bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patent foramen ovale closure in non-elderly and elderly patients with cryptogenic stroke: a hospital-based cohort study
Authors: Chen Po-Lin , Wang Chi-Sheng , Huang Jin-An , Fu Yun-Ching , Liao Nien-Chen , Hsu Chiann-Yi , Wu Yu-Hsuan 
Published: May 2023

IntroductionThe efficacy of patent foramen ovale (PFO) closure in the elderly population is unclear. We aimed to investigate the efficacy and safety of PFO closure in non-elderly and elderly patients.MethodsPatients over 18 years of age with cryptogenic stroke (CS) or transient ischemic attack and PFO were prospectively enrolled and classified into two groups according to treatment: (1) closure of PFO (the PFOC group) and (2) medical treatment alone (the non-PFOC group). The primary outcome was a composite of recurrent cerebral ischemic events and all-cause mortality during the follow-up period. A modified Ranking Scale [mRS] at 180 days was recorded. The safety outcomes were procedure-related adverse events and periprocedural atrial fibrillation. The results between the PFOC and non-PFOC groups in non-elderly (&lt;60 years) and elderly (≥60 years) patients were compared.ResultsWe enrolled 173 patients, 78 (45%) of whom were elderly. During a mean follow-up of 2.5 years, the incidence of primary outcome was significantly lower in the PFOC group (6.2% vs. 17.1%, hazard ratio[HR] = 0.35, 95% CI 0.13–0.97, p = 0.043) in adjusted Cox regression analysis. Compared with the non-PFOC group, the PFOC group had a numerically lower risk of the primary outcome in both the elderly (HR 0.26, 95% CI 0.07–1.01, p = 0.051) and the non-elderly (HR 0.61, 95% CI 0.11–3.27, p = 0.574) groups. In addition, patients with PFO closure in the elderly group had a lower median mRS at 180 days (p = 0.002). The rate of safety outcome was similar between the non-elderly and elderly groups.DiscussionPFO closure was associated with a reduced risk of the primary outcome in patients with PFO and CS in our total cohort, which included non-elderly and elderly patients. Compared to those without PFO closure, elderly patients with PFO closure had a better functional outcome at 180 days. PFO closure might be considered in selected elderly patients with PFO.
Diagnosis and treatment of transnasal endoscopic optic canal decompression for traumatic optic neuropathy
Authors: Tu Xiang , Xiong Cheng , Qi Hui , Ou Yangming , Rao Jing , Sun Yueqi , Fan Yunping , Liu Guiqin 
Published: May 2023

ObjectiveTo investigate the clinical efficacy and prognostic factors of transnasal endoscopic optic decompression in the treatment of traumatic optic neuropathy (TON).MethodsA retrospective analysis was performed on 13 TON patients in The Seventh Affiliated Hospital of Sun Yat-sen University and Shenzhen Eye Hospital in Shenzhen City (China) from June 2020 to April 2022. These patients had received transnasal endoscopic optic decompression, and hormonal and neurotrophic drugs were given after surgery. Visual acuity (VA) improvement was used as the criterion to judge clinical efficacy.ResultsIn a total of 13 patients, 13 injured eyes (12 men and 1 woman; mean age, 28.0 ± 11.8 years) received transnasal endoscopic optic decompression. After surgery, nine patients had improved VA, whereas four patients failed to show any improvement, resulting in a total effective rate of 69.2%. Of the six patients with no light perception preoperatively, three had effective results after the operation, giving an effective rate of 50.0%. Of the seven patients with residual light sensation preoperatively, six had effective results after the operation, giving an effective rate of 85.7%. Of the 10 patients operated on within 7 days after injury, seven had effective results, giving an effective rate of 70%. Of the three patients injured and operated on after 7 days, two had effective results, giving an effective rate of 66.7%.ConclusionTransnasal endoscopic optic nerve decompression is an effective treatment method for TON. The presence of residual light perception and the timing of surgery within 7 days are crucial to the prognosis.
Aging affects GABAergic function and calcium homeostasis in the mammalian central clock
Authors: Olde Engberink Anneke H. O. , de Torres Gutiérrez Pablo , Chiosso Anna , Das Ankita , Meijer Johanna H. , Michel Stephan 
Published: May 2023

IntroductionAging impairs the function of the central circadian clock in mammals, the suprachiasmatic nucleus (SCN), leading to a reduction in the output signal. The weaker timing signal from the SCN results in a decline in rhythm strength in many physiological functions, including sleep–wake patterns. Accumulating evidence suggests that the reduced amplitude of the SCN signal is caused by a decreased synchrony among the SCN neurons. The present study was aimed to investigate the hypothesis that the excitation/inhibition (E/I) balance plays a role in synchronization within the network.MethodsUsing calcium (Ca2+) imaging, the polarity of Ca2+ transients in response to GABA stimulation in SCN slices of old mice (20–24 months) and young controls was studied.ResultsWe found that the amount of GABAergic excitation was increased, and that concordantly the E/I balance was higher in SCN slices of old mice when compared to young controls. Moreover, we showed an effect of aging on the baseline intracellular Ca2+ concentration, with higher Ca2+ levels in SCN neurons of old mice, indicating an alteration in Ca2+ homeostasis in the aged SCN. We conclude that the change in GABAergic function, and possibly the Ca2+ homeostasis, in SCN neurons may contribute to the altered synchrony within the aged SCN network.
Nomophobia and smartphone addiction amidst COVID-19 home confinement: the parallel mediating role of digital gaming and social media tools usage across secondary school students
Authors: Aydin Mehmet Kemal , Kuş Metin 
Published: May 2023

IntroductionWith the inevitable technological boom enforced by the COVID-19 lockdowns and online emergency remote teaching practices, the prevalence of nomophobia (NMP) and smartphone addiction (SA) among adolescents has become a pressing issue, which has come under scrutiny. However, the impact of social media tools usage (SMTU) and digital gaming behavior (DGB) on these phenomena remains unclear since there is little research focusing on the complex interplay among these variables. Regarding this context, the present study aimed to explore the parallel mediating role of secondary school students’ SMTU and DGB in the relation between NMP and SA.MethodsIn line with this aim, we employed a cross-sectional design with a critical case sampling strategy and collected data through an online survey from a total of 427 secondary school students in Istanbul in the 2021-2022 academic year. In order to test the parallel mediation model, we employed multiple linear regression models by utilizing PROCESS models with 5000 BC bootstrap samples and 95% CI.Results and discussionResults illustrated that there was an increase in the prevalence of NMP and SA during the COVID-19 home confinement as consistent with the previous research. The results also indicated that among the multiple mediators, the mediating role of SMTU was significant in the relation between NMP and SA. This means NMP has direct and indirect significant impact on SA through SMTU. However, the mediating role of DGB was found nonsignificant in this relationship. Our results are robust and hold key contributions to both theoria and praxis in educational psychology research realm by disentangling the complex underlying mechanism between NMP, SMTU, DGB, and SA. On the practical side, our results provide insightful implications for school boards and researchers in the development of effective interventions.
A balancing act: how interpreters affect the therapeutic alliance in psychotherapy with trauma-affected refugees—a qualitative study with therapists
Authors: Hanft-Robert Saskia , Lindberg Laura Glahder , Mösko Mike , Carlsson Jessica 
Published: May 2023

ObjectiveThe therapeutic alliance (TA) has the highest predictive value concerning the success of psychotherapy. The presented study aimed to explore how the presence of an interpreter affects the TA when working with trauma-affected refugees.MethodSemi-structured interviews were conducted with seven psychologists working in an outpatient clinic specialized in mental health care for migrant and refugee patients with trauma-related mental health problems in Denmark. Interviews were transcribed verbatim and analyzed using a structuring content analysis approach.ResultsTA has been described as a dynamic therapist-interpreter-patient alliance triangle consisting of three distinct but highly intertwined and mutually influential dyadic alliances. Specific factors affecting the quality of the TA were identified, e.g., interpreter being emotionally attuned yet not overly involved; interpreter being barely visible yet present as a human being. Characteristics of trauma-affected refugee patients affecting the TA formation were also identified, e.g., a high level of personal distrust, different understandings of mental disorders and psychotherapy, stigmatization, perceptions of authorities.ConclusionThe presence of interpreters was perceived ambivalently and the formation of a good TA seems to be a balancing act. Based on the findings, recommendations for forming and maintaining a good TA in interpreter-mediated psychotherapy are provided.
Dual career competency questionnaire for athletes: psychometric properties of the Brazilian version
Authors: Grubertt Guilherme Alves , Márquez Sara , Serassuelo Junior Helio 
Published: May 2023

IntroductionNo studies have yet attempted to quantitatively measure the competencies of Brazilian student-athletes. Consequently, there are no validated measures suitable for this purpose. The aim of this research was to examine the psychometric properties and assess content validity, factorial validity and evidence based on response processes of the Brazilian version of the Dual Career Competency Questionnaire for Athletes (DCCQ-A).MethodsThe Brazilian DCCQ-A was administered to 745 student-athletes (Mage = 17.3 ± 5.4; 54% female; 8% student-athletes with disabilities).ResultsContent validity coefficient analysis indicated clarity of language, theoretical pertinence, and practical relevance of the Brazilian DCCQ-A items. Confirmatory factorial analysis revealed excellent goodness-of-fit indices of the 4-factor structure model. Polytomous Rasch analysis demonstrated an acceptable adjustment of the items and good organization in the item response categories.DiscussionConsidering the psychometric strength of the Brazilian DCCQ-A, this instrument can contribute to the practical and research applicability of sport psychology, providing support to those involved with student-athletes’ dual career by identifying their competencies and possible limitations.
Association between duration of electronic screen use for non-educational purposes and depression symptoms among middle and high school students: a cross-sectional study in Zhejiang Province, China
Authors: Wang Hao , Bragg Fiona , Guan Yunqi , Zhong Jieming , Li Na , Pan Jin , Yu Min 
Published: May 2023

BackgroundExisting literature on the association of electronic screen use duration with depression among adolescents is contradictory. The current study aimed to elucidate the association between duration of electronic screen use for non-educational purposes and depression symptoms among middle and high school students in Zhejiang Province, China.MethodsA cross-sectional study of 27,070 students in grades 7–12 from 376 middle and high schools was conducted through an anonymous self-administered questionnaire between April and June 2022. Poisson regression was utilized to examine the association between electronic screen use duration for non-educational purposes and depression symptoms.ResultsOf the 27,006 eligible students, 51.6% (13932) were boys and the mean (SD) age was 15.6(1.7) years. The overall prevalence of symptoms of depression was 22.4% (95%CI 21.4–23.4); girls (27.6%, 26.2–29.0) had a higher prevalence than boys (17.7%, 16.7–18.8). After adjustment for socio-demographic status, lifestyle factors, self-perceived health, academic performance, loneliness and sadness, compared to those who did not use electronic screens for non-educational purposes, the prevalence ratios (PRs) for depression symptoms were 1.03 (95% CI 1.02–1.04) for those exposed to electronic screens for &lt;1 h/day, 1.07 (1.05–1.09) for 1.0–1.9 h/day, 1.10 (1.07–1.13) for 2.0–2.9 h/day, 1.14 (1.10–1.18) for 3.0–3.9 h/day, 1.18 (1.12–1.23) for 4.0–4.9 h/day, and 1.21 (1.15–1.29) for ≥5 h/day.ConclusionDuration of electronic screen use for non-educational purposes was positively associated with symptoms of depression among middle and high school students, even with a relatively short daily duration of use.
Toward social-health integration in Sicily: description of the first hub and spoke model to improve the diagnostic therapeutic care paths for neurorehabilitation
Authors: De Cola Maria Cristina , Ielo Augusto , Lo Buono Viviana , Quartarone Angelo , Calabrò Rocco Salvatore 
Published: May 2023

IntroductionThe study describes a hub and spoke network for neuro-rehabilitation recently activated in Sicily, and evaluates the before-after changes yielded, in terms of integrated care.MethodsA set of indicators based on data contained in the administrative database of inpatients of the Regional Health System are presented and discussed. Statistical analysis was conducted both globally and separately for the 9 Sicilian provinces (Agrigento, Caltanissetta, Catania, Enna, Messina, Palermo, Siracusa, Ragusa, and Trapani).ResultsResults showed an increase in admissions of people residing in the province where the Spokes have been opened: Trapani (+32.4%), Messina (+7.8%) and Palermo (+4.4%); besides a significant increase of patients from healthcare facilities proportion (p = 0.001) and from acute wards (p = 0.029). In addition, we found a decrease of discharge to protected healthcare facilities (p = 0.001) and to acute wards (p &lt; 0.001), as well as an increase of discharges to home (p = 0.018).DiscussionIn conclusion, it would seem that the activation of this network has facilitated the management of these patients, avoiding unnecessary migrations to other provinces and/or regions, and improving the regional care service for neuro-rehabilitation. Future research will be direct to investigate this aspect, focusing on before-after variations in hospitalization rates and origin– destination patient flows.
From research to a political commitment to strengthen access to surgical, obstetric, and anesthesia care in Africa by 2030
Authors: M'pele Pierre , Seyi-Olajide Justina O. , Elongo Tarcisse , Lemvik Jorn , Dovlo Delanyo , Ameh Emmanuel A. 
Published: May 2023

ObjectiveThis study aimed to engage African leaders and key stakeholders to commit themselves toward the strengthening of surgical, obstetric, and anesthesia care systems by 2030 in Africa.MethodsFrom research to a political commitment, a baseline assessment was performed to foster the identification of the gaps in surgical care as a first step of an inclusive process. The preliminary findings were discussed during the International Symposium on Surgical, Obstetric, and Anesthesia Systems Strengthening by 2030 in Africa. The conclusions served to draft the Dakar Declaration and its Regional Action Plan 2022–2030 to improve access to surgical care by 2030 in Africa, endorsed by Heads of State.ResultsThe International Symposium was composed of two meetings that gathered (i) 85 scientific experts and (ii) 28 ministers of health or representatives from 28 sub-Saharan African countries. The 28 African countries represent (i) 51% of the continent's total population, (ii) 68% of the 47 African countries of the WHO Africa Region, (iii) 58% of all African Union countries, and (vi) 79% (3,371) of the WHO Africa Region's total (4,271) health districts. The International Symposium and the Heads of State Summit successfully produced the Dakar Declaration on access to equitable, affordable, and quality Surgical, Obstetric, and Anesthesia Care by 2030 in Africa and its Regional Actions Plan 2022–2030 which prioritizes 12 urgent actions needed to be implemented, six strategic priorities, 16 key indicators, and an annual dashboard to monitor progress.ConclusionThe Dakar Declaration and its Regional Action Plan 2022–2030 are a commitment to establish quality and sustainable surgical, obstetric, and anesthesia care in each African country within the ambitious framework of “The Africa we want” Agenda 2063.
Preparation, structure characterization and functional properties of pea dregs resistant dextrin
Authors: Li Liangyu , He Tianfeng , Ling Yang , Li Xiaohong , Sui Chunguang , Cao Rong-an , Li Chaoyang 
Published: May 2023

BackgroundPeas (Pisum sativum L.), the second largest edible bean in the world, have comprehensive and balanced nutrition. In China, peas are mainly used in the processing of starch and related products, during which a large amount of processing by-products—pea dregs—is produced. Because of its large particle size, coarse texture, and difficulty in storage, it is mostly discarded or used as feed, resulting in unnecessary waste.Materials and methodsThe preparation and simulated moving bed chromatographic purification process conditions of pea-resistant dextrin were optimized using pea production waste-pea residue as raw material, and structural characterization and functional properties of pea residue-resistant dextrin were analyzed.ResultsThe results showed that the optimal preparation process conditions for pea-resistant dextrin were as follows: acid concentration 1.0%, acid addition 7.3%, treatment temperature 178.8°C, and treatment time 92.5 min. Subsequently, the pea-resistant dextrin content of 42.15 ± 0.16% was obtained. The optimal SSMB purification conditions were as follows: feed volume 455 g/h, feed volume 682 g/h, circulation volume 346 mL, outlet concentration 24.8 ± 0.2%, purity 99.35 ± 0.17%, and yield 91.08 ± 0.42%. The structural characterization revealed that pea-resistant dextrin had large and variable particle size and amorphous structure; the chemical bond or functional group differences between pea-resistant dextrin and pea starch were not significant; pea-resistant dextrin was a glucose-based dextran with a monosaccharide composition of 2.6% arabinose, 1.5% xylose, and 95.9% glucose, and its molecular weight was (601.1 ± 8.5) × 103 u. Functional characterization revealed that the RS content of pea-resistant dextrin was 92.35%, which had significantly slow digestive properties as well as hypoglycemic and hypolipidemic effects.ConclusionsUsing pea dregs to produce pea dregs resistant dextrin has low production cost and significant functional characteristics, which can be widely applied in the food industry.
Transtorno de Personalidade Borderline e os fatores que influenciam seu desenvolvimento: uma relação entre o comportamento autodestrutivo, relações familiares, traumas infantis e alterações fisiopatológicas
Authors: Matias Camila Caroline , Reis Gabriela Thomé , Besson Jean Carlos Fernando 
Published: May 2023

O Transtorno de Personalidade Borderline (TPB) consiste em um distúrbio que possui como principais manifestações padrões de instabilidade e disfunção nos domínios emocional, comportamental, cognitivo e interpessoal, não possuindo uma fisiopatologia única definida na literatura. No entanto, acredita-se que está diretamente associado a diversos fatores que vão interferir no desenvolvimento cerebral, seja estrutural ou funcionalmente. As causas mais citadas na literatura incluem alterações neurológicas, influências genéticas e influências psicossociais. Contudo, a expressão do fenótipo do TPB e a manifestação dos sintomas está diretamente relacionada aos fatores ambientais em que o indivíduo está inserido. Por conseguinte, esses pacientes desenvolvem em sua personalidade traços marcantes como impulsividade, instabilidade afetiva, sentimentos de vazio, situações de raiva intensa e sintomas dissociativos, que podem se manifestar, muitas vezes, em comportamentos autodestrutivos na tentativa de sanar as suas aflições. Esses sintomas se acentuam por volta dos 14 aos 17 anos que, concomitantemente, corresponde ao período da adolescência em que o jovem experimenta mudanças significativas na consolidação da sua identidade, influenciada pelos fatores já relatados. No presente artigo de revisão sistemática, buscamos elucidar a definição de Transtorno de Personalidade Borderline. Além de caracterizar a expressão do fenótipo TPB e a manifestação dos sintomas; o diagnóstico; e a fisiopatologia envolvida na doença, bem como os fatores ambientais, biológicos e genéticos envolvidos no transtorno que são considerados gatilhos para o desenvolvimento da personalidade Borderline. Para a realização desta revisão narrativa de literatura, foram realizadas buscas nas bases de dados eletrônicas Scientific Eletronic Library Online (Scielo), Google Acadêmico (SCHOLAR), Portal Caps e Science Direct. Além disso, foram efetuadas consultas ao Manual de Diagnóstico e Estatística de Transtornos Mentais - DSM-5 (APA, 2014).
Perfil epidemiológico de pacientes com fissura labiopalatinas atendidos em um hospital de referência do interior de Alagoas
Authors: Looze Giovanna Francina , Bengo Leticia Pereira Macambira , De Andrade Clarisse Samara , Ribeiro Igor Lerner Hora , De Barros Silva Paulo Goberlânio , Sales Pedro Henrique da Hora 
Published: May 2023

Objetivo: Traçar um perfil epidemiológico e socioeconômico de pacientes com fissuras labiopalatinas atendidos em um hospital de referência do interior de Alagoas. Materiais e Métodos: Trata-se de um estudo transversal analítico descritivo, onde foi realizada a consulta aos prontuários de pacientes com fissura labiopalatina no ano de 2019 em um hospital de referência do interior de Alagoas. Variáveis como: idade, gênero, tipo de fissura, renda familiar, grau de escolaridade dos pais, acesso a terapias complementares e o CPOD foram coletados. Foi realizada uma análise estatística descritiva bem como análises através do teste exato de Fisher ou qui-quadrado e t de Student. Resultados: Ao todo foram analisados 32 prontuários observando-se uma predominância do gênero masculino (67,7%), e de etnia parda (45,2%). A maior parte dos pacientes (56,7%) relataram que possuíam renda familiar entre 1 a 3 salários mínimos e 36,7% menos de 1 salário mínimo. As fissuras unilaterais foram mais prevalentes (65,4%,) sendo o lado esquerdo mais afetado (76,5%). A maioria dos pacientes não realizou terapia com fonoaudiólogo ou ortodontista (61,3% e 61,5% respectivamente). Não foi observada relação estatisticamente significante entre o índice CPO-D, renda familiar e escolaridade dos pais (p > 0,05). Considerações finais: O tratamento de fissuras labiopalatinas é multidisciplinar, longo e de alto custo. É necessário a criação de centros de tratamento especialmente em regiões com baixo IDH, melhorando o acesso e a assistência a saúde desses pacientes, minimizando as sequelas e melhorando sua qualidade de vida.