bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of the Partial Substitution of Sodium Chloride on the Gel Properties and Flavor Quality of Unwashed Fish Mince Gels from Grass Carp
Authors: Pi Ruobing , Li Gaojing , Zhuang Shuai , Yu Qinye , Luo Yongkang , Tan Yuqing , Dai Ruitong , Hong Hui
Published: February 2022

Excessive salt is usually required to maintain good gel properties and quality characteristics for unwashed fish mince gels (UFMG). This study aimed to investigate the effects of partial sodium chloride substitution (30%) with different substitutes (potassium chloride, disodium inosine-5′-monophosphate, basil) on the gel and flavor properties of UFMG from Ctenopharyngodon idellus. The results indicated that the texture and gel strength of NK (30% NaCl was replaced with 30% KCl) were fairly similar to that of N group (NaCl only), and the whiteness had improved significantly (p < 0.05), while the product eventually yielded a certain bitter taste. The addition of disodium inosine-5′-monophosphate (DIMP) significantly (p < 0.05) increased the hardness, chewiness, buriedness degree of tryptophan and gel strength, decreased the content of α-helix structure in the gels, while less change occurred in gel whiteness and network structure. Basil significantly (p < 0.05) reduced the buriedness degree of tryptophan, gel strength and whiteness, and deteriorated the gel structure. Nevertheless, the addition of DIMP or basil reduced the bitterness induced by KCl and improved the overall acceptability scores of gels of the N group. Moreover, there was no distinct difference in moisture content and water-holding capacity between all groups. Therefore, replacing sodium chloride in UFMG with 25% potassium chloride and 5% DIMP may be an ideal sodium salt substitution strategy.
The Effect of p-Coumaric Acid on Browning Inhibition in Potato Polyphenol Oxidase-Catalyzed Reaction Mixtures
Authors: Jiang Shu , Penner Michael H.
Published: February 2022

There has been considerable interest in using natural polyphenol oxidase (PPO) inhibitors to control browning in fruit and vegetable products. p-Coumaric acid (pCA), a common secondary metabolite of plants, has been studied as an inhibitor of PPOs/tyrosinases from several foods (e.g., mushroom, apple, and potato). However, studies on the use of pCA for the inhibition of PPO-initiated browning in actual food systems are limited. Therefore, a study was carried out to ascertain the efficacy of using pCA to limit PPO-initiated browning in fresh potato juice. The extent of browning inhibition by pCA was shown to be reaction system-dependent. Browning in potato juice was unexpectedly enhanced by the addition of pCA. This was interpreted as pCA acting as an alternative substrate with significantly higher browning efficiency; extent of browning under this condition was higher than that observed in the native potato juice. The addition of pCA to any of the model reaction mixtures (i.e., those containing semi-purified enzymes and substrates) significantly inhibited browning. The discrepancy in pCA effects on browning inhibition in different reaction systems is postulated to be mainly due to non-enzyme and non-substrate components in potato juice that participate in the post-PPO reaction sequences, which ultimately lead to brown color formation.
Hydrogel Containing Borassus flabellifer L. Male Flower Extract for Antioxidant, Antimicrobial, and Anti-Inflammatory Activity
Authors: Tunit Prakairat , Thammarat Phanit , Okonogi Siriporn , Chittasupho Chuda
Published: February 2022

Borassus flabellifer L. is a plant in Arecaceae family, widely distributed and cultivated in tropical Asian countries. The purpose of this study was to identify the bioactive compounds of B.flabellifer L. male flower ethanolic extract and investigate the antioxidant, anti-inflammatory, and antibacterial activities against Cutibacterium acnes. Total phenolic compounds and total flavonoids in B.flabellifer L. male flower ethanolic extract were determined by the Folin–Ciocalteu method and aluminum chloride colorimetric assay, respectively. Active substances in the extract and their quantities were analyzed by liquid chromatography and mass spectrometry (LC–MS/MS). The antioxidant evaluation was carried out using DPPH, ABTS free radical scavenging assays, and FRAP assay. C. acnes inhibitory activity was performed by the broth microdilution method. Anti-inflammatory activity was determined by the protein denaturation assay. In addition, gel containing different amounts of B.flabellifer L. male flower extract was formulated. The physical stability of the gel was observed by measuring viscosity and pH after six heating and cooling cycles, as well as 1-month storage at 4, 30, and 45 °C. The total phenolic content in the extract was 268.30 ± 12.84 mg gallic acid equivalent/g crude dry extract. The total flavonoid contents in the extract were 1886.38 ± 55.86 mg quercetin equivalent/g extract and 2884.88 ± 128.98 mg EGCG equivalent/g extract, respectively. The LC–MS/MS analysis revealed the presence of gallic acid, coumarin, and quercetin and the concentrations of quercetin, coumarin, and gallic acid in B. flabellifer male flower ethanolic extract were 0.912, 0.021, and 1.610 µg/mL, respectively. DPPH and ABTS antioxidant assays indicated that the B.flabellifer L. male flower extract had IC50 values of 31.54 ± 0.43 and 164.5 ± 14.3 µg/mL, respectively. FRAP assay revealed that the B.flabellifer male flower extract had high ferric ion reducing power. The extract was able to inhibit C.acnes bacteria with a minimum inhibitory concentration (MIC) of 250 mg/mL. At 250 and 500 µg/mL, the extract demonstrated the highest anti-inflammatory activity. The gel containing 31.25% w/w and 62.5% w/w showed good physical stability after six heating and cooling cycles, as well as 1-month storage.
Small RNA and Degradome Sequencing Reveal Important MicroRNA Function in Nicotiana tabacum Response to Bemisia tabaci
Authors: Han Wen-Hao , Wang Jun-Xia , Zhang Feng-Bin , Liu Yu-Xiao , Wu He , Wang Xiao-Wei
Published: February 2022

MicroRNAs (miRNAs), a class of small non-coding regulatory RNAs, are key molecules in many biological and metabolic processes of plant growth, development and stress response via targeting mRNAs. The phloem-feeding insect whitefly Bemisia tabaci (Hemiptera, Aleyrodidae) is a serious pest that causes devastating harm to agricultural production worldwide. However, the function of host miRNAs in the response to whitefly infestation remains unclear. Here, we sequenced the small RNA and degradome of tobacco (Nicotiana tabacum L.), after and before infestation by B. tabaci. We identified 1291 miRNAs belonging to 138 miRNA families including 706 known miRNAs and 585 novel miRNAs. A total of 47 miRNAs were differentially expressed, of which 30 were upregulated and 17 were downregulated by whitefly exposure. Then, computational analysis showed that the target genes of differential miRNAs were involved in R gene regulation, plant innate immunity, plant pathogen defense, the plant hormone signal pathway and abiotic stress tolerance. Furthermore, degradome analysis demonstrated that 253 mRNAs were cleaved by 66 miRNAs. Among them, the targets cleaved by upregulated miR6025, miR160, miR171, miR166 and miR168 are consistent with our prediction, suggesting that pathogen-related miRNAs may function in plant defense against whitefly. Moreover, our results show that plant miRNA response and miRNA-mediated post-transcriptional regulation for phloem-feeding insect infestation are similar to pathogen invasion. Our study provides additional data to further elucidate how host plants respond and defend the phloem-feeding insects.
The Role of VHL in the Development of von Hippel-Lindau Disease and Erythrocytosis
Authors: Hudler Petra , Urbancic Mojca
Published: February 2022

Von Hippel-Lindau disease (VHL disease or VHL syndrome) is a familial multisystem neoplastic syndrome stemming from germline disease-associated variants of the VHL tumor suppressor gene on chromosome 3. VHL is involved, through the EPO-VHL-HIF signaling axis, in oxygen sensing and adaptive response to hypoxia, as well as in numerous HIF-independent pathways. The diverse roles of VHL confirm its implication in several crucial cellular processes. VHL variations have been associated with the development of VHL disease and erythrocytosis. The association between genotypes and phenotypes still remains ambiguous for the majority of mutations. It appears that there is a distinction between erythrocytosis-causing VHL variations and VHL variations causing VHL disease with tumor development. Understanding the pathogenic effects of VHL variants might better predict the prognosis and optimize management of the patient.
Epigenetic and Physiological Responses to Varying Root-Zone Temperatures in Greenhouse Rocket
Authors: Tsaballa Aphrodite , Sperdouli Ilektra , Avramidou Evangelia V. , Ganopoulos Ioannis , Koukounaras Athanasios , Ntinas Georgios K.
Published: February 2022

Greenhouse production of baby leaf vegetables grown in hydroponic floating trays has become extremely popular in recent years. Rocket (Eruca sativa Mill.) can grow in temperatures varying between 10 and 20 °C; nevertheless, a root-zone temperature (RZT) range of 18–23 °C is considered optimal for high productivity, photosynthesis, and production of metabolites. Maintaining such temperatures in winter raises production costs and prevents sustainability. In this study, we tested the impact of lower RZT on plants’ status and recorded their responses while providing energy for heating using photovoltaic solar panels. We used three hydroponic tanks for cultivation; a non-heated (control) tank (12 °C) and two heated tanks; a solar panel-powered one (16 °C) and a public grid-powered one (22 °C). Methylation-sensitive amplified polymorphisms (MSAP) analysis of global methylation profiles and chlorophyll fluorescence analysis were employed to assess methylation and physiology levels of rocket leaves. We found that there is demethylation at 16 °C RZT in comparison to 22 °C RZT. Reduction of temperature at 12 °C did not reduce methylation levels further but rather increased them. Furthermore, at 16 °C, the effective quantum yield of photosystem II (PSII) photochemistry (ΦPSII) was significantly higher, with a higher PSII electron transport rate (ETR) and a significantly decreased non-regulated energy loss (ΦΝO), suggesting a better light energy use by rocket plants with higher photosynthetic performance. ΦPSII was significantly negatively correlated with DNA methylation levels. Our results show that at 16 °C RZT, where plants grow efficiently without being affected by the cold, DNA methylation and photosynthesis apparatus systems are altered. These findings corroborate previous results where hydroponic production of rocket at RZT of 16 °C is accompanied by sufficient yield showing that rocket can effectively grow in suboptimal yet sustainable root-zone temperatures.
Myotonic Dystrophies: A Genetic Overview
Authors: Soltanzadeh Payam
Published: February 2022

Myotonic dystrophies (DM) are the most common muscular dystrophies in adults, which can affect other non-skeletal muscle organs such as the heart, brain and gastrointestinal system. There are two genetically distinct types of myotonic dystrophy: myotonic dystrophy type 1 (DM1) and myotonic dystrophy type 2 (DM2), both dominantly inherited with significant overlap in clinical manifestations. DM1 results from CTG repeat expansions in the 3′-untranslated region (3′UTR) of the DMPK (dystrophia myotonica protein kinase) gene on chromosome 19, while DM2 is caused by CCTG repeat expansions in intron 1 of the CNBP (cellular nucleic acid-binding protein) gene on chromosome 3. Recent advances in genetics and molecular biology, especially in the field of RNA biology, have allowed better understanding of the potential pathomechanisms involved in DM. In this review article, core clinical features and genetics of DM are presented followed by a discussion on the current postulated pathomechanisms and therapeutic approaches used in DM, including the ones currently in human clinical trial phase.
Non-Vitamin K Oral Anticoagulants Assessment in High Risk of Bleeding Patients with Non-Valvular Atrial Fibrillation
Authors: Silva Cunha Pedro , Viveiros Monteiro André , Coutinho Cruz Madalena , Malveiro Paula , Reis João Pedro , Portugal Guilherme , Dias Ana , Ferreira Rui Cruz , Oliveira Mário Martins
Published: February 2022

Atrial fibrillation (AF) is commonly associated with advanced age and the presence of multiple, concomitant acute and chronic health conditions, placing this population at high risk for serious therapeutic side effects. Nonvitamin K antagonist oral anticoagulants (NOACs) are increasingly used for stroke prevention in patients with atrial fibrillation. The purpose of this study was to investigate the effectiveness and safety of NOAC in a group at high risk of bleeding complications, in a real-world setting. We conducted a retrospective analysis of a high-risk cohort of 418 patients (pts) followed-up in our anticoagulation unit; data on patient characteristics, anticoagulation treatment, and bleeding and thrombotic complications were evaluated. The population had a median age of 77.8 ± 10.3 years and the mean CHA2DS2-VASc score was 3.85 (SD ± 1.4). Overall, 289 (69.1%) were ≥75 years old. During a mean follow-up time of 51.2 ± 35.7 months, we observed a rate of any bleeding of 7, a clinically relevant non-major bleeding rate of 4.8, a major bleeding rate of 2.2, a stroke rate of 1.6, and a rate of thrombotic events of 0.28 per 100 patient-years. There were 59 hospitalizations due to any cause (14.1%) and 36 (8.6%) deaths (one due to ischemic stroke). A structured follow-up, with judicious prescribing and drug compliance, may contribute to preventing potential complications.
An Efficient Data Driven-Based Model for Prediction of the Total Sediment Load in Rivers
Authors: Noori Roohollah , Ghiasi Behzad , Salehi Sohrab , Esmaeili Bidhendi Mehdi , Raeisi Amin , Partani Sadegh , Meysami Rojin , Mahdian Mehran , Hosseinzadeh Majid , Abolfathi Soroush
Published: February 2022

Sediment load in fluvial systems is one of the critical factors shaping the river geomorphological and hydraulic characteristics. A detailed understanding of the total sediment load (TSL) is required for the protection of physical, environmental, and ecological functions of rivers. This study develops a robust methodological approach based on multiple linear regression (MLR) and support vector regression (SVR) models modified by principal component analysis (PCA) to predict the TSL in rivers. A database of sediment measurement from large-scale physical modelling tests with 4759 datapoints were used to develop the predictive model. A dimensional analysis was performed based on the literature, and ten dimensionless parameters were identified as the key drivers of the TSL in rivers. These drivers were converted to uncorrelated principal components to feed the MLR and SVR models (PCA-based MLR and PCA-based SVR models) developed within this study. A stepwise PCA-based MLR and a 10-fold PCA-based SVR model with different kernel-type functions were tuned to derive an accurate TSL predictive model. Our findings suggest that the PCA-based SVR model with the kernel-type radial basis function has the best predictive performance in terms of statistical error measures including the root-mean-square error normalized with the standard deviation (RMSE/StD) and the Nash–Sutcliffe coefficient of efficiency (NSE), for the estimation of the TSL in rivers. The PCA-based MLR and PCA-based SVR models, with an overall RMSE/StD of 0.45 and 0.35, respectively, outperform the existing well-established empirical formulae for TSL estimation. The analysis of the results confirms the robustness of the proposed PCA-based SVR model for prediction of the cases with high concentration of sediments (NSE = 0.68), where the existing sediment estimation models usually have poor performance.
Fluctuations of Winter Floods in Small Austrian and Ukrainian Catchments
Authors: Zabolotnia Tetiana , Parajka Juraj , Gorbachova Liudmyla , Széles Borbála , Blöschl Günter , Aksiuk Oleksandr , Tong Rui , Komma Jürgen
Published: February 2022

Studying the changes in extreme river runoff induced by climate change is of utmost importance, as the variability of floods directly affects life and human activities. This study examines the fluctuations and persistence of winter floods in 14 catchments in the Rika River Basin (Ukraine) and ten catchments in the Steyr River Basin (Austria). The catchments represent typical hydrological regimes in the Danube River region. The fluctuations and persistence of floods are analyzed by the hydro-genetic method and a seasonality analysis for the period 1951–2015. The results show a much more pronounced fluctuation pattern in the upper Rika catchments than in the upper Steyr catchments. This pattern indicates an increase in winter flood magnitudes between the mid-1960s and the 1990s, followed by a decrease until recently. The flood seasonality shows a large inter-annual variability in both regions. The most significant winter floods tend to occur in November and December. The winter flood fluctuations are compared with changes in associated climate characteristics, i.e., seven-day maximum precipitation, a melt index, and annual maximum snow depth. The seasonality of these characteristics has a strong inter-annual variability and only partly explains the winter flood fluctuations.
Physical Activity Levels and Screen Time among Youth with Overweight/Obesity Using Mental Health Services
Authors: Jerome Gerald J. , Fink Tyler , Brady Tammy , Young Deborah R. , Dickerson Faith B. , Goldsholl Stacy , Findling Robert L. , Stepanova Ekaterina A. , Scheimann Ann , Dalcin Arlene T. , Terry Alison , Gennusa Joseph , Cook Courtney , Daumit Gail L. , Wang Nae-Yuh
Published: February 2022

Youth with mental illness have higher levels of obesity than children in the general population. Both regular physical activity and limited screen time have been recommended to reduce and prevent childhood obesity. This study examines accelerometer-based moderate–vigorous physical activity (MVPA) and screen time among youth with overweight/obesity issues who are receiving mental health care. This study looked at a 12-month weight management randomized clinical trial for overweight/obese youth aged 8–18 years who are receiving mental health services. At baseline, MVPA was assessed using accelerometers, and screen time was self-reported. Among 100 youth, 43% were female, 44% were Black, and 48% were <13 years old. In an adjusted general linear model, higher levels of MVPA were associated with the younger age group (p = 0.012), male participants (p = 0.013), and lower BMI z-scores (p = 0.014). In a separate model, higher screen time was associated with participants who were Black (p = 0.007). Achieving optimal cardiovascular health at the population level requires an understanding of the groups that are most in need of additional assistance. These data reinforce that targeted lifestyle approaches to promote increased physical activity and decreased screen time among overweight/obese youth using mental health services may need additional tailoring for sex, age, and race subgroups.
Trends in Overall and Menthol Market Shares of Leading Cigarette Brands in the USA: 2014–2019
Authors: Miller Lo Erin J. , Young William J. , Ganz Ollie , Talbot Eugene M. , O’Connor Richard J. , Delnevo Cristine D.
Published: February 2022

Many factors can shift cigarette brand preference, and surveillance is an important tactic to inform regulatory strategy. The objective of this study was to identify shifts in top brands’ overall and menthol market share from 2014 to 2019. We used data from the National Survey on Drug Use and Health public use datasets, which are a nationally representative, cross-sectional survey of people aged 12+ in the USA. In our analysis of top brands, we accounted for consumption patterns and computed the percent change in market share for each brand. We observed that overall market share declined for nearly all brands, though top moderately priced brands gained share. Half of the top brands with menthol styles grew in menthol market share. We observed three primary shifts in the cigarette market: brands that gained the most menthol market share were brands with both menthol and non-menthol in their product lineups; menthol contributed substantially to discount brands’ market share increases; the two premium brands that employed “natural” descriptors experienced increased market share. Research should continue to focus on trends that influence cigarette market share, as the cigarette market in the USA is likely to look very different in five years than it does today.
Using Metrics of a Mixture Effect and Nutrition from an Observational Study for Consideration towards Causal Inference
Authors: Gennings Chris , Svensson Katherine , Wolk Alicja , Lindh Christian , Kiviranta Hannu , Bornehag Carl-Gustaf
Published: February 2022

Environmental exposures to a myriad of chemicals are associated with adverse health effects in humans, while good nutrition is associated with improved health. Single chemical in vivo and in vitro studies demonstrate causal links between the chemicals and outcomes, but such studies do not represent human exposure to environmental mixtures. One way of summarizing the effect of the joint action of chemical mixtures is through an empirically weighted index using weighted quantile sum (WQS) regression. My Nutrition Index (MNI) is a metric of overall dietary nutrition based on guideline values, including for pregnant women. Our objective is to demonstrate the use of an index as a metric for more causally linking human exposure to health outcomes using observational data. We use both a WQS index of 26 endocrine-disrupting chemicals (EDCs) and MNI using data from the SELMA pregnancy cohort to conduct causal inference using g-computation with counterfactuals for assumed either reduced prenatal EDC exposures or improved prenatal nutrition. Reducing the EDC exposure using the WQS index as a metric or improving dietary nutrition using MNI as a metric, the counterfactuals in a causal inference with one SD change indicate significant improvement in cognitive function. Evaluation of such a strategy may support decision makers for risk management of EDCs and individual choices for improving dietary nutrition.
Development and Testing of a Portable Virtual Reality-Based Mirror Visual Feedback System with Behavioral Measures Monitoring
Authors: Rey Beatriz , Oliver Alejandro , Monzo Jose M. , Riquelme Inmaculada
Published: February 2022

Virtual Reality (VR) is a technology that has been used to provide the Mirror Visual Feedback (MVF) illusion to patients with promising results. In the present work, the goal is to design, develop and test a portable VR-based MVF system that monitors behavioral information about the performance of a simple motor task. The developed application runs in a stand-alone VR system and allows the researcher to select the real and virtual hands used to perform the motor task. The system was evaluated with a group of twenty healthy volunteers (12 men and 8 women) with ages between 18 and 66 years. Participants had to repetitively perform a motor task in four different experimental conditions: two mirror conditions (performing real movements with the dominant and with the non-dominant hand) and two non-mirror conditions. A significant effect of the experimental condition on embodiment score (p < 0.001), response time (p < 0.001), performance time (p < 0.001), trajectory length (p < 0.004) and trajectory maximum horizontal deviation (p < 0.001) was observed. Furthermore, a significant effect of the experimental moment (initial, middle and final parts of the training) on the performance time was observed (p < 0.001). These results show that the monitored parameters provide relevant information to evaluate the participant’s task performance in different experimental conditions.
The Quality of Life of Children with Epilepsy and the Impact of the Disease on the Family Functioning
Authors: Rozensztrauch Anna , Kołtuniuk Aleksandra
Published: February 2022

Epilepsy is a neurological chronic disease, which negatively affects physical, psychological and social functioning of children and their families. The main objective of this study was to assess the quality of life (QoL) in children with diagnosed epilepsy and the impact of a child’s disease on the functioning of the family. Method: A cross-sectional survey involved a total of 103 legal guardians of children with diagnosed epilepsy. QoL was measured by PedsQL 4.0, with appropriate forms for specific age groups, the impact of a child’s condition on the functioning of the family was measured by PedsQL 2.0 Family Impact Module, and the authors’ own questionnaire was used to collect sociodemographic and medical data. Results: Subjects reported a decreased level of family daily activities (total score: 32.4 out of 100, SD = 26.5) and relationships (total score: 55.63 out of 100, SD = 24.03). QoL in children aged 5–7 years is lower by an average of 11.956 points as compared with children aged 2–4 years. Comorbidities had a significant impact (p < 0.05) on QoL in all domains. The overall QoL has reported a low score of 46.42 out of 100, respectively (SD ± 20.95), with the highest mean scores reported for the social functioning (total score: 49.4, SD = 27.3) and the physical functioning (total score: 49.4, SD = 28.4) and with the lowest mean score reported for the work/school functioning (total score: 42.3, SD = 27.8). Conclusions: Child’s epilepsy shows a considerable negative impact on the QoL of children and family functioning.
The Impacts of COVID-19 on Healthcare Quality in Tertiary Medical Centers—A Retrospective Study on Data from Taiwan Clinical Performance Indicators System
Authors: Liu Shih-An , Wu Chieh-Liang , Chou I-Ju , Wang Pa-Chun , Hsu Chia-Ling , Chen Chia-Pei
Published: February 2022

To date, COVID-19 is by far the most impactful contagious disease of the 21st century and it has had a devastating effect on public health in countries around the globe. Elective medical services have declined markedly since the outbreak of the COVID-19 pandemic. Few studies have compared changes in healthcare quality before and during the outbreak of COVID-19 in Eastern Asian countries. We aimed to explore the impacts of COVID-19 on healthcare quality among medical centers in Taiwan. This was a retrospective study that collected anonymized data from the Taiwan Clinical Performance Indicator system, which was founded by the Joint Commission of Taiwan, an organization to promote, execute, and certify the nation’s healthcare quality policies. We explored quality indicators reported by more than three-quarters of medical centers in Taiwan from January 2019 to December 2020. The year 2019 was defined as the baseline period and 2020 was defined as the period after the start of the outbreak of COVID-19. Quality indicators from different regions were analyzed. Unscheduled returns of emergency patients within 72 h of their discharge, unscheduled returns of hospitalized patients within 14 days of their discharge, and unscheduled returns of surgical patients to the operating room during hospitalization all declined during the COVID-19 outbreak. Interestingly, the proportion of acute ischemic stroke patients receiving intravenous tissue-type plasminogen activator (IV-tPA) increased during outbreak of COVID-19. There were significant regional variations in healthcare quality indicators among medical centers in northern and middle/southern Taiwan. The outbreak of COVID-19 changed different patterns of healthcare systems. Although healthcare quality seemed to improve, further investigation is warranted to better understand whether those who were in need of returning to the emergency room or hospital were reluctant or were prevented from travel by the shelter-in-place policy.
The Malay-Version Knowledge, Risk Perception, Attitude and Practice Questionnaire on Heatwaves: Development and Construct Validation
Authors: Arsad Fadly Syah , Hod Rozita , Ahmad Norfazilah , Baharom Mazni , Tangang Fredolin
Published: February 2022

Background: Heatwaves have long been recognised as a serious public health concern. This study was aimed at developing and validating a Malay-version of a questionnaire for evaluating knowledge, risk perception, attitudes, and practices regarding heatwaves. Method: The knowledge construct was evaluated with item analysis and internal reliability. The psychometric characteristics, construct and discriminant validity, and internal consistency of the risk perception, attitude and practice constructs were evaluated with exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Results: The 16 items in the knowledge construct had a good difficulty, discrimination, and reliability index of 0.81. A total of 16 items were maintained in EFA with Cronbach’s alpha of 0.84 and 0.82, 0.78 and 0.84 obtained for total items and risk perception, attitude, and practice constructs, respectively. A total of 15 items were retained after CFA. The finalised model met the fitness indices threshold. The convergent and discriminant validity were good. Conclusion: This newly developed Malay-version KRPAP questionnaire is reliable and valid for assessing Malaysians’ knowledge, risk perception, attitudes, and practices regarding heatwaves.
Multiple COVID-19 Waves and Vaccination Effectiveness in the United States
Authors: Lin Lixin , Zhao Yanji , Chen Boqiang , He Daihai
Published: February 2022

(1) Background: The coronavirus 2019 (COVID-19) pandemic has caused multiple waves of cases and deaths in the United States (US). The wild strain, the Alpha variant (B.1.1.7) and the Delta variant (B.1.617.2) of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were the principal culprits behind these waves. To mitigate the pandemic, the vaccination campaign was started in January 2021. While the vaccine efficacy is less than 1, breakthrough infections were reported. This work aims to examine the effects of the vaccination across 50 US states and the District of Columbia. (2) Methods: Based on the classic Susceptible—Exposed—Infectious–Recovered (SEIR) model, we add a delay class between infectious and death, a death class and a vaccinated class. We compare two special cases of our new model to simulate the effects of the vaccination. The first case expounds the vaccinated individuals with full protection or not, compared to the second case where all vaccinated individuals have the same level of protection. (3) Results: Through fitting the two approaches to reported COVID-19 deaths in all 50 US states and the District of Columbia, we found that these two approaches are equivalent. We calculate that the death toll could be 1.67–3.33 fold in most states if the vaccine was not available. The median and mean infection fatality ratio are estimated to be approximately 0.6 and 0.7%. (4) Conclusions: The two approaches we compared were equivalent in evaluating the effectiveness of the vaccination campaign in the US. In addition, the effect of the vaccination campaign was significant, with a large number of deaths averted.
Mediterranean Diet Adherence and Nutritional Status in Dalmatian Diabetic Hypertensive Patients Regarding Presence of Chronic Kidney Disease—Is There Any Difference?
Authors: Bučan Nenadić Dora , Radić Josipa , Kolak Ela , Vučković Marijana , Novak Ivana , Selak Marija , Radić Mislav
Published: February 2022

In recent years, the Mediterranean diet has emerged as one of the dietary patterns that could have positive effects on overall health as well in the treatment of non-communicable chronic diseases. The aim of this cross-sectional study was to determine differences in adherence to the Mediterranean diet (MeDi) and nutritional status in patients with type 2 diabetes mellitus (T2DM) and arterial hypertension (AH) regarding the presence of chronic kidney disease (CKD). Two hundred and forty-eight Dalmatian diabetic hypertensive patients (DDHP) were included, and 164 (66.1%) of them had CKD. Data about anthropometric parameters, clinical and laboratory parameters, as well as lifestyle questionnaire and Mediterranean Diet Serving Score (MDSS) were collected for each study participant. Furthermore, body composition was assessed using MC-780 Multi Frequency Segmental Body Mass Analyzer (Tanita). Body mass index (BMI) as well as waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) were calculated. Results showed that only 8.9% of DDHP were adherent to the MeDi without significant differences regarding the presence of CKD. Therefore, only 9.1% of participants with CKD were adherent to the MeDi. Dietary recommendations were received by 52.8% of DDHP and 49.4% with CKD, while only 12.8% of those with CKD were adherent to the given recommendations. The results showed that 88.3% of DDHP and 87.8% of the DDHP with CKD were overweight or obese. Statically significant lower frequency of nut intake suggested by the MeDi was found in those participants with CKD (p = 0.02). Therefore, the significant associations between adherence to each MeDi component as well as MDSS score with the development of CKD among all study subjects were not found. In conclusion, the results showed a low level of nutritional care in our region and low adherence to MeDi among DDHP. According to the results, there is an urgent need to improve nutritional care in our region, with a special focus on the MeDi for this especially vulnerable population of patients.
Adenomyosis as a Risk Factor for Myometrial or Endometrial Neoplasms—Review
Authors: Szubert Maria , Kozirog Edward , Wilczynski Jacek
Published: February 2022

Adenomyosis is a common benign gynecological condition, defined as an extension of endometrial tissue into the myometrium. Some studies suggest that adenomyosis could be a favorable prediction factor associated with survival outcomes in endometrial cancer. The aim of our systematic review was to investigate the current knowledge regarding adenomyosis and a possible molecular mechanism of carcinogenesis in adenomyotic lesions. In addition, the long-term prognosis for patients with endometrial cancer and coexisting adenomyosis (and endometriosis) was a key point of the research. The current literature was reviewed by searching PubMed, using the following phrases: “adenomyosis and endometrial cancer” and “malignant transformation of adenomyosis”. According to the literature, genetic mutations, epigenetic changes, and inactivation of specific tumor suppressor genes in adenomyosis are still poorly understood. Data regarding the influence of adenomyosis on survival outcomes in endometrial cancer seem to be contradictory and require further clinical and molecular investigation.
The Effectiveness of Brolucizumab and Aflibercept in Patients with Neovascular Age-Related Macular Degeneration
Authors: Musiał-Kopiejka Magdalena , Polanowska Katarzyna , Dobrowolski Dariusz , Krysik Katarzyna , Wylęgała Edward , Grabarek Beniamin Oskar , Lyssek-Boroń Anita
Published: February 2022

Age-related macular degeneration (AMD) is a progressive, chronic disease of the central area of the retina, which, if untreated, leads to blindness. This study aimed to compare the effectiveness of therapy using anti-VEGF drugs, namely brolucizumab and aflibercept, in patients with neovascular AMD (nAMD) during a monitoring period lasting around 20 weeks. The analysis consisted of 40 patients diagnosed with neovascular age-related macular degeneration, with 20 patients receiving aflibercept (Eylea, Bayer) at a dose of 2 mg/50 µL into the vitreous chamber at the following intervals—3 doses, 4 weeks apart, followed by a fourth dose after 8 weeks. The remaining 20 patients received brolucizumab (Beovu, Novartis) at a dose of 6 mg/50 µL, administered in the following schedule—3 initial doses, 4 weeks apart, with the administration of a fourth dose decided for each patient individually by the doctor, depending on disease activity, assessed through imaging tests. To evaluate treatment effectiveness, the following measurements were used: ‘read distance and near visual acuity’ for each eye separately using the Snellen chart; and non-invasive retinal imaging techniques—optical coherence tomography (OCT) and OCT angiography (OCTA). In patients treated using brolucizumab, during the observation period, statistically significant differences were found in the following parameters: flow area (p = 0.0277); select area (p = 0.0277); FOVEA (p = 0.0073); visus (p = 0.0064). In brolucizumab-treated patients, changes in OCT and OCTA, indicating an improvement, were already visible after the first injection of the drug, whereas in the aflibercept-treated group, changes were only visible after the fourth injection. We found a higher effectiveness of brolucizumab therapy compared to aflibercept in patients with nAMD during an observations period lasting 20 weeks. Our observations are significant, although they require further research.
Removal of Inorganic Salts in Municipal Solid Waste Incineration Fly Ash Using a Washing Ejector and Its Application for CO2 Capture
Authors: Kim Hyunsoo , Purev Oyunbileg , Cho Kanghee , Choi Nagchoul , Lee Jaewon , Yoon Seongjin
Published: February 2022

This study investigated the effects of washing equipment for inorganic salts, such as NaCl, KCl, and CaClOH, to decontaminate municipal solid waste incineration fly ash (MSW-IFA). Based on the feature of hydrodynamic cavitation, the device developed in this study (referred to as a ‘washing ejector’) utilizes the cavitation bubbles. A washing ejector was analyzed under a range of conditions, employing as little water as possible. In hydrodynamic cavitation, the increase in fluid pressure with increasing static pressure is mainly attributed to the increase in particle–bubble collisions via the cavitation flow. The results revealed that the fluid pressure influenced the removal of inorganic salts during cavitation in water. This is because during the washing process from the collapse of cavitation bubbles, the release is achieved through the dissolution of inorganic salts weakly bound to the surface. After treatment by a washing ejector, the removal of soluble salts elements such as Cl, Na, and K was reduced by approximately 90%. Removing the inorganic salts in the IFA altered the characteristics of the Ca-related phase, and amorphous CaCO3 was formed as the cavitation flow reacted with CO2 in the ambient air. Furthermore, the washing effluent produced by washing IFA was found to be beneficial for CO2 capture. The washing effluent was enriched with dissolved Ca from the IFA, and the initial pH was the most favorable condition for the formation of CaCO3; thus, the effluent was sufficient for use as a CO2 sequestration medium and substitute for the reuse of water. Overall, the process presented herein could be effective for removing soluble salts from IFA, and this process is conducive to utilizing IFA as a resource.
Comparison of the Functional State and Motor Skills of Patients after Cerebral Hemisphere, Ventricular System, and Cerebellopontine Angle Tumor Surgery
Authors: Krajewski Stanisław , Furtak Jacek , Zawadka-Kunikowska Monika , Kachelski Michał , Birski Marcin , Harat Marek
Published: February 2022

Brain tumor location is an important factor determining the functional state after brain tumor surgery. We assessed the functional state and course of rehabilitation of patients undergoing surgery for brain tumors and assessed the location-dependent risk of loss of basic motor skills and the time needed for improvement after surgery. There were 835 patients who underwent operations, and 139 (16.6%) required rehabilitation during the inpatient stay. Karnofsky Performance Scale, Barthel Index, and the modified Rankin scale were used to assess functional status, whereas Gait Index was used to assess gait efficiency. Motor skills, overall length of stay (LOS) in hospital, and LOS after surgery were recorded. Patients were classified into four groups: cerebral hemisphere (CH), ventricular system (VS), and cerebellopontine angle (CPA) tumors; and a control group not requiring rehabilitation. VS tumor patients had the lowest scores in all domains compared with the other groups before surgery (p < 0.001). Their performance further deteriorated after surgery and by the day of discharge. They most often required long-lasting postoperative rehabilitation and had the longest LOS (35 days). Operation was most often required for CH tumors (77.7%), and all metrics and LOS parameters were better in these patients (p < 0.001). Patients with CPA tumors had the best outcomes (p < 0.001). Most patients (83.4%) with brain tumors did not require specialized rehabilitation, and LOS after surgery in the control group was on average 5.1 days after surgery. VS tumor patients represent a rehabilitation challenge. Postoperative rehabilitation planning must take the tumor site and preoperative condition into account.
Treatment Pattern, Financial Burden, and Outcomes in Elderly Patients with Acute Myeloid Leukemia in Korea: A Nationwide Cohort Study
Authors: Ha Hyerim , Jeong Yujin , Lim Joo Han , Suh Young Ju
Published: February 2022

Although approximately 50% of patients with acute myeloid leukemia (AML) are diagnosed over the age of 60 years, there is currently no established consensus on the treatment of elderly AML patients. Herein, we aimed to explore the incidence, medical expenditure, treatment, and outcomes of elderly AML patients in Korea by analyzing a nationwide cohort. We employed the Korean National Health Insurance Service-Senior cohort, which represents 10% of a random selection from a total of 5.5 million subjects aged 60 years or older. AML patients were identified according to the main diagnostic criteria of acute leukemia. Treatment for AML was divided into high- (high-dose cytarabine ± idarubicin) and low- (low-dose cytarabine or hypomethylating agents) intensity chemo-therapy and classified according to the chemotherapeutics protocol. We analyzed the survival outcomes and medical expenditures. Among 558,147 elderly patients, 471 were diagnosed with AML, and 195 (41.4%) were treated with chemotherapy. The median age was 65 years, and the median overall survival (OS) was 4.93 months (95% confidence interval, 4.47–5.43). Median OS was longer in patients undergoing chemotherapy than those in the best supportive care group (6.28 vs. 3.45 months, p < 0.001), and the difference was prominent in patients aged < 70 years. Twenty-eight (5.9%) patients received high-intensity chemotherapy, while 146 (31.0%) received low-intensity chemotherapy. The difference in median OS according to dose intensity was 4.6 months, which was longer in the high-intensity chemotherapy group (9.8 vs. 5.2 months in low-intensity group); however, the difference was not statistically significant. Patients who received high-intensity chemotherapy recorded longer hospital stays and incurred greater expenses on initial hospitalization. Elderly AML patients in Korea exhibited clinical benefits from chemotherapy. Although patients should be carefully selected for intensive treatment, chemotherapy, including low-intensity treatment, can be considered in elderly patients. Moreover, prospective studies on new agents or new treatment strategies are needed.
SARS-CoV-2 Seroprevalence in Healthcare Workers before the Vaccination in Poland: Evolution from the First to the Second Pandemic Outbreak
Authors: Korona-Głowniak Izabela , Mielnik Michał , Podgajna Martyna , Grywalska Ewelina , Hus Marek , Matuska Katarzyna , Wojtysiak-Duma Beata , Duma Dariusz , Glowniak Andrzej , Malm Anna
Published: February 2022

Healthcare workers (HCWs) are on the frontline, struggling with the pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). To describe recent or past infections, the serological assays enabled the assessment of the immune response developed in coronavirus disease (COVID-19) in the period when testing was hardly available. In this study, we investigated SARS-CoV-2 seroprevalence in HCWs in a Polish teaching hospital and the Regional Occupational Medicine Center after both the first and the second waves. ELISA-based tests for anti-SARS-CoV-2 IgA and IgG were used to determine immune response to SARS-CoV-2 in volunteer HCWs who worked in those institutions in May 2020 (208 participants aged 47.1 ± 12.5, 88% women) and in December 2020 (179 participants aged 45.2 ± 12.4, 86% woman). Risk factors for seropositivity were also assessed using a questionnaire filled out by all participants. We reported a significant increase in seroprevalence after the second wave (22.9%) compared with the first outbreak (2.4%) (OR 12.1; 95%CI 4.6–31.3; p < 0.0001). An association between IgG seroprevalence and severity of infections was noted. Furthermore, we demonstrated that amongst medical personnel, nurses exhibited a proportionally higher SARS-CoV-2 seroprevalence. Moreover, given the high seroprevalence in non-clinical group of HCWs, we suggest that community transmission can play a superior role to workplace exposure.
Driving Factors behind Energy-Related Carbon Emissions in the U.S. Road Transport Sector: A Decomposition Analysis
Authors: Jiang Rui , Wu Peng , Wu Chengke
Published: February 2022

The U.S. is the second largest contributor to carbon emissions in the world, with its road transport sector being one of the most significant emission sources. However, few studies have been conducted on factors influencing the emissions changes for the U.S. from the perspective of passenger and freight transport. This study aimed to evaluate the carbon emissions from the U.S. road passenger and freight transport sectors, using a Logarithmic Mean Divisia Index approach. Emissions from 2008 to 2017 in the U.S. road transport sector were analysed and key findings include: (1) energy intensity and passenger transport intensity are critical for reducing emissions from road passenger transport, and transport structure change is causing a shift in emissions between different passenger transport modes; and (2) the most effective strategies to reduce carbon emissions in the road freight transport sector are to improve energy intensity and reduce freight transport intensity. Several policy recommendations regarding reducing energy and transport intensity are proposed. The results and policy recommendations are expected to provide useful references for policy makers to form carbon emissions reduction strategies for the road transport sector.