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The primary objective of this study was to determine whether Altmetric score, number of reads, and citations for paediatric cardiology manuscripts correlate with one another. A secondary objective was to determine the extent to which factors mediated citation number for paediatric cardiology manuscripts.
Data for this study came from manuscripts published in Cardiology in the Young (2010–2021). Data were extracted by using data shared on the journal website. Spearman’s correlation analyses were conducted between manuscript reads, citations, and Altmetric score. Regression analyses were conducted with number of citations as the dependent variable and year of publication, publication type, number of reads, and Altmetric score as independent variables.
A total of 2642 manuscripts were included in the final analyses. Reads and citations had poor correlation (r-value 0.32); reads and Altmetric score had negligible correlation (r-value 0.26); and Altmetric score and citations had negligible correlation (r-value 0.07). Year of publication was independently associated with number of citations (β –0.95, p-value <0.01). Manuscript type was independently associated with number of citations (β 1.04, p-value <0.01). Number of reads was independently associated with citations (β 0.01, p-value <0.01). Altmetric score was independently associated with number of citations (β 0.05, p-value <0.01).
This study describes the correlation of reads, citations, and Altmetric score in manuscripts published in Cardiology in the Young, demonstrating poor correlation, at best, between these metrics. Each bibliometric index seems to represent a different phenomenon of manuscript consumption. No single bibliometric index in isolation offers ample representation of manuscript consumption.
Background: The coronavirus disease 2019 (COVID-19) pandemic has led the implementation of institutional infection control protocols. This study will determine the effects of these protocols on outcomes of acute ischemic stroke (AIS) patients treated with endovascular therapy (EVT). Methods: Uninterrupted time series analysis of the impact of COVID-19 safety protocols on AIS patients undergoing EVT. We analyze data from prospectively collected quality improvement databases at 6 centers from March 11, 2019 to March 10, 2021. The primary outcome is 90-day modified Rankin Score (mRS). The secondary outcomes are angiographic time metrics. Results: Preliminary analysis of one stroke center included 214 EVT patients (n=150 pre-pandemic). Baseline characteristics were comparable between the two periods. Time metrics “last seen normal to puncture” (305.7 vs 407.2 min; p=0.05) and “hospital arrival to puncture” (80.4 vs 121.2 min; p=0.04) were significantly longer during pandemic compared to pre-pandemic. We found no significant difference in 90-day mRS (2.0 vs 2.2; p=0.506) or successful EVT rate (89.6% vs 90%; p=0.93). Conclusions: Our results indicate an increase in key time metrics of EVT in AIS during pandemic, likely related to infection control measures. Despite the delays, we found no difference in clinical outcomes between the two periods.
Globally, women have been shown to have high rates of common mental disorders (CMDs). In low and middle-income countries (LMICs), women face significant challenges related to maternity. However, no study has compared mental health problems among pregnant/post-partum women, childless women of childbearing age, and women with children in a low-income country. We sought to compare the frequency of CMD and suicide risk in a sample of women presenting or accompanying patients in primary care in two Mozambican semi-urban settings.
We administered the MINI International Neuropsychiatric Interview to 853 women, of whom 220 (25.8%) were pregnant/post-partum, 177 (20.8%) were non-pregnant and childless, and 456 (53.5%) were non-pregnant and with children more than 1-year-old. Logistic regression models compared the likelihood of a psychiatric disorder across groups, adjusting for sociodemographic and chronic-illness covariates.
We found a high frequency of CMD and suicide risk among all women in this low-income context sample. In adjusted models, no differences in rates of depression, anxiety, or panic disorder were observed among groups. However, suicide risk was higher in women without children than pregnant/post-partum women.
The frequency of CMD among women of childbearing age in our study was higher than documented rates in high-income countries and other LMIC. Additionally, we found that motherhood was not protective and that pregnancy and the postpartum period were not stages of increased risk for most disorders. This highlights the need to expand mental health services not only for perinatal women but all women of childbearing age in this and possibly similar settings.
From a systematic review framework, we assessed the preclinical evidence on the effectiveness of drug combinations for visceral leishmaniasis (VL) treatment. Research protocol was based on the PRISMA guideline. Research records were identified from Medline, Scopus and Web of Science. Animal models, infection and treatment protocols, parasitological and immunological outcomes were analysed. The SYRCLE's (SYstematic Review Center for Laboratory Animal Experimentation) toll was used to evaluate the risk of bias in all studies reviewed. Fourteen papers using mice, hamster and dogs were identified. Leishmania donovani was frequently used to induce VL, which was treated with 23 drugs in 40 different combinations. Most combinations allowed to reduce the effective dose, cost and time of treatment, in addition to improving the parasitological control of Leishmania spp. The benefits achieved from drug combinations were associated with an increased drug's half-life, direct parasitic toxicity and improved immune defences in infected hosts. Selection, performance and detection bias were the main limitations identified. Current evidence indicates that combination chemotherapy, especially those based on classical drugs (miltefosine, amphotericin B antimony-based compounds) and new drugs (CAL-101, PAM3Cys, tufisin and DB766), develops additive or synergistic interactions, which trigger trypanocidal and immunomodulatory effects associated with reduced parasite load, organ damage and better cure rates in VL.
The purpose of this study was to evaluate the quality of Marandu grass (Brachiaria brizantha) haylage according to different dry matter (DM) contents in storage. The design adopted was completely randomized with four treatments and five replications. The treatments were DM contents of the plant at the moment of storage (in natura, 30–40, 40–50 and 50–60% DM). The analyses to assess the quality of the haylage were performed after 90 days of storage. The chemical composition, microbiological population, gas quantification, pH, N-NH3, volatile fatty acids, soluble carbohydrates (CHO) and the aerobic stability were evaluated. The means were compared through the Tukey's test and linear regression. The treatment with 50–60% DM presented the highest DM and CHO contents which were 563.8 and 42.0 g/kg, respectively. There was a higher presence of oxygen in the haylage of in natura material, which was 4.8%. There was no difference between treatments for the population of lactic acid bacteria; however, the treatment with 50–60% DM had the highest concentration of enterobacteria. The haylage with 30–40% DM and 50–60% DM presented high concentrations of acetic acid. There was no break in aerobic stability for any treatment within 120 h after opening the bales. There was a smaller amount of N-NH3 in treatments with 40–50% DM and 50–60% DM. The Marandu grass with a DM content of 50–60% for haylage making demonstrated better quality characterization of conserved forage.
Metazoan parasite communities can experience temporal structural changes related to seasonal and/or local variations in several biotic and abiotic environmental factors. However, few studies have addressed this issue in tropical regions, where changes in water temperature are less extreme than in temperate regions, so the factors or processes that can generate variations in these parasite communities are as yet unclear. We quantified and analysed the parasite communities of 421 Lutjanus peru (Nichols & Murphy, 1922) collected from Acapulco Bay in Guerrero, Mexico, over a four-year period (August 2018 to April 2021), to identify any interannual variation due to local biotic and abiotic factors influenced by natural oceanographic phenomena, such as El Niño–Southern Oscillation, or La Niña. Twenty-five metazoan parasite taxa were recovered and identified: seven Digenea species; two Monogenea; one Cestoda; one Acanthocephala; four Nematoda; and ten of Crustacea (seven Copepoda and three Isopoda). The digeneans and copepods were the best represented parasite groups. The parasite communities were characterized by a high numerical dominance of helminth larvae. Species richness at the component community level (13 to 19 species) was similar to reported richness in other Lutjanus spp. The parasite communities of L. peru had a high variability in species composition, but low aggregate variability (e.g. species diversity), suggesting that structure of these communities may be quite stable over time. A clear interannual variation pattern was not observed, suggesting that parasite species of this host may respond differently to variations in environmental factors. Interannual variations were possibly caused by a combination of biotic (i.e. host feeding behaviour and body size) and local abiotic factors (influenced by climatic anomalies) which generated notable changes in the infection levels of several component species.
To evaluate the prevalence of diabetes mellitus type 2 in subjects with presbylarynx.
A case–control, prospective study was carried out on consecutive subjects who presented to the otorhinolaryngology department.
The study comprised 174 subjects (60 males and 114 females) with a mean age of 73.99 years (65–95 years). Presbylarynx was identified in 71 patients (41 per cent). Among patients with diabetes mellitus type 2, 20 patients (77 per cent) exhibited endoscopic signs of presbylarynx. A statistically significant difference was found between presbylarynx versus no presbylarynx concerning diabetes mellitus type 2 (p < 0.001). Subjects with diabetes mellitus type 2 were approximately eight times more likely to have presbylarynx compared to subjects without diabetes mellitus type 2.
In this study, 77 per cent of patients with diabetes mellitus type 2 had endoscopic signs of presbylarynx. A multivariable analysis, which took into account co-morbidities of the elderly, identified diabetes mellitus type 2 as a possible risk factor for presbylarynx. Many physiopathological mechanisms might explain this result, as diabetes mellitus type 2 is known to affect muscular, neurological and vascular systems.
This paper presents a compilation of atmospheric radiocarbon for the period 1950–2019, derived from atmospheric CO2 sampling and tree rings from clean-air sites. Following the approach taken by Hua et al. (2013), our revised and extended compilation consists of zonal, hemispheric and global radiocarbon (14C) data sets, with monthly data sets for 5 zones (Northern Hemisphere zones 1, 2, and 3, and Southern Hemisphere zones 3 and 1–2). Our new compilation includes smooth curves for zonal data sets that are more suitable for dating applications than the previous approach based on simple averaging. Our new radiocarbon dataset is intended to help facilitate the use of atmospheric bomb 14C in carbon cycle studies and to accommodate increasing demand for accurate dating of recent (post-1950) terrestrial samples.
The current study aimed to evaluate the effects of cactus pear as a moistening additive on fermentative and microbiological characteristics, aerobic stability (AS), chemical composition and in situ rumen degradability of corn grain silage at different opening times. A completely randomized experimental design was adopted in a 4 × 3 factorial scheme with four levels of dry matter (DM) (50; 60; 70 and 80% of DM) and three opening times (30; 60 and 120 days after ensiling), with four replications. There was an effect of interaction (P < 0.05) between the DM levels and opening times on silage yeast population, effluent losses, gas losses, dry matter recovery (DMR), AS of the silage and on lactic acid bacteria, mould and yeast populations after AS trial. The 60% DM level presented DMR values above 930 g/kg of DM. However, the lowest AS time (96.52 h) was observed in silages with 60% DM at 60 days after ensiling, although all silages have shown high AS. The DM in situ degradability of the ensiled mass increased after the ensiling process at all DM levels and opening times, with the 60% DM content showing the best result. When using cactus pear as a corn grain moistening additive, the 60% DM level is recommended when the opening time is up 120 days.
Background: The coronavirus disease 2019 (COVID-19) pandemic has led an implementation of institutional infection control protocols. This study will determine the effects of these protocols on outcomes of acute ischemic stroke (AIS) patients treated with endovascular therapy (EVT). Methods: Uninterrupted time series analysis of the impact of COVID-19 safety protocols on AIS patients undergoing EVT. We analyze data from prospectively collected quality improvement databases at 9 centers from March 11, 2019 to March 10, 2021. The primary outcome is 90-day modified Rankin Score (mRS). The secondary outcomes are angiographic time metrics. Results: Preliminary analysis of one stroke center included 214 EVT patients (n=144 pre-pandemic). Baseline characteristics were comparable between the two periods. Time metrics “last seen normal to puncture” (305.7 vs 407.2 min; p=0.05) and “hospital arrival to puncture” (80.4 vs 121.2 min; p=0.04) were significantly longer during pandemic compared to pre-pandemic. We found no significant difference in 90-day mRS (2.0 vs 2.2; p=0.506) or successful EVT rate (89.6% vs 90%; p=0.93). Conclusions: Our results indicate an increase in key time metrics of EVT in AIS during the pandemic, likely related to infection control measures. Despite the delays, we found no difference in clinical outcomes between the two periods.
To assess the influence of presbylarynx and presbycusis on Voice Handicap Index and emotional status.
A case–control, prospective, observational, cross-sectional study was conducted of patients aged 65 years or older referred to an otorhinolaryngology department from January to September 2020. Presbycusis was assessed by pure tone and vocal audiometry. Each subject underwent fibre-optic videolaryngoscopy with stroboscopy, and presbylarynx was considered when two or more of the following endoscopic findings were identified: vocal fold bowing, prominence of vocal processes in abduction, and a spindle-shaped glottal gap. Each subject completed two questionnaires: Voice Handicap Index and Geriatric Depression Scale (short-form).
The studied population included 174 White European subjects, with a mean age of 73.99 years, of whom 22.8 per cent presented both presbylarynx and presbycusis. Multivariate linear regression revealed that only presence and severity of presbylarynx had an influence on Voice Handicap Index-30 scores. However, both spindle-shaped glottal gap and presbycusis influenced Geriatric Depression Scale scores.
Presbylarynx has a strong association with the impact of voice on quality of life. Presbylarynx and presbycusis seem to have a cumulative effect on emotional status.
Dietary supplements have been increasingly used by gym users and are often consumed without the guidance of a health professional. Moreover, the indiscriminate supplements use can have adverse health effects, such as changes in liver and kidney function. The aim of this study was to verify the association between dietary supplements intake with alterations in the liver and kidney function among gym users. A cross-sectional study was conducted with 594 gym users (mean age 37 (sd 14) years, 55·2 % women) from a city in southern Brazil. A questionnaire was used to evaluate the use of dietary supplements. The markers of the liver (alanine aminotransferase, aspartate aminotransferase (AST), alkaline phosphatase, γ-glutamyltransferase) and renal (creatinine and urea) function were also evaluated on a subsample of the study population. Data were analysed by binary logistic regression, adjusted for sex, age and education. The prevalence of dietary supplement intake was 36·0 %. Individuals who intake dietary supplements showed a higher prevalence to present slight alterations in the AST enzyme and in the urea after adjustments for potential confounders. In conclusion, the use of dietary supplement was associated with slight alterations in AST enzyme and in the urea among gym users. These findings show the importance of using supplements correctly, especially with guidance from professionals trained to avoid possible risks to health.
In different parts of the world, aphid populations and their natural enemies are influenced by landscapes and climate. In the Neotropical region, few long-term studies have been conducted, maintaining a gap for comprehension of the effect of meteorological variables on aphid population patterns and their parasitoids in field conditions. This study describes the general patterns of oscillation in cereal winged aphids and their parasitoids, selecting meteorological variables and evaluating their effects on these insects. Aphids exhibit two annual peaks, one in summer–fall transition and the other in winter-spring transition. For parasitoids, the highest annual peak takes place during winter and a second peak occurs in winter–spring transition. Temperature was the principal meteorological regulator of population fluctuation in winged aphids and parasitoids during the year. The favorable temperature range is not the same for aphids and parasitoids. For aphids, temperature increase resulted in population growth, with maximum positive effect at 25°C. Temperature also positively influenced parasitoid populations, but the growth was asymptotic around 20°C. Although rainfall showed no regulatory function on aphid seasonality, it influenced the final number of insects over the year. The response of aphids and parasitoids to temperature has implications for trophic compatibility and regulation of their populations. Such functions should be taken into account in predictive models.
The diagnosis of visceral leishmaniasis (VL) has improved with the search of novel antigens; however, their performance is limited when samples from VL/human immunodeficiency virus (HIV)-coinfected patients are tested. In this context, studies conducted to identify more suitable antigens to detect both VL and VL/HIC coinfection cases should be performed. In the current study, phage display was performed using serum samples from healthy subjects and VL, HIV-infected and VL/HIV-coinfected patients; aiming to identify novel phage-exposed epitopes to be evaluated with this diagnostic purpose. Nine non-repetitive and valid sequences were identified, synthetized and tested as peptides in enzyme-linked immunosorbent assay experiments. Results showed that three (Pep2, Pep3 and Pep4) peptides showed excellent performance to diagnose VL and VL/HIV coinfection, with 100% sensitivity and specificity values. The other peptides showed sensitivity varying from 50.9 to 80.0%, as well as specificity ranging from 60.0 to 95.6%. Pep2, Pep3 and Pep4 also showed a potential prognostic effect, since specific serological reactivity was significantly decreased after patient treatment. Bioinformatics assays indicated that Leishmania trypanothione reductase protein was predicted to contain these three conformational epitopes. In conclusion, data suggest that Pep2, Pep3 and Pep4 could be tested for the diagnosis of VL and VL/HIV coinfection.
Literature on childhood Functional Neurological Disorders (FNDs) is spare. Clinical presentations are vaguely characterized and often misdiagnosed in younger ages. Their main neurological features enrol: Psychogenic non-epileptic seizures (PNES), Functional movement disorders (FMDs), sensory alterations, cephalgia and feeding problems.
The study was aimed to better characterize the childhood population of FND, because of they represent an emerging challenge for clinicians, giving its higher presentation in the younger age and the difficulties of an early and differential diagnosis as well as an effective management.
Our study retrospectively examined the characteristics of 82 FNDs children and adolescents (8 to 16 y.o.; 13 males; 29 females) referred as neurological inpatients of an urban academic neuropsychiatric department, from 2014 to 2019. Three main clinical aspects were analysed: type and pattern of symptoms manifestations (DSM-5 criteria); Life Events; family functioning.
FND accounted for 2% of 5-years consultations of neurological inpatients (M: F=1:2). The clinical presentation was characterized in 70% by pattern of co-expressed neurological symptoms: FMDs (9.5%); PNES (12%); dizziness/lipothymia (12%); paraesthesia/anaesthesia (16%). Generalized pain was associated in 38% of the reported patterns while cephalgia in 44%. Sleep disorders were reported in 40%. Previous psychiatric diagnoses were uncommon (2 out 82). Antecedent stressors were identified in 97% of patients for personal illness history and in the 93% for chronic illness in the family anamnesis. Family problems were in 25% of cases.
Our data contributes to better characterize the childhood population of FND, describing clinical patterns of presentation, highlighting putative antecedent stressors and risk factors
The SARS-CoV-2 pandemic is affecting numerous dimensions of our society since the beginning of the outbreak. A significant increase in emotional distress was expected in the general population, particularly among the high-risk groups such as the oldest, chronic patients, healthcare professionals, and psychopathology vulnerable people. There was an urgent need to adapt and create solutions to promote mental health. Given the recommendations to minimize face-to-face interactions, several helplines were widely developed.
In this work, we aim to reflect on the experience of a university helpline, that integrated efforts with the regional mental health care services.
A University helpline was created to give support to the regional community outside academia. The team was created on an online teamwork platform, to communicate through the chat, carry videoconference meetings, and store useful files. A Manchester screening decision tree was adopted, to define a set of guidelines to provide support to the callers, based mainly on the guidelines defined by the Order of Portuguese Psychologists. Liaison with the mental health care services, including other specific helplines, was established.
Notwithstanding all the efforts, the number of received calls was scarce, similarly to helplines created by other national universities and by other entities.
A new approach to psychological intervention in crisis is needed, maintaining integrated efforts, and taking advantage of the opportunity to foster personalized mental health care in the digital era. It is important to continuously assess the value of integrated efforts in patient care and to the healthcare system.
Hepatitis C virus (HCV) infection is known to be associated with neuropsychiatric manifestations as part of the disease. Previous neuroimaging studies showed brain connectivity dysfunction among HCV-infected patients
To assess, by MR in resting state, the potential structural and connectivity changes before (BL) and after HCV eradication (FU12) with direct-acting antivirals (DAA), along with clinical parameters.
Twenty-one HCV-patients, aged≤55 years, without psychiatric history, nor advanced liver disease, and eligible for DAA, and 25 healthy controls were included. Evaluations were performed at BL and FU12. Brain volume and local gyrification index (LGI) were assessed in MR-T1, and functional connectivity by seed-based analysis (left insula). Depression (MADRS/PHQ9) and neurotoxicity symptomatology (NRS) were assessed. We compared patients between BL/FU12, and controls by means of paired/independent T-test analysis.
Substained virologycal response was obtained in all patients (100%). Depressive and neurotoxicity symptomatology improved after cure (p<0.01). HCV-patients showed a reduced volume in a right latero-occipital area compared to controls (CWP<0.005) in both BL and FU12. This difference was smaller between FU12 and controls. LGI was higher in FU12-HCV compared to BL-HCV. fMRI connectivity showed a high association between insula and occipital/parietal territories in patients than controls, being higher among BL-HCV and controls. Differences were limited to occipital areas among FU12-HCV and controls.
Neuropsychiatric symptomatology improved after cure. Left insula is altered among HCV-patients in structured and connectivity (mainly occipital areas). After cure differences with controls were reduced, suggesting a partial restoration of brain connectivity.
This study aimed to analyse the geographical distribution of coronavirus disease 2019 (COVID-19) and to identify high-risk areas in space and time for the occurrence of cases and deaths in the indigenous population of Brazil. This is an ecological study carried out between 24 March and 26 October 2020 whose units of analysis were the Special Indigenous Sanitary Districts. The Getis-Ord General G and Getis-Ord Gi* techniques were used to verify the spatial association of the phenomena and a retrospective space–time scan was performed. There were 32 041 confirmed cases of COVID-19 and 471 deaths. The non-randomness of cases (z score = 5.40; P < 0.001) and deaths (z score = 3.83; P < 0.001) were confirmed. Hotspots were identified for cases and deaths in the north and midwest regions of Brazil. Sixteen high-risk space–time clusters were identified for the occurrence of cases with a higher RR = 21.23 (P < 0.001) and four risk clusters for deaths with a higher RR = 80.33 (P < 0.001). These clusters were identified from 22 May and were active until 10 October 2020. The results indicate critical areas in the indigenous territories of Brazil and contribute to better directing the actions of control of COVID-19 in this population.
Developing health promotion activities, aimed at healthy food intake, is essential for improving quality of life and reducing the prevalence of chronic diseases. Thus, the objective of this study is to describe both dietary and nutrient intake, according to length of participation in a health promotion service (Programa Academia da Saúde – PAS).
A cross-sectional study was carried out with a representative sample of PAS units in vulnerable areas of the city. Dietary and nutrient intake were assessed, using the average of two 24-h recalls. Food was categorised according to the NOVA (a systematic grouping of all foods according to the nature, extent and purpose of the industrial processes they undergo) classification. The length of participation in PAS is presented in months and is then examined in tertiles for analysis.
Belo Horizonte – Brazil.
3372 adults (≥20 years).
Users in the third tertile of PAS (24·4–61·6 months) experienced less energy intake, lipids and ultra-processed foods, and more culinary preparations, compared to others. Users in the second (10·1–24·3 months) and third tertiles of PAS had higher carbohydrate intake, Ca and vitamin C v those in the first tertile (0–10 months).
Results suggest that greater participation in PAS can improve dietary and nutrient intake, showing its potential to promote healthy lifestyles, prevent chronic diseases and offer longitudinal health care.