bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mediation Role of Physical Fitness and Its Components on the Association Between Distribution-Related Fat Indicators and Adolescents’ Cognitive Performance: Exploring the Influence of School Vulnerability. The Cogni-Action Project
Authors: Hernández-Jaña Sam , Sanchez-Martinez Javier , Solis-Urra Patricio , Esteban-Cornejo Irene , Castro-Piñero Jose , Sadarangani Kabir P. , Aguilar-Farias Nicolas , Ferrari Gerson , Cristi-Montero Carlos 
Published: September 2021

Background: Physical fitness and fatness converge simultaneously modulating cognitive skills, which in turn, are associated with children and adolescents’ socioeconomic background. However, both fitness components and fat mass localization are crucial for understanding its implication at the cognitive level.Objective: This study aimed to determine the mediation role of a global physical fitness score and its components on the association between different fatness indicators related to fat distribution and adolescents’ cognitive performance, and simultaneously explore the influence of school vulnerability.Methods: In this study, 1,196 Chilean adolescents participated (aged 10–14; 50.7% boys). Cardiorespiratory fitness (CRF), muscular fitness (MF), and speed-agility fitness (SAF) were evaluated, and a global fitness score (GFS) was computed adjusted for age and sex (CRF + MF + SAF z-scores). Body mass index z-score (BMIz), sum-of-4-skinfolds (4SKF), and waist-to-height ratio (WHtR) were used as non-specific, peripheral, and central adiposity indicators, respectively. A global cognitive score was computed based on eight tasks, and the school vulnerability index (SVI) was registered as high, mid or low. A total of 24 mediation analyses were performed according to two models, adjusted for sex and peak high velocity (Model 1), and adding the school vulnerability index (SVI) in Model 2. The significance level was set at p &lt; 0.05.Results: The fitness mediation role was different concerning the fatness indicators related to fat distribution analyzed. Even after controlling for SVI, CRF (22%), and SAF (29%), but not MF, mediated the association between BMIz and cognitive performance. Likewise, CRF, SAF and GFS, but not MF, mediated the association between WHtR and cognitive performance (38.6%, 31.9%, and 54.8%, respectively). No mediations were observed for 4SKF.Conclusion: The negative association between fatness and cognitive performance is mitigated by the level of adolescents’ physical fitness, mainly CRF and SAF. This mediation role seems to be more consistent with a central fat indicator even in the presence of school vulnerability. Strategies promoting physical fitness would reduce the cognitive gap in children and adolescents related to obesity and school vulnerability.
Association of Regular Thrombus Surface Phenotype With Complete Recanalization in First-Line Contact Aspiration Thrombectomy for Basilar Artery Occlusion
Authors: Kaiser Daniel , Krukowski Pawel , Hädrich Kevin , Winzer Robert , Pallesen Lars-Peder , Gawlitza Matthias , Linn Jennifer , Puetz Volker , Gerber Johannes C. 
Published: September 2021

Objective: To assess whether angiographic thrombus surface phenotype has an impact on efficacy of contact aspiration (CA) thrombectomy in patients with basilar artery occlusion (BAO).Methods: From January 2016 to December 2019, consecutive stroke patients with a BAO and first-line CA were analyzed in this retrospective study. We assessed baseline and imaging characteristics and treatment and clinical outcomes. We rated thrombus surface phenotype on pre-treatment digital subtraction angiography in a three-reader-consensus setting. Primary outcome was complete recanalization (modified treatment in cerebral ischemia [mTICI] 3 and arterial occlusive lesion [AOL] 3) after first-line CA without additionally stent retriever passes. Data analysis was stratified according to thrombus surface phenotype and complete first-line recanalization.Results: Seventy-eight patients met the inclusion criteria. Median age was 74 years (IQR 64–80), 64% were male, and median baseline NIHSS score was 24 (IQR 7–32). Thirty patients had a regular and 16 patients had an irregular thrombus phenotype. Thrombus surface was not assessable in 32 patients. In patients with a regular phenotype, complete recanalization was more often achieved compared to irregular and non-ratable phenotypes (50 vs. 18.8% and 21.9%; p = 0.027). Patients with a regular phenotype [odds ratio [OR] 8.3; 95% confidence interval [CI]: 1.9–35.8; p = 0.005], cardioembolic stroke (OR 12.1, 95% CI: 2.0–72.8; p = 0.007), and proximal end of the thrombus in the middle basilar artery segment (OR 5.2, 95% CI: 1.0–26.6; p = 0.046) were more likely to achieve complete recanalization after first-line CA without rescue therapy.Conclusion: The efficacy of CA may differ according to the angiographic thrombus surface phenotype in patients with BAO. A regular phenotype is associated with higher rates of complete recanalization in first-line CA. However, assessment of thrombus phenotype is frequently not feasible in BAO.
Impact of COVID-19 on Acute Stroke Presentation in a Designated COVID-19 Hospital
Authors: Tan Qing , Liu Qing-Jun , Fan Wen-Hui , Du Xiao-Yan , Wu Lin , Gong Hong-Min , Wei Jing , Zhao Rui , Lei Ming , Zhao Li-Bo 
Published: September 2021

Objectives: Thousands of designated COVID-19 hospitals have been set up in China to fight the ongoing COVID-19 pandemic. Anecdotal reports indicate a falling rate of acute stroke diagnoses in these hospitals during the COVID-19 period. We conducted an exploratory single-center analysis to estimate the change in acute stroke presentation at the designated COVID-19 hospitals.Methods: This retrospective observational study included all patients admitted to Yongchuan Hospital Affiliated to Chongqing Medical University with acute stroke between January 24 and March 10, 2020. Patient demographics, characteristics of the stroke, treatment details, and clinical outcomes were compared with those of patients admitted in the corresponding period in the year before (2019, “the pre-COVID-19 period”). Subgroup analysis was performed in the ischemic and hemorrhagic stroke groups.Results: A total of 110 patients presented with acute stroke symptoms during the COVID-19 pandemic, compared with 173 patients in the pre-COVID-19 period. A higher proportion of stroke patients presented to the hospital via emergency medical services during the pandemic (48.2 vs. 31.8%, p = 0.006). There was a lower proportion of ischemic stroke patients (50.9 vs. 65.3%, p = 0.016) than in the preceding year. There were significantly fewer patients with 90-day modified Rankin Scale score ≥3 in the COVID-19 period compared with the pre-COVID-19 period (17.3 vs. 30.6%, p = 0.012). Among patients with ischemic stroke, the mean time from patient arrival to vessel puncture for emergency endovascular therapy in the COVID-19 period was shorter than that in the pre-COVID-19 period (109.18 ± 71.39 vs. 270.50 ± 161.51 min, p = 0.002). Among patients with hemorrhagic stroke, the rate of emergency surgical operation in the COVID-19 period was higher than that in the pre-COVID-19 period (48.1 vs. 30.0%, p = 0.047). The mean time from patient arrival to emergency surgical operation (15.31 ± 22.89 vs. 51.72 ± 40.47 min, p = 0.002) was shorter in the COVID-19 period than in the pre-COVID-19 period.Conclusions: Although fewer acute stroke patients sought medical care in this designated COVID-19 hospital during the COVID-19 pandemic, this type of hospital was more efficient for timely treatment of acute stroke. Recognizing how acute strokes presented in designated COVID-19 hospitals will contribute to appropriate adjustments in strategy for dealing with acute stroke during COVID-19 and future pandemics.
Korean Model for Post-acute Comprehensive rehabilitation (KOMPACT): The Study Protocol for a Pragmatic Multicenter Randomized Controlled Study on Early Supported Discharge
Authors: Chang Won Kee , Kim Won-Seok , Sohn Min Kyun , Jee Sungju , Shin Yong-Il , Ko Sung-Hwa , Ock Minsu , Kim Hyun Joo , Paik Nam-Jong 
Published: September 2021

Introduction: Early supported discharge (ESD) is a transitional care model aimed at facilitating post-acute stroke patients' discharge to home. Previous studies have demonstrated that ESD provides equivalent patient and caregiver outcomes with superior cost-effectiveness compared to conventional rehabilitation (CR). This study intends to examine the feasibility of ESD in Korea.Methods and Analysis: This study is designed as a multicenter assessor-blinded, randomized controlled trial. Ninety post-acute stroke patients with mild to moderate disability (modified Rankin Scale 1–3) will be recruited from three university hospitals (30 patients per hospital) in Korea and allocated to either the ESD group or the CR group in a 1:1 ratio. Patients in the ESD group will receive individualized discharge planning and goal setting, a 4-week home-based rehabilitation program, and liaison service to community-based resources by a multidisciplinary team. Patients in the CR group will receive rehabilitation practices according to their current hospital policy.Outcomes: The primary outcome is the Korean version of the modified Barthel Index, and the primary endpoint was post-onset 3 months. Clinical outcomes, patient/caregiver reported outcomes, and socioeconomic outcomes will be measured at baseline, 1 month after discharge, 2 months after discharge, and 3 months after onset.Discussion: The efficacy and cost-effectiveness of ESD can vary according to the healthcare system and sociocultural aspects. To establish ESD as an alternative transitional care model for post-acute stroke patients in Korea, its feasibility needs to be examined in prior. This study will add evidence on the applicability of ESD in Korea.Ethical Considerations: The study protocol was reviewed and approved by the Institutional Review Board of Seoul National University Bundang Hospital (IRB number B-2012/654-308). The study protocol was registered at ClinicalTrials.gov (Identifier NCT04720820). Disseminations will include submission to peer-reviewed journals and presentations at conferences.
Increased Autoimmunity in Individuals With Down Syndrome and Moyamoya Disease
Authors: Santoro Jonathan D. , Lee Sarah , Wang Anthony C. , Ho Eugenia , Nagesh Deepti , Khoshnood Mellad , Tanna Runi , Durazo-Arvizu Ramon A. , Manning Melanie A. , Skotko Brian G. , Steinberg Gary K. , Rafii Michael S. 
Published: September 2021

Objective: To determine if elevated rates of autoimmune disease are present in children with both Down syndrome and moyamoya disease given the high rates of autoimmune disease reported in both conditions and unknown etiology of angiopathy in this population.Methods: A multi-center retrospective case-control study of children with Down syndrome and moyamoya syndrome, idiopathic moyamoya disease, and Down syndrome without cerebrovascular disease was performed. Outcome measures included presence of autoimmune disease, presence of autoantibodies and angiopathy severity data. Comparisons across groups was performed using the Kruskal-Wallis, χ2 and multivariate Poisson regression.Results: The prevalence of autoimmune disease were 57.7, 20.3, and 35.3% in persons with Down syndrome and moyamoya syndrome, idiopathic moyamoya disease, and Down syndrome only groups, respectively (p &lt; 0.001). The prevalence of autoimmune disease among children with Down syndrome and moyamoya syndrome is 3.2 times (p &lt; 0.001, 95% CI: 1.82–5.58) higher than the idiopathic moyamoya group and 1.5 times (p = 0.002, 95% CI: 1.17–1.99) higher than the Down syndrome only group when adjusting for age and sex. The most common autoimmune diseases were thyroid disorders, type I diabetes and Celiac disease. No individuals with idiopathic moyamoya disease had more than one type of autoimmune disorder while 15.4% of individuals with Down syndrome and moyamoya syndrome and 4.8% of individuals with Down syndrome only had &gt;1 disorder (p = 0.05, 95%CI: 1.08–6.08).Interpretation: This study reports elevated rates of autoimmune disease in persons with Down syndrome and moyamoya syndrome providing a nidus for study of the role of autoimmunity in angiopathy in this population.
Demographics, Pattern of Care, and Outcome Analysis of Malignant Melanomas - Experience From a Tertiary Cancer Centre in India
Authors: Bajpai Jyoti , Abraham George , Saklani Avanish P. , Agarwal Anshul , Das Sashanka , Chatterjee Ambarish , Kapoor Akhil , Eaga Prathyusha , Mondal Pradip Kumar , Chandrasekharan Arun , Bhargava Prabhat Ghanshyam , Srinivas Sujay , Turkar Siddharth , Rekhi Bharat , Khanna Nehal , Janu Amit Kumar , Bal Munita , Ostwal Vikas Sureshchand , Ramaswamy Anant , Rohila Jitender , Desouza Ashwin L. , Guha Amrita , Kumar Rajiv , Menon Nandini Sharrel , Rath Sushmita , Patil Vijay Maruti , Noronha Vanita Maria , Joshi Amit Prakashchandra , Laskar Siddhartha , Rangarajan Venkatesh , Prabhash Kumar , Gupta Sudeep , Banavali Shripad 
Published: September 2021

BackgroundTreatment of malignant melanoma has undergone a paradigm shift with the advent of immune checkpoint inhibitors (ICI) and targeted therapies. However, access to ICI is limited in low-middle income countries (LMICs).Patients and MethodsHistologically confirmed malignant melanoma cases registered from 2013 to 2019 were analysed for pattern of care, safety, and efficacy of systemic therapies (ST).ResultsThere were 659 patients with a median age of 53 (range 44–63) years; 58.9% were males; 55.2% were mucosal melanomas. Most common primary sites were extremities (36.6%) and anorectum (31.4%). Nearly 10.8% of the metastatic cohort were BRAF mutated. Among 368 non-metastatic patients (172 prior treated, 185 de novo, and 11 unresectable), with a median follow-up of 26 months (0–83 months), median EFS and OS were 29.5 (95% CI: 22–40) and 33.3 (95% CI: 29.5–41.2) months, respectively. In the metastatic cohort, with a median follow up of 24 (0–85) months, the median EFS for BSC was 3.1 (95% CI 1.9–4.8) months versus 3.98 (95% CI 3.2–4.7) months with any ST (HR: 0.69, 95% CI: 0.52–0.92; P = 0.011). The median OS was 3.9 (95% CI 3.3–6.4) months for BSC alone versus 12.0 (95% CI 10.5–15.1) months in any ST (HR: 0.38, 95% CI: 0.28–0.50; P &lt; 0.001). The disease control rate was 51.55%. Commonest grade 3–4 toxicity was anemia with chemotherapy (9.5%) and ICI (8.8%). In multivariate analysis, any ST received had a better prognostic impact in the metastatic cohort.ConclusionsLarge real-world data reflects the treatment patterns adopted in LMIC for melanomas and poor access to expensive, standard of care therapies. Other systemic therapies provide meaningful clinical benefit and are worth exploring especially when the standard therapies are challenging to administer.
Bottom-Up Interventions Effective in Promoting Work Engagement: A Systematic Review and Meta-Analysis
Authors: Björk Janina M. , Bolander Pernilla , Forsman Anna K. 
Published: September 2021

Background: Promoting work engagement is of interest to organizations across sectors due to the associated positive outcomes. This interest warrants research on the evidence of work engagement interventions. Intervention research increasingly advocates a bottom-up approach, highlighting the role of employees themselves. These workplace interventions often encourage employees to identify, develop, and make use of workplace resources. The aim of this systematic review and meta-analysis is to investigate the effectiveness and potential underlying mechanisms of these bottom-up, resource-developing interventions.Method: Systematic searches were conducted in the online databases Web of Science, Academic Search Complete, Business Source Ultimate, PsycInfo, PsycArticles, SCOPUS, and Google Scholar. Publication year range was 2000–2020. Eligibility criteria were defined using PICOS. To be eligible for the systematic review, the intervention study identified had to aim at promoting working individuals’ work engagement by developing workplace resources from bottom-up. Work engagement had to be measured using the Utrecht Work Engagement Scale. The systematic review included one-, two-, or multiple-armed – randomized or non-randomized – intervention studies with various study designs. Further, a meta-analysis was conducted on a sub-set of the studies included in the systematic review. To be eligible for the meta-analysis, the studies had to be two- or multiple-armed and provide the information necessary to compute effect sizes.Results: Thirty-one studies were included in the systematic review. The majority reported that overall work engagement increased as an effect of the intervention. The evidence regarding the sub-components of work engagement was scattered. Potential underlying mechanisms explored were intervention foci, approach, and format. Dimensions of satisfaction and performance were identified as secondary outcomes. Participant experiences were generally described as positive in most of the studies applying mixed methods. The meta-analysis showed a small but promising intervention effect on work engagement (24 studies, SMD: −0.22, 95% CI: −0.34 to −0.11, with I2=53%, indicating moderate inconsistency in the evidence).Conclusion: The synthesized evidence suggests that bottom-up, resource-developing interventions are effective in the promotion of work engagement. The meta-analysis suggests that focusing on strengths use or mobilizing ego resources and adopting a universal approach increase intervention effectiveness.
The Impact of Chinese College Students' Perceived Stress on Anxiety During the COVID-19 Epidemic: The Mediating Role of Irrational Beliefs
Authors: Chi Zhang , Qian Liu , Haihua Liu , Nuoxun Lin 
Published: September 2021

Objective: To explore the underlying mechanism of the impact of perceived stress on anxiety of the Chinese college students during the COVID-19 epidemic.Methods: The Perceived Stress Scale, Irrational Belief Scale, and General Anxiety Scale were adopted in the current study. College students were randomly selected for online questionnaire survey. There were 1,598 valid questionnaires, and the proportion of women was 47.81%.Results: The perceived stress and anxiety, as well as the three dimensions of irrational beliefs (catastrophizing, low frustration tolerance, and depreciation) were significantly positively correlated; demandingness was not significantly correlated with anxiety. Further analysis found that the perceived stress had a significant positive predictive effect on the anxiety of college students. Catastrophizing, low frustration tolerance, and depreciation played part of the mediating role, and there was no significant difference in the strength of these mediating roles.Conclusion: The perceived stress of the COVID-19 epidemic had a positive effect on the anxiety of Chinese college students, this was partly mediated by irrational beliefs.
Social Factors Associated With Adherence to Preventive Behaviors Related to COVID-19 Among Rural and Semi-urban Communities in Western Maharashtra, India
Authors: Shewale Suhas P. , Sane Suvarna Sanjay , Ujagare Dhammasagar Dnyaneshwar , Patel Rais , Roy Sudipto , Juvekar Sanjay , Kohli Rewa , Bangar Sampada , Jadhav Asha , Sahay Seema 
Published: September 2021

Background: To control the transmission of the coronavirus disease 2019 (COVID-19) infection, the Government of India (GoI) had taken stringent precautionary measures during the lockdown period. This study aimed to explore determinants affecting adherence to protective measures against COVID-19 infection among rural and semi-urban settings of Maharashtra, India.Methods: A cross-sectional telephonic survey among 1,016 adults from randomly selected households was conducted between June 5 and July 16, 2020. The data were explored for knowledge, awareness, practices related to protective measures, and self-risk perception. Socio-demographic and attitudinal correlates of failure to use protective measures against COVID-19 were measured.Results: In the survey, 72% of the participants were men. The mean age was 46 years (SD: 13.8). The main source of information was television (91%); however, information from healthcare providers (65%) and mass media announcements (49%) was trustworthy. Washing hands immediately with soap after returning from outdoors was reported by 95% of the respondents, always using a mask while outdoors by 94%, never attended social gatherings by 91%, always using hand sanitizer while outside by 77%, and 68% of the respondents followed all protective measures. The knowledge score [mean score 20.3 (SD: 2.4) out of 24] was independently associated with the risk of not using protective measures, with each unit increase in knowledge score, the risk of not using protective measures reduced by 16%. No source of income was independently associated with not using protective measures [AOR 1.5 95% CI (1.01–2.3)].Conclusions: The COVID-19 public health interventions and behavior change communication strategies should be specifically directed towards the low socio-economic populations through trusted sources. The association between knowledge and practices demonstrates the importance of accurate public health communication to optimally follow preventive measures, such as structural interventions to address poverty and employment policies to address the unemployment crisis are required. Surveillance activity is needed to understand the actual behavior change among the population.
Thermal Management Systems and Waste Heat Recycling by Thermoelectric Generators—An Overview
Authors: Hooshmand Zaferani Sadeq , Jafarian Mehdi , Vashaee Daryoosh , Ghomashchi Reza 
Published: September 2021

With the fast evolution in greenhouse gas (GHG) emissions (e.g., CO2, N2O) caused by fossil fuel combustion and global warming, climate change has been identified as a critical threat to the sustainable development of human society, public health, and the environment. To reduce GHG emissions, besides minimizing waste heat production at the source, an integrated approach should be adopted for waste heat management, namely, waste heat collection and recycling. One solution to enable waste heat capture and conversion into useful energy forms (e.g., electricity) is employing solid-state energy converters, such as thermoelectric generators (TEGs). The simplicity of thermoelectric generators enables them to be applied in various industries, specifically those that generate heat as the primary waste product at a temperature of several hundred degrees. Nevertheless, thermoelectric generators can be used over a broad range of temperatures for various applications; for example, at low temperatures for human body heat harvesting, at mid-temperature for automobile exhaust recovery systems, and at high temperatures for cement industries, concentrated solar heat exchangers, or NASA exploration rovers. We present the trends in the development of thermoelectric devices used for thermal management and waste heat recovery. In addition, a brief account is presented on the scientific development of TE materials with the various approaches implemented to improve the conversion efficiency of thermoelectric compounds through manipulation of Figure of Merit, a unitless factor indicative of TE conversion efficiency. Finally, as a case study, work on waste heat recovery from rotary cement kiln reactors is evaluated and discussed.