bluuebunny/crossref_metadata_2025 huggingface dataset:
Investigation of the Relationship between Vitamin D Deficiency and Vitamin D-Binding Protein Polymorphisms in Severe COVID-19 Patients
Authors: Karcıoğlu Batur Lutfiye , Dokur Mehmet , Koç Suna , Karabay Mehmet , Akcay Zeyneb Nur , Gunger Ezgi , Hekim Nezih
Published: September 2024

This study explores the association of vitamin D-binding protein (VDBP) gene polymorphisms, vitamin D levels, and the severity of COVID-19, including the need for intensive care unit (ICU) hospitalization. We analyzed a cohort of 56 consecutive age- and gender-matched adult COVID-19-positive patients and categorized them into three groups: outpatients with mild illness, inpatients with moderate disease, and ICU patients. We measured levels of free, total, and bioavailable 25-hydroxyvitamin D [25(OH)D], VDBP, and albumin. VDBP polymorphisms rs5488 and rs7041 were identified using real-time PCR. A significant proportion of ICU patients were vitamin D-deficient (56.25%) compared to outpatients (10%) and inpatients (5%) (p = 0.0003). ICU patients also had notably lower levels of VDBP (median: 222 mg/L) and total 25(OH)D (median: 18.8 ng/mL). Most patients carried heterozygous rs7041 (60.7%) and wild-type rs4588 (58.9%) genotypes. The distribution of rs7041 SNP varied significantly among groups (p = 0.0301), while rs4588 SNP distribution did not (p = 0.424). Heterozygous rs4588 patients had significantly lower VDBP levels (p = 0.029) and reduced bioavailable 25(OH)D compared to those with wild-type rs4588 (p = 0.020). Our findings indicate that VDBP gene polymorphisms, particularly rs7041 and rs4588, are associated with vitamin D status and the severity of COVID-19. The lower VDBP levels and bioavailable vitamin D in ICU patients suggest that these genetic variants may influence disease severity and hospitalization needs. These results highlight the potential role of VDBP polymorphisms in COVID-19 severity, suggesting that genetic screening could be valuable in assessing the risk of severe outcomes and guiding personalized treatment strategies.
Clinical and Morphological Aspects of Aggressive Salivary Gland Mixed Tumors: A Narrative Review
Authors: Faur Alexandra Corina , Șișu Alina Maria , Ghenciu Laura Andreea , Iacob Roxana , Stoicescu Emil Robert , Hațegan Ovidiu Alin , Cornianu Mărioara
Published: September 2024

Salivary gland tumors are a rare and heterogeneous group of neoplasms of the head and neck region. The mixed category of these tumors include the following entities: pleomorphic adenoma (PA), carcinoma ex pleomorphic adenoma (CEPA), salivary carcinosarcoma (CS), and metastasizing PA (MPA). The most common benign tumor of the salivary glands is PA. Metastasis and malignant degeneration have been reported in cases of PA of a salivary gland origin. Judging by their behavior, MPA, CEPA, and CS can be considered aggressive tumors. Invasive CEPA has been identified in the parotid gland more frequently. MPA and CS cases reported in the current literature are rare. In this paper, we present, narratively, the clinico-morphological features of this group of mixed tumors.
Radiotracer Innovations in Breast Cancer Imaging: A Review of Recent Progress
Authors: Haidar Mohamad , Rizkallah Joe , El Sardouk Omar , El Ghawi Nour , Omran Nadine , Hammoud Zeinab , Saliba Nina , Tfayli Arafat , Moukadem Hiba , Berjawi Ghina , Nassar Lara , Marafi Fahad , Choudhary Partha , Dadgar Habibollah , Sadeq Alyaa , Abi-Ghanem Alain S.
Published: September 2024

This review focuses on the pivotal role of radiotracers in breast cancer imaging, emphasizing their importance in accurate detection, staging, and treatment monitoring. Radiotracers, labeled with radioactive isotopes, are integral to various nuclear imaging techniques, including positron emission tomography (PET) and positron emission mammography (PEM). The most widely used radiotracer in breast cancer imaging is 18F-fluorodeoxyglucose (18F-FDG), which highlights areas of increased glucose metabolism, a hallmark of many cancer cells. This allows for the identification of primary tumors and metastatic sites and the assessment of tumor response to therapy. In addition to 18F-FDG, this review will explore newer radiotracers targeting specific receptors, such as estrogen receptors or HER2, which offer more personalized imaging options. These tracers provide valuable insights into the molecular characteristics of tumors, aiding in tailored treatment strategies. By integrating radiotracers into breast cancer management, clinicians can enhance early disease detection, monitor therapeutic efficacy, and guide interventions, ultimately improving patient outcomes. Ongoing research aimed at developing more specific and sensitive tracers will also be highlighted, underscoring their potential to advance precision medicine in breast cancer care.
Cardiovascular Aging and Risk Assessment: How Multimodality Imaging Can Help
Authors: Hrabak Paar Maja , Muršić Miroslav , Bremerich Jens , Heye Tobias
Published: September 2024

Aging affects the cardiovascular system, and this process may be accelerated in individuals with cardiovascular risk factors. The main vascular changes include arterial wall thickening, calcification, and stiffening, together with aortic dilatation and elongation. With aging, we can observe left ventricular hypertrophy with myocardial fibrosis and left atrial dilatation. These changes may lead to heart failure and atrial fibrillation. Using multimodality imaging, including ultrasound, computed tomography (CT), and magnetic resonance imaging, it is possible to detect these changes. Additionally, multimodality imaging, mainly via CT measurements of coronary artery calcium or ultrasound carotid intima-media thickness, enables advanced cardiovascular risk stratification and helps in decision-making about preventive strategies. The focus of this manuscript is to briefly review cardiovascular changes that occur with aging, as well as to describe how multimodality imaging may be used for the assessment of these changes and risk stratification of asymptomatic individuals.
The Effect of COVID-19 and COVID-19 Vaccination on Assisted Human Reproduction Outcomes: A Systematic Review and Meta-Analysis
Authors: Milostić-Srb Andrea , Srb Nika , Talapko Jasminka , Meštrović Tomislav , Žiger Tihomil , Pačarić Stana , Fureš Rajko , Makarović Vedrana , Škrlec Ivana
Published: September 2024

The most discussed infectious disease is coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus. Many research endeavors have focused on the effects of the virus on reproductive organs, as these have also been shown to carry the receptors to which the virus attaches. The results of assisted reproductive technology (ART) have been significantly affected by the pandemic, with some in vitro fertilization (IVF) centers being closed due to the risk of further spread of the disease. According to World Health Organization statistics, 17.5% of adults worldwide suffered from fertility problems in 2023; in other words, one in six people in the world have reproductive health problems. As infertility is a growing problem in the modern world and new developments in assisted reproduction are always a topic of profound interest, it is important to understand the impact of SARS-CoV-2 on reproductive health. This systematic review aimed to examine studies describing patients undergoing ART procedures with a COVID-19-positive history and to shed light on the recent evidence on the safety of COVID-19 vaccination in the ART context. A meta-analysis was conducted to confirm the results of the systematic review. The results showed a significant difference in clinical pregnancy rates between the vaccinated and unvaccinated groups and an increased miscarriage rate in those with a COVID-19-positive history. However, no significant difference in clinical pregnancy and birth rates was found in participants with a previous COVID-19 infection. The results show that further studies and research are needed, even though the spread and impact of the virus have decreased. Evidence-based information for individuals and couples undergoing infertility treatment is vital to enable informed decision-making.
Underestimating the Pandemic: The Impact of COVID-19 on Income Distribution in the U.S. and Brazil
Authors: Alfani Federica , Clementi Fabio , Fabiani Michele , Molini Vasco , Schettino Francesco
Published: September 2024

The COVID-19 pandemic has exposed individuals to various risks, including job loss, income reduction, deteriorating well-being, and severe health complications and death. In Brazil and the U.S., as well as in other countries, the initial response to the pandemic was marked by governmental underestimation, leading to inadequate public health measures to curb the spread of the virus. Although progressively mitigated, this approach played a crucial role in the impacts on local populations. Therefore, the principal aim of this paper is to evaluate the impact of COVID-19 and, indirectly, of the policies adopted by the U.S. and the Brazilian governments to prevent pandemic diffusion on income distribution. Utilizing available microdata and employing novel econometric methods (RIF-regression for inequality measures) this study shows that growth in COVID-19 prevalence significantly exacerbates economic disparities. Furthermore, the impact of COVID-19 on inequality has increased over time, suggesting that this negative impact has been intensifying. In the U.S., results indicate that working from home, the inability to work, and barriers to job-seeking significantly increase inequalities. Although further data are necessary to validate the hypothesis, this preliminary evidence suggests that the pandemic has significantly contributed to increased inequality in these two countries already characterized by increasing polarization and significant social disparities.
Air Transport Resilience, Tourism and Its Impact on Economic Growth
Authors: Nguyen Chien-Van
Published: September 2024

The aims of this study are to evaluate the influence of air transport and tourism on economic growth in selected Southeast Asian countries such as Thailand, Philippines, Vietnam, Indonesia, Malaysia, and Singapore in the period 1970 to 2021. The study applies the ordinary least squares (OLS), fixed effects (FEM), and random effects (REM), especially to robustness test of the research results by deploying the DOLS, and IV-GMM regression for endogeneity and autocorrelation analysis. The research results confirmed that air transport has a significant and positive impact on economic growth, especially because the positive impact increased in normal economic conditions and decreased during the COVID-19 pandemic. Therefore, if the air transport recovers, it is likely to boost economic development. In addition, there is no impact of tourism on economic growth. The research results also confirmed the positive impact of foreign direct investment and international trade on the economic growth of Southeast Asian countries; however, there is a negative impact of renewable energy consumption on economic growth.
Linking Traditional Teaching to Innovative Approaches: Student Conceptions in Kinematics
Authors: Sengul Ozden
Published: September 2024

This study delves into the problem-solving approaches of students who attend classes with traditional teaching methods in university physics education with innovative curriculum materials. This research, conducted with university physics and engineering students, focused on applying research-based curriculum materials in solving kinematic problems. The study analyzes the impact of student knowledge and the distinction between rote learning and scientific practices on conceptual understanding. Student responses are categorized based on the depth of knowledge demonstrated, the skill type utilized, and the degree to which responses indicate a logical progression. These, together with demographic data, are analyzed to determine any patterns. Findings reveal that students use intuitive and mathematical skills to solve a graphical question. However, students employ qualitative and mathematical skill types when they are required to design an experiment. Notably, gender disparity appears to influence the approach to graphical questions, but the design-based question shows no significant relationship between males and females. Gender was likely to contribute to knowledge and logical progression levels, but grades might not show a positive relationship with knowledge level. This study aims to contribute to developing physics education at the university level by highlighting the gap between innovative course materials and their enactment.
Complementary Polarizer SOT-MRAM for Low-Power and Robust On-Chip Memory Applications
Authors: Kim Hyerim , Kwon Kon-Woo , Seo Yeongkyo
Published: September 2024

Complementary polarized spin-transfer torque magnetic random-access memory (CPSTT-MRAM) has been proposed to address the sensing reliability issues caused by the single-ended sensing of STT-MRAM. However, it results in a three-fold increase in the free layer (FL) area compared to STT-MRAM, leading to a higher write current. Moreover, the read and write current paths in this memory are the same, thus preventing the optimization of each operation. To address these, in this study, we proposed a complementary polarized spin-orbit torque MRAM (CPSOT-MRAM), which tackles these issues through the SOT mechanism. This CPSOT-MRAM retains the advantages of CPSTT-MRAM while significantly alleviating the high write current requirement issue. Furthermore, the separation of the read and write current paths enables the optimization of each operation. Compared to CPSTT-MRAM, the proposed CPSOT-MRAM achieves a 4.0× and 2.8× improvement in write and read power, respectively, and a 20% reduction in layout area.
ECF-Net: Enhanced, Channel-Based, Multi-Scale Feature Fusion Network for COVID-19 Image Segmentation
Authors: Ji Zhengjie , Zhou Junhao , Wei Linjing , Bao Shudi , Chen Meng , Yuan Hongxing , Zheng Jianjun
Published: September 2024

Accurate segmentation of COVID-19 lesion regions in lung CT images aids physicians in analyzing and diagnosing patients’ conditions. However, the varying morphology and blurred contours of these regions make this task complex and challenging. Existing methods utilizing Transformer architecture lack attention to local features, leading to the loss of detailed information in tiny lesion regions. To address these issues, we propose a multi-scale feature fusion network, ECF-Net, based on channel enhancement. Specifically, we leverage the learning capabilities of both CNN and Transformer architectures to design parallel channel extraction blocks in three different ways, effectively capturing diverse lesion features. Additionally, to minimize irrelevant information in the high-dimensional feature space and focus the network on useful and critical information, we develop adaptive feature generation blocks. Lastly, a bidirectional pyramid-structured feature fusion approach is introduced to integrate features at different levels, enhancing the diversity of feature representations and improving segmentation accuracy for lesions of various scales. The proposed method is tested on four COVID-19 datasets, demonstrating mIoU values of 84.36%, 87.15%, 83.73%, and 75.58%, respectively, outperforming several current state-of-the-art methods and exhibiting excellent segmentation performance. These findings provide robust technical support for medical image segmentation in clinical practice.
Modeling and Experimental Validation of Dual-Output Flyback Converters with Capacitive Coupling for Improved Cross-Regulation
Authors: Granello Pierpaolo , Schirone Luigi
Published: September 2024

This paper addresses cross-regulation in dual-output flyback converters. An original analytical framework is developed to model the impact of a balancing capacitor connected among a transformer’s secondary windings in order to mitigate the cross-regulation among different outputs. To validate the proposed model, a prototype dual-output flyback converter was built and tested for a wide range of load unbalances. The measured cross-regulation error was compared with the theoretical predictions provided by the proposed model, obtaining a tight fit, which confirms the validity of the proposed approach.
Analysis of PM2.5 Concentration Released from Forest Combustion in Liangshui National Natural Reserve, China
Authors: Wu Zhiyuan , Hasham Ahmad , Zhang Tianbao , Gu Yu , Lu Bingbing , Sun Hu , Shu Zhan
Published: September 2024

(1) Background: In recent years, forest fires have become increasingly frequent both domestically and internationally. The pollutants emitted from the burning of fuel have exerted considerable environmental stress. To investigate the influence of forest fires on the atmospheric environment, it is crucial to analyze the variations in PM2.5 emissions from various forest fuels under differing fire conditions. This assessment is essential for evaluating the effects on both the atmospheric environment and human health. (2) Methods: Indoor simulated combustion experiments were conducted on the branches, leaves, and bark of typical tree species in the Liangshui National Natural Reserve, including Pinus koraiensis (PK), Larix gmelinii (LG), Picea koraiensis (PAK), Betula platyphylla (BP), Fraxinus mandshurica (FM), and Populus davidiana (PD). The PM2.5 concentrations emitted by six tree species under various combustion states were measured and analyzed, reflecting the impact of moisture content on the emission of pollutants from fuel combustion, as indicated by the emission factors for pollutants. (3) Results: Under different fuel loading and moisture content conditions, the mass concentration values of PM2.5 emitted from the combustion of different organs of various tree species exhibit variability. (4) Conclusions: Among the various tree species, broad-leaved varieties release a greater quantity of PM2.5 compared to coniferous ones. A positive correlation exists between the moisture content of the fuel and the concentration of PM2.5; changes in moisture content notably influence PM2.5 levels. The emission of PM2.5 from fuel with varying loads increases exponentially. Utilizing the Response Surface Methodology (RSM) model for simulation, it was determined that both moisture content and fuel load exert a significant combined effect on the release of PM2.5 during combustion.
Enhancing Mushroom Freezing Quality Using Microwave-Assisted Technology
Authors: Vardanjani Majid Yousefi , Hamdami Nasser , Dalvi-Isfahan Mohsen , Le-Bail Alain
Published: September 2024

This study investigated the effects of microwave-assisted freezing on the quality attributes of button mushrooms (Agaricus bisporus). Four levels of microwave power (0, 10, 20, 30%) were applied to the mushroom samples during freezing. The quality attributes of the frozen and thawed mushrooms were then evaluated. The results suggested that higher microwave power produced the smaller and more uniform ice crystals. Moreover, the browning index of the mushroom samples increased with increasing microwave power. The textural properties (hardness) of the mushrooms were also affected by the microwave power, showing higher values as the power increased. Furthermore, the ratio of the microwave operating system’s power to the freezer power was low and approximately 20% at the highest power level. Therefore, these findings confirm the potential of microwave-assisted freezing for reducing freeze damage to mushroom tissue and, thus, provide frozen mushroom with a better texture.
Development and Evaluation of the Biological Activities of a Plain Mucoadhesive Hydrogel as a Potential Vehicle for Oral Mucosal Drug Delivery
Authors: Pardo-Rendón Ana G. , Mejía-Méndez Jorge L. , López-Mena Edgar R. , Bernal-Chávez Sergio A.
Published: September 2024

This study aimed to develop HGs based on cationic guar gum (CGG), polyethylene glycol (PEG), propylene glycol (PG), and citric acid (CA) using a 2k factorial experimental design to optimize their properties. HGs were characterized through FTIR and Raman spectroscopy, scanning electron microscopy (SEM), and thermogravimetric analysis (TGA). The biological activities of HGs were determined by evaluating their mucoadhesive capacity and antibacterial activity in vitro, whereas their toxicity was analyzed using Artemia salina nauplii as an in vivo model. Results revealed that HGs were successfully optimized for their viscosity, pH, and sensory properties, and it was observed that varying concentrations of PEG-75 did not influence them. Through SEM analyses, it was noted that increased levels of PEG-75 resulted in HGs with distinct porosity and textures, whereas FTIR and Raman spectroscopy exhibited representative peaks of the raw materials used during the synthesis process. TGA studies indicated the thermal stability of HGs, as they presented degradation patterns at 100 and 300 °C. The synthesized HGs exhibited similar mucoadhesion kinetic profiles, demonstrating a displacement factor at an equilibrium of 0.57 mm/mg at 5 min. The antibacterial activity of HGs was appraised as poor against Gram-positive and Gram-negative bacteria due to their MIC90 values (>500 μg/mL). Regarding A. salina, treatment with HGs neither decreased their viability nor induced morphological changes. The obtained results suggest the suitability of CGG/PEG HGs for oral mucosa drug delivery and expand the knowledge about their mucoadhesive capacity, antibacterial potential, and in vivo biocompatibility.
Can We Succeed with Inclusive Education for Sámi Pupils?
Authors: Somby Hege Merete
Published: September 2024

Since Norwegian compulsory education increasingly recognises Sámi rights and the Sámi as an Indigenous people, the question of how we can provide inclusive education for Sámi pupils by recognising Sámi culture in teaching remains. I argue in this literary research, that inclusive education, both as a concept and as a practice in school, stems from a pathological field, targeting individual needs, and therefore misses the target when educating pupils with an Indigenous cultural belonging. Inclusion as a concept centres on practices such as fellowship, participation, equal access, quality, equity and justice, but its legacy is anchored in individual needs, influencing how we think about inclusion and implementing inclusive measures. This way of thinking still guides the national strategy for inclusive education but will not be sufficient for Sámi pupils, since they, as a group, are not disabled. So-called inclusive measures will rather enhance the integration of Sámi pupils into the Norwegian framework of schooling defined by the majority’s expectations for fellowship, participation and so forth. While Indigenous inclusion takes integrative measures which uphold the status quo, thus dependent on a majority perspective, indigenising has an Indigenous baseline. I argue that non-Sámi society needs to re-contextualise itself towards the Sámi society if we want an education for all.
The Role of Patient Organizations in Shaping Research, Health Policies, and Health Services for Rare Genetic Diseases: The Dutch Experience
Authors: Poortman Ysbrand , Ens-Dokkum Martina , Nippert Irmgard
Published: September 2024

In 2023, the genetics scientific community celebrated two special anniversaries: the discovery of the double helix structure of DNA was published in 1953 and in 2003 the Human Genome Project was declared completed and made publicly available. To this day, genetics and genomics research is continuing to evolve at high pace and is identifying a steadily increasing number of genes as causal for distinct genetic diseases. The success story of genetics and genomics would not be complete without taking due account of the role of patient advocacy organizations in this process. This paper is based on the personal narrative (oral history) of a father whose daughter was born with a rare genetic disease (RGD) in the 1960s. The first-hand experience of living as a family with an RGD in those days made him a leading pioneer not only in the foundation of patient organizations at national, pan-European, and international levels but also in the development of multi-stakeholder co-operation and networking. Today, patient advocacy organizations play an active role in shaping health and research policies at national, EU, and international levels to ensure that their needs in regard to advancing RGD diagnostics, care, and treatment are addressed.
Cenozoic Carbon Dioxide: The 66 Ma Solution
Authors: Frank Patrick
Published: September 2024

The trend in partial pressure of atmospheric CO2, P(CO2), across the 66 MYr of the Cenozoic requires elucidation and explanation. The Null Hypothesis sets sea surface temperature (SST) as the baseline driver for Cenozoic P(CO2). The crystallization and cooling of flood basalt magmas is proposed to have heated the ocean, producing the Paleocene–Eocene Thermal Maximum (PETM). Heat of fusion and heat capacity were used to calculate flood basalt magmatic Joule heating of the ocean. Each 1 million km3 of oceanic flood basaltic magma liberates ~5.4 × 1024 J, able to heat the global ocean by ~0.97 °C. Henry’s Law for CO2 plus seawater (HS) was calculated using δ18O proxy-estimated Cenozoic SSTs. HS closely parallels Cenozoic SST and predicts the gas solute partition across the sea surface. The fractional change of Henry’s Law constants, Hn−HiHn−H0 is proportional to ΔP(CO2)i, and Hn−HiHn−H0×∆P(CO2)+P(CO2)min, where ΔP(CO2) = P(CO2)max − P(CO2)min, closely reconstructs the proxy estimate of Cenozoic P(CO2) and is most consistent with a 35 °C PETM ocean. Disparities are assigned to carbonate drawdown and organic carbon sedimentation. The Null Hypothesis recovers the glacial/interglacial P(CO2) over the VOSTOK 420 ka ice core record, including the rise to the Holocene. The success of the Null Hypothesis implies that P(CO2) has been a molecular spectator of the Cenozoic climate. A generalizing conclusion is that the notion of atmospheric CO2 as the predominant driver of Cenozoic global surface temperature should be set aside.
Virtual Reality Cognitive Remediation in Older Adults with Bipolar Disorder: The Effects on Cognitive Performance and Depression in a Feasibility Randomized Controlled Trial
Authors: Primavera Diego , Aviles Gonzalez Cesar , Perra Alessandra , Kalcev Goce , Cantone Elisa , Cossu Giulia , Holzinger Anita , Carta Mauro Giovanni , Sancassiani Federica
Published: September 2024

Introduction: Dementia, depression, and cardiovascular disease are major public health concerns for older adults, requiring early intervention. This study investigates whether a virtual reality cognitive remediation program (VR-CR) can improve cognitive function and depressive symptoms in older adults, and determines the necessary sample size for future studies. Integrated VR and CR interventions have shown promising outcomes in older adults with neurodegenerative and mental health disorders. Methods: This secondary analysis of a randomized controlled trial involves adults aged 58–75 years with bipolar disorder, excluding those with acute episodes, epilepsy, or severe eye diseases. The experimental group received standard treatment plus VR-CR, while the control group received only standard treatment. Results: No baseline differences were found between the experimental and control groups. No significant improvement was observed in the overall cognitive function test (p = 0.897) or in depressive symptoms (p = 0.322). A phase III efficacy study requires a sample size of 28 participants (alpha = 0.05, beta = 0.20). Conclusions: VR-CR can potentially treat depressive symptoms in adults and older adults, but the results support conducting phase III studies to further investigate these outcomes. However, the improvement in cognitive performance in the elderly is less pronounced than in younger individuals.
Efficacy of a Comprehensive and Personalised Approach for Frail Older People in Valencia (Spain): A Pre–Post Controlled Trial
Authors: Fernández-Salido Mirian , Alhambra-Borrás Tamara , Garcés-Ferrer Jorge
Published: September 2024

Frailty is a common condition in older adults that negatively impacts health and quality of life. This study evaluated a comprehensive, personalised, and coordinated intervention under the value-based care approach to address frailty’s multidimensional nature in older people in the primary care setting. It employed a pre–post randomised controlled design involving 242 frail individuals aged over 65 years living in the community in Valencia (Spain) between 2021 and 2023. Assessments were conducted at baseline, 12 months (immediately post-intervention), and 18 months. The intervention included a personalised care plan supported by technology, with monthly motivational follow-ups and plan updates by health professionals and participants. Outcomes were measured using an assessment questionnaire that included the International Consortium for Health Outcomes Measurement dataset for the older population: physical health, physical functioning, general mental health, satisfaction with social activities and relationships, ability to carry out usual social roles and activities, pain, general quality of life, loneliness, physical frailty, psychological frailty, and social frailty. The study found significant improvements in physical frailty, quality of life, reduced health resource use and hospitalisations and lower levels of pain and depression/anxiety compared to baseline. The findings suggest further research into value-based care approaches, emphasizing the development and activation of personalised, comprehensive programs for older individuals with frailty.
The Translation, Cross-Cultural Adaptation and Validation of the Italian Version of the Hip and Groin Outcome Score Questionnaire for a Young and Active Population
Authors: Ricci Andrea , Rossi Alex , Zitti Mirko
Published: September 2024

The HAGOS (Hip and Groin Outcome Score) questionnaire is a valid and reliable measure of the self-assessment of symptoms, activity limitation, participation restriction, and quality of life (Qol) of subjects with hip and/or groin pain. The aims of this study are to translate and transculturally adapt the HAGOS into Italian (HAGOS-I) and to assess its internal consistency, validity, and reliability in physically active, young, and middle-aged subjects. The translation and transcultural adaptation of (HAGOS-I) was carried out according to international guidelines. Eight-one subjects (mean age 28.19) were included in this study. All the participants completed the HAGOS-I, the Lower Extremity Functional Scale (LEFS-I), the Oxford Hip Score (OHS-I), and the Short Form 36 Health Surveys (SF-36-I). The Cronbach’s α for the six HAGOS subscales ranged from 0.63 to 0.87. Statistically significant correlations were obtained between the six HAGOS-I subscales and the LEFS-I (rs = 0.44–0.68; p < 0.01). Only one HAGOS-I subscale (Participation in Physical Activities) did not reach statistical significance with the OHS-I, while the remaining five had a moderate correlation (rs = 0.40–0.60; p < 0.01). The test–retest reliability (Intraclass Correlation Coefficient) ranged from 0.57 to 0.86 for the six HAGOS-I subscales. The HAGOS-I is a valid and reliable instrument that can be used in clinical settings with young and middle-aged subjects with hip and/or groin pathologies.
Delphi Technique on Nursing Competence Studies: A Scoping Review
Authors: Furtado Luís , Coelho Fábio , Pina Sara , Ganito Cátia , Araújo Beatriz , Ferrito Cândida
Published: September 2024

This scoping review was conducted under the Joanna Briggs Institute (JBI) framework. It included primary studies published until 30 April 2023, obtained through a systematic search across PubMed, Web of Science, CINAHL, and MEDLINE databases. The review focused on primary studies that used the Delphi technique in nursing competence research, especially those related to defining core competency frameworks and developing instruments to assess professional competence. The goal was to analyze the different methodological approaches used by authors, synthesize them, and propose recommendations to enhance methodological rigor, reliability, and validity in the application of the Delphi technique. For this purpose, the following review question was established: “What is the available evidence on the use of the Delphi technique in the study of professional competence in nursing?”. The extracted textual elements underwent a content analysis, resulting in dimensions established through an inductive approach. Twenty studies were included, yielding insights into diverse methodological options for conducting Delphi studies, organised around a set of dimensions: (1) preparatory procedures; (2) procedures for accessing and selecting experts; (3) acquisition of expert input; (4) data analysis and consensus; and (5) ethical and legal procedures and guarantees. The study’s limitations include the inability to include certain studies due to a lack of response to requests for clarification from corresponding authors. Additionally, the primary studies’ methodological quality was not assessed, which is another relevant aspect. The study’s results offer valuable insights for researchers intending to utilise the Delphi technique within the context of the research referenced in the included studies. This information encompasses important methodological choices, highlighting their potential benefits and associated risks. The review was prospectively registered on the Open Science Framework (Registration No: osf.io/kp2vw).
Atherosclerosis and Cardiovascular Complications in People Living with HIV: A Focused Review
Authors: Paternò Raddusa Michele Salvatore , Marino Andrea , Celesia Benedetto Maurizio , Spampinato Serena , Giarratana Carmen , Venanzi Rullo Emmanuele , Cacopardo Bruno , Nunnari Giuseppe
Published: September 2024

The intersection of Human Immunodeficiency Virus (HIV) infection and cardiovascular disease (CVD) represents a significant area of concern; advancements in antiretroviral therapy (ART) have notably extended the life expectancy of people living with HIV (PLWH), concurrently elevating the prevalence of chronic conditions such as CVD. This paper explores the multifaceted relationship between HIV infection, ART, and cardiovascular health, focusing on the mechanisms by which HIV and ART contribute to increased cardiovascular risk, including the promotion of endothelial dysfunction, inflammation, immune activation, and metabolic disturbances. We highlight the critical roles of HIV-associated proteins—Tat, Nef, and gp120—in accelerating atherosclerosis through direct and indirect pathways that exacerbate endothelial damage and inflammation. Additionally, we address the persistent challenge of chronic inflammation and immune activation in PLWH, factors that are strongly predictive of non-AIDS-related diseases, including CVD, even in the context of effective viral suppression. The impact of ART on cardiovascular risk is examined, with particular attention to the metabolic implications of specific ART regimens, which can influence lipid profiles and body composition, thereby modifying CVD risk. The therapeutic potential of statins, aspirin, and emerging treatments such as PCSK9 inhibitors in mitigating cardiovascular morbidity and mortality among PLWH is discussed, alongside considerations for their use in conjunction with ART. Our review underscores the necessity for a comprehensive, multidisciplinary approach to cardiovascular care in PLWH, which integrates vigilant cardiovascular risk assessment and management with HIV treatment. As we navigate the evolving landscape of HIV care, the goal remains to optimize treatment outcomes while minimizing cardiovascular risk, ensuring that the gains in longevity afforded by ART translate into improved overall health and quality of life for PLWH.
Insights into the Preparation of and Evaluation of the Bactericidal Effects of Phage-Based Hydrogels
Authors: Gao Mengyuan , Wang Yuhan , Zhuang Hanyue , Zhu Yanxia , Chen Na , Teng Tieshan
Published: September 2024

The rise of antibiotic-resistant strains demands new alternatives in antibacterial treatment. Bacteriophages, with their precise host specificity and ability to target and eliminate bacteria safely, present a valuable option. Meanwhile, hydrogels, known for their excellent biodegradability and biocompatibility, serve as ideal carriers for bacteriophages. The combination of bacteriophages and hydrogels ensures heightened phage activity, concentration, controlled release, and strong antibacterial properties, making it a promising avenue for antibacterial treatment. This article provides a comprehensive review of different crosslinking methods for phage hydrogels, focusing on their application in treating infections caused by various drug-resistant bacteria and highlighting their effective antibacterial properties and controlled release capabilities.
Nitrofurantoin as an Add-On to Conventional Prophylaxis for the Treatment of Urinary Tract Infections in Kidney Recipients: A Prospective Cohort Study
Authors: Gutiérrez-Aceves J. Ahuixotl , Avalos-Salgado Felipe Alexis , Gamez-Nava Jorge Ivan , Gonzalez-Lopez Laura , González-Vázquez Sergio Antonio , Arellano-Cervantes Reynaldo , Mireles-Ramírez Mario Alberto , Marquez-Pedroza Jazmin , Ramirez-Villafaña Melissa , Gomez-Ramirez Eli Efrain , Gonzalez-Ponce Fabiola , Saldaña-Cruz Ana Miriam , Rodriguez-Jimenez Norma Alejandra , Cardona-Muñoz Ernesto German , Totsuka-Sutto Sylvia , Ponce-Guarneros Juan Manuel
Published: September 2024

Urinary tract infections (UTIs) constitute one of the main complications in kidney recipients, increasing both morbidity and mortality. Due to the resurgence of antimicrobial resistance, new prophylactic approaches are being investigated. Nitrofurantoin is an antibiotic from the nitrofuran group that is effective against several Gram-negative and Gram-positive organisms; hence, there has been a resurgence in its prescription for treating MDR pathogens. Objectives: This study aims to assess the effectiveness of nitrofurantoin as an add-on to conventional therapy (amikacin + ceftriaxone or cefotaxime) for the treatment of urinary tract infections in kidney recipients. Methods: In a prospective cohort study, we included patients who received a kidney in a tertiary-care hospital. According to the intensive care specialist, group 1 patients were treated with the conventional prophylactic treatment plus nitrofurantoin as an add-on. Group 2 patients were treated only with the conventional prophylactic treatment. They were followed-up for 3 months, and the incidence of urinary tract infections was reported. Results: The UTI incidence for group 1 at 3 months was 20.6%, and for group 2, it was 20.0%; no statistical difference between treatments was observed (p = 0.9). The most commonly isolated pathogens were E. coli (28.5) and K. pneumonie (28.5%). The factor most associated with developing a UTI was female gender (aHR: 7.0; 95% IC 2.3–20.9, p < 0.001). Conclusions: In our cohort study, nitrofurantoin as an add-on in conventional therapy did not prove to be effective in preventing UTI development; therefore, other treatment options should be considered as a part of prophylactic treatment.
Effects of Small-Sided Soccer Games on Physical Fitness and Cardiometabolic Health Biomarkers in Untrained Children and Adolescents: A Systematic Review and Meta-Analysis
Authors: Gómez-Álvarez Nicolás , Boppre Giorjines , Hermosilla-Palma Felipe , Reyes-Amigo Tomás , Oliveira José , Fonseca Hélder
Published: September 2024

Objective: This systematic review and meta-analysis aimed to determine the benefits of an exercise intervention based on small-sided soccer games (SSSGs) on health-related physical fitness and cardiometabolic health in previously untrained children and adolescents. Methods: A systematic search on PubMed/MEDLINE, Web of Science, Scopus, Cochrane, and EBSCO databases was performed. Randomized or non-randomized controlled trials conducted in previously untrained children or adolescents (age < 18 years) that assessed the effect of SSSG-based intervention on health-related physical fitness and cardiometabolic risk biomarkers were included. Primary outcomes were cardiorespiratory fitness and waist circumference. Evidence was synthesized as the mean difference or standardized mean difference using a random-effects meta-analysis. The quality of evidence was assessed using ROB2 and ROBINS-I tools. Results: Sixteen studies (n = 2872 participants) were included in this meta-analysis. SSSGs significantly improved cardiorespiratory fitness (SMD, 0.12 [0.01; 0.23]) and showed a non-significant trend in decreased waist circumference (−7.49 cm [−15.03; 0.06]). Additionally, SSSGs significantly decreased systolic (MD, −3.85 mmHg [−5.75; −1.94]) and diastolic blood pressure (MD, −1.26 mmHg [−2.44; −0.08]) and triglycerides (−30.34 mg·dL−1 [−45.99; −14.69]). No effects on body composition or other cardiometabolic risk biomarkers were observed. After a sensitivity analysis, waist circumference and muscle strength were also shown to improve significantly following SSSGs. Comparisons between SSSG and other types of exercise interventions showed no differences in improved physical fitness or cardiometabolic risk. Conclusions: SSSG-based interventions effectively improve cardiorespiratory fitness, blood pressure, triglycerides, muscle strength, and waist circumference. There is less evidence of the effects of SSSGs on other health markers. Particular attention should be given to improving SSSG protocol reporting in future studies.
Adenomyosis: An Update Concerning Diagnosis, Treatment, and Fertility
Authors: Selntigia Aikaterini , Molinaro Pietro , Tartaglia Silvio , Pellicer Antonio , Galliano Daniela , Cozzolino Mauro
Published: September 2024

This review article aims to summarize current tools used in the diagnosis of adenomyosis with relative pharmacological and surgical treatment and to clarify the relative association between adenomyosis and infertility, considering the importance of an accurate diagnosis of this heterogeneous disease. Among different reported concepts, direction invagination of gland cells from the basalis endometrium deep into the myometrium is the most widely accepted opinion on the development of adenomyosis. Adenomyosis has been increasingly identified in young women with pain, AUB, infertility, or no symptoms by using imaging techniques such as transvaginal ultrasound and magnetic resonance. Furthermore, adenomyosis often coexists with other gynecological conditions, such as endometriosis and uterine fibroids, increasing the heterogeneity of available data. However, there is no agreement on the definition and classification of adenomyotic lesions from both the histopathology and the imaging points of view, and diagnosis remains difficult and unclear. A standard, universally accepted classification system needs to be implemented to improve our understanding and inform precise diagnosis of the type of adenomyosis. This could be the key to designing RCT studies and evaluating the impact of adenomyosis on quality of life in terms of menstrual symptoms, fertility, and pregnancy outcome, given the high risk of miscarriage and obstetric complications.
The IntegraPark Study: An Opportunity to Facilitate High-Intensity Exercise with Immersive Virtual Reality in Parkinson’s Disease Patients
Authors: Cancela-Carral José M. , Campo-Prieto Pablo , Rodríguez-Fuentes Gustavo
Published: September 2024

Background: high-intensity exercise is a feasible and effective modality in the early stages of Parkinson’s disease (PD). However, there are only a few studies that have carried out this type of intervention in customizable immersive virtual reality (IVR) environments. We explore the feasibility and effects of IVR-based high-intensity training through rowing and cycling exercises on the functional capacity, quality of life, and progression of PD. Methods: a total of 12 participants (61.50 ± 10.49 years old; 41.7% female, 58.3% male; stages I–III) were part of the study, which consisted of interventions of rowing and cycling in an IVR commercial exergame (25 min; twice per week for 14 weeks). The main variables measured were functional capacity, handgrip strength, functional mobility (TUG), functional lower-limb strength (FTSST), aerobic capacity (2-min step test), quality of life (PDQ-39), and Parkinson’s disease progression (MDS-UPDRS). Results: the results showed a general improvement in handgrip strength in both hands (p = 0.008; d = 0.28), FTSST (p = 0.029; d = 0.96), and TUG times (p = 0.152; d = 0.22). Aerobic capacity, assessed by a 2-min step test, showed enhanced scores (p = 0.031; d = 0.78). Related to the PDQ-39, all dimensions of the scale were enhanced, highlighting activities of daily living (p = 0.047; d = 0.29) and bodily discomfort (p = 0.041; d = 0.37). Finally, the main symptoms of the disease were reduced, with an improvement in the parameters that show a better incidence of disease progression, such as Part IA and IB (p = 0.013; d = 0.29 and p = 0.021; d = 0.25, respectively), Part II (p = 0.021; d = 0.23), Part III (p = 0.040; d = 0.39), and Part IV (p = 0.013; d = 0.39). Conclusions: the therapeutic exercise (rowing and cycling), when carried out at a high intensity and in a personalized IVR scenario, appear to be a feasible and safe modality for patients with stages I–III of PD, improving their functional capacity, quality of life, and disease progression.
A Special Issue Introduction: The Intersection of Metacognition and Intelligence
Authors: Son Lisa K. , Hausman Hannah
Published: September 2024

What makes someone intelligent [...]
Emotional Regulation Challenges in Chilean Teachers: An Analysis of the Measurement Invariance of the DERS-E and the Influence of Gender and Age
Authors: Muñoz-Troncoso Flavio , Riquelme-Mella Enrique , Halberstadt Amy G. , Montero Ignacio , Sepúlveda-Bernales Valeria , Fuentes-Vilugrón Gerardo , Miranda-Zapata Edgardo , Legaz-Vladímisrkaya Ekaterina , Caamaño-Navarrete Felipe , Muñoz-Troncoso Gerardo
Published: September 2024

The study investigates the emotional dysregulation in teachers of the Chilean school system, focusing on gender and age similarities and differences. The sample included 1059 teachers from various regions of Chile, of whom 80.3% were female and 19.7% were male. Participants completed the Spanish version of the Difficulties in Emotional Regulation Scale (DERS-E). A confirmatory factor analysis was carried out to evaluate the structure of the theoretical model, along with the convergent, discriminant, and internal consistency of the instrument. Additionally, a measurement invariance analysis was performed to identify possible differences between demographic groups, which is crucial to ensure that comparisons between these groups are valid and unbiased. The results indicated that the theoretical model presents a good fit to the data and confirms the validity and reliability of the DERS-E. Scalar invariance was achieved among the analyzed groups. We found significant differences in emotional dysregulation between men and women, which also varied by teacher age. The importance of understanding the specific needs of teachers in terms of their emotional regulation is discussed and the urgency of implementing training programs that improve their emotional skills, fostering a positive and effective learning environment, is highlighted.