bluuebunny/crossref_metadata_2025 huggingface dataset:
Tristetraprolin, Inflammation, and Metabolic Syndrome in Arab Adults: A Case Control Study
Authors: Al-Daghri Nasser M. , Al-Shuwaie Albatul Y.A. , Alghamdi Amani , Amer Osama E. , Khattak Malak N.K. , Ansari Mohammed G.A. , Alnaami Abdullah M. , Sabico Shaun
Published: June 2021

Tristetraprolin (TTP) is an mRNA binding protein suggested to have a substantial role in regulating the mRNA expression of numerous inflammatory factors, but data on TTP and its association with metabolic syndrome (MetS), a chronic low-grade inflammatory disorder, are scarce. We hypothesize that TTP may modulate MetS and its components. A total of 200 Saudi adults (aged 38.6 ± 8.3 years) were included in this cross-sectional study. Anthropometrics data were collected and fasting blood glucose taken for the assessment of glycemic, lipids and inflammatory markers using commercially available assays. The National Cholesterol Education Program Adult Treatment Panel (NCEP ATP III) criteria were used to define MetS. Results showed significantly higher levels of TTP in the MetS group than in controls [288.1 pg/mL vs. 150.9 pg/mL, p < 0.001]. Circulating TTP was significantly associated with tumor necrosis factor alpha [TNF-α, R = 0.30, p < 0.05], interleukin 1β [IL-1β, R = 0.41, p < 0.01] and C-reactive protein [CRP, R = 0.36, p < 0.01], adiponectin [R = 0.36, p < 0.05], insulin [R = 0.37, p < 0.05], and insulin resistance [HOMA-IR, R = 0.40, p < 0.05]. Receiver operating characteristics (ROC) suggest a potential use of TTP as diagnostic biomarker for MetS [AUC = 0.819, p < 0.001]. The findings suggest that TTP is associated with inflammation and glycemia, which may influence MetS. TTP is a promising diagnostic biomarker for MetS which can be confirmed in larger cohorts.
Significance of BK Polyomavirus in Long-Term Survivors after Adult Allogeneic Stem Cell Transplantation
Authors: Neumann Thomas , Peters Nadette , Kranz Jennifer , Dräger Desiree , Heidel Florian , Krüger William , Schneidewind Laila
Published: June 2021

Background: Allogeneic stem cell transplantation (aSCT) is a common treatment for a variety of hematological diseases. Advances in transplantation practices have led to an increasing number of long-term aSCT survivors, but data about health status and late complications are sparse. This analysis focusses on kidney function and urological complications in this population. Methods: This study is a prospective unicentric non-interventional trial. Before starting the study, we obtained the approval of the local ethics review board. Furthermore, the study was registered at WHO Clinical Trial Registry. The study protocol is available via UTN. Results: We were able to include 33 patients with a mean age of 60.5 years (SD 11.1). The median survival time following allogeneic stem cell transplantation was 9.0 years (IQR 8.5–13.0). Five patients (15.2%) had BKPyV viruria with mean 218.3 (SD 674.2) copies/mL. BKPyV viruria was significantly linked to pre-existing chronic kidney failure (p = 0.019), creatine > 100 µmol/L (p < 0.001), and cystatin c > 1.11 mg/L (p = 0.021), respectively. We were not able to identify a single risk factor for BKPyV viruria in univariate or multivariate Cox regression. Conclusions: BKPyV-associated nephropathy might be one reason for impaired kidney function in long-term survivors of aSCT.
High Fecal Contamination and High Levels of Antibiotic-Resistant Enterobacteriaceae in Water Consumed in the City of Maputo, Mozambique
Authors: Salamandane Acácio , Vila-Boa Filipa , Malfeito-Ferreira Manuel , Brito Luísa
Published: June 2021

In the city of Maputo, Mozambique, food and water are often sold on the streets. Street water is packaged, distributed, and sold not paying attention to good hygienic practices, and its consumption is often associated with the occurrence of diarrheal diseases. Coincidentally, the increase of diarrheal diseases promotes the inappropriate use of antibiotics that might cause the emergence of antibiotic-resistant bacterial strains. In this context, the present study aimed to assess the microbiological quality of water sold on the streets of Maputo, as well as the antibiotic resistance profile of selected Enterobacteriaceae isolates. The 118 water samples analyzed were from street home-bottled water (n = 81), municipal water distribution systems (tap water) (n = 25), and selected supply wells in several neighborhoods (n = 12). The samples were analyzed for total mesophilic microorganisms, fecal enterococci, fecal coliforms, Escherichia coli, and Vibrio spp. The results showed a high level of fecal contamination in all types of water samples. In home-bottled water, fecal coliforms were found in 88% of the samples, and E. coli in 66% of the samples. In tap water, fecal coliforms were found in 64%, and E. coli in 28% of the samples. In water from supply wells, fecal coliforms and E. coli were found in 83% of the samples. From 33 presumptive Vibrio spp. colonies, only three were identified as V. fluvialis. The remaining isolates belonged to Aeromonas spp. (n = 14) and Klebsiella spp. (n = 16). Of 44 selected Enterobacteriaceae isolates from water samples (28 isolates of E. coli and 16 isolates of Klebsiella spp.), 45.5% were not susceptible to the beta-lactams ampicillin and imipenem, 43.2% to amoxicillin, and 31.8% to amoxicillin/clavulanic acid. Regarding non-beta-lactam antibiotics, there was a high percentage of isolates with tolerance to tetracycline (52.3%) and azithromycin (31.8%). In conclusion, water in Maputo represents a risk for human health due to its high fecal contamination. This situation is made more serious by the fact that a relatively high percentage of isolates with multidrug resistance (40%) were found among Enterobacteriaceae. The dissemination of these results can raise awareness of the urgent need to reduce water contamination in Maputo and other cities in Mozambique.
Leptin, Both Bad and Good Actor in Cancer
Authors: Jiménez-Cortegana Carlos , López-Saavedra Ana , Sánchez-Jiménez Flora , Pérez-Pérez Antonio , Castiñeiras Jesús , Virizuela-Echaburu Juan A. , de la Cruz-Merino Luis de la , Sánchez-Margalet Víctor
Published: June 2021

Leptin is an important regulator of basal metabolism and food intake, with a pivotal role in obesity. Leptin exerts many different actions on various tissues and systems, including cancer, and is considered as a linkage between metabolism and the immune system. During the last decades, obesity and leptin have been associated with the initiation, proliferation and progression of many types of cancer. Obesity is also linked with complications and mortality, irrespective of the therapy used, affecting clinical outcomes. However, some evidence has suggested its beneficial role, called the “obesity paradox”, and the possible antitumoral role of leptin. Recent data regarding the immunotherapy of cancer have revealed that overweight leads to a more effective response and leptin may probably be involved in this beneficial process. Since leptin is a positive modulator of both the innate and the adaptive immune system, it may contribute to the increased immune response stimulated by immunotherapy in cancer patients and may be proposed as a good actor in cancer. Our purpose is to review this dual role of leptin in cancer, as well as trying to clarify the future perspectives of this adipokine, which further highlights its importance as a cornerstone of the immunometabolism in oncology.
Tin Mesoporphyrin Selectively Reduces Non-Small-Cell Lung Cancer Cell Line A549 Proliferation by Interfering with Heme Oxygenase and Glutathione Systems
Authors: Sorrenti Valeria , D’Amico Agata Grazia , Barbagallo Ignazio , Consoli Valeria , Grosso Salvo , Vanella Luca
Published: June 2021

In order to maintain redox homeostasis, non-small-cell lung cancer (NSCLC) increases the activation of many antioxidant systems, including the heme-oxygenase (HO) system. The overexpression of HO-1 has been often associated with chemoresistance and tumor aggressiveness. Our results clearly showed an overexpression of the HO-1 protein in A549 NSCLC cell lines compared to that in non-cancerous cells. Thus, we hypothesized that “off-label” use of tin mesoporphyrin, a well-known HO activity inhibitor clinically used for neonatal hyperbilirubinemia, has potential use as an anti-cancer agent. The pharmacological inhibition of HO activity caused a reduction in cell proliferation and migration of A549. SnMP treatment caused an increase in oxidative stress, as demonstrated by the upregulation of reactive oxygen species (ROS) and the depletion of glutathione (GSH) content. To support these data, Western blot analysis was performed to analyze glucose-6-phosphate dehydrogenase (G6PD), TP53-induced glycolysis and the apoptosis regulator (TIGAR), and the glutamate cysteine ligase catalytic (GCLC) subunit, as they represent the main regulators of the pentose phosphate pathway (PPP) and glutathione synthesis, respectively. NCI-H292, a subtype of the NSCLC cell line, did not respond to SnMP treatment, possibly due to low basal levels of HO-1, suggesting a cellular-dependent antitumorigenic effect. Altogether, our results suggest HO activity inhibition may represent a potential target for selective chemotherapy in lung cancer subtypes.
Development of a Novel Bi-Enzymatic Nanobiocatalyst for the Efficient Bioconversion of Oleuropein to Hydroxytyrosol
Authors: Giannakopoulou Archontoula , Chatzikonstantinou Alexandra V. , Chalmpes Nikolaos , Tsapara Georgia , Gournis Dimitrios , Polydera Angeliki C. , Stamatis Haralambos
Published: June 2021

Lipase A from Candida antarctica (CalA) and β-glucosidase from Thermotoga maritima (bgl) were covalently co-immobilized onto the surface of chitosan-coated magnetic nanoparticles (CS-MNPs). Several parameters regarding the co-immobilization procedure (glutaraldehyde concentration, incubation time, CS-MNPs to enzyme mass ratio and bgl to CalA mass ratio) were evaluated and optimized. The developed nanobiocatalyst was characterized by various spectroscopic techniques. Biochemical parameters such as kinetic constants and thermal stability were also evaluated. The nanobiocatalytic system revealed an increase in the Km constant followed by a decrease in Vmax value compared with the native enzymes, while a significant increase (>5-fold higher) of the thermal stability of the immobilized CalA, both in individual and in co-immobilized form, was observed after 24 h incubation at 60 °C. Finally, the nanobiocatalyst was efficiently applied for the bioconversion of oleuropein to hydroxytyrosol, one of the most powerful naturally derived antioxidants, and it could be recycled for up to 10 reaction cycles (240 h of constant operation) at 60 °C, retaining more than 50% of its initial activity.
Detection of COVID-19 Virus on Surfaces Using Photonics: Challenges and Perspectives
Authors: Taha Bakr Ahmed , Al Mashhadany Yousif , Bachok Nur Nadia , Ashrif A Bakar Ahmad , Hafiz Mokhtar Mohd Hadri , Dzulkefly Bin Zan Mohd Saiful , Arsad Norhana
Published: June 2021

The propagation of viruses has become a global threat as proven through the coronavirus disease (COVID-19) pandemic. Therefore, the quick detection of viral diseases and infections could be necessary. This study aims to develop a framework for virus diagnoses based on integrating photonics technology with artificial intelligence to enhance healthcare in public areas, marketplaces, hospitals, and airfields due to the distinct spectral signatures from lasers’ effectiveness in the classification and monitoring of viruses. However, providing insights into the technical aspect also helps researchers identify the possibilities and difficulties in this field. The contents of this study were collected from six authoritative databases: Web of Science, IEEE Xplore, Science Direct, Scopus, PubMed Central, and Google Scholar. This review includes an analysis and summary of laser techniques to diagnose COVID-19 such as fluorescence methods, surface-enhanced Raman scattering, surface plasmon resonance, and integration of Raman scattering with SPR techniques. Finally, we select the best strategies that could potentially be the most effective methods of reducing epidemic spreading and improving healthcare in the environment.
Arterial Digital Pulse Photoplethysmography in Patients with Suspected Thoracic Outlet Syndrome: A Study of the “Ca+Pra” Maneuver
Authors: Hersant Jeanne , Ramondou Pierre , Thouveny Francine , Daligault Mickael , Feuilloy Mathieu , Saulnier Patrick , Abraham Pierre , Henni Samir
Published: June 2021

The level of pulse amplitude (PA) change in arterial digital pulse plethysmography (A-PPG) that should be used to diagnose thoracic outlet syndrome (TOS) is debated. We hypothesized that a modification of the Roos test (by moving the arms forward, mimicking a prayer position (“Pra”)) releasing an eventual compression that occurs in the surrender/candlestick position (“Ca”) would facilitate interpretation of A-PPG results. In 52 subjects, we determined the optimal PA change from rest to predict compression at imaging (ultrasonography +/− angiography) with receiver operating characteristics (ROC). “Pra”-PA was set as 100%, and PA was expressed in normalized amplitude (NA) units. Imaging found arterial compression in 23 upper limbs. The area under ROC was 0.765 ± 0.065 (p < 0.0001), resulting in a 91.4% sensitivity and a 60.9% specificity for an increase of fewer than 3 NA from rest during “Ca”, while results were 17.4% and 98.8%, respectively, for the 75% PA decrease previously proposed in the literature. A-PPG during a “Ca+Pra” test provides demonstrable proof of inflow impairment and increases the sensitivity of A-PPG for the detection of arterial compression as determined by imaging. The absence of an increase in PA during the “Ca” phase of the “Ca+Pra” maneuver should be considered indicative of arterial inflow impairment.
Socioeconomic Patterns of Twitter User Activity
Authors: Abitbol Jacob Levy , Morales Alfredo J.
Published: June 2021

Stratifying behaviors based on demographics and socioeconomic status is crucial for political and economic planning. Traditional methods to gather income and demographic information, like national censuses, require costly large-scale surveys both in terms of the financial and the organizational resources needed for their successful collection. In this study, we use data from social media to expose how behavioral patterns in different socioeconomic groups can be used to infer an individual’s income. In particular, we look at the way people explore cities and use topics of conversation online as a means of inferring individual socioeconomic status. Privacy is preserved by using anonymized data, and abstracting human mobility and online conversation topics as aggregated high-dimensional vectors. We show that mobility and hashtag activity are good predictors of income and that the highest and lowest socioeconomic quantiles have the most differentiated behavior across groups.
Multi-Touch Interaction Generation Device by Spatiotemporally Switching Electrodes
Authors: Okamoto Masahiro , Murao Kazuya
Published: June 2021

With the spread of devices equipped with touch panels, such as smartphones, tablets, and laptops, the opportunity for users to perform touch interaction has increased. In this paper, we constructed a device that generates multi-touch interactions to realize high-speed, continuous, or hands-free touch input on a touch panel. The proposed device consists of an electrode sheet printed with multiple electrodes using conductive ink and a voltage control board, and generates eight multi-touch interactions: tap, double-tap, long-press, press-and-tap, swipe, pinch-in, pinch-out, and rotation, by changing the capacitance of the touch panel in time and space. In preliminary experiments, we investigated the appropriate electrode size and spacing for generating multi-touch interactions, and then implemented the device. From the evaluation experiments, it was confirmed that the proposed device can generate multi-touch interactions with high accuracy. As a result, tap, press-and-tap, swipe, pinch-in, pinch-out, and rotation can be generated with a success rate of 100%. It was confirmed that all the multi-touch interactions evaluated by the proposed device could be generated with high accuracy and acceptable speed.
autoCoin: Secure Content Sharing Based on Blockchain for Vehicular Cloud
Authors: Kim Wooseong , Ryu Kyungho
Published: June 2021

A future smart car will be more than a means of transportation, as it will not only move people to a destination without requiring them to drive but will enable people to work or enjoy a trip with entertainment. For this, smart vehicles need to deal with various types of data for safety and infotainment, such as real-time traffic, multi-media contents, documents and weather information. Recently, a fleet of vehicles connected to other vehicles and infrastructure (i.e., road side units) using a legacy or 5G mmWave spectrum has been considered as a platform to cooperate for those new tasks, known as the vehicular cloud or fog. Within the vehicular cloud, data management should consider security, high availability and interoperability between vehicles. However, these are not easily achievable without a centralized service provider; it is difficult for an autonomous P2P system to guarantee data integrity, and it cannot compensate drivers that actively participate in the vehicular cloud. Fortunately, the many successes achieved in the field of crypto-currency raise the possibility of defining incentives that are necessary for a sustainable digital economy. In this paper, we propose autoCoin—an approach that aims to encourage smart vehicles to cooperate to create and exchange infotainment data securely under the assumption of rationality. We introduce a scalable blockchain architecture for autoCoin and a smart contract to exchange contents without third-parties using an off-chain technique.
Distance Protection for Coexistence of 5G Base Station and Satellite Earth Station
Authors: Wei Yiqiao , Liu Shuzhi , Hwang Seung-Hoon
Published: June 2021

In this paper, we investigate the coexistence of the 5G communication network with a fixed-satellite service (FSS) in the 3.5 GHz and 26 GHz frequency bands. We analyze a distance protection scheme for the FSS Earth station (ES) and 5G base stations (BS). Furthermore, we define the exclusion and restriction zones to develop a transmit power control scheme based on the Citizens Broadband Radio Service (CBRS). An interactive power control scheme is also devised for the restriction zone and extensively analyzed through simulations. The proposed scheme is examined for practical scenarios such as the rural macrocells (RMa), urban macrocells (UMa), and urban microcells (UMi) as defined by the 3GPP. The impact of the antenna type is also investigated, and BSs with omnidirectional, 4 × 4, 8 × 8, and 16 × 16 antenna arrays are examined, as defined by 3GPP, for the 5G networks. The results confirm that 5G systems can coexist with the FSS and provide quantitative insights into the selection of the system parameters, including interference margins, exclusion sizes, and reduction zones, for different scenarios and antenna types.
State of Health Prediction of Lithium-Ion Batteries Based on the Discharge Voltage and Temperature
Authors: Yang Yanru , Wen Jie , Shi Yuanhao , Zeng Jianchao
Published: June 2021

Accurate state of health (SOH) prediction of lithium-ion batteries is essential for battery health management. In this paper, a novel method of predicting the SOH of lithium-ion batteries based on the voltage and temperature in the discharging process is proposed to achieve the accurate prediction. Both the equal voltage discharge time and the temperature change during the discharge process are regarded as health indicators (HIs), and then, the Pearson and Spearman relational analysis methods are applied to evaluate the relevance between HIs and SOH. On this basis, we modify the relevance vector machine (RVM) to a multiple kernel relevance vector machine (MKRVM) by combining Gaussian with sigmoid function to improve the accuracy of SOH prediction. The particle swarm optimization (PSO) is used to find the optimal weight and kernel function parameters of MKRVM. The aging data from NASA Ames Prognostics Center of Excellence are used to verify the effectiveness and accuracy of the proposed method in numerical simulations, whose results show that the MKRVM method has higher SOH prediction accuracy of lithium-ion batteries than the relevant methods.
Numerical Analysis of the High Pressure MOVPE Upside-Down Reactor for GaN Growth
Authors: Niedzielski Przemyslaw , Raj Ewa , Lisik Zbigniew , Plesiewicz Jerzy , Grzanka Ewa , Czernecki Robert , Leszczynski Mike
Published: June 2021

The present paper focuses on the high-pressure metal-organic vapor phase epitaxy (MOVPE) upside-down vertical reactor (where the inlet of cold gases is below a hot susceptor). This study aims to investigate thermo-kinetic phenomena taking place during the GaN (gallium nitride) growth process using trimethylgallium and ammonia at a pressure of above 2 bar. High pressure accelerates the growth process, but it results in poor thickness and quality in the obtained layers; hence, understanding the factors influencing non-uniformity is crucial. The present investigations have been conducted with the aid of ANSYS Fluent finite volume method commercial software. The obtained results confirm the possibility of increasing the growth rate by more than six times through increasing the pressure from 0.5 bar to 2.5 bar. The analysis shows which zones vortexes form in. Special attention should be paid to the transitional flow within the growth zone as well as the viewport. Furthermore, the normal reactor design cannot be used under the considered conditions, even for the lower pressure value of 0.5 bar, due to high turbulences.
The Effect of Ceiling Heating and Mechanical Ventilation on Thermal Comfort
Authors: András-Tövissi Balázs , Kajtár László , Nyers Árpád
Published: June 2021

In the case of public buildings with ceiling heating and mechanical ventilation, radiant temperature asymmetry caused by the warm ceiling and draught occur simultaneously. The currently available literature does not offer an exhaustive description of the comfort conditions resulting from such a thermal environment. This research focuses on complementing the available knowledge, using instrumental measurements, as well as subject measurements carried out on 20 individuals. Relying on these measurements, the purpose of the research is to support the understanding of the combined mechanisms of action of the two local discomfort parameters. The main result of this research is that, if the predicted percentage dissatified is less than 6%, the radiant temperature asymmetry is in an interval of 5–15 °C, and the draught rate is 15% or 25%, the actual mean vote and the predicted mean vote values differ significantly, and the actual mean vote is always lower, with a few exceptions. In addition, the research highlights the changes of the actual mean vote caused by raising the draught rate from 15% to 25%, in the presence of radiant temperature asymmetry caused by warm ceilings.
Investigation of the Effectiveness of Disinfectants Used in Meat-Processing Facilities to Control Clostridium sporogenes and Clostridioides difficile Spores
Authors: McSharry Siobhán , Koolman Leonard , Whyte Paul , Bolton Declan
Published: June 2021

Spore-forming bacteria are a major concern for the food industry as they cause both spoilage and food safety issues. Moreover, as they are more resistant than vegetative cells, their removal from the food processing environment may be difficult to achieve. This study investigated the efficacy of the ten most commonly used disinfectant agents (assigned 1–10), used at the recommended concentrations in the meat industry, for their ability to eliminate Clostridium sporogenes and Clostridioides difficile spores. Test-tube based suspension assays suggested that disinfectants 2 (10% v/v preparation of a mixture of hydrogen peroxide (10–30%), acetic acid (1–10%) and peracetic acid (1–10%)), 7 (4% w/v preparation of a mixture of peroxymonosulphate (30–50%), sulphamic acid (1–10%) and troclosene sodium (1–10%)) and 10 (2% v/v preparation of a mixture of glutaraldehyde (10–30%), benzalkonium chloride (1–10%)) were the most effective formulations. D-values for these ranged from 2.1 to 8.4 min at 20 °C for the target spores. Based on these findings, it is recommended that these disinfectants are used to control Clostridium spores in the meat plant environment.
Effects of 2HDM in Electroweak Phase Transition
Authors: Chaudhuri Arnab , Khlopov Maxim Yu. , Porey Shiladitya
Published: June 2021

The entropy production scenarios due to the electroweak phase transition (EWPT) in the framework of the minimal extension of standard model, namely the two Higgs doublet model (2HDM), are revisited. The possibility of first order phase transition is discussed. Intense parameter scanning was done with the help of BSMPT, a C++ package. We perform numerical calculations in order to calculate the entropy production with numerous benchmark points.
Patients’ and Relatives’ Preferences for a Palliative/Oncology Day Ward and Out-of-Hours Telemedicine—An Interpretive Description
Authors: Hayes Bauer Eithne , Ørsted Schultz Anders Nikolai , Brink Anette , Oechsle Jørgensen Lena , Bollig Georg
Published: June 2021

Demographical challenges require adaptation and tailoring of services to suit palliative patients’ and relatives’ needs. Therefore, an interpretive descriptive study was performed to explore patients’ and relatives’ preferences for the establishment of a day ward and out-of-hours telemedicine. Semi-structured interviews were performed, and data were analysed using thematic analysis. Participants included patients (n = 12) and relatives (n = 5). Three themes emerged: (1) ‘Transport burden’ relates to transition from home-to-hospital-to-home and acknowledges the strain placed on patients and relatives. (2) ‘Role of relatives’ contemplates how the role of families in patient care influences patient preferences. (3) ‘Telemedicine—preferences and concerns’ covers preferences and concerns related to telemedicine in palliative care. The burden of transport and living alone play substantial roles in preferences for place of treatment. Relatives of palliative patients who avail of a day ward and telemedicine may experience an increase in the burden of care. Recognition of concerns pertinent to palliative patients and relatives is an important step in planning new services in palliative care. Concerns may be mitigated by rethinking referral guidelines, incorporating voluntary services, early integration of telemedicine into palliative care and examining patients and relatives’ expectations to care, but requires further research.
Wound-Healing and Skin-Moisturizing Effects of Sasa veitchii Extract
Authors: Ikarashi Nobutomo , Kaneko Miho , Fujisawa Izumi , Fukuda Natsuko , Yoshida Ryotaro , Kon Risako , Sakai Hiroyasu , Sugiyama Kiyoshi , Kamei Junzo
Published: June 2021

Sasa veitchii (S. veitchii) is a traditional herb derived from the bamboo genus, which is collectively called Kumazasa. Although Kumazasa extract is believed to have various effects on the skin, there is little scientific evidence for these effects. In this study, we aimed to obtain scientific evidence regarding the wound-healing and skin-moisturizing effects of Kumazasa extract. Kumazasa extract was applied to the skin of a mouse wound model for 14 days, and the wound area and dermal water content were measured. Mice treated with Kumazasa extract had smaller wound areas than control mice. The dermal water content in the Kumazasa extract-treated group was significantly higher than that in the control group. The mRNA and protein expression levels of cutaneous aquaporin-3 (AQP3), which is involved in wound healing and increases in dermal water content, were significantly increased by treatment with Kumazasa extract. Kumazasa extract-treated HaCaT cells exhibited significantly higher AQP3 expression and p38 mitogen-activated protein kinase (MAPK) phosphorylation than control cells. With continuous application, Kumazasa extract increases AQP3 expression and exerts wound-healing and moisturizing effects. The increase in AQP3 expression elicited by Kumazasa extract may be due to enhancement of transcription via activation of p38 MAPK signaling.
Improving Hospital Length of Stay: Results of a Retrospective Cohort Study
Authors: Patel Swapnil , Alshami Abbas , Douedi Steven , Campbell Natasha , Hossain Mohammad , Mushtaq Arman , Tarina Dana , Sealove Brett , Kountz David , Carpenter Kim , Angelo Ellen , Buccellato Vito , Sable Kenneth , Frank Elliot , Asif Arif
Published: June 2021

(1) Background: Jersey Shore University Medical Center (JSUMC) is a 646-bed tertiary medical center located in central New Jersey. Over the past several years, development and maturation of tertiary services at JSUMC has resulted in tremendous growth, with the inpatient volume increasing by 17% between 2016 and 2018. As hospital floors functioned at maximum capacity, the medical center was frequently forced into crisis mode with substantial increases in emergency department (ED) waiting times and a paradoxical increase in-hospital length of stay (hLOS). Prolonged hLOS can contribute to worse patient outcomes and satisfaction, as well as increased medical costs. (2) Methods: A root cause analysis was conducted to identify the factors leading to delays in providing in-hospital services. Four main bottlenecks were identified by the in-hospital phase sub-committee: incomplete orders, delays in placement to rehabilitation facilities, delays due to testing (mainly imaging), and delays in entering the discharge order. Similarly, the discharge process itself was analyzed, and obstacles were identified. Specific interventions to address each obstacle were implemented. Mean CMI-adjusted hospital LOS (CMI-hLOS) was the primary outcome measure. (3) Results: After interventions, CMI-hLOS decreased from 2.99 in 2017 to 2.84 and 2.76 days in 2018 and 2019, respectively. To correct for aberrations due to the COVID pandemic, we compared June–August 2019 to June–August 2020 and found a further decrease to 2.42 days after full implementation of all interventions. We estimate that the intervention led to an absolute reduction in costs of USD 3 million in the second half of 2019 and more than USD 7 million in 2020. On the other hand, the total expenses, represented by salaries for additional staffing, were USD 2,103,274, resulting in an estimated net saving for 2020 of USD 5,400,000. (4) Conclusions: At JSUMC, hLOS was found to be a complex and costly issue. A comprehensive approach, starting with the identification of all correctable delays followed by interventions to mitigate delays, led to a significant reduction in hLOS along with significant cost savings.
Interpretative Phenomenological Analysis for the Comparison of Polish and Foreign Dentistry Students’ Concerns during the Covid-19 Pandemic
Authors: Trzcionka Agata , Zalewska Irena , Tanasiewicz Marta
Published: June 2021

Introduction: At the beginning of 2020, the worldwide infection of coronavirus (SARS-CoV-2) changed many aspects of human lives. The controlled lockdown was not only an obligatory lifestyle change to communities across the globe, but it was also an emotional struggle. The aim of the presented study was to identify and compare the main difficulties that final-year students (both Polish and foreigners) of Dentistry, Faculty of Medical Sciences in Zabrze Medical University of Silesia had to cope with during the first wave of the pandemic. Application of the biographical method in the form of essays written was done. Authors discussed the following issues: possible losses and benefits subjectively felt by individuals due to the COVID-19 pandemic, adaptation to online type of studying, students’ opinions regarding change of habits, and psychological impact of the lockdown. Students’ responses varied between groups in the aspect of what they considered as the biggest struggle of the pandemic time period. Adaptation to e-learning was easier for the group of foreign students. The Polish group considered it as a serious stress factor. Foreigners were much more worried about not being able to help their families in comparison to Polish students. Polish students’ fear was related to the fear of virus transmission to their older relatives. Both groups were aware of how serious the situation was and of the possible impact of lack of practical classes on their future internships. As benefits of that situation, both groups listed development of new hobbies and increased sport activities. The Polish group emphasized improvement of interpersonal bonds during the lockdown in their families. The main conclusion proved an awareness of the seriousness of the situation in which students of medical, especially dental faculties found themselves. Concerns were related to the form of further studies and the possibility of taking up employment after graduation. Polish students declared more intense concerns about e-learning and remote study than foreign-language students who were more familiar with this form of communication. A particularly valuable form of teaching for students may be increased numbers of online consultations, since even though they cannot replace practical classes, they may still be helpful in explaining doubts and simply “being there”. Encouraging young people to discover constructive benefits of the pandemic can also be one of a task-oriented strategies of help.
Psychological Determinants of Attitude to Surgery in Internal Carotid Artery Stenosis Patients
Authors: Stanišić Michał-Goran , Rzepa Teresa , Kubaszewski Przemysław
Published: June 2021

The basic way to prevent cerebral stroke in symptomatic 70–99% stenosis of internal carotid artery (ICA) is an open or endovascular surgical procedure. Psychological research done so far among ICA stenosis patients focused on cognitive functioning changes. The objective was to assess attitude to surgery in relation to self-efficacy, life quality perception, and health locus of control in ICA stenosis patients. Materials and Methods: The study involved 53 asymptomatic ICA stenosis patients, aged from 53 to 81. Four scales were applied: Generalized Self-Efficacy Scale (GSES); Satisfaction With Life Scale (SWLS); Multidimensional Health Locus of Control Scale (MHLC); and a simple scale to examine the attitude to surgery, where “−10” stands for the maximally negative attitude, “0”—neutral, and “+10”—maximally positive. The obtained results were put to statistical analysis. Results: It was found that women and men assessed their attitude to the surgery as positive (M = 7.92; SD = 3.094), though the men estimated it slightly higher (M = 8.03; SD = 3.02) than the women (M = 7.67; SD = 3.37). The mean value of self-efficacy was high (M = 32.53; SD = 6.231), and slightly higher for the men (M = 32.79; SD = 5.576) compared to the women (M = 31.87; SD = 7.836). The patients generally tended to manifest the external personal health locus of control (M = 28.62; SD = 3.17). The runner-up was internal health locus of control (M = 26.02; SD = 3.775), and the next one—external impersonal aspect (chance/luck) (M = 23.57; SD = 4.457). The mean assessment of the patients’ own life quality proved to be above average (M = 23.60) but varied (SD = 5.95). The women perceived the quality of their lives as better (M = 24.33; SD = 6.422) than the men (M = 23.32; SD = 5.818). Very strong positive correlations were found between self-efficacy and life quality assessment (p < 0.001) and between the internal and external personal aspects of health locus of control (p < 0.007) in the women, and positive correlations were found between the attitude to surgery and internal health locus of control (p < 0.021) in the men. Conclusions: When breaking the news of a need to have a surgical intervention due to ICA stenosis, the physician should strongly refer to the value of human life and health. The message should arise from external (in the case of women) or internal (in the case of men) motivation to undergo surgery, and enhance the patient’s conviction that the disease should be considered a challenge which must be taken to reverse their unfavorable situation and improve life quality.
Risk Factors and Prediction Models for Venous Thromboembolism in Ambulatory Patients with Lung Cancer
Authors: Yan Ann-Rong , Samarawickrema Indira , Naunton Mark , Peterson Gregory M. , Yip Desmond , De Rosa Salvatore , Mortazavi Reza
Published: June 2021

Venous thromboembolism (VTE) is a significant cause of mortality in patients with lung cancer. Despite the availability of a wide range of anticoagulants to help prevent thrombosis, thromboprophylaxis in ambulatory patients is a challenge due to its associated risk of haemorrhage. As a result, anticoagulation is only recommended in patients with a relatively high risk of VTE. Efforts have been made to develop predictive models for VTE risk assessment in cancer patients, but the availability of a reliable predictive model for ambulate patients with lung cancer is unclear. We have analysed the latest information on this topic, with a focus on the lung cancer-related risk factors for VTE, and risk prediction models developed and validated in this group of patients. The existing risk models, such as the Khorana score, the PROTECHT score and the CONKO score, have shown poor performance in external validations, failing to identify many high-risk individuals. Some of the newly developed and updated models may be promising, but their further validation is needed.
Resuscitation in Community Healthcare Facilities in Israel
Authors: Zherebovich Irena , Goldberg Avishay , Ben Tov Amir , Schwartz Dagan
Published: June 2021

Background: Out-of-hospital cardiac-arrest (OHCA) is a major public health challenge. Community health care providers (CHP) may play an important role through early identification, basic life support and defibrillation. Few studies have evaluated the incidence and characteristics of OHCAs initially cared for by CHP, most finding improved survival. This study combined CHP treated OHCA case analysis, with assessment of provider resuscitation preparedness. Methods: An analysis of all CHP initiated resuscitations in a large Health Maintenance Organization (HMO) reported over 42 months, coupled with an online survey assessing CHP resuscitation knowledge, experience, training and self-confidence. Results: 22 resuscitations met inclusion criteria. In 21 CHP initiated chest-compressions but in only 8 cases they utilized the clinic’s automated external defibrillator (AED) prior to emergency medical services (EMS) arrival. There were 275 providers surveyed. Of the surveyed providers, 89.4% reported previous basic life support (BLS)/advanced cardiovascular life support (ALS) training, 67.9% within the last three years. Previous resuscitation experience was reported by 72.7%. The lowest scoring knowledge question was on indications for AED application −56.3%. Additionally, 44.4% reported low confidence in their resuscitation skills. CHP with previous cardiopulmonary resuscitation (CPR) experience reported higher confidence. Longer time since last CPR training lowered self-confidence. Conclusions: Early AED application is crucial for patients with OHCA. All clinics in our study were equipped with AED’s and most CHP received training in their use, but remained insecure regarding their use, often failing to do so.
Effectiveness of Acceptance and Commitment Therapy in Central Pain Sensitization Syndromes: A Systematic Review
Authors: Galvez-Sánchez Carmen M. , Montoro Casandra I. , Moreno-Padilla María , Reyes del Paso Gustavo A. , de la Coba Pablo
Published: June 2021

Objectives: Acceptance and commitment therapy (ACT) is considered by the American Psychological Association as an evidence-based treatment for a variety of disorders, including chronic pain. The main objective of the present systematic review was to determine the effectiveness of ACT in patients with central pain sensitization syndromes (CPSS). Methods: This systematic review was conducted according to the guidelines of the Cochrane Collaboration and PRISMA statements. The protocol was registered in advance in the Prospective Register of Systematic Reviews (PROSPERO) international database. The selected articles were evaluated using the Cochrane risk of bias (ROB) assessment tool. The PubMed, Scopus, and Web of Science databases were searched. Results: The literature search identified 21 studies (including investigations of fibromyalgia syndrome, irritable bowel syndrome, and migraine) eligible for the systematic review. There were no studies regarding the effectiveness of ACT for chronic tension-type headache (CTTH), interstitial cystitis (IC), or temporomandibular disorder (TMD). The evaluation of ROB showed that 12 of the selected studies were of low quality, 5 were of moderate quality, and 4 were high quality. ACT reduces some clinical symptoms, such as anxiety, depression, and pain. This positive effect of ACT might be mediated by pain acceptance, psychological flexibility, optimism, self-efficacy, or adherence to values. ACT showed better results in comparison to non-intervention (e.g., “waiting list”) conditions, as well as pharmacological and psychoeducational interventions. It is not entirely clear whether extended ACT treatments are more advantageous than briefer interventions. Conclusions: There are few studies about the effectiveness of ACT on CPSS. However, ACT seems to reduce subjective CPSS symptoms and improve the health-related quality of life of these patients. The absence of studies on the effectiveness of ACT in CTTH, IC, and TMD, indicate the pressing need for further ACT studies in these CPSS.
Impact of Bundle Branch Block on Permanent Pacemaker Implantation after Transcatheter Aortic Valve Implantation: A Meta-Analysis
Authors: Ravaux Justine M. , Mauro Michele Di , Vernooy Kevin , Mariani Silvia , Ronco Daniele , Simons Jorik , Van't Hof Arnoud W. , Veenstra Leo , Kats Suzanne , Maessen Jos G. , Lorusso Roberto
Published: June 2021

Data regarding the impact of infra-Hisian conduction disturbances leading to permanent pacemaker implantation (PPI) after transcatheter aortic valve implantation (TAVI) remain limited. The aim of this study was to determine the impact of right and/or left bundle branch block (RBBB/LBBB) on post-TAVI PPI. We performed a systematic literature review to identify studies reporting on RBBB and/or LBBB status and post-TAVI PPI. Study design, patient characteristics, and the presence of branch block were analyzed. Odds ratios (ORs) with 95% CI were extracted. The final analysis included 36 studies, reporting about 55,851 patients. Data on LBBB were extracted from 33 studies. Among 51,026 patients included, 5503 showed pre-implant LBBB (11.9% (10.4%–13.8%)). The influence of LBBB on post-TAVI PPI was not significant OR 1.1474 (0.9025; 1.4588), p = 0.2618. Data on RBBB were extracted from 28 studies. Among 46,663 patients included, 31,603 showed pre-implant RBBB (9.2% (7.3%–11.6%)). The influence of RBBB on post-TAVI PPI was significant OR 4.8581 (4.1571; 5.6775), p < 0.0001. From this meta-analysis, the presence of RBBB increased the risk for post-TAVI PPI, independent of age or LVEF, while this finding was not confirmed for patients experimenting with LBBB. This result emphasizes the need for pre-operative evaluation strategies in patient selection for TAVI.
Effects of Monotherapy with Clopidogrel vs. Aspirin on Vascular Function and Hemostatic Measurements in Patients with Coronary Artery Disease: The Prospective, Crossover I-LOVE-MONO Trial
Authors: Park Hyun-Woong , Kang Min-Gyu , Ahn Jong-Hwa , Bae Jae-Seok , Tantry Udaya S. , Gurbel Paul A. , Jeong Young-Hoon
Published: June 2021

Objectives: To evaluate the effect of clopidogrel vs. aspirin monotherapy on vascular function and hemostatic measurement. Background: Monotherapy with P2Y12 receptor inhibitor vs. aspirin can be a useful alterative to optimize clinical efficacy and safety in high-risk patients with coronary artery disease (CAD). Methods: We performed a randomized, open-label, two-period crossover study in stented patients receiving at least 6-month of dual antiplatelet therapy (DAPT). Thirty CAD patients with moderate-to-high ischemic risk were randomly assigned to receive either 75 mg of clopidogrel or 100 mg of aspirin daily for 4 weeks, and were crossed over to the other strategy for 4 weeks. Vascular function was evaluated with reactive hyperemia-peripheral arterial tonometry (RH-PAT) and brachial-ankle pulse wave velocity (baPWV). Hemostatic profiles were measured with VerifyNow and thromboelastography (TEG). The primary endpoint was the reactive hyperemia index (RHI) during clopidogrel or aspirin monotherapy. Results: Clopidogrel vs. aspirin monotherapy was associated with better endothelial function (RHI: 2.11 ± 0.77% vs. 1.87 ± 0.72%, p = 0.045), lower platelet reactivity (130 ± 64 vs. 214 ± 50 P2Y12 reaction unit [PRU], p < 0.001) and prolonged reaction time (TEG R: 5.5 ± 1.2 vs. 5.1 ± 1.1 min, p = 0.037). In multivariate analysis, normal endothelial function (RHI ≥ 2.1) was significantly associated with clot kinetics (TEG angle ≤ 68 degree) and ‘PRU ≤ 132’. ‘PRU ≤ 132’ was achieved in 46.2% vs. 3.8% during clopidogrel administration vs. aspirin monotherapy (odds ratio 21.4, 95% confidence interval 2.7 to 170.1, p < 0.001). Conclusions: In CAD patients, clopidogrel vs. aspirin monotherapy was associated with better endothelial function, greater platelet inhibition and lower coagulation activity, suggesting pleiotropic effects of clopidogrel on endothelial function and hemostatic profiles.
Rectus Femoris Mimicking Ultrasound Phantom for Muscle Mass Assessment: Design, Research, and Training Application
Authors: Nakanishi Nobuto , Inoue Shigeaki , Tsutsumi Rie , Akimoto Yusuke , Ono Yuko , Kotani Joji , Sakaue Hiroshi , Oto Jun
Published: June 2021

Ultrasound has become widely used as a means to measure the rectus femoris muscle in the acute and chronic phases of critical illness. Despite its noninvasiveness and accessibility, its accuracy highly depends on the skills of the technician. However, few ultrasound phantoms for the confirmation of its accuracy or to improve technical skills exist. In this study, the authors created a novel phantom model and used it for investigating the accuracy of measurements and for training. Study 1 investigated how various conditions affect ultrasound measurements such as thickness, cross-sectional area, and echogenicity. Study 2 investigated if the phantom can be used for the training of various health care providers in vitro and in vivo. Study 1 showed that thickness, cross-sectional area, and echogenicity were affected by probe compression strength, probe angle, phantom compression, and varying equipment. Study 2 in vitro showed that using the phantom for training improved the accuracy of the measurements taken within the phantom, and Study 2 in vivo showed the phantom training had a short-term effect on improving the measurement accuracy in a human volunteer. The new ultrasound phantom model revealed that various conditions affected ultrasound measurements, and phantom training improved the measurement accuracy.