for the patient–physician relationship and drug adherence, measured as the probability of non-adherence. Methods: In an online survey, people with HIV were asked about their relationship with their physicians and the extent to which they felt involved in treatment-related decisions. A statistical analysis was conducted to determine whether a better patient–physician relationship was associated with higher adherence to therapy. This was performed by univariate group comparison (Mann–Whitney-U, Fishers Exact Test) and logistic regression. Results: A total of 303 persons living with HIV participated in the survey, and 257 patients were included in the analysis. Overall, 27.6% were classified as non-adherent and self-reporting based on whether an antiretroviral therapy (ART) was taken in the past or how often the ART was interrupted. This proportion was significantly higher among patients aged 50–74 years (39.7%) and those with a longer therapy duration (9–15 years: 46.6%; from 15 years on: 55.8%). Therapy-non-adherent patients showed significantly lower scores in the relationship aspects understanding (2.68 vs. 3.03), participation (2.63 vs. 3.07), and perception (3.00 vs. 3.24) compared to adherent patients. Logistic regression analysis confirms that higher scores for understanding, involvement, and perception are strongly associated with a reduction in the risk of becoming non-adherent. This was true for all examined regression models, regardless of whether they were adjusted for the length of therapy and socio-demographic characteristics. Conclusion: The results reinforce the need for awareness among health care professionals (HCP) regarding understanding, involvement, and perception as important aspects to improve the quality of the patient–physician relationship for high adherence levels with maximized non-adherence in ART management by PLWH.
Risks of Accidents Caused by the Use of Smartphone by Pedestrians Are Task- and Environment-Dependent
Authors: Sobrinho-Junior Sidney Afonso , de Almeida Azriel Cancian Nepomuceno , Ceabras Amanda Aparecida Paniago , da Silva Carvalho Carolina Leonel , Lino Tayla Borges , Christofoletti Gustavo
Published: August 2022

Using smartphones during a task that requires an upright posture can be detrimental for the overall motor performance. The aim of this study was to determine the risks of accidents caused by the use of smartphones by pedestrians while walking in a controlled (laboratory) and a non-controlled (public street) environment. Two hundred and one participants, 100 men and 101 women, all young adults, were submitted to walking activities while texting messages and talking on the phone. The risk of accident was measured by the time and the number of steps necessary to walk a 20 ft distance. Assessments were performed with no external distractors (laboratory) and on a public street with vehicles, pedestrians, lights, and noises. Multivariate analysis of variance tests provided the main effect of task (using × not using smartphone), environment (laboratory × street), sex (men × women), and interactions. Significance was set at 5%. The results showed that using a smartphone while walking demanded a greater number of steps and time to perform the task (main effect of task: 0.84; p = 0.001). The risk of accident was higher on the streets where, due to traffic hazards, pedestrians performed the task faster and with a lower number of steps (the main effect of environment: 0.82; p = 0.001). There was no difference of risks between men and women (main effect of sex: 0.01; p = 0.225), whether in the laboratory or on the street (main effect of sex × environment: 0.01; p = 0.905). The task × environment interaction showed that using a smartphone on the street potentiates risks of accidents of pedestrians (main effect of task × environment: 0.41; p = 0.001). In conclusion, using a smartphone while walking can be risky for pedestrians, especially in a traffic environment. People should avoid using their smartphone while crossing streets.